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https://www.readbyqxmd.com/read/28933744/energy-and-protein-in-critically-ill-patients-with-aki-a-prospective-multicenter-observational-study-using-indirect-calorimetry-and-protein-catabolic-rate
#1
Alice Sabatino, Miriam Theilla, Moran Hellerman, Pierre Singer, Umberto Maggiore, Maria Barbagallo, Giuseppe Regolisti, Enrico Fiaccadori
The optimal nutritional support in Acute Kidney Injury (AKI) still remains an open issue. The present study was aimed at evaluating the validity of conventional predictive formulas for the calculation of both energy expenditure and protein needs in critically ill patients with AKI. A prospective, multicenter, observational study was conducted on adult patients hospitalized with AKI in three different intensive care units (ICU). Nutrient needs were estimated by different methods: the Guidelines of the European Society of Parenteral and Enteral Nutrition (ESPEN) for both calories and proteins, the Harris-Benedict equation, the Penn-State and Faisy-Fagon equations for energy...
July 26, 2017: Nutrients
https://www.readbyqxmd.com/read/28931363/a-guideline-based-policy-to-decrease-intensive-care-unit-admission-rates-for-accidental-hypothermia
#2
Herman R Sequeira, Hesham E Mohamed, Neal Hakimi, Dorothy B Wakefield, Jonathan Fine
RATIONALE: Despite guidelines advising passive rewarming for mild accidental hypothermia (AH), patients are frequently admitted to intensive care unit (ICU) for active rewarming using a forced-air warming device. We implemented a new policy at our institution aimed at safely reducing ICU admissions for AH. We analyzed our practice pre- and post-policy intervention and compared our experiences with acute care hospitals in Connecticut. METHODS: A retrospective chart review was performed on 203 participants with AH identified by primary and secondary discharge codes...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28929012/current-practice-in-the-management-of-new-onset-atrial-fibrillation-in-critically-ill-patients-a-uk-wide-survey
#3
Chung Shen Chean, Daniel McAuley, Anthony Gordon, Ingeborg Dorothea Welters
BACKGROUND: New-onset atrial fibrillation (AF) is the most common arrhythmia in critically ill patients. Although evidence base and expert consensus opinion for management have been summarised in several international guidelines, no specific considerations for critically ill patients have been included. We aimed to establish current practice of management of critically ill patients with new-onset AF. METHODS: We designed a short user-friendly online questionnaire...
2017: PeerJ
https://www.readbyqxmd.com/read/28927965/optimal-marine-mammal-welfare-under-human-care-current-efforts-and-future-directions
#4
Sabrina Brando, Donald M Broom, Cristina Acasuso-Rivero, Fay Clark
Marine mammals include cetaceans, pinnipeds, sirenians, sea otters and polar bears, many of which are charismatic and popular species commonly kept under human care in zoos and aquaria. However, in comparison with their fully terrestrial counterparts their welfare has been less intensively studied, and their partial or full reliance on the aquatic environment leads to unique welfare challenges. In this paper we attempt to collate and review the research undertaken thus far on marine mammal welfare, and identify the most important gaps in knowledge...
September 16, 2017: Behavioural Processes
https://www.readbyqxmd.com/read/28925635/diabetes-self-management-facilitating-lifestyle-change
#5
Marlon Russell Koenigsberg, Jennifer Corliss
Healthy eating and increased physical activity can prevent or delay the onset of diabetes mellitus and facilitate diabetes management. Current guidelines recommend long-term weight loss of 5% to 7% of body weight and 150 minutes of at least moderate-intensity physical activity per week for most patients with prediabetes and diabetes. Techniques to assess and facilitate adherence to these lifestyle changes can be practical in primary care. During office visits, physicians should assess and gradually encourage patients' readiness to work toward change...
September 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28923476/evaluation-of-nutrition-support-practices-results-from-a-nationwide-survey
#6
Wajdy Abi Saleh, Pierre Bou Khalil, Krystel Ouaijan, Fayez Abillama, Sandra Akiki, Nehmat Ahmad, Lama Mattar
BACKGROUND: Multiple clinical guidelines are available to improve and standardize the delivery of nutrition support. However, recommendations are not being universally applied at the bedside due to challenges of resources and barriers of knowledge. Assessing the current level of nutrition support practice is the first step to understand the barriers and ultimately implement potential strategies to increase guideline adherence and promote quality nutrition support in hospitals. There are no published data concerning the practice of nutrition support in Lebanese hospitals...
September 7, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28922268/early-exercise-in-critically-ill-youth-and-children-a-preliminary-evaluation-the-weecycle-pilot-trial
#7
Karen Choong, Saif Awladthani, Adeeb Khawaji, Heather Clark, Asm Borhan, Ji Cheng, Sam Laskey, Charmaine Neu, Aimee Sarti, Lehana Thabane, Brian W Timmons, Katina Zheng, Samah Al-Harbi
OBJECTIVES: To determine the feasibility of conducting a full trial evaluating the efficacy of early mobilization using in-bed cycling as an adjunct to physiotherapy, on functional outcomes in critically ill children. DESIGN: Single center, pilot, randomized controlled trial. SETTING: Twelve-bed tertiary care, medical-surgical PICU at McMaster Children's Hospital, Hamilton, ON, Canada. PATIENTS: Children 3-17 years old who were limited to bed-rest with an expected PICU stay of at least 48 hours...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28918911/mortality-of-severe-septic-patients-between-physician-s-high-and-low-care-volumes
#8
Chun-Yao Lin, Jo-Chi Tseng, Chih-Yu Huang, Chien-Ming Chu, Huang-Pin Wu
BACKGROUND: Patients with severe sepsis frequently require intensive care unit (ICU) admission and different ICU care models may influence their outcomes. The mortality of severe septic patients between physician's high and low care volume remains unclear. METHODS: We analyzed the data from a three-year prospective observation study, which was performed in an adult medical ICU of Chung Gung Memorial Hospital, Keelung. The data included initial bundle therapies based on the Surviving Sepsis Campaign (SSC) guidelines for patients with severe sepsis...
August 2017: Biomedical Journal
https://www.readbyqxmd.com/read/28918680/transcranial-direct-current-stimulation-in-disorders-of-consciousness-a-review
#9
Ye Zhang, Weiqun Song
It is a challenge to evaluate and treat the patients with disorders of consciousness (DOC) in the clinic. Due to the huge costs of prolonged intensive care, the management of these patients raises great financial strain on families and important ethical questions. To date, several studies have attempted to specifically detect pharmacologic or non-pharmacologic effectiveness, until now there were no evidence-based guidelines about the treatment of patients with DOC. Recently, because of ethical and procedural limitations on the use of invasive stimulation techniques, non-invasive brain stimulation, such as the transcranial direct current stimulation (tDCS), has been investigated for improving the level of consciousness in patients with DOC...
September 18, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28914279/blood-products-provided-to-patients-receiving-futile-critical-care
#10
Thanh H Neville, Alyssa Ziman, Neil S Wenger
The number of hospitalized patients receiving treatment perceived to be futile is not insignificant. Blood products are valuable resources that are donated to help others in need. We aimed to quantify the amount of blood transfused into patients who were receiving treatment that the critical care physician treating them perceived to be futile. During a 3-month period, critical care physicians in 5 adult intensive care units completed a daily questionnaire to identify patients perceived as receiving futile treatment...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28914210/-sepsis-new-insights-new-definition
#11
W J Wiersinga, A R H van Zanten, K A Kaasjager, T van der Poll
- Incidence of sepsis is increasing, partly due to an ageing population, increased use of immunosuppressants, and antibiotic resistance. Sepsis survival has improved substantially, in part because of continuously improving intensive care and implementation of evidence-based guidelines.- Sepsis is defined as 'life-threatening organ dysfunction due to a dysregulated host response to infection'. The Sequential Organ Failure Assessment (SOFA) score can be used to estimate organ dysfunction severity.- In this article, we discuss the new sepsis definitions - including reactions to these definitions, an overview of current insights in sepsis pathogenesis, and the new treatment guidelines...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28912010/first-week-weight-dip-and-reaching-growth-targets-in-early-life-in-preterm-infants
#12
Jorine A Roelants, Koen F M Joosten, Brigitte M A van der Geest, Jessie M Hulst, Irwin K M Reiss, Marijn J Vermeulen
BACKGROUND & AIMS: Aggressive parenteral nutritional practices were implemented in clinical practice over a decade ago to prevent early growth retardation in preterm infants. We aimed to study adherence to current nutritional recommendations in a population of very preterm infants, and to evaluate growth in early life. METHODS: Preterm infants (gestational age <30 weeks and birth weight <1500 g) were included in a prospective observational cohort study. Data on parenteral and enteral intake were collected on days 1-7, 14, 21 and 28 (d28) of life...
August 31, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28911933/pain-cognition-versus-pain-intensity-in-patients-with-endometriosis-toward-personalized-treatment
#13
Mieke A W van Aken, Joukje M Oosterman, C M van Rijn, Magdalena A Ferdek, Gé S F Ruigt, B W M M Peeters, Didi D M Braat, Annemiek W Nap
OBJECTIVE: To explore how pain intensity and pain cognition are related to health-related quality of life (HRQoL) in women with endometriosis. DESIGN: Cross-sectional questionnaire-based survey. SETTING: Multidisciplinary referral center. PATIENT(S): Women with laparoscopically and/or magnetic resonance imaging-proven endometriosis (n = 50) and healthy control women (n = 42). INTERVENTION(S): For HRQoL, two questionnaires: the generic Short Form Health Survey (SF-36) and the Endometriosis Health Profile 30 (EHP-30)...
September 11, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28903951/managing-problematic-severe-asthma-beyond-the-guidelines
#14
REVIEW
Katharine C Pike, Mark L Levy, John Moreiras, Louise Fleming
This review discusses issues related to managing problematic severe asthma in children and young people. A small minority of children have genuinely severe asthma symptoms which are difficult to control. Children with genuinely severe asthma need investigations and treatments beyond those described within conventional guidelines. However, the majority of children with poor symptom control despite high-intensity treatment achieve improvement in their asthma control once attention has been paid to the basics of asthma management...
September 13, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28903892/effectiveness-of-smartmoms-a-novel-ehealth-intervention-for-management-of-gestational-weight-gain-randomized-controlled-pilot-trial
#15
Leanne M Redman, L Anne Gilmore, Jeffrey Breaux, Diana M Thomas, Karen Elkind-Hirsch, Tiffany Stewart, Daniel S Hsia, Jeffrey Burton, John W Apolzan, Loren E Cain, Abby D Altazan, Shelly Ragusa, Heather Brady, Allison Davis, J Mick Tilford, Elizabeth F Sutton, Corby K Martin
BACKGROUND: Two-thirds of pregnant women exceed gestational weight gain (GWG) recommendations. Because excess GWG is associated with adverse outcomes for mother and child, development of scalable and cost-effective approaches to deliver intensive lifestyle programs during pregnancy is urgent. OBJECTIVE: The aim of this study was to decrease the proportion of women who exceed the Institute of Medicine (IOM) 2009 GWG guidelines. METHODS: In a parallel-arm randomized controlled trial, 54 pregnant women (age 18-40 years) who were overweight (n=25) or obese (n=29) were enrolled to test whether an intensive lifestyle intervention (called SmartMoms) decreased the proportion of women with excess GWG, defined as exceeding the 2009 IOM guidelines, compared to no intervention (usual care group)...
September 13, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28902529/evaluation-of-the-2016-infectious-diseases-society-of-america-american-thoracic-society-guideline-criteria-for-risk-of-multi-drug-resistant-pathogens-in-hospital-acquired-and-ventilator-associated-pneumonia-patients-in-the-intensive-care-unit
#16
Pervin Korkmaz Ekren, Otavio T Ranzani, Adrian Ceccato, Gianluigi Li Bassi, Eva Muñoz Conejero, Miquel Ferrer, Michael S Niederman, Antoni Torres
No abstract text is available yet for this article.
September 13, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28901786/effect-of-gestational-age-on-the-epidemiology-of-late-onset-sepsis-in-neonatal-intensive-care-units-a-review
#17
Elsa de Palma Afonso, Stijn Blot
Neonatal sepsis is a major cause of morbidity and mortality. Late-onset sepsis affects a significant percentage of infants admitted to the neonatal intensive care unit (NICU). Most affected newborns are preterm or low birth weight, but late-onset sepsis also affects late preterm and term infants. Understanding how gestational age affects the epidemiology of late-onset sepsis can be of use when defining strategies for its prevention and clinical management in NICU. Areas covered: Available evidence suggests the incidence and mortality of late-onset sepsis is higher in preterm and VLBW infants, but pathogen distribution and risk exposure is similar across all infants admitted to NICU...
September 13, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28900818/the-effects-of-chronic-aerobic-exercise-on-cardiovascular-risk-factors-in-persons-with-diabetes-mellitus
#18
REVIEW
Emily M Miele, Samuel A E Headley
PURPOSE OF REVIEW: Aerobic exercise training is a component of diabetes mellitus (DM) care guidelines due to its favorable effects on glycemic control and cardiovascular disease (CVD) risk factors. The purpose of this review is to outline the recent evidence regarding the clinical effects of chronic aerobic exercise on CVD risk factors in persons with DM and to compare the effects of varying intensities and types of exercise. RECENT FINDINGS: Among individuals with DM, all types of aerobic exercise training can impact positively on some traditional and non-traditional risk factors for CVD...
September 12, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28894478/diagnosis-of-primary-ciliary-dyskinesia-summary-of-the-ers-task-force-report
#19
Claudia E Kuehni, Jane S Lucas
KEY POINTS: Primary ciliary dyskinesia (PCD) is a genetically and clinically heterogeneous disease characterised by abnormal motile ciliary function.There is no "gold standard" diagnostic test for PCD.The European Respiratory Society (ERS) Task Force Guidelines for diagnosing PCD recommend that patients should be referred for diagnostic testing if they have several of the following features: persistent wet cough; situs anomalies; congenital cardiac defects; persistent rhinitis; chronic middle ear disease with or without hearing loss; or a history, in term infants, of neonatal upper and lower respiratory symptoms or neonatal intensive care admission...
September 2017: Breathe
https://www.readbyqxmd.com/read/28893726/a-web-based-lifestyle-medicine-curriculum-facilitating-education-about-lifestyle-medicine-behavioral-change-and-health-care-outcomes
#20
Elizabeth Pegg Frates, Ryan C Xiao, Deepa Sannidhi, Yasamina McBride, Tracie McCargo, Theodore A Stern
BACKGROUND: Lifestyle medicine is the science and application of healthy lifestyles as interventions for the prevention and treatment of disease, and has gained significant momentum as a specialty in recent years. College is a critical time for maintenance and acquisition of healthy habits. Longer-term, more intensive web-based and in-person lifestyle medicine interventions can have a positive effect. Students who are exposed to components of lifestyle medicine in their education have improvements in their health behaviors...
September 11, 2017: JMIR Medical Education
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