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https://www.readbyqxmd.com/read/28324969/a-clinical-study-of-short-term-sternal-photoplethysmography-recordings-from-patients-with-obstructive-airways-diseases
#1
Shadi S Chreiteh, Dorthe B Saadi, Bo Belhage, Nassim Nabipour, Karsten Hoppe, Erik V Thomsen
Traditionally, measurements of the oxygen saturation (SpO2) has been confound to the extremities. In this study, we therefore investigated the possibility for reliable estimation of clinically relevant SpO2 levels from photoplethysmography (PPG) obtained on the sternum of patients with obstructive airway diseases. We initiated the study with a calibration of a prototype sternal PPG sensor. In accordance with the ISO 80601-2-61:2011 guidelines, the calibration was conducted as a controlled desaturation study...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28324029/vital-directions-for-health-and-health-care-priorities-from-a-national-academy-of-medicine-initiative
#2
Victor J Dzau, Mark B McClellan, J Michael McGinnis, Sheila P Burke, Molly J Coye, Angela Diaz, Thomas A Daschle, William H Frist, Martha Gaines, Margaret A Hamburg, Jane E Henney, Shiriki Kumanyika, Michael O Leavitt, Ruth M Parker, Lewis G Sandy, Leonard D Schaeffer, Glenn D Steele, Pamela Thompson, Elias Zerhouni
Importance: Recent discussion has focused on questions related to the repeal and replacement of portions of the Affordable Care Act (ACA). However, issues central to the future of health and health care in the United States transcend the ACA provisions receiving the greatest attention. Initiatives directed to certain strategic and infrastructure priorities are vital to achieve better health at lower cost. Objectives: To review the most salient health challenges and opportunities facing the United States, to identify practical and achievable priorities essential to health progress, and to present policy initiatives critical to the nation's health and fiscal integrity...
March 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28299972/older-and-incarcerated-policy-implications-of-aging-prison-populations
#3
Zachary Psick, Jonathan Simon, Rebecca Brown, Cyrus Ahalt
Purpose The purpose of this paper is to explore the policy Implications of aging prison populations. Design/methodology/approach An examination of the worldwide aging trend in prison and its implications for correctional policy, including an examination of population aging in California prisons as a case example of needed reform. Findings Prison populations worldwide are aging at an unprecedented rate, and age-related medical costs have had serious consequences for jurisdictions struggling to respond to the changes...
March 13, 2017: International Journal of Prisoner Health
https://www.readbyqxmd.com/read/28297594/the-role-of-staging-in-planning-psychotherapeutic-interventions-in-depression
#4
Jenny Guidi, Elena Tomba, Fiammetta Cosci, Seung K Park, Giovanni A Fava
CONTEXT: The purpose of this critical review is to examine the role of staging in planning a psychotherapeutic intervention in depressive disorders. EVIDENCE ACQUISITION: English-language studies concerned with staging in depressive disorders were identified in MEDLINE, PsycINFO, and Web of Science and by manual search of the literature. Selection of articles was based on their methodological quality and implications for clinical practice. RESULTS: Staging may allow clinicians to apply a psychotherapeutic intervention to specific phases of the development of depressive disorders: certain psychotherapeutic approaches, such as well-being therapy and mindfulness-based cognitive therapy, appear to be uniquely suited for addressing the residual phase of depression, whereas interpersonal psychotherapy has been mainly tested in the acute phase...
March 14, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28296993/clinical-characteristics-and-outcomes-of-patients-with-cellulitis-requiring-intensive-care
#5
Duncan R Cranendonk, Lonneke A van Vught, Maryse A Wiewel, Olaf L Cremer, Janneke Horn, Marc J Bonten, Marcus J Schultz, Tom van der Poll, W Joost Wiersinga
Importance: Cellulitis is a commonly occurring skin and soft tissue infection and one of the most frequently seen dermatological diseases in the intensive care unit (ICU). However, clinical characteristics of patients with cellulitis requiring intensive care treatment are poorly defined. Necrotizing fasciitis is often confused for cellulitis at initial presentation and is considered to be more severe and thus has previously been described in more detail. Objective: To describe the clinical presentation and outcomes of patients with ICU-necessitating cellulitis and to compare them with patients with necrotizing fasciitis...
March 15, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28295248/t-regulatory-cells-are-critical-for-the-maintenance-anamnestic-expansion-and-protection-elicited-by-vaccine-induced-cd8-t-cells
#6
Mitra Bhattacharyya, Pablo Penaloza MacMaster
T regulatory cells (Tregs) are critical for preventing autoimmunity and suppressing immune responses during cancer and chronic infection. However, the role of Tregs in the generation of vaccine-induced immune memory remains ill-defined. Using the mouse model of lymphocytic choriomeningitis virus (LCMV) infection, we demonstrate that transient absence of Tregs during effector to memory CD8 T cell transition results in a permanent impairment in the maintenance, function, and recall capacity of CD8 T cells. Memory CD8 T cells in mice that were transiently depleted of Tregs exhibited defective upregulation of memory markers with a significant decrease in polyfunctionality...
March 14, 2017: Immunology
https://www.readbyqxmd.com/read/28292284/is-bulpa-criteria-suitable-for-the-diagnosis-of-probable-invasive-pulmonary-aspergillosis-in-critically-ill-patients-with-chronic-obstructive-pulmonary-disease-a-comparative-study-with-eortc-msg-and-icu-criteria
#7
Linna Huang, Hangyong He, Jingjing Jin, Qingyuan Zhan
BACKGROUND: Three diagnostic criteria have been proposed used for invasive pulmonary aspergillosis (IPA) diagnosis, namely EORTC/ MSG criteria, Bulpa criteria and intensive care unit (ICU) criteria. The Bulpa criteria were proposed to diagnose IPA in chronic obstructive pulmonary disease (COPD) patients specially. Our aim is to verify that whether the Bulpa criteria are the most suitable for diagnosing probable IPA in critically ill COPD patients compared with the other two criteria. METHODS: We included critically ill COPD patients admitted to the ICU from April 2006 to August 2013...
March 14, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28289816/current-state-of-the-art-for-renal-replacement-therapy-in-critically-ill-patients-with-acute-kidney-injury
#8
REVIEW
Sean M Bagshaw, Michael Darmon, Marlies Ostermann, Fredric O Finkelstein, Ron Wald, Ashita J Tolwani, Stuart L Goldstein, David J Gattas, Shigehiko Uchino, Eric A Hoste, Stephane Gaudry
Acute kidney injury (AKI) is associated with incremental risk for death and chronic kidney disease and represents a mounting clinical challenge for healthcare professionals. Renal replacement therapy (RRT) use in ICU settings is rising, likely in response to similar trends in AKI, taken together with an ageing population burdened by high prevalence of multi-morbidity and high illness acuity. Numerous features of RRT prescription and delivery are not standardized, nor are they supported from high-quality evidence derived from randomized trials...
March 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28288231/-primary-immunodeficiencies-in-seriously-ill-children-report-of-3-clinical-cases
#9
Leticia Yáñez, Pamela Lama, Carolina Rivacoba, Juanita Zamorano, María Angélica Marinovic
Primary immunodeficiency diseases (PID) are congenital disorders secondary to an impaired immune response. Infections, autoimmune disorders, atopy, and lymphoproliferative syndromes are commonly associated with this disorder. OBJECTIVE: To present and discuss 3 infants diagnosed with PID. CLINICAL CASES: The cases are presented of three patients with PID diagnosed during their first admission to a Paediatric Intensive Critical Care Unit. The first patient, a 4-month-old infant affected by a severe pneumonia, and was diagnosed as a Severe Combined Immunodeficiency Disease...
February 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28288028/the-obesity-paradox-is-not-observed-in-critically-ill-patients-on-early-enteral-nutrition
#10
Kimberley Harris, Jiachen Zhou, Xinggang Liu, Erkan Hassan, Omar Badawi
OBJECTIVES: To investigate the association between body mass index and mortality in a large, ICU population and determine if the relationship is observed among a subgroup of patients ordered early enteral nutrition. DESIGN: Retrospective cohort study within a national clinical mixed ICU database of patients admitted between January 1, 2008, and June 30, 2015. SETTING: Initial ICU admissions among patients monitored by tele-ICU programs and recorded in the Philips eICU Research Institute database...
March 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28286811/comparison-of-apache-ii-and-saps-ii-scoring-systems-in-prediction-of-critically-ill-patients-outcome
#11
Hamed Aminiahidashti, Farzad Bozorgi, Seyyed Hosein Montazer, Majid Baboli, Abolfazl Firouzian
INTRODUCTION: Using physiologic scoring systems for identifying high-risk patients for mortality has been considered recently. This study was designed to evaluate the values of Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiologic Score (SAPS II) models in prediction of 1-month mortality of critically ill patients. METHODS: The present prospective cross sectional study was performed on critically ill patients presented to emergency department during 6 months...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28284293/persistent-inflammation-immunosuppression-and-catabolism-syndrome
#12
REVIEW
Juan C Mira, Scott C Brakenridge, Lyle L Moldawer, Frederick A Moore
Following advances in critical care, in-hospital multiple organ failure-related mortality is declining. Consequently, incidence of chronic critical illness is increasing. These patients linger in the intensive care unit, have high resource utilization, and poor long-term outcomes. Within this population, the authors propose that a substantial subset of patients have a new phenotype: persistent inflammation, immunosuppression, and catabolism syndrome. There is evidence that myelodysplasia with expansion of myeloid-derived suppressor cells, innate and adaptive immune suppression, and protein catabolism with malnutrition are major contributors...
April 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28283821/significance-of-admission-hypoalbuminemia-in-acute-intracerebral-hemorrhage
#13
Andrea Morotti, Sandro Marini, Umme K Lena, Katherine Crawford, Kristin Schwab, Christina Kourkoulis, Alison M Ayres, M Edip Gurol, Anand Viswanathan, Steven M Greenberg, Christopher D Anderson, Jonathan Rosand, Joshua N Goldstein
Low levels of serum albumin may increase the risk of infections and mortality in critically ill patients. We tested the hypothesis that admission hypoalbuminemia predicted infectious complications and poor outcome in subjects with acute intracerebral hemorrhage (ICH). We analyzed a single center cohort of ICH patients collected between 1994 and 2015. Pneumonia, urinary tract infection and sepsis were retrospectively identified, according to validated criteria. Serum albumin was measured on admission and hypoalbuminemia was defined as total albumin ≤3...
March 10, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28279489/epidemiology-and-risk-factors-for-clostridium-difficile-infection-in-critically-ill-patients-in-spain-the-procrid-study
#14
Antonio Gutiérrez-Pizarraya, Luis Martín-Villén, Luis Alcalá-Hernández, Mercedes Marín Arriaza, Bárbara Balandín-Moreno, César Aragón-González, José Ferreres-Franco, Miguel Ángel Chiveli Monleón, Paloma Anguita-Alonso, Emilio Bouza-Santiago, José Garnacho-Montero
INTRODUCTION: Our objectives were to describe the incidence, clinical characteristics, and risk factors for Clostridium difficile infection (CDI) in critically ill patients and to determine C. difficile PCR-ribotypes. METHODS: Prospective, observational study in 26 Spanish ICUs. Patients with diarrhea meeting ESCMID criteria for CDI were included. Molecular characterization of isolates was performed using PCR ribotyping. RESULTS: Of 4258 patients admitted to the ICUs, 190 (4...
March 6, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28270177/genetic-variants-in-serpina4-and-serpina5-but-not-bcl2-and-sik3-are-associated-with-acute-kidney-injury-in-critically-ill-patients-with-septic-shock
#15
Laura M Vilander, Mari A Kaunisto, Suvi T Vaara, Ville Pettilä
BACKGROUND: Acute kidney injury (AKI) is a multifactorial syndrome, but knowledge about its pathophysiology and possible genetic background is limited. Recently the first hypothesis-free genetic association studies have been published to explore individual susceptibility to AKI. We aimed to replicate the previously identified associations between five candidate single nucleotide polymorphisms (SNP) in apoptosis-related genes BCL2, SERPINA4, SERPINA5, and SIK3 and the development of AKI, using a prospective cohort of critically ill patients with sepsis/septic shock, in Finland...
March 8, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28263192/the-confusion-assessment-method-for-the-icu-7-delirium-severity-scale-a-novel-delirium-severity-instrument-for-use-in-the-icu
#16
Babar A Khan, Anthony J Perkins, Sujuan Gao, Siu L Hui, Noll L Campbell, Mark O Farber, Linda L Chlan, Malaz A Boustani
OBJECTIVES: Delirium severity is independently associated with longer hospital stays, nursing home placement, and death in patients outside the ICU. Delirium severity in the ICU is not routinely measured because the available instruments are difficult to complete in critically ill patients. We designed our study to assess the reliability and validity of a new ICU delirium severity tool, the Confusion Assessment Method for the ICU-7 delirium severity scale. DESIGN: Observational cohort study...
March 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28260962/searching-for-a-written-patient-feedback-instrument-for-patient-medical-student-consultations
#17
Nicola Hogan, Henry Li, Carmel Pezaro, Noel Roberts, Erica Schmidt, Jenepher Martin
OBJECTIVE: The Patient Teaching Associate (PTA) program at Eastern Health Clinical School uses volunteer patients with chronic illnesses in consultation-based medical student education. The PTA program aims to develop students' patient-centeredness and associated skills. Our study aims, 1) to identify key desirable characteristics of written patient feedback to doctors and/or students that focuses on patient-centeredness in consultations, and 2) to critically evaluate existing instruments to identify any suitable instrument for use for medical student teaching...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28254855/training-and-maintaining-developing-a-successful-and-dynamic-continuous-renal-replacement-therapy-program
#18
Heather Przybyl, Jill Evans, Laurie Haley, Jodi Bisek, Emily Beck
Continuous renal replacement therapy (CRRT) is commonly used to support critically ill patients with acute kidney injury or chronic renal disease whose condition is too unstable for them to tolerate intermittent hemodialysis. Current publications related to CRRT programs in the United States and Canada note key themes related to the development and maintenance of CRRT training programs. A successful CRRT training program should consider and incorporate adult learning principles whenever possible. A variety of teaching methods to deliver information to nurses, including online learning modules, didactic lecture, return demonstration, and high-fidelity patient simulation are key to training programs for this high-risk complex therapy...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/28252537/daily-lowest-hemoglobin-and-risk-of-organ-dysfunctions-in-critically-ill-patients
#19
Sarah J Hemauer, Adam J Kingeter, Xue Han, Matthew S Shotwell, Pratik P Pandharipande, Liza M Weavind
OBJECTIVES: To determine the association between hemoglobin levels and the daily risk of individual organ dysfunctions in critically ill patients. DESIGN: Post hoc analysis of prospectively collected data. SETTING: Vanderbilt University Medical Center and Saint Thomas Hospital Medical and Surgical ICUs. PATIENTS: Medical and surgical ICU patients admitted with respiratory failure or shock. INTERVENTIONS: Baseline demographic data, and detailed in-ICU and hospital data, including daily lowest hemoglobin, were collected up to hospital day 30...
March 1, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28248228/role-of-protein-carbonylation-in-skeletal-muscle-mass-loss-associated-with-chronic-conditions
#20
REVIEW
Esther Barreiro
Muscle dysfunction, characterized by a reductive remodeling of muscle fibers, is a common systemic manifestation in highly prevalent conditions such as chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD), cancer cachexia, and critically ill patients. Skeletal muscle dysfunction and impaired muscle mass may predict morbidity and mortality in patients with chronic diseases, regardless of the underlying condition. High levels of oxidants may alter function and structure of key cellular molecules such as proteins, DNA, and lipids, leading to cellular injury and death...
May 6, 2016: Proteomes
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