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https://www.readbyqxmd.com/read/28431424/sleep-disordered-breathing-postoperative-delirium-and-cognitive-impairment
#1
Enoch W K Lam, Frances Chung, Jean Wong
Sleep-disordered breathing (SDB) is highly prevalent in the general population and has been associated with cognitive impairment in older individuals. Delirium is an acute decline in cognitive function and attention that often occurs after surgery, especially in older individuals. Several recent studies suggest an association between SDB and postoperative delirium. The aim of this systematic review is to examine the current literature on SDB, postoperative delirium, and cognitive impairment and to discuss the pathophysiology and perioperative considerations...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28431334/one-hundred-injured-patients-a-day-multicenter-emergency-room-surveillance-of-trauma-in-pakistan
#2
A A Hyder, S He, W Zafar, M U Mir, J A Razzak
OBJECTIVES: Injuries increasingly contribute to the global burden of disease in low- and middle-income countries. This study presents results from a large-scale surveillance study on injury from several urban emergency departments (EDs) in Pakistan. The objective is to document the burden of injuries that present to the healthcare system in Pakistan and to test the feasibility of an ED-based injury and trauma surveillance system. STUDY DESIGN: Cross-sectional study conducted using active surveillance approach...
April 18, 2017: Public Health
https://www.readbyqxmd.com/read/28431202/pharmacological-interventions-for-acute-pancreatitis
#3
REVIEW
Elisabetta Moggia, Rahul Koti, Ajay P Belgaumkar, Federico Fazio, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: In people with acute pancreatitis, it is unclear what the role should be for medical treatment as an addition to supportive care such as fluid and electrolyte balance and organ support in people with organ failure. OBJECTIVES: To assess the effects of different pharmacological interventions in people with acute pancreatitis. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2016, Issue 9), MEDLINE, Embase, Science Citation Index Expanded, and trial registers to October 2016 to identify randomised controlled trials (RCTs)...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28431119/survival-benefit-of-adding-docetaxel-cisplatin-and-5-fluorouracil-induction-chemotherapy-to-concurrent-chemoradiotherapy-for-locally-advanced-nasopharyngeal-carcinoma-with-nodal-stage-n2-3
#4
Masahiro Kawahira, Tomoya Yokota, Satoshi Hamauchi, Yusuke Onozawa, Hirofumi Ogawa, Tsuyoshi Onoe, Tomoyuki Kamijo, Yoshiyuki Iida, Tetsuo Nishimura, Tetsuro Onitsuka, Hirofumi Yasui
Background: Concurrent chemoradiotherapy followed by adjuvant chemotherapy (CCRT-AC) has been established as the standard of care in locally advanced nasopharyngeal carcinoma (LA-NPC). The survival benefit of induction chemotherapy (ICT) for LA-NPC remains controversial. We analyzed the efficacy and feasibility of docetaxel, cisplatin and 5-fluorouracil (TPF) ICT followed by CCRT for LA-NPC with nodal Stage N2-3. Methods: We performed a retrospective analysis of 28 LA-NPC patients with nodal Stage N2-3 receiving induction TPF followed by CCRT (TPF group; n = 12) or CCRT-AC (CCRT group; n = 16) between October 2006 and May 2016...
April 20, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28430906/past-and-current-cause-specific-mortality-in-eisenmenger-syndrome
#5
Cristel M Sørensen Hjortshøj, Aleksander Kempny, Annette Schophuus Jensen, Keld Sørensen, Edit Nagy, Mikael Dellborg, Bengt Johansson, Virginija Rudiene, Gu Hong, Alexander R Opotowsky, Werner Budts, Barbara J Mulder, Lidia Tomkiewicz-Pajak, Michele D'Alto, Katja Prokšelj, Gerhard-Paul Diller, Konstantinos Dimopoulos, Mette-Elise Estensen, Henrik Holmstrøm, Maila Turanlahti, Ulf Thilén, Michael A Gatzoulis, Lars Søndergaard
Aims: Eisenmenger syndrome (ES) is associated with considerable morbidity and mortality. Therapeutic strategies have changed during the 2000s in conjunction with an emphasis on specialist follow-up. The aim of this study was to determine the cause-specific mortality in ES and evaluate any relevant changes between 1977 and 2015. Methods and results: This is a retrospective, descriptive multicentre study. A total of 1546 patients (mean age 38.7 ± 15.4 years; 36% male) from 13 countries were included...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28430830/assessment-of-global-kidney-health-care-status
#6
Aminu K Bello, Adeera Levin, Marcello Tonelli, Ikechi G Okpechi, John Feehally, David Harris, Kailash Jindal, Babatunde L Salako, Ahmed Rateb, Mohamed A Osman, Bilal Qarni, Syed Saad, Meaghan Lunney, Natasha Wiebe, Feng Ye, David W Johnson
Importance: Kidney disease is a substantial worldwide clinical and public health problem, but information about available care is limited. Objective: To collect information on the current state of readiness, capacity, and competence for the delivery of kidney care across countries and regions of the world. Design, Setting, and Participants: Questionnaire survey administered from May to September 2016 by the International Society of Nephrology (ISN) to 130 ISN-affiliated countries with sampling of key stakeholders (national nephrology society leadership, policy makers, and patient organization representatives) identified by the country and regional nephrology leadership through the ISN...
April 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28430697/abusive-head-trauma-and-mortality-an-analysis-from-an-international-comparative-effectiveness-study-of-children-with-severe-traumatic-brain-injury
#7
Nikki Miller Ferguson, Ajit Sarnaik, Darryl Miles, Nadeem Shafi, Mark J Peters, Edward Truemper, Monica S Vavilala, Michael J Bell, Stephen R Wisniewski, James F Luther, Adam L Hartman, Patrick M Kochanek
OBJECTIVES: Small series have suggested that outcomes after abusive head trauma are less favorable than after other injury mechanisms. We sought to determine the impact of abusive head trauma on mortality and identify factors that differentiate children with abusive head trauma from those with traumatic brain injury from other mechanisms. DESIGN: First 200 subjects from the Approaches and Decisions in Acute Pediatric Traumatic Brain Injury Trial-a comparative effectiveness study using an observational, cohort study design...
April 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28430674/continuous-eeg-in-pediatric-critical-care-yield-and-efficiency-of-seizure-detection
#8
Arnold J Sansevere, Elizabeth D Duncan, Mark H Libenson, Tobias Loddenkemper, Phillip L Pearl, Robert C Tasker
PURPOSE: Our goal was to define the duration of continuous EEG (cEEG) monitoring needed to adequately capture electrographic seizures and EEG status epilepticus in the pediatric intensive care unit using clinical and background EEG features. METHODS: Retrospective study of patients aged 1 month to 21 years admitted to a tertiary pediatric intensive care unit and undergoing cEEG (>3 hours). Clinical data collected included admission diagnosis, EEG background features, and time variables including time to first seizure after initiation of cEEG...
April 20, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28430340/transurethral-contact-ureterolithotripsy-in-gas-%C3%B0-%C3%B0-2-medium
#9
Dmitry O Korolev, Peter V Glybochko, Leonid M Rapoport, Dmitry G Tsarichenko
BACKGROUND: Transurethral intracorporeal lithotripsy is the modality of choice for the endoscopic disintegration of large, long-standing, radiolucent or high-density stones. Despite several advantages and proven benefits of contact ureterolithotripsy/ureterolithoextraction (CULT), the application of irrigation carries significant risks of untoward perioperative events including retrograde stone migration and postoperative pyelonephritis. METHODS: We describe a new technique - endoscopic intracorporeal lithotripsy in the gas (СО2) medium...
April 14, 2017: Urologia
https://www.readbyqxmd.com/read/28429628/relationship-of-steroid-dosing-and-duration-of-mechanical-ventilation-in-adult-patients-with-acute-exacerbations-of-chronic-obstructive-pulmonary-disease
#10
Jennifer McCann, Katherine Teare, Emily Cochard, Brent Toney
BACKGROUND: The optimal steroid dose for patients who require mechanical ventilation (MV) for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is unknown. OBJECTIVE: The primary objective of the study is to describe the relationship between steroid doses prescribed and duration of MV. METHODS: This was a retrospective study of patients admitted between October 2013 and September 2014 who were prescribed steroids and received MV for ≥48 hours for AECOPD...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28428678/productive-cough-in-children-and-adolescents-view-from-primary-health-care-system
#11
REVIEW
Edin Begic, Zijo Begic, Amra Dobraca, Edo Hasanbegovic
Cough is one of the most common symptoms that doctor faces in working with pediatric population, and according to some characteristics of cough, doctors can often conclude localization, and sometimes even the nature of the disease that causes it. Cough is not only the physiological defense reaction, but a symptom of a disease. According to duration it can be acute, chronic and recidivist, recurrent and persistent, strong or discreet, caused by changes in body position and changes in outside temperature. Pathoanatomically it is divided into lobar, lobular, alveolar and interstitial, pathogenetically to bronchogenic and hematogenous, as well as in immuno competent and immunocompromised, and clinically on the local and inpatient (72 hours after hospital admission)...
February 2017: Medical Archives
https://www.readbyqxmd.com/read/28427944/creating-a-global-acute-care-surgery-fellowship-to-meet-international-need
#12
Amina I Merchant, Camila B Walters, Julie Valenzuela, Kelly A McQueen, Addison K May
INTRODUCTION: Existing Acute Care Surgery (ACS) fellowships are positioned to develop well-trained surgeons with specific skills to facilitate improvements in care delivery in Global ACS. Many resident and fellowship programs offer clinical electives that expose trainees to operative experiences, exposing trainees to the needs in resource-challenged settings. However, most lack a focus on long-term development and research designed to enhance the country's local skills, capability, and capacity...
April 17, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28427882/effects-of-bystander-cpr-following-out-of-hospital-cardiac-arrest-on-hospital-costs-and-long-term-survival
#13
Guillaume Geri, Carol Fahrenbruch, Hendrika Meischke, Ian Painter, Lindsay White, Thomas D Rea, Marcia R Weaver
BACKGROUND: Bystander cardiopulmonary resuscitation (CPR) is associated with a greater likelihood of survival to hospital discharge after out-of-hospital cardiac arrest (OHCA). However the long-term survival benefits in relationship to cost have not been well-studied. We evaluated bystander CPR, hospital-based costs, and long-term survival following OHCA in order to assess the potential cost-effectiveness of bystander CPR. PATIENTS AND METHODS: We conducted a retrospective cohort study of consecutive EMS-treated OHCA patients >=12years who arrested prior to EMS arrival and outside a nursing facility between 2001 and 2010 in greater King County, WA...
April 17, 2017: Resuscitation
https://www.readbyqxmd.com/read/28427745/how-to-approach-the-acute-respiratory-distress-syndrome-prevention-plan-and-prudence
#14
REVIEW
Younsuck Koh
The acute respiratory distress syndrome (ARDS) is typically manifested by refractory hypoxemia with high mortality. A correct diagnosis is the first step to achieve better outcomes. An early intervention to manage modifiable risk factors of ARDS development and the avoidance of aggravating factors that increase disease severity and progression should be carefully addressed. A management plan is necessary at an early stage of ARDS to determine the level of intensive care. It should be carefully decided which therapeutic measures should be performed depending on the patient׳s underlying clinical condition...
May 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28427740/a-study-of-the-incidence-and-management-of-admissions-for-cancer-related-symptoms-in-a-district-general-hospital-the-potential-role-of-an-acute-oncology-service
#15
C M Bruce, J Smith, A Price
AIMS: The non-specialist management of cancer patients is becoming increasingly complex. Acute oncology services (AOS), aiming to provide rapid access to specialist advice, have been shown to improve patient experience and reduce length of inpatient stay. The present study aimed to inform service provision in a district general hospital (DGH) by investigating cancer patients, not on active anti-cancer treatment, where the disease itself precipitated admission. This is a vulnerable group who are potentially disenfranchised of focused oncological input due to having less robust care pathways established to date...
April 17, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28427574/acute-noncardiovascular-illness-in-the-cardiac-intensive-care-unit
#16
Eric M Holland, Travis J Moss
BACKGROUND: Fifty years after the inception of the cardiac intensive care unit (CICU), noncardiovascular illnesses have become more prevalent and may contribute to morbidity and mortality. OBJECTIVES: The authors performed multivariate statistical analyses to determine the association of acute noncardiovascular illnesses with outcomes, including length of stay (LOS), mortality, and hospital readmission. METHODS: We studied 1,042 admissions between October 12, 2013 and November 28, 2014 to the CICU at the University of Virginia Health System, a tertiary-care academic medical center...
April 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28427496/mortality-risk-factors-in-intensive-care-unit-patients-with-acute-kidney-injury-requiring-renal-replacement-therapy-a-retrospective-cohort-study%C3%A2
#17
Michael Schmitz, Frank P Tillmann, Ausra Paluckaite, Erich A Laufer, Brian Rayner, Lars C Rump, Peter J Heering
BACKGROUND: Mortality of critically-ill patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) in an intensive-care setting continues to remain high. There is still uncertainty as to which factors should guide clinical judgement. METHODS: A cohort of 155 patients admitted to an intensive-care unit and necessitating RRT due to AKI were retrospectively analyzed. Demographic and clinical parameters at the time of RRT initiation were retrieved...
April 21, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28427471/quality-of-life-and-healthcare-service-utilization-among-methadone-maintenance-patients-in-a-mountainous-area-of-northern-vietnam
#18
Long Hoang Nguyen, Lan Huong Thi Nguyen, Victoria L Boggiano, Canh Dinh Hoang, Hung Van Nguyen, Huong Thi Le, Hai Quan Le, Tho Dinh Tran, Bach Xuan Tran, Carl A Latkin, Nabil Zary, Minh Thuc Thi Vu
BACKGROUND: The expansion of methadone maintenance treatment in mountainous areas in still limited and little is known about its health impacts on drug users. This study aimed to examine health-related quality of life (HRQOL) and health care access among patients engaging in methadone maintenance treatment (MMT) in Tuyen Quang, a mountainous province in Vietnam. METHODS: We conducted a cross-sectional survey with 241 patients conveniently recruited in two MMT clinics (Son Duong and Tuyen Quang)...
April 20, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28427112/acute-encephalopathy-in-a-2-year-old-pot-bellied-pig-following-accidental-intoxication-with-clonazepam
#19
Emilie L Setlakwe, Amy L Johnson
OBJECTIVE: To describe a case of successful management of clonazepam toxicity causing encephalopathy in a pot-bellied pig. CASE SUMMARY: A 2-year-old female pot-bellied pig weighing 13.5 kg was presented for evaluation of clinical signs of acute encephalopathy. Based on the animal's history and clinical signs, a tentative diagnosis of benzodiazepine (BZP) intoxication was made. The results of a urinary drug screening test designed to detect illicit substances in human urine indicated benzodiazepine exposure...
April 20, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28426891/experiences-of-nurses-with-the-care-of-patients-with-dementia-in-acute-hospitals-a-secondary-analysis
#20
Christiane Pinkert, Eva Faul, Susi Saxer, Melanie Burgstaller, Doris Kamleitner, Hanna Mayer
AIM AND OBJECTIVES: The aim was to describe nurses' experiences in caring for people with dementia (PwD) in acute hospital settings. BACKGROUND: Recent research suggests that nurses' experience in caring for PwD in acute hospitals is characterized by frustration, overall job dissatisfaction and feelings of powerlessness and guilt. Despite a growing body of knowledge concerning the care of PwD in acute care settings, it remains unclear how nurses in acute hospitals provide care for PwD and what general conditions characterize the nursing care provided to these patients...
April 20, 2017: Journal of Clinical Nursing
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