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https://www.readbyqxmd.com/read/28231633/barriers-to-regaining-control-within-a-constructivist-grounded-theory-of-family-resilience-in-icu-living-with-uncertainty
#1
Pauline Wong, Pranee Liamputtong, Susan Koch, Helen Rawson
This paper discusses families' experiences of their interactions when a relative is admitted unexpectedly to an Australian intensive care unit BACKGROUND: The overwhelming emotions associated with the unexpected admission of a relative to an intensive care unit (ICU) are often due to the uncertainty surrounding the condition of their critically ill relative. There is limited in-depth understanding of the nature of uncertainty experienced by families in ICU, and interventions perceived by families to minimise their uncertainty are not well documented...
February 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28231607/position-in-the-second-stage-of-labour-for-women-with-epidural-anaesthesia
#2
REVIEW
Marion Kibuka, Jim G Thornton
BACKGROUND: Epidural analgesia for pain relief in labour prolongs the second stage of labour and results in more instrumental deliveries. It has been suggested that a more upright position of the mother during all or part of the second stage may counteract these adverse effects. This is an update of a Cochrane review first published in 2013. OBJECTIVES: To assess the effects of different birthing positions (upright and recumbent) during the second stage of labour, on important maternal and fetal outcomes for women with epidural analgesia...
February 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28231518/early-bronchoalveolar-lavage-for-intubated-trauma-patients-with-tbi-or-chest-trauma
#3
Tyler J Loftus, Stephen J Lemon, Linda L Nguyen, Stacy A Voils, Scott C Brakenridge, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Frederick A Moore, Philip A Efron, Alicia M Mohr
PURPOSE: To evaluate the efficacy of an early bronchoalveolar lavage (E-BAL) protocol. BAL was performed within 48 h for intubated patients with traumatic brain injury or chest trauma. We hypothesized that E-BAL would decrease antibiotic use and improve outcomes compared to late BAL (L-BAL) triggered by clinical signs of pneumonia. METHODS: Retrospective cohort analysis of 132 patients with quantitative BAL and ≥1 risk factor: head Abbreviated Injury Score ≥2, ≥3 rib fractures, or radiographic signs of aspiration or pulmonary contusion...
February 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28230899/shared-care-across-the-interface-between-primary-and-specialty-care-in-management-of-long-term-conditions
#4
REVIEW
Susan M Smith, Gráinne Cousins, Barbara Clyne, Shane Allwright, Tom O'Dowd
BACKGROUND: Shared care has been used in the management of many chronic conditions with the assumption that it delivers better care than primary or specialty care alone; however, little is known about the effectiveness of shared care. OBJECTIVES: To determine the effectiveness of shared care health service interventions designed to improve the management of chronic disease across the primary/specialty care interface. This is an update of a previously published review...
February 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28230713/the-impact-of-ethnic-and-cultural-differences-on-parental-satisfaction-in-the-picu
#5
Qian Wen Sng, Angela H P Kirk, Siti Nur Hanim Buang, Jan Hau Lee
OBJECTIVES: This study examined satisfaction of parents whose children were admitted to the PICU to identify priority areas for improvement. We hypothesized that differences exist in satisfaction of parents of different ethnicities. DESIGN: Prospective observational study. SETTING: PICU in a tertiary care pediatric hospital. PATIENTS: All English-literate parents whose child was admitted to our PICU between February 2014 and February 2015 were eligible after informed consent was obtained...
February 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28230663/mastery-in-bariatric-surgery-the-long-term-surgeon-learning-curve-of-roux-en-y-gastric-bypass
#6
Aristithes G Doumouras, Fady Saleh, Sama Anvari, Scott Gmora, Mehran Anvari, Dennis Hong
OBJECTIVE: To determine the effect of cumulative volume on all-cause morbidity and operative time. BACKGROUND: Gastric bypass is an important public health procedure, but it is difficult to master with little data about how surgeon cumulative volume affects outcomes longitudinally. METHODS: This was a longitudinal study of 29 surgeons during the first 6 years of performing bariatric surgery in a high-volume, regionalized center of excellence system...
February 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28230627/surgical-outcomes-after-trauma-pneumonectomy-revisited
#7
Kazuhide Matsushima, Alberto Aiolfi, Caroline Park, David Rosen, Aaron Strumwasser, Elizabeth Benjamin, Kenji Inaba, Demetrios Demetriades
INTRODUCTION: Trauma pneumonectomy has been historically associated with an exceedingly high morbidity and mortality. The recent advent of standardized reporting and data-collecting measures has facilitated large volume data-analysis on predictors and outcomes of trauma pneumonectomy. The purpose of this study is to describe patient characteristics and outcomes of the patients who underwent trauma pneumonectomy in the modern era and identify clinical factors associated with postoperative mortality...
February 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28230626/resiliency-and-quality-of-life-trajectories-after-injury
#8
Ben L Zarzaur, Teresa M Bell, Stephen A Zanskas
BACKGROUND: Injury can greatly impact patients' long-term quality of life. Resilience refers to an individual's ability to positively adapt after facing stress or trauma. The objective of this study was to examine the relationship between pre-injury resiliency scores and quality of life after injury. METHODS: 225 adults admitted with an injury severity score > 10 but without neurological injury were included. The SF-36 was administered at the time of admission and repeated at 1, 2, 4 and 12 months after injury...
February 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28230012/safety-and-feasibility-within-24-h-of-discharge-in-patents-with-inoperable-malignant-lung-nodules-after-percutaneous-microwave-ablation
#9
Bin Li, Zhiwei Wang, Kang Zhou, Qinzong Gao, Xiaoguang Li
CONTEXT: Minimally invasive interventional therapy is now the more effective treatment strategy for organ-confined malignancy in patients who are poor candidates for surgery. Microwave ablation (MWA) in lung malignancy has been receiving much attention as an effective minimally invasive approach. AIMS: The aim of this study is to evaluate the safety and feasibility within 24 h of discharge of patients treated with percutaneous MWA for inoperable malignant lung nodules, and elucidate the factors predisposing to hospital readmission...
December 2016: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28229983/establishment-and-application-of-early-risk-stratification-method-for-acute-abdominal-pain-in-adults
#10
Yu Wang, Hong Zhao, Zhen Zhou, Ci Tian, Hong-Li Xiao, Bao-En Wang
BACKGROUND: Acute abdominal pain is a common symptom of emergency patients. The severity was always evaluated based on physicians' clinical experience. The aim of this study was to establish an early risk stratification method (ERSM) for addressing adults with acute abdominal pain, which would guide physicians to take appropriate and timely measures following the established health-care policies. METHODS: In Cohort 1, the records of 490 patients with acute abdominal pain that developed within the past 72 h were enrolled in this study...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28229836/-fibrinolytics-in-the-treatment-of-complicated-pleural-effusions
#11
Ana Coelho, Margarida Coelho, Joana Pereira, Vasco Lavrador, Lurdes Morais, Fátima Carvalho
INTRODUCTION: The treatment of complicated pleural parapneumonic effusions with intrapleural instillation of fibrinolytics, has shown similar results as surgical treatment. The present study aimed to evaluate the results of the use of intrapleural instillation of fibrinolytics in the treatment of complicated pleural parapneumonic effusions, in patients followed in our hospital. MATERIAL AND METHODS: A retrospective review of all the patients (aged between one month and 18 years) diagnosed with complicated parapneumonic effusions, which had chest drain insertion with intrapleural instillation of fibrinolytic, between January 2005 and December 2013, was undertaken...
November 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28229625/is-pain-at-discharge-a-risk-factor-for-unplanned-hospital-readmission
#12
Mieke Deschepper, Peter Vermeir, Dirk Vogelaers, Jacques Devulder, Kristof Eeckloo
INTRODUCTION: Unplanned readmissions are associated with a high cost to health insurances and the incidence of preventable readmissions could be considered as a quality indicator for the initial hospital admission. We aimed to assess the predictive value for unplanned readmission of higher pain scores at discharge of the initial admission as well as of other pain and demographic characteristics. The documentation of significant associations would provide further support for a structured pain management policy...
February 23, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28229546/lessons-from-the-past-family-involvement-in-patient-admission-and-discharge-beechworth-lunatic-asylum-1900-1912
#13
Eileen Clark
In this study, document analysis is used to examine case books from the Beechworth Lunatic Asylum with the aim of determining the extent of family involvement in patients' admission and discharge. There were 420 male and 278 female patients admitted in the study period, with over half transferred from other Victorian asylums. Next of kin were identified for 64% of male and 84% of female patients. Families were involved in the admission of 52 (12%) male and 50 (18%) female patients, usually by bringing patients to the asylum or providing evidence of behavioural changes...
February 23, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28229530/an-audit-of-anticholinergic-medication-changes-in-older-hospitalised-patients-using-the-anticholinergic-drug-scale
#14
Michele Lee, Hugh Carl Hanger
OBJECTIVE: In patients discharged from an Older Person's Health hospital, we assessed 1) the prevalence of anticholinergic medications in this study population and 2) changes in anticholinergic drug burden during admission using the Anticholinergic Drug Scale (ADS). METHODS: Cases were identified between September 2010 and January 2011 using discharge coding data. Clinical notes were reviewed to determine which regular oral medications were commenced, altered or ceased during admission with their respective ADS level...
February 23, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28229471/prevalence-of-nursing-diagnoses-as-a-measure-of-nursing-complexity-in-a-hospital-setting
#15
Fabio D'Agostino, Gianfranco Sanson, Antonello Cocchieri, Ercole Vellone, John Welton, Massimo Maurici, Rosaria Alvaro, Maurizio Zega
AIMS: To describe the prevalence of nursing diagnoses on admission among inpatient units and medical diagnoses and to analyze the relationship of nursing diagnoses to patient characteristics and hospital outcomes. BACKGROUND: Nursing diagnoses classify patients according to nursing dependency and can be a measure of nursing complexity. Knowledge regarding the prevalence of nursing diagnoses on admission and their relationship with hospital outcomes is lacking. DESIGN: Prospective observational study...
February 22, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28229353/cardiorespiratory-instability-in-monitored-step-down-unit-patients-using-cluster-analysis-to-identify-patterns-of-change
#16
Eliezer L Bose, Gilles Clermont, Lujie Chen, Artur W Dubrawski, Dianxu Ren, Leslie A Hoffman, Michael R Pinsky, Marilyn Hravnak
Cardiorespiratory instability (CRI) in monitored step-down unit (SDU) patients has a variety of etiologies, and likely manifests in patterns of vital signs (VS) changes. We explored use of clustering techniques to identify patterns in the initial CRI epoch (CRI1; first exceedances of VS beyond stability thresholds after SDU admission) of unstable patients, and inter-cluster differences in admission characteristics and outcomes. Continuous noninvasive monitoring of heart rate (HR), respiratory rate (RR), and pulse oximetry (SpO2) were sampled at 1/20 Hz...
February 22, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28229304/early-elevated-levels-of-soluble-triggering-receptor-expressed-on-myeloid-cells-1-in-subarachnoid-hemorrhage-patients
#17
Xin-Gang Sun, Qian Ma, Gang Jing, Li Wang, Xu-Dong Hao, Gai-Qing Wang
Early brain injury (EBI) contributes to poor prognosis of subarachnoid hemorrhage (SAH). This study aimed to clarify whether triggering receptor expressed on myeloid cells-1 (TREM-1) was implicated in the inflammatory mechanisms of EBI. The cerebrospinal fluid (CSF) levels of soluble TREM-1 (sTREM-1), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) as well as plasma levels of white blood cells (WBC) count and C-reactive protein in 17 SAH patients at early stage (within the EBI period) and 9 volunteers were observed...
February 22, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28228656/incidence-and-long-term-outcome-of-severe-asthma-copd-overlap-compared-to-asthma-and-copd-alone-a-35-year-prospective-study-of-57-053-middle-aged-adults
#18
Camilla Boslev Baarnes, Zorana Jovanovic Andersen, Anne Tjønneland, Charlotte Suppli Ulrik
BACKGROUND: Incidence and prognosis for severe asthma-COPD overlap is poorly characterized. We investigated incidence and long-term outcome for patients with asthma-COPD overlap compared to asthma and COPD alone. MATERIALS AND METHODS: A total of 57,053 adults (aged 50-64 years) enrolled in the Danish Diet, Cancer, and Health cohort (1993-1997) were followed in the National Patients Registry for admissions for asthma (DJ45-46) and COPD (DJ40-44) and vital status...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28228622/a-case-of-hyperammonemia-with-obstructive-urinary-tract-infection-by-urease-producing-bacteria
#19
Toshiaki Goda, Kotaro Watanabe, Junya Kobayashi, Yasuharu Nagai, Nobuyuki Ohara, Daisuke Takahashi
A 79-year-old woman was admitted emergently for disturbance of consciousness. Her consciousness level was Japan coma scale 20, and she presented with hypermyotonia. Brain magnetic resonance imaging and cerebrospinal fluid examination showed normal findings. Her blood tests showed an increased ammonia level of 291 μg/dl with normal liver function. We catheterized the bladder for urinary retention. Eight hours after admission, the blood level of ammonia decreased to 57 μg/dl and the patient's consciousness level improved...
February 22, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28228588/investigation-of-the-role-of-protein-kinase-d-in-human-rhinovirus-replication
#20
Anabel Guedán, Dawid Swieboda, Mark Charles, Marie Toussaint, Sebastian L Johnston, Amin Asfor, Anusha Panjwani, Tobias J Tuthill, Henry Danahay, Tony Raynham, Aurelie Mousnier, Roberto Solari
Picornavirus replication is known to cause extensive remodelling of Golgi and endoplasmic reticulum membranes and a number of the host proteins involved in the viral replication complex have been identified, including oxysterol binding protein (OSBP) and phosphatidylinositol 4-kinase III beta (PI4KB). Since both OSBP and PI4KB are substrates for protein kinase D (PKD) and PKD is known to be involved in the control of Golgi vesicular and lipid transport, we hypothesised that PKD played a role in viral replication...
February 22, 2017: Journal of Virology
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