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https://www.readbyqxmd.com/read/28631455/the-prognostic-importance-of-chronic-end-stage-diseases-in-geriatric-patients-admitted-to-163-italian-icus
#1
Daniele Poole, Stefano Finazzi, Giovanni Nattino, Danilo Radrizzani, Giuseppe Gristina, Paolo Malacarne, Sergio Livigni, Guido Bertolini
BACKGROUND: The number of elderly patients undergoing major surgical interventions and then needing admission to intensive care unit (ICU) grows steadily. We investigated this issue in a cohort of 232,278 patients admitted in 5 years (2011-2015) to 163 Italian general ICUs. METHODS: Surgical patients older than 75 registered in the GiViTI MargheritaPROSAFE project were analysed. The impact on hospital mortality of important chronic conditions (severe COPD, NYHA class IV, dementia, end-stage renal disease, cirrhosis with portal hypertension) was investigated with two prognostic models developed yearly on patients staying in the ICU less or more than 24 hours...
June 14, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28559469/physiological-requirements-to-perform-the-glittre-activities-of-daily-living-test-by-subjects-with-mild-to-severe-copd
#2
Gérson F Souza, Graciane L Moreira, Andréa Tufanin, Mariana R Gazzotti, Antonio A Castro, José R Jardim, Oliver A Nascimento
BACKGROUND: The Glittre activities of daily living (ADL) test is supposed to evaluate the functional capacity of COPD patients. The physiological requirements of the test and the time taken to perform it by COPD patients in different disease stages are not well known. The objective of this work was to compare the metabolic, ventilatory, and cardiac requirements and the time taken to carry out the Glittre ADL test by COPD subjects with mild, moderate, and severe disease. METHODS: Spirometry, Medical Research Council questionnaire, cardiopulmonary exercise test, and 2 Glittre ADL tests were evaluated in 62 COPD subjects...
May 30, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28492295/elderly-versus-non-elderly-patients-with-intra-abdominal-candidiasis-in-the-icu
#3
George Dimopoulos, Dimitrios K Matthaiou, Elda Righi, Maria Merelli, Matteo Bassetti
BACKGROUND: Intra-abdominal candidiasis (IAC) has a considerable cost in terms of mortality and morbidity. We sought to study the epidemiology, characteristics and outcome of elderly (>75 years old) versus non-elderly patients with IAC and risk factors for mortality in elderly patients. METHODS: Post-hoc analysis of a retrospective multinational cohort study over a 3- year period (2011-2013). RESULTS: Of 482 patients, 124 (25.7%) were elderly and 358 (74...
May 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28462236/palliative-and-end-of-life-care-conversations-in-copd-a-systematic-literature-review
#4
REVIEW
Nuno Tavares, Nikki Jarrett, Katherine Hunt, Tom Wilkinson
Chronic obstructive pulmonary disease (COPD) is a chronic life-limiting disorder characterised by persistent airflow obstruction and progressive breathlessness. Discussions/conversations between patients and clinicians ensure palliative care plans are grounded in patients' preferences. This systematic review aimed to explore what is known about palliative care conversations between clinicians and COPD patients. A comprehensive search of all major healthcare-related databases and websites was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
April 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28457921/serum-mirnas-as-potential-biomarkers-for-the-bronchiolitis-obliterans-syndrome-after-lung-transplantation
#5
K Budding, M Rossato, E A van de Graaf, J M Kwakkel-van Erp, T R D J Radstake, H G Otten
Lung transplantation (LTx) is the last treatment for patients suffering from end-stage lung diseases. Survival post-LTx is hampered by the development of the bronchiolitis obliterans syndrome (BOS) and diagnosis is often late. Given the urgent clinical need to recognize BOS patients at an early stage, we analyzed circulating miRNAs to identify possible stratification markers for BOS development post-transplantation. Therefore, pro-fibrotic (miR-21, miR-155), anti-fibrotic (miR-29a) and fibrosis-unrelated (miR-103, miR-191) miRNAs were analyzed in serum of end-stage lung disease patients and during LTx follow-up...
June 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28457746/comparing-the-palliative-care-needs-of-those-with-cancer-to-those-with-common-non-cancer-serious-illness
#6
Doran Bostwick, Steven Wolf, Greg Samsa, Janet Bull, Donald H Taylor, Kimberly S Johnson, Arif H Kamal
BACKGROUND: Historically, palliative care has been focused on those with cancer. Although these ties persist, palliative care is rapidly integrating into the care of patients with common, non-cancer serious illnesses. Despite this, the bulk of literature informing palliative care practices stems from the care of cancer patients. OBJECTIVES: We compared functionality, advanced care planning, hospital admissions, prognosis, quality of life, pain, dyspnea, fatigue, and depression between patients with cancer and three non-cancer diagnoses-end-stage renal disease (ESRD), heart failure (HF), and chronic obstructive pulmonary disease (COPD)...
April 27, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28431865/statin-use-and-other-factors-associated-with-mortality-after-major-lower-extremity-amputation
#7
Charles DeCarlo, Larry Scher, Saadat Shariff, John Phair, Evan Lipsitz, Karan Garg
OBJECTIVE: Above-knee amputations (AKAs) and below-knee amputations (BKAs) are associated with high postoperative mortality rates. In this study, we examined factors associated with 30-day, 90-day, and 1-year mortality in patients who underwent a major lower extremity amputation. METHODS: We queried a prospectively collected institutional database for all patients who underwent AKA or BKA with primary or secondary closure, during a 5-year period, between November 2009 and November 2014...
July 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28429629/developing-indicators-of-appropriate-and-inappropriate-end-of-life-care-in-people-with-alzheimer-s-disease-cancer-or-chronic-obstructive-pulmonary-disease-for-population-level-administrative-databases-a-rand-ucla-appropriateness-study
#8
Robrecht De Schreye, Dirk Houttekier, Luc Deliens, Joachim Cohen
BACKGROUND: A substantial amount of aggressive life-prolonging treatments in the final stages of life has been reported for people with progressive life-shortening conditions. Monitoring appropriate and inappropriate end-of-life care is an important public health challenge and requires validated quality indicators. AIM: To develop indicators of appropriate and inappropriate end-of-life care for people with cancer, chronic obstructive pulmonary disease or Alzheimer's disease, measurable with population-level administrative data...
April 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28422270/characteristics-and-incidence-of-chronic-illness-in-community-dwelling-predominantly-male-u-s-veteran-centenarians
#9
Raya Elfadel Kheirbek, Ali Fokar, Nawar Shara, Leakie K Bell-Wilson, Hans J Moore, Edwin Olsen, Marc R Blackman, Maria D Llorente
OBJECTIVES: To assess the incidence of chronic illness and its effect on veteran centenarians. DESIGN: Retrospective longitudinal cohort study. SETTING: United States Veterans Affairs Corporate Data Warehouse (CDW). PARTICIPANTS: Community-dwelling veterans born between 1910 and 1915 who survived to at least age 80 (N = 86,892; 31,121 octogenarians, 52,420 nonagenarians, 3,351 centenarians). MEASUREMENTS: The Kaplan-Meier method was used to estimate cumulative incidence of chronic conditions according to age group...
April 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28420587/should-recent-smoking-be-a-contraindication-for-sleeve-gastrectomy
#10
Ivy N Haskins, Amy S Nowacki, Zhamak Khorgami, Karen Schulz, Leslie J Heinberg, Phillip R Schauer, Stacy A Brethauer, Ali Aminian
BACKGROUND: One of the ultimate goals of bariatric and metabolic surgery is to decrease cardiovascular morbidity and mortality. Obese individuals who smoke tobacco are at an increased risk of cardiovascular events and may benefit the most by positive effects of bariatric surgery on cardiometabolic risk factors. The safety profile of sleeve gastrectomy in patients who smoke has not yet been characterized. OBJECTIVES: To investigate the independent effect of smoking on early postoperative morbidity and mortality of laparoscopic sleeve gastrectomy...
March 9, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28275174/physiological-and-clinical-relevance-of-exercise-ventilatory-efficiency-in-copd
#11
REVIEW
J Alberto Neder, Danilo C Berton, Flavio F Arbex, Maria Clara Alencar, Alcides Rocha, Priscila A Sperandio, Paolo Palange, Denis E O'Donnell
Exercise ventilation (V'E) relative to carbon dioxide output (V'CO2 ) is particularly relevant to patients limited by the respiratory system, e.g. those with chronic obstructive pulmonary disease (COPD). High V'E-V'CO2 (poor ventilatory efficiency) has been found to be a key physiological abnormality in symptomatic patients with largely preserved forced expiratory volume in 1 s (FEV1). Establishing an association between high V'E-V'CO2 and exertional dyspnoea in mild COPD provides evidence that exercise intolerance is not a mere consequence of detraining...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28258277/differences-in-place-of-death-between-lung-cancer-and-copd-patients-a-14-country-study-using-death-certificate-data
#12
Joachim Cohen, Kim Beernaert, Lieve Van den Block, Lucas Morin, Katherine Hunt, Guido Miccinesi, Marylou Cardenas-Turanzas, Bregje Onwuteaka-Philipsen, Rod MacLeod, Miguel Ruiz-Ramos, Donna M Wilson, Martin Loucka, Agnes Csikos, Yong-Joo Rhee, Joan Teno, Winne Ko, Luc Deliens, Dirk Houttekier
Chronic obstructive pulmonary disease and lung cancer are leading causes of death with comparable symptoms at the end of life. Cross-national comparisons of place of death, as an important outcome of terminal care, between people dying from chronic obstructive pulmonary disease and lung cancer have not been studied before. We collected population death certificate data from 14 countries (year: 2008), covering place of death, underlying cause of death, and demographic information. We included patients dying from lung cancer or chronic obstructive pulmonary disease and used descriptive statistics and multivariable logistic regressions to describe patterns in place of death...
December 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28235525/iatrogenic-tracheal-laceration-in-the-setting-of-chronic-steroids
#13
Punit Singh, Margaret Wojnar, Anita Malhotra
We report the case of a 71-year-old woman with end-stage chronic obstructive pulmonary disease who presented with a 10-cm tracheal laceration from a presumed traumatic intubation in the setting of respiratory distress and chronic obstructive pulmonary disease exacerbation and subsequently developed significant subcutaneous emphysema along her neck and mediastinum in addition to her peritoneum and mesentery. We were successfully able to treat this patient conservatively up until the time that tracheostomy was warranted...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28222988/thirty-day-and-90-day-hospital-readmission-after-outpatient-upper-extremity-hemodialysis-access-creation
#14
Jeffrey J Siracuse, Nishant K Shah, Matthew R Peacock, Georges Tahhan, Jeffrey A Kalish, Denis Rybin, Mohammad H Eslami, Alik Farber
OBJECTIVE: Patients with end-stage renal disease have multiple comorbidities and are at increased risk for postoperative complications and resource utilization. Our goal was to determine the rate and causes of 30-day and 90-day hospital readmissions after the creation of outpatient hemodialysis access. METHODS: We retrospectively reviewed all outpatient upper extremity hemodialysis access creations performed at our medical center from 2008 to 2015. Readmission was defined as any inpatient status admission ≤30 and 90 days...
May 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28220381/pharmacological-management-of-people-living-with-end-stage-chronic-obstructive-pulmonary-disease
#15
Victoria Dalgliesh, Hilary Pinnock
Supportive care and pharmacological treatment can improve the quality of life of people with end-stage chronic obstructive pulmonary disease (COPD) who cope on a daily basis with substantial physical, psychological, social and spiritual morbidity. Smoking cessation is the only intervention that reduces the rate of progression of COPD, but evidence-based drug treatments and non-pharmacological strategies can relieve symptoms and reduce the impact of exacerbations. People with severe COPD live with increasingly troublesome breathlessness and other symptoms such as fatigue, pain, sputum production and weight loss...
April 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28187733/early-detection-of-copd-patients-in-gold-0-population-an-observational-non-interventional-cohort-study-marko-study
#16
Žarko Vrbica, Marina Labor, Ivan Gudelj, Slavica Labor, Iva Jurić, Davor Plavec
BACKGROUND: Main risk factor for the development of chronic obstructive pulmonary disease (COPD) is smoking, although only less than 1/3 of smokers develop clinically manifest COPD. COPD's progressive nature with high disability and mortality makes it plausible to detect it as early as possible thus allowing for an early intervention. The only tool for an early diagnosis that could be used on the global scale is spirometry, even though symptoms and deprivation of health related quality of life (HRQoL) precede relevant spirometric changes...
February 10, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28187049/fiber-bundle-design-for-an-integrated-wearable-artificial-lung
#17
Shalv P Madhani, Brian J Frankowski, William J Federspiel
Mechanical ventilation and ECMO are the only viable treatment options for lung failure patients at the end stage, including ARDS and COPD. These treatments however are associated with high morbidity and mortality due to long wait times for lung transplant. Contemporary clinical literature has shown ambulation improves post-transplant outcomes in lung failure patients. Given this, we are developing the PAAL, a truly wearable artificial lung that allows for ambulation. In this study, we targeted 180 ml/min oxygenation and determined the form factor for a hollow fiber membrane (HFM) bundle for the PAAL...
February 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28182565/comparison-of-the-dyspnoea-12-and-multidimensional-dyspnoea-profile-in-people-with-copd
#18
Marie T Williams, David John, Peter Frith
We directly compared convergent, discriminant and concurrent validity of the Dyspnoea-12 (D-12) and Multidimensional Dyspnoea Profile (MDP) in people with chronic obstructive pulmonary disease.Breathlessness measures (D-12, MDP, visual analogue scales and descriptors) were completed for two focal periods (daily life and end of walk test). Instrument structure (D-12 and MDP item grouping) was assessed with factor analysis. Differences between airflow severity stage and focal periods (ANOVA, t-test and Chi-squared test), associations between D-12 and MDP (r, r(2) for static pulmonary function, 6-min walk test and self-reported measures of impairment) and individual consistency for comparable items of the D-12 and MDP (McNemar's test) were assessed...
December 19, 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28152778/patterns-of-comorbidity-among-older-u-s-patients-with-non-hodgkin-lymphoma
#19
Steven I Park, Jennifer Leigh Lund
304 Background: Evidence suggests that the number and type ofcomorbidities at cancer diagnosis influences cancer treatment and mortality, especially among older patients.We sought to describe comorbidity patterns and identify how patterns predict all-cause mortality among older non-Hodgkin lymphoma (NHL) patients. METHODS: Using the linked Surveillance, Epidemiologic, and End Results (SEER)-Medicare databases, we identified patients aged > 66 with a first diagnosis of stage I-IV NHL from 2007-2009...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28142133/perioperative-hemodynamic-instability-and-fluid-overload-are-associated-with-increasing-acute-kidney-injury-severity-and-worse-outcome-after-cardiac-surgery
#20
Anja Haase-Fielitz, Michael Haase, Rinaldo Bellomo, Paolo Calzavacca, Anke Spura, Hassina Baraki, Ingo Kutschka, Christian Albert
PURPOSE: The study aimed to investigate patients' characteristics, fluid and hemodynamic management, and outcomes according to the severity of cardiac surgery-associated acute kidney injury (CSA-AKI). METHODS: In a single-center, prospective cohort study, we enrolled 282 adult cardiac surgical patients. In a secondary analysis, we assessed preoperative patients' characteristics, physiological variables, and medication for intra- and postoperative fluid and hemodynamic management and outcomes according to CSA-AKI stages by the Renal risk, Injury, Failure, Loss, End-stage renal disease (RIFLE) classification...
2017: Blood Purification
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