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https://www.readbyqxmd.com/read/28108748/-acute-hemorrhage-in-the-upper-gastrointestinal-tract
#1
M Busch, A Schneider, T Lankisch, T von Hahn
Bleeding in the upper gastrointestinal (GI) tract is a frequent and complex emergency. There are guidelines for acute medical treatment, established endoscopic treatment as well as surgical and radiological rescue procedures. Nevertheless, the mortality of the upper GI tract bleeding is high, which is due to the fact that affected patients often have serious preexisting illnesses.
January 20, 2017: Der Internist
https://www.readbyqxmd.com/read/28107357/vasopressor-use-for-severe-hypotension-a-multicentre-prospective-observational-study
#2
Francois Lamontagne, Deborah J Cook, Maureen O Meade, Andrew Seely, Andrew G Day, Emmanuel Charbonney, Karim Serri, Yoanna Skrobik, Paul Hebert, Charles St-Arnaud, Hector Quiroz-Martinez, Michaël Mayette, Daren K Heyland
BACKGROUND: The optimal approach to titrate vasopressor therapy is unclear. Recent sepsis guidelines recommend a mean arterial pressure (MAP) target of 65 mmHg and higher for chronic hypertensive patients. As data emerge from clinical trials comparing blood pressure targets for vasopressor therapy, an accurate description of usual care is required to interpret study results. Our aim was to measure MAP values during vasopressor therapy in Canadian intensive care units (ICUs) and to compare these with stated practices and guidelines...
2017: PloS One
https://www.readbyqxmd.com/read/28107266/early-fluid-overload-prolongs-mechanical-ventilation-in-children-with-viral-lower-respiratory-tract-disease
#3
Sarah A Ingelse, Hanke M G Wiegers, Job C Calis, Job B van Woensel, Reinout A Bem
OBJECTIVES: Viral-lower respiratory tract disease is common in young children worldwide and is associated with high morbidity. Acute respiratory failure due to viral-lower respiratory tract disease necessitates PICU admission for mechanical ventilation. In critically ill patients in PICU settings, early fluid overload is common and associated with adverse outcomes such as prolonged mechanical ventilation and increased mortality. It is unclear, however, if this also applies to young children with viral-lower respiratory tract disease induced acute respiratory failure...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28107264/readmission-and-late-mortality-after-critical-illness-in-childhood
#4
Mary E Hartman, Mohammed J Saeed, Tellen Bennett, Katri Typpo, Renee Matos, Margaret A Olsen
OBJECTIVES: Little is known about the ongoing mortality risk and healthcare utilization among U.S. children after discharge from a hospitalization involving ICU care. We sought to understand risks for hospital readmission and trends in mortality during the year following ICU discharge. DESIGN: Retrospective observational cohort study. SETTING: This study was performed using administrative claims data from 2006-2013 obtained from the Truven Health Analytics MarketScan Database...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28107096/implementation-of-an-aggressive-enteral-nutrition-protocol-and-the-effect-on-clinical-outcomes
#5
Daniel Dante Yeh, Catrina Cropano, Sadeq A Quraishi, Eva Fuentes, Haytham M A Kaafarani, Jarone Lee, Yuchiao Chang, George Velmahos
BACKGROUND: Macronutrient deficiency in critical illness is associated with worse outcomes. We hypothesized that an aggressive enteral nutrition (EN) protocol would result in higher macronutrient delivery and fewer late infections. METHODS: We enrolled adult surgical intensive care unit (ICU) patients receiving >72 hours of EN from July 2012 to June 2014. Our intervention consisted of increasing protein prescription (2.0-2.5 vs 1.5-2.0 g/kg/d) and compensatory feeds for EN interruption...
January 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28106720/25-hydroxy-vitamin-d-concentration-is-not-affected-by-severe-or-non-severe-pneumonia-or-inflammation-in-young-children
#6
Johanne Haugen, Ram K Chandyo, Manjeswori Ulak, Maria Mathisen, Sudha Basnet, Karl A Brokstad, Palle Valentiner-Branth, Prakash S Shrestha, Tor A Strand
Poor vitamin D status has been associated with increased risk and severity of respiratory tract infections. Whether or not inflammation and infection affects 25-hydroxy vitamin D (25(OH)D) concentration is controversial and is important in the interpretation of observational studies using plasma-25(OH)D as a biomarker for status. Our objectives were to measure whether 25(OH)D concentration was altered by an episode of acute lower respiratory tract infection and whether markers of inflammation predicted the 25(OH)D concentration...
January 17, 2017: Nutrients
https://www.readbyqxmd.com/read/28106498/performing-concurrent-operations-in-academic-vascular-neurosurgery-does-not-affect-patient-outcomes
#7
Corinna C Zygourakis, Janelle Lee, Julio Barba, Errol Lobo, Michael T Lawton
OBJECTIVE Concurrent surgeries, also known as "running two rooms" or simultaneous/overlapping operations, have recently come under intense scrutiny. The goal of this study was to evaluate the operative time and outcomes of concurrent versus nonconcurrent vascular neurosurgical procedures. METHODS The authors retrospectively reviewed 1219 procedures performed by 1 vascular neurosurgeon from 2012 to 2015 at the University of California, San Francisco. Data were collected on patient age, sex, severity of illness, risk of mortality, American Society of Anesthesiologists (ASA) status, procedure type, admission type, insurance, transfer source, procedure time, presence of resident or fellow in operating room (OR), number of co-surgeons, estimated blood loss (EBL), concurrent vs nonconcurrent case, severe sepsis, acute respiratory failure, postoperative stroke causing neurological deficit, unplanned return to OR, 30-day mortality, and 30-day unplanned readmission...
January 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28105784/what-prevents-critically-ill-patients-with-respiratory-failure-from-using-non-invasive-positive-pressure-ventilation-a-mixed-methods-study
#8
Hiroaki Murata, Tomoko Inoue, Osamu Takahashi
AIM: To identify the factors that prevent patients in respiratory failure from using noninvasive positive pressure ventilation (NPPV). The following were evaluated: (i) the patients who converted from NPPV to endotracheal intubation; and (ii) the patients who abandoned NPPV. METHODS: Patients were interviewed regarding their experience with NPPV. Next, the factors that prevented the continuation of NPPV were identified and those data were collected retrospectively from medical records...
January 20, 2017: Japan Journal of Nursing Science: JJNS
https://www.readbyqxmd.com/read/28105617/-establishment-of-prediction-model-of-acute-gastrointestinal-injury-classification-of-critically-ill-patients-based-on-digital-gastrointestinal-sounds-monitoring
#9
Yan Wang, Jianrong Wang, Weiwei Liu, Guangliang Zhang
OBJECTIVE: To develop the prediction model of acute gastrointestinal injury (AGI) classification of critically ill patients. METHODS: The binary channel gastrointestinal sounds (GIS) monitor system was used to gather and analyze the GIS of 60 consecutive critically ill patients who were admitted in Critical Care Medicine of PLA General Hospital from April 2015 to November 2015 (patients with chronic gastrointestinal disease or history of gastrointestinal surgery were excluded)...
January 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28104739/relationship-between-prescribed-psychotropic-medications-and-co-ingested-alcohol-in-intentional-self-poisonings
#10
Kate M Chitty, Timothy Dobbins, Andrew H Dawson, Geoffrey K Isbister, Nicholas A Buckley
BACKGROUND: Acute alcohol consumption is a major risk factor for suicide, therefore investigating factors associated with alcohol-related self-harm warrant attention. AIMS: To investigate the influence of prescribed psychotropic medications on the odds of co-ingesting alcohol preceding or during intentional efforts to self-poison. METHOD: A cross-sectional analysis of consecutive hospital presentations following intentional self-poisoning was conducted...
January 19, 2017: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/28104595/frailty-affects-the-initial-treatment-response-and-time-to-recovery-of-mobility-in-acutely-ill-older-adults-admitted-to-hospital
#11
Oliver L Hatheway, Arnold Mitnitski, Kenneth Rockwood
OBJECTIVES: to investigate how frailty and mobility impairment affect recovery of balance and mobility in acutely ill older patients. DESIGN: secondary analysis of cohort study. SETTING: general and geriatric medicine inpatient units, QEII Health Sciences Centre, Dalhousie University, Canada. SUBJECTS: four hundred and nine older adults (mean age = 81 ± 7 standard deviation, 64% women). METHODS: we constructed a frailty index based on a comprehensive geriatric assessment (FI-CGA), at baseline (2 weeks before admission; mean 0...
January 18, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28104058/intervening-early-with-family-members-during-first-episode-psychosis-an-evaluation-of-mental-health-nursing-psychoeducation-within-an-inpatient-unit
#12
Melissa Petrakis, Simon Laxton
Provision of psychoeducation to families of service users experiencing a first-episode psychosis has been found to assist with relapse prevention and promoting recovery for service users. Psychoeducation also assists families to reduce isolation and gain relevant information and support. This study aimed to clarify the role inpatient staff can best have with families, targeted to the acute phase and early stage of the illness. Family members were provided an inpatient carer psychoeducation meeting and recruited for a feedback interview 6 months later...
February 2017: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/28103905/spatio-temporal-analysis-of-the-genetic-diversity-and-complexity-of-plasmodium-falciparum-infections-in-kedougou-southeastern-senegal
#13
Makhtar Niang, Laty G Thiam, Cheikh Loucoubar, Abdourahmane Sow, Bacary D Sadio, Mawlouth Diallo, Amadou A Sall, Aissatou Toure-Balde
BACKGROUND: Genetic analyses of the malaria parasite population and its temporal and spatial dynamics could provide an assessment of the effectiveness of disease control strategies. The genetic diversity of Plasmodium falciparum has been poorly documented in Senegal, and limited data are available from the Kedougou Region. This study examines the spatial and temporal variation of the genetic diversity and complexity of P. falciparum infections in acute febrile patients in Kedougou, southeastern Senegal...
January 19, 2017: Parasites & Vectors
https://www.readbyqxmd.com/read/28103872/the-use-of-the-eq-5d-y-health-related-quality-of-life-outcome-measure-in-children-in-the-western-cape-south-africa-psychometric-properties-feasibility-and-usefulness-a-longitudinal-analytical-study
#14
Des Scott, Gillian D Ferguson, Jennifer Jelsma
BACKGROUND: The EQ-5D-Y, an outcome measure of Health Related Quality of Life (HRQoL) in children, was developed by an international task team in 2010. The multinational feasibility, reliability and validity study which followed was undertaken with mainly healthy children. The aim of this study was to investigate the psychometric properties of the EQ-5D-Y when used to assess the HRQoL of children with different health states. METHOD: A sample of 224 children between eight and twelve years were grouped according to their health state...
January 19, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28103598/coronavirus-infections-in-the-central-nervous-system-and-respiratory-tract-show-distinct-features-in-hospitalized-children
#15
Yuanyuan Li, Haipeng Li, Ruyan Fan, Bo Wen, Jian Zhang, Xiaoying Cao, Chengwu Wang, Zhanyi Song, Shuochi Li, Xiaojie Li, Xinjun Lv, Xiaowang Qu, Renbin Huang, Wenpei Liu
BACKGROUND/AIMS: Coronavirus (CoV) infections induce respiratory tract illnesses and central nervous system (CNS) diseases. We aimed to explore the cytokine expression profiles in hospitalized children with CoV-CNS and CoV-respiratory tract infections. METHODS: A total of 183 and 236 hospitalized children with acute encephalitis-like syndrome and respiratory tract infection, respectively, were screened for anti-CoV IgM antibodies. The expression profiles of multiple cytokines were determined in CoV-positive patients...
January 20, 2017: Intervirology
https://www.readbyqxmd.com/read/28103209/west-nile-virus-and-other-nationally-notifiable-arboviral-diseases-united-states-2015
#16
Elisabeth Krow-Lucal, Nicole P Lindsey, Jennifer Lehman, Marc Fischer, J Erin Staples
Arthropod-borne viruses (arboviruses) are transmitted to humans primarily through the bites of infected mosquitoes and ticks. The leading cause of domestically acquired arboviral disease in the United States is West Nile virus (WNV) (1). Other arboviruses, including La Crosse, St. Louis encephalitis, Jamestown Canyon, Powassan, and eastern equine encephalitis viruses, also cause sporadic cases and outbreaks. This report summarizes surveillance data reported to CDC in 2015 for nationally notifiable arboviruses...
January 20, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28102521/clinical-assessment-and-train-of-four-measurements-in-critically-ill-patients-treated-with-recommended-doses-of-cisatracurium-or-atracurium-for-neuromuscular-blockade-a-prospective-descriptive-study
#17
Pierre Bouju, Jean-Marc Tadié, Nicolas Barbarot, Julien Letheulle, Fabrice Uhel, Pierre Fillatre, Guillaume Grillet, Angélique Goepp, Yves Le Tulzo, Arnaud Gacouin
BACKGROUND: Despite few studies, a monitoring of a neuromuscular blockade with a train of four (TOF) is recommended in intensive care unit (ICU). Our objective was to compare the results of ulnar and facial TOF measurements with an overall clinical assessment for neuromuscular blockade in ICU patients treated with recommended doses of atracurium or cisatracurium, including patients with acute respiratory disease syndrome (ARDS). METHODS: We prospectively included in two ICUs 119 patients, 94 with ARDS, who required a neuromuscular blockade for more than 24 h...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28102514/carbapenemase-producing-klebsiella-pneumoniae-bloodstream-infection-in-critically-ill-patients-risk-factors-and-predictors-of-mortality
#18
M Papadimitriou-Olivgeris, F Fligou, C Bartzavali, A Zotou, A Spyropoulou, K Koutsileou, S Vamvakopoulou, N Sioulas, V Karamouzos, E D Anastassiou, I Spiliopoulou, M Christofidou, M Marangos
A significant increase in carbapenemase-producing Klebsiella pneumoniae (CP-Kp) bacteraemias has been observed worldwide. The objective of the present work was to study the risk factors and predictors of mortality of CP-Kp bacteraemias among critically ill patients. During a 4-year period (2012-3015), a matched 1:2 case-control study was conducted. Klebsiella pneumoniae was identified by Vitek 2 technology. Antibiotic susceptibility was performed by the agar disc diffusion method and Etest. The presence of the bla KPC, bla VIM and bla NDM genes was confirmed by polymerase chain reaction (PCR)...
January 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28101605/surviving-sepsis-campaign-international-guidelines-for-management-of-sepsis-and-septic-shock-2016
#19
Andrew Rhodes, Laura E Evans, Waleed Alhazzani, Mitchell M Levy, Massimo Antonelli, Ricard Ferrer, Anand Kumar, Jonathan E Sevransky, Charles L Sprung, Mark E Nunnally, Bram Rochwerg, Gordon D Rubenfeld, Derek C Angus, Djillali Annane, Richard J Beale, Geoffrey J Bellinghan, Gordon R Bernard, Jean-Daniel Chiche, Craig Coopersmith, Daniel P De Backer, Craig J French, Seitaro Fujishima, Herwig Gerlach, Jorge Luis Hidalgo, Steven M Hollenberg, Alan E Jones, Dilip R Karnad, Ruth M Kleinpell, Younsuk Koh, Thiago Costa Lisboa, Flavia R Machado, John J Marini, John C Marshall, John E Mazuski, Lauralyn A McIntyre, Anthony S McLean, Sangeeta Mehta, Rui P Moreno, John Myburgh, Paolo Navalesi, Osamu Nishida, Tiffany M Osborn, Anders Perner, Colleen M Plunkett, Marco Ranieri, Christa A Schorr, Maureen A Seckel, Christopher W Seymour, Lisa Shieh, Khalid A Shukri, Steven Q Simpson, Mervyn Singer, B Taylor Thompson, Sean R Townsend, Thomas Van der Poll, Jean-Louis Vincent, W Joost Wiersinga, Janice L Zimmerman, R Phillip Dellinger
OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012". DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015...
January 18, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28101555/predictors-for-living-at-home-after-geriatric-inpatient-rehabilitation-a-prospective-cohort-study
#20
Jan Kool, Peter Oesch, Stefan Bachmann
OBJECTIVE: To evaluate patient characteristics predicting living at home after geriatric rehabilitation. DESIGN: Prospective cohort study. PATIENTS: A total of 210 patients aged 65 years or older receiving inpatient rehabilitation. METHODS: Candidate predictors evaluated during rehabilitation were: age, vulnerability (Vulnerable Elders Survey), multimorbidity (Cumulative Illness Rating Scale), cognition (Mini-Mental State Examination), depression (Hospital Anxiety and Depression Scale), living alone, previous independence in activities of daily living, fall risk, and mobility at discharge (Timed Up and Go test)...
January 18, 2017: Journal of Rehabilitation Medicine
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