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https://www.readbyqxmd.com/read/28292454/adolescent-sexuality-updates-to-the-sexually-transmitted-infection-guidelines
#1
REVIEW
Zoon Wangu, Gale R Burstein
Adolescents are at high risk for acquisition and transmission of sexually transmitted infections (STI) secondary to both cognitive and biological susceptibility. The prevention, diagnosis, and treatment of STIs are a critical part of adolescent health care. This article discusses the most common bacterial, parasitic, and viral STIs encountered in this age group with an emphasis on new guidelines for screening and management.
April 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28288231/-primary-immunodeficiencies-in-seriously-ill-children-report-of-3-clinical-cases
#2
Leticia Yáñez, Pamela Lama, Carolina Rivacoba, Juanita Zamorano, María Angélica Marinovic
Primary immunodeficiency diseases (PID) are congenital disorders secondary to an impaired immune response. Infections, autoimmune disorders, atopy, and lymphoproliferative syndromes are commonly associated with this disorder. OBJECTIVE: To present and discuss 3 infants diagnosed with PID. CLINICAL CASES: The cases are presented of three patients with PID diagnosed during their first admission to a Paediatric Intensive Critical Care Unit. The first patient, a 4-month-old infant affected by a severe pneumonia, and was diagnosed as a Severe Combined Immunodeficiency Disease...
February 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28286784/the-influence-of-metabolic-imbalances-and-oxidative-stress-on-the-outcome-of-critically-ill-polytrauma-patients-a-review
#3
REVIEW
Alexandru Florin Rogobete, Dorel Sandesc, Marius Papurica, Emil Robert Stoicescu, Sonia Elena Popovici, Lavinia Melania Bratu, Corina Vernic, Adriana Mariana Sas, Adrian Tudor Stan, Ovidiu Horea Bedreag
The critically ill polytrauma patient presents with a series of associated pathophysiologies secondary to the traumatic injuries. The most important include systemic inflammatory response syndrome (SIRS), sepsis, oxidative stress (OS), metabolic disorders, and finally multiple organ dysfunction syndrome (MODS) and death. The poor outcome of these patients is related to the association of the aforementioned pathologies. The nutrition of the critically ill polytrauma patient is a distinct challenge because of the rapid changes in terms of energetic needs associated with hypermetabolism, sepsis, SIRS, and OS...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28284300/renal-replacement-therapy-in-acute-kidney-injury-controversies-and-consensus
#4
REVIEW
Michael Heung, Lenar Yessayan
Acute kidney injury (AKI) is a common complication among critically ill patents, and 5% of intensive care unit (ICU) patients require initiation of renal replacement therapy (RRT). In recent years, clinical trials have provided evidence-based guidance for some important aspects of RRT management in patients with AKI, such as dialysis dosing and approaches to anticoagulation in patients undergoing continuous RRT. However, there remain many areas of uncertainty, and delivery of RRT in the ICU requires clinical judgment, flexibility, and an understanding of dialysis principles...
April 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28279999/simplified-mortality-score-for-the-intensive-care-unit-sms-icu-protocol-for-the-development-and-validation-of-a-bedside-clinical-prediction-rule
#5
Anders Granholm, Anders Perner, Mette Krag, Peter Buhl Hjortrup, Nicolai Haase, Lars Broksø Holst, Søren Marker, Marie Oxenbøll Collet, Aksel Karl Georg Jensen, Morten Hylander Møller
INTRODUCTION: Mortality prediction scores are widely used in intensive care units (ICUs) and in research, but their predictive value deteriorates as scores age. Existing mortality prediction scores are imprecise and complex, which increases the risk of missing data and decreases the applicability bedside in daily clinical practice. We propose the development and validation of a new, simple and updated clinical prediction rule: the Simplified Mortality Score for use in the Intensive Care Unit (SMS-ICU)...
March 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28276062/ilae-classification-of-the-epilepsies-position-paper-of-the-ilae-commission-for-classification-and-terminology
#6
Ingrid E Scheffer, Samuel Berkovic, Giuseppe Capovilla, Mary B Connolly, Jacqueline French, Laura Guilhoto, Edouard Hirsch, Satish Jain, Gary W Mathern, Solomon L Moshé, Douglas R Nordli, Emilio Perucca, Torbjörn Tomson, Samuel Wiebe, Yue-Hua Zhang, Sameer M Zuberi
The International League Against Epilepsy (ILAE) Classification of the Epilepsies has been updated to reflect our gain in understanding of the epilepsies and their underlying mechanisms following the major scientific advances that have taken place since the last ratified classification in 1989. As a critical tool for the practicing clinician, epilepsy classification must be relevant and dynamic to changes in thinking, yet robust and translatable to all areas of the globe. Its primary purpose is for diagnosis of patients, but it is also critical for epilepsy research, development of antiepileptic therapies, and communication around the world...
March 8, 2017: Epilepsia
https://www.readbyqxmd.com/read/28263704/how-could-health-information-be-improved-recommended-actions-from-the-victorian-consultation-on-health-literacy
#7
Sophie J Hill, Tanya A Sofra
Objective Health literacy is on the policy agenda. Accessible, high-quality health information is a major component of health literacy. Health information materials include print, electronic or other media-based information enabling people to understand health and make health-related decisions. The aim of the present study was to present the findings and recommended actions as they relate to health information of the Victorian Consultation on Health Literacy.Methods Notes and submissions from the 2014 Victorian Consultation workshops and submissions were analysed thematically and a report prepared with input from an advisory committee...
March 7, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28258178/international-criteria-for-electrocardiographic-interpretation-in-athletes
#8
Jonathan A Drezner, Sanjay Sharma, Aaron Baggish, Michael Papadakis, Mathew G Wilson, Jordan M Prutkin, Andre La Gerche, Michael J Ackerman, Mats Borjesson, Jack C Salerno, Irfan M Asif, David S Owens, Eugene H Chung, Michael S Emery, Victor F Froelicher, Hein Heidbuchel, Carmen Adamuz, Chad A Asplund, Gordon Cohen, Kimberly G Harmon, Joseph C Marek, Silvana Molossi, Josef Niebauer, Hank F Pelto, Marco V Perez, Nathan R Riding, Tess Saarel, Christian M Schmied, David M Shipon, Ricardo Stein, Victoria L Vetter, Antonio Pelliccia, Domenico Corrado
Sudden cardiac death (SCD) is the leading cause of mortality in athletes during sport. A variety of mostly hereditary, structural or electrical cardiac disorders are associated with SCD in young athletes, the majority of which can be identified or suggested by abnormalities on a resting 12-lead electrocardiogram (ECG). Whether used for diagnostic or screening purposes, physicians responsible for the cardiovascular care of athletes should be knowledgeable and competent in ECG interpretation in athletes. However, in most countries a shortage of physician expertise limits wider application of the ECG in the care of the athlete...
March 3, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28257562/planned-early-birth-versus-expectant-management-for-women-with-preterm-prelabour-rupture-of-membranes-prior-to-37-weeks-gestation-for-improving-pregnancy-outcome
#9
REVIEW
Diana M Bond, Philippa Middleton, Kate M Levett, David P van der Ham, Caroline A Crowther, Sarah L Buchanan, Jonathan Morris
BACKGROUND: Current management of preterm prelabour rupture of the membranes (PPROM) involves either initiating birth soon after PPROM or, alternatively, adopting a 'wait and see' approach (expectant management). It is unclear which strategy is most beneficial for mothers and their babies. This is an update of a Cochrane review published in 2010 (Buchanan 2010). OBJECTIVES: To assess the effect of planned early birth versus expectant management for women with preterm prelabour rupture of the membranes between 24 and 37 weeks' gestation for fetal, infant and maternal well being...
March 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28254854/continuous-renal-replacement-therapy-update-an-emphasis-on-safe-and-high-quality-care
#10
Hildy Schell-Chaple
Continuous renal replacement therapy (CRRT) was introduced more than 40 years ago as a renal support option for critically ill patients who had contraindications to intermittent hemodialysis and peritoneal dialysis. Despite being the most common renal support therapy used in intensive care units today, the tremendous variability in CRRT management challenges the interpretation of findings from CRRT outcome studies. The lack of standardization in practice and training of clinicians along with the high risk of CRRT-related adverse events has been the impetus for the recent expert consensus work on identifying quality indicators for CRRT programs...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/28244690/neutrophil-dysregulation-during-sepsis-an-overview-and-update
#11
REVIEW
Xiao-Fei Shen, Ke Cao, Jin-Peng Jiang, Wen-Xian Guan, Jun-Feng Du
Sepsis remains a leading cause of death worldwide, despite advances in critical care, and understanding of the pathophysiology and treatment strategies. No specific therapy or drugs are available for sepsis. Neutrophils play a critical role in controlling infection under normal conditions, and it is suggested that their migration and antimicrobial activity are impaired during sepsis which contribute to the dysregulation of immune responses. Recent studies further demonstrated that interruption or reversal of the impaired migration and antimicrobial function of neutrophils improves the outcome of sepsis in animal models...
February 28, 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/28243012/delirium-in-the-intensive-care-unit
#12
REVIEW
Suresh Arumugam, Ayman El-Menyar, Ammar Al-Hassani, Gustav Strandvik, Mohammad Asim, Ahammed Mekkodithal, Insolvisagan Mudali, Hassan Al-Thani
Delirium is characterized by impaired cognition with nonspecific manifestations. In critically ill patients, it may develop secondary to multiple precipitating or predisposing causes. Although it can be a transient and reversible syndrome, its occurrence in Intensive Care Unit (ICU) patients may be associated with long-term cognitive dysfunction. This condition is often under-recognized by treating physicians, leading to inappropriate management. For appropriate management of delirium, early identification and risk factor assessment are key factors...
January 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28229295/benchmarking-of-venous-thromboembolism-prophylaxis-practice-with-ent-uk-guidelines
#13
Ali S Al-Qahtani
The aim of this study was to benchmark our guidelines of prevention of venous thromboembolism (VTE) in ENT surgical population against ENT.UK guidelines, and also to encourage healthcare providers to utilize benchmarking as an effective method of improving performance. The study design is prospective descriptive analysis. The setting of this study is tertiary referral centre (Assir Central Hospital, Abha, Saudi Arabia). In this study, we are benchmarking our practice guidelines of the prevention of VTE in the ENT surgical population against that of ENT...
February 22, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28225422/clinical-updates-in-women-s-health-care-summary-structural-heart-disease-primary-and-preventive-care-review
#14
Tiberio Frisoli, Michele Doughty Voeltz
Reproductive-aged women with structural heart disease who become pregnant as well as postreproductive-aged women with this condition represent a significant proportion of patients seen by obstetrician- gynecologists. Usually, their conditions are complex, and a basic knowledge of the anatomy and physiology of the heart is required. Additionally, understanding the effect of pregnancy on women with structural heart disease is critically important to optimizing maternal and fetal outcomes. This monograph addresses the pathophysiology, signs and symptoms, screening and diagnosis, basic management, and suggested counseling for an obstetric-gynecologic patient with structural heart disease...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28212172/cognitive-decline-associated-with-anesthesia-and-surgery-in-the-elderly-does-this-contribute-to-dementia-prevalence
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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