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https://www.readbyqxmd.com/read/29786826/rare-case-of-bilateral-incarcerated-obturator-hernia-a-case-report
#1
Engin Hatipoğlu, Fatih Dal, Veysel Umman, Süleyman Demiryas, Oktay Demirkıran, Metin Ertem, Sabri Ergüney, Salih Pekmezci
Here, we report the case of an 84-year-old woman with acute mechanical intestinal obstruction (AMIO) who was admitted to our Emergency Department. Computed tomography (CT) scan revealed an incarcerated bilateral obturator hernia, and the defect was resolved using transabdominal preperitoneal (TAPP) technique with polypropylene mesh. The patient was administered an oral regimen two days after the operation. The patient stayed in the intensive care unit for 4 days and was uneventfully discharged on the 9th postoperative day...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29786813/prediction-of-mortality-in-pediatric-traumatic-brain-injury-implementations-from-a-tertiary-pediatric-intensive-care-facility
#2
Ebru Atike Ongun, Oğuz Dursun
BACKGROUND: To explore the mortality risk factors of traumatic brain injury in pediatric intensive care unit admissions. METHODS: Eighty-eight children (categorized using the Glasgow Coma Scale) between September 2014 and December 2016 were analyzed. Emergency department and intensive care course, treatment strategies, axonal injury, intubation and tracheostomy rates, length of intensive care and hospitalization, Rotterdam-CT scores, injury severity scores, and PRISM-III scores were recorded...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29786568/nutritive-support-for-newborns-in-critical-conditions-semi-elemental-formilas-as-a-means-of-enteral-nutrition
#3
Dmytro Shkurupii
OBJECTIVE: Introduction: The goal is to increase the efficiency of nutritional support in intensive care of newborns by substantiating the choice of the enteral blend. PATIENTS AND METHODS: Materials and methods: A prospective cohort study was conducted, which included 173 newborns. The main group consisted of 143 patients of intensive care units. The comparison group - 30 virtually healthy newborns. Physical parameters, changes in protein metabolism, serum immunoglobulins, functioning of the gastrointestinal tract and hepatobiliary system in the development of critical conditions and depending on the type of enteric urine formula were determined...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29786145/pilot-study-demonstrates-that-placental-histology-can-provide-an-additional-tool-for-diagnosing-early-onset-neonatal-sepsis
#4
J M A Ykema, E J D'Haens, M Havenith, J van Eyck, R A van Lingen, M A C Hemels
AIM: We explored whether placental histology could help to diagnose early-onset neonatal sepsis (EONS), guide clinical decision-making 48 hours after birth and reduce antibiotic use. METHODS: This study comprised 109 infants born at less than 32 weeks of gestation, who were admitted to the neonatal intensive care unit of Isala, Zwolle, The Netherlands, between January 2013 and December 2013. EONS was defined as clinical symptoms plus raised serial C-reactive protein >10 mg/L and a positive (proven EONS) or a negative (suspected EONS) blood culture...
May 22, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29786021/developing-and-implementing-a-global-emergency-medicine-course-lessons-learned-from-rwanda
#5
Sojung Yi, Olivier Félix Umuhire, Doris Uwamahoro, Mindi Guptill, Giles N Cattermole
Background: There is a growing demand by medical trainees for meaningful, short-term global emergency medicine (EM) experiences. EM programs in high-income countries (HICs) have forged opportunities for their trainees to access this experience in low-and middle-income countries (LMICs). However, few programs in LMICs have created and managed such courses. As more LMICs establish EM programs, these settings are ideal for developing courses beneficial for all participants. We describe our experience of creating and implementing a short-term global EM course in Rwanda...
September 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/29785938/decision-making-in-end-of-life-care-are-we-really-playing-together-in-the-same-team
#6
M M Lomero-Martínez, M F Jiménez-Herrera, M A Bodí-Saera, M Llauradó-Serra, N Masnou-Burrallo, E Oliver-Juan, A Sandiumenge-Camps
BACKGROUND: Limitation of life-sustaining treatment is increasingly common in critical care units, and controlled donation after circulatory death is starting to be included as an option within patient care plans. Lack of knowledge and misunderstandings can place a barrier between healthcare professionals. OBJECTIVE: To determine the perceptions, knowledge and attitudes of physicians and nurses working in intensive care units regarding Limitation of life-sustaining treatment and controlled donation after circulatory death...
May 18, 2018: Enfermería Intensiva
https://www.readbyqxmd.com/read/29785622/retrospective-surveillance-of-antibiotic-use-in-maternity-wards-and-neonatal-intensive-care-units-in-saint-petersburg-russia
#7
Timofey L Galankin, Alexey S Kolbin, Sergey V Sidorenko, Alexey A Kurylev, Elena A Malikova, Yuri V Lobzin, Dmitry O Ivanov, Nikolay P Shabalov, Anton V Mikhailov, Nikolay N Klimko, Gennadiy V Dolgov
Antibiotic overuse in infants is associated with an increased risk of serious adverse events. Development of antibiotic stewardship programs aimed at reducing overall antibiotic consumption requires epidemiological surveillance. Retrospective surveillance and evaluation of all antibiotics provided to every infant admitted to maternal wards or neonatal intensive care units (NICUs) from 01 January 2014 to 31 December 2014 were performed in five medical centers of Saint Petersburg, Russia. Types of antibiotics and dates of administration were recorded...
May 21, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29785548/operative-vaginal-delivery-in-case-of-persistent-occiput-posterior-position-after-manual-rotation-failure-a-6-month-follow-up-on-pelvic-floor-function
#8
Paul Guerby, Olivier Parant, Elodie Chantalat, Christophe Vayssiere, Fabien Vidal
PURPOSE: To compare the short- and long-term perineal consequences (at 6 months postpartum) and short-term neonatal consequences of instrumental rotation (IR) to those induced by assisted delivery (AD) in the occiput posterior (OP) position, in case of manual rotation failure. METHODS: A prospective observational cohort study; tertiary referral hospital including all women presenting with persistent OP position who delivered vaginally after manual rotation failure with attempted IR or AD in OP position from September 2015 to October 2016...
May 21, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29785504/impact-of-a-vap-bundle-in-belgian-intensive-care-units
#9
Laurent Jadot, Luc Huyghens, Annick De Jaeger, Marc Bourgeois, Dominique Biarent, Adeline Higuet, Koen de Decker, Margot Vander Laenen, Baudewijn Oosterlynck, Patrick Ferdinande, Pascal Reper, Serge Brimioulle, Sophie Van Cromphaut, Stéphane Clement De Clety, Thierry Sottiaux, Pierre Damas
BACKGROUND: In order to decrease the incidence of ventilator-associated pneumonia (VAP) in Belgium, a national campaign for implementing a VAP bundle involving assessment of sedation, cuff pressure control, oral care with chlorhexidine and semirecumbent position, was launched in 2011-2012. This report will document the impact of this campaign. METHODS: On 1 day, once a year from 2010 till 2016, except in 2012, Belgian ICUs were questioned about their ventilated patients...
May 21, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29785406/fluid-extravasation-in-shoulder-arthroscopic-surgery-a-systematic-review
#10
REVIEW
Muzammil Memon, Jeffrey Kay, Arian Gholami, Nicole Simunovic, Olufemi R Ayeni
Background: Arthroscopic surgery of the shoulder joint has become increasingly more common given its advantages over open surgery; however, one rare but potentially life-threatening complication is fluid extravasation into the surrounding tissues, causing edema, respiratory compromise, abnormal results on laboratory blood tests, and possibly death. Currently, no systematic review exists that summarizes the existing clinical research on this topic. Purpose: To perform a systematic review on fluid extravasation as a complication of shoulder arthroscopic surgery, specifically assessing clinical presentation, risk factors, management, and outcomes...
May 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29784752/head-and-neck-cancers-advantages-of-advanced-radiation-therapy-and-importance-of-supportive-care
#11
Sharon Spencer
For more than a decade, the incidence of head and neck cancers has been increasing in the United States. Worldwide, they are the ninth most common cancer. Today, newer advances in radiotherapy (RT), such as fractionation, 4-dimensional cone-beam CT, and intensity-modulated RT, have provided clinicians with the opportunity for improved patient outcomes. At the NCCN 23rd Annual Conference, Sharon Spencer, MD, described the advantages of advances in RT and the means to mitigate untoward side effects.
May 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29784540/recommendations-for-the-use-of-electroencephalography-and-evoked-potentials-in-comatose-patients
#12
REVIEW
Nathalie André-Obadia, Julie Zyss, Martine Gavaret, Jean-Pascal Lefaucheur, Eric Azabou, Sébastien Boulogne, Jean-Michel Guérit, Aileen McGonigal, Philippe Merle, Véronique Mutschler, Lionel Naccache, Cécile Sabourdy, Agnès Trébuchon, Louise Tyvaert, Laurent Vercueil, Benjamin Rohaut, Arnaud Delval
Predicting the outcome of a comatose or poorly responsive patient is a major issue for intensive care unit teams, in order to give the most accurate information to the family and to choose the best therapeutic option. However, determining the level of cortical activity in patients with disorders of consciousness is a real challenge. Reliable criteria are required to help clinicians in the decision-making process, especially in the acute phase of coma. In this paper, we propose recommendations for recording and interpreting electroencephalography and evoked potentials in comatose patients based on the literature and the clinical experience of a group of neurophysiologists trained in the management of comatose patients...
May 18, 2018: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/29784539/revisiting-antithrombin-in-health-and-disease-congenital-deficiencies-and-genetic-variants-and-laboratory-studies-on-%C3%AE-and-%C3%AE-forms
#13
REVIEW
Jean Amiral, Jerard Seghatchian
Antithrombin [AT] is the main inhibitor for activated plasma coagulation serine esterases, inhibiting thrombin, Factors Xa and IXa, but also Factors XIIa, XIa, VIIa, kallicrein, and plasmin. Its activity is highly enhanced by heparin, through binding to the pentasaccharide sequences, for inhibition of all coagulation proteases, except thrombin, which inhibition requires its additional binding to the heparin polysaccharide chain. However, AT is the major inhibitor of thrombin in the blood circulation. Congenital or acquired deficiencies of AT expose affected patients to an increased risk of developing unprovoked and recurrent thrombo-embolic diseases...
April 19, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29784518/impact-of-blood-donor-sex-on-transfusion-related-outcomes-in-preterm-infants
#14
Thomas Murphy, Anju Chawla, Richard Tucker, Betty Vohr
OBJECTIVE: Explore the role of red blood cell donor sex on preterm infant neonatal outcomes. STUDY DESIGN: In a retrospective, exploratory, cohort study, the hospital blood bank database was queried for units of blood released to neonatal intensive care unit patients in 2009-2010. The state blood center provided donor sex, and a department database provided neonatal characteristics and morbidities. Comparisons were made for 2 groups: those who ever received female blood and those who did not...
May 18, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29783818/-continuous-renal-replacement-therapy-combined-with-extracorporeal-membrane-oxygenation-for-pediatric-cardiopulmonary-failure
#15
Y P Zhou, J Y Shi, F Wang, Y Cui, T T Xu, C X Wang, Y C Zhang
Objective: To explore the effectiveness and safety of continuous renal replacement therapy (CRRT) combined with extracorporeal membrane oxygenation (ECMO) on rescuing pediatric patients with cardiopulmonary failure. Methods: The medical records of patients treated with ECMO admitted to pediatric intensive care unit (PICU) in Shanghai Children's Hospital from December 2015 to November 2017 were retrospectively extracted. There were 14 patients treated with ECMO combined with CRRT (ECMO+ CRRT group) due to acute kidney injury (AKI) or fluid overload, while 11 cases treated with ECMO only...
May 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29783737/traceability-in-patient-healthcare-through-the-integration-of-rfid-technology-in-an-icu-in-a-hospital
#16
María Martínez Pérez, Carlos Dafonte, Ángel Gómez
Patient safety is a principal concern for health professionals in the care process and it is, therefore, necessary to provide information management systems to each unit of the hospital, capable of tracking patients and medication to reduce the occurrence of adverse events and therefore increase the quality of care received by patients during their stay in hospital. This work presents a tool for the Intensive Care Unit (ICU), a key service with special characteristics, which computerises and tracks admissions, care plans, vital monitoring, the prescription and medication administration process for patients in this service...
May 19, 2018: Sensors
https://www.readbyqxmd.com/read/29783270/reducing-alarm-fatigue-in-two-neonatal-intensive-care-units-through-a-quality-improvement-collaboration
#17
Kendall R Johnson, James I Hagadorn, David W Sink
OBJECTIVE:  To reduce nonactionable oximeter alarms by 80% without increasing time infants were hypoxemic (oxygen saturation [SpO2 ] ≤ 80%) or hyperoxemic (SpO2  > 95% while on supplemental oxygen). STUDY DESIGN:  In 2015, a multidisciplinary team at Connecticut Children's Medical Center initiated a quality improvement project to reduce nonactionable oximeter alarms in two referral neonatal intensive care units (NICUs). Changes made through improvement cycles included reduction of the low oximeter alarm limit for specific populations, increased low alarm delay, development of postmenstrual age-based alarm profiles, and updated bedside visual reminders...
May 21, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29783252/the-analytical-prognosis-of-the-susceptibility-to-aminoglycosides-and-doxycycline-inacinetobacter-baumanniiisoolated-from-burns-of-intensive-care-unit-patients
#18
Vasyl I Nahaichuk, Oleksandr A Nazarchuk, Neonila I Osadchuk, Dmytro V Dmytriiev, Halyna H Nazarchuk
OBJECTIVE: Introduction: Clinical strains of A.baumannii are becoming highly important in hospital-acquired infections, especially because of their association with low susceptibility to antibiotics, which requires in-depth study with a prognostic determination of the dynamics of antimicrobial efficacy of antibiotics. The aim was to investigate of prognostic models of aminoglycoside antibiotics effectiveness on the basis of the mathematical analysis of real susceptibility of A.baumannii clinical strains, isolated from patients in BICU...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29783184/postoperative-outcomes-in-patients-with-a-do-not-resuscitate-dnr-order-undergoing-elective-procedures
#19
Ethan Y Brovman, Elisa C Walsh, Brittany N Burton, Christine E Kuo, Charlotta Lindvall, Rodney A Gabriel, Richard D Urman
STUDY OBJECTIVE: Do-not-resuscitate (DNR) status has been shown to be an independent risk factor for mortality in the post-operative period. Patients with DNR orders often undergo elective surgeries to alleviate symptoms and improve quality of life, but there are limited data on outcomes for informed decision making. DESIGN: Retrospective cohort study. SETTING: A multi-institutional setting including operating room, postoperative recovery area, inpatient wards, and the intensive care unit...
May 18, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29783031/a-unique-all-payer-rate-setting-system-controls-the-cost-but-not-the-racial-disparity-in-lower-extremity-revascularization-procedures
#20
Besma Nejim, Robert J Beaulieu, Husain Alshaikh, Mohammed Hamouda, Joseph Canner, Mahmoud B Malas
BACKGROUND: Patients with peripheral arterial disease (PAD) often have high comorbidity burden that may complicate post-interventional course and drive increased healthcare expenditures. Racial disparity had been observed in lower extremity revascularization (LER) patterns and outcomes. In 2014, Maryland adopted an all-payer rate setting system to limit the rising hospitalization costs. This resulted in an aggregate payment system in which hospital compensation takes place as an overall per capita expenditure for hospital services...
May 18, 2018: Annals of Vascular Surgery
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