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https://www.readbyqxmd.com/read/28437821/-rapid-cycling-in-bipolar-disorders-symptoms-%C3%A2-background%C3%A2-and-treatment-recommendations
#1
Stephan Köhler, Eva Friedel, Thomas Stamm
Rapid cycling bipolar disorder is encountered frequently in clinical practice with a lifetime prevalence of up to 31 %. Besides its association with greater illness severity, increased suicide and comorbidity rates, rapid cycling bipolar disorder has been closely associated with a longer and more complicated course of disease and inadequate treatment response compared to non-rapid cycling bipolar disorder. However rapid cycling does not serve as a stable characteristic of bipolar disorder, though its prevalence increases with illness duration...
April 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#2
Inge Hommel, Petra J van Gurp, Alfons A den Broeder, Hub Wollersheim, Femke Atsma, Marlies E J L Hulscher, Cees J Tack
As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care...
April 24, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28437586/pathogenesis-of-vascular-leak-in-dengue-virus-infection
#3
REVIEW
Gathsaurie Neelika Malavige, Graham S Ogg
Endothelial dysfunction leading to vascular leak is the hallmark of severe dengue. Vascular leak typically becomes clinically evident during 3-6 days since the onset of illness, which is known as the critical phase. This critical phase follows the period of peak viraemia, and lasts for 24 to 48 hours and usually shows rapid and complete reversal, suggesting it is likely to occur as a result of inflammatory mediators, rather than infection of the endothelium. Cytokines such as TNFα, which are known to be elevated in the critical phase of dengue, are likely to be contributing factors...
April 24, 2017: Immunology
https://www.readbyqxmd.com/read/28437539/safety-and-efficacy-of-antiviral-therapy-for-prevention-of-cytomegalovirus-reactivation-in-immunocompetent-critically-ill-patients-a-randomized-clinical-trial
#4
Nicholas J Cowley, Andrew Owen, Sarah C Shiels, Joanne Millar, Rebecca Woolley, Natalie Ives, Husam Osman, Paul Moss, Julian F Bion
Importance: Latent cytomegalovirus (CMV) infection is present in more than half the adult population, and a viral reactivation (ie, when the virus becomes measurable in body fluids such as blood) can occur in up to one-third of these individuals during episodes of critical illness. Objective: To determine whether antiviral therapy is safe and effective for preventing CMV reactivation in a general population of critically ill patients. Design, Setting, and Participants: A single-center, open-label, randomized, controlled clinical trial recruited 124 CMV-seropositive patients undergoing mechanical ventilation for at least 24 hours in the intensive care unit between January 1, 2012, and January 31, 2014...
April 24, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28437456/correction-modeling-the-potential-impact-on-the-us-blood-supply-of-transfusing-critically-ill-patients-with-fresher-stored-red-blood-cells
#5
(no author information available yet)
[This corrects the article DOI: 10.1371/journal.pone.0174033.].
2017: PloS One
https://www.readbyqxmd.com/read/28437375/both-positive-and-negative-fluid-balance-may-be-associated-with-reduced-long-term-survival-in-the-critically-ill
#6
Vikram Balakumar, Raghavan Murugan, Florentina E Sileanu, Paul Palevsky, Gilles Clermont, John A Kellum
OBJECTIVES: Among critically ill patients with acute kidney injury, exposure to positive fluid balance, compared with negative fluid balance, has been associated with mortality and impaired renal recovery. However, it is unclear whether positive and negative fluid balances are associated with poor outcome compared to patients with even fluid balance (euvolemia). In this study, we examined the association between exposure to positive or negative fluid balance, compared with even fluid balance, on 1-year mortality and renal recovery...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437209/conversations-about-goals-and-values-are-feasible-and-acceptable-in-long-term-acute-care-hospitals-a-pilot-study
#7
Daniela J Lamas, Robert L Owens, R Nicholas Nace, Anthony F Massaro, Nathan J Pertsch, Susan T Moore, Rachelle E Bernacki, Susan D Block
RATIONALE: The chronically critically ill have survived acute critical illness but require prolonged mechanical ventilation. These patients are frequently transferred from acute care to long-term acute care hospitals (LTACHs) for prolonged recovery, yet many suffer setbacks requiring readmission to acute care. The patient's relatively improved condition while at the LTACH might be an opportunity for communication regarding care goals; however, there have been no prior studies of the feasibility of such conversations in the LTACH...
February 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28437207/persistent-delirium-in-chronic-critical-illness-as-a-prodrome-syndrome-before-death
#8
Anna DeForest, Craig D Blinderman
BACKGROUND: Chronic critical illness (CCI) patients have poor functional outcomes, high risk of mortality, and significant sequelae, including delirium and cognitive dysfunction. The prognostic significance of persistent delirium in patients with CCI has not been well described. OBJECTIVE: We report a case of a patient with CCI following major cardiac surgery who was hemodynamically stable following a long course in the cardiothoracic intensive care unit (CTICU), but had persistent and unremitting delirium...
February 21, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28436018/early-clinical-presentations-and-progression-of-calciphylaxis
#9
Toshi Ghosh, Daniel S Winchester, Mark D P Davis, Rokea El-Azhary, Nneka I Comfere
BACKGROUND: Untreated calciphylaxis is a fatal disease of intra- and extravascular calcification, most commonly presenting in end-stage renal disease (ESRD) patients. While early identification is critical for timely treatment, early-stage clinical and histopathological descriptions have not, to our knowledge, been elucidated. As early clinical recognition is essential to prompt definitive histopathological diagnosis, this study describes a range of clinical and histopathological manifestations of early-stage calciphylaxis...
April 23, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28435684/comparison-of-the-clinical-characteristics-and-prognosis-of-primary-versus-secondary-acute-gastrointestinal-injury-in-critically-ill-patients
#10
Dong Zhang, Rao Fu, Yanhua Li, Hongyan Li, Yuting Li, Hongxiang Li
BACKGROUND: This prospective study compared clinical characteristics and prognosis between primary (P) and secondary (S) acute gastrointestinal injury (AGI) (P-AGI)/(S-AGI) in critically ill patients. METHODS: This was a prospective, single-center observational study. Patients were included if they had been hospitalized for at least 72 h before the AGI diagnosis. Patients were classified according to severity of gastrointestinal dysfunction, while P-AGI or S-AGI were defined according to whether the gastrointestinal system was directly or indirectly involved...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28435502/inferior-vena-cava-measurement-with-ultrasound-what-is-the-best-view-and-best-mode
#11
Nathan M Finnerty, Ashish R Panchal, Creagh Boulger, Amar Vira, Jason J Bischof, Christopher Amick, David P Way, David P Bahner
INTRODUCTION: Intravascular volume status is an important clinical consideration in the management of the critically ill. Point-of-care ultrasonography (POCUS) has gained popularity as a non-invasive means of intravascular volume assessment via examination of the inferior vena cava (IVC). However, there are limited data comparing different acquisition techniques for IVC measurement by POCUS. The goal of this evaluation was to determine the reliability of three IVC acquisition techniques for volume assessment: sub-xiphoid transabdominal long axis (LA), transabdominal short axis (SA), and right lateral transabdominal coronal long axis (CLA) (aka "rescue view")...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435486/prevalence-of-homelessness-in-the-emergency-department-setting
#12
Brett J Feldman, Cristina G Calogero, Kareem S Elsayed, Osman Z Abbasi, Joshua Enyart, Timothy J Friel, Yasir H Abunamous, Stephen W Dusza, Marna Rayl Greenberg
INTRODUCTION: According to the National Alliance to End Homelessness, the national rate of homelessness has been cited as 17.7 homeless people/10,000 people in the general population, and 24.8 homeless veterans/10,000 veterans in the general population. However, it is unknown what the prevalence of homelessness is in the emergency department (ED) setting. We set out to determine the prevalence of homelessness or at risk for homelessness in the ED setting. METHODS: Using a five-question screening tool derived from the U...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28433672/montreal-accord-on-patient-reported-outcomes-use-series-paper-1-introduction
#13
Susan J Bartlett, Sara Ahmed
BACKGROUND: Patient-centered healthcare, where we design and deliver care to address the needs and preferences of patients, represents an important paradigm shift. Patient reported outcomes (PROs) are critical to capture the patient voice, understand how illness and treatments affect people, and establish how well services and treatments address what matters most to patients. OBJECTIVE: Originally developed for use in research, PROs are now used to monitor individuals and populations, manage care, evaluate services and providers, and inform policy...
April 19, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28433501/disrupted-in-schizophrenia-1-regulates-the-processing-of-reelin-in-the-perinatal-cortex
#14
Nicholas J Bradshaw, Svenja V Trossbach, Sabrina Köber, Susanne Walter, Ingrid Prikulis, Sascha Weggen, Carsten Korth
Disrupted in Schizophrenia 1 (DISC1) is a prominent gene in mental illness research, encoding a scaffold protein known to be of importance in the developing cerebral cortex. Reelin is a critical extracellular protein for development and lamination of the prenatal cortex and which has also been independently implicated in mental illness. Regulation of reelin activity occurs through processing by the metalloproteinases ADAMTS-4 and ADAMTS-5. Through cross-breeding of heterozygous transgenic DISC1 mice with heterozygous reeler mice, which have reduced reelin, pups heterozygous for both phenotypes were generated...
April 19, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28433239/shame-feeling-in-the-intensive-care-unit-patient-s-family-members
#15
Vasilios Koulouras, Zoe Konstanti, Dimitra Lepida, Georgios Papathanakos, Mary Gouva
OBJECTIVE: To investigate the levels of internal and external shame among family members of critically ill patients. RESEARCH METHODOLOGY/ DESIGN: This prospective study was conducted in 2012/2013 on family members of Intensive Care Unit patients using the Others As Shamer Scale and the Experiential Shame Scale questionnaires. SETTING: Greek university hospital. RESULTS: Two hundred and twenty-three family members mean-aged (41...
April 19, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28433205/federal-research-priorities-in-child-abuse-and-neglect-research-a-commentary-on-multi-site-research-networks
#16
Valerie Maholmes
The National Institutes of Health has a long history of supporting investigator initiated child abuse research, including risk-factor studies on prevalence, course and consequences of child abuse and neglect. These studies laid the ground work for prevention research as well as the development and testing of therapeutic interventions. The newly established Pediatric Trauma and Critical Illness Branch at the Eunice Kennedy Shriver National Institute of Child Health and Human Development represents a new opportunity to call attention to the need for greater collaboration among researchers to build on prior work, pursue complex lines of inquiry, address more medically focused research and new clinical questions that will heighten the awareness of the unique needs for treatment and care of abused children...
April 19, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28432884/use-of-presepsin-and-procalcitonin-for-prediction-of-septifast-results-in-critically-ill-patients
#17
Dunja Mihajlovic, Snezana Brkic, Arsen Uvelin, Biljana Draskovic, Vladimir Vrsajkov
PURPOSE: There is a need for identification of marker that could lead physicians to take the right step towards laboratory techniques for documentation of infection. The aim of this study was to investigate whether presepsin and procalcitonin (PCT) levels in patients with suspected sepsis could predict blood culture (BC) and SeptiFast (SF) results. MATERIAL AND METHODS: 100 patients were included in our study. PCT, C-reactive protein (CRP), and presepsin levels were determined...
April 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28432843/vitamin-b1-in-critically-ill-patients-needs-and-challenges
#18
REVIEW
Jake T B Collie, Ronda F Greaves, Oliver A H Jones, Que Lam, Glenn M Eastwood, Rinaldo Bellomo
BACKGROUND: Thiamine has a crucial role in energy production, and consequently thiamine deficiency (TD) has been associated with cardiac failure, neurological disorders, oxidative stress (lactic acidosis and sepsis) and refeeding syndrome (RFS). This review aims to explore analytical methodologies of thiamine compound quantification and highlight similarities, variances and limitations of current techniques and how they may be relevant to patients. CONTENT: An electronic search of Medline, PubMed and Embase databases for original articles published in peer-reviewed journals was conducted...
April 22, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28432351/early-measurement-of-il-10-predicts-the-outcomes-of-patients-with-acute-respiratory-distress-syndrome-receiving-extracorporeal-membrane-oxygenation
#19
Chia-Hsiung Liu, Shuenn-Wen Kuo, Wen-Je Ko, Pi-Ru Tsai, Shu-Wei Wu, Chien-Heng Lai, Chih-Hsien Wang, Yih-Sharng Chen, Pei-Lung Chen, Tze-Tze Liu, Shu-Chien Huang, Tzuu-Shuh Jou
Patients diagnosed with acute respiratory distress syndrome are generally severely distressed and associated with high morbidity and mortality despite aggressive treatments such as extracorporeal membrane oxygenation (ECMO) support. To identify potential biomarker of predicting value for appropriate use of this intensive care resource, plasma interleukin-10 along with relevant inflammatory cytokines and immune cell populations were examined during the early and subsequent disease courses of 51 critically ill patients who received ECMO support...
April 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28431382/childhood-maltreatment-preceding-depressive-disorder-at-age-18-years-a-prospective-brazilian-birth-cohort-study
#20
Erika Alejandra Giraldo Gallo, Christian Loret De Mola, Fernando Wehrmeister, Helen Gonçalves, Christian Kieling, Joseph Murray
BACKGROUND: Childhood maltreatment is linked with increased risk for mental illness in adolescence and adulthood. However, little evidence is available on whether different forms of maltreatment have specific effects, and no prospective studies in low- or middle-income countries have addressed this issue. METHODS: Participants in a population-based, birth cohort study in Pelotas, Brazil (N=3715) self-reported exposure to maltreatment (emotional abuse, physical neglect, physical abuse, sexual abuse, domestic violence) in confidential questionnaires at age 15 years, and were assessed for major depression in interviews at age 18 years, using the MINI...
April 1, 2017: Journal of Affective Disorders
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