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https://www.readbyqxmd.com/read/29675987/the-usage-of-procalcitonin-in-finland
#1
B Tujula, M Kokki, K Pulkki, J Romppanen, S Sjövall, H Tuominen, H Kokki
BACKGROUND: We have surveyed the use of procalcitonin (PCT) in Finland with a specific emphasis on intensive care unit (ICU) patients. METHODS: The PCT use was surveyed from all 11 laboratories providing services for all 15 secondary and all five tertiary care hospitals in Finland. The laboratories reported the PCT use of each hospital in 2014 and 2015. Four hospitals were analysed for the first 100 adult ICU patients with PCT measurements in 2015. The indication for PCT measurement and whether PCT values affected antibiotic treatment were collected from patient records...
April 19, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29675943/relationship-of-anxiety-with-joint-pain-and-its-management-a-population-survey
#2
Lauren A Barnett, Mark G Pritchard, John J Edwards, Ebenezer K Afolabi, Kelvin P Jordan, Emma L Healey, Andrew G Finney, Carolyn A Chew-Graham, Christian D Mallen, Krysia S Dziedzic
OBJECTIVES: The aims of the present study was to examine the associations between the severity of pain and anxiety in a community population reporting joint pain, and to investigate the management of joint pain in the presence of comorbid anxiety. METHODS: A population survey was carried out of people aged ≥45 years, registered with eight general practices in Cheshire, Shropshire and Staffordshire, UK. Respondents were asked to report pain intensity in their hands, hips, knees and feet (on a numerical rating scale), anxiety symptoms (Generalized Anxiety Disorder seven-item [GAD-7] scale) and guideline-recommended treatments used to manage pain...
April 20, 2018: Musculoskeletal Care
https://www.readbyqxmd.com/read/29675629/-geriatric-trauma-center-dgu%C3%A2-evaluation-of-clinical-and-economic-parameters-a-pilot-study-in-a-german-university-hospital
#3
M Knobe, B Böttcher, M Coburn, T Friess, L C Bollheimer, H J Heppner, C J Werner, J-P Bach, M Wollgarten, S Poßelt, C Bliemel, B Bücking
BACKGROUND: Previous studies on orthogeriatric models of care suggest that there is substantial variability in how geriatric care is integrated in the patient management and the necessary intensity of geriatric involvement is questionable. OBJECTIVE: The aim of the current prospective cohort study was the clinical and economic evaluation of fragility fracture treatment pathways before and after the implementation of a geriatric trauma center in conformity with the guidelines of the German Trauma Society (DGU)...
April 19, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29671037/-geriatric-intensive-care-patients-perspectives-and-limits-of-geriatric-intensive-care-medicine
#4
REVIEW
U Müller-Werdan, H-J Heppner, G Michels
Critically ill geriatric patients are vitally endangered due to the aging processes of organs, the frequently existing multimorbidity with subsequent polypharmacy and the typical geriatric syndrome of functional impairments. Aging processes in organs lower the clinical threshold for organ dysfunction and organ failure. Physiological organ aging processes with practical consequences for intensive care medicine are atypical manifestion of sepsis in immunosenescence, altered pharmacokinetics, reduced tolerance to hypovolemia due to proportionally reduced water compartment of the body in old age, the frequently only apparently normal function of the kidneys and the continuous reduction in pulmonary function in old age...
April 18, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29670654/toxicities-associated-with-cisplatin-based-chemotherapy-and-radiotherapy-in-long-term-testicular-cancer-survivors
#5
REVIEW
Chunkit Fung, Paul Dinh, Shirin Ardeshir-Rouhani-Fard, Kerry Schaffer, Sophie D Fossa, Lois B Travis
Testicular cancer has become the paradigm of adult-onset cancer survivorship, due to the young age at diagnosis and 10-year relative survival of 95%. This clinical review presents the current status of various treatment-related complications experienced by long-term testicular cancer survivors (TCS) free of disease for 5 or more years after primary treatment. Cardiovascular disease and second malignant neoplasms represent the most common potentially life-threatening late effects. Other long-term adverse outcomes include neuro- and ototoxicity, pulmonary complications, nephrotoxicity, hypogonadism, infertility, and avascular necrosis...
2018: Advances in Urology
https://www.readbyqxmd.com/read/29670404/evaluation-of-vancomycin-therapy-in-the-adult-icus-of-a-teaching-hospital-in-southern-iran
#6
Afsaneh Vazin, Motahare Mahi Birjand, Masoud Darake
Background: Vancomycin resistance in intensive care units (ICUs) accounts for significant morbidity and excess costs. The objective of the present study was to determine the appropriateness of vancomycin use in the various ICUs of Nemazee Hospital, Shiraz, Iran. Methods: This prospective study was performed on 95 critically ill patients (48 males and 47 females) who were treated with vancomycin for at least 3 subsequent doses in 6 ICUs during 12 months. Required demographic, clinical, and paraclinical data were collected by a pharmacist...
2018: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/29669956/nosocomial-pneumonia-search-for-an-empiric-and-effective-antibiotic-regimen-in-high-burden-tertiary-care-centre
#7
Nitin Gupta, Manish Soneja, Yogiraj Ray, Monalisa Sahu, Kutty Sharada Vinod, Arti Kapil, Ashutosh Biswas, Naveet Wig, Rita Sood
The clinical practice guidelines on nosocomial pneumonia recommends an empirical regimen that would work in 95% of the patients based on the local antibiogram. The aim of the study was development of an antibiogram for guiding empiric therapy in settings with high prevalence of multi-drug resistant organisms. A retrospective review of electronic health records (e-hospital portal) was done to analyze all respiratory isolates from patients admitted in medical wards and intensive care unit between May 2016 and May 2017...
April 17, 2018: Drug Discoveries & Therapeutics
https://www.readbyqxmd.com/read/29669681/the-diagnosis-and-treatment-of-functional-dyspepsia
#8
Ahmed Madisch
BACKGROUND: Functional dyspepsia (FD) is one of the more common functional disorders, with a prevalence of 10-20%. It affectsthe gastrointestinal tract. METHODS: This article is based on publications retrieved by a selective search of PubMed, with special attention to controlled trials, guidelines, and reviews. RESULTS: Typical dyspeptic symptoms in functional dyspepsia include epigastric pain, sensations of pressure and fullness, nausea, and early subjective satiety...
March 30, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29669670/utilization-and-timeliness-of-an-inpatient-penicillin-allergy-evaluation
#9
Keith A Sacco, Razvan Chirila, Claudia Libertin, Brett Hiroto, Arveen Bhasin, Margaret M Johnson, Thanai Pongdee, M Caroline Burton
BACKGROUND: A history of penicillin allergy is associated with an increased risk of nosocomial infections because patients are exposed to non-beta lactam antibiotics. Ruling out inaccurate penicillin allergy during hospitalization decreases prescription of beta lactam antibiotics. However, the utilization of penicillin allergy testing and timeliness in relation to initiation of antibiotics is not known. OBJECTIVE: Our aim was to describe the proportion and characteristics of patients who underwent inpatient penicillin allergy testing in a hospital without a guideline or infrastructure for inpatient penicillin allergy testing...
May 1, 2018: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/29668967/reducing-blindness-from-retinopathy-of-prematurity-rop-in-argentina-through-collaboration-advocacy-and-policy-implementation
#10
Luxme Hariharan, Clare E Gilbert, Graham E Quinn, Frances K Barg, Celia Lomuto, Ana Quiroga, Joan McLeod-Omawale, Andrea Zin, Zulma Ortiz, Ernesto Alda, Liliana Bouzas, Marina Brussa, Adriana Cattaino, Alejandro Dinerstein, Norma Erpen, Adriana Fandiño, Lidia Galina, Julio Manzitti, Silvia Marinaro, Teresa Sepúlveda, Patricia Visintín, Juan Carlos Silva, Cynthia Magluta, Alicia Benitez
Retinopathy of prematurity (ROP) is a largely avoidable cause of blindness in children worldwide, requiring high-quality neonatal care, early detection and treatment. In middle-income countries throughout Latin America, Eastern Europe and South Asia, there has been a rise in ROP blindness due to a combination of increased survival of preterm infants, resource-scarce medical environments and lack of policies, training and human resources. However, Argentina is an example of country where rates of ROP blindness have declined and ROP programmes have been successfully and effectively embedded within the health and legal system...
April 16, 2018: Health Policy and Planning
https://www.readbyqxmd.com/read/29665981/endotracheal-suction-in-intensive-care-a-point-prevalence-study-of-current-practice-in-new-zealand-and-australia
#11
Eileen Gilder, Rachael L Parke, Andrew Jull
BACKGROUND: Despite the evidence and available guidelines about endotracheal suction (ETS), a discrepancy between published guidelines and clinical practice persists. To date, ETS practice in the adult intensive care unit (ICU) population across New Zealand and Australia has not been described. OBJECTIVE: To describe ICU nurses' ETS practice in New Zealand and Australia including the triggers for performing endotracheal suction. METHODS: A single day, prospective observational, binational, multicentre point prevalence study in New Zealand and Australian ICUs...
April 14, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29663044/procalcitonin-algorithm-to-guide-initial-antibiotic-therapy-in-acute-exacerbations-of-copd-admitted-to-the-icu-a-randomized-multicenter-study
#12
Cédric Daubin, Xavier Valette, Fabrice Thiollière, Jean-Paul Mira, Pascal Hazera, Djillali Annane, Vincent Labbe, Bernard Floccard, François Fournel, Nicolas Terzi, Damien Du Cheyron, Jean-Jacques Parienti
PURPOSE: To compare the efficacy of an antibiotic protocol guided by serum procalcitonin (PCT) with that of standard antibiotic therapy in severe acute exacerbations of COPD (AECOPDs) admitted to the intensive care unit (ICU). METHODS: We conducted a multicenter, randomized trial in France. Patients experiencing severe AECOPDs were assigned to groups whose antibiotic therapy was guided by (1) a 5-day PCT algorithm with predefined cutoff values for the initiation or stoppage of antibiotics (PCT group) or (2) standard guidelines (control group)...
April 16, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29661355/the-structure-of-medical-intensive-care-units-at-training-institutions
#13
Marc Heincelman, Ashley Duckett, Brad Keith, Andrew Schreiner, Jingwen Zhang, Edward Kilb, Benjamin Clyburn
BACKGROUND: As a result of the 2011 Accreditation Council for Graduate Medical Education (ACGME) work hour guideline implementation, the structure of intensive care unit (ICU) teams at training institutions has been affected. The impact these changes have had on the current work environment has not been well described. METHODS: The authors conducted an online survey of internal medicine program directors in 2016. The survey investigated how training institutions structure their intensive care units in reference to volume, resident housestaff and alternative coverage options, with a focus on changes made after the implementation of the 2011 ACGME duty hour restrictions...
April 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29659359/-pneumonia-associated-with-mechanical-ventilation-update-and-recommendations-inter-societies-sadi-sati
#14
Wanda Cornistein, Ángel M Colque, María Inés Staneloni, María Monserrat Lloria, Mónica Lares, Ana Laura González, Alejandro Fernández Garcés, Edith Carbone
Representatives of the Argentine Society of Infectious Diseases (SADI) and the Argentine Society of Intensive Therapy (SATI) worked together on the development of specific recommendations for the diagnosis, treatment and prevention of ventilator-associated pneumonia (VAP). The methodology used was the analysis of the literature published in the last 15 years, complemented with the opinion of experts and local data. This document aims to offer basic tools to optimize diagnosis based on clinical and microbiological criteria, orientation in empirical and targeted antibiotic schemes, news on posology and administration of antibiotics in critical patients and to promote effective measures to reduce the risk of VAP...
2018: Medicina
https://www.readbyqxmd.com/read/29659093/oral-intake-evaluation-in-patients-following-critical-illness-an-icu-cohort-study
#15
Rebecca J Jarden, Lynsey Sutton-Smith, Catherine Boulton
Timely and adequate nutrition improves health outcomes for the critically ill patient. Despite clinical guidelines recommending early oral nutrition, survivors of critical illness experience significant nutritional deficits. This cohort study evaluates the oral nutrition intake in intensive care unit (ICU) patients who have experienced recent critical illness. The oral nutrition intake of a convenience sample of ICU patients post-critical illness was observed during a 1-month period. Data pertaining to both the amount of oral nutrition intake and factors impacting optimal oral nutrition intake were collected and analysed...
April 16, 2018: Nursing in Critical Care
https://www.readbyqxmd.com/read/29658839/comparison-of-emergency-cholecystectomy-with-delayed-cholecystectomy-after-percutaneous-transhepatic-gallbladder-drainage-in-patients-with-moderate-acute-cholecystitis
#16
Chang-Wei Ke, Shuo-Dong Wu
INTRODUCTION: Patients with moderate (grade II) acute cholecystitis patients, as defined by the 2013 Tokyo Guidelines, were retrospectively compared with respect to emergency cholecystectomy (EC) and delayed cholecystectomy (DC) after percutaneous transhepatic gallbladder drainage (PTGBD) to determine the better treatment strategy. METHODS: Forty-nine of 103 patients with PTGBD and 47 of 54 patients with EC were assessed for eligibility from January 2013 to January 2017...
April 16, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29657606/early-biliary-drainage-is-associated-with-favourable-outcomes-in-critically-ill-patients-with-acute-cholangitis
#17
Mohammed Aboelsoud, Osama Siddique, Alexander Morales, Young Seol, Mazen Al-Qadi
Introduction: Acute cholangitis (AC) is a clinical condition that requires prompt medical management with IV fluids, antibiotics, and biliary drainage (BD). The optimal timing for BD remains unclear. Aim: To investigate the effect of biliary drainage timing on clinical outcomes in AC. Material and methods: We conducted a retrospective study of patients with AC admitted to the ICU using the Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III) database...
2018: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/29657372/targeted-interventions-in-critically-ill-children-with-severe-dengue
#18
Suchitra Ranjit, Gokul Ramanathan, Balasubramaniam Ramakrishnan, Niranjan Kissoon
Background: The World Health Organization guidelines provide suggestions on early recognition and treatment of severe dengue (SD); however, mortality in this group can be high and is related both to disease severity and the treatment complications. Subjects and Methods: In this prospective observational study, we report our results where standard therapy (ST) was enhanced by Intensive Care Unit (ICU) supportive measures that have proven beneficial in other conditions that share similar pathophysiology of capillary leak and fluid overload...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29651699/direct-healthcare-costs-of-spinal-disorders-in-brazil
#19
Rodrigo Luiz Carregaro, Everton Nunes da Silva, Maurits van Tulder
OBJECTIVES: To investigate the direct healthcare costs of spinal disorders in Brazil, over 2016. METHODS: Prevalence-based cost-of-illness study, top-down approach and public healthcare system's perspective. International Classification of Diseases codes related to spinal disorders were included. The following costs were obtained: (1) hospitalization; medical professional service costs; intensive care unit costs; companion daily stay; (2) outpatient (services/procedures)...
April 12, 2018: International Journal of Public Health
https://www.readbyqxmd.com/read/29649058/asymptomatic-deep-vein-thrombosis-during-free-flap-concerns-in-free-flap-surgery
#20
Jae-A Jung, Bo Young Park, So-Ra Kang, Min Ji Kim
BACKGROUND: Venous insufficiency is the most frequent cause of failure in free flap reconstruction of the lower extremity. When deep vein thrombosis (DVT) is detected during preoperative assessment of the lower extremity, decisions regarding treatment plans become difficult, and no relevant guidelines regarding surgery and preoperative treatment of patients with DVT who need a free flap transfer are currently available. METHODS: In order to find a relevant guideline in decision-making regarding surgery and preoperative treatment of patients with DVT who require free flap reconstruction, a systematic literature review was conducted searching MEDLINE, PubMed Central, Cochrane, and Embase databases for articles published between 1996 and 2015...
March 30, 2018: Plastic and Reconstructive Surgery
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