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Mary Ann Barnes-Daly, Brenda T Pun, Lori A Harmon, Diane G Byrum, Vishakha K Kumar, John W Devlin, Joanna L Stollings, Kathleen A Puntillo, Heidi J Engel, Patricia J Posa, Juliana Barr, William D Schweickert, Cheryl L Esbrook, Ken D Hargett, Shannon S Carson, J Matthew Aldrich, E Wesley Ely, Michele C Balas
BACKGROUND: Patients admitted to intensive care units (ICUs) often experience pain, oversedation, prolonged mechanical ventilation, delirium, and weakness. These conditions are important in that they often lead to protracted physical, neurocognitive, and mental health sequelae now termed postintensive care syndrome. Changing current ICU practice will not only require the adoption of evidence-based interventions but the development of effective and reliable teams to support these new practices...
May 5, 2018: Worldviews on Evidence-based Nursing
Kellie Sosnowski, Marion L Mitchell, Hayden White, Lynette Morrison, Joanne Sutton, Jessica Sharratt, Frances Lin
Background: Early rehabilitation has been found to prevent delirium and weakness that can hamper the recovery of intensive care unit (ICU) survivors. Integrated clinical practice guidelines for managing patient pain, agitation and delirium (PAD) have been developed. The Awakening and Breathing Coordination, Delirium monitoring/management, and Early exercise/mobility (ABCDE) bundle provides a strategy to implement PAD guidelines into everyday clinical practice. However, there is limited evidence on the effectiveness of the ABCDE bundle in the literature...
2018: Pilot and Feasibility Studies
Joel M Mor, Konrad R Koch, Ludwig M Heindl
The most common iris lesions are iris nevi, iris melanomas and iris pigment epithelium cysts. However, there is an abundance of rare differential diagnoses that have to be considered, including other melanocytic and non-melanocytic lesions. Diagnostic tools include the slit lamp examination, gonioscopy, tonometry, transillumination, ultrasound biomicroscopy (UBM), optical coherence tomography, fluorescein angiography and standardized photography-assisted documentation. The timely identification of malignant lesions (i...
December 2017: Klinische Monatsblätter Für Augenheilkunde
Chun-Song Hu, Qing-Hua Wu, Da-Yi Hu, Tengiz Tkebuchava
In this article, we introduce briefly several strategies for preventing atherosclerotic cardiovascular disease and promoting healthcare for non-communicable diseases (NCDs). These novel strategies include four core elements of health - sleep, emotion, exercise, and diet - and consist of SEED intervention (SEEDi) and E(e)SEEDi due to supplementation of the environment as a core element, and Hu's healthy lifestyles intervention (HHLi) which originates from E(e)SEED-BasED healthy lifestyles. They are suitable for the early evaluation of risk factors, and play a key role in the prevention and management of human NCDs when combined with the RT-ABCDEF strategy and the Grade 210 prevention, which include obesity-OSA-hypertension syndrome and C-type hypertension, especially in halting cardiovascular, diabetes and cancer (CDC) strips we first discovered...
September 2017: Chronic Diseases and Translational Medicine
Kosuke Minagawa, Daisuke Urabe, Masayuki Inoue
C19-diterpene alkaloids are a class of alkaloids with pharmacologically important activities having an intricately fused hexacyclic ABCDEF-ring system. Here we report expeditious assembly of the ACE-ring substructure 4a by applying a three-component coupling strategy. A radical-polar crossover reaction between an AE-ring radical precursor, a C-ring radical acceptor and an aldehyde was realized by the actions of Et3 B and O2 , resulting in the installation of three new stereocenters and extension of the carbon chain corresponding to the B-ring...
February 2018: Journal of Antibiotics
Annachiara Marra, E Wesley Ely, Pratik P Pandharipande, Mayur B Patel
The ABCDEF bundle represents an evidence-based guide for clinicians to approach the organizational changes needed for optimizing intensive care unit patient recovery and outcomes. This article reviews the core evidence and features behind the ABCDEF bundle. The bundle has individual components that are clearly defined, flexible to implement, and help empower multidisciplinary clinicians and families in the shared care of the critically ill. The ABCDEF bundle helps guide well-rounded patient care and optimal resource utilization resulting in more interactive intensive care unit patients with better controlled pain, who can safely participate in higher-order physical and cognitive activities at the earliest point in their critical illness...
April 2017: Critical Care Clinics
Brian J Anderson, Mark E Mikkelsen
No abstract text is available yet for this article.
February 2017: Critical Care Medicine
E Wesley Ely
Over the past 20 years, critical care has matured in a myriad of ways resulting in dramatically higher survival rates for our sickest patients. For millions of new survivors comes de novo suffering and disability called "the postintensive care syndrome." Patients with postintensive care syndrome are robbed of their normal cognitive, emotional, and physical capacity and cannot resume their previous life. The ICU Liberation Collaborative is a real-world quality improvement initiative being implemented across 76 ICUs designed to engage strategically the ABCDEF bundle through team- and evidence-based care...
February 2017: Critical Care Medicine
Yoanna Skrobik
No abstract text is available yet for this article.
January 2017: Critical Care Medicine
Mary Ann Barnes-Daly, Gary Phillips, E Wesley Ely
OBJECTIVES: To track compliance by an interprofessional team with the Awakening and Breathing Coordination, Choice of drugs, Delirium monitoring and management, Early mobility, and Family engagement (ABCDEF) bundle in implementing the Pain, Agitation, and Delirium guidelines. The aim was to study the association between ABCDEF bundle compliance and outcomes including hospital survival and delirium-free and coma-free days in community hospitals. DESIGN: A prospective cohort quality improvement initiative involving ICU patients...
February 2017: Critical Care Medicine
Mary Ann Barnes-Daly, Michele Balas, Gary Phillips, Tae Youn Kim
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Eniliz Gerena, Milagros Figueroa-Ramos, Carmen Arroyo-Novoa, Wilma González-Barreto, Gloria Rodriguez-Vega
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Matthew Zheng, Miranda Tan, Lili Tang, Julie Rogan, Beth Colborn, Elizabth Singh, Cara McDaniel, Michael Baram
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Laetitia Amalou, Frédéric Roca, Florent François, Laurent Druesne, Romuald Langlois, Thierry Pesqué, Philippe Chassagne
The aging population leads to psychological, medical and social reflection for optimal care of the elderly, especially characterized by a frailty state. The frailty is the cause of morbi-mortality require screening to anticipate these complications. The objective was to evaluate the statistical performance and feasibility of the tool "ABCDEF" to screen frailty defined by Fried's criteria. A prospective multicenter study including 300 ambulatory elderly consultants was conducted. ABCDEF appears feasible without major prior training or special equipment by any doctor or caregiver during an assessment in 98% of consultants...
September 1, 2016: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
Yuan Zhang, Jon D Rainier
Yessotoxin and adriatoxin are members of the polycyclic ether family of marine natural products. Outlined in this article is our synthetic approach to two subunits of these targets. Central to our strategy is a coupling sequence that employs an olefinic-ester cyclization reaction. As outlined, this sequence was used in two coupling sequences. First, it was used to merge the A, B- and E, F-bicyclic precursors and in the process generate the C- and D-rings. Second, it was used to couple the F- and I-rings while building the eight-membered G-ring and subsequently the H-ring pyran...
2016: Journal of Antibiotics
Michele C Balas, John W Devlin, Avelino C Verceles, Peter Morris, E Wesley Ely
When robust clinical trials are lacking, clinicians are often forced to extrapolate safe and effective evidence-based interventions from one patient care setting to another. This article is about such an extrapolation from the intensive care unit (ICU) to the long-term acute care hospital (LTACH) setting. Chronic critical illness is an emerging, disabling, costly, and yet relatively silent epidemic that is central to both of these settings. The number of chronically critically ill patients requiring prolonged mechanical ventilation is expected to reach unprecedented levels over the next decade...
February 2016: Seminars in Respiratory and Critical Care Medicine
Mary Ann Barnes-Daly, Gary Phillips, E Wesley Ely
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
J Daniel Jensen, Boni E Elewski
No abstract text is available yet for this article.
February 2015: Journal of Clinical and Aesthetic Dermatology
Carol L Shields, Jane Grant Kels, Jerry A Shields
Melanoma of the eye can involve the uveal tract with iris, ciliary body, or choroid involvement or it can involve the conjunctiva, eyelid, or orbit. Uveal involvement with choroidal melanoma is the most common, found in light complexion Caucasians with an age-adjusted incidence of 4.3 per million persons. Early detection of uveal melanoma is critical. The ABCDEF guide helps to differentiate iris nevus from iris melanoma. The letters represent: A, age young (≤40 years); B, blood in anterior chamber; C, clock hour of mass inferiorly; D, diffuse configuration; E, ectropion; and F, feathery margins...
March 2015: Clinics in Dermatology
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