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https://www.readbyqxmd.com/read/29327527/role-and-relevance-of-blood-pressure-variability-in-hypertension-related-co-morbidities
#1
Ashok Kumar, B C Kalmath, Georgi Abraham, Johann Christopher, Pln Kaparthi, Louie Fischer, Neeta Deshpande, N K Mishra, Praveen Raj, Rajesh Javerani, Ramesh Goyal, Reefa Dsouza, Shashank R Joshi
Despite maintaining mean blood pressure at optimal levels, cardiovascular complications still occur in hypertensive patients. Blood pressure variability (BPV) has been implicated as a prominent factor responsible for incurring this additional risk. In this review we attempted to generate a consensus on the importance of BPV in the hypertension management and to evaluate different therapeutic options available to reduce BPV. Panel comprising of 11 leading experts from India in different areas of clinical practice (including nephrology, diabetes and endocrinology, cardiology, and critical care medicine) was convened...
December 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29326410/-factors-predicting-the-interface-pressure-related-to-pressure-injury-in-intensive-care-unit-patients
#2
Ji Seon Shine, Soo Jin Kim, Ji Hyun Lee, Mi Yu
PURPOSE: Interface pressure is a factor that contributes to the occurrence of pressure injuries. This study aimed to investigate interface pressure at common sites of pressure injury (occipital, gluteal and peritrochanteric areas), to explore the relationships among risk factors, skin condition and interface pressure, and to identify risk factors influencing interface pressure. METHODS: A total of 100 patients admitted to the intensive care unit were enrolled at a tertiary teaching hospital in Korea...
December 2017: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/29319719/a-new-low-cost-negative-pressure-wound-therapy-versus-a-commercially-available-therapy-device-widely-used-to-treat-complex-traumatic-injuries-a-prospective-randomized-non-inferiority-trial
#3
Fabio Kamamoto, Ana Lucia Munhoz Lima, Marcelo Rosa de Rezende, Rames Mattar-Junior, Marcos de Camargo Leonhardt, Kodi Edson Kojima, Carla Chineze Dos Santos
OBJECTIVES: Negative-pressure wound therapy has been widely adopted to reduce the complexity of treating a broad range of acute and chronic wounds. However, its cost is high. The objective of this study was to evaluate the following two different methods of negative-pressure wound therapy in terms of healing time: a low-cost method of negative-pressure wound therapy (a pressure stabilizer device connected to a hospital wall-vacuum system with a gauze-sealed dressing, USP) and the standard of care (vacuum-assisted closure, VAC)...
December 2017: Clinics
https://www.readbyqxmd.com/read/29317188/considering-pharmacy-workflow-in-the-context-of-australian-community-pharmacy-a-pilot-time-and-motion-study
#4
Diana Cavaye, Elin C Lehnbom, Tracey-Lea Laba, Elise El-Boustani, Rohina Joshi, Ruth Webster
BACKGROUND: Given time pressures on primary care physicians, utilising pharmacists for chronic disease management is of great interest. However, limited data are available on the current workflow in community pharmacies to guide these discussions. OBJECTIVE: This study aimed to test the feasibility of collecting workflow data from Australian community pharmacies using the Work Observation Method By Activity Timing (WOMBAT) software and provide preliminary data on Australian pharmacy workflow...
January 4, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29313906/respiratory-complications-of-anaesthesia
#5
REVIEW
G H Mills
Postoperative pulmonary complications are a major determinant of outcome for patients and consume huge resources within hospital, particularly in critical care. Prediction and anticipation of postoperative pulmonary complications are vital for patient selection and, in some cases, for informed patient consent. Being able to assess the likelihood of postoperative pulmonary complications also allows research into methods to reduce them by allowing allocation of patients to the appropriate arms of research trials...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29310612/impending-extrusion-of-ex-press-shunt-treated-by-shunt-position-adjustment-a-case-report
#6
Yong Ju Song, Sumi Kim, Gil Joong Yoon
BACKGROUND: To report a case of impending extrusion of Ex-PRESS shunt treated by shunt-position adjustment. CASE PRESENTATION: A 56-year-old Asian woman presented with impending extrusion and malposition of Ex-PRESS shunt in her left eye. The bleb of the left eye was shallow and diffuse. In the past, the patient was treated by Ex-PRESS shunt implantation under the scleral flap in both eyes. There had been no Ex-PRESS shunt-related complication in her right eye, and she reported no history of left-eye trauma...
January 8, 2018: BMC Ophthalmology
https://www.readbyqxmd.com/read/29308756/-establishment-of-multiple-organ-dysfunction-syndrome-early-warning-score-in-patients-with-severe-trauma-and-its-clinical-significance-a-multicenter-study
#7
Wenjuan Huang, Song Qin, Yu Sun, Shangqi Yin, Xia Fan, Qi Huang, Tao Chen, Huaping Liang
OBJECTIVE: To explore the risk factors of multiple organ dysfunction syndrome (MODS) in severe trauma patients, put forward a new warning scoring system of MODS, and to provide a more accurate scoring method for doctors to judge the clinical condition and prognosis of patients. METHODS: Clinical data of 342 patients with severe trauma admitted to intensive care unit (ICU) of the Affiliated Hospital of Zunyi Medical College and Daping Hospital of the Third Military Medical University from January 1st, 2015 to December 31st, 2016 were retrospectively analyzed...
January 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29307752/a-2-year-comparative-study-of-mold-and-bacterial-counts-in-air-samples-from-neutral-and-positive-pressure-rooms-in-2-tertiary-care-hospitals
#8
Laura Ryan, Niall O'Mara, Sana Tansey, Tom Slattery, Belinda Hanahoe, Akke Vellinga, Maeve Doyle, Martin Cormican
Immunocompromised patients are at risk of invasive fungal infection. These high-risk patients are nursed in protective isolation to reduce the risk of nosocomial aspergillosis while in hospital-ideally in a positive pressure single room with high-efficiency particulate air filtration. However, neutral pressure rooms are a potential alternative, especially for patients requiring both protective and source isolation. This study examined mold and bacterial concentrations in air samples from positive and neutral pressure rooms to assess whether neutral pressure rooms offer a similar environment to that of positive pressure rooms in terms of mold concentrations in the air...
January 4, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29301764/adverse-events-in-patients-in-home-healthcare-a-retrospective-record-review-using-trigger-tool-methodology
#9
Kristina Görel Ingegerd Schildmeijer, Maria Unbeck, Mirjam Ekstedt, Marléne Lindblad, Lena Nilsson
OBJECTIVE: Home healthcare is an increasingly common part of healthcare. The patients are often aged, frail and have multiple diseases, and multiple caregivers are involved in their treatment. This study explores the origin, incidence, types and preventability of adverse events (AEs) that occur in patients receiving home healthcare. DESIGN: A study using retrospective record review and trigger tool methodology. SETTING AND METHODS: Ten teams with experience of home healthcare from nine regions across Sweden reviewed home healthcare records in a two-stage procedure using 38 predefined triggers in four modules...
January 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29300291/incontinence-associated-dermatitis-characteristics-and-relationship-to-pressure-injury-a-multisite-epidemiologic-analysis
#10
Mikel Gray, Karen K Giuliano
PURPOSE: The purpose of this study was to measure the prevalence of incontinence-associated dermatitis (IAD) among incontinent persons in the acute care setting, characteristics of IAD in this group, and associations among IAD, urinary, fecal, and dual incontinence, immobility, and pressure injury in the sacral area. DESIGN: Descriptive and correlational analysis of data from a large database of IAD, and pressure injuries of sacral area and heels. SUBJECTS AND SETTING: The sample comprised 5342 adult patients in acute care facilities in 36 states representing all regions of the United States...
January 2018: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29300285/sacral-skin-temperature-assessed-by-thermal-imaging-role-of-patient-vascular-attributes
#11
Harvey N Mayrovitz, Paige E Spagna, Martha C Taylor
PURPOSE: The purpose of this study was to test the hypothesis that temperature differentials measured by thermal imaging of sacral versus a remote skin area in critically ill patients differentiate those with significant vascular disease and risk for pressure injury of the sacral area. DESIGN: Prospective cohort study. SUBJECTS AND SETTING: The sample comprised 100 patients (58 men, 42 women) with mean ± SD ages of 70.4 ± 14.4 and 74.0 ± 14...
January 2018: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29299473/economic-evaluation-of-different-suture-closure-methods-barbed-versus-traditional-interrupted-sutures
#12
REVIEW
Randa K Elmallah, Anton Khlopas, Mhamad Faour, Morad Chughtai, Arthur L Malkani, Peter M Bonutti, Martin Roche, Steven F Harwin, Michael A Mont
Healthcare systems are receiving increasing pressures from payers, such as the Centers for Medicare and Medicaid (CMS), to reduce the costs associated with procedures, and with the implementation of the Affordable Care Act, high costs are addressed through pay-for-performance programs. Thus, multiple areas of total knee arthroplasty (TKA) surgery are under scrutiny, including surgical times, material costs, and the costs of associated complications and readmissions. Suture type has been determined to be a factor that may influence closure times, as well as direct material costs...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29297431/feasibility-and-yield-of-screening-for-non-communicable-diseases-among-treated-tuberculosis-patients-in-peru
#13
A L Byrne, B J Marais, C D Mitnick, F L Garden, L Lecca, C Contreras, Y Yauri, F Garcia, G B Marks
INTRODUCTION: The increasing prevalence of non-communicable diseases (NCDs) poses a major challenge to low- and middle-income countries. Patients' engagement with health services for anti-tuberculosis treatment provides an opportunity for screening for NCDs and for linkage to care. METHODS: We explored the feasibility and yield of screening for NCDs in patients treated for tuberculosis (TB) in Lima, Peru, as part of a study focused on chronic respiratory sequelae...
January 1, 2018: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/29282399/chronic-retinal-necrosis-severely-complicated-by-neovascular-glaucoma-a-case-report
#14
Takanori Matsuoka, Kazunobu Asao, Noriyasu Hashida, Kohji Nishida
Background: Chronic retinal necrosis (CRN) is a rare chronic granular necrotizing retinitis that was first described in 2013. CRN is characterized by intraocular inflammation accompanied by occlusive vasculitis, granular retinitis, and slowly progressing necrosis around the retina in a host with partial immune dysfunction. Cytomegalovirus (CMV) is reported to be a causative agent. There are several ocular complications such as retinal detachment and neovascular glaucoma; however, there has been no description of a clinical manifestation of neovascular glaucoma in CRN...
September 2017: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/29282052/identifying-gaps-in-the-continuum-of-care-for-hypertension-and-diabetes-in-two-indian-communities
#15
Rose Gabert, Marie Ng, Ruchi Sogarwal, Miranda Bryant, R V Deepu, Claire R McNellan, Sunil Mehra, Bryan Phillips, Marissa Reitsma, Blake Thomson, Shelley Wilson, Alexandra Wollum, Emmanuela Gakidou, Herbert C Duber
BACKGROUND: Non-communicable diseases (NCDs) represent the largest, and fastest growing, burden of disease in India. This study aimed to quantify levels of diagnosis, treatment, and control among hypertensive and diabetic patients, and to describe demand- and supply-side barriers to hypertension and diabetes diagnosis and care in two Indian districts, Shimla and Udaipur. METHODS: We conducted household and health facility surveys, as well as qualitative focus group discussions and interviews...
December 27, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29280169/comparative-analysis-of-the-effect-of-antihypertensive-drugs-on-the-survival-of-perforator-flaps-in-a-rat-model
#16
Jin-Woo Park, Goo-Hyun Mun
BACKGROUND: First-line antihypertensive drugs include calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, and diuretics. In this study, we compared the effects of antihypertensive drugs on the survival of perforator flaps in a rat model. MATERIALS AND METHODS: Fifty normotensive rats were randomly divided into five groups, with 10 rats in each group. Four different antihypertensive drugs were given via oral gavage for 7 days: group I: 1...
December 27, 2017: Microsurgery
https://www.readbyqxmd.com/read/29276653/prevalence-of-cardiovascular-disease-and-evaluation-of-standard-of-care-in-type-2-diabetes-a-nationwide-study-in-primary-care
#17
Jorgen Rungby, Morten Schou, Per Warrer, Lars Ytte, Gert S Andersen
Objective: Cardiovascular disease (CVD) complicates type 2 diabetes. Empagliflozin and liraglutide have demonstrated improved survival in patients with type 2 diabetes and established CVD. We assessed prevalence and standard of care of patients with type 2 diabetes and established CVD managed in primary care. Patients and methods: A total of 129 general practitioners in both rural and urban areas, responsible for 348 373 patients, identified their patients with type 2 diabetes...
December 2017: Cardiovascular Endocrinology
https://www.readbyqxmd.com/read/29262436/multimodality-monitoring-toward-improved-outcomes
#18
Richard Gandee, Chad Miller
Multimodality monitoring provides insights into the critically ill brain-injured patient through the assessment of biochemical, physiological, and electrical data that provides insight into a patient's condition and what strategies may be available to limit further damage and improve the odds for recovery. Modalities utilized include evaluation of intracranial pressure along with cerebral perfusion pressure to determine adequate blood flow; continuous electroencephalography to protect the patient from seizures and to identify early functional manifestations of ischemia and toxicity; transcranial Doppler evaluation for bedside review of circulatory adequacy; tissue oxygen monitoring to establish that brain tissue is receiving adequate oxygen from blood flow; and microdialysis to evaluate the metabolic function of the tissue in areas of concern...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29261569/the-cumulative-partial-pressure-of-arterial-oxygen-is-associated-with-neurological-outcomes-after-cardiac-arrest-treated-with-targeted-temperature-management
#19
Chun Song Youn, Kyu Nam Park, Soo Hyun Kim, Byung Kook Lee, Sang Hoon Oh, Kyung Woon Jeung, Seung Pill Choi
OBJECTIVE: Hyperoxia could lead to a worse outcome after cardiac arrest. The aim of this study was to investigate the relationship between the cumulative partial pressure of arterial oxygen (PaO2) and neurological outcomes after cardiac arrest treated with targeted temperature management. DESIGN: Retrospective analysis of a prospective cohort. SETTING: An academic tertiary care hospital. PATIENTS: A total of 187 consecutive patients treated with targeted temperature management after cardiac arrest...
December 19, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29246340/predicting-pressure-injury-risk-in-pediatric-patients-the-braden-qd-scale
#20
Martha A Q Curley, Natalie R Hasbani, Sandy M Quigley, Judith J Stellar, Tracy A Pasek, Stacey S Shelley, Lindyce A Kulik, Tracy B Chamblee, Mary Anne Dilloway, Catherine N Caillouette, Margaret A McCabe, David Wypij
OBJECTIVE: To describe the development and initial testing of the Braden QD Scale to predict both immobility-related and medical device-related pressure injury risk in pediatric patients. STUDY DESIGN: This was a multicenter, prospective cohort study enrolling hospitalized patients, preterm to 21 years of age, on bedrest for at least 24 hours with a medical device in place. Receiver operating characteristic curves using scores from the first observation day were used to characterize Braden QD Scale performance, including areas under the curve (AUC) with 95% CIs...
January 2018: Journal of Pediatrics
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