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https://www.readbyqxmd.com/read/28444072/chronic-obstructive-pulmonary-disease-exacerbation-in-the-intensive-care-unit-clinical-functional-and-quality-of-life-at-discharge-and-3-months-of-follow-up
#1
Renata Cristina Teixeira Pinto Viana, Mariangela Pimentel Pincelli, Emílio Pizzichini, André Pacheco Silva, Joice Manes, Tatiana Dias Marconi, Leila John Marques Steidle
Objective: The purpose of this study was to evaluate the clinical/functional aspects and quality of life of chronic obstructive pulmonary disease patients who were discharged after an intensive care unit admission for acute respiratory failure. Methods: This prospective study included chronic obstructive pulmonary disease patients who were admitted to two intensive care units between December of 2010 and August of 2011 and evaluated over three visits after discharge...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28444069/predictors-and-pattern-of-weaning-and-long-term-outcome-of-patients-with-prolonged-mechanical-ventilation-at-an-acute-intensive-care-unit-in-north-india
#2
Syed Nabeel Muzaffar, Mohan Gurjar, Arvind K Baronia, Afzal Azim, Prabhakar Mishra, Banani Poddar, Ratender K Singh
Objective: This study aimed to examine the clinical characteristics, weaning pattern, and outcome of patients requiring prolonged mechanical ventilation in acute intensive care unit settings in a resource-limited country. Methods: This was a prospective single-center observational study in India, where all adult patients requiring prolonged ventilation were followed for weaning duration and pattern and for survival at both intensive care unit discharge and at 12 months...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28444068/acute-bag-valve-breathing-maneuvers-plus-manual-chest-compression-is-safe-during-stable-septic-shock-a-randomized-clinical-trial
#3
Clarissa Netto Blattner, Rafael Saldanha Dos Santos, Fernando Suparregui Dias, Alexandre Simões Dias, Régis Gemerasca Mestriner, Silvia Regina Rios Vieira
Objective: To evaluate the effects of bag-valve breathing maneuvers combined with standard manual chest compression techniques on safety, hemodynamics and oxygenation in stable septic shock patients. Design: A parallel, assessor-blinded, randomized trial of two groups. A computer-generated list of random numbers was prepared by an independent researcher to allocate treatments. Setting: The Intensive Care Unit at Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28441971/the-clinical-and-cost-effectiveness-of-stratified-care-for-patients-with-sciatica-the-scopic-randomised-controlled-trial-protocol-isrctn75449581
#4
Nadine E Foster, Kika Konstantinou, Martyn Lewis, Reuben Ogollah, Kate M Dunn, Danielle van der Windt, Ruth Beardmore, Majid Artus, Bernadette Bartlam, Jonathan C Hill, Sue Jowett, Jesse Kigozi, Christian Mallen, Benjamin Saunders, Elaine M Hay
BACKGROUND: Sciatica has a substantial impact on patients, and is associated with high healthcare and societal costs. Although there is variation in the clinical management of sciatica, the current model of care usually involves an initial period of 'wait and see' for most patients, with simple measures of advice and analgesia, followed by conservative and/or more invasive interventions if symptoms fail to resolve. A model of care is needed that does not over-treat those with a good prognosis yet identifies patients who do need more intensive treatment to help with symptoms, and return to everyday function including work...
April 26, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28440211/a-cluster-randomised-trial-cost-effectiveness-analysis-and-psychosocial-evaluation-of-insulin-pump-therapy-compared-with-multiple-injections-during-flexible-intensive-insulin-therapy-for-type-1-diabetes-the-repose-trial
#5
Simon Heller, David White, Ellen Lee, Julia Lawton, Daniel Pollard, Norman Waugh, Stephanie Amiel, Katharine Barnard, Anita Beckwith, Alan Brennan, Michael Campbell, Cindy Cooper, Munyaradzi Dimairo, Simon Dixon, Jackie Elliott, Mark Evans, Fiona Green, Gemma Hackney, Peter Hammond, Nina Hallowell, Alan Jaap, Brian Kennon, Jackie Kirkham, Robert Lindsay, Peter Mansell, Diana Papaioannou, David Rankin, Pamela Royle, W Henry Smithson, Carolin Taylor
BACKGROUND: Insulin is generally administered to people with type 1 diabetes mellitus (T1DM) using multiple daily injections (MDIs), but can also be delivered using infusion pumps. In the UK, pumps are recommended for patients with the greatest need and adult use is less than in comparable countries. Previous trials have been small, of short duration and have failed to control for training in insulin adjustment. OBJECTIVE: To assess the clinical effectiveness and cost-effectiveness of pump therapy compared with MDI for adults with T1DM, with both groups receiving equivalent structured training in flexible insulin therapy...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28438078/ten-year-follow-up-of-a-case-of-necrotizing-fasciitis-successfully-treated-with-negative-pressure-wound-therapy-dermal-regeneration-template-application-and-split-thickness-skin-autograft
#6
Sagi Martinov, Soccoro Ortiz
INTRODUCTION: Necrotizing fasciitis is a rapidly progressive and often fatal infection of the fasciae and subcutaneous tissues. PATIENT AND METHODS: In this case report, we present the treatment of a 63-year-old patient suffering from diabetes mellitus, who was admitted to the emergency unit for severe right gluteal pain, which had begun 24 hours before admission. Cutaneous symptoms, oliguria, metabolic acidosis, acute renal failure, severe hypotension, and tachycardia occurred, and the patient was admitted to Intensive Care a few hours after initial admission...
April 25, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28437793/mindfulness-based-stress-reduction-for-treating-low-back-pain-a-systematic-review-and-meta-analysis
#7
Dennis Anheyer, Heidemarie Haller, Jürgen Barth, Romy Lauche, Gustav Dobos, Holger Cramer
Background: Mindfulness-based stress reduction (MBSR) is frequently used to treat pain-related conditions, but its effects on low back pain are uncertain. Purpose: To assess the efficacy and safety of MBSR in patients with low back pain. Data Sources: Searches of MEDLINE/PubMed, Scopus, the Cochrane Library, and PsycINFO to 15 June 2016. Study Selection: Randomized controlled trials (RCTs) that compared MBSR with usual care or an active comparator and assessed pain intensity or pain-related disability as a primary outcome in patients with low back pain...
April 25, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28437539/safety-and-efficacy-of-antiviral-therapy-for-prevention-of-cytomegalovirus-reactivation-in-immunocompetent-critically-ill-patients-a-randomized-clinical-trial
#8
Nicholas J Cowley, Andrew Owen, Sarah C Shiels, Joanne Millar, Rebecca Woolley, Natalie Ives, Husam Osman, Paul Moss, Julian F Bion
Importance: Latent cytomegalovirus (CMV) infection is present in more than half the adult population, and a viral reactivation (ie, when the virus becomes measurable in body fluids such as blood) can occur in up to one-third of these individuals during episodes of critical illness. Objective: To determine whether antiviral therapy is safe and effective for preventing CMV reactivation in a general population of critically ill patients. Design, Setting, and Participants: A single-center, open-label, randomized, controlled clinical trial recruited 124 CMV-seropositive patients undergoing mechanical ventilation for at least 24 hours in the intensive care unit between January 1, 2012, and January 31, 2014...
April 24, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28436579/infection-related-mortality-in-hispanic-and-non-hispanic-children-with-cancer
#9
Rochelle R Smits-Seemann, Jacob Pettit, Hongyan Li, Anne C Kirchhoff, Mark N Fluchel
BACKGROUND: Hispanic children with cancer experience poorer survival than their White counterparts. Infection is a known cause of cancer-related mortality; however, little is known about the risk of infection-related death among Hispanic children with cancer. We examine the association of Hispanic ethnicity with infection-related mortality and life-threatening events among children with cancer. PROCEDURE: For a cohort of all pediatric cancer patients diagnosed from 1986 to 2012 and treated at a single tertiary care center, we obtained national death records to determine all-cause mortality and infection-related mortality, as well as intensive care unit (ICU) admissions as a surrogate for life-threatening events...
April 24, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28434482/how-to-implement-clinical-guidelines-to-optimise-familial-hypercholesterolaemia-diagnosis-and-treatment
#10
Michel Farnier, Fernando Civeira, Olivier Descamps
BACKGROUND AND AIMS: Familial hypercholesterolaemia (FH) is a genetic disorder associated with significantly elevated plasma low-density lipoprotein cholesterol (LDL-C) and premature coronary heart disease (CHD). Optimal management of FH relies on early identification and treatment with statins alone or in combination with other lipid-lowering therapies. A lack of awareness of FH and its manifestations among primary care physicians and specialists has led to many individuals being misdiagnosed in the early stages of the disease, further increasing the risk of CHD and requiring much more intensive lipid-lowering strategies...
April 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/28434116/activation-of-the-serotonin-pathway-is-associated-with-poor-outcome-in-copd-exacerbation-results-of-a-long-term-cohort-study
#11
Marc A Meier, Manuel Ottiger, Alaadin Vögeli, Christian Steuer, Luca Bernasconi, Robert Thomann, Mirjam Christ-Crain, Christoph Henzen, Claus Hoess, Werner Zimmerli, Andreas Huber, Beat Mueller, Philipp Schuetz
BACKGROUND/INTRODUCTION: Indoleamine 2,3-dioxygenase (IDO) metabolizes tryptophan to kynurenine. An increase of its activity is associated with severity in patients with pneumonia. In chronic obstructive pulmonary disease (COPD) patients, an elevation of serotonin has been reported. Experimental models showed that cigarette smoke inhibits monoamine oxidase (MAO) leading to higher levels of serotonin. We investigated the prognostic ability of tryptophan, serotonin, kynurenine, IDO, and tryptophan hydroxylase (TPH) to predict short- and long-term outcomes in patients with a COPD exacerbation...
April 22, 2017: Lung
https://www.readbyqxmd.com/read/28433509/transcutaneous-aortic-valve-implantation-using-the-carotid-artery-access-feasibility-and-clinical-outcomes
#12
Zacharenia Kallinikou, Alexandre Berger, Patrick Ruchat, Gregory Khatchatourov, Isabelle Fleisch, Branislav Korkodelovic, Emmanuel Henchoz, René-Andréas Marti, Stéphane Cook, Mario Togni, Jean-Jacques Goy
BACKGROUND: Transcarotid access is an alternative route for transcutaneous aortic valve implantation (TAVI) in patients with impossible transfemoral access. AIMS: We evaluated the safety, effectiveness and early and late clinical outcomes of CoreValve(®) implantation via the common carotid artery. METHODS: Eighteen patients (10 men, 8 women; mean age 84±5 years) at high surgical risk (mean EuroSCORE II 16±13%) with significant peripheral artery disease underwent TAVI via common carotid artery access under general anaesthesia...
April 19, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28432539/early-onset-ventilator-associated-pneumonia-in-patients-with-severe-traumatic-brain-injury-incidence-risk-factors-and-consequences-in-cerebral-oxygenation-and-outcome
#13
Pierre Esnault, Cédric Nguyen, Julien Bordes, Erwan D'Aranda, Ambroise Montcriol, Claire Contargyris, Jean Cotte, Philippe Goutorbe, Christophe Joubert, Arnaud Dagain, Henry Boret, Eric Meaudre
BACKGROUND: Early-onset ventilator-associated pneumonia (EOVAP) occurs frequently in severe traumatic brain-injured patients, but potential consequences on cerebral oxygenation and outcome have been poorly studied. The objective of this study was to describe the incidence, risk factors for, and consequences on cerebral oxygenation and outcome of EOVAP after severe traumatic brain injury (TBI). METHODS: We conducted a retrospective, observational study including all intubated TBI admitted in the trauma center...
April 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28431670/use-of-glp-1-receptor-agonists-for-type-2-diabetes-treatment-intensification-after-basal-insulin-failure
#14
M Joubert, Y Reznik
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are part of the armamentarium for the treatment of type 2 diabetes (T2D), although recent guidelines have mainly recommended their use on top of oral treatments when a single or combination of two or three oral hypoglycaemic agents has failed to lower HbA1c levels below the individualized target range. In such situations, the decision to use GLP-1RAs is mostly driven by their high level of efficacy, their effect on body weight balance and their safety considerations, such as low hypoglycaemic risk...
April 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28429611/consensus-statement-on-inpatient-use-of-continuous-glucose-monitoring
#15
Amisha Wallia, Guillermo E Umpierrez, Robert J Rushakoff, David C Klonoff, Daniel J Rubin, Sherita Hill Golden, Curtiss B Cook, Bithika Thompson
In June 2016, Diabetes Technology Society convened a panel of US experts in inpatient diabetes management to discuss the current and potential role of continuous glucose monitoring (CGM) in the hospital. This discussion combined with a literature review was a follow-up to a meeting, which took place in May 2015. The panel reviewed evidence on use of CGM in 3 potential inpatient scenarios: (1) the intensive care unit (ICU), (2) non-ICU, and (3) transitioning outpatient CGM use into the hospital setting. Panel members agreed that data from limited studies and theoretical considerations suggested that use of CGM in the hospital had the potential to improve patient clinical outcomes, and in particular reduction of hypoglycemia...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28428892/a-comparison-of-earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-compared-to-standard-care-rehab-study-protocol-for-a-single-site-randomised-controlled-feasibility-trial
#16
Catherine Snelson, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, David Thickett, Emma Reeves, Aisling McLaughlin, Lauren Cooper, David McWilliams
BACKGROUND: Mortality from critical illness is improving, but survivors suffer from prolonged weakness and psychological and cognitive impairments. Maximising the recovery after critical illness has been highlighted as a research priority, especially in relation to an ageing population who present with higher rates of pre-morbid disability. Small studies have shown that starting rehabilitation early within the intensive care unit (ICU) improves short-term outcomes. Systematic reviews have highlighted the need for robust multicentre randomised controlled trials with longer term follow-up...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28428728/randomized-face-to-face-vs-home-exercise-interventions-in-pregnant-women-with-gestational-diabetes
#17
Danielle Symons Downs, Jennifer M Dinallo, Leann L Birch, Ian M Paul, Jan S Ulbrecht
OBJECTIVES: Evaluate effects of a theoretically-based, semi-intensive (Face-to-Face; F2F) exercise intervention and minimum-contact (Home) exercise intervention to the standard care (Control) on exercise, its motivational determinants, blood glucose levels, and insulin use of pregnant women with gestational diabetes mellitus (GDM). DESIGN: Randomized control trial with two intervention arms and control (standard care). METHOD: Participants (N=65) were randomized to a Control (standard prenatal care/GDM dietary counseling), Home (standard care + phone education/support + home exercise), or F2F (standard care + on-site education/support + guided exercise with instructor on 2 days/week) group from ~20 weeks gestation to delivery...
May 2017: Psychology of Sport and Exercise
https://www.readbyqxmd.com/read/28428012/-retrospective-study-of-children-referred-from-paediatric-intensive-care-to-palliative-care-why-and-for-what
#18
Alberto García-Salido, Paula Santos-Herranz, Verónica Puertas-Martín, María Ángeles García-Teresa, Ricardo Martino-Alba, Ana Serrano-González
INTRODUCTION: The creation of paediatric palliative care units (PPCU) could optimise the management of children with palliative focus after admission to a paediatric intensive care unit (PICU). This study describes the clinical and epidemiological characteristics of children referred from PICU to the UCPP of the Autonomous Community of Madrid (CAM). The overall treatment, relapses, re-admissions, and deaths, if occurred, are described. PATIENTS AND METHOD: A retrospective review was performed using the medical records from children transferred from the CAM paediatric intensive care units to the paediatric palliative care unit (1 March 2008-31 January 2015)...
April 17, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28423388/a-national-study-of-the-effect-of-race-socioeconomic-status-and-gender-on-burn-outcomes
#19
Hala Bedri, Kathleen S Romanowski, Junlin Liao, Ghassan Al-Ramahi, Jason Heard, Thomas Granchi, Lucy Wibbenmeyer
Age, burn size, and inhalation injury are the major contributing variables related to burn mortality. While the female gender has been linked to higher mortality, the impact of socioeconomic status has not been well studied. The interplay between these three factors is also unknown. This study sought to clarify the effects of these variables on outcomes in a national sample of patients with burns. A retrospective review of 172,640 patient records of the National Burn Repository (version 8, 2002-2011) data was conducted...
May 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28423127/evaluation-of-anomalous-coronary-arteries-from-the-pulmonary-artery
#20
Alper Guzeltas, Erkut Ozturk, Ibrahim Cansaran Tanidir, Taner Kasar, Sertac Haydin
Objective: This study evaluated clinical and diagnostic findings, treatment methods, and follow-up of cases of anomalous coronary arteries from the pulmonary artery. Methods: The study included all cases diagnosed with anomalous coronary arteries from the pulmonary artery between January 2012 and January 2016. Data from patients' demographic characteristics, electrocardiography, echocardiography, angiographic findings, operation, intensive care unit stay, and follow-up were evaluated...
January 2017: Brazilian Journal of Cardiovascular Surgery
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