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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
https://www.readbyqxmd.com/read/28432351/early-measurement-of-il-10-predicts-the-outcomes-of-patients-with-acute-respiratory-distress-syndrome-receiving-extracorporeal-membrane-oxygenation
#2
Chia-Hsiung Liu, Shuenn-Wen Kuo, Wen-Je Ko, Pi-Ru Tsai, Shu-Wei Wu, Chien-Heng Lai, Chih-Hsien Wang, Yih-Sharng Chen, Pei-Lung Chen, Tze-Tze Liu, Shu-Chien Huang, Tzuu-Shuh Jou
Patients diagnosed with acute respiratory distress syndrome are generally severely distressed and associated with high morbidity and mortality despite aggressive treatments such as extracorporeal membrane oxygenation (ECMO) support. To identify potential biomarker of predicting value for appropriate use of this intensive care resource, plasma interleukin-10 along with relevant inflammatory cytokines and immune cell populations were examined during the early and subsequent disease courses of 51 critically ill patients who received ECMO support...
April 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28432077/aerobic-exercise-promotes-executive-functions-and-impacts-functional-neural-activity-among-older-adults-with-vascular-cognitive-impairment
#3
Chun Liang Hsu, John R Best, Jennifer C Davis, Lindsay S Nagamatsu, Shirley Wang, Lara A Boyd, Gy Robin Hsiung, Michelle W Voss, Janice Jennifer Eng, Teresa Liu-Ambrose
BACKGROUND: Vascular cognitive impairment (VCI) results from cerebrovascular disease, and worldwide, it is the second most common type of cognitive dysfunction. While targeted aerobic training is a promising approach to delay the progression of VCI by reducing cardiometabolic risk factors, few randomised controlled trials to date have specifically assessed the efficacy of aerobic training on cognitive and brain outcomes in this group at risk for functional decline. AIM: To examine the effect of moderate-intensity aerobic training on executive functions and functional neural activity among older adults with mild subcortical ischaemic VCI (SIVCI)...
April 21, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28431511/validation-of-the-short-version-of-the-10-66-dementia-diagnosis-in-multiethnic-asian-older-adults-in-singapore
#4
Edimansyah Abdin, Janhavi Ajit Vaingankar, Louisa Picco, Boon Yiang Chua, Martin Prince, Siow Ann Chong, Mythily Subramaniam
BACKGROUND: To validate the short version of the 10/66 dementia diagnosis against the standard version of the 10/66 dementia diagnosis and clinical diagnosis and examine concurrent validity with the World Health Organisation Disability Assessment schedule and care needs in a multiethnic Asian older adult population in Singapore. METHODS: Data from the Well-being of the Singapore Elderly study, a nationally representative survey of the older Singapore Resident population aged 60 years and above was used...
April 21, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28431416/caring-for-critically-injured-children-an-analysis-of-56-pediatric-damage-control-laparotomies
#5
Miguel A Villalobos, Joshua P Hazelton, Rachel L Choron, Lisa Capano-Wehrle, Krystal Hunter, John P Gaughan, Steven E Ross, Mark J Seamon
BACKGROUND: Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. METHODS: An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28430540/demystifying-orbital-emergencies-a-pictorial-review
#6
Viet D Nguyen, Achint K Singh, Wilson B Altmeyer, Bundhit Tantiwongkosi
Imaging of the orbit plays an important role in the workup of orbital emergencies. Orbital imaging is particularly useful in the emergency department, where clinical history and physical examination may be limited or delayed until the exclusion or treatment of more life-threatening conditions. Cross-sectional orbital imaging with multidetector computed tomography (CT) and magnetic resonance (MR) imaging is commonly performed in addition to ultrasonography. In an emergent setting, CT is the preferred modality when evaluating for intraorbital foreign bodies, fractures, or calcifications within a mass lesion...
April 21, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28430007/the-feasibility-and-impact-of-prospective-medication-review-in-the-emergency-department
#7
Billy Sin, Kwong Lau, Richard Tong, Josel Ruiz, Kimberly Sarosky, Robert DiGregorio, Shalom Butel, Sylvie de Souza
OBJECTIVE: We evaluated the feasibility and impact of prospective medication review (PMR) in the emergency department (ED). METHODS: This was a retrospective cohort study of all nonadmitted ED patients who were prescribed medication orders by ED clinicians from September 2014 to September 2015 to determine the time intervals utilized during each step of the medication use process and quantify the number of interventions conducted by the pharmacist and cost avoidance accrued from the interventions...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28429886/patients-experiences-of-consultations-with-physician-associates-in-primary-care-in-england-a-qualitative-study
#8
Mary Halter, Vari M Drennan, Louise M Joly, Jonathan Gabe, Heather Gage, Simon de Lusignan
BACKGROUND: Physician associates are new to English general practice and set to expand in numbers. OBJECTIVE: To investigate the patients' perspective on consulting with physician associates in general practice. DESIGN: A qualitative study, using semi-structured interviews, with thematic analysis. SETTING AND PARTICIPANTS: Thirty volunteer patients of 430 who had consulted physician associates for a same-day appointment and had returned a satisfaction survey, in six general practices employing physician associates in England...
April 21, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28429631/household-food-insecurity-among-people-living-with-hiv-in-sagamu-nigeria-a-preliminary-study
#9
Oluwafolahan O Sholeye, Victor J Animasahun, Albert A Salako, Bankole K Oyewole
BACKGROUND: Household food insecurity has been associated with increased risk of transmission of HIV infection and poor treatment outcomes. This study therefore determined the prevalence of household food insecurity and its associated factors among people living with HIV in Sagamu, Ogun State, Nigeria. METHODS: A cross-sectional descriptive study was carried out among 244 adult clients accessing care and support at the teaching hospital in Sagamu, Nigeria, selected via systematic sampling...
January 1, 2017: Nutrition and Health
https://www.readbyqxmd.com/read/28427898/pharmacist-impact-on-pediatric-vaccination-errors-and-missed-opportunities-in-the-setting-of-clinical-decision-support
#10
Kelly A Wise, Sonya J Sebastian, Anna C Haas-Gehres, Melissa D Moore-Clingenpeel, Kristen E Lamberjack
OBJECTIVE: To determine pharmacist impact on vaccination errors and missed opportunities in the pediatric primary care setting with the presence of clinical decision support (CDS) by comparing a clinic with a pharmacist and CDS to a clinic with CDS alone. DESIGN: A retrospective chart review of patients' electronic medical records compared vaccination errors and missed opportunities between 2 pediatric primary care clinics. SETTING: Two urban, pediatric primary care clinics were selected for the study...
April 17, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28427373/a-protocol-for-a-cluster-randomized-controlled-trial-of-a-self-help-psycho-education-programme-to-reduce-diagnosis-delay-in-women-with-breast-cancer-symptoms-in-indonesia
#11
Hari Setyowibowo, Marit Sijbrandij, Aulia Iskandarsyah, Joke A M Hunfeld, Sawitri S Sadarjoen, Dharmayanti F Badudu, Drajat R Suardi, Jan Passchier
BACKGROUND: Breast cancer (BC) is the most frequent cancer occurring in women across the world. Its mortality rate in low-middle income countries (LMICs) is higher than in high-income countries (HICs), and in Indonesia BC is the leading cause of cancer deaths among women. Delay in breast cancer diagnosis negatively impacts cancer prognosis. Only about 30% of patients who come to the hospital to check on their breast abnormalities, continue thorough examination to biopsy to get a diagnosis based on the results of anatomical pathology...
April 20, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28427371/inside-the-nation-s-largest-mental-health-institution-a-prevalence-study-in-a-state-prison-system
#12
Tala Al-Rousan, Linda Rubenstein, Bruce Sieleni, Harbans Deol, Robert B Wallace
BACKGROUND: The United States has the highest incarceration rate in the world which has created a public health crisis. Correctional facilities have become a front line for mental health care. Public health research in this setting could inform criminal justice reform. We determined prevalence rates for mental illnesses and related comorbidities among all inmates in a state prison system. METHODS: Cross-sectional study using the Iowa Corrections Offender Network which contains health records of all inmates in Iowa...
April 20, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28427367/determinants-of-delayed-care-seeking-for-tb-suggestive-symptoms-in-seru-district-oromiya-region-ethiopia-a-community-based-unmatched-case-control-study
#13
Robel Yirgu, Firaol Lemessa, Selamawit Hirpa, Abraham Alemayehu, Eveline Klinkenberg
BACKGROUND: Early tuberculosis (TB) case finding and adequate chemotherapy are essential for interrupting disease transmission and preventing complications due to delayed care seeking. This study was undertaken in order to provide insights into the magnitude and determinants of patient delay. METHODS: The study was conducted in rural Seru district, employing a population based unmatched case-control study design. The WHO standardized TB screening tool was used to identify presumptive TB cases among the district population ages > 15 years...
April 20, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28426466/physician-variation-in-time-to-antimicrobial-treatment-for-septic-patients-presenting-to-the-emergency-department
#14
Ithan D Peltan, Kristina H Mitchell, Kristina E Rudd, Blake A Mann, David J Carlbom, Catherine L Hough, Thomas D Rea, Samuel M Brown
OBJECTIVES: Delayed initiation of appropriate antimicrobials is linked to higher sepsis mortality. We investigated interphysician variation in septic patients' door-to-antimicrobial time. DESIGN: Retrospective cohort study. SETTING: Emergency department of an academic medical center. SUBJECTS: Adult patients treated with antimicrobials in the emergency department between 2009 and 2015 for fluid-refractory severe sepsis or septic shock...
April 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28425571/clinical-factors-affecting-costs-in-patients-receiving-systemic-antifungal-therapy-in-intensive-care-units-in-greece-results-from-the-estimator-study
#15
A Armaganidis, S Nanas, E Antoniadou, K Mandragos, K Liakou, A Koutsoukou, G Baltopoulos, G Nakos, A Kounougeri, K Ganas, A Prekates, M Kompoti, D Georgopoulos, I Pneumatikos, E Zakynthinos
Invasive fungal infections are common in intensive care units (ICUs) but there is a great variability in factors affecting costs of different antifungal treatment strategies in clinical practice. To determine factors affecting treatment cost in adult ICU patients with or without documented invasive fungal infection receiving systemic antifungal therapy (SAT) we have performed a prospective, multicentre, observational study enrolling patients receiving SAT in participating ICUs in Greece. During the study period, 155 patients received SAT at 14 participating ICUs: 37 (23...
April 20, 2017: Mycoses
https://www.readbyqxmd.com/read/28424985/postoperative-complications-and-functional-outcome-after-esophageal-atresia-repair-results-from-longitudinal-single-center-follow-up
#16
Florian Friedmacher, Birgit Kroneis, Andrea Huber-Zeyringer, Peter Schober, Holger Till, Hugo Sauer, Michael E Höllwarth
BACKGROUND: Esophageal atresia (EA) and tracheoesophageal fistula (TEF) represent major therapeutic challenges, frequently associated with serious morbidities following surgical repair. The aim of this longitudinal study was to assess temporal changes in morbidity and mortality of patients with EA/TEF treated in a tertiary-level center, focusing on postoperative complications and their impact on long-term gastroesophageal function. METHODS: One hundred nine consecutive patients with EA/TEF born between 1975 and 2011 were followed for a median of 9...
April 19, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28424596/non-interfering-effects-of-active-post-encoding-tasks-on-episodic-memory-consolidation-in-humans
#17
Samarth Varma, Atsuko Takashima, Sander Krewinkel, Maaike van Kooten, Lily Fu, W Pieter Medendorp, Roy P C Kessels, Sander M Daselaar
So far, studies that investigated interference effects of post-learning processes on episodic memory consolidation in humans have used tasks involving only complex and meaningful information. Such tasks require reallocation of general or encoding-specific resources away from consolidation-relevant activities. The possibility that interference can be elicited using a task that heavily taxes our limited brain resources, but has low semantic and hippocampal related long-term memory processing demands, has never been tested...
2017: Frontiers in Behavioral Neuroscience
https://www.readbyqxmd.com/read/28424459/development-and-outcomes-of-a-primary-care-based-sleep-assessment-service-in-canterbury-new-zealand
#18
Michael J Epton, Paul T Kelly, Brett I Shand, Sallyanne V Powell, Judith N Jones, Graham R B McGeoch, Michael C Hlavac
Prior to 2007, increasing demand for sleep services, plus inability to adequately triage severity, led to long delays in sleep assessment and accessing continuous positive airway pressure. We established a community sleep assessment service carried out by trained general practices using a standardised tool and overnight oximetry. All cases were discussed at a multi-disciplinary meeting, with four outcomes: severe obstructive sleep apnoea treated with continuous positive airway pressure; investigation with more complex studies; sleep physician appointment; no or non-severe sleep disorder for general practitioner management...
April 19, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28424334/glycosaminoglycan-based-hydrogels-capture-inflammatory-chemokines-and-rescue-defective-wound-healing-in-mice
#19
Nadine Lohmann, Lucas Schirmer, Passant Atallah, Elke Wandel, Ruben A Ferrer, Carsten Werner, Jan C Simon, Sandra Franz, Uwe Freudenberg
Excessive production of inflammatory chemokines can cause chronic inflammation and thus impair cutaneous wound healing. Capturing chemokine signals using wound dressing materials may offer powerful new treatment modalities for chronic wounds. Here, a modular hydrogel based on end-functionalized star-shaped polyethylene glycol (starPEG) and derivatives of the glycosaminoglycan (GAG) heparin was customized for maximal chemokine sequestration. The material is shown to effectively scavenge the inflammatory chemokines MCP-1 (monocyte chemoattractant protein-1), IL-8 (interleukin-8), and MIP-1α (macrophage inflammatory protein-1α) and MIP-1β (macrophage inflammatory protein-1β) in wound fluids from patients suffering from chronic venous leg ulcers and to reduce the migratory activity of human monocytes and polymorphonuclear neutrophils...
April 19, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28424135/bladder-fill-after-laparoscopic-inguinal-hernia-repair-reduces-time-to-discharge
#20
Blair A Wormer, Samuel W Ross, Amanda L Walters, Timothy S Kuwada
Laparoscopic inguinal herniorrhaphy (LIH) has a relatively high risk of urinary retention. Bladder dysfunction may delay discharge after LIH. We hypothesized that filling the bladder before Foley catheter removal decreases time to discharge (TTD) after LIH. A secondary aim was to determine incidence of postoperative urinary retention (POUR) after bladder fill (BF). We reviewed a consecutive series of total extraperitoneal and transabdominal preperitoneal LIH procedures performed by a single surgeon at our institution from 2010 to 2013...
April 1, 2017: American Surgeon
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