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Monitoring critical care

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https://www.readbyqxmd.com/read/29244842/intensive-care-treatments-associated-with-favorable-discharge-outcomes-in-argentine-children-with-severe-traumatic-brain-injury-for-the-south-american-guideline-adherence-group
#1
Monica S Vavilala, Silvia B Lujan, Qian Qiu, Michael J Bell, Nicolás M Ballarini, Nahuel Guadagnoli, María Alejandra Depetris, Gabriela A Faguaga, Gloria M Baggio, Leonardo O Busso, Mirta E García, Osvaldo R González Carrillo, Paula L Medici, Silvia S Sáenz, Elida E Vanella, Carly K Farr, Gustavo J Petroni
OBJECTIVE: Little is known about the critical care management of children with traumatic brain injury (TBI) in low middle income countries. We aimed to identify indicators of intensive care unit (ICU) treatments associated with favorable outcomes in Argentine children with severe TBI. METHODS: We conducted a secondary analysis of data from patients previously enrolled in a prospective seven center study of children with severe TBI who were admitted to an ICU in one of the seven study centers...
2017: PloS One
https://www.readbyqxmd.com/read/29242902/effects-of-prenatal-alcohol-exposure-on-the-visual-system-of-monkeys-measured-at-different-stages-of-development
#2
Vanessa Harrar, Laurent Elkrief, Joseph Bouskila, Ryan Kucera, Anders Fink-Jensen, Jean-François Bouchard, Roberta Palmour, Maurice Ptito
Purpose: Fetal alcohol spectrum disorder (FASD) is a developmental disease characterized by behavioral problems and physical defects including malformations of the eye and associated optical defects. How these malformations affect retinal functioning is not well known, although animal models have suggested that scotopic vision is particularly deficient. Age is also known to affect scotopic vision. Here, we determined the combined effects of age and fetal alcohol exposure (FAE) on retinal function using full-field electroretinograms (ERGs) in monkeys (Chlorocebus sabaeus)...
December 1, 2017: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/29240853/the-evaluation-of-medical-inpatients-who-are-admitted-on-long-term-opioid-therapy-for-chronic-pain
#3
Hilary Mosher, Shoshana J Herzig, Itai Danovitch, Christina Boutsicaris, Sameer Hassamal, Karl Wittnebel, Azadeh Dashti, Teryl Nuckols
Individuals who are on long-term opioid therapy (LTOT) for chronic noncancer pain are frequently admitted to the hospital with acute pain, exacerbations of chronic pain, or comorbidities. Consequently, hospitalists find themselves faced with complex treatment decisions in the context of uncertainty about the effectiveness of LTOT as well as concerns about risks of overdose, opioid use disorders, and adverse events. Our multidisciplinary team sought to synthesize guideline recommendations and primary literature relevant to assessing medical inpatients on LTOT, with the objective of assisting practitioners in balancing effective pain treatment and opioid risk reduction...
December 6, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29232365/monitoring-compliance-with-standards-of-care-for-chronic-diseases-using-healthcare-administrative-databases-in-italy-strengths-and-limitations
#4
Rosa Gini, Martijn J Schuemie, Alessandro Pasqua, Emanuele Carlini, Francesco Profili, Iacopo Cricelli, Patrizio Dazzi, Valentina Barletta, Paolo Francesconi, Francesco Lapi, Andrea Donatini, Giulia Dal Co, Modesta Visca, Mariadonata Bellentani, Miriam Sturkenboom, Niek Klazinga
BACKGROUND: A recent comprehensive report on healthcare quality in Italy published by the Organization of Economic Co-operation and Development (OECD) recommended that regular monitoring of quality of primary care by means of compliance with standards of care for chronic diseases is performed. A previous ecological study demonstrated that compliance with standards of care could be reliably estimated on regional level using administrative databases. This study compares estimates based on administrative data with estimates based on GP records for the same persons, to understand whether ecological fallacy played a role in the results of the previous study...
2017: PloS One
https://www.readbyqxmd.com/read/29230392/non-invasive-monitoring-of-cardiac-output-in-critical-care-medicine
#5
REVIEW
Lee S Nguyen, Pierre Squara
Critically ill patients require close hemodynamic monitoring to titrate treatment on a regular basis. It allows administering fluid with parsimony and adjusting inotropes and vasoactive drugs when necessary. Although invasive monitoring is considered as the reference method, non-invasive monitoring presents the obvious advantage of being associated with fewer complications, at the expanse of accuracy, precision, and step-response change. A great many methods and devices are now used over the world, and this article focuses on several of them, providing with a brief review of related underlying physical principles and validation articles analysis...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29229589/the-effect-of-group-support-psychotherapy-delivered-by-trained-lay-health-workers-for-depression-treatment-among-people-with-hiv-in-uganda-protocol-of-a-pragmatic-cluster-randomized-trial
#6
Etheldreda Nakimuli-Mpungu, Seggane Musisi, Kizito Wamala, James Okello, Sheila Ndyanabangi, Ramin Mojtabai, Jean Nachega, Ofir Harari, Edward Mills
BACKGROUND: There is limited information on the effectiveness of task shifting of mental health services in populations with HIV. OBJECTIVE: This trial aims to evaluate the effectiveness of group support psychotherapy delivered by trained lay health workers to persons living with HIV (PLWH) with depression in primary care. METHODS: Thirty eligible primary care health centers across three districts were randomly allocated to have their lay health workers trained to deliver group support psychotherapy (intervention arm) or group HIV education and treatment as usual (control arm) to PLWH with depression...
December 11, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29227146/time-dependent-recovery-of-human-synovial-membrane-mesenchymal-stem-cell-function-after-high-dose-steroid-therapy-case-report-and-laboratory-study
#7
Yukihiko Yasui, David A Hart, Norihiko Sugita, Ryota Chijimatsu, Kota Koizumi, Wataru Ando, Yu Moriguchi, Kazunori Shimomura, Akira Myoui, Hideki Yoshikawa, Norimasa Nakamura
BACKGROUND: The use of mesenchymal stem cells from various tissue sources to repair injured tissues has been explored over the past decade in large preclinical models and is now moving into the clinic. PURPOSE: To report the case of a patient who exhibited compromised mesenchymal stem cell (MSC) function shortly after use of high-dose steroid to treat Bell's palsy, who recovered 7 weeks after therapy. STUDY DESIGN: Case report and controlled laboratory study...
December 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29225949/improving-postpartum-care-delivery-and-uptake-by-implementing-context-specific-interventions-in-four-countries-in-africa-a-realist-evaluation-of-the-missed-opportunities-in-maternal-and-infant-health-momi-project
#8
Nehla Djellouli, Sue Mann, Bejoy Nambiar, Paula Meireles, Diana Miranda, Henrique Barros, Fadima Y Bocoum, W Maurice E Yaméogo, Clarisse Yaméogo, Sylvie Belemkoabga, Halima Tougri, Abou Coulibaly, Seni Kouanda, Vernon Mochache, Omar K Mwakusema, Eunice Irungu, Peter Gichangi, Zione Dembo, Angela Kadzakumanja, Charles Vidonji Makwenda, Judite Timóteo, Misete G Cossa, Malica de Melo, Sally Griffin, Nafissa B Osman, Severiano Foia, Emilomo Ogbe, Els Duysburgh, Tim Colbourn
Postpartum care (PPC) has remained relatively neglected in many interventions designed to improve maternal and neonatal health in sub-Saharan Africa. The Missed Opportunities in Maternal and Infant Health project developed and implemented a context-specific package of health system strengthening and demand generation in four African countries, aiming to improve access and quality of PPC. A realist evaluation was conducted to enable nuanced understanding of the influence of different contextual factors on both the implementation and impacts of the interventions...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29224825/head-and-neck-free-flap-reconstruction-what-is-the-appropriate-post-operative-level-of-care
#9
Varun V Varadarajan, Hassan Arshad, Peter T Dziegielewski
Patients undergoing head and neck reconstruction require complex, multidisciplinary postoperative care which may include wound care, flap monitoring, tracheostomy management, and management of comorbid conditions. Historically, patients undergoing major resection of a head and neck or aerodigestive tract malignancy with regional or free flap reconstruction were routinely admitted to the ICU. Although head and neck cancer patients may have multiple medical comorbidities that may require postoperative critical care, the current trend in many institutions is to transfer stable and less medically complex patients to non-intensive care-level units with specialty trained nursing staff...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29224570/mapping-the-evidence-on-pharmacological-interventions-for-non-affective-psychosis-in-humanitarian-non-specialised-settings-a-unhcr-clinical-guidance
#10
Giovanni Ostuzzi, Corrado Barbui, Charlotte Hanlon, Sudipto Chatterjee, Julian Eaton, Lynne Jones, Derrick Silove, Peter Ventevogel
BACKGROUND: Populations exposed to humanitarian emergencies are particularly vulnerable to mental health problems, including new onset, relapse and deterioration of psychotic disorders. Inadequate care for this group may lead to human rights abuses and even premature death. The WHO Mental Health Gap Action Programme Intervention Guide (mhGAP-IG), and its adaptation for humanitarian settings (mhGAP-HIG), provides guidance for management of mental health conditions by non-specialised healthcare professionals...
December 11, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29220884/a-black-swan-in-clinical-laboratory-practice-the-analytical-error-due-to-interferences-in-immunoassay-methods
#11
Aldo Clerico, Lucia Belloni, Cinzia Carrozza, Mario Correale, Ruggero Dittadi, Claudio Dotti, Antonio Fortunato, Giulio Vignati, Gian Carlo Zucchelli, Marco Migliardi
It is well known that the results of immunoassay methods can be affected by specific or non-specific interferences, ranging from 0.4% to 4.0%. The presence of interference may greatly compromise the accuracy of immunoassay analyses causing an error in the measurement, producing false-positive or false-negative results. From a clinical point of view, these analytical errors may have serious implications for patient care because they can cause misdiagnosis or inappropriate treatment. Unfortunately, it is a very difficult task to identify the irregular analytical errors related to immunoassay methods because they are not detectable by normal laboratory quality control procedures, are reproducible within the test system, may be clinically plausible and are relatively rare...
December 7, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29218549/accuracy-and-reliability-of-a-subcutaneous-continuous-glucose-monitoring-device-in-critically-ill-patients
#12
S Rijkenberg, S C van Steen, J H DeVries, P H J van der Voort
Subcutaneous continuous glucose monitoring (CGM) may have benefits in achieving glycemic control in critically ill patients. The aim of this study was to assess the accuracy and reliability of the FreeStyle Navigator I in critically ill patients and to assess patient related factors influencing the accuracy and reliability. This study is a retrospective analysis of data from a randomized controlled trial conducted in a 20-bed mixed intensive care unit. Analytical accuracy, clinical accuracy and reliability were assessed against arterial blood glucose samples as reference...
December 7, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29217500/peripheral-neuropathy-as-a-complication-of-diabetic-ketoacidosis-in-a-child-with-newly-diagnosed-diabetes-type-1-case-report
#13
Marta Baszyńska-Wilk, Marta Wysocka-Mincewicz, Anna Świercz, Jolanta Świderska, Magdalena Marszał, Mieczysław Szalecki
BACKGROUND: Neurological complications of diabetic ketoacidosis are considered to be very serious clinical problem. The most common complication is cerebral edema. However this group includes also less common syndromes such as ischemic or hemorrhagic stroke, cerebral venous and sinus thrombosis or very rare peripheral neuropathy. CASE REPORT: We present a case of 9-year old girl with new onset type 1 diabetes, diabetic ketoacidosis, cerebral edema, multifocal vasogenic brain lesions and lower limbs peripheral paresis...
December 8, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/29214676/platelet-function-monitoring-for-stent-thrombosis-in-critically-iii-patients-with-an-acute-coronary-syndrome
#14
Lisa Tilemann, Sarah K Mohr, Michael Preusch, Emanuel Chorianopoulos, Evangelos Giannitsis, Hugo A Katus, Oliver J Müller
BACKGROUND: Patients after cardiac arrest or in cardiogenic shock due to acute coronary syndrome (ACS) are at high risk for stent thrombosis (ST) and recurrent cardiovascular events after primary percutaneous coronary intervention (PCI). High post-interventional platelet reactivity (HPR) might be an additional risk factor for ST in these critically ill patients. METHODS: Between 2006 and 2016, 401 critically ill patients from a cardiologic intensive care unit underwent platelet function testing after primary PCI using whole blood impedance aggregometry...
December 6, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29214566/improved-diagnosis-and-care-for-rare-diseases-through-implementation-of-precision-public-health-framework
#15
Gareth Baynam, Faye Bowman, Karla Lister, Caroline E Walker, Nicholas Pachter, Jack Goldblatt, Kym M Boycott, William A Gahl, Kenjiro Kosaki, Takeya Adachi, Ken Ishii, Trinity Mahede, Fiona McKenzie, Sharron Townshend, Jennie Slee, Cathy Kiraly-Borri, Anand Vasudevan, Anne Hawkins, Stephanie Broley, Lyn Schofield, Hedwig Verhoef, Tudor Groza, Andreas Zankl, Peter N Robinson, Melissa Haendel, Michael Brudno, John S Mattick, Marcel E Dinger, Tony Roscioli, Mark J Cowley, Annie Olry, Marc Hanauer, Fowzan S Alkuraya, Domenica Taruscio, Manuel Posada de la Paz, Hanns Lochmüller, Kate Bushby, Rachel Thompson, Victoria Hedley, Paul Lasko, Kym Mina, John Beilby, Cynthia Tifft, Mark Davis, Nigel G Laing, Daria Julkowska, Yann Le Cam, Sharon F Terry, Petra Kaufmann, Iiro Eerola, Irene Norstedt, Ana Rath, Makoto Suematsu, Stephen C Groft, Christopher P Austin, Ruxandra Draghia-Akli, Tarun S Weeramanthri, Caron Molster, Hugh J S Dawkins
Public health relies on technologies to produce and analyse data, as well as effectively develop and implement policies and practices. An example is the public health practice of epidemiology, which relies on computational technology to monitor the health status of populations, identify disadvantaged or at risk population groups and thereby inform health policy and priority setting. Critical to achieving health improvements for the underserved population of people living with rare diseases is early diagnosis and best care...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29211187/the-epimed-monitor-icu-database%C3%A2-a-cloud-based-national-registry-for-adult-intensive-care-unit-patients-in-brazil
#16
Fernando Godinho Zampieri, Márcio Soares, Lunna Perdigão Borges, Jorge Ibrain Figueira Salluh, Otávio Tavares Ranzani
OBJECTIVE: To describe the Epimed Monitor Database®, a Brazilian intensive care unit quality improvement database. METHODS: We described the Epimed Monitor® Database, including its structure and core data. We presented aggregated informative data from intensive care unit admissions from 2010 to 2016 using descriptive statistics. We also described the expansion and growth of the database along with the geographical distribution of participating units in Brazil...
November 30, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29210766/tele-icu-and-patient-safety-considerations
#17
Erkan Hassan
The tele-ICU is designed to leverage, not replace, the need for bedside clinical expertise in the diagnosis, treatment, and assessment of various critical illnesses. Tele-ICUs are primarily decentralized or centralized models with differing advantages and disadvantages. The centralized model has sufficiently powered published data to be associated with improved mortality and ICU length of stay in a cost-effective manner. Factors associated with improved clinical outcomes include improved compliance with best practices; providing off-hours implementation of the bedside physician's care plan; and identification of and rapid response to physiological instability (initial clinical review within 1 hour) and rapid response to alerts, alarms, or direct notification by bedside clinicians...
January 2018: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/29210762/decentralization-the-corridor-is-the-problem-not-the-alcove
#18
D Kirk Hamilton, Sandra M Swoboda, Jin-Ting Lee, Diana C Anderson
There is controversy today about whether decentralized intensive care unit (ICU) designs featuring alcoves and multiple sites for charting are effective. There are issues relating to travel distance, visibility of patients, visibility of staff colleagues, and communications among caregivers, along with concerns about safety risk. When these designs became possible and popular, many ICU designs moved away from the high-visibility circular, semicircular, or box-like shapes and began to feature units with more linear shapes and footprints similar to acute bed units...
January 2018: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/29210514/30-s-response-time-of-k-ion-selective-hydrogels-functionalized-with-18-crown-6-ether-based-on-qcm-sensor
#19
Zhenxiao Zhang, Qian Dou, Hongkai Gao, Bing Bai, Yongmei Zhang, Debo Hu, Ali K Yetisen, Haider Butt, Xiaoxia Yang, Congju Li, Qing Dai
Potassium detection is critical in monitoring imbalances in electrolytes and physiological status. The development of rapid and robust potassium sensors is desirable in clinical chemistry and point-of-care applications. In this study, composite supramolecular hydrogels are investigated: polyethylene glycol methacrylate and acrylamide copolymer (P(PEGMA-co-AM)) are functionalized with 18-crown-6 ether by employing surface initiated polymerization. Real-time potassium ion monitoring is realized by combining these compounds with quartz crystal microbalance...
December 6, 2017: Advanced Healthcare Materials
https://www.readbyqxmd.com/read/29207770/making-nutrition-management-scientific-objective-and-simple-with-the-help-of-technology
#20
Sanjith Saseedharan, Edwin Joseph Pathrose
Nutrition management is one of the cornerstones of care in the management of hospitalized patients, especially, for those who are critically ill. Significant numbers of hospitalized patients have alteration in appetite and the function of the gastrointestinal tract. Calculating the caloric goal, prescribed proteins to be delivered in a finite amount of water at a certain rate is the need of the hour and it becomes a daunting task to complete daily. With the help of technology such tasks can be completed easily and accurately...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
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