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https://www.readbyqxmd.com/read/29334697/sepsis-induced-activation-of-endogenous-glp-1-system-is-enhanced-in-type-2-diabetes
#1
Sivan H Perl, Olga Bloch, Dana Zelnic-Yuval, Itamar Love, Lior Mendel-Cohen, Hadar Flor, Micha J Rapoport
BACKGROUND: High levels of circulating GLP-1 are associated with severity of sepsis in critically ill non-diabetic patients. Whether type 2 diabetes (T2D) patients display different activation of the endogenous GLP-1 system during sepsis and whether it is affected by diabetes related metabolic parameters is not known. METHODS: Serum levels of GLP-1 (total and active forms) and its inhibitor enzyme sDPP-4 were determined by ELISA on admission and after 2-4 days in 37 sepsis patients with (n=13) and without T2D (n=24) and compared to normal healthy controls (n=25)...
January 15, 2018: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/29334522/themes-in-literature-related-to-incidence-risk-and-prevention-of-cancer-in-solid-organ-transplantation-recipients-on-immunosuppressive-therapy
#2
Stefanie L Rashti
BACKGROUND: Solid-organ transplants provide a second chance to thousands of critically ill patients with end-organ failure each year. Immunosuppressants are administered to patients to prevent graft rejection of a transplanted organ, such as a heart, kidney, or liver, while placing the recipient at greater risk for infection and cancer. OBJECTIVE: The literature provides evidence of various cancers that have been found to develop in patients' posttransplantation...
January 12, 2018: Cancer Nursing
https://www.readbyqxmd.com/read/29334496/oxygen-in-the-critically-ill-friend-or-foe
#3
Elisa Damiani, Abele Donati, Massimo Girardis
PURPOSE OF REVIEW: To examine the potential harmful effects of hyperoxia and summarize the results of most recent clinical studies evaluating oxygen therapy in critically ill patients. RECENT FINDINGS: Excessive oxygen supplementation may have detrimental pulmonary and systemic effects because of enhanced oxidative stress and inflammation. Hyperoxia-induced lung injury includes altered surfactant protein composition, reduced mucociliary clearance and histological damage, resulting in atelectasis, reduced lung compliance and increased risk of infections...
January 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29334366/modified-colistin-regimen-for-critically-ill-patients-with-acute-renal-impairment-and-continuous-renal-replacement-therapy
#4
Pierantonio Menna, Emanuela Salvatorelli, Alessia Mattei, Dario Cappiello, Giorgio Minotti, Massimiliano Carassiti
Colistin is a last resort antibiotic to treat multidrug-resistant Gram-negative bacteria infections. Colistin is administered intravenously in the form of its inactive prodrug colistin methanesulfonate (CMS). For patients with acute kidney impairment and continuous renal replacement therapy high extracorporeal clearance may cause a substantial removal of active colistin from the bloodstream, eventually decreasing its antibacterial efficacy. Currently recommended doses of CMS may therefore be inadequate for these patients...
December 22, 2017: Chemotherapy
https://www.readbyqxmd.com/read/29332784/air-transport-of-a-patient-with-impending-cerebral-herniation-from-tension-pneumocephalus
#5
Etzer Augustin, Michael Karsy, Jim Bryan, Jian Guan, Richard H Schmidt
Tension pneumocephalus is a rare but dangerous complication of craniotomy, sinus surgery, and traumatic cranial injury. Compared with simple pneumocephalus, which often resolves spontaneously over the course of a few days, tension pneumocephalus tends to increase with ongoing cerebrospinal fluid leak and requires immediate neurosurgical treatment to prevent cerebral herniation. Air transport of patients with tension pneumocephalus for neurosurgical care entails a risk of neurologic worsening because of changes in ambient air pressure with altitude and cabin pressurization...
January 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29332427/serum-potassium-levels-and-outcomes-in-critically-ill-patients-in-the-medical-intensive-care-unit
#6
Surat Tongyoo, Tanuwong Viarasilpa, Chairat Permpikul
Objective To compare the outcomes of patients with and without a mean serum potassium (K+) level within the recommended range (3.5-4.5 mEq/L). Methods This prospective cohort study involved patients admitted to the medical intensive care unit (ICU) of Siriraj Hospital from May 2012 to February 2013. The patients' baseline characteristics, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, serum K+ level, and hospital outcomes were recorded. Patients with a mean K+ level of 3.5 to 4.5 mEq/L and with all individual K+ values of 3...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29332421/comparison-of-two-weight-based-desmopressin-dosing-strategies-for-spontaneous-bleeding
#7
Miguel J Franquiz, Michelle C Hines, Siu Yan Amy Yeung
BACKGROUND: The pharmacokinetics and pharmacodynamics of desmopressin are appropriate for adjusted body weight-based dosing, particularly in obese patients. OBJECTIVE: The objective of this study was to describe desmopressin dosing strategies, with emphasis on hemostatic outcomes among patients without preexisting bleeding disorders. METHODS: This was a single-center, retrospective cohort study of patients who received intravenous weight-based desmopressin for a hemostatic indication...
January 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29332180/cd39-adenosinergic-axis-in-renal-pathophysiology-and-therapeutics
#8
REVIEW
Bellamkonda K Kishore, Simon C Robson, Karen M Dwyer
Extracellular ATP interacts with purinergic type 2 (P2) receptors and elicits many crucial biological functions. Extracellular ATP is sequentially hydrolyzed to ADP and AMP by the actions of defined nucleotidases, such as CD39, and AMP is converted to adenosine, largely by CD73, an ecto-5'-nucleotidase. Extracellular adenosine interacts with P1 receptors and often opposes the effects of P2 receptor activation. The balance between extracellular ATP and adenosine in the blood and extracellular fluid is regulated chiefly by the activities of CD39 and CD73, which constitute the CD39-adenosinergic axis...
January 13, 2018: Purinergic Signalling
https://www.readbyqxmd.com/read/29331796/determination-of-meropenem-in-endotracheal-tubes-by-in-tube-solid-phase-microextraction-coupled-to-capillary-liquid-chromatography-with-diode-array-detection
#9
L Hakobyan, J Pla Tolos, Y Moliner-Martinez, C Molins-Legua, Jesús Ruiz Ramos, M Gordon, Paula Ramirez-Galleymore, P Campins-Falco
Meropenem is a widely used antimicrobial for the treatment of infections associated with the use of invasive medical devices in intensive care unit patients. These treatments are not always effective, in fact, in-vitro studies have demonstrated the difficulty of antimicrobials to penetrate into the biofilm, however in-vivo studies of the effect of these compounds is a trend, mostly because of the complexity of pulmonary samples extracted from ETTs. Therefore, the objective of this study was to evaluate in-tube solid phase microextraction (in-tube SPME) coupled to capillary liquid chromatography (CapLC) with DAD to determine meropenem in ETTs in order to estimate the penetration capability into the biofilm...
January 8, 2018: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29331668/earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-a-feasibility-randomised-controlled-trial
#10
David McWilliams, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, Emma Reeves, Lauren Cooper, Catherine Snelson
BACKGROUND: Systematic reviews of early rehabilitation within intensive care units have highlighted the need for robust multi-centre randomised controlled trials with longer term follow up. This trial aims to explore the feasibility of earlier and enhanced rehabilitation for patients mechanically ventilated for ≥5days and to assess the impact on possible long term outcome measures for use in a definitive trial. METHODS: Patients admitted to a large UK based intensive care unit and invasively ventilated for ≥5days were randomised to the rehabilitation intervention or standard care on a 1:1 basis, stratified by age and SOFA score...
January 4, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29331011/transfusion-related-acute-lung-injury-in-a-paediatric-intensive-care-unit-of-pakistan
#11
Muhammad Tariq Jamil, Zehra Dhanani, Qalab Abbas, Humaira Jurair, Farheen Karim Mahar, Anwarul Haque
Background: Transfusion-Related Acute Lung Injury (TRALI) is a major cause of transfusionrelated morbidity and mortality in the intensive care unit setting. There is a paucity of such data from Pakistan. The purpose of this study is to assess the incidence and outcome of TRALI in critically ill children admitted in a pediatric intensive care unit (PICU) of Pakistan. Methods: This is a retrospective cohort study of all critically ill or injured children who developed TRALI or "possible" TRALI after blood transfusion based on Canadian Conference Consensus criteria in a closed multidisciplinary-cardiothoracic PICU from January 2012 to June 2016...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29330753/transfer-of-critically-ill-adults-assessing-the-need-for-training
#12
Ruth-Aoibheann O'Leary, Brian Marsh, Paul O'Connor
BACKGROUND: Transfer of critically ill patients within the hospital is commonly associated with adverse incidents, but, despite this, no standardised training exists on how to carry out this task. Very little information is published in the literature on the learning needs of staff undertaking these transfers, and this limits our ability to provide a focused and appropriate educational intervention. AIMS: This study aimed to explore the organisational, environmental and individual issues that increase risk to patients during intrahospital transport (IHT) and to explore the potential educational solutions to these issues as articulated by these practitioners...
January 12, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29330241/primary-care-physician-involvement-in-shared-decision-making-for-critically-ill-patients-and-family-satisfaction-with-care
#13
Kevin B Huang, Urs Weber, Jennifer Johnson, Nathanial Anderson, Andrea K Knies, Belinda Nhundu, Cynthia Bautista, Kelly Poskus, Kevin N Sheth, David Y Hwang
PURPOSE: An intensive care unit (ICU) patient's primary care physician (PCP) may be able to assist family with certain ICU shared medical decisions. We explored whether families of patients in nonopen ICUs who nevertheless report involvement of a patient's PCP in medical decision making are more satisfied with ICU shared decision making than families who do not. METHODS: Between March 2013 and December 2015, we administered the Family Satisfaction in the ICU 24 survey to family members of adult neuroscience ICU patients...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29329922/a-multistate-investigation-of-health-care-associated-burkholderia-cepacia-complex-infections-related-to-liquid-docusate-sodium-contamination-january-october-2016
#14
Janet Glowicz, Matthew Crist, Carolyn Gould, Heather Moulton-Meissner, Judith Noble-Wang, Tom J B de Man, K Allison Perry, Zachary Miller, William C Yang, Stephen Langille, Jessica Ross, Bobbiejean Garcia, Janice Kim, Erin Epson, Stephanie Black, Massimo Pacilli, John J LiPuma, Ryan Fagan
BACKGROUND: Outbreaks of health care-associated infections (HAIs) caused by Burkholderia cepacia complex (Bcc) have been associated with medical devices and water-based products. Water is the most common raw ingredient in nonsterile liquid drugs, and the significance of organisms recovered from microbiologic testing during manufacturing is assessed using a risk-based approach. This incident demonstrates that lapses in manufacturing practices and quality control of nonsterile liquid drugs can have serious unintended consequences...
January 9, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29329694/management-of-refractory-vasodilatory-shock
#15
REVIEW
Jacob C Jentzer, Saraschandra Vallabhajosyula, Ashish K Khanna, Lakhmir S Chawla, Laurence W Busse, Kianoush B Kashani
Refractory shock is a lethal manifestation of cardiovascular failure defined by an inadequate hemodynamic response to high doses of vasopressor medications. Approximately 7% of critically ill patients will develop refractory shock, with short-term mortality exceeding 50%. Refractory vasodilatory shock develops from uncontrolled vasodilation and vascular hyporesponsiveness to endogenous vasoconstrictors, causing failure of physiologic vasoregulatory mechanisms. Standard approaches to initial management of shock include fluid resuscitation and initiation of norepinephrine...
January 9, 2018: Chest
https://www.readbyqxmd.com/read/29329165/repeat-rapid-response-events-in-children-characteristics-and-outcomes
#16
Kristen M Meulmester, Nancy Jaimon, Aarti C Bavare
OBJECTIVE: We describe the characteristics and outcomes of pediatric repeat rapid response events within a single hospitalization. We hypothesized that triggers for repeat rapid response and initial rapid response events are similar, and repeat rapid response events are associated with high prevalence of medical complexity and worse outcomes. DESIGN: A 3-year retrospective study. SETTING: High-volume tertiary academic pediatric hospital. PATIENTS: All rapid response events were reviewed to identify repeat rapid response events...
January 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29329164/a-systematic-review-of-risk-factors-associated-with-cognitive-impairment-after-pediatric-critical-illness
#17
Alicia G Kachmar, Sharon Y Irving, Cynthia A Connolly, Martha A Q Curley
OBJECTIVES: To identify risk factors associated with cognitive impairment as assessed by neuropsychologic tests in neurotypical children after critical illness. DATA SOURCES: For this systematic review, we searched the Cochrane Library, Scopus, PubMed, Ovid, Embase, and CINAHL databases from January 1960 to March 2017. STUDY SELECTION: Included were studies with subjects 3-18 years old at the time of post PICU follow-up evaluation and use of an objective standardized neuropsychologic test with at least one cognitive functioning dimension...
January 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29329118/ce-managing-sepsis-and-septic-shock-current-guidelines-and-definitions
#18
Mary Beth Flynn Makic, Elizabeth Bridges
Recent updates emphasize early recognition and prompt intervention. ABSTRACT: Sepsis is a leading cause of critical illness and hospital mortality. Early recognition and intervention are essential for the survival of patients with this syndrome. In 2002, the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) launched the Surviving Sepsis Campaign (SSC) to reduce overall patient morbidity and mortality from sepsis and septic shock by driving practice initiatives based on current best evidence...
January 11, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29328980/consequence-of-intraventricular-hemorrhage-on-neurovascular-coupling-evoked-by-speech-syllables-in-preterm-neonates
#19
Mahdi Mahmoudzadeh, Ghislaine Dehaene-Lambertz, Guy Kongolo, Marc Fournier, Sabrina Goudjil, Fabrice Wallois
Intraventricular Hemorrhage (IVH) is the leading cause of neurological and cognitive impairment in preterm neonates with an incidence that increases with increasing prematurity. In the present study, we tested how preterm neonates with IVH react to external stimulation (i.e. speech syllables). We compared their neural responses measured by electroencephalography (EEG), and hemodynamic responses measured by functional near-infrared spectroscopy (fNIRS), with those of healthy preterms. A neural response to syllables was observed in these infants, but did not induce a vascular response in contrast with healthy neonates...
January 5, 2018: Developmental Cognitive Neuroscience
https://www.readbyqxmd.com/read/29328743/man-behind-the-laryngoscopy-is-important
#20
Nadeem Zaidi
Tracheal intubation is the most fundamental and effective resuscitation skill in many emergency situations. It is also performed to facilitate various surgical procedures and mechanical ventilation in critically ill patients. Tracheal intubation is also one of the most commonly taught clinical skills.
March 2017: Journal of Perioperative Practice
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