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https://www.readbyqxmd.com/read/28231607/position-in-the-second-stage-of-labour-for-women-with-epidural-anaesthesia
#1
REVIEW
Marion Kibuka, Jim G Thornton
BACKGROUND: Epidural analgesia for pain relief in labour prolongs the second stage of labour and results in more instrumental deliveries. It has been suggested that a more upright position of the mother during all or part of the second stage may counteract these adverse effects. This is an update of a Cochrane review first published in 2013. OBJECTIVES: To assess the effects of different birthing positions (upright and recumbent) during the second stage of labour, on important maternal and fetal outcomes for women with epidural analgesia...
February 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28230713/the-impact-of-ethnic-and-cultural-differences-on-parental-satisfaction-in-the-picu
#2
Qian Wen Sng, Angela H P Kirk, Siti Nur Hanim Buang, Jan Hau Lee
OBJECTIVES: This study examined satisfaction of parents whose children were admitted to the PICU to identify priority areas for improvement. We hypothesized that differences exist in satisfaction of parents of different ethnicities. DESIGN: Prospective observational study. SETTING: PICU in a tertiary care pediatric hospital. PATIENTS: All English-literate parents whose child was admitted to our PICU between February 2014 and February 2015 were eligible after informed consent was obtained...
February 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28230563/implementation-of-an-early-mobility-pathway-in-neurointensive-care-unit-patients-with-external-ventricular-devices
#3
Megan Moyer, Bethany Young, Joseph Borst, William Pino, Marisa Hart, Jesse LoBreglio, Derek Zaleski, Isaira Leonor, David Kung, Michelle Smith, Eric Zager, M Sean Grady, Monisha Kumar
BACKGROUND: Patients with an external ventricular drain (EVD) may not be readily mobilized because of concerns of catheter dislodgment and/or inappropriate cerebrospinal fluid drainage. Delayed mobilization may result in longer hospital stays and an increased risk for complications related to immobility. We aimed to determine the safety, feasibility, and outcome of an EVD mobilization protocol in patients with subarachnoid hemorrhage (SAH). METHODS: A multidisciplinary group developed a formal algorithm for the mobilization of patients with SAH with EVDs...
February 23, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28229983/establishment-and-application-of-early-risk-stratification-method-for-acute-abdominal-pain-in-adults
#4
Yu Wang, Hong Zhao, Zhen Zhou, Ci Tian, Hong-Li Xiao, Bao-En Wang
BACKGROUND: Acute abdominal pain is a common symptom of emergency patients. The severity was always evaluated based on physicians' clinical experience. The aim of this study was to establish an early risk stratification method (ERSM) for addressing adults with acute abdominal pain, which would guide physicians to take appropriate and timely measures following the established health-care policies. METHODS: In Cohort 1, the records of 490 patients with acute abdominal pain that developed within the past 72 h were enrolled in this study...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28229021/the-preventive-effect-of-dexmedetomidine-on-paroxysmal-sympathetic-hyperactivity-in-severe-traumatic-brain-injury-patients-who-have-undergone-surgery-a-retrospective-study
#5
Qilin Tang, Xiang Wu, Weiji Weng, Hongpeng Li, Junfeng Feng, Qing Mao, Guoyi Gao, Jiyao Jiang
BACKGROUND: Paroxysmal sympathetic hyperactivity (PSH) results and aggravates in secondary brain injury, which seriously affects the prognosis of severe traumatic brain injury patients. Although several studies have focused on the treatment of PSH, few have concentrated on its prevention. METHODS: Ninety post-operation (post-op) severe traumatic brain injury (sTBI) patients admitted from October 2014 to April 2016 were chosen to participate in this study. Fifty of the post-op sTBI patients were sedated with dexmedetomidine and were referred as the "dexmedetomidine group" (admitted from May 2015 to April 2016)...
2017: PeerJ
https://www.readbyqxmd.com/read/28228969/prevention-and-treatment-of-neonatal-nosocomial-infections
#6
REVIEW
Jayashree Ramasethu
Nosocomial or hospital acquired infections threaten the survival and neurodevelopmental outcomes of infants admitted to the neonatal intensive care unit, and increase cost of care. Premature infants are particularly vulnerable since they often undergo invasive procedures and are dependent on central catheters to deliver nutrition and on ventilators for respiratory support. Prevention of nosocomial infection is a critical patient safety imperative, and invariably requires a multidisciplinary approach. There are no short cuts...
2017: Maternal Health, Neonatology and Perinatology
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
#7
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/28227227/multi-task-transfer-learning-for-in-hospital-death-prediction-of-icu-patients
#8
Chandan Karmakar, Budhaditya Saha, Marimuthu Palaniswami, Svetha Venkatesh, Chandan Karmakar, Budhaditya Saha, Marimuthu Palaniswami, Svetha Venkatesh, Budhaditya Saha, Marimuthu Palaniswami, Svetha Venkatesh, Chandan Karmakar
Multi-Task Transfer Learning (MTTL) is an efficient approach for learning from inter-related tasks with small sample size and imbalanced class distribution. Since the intensive care unit (ICU) data set (publicly available in Physionet) has subjects from four different ICU types, we hypothesize that there is an underlying relatedness amongst various ICU types. Therefore, this study aims to explore MTTL model for in-hospital mortality prediction of ICU patients. We used single-task learning (STL) approach on the augmented data as well as individual ICU data and compared the performance with the proposed MTTL model...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227033/advanced-analytics-for-outcome-prediction-in-intensive-care-units
#9
Ali Jalali, Dieter Bender, Mohamed Rehman, Vinay Nadkanri, C Nataraj, Ali Jalali, Dieter Bender, Mohamed Rehman, Vinay Nadkanri, C Nataraj, Mohamed Rehman, Ali Jalali, Vinay Nadkanri, Dieter Bender, C Nataraj
In this paper we present a new expert knowledge based clinical decision support system for prediction of intensive care units outcome based on the physiological measurements collected during the first 48 hours of the patient's admission to the ICU. The developed CDSS algorithm is composed of several stages. First, we categorize the collected data based on the physiological organ that they represent. We then extract clinically relevant features from each data category and then rank these features based on their mutual information with the outcome...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227012/detection-of-mitotic-nuclei-in-breast-histopathology-images-using-localized-acm-and-random-kitchen-sink-based-classifier
#10
K Sabeena Beevi, Madhu S Nair, G R Bindu, K Sabeena Beevi, Madhu S Nair, G R Bindu, G R Bindu, Madhu S Nair
The exact measure of mitotic nuclei is a crucial parameter in breast cancer grading and prognosis. This can be achieved by improving the mitotic detection accuracy by careful design of segmentation and classification techniques. In this paper, segmentation of nuclei from breast histopathology images are carried out by Localized Active Contour Model (LACM) utilizing bio-inspired optimization techniques in the detection stage, in order to handle diffused intensities present along object boundaries. Further, the application of a new optimal machine learning algorithm capable of classifying strong non-linear data such as Random Kitchen Sink (RKS), shows improved classification performance...
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
#11
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/28226653/lomb-algorithm-versus-fast-fourier-transform-in-heart-rate-variability-analyses-of-pain-in-premature-infants
#12
Anas Delane, Jorge Bohorquez, Subhanshu Gupta, Martin Schiavenato, Anas Delane, Jorge Bohorquez, Subhanshu Gupta, Martin Schiavenato, Martin Schiavenato, Jorge Bohorquez, Subhanshu Gupta, Anas Delane
Heart rate variability analysis is a promising method for measuring pain in premature infants. The Lomb algorithm was adapted and compared with fast Fourier transform (FFT) for the purposes of PSD estimation. Both FFT and the Lomb algorithm had similar low frequency (LF) estimation error rates. However, the Lomb algorithm had a significant smaller error rate than FFT when estimating high frequency (HF). In addition, the ECG signals of two premature infants in the newborn intensive care unit were analyzed while undergoing a routine heel stick, a common painful procedure...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226652/early-warnings-of-heart-rate-deterioration
#13
Vania G Almeida, Ian T Nabney, Vania G Almeida, Ian T Nabney, Ian T Nabney, Vania G Almeida
Hospitals can experience difficulty in detecting and responding to early signs of patient deterioration leading to late intensive care referrals, excess mortality and morbidity, and increased hospital costs. Our study aims to explore potential indicators of physiological deterioration by the analysis of vital-signs. The dataset used comprises heart rate (HR) measurements from MIMIC II waveform database, taken from six patients admitted to the Intensive Care Unit (ICU) and diagnosed with severe sepsis. Different indicators were considered: 1) generic early warning indicators used in ecosystems analysis (autocorrelation at-1-lag (ACF1), standard deviation (SD), skewness, kurtosis and heteroskedasticity) and 2) entropy analysis (kernel entropy and multi scale entropy)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226613/using-demographic-and-time-series-physiological-features-to-classify-sepsis-in-the-intensive-care-unit
#14
Kristin Gunnarsdottir, Vijay Sadashivaiah, Matthew Kerr, Sabato Santaniello, Sridevi V Sarma, Kristin Gunnarsdottir, Vijay Sadashivaiah, Matthew Kerr, Sabato Santaniello, Sridevi V Sarma, Sridevi V Sarma, Sabato Santaniello, Kristin Gunnarsdottir, Matthew Kerr, Vijay Sadashivaiah
Sepsis, a systemic inflammatory response to infection, is a major health care problem that affects millions of patients every year in the intensive care units (ICUs) worldwide. Despite the fact that ICU patients are heavily instrumented with physiological sensors, early sepsis detection remains challenging, perhaps because clinicians identify sepsis by (i) using static scores derived from bed-side measurements individually, and (ii) deriving these scores at a much slower rate than the rate for which patient data is collected...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226308/preliminary-examination-of-metabolic-syndrome-response-to-motivational-interviewing-for-weight-loss-as-compared-to-an-attentional-control-and-usual-care-in-primary-care-for-individuals-with-and-without-binge-eating-disorder
#15
Rachel D Barnes, Jessica A Barber
Motivational interviewing (MI) treatment for weight loss is being studied in primary care. The effect of such interventions on metabolic syndrome or binge eating disorder (BED), both highly related to excess weight, has not been examined in primary care. This study conducted secondary analyses from a randomized controlled trial to test the impact of MI for weight loss in primary care on metabolic syndrome. 74 adult participants with overweight/obesity recruited through primary care were randomized to 12weeks of either MI, an attentional control, or usual care...
February 14, 2017: Eating Behaviors
https://www.readbyqxmd.com/read/28226040/assessing-the-adequacy-of-workload-measurement-tools-using-a-quality-based-methodology
#16
Maria Fuensanta Hellín Gil, Maria José López Montesinos, Ana Myriam Seva Llor, Maria Pilar Ferrer Bas, Maria Loreto Maciá Soler
Objective: determine which tool (NEMS and NAS) is most suitable for use in intensive care units using a quality-based methodology. Method: after identifying the opportunity for improvement "Inadequacy of the NEMS for determining nursing workload in the intensive care unit (ICU)", we assessed the NEMS and the NAS, as a proposed improvement to the NEMS, using quality improvement cycles methodology based on the following criteria: measurement of daily nursing workload on a daily and shift basis; the tool encompasses all nursing activities undertaken in the ICU; and workload assessed per patient and unit...
January 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28226029/predictive-value-of-c-reactive-protein-in-critically-ill-patients-after-abdominal-surgery
#17
Frédéric Sapin, Patrick Biston, Michael Piagnerelli
OBJECTIVES: The development of sepsis after abdominal surgery is associated with high morbidity and mortality. Due to inflammation, it may be difficult to diagnose infection when it occurs, but measurement of C-reactive protein could facilitate this diagnosis. In the present study, we evaluated the predictive value and time course of C-reactive protein in relation to outcome in patients admitted to the intensive care unit (ICU) after abdominal surgery. METHODS: We included patients admitted to the ICU after abdominal surgery over a period of two years...
January 1, 2017: Clinics
https://www.readbyqxmd.com/read/28225527/neuro-trauma-or-med-surg-intensive-care-unit-does-it-matter-where-multiple-injuries-patients-with-traumatic-brain-injury-are-admitted-secondary-analysis-of-the-american-association-for-the-surgery-of-trauma-multi-institutional-trials-committee-decompressive
#18
Sarah Lombardo, Thomas Scalea, Jason Sperry, Raul Coimbra, Gary Vercruysse, Toby Enniss, Gregory J Jurkovich, Raminder Nirula
INTRODUCTION: Patients with nontraumatic acute intracranial pathology benefit from neurointensivist care. Similarly, trauma patients with and without traumatic brain injury (TBI) fare better when treated by a dedicated trauma team. No study has yet evaluated the role of specialized neurocritical (NICU) and trauma intensive care units (TICU) in the management of TBI patients, and it remains unclear which TBI patients are best served in NICU, TICU, or general (Med/Surg) ICU. METHODS: This study is a secondary analysis of The American Association for the Surgery of Trauma Multi-Institutional Trials Committee (AAST-MITC) decompressive craniectomy study...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28224564/increased-glucocorticoid-receptor-expression-in-sepsis-is-related-to-heat-shock-proteins-cytokines-and-cortisol-and-is-associated-with-increased-mortality
#19
Konstantinos Vardas, Stavroula Ilia, Amalia Sertedaki, Evangelia Charmandari, Efrossini Briassouli, Dimitris Goukos, Kleovoulos Apostolou, Katerina Psarra, Efthimia Botoula, Stylianos Tsagarakis, Eleni Magira, Christina Routsi, Constantine A Stratakis, Serafim Nanas, George Briassoulis
BACKGROUND: The purposes of this study are to examine if the human glucocorticoid receptor (hGR) isoform-α mRNA and hGR protein expressions are deficient in the acute phase of sepsis (S) compared to systemic inflammatory response syndrome (SIRS) and healthy subjects (H) and to evaluate if the hGRα and hGR alterations are associated with cortisol changes and if they are related to (1) extracellular and intracellular heat shock proteins (HSP) 72 and 90α; (2) ACTH, prolactin, and interleukins (ILs); and (3) outcome...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28224110/comparison-of-inhaled-milrinone-nitric-oxide-and-prostacyclin-in-acute-respiratory-distress-syndrome
#20
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
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