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https://www.readbyqxmd.com/read/28231475/the-use-and-yield-of-continuous-eeg-in-critically-ill-patients-a-comparative-study-of-three-centers
#1
Vincent Alvarez, Andres A Rodriguez Ruiz, Suzette LaRoche, Lawrence J Hirsch, Christopher Parres, Paula E Voinescu, Andres Fernandez, Ognen A Petroff, Nishi Rampal, Hiba Arif Haider, Jong Woo Lee
OBJECTIVE: Continuous EEG (cEEG) monitoring of critically ill patients has gained widespread use, but there is substantial reported variability in its use. We analyzed cEEG and antiseizure drug (ASD) usage at three high volume centers. METHODS: We utilized a multicenter cEEG database used daily as a clinical reporting tool in three tertiary care sites (Emory Hospital, Brigham and Women's Hospital and Yale - New Haven Hospital). We compared the cEEG usage patterns, seizure frequency, detection of rhythmic/periodic patterns (RPP), and ASD use between the sites...
January 17, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28229295/benchmarking-of-venous-thromboembolism-prophylaxis-practice-with-ent-uk-guidelines
#2
Ali S Al-Qahtani
The aim of this study was to benchmark our guidelines of prevention of venous thromboembolism (VTE) in ENT surgical population against ENT.UK guidelines, and also to encourage healthcare providers to utilize benchmarking as an effective method of improving performance. The study design is prospective descriptive analysis. The setting of this study is tertiary referral centre (Assir Central Hospital, Abha, Saudi Arabia). In this study, we are benchmarking our practice guidelines of the prevention of VTE in the ENT surgical population against that of ENT...
February 22, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28225312/perspectives-on-learning-and-clinical-practice-improvement-for-diabetes-in-the-hospital-a-review-of-educational-interventions-for-providers
#3
Ariana Pichardo-Lowden, Paul Haidet, Guillermo E Umpierrez
BACKGROUND: The management inpatient hyperglycemia and diabetes requires expertise among many healthcare providers. There is limited evidence about how education for healthcare providers can result in optimization of clinical outcomes. The purpose of this critical review of the literature is to examine methods and outcomes related to educational interventions regarding the management of diabetes and dysglycemia in the hospital setting. This report provides recommendations to advance learning, curricular planning and clinical practice...
February 22, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28215660/progress-in-evidence-based-medicine-a-quarter-century-on
#4
REVIEW
Benjamin Djulbegovic, Gordon H Guyatt
In response to limitations in the understanding and use of published evidence, evidence-based medicine (EBM) began as a movement in the early 1990s. EBM's initial focus was on educating clinicians in the understanding and use of published literature to optimise clinical care, including the science of systematic reviews. EBM progressed to recognise limitations of evidence alone, and has increasingly stressed the need to combine critical appraisal of the evidence with patient's values and preferences through shared decision making...
February 16, 2017: Lancet
https://www.readbyqxmd.com/read/28215195/tetanus-a-potential-public-health-threat-in-times-of-disaster
#5
Paige Finkelstein, Laura Teisch, Casey J Allen, Gabriel Ruiz
BACKGROUND: Tetanus is a potentially fatal condition that is rare in urban environments but is seen in developing countries and post-natural-disaster. Therefore, the purpose of this report was to review the epidemiology, pathogenesis, and management of tetanus in the trauma patient. METHODS: A thorough literature review was conducted to look for the most current and thorough guidelines on the prophylaxis and treatment of tetanus. PUBMED (National Center for Biotechnology Information, National Institutes of Health; Bethesda, Maryland USA), MEDLINE (US National Library of Medicine, National Institutes of Health; Bethesda, Maryland USA), and Cochrane Library (The Cochrane Collaboration; Oxford, United Kingdom) databases were searched for articles in English, published from 2005 to 2015, using the keywords "Tetanus," "Trauma/Surgery," and "Disaster...
February 20, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28215131/angiotensin-ii-for-the-treatment-of-high-output-shock-3-athos-3-protocol-for-a-phase-iii-double-blind-randomised-controlled-trial
#6
Lakhmir S Chawla, James A Russell, Sean M Bagshaw, Andrew D Shaw, Stuart L Goldstein, Mitchell P Fink, George F Tidmarsh
OBJECTIVE: Catecholamine-resistant hypotension (CRH) is characterised by inadequate response to standard doses of vasopressors, and increased mortality. Our Angiotensin II for the Treatment of High-Output Shock 3 (ATHOS-3) trial compares the efficacy and safety of angiotensin II (ANGII) versus placebo in CRH. DESIGN, SETTING AND PARTICIPANTS: A phase III, multicentre, randomised, placebo-controlled trial of LJPC-501 (synthetic ANGII) for CRH in up to 120 intensive care units...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28214475/hunter-and-new-england-healthpathways-a-4-year-journey-of-integrated-care
#7
Jane S Gray, Judith R Swan, Margaret A Lynch, Tracey M Tay, Marika-Jane Mackenzie, John H Wiggers, Karen A Harrison, Robert C McDonald, Ian P O'Dea, Louise M Harrigan, Sandra M Fitzgerald
Objective This paper describes the 4-year journey of Hunter and New England HealthPathways - a password-protected web-based portal designed to provide localised evidence-informed clinical and referral information to support general practice at the point of care.Methods A process evaluation was conducted in 2013, with a case study comparison performed in 2014 to assess impact of HealthPathways on patient referral and access to specialist care, followed by a review in 2016 of utilisation of the online portal to assess whether healthcare providers continued to access HealthPathways...
February 20, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28214419/recommendations-for-gonadotoxicity-surveillance-in-male-childhood-adolescent-and-young-adult-cancer-survivors-a-report-from-the-international-late-effects-of-childhood-cancer-guideline-harmonization-group-in-collaboration-with-the-pancaresurfup-consortium
#8
REVIEW
Roderick Skinner, Renee L Mulder, Leontien C Kremer, Melissa M Hudson, Louis S Constine, Edit Bardi, Annelies Boekhout, Anja Borgmann-Staudt, Morven C Brown, Richard Cohn, Uta Dirksen, Alexsander Giwercman, Hiroyuki Ishiguro, Kirsi Jahnukainen, Lisa B Kenney, Jacqueline J Loonen, Lilian Meacham, Sebastian Neggers, Stephen Nussey, Cecilia Petersen, Margarett Shnorhavorian, Marry M van den Heuvel-Eibrink, Hanneke M van Santen, William H B Wallace, Daniel M Green
Treatment with chemotherapy, radiotherapy, or surgery that involves reproductive organs can cause impaired spermatogenesis, testosterone deficiency, and physical sexual dysfunction in male pubertal, adolescent, and young adult cancer survivors. Guidelines for surveillance and management of potential adverse effects could improve cancer survivors' health and quality of life. Surveillance recommendations vary considerably, causing uncertainty about optimum screening practices. This clinical practice guideline recommended by the International Late Effects of Childhood Cancer Guideline Harmonization Group in collaboration with the PanCareSurFup Consortium, developed using evidence-based methodology, critically synthesises surveillance recommendations for gonadotoxicity in male childhood, adolescent, and young adult (CAYA) cancer survivors...
February 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28213888/transfusion-in-critical-care-a-uk-regional-audit-of-current-practice
#9
J O M Plumb, M G Taylor, E Clissold, M P W Grocott, R Gill
A consistent message within critical care publications has been that a restrictive transfusion strategy is non-inferior, and possibly superior, to a liberal strategy for stable, non-bleeding critically ill patients. Translation into clinical practice has, however, been slow. Here, we describe the degree of adherence to UK best practice guidelines in a regional network of nine intensive care units within Wessex. All transfusions given during a 2-month period were included (n = 444). Those given for active bleeding or within 24 h of major surgery, trauma or gastrointestinal bleeding were excluded (n = 148)...
February 18, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28212677/fit-for-purpose-perspectives-on-rapid-reviews-from-end-user-interviews
#10
Lisa Hartling, Jeanne-Marie Guise, Susanne Hempel, Robin Featherstone, Matthew D Mitchell, Makalapua L Motu'apuaka, Karen A Robinson, Karen Schoelles, Annette Totten, Evelyn Whitlock, Timothy J Wilt, Johanna Anderson, Elise Berliner, Aysegul Gozu, Elisabeth Kato, Robin Paynter, Craig A Umscheid
BACKGROUND: There is increasing demand for rapid reviews and timely evidence synthesis. The goal of this project was to understand end-user perspectives on the utility and limitations of rapid products including evidence inventories, rapid responses, and rapid reviews. METHODS: Interviews were conducted with key informants representing: guideline developers (n = 3), health care providers/health system organizations (n = 3), research funders (n = 1), and payers/health insurers (n = 1)...
February 17, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28212182/what-s-new-in-obstetric-anesthesia-the-2016-gerard-w-ostheimer-lecture
#11
Philip E Hess
This special article presents potentially important trends and issues affecting the field of obstetric anesthesia drawn from publications in 2015. Both maternal mortality and morbidity in the United States have increased in recent years because, in part, of the changing demographics of the childbearing population. Pregnant women are older and have more pre-existing conditions and complex medical histories. Cardiovascular and noncardiovascular medical diseases now account for half of maternal deaths in the United States...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28211108/evaluation-of-the-quality-and-health-literacy-demand-of-online-renal-diet-information
#12
K Lambert, J Mullan, K Mansfield, A Koukomous, L Mesiti
BACKGROUND: Dietary modification is critical in the self-management of chronic kidney disease. The present study describes the accuracy, quality and health literacy demand of renal diet information for adults with kidney disease obtained from the Internet and YouTube (www.youtube.com). METHODS: A comprehensive content analysis was undertaken in April and July 2015 of 254 eligible websites and 161 YouTube videos. The accuracy of the renal diet information was evaluated by comparing the key messages with relevant evidence-based guidelines for the dietary management of people with kidney disease...
February 16, 2017: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://www.readbyqxmd.com/read/28209517/inadvertent-hypothermia-and-mortality-in-critically-ill-adults-systematic-review-and-meta-analysis
#13
REVIEW
Panagiotis Kiekkas, Fotini Fligou, Michael Igoumenidis, Nikolaos Stefanopoulos, Evangelos Konstantinou, Vasilios Karamouzos, Diamanto Aretha
OBJECTIVE: Considering that inadvertent hypothermia (IH) is common in Intensive Care Unit (ICU) patients and can be followed by severe complications, this systematic review identified, appraised and synthesized the published literature about the association between IH and mortality in adults admitted to the ICU. DATA SOURCES: By using key terms, literature searches were conducted in Pubmed, CINAHL, Cochrane Library, Web of Science and EMBASE. REVIEW METHODS: According to PRISMA guidelines, articles published between 1980-2016 in English-language, peer-reviewed journals were considered...
February 13, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28204834/-pulmonary-embolism
#14
M Hecker, N Sommer, A Hecker, D Bandorski, M A Weigand, G A Krombach, E Mayer, D Walmrath
Pulmonary embolism is a potentially fatal disorder and frequently seen in critical care and emergency medicine. Due to a high mortality rate within the first few hours, the accurate initiation of rational diagnostic pathways in patients with suspected pulmonary embolism and timely consecutive treatment is essential. In this review, the current European guidelines on the diagnosis and therapy of acute pulmonary embolism are presented. Special focus is put on a structured patient management based on the individual risk of early mortality...
February 15, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28198726/community-acquired-pneumonia-requiring-hospitalization-rational-decision-making-and-interpretation-of-guidelines
#15
Douwe F Postma, Cornelis H van Werkhoven, Jan Jelrik Oosterheert
PURPOSE OF REVIEW: This review focuses on the evidence base for guideline recommendations on the diagnosis, the optimal choice, timing and duration of empirical antibiotic therapy, and the use of microbiological tests for patients hospitalized with community-acquired pneumonia (CAP): issues for which guidelines are frequently used as a quick reference. Furthermore, we will discuss possibilities for future research in these topics. RECENT FINDINGS: Many national and international guideline recommendations, even on critical elements of CAP management, are based on low-to-moderate quality evidence...
February 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28196576/care-coordination-from-a-strengths-perspective-a-practice-based-evidence-evaluation-of-evidence-based-practice
#16
Karen A Monsen, Catherine E Vanderboom, Kirstie S Olson, Mary E Larson, Diane E Holland
BACKGROUND AND PURPOSE: It is critical to accurately represent strengths interventions to improve data and enable intervention effectiveness research from a strengths perspective. However, it is challenging to understand strengths interventions from the multiple perspectives of computerized knowledge representation, evidence-based practice guidelines, and practice-based evidence narratives. Intervention phrases abstracted from nurse care coordinator practice narratives described strengths interventions with community-dwelling elders...
February 1, 2017: Research and Theory for Nursing Practice
https://www.readbyqxmd.com/read/28194641/unsupervised-exercise-in-survivors-of-human-papillomavirus-related-head-and-neck-cancer-how-many-can-go-it-alone
#17
Joshua Bauml, Jiyoung Kim, Xiaochen Zhang, Charu Aggarwal, Roger B Cohen, Kathryn Schmitz
PURPOSE: Patients with human papillomavirus (HPV)-related head and neck cancer (HNC) have a better prognosis relative to other types of HNC, making survivorship an emerging and critical issue. Exercise is a core component of survivorship care, but little is known about how many survivors of HPV-related HNC can safely be advised to start exercising on their own, as opposed to needing further evaluation or supervised exercise. METHODS: We utilized guidelines to identify health issues that would indicate value of further evaluation prior to being safely prescribed unsupervised exercise...
February 13, 2017: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/28190381/guidance-on-conducting-and-reporting-delphi-studies-credes-in-palliative-care-recommendations-based-on-a-methodological-systematic-review
#18
Saskia Jünger, Sheila A Payne, Jenny Brine, Lukas Radbruch, Sarah G Brearley
BACKGROUND: The Delphi technique is widely used for the development of guidance in palliative care, having impact on decisions with relevance for patient care. AIM: To systematically examine the application of the Delphi technique for the development of best practice guidelines in palliative care. DESIGN: A methodological systematic review was undertaken using the databases PubMed, CINAHL, Web of Science, Academic Search Complete and EMBASE...
February 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28188061/evidence-based-guides-in-tracheostomy-use-in-critical-patients
#19
N Raimondi, M R Vial, J Calleja, A Quintero, A Cortés Alban, E Celis, C Pacheco, S Ugarte, J M Añón, G Hernández, E Vidal, G Chiappero, F Ríos, F Castilleja, A Matos, E Rodriguez, P Antoniazzi, J M Teles, C Dueñas, J Sinclair, L Martínez, I Von der Osten, J Vergara, E Jiménez, M Arroyo, C Rodriguez, J Torres, S Fernandez-Bussy, J L Nates
OBJECTIVES: Provide evidence based guidelines for tracheostomy in critically ill adult patients and identify areas needing further research. METHODS: A task force composed of representatives of 10 member countries of the Pan-American and Iberic Federation of Societies of Critical and Intensive Therapy Medicine and of the Latin American Critical Care Trial Investigators Network developed recommendations based on the Grading of Recommendations Assessment, Development and Evaluation system...
February 7, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28188012/-end-of-life-care-difficulties-in-intensive-care-units-the-nurses-perspective
#20
Juan Francisco Velarde-García, Raquel Luengo-González, Raquel González-Hervías, Sergio González-Cervantes, Beatriz Álvarez-Embarba, Domingo Palacios-Ceña
OBJECTIVE: To describe the difficulties perceived by nursing staff in the delivery of end-of-life care to critically ill patients within intensive care units (ICU). METHOD: A descriptive phenomenological qualitative study was performed. A purposeful and snowball sampling of nursing staff with at least 1 year's previous experience working in an ICU was conducted. Twenty-two participants were enrolled. Data collection strategies included in-depth unstructured and semi-structured interviews and researcher's field notes...
February 7, 2017: Gaceta Sanitaria
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