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https://www.readbyqxmd.com/read/29331668/earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-a-feasibility-randomised-controlled-trial
#1
David McWilliams, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, Emma Reeves, Lauren Cooper, Catherine Snelson
BACKGROUND: Systematic reviews of early rehabilitation within intensive care units have highlighted the need for robust multi-centre randomised controlled trials with longer term follow up. This trial aims to explore the feasibility of earlier and enhanced rehabilitation for patients mechanically ventilated for ≥5days and to assess the impact on possible long term outcome measures for use in a definitive trial. METHODS: Patients admitted to a large UK based intensive care unit and invasively ventilated for ≥5days were randomised to the rehabilitation intervention or standard care on a 1:1 basis, stratified by age and SOFA score...
January 4, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29325276/-a-clinical-study-of-antiviral-therapy-for-patients-with-compensated-hepatitis-c-cirrhosis
#2
Z W Xie, J P Li, Y J Guan, X Y Zhang, F X Guo, B B Chen, Calvin Q Pan
Objective: To investigate the effect of antiviral therapy on the progression of liver cirrhosis and related predictive factors through a retrospective analysis of patients with compensated hepatitis C cirrhosis. Methods: The patients with compensated hepatitis C cirrhosis who were treated in our hospital from 2004 to 2015 were divided into sustained virologic response (SVR) group, non-SVR (NSVR) group, and untreated group. The baseline features of patients with or without liver cirrhosis were compared to identify the predictive factors for the progression of liver cirrhosis...
November 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29324862/taking-two-to-tango-fmri-analysis-of-improvised-joint-action-with-physical-contact
#3
Léa A S Chauvigné, Michel Belyk, Steven Brown
Many forms of joint action involve physical coupling between the participants, such as when moving a sofa together or dancing a tango. We report the results of a novel two-person functional MRI study in which trained couple dancers engaged in bimanual contact with an experimenter standing next to the bore of the magnet, and in which the two alternated between being the leader and the follower of joint improvised movements. Leading showed a general pattern of self-orientation, being associated with brain areas involved in motor planning, navigation, sequencing, action monitoring, and error correction...
2018: PloS One
https://www.readbyqxmd.com/read/29324384/flame-retardants-in-uk-furniture-increase-smoke-toxicity-more-than-they-reduce-fire-growth-rate
#4
Sean T McKenna, Robert Birtles, Kathryn Dickens, Richard G Walker, Michael J Spearpoint, Anna A Stec, T Richard Hull
This paper uses fire statistics to show the importance of fire toxicity on fire deaths and injuries, and the importance of upholstered furniture and bedding on fatalities from unwanted fires. The aim was to compare the fire hazards (fire growth and smoke toxicity) using different upholstery materials. Four compositions of sofa-bed were compared: three meeting UK Furniture Flammability Regulations (FFR), and one using materials without flame retardants intended for the mainland European market. Two of the UK sofa-beds relied on chemical flame retardants to meet the FFR, the third used natural materials and a technical weave in order to pass the test...
December 5, 2017: Chemosphere
https://www.readbyqxmd.com/read/29320362/predictive-value-of-serum-gelsolin-and-gc-globulin-in-sepsis-a-pilot-study
#5
Zoltán Horváth-Szalai, Péter Kustán, Balázs Szirmay, Ágnes Lakatos, Per Hjort Christensen, Tamás Huber, Beáta Bugyi, Diána Mühl, Andrea Ludány, Attila Miseta, Gábor L Kovács, Tamás Kőszegi
BACKGROUND: Simultaneous determination of the two main actin scavenger proteins in sepsis has not been investigated until now. In our pilot study, we elucidated the predictive values of Gc globulin and gelsolin (GSN) in sepsis by comparing them to classic laboratory and clinical parameters. METHODS: A 5-day follow-up was performed, including 46 septic patients, 28 non-septic patients and 35 outpatients as controls. Serum Gc globulin and GSN levels were determined by automated immune turbidimetric assay on a Cobas 8000/c502 analyzer...
January 10, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29319770/factors-associated-with-hospital-mortality-in-renal-transplant-patients-admitted-to-the-intensive-care-unit-with-acute-respiratory-failure
#6
Rafael Mendes da Silva, Flavio Geraldo Rezende de Freitas, Antonio Tonete Bafi, Hélio Tedesco Silva Junior, Bartira de Aguiar Roza
INTRODUCTION: The lungs are often involved in a variety of complications after kidney transplantation. Acute respiratory failure (ARF) is one of the most serious manifestations of pulmonary involvement. OBJECTIVE: To describe the main causes of ARF in kidney transplant patients who require intensive care and identify the factors associated with mortality. METHODS: This retrospective study evaluated adult patients with ARF admitted to the intensive care unit of a center with high volume of transplants from August 2013 to August 2015...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29319365/the-prognostic-value-of-mid-regional-pro-adrenomedullin-in-the-evaluation-of-acute-dyspnea
#7
Justin J Choi, Matthew W McCarthy
Acute dyspnea is a common chief complaint among patients who visit an emergency room and presents diagnostic challenges for clinicians in both identifying the etiology and determining the clinical severity. The study of biomarkers in the prognostication and risk stratification of these patients has been increasing, including the investigation of the prognostic value for mid-regional pro-adrenomedullin (MR-proADM). Areas Covered: In this review, the authors cover what is known about MR-proADM testing in patients presenting with acute dyspnea and the supporting evidence of its prognostic value in common conditions in medical patients with acute dyspnea, including acute heart failure, community acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease, and acute pulmonary embolism...
January 10, 2018: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/29317824/selection-of-piperacillin-tazobactam-infusion-mode-guided-by-sofa-score-in-cancer-patients-with-hospital-acquired-pneumonia-a-randomized-controlled-study
#8
Yang Lyu, Yang Yang, Xin Li, Min Peng, Xin He, Peng Zhang, Shangwen Dong, Wanhua Wang, Donghao Wang
Background: This study aimed to select piperacillin/tazobactam (TZP) infusion mode guided by Sequential Organ Failure Assessment (SOFA) score in cancer patients with hospital-acquired pneumonia (HAP) postoperation. Patients and methods: A total of 120 cancer patients with postoperative HAP were divided into two groups: improved administration group (L group) and conventional treatment group (Con group). The Con group received traditional infusion of TZP and the L group received it as prolonged infusion...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29316571/validation-of-three-postoperative-risk-prediction-models-for-intensive-care-unit-mortality-after-cardiac-surgery
#9
Samuel Henry Howitt, Camila Caiado, Charles McCollum, Michael Goldstein, Ignacio Malagon, Rajamiyer Venkateswaran, Stuart William Grant
BACKGROUND:  Several cardiac surgery risk prediction models based on postoperative data have been developed. However, unlike preoperative cardiac surgery risk prediction models, postoperative models are rarely externally validated or utilized by clinicians. The objective of this study was to externally validate three postoperative risk prediction models for intensive care unit (ICU) mortality after cardiac surgery. METHODS:  The logistic Cardiac Surgery Scores (logCASUS), Rapid Clinical Evaluation (RACE), and Sequential Organ Failure Assessment (SOFA) scores were calculated over the first 7 postoperative days for consecutive adult cardiac surgery patients between January 2013 and May 2015...
January 9, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29308761/-correlation-between-model-for-end-stage-liver-disease-score-and-prognosis-in-mushroom-poisoning-patients-a-multicenter-clinical-study
#10
Quan Cai, Ziyi Jia, Tianming Liu, Chunwu Zhang, Zhigang Hui, Xuesong Dong, Zhi Liu
OBJECTIVE: To find out the clinical indicators related to prognosis in patients with acute mushroom poisoning, and approach its correlation with prognosis. METHODS: Clinical data of patients with mushroom poisoning admitted to the First Hospital of China Medical University, the Ninth People's Hospital of Shenyang, Xiuyan Central People's Hospital, and Fushun Central Hospital from August 2015 to August 2017 were retrospectively analyzed. The biochemical indicators within 24 hours after admission, sequential organ failure assessment (SOFA) score, model for end-stage liver disease (MELD) score, whether plasmapheresis (PE) was carried out or not and 28-day prognosis of patients were collected...
January 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29308756/-establishment-of-multiple-organ-dysfunction-syndrome-early-warning-score-in-patients-with-severe-trauma-and-its-clinical-significance-a-multicenter-study
#11
Wenjuan Huang, Song Qin, Yu Sun, Shangqi Yin, Xia Fan, Qi Huang, Tao Chen, Huaping Liang
OBJECTIVE: To explore the risk factors of multiple organ dysfunction syndrome (MODS) in severe trauma patients, put forward a new warning scoring system of MODS, and to provide a more accurate scoring method for doctors to judge the clinical condition and prognosis of patients. METHODS: Clinical data of 342 patients with severe trauma admitted to intensive care unit (ICU) of the Affiliated Hospital of Zunyi Medical College and Daping Hospital of the Third Military Medical University from January 1st, 2015 to December 31st, 2016 were retrospectively analyzed...
January 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29308749/-2017-clinical-breakthroughs-in-critical-care-medicine
#12
Wei Huang
New achievements in critical care medicine 2017 may include updating of "Surviving Sepsis Campaign" international guideline. Comparing evaluation of sequential (sepsis-related) organ failure assessment (SOFA) and quick sequential organ failure assessment (qSOFA), combination therapies with steroid, vitamin B1 and vitamin C in patients with sepsis, identification of endophenotype of sepsis, as well phenotype of acute respiratory distress syndrome (ARDS). However, it is also need to mention some of negative trials, such as levosimendan in patients undergoing cardiac surgery, low-dose immunoglobulin G and polymyxin B hemoperfusion for patient with septic shock, and enteral versus parenteral early nutrition in ventilated adults with shock...
January 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29308208/early-versus-late-tracheostomy-after-decompressive-craniectomy-for-stroke
#13
Michael P Catalino, Feng-Chang Lin, Nathan Davis, Keith Anderson, Casey Olm-Shipman, J Dedrick Jordan
Background: Stroke patients requiring decompressive craniectomy are at high risk of prolonged mechanical ventilation and ventilator-associated pneumonia (VAP). Tracheostomy placement may reduce the duration of mechanical ventilation. Predicting which patients will require tracheostomy and the optimal timing of tracheostomy remains a clinical challenge. In this study, the authors compare key outcomes after early versus late tracheostomy and develop a useful pre-operative decision-making tool to predict post-operative tracheostomy dependence...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29303209/point-of-care-gastrointestinal-and-urinary-tract-sonography-in-daily-evaluation-of-gastrointestinal-dysfunction-in-critically-ill-patients-guts-protocol
#14
Angel Augusto Perez-Calatayud, Raul Carrillo-Esper, Eduardo Daniel Anica-Malagon, Jesus Carlos Briones-Garduño, Emilio Arch-Tirado, Robert Wise, Manu L N G Malbrain
PURPOSE: There is currently a lack of universally accepted criteria for gastrointestinal (GI) failure or dysfunction in critical care. Also, the clinical assessment of intestinal function is notoriously difficult and thus often goes unrecognized, contributing to poor outcomes. A recent grading system has been proposed to define acute gastrointestinal injury (AGI) in conjunction with other organ function scores (e.g., SOFA). Ultrasonography has become widely accepted as a diagnostic tool for GI problems and pathology...
January 5, 2018: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29301176/sudden-paraplegia-caused-by-nontraumatic-cervical-disc-rupture-a-case-report
#15
Sung Min Kim, Byeong Sam Choi, Sungjoon Lee
A 38-year-old man visited our Emergency Department for sudden onset paraplegia that occurred 1 hour ago. He felt a piercing pain in the posterior neck and became paraplegic while he was watching television, lying down on a sofa. Neurological examination showed motor power grades II-III in both arms and grade 0 in both legs. His cervical magnetic resonance imaging (MRI) showed a large ruptured disc at the C5-6 level, severely compressing the spinal cord. Emergency anterior cervical discectomy and fusion at C5-6 were performed...
December 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/29291417/performance-of-qsofa-and-sofa-for-predicting-mortality-in-patients-with-acute-pyelonephritis-associated-with-upper-urinary-tract-calculi
#16
Hiroshi Fukushima, Masaki Kobayashi, Keizo Kawano, Shinji Morimoto
PURPOSE: The Sepsis-3 Task Force proposed a new definition of sepsis based on SOFA and introduced a novel scoring system, qSOFA, for screening high-risk patients for sepsis. Their clinical usefulness, however, is unclear. Therefore, we investigated their predictive performance for mortality in APN-UTC patients. MATERIALS AND METHODS: This retrospective study included 141 consecutive patients clinically diagnosed with APN-UTC outside the ICU. We evaluated the performance of qSOFA, SOFA, and SIRS in predicting in-hospital mortality and ICU admission using the AUC of the ROC curve, NRI, IDI, and decision curve analysis...
December 29, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29290034/pharmacokinetics-of-dexmedetomidine-during-analgosedation-in-icu-patients
#17
Piotr Smuszkiewicz, Paweł Wiczling, Justyna Ber, Justyna Warzybok, Tomasz Małkiewicz, Jan Matysiak, Agnieszka Klupczyńska, Iwona Trojanowska, Zenon Kokot, Edmund Grześkowiak, Wojciech Krzyzanski, Agnieszka Bienert
Dexmedetomidine (DEX) is a fairly new alfa2-agonist which has been increasingly used in recent years for analgosedation, mostly because it offers a unique ability of providing both moderate level of sedation and analgesia without respiratory depression. Despite of many papers published, there are still only a few concerning the PK of the drug given as long-term infusion in ICU patients. The aim of this work was to characterize the population pharmacokinetics of dexmedetomidine and to investigate the potential benefits of individualization of drug dosing based on patient characteristics in the heterogeneous group of medical and surgical patients staying in intensive care unit...
December 30, 2017: Journal of Pharmacokinetics and Pharmacodynamics
https://www.readbyqxmd.com/read/29289687/a-comparison-of-the-quick-sofa-qsofa-and-sirs-criteria-for-the-diagnosis-of-sepsis-and-prediction-of-mortality-a-systematic-review-and-meta-analysis
#18
Rodrigo Serafim, Jose Andrade Gomes, Jorge Salluh, Pedro Póvoa
BACKGROUND: Several studies were published to validate quick-SOFA (qSOFA), namely in comparison with Systemic Inflammatory Response Syndrome (SIRS) criteria. We performed a systematic review and a meta-analysis with the aim of comparing qSOFA and SIRS in patients outside the ICU. METHOD: We searched the MEDLINE, CINAHL, and Web of Science database, from February 23rd, 2016 until June 30th, 2017, to identify full-text English language studies published after the Sepsis-3 publication that compared qSOFA and SIRS as well as sensitivity or specificity to diagnose sepsis, the hospital and ICU length of stay (LOS) and hospital mortality...
December 28, 2017: Chest
https://www.readbyqxmd.com/read/29286009/efficacy-of-loading-dose-of-colistin-in-acinetobacter-baumannii-ventilator-associated-pneumonia
#19
Emine Alp, Esma Eren, Gülseren Elay, Fatma Cevahir, Aliye Esmaoğlu, Jordi Rello
Colistin loading dose (LD) has been postulated as an advance in therapy. The clinical, microbiological effectiveness and nephrotoxicity of adding an LD to systemic colistin in ventilator-associated pneumonia (VAP) caused by multidrug-resistant (MDR) Acinetobacter baumannii remain unknown. In this quasi experimental study, the efficacy, outcomes and nephrotoxicity in 30 adults who received intravenous colistin with LD for MDR A. baumannii ventilator associated pneumonia were compared with 22 in absence of LD...
December 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/29282483/soluble-trem-1-serum-level-can-early-predict-mortality-of-patients-with-sepsis-severe-sepsis-and-septic-shock
#20
Monika Jedynak, Andrzej Siemiatkowski, Barbara Mroczko, Magdalena Groblewska, Robert Milewski, Maciej Szmitkowski
Early prognostic prediction of sepsis is essential in adjusting therapeutic protocols to prevent deterioration and reduce mortality. We compared the predictive value of the serum concentration of the soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) for 28-day mortality and for the development of severe sepsis or septic shock on the third day with the levels of interleukin (IL)-6, C-reactive protein (CRP) and procalcitonin (PCT). The study was conducted on 85 patients with sepsis. sTREM-1, CRP, PCT and IL-6 concentrations were measured upon study inclusion (day 0) and on days 1, 2, 3 and 5...
December 27, 2017: Archivum Immunologiae et Therapiae Experimentalis
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