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https://www.readbyqxmd.com/read/28453590/-understanding-cortisol-action-in-acute-inflammation-a-view-from-the-adrenal-gland-to-the-target-cell
#1
Julia Guerrero
Glucocorticoids (cortisol in humans) are essential for numerous biological functions. Among critically ill patients, therapy with cortisol has gained strength in recent years, but clinical results have been mixed. A series of events, that may explain the diversity of clinical responses, occur from the synthesis of cortisol in the adrenal gland to the activation of the cortisol receptor by the hormone when it enters the nucleus of the target cell. Some of these events are revised; a proposition for identifying critically ill patients who may benefit with this therapy is suggested...
February 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28453497/rasch-analysis-of-a-behavioral-checklist-for-the-assessment-of-pain-in-critically-ill-adults
#2
Christophe Chenier, Gilles Raiche, Nadine Talbot, Bianca Carignan, Celine Gelinas
Patients hospitalized in the intensive care unit (ICU) are often unable to report their pain, which is a problem since untreated pain is associated with negative health outcomes. The use of behavioral pain scales are recommended for the detection of the presence of pain in this vulnerable population. Previous validation studies have used classical techniques, and several psychometrics properties remain unknown. In this paper, data obtained from a behavioral checklist of dichotomized items was utilized to evaluate the instrument's dimensionality, its construct validity and its capacity to distinguish between levels of pain by using Rasch measurement...
2017: Journal of Applied Measurement
https://www.readbyqxmd.com/read/28449529/do-hospitals-need-oncological-critical-care-units
#3
EDITORIAL
Abby Koch, William Checkley
Since the inception of critical care as a formal discipline in the late 1950s, we have seen rapid specialization to many types of intensive care units (ICUs) to accommodate evolving life support technologies and novel therapies in various disciplines of medicine. Indeed, the field has expanded such that specialized ICUs currently exist to address critical care problems in medicine, cardiology, neurology and neurosurgery, trauma, burns, organ transplant and cardiothoracic surgeries. Specialization does not only need new infrastructure, but also training and staffing of health care providers, ancillary staff, and development and implementation of processes of care...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449449/echocardiography-to-guide-fluid-therapy-in-critically-ill-patients-check-the-heart-and-take-a-quick-look-at-the-lungs
#4
EDITORIAL
Federico Franchi, Luigi Vetrugno, Sabino Scolletta
No abstract text is available yet for this article.
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28448243/the-patient-experience-of-illness-treatment-and-change-during-intensive-community-treatment-for-severe-anorexia-nervosa
#5
Julia Hannon, Lindsey Eunson, Calum Munro
This study explores experiences of intensive community treatment, illness, and change among patients with severe anorexia nervosa (sAN), particularly seeking to understand the processes involved in change and inability to change. A qualitative design with purposive semi-stratified sampling, using semi-structured interviews and interpretive phenomenological analysis, investigated in detail the experiences of five participants. Participants all had sAN at the start of treatment and represented a spectrum of outcomes from deterioration to full recovery...
April 27, 2017: Eating Disorders
https://www.readbyqxmd.com/read/28447886/drug-induced-hyperlactatemia
#6
Eike Blohm, Jeffrey Lai, Mark Neavyn
BACKGROUND: Hyperlactatemia is common in critically ill patients and has a variety of etiologies. Medication toxicity remains an uncommon cause that providers often fail to recognize. In this article, we review several medications that cause hyperlactatemia in either therapeutic or supratherapeutic dosing. When known, the incidence, mortality, pathophysiology, and treatment options are discussed. METHODS: We performed a literature search using PUBMED and Google Scholar for English language articles published after 1980 regarding medication induced hyperlactatemia and its management...
April 27, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28447145/-recommendations-for-education-in-ultrasound-in-medical-intensive-care-and-emergency-medicine-position-paper-of-dgiin-degum-and-dgk
#7
G Michels, H Zinke, M Möckel, D Hempel, C Busche, U Janssens, S Kluge, R Riessen, M Buerke, M Kelm, R S von Bardeleben, F Knebel, H-J Busch
Point-of-care ultrasound in acute care medicine is a prerequisite for diagnosis and therapy monitoring of critically ill patients. There is currently no uniform education strategy for medical intensive care and emergency medicine. As part of the basic level, the trainee takes theoretical and clinical training covering abdominal and thoracic ultrasonography and focused cardiovascular ultrasound. In a second step, special knowledge and skills can be acquired at an expert level. This two-stage concept is intended to guarantee quality assurance in ultrasound education in medical intensive care and emergency medicine...
April 26, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28446775/delivering-prolonged-intensive-care-to-a-non-human-primate-a-high-fidelity-animal-model-of-critical-illness
#8
P Guillaume Poliquin, Mia Biondi, Charlene Ranadheera, Mable Hagan, Alexander Bello, Trina Racine, Mark Allan, Duane Funk, Gregory Hansen, B J Hancock, Murray Kesselman, Todd Mortimer, Anand Kumar, Shane Jones, Anders Leung, Allen Grolla, Kaylie N Tran, Kevin Tierney, Xiangguo Qiu, Darwyn Kobasa, James E Strong
Critical care needs have been rising in recent decades as populations age and comorbidities increase. Sepsis-related admissions to critical care contribute up to 50% of volume and septic shock carries a 35-54% fatality rate. Improvements in sepsis-related care and mortality would have a significant impact of a resource-intensive area of health care delivery. Unfortunately, research has been hampered by the lack of an animal model that replicates the complex care provided to humans in an intensive care unit (ICU)...
April 26, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28446744/levetiracetam-pharmacokinetics-in-a-patient-with-intracranial-hemorrhage-undergoing-continuous-veno-venous-hemofiltration
#9
Edward T Van Matre, Scott W Mueller, Douglas N Fish, Robert MacLaren, Luis F Cava, Robert T Neumann, Tyree H Kiser
BACKGROUND Levetiracetam is an antiepileptic drug frequently used in critically ill patients. Levetiracetam is primarily eliminated as a parent compound via glomerular filtration and requires dose adjustment in renal insufficiency, but the literature on patients receiving continuous veno-venous hemofiltration (CVVH) is scant. CASE REPORT We report the levetiracetam pharmacokinetic profile of a patient being treated with levetiracetam 1000 mg intravenously every 12 h who required continuous veno-venous hemofiltration (CVVH)...
April 27, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28446075/comparison-of-bronchoscopy-guided-and-real-time-ultrasound-guided-percutaneous-dilatational-tracheostomy-safety-complications-and-effectiveness-in-critically-ill-patients
#10
Aykut Sarıtaş, Muhammed M Kurnaz
OBJECTIVE: To compare the efficacy, safety, and incidence of complications between fiber-optic bronchoscopy-guided percutaneous dilatational tracheostomy (FOB-PDT) and ultrasound-guided percutaneous dilatational tracheostomy (US-PDT) and to determine whether US-PDT is a viable alternative to FOB-PDT. METHODS: This randomized prospective study was carried out in 80 patients who were randomly divided into US-PDT and FOB-PDT groups. Demographic data and Acute Physiology and Chronic Health Evaluation II (APACHE II), procedure duration, hemorrhage status, complications, procedure difficulty, displacement of entry location after US, and hemodynamic data were evaluated in both groups...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28445681/restoring-the-microbiome-in-critically-ill-patients-are-probiotics-our-true-friends-when-we-are-seriously-ill
#11
William Manzanares, Pascal L Langlois, Paul E Wischmeyer
No abstract text is available yet for this article.
May 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28445241/serum-neutrophil-gelatinase-associated-lipocalin-a-diagnostic-marker-in-pediatric-sepsis
#12
Nagwan Yossery Saleh, Wafaa Moustafa M Abo El Fotoh, Mahmoud A El-Hawy
OBJECTIVES: Sepsis is a life-threatening condition that arises when the response of the body to infection injures its own tissues and organs. The early prediction of sepsis by current clinical and laboratory methods remains inadequate. Serum neutrophil gelatinase-associated lipocalin level is increased in sepsis irrespective of renal dysfunction. Therefore, we aimed to correlate the serum neutrophil gelatinase-associated lipocalin value determined at admission with clinical progression and severity of disease in critically ill children and to declare its role as a potential diagnostic and prognostic marker for sepsis in critically ill children in the emergency department...
April 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28444828/labeling-and-defining-severe-and-enduring-anorexia-nervosa-a-systematic-review-and-critical-analysis
#13
REVIEW
Catherine Broomfield, Kristin Stedal, Stephen Touyz, Paul Rhodes
OBJECTIVE: With anorexia nervosa (AN) having various presentations, attention has been directed towards particularly durable forms of the condition in both research and clinical contexts. A major hindrance in terms of advancing the field is the inconsistent labeling and defining of this subgroup. This has two implications; first, the inconsistent recruitment of participants when researching this sample, and second, the misdiagnosing of patients who may or may not have a durable course of the disease...
April 25, 2017: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/28444760/vancomycin-levels-are-frequently-subtherapeutic-in-critically-ill-patients-a-prospective-observational-study
#14
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/28444409/diagnostic-work-up-and-specific-causes-of-acute-kidney-injury
#15
REVIEW
Michael Darmon, Marlies Ostermann, Jorge Cerda, Meletios A Dimopoulos, Lui Forni, Eric Hoste, Matthieu Legrand, Nicolas Lerolle, Eric Rondeau, Antoine Schneider, Bertrand Souweine, Miet Schetz
Acute kidney injury (AKI) is common in critically ill patients and associated with grim short- and long-term outcome. Although in the vast majority of cases AKI is multifactorial, with sepsis, shock and nephrotoxicity accounting for most episodes, specific causes of AKI are not uncommon. Despite remaining uncertainties regarding their prevalence in the ICU, prompt recognition of specific aetiologies of AKI is likely to ensure timely management, limit worsening of renal dysfunction, and ultimately limit renal and systemic consequences of AKI...
April 25, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28444224/pharmacodynamics-of-colistin-and-fosfomycin-a-treasure-trove-combination-combats-kpc-producing-klebsiella-pneumoniae
#16
Miao Zhao, Zackery P Bulman, Justin R Lenhard, Michael J Satlin, Barry N Kreiswirth, Thomas J Walsh, Amanda Marrocco, Phillip J Bergen, Roger L Nation, Jian Li, Jing Zhang, Brian T Tsuji
Objectives: KPC-producing Klebsiella pneumoniae are an emerging public health problem around the globe. We defined the combinatorial pharmacodynamics and ability to suppress resistance of two 'old' antibiotics, fosfomycin and colistin, in time-kill experiments and hollow-fibre infection models (HFIM). Methods: Two KPC-2-producing K. pneumoniae isolates were used: one susceptible to both colistin and fosfomycin (KPC 9A: MIC colistin 0.25 mg/L and MIC fosfomycin ≤8 mg/L) and the other resistant to colistin and susceptible to fosfomycin (KPC 5A: MIC colistin 64 mg/L and MIC fosfomycin 32 mg/L)...
April 21, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28444077/chronic-critical-illness-are-we-saving-patients-or-creating-victims
#17
Sergio Henrique Loss, Diego Silva Leite Nunes, Oellen Stuani Franzosi, Gabriela Soranço Salazar, Cassiano Teixeira, Silvia Regina Rios Vieira
The technological advancements that allow support for organ dysfunction have led to an increase in survival rates for the most critically ill patients. Some of these patients survive the initial acute critical condition but continue to suffer from organ dysfunction and remain in an inflammatory state for long periods of time. This group of critically ill patients has been described since the 1980s and has had different diagnostic criteria over the years. These patients are known to have lengthy hospital stays, undergo significant alterations in muscle and bone metabolism, show immunodeficiency, consume substantial health resources, have reduced functional and cognitive capacity after discharge, create a sizable workload for caregivers, and present high long-term mortality rates...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28444075/applicability-of-respiratory-variations-in-stroke-volume-and-its-surrogates-for-dynamic-fluid-responsiveness-prediction-in-critically-ill-patients-a-systematic-review-of-the-prevalence-of-required-conditions
#18
Leandro Utino Taniguchi, Fernando Godinho Zampieri, Antonio Paulo Nassar
Objective: The present systematic review searched for published data on the prevalence of required conditions for proper assessment in critically ill patients. Methods: The Medline, Scopus and Web of Science databases were searched to identify studies that evaluated the prevalence of validated conditions for the fluid responsiveness assessment using respiratory variations in the stroke volume or another surrogate in adult critically ill patients. The primary outcome was the suitability of the fluid responsiveness evaluation...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28443595/evaluation-of-the-diagnostic-role-of-bedside-lung-ultrasonography-in-patients-with-suspected-pulmonary-embolism-in-the-emergency-department
#19
Hüseyin Acar, Serkan Yılmaz, Elif Yaka, Nurettin Özgür Doğan, Asım Enes Özbek, Murat Pekdemir
BACKGROUND: Despite the existence of detailed consensus guidelines, challenges continue to exist regarding efficient, appropriate and safe imaging methods for the diagnosis of suspected pulmonary embolism. AIMS: This study was conducted to investigate the role of wedge sign, B-lines and pleural effusion seen on bedside lung ultrasound in the diagnosis of pulmonary embolism. STUDY DESIGN: Diagnostic accuracy study. METHODS: During the first evaluation of patients with suspected pulmonary embolism, bedside lung ultrasound was performed, and the B-lines, wedge sign, and pleural effusion were investigated...
April 6, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28443283/vascular-access-site-for-renal-replacement-therapy-in-acute-kidney-injury-a-post-hoc-analysis-of-the-atn-study
#20
Yue-Harn Ng, Kavitha Ganta, Herbert Davis, V Shane Pankratz, Mark Unruh
BACKGROUND: Acute kidney injury requiring renal replacement therapy (RRT) in the intensive care unit portends a poor prognosis. The decisions regarding dialysis catheter placement is based mainly on physician discretion with little evidence to support the choice of dialysis catheter location. METHODS: The Veterans Affairs/National Institutes of Health Acute Renal Failure Trial Network Study was a multicenter, prospective, randomized trial of intensive vs. less intensive RRT in critically ill patients with AKI...
2017: Frontiers in Medicine
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