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https://www.readbyqxmd.com/read/28091723/changes-in-the-severity-and-subtype-of-guillain-barr%C3%A3-syndrome-admitted-to-a-specialist-neuromedical-icu-over-a-25%C3%A2-year-period
#1
C J Taylor, N P Hirsch, D M Kullmann, Robin S Howard
We report a retrospective review of 110 patients with acute Guillain-Barré syndrome (GBS) admitted to a specialised intensive care unit (ICU) in a tertiary referral centre over a 25 year period, the start of which coincided with the widespread introduction of plasma exchange (PE) and intravenous immunoglobulin (IVIG). The results were analysed by comparing 52 patients admitted in the first decade (1991-2000; Group 1) with 58 patients admitted between 2001-2014 (Group 2). Patients in both groups were comparable with respect to age and sex, and had a similar incidence and range of ICU complications...
January 16, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28051172/therapeutic-hypothermia-for-neonatal-encephalopathy-a-report-from-the-first-3-years-of-the-baby-cooling-registry-of-japan
#2
Kennosuke Tsuda, Takeo Mukai, Sachiko Iwata, Jun Shibasaki, Takuya Tokuhisa, Tomoaki Ioroi, Hiroyuki Sano, Nanae Yutaka, Akihito Takahashi, Akihito Takeuchi, Toshiki Takenouchi, Yuko Araki, Hisanori Sobajima, Masanori Tamura, Shigeharu Hosono, Makoto Nabetani, Osuke Iwata
Therapeutic hypothermia is recommended for moderate and severe neonatal encephalopathy, but is being applied to a wider range of neonates than originally envisaged. To examine the clinical use of therapeutic hypothermia, data collected during the first 3 years (2012-2014) of the Baby Cooling Registry of Japan were analysed. Of 485 cooled neonates, 96.5% were ≥36 weeks gestation and 99.4% weighed ≥1,800 g. Severe acidosis (pH < 7 or base deficit ≥16 mmol/L) was present in 68.9%, and 96.7% required resuscitation for >10 min...
January 4, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28050900/planned-early-birth-versus-expectant-management-waiting-for-prelabour-rupture-of-membranes-at-term-37-weeks-or-more
#3
REVIEW
Philippa Middleton, Emily Shepherd, Vicki Flenady, Rosemary D McBain, Caroline A Crowther
BACKGROUND: Prelabour rupture of membranes (PROM) at term is managed expectantly or by planned early birth. It is not clear if waiting for birth to occur spontaneously is better than intervening, e.g. by inducing labour. OBJECTIVES: The objective of this review is to assess the effects of planned early birth (immediate intervention or intervention within 24 hours) when compared with expectant management (no planned intervention within 24 hours) for women with term PROM on maternal, fetal and neonatal outcomes...
January 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28041655/trends-in-outcomes-and-hospitalization-charges-of-infant-botulism-in-the-united-states-a-comparative-analysis-between-kids-inpatient-database-and-national-inpatient-sample
#4
Tamara Opila, Asha George, Mohammad El-Ghanem, Nizar Souayah
BACKGROUND: New therapeutic strategies, including immune globulin intravenous, have emerged in the past two decades for the management of botulism. However, impact on outcomes and hospitalization charges among infants (aged ≤1 year) with botulism in the United States is unknown. METHODS: We analyzed the Kids' Inpatient Database (KID) and National Inpatient Sample (NIS) for in-hospital outcomes and charges for infant botulism cases from 1997 to 2009. Demographics, discharge status, mortality, length of stay, and hospitalization charges were reported from the two databases and compared...
October 20, 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/28033033/long-term-outcomes-and-health-care-utilization-following-prolonged-mechanical-ventilation
#5
Andrea D Hill, Robert A Fowler, Karen E A Burns, Louise Rose, Ruxandra L Pinto, Damon C Scales
RATIONALE: Limited data are available to characterize the long-term outcomes and associated costs for patients who require prolonged mechanical ventilation (PMV) (defined here as mechanical ventilation for longer than 21 days). OBJECTIVES: To examine the association between prolonged mechanical ventilation and mortality, health care utilization, and costs after critical illness. METHODS: Population-based cohort study of adults who received mechanical ventilation in an intensive care unit (ICU) in Ontario, Canada between 2002 and 2013...
December 29, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28005689/epidemiology-and-outcomes-of-hospitalized-children-with-necrotizing-soft-tissue-infections
#6
Balagangadhar R Totapally
OBJECTIVE: The purpose of this study was to evaluate the epidemiology and outcome of hospitalized children with a diagnosis of necrotizing soft tissue infections (NSTIs). METHODS: Demographic and outcome data of children 1 month to 18 years of age with a diagnosis of NSTI (ICD-9 diagnosis codes 728.86 and 729.4) were extracted from the Kids' Inpatient Database 2009 and 2012. Univariate and multivariate analyses were done to determine the factors affecting the mortality...
December 21, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27999847/tube-feeding-among-elder-in-long-term-care-facilities-a-systematic-review-and-meta-analysis
#7
S-H Lan, L-C Lu, Y-Y Yen, Y-P Hsieh, J-C Chen, W J Wu, S-J Lan, L-Y Lin
OBJECTIVE: The use of tube feeding for elderly patients with poor nutritional intake is a ubiquitous method of feeding. This systematic review and meta-analysis were carried out to compare nutritional benefits of enteral feeding versus oral feeding in long-term care facilities. SETTING: Databases including the Cochrane Library, ProQuest, PubMed, EMBASE, EBSCO, Web of Science and Google Scholar through April 2014 using keywords including enteral feeding, tube feeding or oral feeding combined with long term care facilities or nursing home...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/27994384/severe-acute-respiratory-distress-syndrome-caused-by-unintentional-sewing-machine-lubricant-ingestion-a-case-report
#8
Sunil Kishore, Sudha Chandelia, Neha Patharia, Swarnim
Sewing machine oil ingestion is rare but is possible due to its availability at home. Chemically, it belongs to hydrocarbon family which is toxic if aspirated, owing to their physical properties such as high volatility and low viscosity. On the contrary, sewing machine lubricant has high viscosity and low volatility which makes it aspiration less likely. The main danger of hydrocarbon ingestion is chemical pneumonitis which may be as severe as acute respiratory distress syndrome (ARDS). We report a case of a 5-year-old girl with accidental ingestion of sewing machine lubricant oil, who subsequently developed ARDS refractory to mechanical ventilation...
November 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27960212/severity-assessment-and-the-immediate-and-long-term-prognosis-in-community-acquired-pneumonia
#9
Martin Kolditz, Dionne Braeken, Santiago Ewig, Gernot Rohde
Severity assessment is a crucial step in the initial management of patients with community-acquired pneumonia (CAP). While approximately half of patients are at low risk of death and can be safely treated as outpatients, around 20% are at increased risk. While CURB-65 (confusion, respiratory rate, blood pressure, urea) and pneumonia severity index (PSI) scores are equally useful as an adjunct to clinical judgment to identify patients at low risk, the so-called minor American Thoracic Society/Infectious Diseases Society of America criteria are predictive of patients in need of intensified treatment (i...
December 2016: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27958617/results-of-the-fontan-operation-with-no-early-mortality-in-248-consecutive-patients
#10
Edward Malec, Christoph Schmidt, Anja Lehner, Katarzyna Januszewska
BACKGROUND: Fontan operation has undergone several modifications and today is the primary way to treat a broad spectrum of congenital heart defects AIM: The purpose of this study is to present the results of treatment of children with a single ventricle operated by the same surgical team and managed according to a uniform strategy. METHODS: In the years 2007-2015, in 248 children aged 3.7 ± 2.6 years and weigh of 14.6 ± 6.1 kg with a single ventricle the Fontan surgery was performed...
December 13, 2016: Kardiologia Polska
https://www.readbyqxmd.com/read/27900922/-extracorporeal-life-support-for-legionella-pneumonia
#11
W A C Koekkoek, C Savelkoul, P R Wijnandts, M Platenkamp, D W Donker, D H T Tjan
BACKGROUND: Legionella species cause 5% of all community acquired pneumonias. However, Legionella pneumonia results relatively often in admission to the intensive care unit (ICU). A significant complication is the development of acute respiratory distress syndrome (ARDS). The ICU mortality rate for Legionella pneumonia is > 30% with conventional treatments. CASE DESCRIPTION: A 64-year-old male was admitted to the ICU with respiratory failure due to Legionella pneumonia complicated by ARDS...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27899532/long-term-management-for-ventilator-assisted-children-in-hong-kong-2-decades-experience
#12
Shuk-Kuen Chau, Ada Wing-Yan Yung, So-Lun Lee
BACKGROUND: The population of children receiving long-term mechanical ventilation is growing worldwide, but only limited data exist in Asian regions. The objective of the study was to review the management of these children in Hong Kong over the past 2 decades. METHODS: This was a retrospective cohort study. Hospital records from subjects receiving mechanical ventilation for >3 months were retrieved. Demographic characteristics and medical information of subjects (≤21 y old) under the care of the ventilator program at the Duchess of Kent Children's Hospital between 1997 and 2015 were reviewed...
January 2017: Respiratory Care
https://www.readbyqxmd.com/read/27873512/antimicrobial-resistance-and-clinical-outcomes-in-nursing-home-acquired-pneumonia-compared-to-community-acquired-pneumonia
#13
Yun Seong Kang, Soo Ryeong Ryoo, Seung Joo Byun, Yun Jeong Jeong, Jin Young Oh, Young Soon Yoon
PURPOSE: Patients with nursing home-acquired pneumonia (NHAP) should be treated as hospital-acquired pneumonia (HAP) according to guidelines published in 2005. However, controversy still exists on whether the high mortality of NHAP results from multidrug resistant pathogens or underlying disease. We aimed to outline differences and factors contributing to mortality between NHAP and community-acquired pneumonia (CAP) patients. MATERIALS AND METHODS: We retrospectively evaluated patients aged 65 years or older with either CAP or NHAP from 2008 to 2014...
January 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27865060/reducing-variation-in-feeding-newborns-with-congenital-heart-disease
#14
Janet M Simsic, Kirby-Rose Carpenito, Kristin Kirchner, Stephanie Peters, Holly Miller-Tate, Brian Joy, Mark Galantowicz
OBJECTIVE: Enteral feeding is associated with decreased infection rates, decreased mechanical ventilation, decreased hospital length of stay, and improved wound healing. Enteral feeding difficulties are common in congenital heart disease. Our objective was to develop experience-based newborn feeding guidelines for the initiation and advancement of enteral feeding in the cardiothoracic intensive care unit. DESIGN: This is a retrospective analysis of a quality improvement project...
November 16, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27861340/prognostic-factors-associated-with-mortality-and-major-in-hospital-complications-in-patients-with-bacteremic-pneumococcal-pneumonia-population-based-study
#15
Jessica A Beatty, Sumit R Majumdar, Gregory J Tyrrell, Thomas J Marrie, Dean T Eurich
Bacteremic pneumococcal pneumonia (BPP) causes considerable mortality and morbidity. We aimed to identify prognostic factors associated with mortality and major in-hospital complications in BPP.A prospective, population-based clinical registry of 1636 hospitalized adult patients (≥18 years) with BPP was established between 2000 and 2010 in Northern Alberta, Canada. Prognostic factors for mortality and major in-hospital complications (e.g., cardiac events, mechanical ventilation, aspiration) were evaluated using multivariable logistic regression...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27852953/effectiveness-of-an-exercise-programme-on-physical-function-in-patients-discharged-from-hospital-following-critical-illness-a-randomised-controlled-trial-the-revive-trial
#16
Kathryn McDowell, Brenda O'Neill, Bronagh Blackwood, Chris Clarke, Evie Gardner, Paul Johnston, Michaeline Kelly, John McCaffrey, Brian Mullan, Sally Murphy, T John Trinder, Gavin Lavery, Daniel F McAuley, Judy M Bradley
OBJECTIVE: To investigate the effectiveness of a 6-week exercise programme in patients discharged home following critical illness compared with standard care. DESIGN: Multicentre prospective phase II randomised controlled trial, with blinded outcome assessment after hospital discharge, following the 6-week intervention and at 6 months. PARTICIPANTS: 60 patients (30 per group) aged ≥18 years, mechanically ventilated >96 hours, and not in other rehabilitation, that is, cardiac or pulmonary rehabilitation programmes...
November 15, 2016: Thorax
https://www.readbyqxmd.com/read/27824402/-pathways-of-invasive-ventilated-patients-released-into-intensive-home-care-the-perspective-of-home-care-providers
#17
Y Lehmann, M Ewers
Introduction: Over the past years, many home respiratory care services for invasively mechanically ventilated patients have been set up in Germany. However, little is known about the pathways used by these patients in order to access such specialized care. Methods: A qualitative, exploratory study was undertaken. Semi-structured interviews with 15 leading experts or employees responsible for care transition were conducted and subjected to content analysis. Results: Invasively ventilated patients' pathways into intensive home care tend to be highly random, risky and uncertain...
November 7, 2016: Das Gesundheitswesen
https://www.readbyqxmd.com/read/27809826/hospitalizations-due-to-respiratory-failure-in-patients-with-amyotrophic-lateral-sclerosis-and-their-impact-on-survival-a-population-based-cohort-study
#18
Federica Edith Pisa, Giancarlo Logroscino, Paolo Giacomelli Battiston, Fabio Barbone
BACKGROUND: Respiratory failure, infections and aspiration pneumonia, are the main causes of morbidity and mortality in Amyotrophic Lateral Sclerosis (ALS). In a population-based cohort, we assessed (a) hospital utilization and (b) impact of hospitalization for respiratory failure on survival. METHODS: All patients with incident ALS in Friuli Venezia Giulia region, Italy, from 2002 to 2009, were identified through multiple sources. Diagnosis was validated through clinical documentation review...
November 3, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27801708/pediatric-critical-care-transport-as-a-conduit-to-terminal-extubation-at-home-a-case-series
#19
Corina Noje, Meghan L Bernier, Philomena M Costabile, Bruce L Klein, Sapna R Kudchadkar
OBJECTIVES: To present our single-center's experience with three palliative critical care transports home from the PICU for terminal extubation. DESIGN: We performed a retrospective chart review of patients transported between January 1, 2012, and December 31, 2014. SETTING: All cases were identified from our institutional pediatric transport database. PATIENTS: Patients were terminally ill children unable to separate from mechanical ventilation in the PICU, who were transported home for terminal extubation and end-of-life care according to their families' wishes...
January 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27796127/-impact-of-reorganization-of-the-hungarian-system-of-intensive-care-units-in-2012
#20
Miklós Gresz
INTRODUCTION: In 2012, the Hungarian system of intensive care units was reorganized. During this process, multidisciplinary units were separated from observation units. AIM: The author analysed certain indicators of the remaining intensive care units. METHOD: The study was based on reports of National Health Insurance Fund between 2000 and 2015. RESULTS: After reorganization the number of the multidisciplinary intensive care units decreased by 20% and the number of beds decreased by 10%...
October 2016: Orvosi Hetilap
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