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"Intensive Care" OR "ICU"

Sharon R Lewis, Michael W Pritchard, Oliver J Schofield-Robinson, David Jw Evans, Phil Alderson, Andrew F Smith
BACKGROUND: During intensive care unit (ICU) admission, patients and their carers experience physical and psychological stressors that may result in psychological conditions including anxiety, depression, and post-traumatic stress disorder (PTSD). Improving communication between healthcare professionals, patients, and their carers may alleviate these disorders. Communication may include information or educational interventions, in different formats, aiming to improve knowledge of the prognosis, treatment, or anticipated challenges after ICU discharge...
October 13, 2018: Cochrane Database of Systematic Reviews
Anastasia N L Newman, Janelle Gravesande, Stephanie Rotella, Stephen S Wu, Nam Topp-Nguyen, Michelle E Kho, Jocelyn E Harris, Alison Fox-Robichaud, Patricia Solomon
PURPOSE: This scoping review summarizes the literature on the safety and effectiveness of physiotherapy interventions in patients with neurological and/or traumatic injuries in the intensive care unit (ICU), identifies literature gaps and provides recommendations for future research. MATERIALS AND METHODS: We searched five databases from inception to June 2, 2018. We included published retrospective studies, case studies, observation and randomized controlled trials describing physiotherapy interventions in ICU patients with neurotrauma injuries...
October 3, 2018: Journal of Critical Care
C Miglis, N J Rhodes, J Liu, J Gener, E Hang, M Scheetz
The quantitative importance of active antibiotic treatment relative to other modifiable and non-modifiable risk factors for mortality has not been well defined in the literature. Here we quantify the impact of active antibiotic treatment on mortality relative to other disease modifiers in patients with Gram-negative bacteremia. Patients with at least one positive blood culture who were treated with ≥24 hours of cefepime for GNBSI were included for study. To examine in-hospital survival, a full primary model and a base model with the least significant covariate from the primary model were established...
October 10, 2018: International Journal of Antimicrobial Agents
Sarah Chuzi, Sarah Hale, Jason Arnold, Amy Zhou, Rebecca Harap, Kathleen L Grady, Jonathan D Rich, Clyde W Yancy, Adeboye Ogunseitan, Eytan Szmuilowicz, Jane E Wilcox
INTRODUCTION: In 2013 the Centers for Medicare and Medicaid Services (CMS) issued a mandate requiring that all patients undergoing destination therapy ventricular assist device (DT VAD) implantation have access to a palliative care team prior to surgery. Subsequently, many VAD programs implemented a mandatory pre-implantation palliative care consultation for patients considering DT VAD. However, little is known about the quality of these consults. METHODS: All patients undergoing DT VAD at Northwestern Memorial Hospital from October 30, 2013 (the CMS decision date) through March 1, 2018 were included...
October 10, 2018: Journal of Pain and Symptom Management
Bernard Prado, Ali Haider, Syed Naqvi, Roberto C Pestana, Janet L Williams, Seyedeh Dibaj, Diane Liu, Julio Allo, Vera De La Cruz, Eduardo Bruera
CONTEXT: Optimal benefits from Palliative Cancer Care (PC) are achieved when first consults (PC1) occur early, in the outpatient setting. Late PC1, like those in the intensive care unit (ICU), limit these benefits. OBJECTIVES: To determine the proportion of PC1 over time in the outpatient, ICU, and inpatient non-ICU settings. We also examined patients' baseline characteristics and the timing of PC access (from PC1 to death) by the setting of PC1. METHODS: We retrospectively evaluated consecutive cancer patients' records at our cancer center to ascertain the annual number of PC1 and its distribution across settings (2011 to 2017)...
October 10, 2018: Journal of Pain and Symptom Management
David Wang, Caleb Ing, Craig Blinderman, May Hua
CONTEXT: In the intensive care unit (ICU), 14% of patients meet criteria for specialized palliative care, but whether subgroups of patients differ in their palliative care needs is unknown. OBJECTIVES: To use latent class analysis (LCA) to separate ICU patients into different classes of palliative care needs, and determine if such classes differ in their palliative care resource requirements. METHODS: Retrospective cohort study of ICU patients who received specialized palliative care, August 2013 - August 2015...
October 10, 2018: Journal of Pain and Symptom Management
M A Maher, T M Sayyed, S W El-Khadry
OBJECTIVE: To study the tocolytic action of nifedipine combined with sildenafil citrate (SC) and if the combination is superior to nifedipine alone in inhibiting threatened preterm labour (PTL). DESIGN: Prospective randomised study. SETTING: An Egyptian university hospital. POPULATION: Women with threatened PTL who received either nifedipine with SC or nifedipine alone. METHODS: Patients were randomly allocated to receive either (1) nifedipine 20 mg orally (stat dose), followed by 10 mg orally every 6-8 hours at the same time as vaginal administration of SC (25 mg at 8-hourly intervals) or (2) nifedipine alone...
October 13, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
Mark G Elliman, Oulaivanh Vongxay, Bandith Soumphonphakdy, Amy Gray
AIM: Hyponatraemia is a common and potentially deadly complication affecting hospitalised children world-wide. Hypotonic intravenous fluids can be a significant exacerbating factor. Exclusive use of isotonic fluids, coupled with rigorous blood monitoring, has proven effective in reducing hyponatraemia in developed settings. In developing countries, where hyponatraemia is often more common and severe, different factors may contribute to its incidence and detection. We aimed to determine the prevalence and disease associations of hyponatraemia and describe the intravenous maintenance fluid prescribing practices in a Lao paediatric intensive care unit...
October 13, 2018: Journal of Paediatrics and Child Health
Stephanie N Cripps, Marvin S Swartz
PURPOSE OF REVIEW: Assisted outpatient treatment (AOT) is an outpatient court-ordered treatment for people with severe mental illness (SMI) whose care needs are often unmet in the community due, in part, to treatment non-adherence. AOT is controversial, and the goal of this review is to provide an update on recent research, the status of AOT in the United States, and future directions for research and implementation. RECENT FINDINGS: Several recent studies have demonstrated that it is not just a lack of access to appropriately intensive care that prevents some individuals with SMI from engaging in and benefiting from treatment and that AOT can improve engagement and patient outcomes over and above the provision of care...
October 13, 2018: Current Psychiatry Reports
Eugene Ng, Amanda D Loewy
Newborns are at risk for vitamin K deficiency bleeding (VKDB) caused by inadequate prenatal storage and deficiency of vitamin K in breast milk. Systematic review of evidence to date suggests that a single intramuscular (IM) injection of vitamin K at birth effectively prevents VKDB. Current scientific data suggest that single or repeated doses of oral (PO) vitamin K are less effective than IM vitamin K in preventing VKDB. The Canadian Paediatric Society and the College of Family Physicians of Canada recommend routine IM administration of a single dose of vitamin K at 0...
October 2018: Canadian Family Physician Médecin de Famille Canadien
Paul S Jansson, David C Leisten, Todd M Sarkisian, Susan R Wilcox, Jarone Lee
BACKGROUND: Hydrochlorothiazide (HCTZ) is a commonly prescribed sulfonamide thiazide-type diuretic medication that has been associated with rare cases of noncardiogenic pulmonary edema. CASE REPORT: A man in his 50s with a medical history notable for hypertension was transferred to our institution for evaluation of refractory hypoxemia. After taking an initial dose of HCTZ earlier in the day, he developed progressive respiratory failure and was intubated at a referring hospital...
October 9, 2018: Journal of Emergency Medicine
Christopher A VanFosson, Terry L Jones, Linda H Yoder
OBJECTIVE: To describe the monthly variation in the prevalence and patterns of unfinished nursing care and to determine the relationships between the system of nursing care and unfinished nursing care at the US Army Burn Center. METHODS: This was a repeated measures, descriptive study. For one week per month for six months, all nurses providing direct patient care on two inpatient burn units (intensive care and progressive care) were asked to complete an anonymous paper survey, which contained the Perceived Implicit Rationing of Nursing Care instrument, to estimate the prevalence of unfinished nursing care on their unit...
October 9, 2018: Burns: Journal of the International Society for Burn Injuries
Margaret Louise Phillips, Vijo Kuruvilla, Michael Bailey
BACKGROUND: Pain is a common stressor for ICU patients, necessitating routine assessment. For patients who are unable to communicate, self-report tools are unsuitable, and the use of an observational tool is required to assess pain appropriately. The Critical Care Pain Observation Tool (CPOT) is the most reliable tool currently available to assess pain in these patients. We investigated whether the implementation of the CPOT in one Australian ICU could increase frequency of appropriate pain assessments, and if this would affect the administration of analgesia and sedation...
October 9, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Carlos Ferre Aracil, Laura Núñez Gómez, Luis Téllez Villajos, Agustín Albillos Martínez
INTRODUCTION: Epistaxis in cirrhotic patients is a common issue. However, the literature published to date is very scarce. MATERIAL AND METHODS: Retrospective case series of patients with cirrhosis who presented with a significant epistaxis, between 2006 and 2016. RESULTS: Data were collected from 39 cirrhotic patients with a mean age of 61.4 (±14) years, 75% of which were males. The main comorbidities were hypertension (33%) and diabetes mellitus (26%)...
October 9, 2018: Gastroenterología y Hepatología
Fahad D Alosaimi, Ayedh Alghamdi, Raya Alsuhaibani, Ghadah Alhammad, Amjad Albatili, Latifah Albatly, Bandar Althomali, Fadi Aljamaan, José R Maldonado
BACKGROUND: The Stanford Proxy Test for Delirium (S-PTD) is a tool developed to be completed by nurses at the end of their shift. It was designed to use the knowledge acquired during a full shift of nurse-patient interaction. The objective of our study was to validate the S-PTD among a mixed sample of patients in both the intensive care unit (ICU) and non-ICU settings. METHODS: A cross-sectional study was conducted in an ICU and three general medical wards in a tertiary care hospital...
November 2018: Journal of Psychosomatic Research
Aleksandra Świderska, Marek Wiśniewski, Marek Wiergowski, Anna Krakowiak, Jacek Sein Anand
BACKGROUND: Poisonings constitute a significant medical, social and economic problem worldwide. In Poland there is no nationwide registry of poisonings, which results in a lack of accurate epidemiological data. Few publications dealing with the problem are based on data obtained from toxicology units and therefore do not include information about cases treated at emergency departments and other non-toxicology units. METHODS: We analyzed all admissions due to poisonings reported to the Polish National Health Fund by all hospital units in Poland in the 2009-2011 period...
October 10, 2018: BMC Pharmacology & Toxicology
Christian Niels Meyer, Karin Armbruster, Michael Kemp, Trine Rolighed Thomsen, Ram Benny Dessau
BACKGROUND: We explored the hypothesized importance of early knowledge of microbiological etiology in patients with pleural infection, including comorbidity and treatment factors in the outcome analyses. METHODS: Data from the medical records of a large cohort of 437 consecutive patients in 9 hospitals in East-Denmark were included retrospectively. RESULTS: Microbiology, co-morbidity, therapy and outcome are described in detail. Patient groups with microbiology negative and known bacterial etiology had a similar 30-day and 90-day mortality...
October 12, 2018: BMC Pulmonary Medicine
Elias Iosifidis, Savvas Papachristou, Emmanuel Roilides
The main indications for antifungal drug administration in pediatrics are reviewed as well as an update of the data of antifungal agents and antifungal policies performed. Specifically, antifungal therapy in three main areas is updated as follows: a) Prophylaxis of premature neonates against invasive candidiasis; b) management of candidemia and meningoencephalitis in neonates; and c) prophylaxis, empiric therapy, and targeted antifungal therapy in children with primary or secondary immunodeficiencies. Fluconazole remains the most frequent antifungal prophylactic agent given to high-risk neonates and children...
October 11, 2018: Journal of Fungi (Basel, Switzerland)
Xiu Wu, Wei Cao, Bin Zhang, Shengyu Wang
INTRODUCTION: The effect of high-flow nasal cannula (HFNC) on adult post cardiothoracic operation remains controversial. We conducted a meta-analysis of randomized controlled trials to evaluate the effect of HFNC and conventional oxygen therapy (COT) on postcardiothoracic surgery. METHODS: A search was conducted in Embase, MEDLINE, Ovid, and Cochrane databases until December, 2017 for all the controlled study to compare HFNC with COT in adult postcardiothoracic surgery...
October 2018: Medicine (Baltimore)
Naoki Hayase, Kent Doi, Takahiro Hiruma, Ryota Inokuchi, Yoshifumi Hamasaki, Eisei Noiri, Masaomi Nangaku, Naoto Morimura
Acute liver injury (ALI) is frequently detected in an intensive care unit (ICU) and reportedly affects prognosis. Experimental animal studies suggested that increased extracellular histone and high morbidity group box-1 (HMGB1) levels might contribute to ALI development. Whether these damage-associated molecular patterns (DAMPs) play a crucial role in ALI remains unclear in the human clinical setting.We consecutively enrolled the patients admitted to our ICU. The patients with ALI were included in the analysis together with those without ALI by using frequency matching...
October 2018: Medicine (Baltimore)
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