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Intensive AND Care

Salam Abbara, Aurélia Pitsch, Sébastien Jochmans, Kyann Hodjat, Dr Pascale Cherrier, Mehran Monchi, Christophe Vinsonneau, Sylvain Diamantis
OBJECTIVES: To assess if the postprescription review and feedback (PPRF) of all antibiotics with restriction of carbapenems, fluoroquinolones and third generation cephalosporins, along with a change of medical standard of care, impacted the consumption of antibiotics and bacterial resistance in a medical/surgical intensive care unit (MSICU). METHODS: A four years before (2007-2010) and after (2011-2014) retrospective comparative study. Antibiotics consumption was evaluated in Defined Daily Doses per 1000 patient days...
December 8, 2018: International Journal of Antimicrobial Agents
Rachel Rosenblum, Ran Huo, Bethann Scarborough, Nathan Goldstein, Cardinale B Smith
PURPOSE: The Quality Oncology Practice Initiative (QOPI) is a quality measurement and improvement program designed to assess practice performance for various consensus-based and evidence-based measures. In this study, we evaluated differences in QOPI metrics met among patients with advanced solid cancer receiving routine oncologic care alone (routine care) compared with patients receiving integrated oncology and specialty-level palliative care (supportive care). METHODS: We conducted a retrospective chart review of 100 randomly selected patients treated between June 2013 and June 2015 from our supportive care group and matched these patients to 100 routine care group patients on the basis of tumor type and initial oncology visit date...
December 2018: Journal of Oncology Practice
Yusmiati Liau, Ignatius Chua, Martin A Kennedy, Simran Maggo
Angioedema is a rare adverse effect of the commonly used angiotensin converting enzyme inhibitors (ACEi) and is reported to occur with a prevalence of 0.1 - 0.7%. Although most ACEi-induced angioedema (ACEi-A) cases are mild, severe cases requiring intensive care and even resulting in death have been reported in the literature. The mechanisms underlying ACEi-A are not yet fully understood, but bradykinin and/or substance P accumulation resulting from inhibition of ACE, is believed to play a crucial role. ACEi-A occurs at variable frequencies across different racial groups, suggesting a genetic association to the development of ACEi-A...
December 8, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
Francesca Marino, Luca Nunziata
Policy Points Policymakers should invest more on researching the long-term health effects of low-ionizing radiation exposure, as we are far from reaching a consensus on a topic that is of enormous importance for public health and safety. Public policies such as those limiting the import of contaminated food from areas hit by a radioactive disaster or those regulating the resident population's access to such areas should follow a precautionary approach. Neoplasm diagnosis and medical care should be designed in order to take into account the possible role of long-term, low-dose radiation exposure...
December 2018: Milbank Quarterly
Eman Saad Elzanfaly, Enas Abdel Hakim Amer, Sara Abdel Basset Galal, Hala Elsayed Zaazaa
A spectrofluorimetric method for the determination of eptifibatide is presented based on its native fluorescence. The type of solvent and the wavelength of maximum excitation and emission were carefully selected to optimize the experimental conditions. Under the specified experimental conditions, the linearities obtained between the emission intensity and the corresponding concentrations of eptifibatide were in the range 0.1-2.5 μg/ml for the calibration curve constructed for direct determination of eptifibatide in dosage form and 0...
December 11, 2018: Luminescence: the Journal of Biological and Chemical Luminescence
Andréa Araujo de Oliveira Cortines, Patrícia Corrêa-Faria, Liselotte Paulsson, Paulo Sucasas Costa, Luciane Rezende Costa
OBJECTIVE: Developmental defects of enamel (DDE) in preterm infants still require clarification and may favour dental caries, lower food intake, and greater difficulty with weight-height gain. We evaluated factors associated with DDE in preterm infants. SUBJECTS AND METHODS: In this prospective cohort study, we monitored 54 prematurely born infants from birth to 24 months of age. Trained and calibrated dentists examined the oral cavity of these children to identify and categorize DDE...
December 7, 2018: Oral Diseases
Emily J Georgia Salivar, Karen Rothman, McKenzie K Roddy, Brian D Doss
While the efficacy of couple therapy has been repeatedly demonstrated, most distressed couples do not seek treatment. To improve reach and overcome barriers to therapy, Integrative Behavioral Couple Therapy (IBCT) was translated into a web-based program, OurRelationship (OR). While both IBCT and OR have been shown to improve relationship and individual functioning, the goal of the present study was to compare the relative cost effectiveness of these two treatment modalities. In IBCT, 74% of couples experienced reliable improvement, compared to 55% of couples in OR...
December 10, 2018: Family Process
Zoe C Bedford, Suzanne Bench
BACKGROUND: Having a child admitted to a paediatric intensive care unit (PICU) is a highly stressful experience, and post-traumatic stress among parents is well documented. How best to support these parents is currently unclear. AIM: To review research on interventions to support the psychological well-being of parents after their child's discharge from paediatric intensive care. METHODS: Searches were conducted using Medline, PsycINFO, PubMed, CINAHL and The Cochrane library in January 2017...
December 10, 2018: Nursing in Critical Care
Danyang Li, Xueyang Li, Wei Cui, Huahao Shen, Hong Zhu, Yi Xia
BACKGROUND: Sepsis and septic shock are potentially life-threatening complications of infection that are associated with high morbidity and mortality in adults and children. Fluid therapy is regarded as a crucial intervention during initial treatment of sepsis. Whether conservative or liberal fluid therapy can improve clinical outcomes in patients with sepsis and septic shock remains unclear. OBJECTIVES: To determine whether liberal versus conservative fluid therapy improves clinical outcomes in adults and children with initial sepsis and septic shock...
December 10, 2018: Cochrane Database of Systematic Reviews
Carolina Cabral-Santos, Edson Alves de Lima Junior, Isabela Maia da Cruz Fernandes, Rafael Zambelli Pinto, José César Rosa-Neto, Nicolette Charllote Bishop, Fábio Santos Lira
PURPOSE: Interleukin 10 (IL-10) is a cytokine that plays a critical role with potent anti-inflammatory properties when produced during exercise, limiting host immune response to pathogens and preventing tissue damage. The purpose of this systematic review was to assess the response of IL-10 after acute exercise session in healthy adults. METHODS: Databases of Ovid Medline (1978-2016), CINAHL (1998-2016), EMBASE (2003-2016), SportDiscus (1990-2016), and Web of Science library (1990-2016) were carefully screened...
December 7, 2018: Journal of Cellular Physiology
Reinhard Strametz, Martin N Bergold, Tobias Weberschock
BACKGROUND: Percutaneous dilatational tracheostomy (PDT) is one of the most common bedside surgical procedures performed in critically ill adults, on intensive care units (ICUs), who require long-term ventilation. PDT is associated with relevant life-threatening complications: Cuff rupture or accidental extubation may lead to hypoxia, aspiration or loss of airway. Puncture of the oesophagus, or creating a false passage during dilatation or replacement of the tracheostomy tube, can lead to pneumothorax or emphysema...
November 15, 2018: Cochrane Database of Systematic Reviews
M L Eckstein, D M Williams, L K O'Neil, J Hayes, J W Stephens, R M Bracken
In the UK the National Institute of Health and Care Excellence (NICE) advocates intensive lifestyle programmes that attain the levels of daily physical activity set out by the Chief Medical Officer as a first-line strategy for improving the health of people at risk of developing diabetes or reducing the risk of development of Type 2 diabetes. For people with Type 2 diabetes, lifestyle measures complement pharmacological treatments that include both oral and injectable therapies. In line with this, NICE guidelines also support intensification of efforts to improve patient lifestyle along with these glucose-lowering therapies...
December 7, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Léanne Swart, Elise Schapkaitz, Johnny N Mahlangu
INTRODUCTION: Thrombotic thrombocytopenic purpura (TTP) is associated with high mortality if not managed timeously with therapeutic plasma exchange (TPE). TTP secondary to human immunodeficiency virus (HIV) infection is unique to sub-Saharan Africa. The management and outcome of TTP in the era of improved access to therapy has not been described. METHODS: The present study describes the clinical presentation, treatment, therapeutic endpoints, and outcome of TTP patients at the Charlotte Maxeke Johannesburg Academic Hospital, South Africa...
December 8, 2018: Journal of Clinical Apheresis
Claire E Kelly, Deanne K Thompson, Jeanie Ly Cheong, Jian Chen, Joy E Olsen, Abbey L Eeles, Jennifer M Walsh, Marc L Seal, Peter J Anderson, Lex W Doyle, Alicia J Spittle
AIM: To examine: (1) relationships between brain structure, and concurrently assessed neurological and behavioural functioning, in infants born preterm at term-equivalent age (TEA; approximately 38-44wks); and (2) whether brain structure-function relationships differ between infants born very (24-29wks) and moderate-late (32-36wks) preterm. METHOD: A total of 257 infants (91 very preterm, 166 moderate-late preterm; 120 males, 137 females) had structural magnetic resonance imaging (MRI) and neurological and behavioural assessments (Prechtl's general movements assessment, Neonatal Intensive Care Unit Network Neurobehavioral Scale [NNNS] and Hammersmith Neonatal Neurological Examination [HNNE])...
December 10, 2018: Developmental Medicine and Child Neurology
Y-M Li, Y Jiang, S-D Feng, Z-H Lin
OBJECTIVE: Infection can be caused by severe burnt, trauma and hypoxia, further causing systemic inflammatory syndrome or sepsis. The sepsis occurs in about 2% of all hospitalizations and ranges from 6% to 30% in intensive care unit (ICU) in developed countries This study aimed to investigate the effects of normal lymph fluid on sepsis complicated with pulmonary injury. MATERIALS AND METHODS: Wistar rats were prepared for sepsis complicated with acute pulmonary model via cecal ligation and puncture, and received normal lymph fluid injection 60 min later...
November 2018: European Review for Medical and Pharmacological Sciences
Joana Gomes de Amorim, Manuel Rocha Abecasis, Filipa Maria Nogueira Lança Rodrigues
Thrombocytopenia is the most common hemostatic change in pregnancy, but severe thrombocytopenia is rare. One of the causes, immune thrombocytopenic purpura (ITP), is characterized by increased platelet destruction by immunoglobulin G (IgG) antibodies, presenting a high risk of hemorrhage for the patient, but also for the fetus, since antibodies may cross the placenta. We present the case of a 23-year-old pregnant woman with a history of Langerhans cell histiocytosis of the mandible submitted to surgery and chemotherapy when she was 10 years old, with diagnosis of ITP since then...
December 2018: Revista Brasileira de Ginecologia e Obstetrícia
Maxens Decavèle, Isabelle Rivals, Clémence Marois, Marie Cantier, Nicolas Weiss, Léa Lemasle, Hélène Prodanovic, Khe Hoang-Xuan, Ahmed Idbaih, Thomas Similowski, Alexandre Demoule
PURPOSE: Acute respiratory failure (ARF) is common and potentially fatal in patients with primary malignant brain tumors (PMBT). However, few data are available regarding its precipitating factors and prognosis. We sought to: (1) compare the causes of ARF and the outcome between patients with PMBT and patients with other peripheral solid tumors (PST), (2) identify the factors influencing ICU survival in PMBT patients. METHODS: Two-center retrospective case-control study from March 1996 to May 2014...
December 7, 2018: Journal of Neuro-oncology
Antoine Lafarge, R Bertinchamp, C Pichereau, S Valade, A Chermak, I Theodose, E Canet, V Lemiale, B Schlemmer, L Galicier, E Azoulay, E Mariotte
Patients with autoimmune hemolytic anemia (AIHA) may require intensive care unit (ICU) admission. In order to describe the characteristics of AIHA patients in ICU and identify prognosis factors, clinical and biological data from 44 patients admitted in one ICU between 2002 and 2015 were retrospectively analyzed. The main reasons for ICU admission were profound anemia without any organ failure in 19 patients (either for safer transfusion or continuous monitoring only). Twenty-five (57%) patients had a past history of hemopathy...
December 10, 2018: Annals of Hematology
Giorgio Berlot, Claudio Michele Vassallo, Nicola Busetto, Margarita Nieto Yabar, Tatiana Istrati, Silvia Baronio, Giada Quarantotto, Mattia Bixio, Giulia Barbati, Roberto Dattola, Irene Longo, Antonino Chillemi, Alice Scamperle, Fulvio Iscra, Ariella Tomasini
BACKGROUND: The administration of endovenous immunoglobulins in patients with septic shock could be beneficial and preparations enriched with IgA and IgM (ivIgGAM) seem to be more effective than those containing only IgG. In a previous study Berlot et al. demonstrated that early administration of ivIgGAM was associated with lower mortality rate. We studied a larger population of similar patients aiming either to confirm or not this finding considering also the subgroup of patients with septic shock by multidrug-resistant (MDR) pathogens...
December 10, 2018: Annals of Intensive Care
Ana Navas, Ricard Ferrer, Maria Luisa Martínez, Gemma Gomà, Gisela Gili, Jordi Masip, David Suárez, Antonio Artigas
BACKGROUND: Septic shock is a leading cause of death in critical patients. In patients with gram-negative septic shock, hemoperfusion with polymyxin B aims to remove endotoxins from plasma. We analyzed the clinical and biological response to hemoperfusion in patients with septic shock and acute kidney injury. METHODS: This prospective case-control study in the medical-surgical intensive care unit of a university hospital included consecutive adults patients with septic shock and suspected gram-negative bacteria infection with elevated plasma endotoxin activity (EAA > 0...
December 7, 2018: Annals of Intensive Care
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