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https://www.readbyqxmd.com/read/28110421/dendritic-cell-immune-responses-in-hiv-1-controllers
#1
REVIEW
Enrique Martin-Gayo, Xu G Yu
PURPOSE OF REVIEW: Robust HIV-1-specific CD8 T cell responses are currently regarded as the main correlate of immune defense in rare individuals who achieve natural, drug-free control of HIV-1; however, the mechanisms that support evolution of such powerful immune responses are not well understood. Dendritic cells (DCs) are specialized innate immune cells critical for immune recognition, immune regulation, and immune induction, but their possible contribution to HIV-1 immune defense in controllers remains ill-defined...
January 21, 2017: Current HIV/AIDS Reports
https://www.readbyqxmd.com/read/28110410/neurophysiological-assessment-of-brain-dysfunction-in-critically-ill-patients-an-update
#2
REVIEW
Eric Azabou, Catherine Fischer, Jean Michel Guerit, Djillali Annane, François Mauguiere, Fréderic Lofaso, Tarek Sharshar
The aim of this review was to provide up-to-date information about the usefulness of clinical neurophysiology testing in the management of critically ill patients. Evoked potentials (EPs) and electroencephalogram (EEG) are non-invasive clinical neurophysiology tools that allow an objective assessment of the central nervous system's function at the bedside in intensive care unit (ICU). These tests are quite useful in diagnosing cerebral complications, and establishing the vital and functional prognosis in ICU...
January 21, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28109690/-effect-of-daily-cleaning-with-chlorhexidine-on-the-incidence-of-contamination-of-blood-cultures-in-the-critical-patient
#3
P Garrido-Benedicto, P Cueto-Quintana, E Farré-Termens, M Mariné-Cabré, J Riba-Reig, R Molina-Chueca
OBJECTIVE: To evaluate the efficacy of daily cleaning with 4% chlorhexidine-impregnated sponges in decreasing contamination of blood cultures in critically-ill patients. MATERIAL AND METHODS: Prospective, quasi-experimental, longitudinal, single-centre trial. During 24 months (April 2013 to March 2015), we analysed 237 patients who fulfilled the inclusion criteria, divided into 2groups: one underwent daily cleaning with common soap (control group, n= 108), and the other with chlorhexidine (intervention group, n= 109)...
January 18, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28109276/introduction-of-microsystems-in-a-level-3-neonatal-intensive-care-unit-an-interprofessional-approach
#4
Salhab El Helou, Samira Samiee-Zafarghandy, Gerhard Fusch, Muzafar Gani Abdul Wahab, Lynda Aliberti, Ahmad Bakry, Deborah Barnard, Joanne Doucette, Enas El Gouhary, Michael Marrin, Carrie-Lynn Meyer, Amit Mukerji, Anne Nwebube, David Pogorzelski, Edward Pugh, Karen Schattauer, Jay Shah, Sandesh Shivananda, Sumesh Thomas, Jennifer Twiss, Connie Williams, Sourabh Dutta, Christoph Fusch
BACKGROUND: Growth of neonatal intensive care units in number and size has raised questions towards ability to maintain continuity and quality of care. Structural organization of intensive care units is known as a key element for maintaining the quality of care of these fragile patients. The reconstruction of megaunits of intensive care to smaller care units within a single operational service might help with provision of safe and effective care. METHODS/DESIGN: The clinical team and patient distribution lay out, admission and discharge criteria and interdisciplinary round model was reorganized to follow the microstructure philosophy...
January 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28108169/learning-to-manage-vasoactive-drugs-a-qualitative-interview-study-with-critical-care-nurses
#5
Marie Häggström, Ann-Christin Bergsman, Ulrika Månsson, Malin Rising Holmström
OBJECTIVE: Being a nurse in an intensive care unit entails caring for seriously ill patients. Vasoactive drugs are one of the tools that are used to restore adequate circulation. Critical care nurses often manage and administer these potent drugs after medical advice from physicians. AIM: To describe the experiences of critical care nurses learning to manage vasoactive drugs, and to highlight the competence required to manage vasoactive drugs. RESEARCH METHODOLOGY/SETTING: Twelve critical care nurses from three hospitals in Sweden were interviewed...
January 17, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28108105/performance-of-predictive-equations-specifically-developed-to-estimate-resting-energy-expenditure-in-ventilated-critically-ill-children
#6
Corinne Jotterand Chaparro, Patrick Taffé, Clémence Moullet, Jocelyne Laure Depeyre, David Longchamp, Marie-Hélène Perez, Jacques Cotting
OBJECTIVE: To determine, based on indirect calorimetry measurements, the biases of predictive equations specifically developed recently for estimating resting energy expenditure (REE) in ventilated critically ill children, or developed for healthy populations but used in critically ill children. STUDY DESIGN: A secondary analysis study was performed using our data on REE measured in a previous prospective study on protein and energy needs in pediatric intensive care unit...
January 18, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28107357/vasopressor-use-for-severe-hypotension-a-multicentre-prospective-observational-study
#7
Francois Lamontagne, Deborah J Cook, Maureen O Meade, Andrew Seely, Andrew G Day, Emmanuel Charbonney, Karim Serri, Yoanna Skrobik, Paul Hebert, Charles St-Arnaud, Hector Quiroz-Martinez, Michaël Mayette, Daren K Heyland
BACKGROUND: The optimal approach to titrate vasopressor therapy is unclear. Recent sepsis guidelines recommend a mean arterial pressure (MAP) target of 65 mmHg and higher for chronic hypertensive patients. As data emerge from clinical trials comparing blood pressure targets for vasopressor therapy, an accurate description of usual care is required to interpret study results. Our aim was to measure MAP values during vasopressor therapy in Canadian intensive care units (ICUs) and to compare these with stated practices and guidelines...
2017: PloS One
https://www.readbyqxmd.com/read/28107266/early-fluid-overload-prolongs-mechanical-ventilation-in-children-with-viral-lower-respiratory-tract-disease
#8
Sarah A Ingelse, Hanke M G Wiegers, Job C Calis, Job B van Woensel, Reinout A Bem
OBJECTIVES: Viral-lower respiratory tract disease is common in young children worldwide and is associated with high morbidity. Acute respiratory failure due to viral-lower respiratory tract disease necessitates PICU admission for mechanical ventilation. In critically ill patients in PICU settings, early fluid overload is common and associated with adverse outcomes such as prolonged mechanical ventilation and increased mortality. It is unclear, however, if this also applies to young children with viral-lower respiratory tract disease induced acute respiratory failure...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28107265/long-term-function-after-pediatric-critical-illness-results-from-the-survivor-outcomes-study
#9
Neethi P Pinto, Elizabeth W Rhinesmith, Tae Yeon Kim, Peter H Ladner, Murray M Pollack
OBJECTIVE: Knowledge of the long-term outcomes of survivors of pediatric critical illness is sparse but important. The aim of this study was to evaluate morbidity and mortality 6 months and 3 years after hospital discharge. DESIGN: Prospective cohort study. SETTING: Urban, inner city, academic PICU. PATIENTS: Consecutive patients admitted to the PICU from June 2012 to August 2012. INTERVENTIONS: None...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28107264/readmission-and-late-mortality-after-critical-illness-in-childhood
#10
Mary E Hartman, Mohammed J Saeed, Tellen Bennett, Katri Typpo, Renee Matos, Margaret A Olsen
OBJECTIVES: Little is known about the ongoing mortality risk and healthcare utilization among U.S. children after discharge from a hospitalization involving ICU care. We sought to understand risks for hospital readmission and trends in mortality during the year following ICU discharge. DESIGN: Retrospective observational cohort study. SETTING: This study was performed using administrative claims data from 2006-2013 obtained from the Truven Health Analytics MarketScan Database...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28107096/implementation-of-an-aggressive-enteral-nutrition-protocol-and-the-effect-on-clinical-outcomes
#11
Daniel Dante Yeh, Catrina Cropano, Sadeq A Quraishi, Eva Fuentes, Haytham M A Kaafarani, Jarone Lee, Yuchiao Chang, George Velmahos
BACKGROUND: Macronutrient deficiency in critical illness is associated with worse outcomes. We hypothesized that an aggressive enteral nutrition (EN) protocol would result in higher macronutrient delivery and fewer late infections. METHODS: We enrolled adult surgical intensive care unit (ICU) patients receiving >72 hours of EN from July 2012 to June 2014. Our intervention consisted of increasing protein prescription (2.0-2.5 vs 1.5-2.0 g/kg/d) and compensatory feeds for EN interruption...
January 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28106832/plaimos-a-remote-mobile-healthcare-platform-to-monitor-cardiovascular-and-respiratory-variables
#12
Ramses Miramontes, Raúl Aquino, Arturo Flores, Guillermo Rodríguez, Rafael Anguiano, Arturo Ríos, Arthur Edwards
The number of elderly and chronically ill patients has grown significantly over the past few decades as life expectancy has increased worldwide, leading to increased demands on the health care system and significantly taxing traditional health care practices. Consequently, there is an urgent need to use technology to innovate and more constantly and intensely monitor, report and analyze critical patient physiological parameters beyond conventional clinical settings in a more efficient and cost effective manner...
January 19, 2017: Sensors
https://www.readbyqxmd.com/read/28105784/what-prevents-critically-ill-patients-with-respiratory-failure-from-using-non-invasive-positive-pressure-ventilation-a-mixed-methods-study
#13
Hiroaki Murata, Tomoko Inoue, Osamu Takahashi
AIM: To identify the factors that prevent patients in respiratory failure from using noninvasive positive pressure ventilation (NPPV). The following were evaluated: (i) the patients who converted from NPPV to endotracheal intubation; and (ii) the patients who abandoned NPPV. METHODS: Patients were interviewed regarding their experience with NPPV. Next, the factors that prevented the continuation of NPPV were identified and those data were collected retrospectively from medical records...
January 20, 2017: Japan Journal of Nursing Science: JJNS
https://www.readbyqxmd.com/read/28105617/-establishment-of-prediction-model-of-acute-gastrointestinal-injury-classification-of-critically-ill-patients-based-on-digital-gastrointestinal-sounds-monitoring
#14
Yan Wang, Jianrong Wang, Weiwei Liu, Guangliang Zhang
OBJECTIVE: To develop the prediction model of acute gastrointestinal injury (AGI) classification of critically ill patients. METHODS: The binary channel gastrointestinal sounds (GIS) monitor system was used to gather and analyze the GIS of 60 consecutive critically ill patients who were admitted in Critical Care Medicine of PLA General Hospital from April 2015 to November 2015 (patients with chronic gastrointestinal disease or history of gastrointestinal surgery were excluded)...
January 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28104387/impact-of-echinocandin-on-prognosis-of-proven-invasive-candidiasis-in-icu-a-post-hoc-causal-inference-model-using-the-amarcand2-study
#15
Sébastien Bailly, Olivier Leroy, Elie Azoulay, Philippe Montravers, Jean-Michel Constantin, Hervé Dupont, Didier Guillemot, Olivier Lortholary, Jean-Paul Mira, Pierre-François Perrigault, Jean-Pierre Gangneux, Jean-François Timsit
OBJECTIVE: guidelines recommend first-line systemic antifungal treatment (SAT) with echinocandins in invasive candidiasis (IC), especially in critically ill patients. This study aimed at assessing the impact of echinocandins compared to azoles as initial SAT on the 28-day prognosis in adult ICU patients. METHODS: From the prospective multicenter AmarCAND2 cohort (835 patients), we selected those with documented IC and treated with echinocandins (ECH) or azoles (AZO)...
January 16, 2017: Journal of Infection
https://www.readbyqxmd.com/read/28104277/microcirculatory-monitoring-in-septic-patients-where-do-we-stand
#16
G Gruartmoner, J Mesquida, C Ince
Microcirculatory alterations play a pivotal role in sepsis-related morbidity and mortality. However, since the microcirculation has been a "black box", current hemodynamic management of septic patients is still guided by macrocirculatory parameters. In the last decades, the development of several technologies has shed some light on microcirculatory evaluation and monitoring, and the possibility of incorporating microcirculatory variables to clinical practice no longer seems to be beyond reach. The present review provides a brief summary of the current technologies for microcirculatory evaluation, and attempts to explore the potential role and benefits of their integration to the resuscitation process in critically ill septic patients...
January 16, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28103536/evidence-based-guidelines-for-the-use-of-tracheostomy-in-critically-ill-patients
#17
Néstor Raimondi, Macarena R Vial, José Calleja, Agamenón Quintero, Albán Cortés, Edgar Celis, Clara Pacheco, Sebastián Ugarte, José M Añón, Gonzalo Hernández, Erick Vidal, Guillermo Chiappero, Fernando Ríos, Fernando Castilleja, Alfredo Matos, Enith Rodriguez, Paulo Antoniazzi, José Mario Teles, Carmelo Dueñas, Jorge Sinclair, Lorenzo Martínez, Ingrid von der Osten, José Vergara, Edgar Jiménez, Max Arroyo, Camilo Rodríguez, Javier Torres, Sebastián Fernandez-Bussy, Joseph L Nates
OBJECTIVES: To provide evidence-based guidelines for tracheostomy in critically ill adult patients and identify areas needing further research. METHODS: A taskforce composed of representatives of 10 member countries of the Pan-American and Iberic Federation of Societies of Critical and Intensive Therapy Medicine and of the Latin American Critical Care Trial Investigators Network developed recommendations based on the Grading of Recommendations Assessment, Development and Evaluation system...
October 20, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28102853/skin-to-skin-contact-after-birth-and-the-natural-course-of-neurosteroid-levels-in-healthy-term-newborns
#18
K R McCallie, N W Gaikwad, M E Castillo Cuadrado, M Aleman, J E Madigan, D K Stevenson, V K Bhutani
OBJECTIVE: To determine the postnatal course of neurosteroid levels in relation to gender, mode of delivery and the extent of skin-to-skin (STS) contact during the first days of life in healthy term newborns. STUDY DESIGN: Prospective observational study of 39 neonates in which parents recorded total duration of STS in the first 2 days and nine neurosteroids (dehydroepiandrosterone-sulfate, progesterone, pregnenolone, pregnenolone-sulfate, allopregnanolone, isopregnanolone, epipregnanolone, pregnanolone and pregnanolone-sulfate) were assayed from blood samples at birth and at 1-2 days of age...
January 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28102522/present-and-future-of-interventional-treatment-of-resistant-hypertension
#19
REVIEW
Ayhan Yoruk, Sinan S Tankut, John P Gassler, John D Bisognano
The increasing prevalence of hypertension, a significant cause of disability and premature death throughout the world, is a major public health concern. This is especially true for the subset of patients who suffer from resistant hypertension, which is associated with a fourfold greater risk of cardiovascular events as compared to those hypertensive patients able to achieve target blood pressure. Though quite daunting in number and ill effect, hypertension remains the most common and the most important modifiable risk factor for coronary heart disease, congestive heart failure, peripheral vascular disease, stroke, and chronic kidney disease...
January 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28102521/clinical-assessment-and-train-of-four-measurements-in-critically-ill-patients-treated-with-recommended-doses-of-cisatracurium-or-atracurium-for-neuromuscular-blockade-a-prospective-descriptive-study
#20
Pierre Bouju, Jean-Marc Tadié, Nicolas Barbarot, Julien Letheulle, Fabrice Uhel, Pierre Fillatre, Guillaume Grillet, Angélique Goepp, Yves Le Tulzo, Arnaud Gacouin
BACKGROUND: Despite few studies, a monitoring of a neuromuscular blockade with a train of four (TOF) is recommended in intensive care unit (ICU). Our objective was to compare the results of ulnar and facial TOF measurements with an overall clinical assessment for neuromuscular blockade in ICU patients treated with recommended doses of atracurium or cisatracurium, including patients with acute respiratory disease syndrome (ARDS). METHODS: We prospectively included in two ICUs 119 patients, 94 with ARDS, who required a neuromuscular blockade for more than 24 h...
December 2017: Annals of Intensive Care
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