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https://www.readbyqxmd.com/read/28816870/spinal-cord-injury-what-are-the-controversies
#1
Christopher S Ahuja, Gregory D Schroeder, Alexander R Vaccaro, Michael G Fehlings
Traumatic spinal cord injuries have a tremendous impact on individuals, families, and society as a whole. Substantial heterogeneity in the patient population, their presentation and underlying pathophysiology has sparked debates along the care spectrum from initial assessment to definitive treatment. This article reviews spinal cord injury (SCI) management followed by a discussion of the salient controversies in the field. Current care practices modeled on the American Association of Neurological Surgeons/Congress of Neurological Surgeons joint section guidelines are highlighted including key recommendations regarding immobilization, avoidance of hypotension, early International Standards for Neurological Classification of SCI examination and intensive care unit treatment...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28816063/acute-cardiovascular-care-association-position-paper-on-intensive-cardiovascular-care-units-an-update-on-their-definition-structure-organisation-and-function
#2
Eric Bonnefoy-Cudraz, Hector Bueno, Gianni Casella, Elia De Maria, Donna Fitzsimons, Sigrun Halvorsen, Christian Hassager, Zaza Iakobishvili, Ahmed Magdy, Toomas Marandi, Jorge Mimoso, Alexander Parkhomenko, Susana Price, Richard Rokyta, Francois Roubille, Pranas Serpytis, Avi Shimony, Janina Stepinska, Diana Tint, Elina Trendafilova, Marco Tubaro, Christiaan Vrints, David Walker, Doron Zahger, Endre Zima, Robert Zuckerman, Maddalena Lettino
Acute cardiovascular care has progressed considerably since the last position paper was published 10 years ago. It is now a well-defined, complex field with demanding multidisciplinary teamworking. The Acute Cardiovascular Care Association has provided this update of the 2005 position paper on acute cardiovascular care organisation, using a multinational working group. The patient population has changed, and intensive cardiovascular care units now manage a large range of conditions from those simply requiring specialised monitoring, to critical cardiovascular diseases with associated multi-organ failure...
August 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28816042/rapid-and-reliable-detection-of-alkaline-phosphatase-by-a-hot-spots-amplification-strategy-based-on-well-controlled-assembly-on-single-nanoparticle
#3
Yi Zeng, Jia-Qiang Ren, Shaokai Wang, Jiaming Mai, Bing Qu, Yan Zhang, Ai-Guo Shen, Jiming Hu
The first appeal of clinical assay is always accurate and rapid. For alkaline phosphatase (ALP) monitoring in medical treatment, a rapid, reliable surface-enhanced Raman scattering (SERS) test kit is designed based on a "hot spots" amplification strategy. Consisting of alkyne-tagged Au nanoparticles (NPs), Ag+, and enzyme substrate, the packaged test kit can achieve one-step clinical assay of ALP in human serum within several minutes, while the operation is simple as it directly inputs the sample into the test kit...
August 17, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28816029/development-of-a-3d-tissue-lung-phantom-of-a-preterm-infant-for-optical-measurements-of-oxygen-laser-detector-position-considerations
#4
Jim Larsson, Peilang Liao, Patrik Lundin, Emilie Krite Svanberg, Johannes Swartling, Märta Lewander Xu, Joakim Bood, Stefan Andersson-Engels
There is a need for further improving the clinical care of our most vulnerable patients - preterm infants. Novel diagnostic and treatment tools facilitate such advances. Here we are evaluating a potential percutaneous optical monitoring tool to assess the oxygen and water vapor contents in the lungs of preterm babies. The aim is to prepare for further clinical studies by gaining detailed understanding of how the measured light intensity and gas absorption signal behave for different possible geometries of the light delivery and receiver...
August 16, 2017: Journal of Biophotonics
https://www.readbyqxmd.com/read/28811051/patient-blood-management-in-the-intensive-care-unit
#5
REVIEW
Aryeh Shander, Mazyar Javidroozi, Gregg Lobel
Patient Blood Management underscores a fundamental shift from a product-centered approach to a patient-centric approach through timely application of evidence-based medical and surgical concepts designed to maintain hemoglobin concentration, optimize hemostasis, and minimize blood loss in an effort to improve patient outcome. In this concept, allogeneic blood transfusion is not viewed as the treatment of default for anemic patients, but one among many treatment modalities that should be weighed based on its merits-potentials risks and benefits-for the individual patient in the context of other alternatives...
July 31, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28810887/dietary-diversity-and-meal-frequency-among-infant-and-young-children-a-community-based-study
#6
Aysheshim Kassahun Belew, Bekrie Mohammed Ali, Zegeye Abebe, Berihun Assefa Dachew
BACKGROUND: Insufficient quantities, frequencies, and inadequate quality of complementary feedings have a negative effect on child health and growth, especially in the first two years of life. Therefore, the aim of this study was to assess the minimum dietary diversity, meal frequency and its associated factors among infants and young children aged 6-23 months at Dabat District, northwest, Ethiopia. METHODS: A community- based cross-sectional study was conducted from February 15 to March 10, 2016...
August 15, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28807922/are-standard-doses-of-piperacillin-in-piperacillin-tazobactam-regimens-adequate-for-the-management-of-febrile-neutropenia-answers-from-population-pharmacokinetic-modelling-and-monte-carlo-simulations
#7
Fekade Bruck Sime, Uwe Hahn, Morgyn S Warner, Ing Soo Tiong, Michael S Roberts, Jeffrey Lipman, Sandra L Peake, Jason A Roberts
Changes in the pharmacokinetics of piperacillin in febrile neutropenic patients have been reported to result in sub-optimal exposures. This study aimed to develop a population pharmacokinetic model for piperacillin and perform dosing simulation to describe optimal dosing regimens for haematological malignancy patients with febrile neutropenia. Concentration-time data were obtained from previous prospective observational pharmacokinetic and interventional therapeutic drug monitoring studies. Non-parametric population pharmacokinetic analysis and Monte Carlo dosing simulations were performed with Pmetrics® package for R...
August 14, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28806954/-usability-of-data-integration-and-visualization-software-for-multidisciplinary-pediatric-intensive-care-a-human-factors-approach-to-assessing-technology
#8
Ying Ling Lin, Anne-Marie Guerguerian, Jessica Tomasi, Peter Laussen, Patricia Trbovich
BACKGROUND: Intensive care clinicians use several sources of data in order to inform decision-making. We set out to evaluate a new interactive data integration platform called T3™ made available for pediatric intensive care. Three primary functions are supported: tracking of physiologic signals, displaying trajectory, and triggering decisions, by highlighting data or estimating risk of patient instability. We designed a human factors study to identify interface usability issues, to measure ease of use, and to describe interface features that may enable or hinder clinical tasks...
August 14, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28805619/intrauterine-fetal-death-caused-by-seatbelt-injury
#9
Shizuka Yamada, Koji Nishijima, Jin Takahashi, Nozomu Takahashi, Chiyo Tamamura, Yoshio Yoshida
OBJECTIVE: Severe motor vehicle accidents involving pregnant women can result in fetal and neonatal death. We describe a case in which fetal death occurred due to relatively mild seatbelt injuries and present the characteristic magnetic resonance imaging (MRI) findings of the placenta. CASE REPORT: A 26-year-old primigravid woman at 20 weeks gestation was involved in an automobile accident. Although she suffered only a seatbelt injury, fetal death subsequently occurred...
August 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28804720/integron-mediated-antibiotic-resistance-in-acinetobacter-baumannii-isolated-from-intensive-care-unit-patients-babol-north-of-iran
#10
Mitra Deylam Salehi, Elaheh Ferdosi-Shahandashti, Yosef Yahyapour, Soraya Khafri, Abazar Pournajaf, Ramazan Rajabnia
BACKGROUND: We investigated the integron types and their relation with antibiotic resistance among A. baumannii isolates collected from intensive care unit patients, Babol, north of Iran. METHODS: In this cross-sectional study, a total of 73 bronchoalveolar lavage samples were obtained from patients in ICU. Susceptibility testing was performed by disk diffusion method. Types of integrons were identified by an integrase gene PCR. RESULTS: In total, 47...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28803440/electrical-impedance-tomography-for-diagnosis-and-monitoring-of-pulmonary-function-disorders-in-the-intensive-care-unit-case-report-and-review-of-literature
#11
Szymon Białka, Maja Copik, Katarzyna Rybczyk, Hanna Misiołek
The aim of this paper is to describe the possibility of using Electrical Impedance Tomography (EIT) as a treatment monitoring tool in the ICU. It was based on case report and literature review. A 19-year-old female was admitted to ICU due to severe acute respiratory distress syndrome. Despite aggressive treatment there was no improvement. We decided to use EIT in the monitoring of treatment because of difficulties in transporting the patient to the radiology department in order to perform a control CT scan...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28802344/creating-a-highly-reliable-neonatal-intensive-care-unit-through-safer-systems-of-care
#12
REVIEW
Patoula G Panagos, Stephen A Pearlman
Neonates requiring intensive care are at high risk for medical errors due to their unique characteristics and high acuity. Designing a safer work environment begins with safe processes. Creating a culture of safety demands the involvement of all organizational levels and an interdisciplinary approach. Adverse events can result from suboptimal communication and lack of a shared mental model. This chapter describes tools to promote better patient safety in the NICU through monitoring adverse events, improving communication and using information technology...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28801969/anesthetic-management-for-intestinal-transplantation-a-decade-of-experience
#13
Jeron Zerillo, Sang Kim, Bryan Hill, David Shapiro, Hung-Mo Lin, Alyssa Burnham, Jang Moon, Kishore Iyer, Samuel DeMaria
BACKGROUND: Intestinal transplantation (ITx) is the definitive therapy for patients suffering from intestinal failure. Previous published reports suggest that these cases should be managed peri-operatively with the same intensive monitors and techniques as in liver transplantation. METHODS: We retrospectively reviewed the anesthetic management of sixty-seven isolated intestinal, intestinal-pancreas and intestinal-kidney transplants over the previous decade (2005-2015) in our tertiary care institution...
August 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28798200/wearable-physiological-monitoring-for-human-thermal-work-strain-optimization
#14
Mark J Buller, Alexander Pearson Welles, Karl E Friedl
Safe performance limits of soldiers and athletes have typically relied on predictive work-rest models of ambient conditions, average work intensity, and characteristics of the population. Bioengineering advances in noninvasive sensor technologies including miniaturization, reduced cost, power requirements, and comfort now make it possible to produce individual predictions of safe thermal-work limits. These precision medicine assessments depend on the development of thoughtful algorithms based on physics and physiology...
August 10, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28797619/mechanical-ventilation-weaning-protocol-improves-medical-adherence-and-results
#15
Luís Guilherme Alegretti Borges, Augusto Savi, Cassiano Teixeira, Roselaine Pinheiro de Oliveira, Marcio Luiz Ferreira De Camillis, Ricardo Wickert, Sérgio Fernando Monteiro Brodt, Túlio Frederico Tonietto, Ricardo Cremonese, Leonardo Silveira da Silva, Fernanda Gehm, Eubrando Silvestre Oliveira, Jose Herve Diel Barth, Juçara Gasparetto Macari, Cíntia Dias de Barros, Sílvia Regina Rios Vieira
INTRODUCTION: Implementation of a weaning protocol is related to better patient prognosis. However, new approaches may take several years to become the standard of care in daily practice. We conducted a prospective cohort study to investigate the effectiveness of a multifaceted strategy to implement a protocol to wean patients from mechanical ventilation (MV) and to evaluate the weaning success rate as well as practitioner adherence to the protocol. METHODS: We investigated all consecutive MV-dependent subjects admitted to a medical-surgical intensive care unit (ICU) for >24h over 7years...
July 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28796408/use-of-the-anion-gap-and-intermittent-hemodialysis-following-continuous-hemodiafiltration-in-extremely-high-dose-acute-on-chronic-lithium-poisoning-a-case-report
#16
Yohei Komaru, Ryota Inokuchi, Yoshihiro Ueda, Masaomi Nangaku, Kent Doi
A 35-year-old woman intentionally took 40,000 mg of lithium carbonate, and she was transferred to our hospital with nausea, vomiting, and diarrhea. She was diagnosed as having bipolar disorder 10 years ago and was receiving oral lithium therapy. Blood test results on arrival were remarkable for a negative anion gap of -2.1 and later, the serum lithium level turned out to be as high as 15.4 mEq/L. Intubation was required because of disrupted consciousness, and continuous hemodiafiltration (CHDF) was immediately started in the intensive care unit to obtain constant removal of lithium...
August 10, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28795669/-evaluation-of-volume-overload-in-critical-patients-by-monitoring-change-of-cardiac-output-under-bed-head-raising-combined-with-passive-leg-raising
#17
Long Zhang, Luhao Wang, Weixiong Luo, Meihua Mei, Youjuan Chen, Bin Ouyang
OBJECTIVE: To investigate whether the change of cardiac output (CO) with bed head raising (BHR) combined with passive leg raising (PLR) can be used to assess volume overload in critical patients. METHODS: A prospective observational diagnostic trial was designed. The patients who underwent fluid resuscitation 6 hours or more, and admitted to intensive care unit (ICU) of Meizhou People's Hospital in Guangdong Province from January to December in 2016 were enrolled...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28793031/airborne-fungi-in-an-intensive-care-unit
#18
C L Gonçalves, F V Mota, G F Ferreira, J F Mendes, E C Pereira, C H Freitas, J N Vieira, J P Villarreal, P S Nascente
The presence of airborne fungi in Intensive Care Unit (ICUs) is associated with increased nosocomial infections. The aim of this study was the isolation and identification of airborne fungi presented in an ICU from the University Hospital of Pelotas - RS, with the attempt to know the place's environmental microbiota. 40 Petri plates with Sabouraud Dextrose Agar were exposed to an environment of an ICU, where samples were collected in strategic places during morning and afternoon periods for ten days. Seven fungi genera were identified: Penicillium spp...
July 27, 2017: Brazilian Journal of Biology, Revista Brasleira de Biologia
https://www.readbyqxmd.com/read/28791567/the-oxygen-reserve-index-ori-a-new-tool-to-monitor-oxygen-therapy
#19
REVIEW
T W L Scheeren, F J Belda, A Perel
Supplemental oxygen is administered in the vast majority of patients in the perioperative setting and in the intensive care unit to prevent the potentially deleterious effects of hypoxia. On the other hand, the administration of high concentrations of oxygen may induce hyperoxia that may also be associated with significant complications. Oxygen therapy should therefore be precisely titrated and accurately monitored. Although pulse oximetry has become an indispensable monitoring technology to detect hypoxemia, its value in assessing the oxygenation status beyond the range of maximal arterial oxygen saturation (SpO2 ≥97%) is very limited...
August 8, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28790536/comparison-of-results-classical-and-eversion-carotid-endarterectomy
#20
Muhamed Djedovic, Emir Mujanovic, Amel Hadzimehmedagic, Dragan Totic, Haris Vukas, Haris Vranic
INTRODUCTION: Atherosclerosis blood vessels, be it on extra-cranial or intra-cranial circulation, the most common cause of incidents such as cerebro-vascular insult (ICV). Carotid endarterectomy (CEA) is a preventive operation to reduce the risk of stroke and it can be performed by eversion carotid endarterectomy (E-CEA) or a classical carotid endarterectomy (C-CEA). The aim of this study was to investigate the influence of the used techniques in basic perioperative results and the incidence of postoperative complications...
April 2017: Medical Archives
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