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Prolonged field care

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https://www.readbyqxmd.com/read/28523156/predictors-of-length-of-stay-and-duration-of-tracheal-intubation-after-transcatheter-aortic-valve-implantation
#1
Vasileios Patris, Konstantinos Giakoumidakis, Mihalis Argiriou, Katerina K Naka, Efstratios Apostolakis, Mark Field, Manoj Kuduvalli, Aung Oo, Stavros Siminelakis
BACKGROUND: While short-term outcomes for patients undergoing transcatheter aortic valve implantation (TAVI) have long been studied, there is very little data on their predictors. We aimed to identify the predictors of outcomes, such as intensive care unit (ICU) and in-hospital length of stay (LOS), duration of postoperative intubation and in-hospital mortality, after TAVI procedures. METHODS: We conducted a retrospective cohort study of 162 consecutive patients with aortic valve disease, who were admitted to a tertiary hospital of Liverpool for TAVI, during a five-year period...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28514469/association-of-very-low-volume-practice-with-vascular-surgery-outcomes-in-new-york
#2
Jialin Mao, Philip Goodney, Jack Cronenwett, Art Sedrakyan
Importance: Little research has focused on very low-volume surgery, especially in the context of decreasing vascular surgery volume with the adoption of endovascular procedures. Objective: To investigate the existence and outcomes of open abdominal aortic aneurysm repair (OAR) and carotid endarterectomy (CEA) performed by very low-volume surgeons in New York. Design, Settings, and Participants: This cohort study examined inpatient data of patients undergoing elective OAR or CEA from 2000 to 2014 from all New York hospitals...
May 17, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28479568/portable-qeeg-and-hd-tcs-device-for-point-of-injury-traumatic-brain-injury-diagnostics
#3
Frode Strisland, Jon Vedum, Anders Liverud, Steffen Dalgard, Tomas Brødreskift, Bruno Albert, Alexandre Noyvirt, Rossitza Setchi, Karl Vene, Henrik Herranen, Maarjus Kirs, Andrea Antal, Klaus Schellhorn, Haldor Sjaaheim
Mild Traumatic Brain Injury (mTBI) can cause prolonged or permanent injuries if left undetected and ignored. It is therefore of great interest to lower the threshold for diagnosis of individuals with mTBI injury. We report on the development of a prototype of a portable quantified EEG (qEEG) system intended for in-the-field mTBI diagnostics. The 32-electrode system is fully battery driven, is interfaced with a control unit being part of a telemedicine care system. Electrode montage is a central problem effectively challenging measurements outside clinical environments...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28443559/the-evolution-of-modern-respiratory-care-for-preterm-infants
#4
REVIEW
Louise S Owen, Brett J Manley, Peter G Davis, Lex W Doyle
Preterm birth rates are rising, and many preterm infants have breathing difficulty after birth. Treatments for infants with prolonged breathing difficulty include oxygen therapy, exogenous surfactant, various modes of respiratory support, and postnatal corticosteroids. In this Series paper, we review the history of neonatal respiratory care and its effect on long-term outcomes, and we outline the future direction of the research field. The delivery and monitoring of oxygen therapy remains controversial, despite being in use for more than 50 years...
April 22, 2017: Lancet
https://www.readbyqxmd.com/read/28347538/infant-motor-skills-after-a-cardiac-operation-the-need-for-developmental-monitoring-and-care
#5
Karen Uzark, Cynthia Smith, Janet Donohue, Sunkyung Yu, Jennifer C Romano
BACKGROUND: Neurodevelopmental dysfunction is increasingly recognized as a common outcome of congenital heart defects and their treatment in infancy. The effects of the intensive care unit (ICU) experience and environment on these infants are unknown and potentially modifiable, but no validated metric is available for objective evaluation of early motor impairments in the ICU/hospital setting. The purpose of this study was to characterize the motor status of hospitalized infants after cardiac operations, including the development and field-testing of the Congenital Heart Assessment of Sensory and Motor Status (CHASMS) metric...
March 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28334728/does-emergency-presentation-of-cancer-represent-poor-performance-in-primary-care-insights-from-a-novel-analysis-of-linked-primary-and-secondary-care-data
#6
Peter Murchie, Sarah M Smith, Michael S Yule, Rosalind Adam, Melanie E Turner, Amanda J Lee, Shona Fielding
BACKGROUND: People diagnosed with cancer following emergency presentation have poorer short-term survival. To what extent this signifies a missed opportunity for earlier diagnosis in primary care remains unclear as little detailed data exist on the patient/general practitioner interaction beforehand. METHODS: Analysis of primary care and regional data for 1802 cancer patients from Northeast Scotland. Adjusted odds ratios (OR) and 95% confidence intervals (CIs) for patient and GP practice predictors of emergency presentation...
April 25, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28285490/review-of-54-cases-of-prolonged-field-care
#7
Erik DeSoucy, Stacy Shackelford, Joseph J DuBose, Seth Zweben, Stephen C Rush, Russ S Kotwal, Harold R Montgomery, Sean Keenan
BACKGROUND: Prolonged field care (PFC) is field medical care applied beyond doctrinal planning time-lines. As current and future medical operations must include deliberate and contingency planning for such events, data are lacking to support efforts. A case review was conducted to define the epidemiology, environment, and operational factors that affect PFC outcomes. METHODS: A survey distributed to US military medical providers solicited details of PFC encounters lasting more than 4 hours and included patient demographics, environmental descriptors, provider training, modes of transportation, injuries, mechanism of injury, vital signs, treatments, equipment and resources used, duration of PFC, and morbidity and mortality status on delivery to the next level of care...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28285489/analgesia-and-sedation-management-during-prolonged-field-care
#8
Jeremy C Pamplin, Andrew D Fisher, Andrew Penny, Robert Olufs, Justin Rapp, Katarzyna Kasia Hampton, Jamie Riesberg, Douglas Powell, Sean Keenan, Stacy Shackelford
No abstract text is available yet for this article.
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28265453/automated-closed-loop-resuscitation-of-multiple-hemorrhages-a-comparison-between-fuzzy-logic-and-decision-table-controllers-in-a-sheep-model
#9
Nicole Ribeiro Marques, Brent J Ford, Muzna N Khan, Michael Kinsky, Donald J Deyo, William J Mileski, Hao Ying, George C Kramer
BACKGROUND: Hemorrhagic shock is the leading cause of trauma-related death in the military setting. Definitive surgical treatment of a combat casualty can be delayed and life-saving fluid resuscitation might be necessary in the field. Therefore, improved resuscitation strategies are critically needed for prolonged field and en route care. We developed an automated closed-loop control system capable of titrating fluid infusion to a target endpoint. We used the system to compare the performance of a decision table algorithm (DT) and a fuzzy logic controller (FL) to rescue and maintain the mean arterial pressure (MAP) at a target level during hemorrhages...
2017: Disaster and Military Medicine
https://www.readbyqxmd.com/read/28222830/impact-of-early-vasopressor-administration-on-neurological-outcomes-after-prolonged-out-of-hospital-cardiac-arrest
#10
Michael W Hubble, Clark Tyson
Introduction Vasopressors are associated with return of spontaneous circulation (ROSC), but no long-term benefit has been demonstrated in randomized trials. However, these trials did not control for the timing of vasopressor administration which may influence outcomes. Consequently, the objective of this study was to develop a model describing the likelihood of favorable neurological outcome (cerebral performance category [CPC] 1 or 2) as a function of the public safety answering point call receipt (PSAP)-to-pressor-interval (PPI) in prolonged out-of-hospital cardiac arrest...
February 22, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28190429/the-scope-of-neurology-of-critical-illness
#11
REVIEW
E F M Wijdicks
Critical illness increases the probability of a neurologic complication. There are many reasons to consult a neurologist in a critically ill patient and most often it is altered alertness with no intuitive plausible explanation. Other common clinical neurologic problems facing the intensive care specialist and consulting neurologist in everyday decisions are coma following prolonged cardiovascular surgery, newly perceived motor asymmetry, seizures or other abnormal movements, and generalized muscle weakness...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28163191/csahi-study-detection-of-drug-induced-ion-channel-receptor-responses-qt-prolongation-and-arrhythmia-using-multi-electrode-arrays-in-combination-with-human-induced-pluripotent-stem-cell-derived-cardiomyocytes
#12
Takashi Kitaguchi, Yuta Moriyama, Tomohiko Taniguchi, Sanae Maeda, Hiroyuki Ando, Takaaki Uda, Koji Otabe, Masao Oguchi, Shigekazu Shimizu, Hiroyuki Saito, Atsushi Toratani, Mahoko Asayama, Wataru Yamamoto, Emi Matsumoto, Daisuke Saji, Hiroki Ohnaka, Norimasa Miyamoto
INTRODUCTION: The use of multi-electrode arrays (MEA) in combination with human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) provides a promising method to predict comprehensive cardiotoxicity, including drug-induced QT prolongation and arrhythmia. We previously demonstrated that MEA in combination with hiPSC-CMs could provide a generalizable platform by using 7 reference drugs at 10 testing facilities. Using this approach, we evaluated responses to reference drugs that modulate a range of cardiac ion currents and have a range of arrhythmogenic effects...
February 2, 2017: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/28132729/malnutrition-an-underestimated-factor-in-the-inpatient-treatment-of-traumatology-and-orthopedic-patients-a-prospective-evaluation-of-1055-patients
#13
Christoph Ihle, Thomas Freude, Christian Bahrs, Eva Zehendner, Janick Braunsberger, Hans Konrad Biesalski, Christine Lambert, Ulrich Stöckle, Elke Wintermeyer, Julia Grünwald, Leonard Grünwald, Gunnar Ochs, Ingo Flesch, Andreas Nüssler
INTRODUCTION: Suboptimal nutritional status is often observed among hospitalized patients across all medical specialties. The objective of the present study was to (1) analyze the prevalence of malnutrition in hospitalized orthopedic and trauma patients and (2) to evaluate the relationship between malnutrition and selected clinical outcomes. MATERIALS AND METHODS: The prospective field study was conducted between 06/2014 and 06/2015 in a German level I trauma center (Department of Traumatology, Septic Trauma Surgery and Arthroplasty) with a total number of 1055 patients...
January 22, 2017: Injury
https://www.readbyqxmd.com/read/28087566/application-of-whole-exome-sequencing-in-the-clinical-diagnosis-and-management-of-inherited-cardiovascular-diseases-in-adults
#14
Sara B Seidelmann, Emily Smith, Lakshman Subrahmanyan, Daniel Dykas, Maen D Abou Ziki, Bani Azari, Fady Hannah-Shmouni, Yuexin Jiang, Joseph G Akar, Mark Marieb, Daniel Jacoby, Allen E Bale, Richard P Lifton, Arya Mani
BACKGROUND: With the advent of high throughput sequencing, the identification of genetic causes of cardiovascular disease (CVD) has become an integral part of medical diagnosis and management and at the forefront of personalized medicine in this field. The use of whole exome sequencing for clinical diagnosis, risk stratification, and management of inherited CVD has not been previously evaluated. METHODS AND RESULTS: We analyzed the results of whole exome sequencing in first 200 adult patients with inherited CVD, who underwent genetic testing at the Yale Program for Cardiovascular Genetics...
February 2017: Circulation. Cardiovascular Genetics
https://www.readbyqxmd.com/read/27883296/adjuvant-trastuzumab-a-10-year-overview-of-its-benefit
#15
REVIEW
Matteo Lambertini, Noam F Pondé, Cinzia Solinas, Evandro de Azambuja
Anti-HER2 targeted therapy is one of the key advances in the treatment of breast cancer that have occurred in the last 20 years. In the adjuvant setting, the use of trastuzumab has led to prolonged and sustained survival benefit with very little toxicity as also confirmed by the 10-year follow-up results from the pivotal trials. Despite the survival improvement, several key issues are not entirely resolved in this field. These issues have led to multiple research efforts in de-escalating or escalating the standard treatment with chemotherapy and 1 year of adjuvant trastuzumab...
January 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/27879534/physician-provided-prehospital-critical-care-effect-on-patient-physiology-dynamics-and-on-scene-time
#16
Bjørn O Reid, Marius Rehn, Oddvar Uleberg, Andreas J Krüger
INTRODUCTION: Improved physiologic status can be seen as a surrogate measure of improved outcome and a field-friendly prognostic model such as the Mainz Emergency Evaluation Score (MEES) could quantify the effect on physiological response. We aim to examine the dynamic physiological profile as measured by this score on patients managed by physician-manned helicopter emergency medical services and how this profile was related to on-scene time expenditure and critical care interventions...
November 22, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27832046/periodic-discharges-insight-from-magnetoencephalography
#17
Vladimir Shvarts, Gabor Zoltay, Susan M Bowyer, Andrew Zillgitt, John E Moran, Karen Mason, Norman Tepley, David Burdette
PURPOSE: This study used magnetoencephalography (MEG) dipole localization and coherence measurement to evaluate the magnetic fields associated with periodic discharges. The primary goal of the study was to evaluate whether MEG could consistently localize quasiperiodic discharges that were observed on the EEG portion of the recording. The secondary objective was to evaluate whether coherence measurements would correlate with topographic maxima of epileptiform activity. METHODS: A total of 13 inpatients, whose electrographic records demonstrated lateralized periodic discharges (LPDs), were recruited from Henry Ford Hospital neurology and intensive care units...
May 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27756644/intraoperative-modifiable-risk-factors-of-colorectal-anastomotic-leakage-why-surgeons-and-anesthesiologists-should-act-together
#18
REVIEW
S J van Rooijen, D Huisman, M Stuijvenberg, J Stens, R M H Roumen, F Daams, G D Slooter
BACKGROUND: Colorectal anastomotic leakage (CAL) is a major surgical complication in intestinal surgery. Despite many optimizations in patient care, the incidence of CAL is stable (3-19%) [1]. Previous research mainly focused on determining patient and surgery related risk factors. Intraoperative non-surgery related risk factors for anastomotic healing also contribute to surgical outcome. This review offers an overview of potential modifiable risk factors that may play a role during the operation...
December 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27752059/klebsiella-pneumoniae-carbapenemase-producing-k-pneumoniae-kpc-kp-in-brain-and-spinal-cord-injury-patients-potential-for-prolonged-colonization
#19
N R Zembower, A Zhu, M Malczynski, C Qi
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To determine the prevalence of brain and spinal cord injury (BSCI) patients among all patients with Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) and to evaluate clinical characteristics and duration of colonization. SETTING: Tertiary care academic medical center. METHODS: Electronic medical records of BSCI patients with KPC-KP from February 2009 to December 2014 were reviewed to determine clinical characteristics...
April 2017: Spinal Cord
https://www.readbyqxmd.com/read/27734449/management-of-crush-syndrome-under-prolonged-field-care
#20
Thomas J Walters, Douglas Powell, Andrew Penny, Ian Stewart, Kevin Chung, Sean Keenan, Stacy Shackelford
No abstract text is available yet for this article.
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
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