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Critical Care*

Tomoaki Yatabe, Moritoki Egi, Masahiko Sakaguchi, Takashi Ito, Nobuhiro Inagaki, Hiromi Kato, Jun Kaminohara, Amane Konishi, Michiko Takahashi, Hiroomi Tatsumi, Masaru Tobe, Ikue Nakashima, Naoki Nakamoto, Takeshi Nishimura, Masakazu Nitta, Masaji Nishimura
BACKGROUND: There is lack of evidence regarding nutritional management among intensive care unit (ICU) patients in a population with relatively low body mass index. Therefore, we conducted an observational study to assess the nutritional management in Japanese ICUs. Also, we investigated the impact of nutritional management and rehabilitation on physical outcome. METHODS: The study population comprised 389 consecutive patients who received mechanical ventilation for at least 24 h and those admitted to the ICU for > 72 h in 13 hospitals...
December 12, 2018: Annals of Nutrition & Metabolism
Greg S Martin, Paul Bassett
PURPOSE: Guidelines recommend crystalloids for fluid resuscitation in sepsis/shock and switching to albumin in cases where crystalloids are insufficient. We evaluated hemodynamic response to crystalloids/colloids in critically ill adults. MATERIALS AND METHODS: The primary research question was: "Are crystalloids sufficient for volume replacement in severe indications (intensive care unit [ICU]/critical illness)?" Randomized, controlled trials (RCTs) were identified using PubMed and EMBASE, and screened against predefined inclusion/exclusion criteria...
November 30, 2018: Journal of Critical Care
Lex M van Loon, Johannes G van der Hoeven, Joris Lemson
The administration of β-blockers in patients with sepsis is a trending topic in intensive care medicine since the landmark study by Morelli and colleagues, showing a striking decrease in 28-day mortality compared to standard care. While the available evidence suggests that the use of β-blockers in septic shock is safe, the effects on hemodynamics are controversial. In this paper, we review the effect of β-blockade in septic shock on hemodynamics from animal models to critically ill patients.
December 5, 2018: Journal of Critical Care
Josué J Aliaga Ramos, Jorge Espinoza-Ríos, Vanessa Valenzuela Granados, José Pinto Valdivia, Alejandro Bussalleu Rivera
Ischemic Hepatitis is an uncommon entity in daily clinical practice with a prevalence of 0.16 to 0.5% among patients admitted to a critical care unit, associated with an approximate 60% mortality rate. This liver disease is characterized by a rapid and marked increase (more than 20 times the normal value) of the level of transaminases secondary to a severe and persistent hepatic hypoperfusion caused by multiple etiologies, which may be transient when the triggering cause is timely identified and appropiately treated...
July 2018: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Gene Harkless, Loretta Vece
BACKGROUND AND PURPOSE: The growth and sustainability of nurse practitioners (NPs) requires transparent, fair and equitable reimbursement policies. Complicating this issue is variation in reimbursement policy within and across federal, state, and other payers. Even with explicit regulations, there remain questions on how reimbursement policies are covertly operationalized in practice. This systematic review aims to identify knowledge gaps related to reimbursement policy issues and outlines recommendations for further research...
December 2018: Journal of the American Association of Nurse Practitioners
Isabela Bernasconi José, Vânia Aparecida Leandro-Merhi, José Luis Braga de Aquino
BACKGROUND: Enteral nutritional therapy (ENT) is the best route for the nutrition of critically ill patients with improved impact on the clinical treatment of such patients. OBJECTIVE: To investigate the energy and protein supply of ENT in critically ill in-patients of an Intensive Care Unit (ICU). METHODS: Prospective longitudinal study conducted with 82 critically ill in-patients of an ICU, receiving ENT. Anthropometric variables, laboratory tests (albumin, CRP, CRP/albumin ratio), NUTRIC-score and Nutritional Risk Screening (NRS-2002), energy and protein goals, and the inadequacies and complications of ENT were assessed...
July 2018: Arquivos de Gastroenterologia
Bruna de Souza Lima Marski, Beatriz Castanheira Facio, Sueli Mutsumi Tsukuda Ichisato, Patricia Carla de Souza Della Barba, Monika Wernet
OBJECTIVE: to analyze the Developmental Care in nursing care for Newborns in critical Neonatal Intensive Care Units. METHOD: a qualitative study with 11 nurses from Neonatal Intensive Care Units of a city in the State of São Paulo countryside, based on the Developmental Care. Data collection was based on non-participant observation, documentary research in medical records and semi-structured interviews. The Symbolic Interactionism was adopted as theoretical framework, and the Bardin Content Analysis, as method of analysis...
2018: Revista Brasileira de Enfermagem
Mayara Ruiz Chotolli, Danielle Fabiana Cucolo, Marcia Galan Perroca
OBJECTIVE: To evaluate the product of care in units of specialized hospitals, identifying the items that most contributed to the score; to compare the product of care among hospitals, units, and shifts; to verify the association between demographic and professionals variables and the product of care. METHOD: Descriptive study, conducted in eight units of two specialized hospitals in the State of São Paulo. The evaluation of the product of care was performed by applying an instrument to 44 nurses...
2018: Revista Brasileira de Enfermagem
Aline Spanevello Alvares, Áurea Christina de Paula Corrêa, Janete Tamami Tomiyoshi Nakagawa, Renata Cristina Teixeira, Ana Beatriz Nicolini, Renata Marien Knupp Medeiros
OBJECTIVE: To analyze the practice of obstetric nurses operating in a prenatal/delivery/postpartum unit of a university hospital in Mato Grosso and the maternal welfare resulted from the care provided in this scenario. METHOD: Study with a quantitative approach, carried out in a prenatal/delivery/postpartum unit of a university hospital in Cuiabá, Mato Grosso. The data were collected through the Scale of Maternal Welfare in Delivery Situation 2, and the study included 104 recent mothers in the period from June to September 2016...
2018: Revista Brasileira de Enfermagem
Leonardo Baldaçara, Flávia Ismael, Verônica Leite, Lucas A Pereira, Roberto M Dos Santos, Vicente de P Gomes Júnior, Elie L B Calfat, Alexandre P Diaz, Cintia A M Périco, Deisy M Porto, Carlos E Zacharias, Quirino Cordeiro, Antônio Geraldo da Silva, Teng C Tung
OBJECTIVE: To present the essential guidelines for non-pharmacological management of patients with psychomotor agitation in Brazil. METHODS: These guidelines were developed based on a systematic review of articles published from 1997 to 2017, retrieved from MEDLINE (PubMed), Cochrane Database of Systematic Review, and SciELO. Other relevant articles identified by searching the reference lists of included studies were also used to develop these guidelines. The search strategy used structured questions formulated using the PICO model, as recommended by the Guidelines Project of the Brazilian Medical Association...
December 6, 2018: Revista Brasileira de Psiquiatria
Roberto de Queiroz Padilha, Romeu Gomes, Valéria Vernaschi Lima, Everton Soeiro, José Maurício de Oliveira, Laura Maria Cesar Schiesari, Silvio Fernandes da Silva, Marilda Siriani de Oliveira
This paper aims at proposing validated principles to underpin clinical management as a means to transform healthcare for integrated healthcare systems. The starting point was the conception of clinical management based on structuring elements that do not separate management, care and education. The authors' proposal was submitted to specialists so that a consensus could be reached. At the end of the process, the following principles of clinical management were presented: (1) Focus on health needs and comprehensive care, (2) Quality and safety in healthcare, (3) Articulation and legitimation of different health practices and types of knowledge to face health problems, (4) Power sharing and co-accountability among managers, health professionals and citizens in healthcare production; (5) Education of people and organizations; (6) Focus on outcomes that add value to health and life; (7) Transparency and accountability regarding collective interests...
December 2018: Ciência & Saúde Coletiva
Francesco Sulla, Melania Lachimia, Lucrezia Barbieri, Antonella Gigantiello, Concetta Iraci, Giulia Virgili, Giovanna Artioli, Leopoldo Sarli
BACKGROUND AND AIM OF THE WORK: Numerous negative outcomes of inadequate pain management among children have been cited in the literature. Inadequate pain management may be particularly detrimental to children and adolescents facing life-threatening injury or illness on a Paediatric Intensive Care Unit (PICU). It is therefore absolutely necessary that professionals utilize effective and efficient tools in order to evaluate a person's sensations of pain in the most objective way possible...
December 7, 2018: Acta Bio-medica: Atenei Parmensis
Sara Oliveira, Cláudia Pires, Cláudia Ferreira
PURPOSE: The central role of caregiver eating messages has been recognized on later individual's eating behaviour, body image and weight status. Additionally, shame is a painful emotion also associated with the development and maintenance of body image and eating-related difficulties. The main aim of the present study was to explore the moderator effect of the recall of caregiver eating messages on the associations between external shame, body weight and shape-related concerns, and the adoption of inflexible eating rules...
December 11, 2018: Eating and Weight Disorders: EWD
Simona Ispas, Samuel So, Mehlika Toy
Chronic hepatitis B infection (CHB) is a condition that needs ongoing care such as monitoring for liver enzymes (ALT) and HBV DNA tests in treated and untreated patients, and annual imaging evaluation for liver cancer. Although follow-up care and treatment might seem straight forward, an estimated two-thirds of those who are aware of their infection are not seeing a health care provider, and more than half of those who are eligible for treatment do not receive it. This study aimed to compile and examine studies related to the barriers of disease monitoring, treatment, and liver cancer surveillance for CHB patients in the United States (US)...
December 11, 2018: Journal of Community Health
Earl R Byron, Gary M Santolo
The Total Maximum Daily Load (TMDL) for selenium in the freshwater drainages to Newport Bay, California, is being developed based on selenium concentration in the tissues of fish and bird eggs. This paper demonstrates the use of fish mesocosms and monitoring results to facilitate the comparisons of selenium contamination across fish species and areas of the watershed with differing fish assemblages. In this watershed, mosquitofish dominate across all the small, upper watershed drainages while sunfish family species dominate in deeper, ponded reaches of the lower watershed...
December 12, 2018: Environmental Monitoring and Assessment
Shokei Matsumoto, Kyoungwon Jung, Alan Smith, Motoyasu Yamazaki, Mitsuhide Kitano, Raul Coimbra
Background: The National Trauma Data Bank (NTDB) has served as a global benchmark for trauma care quality and outcomes. Herein, we compared patient characteristics, trauma management, and outcomes between Japanese emergency and critical care centers and US level 1 trauma centers using the Japanese Trauma Data Bank (JTDB) and NTDB. Methods: A retrospective cohort matching (1:1) study was performed. Patients treated in 2013 with an Injury Severity Score ≥9 were included...
2018: Trauma surgery & acute care open
Daniela Villani, Chiara Cognetta, Claudia Repetto, Silvia Serino, Davide Toniolo, Francesco Scanzi, Giuseppe Riva
Breast cancer is the most common cancer in women worldwide, with increases in diagnoses at all ages. Due to several age-related factors, older breast cancer patients show particular difficulties in adjusting to breast cancer and its related treatments. One consistent indicator of vulnerability to long-term complications is emotional distress occurring within 3 months of diagnosis. Thus, it is critical to develop early interventions specifically aimed at mitigating distress and promoting emotional wellbeing in older breast cancer patients...
2018: Frontiers in Psychology
Judith Fullerton, Michelle M Butler, Cheryl Aman, Tobi Reid, Melanie Dowler
Introduction: The International Confederation of Midwives (ICM) represents 132 midwifery associations in 113 countries. The ICM disseminates the Essential Competencies for Basic Midwifery Practice (EC) that describes the global scope of midwifery practice. The basic (core) and expanded (additional or optional) role of midwives in providing abortion-related care services was first described in 2010. A literature review about three items that are particularly critical to access to abortion services was conducted...
2018: International Journal of Women's Health
Isabela Freire Azevedo-Santos, Josimari Melo DeSantana
Background: Procedural pain is a frequent problem in intensive care units (ICUs). For that, pain assessment has been increasingly introduced to the ICU professional's routine, and studies have been developed to show the relevance of measuring pain in critically ill patients. Objective: This review aimed to describe pain measurement techniques for mechanically ventilated adult patients based on evidence and already published. Method: Systematic literature search was performed on PubMed and Google Scholar...
2018: Journal of Pain Research
Weigang Dong, Yan Du, Shuping Ma
Background: The aim of the study was to investigate if first-line chemotherapy improves total survival time in non-small-cell lung cancer (NSCLC) patients complicated with severe to very severe COPD. Materials and methods: This retrospective observational clinical study included 267 consecutive NSCLC patients with COPD complications at the Department of Respiratory and Critical Care Medicine of Tianjin Chest Hospital between January 2009 and January 2018. Sixty-nine evaluable patients were included...
2018: International Journal of Chronic Obstructive Pulmonary Disease
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