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https://www.readbyqxmd.com/read/27898439/limiting-sedation-for-patients-with-acute-respiratory-distress-syndrome-time-to-wake-up
#1
Faraaz Ali Shah, Timothy D Girard, Sachin Yende
PURPOSE OF REVIEW: Critically ill patients with acute respiratory distress syndrome (ARDS) may require sedation in their clinical care. The goals of sedation in ARDS patients are to improve patient comfort and tolerance of supportive and therapeutic measures without contributing to adverse outcomes. This review discusses the current evidence for sedation management in patients with ARDS. RECENT FINDINGS: Deep sedation strategies should be avoided in the care of patients with ARDS because deep sedation has been associated with increased time on mechanical ventilation, longer ICU and hospital length of stay, and higher mortality in critically ill patients...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27885658/early-skin-to-skin-contact-for-mothers-and-their-healthy-newborn-infants
#2
REVIEW
Elizabeth R Moore, Nils Bergman, Gene C Anderson, Nancy Medley
BACKGROUND: Mother-infant separation post birth is common. In standard hospital care, newborn infants are held wrapped or dressed in their mother's arms, placed in open cribs or under radiant warmers. Skin-to-skin contact (SSC) begins ideally at birth and should last continually until the end of the first breastfeeding. SSC involves placing the dried, naked baby prone on the mother's bare chest, often covered with a warm blanket. According to mammalian neuroscience, the intimate contact inherent in this place (habitat) evokes neuro-behaviors ensuring fulfillment of basic biological needs...
November 25, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27885446/post-cardiotomy-rescue-extracorporeal-cardiopulmonary-resuscitation-in-neonates-with-single-ventricle-after-intractable-cardiac-arrest-attrition-after-hospital-discharge-and-predictors-of-outcome
#3
Anastasios C Polimenakos, Vincent Rizzo, Chawki F El-Zein, Michel N Ilbawi
Extracorporeal cardiopulmonary resuscitation (ECPR) in children with cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR) has been reported with encouraging results. We reviewed outcomes of neonates with functional single ventricle (FSV) surviving post-cardiotomy ECPR after hospital discharge. Fifty-eight patients who required post-cardiotomy extracorporeal membrane oxygenation (ECMO) since the introduction of our ECPR protocol (January 2007-December 2011) were identified. Forty-one were neonates...
November 24, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27882118/atypical-miyoshi-distal-myopathy-a-case-report
#4
Meiling Wang, Yujie Guo, Yong Fu, Rui Jia, Gang Chen
Five distinct predominant distal myopathies have been identified with discrete clinical and genetic patterns. Miyoshi myopathy (MM; early adult-onset, type 2) is a subtype of dysferlinopathy. Furthermore, MM is the most common form of autosomal recessive distal myopathy. MM is typically characterized by muscular weakness, initially affecting the gastrocnemius or soleus muscle from the late teens or early adulthood. The present study reports a case of MM that was confirmed by pathological and immunohistochemical methods, in addition to a review of the relevant literature...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27872993/cardiac-catheterization-in-pediatric-patients-supported-by-extracorporeal-membrane-oxygenation-a-15-year-experience
#5
Nicholas S Boscamp, Mariel E Turner, Matthew Crystal, Brett Anderson, Julie A Vincent, Alejandro J Torres
Cardiac catheterization is commonly performed in patients being supported by extracorporeal membrane oxygenation (ECMO). We aimed to evaluate the safety, benefit, and outcomes of catheterization in pediatric patients supported by ECMO. Retrospective review of cardiac catheterizations performed in patients ≤18 years of age while on ECMO at a large tertiary care center between January 2000 and May 2015. A total of 55 catheterizations were performed on 51 patients during 53 unique ECMO courses. Indications for ECMO include ventricular dysfunction (22), cardiac arrest (20), inability to wean from cardiopulmonary bypass (7), and persistent cyanosis (4)...
November 21, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27870576/airway-management-strategies-for-brain-injured-patients-meeting-standard-criteria-to-consider-extubation-a-prospective-cohort-study
#6
Victoria A McCredie, Niall D Ferguson, Ruxandra L Pinto, Neill Kj Adhikari, Robert A Fowler, Martin G Chapman, Althea Burrell, Andrew J Baker, Deborah J Cook, Maureen O Meade, Damon C Scales
RATIONALE: Patients with acute brain injury are frequently capable of breathing spontaneously with minimal ventilatory support despite persistent neurological impairment. OBJECTIVES: We sought to describe factors associated with extubation timing, success and primary tracheostomy in these patients. METHODS: We conducted a prospective multicenter observational cohort study in three academic hospitals in Toronto, Canada. Consecutive brain-injured adults receiving mechanical ventilation for at least 24 hours in 3 ICUs were screened by study personnel daily for extubation consideration criteria...
November 21, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27867816/severe-ards-caused-by-adenovirus-early-initiation-of-ecmo-plus-continuous-renal-replacement-therapy
#7
Sang Ook Ha, Hyoung Soo Kim, Sunghoon Park, Ki-Suck Jung, Seung Hun Jang, Sang Jin Han, Hyun-Sook Kim, Sun Hee Lee
The reported survival rates of patients with acute respiratory distress syndrome (ARDS) caused by human adenovirus (HAdV) pneumonia are poor. The results do not differ much in immunocompetent patients supported by extracorporeal membrane oxygenation (ECMO). We report two immunocompetent patients with severe ARDS complicating HAdV pneumonia who were treated successfully and survived to discharge. Compared with previous cases, our cases might have benefited from several factors. First, the time interval between mechanical ventilator support and ECMO implantation was shorter...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27865429/maternal-education-is-associated-with-disparities-in-breastfeeding-at-time-of-discharge-but-not-at-initiation-of-enteral-feeding-in-the-neonatal-intensive-care-unit
#8
Lena Carolin Herich, Marina Cuttini, Ileana Croci, Francesco Franco, Domenico Di Lallo, Dante Baronciani, Katia Fares, Giancarlo Gargano, Massimiliano Raponi, Jennifer Zeitlin
OBJECTIVE: To investigate the relationship between maternal education and breastfeeding in very preterm infants admitted to neonatal intensive care units. STUDY DESIGN: This prospective, population-based cohort study analyzed the data of all very preterm infants admitted to neonatal care during 1 year in 3 regions in Italy (Lazio, Emilia-Romagna, and Marche). The use of mothers' own milk was recorded at initial enteral feedings and at hospital discharge. We used multilevel logistic analysis to model the association between maternal education and breastfeeding outcomes, adjusting for maternal age and country of birth...
November 17, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27849331/-fournier-s-gangrene-after-anorectal-surgery-in-infant-two-case-reports
#9
Murat Sütçü, Güntulu Duran Şık, Feryal Gün, Ayper Somer, Nuran Salman
Necrotizing fasciitis is a life-threatening soft tissue infection characterized by progressive necrosis of the skin, subcutaneous tissues and fascia. Fournier's gangrene (FG) is a serious and aggressive form of infective necrotizing fasciitis involving perineal region and genitalia. Presently described are 2 pediatric cases of FG with widespread necrosis of surrounding tissue following anorectal surgery, causing severe septic shock. Case 1: Six-month-old female patient with anal stenosis and duplication presented at emergency clinic with fever, somnolence, irritability, and feeding difficulty...
September 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27843101/is-transesophageal-echocardiography-needed-before-hospital-discharge-in-patients-after-bentall-surgery
#10
Victor Waldmann, Olivier Milleron, Bernard Iung, David Messika-Zeitoun, Laurent Lepage, Walid Ghodbane, Eric Brochet, Alec Vahanian, Patrick Nataf, Guillaume Jondeau
BACKGOUND: Whether transesophageal echocardiography (TEE) should be routinely performed before hospital discharge after Bentall surgery remains unclear. The investigators took advantage of this practice at their institution to evaluate its benefit. METHODS: All patients who had undergone the Bentall procedure at Bichat Hospital from January 2010 to March 2014 were included. For each patient, transthoracic echocardiographic and transesophageal echocardiographic data and clinical events were retrospectively collected from the various reports...
November 11, 2016: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/27829640/experiences-with-aggressive-cardiac-rehabilitation-in-pediatric-patients-receiving-mechanical-circulatory-supports
#11
Rie Amao, Teruhiko Imamura, Yusuke Sawada, Sachiko Endo, Shinichi Ozaki, Kenichi Okamura, Akihiro Masuzawa, Tetsuhiro Takaoka, Yasutaka Hirata, Takahiro Shindo, Minoru Ono, Nobuhiko Haga
Although some patients with fulminant myocarditis can be rescued owing to the improvements in mechanical circulatory support therapy, there are few reports providing evidence of cardiac rehabilitation during mechanical circulatory supports, particularly among pediatric patients. We treated two pediatric patients who underwent aggressive cardiac rehabilitation during mechanical support. Five days after the initiation of extracorporeal membrane oxygenation therapy aggressive cardiac rehabilitation was started in a 10-year-old girl with fulminant myocarditis...
November 9, 2016: International Heart Journal
https://www.readbyqxmd.com/read/27828726/early-breast-milk-pumping-intentions-among-postpartum-women
#12
Yiska Loewenberg Weisband, Sarah A Keim, Lisa M Keder, Sheela R Geraghty, Maria F Gallo
INTRODUCTION: Milk expression has become common, but little is known about women's intentions and motivations for pumping. Our objectives were to measure, among newly postpartum women, intentions related to breast milk feeding and pumping, reasons for intending to pump, and timing of pumping initiation. METHODS: We conducted a cross-sectional study at a large university hospital in 2015 using a convenience sample of 100 women before their discharge following delivery, who intended to feed their infant breast milk for at least 6 months...
November 9, 2016: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/27819175/early-versus-late-inguinal-hernia-repair-in-extremely-low-birth-weight-infants
#13
Rajesh Pandey, Joleen Dako, Sarah Venus, Deepak Kumar, Maroun Mhanna
OBJECTIVE: Compare outcomes of Extremely Low Birth Weight (ELBW) Infants following early (before discharge) versus late (after discharge) inguinal hernia (IH) repair. STUDY DESIGN: In a retrospective study of ELBW infants with IH, data was abstracted for clinical characteristics, IH and related outcomes. RESULT: Of the 39/252 (15.4%) ELBW infants who developed IH, those with early (59%) versus late (41%) repair were comparable in birth weight (753±158 vs...
November 6, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27815374/treatment-with-tpa-in-the-golden-hour-and-the-shape-of-the-4-5-hour-time-benefit-curve-in-the-national-us-get-with-the-guidelines-stroke-population
#14
Joon-Tae Kim, Gregg C Fonarow, Eric E Smith, Mathew J Reeves, Digvijaya D Navalkele, James C Grotta, Maria V Grau-Sepulveda, Adrian F Hernandez, Eric D Peterson, Lee H Schwamm, Jeffrey L Saver
BACKGROUND: -Earlier tissue plasminogen activator (tPA) treatment improves ischemic stroke outcome, but aspects of the time-benefit relationship still not well delineated are: 1) the degree of additional benefit accrued with treatment in the first 60 minutes after onset, and 2) the shape of the time-benefit curve through 4.5 hours. METHODS: -We analyzed acute ischemic stroke patients treated with intravenous tPA within 4.5 hours of onset from the Get With The Guidelines-Stroke US national program...
November 4, 2016: Circulation
https://www.readbyqxmd.com/read/27812152/the-comparison-of-the-outcomes-between-primary-pci-fibrinolysis-and-no-reperfusion-in-patients-%C3%A2-75-years-old-with-st-segment-elevation-myocardial-infarction-results-from-the-chinese-acute-myocardial-infarction-cami-registry
#15
He Peiyuan, Yang Jingang, Xu Haiyan, Gao Xiaojin, Xian Ying, Wu Yuan, Li Wei, Wang Yang, Tang Xinran, Yan Ruohua, Jin Chen, Song Lei, Zhang Xuan, Fu Rui, Ye Yunqing, Dong Qiuting, Sun Hui, Yan Xinxin, Gao Runlin, Yang Yuejin
BACKGROUND: Only a few randomized trials have analyzed the clinical outcomes of elderly ST-segment elevation myocardial infarction (STEMI) patients (≥ 75 years old). Therefore, the best reperfusion strategy has not been well established. An observational study focused on clinical outcomes was performed in this population. METHODS: Based on the national registry on STEMI patients, the in-hospital outcomes of elderly patients with different reperfusion strategies were compared...
2016: PloS One
https://www.readbyqxmd.com/read/27806794/-follow-up-of-survived-children-supported-by-extracorporeal-membrane-oxygenation
#16
Y Cheng, Z J Lu, X G Yan, J He, G F Yan, X D Cai, W J Shen, A L Jin, G P Lu
Objective: To summarize the follow-up of children treated with venoarterial extracorporeal membrane oxygenation (ECMO) by incision of internal carotid artery-vein. Method: This was a retrospective study, 10 children in whom the conventional therapy failed, but survived after treatment with ECMO technique through right internal jugular artery-venous incision and ligation after ECMO in pediatric intensive care unit (PICU) of Fudan University were followed up from December 2011 to December 2015. Primary disease situation, neurological development, growth and development, quality of life and personality development were included...
November 2, 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/27798032/china-peace-risk-estimation-tool-for-in-hospital-death-from-acute-myocardial-infarction-an-early-risk-classification-tree-for-decisions-about-fibrinolytic-therapy
#17
Xi Li, Jing Li, Frederick A Masoudi, John A Spertus, Zhenqiu Lin, Harlan M Krumholz, Lixin Jiang
OBJECTIVES: As the predominant approach to acute reperfusion for ST segment elevation myocardial infarction (STEMI) in many countries, fibrinolytic therapy provides a relative risk reduction for death of ∼16% across the range of baseline risk. For patients with low baseline mortality risk, fibrinolytic therapy may therefore provide little benefit, which may be offset by the risk of major bleeding. We aimed to construct a tool to determine if it is possible to identify a low-risk group among fibrinolytic therapy-eligible patients...
October 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27791240/feasibility-of-day-case-total-hip-arthroplasty-a-single-centre-observational-study
#18
Jens Rolighed Larsen, Birgitte Skovgaard, Thomas Prynø, Laimonas Bendikas, Lone R Mikkelsen, Malene Laursen, Mette T Høybye, Søren Mikkelsen, Lene Bastrup Jørgensen
INTRODUCTION: Recent reports indicate that total hip arthroplasty (THA) can be further accelerated and might be managed as day-case. This could provide benefits to health care expenditure, lower patient risks and change patient satisfaction. We evaluated the feasibility, efficacy, safety and patient satisfaction of same-day (<12 hours) THA operation and discharge. METHODS: Consecutive patients were screened for eligibility (primary THA, ASA 1 or 2 physical status) and the presence of a support person to follow the patient for 48 hours postoperatively in an observational study...
October 24, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27782829/the-effect-of-skin-to-skin-contact-at-birth-early-versus-immediate-on-the-duration-of-exclusive-human-lactancy-in-full-term-newborns-treated-at-the-cl%C3%A3-nica-universidad-de-la-sabana-study-protocol-for-a-randomized-clinical-trial
#19
Sergio Agudelo, Oscar Gamboa, Fabio Rodríguez, Sandra Cala, Nathalie Gualdrón, Evelyn Obando, María Lucía Padrón
BACKGROUND: Human lactancy is a simple and cost-effective strategy that influences infant and maternal mortality rates. Skin-to-skin contact (SSC) is an immediate postpartum period strategy that has proven to benefit the initiation and continuation of human lactation and to decrease hospitalization during the first week of life. This study aims to determine the effect of SSC initiation at birth (immediate versus early) in healthy, full-term newborns treated at the Universidad de La Sabana Clinic on the duration of exclusive human lactation...
October 26, 2016: Trials
https://www.readbyqxmd.com/read/27782349/quantifying-the-risk-of-nosocomial-infection-within-ebola-holding-units-a-retrospective-cohort-study-of-negative-patients-discharged-from-five-ebola-holding-units-in-western-area-sierra-leone
#20
Paul Arkell, Daniel Youkee, Colin S Brown, Abdul Kamara, Thaim B Kamara, Oliver Johnson, Marta Lado, Viginia George, Fatmata Koroma, Matilda B King, Benson E Parker, Peter Baker
OBJECTIVES: A central pillar in the response to the 2014 Ebola Virus Disease (EVD) epidemic in Sierra Leone was the role of Ebola Holding Units (EHUs). These units isolated patients meeting a suspect case definition, tested them for EVD, initiated appropriate early treatment, and discharged negative patients to onward inpatient care or home. Positive patients were referred to Ebola Treatment Centres. We aimed to estimate the risk of nosocomial transmission within these EHUs. METHODS: We followed up a cohort of 543 patients discharged with a negative EVD-test from five EHUs in the Western Area, Sierra Leone, and examined all line-listed subsequent EVD-tests from any facility in the Western Area to see if the patient was re-tested within 30 days, matching by name, age and address...
October 26, 2016: Tropical Medicine & International Health: TM & IH
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