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https://www.readbyqxmd.com/read/28538442/impact-of-moderate-hyperchloremia-on-clinical-outcomes-in-intracerebral-hemorrhage-patients-treated-with-continuous-infusion-hypertonic-saline-a-pilot-study
#1
Heidi M Riha, Michael J Erdman, Joseph E Vandigo, Lauren A Kimmons, Nitin Goyal, K Erin Davidson, Abhi Pandhi, G Morgan Jones
OBJECTIVES: Hyperchloremia has been associated with increased morbidity and mortality in critically ill patients. While previous research has demonstrated an association between hypertonic saline and hyperchloremia, limited data exist in neurocritical care patients. The objective of this study is to determine the impact of moderate hyperchloremia (chloride ≥ 115 mmol/L) on clinical outcomes in intracerebral hemorrhage patients treated with continuous IV infusion 3% hypertonic saline...
May 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28536932/thromboprophylaxis-in-extracorporeal-circuits-current-pharmacological-strategies-and-future-directions
#2
REVIEW
Gail M Annich, Oshri Zaulan, Megan Neufeld, Deborah Wagner, Melissa M Reynolds
The development of extracorporeal devices for organ support has been a part of medical history and progression since the late 1900s. These types of technology are primarily used and developed in the field of critical care medicine. Unfractionated heparin, discovered in 1916, has really been the only consistent form of thromboprophylaxis for attenuating or even preventing the blood-biomaterial reaction that occurs when such technologies are initiated. The advent of regional anticoagulation for procedures such as continuous renal replacement therapy and plasmapheresis have certainly removed the risks of systemic heparinization and heparin effect, but the challenges of the blood-biomaterial reaction and downstream effects remain...
May 23, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28530846/monitoring-nutrition-in-critical-illness-what-can-we-use
#3
Suzie Ferrie, Erica Tsang
BACKGROUND: Nutrition monitoring in the context of critical care presents unique challenges. Traditionally used anthropometric and biochemical markers may be difficult to obtain or confounded by factors such as fluid status and the inflammatory response. A previous survey identified 15 parameters in common use, all of which have confounding influences during critical illness. MATERIALS AND METHODS: A literature search was conducted to assess current use of commonly used nutrition-monitoring parameters and to explore other possible methods that might be more useful...
May 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28530772/characteristics-of-the-injuries-of-syrian-refugees-sustained-during-the-civil-war
#4
Betül Kocamer Şimşek, Mehmet Dokur, Erdal Uysal, Necdet Çalıker, Oruç Numan Gökçe, İbrahim Kürşat Deniz, Murat Uğur, Murat Geyik, Mehmet Kaya, Güner Dağlı
BACKGROUND: During a war, many civilians are severely injured by firearms, bombs, and shrapnel. The triage of war injuries involves difficult and complicated processes requiring surgical procedures and patient monitoring in the Intensive Care Unit (ICU) of hospitals. In this study, we examine the demographic, traumatic, and critical care characteristics of cases injured during the civil war in Syria and requiring emergency surgery. METHODS: Electronic data of the traumatic, surgical, and ICU monitoring features of 707 patients admitted to Kilis Public Hospital between March 2012 and January 2013 were analyzed retrospectively RESULTS: Most of the patients reported having been injured due to firearms (83...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28530380/diabetes-update-primary-care-of-patients-with-type-1-diabetes
#5
Beth Choby
The incidence and prevalence of type 1 diabetes (T1D) are increasing among white, black, Hispanic, and Asian individuals in the United States. Children often present with acute symptoms, including severe polyuria, polydipsia, weight loss, and ketonemia; adults may develop more gradual symptoms that initially appear similar to those of type 2 diabetes (T2D). Latent autoimmune diabetes of adults and maturity-onset diabetes of the young are conditions that may be confused with T1D, although they are actually more closely related to T2D...
May 2017: FP Essentials
https://www.readbyqxmd.com/read/28530251/impact-of-resection-margin-status-on-oncological-outcomes-after-co2-laser-cordectomy
#6
P Aluffi Valletti, F Taranto, A Chiesa, F Pia, G Valente
The management of positive resection margins in micro-endoscopic glottic laser surgery remains a controversial and critical point. This study aims to assess the impact of margin status after transoral laser surgery on local control, survival and organ preservation rates; the decision- making process and treatment options in cases with positive margins are also discussed. We retrospectively reviewed the clinical and histological records of 308 consecutive patients with primary early glottic carcinoma (T1a, T1b, selected T2) and treated with endoscopic laser cordectomy...
May 22, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28530038/hiv-treatment-and-care-services-for-adolescents-a-situational-analysis-of-218-facilities-in-23-sub-saharan-african-countries
#7
Daniella Mark, Alice Armstrong, Catarina Andrade, Martina Penazzato, Luann Hatane, Lina Taing, Toby Runciman, Jane Ferguson
INTRODUCTION: In 2013, an estimated 2.1 million adolescents (age 10-19 years) were living with HIV globally. The extent to which health facilities provide appropriate treatment and care was unknown. To support understanding of service availability in 2014, Paediatric-Adolescent Treatment Africa (PATA), a non-governmental organisation (NGO) supporting a network of health facilities across sub-Saharan Africa, undertook a facility-level situational analysis of adolescent HIV treatment and care services in 23 countries...
May 16, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28527880/intensive-monitoring-of-urine-output-is-associated-with-increased-detection-of-acute-kidney-injury-and-improved-outcomes
#8
Kui Jin, Raghavan Murugan, Florentina E Sileanu, Emily Foldes, Priyanka Priyanka, Gilles Clermont, John A Kellum
BACKGROUND: Urine output (UO) is a vital sign for critical ill patients but standards for monitoring and reporting vary widely between ICUs. Careful monitoring of UO could lead to earlier recognition of acute kidney injury (AKI) and better fluid management. We sought to determine if intensity of UO monitoring is associated with outcomes in patients with and without AKI. METHODS: Retrospective cohort study including 15,724 adults admitted to ICUs from 2000-2008. Intensive UO monitoring was defined as hourly recordings and no gaps >3 hours for the first 48 hours after ICU admission...
May 17, 2017: Chest
https://www.readbyqxmd.com/read/28524024/-efficacy-and-safety-of-colistimethate-sodium-in-critical-patients-an-in-vitro-study-by-using-of-monte-carlo-simulation
#9
Aijun Pan, Qing Mei, Tianjun Yang, Xiaolan Gao, Huaiwei Lu, Ying Ye, Jiabin Li, Bao Liu
OBJECTIVE: To evaluate the efficacy and safety of colistimethate sodium (CMS) for the treatment of critical patients infected by pan-drug resistant Acinetobacter baumannii (PDR-AB) or pan-drug resistant Pseudomonas aeruginosa (PDR-PA). METHODS: 321 isolates of PDR-AB and 204 isolates of PDR-PA from critical patients admitted to 35 intensive care units (ICUs) of grade two or above were collected from the Anhui Antimicrobial Resistance Investigation Net (AHARIN) program from September 2012 to September 2015, while the minimal inhibitory concentrations (MIC) of colistin were determined by the E-test...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28521715/conducting-hiv-seroprevalence-and-behavioral-epidemiology-risk-surveys-sabers-among-partner-military-populations
#10
Caroline A Macera, Stanley I Ito, Braden R Hale, Richard A Shaffer, Anne G Thomas, Janet Dickieson
BACKGROUND: Characterizing HIV infection and associated risk behaviors within military populations is critical for understanding the epidemic and informing prevention activities. However, the prevalence of HIV and related risk behaviors is often unknown. Further, militaries may not have the systems in place or the staff expertise to conduct HIV surveillance and risk behavior studies. METHODS: The Department of Defense HIV/AIDS Prevention Program (DHAPP), funded by the President's Emergency Plan for AIDS Relief and the US Department of Defense, provides technical assistance, management and administrative support for HIV/AIDS prevention, care and treatment for approximately 65 partner militaries...
May 16, 2017: Current HIV Research
https://www.readbyqxmd.com/read/28515601/quality-indicators-compliance-survey-in-indian-intensive-care-units
#11
Munta Kartik, Palepu B N Gopal, Rahul Amte
CONTEXT: The quality of health care and outcomes of Intensive Care Unit (ICU) have been a major subject of discussion in the past decade. Quality indicators in ICUs maintain an order of uniformity and standard care of delivery across ICUs. AIMS: In this study, we tried to analyze the percentage compliance of quality indicators in ICU across our country. METHODS: Four hundred complete questionnaire forms were collected in two stages by means of conducting a survey and through email responses to the survey questionnaire...
April 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28514963/patient-centered-primary-care-for-adults-at-high-risk-for-auds-the-choosing-healthier-drinking-options-in-primary-care-choice-trial
#12
Katharine A Bradley, Evette Joy Ludman, Laura J Chavez, Jennifer F Bobb, Susan J Ruedebusch, Carol E Achtmeyer, Joseph O Merrill, Andrew J Saxon, Ryan M Caldeiro, Diane M Greenberg, Amy K Lee, Julie E Richards, Rachel M Thomas, Theresa E Matson, Emily C Williams, Eric Hawkins, Gwen Lapham, Daniel R Kivlahan
BACKGROUND: Most patients with alcohol use disorders (AUDs) never receive alcohol treatment, and experts have recommended management of AUDs in primary care. The Choosing Healthier Drinking Options In primary CarE (CHOICE) trial was a randomized controlled effectiveness trial of a novel intervention for primary care patients at high risk for AUDs. This report describes the conceptual and scientific foundation of the CHOICE model of care, critical elements of the CHOICE trial design consistent with the Template for Intervention Description and Replication (TIDieR), results of recruitment, and baseline characteristics of the enrolled sample...
May 17, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28513820/intra-abdominal-hypertension-and-abdominal-compartment-syndrome-in-acute-pancreatitis-hepato-pancreato-biliary-operations-and-liver-transplantation
#13
Alexsander K Bressan, Chad G Ball
Intra-abdominal hypertension, even preceding the onset of abdominal compartment syndrome, is still recognized as an adverse prognostic factor. Unfortunately, most of the current supporting evidence within the critical care environment remains observational in nature. In acute pancreatitis, an active role for intra-abdominal hypertension early in the disease process follows a strong intuitive basis, and it is corroborated by preliminary evidence from animal models. Additional studies are needed to better characterize the optimal fluid resuscitation strategy, as well as the importance of intra-abdominal hypertension as an early therapeutic target...
May 17, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28508384/endoscopic-management-of-benign-esophageal-ruptures-and-leaks
#14
REVIEW
Milena Di Leo, Roberta Maselli, Elisa Chiara Ferrara, Laura Poliani, Sameer Al Awadhi, Alessandro Repici
Esophageal leaks (EL) and ruptures (ER) are rare conditions associated with a high risk of mortality and morbidity. Historically, EL and ER have been surgically treated, but current treatment options also include conservative management and endoscopy. Over the last decades, interventional endoscopy has evolved as an effective and less invasive alternative to primary surgery in these cases. A variety of techniques are currently available to re-establish the continuity of the digestive tract, prevent or treat infection related to the leak/rupture, prevent further contamination, drain potential collections, and provide nutritional support...
May 15, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28506952/retrospective-evaluation-of-pregnant-women-with-celiac-disease
#15
Kemal Beksaç, Gökçen Örgül, Murat Çağan, Ergun Karaağaoğlu, Serap Arslan, Mehmet Sinan Beksaç
OBJECTIVE: To show celiac disease (CD) and its poor pregnancy outcome relationship, and to demonstrate the importance of a gluten-free diet together with low-dose low-molecular-weight heparin (LMWH) and low-dose corticosteroid (LDC) in the management of pregnancies with CD. MATERIAL AND METHODS: This study consisted of 2 groups of patients. Six patients with CD (control group) on a gluten-free diet were monitored during their first pregnancies within the framework of antenatal care program and their pregnancy outcomes were compared with eight poorly-treated pregnant patients with CD (study group) who were referred from other medical institutions...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28503704/use-of-eeg-in-critically-ill-children-and-neonates-in-the-united-states-of-america
#16
Marina Gaínza-Lein, Iván Sánchez Fernández, Tobias Loddenkemper
The objective of the study was to estimate the proportion of patients who receive an electroencephalogram (EEG) among five common indications for EEG monitoring in the intensive care unit: traumatic brain injury (TBI), extracorporeal membrane oxygenation (ECMO), cardiac arrest, cardiac surgery and hypoxic-ischemic encephalopathy (HIE). We performed a retrospective cross-sectional descriptive study utilizing the Kids' Inpatient Database (KID) for the years 2010-2012. The KID is the largest pediatric inpatient database in the USA and it is based on discharge reports created by hospitals for billing purposes...
May 13, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28502246/time-in-assertive-community-treatment-a-statewide-quality-improvement-initiative-to-reduce-length-of-participation
#17
Steven Huz, Helle Thorning, Candace N White, Lin Fang, Bikki Tran Smith, Marleen Radigan, Lisa B Dixon
The investigators describe a New York State initiative to increase flow through assertive community treatment (ACT) while encouraging transition to less intensive services. This initiative began as ACT approached full capacity and as evidence emerged that participants can sustain recovery post-ACT. Comparison of performance indicators over time showed that time in ACT decreased, turnover rate increased, and the percentage of ACT participants who met treatment objectives rose. Also, post-ACT rates of ambulatory behavioral health follow-up increased while rates of psychiatric inpatient hospitalization decreased...
May 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28501751/the-state-of-everyday-quantitative-eeg-use-in-canada-a-national-technologist-survey
#18
Marcus C Ng, Kara Gillis
PURPOSE: This study sought to determine the state of quantitative EEG (QEEG) use in Canada, as QEEG may provide a partial solution to the issue of escalating EEG demand against insufficient health care resources. METHODS: A 10-item survey questionnaire was administered to participants at the annual meeting of the Canadian Association of Electroneurophysiology Technologists, which was held in parallel with the annual meeting of the Canadian Neurological Sciences Federation...
May 5, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28501674/target-attainment-with-continuous-dosing-of-piperacillin-tazobactam-in-critical-illness-a-prospective-observational-study
#19
Heleen Aardema, Prashant Nannan Panday, Mireille Wessels, Kay van Hateren, Willem Dieperink, Jos G W Kosterink, Jan-Willem Alffenaar, Jan G Zijlstra
Optimal dosing of β-lactam antibiotics in critically ill patients is a challenge given the unpredictable pharmacokinetic profile of this patient population. Several studies have shown intermittent dosing to often yield inadequate drug concentrations. Continuous dosing is an attractive alternative from a pharmacodynamic point of view. This study evaluated whether, during continuous dosing, piperacillin concentrations reached and maintained a pre-defined target in critically ill patients. Adult patients treated with piperacillin by continuous dosing in the intensive care unit of a university medical centre in The Netherlands were prospectively studied...
May 10, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28499680/a-systematic-review-of-the-prevalence-and-types-of-adverse-events-in%C3%A2-interfacility-critical-care-transfers-by-paramedics
#20
Abdullah Alabdali, Joanne D Fisher, Chetan Trivedy, Richard J Lilford
OBJECTIVE: The aim of this study was to investigate if paramedics can safely transfer interfacility critically ill adult patients and to determine the prevalence and types of adverse events when paramedics lead interfacility critical care transfers. METHODS: MEDLINE, Web of Science, Embase, and CINAHL databases were searched from 1990 up to February 2016. Eligibility criteria were adult patients (16 years and over), interfacility transfer (between two health care facilities), quantitative or qualitative description of adverse events, and a paramedic as the primary care provider or the sole health care provider...
May 2017: Air Medical Journal
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