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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/28922383/timing-and-adequate-attendance-of-antenatal-care-visits-among-women-in-ethiopia
#2
Sanni Yaya, Ghose Bishwajit, Michael Ekholuenetale, Vaibhav Shah, Bernard Kadio, Ogochukwu Udenigwe
INTRODUCTION: Although ANC services are increasingly available to women in low and middle-income countries, their inadequate use persists. This suggests a misalignment between aims of the services and maternal beliefs and circumstances. Owing to the dearth of studies examining the timing and adequacy of content of care, this current study aims to investigate the timing and frequency of ANC visits in Ethiopia. METHODS: Data was obtained from the nationally representative 2011 Ethiopian Demographic and Health Survey (EDHS) which used a two-stage cluster sampling design to provide estimates for the health and demographic variables of interest for the country...
2017: PloS One
https://www.readbyqxmd.com/read/28922293/the-role-of-vitamin-d-in-cancer-cachexia
#3
Fabio Penna, Andrea Camperi, Maurizio Muscaritoli, Nicoletta Filigheddu, Paola Costelli
PURPOSE OF REVIEW: The possibility to use vitamin D supplementation to improve muscle wasting, with particular focus on cancer cachexia, is discussed. RECENT FINDINGS: Vitamin D exerts biological actions on myogenic precursor proliferation and differentiation, impinging on muscle regeneration. However, the effects of VitD supplementation in diseases associated with muscle atrophy, such as cancer cachexia, are poorly investigated. Data obtained in experimental models of cancer cachexia show that the administration of vitamin D to tumor-bearing animals is not able to prevent or delay both muscle wasting and adipose tissue depletion, despite increased expression of muscle vitamin D receptor...
September 15, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28921607/in-labor-or-in-limbo-the-experiences-of-women-undergoing-induction-of-labor-in-hospital-findings-of-a-qualitative-study
#4
Annabel Jay, Hilary Thomas, Fiona Brooks
BACKGROUND: Induction of labor currently accounts for around 25% of all births in high-resource countries, yet despite much research into medical aspects, little is known about how women experience this process. This study aimed to explore in depth the induction experience of primiparous women. METHODS: A qualitative study was undertaken, using a sample of 21 first-time mothers from a maternity unit in the south of England. Semi-structured interviews were conducted in women's homes between 3 and 6 weeks postnatally...
September 17, 2017: Birth
https://www.readbyqxmd.com/read/28921502/delayed-cord-clamping-and-cord-gas-analysis-at-birth
#5
Serena Xodo, Luigi Xodo, Vincenzo Berghella
Delayed cord clamping for at least 60 seconds in both term and preterm babies is a major recent change in clinical care. Delayed cord clamping has several effects on other possible interventions. One of these is the effect of delayed cord clamping on umbilical artery gas analysis. When indicated, umbilical artery gas analysis can safely be done either with early cord clamping, or, probably most of the times it is necessary, during delayed cord clamping with the cord still unclamped. Paired blood samples (one from the umbilical artery and one from the umbilical vein) can be taken from the pulsating and unclamped cord, immediately after birth, during delayed cord clamping, without any effect on either the accuracy of umbilical artery gas analysis or on the transfusion of blood through delayed cord clamping...
September 16, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28920154/pharmacokinetics-of-doripenem-in-plasma-and-epithelial-lining-fluid-elf-comparison-of-two-dosage-regimens
#6
Zoe Oesterreicher, Iris Minichmayr, Robert Sauermann, Daniela Marhofer, Edith Lackner, Walter Jäger, Alexandra Maier-Salamon, Richard Schwameis, Charlotte Kloft, Markus Zeitlinger
PURPOSE: In 2014, FDA released a warning for prescription of doripenem for ventilator-associated bacterial pneumonia due to unsatisfactory clinical cure rates. The present study explores if the observed lack of efficacy might be explained by insufficient target site pharmacokinetics in intensive care patients after two different infusion schemes. METHODS: Plasma and bronchoalveolar lavage sampling was performed in 16 intubated patients with pneumonia receiving doripenem either as 1-h or as 4-h infusion...
September 17, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28919799/maple-syrup-urine-disease-mechanisms-and-management
#7
REVIEW
Patrick R Blackburn, Jennifer M Gass, Filippo Pinto E Vairo, Kristen M Farnham, Herjot K Atwal, Sarah Macklin, Eric W Klee, Paldeep S Atwal
Maple syrup urine disease (MSUD) is an inborn error of metabolism caused by defects in the branched-chain α-ketoacid dehydrogenase complex, which results in elevations of the branched-chain amino acids (BCAAs) in plasma, α-ketoacids in urine, and production of the pathognomonic disease marker, alloisoleucine. The disorder varies in severity and the clinical spectrum is quite broad with five recognized clinical variants that have no known association with genotype. The classic presentation occurs in the neonatal period with developmental delay, failure to thrive, feeding difficulties, and maple syrup odor in the cerumen and urine, and can lead to irreversible neurological complications, including stereotypical movements, metabolic decompensation, and death if left untreated...
2017: Application of Clinical Genetics
https://www.readbyqxmd.com/read/28918410/-just-like-a-normal-pain-what-do-people-with-diabetes-mellitus-experience-when-having-a-myocardial-infarction-a-qualitative-study-recruited-from-uk-hospitals
#8
Nikita Berman, Melvyn Mark Jones, Daan A De Coster
OBJECTIVE: The objective of the study was to investigate the symptoms people with diabetes experience when having a myocardial infarction (MI), their illness narrative and how they present their symptoms to the health service. SETTING: Three London (UK) hospitals (coronary care units and medical wards). PARTICIPANTS: Patients were recruited with diabetes mellitus (DM) (types 1 and 2) with a clinical presentation of MI (ST elevated MI (STEMI), non-ST elevated MI (NSTEMI), acute MI unspecified and cardiac arrest)...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28918409/qualitative-interview-study-of-parents-perspectives-concerns-and-experiences-of-the-management-of-lower-respiratory-tract-infections-in-children-in-primary-care
#9
Amy Halls, Catherine Van't Hoff, Paul Little, Theo Verheij, Geraldine M Leydon
OBJECTIVE: To explore parents' perspectives, concerns and experiences of the management of lower respiratory tract infections (LRTIs) in children in primary care. DESIGN: Qualitative semistructured interview study. SETTING: UK primary care. PARTICIPANTS: 23 parents of children aged 6 months to 10 years presenting with LRTI in primary care. METHOD: Thematic analysis of semistructured interviews (either in person or by telephone) conducted with parents to explore their experiences and views on their children being prescribed antibiotics for LRTI...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28918401/return-to-work-and-lost-earnings-after-acute-respiratory-distress-syndrome-a-5-year-prospective-longitudinal-study-of-long-term-survivors
#10
Biren B Kamdar, Kristin A Sepulveda, Alexandra Chong, Robert K Lord, Victor D Dinglas, Pedro A Mendez-Tellez, Carl Shanholtz, Elizabeth Colantuoni, Till M von Wachter, Peter J Pronovost, Dale M Needham
BACKGROUND: Delayed return to work is common after acute respiratory distress syndrome (ARDS), but has undergone little detailed evaluation. We examined factors associated with the timing of return to work after ARDS, along with lost earnings and shifts in healthcare coverage. METHODS: Five-year, multisite prospective, longitudinal cohort study of 138 2-year ARDS survivors hospitalised between 2004 and 2007. Employment and healthcare coverage were collected via structured interview...
September 16, 2017: Thorax
https://www.readbyqxmd.com/read/28918296/trichobezoar-with-and-without-rapunzel-syndrome-in-paediatric-population-a-case-series-from-a-tertiary-care-centre-of-northern-india
#11
Pradeep Kajal, Namita Bhutani, Niharika Tyagi, Pratibha Arya
INTRODUCTION: Trichobezoars are concretions formed by accumulation of hair in stomach. Usually, trichobezoar is confined to the stomach, but rarely it may extend from the stomach to the small intestine and even colon. This is an unusual form called Rapunzel syndrome. Our experience with this rare entity of Rapunzel syndrome and interesting entity of trichobezoar is being presented with review of literature. PRESENTATION OF CASES: We, at our institute, encountered four cases of trichobezoar in last five years, out of which two were found to be of Rapunzel syndrome...
September 8, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28916175/early-sepsis-detection-in-critical-care-patients-using-multiscale-blood-pressure-and-heart-rate-dynamics
#12
Supreeth P Shashikumar, Matthew D Stanley, Ismail Sadiq, Qiao Li, Andre Holder, Gari D Clifford, Shamim Nemati
Sepsis remains a leading cause of morbidity and mortality among intensive care unit (ICU) patients. For each hour treatment initiation is delayed after diagnosis, sepsis-related mortality increases by approximately 8%. Therefore, maximizing effective care requires early recognition and initiation of treatment protocols. Antecedent signs and symptoms of sepsis can be subtle and unrecognizable (e.g., loss of autonomic regulation of vital signs), causing treatment delays and harm to the patient. In this work we investigated the utility of high-resolution blood pressure (BP) and heart rate (HR) times series dynamics for the early prediction of sepsis in patients from an urban, academic hospital, meeting the third international consensus definition of sepsis (sepsis-III) during their ICU admission...
August 16, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28914683/primum-non-nocere-and-the-5-rights
#13
Gabriele Popp, Dick Clarke, Stephen Rothstein
Overutilization of hyperbaric oxygen therapy (HBOT) is commonplace and primarily associated with outpatient wound care. While the number of hospitals providing HBOT is at an all-time high, the number of those willing to treat patients in immediate need is at an all-time low. Huge areas of the country, including major population areas, are now completely devoid of 24/7 HBOT availability and inpatient access. Purchasers of healthcare, including the Centers for Medicare and Medicaid Services, have become increasingly concerned to the point that several strategies have been introduced to constructively deal with this issue...
October 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28914678/update-topical-antimicrobial-agents-for-chronic-wounds
#14
R Gary Sibbald, James A Elliott, Luvneed Verma, Alisa Brandon, Reneeka Persaud, Elizabeth A Ayello
GENERAL PURPOSE: To provide information on the use of topical antimicrobial agents for the treatment of chronic wounds. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1. Examine features of wounds and wound healing as well as the purpose of specific antimicrobial agents...
October 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28914366/geriatric-assessment-with-management-intervention-in-older-adults-with-cancer-a-randomized-pilot-study
#15
Allison Magnuson, Tatyana Lemelman, Chintan Pandya, Molly Goodman, Marcus Noel, Mohammed Tejani, David Doughtery, William Dale, Arti Hurria, Michelle Janelsins, Feng Vankee Lin, Charles Heckler, Supriya Mohile
BACKGROUND: Older adults receiving cancer therapy have heightened risk for treatment-related toxicity. Geriatric assessment (GA) can identify impairments, which may contribute to vulnerability and adverse outcomes. GA management interventions can address these impairments and have the potential to improve outcomes when implemented. METHODS: We conducted a randomized pilot study comparing GA with management interventions versus usual care in patients with stage III/IV solid tumor malignancies (N = 71)...
September 15, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28914178/-you-just-have-to-learn-to-keep-moving-on-young-women-s-experiences-with-unplanned-pregnancy-in-the-cook-islands
#16
Ashley L White, Emily S Mann, Fiona Larkan
The Cook Islands is one of several countries in the Pacific region that has high rates of teenage pregnancy and birth. While the social determinants of pregnancy and early motherhood are well established in the global context, little is known about how Cook Islands young women who become pregnant before age 20 make sense of their experiences. Drawing on individual interviews with a purposive sample of 10 young mothers, this paper examines the phenomenology of early pregnancy from their perspectives. Structural, cultural and individual factors emerged as salient themes in participants' accounts...
September 15, 2017: Culture, Health & Sexuality
https://www.readbyqxmd.com/read/28913711/emergency-neurological-life-support-resuscitation-following-cardiac-arrest
#17
Jonathan Elmer, Kees H Polderman
Cardiac arrest is the most common cause of death in North America. An organized bundle of neurocritical care interventions can improve chances of survival and neurological recovery in patients who are successfully resuscitated from cardiac arrest. Therefore, resuscitation following cardiac arrest was chosen as an Emergency Neurological Life Support protocol. Key aspects of successful early post-arrest management include: prevention of secondary brain injury; identification of treatable causes of arrest in need of emergent intervention; and, delayed neurological prognostication...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28912338/duration-of-post-operative-hypocortisolism-predicts-sustained-remission-after-pituitary-surgery-for-cushing-s-disease
#18
Prachi Ashok Kumar Bansal, Anurag Ranjan Lila, Manjunath Goroshi, Swati Jadhav, Nilesh Keshavrao Lomte, Kunal Thakkar, Atul Goel, Abhidha Shah, Shilpa S Sankhe, Naina Goel, Neelam Jaguste, Tushar Ramkrishna Bandgar, Nalini Shah
PURPOSE: Transsphenoidal surgery(TSS) is the primary treatment modality for Cushing's disease(CD). However, the predictors of post-operative remission and recurrence remain debatable. Thus, we studied the post-operative remission and long term recurrence rates, as well as their respective predictive factors. METHODS: Retrospective analysis of case records of 230 CDpatients who underwent primary microscopic TSS at our tertiary care referral center between 1987-2015was undertaken...
September 14, 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28911361/detecting-mycobacterium-tuberculosis-using-the-loop-mediated-isothermal-amplification-test-in-south-africa
#19
S Reddy, S Ntoyanto, Y Sakadavan, T Reddy, S Mahomed, M Dlamini, B Spooner, G Ramjee, A Coutsoudis, N Ngomane, K Naidoo, K Mlisana, P Kiepiela
SETTING: In South Africa, KwaZulu-Natal is the epicentre of the human immunodeficiency virus (HIV) epidemic, where approximately 70% of people with tuberculosis (TB) are co-infected with HIV. Undiagnosed TB contributes to high mortality in HIV-infected patients. Delays in diagnosing TB and treatment initiation result in prolonged transmission and increased infectiousness. OBJECTIVE: To evaluate the LoopampTM MTBC Detection kit (TB-LAMP; based on the loop-mediated isothermal amplification assay), smear microscopy and Xpert test with the gold standard of mycobacterial culture...
October 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28911351/comprehensive-understanding-of-health-seeking-behaviour-among-pulmonary-tuberculosis-patients-in-china
#20
Y Jiang, B Cao, N Ohmagari, A-H Wu, Y-X Liu, L-P Guo
SETTING: In China, there were 918 000 tuberculosis (TB) cases in 2015 alone. The primary challenge facing TB control is the allocation of limited health care resources. OBJECTIVE: To gain a comprehensive understanding of the first choice of health care facility among Chinese patients with suspected pulmonary TB (PTB) and the number of visits required to make the diagnosis. DESIGN: Relevant full-text articles in three Chinese and one English literature databases up to November 2016 were reviewed...
October 1, 2017: International Journal of Tuberculosis and Lung Disease
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