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https://www.readbyqxmd.com/read/28817480/revised-national-estimates-of-emergency-department-visits-for-sepsis-in-the-united-states
#1
Henry E Wang, Allison R Jones, John P Donnelly
OBJECTIVES: The emergency department is an important venue for initial sepsis recognition and care. We sought to determine contemporary estimates of the epidemiology of U.S. emergency department visits for sepsis. DESIGN: Analysis of data from the National Hospital Ambulatory Medical Care Survey. SETTING: U.S. emergency department visits, 2009-2011. PATIENTS: Adult (age, ≥ 18 yr) emergency department sepsis patients...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28817366/trajectory-of-dyspnea-and-respiratory-distress-among-patients-in-the-last-month-of-life
#2
Margaret L Campbell, Jason M Kiernan, John Strandmark, Hossein N Yarandi
BACKGROUND: The trajectory of dyspnea has been reported among patients approaching the end of life. However, patients near death have been dropped from longitudinal studies or excluded altogether because of an inability to self-report; proxy estimates have been reported. It is not known whether dyspnea or respiratory distress remains stable, escalates, or abates as patients reach last days. OBJECTIVE: Determine trajectory of dyspnea (self-reported) and respiratory distress (observed) among patients who were approaching death...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28816799/successful-extracorporeal-life-support-in-a-pediatric-hematopoietic-stem-cell-transplant-recipient-with-periengraftment-respiratory-failure
#3
Jenny Potratz, Martina Ahlmann, Claudia Rössig, Heymut Omran, Katja Masjosthusmann
The use of extracorporeal life support (ECLS) as ultimate salvage therapy for hematopoietic stem cell transplant recipients remains controversial among oncologists and critical care specialists. Prognosis is poor, particularly after allogeneic transplantation, and literature to guide clinical decision-making is scarce. Our report describes successful ECLS in a pediatric patient undergoing allogeneic hematopoietic stem cell transplantation, who developed acute respiratory failure during severe neutropenia, followed by immediate neutrophil engraftment...
August 14, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28816591/final-year-physiotherapy-student-s-reliability-in-chest-x-ray-interpretation
#4
Valerie Ball, Caren Sze Chui, Yun-Perng Lian, Laksmini Lingeswaran
BACKGROUND: Newly qualified physiotherapists may be required to interpret an unreported chest X-ray (CXR) as part of their physiotherapy assessment in "on call" situations. Their interpretation may influence the patient management strategies they adopt. There is no research published which have tested the reliability of final year physiotherapy students in CXR interpretation. METHODS: Twenty-five final year physiotherapy students were asked to view and interpret the findings of six CXRs, together with a brief vignette, typical of a single commonly encountered diagnosis...
August 17, 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28816212/scrub-typhus-a-prospective-observational-study-during-an-outbreak-in-rajasthan-india
#5
Rajendra Prasad Takhar, Moti Lal Bunkar, Savita Arya, Nitin Mirdha, Arif Mohd
BACKGROUND: Scrub typhus, a potentially fatal rickettsial infection, is common in India. It usually presents with acute febrile illness along with multi-organ involvement caused by Orientia tsutsugamushi. As there was an outbreak of scrub typhus in the Hadoti region of Rajasthan and there is a paucity of data from this region, we studied this entity to describe the diverse epidemiological, clinico-radiological, laboratory parameters and outcome profile of patients with scrub typhus in a tertiary care hospital...
March 2017: National Medical Journal of India
https://www.readbyqxmd.com/read/28816198/lingual-frenectomy-in-joubert-syndrome
#6
Vivek Gurjar, Minal Gurjar, Channaveer Pattanshetti, Banashree Sankeshwari
AIM: Our aim is to present a case of a rare disorder, such as Joubert syndrome (JS) which required oral surgical intervention under general anesthesia at a very young age to help in achieving normal developmental milestones. BACKGROUND: Ciliopathies are an emerging class of diseases of which JS is a significant member. There have been very few cases of JS with its distinguishing features which have been reported in recent literature. CASE REPORT: We herewith present a case of JS who reported to our unit with a complaint of speech abnormality...
August 1, 2017: Journal of Contemporary Dental Practice
https://www.readbyqxmd.com/read/28815143/analyzing-electronic-medical-records-to-predict-risk-of-dit-death-intubation-or-transfer-to-icu-in-pediatric-respiratory-failure-or-related-conditions
#7
Teeradache Viangteeravat, Oguz Akbilgic, Robert Lowell Davis
Large volumes of data are generated in hospital settings, including clinical and physiological data generated during the course of patient care. Our goal, as proof of concept, was to identify early clinical factors or traits useful for predicting the outcome, of death, intubation, or transfer to ICU, for children with pediatric respiratory failure. We implemented both supervised and unsupervised methods to extend our understanding on statistical relationships in clinical and physiological data. As a supervised learning method, we use binary logistic regression to predict the risk of developing DIT outcome...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28815081/robot-assisted-minimally-invasive-thoraco-laparoscopic-esophagectomy-for-esophageal-cancer-in-the-upper-mediastinum
#8
Sylvia van der Horst, Teun Johannes Weijs, Jelle Pieter Ruurda, Nadia Haj Mohammad, Stella Mook, Lodewijk Adriaan Anton Brosens, Richard van Hillegersberg
BACKGROUND: Patients with upper third esophageal cancer or esophageal cancer with upper mediastinal paratracheal lymph node metastases are often precluded from surgery because of technical difficulties. With the aid of robotic surgery, an excellent overview and reach of the thoracic inlet can be accomplished. In this way, patients with upper mediastinal esophageal cancer are eligible for esophageal resection with curative intent. The aim of this study was to review the results of a consecutive series of patients who underwent robot-assisted minimally invasive esophagectomy (RAMIE) for tumors of the upper 1/3 of the esophagus or positive lymph nodes in the upper mediastinum...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28815072/hybrid-and-total-minimally-invasive-esophagectomy-how-i-do-it
#9
REVIEW
Luigi Bonavina, Emanuele Asti, Andrea Sironi, Daniele Bernardi, Alberto Aiolfi
Esophagectomy is a major surgical procedure associated with a significant risk of morbidity and mortality. Minimally invasive esophagectomy is becoming the preferred approach because of the potential to limit surgical trauma, reduce respiratory complications, and promote earlier functional recovery. Various hybrid and total minimally invasive surgical techniques have been introduced in clinical practice over the past 20 years, and minimally invasive esophagectomy has been shown equivalent to open surgery concerning the short-term outcomes...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28813495/establishing-failure-predictors-for-the-planned-extubation-of-overweight-and-obese-patients
#10
Chien-Ming Chao, Chih-Cheng Lai, Ai-Chin Cheng, Shyh-Ren Chiang, Wei-Lun Liu, Chung-Han Ho, Shu-Chen Hsing, Chin-Ming Chen, Kuo-Chen Cheng
We investigated failure predictors for the planned extubation of overweight (body mass index [BMI] = 25.0-29.9) and obese (BMI ≥ 30) patients. All patients admitted to the adult intensive care unit (ICU) of a tertiary hospital in Taiwan were identified. They had all undergone endotracheal intubation for > 48 h and were candidates for extubation. During the study, 595 patients (overweight = 458 [77%]); obese = 137 [23%]) with planned extubation after weaning were included in the analysis; extubation failed in 34 patients (5...
2017: PloS One
https://www.readbyqxmd.com/read/28813449/influenza-virus-infections-among-patients-attending-emergency-department-according-to-main-reason-to-presenting-to-ed-a-3-year-prospective-observational-study-during-seasonal-epidemic-periods
#11
Enrique Casalino, Stephanie Antoniol, Nadhira Fidouh, Christophe Choquet, Jean-Christophe Lucet, Xavier Duval, Benoit Visseaux, Laurent Pereira
OBJECTIVE: The role of influenza virus in patients presenting at ED during seasonal-epidemic periods has not previously been specified. Our objective was to determine its frequency according to clinical presentation. METHODS: This is a prospective observational study conducted during three-consecutive seasonal Influenza epidemics (2013-2015), including patients presenting i) community-acquired pneumonia (CAP); ii) severe acute symptoms (SAS): respiratory failure (RF), hemodynamic failure (HF), cardiac failure (CF), and miscellaneous symptoms (M); iii) symptoms suggesting influenza (PSSI)...
2017: PloS One
https://www.readbyqxmd.com/read/28811792/antimicrobial-susceptibility-patterns-of-clinical-isolates-of-pseudomonas-aeruginosa-isolated-from-patients-of-respiratory-tract-infections-in-a-tertiary-care-hospital-peshawar
#12
Abdul Samad, Tanveer Ahmed, Afaq Rahim, Abdul Khalil, Iftikhar Ali
OBJECTIVE: This study aims to determine the prevalence and susceptibility pattern of Pseudomonas aeruginosa and multidrug-resistant (MDR) isolates in patients suffering from respiratory tract infection. METHODS: A cross sectional study was conducted from January to December 2014 in Northwest General Hospital and Research Centre, Peshawar. A total of 615 sputum samples were collected from both in and out-patients. Sputum samples were collected as per standard procedure and were inoculated on Blood, MacConkey and Chocolate agar...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28811770/clinical-and-laboratory-profile-of-children-with-cystic-fibrosis-experience-of-a-tertiary-care-center-in-pakistan
#13
Danish Abdul Aziz, Abdul Gaffar Billoo, Ahad Qureshi, Misha Khalid, Salman Kirmani
OBJECTIVE: To determine the clinical presentation, diagnostic investigations and laboratory workup done in admitted children with cystic fibrosis at Aga Khan University Hospital Karachi, Pakistan. METHODS: This is athree years retrospective study from January 2013 to December 2015 conducted at The Aga Khan University Hospital Karachi Pakistan, enrolling admitted patient from birth to 15 years of either gender, diagnosed with CF on the basis of clinical features and positive sweat chloride test...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28811766/prognostic-factors-determining-morbidity-and-mortality-in-organophosphate-poisoning
#14
Ayca Acikalin, Nezihat Rana Dişel, Selcuk Matyar, Ahmet Sebe, Zeynep Kekec, Yuksel Gokel, Emre Karakoc
OBJECTIVE: Our aim in this retrospective study was to determine the factors affecting poor prognosis and mortality of organophosphate (OP) poisoning by reviewing patient data. We also reviewed present knowledge to make conclusions on certain longstanding debates in light of the literature. METHODS: In this retrospective descriptive study, patients who were admitted to and hospitalized in the emergency department (ED) or intensive care unit (ICU) of a university hospital with the diagnosis of OP poisoning between December 2010 and December 2015 were evaluated...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28811746/oral-care-and-prevention-of-pneumonia-in-hospitalized-patients-with-psychiatric-disorders-in-japan
#15
Atsushi Hamuro, Hideki Kawaguchi, Kazuaki Yamazoe, Minoru Honda, Ryuichi Tanaka
PURPOSE: Oral care in hospitalized patients with psychiatric disorders is important. However, some patients with psychiatric disorders cannot undergo oral care because of psychiatric symptoms and cognitive decline. The effect of a standardized oral hygiene intervention on the prevention of pneumonia in hospitalized patients with psychiatric disorders was investigated. METHOD: Patients were divided into 2 groups: control group (N = 259), patients without standardized intervention who were enrolled on April 2014 as the time point of baseline, and intervention group (N = 263), patients with standardized intervention who were enrolled on April 2015 as the time point of baseline...
2017: Japanese Clinical Medicine
https://www.readbyqxmd.com/read/28810801/may-dietary-supplementation-augment-respiratory-burst-in-wound-site-inflammatory-cells
#16
Amitava Das, Ryan Dickerson, Piya Das Ghatak, Gayle Gordillo, Scott Chaffee, Abhijoy Saha, Savita Khanna, Sashwati Roy
Persistent infection contributes to wound chronicity. At the wound-site, NADPH oxidase activity in immune cells fights infection to enable the healing process. Fermented Papaya Preparation (FPP) is a carbohydrate-rich nutritional supplement that has demonstrated ability to bolster respiratory burst in experimental rodent systems. In FPP, glucose co-exists with fructose and maltose in addition to multiple other sugar alcohols such as inositol. We have previously reported that FPP supplementation augments wound healing in diabetic mice via improvement of respiratory-burst activity of wound innate immune cells...
August 16, 2017: Antioxidants & Redox Signaling
https://www.readbyqxmd.com/read/28810277/-concepts-to-optimize-home-care-of-patients-with-mechanical-ventilation
#17
Miranda Nafe, Kristian Herberger, Barbara Wiesner, Christian Grohé
The care of patients with extraclinical mechanical ventilation has to be improved particularly with regard to their specialist care. One care option is the empowering of clinicians at the respiratory centers to enable ambulant care of patients and home visits. An intersectoral linkage in the form of transfer management is the basis for competent coordination. Aim is to ensure the necessary multidisciplinary collaboration in the outpatient care of multimorbid chronically ill patients. For the optimal care of chronically ill patients, sectoral limits should become more permeable...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28810276/-home-mechanical-ventilation-concepts-and-therapy-recommendations
#18
Sarah Bettina Schwarz, Friederike Sophie Magnet, Bernd Schönhofer, Wolfram Windisch
The prognosis of patients receiving home mechanical ventilation is very heterogeneous and depends on the underlying disease, the degree of respiratory dependency and the comorbidities. Due to the severe chronic diseases, the initiation of a long-term NIV must be done during an inpatient treatment. Two recently published randomized controlled trials using more aggressive forms of NPPV targeted at normalizing hypercapnic PaCO2 values, showed improved long term survival also in patients with an underlying diagnosis of COPD...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28809926/impact-of-fortified-versus-unfortified-lipid-based-supplements-on-morbidity-and-nutritional-status-a-randomised-double-blind-placebo-controlled-trial-in-ill-gambian-children
#19
Stefan A Unger, Saikou Drammeh, Jahid Hasan, Kabiru Ceesay, Edrisa Sinjanka, Sainey Beyai, Bakary Sonko, Bai Lamin Dondeh, Anthony J Fulford, Sophie E Moore, Andrew M Prentice
BACKGROUND: Multiple micronutrients (MMN) are commonly prescribed in pediatric primary healthcare in sub-Saharan Africa to improve nutritional status and appetite without evidence for their effectiveness or international clinical guidelines. Community-wide MMN supplementation has shown limited and heterogeneous impact on growth and morbidity. Short-term ready-to-use therapeutic foods in acutely sick children in a hospital setting also had limited efficacy regarding subsequent growth. The effectiveness of MMN in improving morbidity or growth in sick children presenting for primary care has not been assessed...
August 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28808954/heavy-metal-pollutants-in-selected-organs-of-african-giant-rats-from-three-agro-ecological-zones-of-nigeria-evidence-for-their-role-as-an-environmental-specimen-bank
#20
Ifukibot Levi Usende, Benjamin O Emikpe, James Olukayode Olopade
An assessment of the concentration of heavy metals in the liver, brain, kidney, bone, and lungs of African giant rats (AGRs) from three agro-ecological zones of Nigeria having different industrial activities was carried out using atomic absorption spectrophotometer. Twenty adult AGRs from cities in mangrove/freshwater swamp, rainforest, and woodland/tall grass savanna agro-ecological zones of Nigeria were used for this study. AGRs were euthanized, carefully dissected, and the brains, liver, lungs, bone, and kidneys were harvested, digested, and analyzed for concentrations of vanadium (V), lead (Pb), cadmium (Cd), zinc (Zn), selenium (Se), copper (Cu), and iron (Fe)...
August 14, 2017: Environmental Science and Pollution Research International
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