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https://www.readbyqxmd.com/read/29775083/comparing-efficacy-of-enteral-nutrition-plus-ranitidine-and-enteral-nutrition-alone-as-stress-ulcer-prophylaxis
#1
Anahid Nourian, Mostafa Mohammadi, Mohammad-Taghi Beigmohammadi, Mohammad Taher, Zohreh Dadvar, Masoume Malekolkottab, Masoud Ramezani, Hossein Khalili
AIM: Adequacy of enteral nutrition (EN) alone as stress ulcer prophylaxis (SUP) is controversial. The aim of this study was to compare efficacy of EN alone and ranitidine plus EN as SUP. METHOD: Critically ill adults with indications to receive SUP were randomized to ranitidine 50 mg IV every 8 h plus EN (SUP) or EN alone (non-SUP) group for 7 days. Besides, endoscopy was performed at the time of recruitment and on day 7. RESULTS: During the study period, only one patient in each group of SUP and non-SUP experienced gastrointestinal bleeding...
May 18, 2018: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29775015/-the-safety-study-of-percutaneous-dilational-tracheostomy-in-a-large-sample
#2
X Zhai, J L Zhang, J C He, G Liu
Objective: The aim of this study is to analyze the safety of a large number cases of percutaneous dilatation tracheostomy. Method: Retrospective analyzed the clinical data of PDT (1 200 cases) and TT (326 cases) patients which were recruited. The postoperative complications were analyzed statistically. PDT and TT randomized controlled trials (PDT and TT) were conducted with 80 cases in each group. The intraoperative conditions (including operative time, intraoperative bleeding volume and incision size) and postoperative complications in the two groups were statistically analyzed...
February 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/29774649/end-of-life-trajectory-of-coping-and-self-care-of-patients-with-idiopathic-pulmonary-fibrosis-a-meta-synthesis-using-meta-ethnography
#3
Yasuko Igai
AIM: This study aimed to extract patient narratives regarding the end-of-life trajectory of their self-care and coping experiences as patients with idiopathic pulmonary fibrosis and to use meta-ethnography to discover common metaphors of their experience in order to inform the development of nursing interventions. METHODS: A comprehensive search of qualitative research using electronic databases, in English and Japanese, regarding patients with IPF, identified four articles...
May 17, 2018: Japan Journal of Nursing Science: JJNS
https://www.readbyqxmd.com/read/29774088/endoscopic-ultrasound-guided-drainage-of-pancreatic-walled-off-necrosis-using-self-expanding-metal-stents-without-fluoroscopy
#4
Barbara Braden, Andreas Koutsoumpas, Michael A Silva, Zahir Soonawalla, Christoph F Dietrich
AIM: To investigate whether endoscopic ultrasound (EUS)-guided insertion of fully covered self-expandable metal stents in walled-off pancreatic necrosis (WOPN) is feasible without fluoroscopy. METHODS: Patients with symptomatic pancreatic WOPN undergoing EUS-guided transmural drainage using self-expandable and fully covered self expanding metal stents (FCSEMS) were included. The EUS visibility of each step involved in the transmural stent insertion was assessed by the operators as "visible" or "not visible": (1) Access to the cyst by needle or cystotome; (2) insertion of a guide wire; (3) introducing of the diathermy and delivery system; (4) opening of the distal flange; and (5) slow withdrawal of the delivery system until contact of distal flange to cavity wall...
May 16, 2018: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29773846/appetite-during-the-recovery-phase-of-critical-illness-a-cohort-study
#5
Judith L Merriweather, David M Griffith, Timothy S Walsh
BACKGROUND/OBJECTIVES: Reduced appetite is a recognised physiological symptom in survivors of critical illness. While reduced appetite has been reported by patients after intensive care unit (ICU) discharge, quantification using visual analogue scales (VAS) has not been previously performed, and follow-up duration has been limited. We aimed to describe appetite scores in ICU survivors during the first 3 months after ICU discharge and explore association with systemic inflammation. SUBJECTS/METHODS: Secondary analysis of data collected in a complex rehabilitation intervention trial (RECOVER)...
May 17, 2018: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29773703/investigating-admitted-patients-satisfaction-with-nursing-care-at-debre-berhan-referral-hospital-in-ethiopia-a-cross-sectional-study
#6
Nigussie Tadesse Sharew, Hailegiorgis Teklegiorgis Bizuneh, Hilina Ketema Assefa, Tesfa Dejenie Habtewold
OBJECTIVES: The aims of the study were (1) to assess the level of patient satisfaction with nursing care and (2) to identify factors influencing patient satisfaction. DESIGN: A hospital-based, cross-sectional study was conducted with 252 admitted patients in the medical, surgical and paediatric wards. SETTING: Debre Berhan Referral Hospital, Debre Berhan, Ethiopia, with a catchment population of 2.8 million. PARTICIPANTS: All patients admitted at least for 2 days and capable of independent communication were included...
May 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29773518/developmental-trajectories-of-brain-maturation-and-behavior-relevance-to-major-mental-illnesses
#7
REVIEW
Sedona Lockhart, Akira Sawa, Minae Niwa
Adverse events in childhood and adolescence, such as social neglect or drug abuse, are known to lead to behavioral changes in young adulthood. This is particularly true for the subset of people who are intrinsically more vulnerable to stressful conditions. Yet the underlying mechanisms for such developmental trajectory from early life insult to aberrant adult behavior remains elusive. Adolescence is a period of dynamic physiological, psychological, and behavioral changes, encompassing a distinct neurodevelopmental stage called the 'critical period'...
May 3, 2018: Journal of Pharmacological Sciences
https://www.readbyqxmd.com/read/29773510/implications-of-the-abcd-study-for-developmental-neuroscience
#8
Sarah W Feldstein Ewing, James M Bjork, Monica Luciana
The Adolescent Brain Cognitive Development Study (ABCD) will capture a breadth of multi-faceted biobehavioral, environmental, familial, and genetic longitudinal developmental open-access data from over 11,000 9-10 year olds throughout the United States of America (USA) for an envisioned ten-year span. This will subsequently represent the largest study ever attempted with this level of brain phenotypic detail. This study holds the opportunity for exciting advances in the understanding of typical adolescent neurodevelopment, discovery of neurodevelopmental underpinnings of mental illness, as well as the neurodevelopmental influences of (and on) social factors, substance use, and critically - their interaction...
May 14, 2018: Developmental Cognitive Neuroscience
https://www.readbyqxmd.com/read/29773497/indications-for-red-cell-transfusions-in-pediatric-patients
#9
REVIEW
Jill M Cholette, Suzie A Noronha, Jerard Seghatchian, Neil Blumberg
Red cell transfusions are amongst the most common therapeutic procedures in seriously ill children, particularly in the inpatient setting. This is despite the fact that there is no evidence base for most clinical settings, with the exception of patients with hemoglobinopathies, particularly thalassemia and sickle cell anemia. Obviously exsanguinating hemorrhage and life threatening anemia are urgent indications for which no other therapeutic approach is currently available. Most transfusions are, however, given prophylactically to prevent the complications of hypoxia or hemodynamic stability, based upon expert opinion and a faith in the oxygen carrying capacity and beneficial hemodynamic properties of transfused red cells...
May 10, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29773298/veno-venous-extracorporeal-membrane-oxygenation-bridged-living-donor-lung-transplantation-for-rapid-progressive-respiratory-failure-with-pleuroparenchymal-fibroelastosis-after-allogeneic-hematopoietic-stem-cell-transplantation
#10
Ayako Shimada, Jiro Terada, Kenji Tsushima, Yoshihisa Tateishi, Ryuzo Abe, Shigeto Oda, Motomu Kobayashi, Masaomi Yamane, Takahiro Oto, Koichiro Tatsumi
Cases of extracorporeal membrane oxygenation (ECMO) bridged lung transplantation (LTx) are rare in Japan because an allocation system to prioritize patients based on urgency remains to be established. For critically ill patients who cannot wait for a brain-dead donor LTx, ECMO bridge to living-donor LTx may be the only practical option. A 21-year-old woman with pleuroparenchymal fibroelastosis after hematopoietic stem cell transplantation was admitted to our hospital with rapidly progressive respiratory failure...
May 2018: Respiratory Investigation
https://www.readbyqxmd.com/read/29772781/the-potential-role-of-fc-receptor-functions-in-the-development-of-a-universal-influenza-vaccine
#11
Sinthujan Jegaskanda
Despite global vaccination efforts, influenza virus continues to cause yearly epidemics and periodic pandemics throughout most of the world. Many of us consider the generation of broader, potent and long-lasting immunity against influenza viruses as critical in curtailing the global health and economic impact that influenza currently plays. To date, classical vaccinology has relied on the generation of neutralizing antibodies as the benchmark to measure vaccine effectiveness. However, recent developments in numerous related fields of biomedical research including, HIV, HSV and DENV have emphasized the importance of Fc-mediate effector functions in pathogenesis and immunity...
May 17, 2018: Vaccines
https://www.readbyqxmd.com/read/29771711/respiratory-muscle-effort-during-expiration-in-successful-and-failed-weaning-from-mechanical-ventilation
#12
Jonne Doorduin, Lisanne H Roesthuis, Diana Jansen, Johannes G van der Hoeven, Hieronymus W H van Hees, Leo M A Heunks
BACKGROUND: Respiratory muscle weakness in critically ill patients is associated with difficulty in weaning from mechanical ventilation. Previous studies have mainly focused on inspiratory muscle activity during weaning; expiratory muscle activity is less well understood. The current study describes expiratory muscle activity during weaning, including tonic diaphragm activity. The authors hypothesized that expiratory muscle effort is greater in patients who fail to wean compared to those who wean successfully...
May 16, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29771700/the-effect-of-iv-amino-acid-supplementation-on-mortality-in-icu-patients-may-be-dependent-on-kidney-function-post-hoc-subgroup-analyses-of-a-multicenter-randomized-trial
#13
Ran Zhu, Matilde J Allingstrup, Anders Perner, Gordon S Doig
OBJECTIVES: We investigated whether preexisting kidney function determines if ICU patients may benefit from increased (2.0 g/kg/d) protein intake. DESIGN: Post hoc, hypothesis-generating, subgroup analysis of a multicenter, phase 2, randomized clinical trial. All analyses were conducted by intention to treat and maintained group allocation. Ninety-day mortality was the primary outcome. SETTING: ICUs of 16 hospitals throughout Australia and New Zealand...
May 15, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29770452/the-effects-of-blood-transfusion-on-red-blood-cell-distribution-width-in-critically-ill-patients-a-pilot-study
#14
Savino Spadaro, Fabio Silvio Taccone, Alberto Fogagnolo, Federico Franchi, Sabino Scolletta, Riccardo Ragazzi, Alberto Fanni, Elisabetta Marangoni, Maurizio Govoni, Roberto Reverberi, Carlo Alberto Volta
BACKGROUND: Red blood cell distribution width (RDW) is a measure of anisocytosis, generally used in the differential diagnosis of anemia. Recently, RDW was associated with increased mortality in critically ill patients. Red blood cell (RBC) transfusions are potential confounders on RDW values interpretation. The aim of this study was to analyze the changes in RDW after RBC transfusion in intensive care unit (ICU) patients. STUDY DESIGN AND METHODS: This was a prospective, observational study including patients admitted to ICU requiring 1 RBC unit...
May 16, 2018: Transfusion
https://www.readbyqxmd.com/read/29770293/current-monitoring-and-innovative-predictive-modeling-to-improve-care-in-the-pediatric-cardiac-intensive-care-unit
#15
REVIEW
Mary K Olive, Gabe E Owens
The objectives of this review are (I) to describe the challenges associated with monitoring patients in the pediatric cardiac intensive care unit (PCICU) and (II) to discuss the use of innovative statistical and artificial intelligence (AI) software programs to attempt to predict significant clinical events. Patients cared for in the PCICU are clinically fragile and at risk for fatal decompensation. Current monitoring modalities are often ineffective, sometimes inaccurate, and fail to detect a deteriorating clinical status in a timely manner...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29769112/association-between-%C3%AE-blocker-use-and-mortality-in-critically-ill-patients-a-nested-cohort-study
#16
Shmeylan A Al Harbi, Khalid A Al Sulaiman, Hani Tamim, Hasan M Al-Dorzi, Musharaf Sadat, Yaseen Arabi
BACKGROUND: β-blockers have several indications in critically ill patients and are commonly used. The aim of this study is to examine the relationship between the use of β-blockers in critically ill patients and mortality. METHODS: This was a nested cohort study in which all medical-surgical ICU patients (N = 523) enrolled in a randomized clinical trial of intensive insulin therapy (ISRCTN07413772) were grouped according to β-blocker use during ICU stay. To account for the indication of β-blockers, we constructed a propensity score using selected clinically-relevant and statistically-significant variables related to β-blocker exposure and outcome...
May 16, 2018: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29769084/resilience-trust-and-civic-engagement-in-the-post-ccsvi-era
#17
Shelly Benjaminy, Andrew Schepmyer, Judy Illes, Anthony Traboulsee
BACKGROUND: Scientific and financial investments in chronic cerebrospinal venous insufficiency (CCSVI) research have been made to address both the hope for and scepticism over this interventional strategy for MS. Despite limited evidence in support of the CCSVI hypothesis, the funding of clinical research was responsive to a demand by the public rarely seen in the history of medicine. We characterize patient perspectives about the CCSVI research trajectory, with particular attention to its impact on other non-pharmaceutical areas of MS research with a focus on stem cell interventions...
May 16, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29768348/a-new-strategy-for-enteral-nutrition-using-a-deflection-flexible-visual-gastric-tube-a-randomized-crossover-manikin-trial
#18
Jie Li, Yan-Mei Feng, Dong Wan, Hui-Sheng Deng, Rui Guo
BACKGROUND: Enteral nutrition via gastric tube insertion is a routine clinical practice for critically ill patients, although complications due to blind manipulation are occasionally reported. METHODS: An 8.4Fr deflection flexible ureteroscope was delivered into a 15Fr conventional gastric tube to create a gastric visual guidance system. Twenty inexperienced physicians were randomly assigned to perform 5 repeated orogastric tube placements in a manikin using both the conventional method and the deflection visual gastric tube, for a total of 10 procedures per physician...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29768025/the-post-injury-inflammatory-state-and-the-bone-marrow-response-to-anemia
#19
Tyler J Loftus, Juan C Mira, Elizabeth S Miller, Kolenkode B Kannan, Jessica M Plazas, Daniel Delitto, Julie A Stortz, Jennifer E Hagen, Hari K Parvataneni, Kalia K Sadasivan, Scott C Brakenridge, Frederick A Moore, Lyle L Moldawer, Philip A Efron, Alicia M Mohr
RATIONALE: The pathophysiology of persistent injury-associated anemia is incompletely understood, and human data are sparse. OBJECTIVE: To translate pre-clinical findings by characterizing injury-associated anemia among critically ill trauma patients. This study compared elective hip repair patients with an acute stress response to severely injured trauma patients with a prolonged stress response and evaluated the bone marrow response to anemia. METHODS: A translational prospective observational cohort study comparing severely injured, blunt trauma patients who had operative fixation of a hip or femur fracture (n=17) with elective hip repair patients (n=22) and healthy donors (n=8)...
May 16, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29767451/feline-ureteral-obstructions-part-1-medical-management
#20
REVIEW
D L Clarke
Feline ureteral obstructions are an increasingly recognised and challenging diagnostic and management problem. Many cats with ureteral obstructions are critically ill at the time of diagnosis, especially if there is dysfunction of the contralateral kidney. They may present with varying severities of acute kidney injury, electrolyte disturbances, and may have comorbidities such as heart disease that complicate perioperative and long-term management. Medical management, which may consist of rehydration and restoration of intravascular volume with intravenous fluid therapy, osmotic diuresis, ureteral muscle relaxation, and antimicrobials for infection, is important in feline ureteral obstruction patients...
May 16, 2018: Journal of Small Animal Practice
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