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https://www.readbyqxmd.com/read/28732314/the-effect-of-low-dose-furosemide-in-critically-ill-patients-with-early-acute-kidney-injury-a-pilot-randomized-blinded-controlled-trial-the-spark-study
#1
Sean M Bagshaw, R T Noel Gibney, Peter Kruger, Imran Hassan, Finlay A McAlister, Rinaldo Bellomo
PURPOSE: Furosemide is commonly prescribed in acute kidney injury (AKI). Prior studies have found conflicting findings on whether furosemide modifies the course and outcome of AKI. METHODS: Pilot multi-center randomized blinded placebo-controlled trial in adult patients with AKI admitted to three intensive care units. Participants were randomly allocated to furosemide bolus and infusion or 0.9% saline placebo. Primary endpoint was worsening AKI, defined by the RIFLE criteria...
July 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28732153/hepatitis-b-and-c-viruses-and-biologics
#2
P Grewal, R Sanghera
Hepatitis B virus (HBV) and hepatitis C virus (HCV) are common, worldwide viral illnesses that potentially impact the clinician's ability to manage patients with immunosuppressive medications such as biological therapy. In light of recent literature reviews, patients with HBV and HCV should be referred to a hepatologist or infectious disease expert prior to initiation of biological therapy.
July 2017: Skin Therapy Letter
https://www.readbyqxmd.com/read/28732071/the-ideas-about-advanced-life-support-and-affecting-factors-at-the-end-stage-of-life-in-a-hospital-in-turkey
#3
Turgay Albayrak, İrfan Şencan, Ömer Akça, Esra Meltem Koç, Hilal Aksoy, Selim Ünsal, İskender Bülbül, Adem Bahadır, İsmail Kasım, Rabia Kahveci, Adem Özkara
BACKGROUND: The participation of the people in health decisions may be structured in various levels. One of these is participation in decisions for the treatment. "Advanced directives" is one of the examples for the participation in decisions for the treatment. AIM: We wanted to determine the decisions on advanced life support at the end-stage of life in case of a life-threatening illness for the people themselves and their first degree relatives and the factors effecting these decisions...
2017: PloS One
https://www.readbyqxmd.com/read/28731388/electronic-visits-for-minor-acute-illnesses-analysis-of-patient-demographics-prescription-rates-and-follow-up-care-within-an-asynchronous-text-based-online-visit
#4
Kristine S Penza, Martha A Murray, Jennifer L Pecina, Jane F Myers, Joseph W Furst
INTRODUCTION: Patients can obtain medical advice and treatment from a healthcare provider asynchronously through an electronic visit (eVisit) within a secure online portal. METHODS: We conducted a retrospective record review of Mayo Clinic Rochester primary care empaneled patients who had an eVisit for a minor acute illness and were reviewed for 30-day outcomes of follow-up. RESULTS: Of the 1,009 eVisits analyzed, a total of 340 (34%) had follow-up within 30 days, with a follow-up rate of 154 (20%) when those who were advised to follow-up were excluded...
July 20, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28731001/economic-and-social-impact-of-out-of-pocket-expenditure-on-households-of-patients-attending-public-hospitals
#5
Vikas Bajpai, Namrata Singh, Hardik Sardana, Sanjana Kumari, Beth Vettiyil, Anoop Saraya
BACKGROUND: We aimed to generate evidence on the social and economic impact of out-of-pocket expenses incurred by households on illness. METHODS: We did a hospital-based cross-sectional study including a convenience sample of 374 inpatients and outpatients. RESULTS: The median illness expenditure was the same (₹62 500) for inpatients and outpatients. Of all respondents, 51.3% among the rural and 65.5% among the urban patients were employed before illness, but after illness only 24...
January 2017: National Medical Journal of India
https://www.readbyqxmd.com/read/28730890/the-biopsychosocial-model-of-illness-a-model-whose-time-has-come
#6
Derick T Wade, Peter W Halligan
The biopsychosocial model outlined in Engel's classic Science paper four decades ago emerged from dissatisfaction with the biomedical model of illness, which remains the dominant healthcare model. Engel's call to arms for a biopsychosocial model has been taken up in several healthcare fields, but it has not been accepted in the more economically dominant and politically powerful acute medical and surgical domains. It is widely used in research into complex healthcare interventions, it is the basis of the World Health Organisation's International Classification of Functioning (WHO ICF), it is used clinically, and it is used to structure clinical guidelines...
August 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28730847/guidelines-for-the-assessment-and-diagnosis-of-patients-with-schizophrenia-spectrum-and-other-psychotic-disorders
#7
Donald Addington, Sabina Abidi, Iliana Garcia-Ortega, William G Honer, Zahinoor Ismail
OBJECTIVE: The objective of this article is to identify best practices in the diagnosis and assessment of patients with schizophrenia spectrum and other psychotic disorders. The diagnosis and assessment may occur in a range of situations from the emergency room to the outpatient clinic and at different stages of the disorder. The focus may be on acute exacerbations of illness, residual symptoms, levels of function, or changes in the response to treatment. METHODS: A systematic search was conducted for guidelines published in the last 5 years for schizophrenia and schizophrenia spectrum disorders...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28730691/effect-of-abrupt-discontinuation-of-antidepressants-in-critically-ill-hospitalized-adults
#8
Taryn B Bainum, David S Fike, Diana Mechelay, Krystal K Haase
OBJECTIVES: To determine whether discontinuation of chronic antidepressant therapy is associated with a higher risk of antidepressant discontinuation syndrome (ADS) symptoms in patients admitted to the intensive care unit (ICU) when compared with those who were continued on therapy and to identify factors associated with increased risk of ADS in this population. DESIGN: Single-center retrospective observational cohort study. SETTING: ICUs in a tertiary care hospital...
July 21, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28729755/social-cognition-deficits-current-position-and-future-directions-for-neuropsychological-interventions-in-cerebrovascular-disease
#9
REVIEW
Progress Njomboro
Neuropsychological assessments of cognitive dysfunction in cerebrovascular illness commonly target basic cognitive functions involving aspects of memory, attention, language, praxis, and number processing. Here, I highlight the clinical importance of often-neglected social cognition functions. These functions recruit a widely distributed neural network, making them vulnerable in most cerebrovascular diseases. Sociocognitive deficits underlie most of the problematic social conduct observed in patients and are associated with more negative clinical outcomes (compared to nonsocial cognitive deficits)...
2017: Behavioural Neurology
https://www.readbyqxmd.com/read/28729329/fluids-in-sepsis-and-septic-shock-fissh-protocol-for-a-pilot-randomised-controlled-trial
#10
Bram Rochwerg, Tina Millen, Peggy Austin, Michelle Zeller, Frédérick D'Aragon, Roman Jaeschke, Marie-Hélène Masse, Sangeeta Mehta, Francois Lamontagne, Maureen Meade, Gordon Guyatt, Deborah J Cook
INTRODUCTION: Observational evidence suggests physiological benefits and lower mortality with lower chloride solutions; however, 0.9% saline remains the most widely used fluid worldwide. Given uncertainty regarding the association of lower chloride on mortality, it is unlikely that practice will change without direct randomised clinical trial (RCT) evidence. This pilot RCT will investigate the feasibility of a large-scale trial directly comparing low chloride with high chloride fluids in patients with septic shock...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28729130/information-needs-about-palliative-care-and-euthanasia-a-survey-of-patients-in-different-phases-of-their-cancer-trajectory
#11
Kim Beernaert, Chloë Haverbeke, Simon Van Belle, Luc Deliens, Joachim Cohen
OBJECTIVE: We assessed information provision and information needs about illness course, treatments, palliative care and euthanasia in cancer patients. METHODS: Cancer patients consulting a university hospital (N=620) filled out a questionnaire. Their cancer related data were collected through the treating oncologist. This study is performed in Belgium, where "palliative care for all" is a patient's right embedded in the law and euthanasia is possible under certain conditions...
July 1, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28729037/increased-gyrification-in-schizophrenia-and-non-affective-first-episode-of-psychosis
#12
Riccardo Zuliani, Giuseppe Delvecchio, Carolina Bonivento, Giulia Cattarinussi, Cinzia Perlini, Marcella Bellani, Veronica Marinelli, Maria Gloria Rossetti, Antonio Lasalvia, Andrew McIntosh, Stephen M Lawrie, Matteo Balestrieri, Mirella Ruggeri, Paolo Brambilla
BACKGROUND: Prefrontal cortex gyrification has been suggested to be altered in patients with schizophrenia and first episode psychosis. Therefore, it may represent a possible trait marker for these illnesses and an indirect evidence of a disrupted underlying connectivity. The aim of this study was to add further evidence to the existing literature on the role of prefrontal gyrification in psychosis by carrying out a study on a sizeable sample of chronic patients with schizophrenia and non-affective first-episode psychosis (FEP-NA) patients...
July 17, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28729006/a-representative-assessment-of-the-management-of-open-fractures-of-the-lower-limb-within-uk-orthoplastic-centres-a-two-centre-audit-of-compliance-with-national-standards
#13
B Rymer, E O F Dimovska, D T S Chou, R Choa, B Davis, S Huq
BACKGROUND: Open fractures of the lower limb represent a complex and varied array of injuries. The BOAST 4 document produced by BAPRAS and the BOA provides standards on how to manage these patients, and NICE have recently produced additional guidance. We aimed to assess concordance with these standards in a large cohort representative of UK orthoplastic centres. METHODS: Patients admitted to the orthoplastic units at Norfolk and Norwich University Hospital and Royal Stoke University Hospital with open lower limb fractures between 2009 and 2014 were included...
July 11, 2017: Injury
https://www.readbyqxmd.com/read/28729005/influence-of-late-fluid-management-on-the-outcomes-of-severe-trauma-patients-a-retrospective-analysis-of-294-severely-injured-patients
#14
Mehdi Mezidi, Mehdi Ould-Chikh, Pauline Deras, Camille Maury, Orianne Martinez, Xavier Capdevila, Jonathan Charbit
BACKGROUND: Liberal late fluid management (LFM) is associated with higher morbi-mortality in critically ill populations. The aim of the study was to assess the association between LFM and duration of mechanical ventilation in a severe trauma population. METHODS: A retrospective analysis of consecutive patients with an ISS≥16 and a length of stay in the intensive care unit (ICU)≥7 days was performed. The conservative LFM group included patients with at least 2 consecutive days with a negative fluid balance between day 3 and day 7; other patients were allocated to the liberal LFM group...
June 15, 2017: Injury
https://www.readbyqxmd.com/read/28728926/diagnostic-delays-in-537-symptomatic-cases-of-mers-cov-infection-in-saudi-arabia
#15
Anwar E Ahmed
BACKGROUND: Although the literature indicates the potential outcomes of a patient's delay in seeking medical support is associated with poor clinical outcomes, delays in the diagnosis itself remain poorly understood in patients with Middle East Respiratory Syndrome - Coronavirus (MERS-CoV). This study aims to estimate the median time interval of confirmed diagnosis after symptom onset and identify its potential predictors in Saudi Arabian MERS patients. METHODS: A retrospective study involved patients confirmed with MERS who were publicly reported by the World Health Organization (WHO)...
July 17, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28728807/the-impact-of-team-based-primary-care-on-health-care-services-utilization-and-costs-quebec-s-family-medicine-groups
#16
Erin Strumpf, Mehdi Ammi, Mamadou Diop, Julie Fiset-Laniel, Pierre Tousignant
We investigate the effects on health care costs and utilization of team-based primary care delivery: Quebec's Family Medicine Groups (FMGs). FMGs include extended hours, patient enrolment and multidisciplinary teams, but they maintain the same remuneration scheme (fee-for-service) as outside FMGs. In contrast to previous studies, we examine the impacts of organizational changes in primary care settings in the absence of changes to provider payment and outside integrated care systems. We built a panel of administrative data of the population of elderly and chronically ill patients, characterizing all individuals as FMG enrollees or not...
July 1, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28728560/patient-oriented-education-and-medication-management-intervention-for-people-with-decompensated-cirrhosis-study-protocol-for-a-randomized-controlled-trial
#17
Kelly L Hayward, Jennifer H Martin, W Neil Cottrell, Antara Karmakar, Leigh U Horsfall, Preya J Patel, David D Smith, Katharine M Irvine, Elizabeth E Powell, Patricia C Valery
BACKGROUND: People with decompensated cirrhosis require complex medical care and are often prescribed an intricate and frequently changing medication and lifestyle regimen. However, many patients mismanage their medications or have poor comprehension of their disease and self-management tasks. This can lead to harm, hospitalization, and death. METHODS/DESIGN: A patient-oriented education and medication management intervention has been developed for implementation at a tertiary hospital hepatology outpatient center in Queensland, Australia...
July 20, 2017: Trials
https://www.readbyqxmd.com/read/28728429/palliative-care-for-respiratory-disease-an-education-model-of-care
#18
Brynn Bowman, Diane E Meier
That palliative care improves quality of life for seriously ill patients and their families is well known - but how can healthcare providers ensure that the palliative needs of all patients are being assessed and addressed? A growing number of curricula in core palliative care practices have been developed to ensure that clinicians from all specialties and disciplines have the necessary training to manage pain and symptoms and discuss care goals with patients and families. Through broad-based training in core palliative care skills, combined with referral to specialty palliative care for high-need patients, providers can improve quality of life for their patients with respiratory disease...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28728201/-fever-and-headache-after-a-vacation-in-thailand
#19
Benedikt Schwermer, Daniel Eschle, Constantine Bloch-Infanger
History 50 year-old man with fever and headache starting one week after returning from his vacation in Thailand. His general practitioner prescribed amoxicillin/clavulanic acid, without further analyses to pinpoint the infection. Examinations The examination of cerebro-spinal fluid was crucial for the final diagnosis. Lumbar puncture demonstrated a predominantly mononuclear pleocytosis of 80 cells/µl (< 5) with an elevated protein of 782 mg/l (< 450); glucose and lactate were within normal limits...
July 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28728091/age-at-the-time-of-onset-of-psychosis-a-marker-of-specific-needs-rather-than-a-determinant-of-outcome
#20
P Golay, L Alameda, N Mebdouhi, P Baumann, C Ferrari, A Solida, P Progin, J Elowe, P Conus
BACKGROUND: While there is suggestion that early onset of psychosis is a determinant of outcome; knowledge regarding correlates of later onset age is more limited. This study explores the characteristics of patients developing psychosis after age 26, towards the end of the usual age range of early intervention programs, in order to identify potential specific needs of such patients. METHODS: Two hundred and fifty-six early psychosis patients aged 18-35 were followed-up prospectively over 36 months...
June 21, 2017: European Psychiatry: the Journal of the Association of European Psychiatrists
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