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https://www.readbyqxmd.com/read/29240847/characterizing-hospitalist-practice-and-perceptions-of-critical-care-delivery
#1
Joseph R Sweigart, David Aymond, Alfred Burger, Andy Kelly, Nick Marzano, Thomas McIlraith, Peter Morris, Mark V Williams, Eric M Siegal
BACKGROUND: Intensivist shortages have led to increasing hospitalist involvement in critical care delivery. OBJECTIVE: To characterize the practice of hospitalists practicing in the intensive care unit (ICU) setting. DESIGN: Survey of hospital medicine physicians. SETTING: This survey was conducted as a needs assessment for the ongoing efforts of the Critical Care Task Force of the Society of Hospital Medicine Education Committee...
December 6, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29239945/error-grid-analysis-for-arterial-pressure-method-comparison-studies
#2
Bernd Saugel, Oliver Grothe, Julia Y Nicklas
The measurement of arterial pressure (AP) is a key component of hemodynamic monitoring. A variety of different innovative AP monitoring technologies became recently available. The decision to use these technologies must be based on their measurement performance in validation studies. These studies are AP method comparison studies comparing a new method ("test method") with a reference method. In these studies, different comparative statistical tests are used including correlation analysis, Bland-Altman analysis, and trending analysis...
December 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29239150/gender-differences-in-septic-intensive-care-unit-patients
#3
Francesco Campanelli, Giovanni Landoni, Luca Cabrini, Alberto Zangrillo
BACKGROUND: The world population is mostly male at birth, although there is a shift in predominance over 55 years of age with more females than males. Male gender was recently hypothesized to be a risk factor for sepsis and septic shock; the reasons and the consequences of this odd discrepancy are yet a matter of debate. We investigated the percentage of males and females in a large number of trials performed on septic adult patients admitted to Intensive Care Units. METHODS: We analysed all the multicentre randomized controlled trials ever published in peer-reviewed Journals reporting a significant effect on mortality in intensive care unit septic adult patients; furthermore, we retrieved all the manuscripts dealing with sepsis or septic shock patients published in the last 3 years in the three medical Journals with the highest impact factor...
December 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29237706/patient-characteristics-resource-use-and-outcomes-associated-with-general-internal-medicine-hospital-care-the-general-medicine-inpatient-initiative-gemini-retrospective-cohort-study
#4
Amol A Verma, Yishan Guo, Janice L Kwan, Lauren Lapointe-Shaw, Shail Rawal, Terence Tang, Adina Weinerman, Peter Cram, Irfan A Dhalla, Stephen W Hwang, Andreas Laupacis, Muhammad M Mamdani, Steven Shadowitz, Ross Upshur, Robert J Reid, Fahad Razak
BACKGROUND: The precise scope of hospital care delivered under general internal medicine services remains poorly quantified. The purpose of this study was to describe the demographic characteristics, medical conditions, health outcomes and resource use of patients admitted to general internal medicine at 7 hospital sites in the Greater Toronto Area. METHODS: This was a retrospective cohort study involving all patients who were admitted to or discharged from general internal medicine at the study sites between Apr...
December 11, 2017: CMAJ Open
https://www.readbyqxmd.com/read/29230125/older-patients-with-acute-myeloid-leukemia-treatment-challenges-and-future-directions
#5
REVIEW
Laura Finn, Andrew Dalovisio, James Foran
Background: Even though acute myeloid leukemia (AML) occurs most commonly in adults ≥60 years, the treatment of AML in older patients remains a significant challenge. Methods: We reviewed the current literature regarding patient assessment tools, treatment options, and current therapies in clinical trial for patients with AML who are ≥60 years. Results: Our approach to the older patient with AML is evolving with better understanding of the unique disease epidemiology in this population and the development of tools to assess individual patient functional status, including grading systems for comorbidities, geriatric assessment tools, and measurements of frailty...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29226232/connecting-undergraduate-and-postgraduate-medical-education-through-an-elective-epa-based-transitional-year-in-acute-care-an-early-project-report
#6
Gersten Jonker, Reinier G Hoff, Stefan Max, Cor J Kalkman, Olle Ten Cate
Objective: A well-designed final year may ease the transition from medical school to postgraduate training, if it has enough depth to enable the acquisition of early specialty expertise, while keeping enough breadth to support the graduation as all-round physician. Aim of this article is to describe the design of a multidisciplinary dedicated transitional year (DTY) around the theme of recognition and initial treatment of vitally threatened patients. Methods: Undergraduate and postgraduate training directors from the departments of Anaesthesiology, Cardiology, Emergency Medicine, Intensive Care Medicine and Respiratory Medicine at UMC Utrecht and partnering hospitals have collaboratively developed and implemented a curriculum for a final year focusing on three entrustable professional activities (EPAs) in the domain of acute care...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/29223941/-medical-futility-and-family-obstinacy-in-intensive-therapy-when-to-stop-and-when-to-keep-going
#7
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/29221616/dengue-fever-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#8
REVIEW
Pravin Amin, Özlem Acicbe, Jorge Hidalgo, Juan Ignacio Silesky Jiménez, Tim Baker, Guy A Richards
Dengue is an arbovirus affecting humans and spread by mosquitoes. Severe dengue follows a secondary infection with a different virus serotype. The problem is truly global as it is endemic in over 100 countries. Severe dengue can be a life-threatening because of increased vascular permeability, resulting in leakage of fluid from the intravascular compartment to the extravascular space. When major bleeding does occur, it is almost invariably combined with profound shock since this, in combination with thrombocytopenia, hypoxia, and acidosis, can lead to multiple organ failure and disseminated intravascular coagulation...
November 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29217106/a-novel-mortality-prediction-model-for-the-current-population-in-an-adult-intensive-care-unit
#9
Sofia Fika, Serafeim Nanas, Georgios Baltopoulos, Efstratia Charitidou, Pavlos Myrianthefs
BACKGROUND: The accurate and reliable mortality prediction is very useful, in critical care medicine. There are various new variables proposed in the literature that could potentially increase the predictive ability for death in ICU of the new predictive scoring model. OBJECTIVE: To develop and validate a new intensive care unit (ICU) mortality prediction model, using data that are routinely collected during the first 24 h of ICU admission, and compare its performance to the most widely used conventional scoring systems...
January 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29211225/off-pump-versus-on-pump-coronary-artery-bypass-grafting-in-frail-patients-study-protocol-for-the-fragile-multicenter-randomized-controlled-trial
#10
Omar Asdrúbal Vilca Mejía, Michel Pompeu Barros Oliveira Sá, Maurilio Onofre Deininger, Luís Roberto Palma Dallan, Rodrigo Coelho Segalote, Marco Antonio Praça de Oliveira, Fernando Antibas Atik, Magaly Arrais Dos Santos, Pedro Gabriel Melo de Barros E Silva, Rodrigo Mussi Milani, Alexandre Ciappina Hueb, Rosangela Monteiro, Ricardo Carvalho Lima, Luiz Augusto Ferreira Lisboa, Luís Alberto Oliveira Dallan, John Puskas, Fabio Biscegli Jatene
INTRODUCTION: Advances in modern medicine have led to people living longer and healthier lives. Frailty is an emerging concept in medicine yet to be explored as a risk factor in cardiac surgery. When it comes to CABG surgery, randomized controlled clinical trials have primarily focused on low-risk (ROOBY, CORONARY), elevated-risk (GOPCABE) or high-risk patients (BBS), but not on frail patients. Therefore, we believe that off-pump CABG could be an important technique in patients with limited functional capacity to respond to surgical stress...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29209788/-reform-of-emergency-physician-training-in-austria-finally-up-to-date
#11
REVIEW
H Trimmel, M Baubin, J Kreutziger, G Frank, G Prause
During the last 20 years Austrian prehospital emergency medical services (EMS) have significantly improved. The structure and organization of Austrian EMS comply with European standards but training requirements for prehospital EMS physicians are insufficient when compared with other countries. Although some EMS systems follow the German or Swiss postgraduate training concepts, the legal requirements in Austria defining the scope of mandatory training for physicians in the prehospital setting are only minimal...
December 5, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29209722/association-between-treatment-by-locum-tenens-internal-medicine-physicians-and-30-day-mortality-among-hospitalized-medicare-beneficiaries
#12
Daniel M Blumenthal, Andrew R Olenski, Yusuke Tsugawa, Anupam B Jena
Importance: Use of locum tenens physicians has increased in the United States, but information about their quality and costs of care is lacking. Objective: To evaluate quality and costs of care among hospitalized Medicare beneficiaries treated by locum tenens vs non-locum tenens physicians. Design, Setting, and Participants: A random sample of Medicare fee-for-service beneficiaries hospitalized during 2009-2014 was used to compare quality and costs of hospital care delivered by locum tenens and non-locum tenens internal medicine physicians...
December 5, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29208884/role-of-oral-clonidine-premedication-on-intra-operative-haemodynamics-and-ponv-in-laparoscopic-cholecystectomy
#13
M Masud, S Yeasmeen, A K Haque, S Jahan, N C Saha, D Banik
Laparoscopic cholecystectomy is a gold standard surgical procedure for gallbladder operation. It causes altered haemodynamic responses due to pneumoperitoneum and surgical procedure also causes high incidence of postoperative nausea &vomiting. Clonidine has been shown to reduce intraoperative haemodynamic instability. This randomized prospective single blind clinical study was designed to evaluate the efficacy of oral clonidine premedication for attenuation of haemodynamic responses associated with pneumoperitoneum & also reduce the incidence of postoperative nausea & vomiting and carried out in the department of Anaesthesia Analgesia and Intensive care Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2010 to June 2010...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29207995/physicians-using-spinal-manipulative-treatment-in-the-netherlands-a-description-of-their-characteristics-and-their-patients
#14
Wouter Schuller, Raymond W J G Ostelo, Daphne C Rohrich, Adri T Apeldoorn, Henrica C W de Vet
BACKGROUND: Various health care professionals apply Spinal Manipulative Treatment (SMT) in daily practice. While the characteristics of chiropractors and manual therapists and the characteristics of their patient populations are well described, there is little research about physicians who use SMT techniques. A distinct group of physicians in The Netherlands has been trained in musculoskeletal (MSK) medicine, which includes the use of SMT. Our objective was to describe the characteristics of these physicians and their patient population...
December 6, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29202811/high-prevalence-of-prescription-of-psychotropic-drugs-for-older-patients-in-a-general-hospital
#15
Inken Arnold, Kati Straube, Wolfgang Himmel, Stephanie Heinemann, Vivien Weiss, Laura Heyden, Eva Hummers-Pradier, Roland Nau
BACKGROUND: Many elderly patients receive psychotropic drugs. Treatment with psychotropic agents is associated with serious side effects including an increased risk of falls and fractures. Several psychotropic drugs are considered potentially inappropriate for treatment of the elderly. METHODS: A retrospective chart review was conducted covering all patients aged ≥ 65 years who were admitted to Evangelisches Krankenhaus Göttingen-Weende between 01/01/2013 and 03/31/2013...
December 4, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29202320/screening-itself-for-disseminated-intravascular-coagulation-may-reduce-mortality-in-sepsis-a-nationwide-multicenter-registry-in-japan
#16
Yutaka Umemura, Kazuma Yamakawa, Mineji Hayakawa, Toshimitsu Hamasaki, Satoshi Fujimi
OBJECTIVES: Screening of patients with sepsis for disseminated intravascular coagulation (DIC) has been recommended in several guidelines. However, DIC screening is still not widely accepted as an essential component of sepsis management, partly because of a lack of evidence that DIC screening has an effect on mortality. We investigated whether DIC screening was associated with a survival benefit in patients with sepsis. DESIGN: Post hoc analysis of a nationwide multicenter retrospective cohort study...
November 26, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29202253/the-evolution-of-intensive-care-medicine-a-personal-journey
#17
John Myburgh
No abstract text is available yet for this article.
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29202251/determining-the-optimum-capacity-to-train-a-challenge-for-the-college-of-intensive-care-medicine-of-australia-and-new-zealand
#18
Michael Ashbolt, Charles Corke, Balasubramanian Venkatesh
No abstract text is available yet for this article.
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29199252/-evaluation-of-pharmacotherapy-on-emergency-and-intensive-care-medicine-the-influence-of-intensity-and-duration-of-invasion
#19
Toru Imai
 Critically ill patients who receive high-level invasion show physiological changes different from those under more normal conditions, along with variable therapeutic effects and pharmacokinetics. The concept of systemic inflammatory response syndrome (SIRS) has been introduced to describe the clinical state resulting from invasive actions taken under acute circumstances, resulting in an acute-phase systemic response. In particular, dosages of vancomycin (VCM) and phenytoin (PHT) need to be adjusted by therapeutic drug monitoring (TDM) because of their narrow therapeutic concentration windows...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/29196585/feasibility-of-a-nurse-managed-pain-agitation-and-delirium-protocol-in-the-surgical-intensive-care-unit
#20
Alan Rozycki, Andrew S Jarrell, Rachel M Kruer, Samantha Young, Pedro A Mendez-Tellez
BACKGROUND: Society of Critical Care Medicine guidelines recommend the use of pain, agitation, and delirium protocols in the intensive care unit. The feasibility of nurse management of such protocols in the surgical intensive care unit has not been well assessed. OBJECTIVES: To evaluate the percentage of adherent medication interventions for patients assessed by using a pain, sedation, and delirium protocol. METHODS: Data on all adult patients admitted to a surgical intensive care unit from January 2013 through September 2013 who were assessed at least once by using a pain, sedation, and delirium protocol were retrospectively reviewed...
December 2017: Critical Care Nurse
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