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https://www.readbyqxmd.com/read/29149476/clinical-parameters-before-and-after-the-transition-to-dialysis
#1
Dugan W Maddux, Len A Usvyat, Terry Ketchersid, Yue Jiao, Tommy C Blanchard, Peter Kotanko, Frank M van der Sande, Jeroen P Kooman, Franklin W Maddux
INTRODUCTION: The transition from pre-dialysis chronic kidney disease (CKD) to post-dialysis start is a critical period associated with high patient mortality and increased hospital admissions. Little is known about the trends of key clinical and laboratory parameters through this time of transition to start dialysis. METHODS: De-identified data including demographics, vital signs, lab results, and eGFR from the Fresenius Medical Care-CKD Registry were analyzed to determine trends in clinical and laboratory parameters through the time of transition from 12 months pre-dialysis start to 12 months post-dialysis start...
November 17, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29149418/randomized-multicenter-trial-of-lateral-trendelenburg-versus-semirecumbent-body-position-for-the-prevention-of-ventilator-associated-pneumonia
#2
Gianluigi Li Bassi, Mauro Panigada, Otavio T Ranzani, Alberto Zanella, Lorenzo Berra, Massimo Cressoni, Vieri Parrini, Hassan Kandil, Giovanni Salati, Paola Selvaggi, Alessandro Amatu, Miquel Sanz-Moncosi, Emanuela Biagioni, Fernanda Tagliaferri, Mirella Furia, Giovanna Mercurio, Antonietta Costa, Tullio Manca, Simone Lindau, Jaksa Babel, Marco Cavana, Chiara Chiurazzi, Joan-Daniel Marti, Dario Consonni, Luciano Gattinoni, Antonio Pesenti, Janine Wiener-Kronish, Cecilia Bruschi, Andrea Ballotta, Pierpaolo Salsi, Sergio Livigni, Giorgio Iotti, Javier Fernandez, Massimo Girardis, Maria Barbagallo, Gabriella Moise, Massimo Antonelli, Maria Luisa Caspani, Antonella Vezzani, Patrick Meybohm, Vladimir Gasparovic, Edoardo Geat, Marcelo Amato, Michael Niederman, Theodor Kolobow, Antoni Torres
PURPOSE: The lateral Trendelenburg position (LTP) may hinder the primary pathophysiologic mechanism of ventilator-associated pneumonia (VAP). We investigated whether placing patients in the LTP would reduce the incidence of VAP in comparison with the semirecumbent position (SRP). METHODS: This was a randomized, multicenter, controlled study in invasively ventilated critically ill patients. Two preplanned interim analyses were performed. Patients were randomized to be placed in the LTP or the SRP...
November 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29149384/brain-metabolism-and-severe-pediatric-traumatic-brain-injury
#3
Heidi Griffiths, Manu S Goyal, Jose A Pineda
Age-dependent changes in brain metabolism may influence the response to and tolerance of secondary insults, potentially affecting outcomes. More complete characterization of brain metabolism across the clinical trajectory of severe pediatric TBI is needed to improve our ability to measure and better mitigate the impact of secondary insults. Better management of secondary insults will impact clinical care and the probability of success of future neuroprotective clinical trials. Improved bedside monitoring and imaging technologies will be required to achieve these goals...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29149182/comparison-between-public-and-private-sectors-of-care-and-disparities-in-adverse-neonatal-outcomes-following-emergency-intrapartum-cesarean-at-term-a-retrospective-cohort-study
#4
Woonji Jang, Christopher Flatley, Ristan M Greer, Sailesh Kumar
BACKGROUND: Perinatal outcomes may be influenced by a variety of factors including maternal demographics and medical condition as well as socio-economic status. The evidence for disparities in health outcomes stratified by type of care (public or private) is lacking. The aim of this study was to investigate short term neonatal outcomes following category 1 and 2 emergency cesareans at term between publicly and privately funded women at a single major tertiary centre in Australia. Category 1-immediate threat to life (maternal or fetal); Category 2-maternal or fetal compromise that is not immediately life-threatening...
2017: PloS One
https://www.readbyqxmd.com/read/29149122/leukostasis-management-to-prevent-crisis-in-acute-leukemia%C3%A2
#5
Lisa M Blackburn, Shelly Brown, Aimee Munyon, Michelle Orovets
BACKGROUND: Hyperleukocytosis, a peripheral white blood cell count greater than 100,000/mm3,is most commonly seen in patients with newly diagnosed or relapsed acute lymphoblastic leukemia and acute myeloid leukemia. Leukostasis is a reduction in blood flow related to hyperviscosity. Hyperleukocytosis, causing leukostasis, is an oncologic emergency and requires an exacting assessment and rapid response with appropriate intervention to prevent morbidity and mortality in the first week after diagnosis...
December 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29148994/critical-care-resources-in-mainland-china-when-more-may-not-always-be-better
#6
Bin Du, Xiaoyun Hu, Ming Hou
No abstract text is available yet for this article.
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29148864/morphologic-criteria-of-lesion-activity-in-neovascular-age-related-macular-degeneration-a-consensus-article
#7
Stefania Miotto, Nicola Zemella, Elena Gusson, Giacomo Panozzo, Sandro Saviano, Giuseppe Scarpa, Giorgio Boschi, Stefano Piermarocchi
Intravitreal antivascular endothelial growth factor drugs represent the current standard of care for neovascular age-related macular degeneration (nAMD). Individualized treatment regimens aim at obtaining the same visual benefits of monthly injections with a reduced number of injections and follow-up visits, and, consequently, of treatment burden. The target of these strategies is to timely recognize lesion recurrence, even before visual deterioration. Early detection of lesion activity is critical to ensure that clinical outcomes are not compromised by inappropriate delays in treatment, but questions remain on how to effectively monitor the choroidal neovascularization (CNV) activity...
November 17, 2017: Journal of Ocular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29148635/admission-patterns-and-outcomes-in-the-medical-intensive-care-unit-of-st-paul%C3%A2-s-hospital-millennium-medical-college-addis-ababa-ethiopia
#8
Seman Kedir, Abreham Berhane, Tola Bayisa, Tewodros Wuletaw
Background: Knowledge of the characteristics and outcomes of critically ill patients admitted to Medical Intensive Care Unit (MICU) helps with identification of priorities and the resources required to improve care. The objective of this study was to examine admission patterns and outcomes in MICU at St. Paul’s Hospital Millennium Medical College. Materials: A retrospective review of 1256 patients’ case notes who were admitted to the MICU at St. Paul’s Hospital Millennium Medical College from 2007 to 2012 was carried out...
January 2017: Ethiopian Medical Journal
https://www.readbyqxmd.com/read/29148343/lessons-learned-from-the-affordable-care-act-the-premium-subsidy-design-may-promote-adverse-selection
#9
Ilana Graetz, Caitlin N McKillop, Cameron M Kaplan, Teresa M Waters
Since 2014, average premiums for health plans available in the Affordable Care Act marketplaces have increased. We examine how premium price changes affected the amount consumers pay after subsidies for the lowest-cost bronze and silver plans available by age in the federally facilitated exchanges. Between 2015 and 2016, benchmark plan premiums increased in 83.3% of counties. Overall, rising benchmark premiums were associated with lower average after-subsidy premiums for the lowest-cost bronze and silver plans for older subsidy-eligible adults, but with higher after-subsidy premiums for younger adults purchasing the same plans, regardless of income...
May 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148330/risk-factors-for-falls-among-older-adults-following-transition-from-nursing-home-to-the-community
#10
Jing Marrero, Richard H Fortinsky, George A Kuchel, Julie Robison
This study analyzes the incidence of falls for older adults who transitioned from institutions to the community through the Connecticut Money Follows the Person demonstration program, identifying intrinsic and extrinsic fall risk factors for this population. This prospective cohort study analyzed data from 648 Money Follows the Person participants aged 65 years and older, using 6- and 12-month posttransition surveys. Of the 648 participants, 161 (25.2%) fell in the first 6 months after transition, while 156 (24...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148125/understanding-the-factors-which-promote-registered-nurses-intent-to-stay-in-critical-care-and-emergency-areas
#11
Mary Van Osch, Kathy Scarborough, Sarah Crowe, Angela C Wolff, Sheryl Reimer-Kirkham
BACKGROUND: Turnover among registered nurses (herein referred to as nurses) working in specialty areas of practice can result in a range of negative outcomes. The retention of specialty nurses at the unit level has important implications for hospital and health systems. These implications include lost knowledge and experience which may in turn impact staff performance levels, patient outcomes, hiring, orientating, development of clinical competence and other aspects of organizational performance...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29148105/experiences-of-nurse-case-managers-within-a-central-discharge-planning-role-of-collaboration-between-physicians-patients-and-other-healthcare-professionals-a-sociocultural-qualitative-study
#12
Jorun E Thoma, Marion A Waite
AIMS AND OBJECTIVES: Purpose of this study was to gain knowledge of Nurse Case Managers' (NCM) experiences within the German acute care context of collaboration with patients and physicians in a discharge planning role. Further to learn about patients' assignment to the management of the NCMs. Explicitly, to explore critical incidences of interactions between NCM, patients and health care practitioner in discharge planning to understand the factor that contributes to effective collaboration...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29148093/keeping-and-breeding-the-rescued-sunda-pangolins-manis-javanica-in-captivity
#13
Fuhua Zhang, Jiaming Yu, Shibao Wu, Shaoshan Li, Cuiyun Zou, Qiaoyun Wang, Ruyong Sun
The Sunda pangolin (Manis javanica Desmarest, 1822) is a Critically Endangered species. Given that this species lacks effective policies for in situ conservation and prevention of poaching in the wild, ex situ conservation and a captive breeding program are urgently needed to save this species from extinction. However, techniques for the maintenance and captive breeding of pangolins have not been well developed. In June 2010, we established the Pangolin Research Base for Artificial Rescue and Conservation Breeding of South China Normal University (PRB-SCNU)...
November 17, 2017: Zoo Biology
https://www.readbyqxmd.com/read/29148076/subjective-cognitive-complaints-psychosocial-factors-and-nursing-work-function-in-nurses-providing-direct-patient-care
#14
Tammy Barbe, Laura P Kimble, Cynthia Rubenstein
AIMS: The aim of this study was to examine relationships among subjective cognitive complaints, psychosocial factors and nursing work function in nurses providing direct patient care. BACKGROUND: Cognitive functioning is a critical component for nurses in the assurance of error prevention, identification and correction when caring for patients. Negative changes in nurses' cognitive and psychosocial functioning can adversely affect nursing care and patient outcomes...
November 17, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29148046/delirium-and-effect-of-circadian-light-in-the-intensive-care-unit-a-retrospective-cohort-study
#15
S Estrup, C K W Kjer, L M Poulsen, I Gøgenur, O Mathiesen
BACKGROUND: Delirium is a serious condition often experienced by critically ill patients in intensive care units (ICUs). The role of circadian light for this condition is unclear. The aim of this study was to describe incidence of delirium, risk factors for delirium, and the association between delirium and circadian light for patients in the ICU. METHODS: This is a retrospective cohort study of all patients at a Danish ICU from 1 August 2015 to 31 January 2016...
November 17, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29148002/targeting-zero-catheter-related-bloodstream-infections-in-pediatric-intensive-care-unit-a-retrospective-matched-case-control-study
#16
Daniele G Biasucci, Mauro Pittiruti, Alessandra Taddei, Enzo Picconi, Alessandro Pizza, Davide Celentano, Marco Piastra, Giancarlo Scoppettuolo, Giorgio Conti
INTRODUCTION: The aim of this study was to evaluate the effectiveness and safety of a new three-component 'bundle' for insertion and management of centrally inserted central catheters (CICCs), designed to minimize catheter-related bloodstream infections (CRBSIs) in critically ill children. METHODS: Our 'bundle' has three components: insertion, management, and education. Insertion and management recommendations include: skin antisepsis with 2% chlorhexidine; maximal barrier precautions; ultrasound-guided venipuncture; tunneling of the catheter when a long indwelling time is expected; glue on the exit site; sutureless securement; use of transparent dressing; chlorhexidine sponge dressing on the 7th day; neutral displacement needle-free connectors...
November 8, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29147950/mental-health-consultation-among-ontario-s-immigrant-populations
#17
Farah Islam, Nazilla Khanlou, Alison Macpherson, Hala Tamim
To determine the prevalence rates and characteristics of past-year mental health consultation for Ontario's adult (18 + years old) immigrant populations. The Canadian Community Health Survey (CCHS) 2012 was used to calculate the prevalence rates of past-year mental health consultation by service provider type. Characteristics associated with mental health consultation were determined by carrying out multivariable logistic regression analysis on merged CCHS 2008-2012 data. Adult immigrant populations in Ontario (n = 3995) had lower estimated prevalence rates of past-year mental health consultation across all service provider types compared to Canadian-born populations (n = 14,644)...
November 16, 2017: Community Mental Health Journal
https://www.readbyqxmd.com/read/29147931/horses-for-courses-moving-india-towards-universal-health-coverage-through-targeted-policy-design
#18
Dayashankar Maurya, Altaf Virani, S Rajasulochana
The debate on how India's health system should move towards universal health coverage was (meant to be) put to rest by the recent National Health Policy 2017. However, the new policy is silent about tackling bottlenecks mentioned in the said policy proposal. It aims to provide universal access to free primary care by strengthening the public system, and to secondary and tertiary care through strategic purchasing from the private sector, to overcome deficiencies in public provisioning in the short run. Yet, in doing so, it ignores critical factors needed to replicate successful models of public healthcare delivery from certain states that it hopes to emulate...
November 16, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/29147893/high-elective-surgery-cancellation-rate-in-malawi-primarily-due-to-infrastructural-limitations
#19
Meghan Prin, Jessica Eaton, Onias Mtalimanja, Anthony Charles
BACKGROUND: The provision of safe and timely surgical care is essential to global health care. Low- and middle-income countries have a disproportionate share of the global surgical disease burden and struggle to provide care with the given resources. Surgery cancellation worldwide occurs for many reasons, which are likely to differ between high-income and low-income settings. We sought to evaluate the proportion of elective surgery that is cancelled and the associated reasons for cancellation at a tertiary hospital in Malawi...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29147598/dbs-programming-an-evolving-approach-for-patients-with-parkinson-s-disease
#20
REVIEW
Aparna Wagle Shukla, Pam Zeilman, Hubert Fernandez, Jawad A Bajwa, Raja Mehanna
Deep brain stimulation (DBS) surgery is a well-established therapy for control of motor symptoms in Parkinson's disease. Despite an appropriate targeting and an accurate placement of DBS lead, a thorough and efficient programming is critical for a successful clinical outcome. DBS programming is a time consuming and laborious manual process. The current approach involves use of general guidelines involving determination of the lead type, electrode configuration, impedance check, and battery check. However there are no validated and well-established programming protocols...
2017: Parkinson's Disease
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