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https://www.readbyqxmd.com/read/29234525/invasive-candida-infection-after-upper-gastrointestinal-tract-surgery-for-gastric-cancer
#1
Evgeni Brotfain, Gilbert Sebbag, Michael Friger, Boris Kirshtein, Abraham Borer, Leonid Koyfman, Dmitry Frank, Yoav Bichovsky, Jochanan G Peiser, Moti Klein
Upper gastrointestinal tract (GIT) surgical procedures are more likely to cause nosocomial Candida peritonitis than lower GIT procedures and they thus constitute an independent risk factor for mortality. Because of the severity of postsurgical fungal infections complications, intensivists and surgeons need to be extremely aware of their clinical importance in critically ill postsurgical intensive care unit (ICU) patients. We analyzed the clinical and microbiological data of 149 oncologic patients who were hospitalized in the ICU at Soroka Medical Center between January 2010 and January 2015 after undergoing upper GIT surgery for gastric cancer...
2017: International Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29234503/study-protocol-for-a-phase-ii-dose-evaluation-randomized-controlled-trial-of-cholecalciferol-in-critically-ill-children-with-vitamin-d-deficiency-vitdal-picu-study
#2
Dayre McNally, Karin Amrein, Katharine O'Hearn, Dean Fergusson, Pavel Geier, Matt Henderson, Ali Khamessan, Margaret L Lawson, Lauralyn McIntyre, Stephanie Redpath, Hope A Weiler, Kusum Menon
Background: Clinical research has recently demonstrated that vitamin D deficiency (VDD) is highly prevalent in the pediatric intensive care unit (PICU) and associated with worse clinical course. Multiple adult ICU trials have suggested that optimization of vitamin D status through high-dose supplementation may reduce mortality and improve other clinically relevant outcomes; however, there have been no trials of rapid normalization in the PICU setting. The objective of this study is to evaluate the safety and efficacy of an enteral weight-based cholecalciferol loading dose regimen in critically ill children with VDD...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29234370/electroacupuncture-improves-gastric-emptying-in-critically-ill-neurosurgical-patients-a-pilot-study
#3
Man-Ling Kao, Yao-Li Chen, Shu-Ching Lee, Sung-Yen Huang, Ping-Yi Lin
Objective: To compare the efficacy of combined electroacupuncture and metoclopramide treatment with that of metoclopramide only in improving gastric emptying in critically ill neurosurgical patients. Methods: In this prospective case-control pilot study, a total of 16 adult critically ill mechanically ventilated patients who were treated in the surgical intensive care unit were enrolled. Electrical stimulation was applied to 4 pairs of points (maximum intensity < 9...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/29232903/pediatric-thermal-burns-and-treatment-a-review-of-progress-and-future-prospects
#4
REVIEW
Elton Mathias, Madhu Srinivas Murthy
Burn injuries are a devastating critical care problem. In children, burns continue to be a major epidemiologic problem around the globe resulting in significant morbidity and death. Apparently, treating these burn injuries in children and adults remains similar, but there are significant physiological and psychological differences. The dermal layer of the skin is generally thinner in neonates, infants, and children than in adults. Enhanced evaporative loss and need for isotonic fluids increases the risk of hypothermia in the pediatric population...
December 11, 2017: Medicines (Basel, Switzerland)
https://www.readbyqxmd.com/read/29228951/hypovitaminosis-c-and-vitamin-c-deficiency-in-critically-ill-patients-despite-recommended-enteral-and-parenteral-intakes
#5
Anitra C Carr, Patrice C Rosengrave, Simone Bayer, Steve Chambers, Jan Mehrtens, Geoff M Shaw
BACKGROUND: Vitamin C is an essential water-soluble nutrient which cannot be synthesised or stored by humans. It is a potent antioxidant with anti-inflammatory and immune-supportive roles. Previous research has indicated that vitamin C levels are depleted in critically ill patients. In this study we have assessed plasma vitamin C concentrations in critically ill patients relative to infection status (septic shock or non-septic) and level of inflammation (C-reactive protein concentrations)...
December 11, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29228858/common-patterns-of-regional-brain-injury-detectable-by-dti-in-otherwise-normal-appearing-white-matter-in-patients-with-early-moderate-to-severe-traumatic-brain-injury
#6
Kristine O'Phelan, Chad Kuniyuki Otoshi, Thomas M Ernst, Linda Chang
Traumatic brain injury (TBI) alters the lives of millions of people every year. Although mortality rates have improved, due to better prehospital care and reduction of secondary injury in the critical care setting, improvements in functional outcomes after TBI have been difficult to achieve. Diffusion-tensor imaging (DTI) allows detailed measurement of microstructural damage in regional brain tissue after TBI, thus improving our understanding of the extent and severity of TBI. METHODS: Twenty subjects were recruited from a Neurological Intensive Care Unit, and compared to 18 healthy control subjects...
December 11, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29228380/elderly-versus-nonelderly-patients-with-invasive-aspergillosis-in-the-icu-a-comparison-and-risk-factor-analysis-for-mortality-from-the-aspicu-cohort
#7
D K Matthaiou, G Dimopoulos, F S Taccone, P Bulpa, A M Van den Abeele, B Misset, W Meersseman, H Spapen, T Cardoso, P E Charles, D Vogelaers, S Blot
Data regarding the epidemiology and diagnosis of invasive aspergillosis in the critically ill population are limited, with data regarding elderly patients (≥75 years old) even scarcer. We aimed to further compare the epidemiology, characteristics and outcome of elderly versus nonelderly critically ill patients with invasive aspergillosis (IA) Prospective, international, multicenter observational study (AspICU) including adult intensive care unit (ICU) patients, with a culture and/or direct examination and/or histopathological sample positive for Aspergillus spp...
December 8, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/29228133/regional-epidemiology-of-methicillin-resistant-staphylococcus-aureus-among-adult-intensive-care-unit-patients-following-state-mandated-active-surveillance
#8
Michael Y Lin, Mary K Hayden, Rosie D Lyles, Karen Lolans, Louis F Fogg, Alexander J Kallen, Stephen G Weber, Robert A Weinstein, William E Trick
Background: In 2007, Illinois became the first state in the United States to mandate active surveillance of methicillin-resistant Staphylococcus aureus (MRSA). The Illinois law applies to intensive care unit (ICU) patients; contact precautions are required for patients found to be MRSA-colonized. However, the effectiveness of a legislated "search and isolate" approach to reduce MRSA burden among critically ill patients is uncertain. We evaluated whether the prevalence of MRSA colonization declined in the 5 years after the start of mandatory active surveillance...
December 7, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29225790/update-on-ventilator-associated-pneumonia
#9
REVIEW
Jean-Francois Timsit, Wafa Esaied, Mathilde Neuville, Lila Bouadma, Bruno Mourvllier
Ventilator-associated pneumonia (VAP) is the most frequent life-threatening nosocomial infection in intensive care units. The diagnostic is difficult because radiological and clinical signs are inaccurate and could be associated with various respiratory diseases. The concept of infection-related ventilator-associated complication has been proposed as a surrogate of VAP to be used as a benchmark indicator of quality of care. Indeed, bundles of prevention measures are effective in decreasing the VAP rate. In case of VAP suspicion, respiratory secretions must be collected for bacteriological secretions before any new antimicrobials...
2017: F1000Research
https://www.readbyqxmd.com/read/29224825/head-and-neck-free-flap-reconstruction-what-is-the-appropriate-post-operative-level-of-care
#10
Varun V Varadarajan, Hassan Arshad, Peter T Dziegielewski
Patients undergoing head and neck reconstruction require complex, multidisciplinary postoperative care which may include wound care, flap monitoring, tracheostomy management, and management of comorbid conditions. Historically, patients undergoing major resection of a head and neck or aerodigestive tract malignancy with regional or free flap reconstruction were routinely admitted to the ICU. Although head and neck cancer patients may have multiple medical comorbidities that may require postoperative critical care, the current trend in many institutions is to transfer stable and less medically complex patients to non-intensive care-level units with specialty trained nursing staff...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29223941/-medical-futility-and-family-obstinacy-in-intensive-therapy-when-to-stop-and-when-to-keep-going
#11
Alejandro R Grinberg, Vilma A Tripodoro
There have been several recent publications related to therapeutic obstinacy and futility in the Intensive Care Unit. However, little has been published about "the family obstinacy" in persisting with invasive measures in seriously ill patients, despite the appropriate information provided to them about the patient's poor short-term prognosis. On certain occasions, these critical patients are unable to make decisions on the proposed treatments and, unfortunately, many of them have not previously indicated their preferences in terms of limits to invasive measures (advanced directives)...
2017: Medicina
https://www.readbyqxmd.com/read/29223744/effect-of-various-antipsychotic-regimens-on-incidence-of-delirium-in-critically-ill-adults
#12
W Anthony Hawkins, Stephanie V Phan, Stacey L Campbell
PURPOSE: Delirium is common during critical illness but it is unknown whether the choice of antipsychotic or dosing strategy impacts delirium outcomes. We evaluated the incidence of delirium in critically ill adults receiving different antipsychotic regimens. MATERIALS AND METHODS: Single center retrospective cohort study of adult patients admitted to the intensive care unit (ICU). Patients who received haloperidol or quetiapine and scored negative on the Confusion Assessment Method for the ICU (CAM-ICU) prior to initiation were included...
November 28, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29223743/early-vs-late-tracheostomy-in-intensive-care-settings-impact-on-icu-and-hospital-costs
#13
Brent Herritt, Dipayan Chaudhuri, Kednapa Thavorn, Dalibor Kubelik, Kwadwo Kyeremanteng
INTRODUCTION: Up to 12% of the 800,000 patients who undergo mechanical ventilation in the United States every year require tracheostomies. A recent systematic review showed that early tracheostomy was associated with better outcomes: more ventilator-free days, shorter ICU stays, less sedation and reduced long-term mortality. However, the financial impact of early tracheostomies remain unknown. OBJECTIVES: To conduct a cost-analysis on the timing of tracheostomy in mechanically ventilated patients...
December 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29223725/transfusion-associated-circulatory-overload-a-survey-among-dutch-intensive-care-fellows
#14
R B Klanderman, I Attaye, J J Bosboom, D P Veelo, B F Geerts, A P J Vlaar
OBJECTIVES: Transfusion-associated circulatory overload (TACO) is a severe pulmonary transfusion reaction and leading cause of transfusion-related morbidity and mortality in Europe. TACO is of particular importance in critically ill patients, since they often receive blood transfusions and have multiple risk factors for TACO. This study investigates transfusion practices in patients at risk of developing TACO, and furthermore knowledge concerning risk factors, diagnoses and treatment strategies among Dutch intensive care unit (ICU) fellows...
December 6, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/29223567/predictive-ability-of-the-evaruci-scale-and-comhon-index-for-pressure-injury-risk-in-critically-ill-patients-a-diagnostic-accuracy-study
#15
M de Los Ángeles Leal-Felipe, M Del Carmen Arroyo-López, M Del Cristo Robayna-Delgado, Ana Gómez-Espejo, Patricia Perera-Díaz, Carmen D Chinea-Rodríguez, Natalia García-Correa, Alejandro Jiménez-Sosa
BACKGROUND: Hospital-acquired pressure injuries are a costly and largely preventable complication occurring in a variety of acute care settings. Patients admitted to the intensive care unit are at greater risk of developing pressure injuries. OBJECTIVE: To determine whether the efficiency of scales to measure pressure injury risk increase when a continuously updated 3-day moving average method is used. METHODS: With a retrospective cohort design we recruited 3085 patients treated between June 2011 and February 2015 in the intensive care unit of a tertiary level university hospital...
December 6, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29222857/serum-levels-of-the-s100b-protein-and-neuron-specific-enolase-are-associated-with-mortality-in-critically-ill-patients
#16
Izabela Duda, Łukasz Krzych, Halina Jędrzejowska-Szypułka, Joanna Lewin-Kowalik
INTRODUCTION: Evaluation of the prognostic potential of the S100B protein and neuron-specific enolase (NSE) as predictors of mortality in critically ill patients in intensive care units (ICU). MATERIALS AND METHODS: The study was conducted on 62 patients. Basic clinical variables and blood samples for S100B and NSE level testing were obtained during the first four days after admission. Mortality was described as the patient's death during hospitalization in the ICU...
December 10, 2017: Acta Biochimica Polonica
https://www.readbyqxmd.com/read/29221978/influence-of-6-hydroxyethyl-starch-130-0-4-versus-crystalloid-solution-on-structural-renal-damage-markers-after-coronary-artery-bypass-grafting-a-post-hoc-subgroup-analysis-of-a-prospective-trial
#17
Thomas Datzmann, Markus Hoenicka, Helmut Reinelt, Andreas Liebold, Hagen Gorki
OBJECTIVE: The restriction of hydroxyethyl starch (HES) has mandated changes in volume management based on data of critically ill patients. Reliable data of structural renal damage after HES treatment in cardiac surgical patients are lacking. The influence of 6% HES 130/0.4 was investigated in this study. DESIGN: An exploratory post hoc subgroup analysis of a prospective trial was performed. SETTING: The study was carried out at a university hospital...
May 25, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29221433/hyporesponsiveness-of-natural-killer-cells-and-impaired-inflammatory-responses-in-critically-ill-patients
#18
Minkyung Kim, Minjoo Kim, Hana Jeong, Jey Sook Chae, Young Sam Kim, Jae Gil Lee, Younsoo Cho, Jong Ho Lee
BACKGROUND: To investigate natural killer (NK) cell activity, circulating cytokine level and peripheral blood mononuclear cell (PBMC) cytokine production status in critically ill patients. METHODS: Blood samples were collected <24 h after admission from 24 intensive care unit (ICU) patients and 24 age-, sex-, and body mass index (BMI)-matched healthy controls. Serum cytokine concentrations and cytokine production by PBMCs and lipopolysaccharide (LPS)-stimulated PBMCs were measured...
December 8, 2017: BMC Immunology
https://www.readbyqxmd.com/read/29220756/the-impact-of-sustained-new-onset-atrial-fibrillation-on-mortality-and-stroke-incidence-in-critically-ill-patients-a-retrospective-cohort-study
#19
Takuo Yoshida, Shigehiko Uchino, Taisuke Yokota, Tomoko Fujii, Shoichi Uezono, Masanori Takinami
PURPOSE: The purpose of the study is to evaluate the impact of sustained new-onset AF on mortality and the incidence of stroke in critically ill non-cardiac surgery patients. MATERIAL AND METHODS: This was a retrospective cohort study of non-cardiac surgery patients with new-onset AF conducted in a general intensive care unit. We compared patients remaining in AF with those restored to sinus rhythm (SR) at 6h after the onset of AF and conducted multivariable logistic regression analysis for in-hospital mortality...
December 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29219939/psychometric-evaluation-of-the-chinese-respiratory-distress-observation-scale-on-critically-ill-patients-with-cardiopulmonary-diseases
#20
Ya-Hsiang Chan, Hua-Shan Wu, Chih-Ching Yen, Margaret L Campbell
BACKGROUND: Respiratory distress is a common and distressing experience that strikes most critically ill patients with cardiopulmonary diseases. Now, most dyspnea assessment tools rely on patient's self-report. Only one instrument, the Respiratory Distress Observation Scale (RDOS), is valid for assessing respiratory distress when the patient cannot provide a dyspnea self-report. PURPOSE: The aims of this study were to develop the Chinese version of RDOS through two-way translation and examine its reliability and validity...
December 6, 2017: Journal of Nursing Research: JNR
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