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https://www.readbyqxmd.com/read/29351496/implementation-of-a-prehospital-protocol-change-for-asthmatic-children
#1
Anriada Nassif, Daniel G Ostermayer, Kim B Hoang, Mary K Claiborne, Elizabeth A Camp, Manish I Shah
BACKGROUND: Respiratory distress due to asthma is a common reason for pediatric emergency medical services (EMS) transports. Timely initiation of asthma treatment, including glucocorticoids, improves hospital outcomes. The impact of EMS-administered glucocorticoids on hospital-based outcomes for pediatric asthma patients is unknown. OBJECTIVE: The objective of this study was to evaluate the effect of an evidence-based pediatric EMS asthma protocol update, inclusive of oral glucocorticoid administration, on time to hospital discharge...
January 19, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29351331/the-association-between-previous-and-future-severe-exacerbations-of-chronic-obstructive-pulmonary-disease-updating-the-literature-using-robust-statistical-methodology
#2
Mohsen Sadatsafavi, Hui Xie, Mahyar Etminan, Kate Johnson, J Mark FitzGerald
BACKGROUND: There is minimal evidence on the extent to which the occurrence of a severe acute exacerbation of COPD that results in hospitalization affects the subsequent disease course. Previous studies on this topic did not generate causally-interpretable estimates. Our aim was to use corrected methodology to update previously reported estimates of the associations between previous and future exacerbations in these patients. METHODS: Using administrative health data in British Columbia, Canada (1997-2012), we constructed a cohort of patients with at least one severe exacerbation, defined as an episode of inpatient care with the main diagnosis of COPD based on international classification of diseases (ICD) codes...
2018: PloS One
https://www.readbyqxmd.com/read/29350791/comparison-of-outpatient-medically-attended-and-community-level-influenza-like-illness-new-york-city-2013-2015
#3
Kate E Russell, Ashley Fowlkes, Melissa S Stockwell, Celibell Y Vargas, Lisa Saiman, Elaine L Larson, Philip LaRussa, Steve Di Lonardo, Michael Popowich, Kirsten St George, Andrea Steffens, Carrie Reed
BACKGROUND: Surveillance of influenza-like illness (ILI) in the United States is primarily conducted through medical settings despite a significant burden of non-medically attended ILI. OBJECTIVES: To assess consistency between surveillance for respiratory viruses in outpatient and community settings using ILI surveillance from the Centers for Disease Control and Prevention Influenza Incidence Surveillance Project (IISP) and the Mobile Surveillance for Acute Respiratory Infections (ARI) and Influenza-Like Illness in the Community (MoSAIC) Study...
January 19, 2018: Influenza and Other Respiratory Viruses
https://www.readbyqxmd.com/read/29350143/adenovirus-type-4-respiratory-infections-among-civilian-adults-northeastern-united-states-2011-20151
#4
Adriana E Kajon, Daryl M Lamson, Camden R Bair, Xiaoyan Lu, Marie L Landry, Marilyn Menegus, Dean D Erdman, Kirsten St George
Human adenovirus type 4 (HAdV-4) is most commonly isolated in military settings. We conducted detailed molecular characterization on 36 HAdV-4 isolates recovered from civilian adults with acute respiratory disease (ARD) in the northeastern United States during 2011-2015. Specimens came from college students, residents of long-term care facilities or nursing homes, a cancer patient, and young adults without co-morbidities. HAdV-4 genome types 4a1 and 4a2, the variants most frequently detected among US military recruits in basic training before the restoration of vaccination protocols, were isolated in most cases...
February 2018: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/29347991/the-benefits-and-tolerance-of-exercise-in-myasthenia-gravis-mgex-study-protocol-for-a-randomised-controlled-trial
#5
Simone Birnbaum, Jean-Yves Hogrel, Raphael Porcher, Pierre Portero, Bernard Clair, Bruno Eymard, Sophie Demeret, Guillaume Bassez, Marcela Gargiulo, Estelle Louët, Sonia Berrih-Aknin, Asmaa Jobic, Philippe Aegerter, Philippe Thoumie, Tarek Sharshar
BACKGROUND: Research exploring the effects of physical exercise in auto-immune myasthenia gravis (MG) is scarce. The few existing studies present methodological shortcomings limiting the conclusions and generalisability of results. It is hypothesised that exercise could have positive physical, psychological as well as immunomodulatory effects and may be a beneficial addition to current pharmacological management of this chronic disease. The aim of this study is to evaluate the benefits on perceived quality of life (QOL) and physical fitness of a home-based physical exercise program compared to usual care, for patients with stabilised, generalised auto-immune MG...
January 18, 2018: Trials
https://www.readbyqxmd.com/read/29346836/emergency-demand-repeat-and-frequent-presentations-by-older-patients-in-metropolitan-melbourne-a-retrospective-cohort-study-using-routinely-collected-hospital-data
#6
Judy Lowthian, Lyle Turner, Angela Joe, Christopher Pearce, Bianca Brijnath, Colette Browning, Marianne Shearer, Danielle Mazza
OBJECTIVE: To describe patterns for potentially avoidable general practice (PAGP)-type and non-PAGP-type ED presentations by older patients during 2008 and 2012. METHODS: Retrospective analysis of ED presentations by patients ≥70 years for 2008 and 2012. Metropolitan Melbourne public hospital data were obtained from the Victorian Emergency Minimum Dataset. Outcomes were characteristics of PAGP-type and non-PAGP-type presentations as defined by the Australian Institute of Health and Welfare; numbers and rates per 1000 population ≥70 years of repeat (×2-3/year) and frequent (≥ ×4/year) PAGP-type and non-PAGP-type presentations...
January 18, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29346336/respiratory-syncytial-virus-seasonality-united-states-2014-2017
#7
Erica Billig Rose, Alexandra Wheatley, Gayle Langley, Susan Gerber, Amber Haynes
Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infection in young children worldwide (1-3). In the United States, RSV infection results in >57,000 hospitalizations and 2 million outpatient visits each year among children aged <5 years (3). Recent studies have highlighted the importance of RSV in adults as well as children (4). CDC reported RSV seasonality nationally, by U.S. Department of Health and Human Services (HHS) regions* and for the state of Florida, using a new statistical method that analyzes polymerase chain reaction (PCR) laboratory detections reported to the National Respiratory and Enteric Virus Surveillance System (NREVSS) (https://www...
January 19, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29343585/rhinovirus-in-febrile-infants-and-risk-of-bacterial-infection
#8
Anne J Blaschke, E Kent Korgenski, Jacob Wilkes, Angela P Presson, Emily A Thorell, Andrew T Pavia, Elizabeth D Knackstedt, Carolyn Reynolds, Jeff E Schunk, Judy A Daly, Carrie L Byington
BACKGROUND: Febrile infants with viral respiratory infections have a reduced risk of bacterial infection compared with virus-negative infants. The risk of concomitant bacterial infection in febrile infants positive for human rhinovirus (HRV) by polymerase chain reaction (PCR) is unknown. METHODS: Infants 1-90 days old managed using the care process model for well-appearing febrile infants and with respiratory viral testing by PCR (RVPCR) in the emergency department or inpatient setting of 22 hospitals in the Intermountain Healthcare system from 2007-2016 were identified...
January 17, 2018: Pediatrics
https://www.readbyqxmd.com/read/29343171/prognosis-of-acute-respiratory-distress-syndrome-in-patients-with-hematological-malignancies
#9
Gil Myeong Seong, Yunkyoung Lee, Sang-Bum Hong, Chae-Man Lim, Younsuck Koh, Jin Won Huh
INTRODUCTION: The intensive care unit (ICU) admission of patients with hematologic malignancies is gradually increasing. Life-threatening events are common, and acute respiratory distress syndrome (ARDS) is one of the most critical conditions. The aim of this study was to investigate the clinical characteristics and outcomes of ARDS in patients with hematological malignancies admitted to the ICU. METHODS: A retrospective study was performed on all patients with ARDS with hematological malignancies in a single tertiary teaching hospital between 2008 and 2015...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29343167/a-cluster-randomised-feasibility-trial-of-clinically-assisted-hydration-in-cancer-patients-in-the-last-days-of-life
#10
Andrew N Davies, Melanie Waghorn, Katherine Webber, Sigurd Johnsen, Jeewaka Mendis, Julia Boyle
BACKGROUND: The provision of clinically assisted hydration at the end-of-life is one of the most contentious issues in medicine. AIM: The aim of this feasibility study was to answer the question 'can a definitive (adequately powered) study be done?' DESIGN: The study was a cluster randomised trial, with sites randomised on a one-to-one basis to intervention 'A' (regular mouth care and usual other care) or intervention 'B' (clinically assisted hydration, mouth care and usual other care)...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29341940/mucocele-of-the-sphenoid-sinus
#11
Karen B Djambazov, Borislav D Kitov, Christo B Zhelyazkov, Atanas N Davarski, Alexandrina R Topalova
Mucocele of the paranasal sinuses is a rare disease with slow evolution. It is a benign, encapsulated and destructive formation filled with mucous fluid and tapistrated with respiratory epithelium. Of all the paranasal sinuses, the sphenoid sinus is affected in only 1-7% of the cases. We present two cases of mucocele of the sphenoid sinus involving the posterior ethmoidal cells. We consider here their clinical presentation, use of neuroimaging in the diagnosis, surgical care and postoperative results. Both patients presented with a history of persistent headache and in addition, one of them had a paresis of the right oculomotor and abducens nerves...
December 20, 2017: Folia Medica
https://www.readbyqxmd.com/read/29341518/harlequin-ichthyosis-a-case-report
#12
C H Ugezu, A Mazumdar, E Dunn, A Das
Harlequin Ichthyosis is a very rare genetic disorder affecting mainly the skin with severe morbidity and mortality. It affects both sexes with incidence of about 1 in 300,000 live births. Autosomal recessive inheritance has been inferred with mutation in ABCA 12 gene identified. Hence, genetic counseling and mutation screening of this gene should be considered in at-risk patients. Death usually occurred in the first 3 months of life due to sepsis, feeding problems and respiratory distress. With improved neonatal care and early introduction of retinoids, its survival rate has increased...
August 8, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/29341387/health-service-utilisation-amongst-urban-aboriginal-and-torres-strait-islander-children-aged-younger-than-5-years-registered-with-a-primary-health-care-service-in-south-east-queensland
#13
Kerry K Hall, Anne B Chang, Jennie Anderson, Daniel Arnold, Michael Otim, Kerry-Ann F O'Grady
AIM: The majority of Australia's Aboriginal and/or Torres Strait Islander children live in urban areas; however, little is known about their health service use. We aimed to describe health service utilisation amongst a cohort of urban Aboriginal and/or Torres Strait Islander children aged <5 years. METHODS: We analysed health service utilisation data collected in an ongoing prospective cohort study of children aged <5 years registered with an Aboriginal-owned and operated primary health-care service...
January 17, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29341045/approach-to-infants-born-through-meconium-stained-amniotic-fluid-evolution-based-on-evidence
#14
Munmun Rawat, Sushma Nangia, Praveen Chandrasekharan, Satyan Lakshminrusimha
Meconium-stained amniotic fluid (MSAF) during delivery is a marker of fetal stress. Neonates born through MSAF often need resuscitation and are at risk of meconium aspiration syndrome (MAS), air leaks, hypoxic-ischemic encephalopathy, extracorporeal membrane oxygenation (ECMO), and death. The neonatal resuscitation approach to MSAF has evolved over the last three decades. Previously, nonvigorous neonates soon after delivery were suctioned under the vocal cords with direct visualization technique using a meconium aspirator...
January 16, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29341032/-epidemiology-diagnosis-and-treatment-of-adult-patients-with-nosocomial-pneumonia-update-2017-s3-guideline-of-the-german-society-for-anaesthesiology-and-intensive-care-medicine-the-german-society-for-infectious-diseases-the-german-society-for-hygiene-and-microbiology
#15
K Dalhoff, M Abele-Horn, S Andreas, M Deja, S Ewig, P Gastmeier, S Gatermann, H Gerlach, B Grabein, C P Heußel, G Höffken, M Kolditz, E Kramme, H Kühl, C Lange, K Mayer, I Nachtigall, M Panning, M Pletz, P-M Rath, G Rohde, S Rosseau, B Schaaf, D Schreiter, H Schütte, H Seifert, C Spies, T Welte
Nosocomial pneumonia (HAP) is a frequent complication of hospital care. Most data are available on ventilator-associated pneumonia. However, infections on general wards are increasing. A central issue are infections with multidrug resistant (MDR) pathogens which are difficult to treat in the empirical setting potentially leading to inappropriate use of antimicrobial therapy.This guideline update was compiled by an interdisciplinary group on the basis of a systematic literature review. Recommendations are made according to GRADE giving guidance for the diagnosis and treatment of HAP on the basis of quality of evidence and benefit/risk ratio...
January 2018: Pneumologie
https://www.readbyqxmd.com/read/29340875/thromboelastography-based-anticoagulation-management-during-extracorporeal-membrane-oxygenation-a-safety-and-feasibility-pilot-study
#16
Mauro Panigada, Giacomo E Iapichino, Matteo Brioni, Giovanna Panarello, Alessandro Protti, Giacomo Grasselli, Giovanna Occhipinti, Cristina Novembrino, Dario Consonni, Antonio Arcadipane, Luciano Gattinoni, Antonio Pesenti
BACKGROUND: There is no consensus on the management of anticoagulation during extracorporeal membrane oxygenation (ECMO). ECMO is currently burdened by a high rate of hemostatic complications, possibly associated with inadequate monitoring of heparin anticoagulation. This study aims to assess the safety and feasibility of an anticoagulation protocol for patients undergoing ECMO based on thromboelastography (TEG) as opposed to an activated partial thromboplastin time (aPTT)-based protocol...
January 16, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29340799/fully-automated-life-support-an-implementation-and-feasibility-pilot-study-in-healthy-pigs
#17
Wilfried Klingert, Jörg Peter, Christian Thiel, Karolin Thiel, Wolfgang Rosenstiel, Kathrin Klingert, Christian Grasshoff, Alfred Königsrainer, Martin Schenk
BACKGROUND: Automated systems are available in various application areas all over the world for the purpose of reducing workload and increasing safety. However, such support systems that would aid caregivers are still lacking in the medical sector. With respect to workload and safety, especially, the intensive care unit appears to be an important and challenging application field. Whereas many closed-loop subsystems for single applications already exist, no comprehensive system covering multiple therapeutic aspects and interactions is available yet...
January 16, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29340723/veno-venous-extracorporeal-membrane-oxygenation-vv-ecmo-for-acute-respiratory-failure-following-injury-outcomes-in-a-high-volume-adult-trauma-center-with-a-dedicated-unit-for-vv-ecmo
#18
Jay Menaker, Ronald B Tesoriero, Ali Tabatabai, Ronald P Rabinowitz, Christopher Cornachione, Terence Lonergan, Katelyn Dolly, Raymond Rector, James V O'Connor, Deborah M Stein, Thomas M Scalea
INTRODUCTION: The use of veno-venous extracorporeal membrane oxygenation (VV ECMO) has increased over the past decade. The purpose of this study was to evaluate outcomes in adult trauma patients requiring VV ECMO. METHODS: Data were collected on adult trauma patients admitted between January 1, 2015, and November 1, 2016. Demographics, injury-specific data, ECMO data, and survival to discharge were recorded. Medians [interquartile range (IQR)] were reported. A p value ≤0...
January 16, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29340619/recurrent-serious-infections-in-patients-with-rheumatoid-arthritis-results-from-the-british-society-for-rheumatology-biologics-register
#19
Sujith Subesinghe, Andrew Ian Rutherford, Rachel Byng-Maddick, Kimme Leanne Hyrich, James Benjamin Galloway
Objectives: To establish the rate of recurrent infection in RA patients recruited to the British Society for Rheumatology Biologics Register - Rheumatoid Arthritis. Secondary objectives were to establish whether the organ class of index infection predicted future serious infection (SI). Methods: Using data from the British Society for Rheumatology Biologics Register - Rheumatoid Arthritis, a prospective observational cohort, we identified patients with at least one episode of SI...
January 10, 2018: Rheumatology
https://www.readbyqxmd.com/read/29340541/safety-criteria-to-start-early-mobilization-in-intensive-care-units-systematic-review
#20
Thais Martins Albanaz da Conceição, Ana Inês Gonzáles, Fernanda Cabral Xavier Sarmento de Figueiredo, Danielle Soares Rocha Vieira, Daiana Cristine Bündchen
Mobilization of critically ill patients admitted to intensive care units should be performed based on safety criteria. The aim of the present review was to establish which safety criteria are most often used to start early mobilization for patients under mechanical ventilation admitted to intensive care units. Articles were searched in the PubMed, PEDro, LILACS, Cochrane and CINAHL databases; randomized and quasi-randomized clinical trials, cohort studies, comparative studies with or without simultaneous controls, case series with 10 or more consecutive cases and descriptive studies were included...
October 2017: Revista Brasileira de Terapia Intensiva
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