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https://www.readbyqxmd.com/read/28453590/-understanding-cortisol-action-in-acute-inflammation-a-view-from-the-adrenal-gland-to-the-target-cell
#1
Julia Guerrero
Glucocorticoids (cortisol in humans) are essential for numerous biological functions. Among critically ill patients, therapy with cortisol has gained strength in recent years, but clinical results have been mixed. A series of events, that may explain the diversity of clinical responses, occur from the synthesis of cortisol in the adrenal gland to the activation of the cortisol receptor by the hormone when it enters the nucleus of the target cell. Some of these events are revised; a proposition for identifying critically ill patients who may benefit with this therapy is suggested...
February 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28453588/-diverticular-disease-myths-and-realities
#2
Daniela Fluxá, Rodrigo Quera
Diverticulosis and diverticular disease of the colon are common conditions in Western countries. The incidence and prevalence of these diseases are increasing and becoming significant for health systems. A growing body of knowledge is shifting the paradigm of the pathogenesis and treatment of diverticular disease. Low-grade inflammation, altered intestinal microbiota, visceral hypersensitivity, and abnormal colonic motility have been identified as factors leading to diverticular disease. The risk of developing diverticulitis among individuals with diverticulosis is lower than 10 to 25%...
February 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28449088/clinical-manifestations-of-scrub-typhus
#3
Senaka Rajapakse, Praveen Weeratunga, Sriharan Sivayoganathan, Sumadhya Deepika Fernando
The mite-borne rickettsial zoonosis scrub typhus is widely prevalent in parts of Southeast and Far East Asia, and northern Australia. The disease is an acute febrile illness, associated with rash and often an eschar, which responds dramatically to treatment with antibiotics. In some cases it results in a serious illness leading to multiple organ involvement and death. The disease manifestations are thought to result from a systemic vasculitis, caused by both direct effects of the organisms as well as an exaggerated immune response, although little is understood about its pathogenesis...
April 25, 2017: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28448386/barriers-to-goal-concordant-care-for-older-patients-with-acute-surgical-illness-communication-patterns-extrinsic-to-decision-aids
#4
Lauren J Taylor, Sara K Johnson, Michael J Nabozny, Jennifer L Tucholka, Nicole M Steffens, Kristine L Kwekkeboom, Karen J Brasel, Toby C Campbell, Margaret L Schwarze
OBJECTIVE: We sought to characterize patterns of communication extrinsic to a decision aid that may impede goal-concordant care. BACKGROUND: Decision aids are designed to facilitate difficult clinical decisions by providing better treatment information. However, these interventions may not be sufficient to effectively reveal patient values and promote preference-aligned decisions for seriously ill, older adults. METHODS: We conducted a secondary analysis of 31 decision-making conversations between surgeons and frail, older inpatients with acute surgical problems at a single tertiary care hospital...
April 26, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28447217/swallowing-disorders-in-schizophrenia
#5
REVIEW
Deepika P Kulkarni, Vandan D Kamath, Jonathan T Stewart
Disorders of swallowing are poorly characterized but quite common in schizophrenia. They are a source of considerable morbidity and mortality in this population, generally as a result of either acute asphyxia from airway obstruction or more insidious aspiration and pneumonia. The death rate from acute asphyxia may be as high as one hundred times that of the general population. Most swallowing disorders in schizophrenia seem to fall into one of two categories, changes in eating and swallowing due to the illness itself and changes related to psychotropic medications...
April 26, 2017: Dysphagia
https://www.readbyqxmd.com/read/28447145/-recommendations-for-education-in-ultrasound-in-medical-intensive-care-and-emergency-medicine-position-paper-of-dgiin-degum-and-dgk
#6
G Michels, H Zinke, M Möckel, D Hempel, C Busche, U Janssens, S Kluge, R Riessen, M Buerke, M Kelm, R S von Bardeleben, F Knebel, H-J Busch
Point-of-care ultrasound in acute care medicine is a prerequisite for diagnosis and therapy monitoring of critically ill patients. There is currently no uniform education strategy for medical intensive care and emergency medicine. As part of the basic level, the trainee takes theoretical and clinical training covering abdominal and thoracic ultrasonography and focused cardiovascular ultrasound. In a second step, special knowledge and skills can be acquired at an expert level. This two-stage concept is intended to guarantee quality assurance in ultrasound education in medical intensive care and emergency medicine...
April 26, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28446075/comparison-of-bronchoscopy-guided-and-real-time-ultrasound-guided-percutaneous-dilatational-tracheostomy-safety-complications-and-effectiveness-in-critically-ill-patients
#7
Aykut Sarıtaş, Muhammed M Kurnaz
OBJECTIVE: To compare the efficacy, safety, and incidence of complications between fiber-optic bronchoscopy-guided percutaneous dilatational tracheostomy (FOB-PDT) and ultrasound-guided percutaneous dilatational tracheostomy (US-PDT) and to determine whether US-PDT is a viable alternative to FOB-PDT. METHODS: This randomized prospective study was carried out in 80 patients who were randomly divided into US-PDT and FOB-PDT groups. Demographic data and Acute Physiology and Chronic Health Evaluation II (APACHE II), procedure duration, hemorrhage status, complications, procedure difficulty, displacement of entry location after US, and hemodynamic data were evaluated in both groups...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28444409/diagnostic-work-up-and-specific-causes-of-acute-kidney-injury
#8
REVIEW
Michael Darmon, Marlies Ostermann, Jorge Cerda, Meletios A Dimopoulos, Lui Forni, Eric Hoste, Matthieu Legrand, Nicolas Lerolle, Eric Rondeau, Antoine Schneider, Bertrand Souweine, Miet Schetz
Acute kidney injury (AKI) is common in critically ill patients and associated with grim short- and long-term outcome. Although in the vast majority of cases AKI is multifactorial, with sepsis, shock and nephrotoxicity accounting for most episodes, specific causes of AKI are not uncommon. Despite remaining uncertainties regarding their prevalence in the ICU, prompt recognition of specific aetiologies of AKI is likely to ensure timely management, limit worsening of renal dysfunction, and ultimately limit renal and systemic consequences of AKI...
April 25, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28444077/chronic-critical-illness-are-we-saving-patients-or-creating-victims
#9
Sergio Henrique Loss, Diego Silva Leite Nunes, Oellen Stuani Franzosi, Gabriela Soranço Salazar, Cassiano Teixeira, Silvia Regina Rios Vieira
The technological advancements that allow support for organ dysfunction have led to an increase in survival rates for the most critically ill patients. Some of these patients survive the initial acute critical condition but continue to suffer from organ dysfunction and remain in an inflammatory state for long periods of time. This group of critically ill patients has been described since the 1980s and has had different diagnostic criteria over the years. These patients are known to have lengthy hospital stays, undergo significant alterations in muscle and bone metabolism, show immunodeficiency, consume substantial health resources, have reduced functional and cognitive capacity after discharge, create a sizable workload for caregivers, and present high long-term mortality rates...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28444069/predictors-and-pattern-of-weaning-and-long-term-outcome-of-patients-with-prolonged-mechanical-ventilation-at-an-acute-intensive-care-unit-in-north-india
#10
Syed Nabeel Muzaffar, Mohan Gurjar, Arvind K Baronia, Afzal Azim, Prabhakar Mishra, Banani Poddar, Ratender K Singh
Objective: This study aimed to examine the clinical characteristics, weaning pattern, and outcome of patients requiring prolonged mechanical ventilation in acute intensive care unit settings in a resource-limited country. Methods: This was a prospective single-center observational study in India, where all adult patients requiring prolonged ventilation were followed for weaning duration and pattern and for survival at both intensive care unit discharge and at 12 months...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28443957/major-depression-and-acute-coronary-syndrome-related-factors
#11
Jose Henrique Cunha Figueiredo, Nelson Albuquerque de Souza E Silva, Basilio de Bragança Pereira, Glaucia Maria Moraes de Oliveira
BACKGROUND: Major Depressive Disorder (MDD) is one of the most common mental illnesses in psychiatry, being considered a risk factor for Acute Coronary Syndrome (ACS). OBJECTIVE: To assess the prevalence of MDD in ACS patients, as well as to analyze associated factors through the interdependence of sociodemographic, lifestyle and clinical variables. METHODS: Observational, descriptive, cross-sectional, case-series study conducted on patients hospitalized consecutively at the coronary units of three public hospitals in the city of Rio de Janeiro over a 24-month period...
March 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28443581/bocavirus-viremia-and-hepatitis-in-an-%C3%A4-mmunocompetent-childa
#12
Zeliha Haytoğlu, Oğuz Canan
BACKGROUND: So far, many studies have shown that Human Bocavirus (HBoV) is the main pathogen of the respiratory tract. In most studies about HBoV, detection of the virus were made from mainly respiratory samples obtained from the patients admitted to the hospital with acute respiratory tract infection. Until now, there is no study that proves the association between HBoV and hepatitis. HBoV viremia/DNAemia has been associated closely with acute primary infection and moderate-to-severe illness but, more detailed clinical data about HBoV dissemination are still unknown...
April 13, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28443283/vascular-access-site-for-renal-replacement-therapy-in-acute-kidney-injury-a-post-hoc-analysis-of-the-atn-study
#13
Yue-Harn Ng, Kavitha Ganta, Herbert Davis, V Shane Pankratz, Mark Unruh
BACKGROUND: Acute kidney injury requiring renal replacement therapy (RRT) in the intensive care unit portends a poor prognosis. The decisions regarding dialysis catheter placement is based mainly on physician discretion with little evidence to support the choice of dialysis catheter location. METHODS: The Veterans Affairs/National Institutes of Health Acute Renal Failure Trial Network Study was a multicenter, prospective, randomized trial of intensive vs. less intensive RRT in critically ill patients with AKI...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28442451/using-mobile-phones-to-collect-patient-data-lessons-learned-from-the-simple-study
#14
Sinead Duane, Meera Tandan, Andrew W Murphy, Akke Vellinga
BACKGROUND: Mobile phones offer new opportunities to efficiently and interactively collect real-time data from patients with acute illnesses, such as urinary tract infections (UTIs). One of the main benefits of using mobile data collection methods is automated data upload, which can reduce the chance of data loss, an issue when using other data collection methods such as paper-based surveys. OBJECTIVE: The aim was to explore differences in collecting data from patients with UTI using text messaging, a mobile phone app (UTI diary), and an online survey...
April 25, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28442215/-neopterin-levels-and-systemic-inflammatory-response-syndrome-in-pediatric-critically-ill-patients
#15
Raquel Gil-Gómez, Javier Blasco-Alonso, Pilar Sánchez-Yáñez, Vanessa Rosa-Camacho, Guillermo Milano Manso
INTRODUCTION: Neopterin and biopterin are sub-products of redox reactions, which act as cofactors of enzymes responsible for nitric oxide production. The hypothesis is presented that plasma neopterin and biopterin evolve differently during the first days in a critically ill child. METHODS: A single-centre prospective observational study was conducted on patients 7 days to 14 years admitted to our Paediatric Intensive Care Unit (PICU) and that met Systemic inflammatory response syndrome (SIRS) criteria...
April 22, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28441453/brainstem-response-patterns-in-deeply-sedated-critically-ill-patients-predict-28-day-mortality
#16
Benjamin Rohaut, Raphael Porcher, Tarik Hissem, Nicholas Heming, Patrick Chillet, Kamel Djedaini, Guy Moneger, Stanislas Kandelman, Jeremy Allary, Alain Cariou, Romain Sonneville, Andréa Polito, Marion Antona, Eric Azabou, Djillali Annane, Shidasp Siami, Fabrice Chrétien, Jean Mantz, Tarek Sharshar
BACKGROUND AND PURPOSE: Deep sedation is associated with acute brain dysfunction and increased mortality. We had previously shown that early-assessed brainstem reflexes may predict outcome in deeply sedated patients. The primary objective was to determine whether patterns of brainstem reflexes might predict mortality in deeply sedated patients. The secondary objective was to generate a score predicting mortality in these patients. METHODS: Observational prospective multicenter cohort study of 148 non-brain injured deeply sedated patients, defined by a Richmond Assessment sedation Scale (RASS) <-3...
2017: PloS One
https://www.readbyqxmd.com/read/28440879/tick-borne-encephalitis-in-patients-vaccinated-against-this-disease
#17
S Lotrič-Furlan, P Bogovič, T Avšič-Županc, M Jelovšek, L Lusa, F Strle
BACKGROUND: Information on tick-borne encephalitis (TBE) in patients already vaccinated against the disease is limited. OBJECTIVES: To compare the course and outcome in patients with vaccination breakthrough TBE with findings in patients who developed TBE without previous vaccination. METHODS: All adult patients diagnosed with TBE at a single medical centre during a 16-year period and who had received at least two doses of TBE vaccine before the onset of illness qualified for the study...
April 25, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28440255/clinical-profile-and-neuroimaging-in-pediatric-optic-neuritis-in-indian-population-a-case-series
#18
Rutika Khadse, Meenakshi Ravindran, Neelam Pawar, Padmavathy Maharajan, Ramakrishnan Rengappa
PURPOSE OF THE STUDY: The purpose of this study was to report clinical features, neuroimaging, and visual outcome in pediatric optic neuritis (ON) in Indian population. MATERIALS AND METHODS: This is a retrospective study of children up to the age of 16 years, diagnosed with ON, that presented at pediatric and neuroophthalmology clinic of a tertiary eye care center, in South India, within the period of 2010-2015. RESULTS: We identified 62 eyes of 40 children diagnosed as ON within the study period...
March 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28440124/perspectives-on-advance-care-planning-among-patients-recently-requiring-non-invasive-ventilation-for-acute-respiratory-failure-a-qualitative-study-using-thematic-analysis
#19
Tracy A Smith, Rebecca T Disler, Christine R Jenkins, Jane M Ingham, Patricia M Davidson
BACKGROUND: Patients requiring non-invasive ventilation for acute-on-chronic respiratory failure due to chronic obstructive pulmonary disease or heart failure exacerbations may have a poor prognosis underscoring the importance of advance care planning. AIM: We aimed to describe attitudes to, and experiences of, discussing the future among patients recently treated with non-invasive ventilation. DESIGN: Qualitative research using thematic analysis...
June 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28440047/mental-illness-in-bariatric-surgery-a-cohort-study-from-the-portal-network
#20
David Fisher, Karen J Coleman, David E Arterburn, Heidi Fischer, Ayae Yamamoto, Deborah R Young, Nancy E Sherwood, Connie Mah Trinacty, Kristina H Lewis
OBJECTIVE: To compare bariatric surgery outcomes according to preoperative mental illness category. METHODS: Electronic health record data from several US healthcare systems were used to compare outcomes of four groups of patients who underwent bariatric surgery in 2012 and 2013. These included the following: people with (1) no mental illness, (2) mild-to-moderate depression or anxiety, (3) severe depression or anxiety, and (4) bipolar, psychosis, or schizophrenia spectrum disorders...
May 2017: Obesity
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