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Intensive care

Nehemiah T Liu, José Salinas, Craig A Fenrich, Maria L Serio-Melvin, George C Kramer, Ian R Driscoll, Martin A Schreiber, Leopoldo C Cancio, Kevin K Chung
INTRODUCTION: The depth of burn has been an important factor often overlooked when estimating the total resuscitation fluid needed for early burn care. The goal of this study was to determine the degree to which full-thickness (FT) involvement affected overall 24-hour burn resuscitation volumes. METHODS: We performed a retrospective review of patients admitted to our burn intensive care unit from December 2007 to April 2013, with significant burns that required resuscitation using our computerized decision support system for burn fluid resuscitation...
November 2016: Journal of Trauma and Acute Care Surgery
Caterina Magnani, Diana Giannarelli, Giuseppe Casale
OBJECTIVES: To assess the prevalence of breakthrough pain (BTP) provoked by 6 common procedures in patients with advanced disease. METHODS: A prospective, cross-sectional, multicenter, national study was performed in 23 palliative care units in Italy. Patients were recruited if they were undergoing one of the following procedures as part of normal care: turning, personal hygiene care, transfer from bed to chair, bladder catheterization, pressure ulcer care, and subcutaneous drug administration...
October 20, 2016: Clinical Journal of Pain
Gregory Plotnikoff, Melissa Barber
INTRODUCTION: Single-disorder or single-organ-system clinical practice guidelines are often of limited usefulness in guiding effective management of patients with chronic multidimensional signs and symptoms. The presence of multiple long-standing medical problems in a given patient despite intensive medical effort suggests that addressing systemic core imbalances could complement more narrowly focused approaches. CASE PRESENTATION: A 72-year-old man experiencing longstanding depression, fatigue, irritable bowel syndrome, and chronic pain in the context of additional refractory illnesses was assessed and treated, guided by a system-oriented approach to underlying core imbalances termed functional medicine...
October 14, 2016: Permanente Journal
Yongyue Wei, Paula Tejera, Zhaoxi Wang, Ruyang Zhang, Feng Chen, Li Su, Xihong Lin, Ednan K Bajwa, B Taylor Thompson, David C Christiani
RATIONALE: Platelets are believed to contribute to the acute respiratory distress syndrome (ARDS) pathogenesis through inflammatory coagulation pathways. We recently reported that LRRC16A modulates baseline platelet counts to mediate ARDS risk. OBJECTIVES: To examine the role of LRRC16A in ARDS survival and its mediating effect through platelets. METHODS: 414 ARDS cases from intensive care unit (ICU) were recruited which had exome-wide genotyping data, detailed platelet counts and follow-up data during ICU hospitalizaiton...
October 21, 2016: American Journal of Respiratory and Critical Care Medicine
Jeannine M Brant, Karyl Blaseg, Kathy Aders, Dona Oliver, Evan Gray, William N Dudley
PURPOSE/OBJECTIVES: To examine symptom and quality-of-life (QOL) trajectories in breast cancer and lymphoma survivors enrolled in a survivorship navigation intervention and to explore patient, caregiver, and primary care provider (PCP) satisfaction with receipt of a survivorship care plan (SCP). 
. DESIGN: Prospective, cohort, longitudinal.
. SETTING: The Billings Clinic, an integrated cancer center in Montana. 
. SAMPLE: 67 patients with breast cancer or lymphoma who recently completed cancer treatment, along with 39 of their caregivers and 23 PCPs...
November 1, 2016: Oncology Nursing Forum
Patrícia Napoleão, Ekaterina Potapova, Sara Moleirinho, Carlota Saldanha, António Messias
AIM: Soluble CD40 ligand (sCD40L) has been considered as a marker of thrombosis and inflammation in several diseases, including sepsis. Recent studies challenge this view and point to a role of sCD40L in vascular and endothelial function. An indication of that association in sepsis has not been obtained so far. Therefore, herein we evaluated association between sCD40L and markers of hemorheology and inflammation on context of septic shock. METHODS: Time-changes of sCD40L levels over 72 hours of Intensive Care Unit (ICU) internment were assessed in 22 patients with septic shock and compared with 36 healthy volunteers...
October 20, 2016: Clinical Hemorheology and Microcirculation
Finja Jockenhöfer, Katharina Herberger, Jörg Schaller, Katja Christina Hohaus, Maren Stoffels-Weindorf, Philipp Al Ghazal, Matthias Augustin, Joachim Dissemond
INTRODUCTION: Pyoderma gangrenosum (PG) is a rare neutrophilic, ulcerative skin disease of largely unknown pathophysiology. MATERIAL AND METHODS: In this study, potentially relevant cofactors and comorbidities in patients with PG from three dermatological wound care centers in Germany were evaluated. RESULTS: Of the 121 patients assessed, women (66.9 %) were more frequently affected than men. Patient age ranged from 18 to 96 years (mean 59...
October 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
Moira S Lewitt, Emma Strage, David Church
BACKGROUND: Achieving insulin independence is emerging as a realistic therapeutic goal in the management of feline diabetes mellitus. CASE PRESENTATION: The management of an 11-year-old spayed female Burmese cat presenting with diabetes mellitus after corticosteroid administration is described. Remission was achieved after the frequency of insulin administration was increased to four times a day, and supported by intensive home blood glucose monitoring and a high protein, low carbohydrate diet...
October 20, 2016: Acta Veterinaria Scandinavica
Ishfaq A Sheikh, Ejaz Ahmad, Mohammad S Jamal, Mohd Rehan, Mourad Assidi, Iftikhar A Tayubi, Samera F AlBasri, Osama S Bajouh, Rola F Turki, Adel M Abuzenadah, Ghazi A Damanhouri, Mohd A Beg, Mohammed Al-Qahtani
BACKGROUND: Preterm birth (PTB), birth at <37 weeks of gestation, is a significant global public health problem. World-wide, about 15 million babies are born preterm each year resulting in more than a million deaths of children. Preterm neonates are more prone to problems and need intensive care hospitalization. Health issues may persist through early adulthood and even be carried on to the next generation. Majority (70 %) of PTBs are spontaneous with about a half without any apparent cause and the other half associated with a number of risk factors...
October 17, 2016: BMC Genomics
Jae Seung Yun, Seung Hyun Ko
Hypoglycemia has been considered as a major barrier to achieving the proper glycemic target in type 2 diabetes mellitus patients. In particular, severe hypoglycemia (SH), which is defined as a hypoglycemic episode requiring the assistance of another person to raise the patient's glucose level, is a serious complication of diabetes because of its possible fatal outcomes. Recently, the recommendations for diabetes care have emphasized a patient-centered approach, considering the individualized patient factors including hypoglycemia...
October 5, 2016: Diabetes & Metabolism Journal
Leng Zhou, Haidan Lan, Qinghua Zhou, Xiao Jun Tang, Daxing Zhu, Jianming Yue, Bin Liu
BACKGROUND: Ulinastatin can prevent the perioperative increase in proinflammatory cytokines for lung resection surgery; however, its impact on early clinical outcomes remains unknown. METHODS: The study enrolled 108 non-small cell lung cancer (NSCLC) patients who were randomly allocated into two groups: ulinastatin (group U) and control (group C). Patients in group U ( n = 52) were continuously intravenously infused with ulinastatin at a rate of 20 000 U/kg/hour for the first hour after anesthesia induction, and then at a rate of 5000 U/kg/hour until the conclusion of surgery...
September 2016: Thoracic Cancer
Marina Pieri, Anna Mara Scandroglio, Marcus Müller, Panagiotis Pergantis, Alexandra Kretzschmar, Friedrich Kaufmann, Volkmar Falk, Thomas Krabatsch, Georg Arlt, Evgenij Potapov, Marian Kukucka
BACKGROUND AND AIM OF THE STUDY: Driveline infections in patients with implantable left ventricular assist devices (VAD) carry increasing risk for pump infection, thromboembolic events, decreased quality of life, and increased hospitalization. We report our experience with a surgical technique for refractory driveline infections without mediastinitis consisting of translocation and wrapping of the driveline with greater omentum tissue. METHODS: We retrospectively reviewed data of VAD patients who underwent surgical treatment by translocation and wrapping with omentum for severe chronic driveline infection...
October 20, 2016: Journal of Cardiac Surgery
Henrik Hasle, Gertjan J L Kaspers
Over the last four decades the survival of paediatric patients with acute myeloid leukaemia has gradually increased to 70% in high-income countries. The therapy is very intensive and associated with many acute and long-term side effects. The early death rate has been reduced to 1-4%. The acute toxicity is a limiting factor for improving survival in low-income countries. Transplant is associated with more endocrinological late effects while cardiotoxicity is more common after relapse. Reducing the physical costs of therapy without jeopardizing survival may be accomplished by optimal supportive care, less cardiotoxic anthracyclines, less consolidation courses and strict indications for stem cell transplantation...
October 21, 2016: British Journal of Haematology
Cameron A Elliott, Vijay Ramaswamy, Francois D Jacob, Tejas Sankar, Vivek Mehta
BACKGROUND: Traumatic brain injury (TBI) is a major cause of infant morbidity and mortality. In these patients, magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI) is the test of choice to describe the extent of microstructural injury. CASE PRESENTATION AND DISCUSSION: In this case series, we describe novel acute and chronic MRI findings in four infants (6-19 months) with small, unilateral subdural hematomas in whom the etiology of head injury was suspicious for non-accidental trauma (NAT)...
October 20, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
R Fussen, S Lemmen
Multidrug resistant (MDR) bacteria present an increasing threat for intensive care patients. Whereas colonization of intensive care patients with methicillin-resistant staphylococcus aureus (MRSA) in German ICUs has remained at a constant level in recent years and therapeutic options have improved, colonization and infections with MDR gram-negative bacteria and vancomycin-resistant enterococci are increasing year by year. Only a few or even no therapeutic options remain for the treatment of these bacteria...
October 20, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Olubukunola Adesanya, Mubariz Naqvi
We report a rare, but serious, complication of a malpositioned umbilical venous catheter in a term male infant who developed laceration, hematoma, and necrosis of liver, ascites, and left-sided obstructive uropathy secondary to extravasation of total parenteral nutrition. Abdominal paracentesis confirmed the presence of parenteral nutrition in the peritoneal cavity. Although, the umbilical venous catheterization is a common intravenous access used in neonatal intensive care units, judicious continued monitoring of its use should be practiced to avoid serious complications...
2016: Global Pediatric Health
Faisal R Jahangiri, Sami Al Eissa, Samir Sayegh, Fahad Al Helal, Shomoukh A Al-Sharif, Monerah M Annaim, Sheryar Muhammad, Tanweer Aziz
A 16-year-old male patient with Ehler-Danlos syndrome (EDS) and a back deformity since birth presented with severe kyphoscoliosis. The patient was neurologically intact but had respiratory and cardiac insufficiencies. A two-stage vertebral column resection (VCR) at T9-T10 with multiple level fusion with multimodality intraoperative neurophysiological monitoring (IONM) was planned.  During the first stage, pedicle screws were placed at multiple spinal levels above and below the VCR level. Upper and lower somatosensory evoked potentials (SSEP), transcranial electrical motor evoked potentials (TCeMEP), and electromyography were monitored continuously and showed no significant changes...
August 31, 2016: Curēus
G Odewale, O J Adefioye, J Ojo, F A Adewumi, O A Olowe
Acinetobacter baumannii is a ubiquitous pathogen that has emerged as a major cause of healthcare-associated infections at Ladoke Akintola University Teaching Hospital. Isolates were assayed according to standard protocol. The isolates were subjected to molecular techniques to detect blaOXA, blaTEM, blaCTX-M, and blaSHV genes in strains of the A. baumannii isolates. The prevalence of A. baumannii was 8.5% and was most prevalent among patients in the age group 51-60 (36%); the male patients (63.6%) were more infected than their female counterparts...
September 29, 2016: European Journal of Microbiology & Immunology
Walaa S Khater, Noha N Salah-Eldeen, Mohamed S Khater, Asghraf N Saleh
This study investigated the diagnostic value of soluble urokinase plasminogen activator receptor (suPAR) and serum lactate in elderly patients with sepsis and evaluated their capacity to predict mortality and their correlation to Sequential Organ Failure Assessment (SOFA) score. The study included 80 participants, divided into two groups: 40 cases (mean age, 68.9 ± 5.9) admitted to the intensive care unit and 40 healthy controls (mean age, 67.1 ± 6.2). Elderly patients with sepsis had significantly higher levels of serum suPAR and lactic acid compared to healthy controls...
September 29, 2016: European Journal of Microbiology & Immunology
Bryan M Corbett, Charles O'Connell, Mallory A Boutin, Nabil I Fatayerji, Charles W Sauer
BACKGROUND Methylergonovine is an ergot alkaloid used to treat post-partum hemorrhage secondary to uterine atony. Mistaking methylergonovine for vitamin K with accidental administration to the neonate is a rare iatrogenic illness occurring almost exclusively in the delivery room setting. Complications of ergot alkaloids in neonates include respiratory depression, seizures, and death. CASE REPORT A term infant was inadvertently given 0.1 mg of methylergonovine intramuscularly in the right thigh. The error was only noted when the vial of medication was scanned, after administration, identifying it as methylergonovine rather than vitamin K...
October 21, 2016: American Journal of Case Reports
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