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JOURNAL ARTICLE
Kristine Godziuk, Andrew Fast, Christiaan H Righolt, Nicholas J Giori, Alex H S Harris, Eric R Bohm
BACKGROUND: Body mass index (BMI) thresholds are used as eligibility criteria to reduce complication risk in total joint arthroplasty (TJA). This approach oversimplifies preoperative risk assessment and inadvertently restricts access to effective surgical treatment for osteoarthritis. A prior survey of orthopaedic surgeons in the United States identified complex underlying factors that influence BMI considerations. To understand whether similar factors exist and influence surgeons in a different health-care system setting, we investigated Canadian surgeons' views and use of BMI criterion thresholds for TJA access...
May 3, 2024: Journal of Bone and Joint Surgery. American Volume
#2
RANDOMIZED CONTROLLED TRIAL
Brittany Dennis, Adam Deane, François Lauzier, Nicole Zytaruk, Miranda Hardie, Naomi Hammond, Simon Finfer, Yaseen Arabi, John Marshall, Lois Saunders, Diane Heels-Ansdell, John Myburgh, Serena Knowles, John Muscedere, Marlies Ostermann, Dorrilyn Rajbhandari, Shane English, Karlo Matic, Bala Venkatesh, Abdulrahman Al Fares, Gordon Guyatt, Waleed Alhazzani, Hassan Mumtaz, Alexis Poole, Feng Xie, Lehana Thabane, Richard Hall, Deborah Cook
BACKGROUND: During the COVID-19 pandemic, many intensive care units (ICUs) halted research to focus on COVID-19-specific studies. OBJECTIVE: To describe the conduct of an international randomized trial of stress ulcer prophylaxis (Re-Evaluating the Inhibition of Stress Erosions in the ICU [REVISE]) during the pandemic, addressing enrolment patterns, center engagement, informed consent processes, data collection, a COVID-specific substudy, patient transfers, and data monitoring...
May 4, 2024: BMC Medical Research Methodology
#3
JOURNAL ARTICLE
Adrián Avila-Hilari, Amilcar Tinoco-Solórzano, Jorge Vélez-Páez, Manuel Luis Avellanas-Chavala
Critical pregnancy at high altitudes increases morbidity and mortality from 2500 m above sea level. In addition to altitude, there are other influential factors such as social inequalities, cultural, prehospital barriers, and lack the appropriate development of healthcare infrastructure. The most frequent causes of critical pregnancy leading to admission to Intensive Care Units are pregnancy hypertensive disorders (native residents seem to be more protected), hemorrhages and infection/sepsis. In Latin America, there are 32 Intensive Care Units above 2500 m above sea level...
May 3, 2024: Medicina intensiva
#4
JOURNAL ARTICLE
M Jarnalo, P Videira Reis, R Horta
Indwelling intravascular catheters are important tools in the care of critically ill patients; however, they have an inherent risk of infection or thromboembolic events. Reports on catheter associated thromboembolic events in burn units are rare, despite being well recognized that burn patients bear an increased baseline risk for thromboembolic events. We describe two catheter-associated thromboembolic complications in burn patients in a burn unit and the morbidity associated with these events. Patients with endovascular catheters in burn units may be at increased risk for severe thromboembolic events associated with intravascular catheters, but specific guidelines for prevention and management of these patients are still missing...
2024: Acta Chirurgiae Plasticae
#5
JOURNAL ARTICLE
Fariba Moalem Borazjani, Mahsa Raeisi Sarkhuni, Azin Nahvijou
BACKGROUND: The COVID-19 pandemic in 2020 posed significant communication challenges, especially in the healthcare sector. Telepathology provides a valuable means for healthcare providers to communicate. This study investigated the key challenges and benefits of telepathology in education through a systematic review of relevant studies conducted during this period. METHODS: This systematic review was conducted in 2022. We utilized databases, including PubMed, Google Scholar and ScienceDirect...
May 4, 2024: Journal of Public Health
#6
REVIEW
Miles Hudson, Jenna Meyer, Alexander Evans, Chandan Krishna, Zachary A Smith, Joshua Bakhsheshian
Surgical management paradigms of spinal pathologies in the aging population carry inherent substantial risks, with surgical complications being more prevalent among patients with osteoporosis compared to those with normal bone mineral density. In this narrative review, we aim to highlight important clinical understanding and considerations in perioperative evaluation and management of patients elected to undergo spinal surgery. Osteoporosis is a well-defined risk factor for mechanical complications following spinal surgery, and as such, perioperative optimization of bone health in the setting of surgery for geriatric patients remains a critical research area alongside intraoperative surgical augmentation techniques...
May 4, 2024: GeroScience
#7
JOURNAL ARTICLE
Alessandro De Cassai, Tommaso Pettenuzzo, Veronica Busetto, Christian Legnaro, Chiara Pretto, Alessio Rotondi, Annalisa Boscolo, Nicolò Sella, Marina Munari, Paolo Navalesi
INTRODUCTION: Oral chlorhexidine has been widely used for ventilator-associated pneumonia prevention in the critical care setting; however, previous studies and evidence synthesis have generated inconsistent findings. Our study aims to investigate if different concentrations of oral chlorhexidine may be effective in preventing such complication in intensive care unit patients. METHODS: After pre-registration (Open Science Framework: 8CUKF), we conducted a network meta-analysis with the following PICOS: adult patients (age > 18 years old) undergoing invasive mechanical ventilation admitted in ICU (P); any concentration of chlorhexidine used for oral hygiene (I); placebo, sham intervention, usual care, or no intervention (C); rate of VAP (primary outcome), mechanical ventilation length, ICU length of stay (LOS), hospital LOS, mortality (secondary outcomes) (O); randomized controlled trials (S)...
May 3, 2024: J Anesth Analg Crit Care
#8
JOURNAL ARTICLE
Ghazwan Altabbaa, Tanya Nathalie Beran, Marcia Clark, Elizabeth Oddone Paolucci
BACKGROUND: Existing handover communication tools often lack a clear theoretical foundation, have limited psychometric evidence, and overlook effective communication strategies for enhancing diagnostic reasoning. This oversight becomes critical as communication breakdowns during handovers have been implicated in poor patient care. To address these issues, we developed a structured communication tool: Background, Responsible diagnosis, Included differential diagnosis, Excluded differential diagnosis, Follow-up, and Communication (BRIEF-C)...
May 3, 2024: BMJ Open Quality
#9
JOURNAL ARTICLE
Matthew F Mart, Leanne M Boehm, Amy L Kiehl, Michelle N Gong, Atul Malhotra, Robert L Owens, Babar A Khan, Margaret A Pisani, Gregory A Schmidt, R Duncan Hite, Matthew C Exline, Shannon S Carson, Catherine L Hough, Peter Rock, Ivor S Douglas, Daniel J Feinstein, Robert C Hyzy, William D Schweickert, David L Bowton, Andrew Masica, Onur M Orun, Rameela Raman, Brenda T Pun, Cayce Strength, Mark L Rolfsen, Pratik P Pandharipande, Nathan E Brummel, Christopher G Hughes, Mayur B Patel, Joanna L Stollings, E Wesley Ely, James C Jackson, Timothy D Girard
BACKGROUND: Delirium is common during critical illness and is associated with long-term cognitive impairment and disability. Antipsychotics are frequently used to treat delirium, but their effects on long-term outcomes are unknown. We aimed to investigate the effects of antipsychotic treatment of delirious, critically ill patients on long-term cognitive, functional, psychological, and quality-of-life outcomes. METHODS: This prespecified, long-term follow-up to the randomised, double-blind, placebo-controlled phase 3 MIND-USA Study was conducted in 16 hospitals throughout the USA...
April 30, 2024: Lancet Respiratory Medicine
#10
JOURNAL ARTICLE
Kelsey M Owsley, Romana Hasnain-Wynia, Ronica N Rooks, Gregory J Tung, Glen P Mays, Richard C Lindrooth
IMPORTANCE: The US 340B Drug Pricing Program enables eligible hospitals to receive substantial discounts on outpatient drugs to improve hospitals' financial sustainability and maintain access to care for patients who have low income and/or are uninsured. However, it is unclear whether hospitals use program savings to subsidize access as intended. OBJECTIVE: To evaluate whether the 340B program is associated with improvements in access to hospital-based services and to test whether the association varies by hospital ownership...
May 3, 2024: JAMA health forum
#11
JOURNAL ARTICLE
Joshua Solomon, Daniel Gabbay, Michael Goldfarb
Background: Family engagement in care is increasingly recognized as an essential component of optimal critical care delivery. However, family engagement strategies have traditionally involved in-person family participation. Virtual approaches to family engagement may overcome barriers to family participation in care. The objective of this study was to perform a scoping review of virtual family engagement strategies in the intensive care unit (ICU). Methods: Studies were included if they involved a virtual engagement strategy with family members of an ICU patient and reported either (1) outcomes, (2) user perspectives, and/or (3) barriers or facilitators to virtual engagement in the ICU...
May 3, 2024: Telemedicine Journal and E-health
#12
JOURNAL ARTICLE
Hessa Tamim, Rosnani Hashim, Nurdiana Jamil, Li Yin Chong, Zainol Johari
BACKGROUND: The SARS-CoV-2 pandemic drove global vaccination. However, breakthrough infections raised concerns about vaccine performance, leading the World Health Organization (WHO) to recommend investigations thereof. This study aimed to evaluate the clinical outcomes (time to breakthrough infection, intensive care unit [ICU] admission, and in-hospital mortality) of hospitalised patients with SARS-CoV-2 breakthrough infection. This was the primary outcome and the risk factors associated with its severity were the secondary outcomes...
April 30, 2024: Heliyon
#13
JOURNAL ARTICLE
Marcelo Germani, Panmella Alegria, Gabriela Giro, Victor R M Munoz-Lora
The growing popularity of soft tissue filler injections has brought attention to the associated risks, particularly vascular complications, and their treatments. This case report focuses on a 34-year-old female who developed nasal skin necrosis following hyaluronic acid (HA) filler injection for nasolabial fold (NLF) enhancement. Despite the careful procedure, complications emerged rapidly, emphasizing the critical importance of prompt diagnosis and intervention. A total of 10,000 turbidity reducing units (TRU) of hyaluronidase (HSE) were administered in a high-dose pulsed manner, alongside hyperbaric oxygen therapy...
2024: Journal of Oral Biology and Craniofacial Research
#14
JOURNAL ARTICLE
Andrea Sikora, Kelli Keats, David J Murphy, John W Devlin, Susan E Smith, Brian Murray, Mitchell S Buckley, Sandra Rowe, Lindsey Coppiano, Rishikesan Kamaleswaran
OBJECTIVE: Common data models provide a standard means of describing data for artificial intelligence (AI) applications, but this process has never been undertaken for medications used in the intensive care unit (ICU). We sought to develop a common data model (CDM) for ICU medications to standardize the medication features needed to support future ICU AI efforts. MATERIALS AND METHODS: A 9-member, multi-professional team of ICU clinicians and AI experts conducted a 5-round modified Delphi process employing conference calls, web-based communication, and electronic surveys to define the most important medication features for AI efforts...
July 2024: JAMIA Open
#15
COMPARATIVE STUDY
Fahimeh Nezhadmoghadam, José Gerardo Tamez-Peña, Emmanuel Martinez-Ledesma
INTRODUCTION: Obesity and gender play a critical role in shaping the outcomes of COVID-19 disease. These two factors have a dynamic relationship with each other, as well as other risk factors, which hinders interpretation of how they influence severity and disease progression. This work aimed to study differences in COVID-19 disease outcomes through analysis of risk profiles stratified by gender and obesity status. METHODS: This study employed an unsupervised clustering analysis, using Mexico's national COVID-19 hospitalization dataset, which contains demographic information and health outcomes of patients hospitalized due to COVID-19...
2024: Frontiers in Public Health
#16
Alec Gleason, Florian Richter, Nathalia Beller, Naveen Arivazhagan, Rui Feng, Emma Holmes, Benjamin S Glicksberg, Sarah U Morton, Maite La Vega-Talbott, Madeline Fields, Katherine Guttmann, Girish N Nadkarni, Felix Richter
IMPORTANCE: Infant alertness and neurologic changes are assessed by exam, which can be intermittent and subjective. Reliable, continuous methods are needed. OBJECTIVE: We hypothesized that our computer vision method to track movement, pose AI, could predict neurologic changes. DESIGN: Retrospective observational study from 2021-2022. SETTING: A level four urban neonatal intensive care unit (NICU). PARTICIPANTS: Infants with corrected age ≤1 year, comprising 115 patients with 4,705 hours of video data linked to electroencephalograms (EEG), including 46% female and 25...
April 19, 2024: medRxiv
#17
Alex Yartsev, Amelia Scott
We present the extraordinary circumstance of a female patient in her sixties who suffered a massive lignocaine overdose while undergoing treatment with Veno-Arterial Extracorporeal Membrane Oxygenation (VA ECMO) following an emergency coronary artery bypass graft (CABG). The patient was initially admitted to the Intensive Care Unit (ICU) due to unstable angina and a history of insulin-dependent type two diabetes mellitus, hypertension, hypercholesterolemia, carotid artery stenosis, and an extensive smoking history...
June 2024: Toxicology Reports
#18
JOURNAL ARTICLE
Morgan S Levy, Kelby N Hunt, Sarah Rinehart, Alyssa D Brown, Amelia G Kelly, Padmaja Sundaram, Alisha Crump, Tiffany J Sinclair, Kally Dey, Alexander Zoroufy, Alberto J Caban-Martinez, Torie Comeaux Plowden
OBJECTIVE: This study aimed to evaluate misinformation surrounding infertility and the COVID-19 vaccine on X (formerly known as Twitter) by analyzing the prevalence and content of this misinformation across a sample of posts on X. METHODS: This study is a retrospective review of posts on X (formerly known as tweets) from the COVID-19-TweetIDs dataset from July 2021 and November 2021. Included posts were from crucial time points in the COVID-19 vaccine discourse and contained at least one word related to COVID-19 vaccination and fertility...
May 3, 2024: Permanente Journal
#19
JOURNAL ARTICLE
Carri S Polick, Paul Dennis, Patrick S Calhoun, Tiffany J Braley, Eunice Lee, Sarah Wilson
BACKGROUND AND AIMS: Smoking is a risk factor for multiple sclerosis (MS) development, symptom burden, decreased medication efficacy, and increased disease-related mortality. Veterans with MS (VwMS) smoke at critically high rates; however, treatment rates and possible disparities are unknown. To promote equitable treatment, we aim to investigate smoking cessation prescription practices for VwMS across social determinant factors. METHODS: We extracted data from the national Veterans Health Administration electronic health records between October 1, 2017, and September 30, 2018...
May 2024: Brain and Behavior
#20
JOURNAL ARTICLE
Yaseen M Arabi, Hasan M Al-Dorzi, Omar Aldibaasi, Musharaf Sadat, Jesna Jose, Dina Muharib, Haifa Algethamy, Abdulrahman A Al-Fares, Fahad Al-Hameed, Ahmed Mady, Ayman Kharaba, Ali Al Bshabshe, Khalid Maghrabi, Khalid AlGhamdi, Ghulam Rasool, Adnan AlGhamdi, Ghaleb A Almekhlafi, Jamal Chalabi, Haifaa Ibrahim AlHumedi, Maram Hasan Sakkijha, Norah Khalid Alamrey, Amjad Sami Alaskar, Rabeah Hamad Alhutail, Kaouthar Sifaoui, Rakan Alqahtani, Ahmad S Qureshi, Mohammed Moneer Hejazi, Hatim Arishi, Samah AlQahtani, Amro Mohamed Ghazi, Saleh T Baaziz, Abeer Othman Azhar, Sara Fahad Alabbas, Mohammed AlAqeely, Ohoud AlOrabi, Aliaa Al-Mutawa, Maha AlOtaibi, Madiha Fawazy Elghannam, Mohammed Almaani, Sarah Fadel Buabbas, Wadiah Alawi M Alfilfil, Mohammed S Alshahrani, Joel Starkopf, Jean-Charles Preiser, Anders Perner, Jumana Hani AlMubarak, Wafa Mansoor Hazem, Talal Albrahim, Abdulaziz Al-Dawood
BACKGROUND: The optimal amount and timing of protein intake in critically ill patients are unknown. REPLENISH (Replacing Protein via Enteral Nutrition in a Stepwise Approach in Critically Ill Patients) trial evaluates whether supplemental enteral protein added to standard enteral nutrition to achieve a high amount of enteral protein given from ICU day five until ICU discharge or ICU day 90 as compared to no supplemental enteral protein to achieve a moderate amount of enteral protein would reduce all-cause 90-day mortality in adult critically ill mechanically ventilated patients...
May 2, 2024: Trials
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