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Post-intensive care syndrome

Victoria Sadick, Stuart Lane, Eddy Fischer, Ian Seppelt, Anita Shetty, Anthony McLean
Catastrophic antiphospholipid syndrome is a rare multisystem autoimmune condition characterised by rapid development of widespread thrombotic disease and subsequent multi-organ failure. It is the most severe complication of antiphospholipid syndrome, carrying significant morbidity and mortality. We report a patient with post-partum catastrophic antiphospholipid syndrome with cardiac, hepatic, renal and cutaneous manifestations. The diagnostic challenges in establishing a definitive diagnosis in catastrophic antiphospholipid syndrome is discussed, along with the difficulties in managing these patients in the intensive care unit...
November 2018: Journal of the Intensive Care Society
Barbara Riegel, Liming Huang, Mark E Mikkelsen, Ann Kutney-Lee, Alexandra L Hanlon, Christopher M Murtaugh, Kathryn H Bowles
BACKGROUND/OBJECTIVES: New or worsened disabilities in functional, cognitive, or mental health following an intensive care unit (ICU) stay are referred to as post-intensive care syndrome (PICS). PICS has not been described in older adults receiving home care. Our aim was to examine the relationship between length of ICU stay and PICS among older adults receiving home care. We expected that patients in the ICU for 3 days or longer would demonstrate significantly more disability in all three domains on follow-up than those not in the ICU...
November 30, 2018: Journal of the American Geriatrics Society
Maja Dolanc Merc, Miha Lučovnik, Andreja Trojner Bregar, Ivan Verdenik, Nataša Tul, Isaac Blickstein
Objective To determine the association between pre-gravid obesity and stillbirth. Methods A retrospective study of a population-based dataset of births at ≥34 weeks' gestation. We excluded fetal deaths due to lethal anomalies and intrapartum fetal deaths. We calculated the incidence of stillbirths, neonatal respiratory distress syndrome (RDS) and neonatal intensive care unit (NICU) admissions per ongoing pregnancies for each gestational week in the two body mass index (BMI) categories (≥30 vs.<30). Results Pre-pregnancy obesity (BMI≥30), pre-pregnancy diabetes, oligo- and polyhydramnios, being small for gestational age (SGA) and preeclampsia were significantly associated with stillbirth...
November 29, 2018: Journal of Perinatal Medicine
Q I Talukder, M H Rahman, A K Azad, M Z Rahman, P K Chanda, F Ahmed
To review the experience of surgical repair of post-infarction ventricular septal rupture (VSR) and analyze the associated outcomes in National Heart Foundation Hospital & Research Institute (NHFH & RI). This retrospective review was performed on 19 consecutive cases who had undergone surgical repair of post-infarction VSR between 2009 and 2017. Continuous variables were summarized as mean plus/minus the standard deviation or median. Categorical variables were expressed as percentage of the sample. Comparison between in-hospital survivors versus non-survivors was performed by Student's t-test and chi-square or Fisher's exact test for continuous and categorical variables respectively...
October 2018: Mymensingh Medical Journal: MMJ
Oliver J Schofield-Robinson, Sharon R Lewis, Andrew F Smith, Joanne McPeake, Phil Alderson
BACKGROUND: The intensive care unit (ICU) stay has been linked with a number of physical and psychological sequelae, known collectively as post-intensive care syndrome (PICS). Specific ICU follow-up services are relatively recent developments in health systems, and may have the potential to address PICS through targeting unmet health needs arising from the experience of the ICU stay. There is currently no single accepted model of follow-up service and current aftercare programmes encompass a variety of interventions and materials...
November 2, 2018: Cochrane Database of Systematic Reviews
Miguel G Uriol Rivera, Sheila Cabello Pelegrin, Carmen Ballester Ruiz, Bernardo López Andrade, Javier Lumbreras, Aina Obrador Mulet, Albert Perez Montaña, Mireia Ferreruela Serlavos, José Ignacio Ayestarán Rota, Joana Ferrer Balaguer, Olga Delgado Sanchez, Lucio Pallares Ferreres, Antonio Mas Bonet, María Jose Picado Valles, Rosa María Ruíz de Gopegui Valero
BACKGROUND: Thrombotic microangiopathy (TMA) is an important complication associated with several diseases that are rare and life-threatening. TMA is common to thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS). TTP is defined by a severe deficiency of ADAMTS13, and early treatment is associated with good prognosis. The diagnosis of HUS can be difficult due to the potential multiple etiologies, and the best treatment option in most cases is not well-established yet...
2018: PloS One
Yan Lu, Liping Liu, Jing Wang, Limin Cui
Objective: To explore the effectiveness of controlled blood pressure elevation and limited fluid resuscitation in treating patients with multiple injuries in combination with shock in Intensive Care Unit (ICU). Methods: One hundred and sixty-four patients with multiple injuries in combination with shock who were admitted into the ICU of the hospital between June 2014 and November 2017 were selected and divided into an observation group and a control group using random number table, 82 each group...
September 2018: Pakistan Journal of Medical Sciences Quarterly
Patrice Chevallier, Pierre Peterlin, Alice Garnier, Amandine Le Bourgeois, Beatrice Mahé, Viviane Dubruille, Nicolas Blin, Cyrille Touzeau, Thomas Gastinne, Anne Lok, Yannick Le Bris, Marie C Béné, Steven Le Gouill, Philippe Moreau, Thierry Guillaume
Background: The Baltimore reduced-intensity conditioning (RIC) regimen using high-dose post-transplant cyclophosphamide (PTCY) is considered as a standard of care for haploidentical allogeneic stem cell transplantation (allo-SCT). However, it is associated with relatively low survivals and high incidence of relapse, especially when considering myeloid malignancies. Results: This retrospective study included 36 adults (males n = 18; median age: 60.5 years old; haplodonors n = 27; matched donors n = 8) with myeloid malignancies transplanted between March 2014 and March 2017 at the University Hospital of Nantes...
September 11, 2018: Oncotarget
Nathalie J Farpour-Lambert, Louisa J Ells, Begoña Martinez de Tejada, Courtney Scott
Background: Maternal obesity, excessive gestational weight gain (GWG) and post-partum weight retention (PPWR) constitute new public health challenges, due to the association with negative short- and long-term maternal and neonatal outcomes. The aim of this evidence review was to identify effective lifestyle interventions to manage weight and improve maternal and infant outcomes during pregnancy and postpartum. Methods: A review of systematic reviews and meta-analyses investigating the effects of lifestyle interventions on GWG or PPWR was conducted (Jan 2009-2018) via electronic searches in the databases Medline, Pubmed, Web of Science and Cochrane Library using all keywords related to obesity/weight gain/loss, pregnancy or postpartum and lifestyle interventions;15 relevant reviews were selected...
2018: Frontiers in Endocrinology
Oscar Mancera-Páez, Gustavo C Román, Rodrigo Pardo-Turriago, Yhojan Rodríguez, Juan-Manuel Anaya
We review post-infectious and post-vaccination neurological syndromes involving peripheral and central nervous system (CNS) and report an illustrative case of simultaneous occurrence of Guillain-Barré syndrome (GBS), confirmed by nerve conduction velocities, plus MRI-demonstrated transverse myelitis (TM) and acute encephalitis [acute disseminated encephalomyelitis] (ADEM+GBS) affecting a 24-year-old woman from Cúcuta, Colombia, who developed acute Zika virus (ZIKV) infection confirmed by serum reverse transcriptase-polymerase chain reaction (RT-PCR) and convalescent ZIKV IgG antibodies...
December 15, 2018: Journal of the Neurological Sciences
Emma Fisher, Emily Law, Joanne Dudeney, Tonya M Palermo, Gavin Stewart, Christopher Eccleston
BACKGROUND: This is an update of the original Cochrane review first published in Issue 1, 2003, and previously updated in 2009, 2012 and 2014. Chronic pain, defined as pain that recurs or persists for more than three months, is common in childhood. Chronic pain can affect nearly every aspect of daily life and is associated with disability, anxiety, and depressive symptoms. OBJECTIVES: The aim of this review was to update the published evidence on the efficacy of psychological treatments for chronic and recurrent pain in children and adolescents...
September 29, 2018: Cochrane Database of Systematic Reviews
Ayfer Ekim
Improvements in devices and techniques used to provide life support for patients at intensive care units have reduced patient mortality. Increases in the number of survivors from a critical illness have brought long-term complications experienced during the post-intensive care period into question. The term post-intensive care syndrome (PICS) is defined as a new and deteriorating disorder in the cognitive, mental, and physical health status experienced by the survivor after intensive care unit discharge that might continue for months or even years...
September 25, 2018: Comprehensive child and adolescent nursing
Mustafa Serkan Durdu, Mehmet Cakici, Fatih Gumus, Gunseli Cubukcuoglu Deniz, Sinem Civriz Bozdag, Evren Ozcinar, Nur Dikmen Yaman, Osman Ilhan, Kemalettin Ucanok
OBJECTIVE: Apheresis is performed for treatment of numerous diseases by removing auto-antibodies, antigen-antibody complexes, allo-antibodies, paraproteins, non-Ig proteins, toxins, exogenous poisons. In current study, we present our experience of using therapeutic plasma exchange (TPE) in patients with different types of clinical scenarios. METHODS: Between January 2013 and May 2016, we retrospectively presented the results of 64 patients in whom postoperative TPE was performed in ICU setting after cardiac surgery...
September 18, 2018: Transfusion and Apheresis Science
Michael D Wood, David M Maslove, John Muscedere, Stephen H Scott, J Gordon Boyd
PURPOSE: To assess the feasibility of using an integrated multimodal data collection strategy to characterize the post-intensive care syndrome (PICS). MATERIALS AND METHODS: Adult patients admitted to the ICU requiring invasive mechanical ventilation for >24 h and/or requiring vasopressor support were eligible for enrollment. We assessed cognitive and sensorimotor function at 3- and 12-months after ICU discharge with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and with the KINARM robot...
September 12, 2018: Journal of Critical Care
Jiyeon Kang, Yeon Jin Jeong
OBJECTIVES: This study explored critical care survivors' experience of post-intensive care syndrome. RESEARCH DESIGN AND SETTING: This qualitative study employed a classic grounded theory approach with 13 survivors after intensive care unit treatment. MAIN OUTCOME MEASURES: Data were collected through one-to-one in-depth interviews. Open, axial and selective coding were performed based on interview transcripts, field notes, and memos. FINDINGS: The analysis of survivors' experience with post-intensive care syndrome led to the 'embracing the new vulnerable self' theory...
September 4, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Raiko Blondonnet, Elodie Joubert, Thomas Godet, Pauline Berthelin, Thibaut Pranal, Laurence Roszyk, Russell Chabanne, Nathanael Eisenmann, Alexandre Lautrette, Corinne Belville, Sophie Cayot, Thierry Gillart, Bertrand Souweine, Damien Bouvier, Loic Blanchon, Vincent Sapin, Bruno Pereira, Jean-Michel Constantin, Matthieu Jabaudon
BACKGROUND AND OBJECTIVE: Elevated driving pressure (ΔP) may be associated with increased risk of acute respiratory distress syndrome (ARDS) in patients admitted via the emergency department and with post-operative pulmonary complications in surgical patients. This study investigated the association of higher ΔP with the onset of ARDS in a high-risk, intensive care unit (ICU) population. METHODS: This is a secondary analysis of a prospective multicentre observational study...
September 5, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
Ana Logrado, Júlio Constantino, Jorge Pereira, Carlos Casimiro
INTRODUCTION: Acute appendicitis is the main indication for surgery during pregnancy. Physiologic changes during pregnancy and fear of using ionising radiation exams are some of the reasons to delayed diagnosis and consequently to higher morbidity and mortality rates for mother and fetus. PRESENTATION OF CASE: We present the case of a 38-year-old woman that resorted to the emergency room on the 13th week of pregnancy with abdominal discomfort, nausea and vomiting that lasted for 7 days...
2018: International Journal of Surgery Case Reports
Anis Hasnaoui, Raja Jouini, Dhafer Haddad, Haithem Zaafouri, Ahmed Bouhafa, Anis Ben Maamer, Ehsen Ben Brahim
BACKGROUND: Since the advent of immunohistochemistry for the diagnosis of stromal tumours, the incidence of leiomyosarcomas has significantly decreased. Nowadays, gastric leiomyosarcoma is an exceptionally rare tumour. We report the second case in the English literature of gastric leiomyosarcoma revealed with massive bleeding and hemodynamic instability and diagnostic pitfalls that we encountered. CASE PRESENTATION: A 63-year-old woman, with 2 years' history of dizziness and weakness probably related to an anaemic syndrome, presented to the emergency room with hematemesis, melena and hemodynamic instability...
August 17, 2018: BMC Surgery
Joanne McPeake, Mark E Mikkelsen
No abstract text is available yet for this article.
September 2018: Critical Care Medicine
Adel Elkbuli, Brandon Diaz, John D Ehrhardt, Shaikh Hai, Sean Kaufman, Mark McKenney, Dessy Boneva
INTRODUCTION: Clostridial toxic shock is a rare syndrome traditionally described in case studies and reviews as a uniformly fatal condition associated with post-partum and post-abortion. Clostridium sordellii was first mentioned in scientific literature as a human pathogen in 1922 when Argentinian microbiologist Alfredo Sordellii identified the organism in gangrenous wounds. Over the past century, there has been infrequent discussion and little awareness surrounding this serious condition...
2018: International Journal of Surgery Case Reports
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