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https://www.readbyqxmd.com/read/29678361/chikungunya-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#1
Pravin Amin, Gisele Sampaio Silva, Jorge Hidalgo, Juan Ignacio Silesky Jiménez, Dilip R Karnad, Guy A Richards
Chikungunya is an arbovirus that is transmitted by the Aedes mosquito causing a febrile illness with periodic outbreaks in large parts of the world. In the last decade it has become a public health concern in a host of countries and has affected international tourists. In the vast majority of cases Chikungunya presents as an acute febrile illness, associated with rash, headache, myalgia and debilitating arthralgia or even polyarthritis. A small proportion of patients present atypically with nervous, ocular, renal, myocardial, respiratory and renal system involvement and may require ICU management...
April 7, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29674362/implementation-of-an-evidence-based-model-of-care-for-low-back-pain-in-emergency-departments-protocol-for-the-sydney-health-partners-emergency-department-shaped-trial
#2
Gustavo C Machado, Bethan Richards, Chris Needs, Rachelle Buchbinder, Ian A Harris, Kirsten Howard, Kirsten McCaffery, Laurent Billot, James Edwards, Eileen Rogan, Rochelle Facer, David Lord Cowell, Chris G Maher
INTRODUCTION: Patients with low back pain often seek care in emergency departments, but the problem is that many patients receive unnecessary or ineffective interventions and at the same time miss out on the basics of care, such as advice on self-management. This pattern of care has important consequences for the healthcare system (expensive and inefficient) and for patients (poor health outcomes). We hypothesised that the implementation of an evidence-based model of care for low back pain will improve emergency care by reducing inappropriate overuse of tests and treatments and improving patient outcomes...
April 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29673324/gabriel-richet-when-medicine-combines-with-courage
#3
EDITORIAL
Pierre Ronco
Gabriel Richet, one of the fathers of the French and international Nephrology, was a man remarkable for his courage, vision and empathy. He was proud and brave, and he presented himself proud of being brave. He opens his interview speaking about his youth, when he was injured, and went back to the fight. He cites the number of stitches he received, but doesn't cite being decorated with the Légion d'Honneur, one of the highest honours of the French Republic. This anecdote perfectly illustrates his elegance and detachment from awards and self-satisfaction...
April 19, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29671037/-geriatric-intensive-care-patients-perspectives-and-limits-of-geriatric-intensive-care-medicine
#4
REVIEW
U Müller-Werdan, H-J Heppner, G Michels
Critically ill geriatric patients are vitally endangered due to the aging processes of organs, the frequently existing multimorbidity with subsequent polypharmacy and the typical geriatric syndrome of functional impairments. Aging processes in organs lower the clinical threshold for organ dysfunction and organ failure. Physiological organ aging processes with practical consequences for intensive care medicine are atypical manifestion of sepsis in immunosenescence, altered pharmacokinetics, reduced tolerance to hypovolemia due to proportionally reduced water compartment of the body in old age, the frequently only apparently normal function of the kidneys and the continuous reduction in pulmonary function in old age...
April 18, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29670994/weekend-effects-on-health-outcomes-and-operational-efficiency-in-emergency-admissions-to-general-medicine-services-of-the-central-hospital-of-the-autonomous-province-of-bolzano-italy
#5
C J Wiedermann, M Adami, W Wiedermann
The possibility of higher death rates after admission to hospital during the weekend has been intensively investigated in North America and Northern Europe, while data are almost absent from Southern Europe and other WHOV regions. Increased death rates have not been uniformly confirmed. Differences in hospital care on weekends can vary depending on the reason for hospital admission, place and time. The aim was to verify whether weekend admission from the emergency department to internal medicine services is associated with parameters of operational efficiency in a Northern Italian hospital...
May 2018: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/29669430/providing-palliative-care-in-the-medical-icu-a-qualitative-study-of-micu-physicians-beliefs-and-practices
#6
Brittany Gatta, Jessica Turnbull
CONTEXT: With the current and projected shortage of palliative care (PC) specialists, an integrative model of PC will be needed to meet the needs of patients in intensive care units (ICUs). Prior studies of PC interventions suggest that success depends upon meeting the needs of individual institutions or ICUs. OBJECTIVE: The objective of this study was to qualitatively explore the beliefs and practices of one institution's medical ICU (MICU) physicians in regard to providing an integrative model of PC...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29667143/diagnostic-performance-of-18-f-fdg-pet-ct-and-whole-body-diffusion-weighted-imaging-with-background-body-suppression-dwibs-in-detection-of-lymph-node-and-bone-metastases-from-pediatric-neuroblastoma
#7
Hiroaki Ishiguchi, Shinji Ito, Katsuhiko Kato, Yusuke Sakurai, Hisashi Kawai, Naotoshi Fujita, Shinji Abe, Atsushi Narita, Nobuhiro Nishio, Hideki Muramatsu, Yoshiyuki Takahashi, Shinji Naganawa
OBJECTIVE: Recent many studies have shown that whole body "diffusion-weighted imaging with background body signal suppression" (DWIBS) seems a beneficial tool having higher tumor detection sensitivity without ionizing radiation exposure for pediatric tumors. In this study, we evaluated the diagnostic performance of whole body DWIBS and 18 F-FDG PET/CT for detecting lymph node and bone metastases in pediatric patients with neuroblastoma. METHODS: Subjects in this retrospective study comprised 13 consecutive pediatric patients with neuroblastoma (7 males, 6 females; mean age, 2...
April 17, 2018: Annals of Nuclear Medicine
https://www.readbyqxmd.com/read/29665847/tensions-in-ethics-and-policy-created-by-national-precision-medicine-programs
#8
Jusaku Minari, Kyle B Brothers, Michael Morrison
Precision medicine promises to use genomics and other data-intensive approaches to improve diagnosis and develop new treatments for major diseases, but also raises a range of ethical and governance challenges. Implementation of precision medicine in "real world" healthcare systems blurs the boundary between research and care. This has implications for the meaning and validity of consent, and increased potential for discrimination, among other challenges. Increased sharing of personal information raises concerns about privacy, commercialization, and public trust...
April 17, 2018: Human Genomics
https://www.readbyqxmd.com/read/29662667/genetically-enhanced-t-lymphocytes-and-the-intensive-care-unit
#9
REVIEW
Tiberiu Tat, Huming Li, Catalin-Sorin Constantinescu, Anca Onaciu, Sergiu Chira, Ciprian Osan, Sergiu Pasca, Bobe Petrushev, Vlad Moisoiu, Wilhelm-Thomas Micu, Cristian Berce, Sebastian Tranca, Delia Dima, Ioana Berindan-Neagoe, Jianliang Shen, Ciprian Tomuleasa, Liren Qian
Chimeric antigen receptor-modified T cells (CAR-T cells) and donor lymphocyte infusion (DLI) are important protocols in lymphocyte engineering. CAR-T cells have emerged as a new modality for cancer immunotherapy due to their potential efficacy against hematological malignancies. These genetically modified receptors contain an antigen-binding moiety, a hinge region, a transmembrane domain, and an intracellular costimulatory domain resulting in lymphocyte T cell activation subsequent to antigen binding. In present-day medicine, four generations of CAR-T cells are described depending on the intracellular signaling domain number of T cell receptors...
March 27, 2018: Oncotarget
https://www.readbyqxmd.com/read/29661355/the-structure-of-medical-intensive-care-units-at-training-institutions
#10
Marc Heincelman, Ashley Duckett, Brad Keith, Andrew Schreiner, Jingwen Zhang, Edward Kilb, Benjamin Clyburn
BACKGROUND: As a result of the 2011 Accreditation Council for Graduate Medical Education (ACGME) work hour guideline implementation, the structure of intensive care unit (ICU) teams at training institutions has been affected. The impact these changes have had on the current work environment has not been well described. METHODS: The authors conducted an online survey of internal medicine program directors in 2016. The survey investigated how training institutions structure their intensive care units in reference to volume, resident housestaff and alternative coverage options, with a focus on changes made after the implementation of the 2011 ACGME duty hour restrictions...
April 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29656714/epidemiology-of-sepsis-in-intensive-care-units-in-turkey-a-multicenter-point-prevalence-study
#11
Nur Baykara, Halis Akalın, Mustafa Kemal Arslantaş, Volkan Hancı, Çiğdem Çağlayan, Ferda Kahveci, Kubilay Demirağ, Canan Baydemir, Necmettin Ünal
BACKGROUND: The prevalence and mortality of sepsis are largely unknown in Turkey, a country with high antibiotic resistance. A national, multicenter, point-prevalence study was conducted to determine the prevalence, causative microorganisms, and outcome of sepsis in intensive care units (ICUs) in Turkey. METHODS: A total of 132 ICUs from 94 hospitals participated. All patients (aged > 18 years) present at the participating ICUs or admitted for any duration within a 24-h period (08:00 on January 27, 2016 to 08:00 on January 28, 2016) were included...
April 16, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29655388/the-prevalence-of-healthcare-associated-infections-in-mainland-china-a-systematic-review-and-meta-analysis
#12
Jiancong Wang, Fangfei Liu, Ermira Tartari, Jianan Huang, Stephan Harbarth, Didier Pittet, Walter Zingg
OBJECTIVETo assess the prevalence of healthcare-associated infections (HAIs) in mainland China.DESIGNSystematic review and meta-analysis.SETTINGAdults and children from secondary and tertiary acute-care hospitals in mainland China.METHODSWe searched PubMed, the China National Knowledge Infrastructure, and Wan Fang for multicenter point-prevalence surveys of acute-care hospitals in mainland China from January 2006 to August 2016. All reports related to HAI, using a point-prevalence methodology and published either in English or Chinese were eligible...
April 15, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29649891/erratum
#13
(no author information available yet)
Singer AE, Ash T, Ochotorena C, Lorenz KA, Chong K, Shreve ST, Ahluwalia SC. A Systematic Review of Family Meeting Tools in Palliative and Intensive Care Settings. Am J Hosp Palliat Care. 2016; 33(8):797-806. (DOI: 10.1177/1049909115594353) It was noted that the following references were duplicated in the above mentioned article. (i) Billings JA, Block SD. The end-of-life family meeting in intensive care part III: A guide for structured discussions. J Palliat Med. 2011;14(9):1058-1064. (ii) Fineberg IC, Kawashima M, Asch SM...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29648477/acute-intensive-care-unit-management-of-mustard-gas-victims-the-turkish-experience
#14
Ertugrul Kilic, Mesut Ortatatli, Sermet Sezigen, Rusen Koray Eyison, Levent Kenar
Sulfur mustard (SM) is an highly toxic and vesicant chemical weapon that was used in various military conflicts several times in the history. The severity of ocular, dermal, and pulmonary symptoms that may appear following a characteristic asymptomatic period are depending on the SM concentration and exposure duration. The aim of this study is to present the clinical features and share the intensive care unit (ICU) experiences for the medical management of mustard gas victims. Thirteen Free Syrian Army soldiers near Al-Bab region of North Syria were reportedly exposed to oily blackish smoke with garlic smell due to the explosion of a trapped bomb without causing any blast or thermal effect on 26th November 2016...
April 12, 2018: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/29644912/amalgamation-of-systemic-inflammatory-response-syndrome-score-with-c-reactive-protein-level-in-evaluating-acute-pancreatitis-severity-in-children
#15
Wei Zheng, Linqian Zhang, Gao Long, Bo Chen, Xiaoli Shu, Mizu Jiang
BACKGROUND AND AIM: Systemic inflammatory response syndrome (SIRS) has to do with how the body reacts to injury. Herein, we analyzed the clinical features of acute pancreatitis (AP) in children with SIRS complication and investigated the role of SIRS score combined with C-reactive protein (CRP) level in assessing AP severity in children. METHODS: This retrospective cohort study involved 111 children hospitalized with AP at the Children's Hospital of Zhejiang University School of Medicine between January 2012 and August 2017...
April 12, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29643089/physicians-political-preferences-and-the-delivery-of-end-of-life-care-in-the-united-states-retrospective-observational-study
#16
Anupam B Jena, Andrew R Olenski, Dhruv Khullar, Adam Bonica, Howard Rosenthal
OBJECTIVES: To compare the delivery of end of life care given to US Medicare beneficiaries in hospital by internal medicine physicians with Republican versus Democrat political affiliations. DESIGN: Retrospective observational study. SETTING: US Medicare. PARTICIPANTS: Random sample of Medicare beneficiaries, who were admitted to hospital in 2008-12 with a general medical condition, and died in hospital or shortly thereafter...
April 11, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29643058/a-conceptual-framework-for-addressing-residual-atherosclerotic-cardiovascular-disease-risk-in-the-era-of-precision-medicine
#17
Kershaw V Patel, Ambarish Pandey, James A de Lemos
Until recently, therapies to mitigate atherosclerotic cardiovascular disease (ASCVD) risk have been limited to lifestyle interventions, blood pressure lowering medications, high intensity statin therapy, antiplatelet agents, and in select patients, coronary artery revascularization. Despite administration of these evidence-based therapies, substantial residual risk for cardiovascular events persists, particularly among individuals with known ASCVD. Moreover, the current guideline-based approach does not adequately account for patient-specific, causal pathways that lead to ASCVD progression and complications...
April 11, 2018: Circulation
https://www.readbyqxmd.com/read/29642928/diagnostic-and-management-of-life-threatening-adult-onset-still-disease-a-french-nationwide-multicenter-study-and-systematic-literature-review
#18
Antoine Néel, Anaïs Wahbi, Benoit Tessoulin, Julien Boileau, Dorothée Carpentier, Olivier Decaux, Laurence Fardet, Guillaume Geri, Pascal Godmer, Cécile Goujard, Hervé Maisonneuve, Arnaud Mari, Jacques Pouchot, Jean-Marc Ziza, Cédric Bretonnière, Mohamed Hamidou
BACKGROUND: Adult-onset Still disease (AOSD) is a rare systemic inflammatory disorder. A few patients develop organ complications that can be life-threatening. Our objectives were to describe the disease course and phenotype of life-threatening AOSD, including response to therapy and long-term outcome. METHODS: A multicenter case series of intensive care medicine (ICU) patients with life-threatening AOSD and a systematic literature review. RESULTS: Twenty patients were included...
April 11, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29642825/-investigation-of-carbapenemase-genes-and-molecular-epidemiology-of-enterobacteriaceae-strains-isolated-between-2010-2014-in-a-university-hospitals
#19
Hüseyin Haydar Kutlu, Ebru Us, Alper Tekeli
The worldwide spread of carbapenemase producing Enterobacteriaceae isolates has become a major threat of public health. This worrisome situation leads the development of new methods for carbapenemase screening, detection, prevention of spread and epidemiological data collection as mandatory. In this study, it was aimed to investigate existence and distribution of carbapenemase-encoding genes (CEGs) among carbapenem-resistant Enterobacteriaceae isolated from various clinical samples in Ankara University Faculty of Medicine, Ibni Sina Hospital, Central Microbiology Laboratory between June 2010-May 2014 and detect their clonal relationship...
January 2018: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/29642710/teaching-residents-how-to-talk-about-death-and-dying-a-mixed-methods-analysis-of-barriers-and-randomized-educational-intervention
#20
David C Miller, Amy M Sullivan, Morgan Soffler, Brett Armstrong, Asha Anandaiah, Laura Rock, Jakob I McSparron, Richard M Schwartzstein, Margaret M Hayes
OBJECTIVES: We present a pilot study exploring the effects of a brief, 30-minute educational intervention targeting resident communication surrounding dying in the intensive care unit (ICU). We sought to determine whether simulation or didactic educational interventions improved resident-reported comfort, preparation, and skill acquisition. We also sought to identify resident barriers to using the word "dying." METHODS: In this mixed-methods prospective study, second- and third-year medical residents were randomized to participate in a simulation-based communication training or a didactic session...
January 1, 2018: American Journal of Hospice & Palliative Care
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