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https://www.readbyqxmd.com/read/28239054/critical-care-management-focused-on-optimizing-brain-function-after-cardiac-arrest
#1
Ryuta Nakashima, Toru Hifumi, Kenya Kawakita, Tomoya Okazaki, Satoshi Egawa, Akihiko Inoue, Ryutaro Seo, Nobuhiro Inagaki, Yasuhiro Kuroda
The discussion of neurocritical care management in post-cardiac arrest syndrome (PCAS) has generally focused on target values used for targeted temperature management (TTM). There has been less attention paid to target values for systemic and cerebral parameters to minimize secondary brain damage in PCAS. And the neurologic indications for TTM to produce a favorable neurologic outcome remain to be determined. Critical care management of PCAS patients is fundamental and essential for both cardiologists and general intensivists to improve neurologic outcome, because definitive therapy of PCAS includes both special management of the cause of cardiac arrest, such as coronary intervention to ischemic heart disease, and intensive management of the results of cardiac arrest, such as ventilation strategies to avoid brain ischemia...
February 24, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28236869/intraventricular-hemorrhage-after-dural-fistula-embolization
#2
Joana Chaves Gonçalves Rodrigues de Carvalho, Francisco Javier Tercero Machin, Luis San Roman Manzanera, Jordi Blasco Andaluz, Sílvia Herrero Nogués, Núria Peix Soriano, Victor Obach Baurier, Enrique Jesus Carrero Cardenal
BACKGROUND AND OBJECTIVES: Dural arteriovenous fistulas are anomalous shunts between dural arterial and venous channels whose nidus is located between the dural leaflets. For those circumstances when invasive treatment is mandatory, endovascular techniques have grown to become the mainstay of practice, choice attributable to their reported safety and effectiveness. We describe the unique and rare case of a dural arteriovenous fistula treated by transarterial embolization and complicated by an intraventricular hemorrhage...
March 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28236181/intracranial-pressure-monitoring-after-primary-decompressive-craniectomy-in-traumatic-brain-injury-a-clinical-study
#3
Edoardo Picetti, Maria Luisa Caspani, Corrado Iaccarino, Giulia Pastorello, Pierpaolo Salsi, Edoardo Viaroli, Franco Servadei
BACKGROUND: Intracranial pressure (ICP) monitoring represents an important tool in the management of traumatic brain injury (TBI). Although current information exists regarding ICP monitoring in secondary decompressive craniectomy (DC), little is known after primary DC following emergency hematoma evacuation. METHODS: Retrospective analysis of prospectively collected data. Inclusion criteria were age ≥18 years and admission to the intensive care unit (ICU) for TBI and ICP monitoring after primary DC...
February 24, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28229241/acquired-prolongation-of-qt-interval-as-a-risk-factor-for-torsade-de-pointes-ventricular-tachycardia-a-narrative-review-for-the-anesthesiologist-and-intensivist
#4
REVIEW
Arsen Uvelin, Jasmina Pejaković, Vesna Mijatović
More than 70% of intensive care unit (ICU) patients experience heart rhythm disturbances, and these patients have correspondingly higher mortality rates. Consequently, one of the standards of care in ICUs is continuous electrocardiography monitoring. One of the potentially preventable dysrhythmic events is the occurrence of torsade de pointes ventricular tachycardia in the setting of acquired prolonged QT interval. This type of ventricular tachycardia can be malignant because it often progresses to ventricular fibrillation...
February 22, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28228865/identification-of-beta-cell-dysfunction-at-the-pre-symptomatic-stage-of-diabetes-mellitus-by-novel-analytical-system-liquid-biopsy-measurements-in-femtograms
#5
REVIEW
Kurt Krapfenbauer
BACKGROUND: Diabetes mellitus is produced and progresses as a consequence of complex and gradual processes, in which a variety of alterations of the endocrine pancreas, are involved and which mainly result in beta cell failure. Those molecular alterations can be found in the bloodstream, which suggests that we could quantify specific biomarkers in plasma or serum by very sensitive methods before the onset diabetes mellitus is diagnosed. However, classical methods of protein analysis such as electrophoresis, Western blot, ELISA, and liquid chromatography are generally time-consuming, lab-intensive, and not sensitive enough to detect such alteration in a pre-symptomatic state of the disease...
December 2017: EPMA Journal
https://www.readbyqxmd.com/read/28227709/bayesian-gaussian-processes-for-identifying-the-deteriorating-patient
#6
Glen Wright Colopy, Marco A F Pimentel, Stephen J Roberts, David A Clifton, Glen Wright Colopy, Marco A F Pimentel, Stephen J Roberts, David A Clifton, Glen Wright Colopy, Marco A F Pimentel, Stephen J Roberts, David A Clifton
The step-down unit (SDU) is a high-acuity hospital environment, to which patients may be sent after discharge from the intensive care unit (ICU). About 1- in-7 patients will deteriorate in the SDU and require emergency readmission to the ICU. Upon readmission, these patients experience significantly higher mortality risks and lengths of stay. Gaussian process regression (GPR) models are proposed as a flexible, principled, probabilistic method to address the clinical need to monitor continuously patient time-series of vital signs acquired in the SDU...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227040/representativeness-comparisons-of-nurse-and-computer-charting-of-heart-rate-across-nursing-intensity-protocols
#7
Jorge M Luna, Natalie Yip, Rimma Pivovarov, David K Vawdrey, Jorge M Luna, Natalie Yip, Rimma Pivovarov, David K Vawdrey, David K Vawdrey, Rimma Pivovarov, Jorge M Luna, Natalie Yip
Clinical teams in acute inpatient settings can greatly benefit from automated charting technologies that continuously monitor patient vital status. NewYork-Presbyterian has designed and developed a real-time patient monitoring system that integrates vital signs sensors, networking, and electronic health records, to allow for automatic charting of patient status. We evaluate the representativeness (a combination of agreement, safety and timing) of a core vital sign across nursing intensity care protocols for preliminary feasibility assessment...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227034/a-novel-algorithm-for-reducing-false-arrhythmia-alarms-in-intensive-care-units
#8
Chandan Srivastava, Sonal Sharma, Ali Jalali, Chandan Srivastava, Sonal Sharma, Ali Jalali, Ali Jalali, Chandan Srivastava, Sonal Sharma
Alarm fatigue in intensive care units (ICU) is one of the top healthcare issues in the US. False alarms in ICU will decrease the quality of care and staff response time over the alarms. Normally, false alarm will cause desensitization of the clinical staff which leads to warnings and misleading, if the triggered alarm is true. In this study, we have proposed a multi-model ensemble approach to reduce the false alarm rate in monitoring systems. We have used 750 patient records from PhysioNet database. At First arrhythmia based features from electrocardiogram (ECG), arterial blood pressure (ABP) and photoplethysmogram (PPG) features were extracted from the records...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226988/analysis-and-experimental-simulation-of-blood-pressure-signal-distortions-observed-on-intensive-care-patients-monitored-by-a-catheter-in-radial-artery
#9
Lisa Guigue, Carole Lavault, Francis Grimbert, Yves Lavault, Norbert Noury, Francois R Boucher, Lisa Guigue, Carole Lavault, Francis Grimbert, Yves Lavault, Norbert Noury, Francois R Boucher, Francois R Boucher, Carole Lavault, Lisa Guigue, Yves Lavault, Francis Grimbert, Norbert Noury
The follow-up of patients with hemodynamic instability in intensive care units most often requires blood pressure measurement using a fluid-filled catheter in the radial artery and a fluid-filled tubing connected to a pressure transducer. However, in this usual setup major distortions frequently occur that may alter the pressure signal. Underdamping and overdamping have been well described whereas other types of distortions, including attenuations and varied envelopes of pulse pressure, have been less studied...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226619/application-of-semi-supervised-deep-learning-to-lung-sound-analysis
#10
Daniel Chamberlain, Rahul Kodgule, Daniela Ganelin, Vivek Miglani, Richard Ribon Fletcher, Daniel Chamberlain, Rahul Kodgule, Daniela Ganelin, Vivek Miglani, Richard Ribon Fletcher, Vivek Miglani, Daniel Chamberlain, Richard Ribon Fletcher, Rahul Kodgule, Daniela Ganelin
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/28225342/outcomes-from-the-first-multidrug-resistant-tuberculosis-programme-in-kenya
#11
H Huerga, M Bastard, M Kamene, S Wanjala, A Arnold, N Oucho, I Chikwanha, F Varaine
SETTING: In March 2006, the first multidrug-resistant tuberculosis (MDR-TB) treatment programme was implemented in Kenya. OBJECTIVE: To describe patients' treatment outcomes and adverse events. DESIGN: A retrospective case note review of patients started on MDR-TB treatment at two Médecins Sans Frontières-supported sites and the national referral hospital of Kenya was undertaken. Sites operated an ambulatory model of care. Patients were treated for a minimum of 24 months with at least 4-5 drugs for the intensive phase of treatment, including an injectable agent...
March 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28224110/comparison-of-inhaled-milrinone-nitric-oxide-and-prostacyclin-in-acute-respiratory-distress-syndrome
#12
Martin Albert, Daniel Corsilli, David R Williamson, Marc Brosseau, Patrick Bellemare, Stéphane Delisle, Anne Qn Nguyen, France Varin
AIM: To evaluate the safety and efficacy of inhaled milrinone in acute respiratory distress syndrome (ARDS). METHODS: Open-label prospective cross-over pilot study where fifteen adult patients with hypoxemic failure meeting standard ARDS criteria and monitored with a pulmonary artery catheter were recruited in an academic 24-bed medico-surgical intensive care unit. Random sequential administration of iNO (20 ppm) or nebulized epoprostenol (10 μg/mL) was done in all patients...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28222805/use-of-activity-tracking-in-major-visceral-surgery-the-enhanced-perioperative-mobilization-epm-trial-study-protocol-for-a-randomized-controlled-trial
#13
Steffen Wolk, Theresa Meißner, Sebastian Linke, Benjamin Müssle, Ann Wierick, Andreas Bogner, Dorothée Sturm, Nuh N Rahbari, Marius Distler, Jürgen Weitz, Thilo Welsch
BACKGROUND: Enhanced recovery after surgery (ERAS) programs are aimed at minimizing postoperative stress and accelerating postoperative recovery by implementing multiple perioperative principles. "Early mobilization" is one such principle, but the quality of assessment and monitoring is poor, and evidence of improved outcome is lacking. Activity trackers allow precise monitoring and automatic feedback to the patients to enhance their motivation for early mobilization. The aim of the study is to monitor and increase the postoperative mobilization of patients by giving them continuous automatic feedback in the form of a step count using activity-tracking wristbands...
February 21, 2017: Trials
https://www.readbyqxmd.com/read/28221822/clinical-characteristics-and-spatial-distribution-of-visceral-leishmaniasis-in-children-in-s%C3%A3-o-paulo-state-an-emerging-focus-of-visceral-leishmaniasis-in-brazil
#14
Patricia Rodrigues Naufal Spir, Luiz Euribel Prestes-Carneiro, Elivelton Silva Fonseca, Aline Dayse, Rogério Giuffrida, Lourdes Aparecida Zampieri D'Andrea
BACKGROUND: Visceral leishmaniasis (VL) is an emerging zoonosis, and Brazil harbors about 90% of those infected in Latin America. Since 1998, the disease has been spreading quickly in São Paulo state, and the western region is considered an emerging focus of VL in Brazil. Our aim was to evaluate the clinical characteristics and spatial distribution of VL in children referred to a public tertiary hospital located in the western region of São Paulo state, Brazil. METHODS: Medical records of children up to 18 years of age who were diagnosed with VL between January 2006 and December 2010 were reviewed...
February 21, 2017: Pathogens and Global Health
https://www.readbyqxmd.com/read/28219810/continuous-electroencephalography-in-a-mixed-non-neurological-intensive-care-population-an-observational-study
#15
Patrick Schramm, Judyta Luczak, Kristin Engelhard, Jasmin El Shazly, Martin Juenemann, Marlene Tschernatsch
PURPOSE: Continuous electroencephalography (cEEG) improves monitoring of the brain in unconscious patients, but implementation at ICU is difficult. The present investigation shows a way to introduce cEEG at an anesthesiological ICU and discusses the first experiences. MATERIALS AND METHODS: The study analyzed the feasibility of cEEG, assessed the interpretable cEEG time, importance of automatic seizure detection, the incidence of seizures, the predominant background EEG activity, incidence of delirium and mortality...
February 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28219399/noninvasive-detection-of-alarming-intracranial-pressure-changes-by-auditory-monitoring-in-early-management-of-brain-injury-a-prospective-invasive-versus-noninvasive-study
#16
Fabrice Giraudet, François Longeras, Aurélien Mulliez, Aurélie Thalamy, Bruno Pereira, Paul Avan, Laurent Sakka
BACKGROUND: In brain-injured patients intracranial pressure (ICP) is monitored invasively by a ventricular or intraparenchymal transducer. The procedure requires specific expertise and exposes the patient to complications such as malposition, hemorrhage or infection. As inner-ear fluid compartments are connected to the cerebrospinal fluid space, ICP changes elicit subtle changes in the physiology of the inner ear. Notably, we previously demonstrated that the phase of cochlear microphonic potential (CM) generated by sound stimuli rotates with ICP...
February 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28218962/survey-of-neonatal-resuscitation-practices-showed-post-training-improvements-but-need-to-reinforce-preterm-management-monitoring-and-adrenaline-use
#17
Montserrat Izquierdo, Martín Iriondo, César Ruiz, Gonzalo Zeballos, Miguel Sánchez, Eva Gonzalez, Máximo Vento, Marta Thió
AIM: Neonatal resuscitation surveys have showed practice variations between countries, centres and levels of care. We evaluated delivery room practices after a nationwide neonatal resuscitation training programme focused on non-tertiary centres. METHODS: A 2012 survey sent to all Spanish hospitals handling deliveries covered staff availability and training, equipment and practices in the delivery room and during transfers to neonatal intensive care units. The results from 98 centres that had completed a previous survey in 2007 were analysed by levels of care...
February 20, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28215131/angiotensin-ii-for-the-treatment-of-high-output-shock-3-athos-3-protocol-for-a-phase-iii-double-blind-randomised-controlled-trial
#18
Lakhmir S Chawla, James A Russell, Sean M Bagshaw, Andrew D Shaw, Stuart L Goldstein, Mitchell P Fink, George F Tidmarsh
OBJECTIVE: Catecholamine-resistant hypotension (CRH) is characterised by inadequate response to standard doses of vasopressors, and increased mortality. Our Angiotensin II for the Treatment of High-Output Shock 3 (ATHOS-3) trial compares the efficacy and safety of angiotensin II (ANGII) versus placebo in CRH. DESIGN, SETTING AND PARTICIPANTS: A phase III, multicentre, randomised, placebo-controlled trial of LJPC-501 (synthetic ANGII) for CRH in up to 120 intensive care units...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28213228/smartphone-based-immunosensor-for-ca125-detection
#19
Oana Hosu, Andrea Ravalli, Giuseppe Mattia Lo Piccolo, Cecilia Cristea, Robert Sandulescu, Giovanna Marrazza
In this work, we report the design, the development and the characterization of the analytical performances of a colorimetric smartphone-based immunosensor for the detection of cancer antigen 125 (CA125). The immunosensor was based on a sandwich strategy in which the primary antibody was immobilized by spotting onto the 3D nitrocellulose membrane. The immunospots were subsequently incubated with CA125 solutions, followed by the affinity reaction with a secondary antibody labeled with gold nanoparticles (AuNPs)...
May 1, 2017: Talanta
https://www.readbyqxmd.com/read/28207685/trends-in-postpartum-depressive-symptoms-27-states-2004-2008-and-2012
#20
Jean Y Ko, Karilynn M Rockhill, Van T Tong, Brian Morrow, Sherry L Farr
Postpartum depression is common and associated with adverse infant and maternal outcomes (e.g., lower breastfeeding initiation and duration and poor maternal and infant bonding) (1-3). A developmental Healthy People 2020 objective is to decrease the proportion of women delivering a live birth who experience postpartum depressive symptoms (PDS).* To provide a baseline for this objective, CDC sought to describe self-reported PDS overall, by reporting state, and by selected sociodemographic factors, using 2004, 2008, and 2012 data from the Pregnancy Risk Assessment Monitoring System (PRAMS)...
February 17, 2017: MMWR. Morbidity and Mortality Weekly Report
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