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https://www.readbyqxmd.com/read/29356376/boosting-art-uptake-and-retention-among-hiv-infected-pregnant-and-breastfeeding-women-and-their-infants-the-promise-of-innovative-service-delivery-models
#1
Meena Srivastava, David Sullivan, B Ryan Phelps, Surbhi Modi, Laura N Broyles
INTRODUCTION: With the rapid scale-up of antiretroviral treatment (ART) in the "Treat All" era, there has been increasing emphasis on using differentiated models of HIV service delivery. The gaps within the clinical cascade for mothers and their infants suggest that current service delivery models are not meeting families' needs and prompt re-consideration of how services are provided. This article will explore considerations for differentiated care and encourage the ongoing increase of ART coverage through innovative strategies while also addressing the unique needs of mothers and infants...
January 2018: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/29355414/the-caries-microbiome-implications-for-reversing-dysbiosis
#2
A C R Tanner, C A Kressirer, S Rothmiller, I Johansson, N I Chalmers
The oral microbiome plays a critical role in maintaining oral health. Frequent dietary carbohydrate intake can lead to dysbiosis of the microbial community from overproduction of acid with selection for increases in acidogenic, acid-tolerant bacteria. Knowledge of the caries-associated microbiome is key in planning approaches to reverse the dysbiosis to achieve health. For risk assessment and treatment studies, it would be valuable to establish whether microbial monitoring requires assay of multiple species or whether selected key species would suffice...
February 2018: Advances in Dental Research
https://www.readbyqxmd.com/read/29352416/point-of-care-ultrasound-in-pediatric-anesthesiology-and-critical-care-medicine
#3
REVIEW
Erik Su, Nicholas Dalesio, Aliaksei Pustavoitau
Ultrasound has increasingly become a clinical asset in the hands of the anesthesiologist and intensivist who cares for children. Though many applications for ultrasound parallel adult modalities, children as always are not simply small adults and benefit from the application of ultrasound to their management in various ways. Body composition and size are important factors that affect ultrasound performance in the child, as are the pathologies that may uniquely afflict children and aspects of procedures unique to this patient population...
January 19, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29351143/nutrition-in-the-icu-new-trends-versus-old-fashioned-standard-enteral-feeding
#4
Kristine W A C Koekkoek, Arthur R H van Zanten
PURPOSE OF REVIEW: The narrative review aims to summarize the relevant studies from the last 2 years and provide contextual information to understand findings. RECENT FINDINGS: Recent ICU studies have provided insight in the pathophysiology and time course of catabolism, anabolic resistance, and metabolic and endocrine derangements interacting with the provision of calories and proteins.Early provision of high protein intake and caloric overfeeding may confer harm...
January 18, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29349777/in-bed-cycling-in-the-icu-patient-safety-and-recollections-with-motivational-effects
#5
M Ringdal, M Warren Stomberg, K Egnell, E Wennberg, R Zätterman, C Rylander
BACKGROUND: In-bed cycling (IBC) is gaining interest for implementation in intensive care units. Our main objective was to explore patient recollections and experiences of early mobilization, including IBC. Secondly, we aimed to examine if IBC was safe and feasible. METHODS: Eleven participants were interviewed about their experiences during their critical illnesses and active mobilization in the intensive care unit. The interviews were analyzed thematically. Six participants were also monitored for physiological reactions and adverse events during IBC while mechanically ventilated...
January 18, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29349566/performance-improvement-in-head-and-neck-cancer
#6
REVIEW
Carol M Lewis, Randal S Weber
Performance improvement requires establishing a platform to set benchmarks and monitor the quality of care provided through quality indicators and metrics. This has long been recognized as critical to overall quality improvement and more recently, has become federally mandated. Here, we review recent studies evaluating performance in head and neck cancer care, from those spanning all phases of head and neck cancer care to others focused on head and neck surgical performance, including both national and departmental/institutional efforts...
January 19, 2018: Current Oncology Reports
https://www.readbyqxmd.com/read/29346340/disparities-in-preconception-health-indicators-%C3%A2-behavioral-risk-factor-surveillance-system-2013-2015-and-pregnancy-risk-assessment-monitoring-system-2013-2014
#7
Cheryl Robbins, Sheree L Boulet, Isabel Morgan, Denise V D'Angelo, Lauren B Zapata, Brian Morrow, Andrea Sharma, Charlan D Kroelinger
PROBLEM/CONDITION: Preconception health is a broad term that encompasses the overall health of nonpregnant women during their reproductive years (defined here as aged 18-44 years). Improvement of both birth outcomes and the woman's health occurs when preconception health is optimized. Improving preconception health before and between pregnancies is critical for reducing maternal and infant mortality and pregnancy-related complications. The National Preconception Health and Health Care Initiative's Surveillance and Research work group suggests ten prioritized indicators that states can use to monitor programs or activities for improving the preconception health status of women of reproductive age...
January 19, 2018: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/29344823/long-term-visual-outcomes-of-craniopharyngioma-in-children
#8
Michael J Wan, Michal Zapotocky, Eric Bouffet, Ute Bartels, Abhaya V Kulkarni, James M Drake
Visual function is a critical factor in the diagnosis, monitoring, and prognosis of craniopharyngiomas in children. The aim of this study was to report the long-term visual outcomes in a cohort of pediatric patients with craniopharyngioma. The study design is a retrospective chart review of craniopharyngioma patients from a single tertiary-care pediatric hospital. 59 patients were included in the study. Mean age at presentation was 9.4 years old (range 0.7-18.0 years old). The most common presenting features were headache (76%), nausea/vomiting (32%), and vision loss (31%)...
January 17, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29344100/surgical-site-infection-prevention-an-analysis-of-compliance-with-good-practice-in-a-teaching-hospital
#9
Adriana Cristina de Oliveira, Camila Sarmento Gama
Background: Surgical teams play a critical role in reducing surgery-related risks during preoperative and intraoperative phases. Aim: To analyse the preoperative and intraoperative practices adopted by surgical teams in surgical site infections prevention. Methods: This was a cross-sectional study conducted during April-September 2013 in a large university hospital in Belo Horizonte, Minas Gerais, Brazil. It was conducted through observation of the surgical practice during preoperative and intraoperative phases of procedures used by a gastroenterological, cardiovascular and paediatric surgical team...
November 2017: Journal of Infection Prevention
https://www.readbyqxmd.com/read/29343314/cell-free-dna-the-role-in-pathophysiology-and-as-a-biomarker-in-kidney-diseases
#10
Peter Celec, Barbora Vlková, Lucia Lauková, Janka Bábíčková, Peter Boor
Cell-free DNA (cfDNA) is present in various body fluids and originates mostly from blood cells. In specific conditions, circulating cfDNA might be derived from tumours, donor organs after transplantation or from the foetus during pregnancy. The analysis of cfDNA is mainly used for genetic analyses of the source tissue -tumour, foetus or for the early detection of graft rejection. It might serve also as a nonspecific biomarker of tissue damage in critical care medicine. In kidney diseases, cfDNA increases during haemodialysis and indicates cell damage...
January 18, 2018: Expert Reviews in Molecular Medicine
https://www.readbyqxmd.com/read/29343048/physiology-intervention-and-outcome-three-critical-questions-about-cerebral-tissue-oxygen-saturation-monitoring
#11
Lingzhong Meng, Shaun E Gruenbaum, Feng Dai, Tianlong Wang
The balance between cerebral tissue oxygen consumption and supply can be continuously assessed by cerebral tissue oxygen saturation (SctO2) monitor. A construct consisting of three sequential questions, targeting the physiology monitored, the intervention implemented, and the outcomes affected, is proposed to critically appraise this monitor. The impact of the SctO2- guided care on patient outcome was examined through a systematic literature search and meta- analysis. We concluded that the physiology monitored by SctO2 is robust and dynamic, fragile (prone to derangement), and adversely consequential when deranged...
January 17, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29341970/does-the-use-of-indirect-calorimetry-change-outcome-in-the-icu-yes-it-does
#12
Elisabeth De Waele, Patrick M Honoré, Manu L N G Malbrain
PURPOSE OF REVIEW: To review the recent findings on metabolic monitoring and possible beneficial effects of an adequate nutrition therapy, based on indirect calorimetry as the golden standard to predict energy expenditure. RECENT FINDINGS: in the last decades, major steps are taken in the field of metabolism and nutrition, evolving from nutrition as a baseline support to a therapeutic intervention. The aspect of energy expenditure is of cardinal importance, and technical possibilities have impressively improved: from the first 'calorimetre' in 1789 to the new generation, clinical applicable indirect calorimeters and the high accuracy and easy use model reaching high technology readiness level [Oshima et al...
January 15, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29340538/autonomic-nervous-system-monitoring-in-intensive-care-as-a-prognostic-tool-systematic-review
#13
Luis Bento, Rui Fonseca-Pinto, Pedro Póvoa
OBJECTIVE: To present a systematic review of the use of autonomic nervous system monitoring as a prognostic tool in intensive care units by assessing heart rate variability. METHODS: Literature review of studies published until July 2016 listed in PubMed/Medline and conducted in intensive care units, on autonomic nervous system monitoring, via analysis of heart rate variability as a prognostic tool (mortality study). The following English terms were entered in the search field: ("autonomic nervous system" OR "heart rate variability") AND ("intensive care" OR "critical care" OR "emergency care" OR "ICU") AND ("prognosis" OR "prognoses" OR "mortality")...
October 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29328980/consequence-of-intraventricular-hemorrhage-on-neurovascular-coupling-evoked-by-speech-syllables-in-preterm-neonates
#14
Mahdi Mahmoudzadeh, Ghislaine Dehaene-Lambertz, Guy Kongolo, Marc Fournier, Sabrina Goudjil, Fabrice Wallois
Intraventricular Hemorrhage (IVH) is the leading cause of neurological and cognitive impairment in preterm neonates with an incidence that increases with increasing prematurity. In the present study, we tested how preterm neonates with IVH react to external stimulation (i.e. speech syllables). We compared their neural responses measured by electroencephalography (EEG), and hemodynamic responses measured by functional near-infrared spectroscopy (fNIRS), with those of healthy preterms. A neural response to syllables was observed in these infants, but did not induce a vascular response in contrast with healthy neonates...
January 5, 2018: Developmental Cognitive Neuroscience
https://www.readbyqxmd.com/read/29327527/role-and-relevance-of-blood-pressure-variability-in-hypertension-related-co-morbidities
#15
Ashok Kumar, B C Kalmath, Georgi Abraham, Johann Christopher, Pln Kaparthi, Louie Fischer, Neeta Deshpande, N K Mishra, Praveen Raj, Rajesh Javerani, Ramesh Goyal, Reefa Dsouza, Shashank R Joshi
Despite maintaining mean blood pressure at optimal levels, cardiovascular complications still occur in hypertensive patients. Blood pressure variability (BPV) has been implicated as a prominent factor responsible for incurring this additional risk. In this review we attempted to generate a consensus on the importance of BPV in the hypertension management and to evaluate different therapeutic options available to reduce BPV. Panel comprising of 11 leading experts from India in different areas of clinical practice (including nephrology, diabetes and endocrinology, cardiology, and critical care medicine) was convened...
December 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29324406/a-novel-multi-class-eeg-based-sleep-stage-classification-system
#16
Pejman Memar, Farhad Faradji
Sleep stage classification is one of the most critical steps in effective diagnosis and the treatment of sleep-related disorders. Visual inspection undertaken by sleep experts is a time-consuming and burdensome task. A computer-assisted sleep stage classification system is thus essential for both sleep-related disorders diagnosis and sleep monitoring. In this paper, we propose a system to classify the wake and sleep stages with high rates of sensitivity and specificity. The EEG signals of 25 subjects with suspected sleep-disordered breathing, and the EEG signals of 20 healthy subjects from three data sets are used...
January 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/29322609/peer-teaching-and-information-retrieval-the-role-of-the-nice-evidence-search-student-champion-scheme-in-enhancing-students-confidence
#17
Laura Sbaffi, Elaine Hallsworth, Anne Weist
BACKGROUND: This research reports on the NICE Evidence search (ES) student champion scheme (SCS) first five years of activity (2011-2016) in terms of its impact on health care undergraduate students' information search skills and search confidence. OBJECTIVES: A review of students' evaluation of the scheme was carried out to chart the changes in attitude towards NICE Evidence search as an online health care information source and to monitor students' approach to information seeking...
January 11, 2018: Health Information and Libraries Journal
https://www.readbyqxmd.com/read/29322576/a-mixed-method-thematic-review-health-related-decision-making-by-the-older-person
#18
REVIEW
Lindy King, Ann Harrington, Ecushla Linedale, Elizabeth Tanner
AIMS: To undertake a mixed method thematic literature review that explored how elderly adults approached decision making in regard to their health care following discharge. BACKGROUND: A critical time for appropriate health decisions occurs during hospital discharge planning with nursing staff. However, little is known how the 89% of elderly living at home make decisions regarding their health care. Research into older adults' management of chronic conditions emerges as an important step to potentially encourage symptom monitoring, prevent missed care and detect deterioration...
January 10, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29320720/simultaneous-emergence-and-rapid-spread-of-three-oxa-23-producing-acinetobacter-baumannii-st208-strains-in-intensive-care-units-confirmed-by-whole-genome-sequencing
#19
Qiong Chen, Jia-Wei Zhou, Jian-Zhong Fan, Sheng-Hai Wu, Li-Hui Xu, Yan Jiang, Zhi Ruan, Yun-Song Yu, Dao-Jun Yu, Xian-Jun Wang
Carbapenem-resistant Acinetobacter baumannii (CRAB) is a common nosocomial bacterial pathogen with limited treatment options. CRAB outbreaks are disastrous for critically ill patients. This study investigated carbapenemase-produced A. baumannii outbreaks in a tertiary hospital. Although multiple outbreaks were suggested by pulse-field gel electrophoresis, the genetic lineages and evolution between these isolates were not clear. To investigate the genomic epidemiology of these outbreaks and to reveal possible transmission routes, whole genome sequences (WGS) were compared and analyzed...
January 8, 2018: Infection, Genetics and Evolution
https://www.readbyqxmd.com/read/29318709/complexity-in-internal-medicine-wards-a-novel-screening-method-and-implications-for-management
#20
Fabrizio Bandini, Stefano Guidi, Silvia Blaszczyk, Antonietta Fumarulo, Michela Pierini, Paolo Pratesi, Stefano Spolveri, Margherita Padeletti, Pasquale Petrone, Paolo Zoppi, Giancarlo Landini
RATIONALE: Complexity is increasingly recognized as a critical variable in health care. However, there is still lack of practical tools to assess it and tackle the challenges that stem from it, particularly within hospitals. AIMS AND OBJECTIVE: To validate a simple novel screening method based on both objective and subjective criteria to identify patients with clinically complex hospitalization events. To evaluate the prevalence of patients with complex events, identify their features, and compare them with those of the other patients and to those of patients with multimorbidities...
January 10, 2018: Journal of Evaluation in Clinical Practice
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