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https://www.readbyqxmd.com/read/29151002/management-of-arrhythmia-in-sepsis-and-septic-shock
#1
Martin Balik, Vojtech Matousek, Michal Maly, Tomas Brozek
The occurrence of supraventricular arrhythmias is associated with an unfavourable prognosis in septic shock. Available trials are difficult to apply in sepsis and septic shock patients due to included cohorts, control groups and because "one size does not fit all". The priorities in the critically ill are maintenance of a sinus rhythm and diastolic ventricular filling. The rate control modality should be reserved for chronic AF and in situations when a sinus rhythm is difficult to maintain due to extreme stress conditions resulting from a high dosage of vasoactive agents...
November 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#2
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29148989/chronic-critical-illness-after-trauma-from-description-to-treatment
#3
Iwan A Meynaar, Peter E Spronk
No abstract text is available yet for this article.
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29143899/headache-in-resource-limited-settings
#4
REVIEW
Yohannes W Woldeamanuel
PURPOSE OF REVIEW: This review summarizes the unmet need of headache burden and management in resource-limited settings. It provides a general overview of the nuances and peculiarities of headache disorders in resource-limited settings. The review delivers perspectives and explanations for the emerging burden of both primary and secondary headache disorders. Important discussion on demographic and epidemiologic transition pertinent to low-resource settings is included. A critical analysis of headache disorders is made within the context of growing burden non-communicable disorders in low-resource countries...
November 16, 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29139571/human-prosthetic-joint-infections-are-associated-with-myeloid-derived-suppressor-cells-mdscs-implications-for-infection-persistence
#5
Cortney E Heim, Debbie Vidlak, Jessica Odvody, Curtis W Hartman, Kevin L Garvin, Tammy Kielian
Prosthetic joint infection (PJI) is a devastating complication of joint arthroplasty surgery typified by biofilm formation. Currently, mechanisms whereby biofilms persist and evade immune-mediated clearance in immune competent patients remain largely ill-defined. Therefore, the current study characterized leukocyte infiltrates and inflammatory mediator expression in tissues from patients with PJI compared to aseptic loosening. CD33(+) HLA-DR(-) CD66b(+) CD14(-/low) granulocytic myeloid-derived suppressor cells (G-MDSCs) were the predominant leukocyte population at sites of human PJI compared to aseptic tissues...
November 15, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29137585/association-of-positive-fluid-balance-and-mortality-in-sepsis-and-septic-shock-in-an-australian-cohort
#6
M G Pittard, S J Huang, A S McLean, S R Orde
In patients with septic shock, a correlation between positive fluid balance and worsened outcomes has been reported in multiple observational studies worldwide. No published data exists in an Australasian cohort. We set out to explore this association in our institution. We conducted a retrospective audit of patient records from August 2012 to May 2015 in a single-centre, 24-bed surgical and medical intensive care unit (ICU) in Sydney, Australia. All patients with septic shock were included. Exclusion criteria included length of stay less than 24 hours or vasopressors needed for less than six hours...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29124867/acute-kidney-injury-in-critically-ill-surgical-patients-epidemiology-risk-factors-and-outcomes
#7
Konlawij Trongtrakul, Chaiwut Sawawiboon, Amanda Y Wang, Anusang Chitsomkasem, Ploynapas Limphunudom, Sathit Kurathong, Surasee Prommoon, Thananda Trakarnvanich, Nattachai Srisawat
AIM: Acute kidney injury (AKI) is one of the most serious complications seen in intensive care units (ICUs). However, its epidemiology, risk factors and clinical outcomes in surgical critically ill patients remains unclear. METHODS: A prospective cohort study was conducted in surgical intensive care unit (ICU) of the university hospital in Bangkok, Thailand. AKI was diagnosed according to the KDIGO 2012 criteria. RESULTS: A total of 189 of the 400 patients enrolled in our study developed AKI (47...
November 10, 2017: Nephrology
https://www.readbyqxmd.com/read/29124697/ultraviolet-b-radiation-the-vitamin-d-connection
#8
Michael F Holick
Vitamin D is known as the sunshine vitamin. During exposure to sunlight the skin transforms 7-dehydrocholesterol into vitamin D3. Throughout evolution vitamin D3 has played a pivotal role in the evolution of vertebrates. Vitamin D is not only critically important for bone health but has a multitude of other biologic functions to help reduce chronic illnesses. This Chapter reviews how vitamin D is produced in the skin, factors that affect its production and a prospective on how to obtain vitamin D from sensible sun exposure...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29118760/septic-shock-and-the-aging-process-a-molecular-comparison
#9
Fabiano Pinheiro da Silva, Marcel Cerqueira César Machado
Aging is a continuous process promoted by both intrinsic and extrinsic factors that each trigger a multitude of molecular events. Increasing evidence supports a central role for inflammation in this progression. Here, we discuss how the low-grade chronic inflammation that characterizes aging is tightly interconnected with other important aspects of this process, such as DNA damage, mitochondrial dysfunction, and epigenetic changes. Similarly, inflammation also plays a critical role in many morbid conditions that affect patients who are admitted to Intensive Care...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29117059/vascular-access-in-critically-ill-pediatric-patients-with-obesity
#10
Elizabeth E Halvorson, Doug Case, Joseph A Skelton, Michael C McCrory
OBJECTIVES: Pediatric obesity is highly prevalent and has been associated with poor outcomes for hospitalized children. Vascular access is essential in critically ill patients. The aim of this study was to evaluate whether critically ill children with obesity are more likely to undergo vascular device insertion (excluding peripheral IV catheters) and develop related complications. DESIGN: Multi-institutional retrospective observational cohort study. SETTING: Ninety-four U...
November 7, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29115714/deep-vein-thrombosis-in-pediatric-patients
#11
REVIEW
Julie Jaffray, Guy Young
Due to advances in caring for critically ill children and those with chronic diseases, rates of deep vein thrombosis (DVT) are increasing in children. Risk factors consist of central venous catheters, chronic medical conditions, thrombophilia, and various medications. Compression Doppler ultrasonography is the method most commonly used to diagnose DVT, and patients will usually present with pain and swelling of the affected limb. Anticoagulation via subcutaneous injection is the most common treatment regime for children with DVT, and the new, direct oral anticoagulants are currently under investigation...
November 8, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29098423/hypoglycemia-reduction-strategies-in-the-icu
#12
REVIEW
Susan Shapiro Braithwaite, Dharmesh B Bavda, Thaer Idrees, Faisal Qureshi, Oluwakemi T Soetan
PURPOSE OF REVIEW: We reviewed the strategies associated with hypoglycemia risk reduction among critically ill non-pregnant adult patients. RECENT FINDINGS: Hypoglycemia in the ICU has been associated with increased mortality in a number of studies. Insulin dosing and glucose monitoring rules, response to impending hypoglycemia, use of computerization, and attention to modifiable factors extrinsic to insulin algorithms may affect the risk for hypoglycemia. Recurring use of intravenous (IV) bolus doses of insulin in insulin-resistant cases may reduce reliance upon higher IV infusion rates...
November 2, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/29092656/effect-of-anemia-on-mortality-in-mechanically-ventilated-patients-with-chronic-obstructive-pulmonary-disease
#13
Shruti K Gadre, Aravdeep Singh Jhand, Sami Abuqayyas, Xiaofeng Wang, Jorge Guzman, Abhijit Duggal
RATIONALE: The effect of anemia on patients with chronic obstructive pulmonary disease (COPD) requiring invasive mechanical ventilation for acute respiratory failure is unknown. OBJECTIVES: To examine the association between anemia (hemoglobin <12 g/dL) and 90-day and overall mortality in patients with COPD having acute respiratory failure requiring invasive mechanical ventilation. METHODS: Retrospective study of patients admitted to a quaternary referral medical intensive care unit (ICU) between October 2007 and December 2012 with a diagnosis of COPD and requiring invasive mechanical ventilation for acute respiratory failure of any cause...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29081996/chronic-kidney-disease-in-low-income-to-middle-income-countries-the-case-for-increased-screening
#14
REVIEW
Cindy George, Amelie Mogueo, Ikechi Okpechi, Justin B Echouffo-Tcheugui, Andre Pascal Kengne
Chronic kidney disease (CKD) is fast becoming a major public health issue, disproportionately burdening low-income to middle-income countries, where detection rates remain low. We critically assessed the extant literature on CKD screening in low-income to middle-income countries. We performed a PubMed search, up to September 2016, for studies on CKD screening in low-income to middle-income countries. Relevant studies were summarised through key questions derived from the Wilson and Jungner criteria. We found that low-income to middle-income countries are ill-equipped to deal with the devastating consequences of CKD, particularly the late stages of the disease...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29077863/seen-through-the-patients-eyes-safety-of-chronic-illness-care
#15
Melissa Desmedt, Mirko Petrovic, Jochen Bergs, Dominique Vandijck, Hubertus Vrijhoef, Johan Hellings, Peter Vermeir, Lieselot Cool, Ezra Dessers
Objective: Due to the increasing burden of chronic diseases, a considerable part of care delivery will continue to shift from secondary to primary care, and home care settings. Despite the growing importance of primary care, concerns about the safety of patients in hospitals have thus far driven most research in the field. Therefore, the present study sought to explore patients' perceptions and experiences of the safety of primary chronic care. Design: An observational, cross-sectional study design was applied...
October 25, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29071480/obesity-appetite-and-the-prefrontal-cortex
#16
REVIEW
Marci E Gluck, Pooja Viswanath, Emma J Stinson
PURPOSE OF REVIEW: Obesity is a chronic illness and its prevalence is growing worldwide and numerous factors play a role in the regulation of food intake. The prefrontal cortex (PFC) is involved in high-order executive function, regulation of limbic reward regions, and the inhibition of impulsive behaviors. Understanding the role of the PFC in the control of appetite regulation may contribute to a greater understanding of the etiology of obesity and could improve weight loss outcomes...
October 25, 2017: Current Obesity Reports
https://www.readbyqxmd.com/read/29061552/designing-a-self-management-app-for-young-people-with-type-1-diabetes-methodological-challenges-experiences-and-recommendations
#17
Pernille Castensøe-Seidenfaden, Gitte Reventlov Husted, Grete Teilmann, Eva Hommel, Birthe Susanne Olsen, Finn Kensing
BACKGROUND: Young people with type 1 diabetes often struggle to self-manage their disease. Mobile health (mHealth) apps show promise in supporting self-management of chronic conditions such as type 1 diabetes. Many health care providers become involved in app development. Unfortunately, limited information is available to guide their selection of appropriate methods, techniques, and tools for a participatory design (PD) project in health care. OBJECTIVE: The aim of our study was to develop an mHealth app to support young people in self-managing type 1 diabetes...
October 23, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29049042/atrial-fibrillation-occurring-transiently-with-stress
#18
William F McIntyre, Stuart J Connolly, Jeff S Healey
PURPOSE OF REVIEW: Atrial fibrillation may be detected in the setting of an acute stressor, such as medical illness or surgery. It is uncertain if atrial fibrillation detected in these settings (AFOTS: atrial fibrillation occurring transiently with stress) is secondary to a reversible trigger or is simply paroxysmal atrial fibrillation. This distinction is critical for clinicians, who must decide if AFOTS can be dismissed as a reversible phenomenon, or if it signals the need for chronic therapy; in particular, anticoagulation...
October 18, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29046107/determinants-of-endotracheal-intubation-in-critically-ill-patients-undergoing-gastrointestinal-endoscopy-under-conscious-sedation
#19
Nathan J Smischney, Mohamed O Seisa, Mukesh Kumar, Jillian Deangelis, Darrell R Schroeder, Daniel A Diedrich
OBJECTIVES: Our primary aim was to determine the factors leading to prophylactic endotracheal intubation in intensive care unit (ICU) patients undergoing gastrointestinal endoscopy. Secondary aims were to determine the rate of unplanned endotracheal intubations during endoscopy and to determine the rate of aspiration following endoscopy for patients admitted to the ICU. METHODS: Critically ill adult (≥18 years) patients who underwent upper and lower endoscopic procedures from January 2012 to July 2016 in a medical/surgical ICU were included...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29044341/the-use-of-antimicrobials-in-septic-patients-with-acute-kidney-injury
#20
Fernanda Moreira de Freitas, Welder Zamoner, Durval Sampaio de Souza Garms, Mariele Gobo de Oliveira, André Luis Balbi, Daniela Ponce
Sepsis is the most common cause of death in critically ill patients and it may be associated with multiorgan failure, including acute kidney injury (AKI). This situation can require acute renal support and increase mortality. Therefore, it is essential to administrate antimicrobials in dosis to achieve adequate serum levels, preventing overdosis and drug toxicity or underdosing and risk for resistance to antibiotics and higher mortality. To date, there aren't validated guidelines on antibiotic dosis adjustment in septic patients with AKI and the recommendations are extrapolated from studies conducted in non-critical patients with chronic kidney disease in end stage receiving chronic renal replacement therapy...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
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