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https://www.readbyqxmd.com/read/28212172/cognitive-decline-associated-with-anesthesia-and-surgery-in-the-elderly-does-this-contribute-to-dementia-prevalence
#1
Lisbeth Evered, David A Scott, Brendan Silbert
PURPOSE OF REVIEW: To provide an update on the current state of research investigating the effects of anesthesia and surgery on cognition in the elderly, including consideration of overlap with cognitive disorders in the community. RECENT FINDINGS: The studies reviewed here identify detrimental effects of anesthesia and surgery on cognition in a proportion of elderly individuals. Animal models demonstrate an association between anesthetic agents and Alzheimer's disease pathology...
February 15, 2017: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/28179737/updates-in-nutrition-support-for-critically-ill-adult-patients
#2
Diana Wells Mulherin, Sarah V Cogle
Specialized nutrition support is often employed in critically ill patients who are unable to maintain volitional intake. The Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) recently updated guidelines for the provision of nutrition support in critically ill patients. The purpose of this review is to summarize key changes from the previous guidelines as they relate to recently published literature, which will aid the hospital pharmacist in optimizing nutrition support therapies in the critical care setting...
January 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28157755/coding-in-stroke-and-other-cerebrovascular-diseases
#3
Pearce J Korb, William Jones
Accurate coding is critical for clinical practice and research. Ongoing changes to diagnostic and billing codes require the clinician to stay abreast of coding updates. Payment for health care services, data sets for health services research, and reporting for medical quality improvement all require accurate administrative coding. This article provides an overview of coding principles for patients with strokes and other cerebrovascular diseases and includes an illustrative case as a review of coding principles in a patient with acute stroke...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157386/fifty-years-of-research-in-ards-the-epidemiology-of-ards-a-fiftieth-birthday-review
#4
Tài Pham, Gordon D Rubenfeld
Since its first description 50 years ago, no other ICU syndrome has been as extensively studied as ARDS. Nevertheless intensivists' favorite darling has not revealed all its secrets yet and many epidemiological questions remain unsolved. The lack of gold standard tests jeopardizes accurate diagnosis, leading to uncertainties in the actual incidence of this syndrome across different areas with reported ranges as wide as 3.65 to 81 cases per 100,000 persons-year. Likewise evaluation of its evolution over time is difficult due to changes in ARDS definition and under-recognition by clinicians...
February 3, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28155994/pancreatic-stone-protein-and-soluble-cd25-for-infection-and-sepsis-in-an-emergency-department
#5
Luis García de Guadiana-Romualdo, Mario Berger, Enrique Jiménez-Santos, Sergio Rebollo-Acebes, Roberto Jiménez-Sánchez, Patricia Esteban-Torrella, Ana Hernando-Holgado, Alejandro Ortín-Freire, María Dolores Albaladejo-Otón
BACKGROUND: Infection is a common problem in Emergency Departments (ED) and is associated with high mortality, morbidity and costs. Identifying infection in ED patients can be challenging. Biomarkers can facilitate its diagnosis, enabling an early management and improving outcomes. In the critical care setting, two emerging biomarkers, pancreatic stone protein (PSP) and soluble CD25 (sCD25), have demonstrated to be useful for diagnosis of sepsis. We aimed to assess the diagnostic value of these biomarkers, in comparison to procalcitonin (PCT), for infection and sepsis in an ED population with suspected infection...
February 3, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28152838/a-schematic-case-episode-format-to-aid-in-choosing-wisely
#6
B Brooke Mann, Jad Hayes, Lalan S Wilfong, Marcus A Neubauer
: 181 Background: The recommendations of the Choosing Wisely campaign are evidence -based strategies to reduce cost without sacrificing outcomes. Yet tying the recommendations to indicators of use at the physician and case level has been challenging. As practices become responsible for total cost of care, an easy to use analytic method to determine appropriate use will be critical. We here describe a tool for rapid assessment of individual cases to achieve that objective. METHODS: The population was a payer defined cohort of lung cancer patients treated at Texas Oncology (TxO)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28149031/thoughts-on-the-current-management-of-acute-aluminum-phosphide-toxicity-and-proposals-for-therapy-an-evidence-based-review
#7
REVIEW
Maryam Vasheghani Farahani, Davood Soroosh, Sayed Mahdi Marashi
The majority of aluminum phosphide (ALP) toxicity cases are suicidal attempts. Despite advances in critical care medicine, the mortality rate of ALP remains very high. Unfortunately, knowledge on the toxicokinetics of ALP is very low. An obsolete idea was proposed that inhibition of complex IV of cytochrome C oxidase is responsible for multiorgan dysfunction. However, based on human studies, this effect might be insignificant. Thus, a novel idea proposes that the main mechanism might be vascular wall integrity disruption...
December 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28141912/high-volume-haemofiltration-for-sepsis-in-adults
#8
REVIEW
Emma Mj Borthwick, Christopher J Hill, Kannaiyan S Rabindranath, Alexander P Maxwell, Danny F McAuley, Bronagh Blackwood
BACKGROUND: Severe sepsis and septic shock are leading causes of death in the intensive care unit (ICU), despite advances in the treatment of patients with severe sepsis and septic shock, including early recognition, appropriate treatment with antibiotics and support of organs that may have been affected by the illness. High-volume haemofiltration (HVHF) is a blood purification technique that may improve outcomes in severe sepsis or septic shock. The technique of HVHF has evolved from renal replacement therapies used in the ICU to treat critically ill patients with acute kidney injury (AKI)...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28141899/intravenous-midazolam-infusion-for-sedation-of-infants-in-the-neonatal-intensive-care-unit
#9
REVIEW
Eugene Ng, Anna Taddio, Arne Ohlsson
BACKGROUND: Proper sedation for neonates undergoing uncomfortable procedures may reduce stress and avoid complications. Midazolam is a short-acting benzodiazepine that is used increasingly in neonatal intensive care units (NICUs). However, its effectiveness as a sedative in neonates has not been systematically evaluated. OBJECTIVES: Primary objeciveTo assess the effectiveness of intravenous midazolam infusion for sedation, as evaluated by behavioural and/or physiological measurements of sedation levels, in critically ill neonates in the NICU...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28135807/special-population-child-and-adolescent-psychotherapy
#10
George Halasz
OBJECTIVES: First, to outline the paradigm change of the past 20 years that has transformed the theory and practice of child and adolescent psychodynamic psychotherapy; second, to update aspects of the current Practice Parameters for Psychodynamic Psychotherapy with Children to align with the paradigm change driven by the principles of regulation theory, relational trauma and repair, and the critical need for clinicians' self-care in trauma informed psychotherapy. CONCLUSION: The emerging neuroscience-driven paradigm of psychotherapy poses challenges for the child and adolescent psychotherapist: to embrace the new conceptual reference points as organising principles leads to an urgent need to rethink traditional diagnostic formulations and time-honoured techniques for intervention...
January 1, 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/28133975/lymphoma-classification-update-t-cell-lymphomas-hodgkin-lymphomas-and-histiocytic-dendritic-cell-neoplasms
#11
Manli Jiang, N Nora Bennani, Andrew L Feldman
Lymphomas are classified based on the normal counterpart, or cell of origin, from which they arise. Because lymphocytes have physiologic immune functions that vary both by lineage and by stage of differentiation, the classification of lymphomas arising from these normal lymphoid populations is complex. Recent genomic data have contributed additional depth to this complexity. Areas covered: Lymphoma classification follows the World Health Organization (WHO) system, which reflects international consensus and is based on pathological, genetic, and clinical factors...
January 29, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28132746/acc-aha-special-report-clinical%C3%A2-practice-guideline-implementation-strategies-a%C3%A2-summary-of-systematic-reviews-by-the-nhlbi-implementation-science-work-group-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-practice
#12
Wiley V Chan, Thomas A Pearson, Glen C Bennett, William C Cushman, Thomas A Gaziano, Paul N Gorman, Joel Handler, Harlan M Krumholz, Robert F Kushner, Thomas D MacKenzie, Ralph L Sacco, Sidney C Smith, Victor J Stevens, Barbara L Wells
BACKGROUND: In 2008, the National Heart, Lung, and Blood Institute convened an Implementation Science Work Group to assess evidence-based strategies for effectively implementing clinical practice guidelines. This was part of a larger effort to update existing clinical practice guidelines on cholesterol, blood pressure, and overweight/obesity. OBJECTIVES: Review evidence from the published implementation science literature and identify effective or promising strategies to enhance the adoption and implementation of clinical practice guidelines...
January 18, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28129712/reconsideration-of-the-scheme-of-the-international-classification-of-functioning-disability-and-health-incentives-from-the-netherlands-for-a-global-debate
#13
Yvonne F Heerkens, Marjolein de Weerd, Machteld Huber, Carin P M de Brouwer, Sabina van der Veen, Rom J M Perenboom, Coen H van Gool, Huib Ten Napel, Marja van Bon-Martens, Hillegonda A Stallinga, Nico L U van Meeteren
PURPOSE: The ICF (International Classification of Functioning, Disability and Health) framework (used worldwide to describe 'functioning' and 'disability'), including the ICF scheme (visualization of functioning as result of interaction with health condition and contextual factors), needs reconsideration. The purpose of this article is to discuss alternative ICF schemes. METHOD: Reconsideration of ICF via literature review and discussions with 23 Dutch ICF experts...
January 27, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28126839/acc-aha-special-report-clinical-practice-guideline-implementation-strategies-a-summary-of-systematic-reviews-by-the-nhlbi-implementation-science-work-group-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-practice
#14
Wiley V Chan, Thomas A Pearson, Glen C Bennett, William C Cushman, Thomas A Gaziano, Paul N Gorman, Joel Handler, Harlan M Krumholz, Robert F Kushner, Thomas D MacKenzie, Ralph L Sacco, Sidney C Smith, Victor J Stevens, Barbara L Wells, Graciela Castillo, Susan K R Heil, Jennifer Stephens, Julie C Jacobson Vann
BACKGROUND: In 2008, the National Heart, Lung, and Blood Institute convened an Implementation Science Work Group to assess evidence-based strategies for effectively implementing clinical practice guidelines. This was part of a larger effort to update existing clinical practice guidelines on cholesterol, blood pressure, and overweight/obesity. OBJECTIVES: Review evidence from the published implementation science literature and identify effective or promising strategies to enhance the adoption and implementation of clinical practice guidelines...
January 26, 2017: Circulation
https://www.readbyqxmd.com/read/28125363/evaluation-of-the-asco-value-framework-for-anticancer-drugs-at-an-academic-medical-center
#15
Leslie Wilson, Tracy Lin, Ling Wang, Tanuja Patel, Denise Tran, Sarah Kim, Katie Dacey, Courtney Yuen, Lisa Kroon, Bret Brodowy, Kevin Rodondi
BACKGROUND: Anticancer drug prices have increased by an average of 12% each year from 1996 to 2014. A major concern is that the increasing cost and responsibility of evaluating treatment options are being shifted to patients. This research compared 2 value-based pricing models that were being considered for use at the University of California, San Francisco (UCSF) Medical Center to address the growing burden of high-cost cancer drugs while improving patient-centered care. PROGRAM DESCRIPTION: The Medication Outcomes Center (MOC) in the Department of Clinical Pharmacy, University of California, San Francisco (UCSF), School of Pharmacy focuses on assessing the value of medication-related health care interventions and disseminating findings to the UCSF Medical Center...
February 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28122702/major-publications-in-the-critical-care-pharmacotherapy-literature-in-2015
#16
Adrian Wong, Michael Erdman, Drayton A Hammond, Tara Holt, Jenna M Holzhausen, Michelle Horng, Lori Lynn Huang, Jennifer Jarvis, Bridgette Kram, Shawn Kram, Christine Lesch, Jessica Mercer, Megan A Rech, Ryan Rivosecchi, Brian Stump, Colleen Teevan, Sarah Day
PURPOSE: Recently published practice guidelines and research reports on pharmacotherapy in critical care patient populations are summarized. SUMMARY: The Critical Care Pharmacotherapy Literature Update (CCPLU) Group is composed of over 50 experienced critical care pharmacists who evaluate 31 peer-reviewed journals monthly to identify literature pertaining to pharmacotherapy in critical care populations. Articles are chosen for summarization in a monthly CCPLU Group publication on the basis of applicability and relevance to clinical practice and strength of study design...
January 25, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28120137/smart-choices-for-cancer-education-professional-development-your-voice-and-visibility-for-leadership
#17
Cynthia Kratzke
The purpose of this article is to provide reflections about the important and exciting opportunities for cancer education career advancement and professional development. Advancement in professional, personal, and career growth for clinicians and health professionals is critical to improve quality cancer care and updated health communication with patients and families. Valuable insights from my recent 2-year term as treasurer, Board of Directors, Cancer Patient Education Network, are shared inspiring others to build their rewarding professional development...
January 24, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/28114931/procalcitonin-guided-diagnosis-and-antibiotic-stewardship-revisited
#18
REVIEW
Ramon Sager, Alexander Kutz, Beat Mueller, Philipp Schuetz
Several controlled clinical studies have evaluated the potential of the infection biomarker procalcitonin (PCT) to improve the diagnostic work-up of patients with bacterial infections and its influence on decisions regarding antibiotic therapy. Most research has focused on lower respiratory tract infections and critically ill sepsis patients. A clinical utility for PCT has also been found for patients with urinary tract infections, postoperative infections, meningitis, and patients with acute heart failure with possible superinfection (i...
January 24, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28110410/neurophysiological-assessment-of-brain-dysfunction-in-critically-ill-patients-an-update
#19
REVIEW
Eric Azabou, Catherine Fischer, Jean Michel Guerit, Djillali Annane, François Mauguiere, Fréderic Lofaso, Tarek Sharshar
The aim of this review was to provide up-to-date information about the usefulness of clinical neurophysiology testing in the management of critically ill patients. Evoked potentials (EPs) and electroencephalogram (EEG) are non-invasive clinical neurophysiology tools that allow an objective assessment of the central nervous system's function at the bedside in intensive care unit (ICU). These tests are quite useful in diagnosing cerebral complications, and establishing the vital and functional prognosis in ICU...
January 21, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28109347/how-is-physician-work-valued
#20
Jeffrey P Jacobs, Stephen J Lahey, Francis C Nichols, James M Levett, George Gilbert Johnston, Richard K Freeman, James D St Louis, Julie Painter, Courtney Yohe, Cameron D Wright, Kirk R Kanter, John E Mayer, Keith S Naunheim, Jeffrey B Rich, Joseph E Bavaria
Strategies to value physician work continue to evolve. The Society of Thoracic Surgeons and The Society of Thoracic Surgeons National Database have an increasingly important role in this evolution. An understanding of the Current Procedural Terminology (CPT) system (American Medical Association [AMA], Chicago, IL) and the Relative Value Scale Update Committee (RUC) is necessary to comprehend how physician work is valued. In 1965, with the dawn of increasingly complex medical care, immense innovation, and the rollout of Medicare, the need for a common language describing medical services and procedures was recognized as being of critical importance...
February 2017: Annals of Thoracic Surgery
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