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https://www.readbyqxmd.com/read/28934791/a-practical-guide-for-treatment-of-pain-in-patients-with-systemic-mast-cell-activation-disease
#1
Stefan Wirz, Gerhard J Molderings
Systemic mast cell activation disease (MCAD, a subclass of mastocytosis), which has a prevalence of around 17% (at least in the German population), is characterized by accumulation of genetically altered dysfunctional mast cells with abnormal release of these cells' mediators. Since mast cells affect functions in potentially every organ system, often without causing abnormalities in routine laboratory or radiologic testing, this disease has to be considered routinely in the differential diagnosis of patients with chronic multisystem polymorbidity of a generally inflammatory and allergic theme...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934779/what-are-the-predictors-of-altered-central-pain-modulation-in-chronic-musculoskeletal-pain-populations-a-systematic-review
#2
Jacqui Clark, Jo Nijs, Gillian Yeowell, Peter Charles Goodwin
BACKGROUND: Altered central pain modulation is the predominant pain mechanism in a proportion of chronic musculoskeletal pain disorders and is associated with poor outcomes. Although existing studies predict poor outcomes such as persistent pain and disability, to date there is little consensus on what factors specifically predict altered central pain modulation. OBJECTIVES: To review the existing literature on the predictive factors specifically for altered central pain modulation in musculoskeletal pain populations...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934622/should-i-stay-or-should-i-go-how-healthcare-professionals-close-encounters-with-people-with-dementia-in-the-acute-hospital-setting
#3
Rebecca Allwood, Alison Pilnick, Rebecca O'Brien, Sarah Goldberg, Rowan H Harwood, Suzanne Beeke
Around a quarter of hospital beds in the UK are occupied by patients living with dementia (PWD), and communication impairments are common across all types of dementia, often exacerbated by the hospital environment. Unsurprisingly, healthcare professionals (HCPs) report particular challenges in caring for this patient group, whilst trying to recognise and value their personhood as per the underpinning ethos of person-centred care. However, whilst there is a growing body of research that underlines the importance of communication in dementia care, there is far less that actually examines this communication in real time interaction...
September 9, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28934525/short-daytime-naps-briefly-attenuate-objectively-measured-sleepiness-under-chronic-sleep-restriction
#4
Jared M Saletin, Cassie J Hilditch, William C Dement, Mary A Carskadon
Study Objectives: Napping is a useful countermeasure to the negative effects of acute sleep loss on alertness. The efficacy of naps to recover from chronic sleep loss is less well understood. Methods: Following 2 baseline nights (10 hours' time-in-bed), participants were restricted to 7 nights of 5-hour sleep opportunity. Ten adults participated in the No-Nap condition, and a further 9 were assigned to a Nap condition with a daily 45-minute nap opportunity at 1300 h...
September 1, 2017: Sleep
https://www.readbyqxmd.com/read/28934324/the-impact-of-community-based-palliative-care-on-acute-hospital-use-in-the-last-year-of-life-is-modified-by-time-to-death-age-and-underlying-cause-of-death-a-population-based-retrospective-cohort-study
#5
Katrina Spilsbury, Lorna Rosenwax, Glenn Arendts, James B Semmens
OBJECTIVE: Community-based palliative care is known to be associated with reduced acute care health service use. Our objective was to investigate how reduced acute care hospital use in the last year of life varied temporally and by patient factors. METHODS: A retrospective cohort study of the last year of life of 12,763 Western Australians who died from cancer or one of seven non-cancer conditions. Outcome measures were rates of hospital admissions and mean length of hospital stays...
2017: PloS One
https://www.readbyqxmd.com/read/28934113/sphingosine-1-phosphate-signaling-and-its-pharmacological-modulation-in-allogeneic-hematopoietic-stem-cell-transplantation
#6
REVIEW
Philip Smith, Catherine O'Sullivan, Peter Gergely
Allogeneic haemopoietic stem cell transplantation (HSCT) is increasingly used to treat haematological malignant diseases via the graft-versus-leukaemia (GvL) or graft-versus-tumour effects. Although improvements in infectious disease prophylaxis, immunosuppressive treatments, supportive care, and molecular based tissue typing have contributed to enhanced outcomes, acute graft-versus-host disease and other transplant related complications still contribute to high mortality and significantly limit the more widespread use of HSCT...
September 21, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28933993/gradual-physical-decline-characterises-the-illness-trajectories-of-care-home-residents
#7
Anne M Finucane, Barbara Stevenson, Scott A Murray
BACKGROUND: Three archetypal trajectories of physical decline have been identified: a short period of rapid decline; long-term limitations with intermittent acute periods; and a prolonged gradual decline. An understanding of illness trajectories can help clarify the evolving needs of people with progressive conditions, and inform the development of palliative care services to meet their needs. Many frail older people live and die in care homes; the present study is the first to explore the illness trajectories of residents in care home settings...
September 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28933991/let-him-not-be-alone-perspectives-of-older-british-south-asian-minority-ethnic-patients-on-dying-in-acute-hospitals
#8
Munikumar Ramasamy Venkatasalu
AIM: To investigate older British South Asians' views on dying at acute hospitals. BACKGROUND: Older people, including those from ethnic minorities prefer 'home as a haven' for their last days of life; however, they are more likely to die in hospital. METHODS: Constructive grounded theory was used as a methodological approach that informed data collection to data analysis. Open meetings with 11 local South Asian community organisations enabled the researchers to recruit a total of 55 older South Asians in this study...
September 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28933744/energy-and-protein-in-critically-ill-patients-with-aki-a-prospective-multicenter-observational-study-using-indirect-calorimetry-and-protein-catabolic-rate
#9
Alice Sabatino, Miriam Theilla, Moran Hellerman, Pierre Singer, Umberto Maggiore, Maria Barbagallo, Giuseppe Regolisti, Enrico Fiaccadori
The optimal nutritional support in Acute Kidney Injury (AKI) still remains an open issue. The present study was aimed at evaluating the validity of conventional predictive formulas for the calculation of both energy expenditure and protein needs in critically ill patients with AKI. A prospective, multicenter, observational study was conducted on adult patients hospitalized with AKI in three different intensive care units (ICU). Nutrient needs were estimated by different methods: the Guidelines of the European Society of Parenteral and Enteral Nutrition (ESPEN) for both calories and proteins, the Harris-Benedict equation, the Penn-State and Faisy-Fagon equations for energy...
July 26, 2017: Nutrients
https://www.readbyqxmd.com/read/28933627/primary-care-for-mentally-ill-adults-in-acute-residential-treatment-facilities
#10
Linda Chafetz, Gerri Collins-Bride
Psychiatric bed capacity has decreased nationally with an impact on the number and the types of patients admitted to acute in-patient units. Acute residential programs provide alternatives to hospitals for patients with problems that do not meet criteria for admission. However, these settings may not have resources to respond to the medical co-morbidities associated with severe mental illness. To understand the medical needs of patients in these settings, this research examined data from a nurse-managed primary care outreach service...
September 21, 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/28933576/impact-of-a-mental-health-nursing-training-programme-on-the-perceived-recovery-orientation-of-patients-and-nurses-on-acute-psychiatric-wards-results-of-a-pilot-study
#11
Gianfranco Zuaboni, Sabine Hahn, Peter Wolfensberger, Thomas Schwarze, Dirk Richter
In mental health nursing, recovery-orientation is regarded as a best practice approach for patient care. To assess the effect of an intervention utilising a recovery-oriented approach in acute practice, a controlled pilot trial was conducted. On intervention wards, mental health nurses received special training. Recovery Self-Assessment Scale was used to assess the effects of the training. No statistically significant effects were found, between the experimental conditions. Reasons for this result may be methodological, practical or due an intervention that was not powerful enough...
September 21, 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/28933421/severe-childhood-malnutrition
#12
REVIEW
Zulfiqar A Bhutta, James A Berkley, Robert H J Bandsma, Marko Kerac, Indi Trehan, André Briend
The main forms of childhood malnutrition occur predominantly in children <5 years of age living in low-income and middle-income countries and include stunting, wasting and kwashiorkor, of which severe wasting and kwashiorkor are commonly referred to as severe acute malnutrition. Here, we use the term 'severe malnutrition' to describe these conditions to better reflect the contributions of chronic poverty, poor living conditions with pervasive deficits in sanitation and hygiene, a high prevalence of infectious diseases and environmental insults, food insecurity, poor maternal and fetal nutritional status and suboptimal nutritional intake in infancy and early childhood...
September 21, 2017: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/28933208/non-st-elevation-acute-coronary-syndromes-timing-and-selection-of-early-invasive-management-ecg-monitoring-need-dapt-duration-pathogenesis-of-recurrence-and-beware-of-delirium-in-the-intensive-acute-cardiac-care-unit
#13
https://www.readbyqxmd.com/read/28932686/a-positive-rapid-strep-test-in-a-young-adult-with-acute-pharyngitis-be-careful-what-you-wish-for
#14
Burke A Cunha
In young adults with acute pharyngitis, the main differential diagnosis is between GAS pharyngitis, EBV infectious mononucleosis, or other causes of viral pharyngitis. A positive RST does not differentiate GAS colonization from infection as is well illustrated by this case. Laboratory test results must be interpreted in the appropriate clinical context to be diagnostically meaningful. The RST only detects group A streptococci, but does not, of itself, implicate a causative role in the patient's pharyngitis...
2017: IDCases
https://www.readbyqxmd.com/read/28932605/is-dementia-screening-of-apparently-healthy-individuals-justified
#15
REVIEW
Larry W Chambers, Saskia Sivananthan, Carol Brayne
Despite efforts to raise awareness and develop guidelines for care of individuals with dementia, reports of poor detection and inadequate management persist. This has led to a call for more identification of people with dementia, that is, screening individuals who may or may not complain of symptoms of dementia in both acute settings and primary care. The following should be considered before recommending screening for dementia among individuals in the general population. Dementia Tests. Low prevalence reduces positive predictive value of tests and screening tests will miss people who have dementia and identify people who do not have dementia in substantial numbers...
2017: Advances in Preventive Medicine
https://www.readbyqxmd.com/read/28932575/pediatric-lung-transplantation
#16
REVIEW
Christian Benden
Pediatric lung transplantation has been undertaken since the 1980s, and it is today considered an accepted therapy option in carefully selected children with end-stage pulmonary diseases, providing carefully selected children a net survival benefit and improved health-related quality of life. Nowadays, >100 pediatric lung transplants are done worldwide every year. Here, specific pediatric aspects of lung transplantation are reviewed such as the surgical challenge, effects of immunosuppression on the developing pediatric immune system, and typical infections of childhood, as it is vital to comprehend that children undergoing lung transplants present a real challenge as children are not 'just small adults'...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28932559/pupillary-abnormalities-in-non-selected-critically-ill-patients-an-observational-study
#17
Philippe Portran, Martin Cour, Romain Hernu, Sylvie de la Salle, Laurent Argaud
BACKGROUND: Repeated pupillary examination is a key element of neurologic surveillance in intensive care units (ICU). However, in non-selected critically ill patients, the clinical interest of monitoring pupillary diameter and light reflex is poorly documented. We aimed to determine the prevalence and the etiologies of pupillary abnormalities (PAs) in this ICU patient population. METHODS: We performed a prospective, observational study in a medical university affiliated ICU over a 6-month period...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28932401/practical-approach-to-detection-and-management-of-acute-kidney-injury-in-critically-ill-patient
#18
REVIEW
Vahid Mohsenin
BACKGROUND: Acute kidney injury (AKI) is a common complication in critically ill patients and is associated with high morbidity and mortality. This paper provides a critical review of the etiologies of AKI and a systematic approach toward its diagnosis and management with emphasis on fluid volume assessment and the use of urine biochemical profile and microscopy in identifying the nature and the site of kidney injury. MATERIALS AND METHODS: The search of PubMed and selection of papers had employed observational designs or randomized control trials relevant to AKI...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28932314/cost-effectiveness-analysis-of-treatment-acute-deep-vein-thrombosis-in-clinic-of-vascular-surgery-sarajevo
#19
Haris Vukas, Samra Kadić-Vukas, Adis Salihbegović, Muhamed Djedović, Dragan Totić, Haris Vranić, Amel Hadžimehmedagić
AIM: To compare hospital costs of acute deep vein thrombosis (ADVT) treatment in two periods of time. Evidence of repercussions on reducing costs during successful treatment. Attention was given to the necessity, costs and effectiveness of diagnostic procedures, treatment and complications. METHODS: A retrospective analysis of data obtained from patients medical history in a period from 2000 to 2016. Model management and safe practice of ADVT care consisted of clinical examination, laboratory, colour Doppler and invasive diagnostics...
August 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28932112/acute-exacerbations-of-copd-risk-factors-for-failure-and-relapse
#20
REVIEW
Marco Mantero, Paola Rogliani, Marta Di Pasquale, Eva Polverino, Ernesto Crisafulli, Monica Guerrero, Andrea Gramegna, Mario Cazzola, Francesco Blasi
Acute exacerbations are a leading cause of worsening COPD in terms of lung function decline, quality of life, and survival. They also have a relevant economic burden on the health care system. Determining the risk factors for acute exacerbation and early relapse could be a crucial element for a better management of COPD patients. This review analyzes the current knowledge and underlines the main risk factors for recurrent acute exacerbations. Comprehensive evaluation of COPD patients during stable phase and exacerbation could contribute to prevent treatment failure and relapses...
2017: International Journal of Chronic Obstructive Pulmonary Disease
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