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Monitoring critical care

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https://www.readbyqxmd.com/read/28449107/the-role-of-dyadic-confidence-on-engagement-in-heart-failure-care-behaviors
#1
Karen S Lyons, Jill M Gelow, Shirin O Hiatt, James O Mudd, Jonathan Auld, Christopher V Chien, Christopher S Lee
Background and Objectives: Increasingly, older adults and their families are expected to manage complex conditions with little support. In the case of heart failure (HF), symptom monitoring and management are critical in preventing acute exacerbations and poor clinical outcomes. The current study examined the role of dyadic confidence on engagement in HF care behaviors by patients and their spouses. Research Design and Methods: A cross-sectional design was used to examine 60 couples living with HF...
April 26, 2017: Gerontologist
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
#2
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/28445441/mining-productive-associated-periodic-frequent-patterns-in-body-sensor-data-for-smart-home-care
#3
Walaa N Ismail, Mohammad Mehedi Hassan
The understanding of various health-oriented vital sign data generated from body sensor networks (BSNs) and discovery of the associations between the generated parameters is an important task that may assist and promote important decision making in healthcare. For example, in a smart home scenario where occupants' health status is continuously monitored remotely, it is essential to provide the required assistance when an unusual or critical situation is detected in their vital sign data. In this paper, we present an efficient approach for mining the periodic patterns obtained from BSN data...
April 26, 2017: Sensors
https://www.readbyqxmd.com/read/28444867/urine-assay-for-tenofovir-to-monitor-adherence-in-real-time-to-tenofovir-disoproxil-fumarate-emtricitabine-as-pre-exposure-prophylaxis
#4
H C Koenig, K Mounzer, G W Daughtridge, C E Sloan, L Lalley-Chareczko, G S Moorthy, S C Conyngham, A F Zuppa, L J Montaner, P Tebas
OBJECTIVES: Tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) is approved for pre-exposure prophylaxis (PrEP) against HIV infection. Adherence is critical for the success of PrEP, but current adherence measurements are inadequate for real-time adherence monitoring. We developed and validated a urine assay to measure tenofovir (TFV) to objectively monitor adherence to PrEP. METHODS: We developed a urine assay using high-performance liquid chromatography coupled to tandem mass spectrometry with high sensitivity/specificity for TFV that allowed us to determine TFV concentrations in log10 categories between 0 and 10 000 ng/mL...
April 26, 2017: HIV Medicine
https://www.readbyqxmd.com/read/28444760/vancomycin-levels-are-frequently-subtherapeutic-in-critically-ill-patients-a-prospective-observational-study
#5
V Bakke, H Sporsem, E Von der Lippe, I Nordøy, Y Lao, H C Nyrerød, L Sandvik, K R Hårvig, J F Bugge, E Helset
BACKGROUND: Appropriate utilization of vancomycin is important to attain therapeutic targets while avoiding clinical failure and the development of antimicrobial resistance. Our aim was to observe the use of vancomycin in an intensive care population, with the main focus on achievement of therapeutic serum concentrations (15-20 mg/l) and to evaluate how this was influenced by dose regimens, use of guidelines and therapeutic drug monitoring. METHODS: A prospective observational study was carried out in the intensive care units at two tertiary hospitals in Norway...
April 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28444071/reducing-pressure-ulcers-in-patients-with-prolonged-acute-mechanical-ventilation-a-quasi-experimental-study
#6
Cecilia Inés Loudet, María Cecilia Marchena, María Roxana Maradeo, Silvia Laura Fernández, María Victoria Romero, Graciela Esther Valenzuela, Isabel Eustaquia Herrera, Martha Teresa Ramírez, Silvia Rojas Palomino, Mariana Virginia Teberobsky, Leandro Ismael Tumino, Ana Laura González, Rosa Reina, Elisa Estenssoro
Objective: To determine the effectiveness of a quality management program in reducing the incidence and severity of pressure ulcers in critical care patients. Methods: This was a quasi-experimental, before-and-after study that was conducted in a medical-surgical intensive care unit. Consecutive patients who had received mechanical ventilation for ≥ 96 hours were included. A "Process Improvement" team designed a multifaceted interventional process that consisted of an educational session, a pressure ulcer checklist, a smartphone application for lesion monitoring and decision-making, and a "family prevention bundle"...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28443837/real-time-plasmonic-qpcr-how-fast-is-ultra-fast-30-cycles-in-54-seconds
#7
Philip J R Roche, Mohamed Najih, Seung S Lee, Lenore K Beitel, Matthew L Carnevale, Miltiadis Paliouras, Andrew G Kirk, Mark A Trifiro
Polymerase Chain Reaction (PCR) is a critical tool for biological research investigators but recently it also has been making a significant impact in clinical, veterinary and agricultural applications. Plasmonic PCR, which employs the very efficient heat transfer of optically irradiated metallic nanoparticles, is a simple and powerful methodology to drive PCR reactions. The scalability of next generation plasmonic PCR technology will introduce various forms of PCR applications ranging from small footprint portable point of care diagnostic devices to large footprint central laboratory multiplexing devices...
April 26, 2017: Analyst
https://www.readbyqxmd.com/read/28440604/a-proposed-novel-framework-for-monitoring-and-evaluation-of-the-cascade-of-hiv-associated-tb-care-at-the-health-facility-level
#8
Colleen F Hanrahan, Annelies Van Rie
INTRODUCTION: The rapid and accurate diagnosis of HIV-associated tuberculosis (TB), timely initiation of curative or preventative treatment and assurance of favourable treatment outcomes is a complex process. The current system of monitoring and reporting TB diagnosis and treatment does not include several key aspects of the care cascade, and may obscure systematic bottlenecks, inefficiencies or sources of sub-optimal care. METHODS: We critically reviewed the current World Health Organizations recommended system of monitoring and reporting, and identified the following key deficiencies that could limit the ability of healthcare workers to identify structural problems in the provision of TB/HIV care...
April 20, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28437376/organizational-issues-structure-and-processes-of-care-in-257-icus-in-latin-america-a-study-from-the-latin-america-intensive-care-network
#9
Elisa Estenssoro, Leyla Alegría, Gastón Murias, Gilberto Friedman, Ricardo Castro, Nicolas Nin Vaeza, Cecilia Loudet, Alejandro Bruhn, Manuel Jibaja, Gustavo Ospina-Tascon, Fernando Ríos, Flavia R Machado, Alexandre Biasi Cavalcanti, Arnaldo Dubin, F Javier Hurtado, Arturo Briva, Carlos Romero, Guillermo Bugedo, Jan Bakker, Maurizio Cecconi, Luciano Azevedo, Glenn Hernandez
OBJECTIVE: Latin America bears an important burden of critical care disease, yet the information about it is scarce. Our objective was to describe structure, organization, processes of care, and research activities in Latin-American ICUs. DESIGN: Web-based survey submitted to ICU directors. SETTINGS: ICUs located in nine Latin-American countries. SUBJECTS: Individual ICUs. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Two hundred fifty-seven of 498 (52%) of submitted surveys responded: 51% from Brazil, 17% Chile, 13% Argentina, 6% Ecuador, 5% Uruguay, 3% Colombia, and 5% between Mexico, Peru, and Paraguay...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28436158/collaborating-on-medication-errors-in-nursing
#10
Marketa Marvanova, Paul J Henkel
BACKGROUND: Nurse educators are faced with changing roles and expanding responsibilities for medication administration and monitoring in pursuit of improved patient safety. The aims of this study were to develop, implement and evaluate clinical simulation experiences that included, along with nursing faculty members, a pharmacist educator for the teaching of preventable medication errors in undergraduate nursing education. METHODS: Four clinical simulation scenarios using high-fidelity patient simulators were developed focusing on select medication problems in nursing practice...
April 24, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28433672/montreal-accord-on-patient-reported-outcomes-use-series-paper-1-introduction
#11
Susan J Bartlett, Sara Ahmed
BACKGROUND: Patient-centered healthcare, where we design and deliver care to address the needs and preferences of patients, represents an important paradigm shift. Patient reported outcomes (PROs) are critical to capture the patient voice, understand how illness and treatments affect people, and establish how well services and treatments address what matters most to patients. OBJECTIVE: Originally developed for use in research, PROs are now used to monitor individuals and populations, manage care, evaluate services and providers, and inform policy...
April 19, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28430674/continuous-eeg-in-pediatric-critical-care-yield-and-efficiency-of-seizure-detection
#12
Arnold J Sansevere, Elizabeth D Duncan, Mark H Libenson, Tobias Loddenkemper, Phillip L Pearl, Robert C Tasker
PURPOSE: Our goal was to define the duration of continuous EEG (cEEG) monitoring needed to adequately capture electrographic seizures and EEG status epilepticus in the pediatric intensive care unit using clinical and background EEG features. METHODS: Retrospective study of patients aged 1 month to 21 years admitted to a tertiary pediatric intensive care unit and undergoing cEEG (>3 hours). Clinical data collected included admission diagnosis, EEG background features, and time variables including time to first seizure after initiation of cEEG...
April 20, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28429475/common-carotid-artery-sonography-versus-transthoracic-echocardiography-for-cardiac-output-measurements-in-intensive-care-unit-patients
#13
Qian-Yi Peng, Li-Na Zhang, Mei-Lin Ai, Li Li, Cheng-Huan Hu, Yan-Xin Zhang, Wei Liu, Qing Feng, Yu Zou, Yu-Hang Ai
OBJECTIVES: This study was designed to test the effectiveness of common carotid artery sonography in comparison with transthoracic echocardiography (TTE) for cardiac output measurements to provide an easier alternative for cardiac output monitoring in the intensive care unit. METHODS: This study included 148 patients who had common carotid artery Doppler examinations and TTE performed within 8 hours of each other, and the cardiac output measurement results were compared with each other...
April 21, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28426506/applications-of-noninvasive-hemodynamic-monitoring-in-obstetric-management
#14
John T Sullivan
Clinicians managing obstetric patients are dependent on valid hemodynamic measurements to guide care. Heart rate and noninvasive blood pressure guide most current care. New hemodynamic monitors are being used to report research findings and are being investigated by clinicians for their value to supplement standard monitoring. These include arterial pulse contour analysis, Doppler velocimetry, and bioimpedance among others. This chapter serves to present these new devices with a critical review of their advantages and limitations, and most importantly the validity of their measurements...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28425787/defining-the-proteomic-landscape-of-rheumatoid-arthritis-progress-and-prospective-clinical-applications
#15
Lucía Lourido, Francisco J Blanco, Cristina Ruiz-Romero
The heterogeneity of Rheumatoid Arthritis (RA) and the absence of clinical tests accurate enough to identify the early stages of this disease have hampered its management. Therefore, proteomics research is increasingly focused on the discovery of novel biological markers, which would not only be able make an early diagnosis, but also to gain insight into the different pathological mechanisms underlying the heterogeneity of RA and also to stratify patients, which is critical to enabling effective treatments...
April 20, 2017: Expert Review of Proteomics
https://www.readbyqxmd.com/read/28421189/optic-nerve-sheath-diameter-ultrasound-evaluation-in-intensive-care-unit-possible-role-and-clinical-aspects-in-neurological-critical-patients-daily-monitoring
#16
M Toscano, G Spadetta, P Pulitano, M Rocco, V Di Piero, O Mecarelli, E Vicenzini
Background. The increase of the optic nerve sheath diameter (ONSD) is a reliable, noninvasive sonographic marker of intracranial hypertension. Aim of the study was to demonstrate the efficacy of ONSD evaluation, when monitoring neurocritical patients, to early identify malignant intracranial hypertension in patients with brain death (BD). Methods. Data from ultrasound ONSD evaluation have been retrospectively analyzed in 21 sedated critical patients with neurological diseases who, during their clinical course, developed BD...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28420900/intracranial-pressure-monitoring-for-pediatric-acute-encephalopathy
#17
Nobuyuki Nosaka, Kohei Tsukahara, Emily Knaup, Toshihiko Yabuuchi, Tomonobu Kikkawa, Yosuke Fujii, Masato Yashiro, Takao Yasuhara, Ayumi Okada, Toyomu Ugawa, Atsunori Nakao, Hirokazu Tsukahara, Isao Date
Newly published clinical practice guidelines recommend intracranial pressure (ICP) monitoring in critical care for the management of pediatric acute encephalopathy (pAE), but the utility of ICP monitoring for pAE has been poorly studied. We recently performed direct ICP monitoring for two patients. We observed that although the direct ICP monitoring had clinical benefits with less body weight gain and no vasopressor use in both cases, this monitoring technique is still invasive. Future studies should determine the utility of non-invasive ICP monitoring systems in pAE to further improve the quality of intensive-care management...
April 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/28420605/scalable-passive-sleep-monitoring-using-mobile-phones-opportunities-and-obstacles
#18
Sohrab Saeb, Thaddeus R Cybulski, Konrad P Kording, David C Mohr
BACKGROUND: Sleep is a critical aspect of people's well-being and as such assessing sleep is an important indicator of a person's health. Traditional methods of sleep assessment are either time- and resource-intensive or suffer from self-reporting biases. Recently, researchers have started to use mobile phones to passively assess sleep in individuals' daily lives. However, this work remains in its early stages, having only examined relatively small and homogeneous populations in carefully controlled contexts...
April 18, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28420158/intelligent-medical-garments-with-graphene-functionalized-smart-cloth-ecg-sensors
#19
Murat Kaya Yapici, Tamador Elboshra Alkhidir
Biopotential signals are recorded mostly by using sticky, pre-gelled electrodes, which are not ideal for wearable, point-of-care monitoring where the usability of the personalized medical device depends critically on the level of comfort and wearability of the electrodes. We report a fully-wearable medical garment for mobile monitoring of cardiac biopotentials from the wrists or the neck with minimum restriction to regular clothing habits. The wearable prototype is based on elastic bands with graphene functionalized, textile electrodes and battery-powered, low-cost electronics for signal acquisition and wireless transmission...
April 16, 2017: Sensors
https://www.readbyqxmd.com/read/28420103/electrochemical-genosensing-of-circulating-biomarkers
#20
REVIEW
Susana Campuzano, Paloma Yáñez-Sedeño, José Manuel Pingarrón
Management and prognosis of diseases requires the measurement in non- or minimally invasively collected samples of specific circulating biomarkers, consisting of any measurable or observable factors in patients that indicate normal or disease-related biological processes or responses to therapy. Therefore, on-site, fast and accurate determination of these low abundance circulating biomarkers in scarcely treated body fluids is of great interest for health monitoring and biological applications. In this field, electrochemical DNA sensors (or genosensors) have demonstrated to be interesting alternatives to more complex conventional strategies...
April 14, 2017: Sensors
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