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https://www.readbyqxmd.com/read/29779083/identifying-nonalcoholic-fatty-liver-disease-advanced-fibrosis-in-the-veterans-health-administration
#1
Yuval A Patel, Elizabeth J Gifford, Lisa M Glass, Marsha J Turner, Byungjoo Han, Cynthia A Moylan, Steve Choi, Ayako Suzuki, Dawn Provenzale, Christine M Hunt
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. Severe NAFLD with advanced fibrosis results in substantial morbidity and mortality. Associated with metabolic syndrome, NAFLD is often initially clinically silent, yet intensive lifestyle intervention with 7% or greater weight loss can improve or resolve NAFLD. Using a Veterans Health Administration (VHA) liver biopsy cohort, we evaluated simple noninvasive fibrosis scoring systems to identify NAFLD with advanced fibrosis (or severe disease) to assist providers...
May 19, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29777555/impact-of-nicu-oral-feeding-on-neuropsychomotor-outcomes-at-9-months-of-corrected-age-in-chinese-low-birth-weight-preterm-infants-a-retrospective-study
#2
Wenwen Ding, Lijin Zhao, Nan Sheng, Jiali Ma, Ying Zhang
AIMS AND OBJECTIVES: To examine the changes in neuropsychomotor development and investigate the effect of feeding progression in Neonatal Intensive Care Unit (NICU) on neuropsychomotor outcomes in low-birth-weight preterm infants within 9 months of corrected age. BACKGROUND: Low-birth-weight (LBW) preterm infants (<37 weeks of gestation and birth weight < 2500 g) are at a high risk for neuropsychomotor development delay. Therefore, exploring NICU practices related to neuropsychomotor development is important...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29776895/islet-transplantation-versus-insulin-therapy-in-patients-with-type-1-diabetes-with-severe-hypoglycaemia-or-poorly-controlled-glycaemia-after-kidney-transplantation-trimeco-a-multicentre-randomised-controlled-trial
#3
Sandrine Lablanche, Marie-Christine Vantyghem, Laurence Kessler, Anne Wojtusciszyn, Sophie Borot, Charles Thivolet, Sophie Girerd, Domenico Bosco, Jean-Luc Bosson, Cyrille Colin, Rachel Tetaz, Sophie Logerot, Julie Kerr-Conte, Eric Renard, Alfred Penfornis, Emmanuel Morelon, Fanny Buron, Kristina Skaare, Gwen Grguric, Coralie Camillo-Brault, Harald Egelhofer, Kanza Benomar, Lionel Badet, Thierry Berney, François Pattou, Pierre-Yves Benhamou
BACKGROUND: Islet transplantation is indicated for patients with type 1 diabetes with severe hypoglycaemia or after kidney transplantation. We did a randomised trial to assess the efficacy and safety of islet transplantation compared with insulin therapy in these patients. METHODS: In this multicentre, open-label, randomised controlled trial, we randomly assigned (1:1) patients with type 1 diabetes at 15 university hospitals to receive immediate islet transplantation or intensive insulin therapy (followed by delayed islet transplantation)...
May 15, 2018: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29774595/long-term-schneiderian-membrane-thickness-changes-following-zygomatic-implant-placement-a-retrospective-radiographic-analysis-using-cone-beam-computed-tomography
#4
Kai Zhao, Meifei Lian, Shengchi Fan, Wei Huang, Feng Wang, Yiqun Wu
OBJECTIVES: The purpose of this retrospective study was to evaluate the long-term changes in the thickness of Schneiderian membranes after zygomatic implant placement using cone beam computed tomography (CBCT). MATERIAL AND METHODS: Twenty-five consecutive patients were included in this study. All the patients underwent bilateral zygomatic implant placement. Schneiderian membrane thickness (SMT) in 49 maxillary sinuses (one sinus was not included because of early loss of the zygomatic implants) was measured using CBCT before and at least 1 year after zygomatic implant placement...
May 17, 2018: Clinical Oral Implants Research
https://www.readbyqxmd.com/read/29774394/longitudinal-health-care-cost-in-hypoplastic-left-heart-syndrome-palliation
#5
Jesse E Hansen, Nicolas L Madsen, Laurie Bishop, David L S Morales, Jeffrey B Anderson
Management of hypoplastic left heart syndrome (HLHS) is resource intensive. Heath care systems are pressured to provide value to patients by improving outcomes while decreasing costs. A single-center retrospective cohort of infants with HLHS who underwent Norwood procedure or hybrid Norwood from 2004 to 2014 and survived to first outpatient follow up were studied. The primary outcome was total cost through 12 months with a sub-analysis of patients with 60 months of data. Costs were calculated using internal cost accounting system and reported by cost center...
May 17, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29774388/withholding-or-withdrawing-of-life-sustaining-therapy-in-older-adults-%C3%A2-80-years-admitted-to-the-intensive-care-unit
#6
Bertrand Guidet, Hans Flaatten, Ariane Boumendil, Alessandro Morandi, Finn H Andersen, Antonio Artigas, Guido Bertolini, Maurizio Cecconi, Steffen Christensen, Loredana Faraldi, Jesper Fjølner, Christian Jung, Brian Marsh, Rui Moreno, Sandra Oeyen, Christina Agwald Öhman, Bernardo Bollen Pinto, Ivo W Soliman, Wojciech Szczeklik, Andreas Valentin, Ximena Watson, Tilemachos Zafeiridis, Dylan W De Lange
PURPOSE: To document and analyse the decision to withhold or withdraw life-sustaining treatment (LST) in a population of very old patients admitted to the ICU. METHODS: This prospective study included intensive care patients aged ≥ 80 years in 309 ICUs from 21 European countries with 30-day mortality follow-up. RESULTS: LST limitation was identified in 1356/5021 (27.2%) of patients: 15% had a withholding decision and 12.2% a withdrawal decision (including those with a previous withholding decision)...
May 17, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29773846/appetite-during-the-recovery-phase-of-critical-illness-a-cohort-study
#7
Judith L Merriweather, David M Griffith, Timothy S Walsh
BACKGROUND/OBJECTIVES: Reduced appetite is a recognised physiological symptom in survivors of critical illness. While reduced appetite has been reported by patients after intensive care unit (ICU) discharge, quantification using visual analogue scales (VAS) has not been previously performed, and follow-up duration has been limited. We aimed to describe appetite scores in ICU survivors during the first 3 months after ICU discharge and explore association with systemic inflammation. SUBJECTS/METHODS: Secondary analysis of data collected in a complex rehabilitation intervention trial (RECOVER)...
May 17, 2018: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29773712/acute-kidney-injury-and-risk-of-heart-failure-and-atherosclerotic-events
#8
Alan S Go, Chi-Yuan Hsu, Jingrong Yang, Thida C Tan, Sijie Zheng, Juan D Ordonez, Kathleen D Liu
BACKGROUND AND OBJECTIVES: AKI in the hospital is common and is associated with excess mortality. We examined whether AKI is also independently associated with a higher risk of different cardiovascular events in the first year after discharge. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective analysis of a cohort between 2006 and 2013 with follow-up through 2014, within Kaiser Permanente Northern California. We identified all adults admitted to 21 hospitals who had one or more in-hospital serum creatinine test result and survived to discharge...
May 17, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29770454/streamlining-a-blood-center-and-hospital-transfusion-service-supply-chain-with-an-informatics-vendor-managed-inventory-solution-development-implementation-and-3-month-follow-up
#9
Hamilton C Tsang, Adam Garcia, Robert Scott, David Lancaster, Dianne Geary, Anh-Thu Nguyen, Raina Shankar, Leslie Buchanan, Tho D Pham
BACKGROUND: The ordering process at Stanford Health Care involved twice-daily shipments predicated upon current stock levels from the blood center to the hospital transfusion service. Manual census determination is time consuming and error prone. We aimed to enhance inventory management by developing an informatics platform to streamline the ordering process and reallocate staff productivity. STUDY DESIGN AND METHODS: The general inventory accounts for more than 50 product categories based on characteristics including component, blood type, irradiation status, and cytomegalovirus serology status...
May 16, 2018: Transfusion
https://www.readbyqxmd.com/read/29765435/mortality-of-adult-intensive-care-units-in-turkey-using-the-apache-ii-and-sofa-systems-outcome-assessment-in-turkish-intensive-care-units
#10
Cetin Kaymak, Irfan Sencan, Seval Izdes, Aydin Sari, Hatice Yagmurdur, Derya Karadas, Derya Oztuna
Introduction: The aim of this study was to evaluate intensive care unit (ICU) performance using risk-adjusted ICU mortality rates nationally, assessing patients who died or had been discharged from the ICU. For this purpose, this study analyzed the Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) databases, containing detailed clinical and physiological information and mortality of mixed critically ill patients in a medical ICU at secondary and tertiary referral ICUs in Turkey...
April 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29764832/large-bowel-obstruction-in-a-27-year-old-woman-caused-by-a-sigmoid-faecal-bolus
#11
Radford Arran James Smith, Muhammad Abdalkoddus, Robert Bethune
A 27-year-old woman presented to the emergency department with a 24-hour history of severe left iliac fossa pain associated with vomiting. She reported a history of ovarian cysts and was provisionally diagnosed with a ruptured ovarian cyst and admitted under the obstetrics and gynaecology team for further investigation. 24 hours later, she became haemodynamically unstable with increasing abdominal distention and developed a metabolic acidosis. A CT scan revealed large bowel obstruction (LBO) secondary to a faecal bolus in the sigmoid colon with appearances suggestive of adult-onset Hirschsprung's disease...
May 14, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29764556/-extra-longtime-continuous-chest-compression-to-rescue-cardiopulmonary-arrest-a-case-report-and-the-literature-review
#12
Yan Zhang, Tianxue Yue, Kexin Sun, Jiang Wang, Ruiwu Zhu
The new cardiopulmonary resuscitation (CPR) guideline emphasize the importance of chest compression, which was considered as the first step to CPR. The duration for CPR is usually limited to 30 minutes. With the development of new technology and evidence-based medicine, the success of extra longtime CPR has become possible, which is of great significance to some patients with cardiac arrest (CA), but the time limit has not been determined. On February 23rd in 2016, a 76-year-old female patient with respiratory and cardiac arrest who was on the third day after transurethral resection of bladder tumor (TUR-BT) was admitted to the intensive care unit of the General Hospital of Fushun Mining Bureau...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29764185/management-of-metastatic-spinal-cord-compression-among-veterans-health-administration-radiation-oncologists
#13
Ruchika Gutt, Sheeta Malhotra, Shruti Jolly, Drew Moghanaki, Alice V Cheuk, Helen Fosmire, Maria Kelly, Lori Hoffman-Hogg, Stephen Lutz, Mitchell Anscher, George Dawson
BACKGROUND: Optimal management of metastatic spinal cord compression (MSCC) improves functional outcomes in patients with metastatic disease. This survey study evaluated management of MSCC by Veterans Health Administration (VHA) radiation oncologists (ROs), to determine whether management of MSCC correlates with American College of Radiology (ACR) guidelines, and to compare times to initiation of treatment between surgery and radiotherapy (RT). METHODS: Surveys emailed to 79 VHA ROs included questions on steroid use, surgical care, palliative care, fractionation of irradiation, re-irradiation, and management of common MSCC case scenarios...
April 2018: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29762453/microvascular-replantation-following-facial-dog-bites-in-children-systematic-review-and-management-algorithm
#14
Amanda J Williams, Jeremy M Powers, Jennifer L Rhodes, Andrea L Pozez
BACKGROUND: Pediatric dog bite injuries account for 1% of emergency department visits per year and represent an underrecognized and underreported public health problem. Reconstructive surgery is frequently utilized, and in the most extreme injuries, microvascular replantation may be considered. We sought to systematically review the available literature on microvascular replantation after facial dog bite injuries in children, with particular attention to perioperative morbidity and long-term follow-up...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#15
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29761488/psychological-therapies-for-treatment-resistant-depression-in-adults
#16
REVIEW
Sharea Ijaz, Philippa Davies, Catherine J Williams, David Kessler, Glyn Lewis, Nicola Wiles
BACKGROUND: Antidepressants are a first-line treatment for adults with moderate to severe major depression. However, many people prescribed antidepressants for depression don't respond fully to such medication, and little evidence is available to inform the most appropriate 'next step' treatment for such patients, who may be referred to as having treatment-resistant depression (TRD). National Institute for Health and Care Excellence (NICE) guidance suggests that the 'next step' for those who do not respond to antidepressants may include a change in the dose or type of antidepressant medication, the addition of another medication, or the start of psychotherapy...
May 14, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29759717/low-level-vagus-nerve-stimulation-suppresses-post-operative-atrial-fibrillation-and-inflammation-a-randomized-study
#17
Stavros Stavrakis, Mary Beth Humphrey, Benjamin Scherlag, Omer Iftikhar, Purvi Parwani, Mubasher Abbas, Adrian Filiberti, Christian Fleming, Yanqing Hu, Paul Garabelli, Arthur McUnu, Marvin Peyton, Sunny S Po
OBJECTIVES: This study sought to examine the efficacy of low-level vagus nerve stimulation (LLVNS) in suppressing post-operative atrial fibrillation (POAF) and inflammatory cytokines in patients undergoing cardiac surgery. BACKGROUND: POAF often complicates cardiac surgery. METHODS: Patients undergoing cardiac surgery were randomized to active or sham LLVNS. In all patients, a bipolar wire was sutured to the vagus nerve pre-ganglionic fibers alongside the lateral aspect of the superior vena cava...
September 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29758192/gastric-mucosal-metastasis-of-prostate-cancer
#18
Hayretdin Koklu, Gokhan Gedikoglu, Taylan Kav
A 65-year-old male patient who had been hospitalized in the ıntensive care unit for pneumonia presented with hematemesis and melena. He was diagnosed with metastatic adenocarcinoma of prostate (multiple bone and lung metastases), which was accompanied by diabetes mellitus, hypertension, and coronary heart disease. The hemoglobin levels decreased from 11.4 g/dL to 7.3 g/dL during follow-up. Upper endoscopy revealed widespread distribution of numerous umbilicated nodules with varying sizes (from 0.5 to 2 cm) on gastric mucosa (A, B, C)...
May 11, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29756290/a-standardized-closed-loop-system-for-monitoring-pediatric-tracheostomy-related-adverse-events
#19
Mallory McKeon, Daphne Munhall, Brian K Walsh, Roger Nuss, Reza Rahbar, Mark Volk, Karen Watters
OBJECTIVES/HYPOTHESIS: Advancement in neonatal and pediatric intensive care has increased the need for chronic-care interventions, including tracheostomy. It is well established that children with a tracheostomy are at a high risk for adverse events, many of which are preventable. Despite this, there is no standardized method of monitoring tracheostomy-related adverse events (TRAEs). Our objective was to describe and assess a standardized, closed-loop system for monitoring TRAEs. STUDY DESIGN: Prospective Study...
May 14, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29756065/the-effects-of-mechanical-ventilation-on-the-quality-of-sleep-of-hospitalised-patients-in-the-intensive-care-unit
#20
REVIEW
Hana Locihová, Katarína Žiaková
Aim: To examine the effects of mechanical ventilation on the quality of sleep in patients in the intensive care unit (ICU) using recent and relevant literature. Methods: To verify the examined objective, the results of the analysis of available original scientific works have been used including defined inclusion/exclusion criteria and search strategy. Appropriate works found were analysed further. The applied methodology was in line with the general principles of Evidence-Based Medicine...
April 2018: Romanian Journal of Anaesthesia and Intensive Care
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