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https://www.readbyqxmd.com/read/28334564/data-driven-implementation-of-alarm-reduction-interventions-in-a-cardiovascular-surgical-icu
#1
Sharon H Allan, Peter A Doyle, Adam Sapirstein, Maria Cvach
BACKGROUND: Alarm fatigue in the ICU setting has been well documented in the literature. The ICU's high-intensity environment requires staff's vigilant attention, and distraction from false and non-actionable alarms pulls staff away from important tasks, creates dissatisfaction, and is a potential patient safety risk if alarms are missed or ignored. This project was intended to improve patient safety by optimizing alarm systems in a cardiovascular surgical intensive care unit (CVSICU)...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28332195/skin-cancer-history-sun-related-attitudes-behaviour-and-sunburn-among-renal-transplant-recipients-versus-general-population
#2
Vivian Ka Ying Leung, Suzanne Jane Dobbinson, David Josef Goodman, John Kanellis, Alvin Heong Chong
BACKGROUND/OBJECTIVES: Renal transplant recipients (RTR) have both an excessive skin cancer incidence and a high mortality rate. In Australia RTR receive extensive public education on skin cancer and many undergo further education pre/post-transplant. This study examines whether RTR have sufficiently rigorous sun protection behaviour compared with the general population. METHODS: Altogether 179 RTR from two large Melbourne hospitals involving skin clinic teams in patient care were recruited to undergo cross-sectional telephone interviews...
March 23, 2017: Australasian Journal of Dermatology
https://www.readbyqxmd.com/read/28332157/systematic-overdosing-of-oxa-and-cloxacillin-in-severe-infections-treated-in-icu-risk-factors-and-side-effects
#3
Mathilde Neuville, Najoua El-Helali, Eric Magalhaes, Aguila Radjou, Roland Smonig, Jean-François Soubirou, Guillaume Voiriot, Alban Le Monnier, Stéphane Ruckly, Lila Bouadma, Romain Sonneville, Jean-François Timsit, Bruno Mourvillier
BACKGROUND: Oxacillin and cloxacillin are the most frequently used penicillins for the treatment of severe methicillin-susceptible Staphylococcus aureus infections in intensive care units (ICUs), especially endocarditis. International recommendations do not suggest any adaptation of the dosage in case of renal impairment. We wanted to assess the risk factors for overdosing in ICU and the related observed side effects. METHODS: All patients with a therapeutic drug monitoring of oxa- or cloxacillin between 2008 and 2014 were included...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28331867/the-content-of-plasma-selenium-in-early-admitted-septic-patients
#4
Omid Moradi Moghaddam, Mohammad Niakan Lahiji, Azadeh Moghaddas, Maryam Farasatinasab, Somayyeh Nasiripour
OBJECTIVE: Selenium depletion has been reported in critical illness correlates with an increase in mortality and morbidity. In this study, we aimed to access the selenium plasma levels of septic patients early at the Intensive Care Unit (ICU) admission in order to compare with reference range. METHODS: We conducted a cross-sectional study in a university affiliated hospital aiming to assess the early plasma level of selenium in ICU admitted patients. eighty patients diagnoses with sepsis were included and considered for characteristic evaluation, monitoring criteria assessment and also blood sampling...
January 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/28331489/reversible-atrial-fibrillation-following-crotalinae-envenomation
#5
Dan Quan, Kenneth Zurcher
BACKGROUND: Cardiotoxicity is a documented complication of Crotalinae envenomation. Reported cardiac complications following snake envenomation have included acute myocardial infarction, electrocardiogram abnormalities and arrhythmias. Few reports exist describing arrhythmia induced by viper envenomation and to our knowledge none describe arrhythmia induced by Crotalinae envenomation. This report concerns the first known case of atrial fibrillation precipitated by rattlesnake bite. CASE PRESENTATION: A 73-year-old Caucasian man with a past medical history of hypertension, hyperlipidemia, type 1 diabetes mellitus, and a baseline first-degree atrioventricular block presented to the emergency department following a rattlesnake bite to his left lower leg...
2017: Journal of Venomous Animals and Toxins Including Tropical Diseases
https://www.readbyqxmd.com/read/28329653/introducing-public-health-themes-in-clinical-dermatology
#6
Scott A Norton
The ACGME's Core Competencies comprise six domains, which in turn contain dozens of often overlapping milestones. Several competencies explicitly invoke public health topics - but if one wears the right set of lenses, nearly every milestone, nearly every aspect of health and medicine, can be viewed from a public health perspective. Why then is Dermatology generally taught - and practiced - in an Intensive Care manner, where seemingly unlimited diagnostic & therapeutic efforts focus on single individuals, not the community?In this presentation, I argue that topics of public health concern should not be relegated to the minor leagues of GME...
September 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28329026/the-effect-of-early-versus-late-initiation-of-renal-replacement-therapy-in-patients-with-acute-kidney-injury-a-meta-analysis-with-trial-sequential-analysis-of-randomized-controlled-trials
#7
Yan-Mei Feng, Yuan Yang, Xiao-Li Han, Fan Zhang, Dong Wan, Rui Guo
BACKGROUND: The optimal timing for initiating renal replacement therapy (RRT) in patients with acute kidney injury (AKI) remains controversial. METHODS: We conducted a meta-analysis with trial sequential analysis (TSA) of randomized controlled trials (RCTs) using PUBMED, Cochrane Library databases, and Web of Science (from January 1, 1985, to August 21, 2016). Adult patients with AKI who received RRT with different timing were included. The primary outcome was mortality...
2017: PloS One
https://www.readbyqxmd.com/read/28328696/enterocolitis-in-a-child-with-hirschsprung-disease
#8
Alexander W D Guillaume, Andrew C Miller, Michael C Nguyen
Hirschsprung disease is a congenital abnormality that can be surgically corrected. However, Hirschsprung-associated enterocolitis can be a life-threatening sequela. Very little has been published in the emergency medicine literature about the risk of enterocolitis and shock in patients with a history of Hirschsprung disease. We describe the case of a 6-month-old male infant with a history of multiple surgeries for Hirschsprung disease who presented to the emergency department with a seemingly benign viral gastrointestinal illness...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28327942/evaluation-of-the-high-frequency-monopolar-stimulation-technique-for-mapping-and-monitoring-the-corticospinal-tract-in-patients-with-supratentorial-gliomas-a-proposal-for-intraoperative-management-based-on-neurophysiological-data-analysis-in-a-series-of-ninety
#9
Gerard Plans, Isabel Fernández-Conejero, Xavier Rifà-Ros, Alejandro Fernández-Coello, Aleix Rosselló, Andreu Gabarrós
BACKGROUND: Intraoperative identification and preservation of the corticospinal tract is often necessary for glioma resection. OBJECTIVE: To make a proposal for intraoperative management with the high-frequency monopolar stimulation technique for monitoring the corticospinal tract. METHODS: Ninety-two patients operated on with the assistance of the high-frequency monopolar stimulation. Clinical and neurophysiological data have been related with the motor status at 3 months to establish prognostic factors of motor deterioration...
January 13, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28325097/regaining-water-swallowing-function-in-the-rehabilitation-of-critically-ill-patients-with-intensive-care-unit-acquired-muscle-weakness
#10
Simone Thomas, Wolfgang Sauter, Ulrike Starrost, Marcus Pohl, Jan Mehrholz
PURPOSE: Treatment in intensive care units (ICUs) often results in swallowing dysfunction. Recent longitudinal studies have described the recovery of critically ill people, but we are not aware of studies of the recovery of swallowing function in patients with ICU-acquired muscle weakness. This paper aims to describe the time course of regaining water swallowing function in patients with ICU-acquired weakness in the post-acute phase and to describe the risks of regaining water swallowing function and the risk factors involved...
March 21, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28324938/application-of-semi-supervised-deep-learning-to-lung-sound-analysis
#11
Daniel Chamberlain, Rahul Kodgule, Daniela Ganelin, Vivek Miglani, Richard Ribon Fletcher
The analysis of lung sounds, collected through auscultation, is a fundamental component of pulmonary disease diagnostics for primary care and general patient monitoring for telemedicine. Despite advances in computation and algorithms, the goal of automated lung sound identification and classification has remained elusive. Over the past 40 years, published work in this field has demonstrated only limited success in identifying lung sounds, with most published studies using only a small numbers of patients (typically N<;20) and usually limited to a single type of lung sound...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28324746/denosumab-in-advanced-unresectable-giant-cell-tumour-of-bone-gctb-for-how-long
#12
E Palmerini, N S Chawla, S Ferrari, M Sudan, P Picci, E Marchesi, M Piccinni Leopardi, I Syed, K K Sankhala, P Parthasarathy, W E Mendanha, M Pierini, A Paioli, S P Chawla
BACKGROUND: Giant-cell tumours of bone (GCTB) are RANK/RANK-ligand (RANKL) positive, aggressive and progressive osteolytic tumours. Denosumab, a RANKL inhibitor, was FDA-approved for adults and skeletally mature adolescents with unresectable GCTB or when surgical resection is likely to result in severe morbidity. Data on long-term toxicity and activity of denosumab monthly 'GCTB-schedule' (120 mg per 12/year, 1440 mg total dose/year) are lacking. METHODS: Patients with GCTB receiving denosumab, 120 mg on days 1, 8, 15, 29 and every 4 weeks thereafter, from 2006 to 2015 treated in two centres were included...
March 17, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28323659/stimulus-induced-rhythmic-periodic-or-ictal-discharges-in-coma-incidence-and-interrater-reliability-of-continuous-eeg-after-a-standard-stimulation-protocol-a-prospective-study
#13
Khalid A Alsherbini, Joao Mc-OʼNeil Plancher, David M Ficker, Brandon P Foreman, Opeolu M Adeoye, Jun Ying, Michael D Privitera
PURPOSE: Stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs) are often seen during continuous electroencephalographic (cEEG) monitoring in coma. Given their uncertain clinical significance, our prospective study evaluated incidence of SIRPIDs in comatose patients in the neuroscience intensive care unit (NSICU) who underwent a standard stimulation protocol and defined interreader reliability for cEEG. METHODS: Of 146 patients prospectively screened who underwent cEEG during a 6-month period, 53 patients were included and 93 patients were excluded...
March 17, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28321913/heart-rate-variability-can-be-used-to-evaluate-wellbeing-in-preterm-infants
#14
K Kaar, J Brandner, B Minnich, J Hilberath, C Weisser, M Wald
Preterm infants are exposed to various potentially stressful procedures during intensive care, which have been shown to compromise development. We explored the potential stress caused by echocardiograph and the correlation between the duration of the investigation and the amplitude of the alteration. The usefulness of the Newborn Infant Parasympathetic Evaluation (NIPE) monitor (Mdoloris Medical Systems, Loos, France) for assessing acute distress during daily routines, based on heart rate variability, was also investigated...
March 21, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28321158/porcine-model-characterizing-various-parameters-assessing-the-outcome-after-acetaminophen-intoxication-induced-acute-liver-failure
#15
Karolin Thiel, Wilfried Klingert, Kathrin Klingert, Matthias H Morgalla, Martin U Schuhmann, Pamela Leckie, Yalda Sharifi, Nathan A Davies, Rajiv Jalan, Andreas Peter, Christian Grasshoff, Alfred Königsrainer, Martin Schenk, Christian Thiel
AIM: To investigate the changes of hemodynamic and laboratory parameters during the course of acute liver failure following acetaminophen overdose. METHODS: Eight pigs underwent a midline laparotomy following jejunal catheter placement for further acetaminophen intoxication and positioning of a portal vein Doppler flow-probe. Acute liver failure was realized by intrajejunal acetaminophen administration in six animals, two animals were sham operated. All animals were invasively monitored and received standardized intensive care support throughout the study...
March 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28321074/epstein-barr-virus-associated-lymphoproliferative-disorder-with-encephalitis-following-anti-thymocyte-globulin-for-aplastic-anemia-resolved-with-rituximab-therapy-a-case-report-and-literature-review
#16
Kiyomi Mashima, Shingo Yano, Hiroki Yokoyama, Takeshi Saito, Tomohito Machishima, Takaki Shimada, Yuichi Yahagi, Shinobu Takahara, Katsuki Sugiyama, Yoji Ogasawara, Jiro Minami, Yutaro Kamiyama, Atsushi Katsube, Kazuhito Suzuki, Sayaka Ohshima, Hisashi Yamada, Noriko Usui, Keisuke Aiba
Epstein-Barr virus (EBV)-associated lymphoproliferative disorders (LPDs) sometimes occur following Anti-thymocyte globulin (ATG) administration for allogenic stem cell transplantation but are rare in aplastic anemia (AA) patients. A 55-year-old woman with AA following ATG developed refractory fever and was diagnosed with EBV-LPD. She was successfully treated with weekly rituximab monotherapy; however, she developed EBV encephalitis. She was admitted to the intensive care unit and finally recovered from unconsciousness...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28320688/implementation-of-a-home-monitoring-system-for-heart-failure-patients-a-feasibility-study
#17
Martin Steven Kohn, Jeffrey Haggard, Jack Kreindler, Kade Birkeland, Ilan Kedan, Raymond Zimmer, Raj Khandwalla
BACKGROUND: Improving the management of patients with complex chronic disease is a substantial undertaking with the simultaneous goals of improving patient outcomes and controlling costs. Reducing avoidable hospitalization for such patients is a step toward both objectives. Some of the deterioration experienced in chronic disease patients occurs outside the view of their clinicians, and before the patient becomes overtly symptomatic. Home monitoring has been used for more than 20 years to detect deterioration earlier so that the patients could be treated before they became ill enough to require hospitalization...
March 20, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28318952/glycaemic-variability-in-patients-with-severe-sepsis-or-septic-shock-admitted-to-an-intensive-care-unit
#18
L M Silveira, A Basile-Filho, E A Nicolini, C A M Dessotte, G C S Aguiar, A M Stabile
BACKGROUND: Sepsis is associated with morbidity and mortality, which implies high costs to the global health system. Metabolic alterations that increase glycaemia and glycaemic variability occur during sepsis. OBJECTIVE: To verify mean body glucose levels and glycaemic variability in Intensive Care Unit (ICU) patients with severe sepsis or septic shock. METHOD: Retrospective and exploratory study that involved collection of patients' sociodemographic and clinical data and calculation of severity scores...
March 15, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28318531/national-survey-on-postoperative-care-and-treatment-circuits-in-neurosurgery
#19
R Valero, E Carrero, N Fàbregas, F Iturri, N Saiz-Sapena, L Valencia
INTRODUCTION: The analysis of surgical processes should be a standard of health systems. We describe the circuit of care and postoperative treatment for neurosurgical interventions in the centres of our country. MATERIAL AND METHODS: From June to October 2014, a survey dealing with perioperative treatments and postoperative circuits after neurosurgical procedures was sent to the chiefs of Anaesthesiology of 73 Spanish hospitals with neurosurgery and members of the Neuroscience Section of SEDAR...
March 16, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28316941/acute-kidney-injury-following-spinal-instrumentation-surgery-in-children
#20
Jasper J Jöbsis, Abdullah Alabbas, Ruth Milner, Christopher Reilly, Kishore Mulpuri, Cherry Mammen
AIM: To determine acute kidney in jury (AKI) incidence and potential risk factors of AKI in children undergoing spinal instrumentation surgery. METHODS: AKI incidence in children undergoing spinal instrumentation surgery at British Columbia Children's Hospital between January 2006 and December 2008 was determined by the Acute Kidney Injury Networ classification using serum creatinine and urine output criteria. During this specific time period, all patients following spinal surgery were monitored in the pediatric intensive care unit and had an indwelling Foley catheter permitting hourly urine output recording...
March 6, 2017: World Journal of Nephrology
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