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https://www.readbyqxmd.com/read/29685062/prospective-observational-evaluation-of-sedation-and-pain-management-guideline-adherence-across-new-jersey-intensive-care-units
#1
Alison Brophy, Maria Cardinale, Liza B Andrews, Justin B Kaplan, Christopher Adams, Yekaterina Opsha, Kimberly A Brandt, Deepali Dixit, Steven F Nerenberg, Julie A Saleh
BACKGROUND: The practice guidelines for the management of pain, agitation, and delirium (PAD) from the Society of Critical Care Medicine shifted from primarily focusing on the treatment of anxiety in 2002 to the treatment of pain in 2013. OBJECTIVE: This prospective, observational, multicenter study aimed to assess the degree of practice adherence to the PAD guidelines for ventilated patients in New Jersey intensive care units (ICUs). METHODS: Pharmacist investigators at 8 centers designated 4 days at least 10 days apart to evaluate all patients on mechanical ventilation...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29684991/postoperative-delirium-in-elderly-patients-with-critical-limb-ischemia-undergoing-major-leg-amputation-a-retrospective-study
#2
Young-Hee Shin, Jin Sun Yoon, Hee Jung Jeon, Youngbae B Kim, Young Soo Kim, Ju Young Park
Background: Critical limb ischemia has been identified as a risk factor for the incidence of postoperative delirium in elderly patients. Limb amputation is the last option in critical limb ischemia treatments. We investigated the incidence and predisposing factors of postoperative delirium in patients undergoing major leg amputation. Methods: From January 2012 to December 2016, 121 patients aged over 60 years who had undergone major leg amputation were enrolled in this study...
April 24, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29683929/18f-fdg-pet-ct-in-the-evaluation-of-cancer-cervix-where-do-we-stand-today
#3
Shanmuga S Palaniswamy, Chaitanya R Borde, Padma Subramanyam
The incidence of gynecological malignancies is on the rise partly because of the availability of screening programmes, awareness, higher technological advancements, and availability of better medical care. Early diagnosis of any malignancy leads to prompt treatment. Use of 18Fluorine-Fluorodeoxyglucose (F-FDG) PET/CT in the treatment and follow-up of patients with Ca cervix considerably improves patient management. The primary diagnosis of Ca cervix is made either by biopsy of a visible tumor on the cervix or by a cone biopsy of a nonvisible malignant cervical focus...
April 20, 2018: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/29682105/when-are-endovascular-and-open-bypass-treatments-preferred-for-femoropopliteal-occlusive-disease
#4
REVIEW
Ali F AbuRahma
Several meta-analyses and multicenter trials have shown that chronic limb ischemia did not occur for up to 5 years in 50%-70% of patients who underwent saphenous vein grafts, with limb salvage and perioperative mortality rates of >80% and 3%, respectively. However, open surgical bypass can have limitations, including postoperative morbidity/wound complications of 10%-20% and prolonged length of hospital stay and outpatient care. Several studies have analyzed clinical outcomes for patients with critical limb ischemia treated with endovascular therapies, but they have been mainly retrospective with significant heterogeneity or were single center...
March 25, 2018: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29680327/clinical-characteristics-of-patients-with-newly-developed-acute-cholecystitis-after-admission-to-the-intensive-care-unit
#5
Soo Jung Kim, Seok Jeong Lee, Su Hwan Lee, Jin Hwa Lee, Jung Hyun Chang, Yon Ju Ryu
INTRODUCTION: Critical care patients have many risk factors for acute cholecystitis (AC). However, less data are available regarding newly developed AC in critically ill patients. OBJECTIVES: To investigate the clinical features of AC occurring in critically ill patients after admission to an intensive care unit (ICU). METHODS: We performed a retrospective cohort study from January 2006 to August 2016 at a tertiary care university hospital...
April 18, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29677975/minimal-important-difference-in-outcome-of-disc-degenerative-disease-treatment-the-patients-perspective
#6
Linda Greta Dui, Federico Cabitza, Pedro Berjano
Evaluation of treatments effectiveness in a context of value-based health care is based on outcomes, and in their assessment. The patient perspective is gaining renovated interest, as demonstrated by the increasing diffusion of Patient Reported Outcome Measure (PROMs) collection initiatives. The concept of Minimal Clinically Important Dif-ference (MID) is generally seen as the basis to estimate the actual effect perceived by the patient after a treatment, like a surgical intervention, but a universally recognized threshold has not yet been established...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29677063/the-anesthesia-perioperative-call-for-help-experience-at-a-quaternary-pediatric-medical-center-analysis-of-67-564-anesthesia-encounters
#7
Bistra G Vlassakova, Sean M Sinnott, Nissa Askins, Matthew X Callahan, Izabela C Leahy, David Zurakowski, Paul R Hickey, Joseph P Cravero
BACKGROUND: During the past several decades, anesthesia has become increasingly safe. Truly major adverse events are rare, and anesthesia quality researchers have instituted programs to evaluate "near miss" or less critical adverse events to evaluate the safety of anesthesia delivery. In this study, we aimed to evaluate calls for emergency help in our institution as a surrogate for pending critical events. We hypothesized that calls would be more common in patients with high American Society of Anesthesiologists (ASA) physical status, history of prematurity, and children with recent respiratory illness compared to those without these characteristics...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29674108/the-effects-of-feedback-fatigue-and-sex-disparities-in-medical-student-feedback-assessed-using-a-minute-feedback-system
#8
Meredith Barrett, Patrick Georgoff, Niki Matusko, Lisa Leininger, Rishindra M Reddy, Gurjit Sandhu, David T Hughes
OBJECTIVE: Feedback is critical to the development of medical students. To enhance feedback, we created a web application, the Minute Feedback System (MFS). This app allows students to request precise, timely, written feedback from residents and staff without the burden of vague, end-of-rotation surveys. In this study, we investigate variations in response rates and feedback fatigue based on sex and rank (resident/fellow vs. faculty). DESIGN: Data were collected from May 2015-October 2016...
April 16, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29668785/accuracy-and-completeness-of-records-of-adverse-events-through-interface-terminology
#9
Maribel González-Samartino, Pilar Delgado-Hito, Jordi Adamuz-Tomás, Maria Fe Viso Cano, Mònica Castellà Creus, María-Eulàlia Juvé-Udina
OBJECTIVE: To determine what adverse events, including pressure ulcers, infection of the surgical site and aspiration pneumonia, nurses record in clinical histories, in terms of diagnostic accuracy and completeness, through ATIC. METHOD: Observational, descriptive, cross-sectional, multicenter study of 64 medical-surgical and semi-critical units of two university hospitals in Catalonia, Spain, during 2015. The diagnostic accuracy was assessed by means of the correspondence between the event declared in the Minimum Basic Data Set and the problem documented by the nurse...
2018: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/29666295/lung-ultrasound-prior-to-spontaneous-breathing-trial-is-not-helpful-in-weaning-the-decision-making-process
#10
Ana Carolina P Antonio, Marli M Knorst, Cassiano Teixeira
BACKGROUND: Lung ultrasound is increasingly becoming a diagnostic tool in the critical care setting. B-pattern on a lung ultrasound is an artifact composed of multiple B-lines and correlates with interstitial edema. A randomized controlled trial concluded that bedside thoracic ultrasound could predict postextubation distress through changes in lung aeration during a weaning procedure; however, it could not screen patients before performance of a spontaneous breathing trial (SBT). METHODS: We conducted a 2-year, prospective, multicenter, observational study in 2 adult medical-surgical ICUs in southern Brazil...
April 17, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29666281/pathogenic-effects-of-ifit2-and-interferon-%C3%AE-during-fatal-systemic-candida-albicans-infection
#11
Marcin Stawowczyk, Shamoon Naseem, Valeria Montoya, Darren P Baker, James Konopka, Nancy C Reich
A balanced immune response to infection is essential to prevent the pathology and tissue damage that can occur from an unregulated or hyperactive host defense. Interferons (IFNs) are critical mediators of the innate defense to infection, and in this study we evaluated the contribution of a specific gene coding for IFIT2 induced by type I IFNs in a murine model of disseminated Candida albicans Invasive candidiasis is a frequent challenge during immunosuppression or surgical medical interventions, and C. albicans is a common culprit that leads to high rates of mortality...
April 17, 2018: MBio
https://www.readbyqxmd.com/read/29664956/you-pray-to-your-god-a-qualitative-analysis-of-challenges-in-the-provision-of-safe-timely-and-affordable-surgical-care-in-uganda
#12
Katherine Albutt, Rachel R Yorlets, Maria Punchak, Peter Kayima, Didacus B Namanya, Geoffrey A Anderson, Mark G Shrime
BACKGROUND: Five billion people lack access to safe, affordable, and timely surgical and anesthesia care. Significant challenges remain in the provision of surgical care in low-resource settings. Uganda is no exception. METHODS: From September to November 2016, we conducted a mixed-methods countrywide surgical capacity assessment at 17 randomly selected public hospitals in Uganda. Researchers conducted 35 semi-structured interviews with key stakeholders to understand factors related to the provision of surgical care...
2018: PloS One
https://www.readbyqxmd.com/read/29660009/critical-care-in-the-military-health-system-a-24-h-point-prevalence-study
#13
Raymond Fisher, Christopher J Colombo, Cristin A Mount, Elizabeth A Mann-Salinas, Adam W Bostick, Konrad Davis, James K Aden, Kevin K Chung, Mary S McCarthy, Jeremy C Pamplin
Background: Healthcare expenditures are a significant economic cost with critical care services constituting one of its largest components. The Military Health System (MHS) is the largest, global healthcare system of its kind. In this project, we sought to describe critical care services and the patients who receive them in the MHS. Methods: We surveyed 26 military treatment facilities (MTFs) representing 38 critical care services or intensive care units (ICUs)...
April 11, 2018: Military Medicine
https://www.readbyqxmd.com/read/29658978/innovation-and-entrepreneurship-perspectives-from-orthopedic-surgery
#14
Kevin J Campbell, Philip K Louie, Derek A Khorsand, Nicholas B Frisch, Tad L Gerlinger, Brett R Levine
Orthopedic surgeons are tasked with treating complex patients while employing critical surgical skills, clinical knowledge, and new technologies. The constant inundation of information, coupled with hours in the hospital setting, provides unique perspectives on various aspects of how health care is delivered, thereby creating a milieu ripe for innovation. The rigors of an orthopedic career make it challenging for physicians to translate an idea into a great product. Through the authors' experiences at a tertiary orthopedic practice, they review the process of taking an idea from concept to fruition...
April 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29657719/inpatient-diabetes-management-by-specialized-diabetes-team-versus-primary-service-team-in-non-critical-care-units-impact-on-30-day-readmission-rate-and-hospital-cost
#15
Vivek Bansal, Adham Mottalib, Taranveer K Pawar, Noormuhammad Abbasakoor, Eunice Chuang, Abrar Chaudhry, Mahmoud Sakr, Robert A Gabbay, Osama Hamdy
Objective: We compared the cost-effectiveness of two inpatient diabetes care models: one offered by a specialized diabetes team (SDT) versus a primary service team (PST). Research design and methods: We retrospectively evaluated 756 hospital admissions of patients with diabetes to non-critical care units over 6 months. Out of 392 patients who met the eligibility criteria, 262 were matched 1:1 based on the mean of the initial four blood glucose (BG) values after admission...
2018: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/29651626/current-topics-in-the-management-of-acute-traumatic-spinal-cord-injury
#16
Christopher D Shank, Beverly C Walters, Mark N Hadley
Acute traumatic spinal cord injury (SCI) affects more than 250,000 people in the USA, with approximately 17,000 new cases each year. It continues to be one of the most significant causes of trauma-related morbidity and mortality. Despite the introduction of primary injury prevention education and vehicle safety devices, such as airbags and passive restraint systems, traumatic SCI continues to have a substantial impact on the healthcare system. Over the last three decades, there have been considerable advancements in the management of patients with traumatic SCI...
April 12, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29649396/surgeons-perceived-barriers-to-palliative-and-end-of-life-care-a-mixed-methods-study-of-a-surgical-society
#17
Pasithorn A Suwanabol, Ari C Reichstein, Z Tuba Suzer-Gurtekin, Jane Forman, Maria J Silveira, Lona Mody, Arden M Morris
BACKGROUND: Nearly 20% of colorectal cancer (CRC) patients present with potentially incurable (Stage IV) disease, yet their physicians do not integrate cancer treatment with palliative care. Compared with patients treated by primary providers, surgical patients with terminal diseases are significantly less likely to receive palliative or end-of-life care. OBJECTIVE: To describe surgeon perspectives on palliative and end-of-life care for patients with Stage IV CRCs...
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29649027/pain-and-its-long-term-interference-of-daily-life-after-critical-illness
#18
Christina J Hayhurst, Jim C Jackson, Kristin R Archer, Jennifer L Thompson, Rameela Chandrasekhar, Christopher G Hughes
BACKGROUND: Persistent pain likely interferes with quality of life in survivors of critical illness, but data are limited on its prevalence and risk factors. We sought to determine the prevalence of persistent pain after critical illness and its interference with daily life. Additionally, we sought to determine if intensive care unit (ICU) opioid exposure is a risk factor for its development. METHODS: In a cohort of adult medical and surgical ICU survivors, we used the brief pain inventory (BPI) to assess pain intensity and pain interference of daily life at 3 and 12 months after hospital discharge...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29644900/discordance-in-preoperative-and-postoperative-histopathology-of-sinonasal-tumors
#19
Ashwin Ganti, Bobby A Tajudeen, Max A Plitt, Isolina Rossi, Paolo Gattuso, Pete S Batra
Background Head and neck surgical pathology has been shown to be prone to histopathologic diagnostic error that can adversely impact patient care due to inappropriate management. Sinonasal tumors, in particular, present a diagnostic challenge given the relative rarity and diversity in histology and thus may have higher rates of discordant histology. Objective The purpose of this study is to determine the rate of discrepancy between preoperative and postoperative diagnoses of sinonasal tumors. Methods Retrospective chart review was performed on 52 patients treated for sinonasal tumors between January 2013 and December 2016...
March 2018: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29642776/the-pink-underside-the-commercialization-of-medical-risk-assessment-and-decision-making-tools-for-hereditary-breast-cancer-risk
#20
Sharlene Hesse-Biber, Bailey Flynn, Keeva Farrelly
The growth of the Internet since the millennium has opened up a myriad of opportunities for education, particularly in medicine. Although those looking for health care information used to have to turn to a face-to-face doctor's visit, an immense library of medical advice is now available at their fingertips. The BRCA genetic predispositions (mutations of the BRCA1 and BRCA2 breast cancer genes) which expose men and women to greater risk of breast, ovarian, and other cancers can be researched extensively online...
April 1, 2018: Qualitative Health Research
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