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https://www.readbyqxmd.com/read/29040561/prospective-evaluation-of-a-continuous-infusion-vancomycin-dosing-nomogram-in-critically-ill-patients-undergoing-continuous-venovenous-haemofiltration
#1
Jonathan H Sin, Kelly Newman, Ramy H Elshaboury, D Dante Yeh, Marc A de Moya, Hsin Lin
Objectives: The most optimal method of attaining therapeutic vancomycin concentrations during continuous venovenous haemofiltration (CVVH) remains unclear. Studies have shown continuous infusion vancomycin (CIV) achieves target concentrations more rapidly and consistently when compared with intermittent infusion. Positive correlations between CVVH intensity and vancomycin clearance (CLvanc) have been noted. This study is the first to evaluate a CIV regimen in patients undergoing CVVH that incorporates weight-based CVVH intensity (mL/kg/h) into the dosing nomogram...
October 11, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29040516/integrated-mental-health-services-in-china-challenges-and-planning-for-the-future
#2
Di Liang, Vickie M Mays, Wei-Chin Hwang
Eager to build an integrated community-based mental health system, in 2004 China started the '686 Programme', whose purpose was to integrate hospital and community services for patients with serious mental illness. In 2015, the National Mental Health Working Plan (2015-2020) proposed an ambitious strategy for implementing this project. The goal of this review is to assess potential opportunities for and barriers to successful implementation of a community-based mental health system that integrates hospital and community mental health services into the general healthcare system...
October 13, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29040511/development-of-the-testis-in-pre-pubertal-boys-with-cancer-after-biopsy-for-fertility-preservation
#3
M Uijldert, A Meißner, A A de Melker, A M M van Pelt, M D van de Wetering, R R van Rijn, M van Wely, F van der Veen, S Repping
STUDY QUESTION: Is testicular growth affected by a testicular biopsy intended for fertility preservation in pre-pubertal boys with cancer? SUMMARY ANSWER: Testicular growth of the biopsied testis is not impeded in comparison to the non-biopsied contralateral testis up until 1 year after surgery. WHAT IS KNOWN ALREADY: Fertility preservation in pre-pubertal boys by means of testicular biopsy has been conducted for more than 15 years. Although immediate adverse effects of testicular biopsy are rare (1%), no data exist on the effect of biopsy on testicular growth...
October 12, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29040469/the-commercialization-of-traditional-medicine-in-modern-cambodia
#4
Bandeth Ros, Gillian Lê, Barbara McPake, Suzanne Fustukian
Globally, traditional medicine has long been used to address relatively common illness, mental ill health and during childbirth and post-natal care. However, traditional medicine is primarily provided by the private sector and it is unclear how far expenditures on traditional medicine contribute to household impoverishment. A life history method was used to understand the health seeking experience of 24 households over the last 60 years in Cambodia, a country with high out-of-pocket expenditures for health...
October 11, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29040344/dilemmas-for-guardians-of-advanced-dementia-patients-regarding-tube-feeding
#5
Efrat Gil, Maayan Agmon, Ayal Hirsch, Miriam Ziv, Anna Zisberg
Background: advanced dementia is an incurable illness, its last stage marked by inability to eat. Tube feeding was deemed a helpful solution at this stage, but in recent years its inefficiency has been proved, and it is no longer practiced in many countries around the world. In Israel, however, the procedure is still accepted. In the gastroenterology department at the Bnai Zion Medical Center, a serious interaction is ongoing with patients' legal guardians, where detailed information is given about the inefficiency of the tube procedure...
October 13, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29040241/barriers-to-implementation-of-recommendations-for-transport-of-children-in-ground-ambulances
#6
Rashida H Woods, Manish Shah, Cara Doughty, Anthony Gilchrest
OBJECTIVES: The National Highway Traffic Safety Administration (NHTSA) released draft recommendations in 2010 on the safe transport of children in ground ambulances. The purpose of this study was to assess awareness of these guidelines among emergency medical service (EMS) agencies and to identify implementation barriers. METHODS: We conducted a cross-sectional, anonymous online survey of 911-responding, ground transport EMS agencies in Texas. Demographics, modes of transport based on case scenarios, and barriers to implementation were assessed...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29040214/untreated-relative-hypotension-measured-as-perfusion-pressure-deficit-during-management-of-shock-and-new-onset-acute-kidney-injury-a-literature-review
#7
Rakshit Panwar
Maintaining an optimal blood pressure (BP) during shock is a fundamental tenet of critical care. Optimal BP targets maybe different for different patients. In current practice, too often, uniform BP targets are pursued which may result in inadvertently accepting a degree of untreated relative hypotension i.e., the deficit between patients' usual pre-morbid basal BP and the achieved BP, during vasopressor support. Relative hypotension is a common but an under-recognized and an under-treated sign among patients with potential shock state...
October 16, 2017: Shock
https://www.readbyqxmd.com/read/29036954/-relationship-between-highly-sensitive-cardiac-troponin-t-and-sepsis-and-outcome-in-critically-ill-patients
#8
T T Wang, L Jiang
Objective: To investigate the prognostic value of highly sensitive cardiac Troponin T (hs-cTn T) for sepsis in critically ill patients. Methods: Patients estimated to stay in the ICU of Fuxing Hospital for more than 24h were enrolled at from March 2014 to December 2014. Serum hs-cTn T was tested within two hours. Univariate and multivariate linear regression analyses were used to determine the association of variables with the hs-cTn T. Multivariable logistic regression analysis was used to evaluate the risk factors of 28-day mortality...
October 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29036843/aberrant-peak-lactate-response-in-ms
#9
Kathrin Schlüter, Josephina Maier, Stefan Patra, Stefan M Gold, Christoph Heesen, Karl-Heinz Schulz
BACKGROUND: The peak blood lactate response to an exhaustive exercise test in a number of chronic conditions has been shown to differ from that seen in healthy, untrained individuals. However, this has not been investigated for patients with multiple sclerosis (MS). OBJECTIVE: The main objective was to determine and compare the peak blood lactate response to exercise and the maximal workload between two groups of MS patients with different illness severity. METHODS: Twenty-five patients with a relapsing-remitting disease course (Group RR) and 41 patients with a secondary- or primary chronic progressive disease course (group CP) performed an exhaustive incremental bicycle ergometry...
October 11, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/29036731/rethinking-body-ownership-in-schizophrenia-experimental-and-meta-analytical-approaches-show-no-evidence-for-deficits
#10
Albulena Shaqiri, Maya Roinishvili, Mariia Kaliuzhna, Ophélie Favrod, Eka Chkonia, Michael H Herzog, Olaf Blanke, Roy Salomon
Schizophrenia is a severe psychiatric disorder, in which patients experience an abnormal sense of self. While deficits in sensorimotor self-representation (agency) are well documented in schizophrenia, less is known about other aspects of bodily self-representation (body ownership). Here, we tested a large cohort (N = 59) of chronic schizophrenia patients and matched controls (N = 30) on a well-established body illusion paradigm, the Full Body Illusion (FBI). In this paradigm, changes in body ownership are induced through prolonged multisensory stimulation, in which participants are stroked on their back while seeing the stroking on the back of a virtual body...
July 25, 2017: Schizophrenia Bulletin
https://www.readbyqxmd.com/read/29036718/glutamatergic-response-to-heat-pain-stress-in-schizophrenia
#11
Joshua Chiappelli, Qiaoyun Shi, Sarah Andrea Wijtenburg, Raimi Quiton, Krista Wisner, Frank Gaston, Priyadurga Kodi, Christopher Gaudiot, Peter Kochunov, Laura M Rowland, Liyi Elliot Hong
Regulation of stress response involves top-down mechanisms of the frontal-limbic glutamatergic system. As schizophrenia is associated with glutamatergic abnormalities, we hypothesized that schizophrenia patients may have abnormal glutamatergic reactivity within the dorsal anterior cingulate cortex (dACC), a key region involved in perception of and reaction to stress. To test this, we developed a somatic stress paradigm involving pseudorandom application of safe but painfully hot stimuli to the forearm of participants while they were undergoing serial proton magnetic resonance spectroscopy to measure changes in glutamate and glutamine levels in the dACC...
September 23, 2017: Schizophrenia Bulletin
https://www.readbyqxmd.com/read/29036388/risk-factors-for-suicidality-in-patients-with-schizophrenia-a-systematic-review-meta-analysis-and-meta-regression-of-96-studies
#12
Ryan Michael Cassidy, Fang Yang, Flávio Kapczinski, Ives Cavalcante Passos
The lifetime risk of suicide and suicide attempt in patients with schizophrenia are 5% and 25%-50%, respectively. The current meta-analysis aims to determine risk factors associated with suicidality in subjects with schizophrenia. We searched Pubmed, Web of Science, EMBASE, and the reference lists of included studies. Inclusion criteria were met if an article reported a dichotomous sample of patients with schizophrenia with suicidal ideation, attempted suicide, or suicide compared to patients without. We also performed a cohort study meta-analysis as a supplemental analysis...
September 23, 2017: Schizophrenia Bulletin
https://www.readbyqxmd.com/read/29036258/serpiginous-purpuric-eruption-of-the-leg
#13
Kristin Totoraitis, Cynthia M Magro, Adam Friedman
A previously healthy 68-year-old male presented with a rash on his right lower leg. The lesions had spread along the leg since onset 9 days prior, and the patient reported localized soreness and pruritus. He denied systemic symptoms including fever, fatigue, myalgia, joint pain, and recent illness. Physical examination revealed a serpiginous, purpuric eruption on the anterior and posterior right thigh and lower leg. A 4mm punch biopsy from the right lower leg revealed a Th2 dominant process reflective of a type IV delayed hypersensitivity reaction...
October 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/29036206/risk-characterization-of-hospitalizations-for-mental-illness-and-or-behavioral-disorders-with-concurrent-heat-related-illness
#14
Michael T Schmeltz, Janet L Gamble
BACKGROUND: Many studies have found significant associations between high ambient temperatures and increases in heat-related morbidity and mortality. Several studies have demonstrated that increases in heat-related hospitalizations are elevated among individuals with diagnosed mental illnesses and/or behavioral disorders (MBD). However, there are a limited number of studies regarding risk factors associated with specific mental illnesses that contribute, at least in part, to heat-related illnesses (HRI) in the United States...
2017: PloS One
https://www.readbyqxmd.com/read/29035924/rotational-therapy-in-thoracic-injuries-what-is-the-evidence
#15
Philipp Störmann, Ingo Marzi, Sebastian Wutzler
PURPOSE OF REVIEW: To review the current use of continuous lateral rotational therapy (CLRT) in patients with thoracic injuries and its impact on clinical course, complications and outcome. RECENT FINDINGS: Patient positioning is a key factor in the treatment of severe thoracic injuries and CLRT, and intermittent supine and prone position are basic options. There is a lack of randomized controlled studies for trauma patients with chest injury undergoing kinetic therapy as standard of care...
October 14, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29035909/dysregulated-myelopoiesis-and-hematopoietic-function-following-acute-physiologic-insult
#16
Tyler J Loftus, Alicia M Mohr, Lyle L Moldawer
PURPOSE OF REVIEW: The purpose of this review is to describe recent findings in the context of previous work regarding dysregulated myelopoiesis and hematopoietic function following an acute physiologic insult, focusing on the expansion and persistence of myeloid-deriver suppressor cells, the deterioration of lymphocyte number and function, and the inadequacy of stress erythropoiesis. RECENT FINDINGS: Persistent myeloid-derived suppressor cell (MDSC) expansion among critically ill septic patients is associated with T-cell suppression, vulnerability to nosocomial infection, chronic critical illness, and poor long-term functional status...
October 13, 2017: Current Opinion in Hematology
https://www.readbyqxmd.com/read/29035757/pulmonary-hypertension-associated-with-bronchopulmonary-dysplasia-in-preterm-infants
#17
REVIEW
Christine B Bui, Merrin A Pang, Arvind Sehgal, Christiane Theda, Jason C Lao, Philip J Berger, Marcel F Nold, Claudia A Nold-Petry
Bronchopulmonary dysplasia (BPD) and BPD-associated pulmonary hypertension (BPD-PH) are chronic inflammatory cardiopulmonary diseases with devastating short- and long-term consequences for infants born prematurely. The immature lungs of preterm infants are ill-prepared to achieve sufficient gas exchange, thus usually necessitating immediate commencement of respiratory support and oxygen supplementation. These therapies are life-saving, but they exacerbate the tissue damage that is inevitably inflicted on a preterm lung forced to perform gas exchange...
October 2, 2017: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/29035422/the-use-of-telemedicine-and-mobile-technology-to-promote-population-health-and-population-management-for-psychiatric-disorders
#18
REVIEW
Carolyn Turvey, John Fortney
PURPOSE OF REVIEW: This article discusses recent applications in telemedicine to promote the goals of population health and population management for people suffering psychiatric disorders. RECENT FINDINGS: The use of telemedicine to promote collaborative care, self-monitoring and chronic disease management, and population screening has demonstrated broad applicability and effectiveness. Collaborative care using videoconferencing to facilitate mental health specialty consults has demonstrated effectiveness in the treatment of depression, PTSD, and also ADHD in pediatric populations...
October 16, 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/29035302/oligoarticular-hemarthroses-and-osteomyelitis-complicating-pasteurella-meningitis-in-an-infant
#19
Charles Nathan Nessle, Allison K Black, Justin Farge, Victoria A Statler
A 5-month-old previously healthy female presented with a one-week history of fever and increased fussiness. Her presentation revealed an ill-appearing infant with an exam and cerebrospinal fluid (CSF) studies concerning bacterial meningitis; CSF cultures grew Pasteurella multocida. Additionally, brain magnetic resonance imaging (MRI) demonstrated cervical osteomyelitis. Despite multiple days of antibiotic therapy, she remained febrile with continued pain; MRI showed oligoarticular effusions, and aspiration of these joints yielded bloody aspirates...
October 16, 2017: Children
https://www.readbyqxmd.com/read/29035188/finding-purpose-honing-the-practice-of-making-meaning-in-medicine
#20
Lois Leveen
Despite decades of advances in diagnosing and treating a broad range of illnesses, many changes in our health care system impede true caregiving, leaving patients and practitioners dissatisfied and creating an emotional burden for practitioners that contributes to the staggering rates of physician burnout. Given this dissatisfaction and disconnection, practitioners and patients alike can benefit from structured opportunities to explore the expectations, assumptions, and emotions that shape our understanding of health and illness, and thus our experiences within the health care system...
2017: Permanente Journal
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