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https://www.readbyqxmd.com/read/28734823/evaluation-of-early-administration-of-simvastatin-in-the-prevention-and-treatment-of-delirium-in-critically-ill-patients-undergoing-mechanical-ventilation-modus-a-randomised-double-blind-placebo-controlled-trial
#1
Valerie J Page, Annalisa Casarin, E Wesley Ely, Xiao Bei Zhao, Cliona McDowell, Lynn Murphy, Daniel F McAuley
BACKGROUND: Delirium in critically ill patients is associated with poor clinical outcomes. Neuroinflammation might be an important mechanism in the pathogenesis of delirium, and since simvastatin has anti-inflammatory properties it might reduce delirium. We aimed to establish whether early treatment with simvastatin would decrease the time that survivors of critical illness spent in delirium or coma. METHODS: We undertook this randomised, double-blind, placebo-controlled trial in a general adult intensive care unit (ICU) in Watford General Hospital (Watford, UK)...
July 19, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28734773/epico-4-0-total-quality-in-the-management-of-invasive-candidiasis-in-critically-ill-patients-by-analysing-the-integrated-process
#2
Rafael Zaragoza, Ricard Ferrer, Pedro Llinares, Emilio Maseda, Alejandro Rodríguez, Santiago Grau, Guillermo Quindós
BACKGROUND: A high quality integrated process in the clinical setting of non-neutropenic critically ill patients at risk for invasive candidiasis is a necessary tool to improve the management of these patients. AIMS: To identify the key points on invasive candidiasis in order to develop a set of recommendations with a high level of consensus required for the creation of a total quality integrated process for the management of non-neutropenic critically ill patients at risk of invasive candidiasis...
July 19, 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/28734618/association-of-asthma-illness-representations-and-reported-controller-medication-adherence-among-school-aged-children-and-their-parents
#3
Jennifer Sonney, Kathleen C Insel, Chris Segrin, Lynn B Gerald, Ida M Ki Moore
This study examined the relationship between asthma illness representations and reported controller medication adherence of school-aged children (6-11 years) with persistent asthma and their parents. Thirty-four parent-child dyads independently reported on asthma controller medication adherence and asthma illness representations. Hierarchical regression analyses were used to test parent and child illness representation domain variables as predictors of reported medication adherence. Parent beliefs about medication necessity versus concerns was a significant predictor of parent-reported adherence (β = ...
July 20, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28734547/management-of-hemostatic-disorders-in-patients-with-advanced-liver-disease-admitted-to-an-intensive-care-unit
#4
REVIEW
Ton Lisman, William Bernal
Patients with liver diseases frequently acquire complex changes in their hemostatic system. Traditionally, bleeding complications in patients with liver disease were ascribed to these hemostatic changes, and liver diseases were considered as an acquired bleeding disorder. Nowadays, it is increasingly acknowledged that patients with liver diseases are in "hemostatic rebalance" due to a commensurate decline in pro- and anticoagulant drivers. Indeed, both thrombosis and bleeding may complicate liver disease. Such complications may be particularly worrisome in critically ill patients with liver disease...
June 23, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28733936/an-examination-of-the-association-of-multiple-acculturation-measures-with-asthma-status-among-elementary-school-students-in-el-paso-texas
#5
Mónica Siañez, Linda Highfield, Héctor Balcazar, Timothy Collins, Sara Grineski
Some researchers posit that the lower prevalence of asthma among those of Mexican descent may result from an under-diagnosis and recommend a critical appraisal of factors related to race/ethnicity, like acculturation, and its influence on asthma status. Survey data were analyzed using multinomial logistic regression to examine the association of child's asthma status (no wheezing/no asthma symptoms, possible undiagnosed and diagnosed asthma) with measures of acculturation among Hispanic students (n = 1095)...
July 21, 2017: Journal of Immigrant and Minority Health
https://www.readbyqxmd.com/read/28733177/transjugular-local-thrombolysis-with-without-tips-in-patients-with-acute-non-cirrhotic-non-malignant-portal-vein-thrombosis
#6
Christoph Klinger, Bettina Riecken, Arthur Schmidt, Andrea De Gottardi, Benjamin Meier, Jaime Bosch, Karel Caca
BACKGROUND & AIMS: Therapeutic anticoagulation is the standard treatment in patients with acute non-cirrhotic portal vein thrombosis (PVT). In critically ill patients, anticoagulation only may not suffice to achive rapid and stable recanalization. This study evaluates efficacy and safety of transjugular interventional therapy in acute non-cirrhotic PVT. METHODS: This retrospective study includes 17 consecutive patients with acute noncirrhotic, non-malignant PVT...
June 27, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28733043/perioperative-hypotension-and-discharge-outcomes-in-non-critically-injured-trauma-patients-a-single-centre-retrospective-cohort-study
#7
Nadav Sheffy, Itay Bentov, Brianna Mills, Bala G Nair, G Alec Rooke, Monica S Vavilala
BACKGROUND: There is a lack of information on the effect of age on perioperative care and outcomes after minor trauma in the elderly. We examined the association between perioperative hypotension and discharge outcome among non-critically injured adult patients. METHODS: We conducted a retrospective study of non-critically ill patients (ISS <9 or discharged within less than 24h) who received anaesthesia care for surgery and Recovery Room care at a level-1 trauma centre between 5/1/2012 and 11/30/2013...
June 24, 2017: Injury
https://www.readbyqxmd.com/read/28732314/the-effect-of-low-dose-furosemide-in-critically-ill-patients-with-early-acute-kidney-injury-a-pilot-randomized-blinded-controlled-trial-the-spark-study
#8
Sean M Bagshaw, R T Noel Gibney, Peter Kruger, Imran Hassan, Finlay A McAlister, Rinaldo Bellomo
PURPOSE: Furosemide is commonly prescribed in acute kidney injury (AKI). Prior studies have found conflicting findings on whether furosemide modifies the course and outcome of AKI. METHODS: Pilot multi-center randomized blinded placebo-controlled trial in adult patients with AKI admitted to three intensive care units. Participants were randomly allocated to furosemide bolus and infusion or 0.9% saline placebo. Primary endpoint was worsening AKI, defined by the RIFLE criteria...
July 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28731656/are-red-blood-cell-transfusions-associated-with-nosocomial-infections-in-critically-ill-children
#9
Omar E Naveda Romero, Andrea F Naveda Meléndez
Although the transfusionofblood products is common practice, its effects on the immune system have not been adequately studied. A prospective cohort study was conducted in critically ill children followed up until their death, transfer or discharge to establish an association between red blood cell transfusions (RBCTs) and nosocomial infections. A nosocomial infection was considered to be post-transfusional if it occurred within 14 days after RBCT. A total of 162 children were included in the study, 35 (21...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28730890/the-biopsychosocial-model-of-illness-a-model-whose-time-has-come
#10
Derick T Wade, Peter W Halligan
The biopsychosocial model outlined in Engel's classic Science paper four decades ago emerged from dissatisfaction with the biomedical model of illness, which remains the dominant healthcare model. Engel's call to arms for a biopsychosocial model has been taken up in several healthcare fields, but it has not been accepted in the more economically dominant and politically powerful acute medical and surgical domains. It is widely used in research into complex healthcare interventions, it is the basis of the World Health Organisation's International Classification of Functioning (WHO ICF), it is used clinically, and it is used to structure clinical guidelines...
August 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28730889/purposefulness-as-a-critical-factor-in-functioning-disability-and-health
#11
Joshua Y Lee, Emily A Ready, Eric N Davis, Philip C Doyle
Guided by theoretical frameworks of health and illness such as the International Classification of Functioning, Disability, and Health (ICF), we seek to describe the importance of purposefulness in the context of rehabilitation. We argue that ascribing meaning to life events, particularly changes in health, and acting in a manner that is driven by purpose is a universal characteristic of human beings. The ability to contextualize purposefulness within the broader biopsychosocial model of illness may provide a greater understanding of the relationship of purpose in the process of rehabilitation...
August 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28730691/effect-of-abrupt-discontinuation-of-antidepressants-in-critically-ill-hospitalized-adults
#12
Taryn B Bainum, David S Fike, Diana Mechelay, Krystal K Haase
OBJECTIVES: To determine whether discontinuation of chronic antidepressant therapy is associated with a higher risk of antidepressant discontinuation syndrome (ADS) symptoms in patients admitted to the intensive care unit (ICU) when compared with those who were continued on therapy and to identify factors associated with increased risk of ADS in this population. DESIGN: Single-center retrospective observational cohort study. SETTING: ICUs in a tertiary care hospital...
July 21, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28729329/fluids-in-sepsis-and-septic-shock-fissh-protocol-for-a-pilot-randomised-controlled-trial
#13
Bram Rochwerg, Tina Millen, Peggy Austin, Michelle Zeller, Frédérick D'Aragon, Roman Jaeschke, Marie-Hélène Masse, Sangeeta Mehta, Francois Lamontagne, Maureen Meade, Gordon Guyatt, Deborah J Cook
INTRODUCTION: Observational evidence suggests physiological benefits and lower mortality with lower chloride solutions; however, 0.9% saline remains the most widely used fluid worldwide. Given uncertainty regarding the association of lower chloride on mortality, it is unlikely that practice will change without direct randomised clinical trial (RCT) evidence. This pilot RCT will investigate the feasibility of a large-scale trial directly comparing low chloride with high chloride fluids in patients with septic shock...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28729312/protocol-a-grounded-theory-of-recovery-perspectives-of-adolescent-users-of-mental-health-services
#14
Lucianne Palmquist, Sue Patterson, Analise O'Donovan, Graham Bradley
INTRODUCTION: Policies internationally endorse the recovery paradigm as the appropriate foundation for youth mental health services. However, given that this paradigm is grounded in the views of adults with severe mental illness, applicability to youth services and relevance to young people is uncertain, particularly as little is known about young people's views. A comprehensive understanding of the experiences and expectations of young people is critical to developing youth mental health services that are acceptable, accessible, effective and relevant...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28729006/a-representative-assessment-of-the-management-of-open-fractures-of-the-lower-limb-within-uk-orthoplastic-centres-a-two-centre-audit-of-compliance-with-national-standards
#15
B Rymer, E O F Dimovska, D T S Chou, R Choa, B Davis, S Huq
BACKGROUND: Open fractures of the lower limb represent a complex and varied array of injuries. The BOAST 4 document produced by BAPRAS and the BOA provides standards on how to manage these patients, and NICE have recently produced additional guidance. We aimed to assess concordance with these standards in a large cohort representative of UK orthoplastic centres. METHODS: Patients admitted to the orthoplastic units at Norfolk and Norwich University Hospital and Royal Stoke University Hospital with open lower limb fractures between 2009 and 2014 were included...
July 11, 2017: Injury
https://www.readbyqxmd.com/read/28729005/influence-of-late-fluid-management-on-the-outcomes-of-severe-trauma-patients-a-retrospective-analysis-of-294-severely-injured-patients
#16
Mehdi Mezidi, Mehdi Ould-Chikh, Pauline Deras, Camille Maury, Orianne Martinez, Xavier Capdevila, Jonathan Charbit
BACKGROUND: Liberal late fluid management (LFM) is associated with higher morbi-mortality in critically ill populations. The aim of the study was to assess the association between LFM and duration of mechanical ventilation in a severe trauma population. METHODS: A retrospective analysis of consecutive patients with an ISS≥16 and a length of stay in the intensive care unit (ICU)≥7 days was performed. The conservative LFM group included patients with at least 2 consecutive days with a negative fluid balance between day 3 and day 7; other patients were allocated to the liberal LFM group...
June 15, 2017: Injury
https://www.readbyqxmd.com/read/28727945/micronutrient-alterations-during-continuous-renal-replacement-therapy-in-critically-ill-adults-a-retrospective-study
#17
Amir Y Kamel, Nisha J Dave, Vivian M Zhao, Daniel P Griffith, Michael J Connor, Thomas R Ziegler
BACKGROUND: Continuous renal replacement therapy (CRRT) is commonly used to provide renal replacement therapy in the intensive care unit. Limited published data suggest that CRRT may lead to depletion of water-soluble vitamins and trace elements. The goal of this study was to identify the incidence of trace element and vitamin deficiencies in critically ill patients during CRRT. MATERIALS AND METHODS: This study is based on a retrospective chart review of patients who were referred to Emory University Hospital's nutrition support services and had at least 1 serum micronutrient level measured during CRRT (thiamin, pyridoxine, ascorbic acid, folate, zinc, and copper) between April 1, 2009, and June 1, 2012...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28727923/height-prediction-from-ulna-length-of-critically-ill-patients
#18
Micheli S Tarnowski, Estela I Rabito, Daieni Fernandes, Mariane Rosa, Manoela L Oliveira, Vânia N Hirakata, Aline Marcadenti
BACKGROUND: Ulna length (UL) has been used in mathematical formulas to predict the body height of healthy and sick individuals. However, the evaluation of its use with patients admitted to intensive care units (ICU) is scarce. The objective of this study was to develop a mathematical equation to estimate critically ill patients' height using the UL measure and to evaluate its agreement with measured standing height. METHODS: This cross-sectional study was performed at the ICU of a tertiary hospital in Brazil...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28727802/diagnostic-accuracy-of-procalcitonin-neutrophil-lymphocyte-count-ratio-c-reactive-protein-and-lactate-in-patients-with-suspected-bacterial-sepsis
#19
Lars Ljungström, Anna-Karin Pernestig, Gunnar Jacobsson, Rune Andersson, Barbara Usener, Diana Tilevik
BACKGROUND: Early recognition is a key factor to achieve improved outcomes for septic patients. Combinations of biomarkers, as opposed to single ones, may improve timely diagnosis and survival. We investigated the performance characteristics of sepsis biomarkers, alone and in combination, for diagnosis of verified bacterial sepsis using Sepsis-2 and Sepsis-3 criteria, respectively. METHODS: Procalcitonin (PCT), neutrophil-lymphocyte count ratio (NLCR), C-reactive protein (CRP), and lactate were determined in a total of 1,572 episodes of adult patients admitted to the emergency department on suspicion of sepsis...
2017: PloS One
https://www.readbyqxmd.com/read/28725926/the-intensive-care-medicine-research-agenda-on-critically-ill-oncology-and-hematology-patients
#20
REVIEW
Elie Azoulay, Peter Schellongowski, Michael Darmon, Philippe R Bauer, Dominique Benoit, Pieter Depuydt, Jigeeshu V Divatia, Virginie Lemiale, Maarten van Vliet, Anne-Pascale Meert, Djamel Mokart, Stephen M Pastores, Anders Perner, Frédéric Pène, Peter Pickkers, Kathryn A Puxty, Francois Vincent, Jorge Salluh, Ayman O Soubani, Massimo Antonelli, Thomas Staudinger, Michael von Bergwelt-Baildon, Marcio Soares
Over the coming years, accelerating progress against cancer will be associated with an increased number of patients who require life-sustaining therapies for infectious or toxic chemotherapy-related events. Major changes include increased number of cancer patients admitted to the ICU with full-code status or for time-limited trials, increased survival and quality of life in ICU survivors, changing prognostic factors, early ICU admission for optimal monitoring, and use of noninvasive diagnostic and therapeutic strategies...
July 19, 2017: Intensive Care Medicine
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