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measurement care intensity

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https://www.readbyqxmd.com/read/27936365/how-much-is-too-much-patterns-of-drinking-during-alcohol-treatment-and-associations-with-post-treatment-outcomes-across-three-alcohol-clinical-trials
#1
Katie Witkiewitz, Corey R Roos, Matthew R Pearson, Kevin A Hallgren, Stephen A Maisto, Megan Kirouac, Alyssa A Forcehimes, Adam D Wilson, Charles S Robinson, Elizabeth McCallion, J Scott Tonigan, Nick Heather
OBJECTIVE: This secondary data analysis examined patterns of drinking during alcohol treatment and associated drinking outcomes during the first year following treatment. The goal was to provide clinicians with guidance on which patients may be most at risk for negative long-term outcomes based on drinking patterns during treatment. METHOD: This study was an analysis of existing data (N = 3,851) from three randomized clinical trials for alcohol use disorder: the COMBINE Study (n = 1,383), Project MATCH (n = 1,726), and the United Kingdom Alcohol Treatment Trial (n = 742)...
January 2017: Journal of Studies on Alcohol and Drugs
https://www.readbyqxmd.com/read/27936243/can-wound-exudate-from-venous-leg-ulcers-measure-wound-pain-status-a-pilot-study
#2
Taichi Goto, Nao Tamai, Gojiro Nakagami, Aya Kitamura, Ayumi Naito, Masayuki Hirokawa, Chisako Shimokawa, Kazuo Takahashi, Junichi Umemoto, Hiromi Sanada
We investigated the associations between the self-evaluated pain status and two pain biomarker candidates, nerve growth factor and S100A8/A9, in exudate from venous leg ulcer to finally develop an objective pain evaluation method. Patients with venous leg ulcer participated in this cross-sectional observational study conducted between April and October 2014 at two medical facilities. During routine wound care, each participant self-evaluated their pain status at each examination using the 10-point numerical rating scale (present pain intensity) and the short-form McGill Pain Questionnaire 2 (continuous pain, intermittent pain, neuropathic pain, affective descriptors, and total score)...
2016: PloS One
https://www.readbyqxmd.com/read/27935773/lung-protective-ventilation
#3
Rex A Marley, Kaycee Simon
Historically, mechanical ventilation of the lungs utilizing relatively large tidal volumes was common practice in the operating room and intensive care unit (ICU). The rationale behind this treatment strategy was to yield better patient outcomes, that is, fewer pulmonary complications, and a reduction in morbidity and mortality. As evidence-based practice has evolved, potential harmful effects of traditional, nonphysiological mechanical ventilation (ventilation with larger tidal volumes and the tolerance of high airway pressures) even in shortterm treatment have been shown to correlate with systemic inflammation and the development of ventilator-associated lung injury...
January 2017: Annual Review of Nursing Research
https://www.readbyqxmd.com/read/27935361/acute-impairment-of-saccadic-eye-movements-is-associated-with-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#4
Matthew J Rowland, Payashi Garry, Jon Westbrook, Rufus Corkill, Chrystalina A Antoniades, Kyle T S Pattinson
OBJECTIVE Delayed cerebral ischemia (DCI) causing cerebral infarction remains a significant cause of morbidity and mortality following aneurysmal subarachnoid hemorrhage (aSAH). Early brain injury in the first 72 hours following rupture is likely to play a key role in the pathophysiology underlying DCI but remains difficult to quantify objectively. Current diagnostic modalities are based on the concept of vasoconstriction causing cerebral ischemia and infarction and are either invasive or have a steep learning curve and user variability...
December 9, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27933180/serum-levels-of-immunoglobulins-and-severity-of-community-acquired-pneumonia
#5
Mari C de la Torre, Pere Torán, Mateu Serra-Prat, Elisabet Palomera, Estel Güell, Ester Vendrell, Joan Carles Yébenes, Antoni Torres, Jordi Almirall
INSTRUCTION: There is evidence of a relationship between severity of infection and inflammatory response of the immune system. The objective is to assess serum levels of immunoglobulins and to establish its relationship with severity of community-acquired pneumonia (CAP) and clinical outcome. METHODS: This was an observational and cross-sectional study in which 3 groups of patients diagnosed with CAP were compared: patients treated in the outpatient setting (n=54), patients requiring in-patient care (hospital ward) (n=173), and patients requiring admission to the intensive care unit (ICU) (n=191)...
2016: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/27932571/esmolol-before-cardioplegia-and-as-cardioplegia-adjuvant-reduces-cardiac-troponin-release-after-cardiac-surgery-a-randomized-trial
#6
Elena Bignami, Marcello Guarnieri, Annalisa Franco, Chiara Gerli, Monica De Luca, Fabrizio Monaco, Giovanni Landoni, Alberto Zangrillo
BACKGROUND: Cardioplegic solutions are the standard in myocardial protection during cardiac surgery, since they interrupt the electro-mechanical activity of the heart and protect it from ischemia during aortic cross-clamping. Nevertheless, myocardial damage has a strong clinical impact. We tested the hypothesis that the short-acting beta-blocker esmolol, given immediately before cardiopulmonary bypass and as a cardioplegia additive, would provide an extra protection to myocardial tissue during cardiopulmonary bypass by virtually reducing myocardial activity and, therefore, oxygen consumption to zero...
December 8, 2016: Perfusion
https://www.readbyqxmd.com/read/27932513/improving-incidence-of-postoperative-atrial-fibrillation-after-cardiac-surgery-using-simplified-clinical-practice-guidelines
#7
Amr S Omar, Hesham Ewila, Mahmoud Allam, Sameh Aboulnagah, Samy Hanoura, Praveen C Sivadasan, Ousama Bilal, Abdul Rasheed A Pattath, Abdulaziz AlKhulaifi
OBJECTIVES: Postoperative atrial fibrillation (POAF) remains a major risk after cardiac surgery. Twelve percent patients admitted to this unit postcardiac surgery experienced POAF, which led to hemodynamic instability, increased risk of stroke, and increased length of postoperative intensive care unit stay. Our aim was to decrease the incidence of POAF in the cardiothoracic intensive care unit by the end of April 2014. METHODS: Design-Retrospective data analysis...
December 8, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27932360/the-effects-of-a-high-intensity-functional-exercise-group-on-clinical-outcomes-in-hospitalised-older-adults-an-assessor-blinded-randomised-controlled-trial
#8
Melissa J M Raymond, Kimberley J Jeffs, Adele Winter, Sze-Ee Soh, Peter Hunter, Anne E Holland
OBJECTIVE: to investigate a high-intensity functional exercise (HIFE) group in hospitalised older adults. DESIGN: assessor-blinded, randomised-controlled trial. SETTING: sub-acute wards at a metropolitan rehabilitation hospital. PARTICIPANTS: older adults ≥65 years (n = 468) able to stand with minimum assistance or less from a chair and follow instructions. INTERVENTION: 'group' participants were offered a standing HIFE group three times a week and individual physiotherapy sessions twice a week...
December 7, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27932136/prognostic-value-of-high-sensitivity-troponin-t-to-identify-patients-at-risk-of-left-ventricular-graft-dysfunction-after-heart-transplantation
#9
A B Méndez, J Ordonez-Llanos, S Mirabet, J Galan, M L Maestre, V Brossa, M T Rivilla, L López, T Koller, A Sionis, E Roig
Primary graft dysfunction after heart transplantation (HTx) has a very high mortality rate, especially if the left ventricle (PGD-LV) is involved. Early diagnosis is important to select the appropriate therapy to improve prognosis. The value of high-sensitivity troponin T (HS-TNT) measurement obtained at patient arrival at the intensive care unit was analyzed in 71 HTx patients. Mild or moderate PGD-LV was defined by hemodynamic compromise with one of the following criteria: left ventricular ejection fraction <40%, hemodynamic compromise with right atrial pressure >15 mm Hg, pulmonary capillary wedge pressure >20 mm Hg, cardiac index <2...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931259/abdominal-septic-shock-endotoxin-adsorption-treatment-asset-endotoxin-removal-in-abdominal-and-urogenital-septic-shock-with-the-alteco%C3%A2-lps-adsorber-study-protocol-for-a-double-blinded-randomized-placebo-controlled-trial
#10
Miklos Lipcsey, Jyrki Tenhunen, Jan Sjölin, Robert Frithiof, Stepani Bendel, Hans Flaatten, Rafael Kawati, Anne Kuitunen, Tor Inge Tønnessen, Sten Rubertsson
BACKGROUND: Severe sepsis and septic shock are common in intensive care and carry high mortality rates. In patients with Gram-negative infections, early and extensive removal of endotoxin may limit the inflammatory response that characterizes septic shock. The Alteco® LPS Adsorber (hereafter referred to cited as the lipopolysaccharide (LPS) Adsorber) can be used for endotoxin removal and attenuate the deleterious inflammatory and clinical responses seen in septic shock. METHODS/DESIGN: The Abdominal Septic Shock - Endotoxin Adsorption Treatment (ASSET) trial is a pilot study investigating the feasibility and safety of LPS Adsorber therapy...
December 8, 2016: Trials
https://www.readbyqxmd.com/read/27930995/predictors-of-clinicians-underuse-of-daily-sedation-interruption-and-sedation-scales
#11
B Sneyers, S Henrard, P F Laterre, M M Perreault, C Beguin, D Wouters, N Speybroeck, A Spinewine
PURPOSE: The purpose of the study is to identify predictors of underuse of sedation scales and daily sedation interruption (DSI). METHODS: We surveyed all physicians and seven nurses in every Belgian intensive care unit (ICU), addressing practices and perceptions on guideline recommendations. Underuse was defined for sedation scales as use less than 3× per day and for DSI as never using it. Classification trees and logistic regressions identified predictors of underuse...
August 11, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27930280/development-of-electronic-medical-record-based-rounds-report-results-in-improved-resident-efficiency-more-time-for-direct-patient-care-and-education-and-less-resident-duty-hour-violations
#12
Phillip B Ham, Toby Anderton, Ryan Gallaher, Mike Hyrman, Erika Simmerman, Annamalai Ramanathan, David Fallaw, Steven Holsten, Charles Gordon Howell
Surgeons frequently report frustration and loss of efficiency with electronic medical record (EMR) systems. Together, surgery residents and a programmer at Augusta University created a rounds report (RR) summarizing 24 hours of vitals, intake/output, labs, and other values for each inpatient that were previously transcribed by hand. The objective of this study was to evaluate the RRs effect on surgery residents. Surgery residents were queried to assess the RRs impact. Outcome measures were time spent preparing for rounds, direct patient care time, educational activity time, rates of incorrect/incomplete data on rounds, and rate of duty hour violations...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27929691/association-between-pediatric-home-management-plan-of-care-compliance-and-asthma-readmission
#13
Ronen Zipkin, Sheree M Schrager, Eugene Nguyen, Mary Rose Mamey, Ingrid Banuelos, Susan Wu
OBJECTIVES: In 2007, The Joint Commission implemented three children's asthma care (CAC) measures to help improve the quality of care for patients admitted with asthma. Due to lack of consistent evidence showing a relationship between home management plan of care (HMPC) compliance and readmission rates, CAC-3 was retired in 2016. We aimed to understand the relationship between HMPC compliance and revisits to the hospital, and investigate which components of the HMPC, if any, were driving the effect...
December 8, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27929527/durations-of-second-stage-of-labor-and-pushing-and-adverse-neonatal-outcomes-a-population-based-cohort-study
#14
A Sandström, M Altman, S Cnattingius, S Johansson, M Ahlberg, O Stephansson
OBJECTIVE: The associations between duration of second stage of labor, pushing time and risk of adverse neonatal outcomes are not fully established. Therefore, we aimed to examine such relationships. STUDY DESIGN: A population-based cohort study including 42 539 nulliparous women with singleton infants born in cephalic presentation at ⩾37 gestational weeks, using the Stockholm-Gotland Obstetric Cohort, Sweden, and the Swedish Neonatal Quality Register, 2008 to 2013...
December 8, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27928634/pressurized-wideband-acoustic-stapedial-reflex-thresholds-normal-development-and-relationships-to-auditory-function-in-infants
#15
Lisa L Hunter, Douglas H Keefe, M Patrick Feeney, Denis F Fitzpatrick
This study analyzed effects of pressurization on wideband acoustic stapedial-muscle reflex (ASR) tests in infants cared for in normal newborn (NN) and neonatal intensive care units (NICU). Effects of hearing-screening outcomes on ASR threshold measurements were also evaluated, and a subsequent longitudinal study established normative threshold ranges over the first year after birth. An initial experiment compared thresholds in newborns measured at ambient pressure in the ear canal and at the tympanometric peak pressure...
December 7, 2016: Journal of the Association for Research in Otolaryngology: JARO
https://www.readbyqxmd.com/read/27925054/prone-position-in-patients-with-acute-respiratory-distress-syndrome
#16
Mariano Setten, Gustavo Adrián Plotnikow, Matías Accoce
Acute respiratory distress syndrome occupies a great deal of attention in intensive care units. Despite ample knowledge of the physiopathology of this syndrome, the focus in intensive care units consists mostly of life-supporting treatment and avoidance of the side effects of invasive treatments. Although great advances in mechanical ventilation have occurred in the past 20 years, with a significant impact on mortality, the incidence continues to be high. Patients with acute respiratory distress syndrome, especially the most severe cases, often present with refractory hypoxemia due to shunt, which can require additional treatments beyond mechanical ventilation, among which is mechanical ventilation in the prone position...
December 1, 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/27924203/the-effects-of-etomidate-and-midazolam-on-adipose-tissue-derived-mesenchymal-stem-cell-proliferation
#17
Ho Park, Kyoungho Ryu, Yun-Hong Kim, Won-Jun Choi, Dongchan Ko
BACKGROUND: Stem cell therapy using adipose tissue-derived mesenchymal stem cells (ADSCs), which are capable of multipotent differentiation, is currently being investigated in the field of tissue regeneration and the treatment of patients in intensive care units. It is known that type-A γ-aminobutyric acid (GABAA) receptor activity has an influence on stem cell proliferation. Thus, we investigated the effects of the clinically available GABAA receptor agonists, etomidate and midazolam, on ADSC proliferation measured by the cell counting kit-8 assay...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27924171/predictors-of-transition-to-hospice-care-among-hospitalized-older-adults-with-a-diagnosis-of-dementia-in-texas-a-population-based-study
#18
Lavi Oud
BACKGROUND: Decedent older adults with dementia are increasingly less likely to die in a hospital, though escalation of care to a hospital setting, often including critical care, remains common. Although hospice is increasingly reported as the site of death in these patients, the factors associated with transition to hospice care during end-of-life (EOL) hospitalizations of older adults with dementia and the extent of preceding escalation of care to an intensive care unit (ICU) setting among those discharged to hospice have not been examined...
January 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/27923478/increased-incidence-of-necrotizing-enterocolitis-in-the-netherlands-after-implementation-of-the-new-dutch-guideline-for-active-treatment-in-extremely-preterm-infants-results-from-three-academic-referral-centers
#19
Fardou H Heida, Lisanne Stolwijk, Marie-Louise H J Loos, Stannie J van den Ende, Wes Onland, Frank A M van den Dungen, Elisabeth M W Kooi, Arend F Bos, Jan B F Hulscher, Roel Bakx
INTRODUCTION: Necrotizing enterocolitis (NEC) is a severe inflammatory disease, mostly occurring in preterm infants. The Dutch guidelines for active treatment of extremely preterm infants changed in 2006 from 26+0 to 25+0weeks of gestation, and in 2010 to 24+0 of gestation. We aimed to gain insight into the incidence, clinical outcomes and treatment strategies, in three academic referral centers in the Netherlands over the last nine years. METHODS: We performed a multicenter retrospective cohort study of all patients with NEC (Bell stage ≥2a) in three academic referral centers diagnosed between 2005 and 2013...
November 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27923433/circulating-anti-coatomer-protein-complex-subunit-epsilon-cope-autoantibodies-as-a-potential-biomarker-for-cardiovascular-and-cerebrovascular-events-in-patients-with-obstructive-sleep-apnea
#20
Takuma Matsumura, Jiro Terada, Taku Kinoshita, Yoriko Sakurai, Misuzu Yahaba, Ryogo Ema, Atsuko Amata, Seiichiro Sakao, Kengo Nagashima, Koichiro Tatsumi, Takaki Hiwasa
STUDY OBJECTIVES: Although moderate to severe obstructive sleep apnea (OSA) is an independent risk factor for severe arteriosclerotic diseases such as cardiovascular disease (CVD) and stroke, the development of atherosclerosis-related diseases cannot yet be predicted in OSA patients. In a pilot study, we identified autoantibodies against the coatomer protein complex, subunit epsilon [circulating anti-coatomer protein complex subunit epsilon autoantibody (COPE-Ab)], a cytosolic complex that mediates protein transport in the Golgi compartment, as a potential novel biomarker of atherosclerosis...
November 28, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
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