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Ruth Martis, Caroline A Crowther, Emily Shepherd, Jane Alsweiler, Michelle R Downie, Julie Brown
BACKGROUND: Successful treatments for gestational diabetes mellitus (GDM) have the potential to improve health outcomes for women with GDM and their babies. OBJECTIVES: To provide a comprehensive synthesis of evidence from Cochrane systematic reviews of the benefits and harms associated with interventions for treating GDM on women and their babies. METHODS: We searched the Cochrane Database of Systematic Reviews (5 January 2018) for reviews of treatment/management for women with GDM...
August 14, 2018: Cochrane Database of Systematic Reviews
Sonia Johnson, Danielle Lamb, Louise Marston, David Osborn, Oliver Mason, Claire Henderson, Gareth Ambler, Alyssa Milton, Michael Davidson, Marina Christoforou, Sarah Sullivan, Rachael Hunter, David Hindle, Beth Paterson, Monica Leverton, Jonathan Piotrowski, Rebecca Forsyth, Liberty Mosse, Nicky Goater, Kathleen Kelly, Mel Lean, Stephen Pilling, Nicola Morant, Brynmor Lloyd-Evans
BACKGROUND: High resource expenditure on acute care is a challenge for mental health services aiming to focus on supporting recovery, and relapse after an acute crisis episode is common. Some evidence supports self-management interventions to prevent such relapses, but their effect on readmissions to acute care following a crisis is untested. We tested whether a self-management intervention facilitated by peer support workers could reduce rates of readmission to acute care for people discharged from crisis resolution teams, which provide intensive home treatment following a crisis...
August 4, 2018: Lancet
Jessica Liang, Stephanie J Lee, Barry E Storer, Bronwen E Shaw, Eric J Chow, Mary E Flowers, Elizabeth F Krakow, Merav Bar, Karen L Syrjala, Rachel B Salit, Chareeni E Kurukulasuriya, Heather S L Jim
BACKGROUND: Hematopoietic cell transplant (HCT) can cause significant distress in patients and their informal caregivers. Despite advances in reduced intensity conditioning and supportive care, few recent studies have reported rates of clinically-significant post-traumatic stress disorder symptomatology (hereafter referred to as PTSD). Goals of the current study were to: 1) examine rates of PTSD and distress in patients and caregivers and 2) identify sociodemographic and clinical risk factors for PTSD...
August 8, 2018: Biology of Blood and Marrow Transplantation
JoAnne M Youngblut, Dorothy Brooten
BACKGROUND: Losing a child is devastating for parents and grandparents. Family and friends generally focus on comforting and supporting the bereaved parents, unintentionally ignoring the bereaved grandparents. Grandmothers and grandfathers often struggle with wanting to help their adult children (deceased child's parents) without usurping the parents' responsibilities and decisions regarding the deceased child. Research on mothers' and grandmothers' health at about the same time after the same child's death in the neonatal or pediatric intensive care unit is lacking...
August 10, 2018: Italian Journal of Pediatrics
Alla Sikorskii, Charles W Given, Barbara A Given, Eric Vachon, John C Krauss, Margaret Rosenzweig, Ruth McCorkle, Victoria L Champion, Asish Banik, Atreyee Majumder
CONTEXT: An increasing number of oral cancer treatments require patient adherence and symptom self-management. OBJECTIVES: The report presents the effects of a medication reminder and symptom management intervention directed at patients initiating new oral oncolytic agents. METHODS: Patients (N=272) were recruited at six comprehensive cancer centers, interviewed over the telephone following oral agent initiation, and randomized to either standard care or a medication reminder and symptom management intervention...
August 7, 2018: Journal of Pain and Symptom Management
Thomas T Joseph, Matthew DiMeglio, Annmarie Huffenberger, Krzysztof Laudanski
Repletion of electrolytes often depends on provider-specific behavior and hospital policy. We examined the pattern of electrolyte repletion across several intensive care units (ICU) in a large healthcare system from 2010-2015. This included 109 723 potassium repletions, 51 833 magnesium repletions, 2 306 calcium repletions, 8 770 phosphate repletions, and 3 128 249 visit-days over 332 018 visits. Potassium, magnesium, and calcium were usually repleted within the institutional reference range. In contrast, the bulk of phosphate repletion was done with pre-repletion serum level below the reference range...
August 9, 2018: Scientific Reports
Kristin Leifsdottir, Huseyin Mehmet, Staffan Eksborg, Eric Herlenius
BACKGROUND: Cerebral ischemia generates neuroinflammation that can induce neural cell death. This cohort study assessed whether Fas-ligand (FasL) and interleukin (IL)-6 levels in the cerebrospinal fluid (CSF) after hypoxic-ischemic encephalopathy (HIE) can serve as biomarkers of hypoxic brain injury in neonates. METHODS: Term infants (> 37-week gestational age) who were admitted to the neonatal intensive care unit of Karolinska University Hospital in years 2002 to 2004 with perinatal asphyxia were enrolled prospectively...
August 8, 2018: Journal of Neuroinflammation
Joseph Philip, Christian Kegg, Dalia Lopez-Colon, Brian J Kelly, Robert M Lawrence, Matthew A Robinson, Ravi S Samraj, Mark S Bleiweis
BACKGROUND: There is no consensus for the length of prophylactic antibiotics after delayed chest closure (DCC) postcardiac surgery in pediatrics. In September 2014, our institution's pediatric cardiac intensive care unit changed the policy on length of prophylactic antibiotics after DCC from 5 days (control) to 2 days (study group). The objective of the study was to determine whether a 2-day course of antibiotics is as effective as a 5-day course in preventing blood stream and sternal wound infections in pediatric DCC...
August 8, 2018: Journal of Intensive Care Medicine
Marcus Vinicius Santos Andrade, Luciana Azevedo Prata Andrade, Alan Freitas Bispo, Luana de Alencar Freitas, Milena Quadros Sampaio Andrade, Gilson Soares Feitosa, Gilson Soares Feitosa-Filho
BACKGROUND: Thrombotic disorders remain one of the leading causes of death in the Western world. Dabigatran appeared as an alternative to warfarin for anticoagulation in the treatment of atrial fibrillation (AF). The risk associated with bleeding due to its use has been documented in several randomized clinical trials, but no large study has examined in detail the risk of bleeding during dental extraction and other dental procedures involving bleeding. OBJECTIVE: To compare the intensity of bleeding in individuals taking dabigatran or vitamin K antagonist (warfarin) and undergoing dental procedures...
August 6, 2018: Arquivos Brasileiros de Cardiologia
Annarita Pilleri, Maurizio Giuseppe Abrignani, Fabio Angeli, Paolo Fontanive, Paolo Silvestri, Gian Francesco Mureddu
BACKGROUND: Cardiovascular risk stratification and perioperative management of subjects undergoing non-cardiac surgery have recently been updated in the 2014 European Society of Cardiology guidelines. Nevertheless, and notwithstanding the epidemiological relevance of this condition, an underevaluation of the importance of perioperative risk stratification is a common feeling. METHODS: The ANMCO Cardiovascular Prevention Area organized, last year, a web-based survey with 15 questions to investigate perioperative management and care pathways in non-cardiac surgery and to evaluate guideline adherence of Italian cardiologists...
September 2018: Giornale Italiano di Cardiologia
Heidi Noels, Wendy Theelen, Marieke Sternkopf, Vera Jankowski, Julia Moellmann, Sandra Kraemer, Michael Lehrke, Nikolaus Marx, Lukas Martin, Gernot Marx, Joachim Jankowski, Andreas Goetzenich, Christian Stoppe
Cardiac surgery with cardiopulmonary bypass (CPB) triggers myocardial ischemia/reperfusion injury contributing to organ dysfunction. Preclinical studies revealed that dipeptidyl peptidase (DPP4) inhibition is protective during myocardial infarction. Here, we assessed for the first time the relation of peri-operative DPP4-activity in serum of 46 patients undergoing cardiac surgery with patients' post-operative organ dysfunction during intensive care unit (ICU) stay. Whereas a prior myocardial infarction significantly reduced pre-operative DDP4-activity, patients with preserved left ventricular function showed an intra-operative decrease of DPP4-activity...
August 7, 2018: Scientific Reports
Pedro N M P Coelho, Luís M R P C Miranda, Pedro M P Barros, José I G Fragata
OBJECTIVES: Cardiac surgery has little effect on life expectancy in elderly patients. Thus, improving the quality of life should be the main factor affecting therapeutic decisions. Most studies on quality of life in elderly patients undergoing cardiac surgery report improvement but have limitations. Consequently, we assessed improvements in the quality of life of elderly patients undergoing elective cardiac surgery, identified influencing variables and established patterns of mental and physical health variations in the first year postoperatively...
July 31, 2018: Interactive Cardiovascular and Thoracic Surgery
Saygin Turkyilmaz, Ali Aycan Kavala
PURPOSE: To compare the operative and post-operative outcomes of mitral valve surgery (MVS) with a superior transseptal (STS) approach and a left atriotomy (LA) approach. METHODS: In a tertiary academic center, the charts of patients who underwent MVS between 2012 and 2016 were analyzed retrospectively. A total of 135 patients underwent MVS. Forty patients who underwent MVS with the STS approach were enrolled in the study as the STS group. In the same period, we selected 40 patients who underwent MVS with the LA approach to serve as the control group (LA group)...
July 26, 2018: Heart Surgery Forum
Giuseppe Filiberto Serraino, Federica Jiritano, Michele Rossi, Pasquale Mastroroberto
BACKGROUND: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) support has emerged as a valuable rescue therapy in patients with severe acute lung failure. A new bicaval dual-lumen percutaneous cannula can be instituted with a single puncture of the right internal jugular vein under image guidance (fluoroscopy and/or trans-esophageal echocardiography) to support VV-ECMO. However, malpositioning of the dual-lumen catheter can jeopardize the efficacy of the ECMO therapy. CASE REPORT: We report an emergency VV-ECMO instituted at a patient's bedside in the intensive care unit...
June 26, 2018: Heart Surgery Forum
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...
July 29, 2018: International Journal of Surgery Case Reports
Julie Alingrin, Benjamin Coiffard, Julien Textoris, Corine Nicolino-Brunet, Morgane Gossez, Pierre-André Jarrot, Françoise Dignat-George, Guillaume Monneret, Pascal Alexandre Thomas, Marc Leone, Martine Reynaud-Gaubert, Laurent Papazian
BACKGROUND: Immunosuppressive strategy targets mainly adaptive immunity after solid organ transplantation. We assessed the influence of early post-operative sepsis on T cell and monocyte reconstitution in anti-thymocyte globulin (ATG)-treated lung transplant recipients. METHODS: We retrospectively included recipients who underwent a first lung transplant at our Lung Transplant Center (Marseille, France) between July 2011 and February 2013. Peripheral blood T-lymphocyte subset counts and monocyte HLA-DR (mHLA-DR) expression routinely performed by flow cytometry within 60 days post-transplant were analyzed...
August 3, 2018: Transplant Immunology
Susan E Warrington, Hailey K Collier, Adam S Himebauch, Heather A Wolfe
OBJECTIVES: To evaluate if institutionally established calculations for transitioning continuous IV midazolam to enteral benzodiazepines maintain Withdrawal Assessment Tool-Version 1 scores equal to or less than preconversion values. DESIGN: Retrospective cohort study evaluating the effectiveness and safety of benzodiazepine conversion calculations embedded within an institution-specific clinical pathway for sedation and weaning of mechanically ventilated pediatric patients...
August 3, 2018: Pediatric Critical Care Medicine
John A Ligon, Janna M Journeycake, Shellie C Josephs, Naureen G Tareen, Eduardo A Lindsay, Lawson A B Copley
BACKGROUND: Children with osteomyelitis are at risk for deep venous thrombosis (DVT). This study evaluates the characteristics of DVT among children to differentiate between those with and without osteomyelitis. METHODS: Children with DVT of any cause were studied between 2008 and 2016. Children with DVT and osteomyelitis were compared with those with DVT without osteomyelitis. Another comparison cohort included children with osteomyelitis but without DVT. Comorbidities, severity of illness (SOI), and clinical course were compared between cohorts...
August 4, 2018: Journal of Pediatric Orthopedics
Salizar Mohamed Ludin, Nor'ain Abdul Rashid
Throughout recovery, patients with severe traumatic brain injury (TBI) show physical and functional improvement, but continue to have cognitive and psychosocial problems. The aim of this article was to review the literature regarding the functional and health-related quality of life (HRQOL) outcomes in severe TBI. There were 15 articles reviewed, 13 of them were quantitative studies and two were narrative review. Most of the articles showed an improvement occurs rapidly at 6 months post-injury. There were several factors that influence the outcome after TBI, most of it was the Glasgow Coma Scale (GCS) on admission, age, educational level, duration of posttraumatic amnesia (PTA), and length of stay (LOS) in the Intensive Care Unit (ICU)...
August 5, 2018: Clinical Nursing Research
Johan M Berghmans, Marten J Poley, Jan van der Ende, Francis Veyckemans, Stephanie Poels, Frank Weber, Bert Schmelzer, Dirk Himpe, Frank C Verhulst, Elisabeth Utens
BACKGROUND: Children undergoing adenotonsillectomy are at risk of severe postoperative pain and sleep problems. Little is known about the specific child risk factors for these problems. AIMS: The aim of this study was to assess the occurrence of postoperative pain, sleep problems, and medication adherence, and assess the influence of internalizing and externalizing problems on postoperative pain. METHODS: This prospective cohort study included 160 children, aged 1...
August 5, 2018: Paediatric Anaesthesia
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