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https://www.readbyqxmd.com/read/28538441/hyperlactatemia-lactate-kinetics-and-prediction-of-citrate-accumulation-in-critically-ill-patients-undergoing-continuous-renal-replacement-therapy-with-regional-citrate-anticoagulation
#1
Dmytro Khadzhynov, Annette Dahlinger, Christin Schelter, Harm Peters, Detlef Kindgen-Milles, Klemens Budde, Lukas Johannes Lehner, Fabian Halleck, Oliver Staeck, Torsten Slowinski
OBJECTIVES: Citrate accumulation is a major complication of regional citrate anticoagulation during continuous renal replacement therapy. We studied the prediction of citrate accumulation during continuous veno-venous hemodialysis with regional citrate anticoagulation by initial lactate concentrations and lactate kinetics. DESIGN: A retrospective follow-up analysis from a cohort of critically ill patients. SETTING: Mixed medical-surgical ICUs at a university hospital...
May 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28530876/research-continuous-surveillance-of-sleep-apnea-patients-in-a-medical-surgical-unit
#2
Dana Supe, Leah Baron, Tom Decker, Kyle Parker, Jeanne Venella, Sarah Williams, Kari Beaton, John Zaleski
This report consists of two separate studies on the use of continuous capnography monitoring conducted in an effort to improve patient safety at Virtua Health System. The desire for improved patient safety is motivating continuous monitoring and improved surveillance in clinical areas not traditionally equipped for such monitoring. We explored the use of remote monitoring of capnography, using enterprise middleware, in patients recovering from surgery in a medical-surgical unit. Continuous monitoring traditionally has been used in higher-acuity settings, such as intensive care units...
May 2017: Biomedical Instrumentation & Technology
https://www.readbyqxmd.com/read/28530118/readmission-to-intensive-care-unit-incidence-risk-factors-resource-use-and-outcomes-a-retrospective-cohort-study
#3
Carolina R Ponzoni, Thiago D Corrêa, Roberto R Filho, Ary Serpa Neto, Murillo Sc Assunção, Andreia Pardini, Guilherme Pp Schettino
RATIONALE: Readmission to intensive care unit (ICU) is associated with poor clinical outcomes, increased length of ICU and hospital stay and higher costs. Nevertheless, knowledge on epidemiology of ICU readmissions, risk factors and attributable outcomes are restricted to developed countries. OBJECTIVES: Determine the effect of ICU readmissions on in-hospital mortality, incidence of ICU readmissions, identify predictors of ICU readmissions and hospital mortality and compare resource use and outcomes between readmitted and nonreadmitted patients in a developing country...
May 21, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28527261/-posterior-reversible-encephalopathy-syndrome-report-of-a-fatal-case-and-analysis-of-predictive-factors-of-a-poor-prognosis
#4
Moisés Ulises Torres, Ligia Victoria Delgado, Natalia Giraldo, Piedad Urueña, Sergio Franco, Olga Helena Hernández
Posterior reversible encephalopathy syndrome is an illness with multiple causes and distinctive clinicalradiological characteristics that should be known by intensivists and emergency room physicians for a timely diagnosis and treatment. A fatal case of posterior reversible encephalopathy syndrome is presented, and the risk factors related to the outcome are identified.A 60-year-old man without a relevant medical history arrived at the emergency room presenting with depressed consciousness, seizures, and high blood pressure...
April 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28523268/the-sedative-effect-of-propranolol-on-critically-ill-patients-a-case-series
#5
Junji Shiotsuka, Andrew Steel, James Downar
INTRODUCTION: Recent studies have examined the effectiveness of alpha-2 adrenergic agonists for controlling delirium and agitation. Propranolol, a non-selective beta-adrenergic antagonist with good penetration of the blood-brain barrier, has not been investigated for this purpose. MATERIALS AND METHODS: We retrospectively reviewed the medical records of all patients who were prescribed propranolol in our Medical Surgical ICU from January 1, 2010, to December 31, 2013...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28513842/expanding-the-field-of-surgical-researchers-the-jahnigen-career-development-award
#6
Stacie Deiner
Under a long-standing collaboration with the John A. Hartford Foundation (JAHF), the Atlantic Philanthropies (AP), and specialty societies in 10 targeted specialties, the American Geriatrics Society (AGS) has been working to improve quality of care provided to older adults by surgical and related medical specialists. To support and nurture future academic leaders, the Geriatrics-for-Specialists Initiative (GSI) established the Dennis W. Jahnigen Career Development Scholar Award (JCDA) program in 2002, with AP joining JAHF as a core funder of the awards in 2003...
May 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28511125/the-many-facets-of-motor-learning-and-their-relevance-for-parkinson-s-disease
#7
REVIEW
Lucio Marinelli, Angelo Quartarone, Mark Hallett, Giuseppe Frazzitta, Maria Felice Ghilardi
The final goal of motor learning, a complex process that includes both implicit and explicit (or declarative) components, is the optimization and automatization of motor skills. Motor learning involves different neural networks and neurotransmitters systems depending on the type of task and on the stage of learning. After the first phase of acquisition, a motor skill goes through consolidation (i.e., becoming resistant to interference) and retention, processes in which sleep and long-term potentiation seem to play important roles...
April 9, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28509699/penis-transplantation-first-us-experience
#8
Curtis L Cetrulo, Kai Li, Harry M Salinas, Matthew D Treiser, Ilse Schol, Glen W Barrisford, Francis J McGovern, Adam S Feldman, Michael T Grant, Cigdem Tanrikut, Jeffrey H Lee, Richard J Ehrlichman, Paul W Holzer, Garry M Choy, Raymond W Liu, Zhi Yang Ng, Alexandre G Lellouch, Josef M Kurtz, William G Austen, Jonathan M Winograd, Branko Bojovic, Kyle R Eberlin, Ivy A Rosales, Robert B Colvin, Dicken S C Ko
OBJECTIVE: We describe the first successful penis transplant in the United States in a patient with a history of subtotal penectomy for penile cancer. BACKGROUND: Penis transplantation represents a new paradigm in restoring anatomic appearance, urine conduit, and sexual function after genitourinary tissue loss. To date, only 2 penis transplants have been performed worldwide. METHODS: After institutional review board approval, extensive medical, surgical, and radiological evaluations of the patient were performed...
May 15, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28508348/cost-analysis-of-minimally-invasive-radical-hysterectomy-for-cervical-cancer-performed-by-a-single-surgeon-in-an-italian-center-an-update-in-gynecologic-oncological-field
#9
Antonio Pellegrino, Gianluca Raffaello Damiani, Giorgio Fachechi, Cecilia Pirovano, Maria Gaetani, Aly Youssef
The objective of this study is to perform an economic analysis and examine the influence of procedural volume of our hospital, evaluating the accounting systems of Robotic radical hysterectomy (RRH) vs Laparoscopic radical hysterectomy (TLRH) in patients with cervical carcinoma, due to the costs widely variable and lack in literature. Costs were collected prospectively, from March 2010 to March 2016. Direct costs were determined by examining the overall medical pathway for each type of intervention. 52 patients with cervical carcinoma, which were matched by age, body mass index, tumor size, International Federation of Gynecology and Obstetrics (FIGO) stage, comorbidity, previous neoadjuvant chemotherapy, histology type, and tumor grade to obtain homogeneous samples...
May 15, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28504496/echinococcosis-in-children-experience-in-a-tertiary-care-hospital-outside-the-endemic-area
#10
Griselda Berberian, Teresa Rosanova, Laura Inda, Claudia Sarkis, Horacio Questa, Patricia Paulin, Marina Costa, Moira Taicz
Echinococcosis is a zoonotic disease that is widely spread across Argentina and worldwide. It is acquired during childhood but it is more common during adulthood. The pediatric population accounts for 10-20% of all cases. This study included 47 children diagnosed with echinococcosis over a 20-year period. Their median age was 8 years old (range: 3-17); most patients had some epidemiological history, such as having lived or living in an endemic or rural area and/ or having dogs that are fed with viscera. Findings included 85% of single cysts in only one parenchyma...
June 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28504109/severe-traumatic-brain-injury-targeted-management-in-the-intensive-care-unit
#11
REVIEW
Nino Stocchetti, Marco Carbonara, Giuseppe Citerio, Ari Ercole, Markus B Skrifvars, Peter Smielewski, Tommaso Zoerle, David K Menon
Severe traumatic brain injury (TBI) is currently managed in the intensive care unit with a combined medical-surgical approach. Treatment aims to prevent additional brain damage and to optimise conditions for brain recovery. TBI is typically considered and treated as one pathological entity, although in fact it is a syndrome comprising a range of lesions that can require different therapies and physiological goals. Owing to advances in monitoring and imaging, there is now the potential to identify specific mechanisms of brain damage and to better target treatment to individuals or subsets of patients...
June 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28502637/bathing-hospitalized-dependent-patients-with-prepackaged-disposable-washcloths-instead-of-traditional-bath-basins-a-case-crossover-study
#12
Emily Toth Martin, Samran Haider, Maria Palleschi, Sommer Eagle, Delfin V Crisostomo, Pamela Haddox, Laura Harmon, Robin Mazur, Judy Moshos, Dror Marchaim, Keith S Kaye
BACKGROUND: Basins used for patient bathing have been shown to be contaminated with multidrug-resistant organisms (MDROs) and have prompted the evaluation of alternatives to soap and water bathing methods. METHODS: We conducted a prospective, randomized, open-label interventional crossover study to assess the impact of replacing traditional bath basins with prepackaged washcloths on the incidence of hospital-associated infections (HAIs), MDROs, and secondarily, rates of skin deterioration...
May 11, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28502236/family-presence-in-the-adult-icu-during-bedside-procedures
#13
Marnie Jakab, Alex Z Day, Alan Kraguljac, Maedean Brown, Sangeeta Mehta
PURPOSE: To understand perspectives of family members of adult patients admitted to the medical-surgical intensive care unit (ICU) regarding their presence during procedures. METHODS: Respondents completed a questionnaire about procedures the patient had undergone, their desire to be present, and their experience. Procedures of interest were endotracheal intubation; chest compressions; vascular catheter insertion; and gastric, chest, and rectal tubes. Impact of Events Scale-Revised (IES-R) was completed at the time of questionnaire completion and again 1 month later to evaluate the psychological impact of witnessing a procedure...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28500920/the-impact-of-delayed-rapid-response-call-activation-on-patient-outcomes
#14
Sachin Gupta, Cameron Green, Ashwin Subramaniam, Lim Dee Zhen, Elizabeth Low, Ravindranath Tiruvoipati
PURPOSE: To investigate the impact of delay in rapid response call (RRC) activation on Hospital mortality. MATERIALS AND METHODS: This study was conducted in a university affiliated hospital providing medical, surgical, mental health, maternity, and pediatric services. RRCs were considered delayed if RRC activation was delayed by ≥15min. The primary outcome measure was in-hospital mortality. Secondary outcomes included hospital length of stay (LOS), requirement of ICU admission, as well as requirement of mechanical ventilation and ICU LOS for patients requiring ICU admission...
May 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28495813/trends-in-the-supply-of-california-s-emergency-departments-and-inpatient-services-2005-2014-a-retrospective-analysis
#15
Jessica L Chow, Matthew J Niedzwiecki, Renee Y Hsia
OBJECTIVES: Given increasing demand for emergency care, there is growing concern over the availability of emergency department (ED) and inpatient resources. Existing studies of ED bed supply are dated and often overlook hospital capacity beyond ED settings. We described recent statewide trends in the capacity of ED and inpatient hospital services from 2005 to 2014. DESIGN: Retrospective analysis. SETTING: Using California hospital data, we examined the absolute and per admission changes in ED beds and inpatient beds in all hospitals from 2005 to 2014...
May 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28495235/prenatal-detection-of-megacystis-not-always-an-adverse-prognostic-factor-experience-in-25-consecutive-cases-in-a-tertiary-referral-center-with-complete-neonatal-outcome-and-follow-up
#16
Marcella Pellegrino, Daniela Visconti, Vincenzo Davide Catania, Luisa D'Oria, Carlo Manzoni, Maria Giovanna Grella, Alessandro Caruso, Lucia Masini, Giuseppe Noia
INTRODUCTION: Megacystis is a condition of abnormal enlarged fetal bladder for gestational age, which is usually associated with urological malformations that may constitute a life-threatening condition for the baby. OBJECTIVE: The purpose of this study was to assess the prognostic and etiological criteria of fetal megacystis and to describe the neonatal outcome in a large series collected in a single tertiary center. STUDY DESIGN: A retrospective observational study was conducted between 2008 and 2012...
April 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28493618/pondering-practice-enhancing-the-art-of-reflection
#17
Carolyn Hayes, Debra Jackson, Patricia M Davidson, John Daly, Tamara Power
AIMS AND OBJECTIVES: The aim of this paper is to describe the effect that immersive simulation experiences and guided reflection can have on the undergraduate nurses' understanding of how stressful environments impact their emotions, performance and ability to implement safe administration of medications. BACKGROUND: Patient safety can be jeopardised if nurses are unsure of how to appropriately manage and respond to interruptions. Medication administration errors are a major patient safety issue and often occur as a consequence of ineffective interruption management...
May 11, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28492463/impact-of-an-alcohol-withdrawal-treatment-pathway-on-hospital-length-of-stay-a-retrospective-observational-study-comparing-pre-and-post-pathway-implementation
#18
Andrew J Muzyk, Rachel E Rogers, Gary Dighe, Jessica Hartung, Robert C Musser, Mary J Stillwagon, Sarah Rivelli
OBJECTIVE: To determine if the implementation of a hospital-specific alcohol withdrawal treatment pathway used in a medical-surgical patient population decreased hospital length of stay (LOS) compared with the standard of care. METHODS: This retrospective observational study, conducted in a large academic tertiary care hospital, involved 582 subjects who met criteria for study inclusion, with 275 subjects in the 2010 cohort and 307 in the 2012 cohort. The Alcohol Withdrawal Project Team was formed with the goal of creating a standardized approach to the recognition and treatment of alcohol withdrawal at Duke University Hospital...
May 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28483606/palliative-care-in-heart-failure-what-triggers-specialist-consultation
#19
REVIEW
Mitchell A Psotka, Kanako Y McKee, Albert Y Liu, Giovanni Elia, Teresa De Marco
Heart failure (HF) continues to cause substantial death and suffering despite the availability of numerous medical, surgical, and technological therapeutic advancements. As a patient-centered holistic discipline focused on improving quality of life and decreasing anguish, palliative care (PC) has a crucial role in the care of HF patients that has been acknowledged by multiple international guidelines. PC can be provided by all members of the HF care team, including but not limited to practitioners with specialty PC training...
May 5, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28473306/using-a-medical-intranet-of-things-system-to-prevent-bed-falls-in-an-acute-care-hospital-a-pilot-study
#20
Henri U Balaguera, Diana Wise, Chun Yin Ng, Han-Wen Tso, Wan-Lin Chiang, Aimee M Hutchinson, Tracy Galvin, Lee Hilborne, Cathy Hoffman, Chi-Cheng Huang, C Jason Wang
BACKGROUND: Hospitalized patients in the United States experience falls at a rate of 2.6 to 17.1 per 1000 patient-days, with the majority occurring when a patient is moving to, from, and around the bed. Each fall with injury costs an average of US $14,000. OBJECTIVE: The aim was to conduct a technology evaluation, including feasibility, usability, and user experience, of a medical sensor-based Intranet of things (IoT) system in facilitating nursing response to bed exits in an acute care hospital...
May 4, 2017: Journal of Medical Internet Research
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