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https://www.readbyqxmd.com/read/28447302/comment-on-the-new-indian-injection-technique-recommendations-critical-appraisal-of-the-real-world-implementation-of-the-current-guidelines
#1
Felice Strollo, Sandro Gentile
With an eye on the sequence of two Indian papers concurrently published in Diabetes Therapy, this paper analyzes skin differences among races and points to a lack of organized structured education sessions as the main cause of the high prevalence of lipodystrophy (LD) and consequent poor metabolic control. Only half of all insulin-treated patients reach their therapeutic targets worldwide. The factors involved in this are manifold, including the choice of overlong and repeatedly reused needles, as well as a failure to systematically rotate injection sites, all of which lead to skin LD...
April 26, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28444760/vancomycin-levels-are-frequently-subtherapeutic-in-critically-ill-patients-a-prospective-observational-study
#2
V Bakke, H Sporsem, E Von der Lippe, I Nordøy, Y Lao, H C Nyrerød, L Sandvik, K R Hårvig, J F Bugge, E Helset
BACKGROUND: Appropriate utilization of vancomycin is important to attain therapeutic targets while avoiding clinical failure and the development of antimicrobial resistance. Our aim was to observe the use of vancomycin in an intensive care population, with the main focus on achievement of therapeutic serum concentrations (15-20 mg/l) and to evaluate how this was influenced by dose regimens, use of guidelines and therapeutic drug monitoring. METHODS: A prospective observational study was carried out in the intensive care units at two tertiary hospitals in Norway...
April 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28442312/expert-statements-on-the-standard-of-care-in-critically-ill-adult-patients-with-atypical-haemolytic-uraemic-syndrome
#3
REVIEW
Elie Azoulay, Paul Knoebl, José Garnacho-Montero, Katerina Rusinova, Gennadii Galstian, Philippe Eggimann, Fekri Abroug, Dominique Benoit, Michael von Bergwelt-Baildon, Julia Wendon, Marie Scully
BACKGROUND: Atypical haemolytic uraemic syndrome (aHUS) presents similarly to thrombotic thrombocytopenic purpura (TTP), and other causes or conditions with thrombotic microangiopathy (TMA) such as DIC or sepsis. Similarity in clinical presentation may hinder diagnosis and optimal treatment selection in the urgent setting in the ICU. However, there is currently no consensus on the diagnosis or treatment of aHUS for ICU specialists. This review aims to summarise available data on the diagnosis and treatment strategies of aHUS in the ICU in order to enhance the understanding of aHUS diagnosis and outcomes in patients managed in the ICU...
April 22, 2017: Chest
https://www.readbyqxmd.com/read/28441255/european-society-of-gynaecological-oncology-guidelines-for-the-management-of-patients-with-vulvar-cancer
#4
Maaike H M Oonk, François Planchamp, Peter Baldwin, Mariusz Bidzinski, Mats Brännström, Fabio Landoni, Sven Mahner, Umesh Mahantshetty, Mansoor Mirza, Cordula Petersen, Denis Querleu, Sigrid Regauer, Lukas Rob, Roman Rouzier, Elena Ulrikh, Jacobus van der Velden, Ignace Vergote, Linn Woelber, Ate G J van der Zee
OBJECTIVE: The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. METHODS: The European Society of Gynaecological Oncology Council nominated an international development group made of practicing clinicians who provide care to patients with vulvar cancer and have demonstrated leadership and interest in the management of patients with vulvar cancer (18 experts across Europe)...
May 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28441153/discharge-criteria-for-the-late-preterm-infant-a-review-of-the-literature
#5
Jenny M Quinn, Marteen Sparks, Sheila M Gephart
BACKGROUND: Standardized late preterm infant (LPI) discharge criteria ensure best practice and help guide the neonatal provider to determine the appropriate level of care following birth. However, the location can vary from the well newborn setting to the neonatal intensive care unit (NICU). PURPOSE: The purpose of this review is to examine differences in LPI discharge criteria between the well newborn setting and the NICU by answering the clinical questions, "What are the recommended discharge criteria for the LPI and do they differ if admitted to the well newborn setting versus the NICU?" SEARCH STRATEGY: Databases searched include CINAHL, TRIP, PubMed, and the Cochrane Library...
April 24, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28439852/stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-a-concise-review-with-a-comprehensive-summary-of-therapeutic-interventions-emphasizing-supportive-measures
#6
REVIEW
Jeremy A Schneider, Philip R Cohen
INTRODUCTION: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are two of the most severe dermatologic conditions occurring in the inpatient setting. There is a lack of consensus regarding appropriate management of SJS and TEN. PURPOSE: The scientific literature pertaining to SJS and TEN (subsequently referred to as SJS/TEN) is summarized and assessed. In addition, an interventional approach for the clinician is provided. METHODS: PubMed was searched with the key words: corticosteroids, cyclosporine, etanercept, intravenous immunoglobulin, Stevens-Johnson syndrome, and toxic epidermal necrolysis...
April 24, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#7
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/28431428/computational-and-in-vitro-experimental-investigation-of-intrathecal-drug-distribution-parametric-study-of-the-effect-of-injection-volume-cerebrospinal-fluid-pulsatility-and-drug-uptake
#8
Kevin M Tangen, Roxanne Leval, Ankit I Mehta, Andreas A Linninger
BACKGROUND: Intrathecal drug delivery is an attractive option to circumvent the blood-brain barrier for pain management through its increased efficacy of pain relief, reduction in adverse side effects, and cost-effectiveness. Unfortunately, there are limited guidelines for physicians to choose infusion or drug pump settings to administer therapeutic doses to specific regions of the spine or the brain. Although empiric trialing of intrathecal drugs is critical to determine the sustained side effects, currently there is no inexpensive in vitro method to guide the selection of spinal drug delivery parameters...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28425132/early-post-operative-management-after-lung-transplantation-results-of-an-international-survey
#9
Christopher S King, Vincent Valentine, Ashok Cattamanchi, Domingo Franco-Palacios, Oksana A Shlobin, A Whitney Brown, Ramesh Singh, Linda Bogar, Steven D Nathan
INTRODUCTION: Little data exists regarding optimal therapeutic strategies post-operatively after lung transplant (LTx). Current practice patterns rely on expert opinion and institutional experience resulting in non-uniform post-operative care. To better define current practice patterns, an international survey of LTx clinicians was conducted. METHODS: A 30-question survey was sent to transplant clinicians via email to the ISHLT open forum mailing list and directly to the chief transplant surgeon and pulmonologist of all LTx centers in the United States...
April 20, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28422775/a-contemporary-assessment-of-acute-mechanical-ventilation-in-beijing-description-costs-and-outcomes
#10
Yanping Ye, Bo Zhu, Li Jiang, Qi Jiang, Meiping Wang, Lin Hua, Xiuming Xi
OBJECTIVE: To evaluate the contemporary practice, outcomes, and costs related to mechanical ventilation among ICUs in China. DESIGN: A prospective observational cohort study. SETTING: Fourteen ICUs among 13 hospitals in Beijing, China. PATIENTS: Seven hundred ninety-three patients who received at least 24 hours of mechanical ventilation within the first 48 hours of ICU stay. INTERVENTION: None...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28421354/perceived-barriers-and-facilitators-to-integrating-hiv-prevention-and-treatment-with-cross-sex-hormone-therapy-for-transgender-women-in-lima-peru
#11
Sari L Reisner, Amaya G Perez-Brumer, Sarah A McLean, Javier R Lama, Alfonso Silva-Santisteban, Leyla Huerta, Jorge Sanchez, Jesse L Clark, Matthew J Mimiaga, Kenneth H Mayer
Transgender women (TW) represent a vulnerable population at increased risk for HIV infection in Peru. A mixed-methods study with 48 TW and 19 healthcare professionals was conducted between January and February 2015 to explore barriers and facilitators to implementing a model of care that integrates HIV services with gender-affirmative medical care (i.e., hormone therapy) in Lima, Peru. Perceived acceptability of the integrated care model was high among TW and healthcare professionals alike. Barriers included stigma, lack of provider training or Peruvian guidelines regarding optimal TW care, and service delivery obstacles (e...
April 18, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28420900/intracranial-pressure-monitoring-for-pediatric-acute-encephalopathy
#12
Nobuyuki Nosaka, Kohei Tsukahara, Emily Knaup, Toshihiko Yabuuchi, Tomonobu Kikkawa, Yosuke Fujii, Masato Yashiro, Takao Yasuhara, Ayumi Okada, Toyomu Ugawa, Atsunori Nakao, Hirokazu Tsukahara, Isao Date
Newly published clinical practice guidelines recommend intracranial pressure (ICP) monitoring in critical care for the management of pediatric acute encephalopathy (pAE), but the utility of ICP monitoring for pAE has been poorly studied. We recently performed direct ICP monitoring for two patients. We observed that although the direct ICP monitoring had clinical benefits with less body weight gain and no vasopressor use in both cases, this monitoring technique is still invasive. Future studies should determine the utility of non-invasive ICP monitoring systems in pAE to further improve the quality of intensive-care management...
April 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/28418451/cost-effectiveness-of-common-diagnostic-approaches-for-evaluation-of-asymptomatic-microscopic-hematuria
#13
Joshua A Halpern, Bilal Chughtai, Hassan Ghomrawi
Importance: Asymptomatic microscopic hematuria (AMH) is highly prevalent and may signal occult genitourinary (GU) malignant abnormality. Common diagnostic approaches differ in their costs and effectiveness in detecting cancer. Given the low prevalence of GU malignant abnormality among patients with AMH, it is important to quantify the cost implications of detecting cancer for each approach. Objective: To estimate the effectiveness, costs, and incremental cost per cancer detected (ICCD) for 4 common diagnostic approaches evaluating AMH...
April 17, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28413938/psychiatric-service-users-experiences-of-emergency-departments-a-cerqual-review-of-qualitative-studies
#14
Kathrine Carstensen, Stina Lou, Lotte Groth Jensen, Nina Konstantin Nissen, Lisbeth Ortenblad, Margarete Pfau, Pia Vedel Ankersen
BACKGROUND: There is increased clinical and political attention towards integrating general and psychiatric emergency departments (ED). However, research into psychiatric service users' experiences regarding general EDs is limited. AIM: To identify and summarize current, qualitative evidence regarding service users' experiences attending EDs. A secondary aim is to apply and test the newly developed CERQual approach to summarizing qualitative review findings. METHODS: A systematic literature review of five databases based on PRISMA guidelines yielded 3334 unique entries...
May 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/28403702/bell-s-palsy-excluding-serious-illness-in-urgent-and-emergency-care-settings
#15
Sean Mower
Bell's palsy is a relatively benign condition that affects about 20 in every 100,000 patients a year, and in most cases the signs and symptoms resolve fully within around six months. The defining characteristic of the condition is a unilateral facial palsy, but this is also apparent in other conditions with a more serious prognosis, including strokes, some viral infections and tumours. This article reviews the literature on recognition of Bell's palsy, examines the underlying pathology, and compares it with other conditions associated with facial palsy...
April 13, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28400685/republication-all-india-difficult-airway-association-2016-guidelines-for-tracheal-intubation-in-the-intensive-care-unit
#16
Sheila Nainan Myatra, Syed Moied Ahmed, Pankaj Kundra, Rakesh Garg, Venkateswaran Ramkumar, Apeksh Patwa, Amit Shah, Ubaradka S Raveendra, Sumalatha Radhakrishna Shetty, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh, Sabyasachi Das, Jigeeshu Vasishtha Divatia
Tracheal intubation (TI) is a routine procedure in the Intensive Care Unit (ICU) and is often lifesaving. In contrast to the controlled conditions in the operating room, critically ill patients with respiratory failure and shock are physiologically unstable. These factors, along with under evaluation of the airway and suboptimal response to preoxygenation, are responsible for a high incidence of life-threatening complications such as severe hypoxemia and cardiovascular collapse during TI in the ICU. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for safe management of the airway in critically ill patients...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28399033/european-society-of-gynaecological-oncology-guidelines-for-the-management-of-patients-with-vulvar-cancer
#17
Maaike H M Oonk, François Planchamp, Peter Baldwin, Mariusz Bidzinski, Mats Brännström, Fabio Landoni, Sven Mahner, Umesh Mahantshetty, Mansoor Mirza, Cordula Petersen, Denis Querleu, Sigrid Regauer, Lukas Rob, Roman Rouzier, Elena Ulrikh, Jacobus van der Velden, Ignace Vergote, Linn Woelber, Ate G J van der Zee
OBJECTIVE: The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. METHODS: The European Society of Gynaecological Oncology Council nominated an international development group made of practicing clinicians who provide care to patients with vulvar cancer and have demonstrated leadership and interest in the management of patients with vulvar cancer (18 experts across Europe)...
April 8, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28398996/lessons-learned-from-option-b-in-the-evolution-toward-test-and-start-from-malawi-cameroon-and-the-united-republic-of-tanzania
#18
Thokozani Kalua, Beth A Tippett Barr, Joep J van Oosterhout, Dorothy Mbori-Ngacha, Erik J Schouten, Sundeep Gupta, Amakobe Sande, Gerald Zomba, Hannock Tweya, Edgar Lungu, Deborah Kajoka, Pius Tih, Andreas Jahn
The acceleration of prevention of mother-to-child transmission (PMTCT) activities, coupled with the rollout of 2010 World Health Organization (WHO) guidelines, led to important discussions and innovations at global and country levels. One paradigm-shifting innovation was Option B+ in Malawi. It was later included in WHO guidelines and eventually adopted by all 22 Global Plan priority countries. This article presents Malawi's experience with designing and implementing Option B+ and provides complementary narratives from Cameroon and Tanzania...
May 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28396643/do-family-interventions-improve-outcomes-in-early-psychosis-a-systematic-review-and-meta-analysis
#19
REVIEW
Melanie Claxton, Juliana Onwumere, Miriam Fornells-Ambrojo
Family interventions for psychosis (FIp) are effective in reducing service user relapse and carer distress in people with schizophrenia-spectrum conditions. Several treatment and best practice guidelines recommend FIp for all people with schizophrenia. However, outcome findings in relation to early psychosis groups have been inconsistent. The current paper reports a systematic review and meta-analyses of articles that evaluated FIp in early psychosis with a clearly defined comparison group. A combination of electronic database searches (using PsychINFO, Medline, and CENTRAL), citation searches and hand searches of key journals and reviews was conducted...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28395535/the-experience-of-attempting-to-return-to-work-following-spinal-cord-injury-a-systematic-review-of-the-qualitative-literature
#20
Gillean Hilton, Carolyn Unsworth, Gregory Murphy
PURPOSE: This review sought to answer the question "What are the barriers and facilitators influencing people's experience of return to work following spinal cord injury?" METHODS: Studies that met the selection criteria were identified, presented and critically appraised using National Institute for Health and Care Excellence guidelines. Thematic synthesis was completed with studies possessing strong methodological rigor. Synthesis and interpretation involved three stages; coding of primary data; development of descriptive themes reflective of the primary data; and establishment of analytical themes to answer the review question...
April 11, 2017: Disability and Rehabilitation
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