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https://www.readbyqxmd.com/read/28931261/carotid-endarterectomy-in-patients-with-thrombocytopenia-analysis-of-the-national-surgical-quality-improvement-program-registry
#1
Adnan I Qureshi, Aiman Zafar, Muhammad Shah Miran, Vishal B Jani
BACKGROUND: Carotid endarterectomy (CEA) is infrequently performed in patients with mild to moderate thrombocytopenia. OBJECTIVE: To determine whether preoperative thrombocytopenia is associated with a higher rate of complications after CEA. METHODS: We analyzed patient characteristics, comorbid conditions, operative details, and 30-day postoperative outcomes for patients who underwent CEA in the CEA-targeted American College of Surgeons National Surgical Quality Improvement Program Registry...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28931169/effect-of-educational-package-on-lifestyle-of-primiparous-mothers-during-postpartum-period-a-randomized-controlled-clinical-trial
#2
Farzaneh Khodabandeh, Mojgan Mirghafourvand, Mahin KamaliFard, Sakineh Mohammad-Alizadeh-Charandabi, Mohammad Asghari Jafarabadi
A healthy lifestyle is important for mothers during the postpartum period. This study was conducted to determine the effects of a lifestyle educational package in primiparous women. This randomized clinical trial was conducted on 220 mothers assigned to two groups using block randomization. In the intervention group, the mothers received face-to-face, phone and SMS counseling and a booklet in addition to routine postpartum training; in the control group, the mothers received only routine training. The Health Behaviors Questionnaire, a Food Frequency Questionnaire and the International Physical Activity Questionnaire were used for data collection...
October 1, 2017: Health Education Research
https://www.readbyqxmd.com/read/28930959/outcomes-after-concomitant-traumatic-brain-injury-and-hemorrhagic-shock-a-secondary-analysis-from-the-pragmatic-randomized-optimal-platelets-and-plasma-ratios-trial
#3
Samuel M Galvagno, Erin E Fox, Savitri N Appana, Sarah Baraniuk, Patrick L Bosarge, Eileen M Bulger, Rachel A Callcut, Bryan A Cotton, Michael Goodman, Kenji Inaba, Terence O'Keeffe, Martin A Schreiber, Charles E Wade, Thomas M Scalea, John B Holcomb, Deborah M Stein
BACKGROUND: Often the clinician is faced with a diagnostic and therapeutic dilemma in patients with concomitant traumatic brain injury (TBI) and hemorrhagic shock (HS), as rapid deterioration from either can be fatal. Knowledge about outcomes after concomitant TBI and HS may help prioritize the emergent management of these patients. We hypothesized that patients with concomitant TBI and HS (TBI + HS) had worse outcomes and required more intensive care compared with patients with only one of these injuries...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930941/thoracic-irrigation-prevents-retained-hemothorax-a-prospective-propensity-scored-analysis
#4
Nathan W Kugler, Thomas W Carver, David Milia, Jasmeet S Paul
BACKGROUND: Thoracic trauma resulting in hemothorax (HTx) is typically managed with thoracostomy tube (TT) placement; however, up to 20% of patients develop retained HTx which may necessitate further intervention for definitive management. While optimal management of retained HTx has been extensively researched, little is known about prevention of this complication. We hypothesized thoracic irrigation at the time of TT placement would significantly decrease the rate of retained HTx necessitating secondary intervention...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930918/neutrophil-to-lymphocyte-ratio-predicts-death-in-acute-on-chronic-liver-failure-patients-admitted-to-the-intensive-care-unit-a-retrospective-cohort-study
#5
Nicolas Moreau, Xavier Wittebole, Yvan Fleury, Patrice Forget, Pierre-François Laterre, Castanares-Zapatero Diego
The neutrophil-to-lymphocyte ratio (NLR) is an inflammation score recognized as associated with outcome. While inflammation has been shown to correlate with the development of acute-on-chronic liver failure (ACLF), we sought to investigate the role of NLR in predicting 90-day mortality in cirrhotic patients experiencing ACLF.We performed a retrospective cohort study involving a total of 108 consecutive cirrhotic patients admitted in the intensive care unit (ICU). NLR, clinical and biological data were recorded...
September 19, 2017: Shock
https://www.readbyqxmd.com/read/28930916/peripheral-muscle-near-infrared-spectroscopy-nirs-variables-are-altered-early-in-septic-shock
#6
Diego Orbegozo, Fuhong Su, Keliang Xie, Lokmane Rahmania, Fabio Silvio Taccone, Daniel De Backer, Jean-Louis Vincent, Jacques Creteur
BACKGROUND: Non-invasive evaluation of muscle perfusion using near infrared spectroscopy (NIRS) coupled with a vascular occlusion test (VOT) may provide an early and simple marker of altered perfusion and microcirculatory function in sepsis. OBJECTIVE: To compare the time-course of NIRS-derived variables with systemic measures of perfusion in an experimental model of peritonitis. METHODS: Peritonitis was induced in eight anesthetized, mechanically ventilated, adult sheep (24-34 Kg), by injecting autologous feces into the peritoneal cavity...
September 19, 2017: Shock
https://www.readbyqxmd.com/read/28930905/effectiveness-of-early-warming-with-self-warming-blankets-on-postoperative-hypothermia-in-total-hip-and-knee-arthroplasty
#7
Baris B Koc, Martijn G M Schotanus, Jean-Paul A P A C Kollenburg, Maurice J A Janssen, Fabian Tijssen, Edwin J P Jansen
BACKGROUND: Hypothermia is an important complication in joint arthroplasty. Commonly, forced air warming (FAW) devices are used intraoperatively to maintain body temperature in patients undergoing surgery. However, it is believed that these convective warming systems could increase the risk of deep surgical site infections due to disruption of unidirectional downward laminar airflow. Conductive warming devices have no noticeable effect on ventilation airflow. Nevertheless, the effectiveness of the self-warming (SW) blanket, a novel conductive warming device, on postoperative hypothermia in elective joint arthroplasty is unknown...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28930848/nociceptive-stimulation-during-macintosh-direct-laryngoscopy-compared-with-mcgrath-mac-videolaryngoscopy-a-randomized-trial-using-indirect-evaluation-using-an-automated-administration-of-propofol-and-remifentanil
#8
Rathvirak Ing, Ngai Liu, Thierry Chazot, Julien Fessler, Jean François Dreyfus, Marc Fischler, Morgan Le Guen
BACKGROUND: Decrease of the nociceptive stimulation induced by laryngoscopy could be an advantage for patients without risk of difficult intubation. The present study aimed to compare the difference in nociceptive stimulation between the use of a conventional laryngoscope or of a videolaryngoscope. Amount of nociception was assessed indirectly using the peak remifentanil concentration determined by a closed-loop administration of propofol and remifentanil with bispectral index (BIS) as the input signal (target 50)...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28930815/variability-in-usual-care-mechanical-ventilation-for-pediatric-acute-respiratory-distress-syndrome-time-for-a-decision-support-protocol
#9
Christopher J L Newth, Katherine A Sward, Robinder G Khemani, Kent Page, Kathleen L Meert, Joseph A Carcillo, Thomas P Shanley, Frank W Moler, Murray M Pollack, Heidi J Dalton, David L Wessel, John T Berger, Robert A Berg, Rick E Harrison, Richard Holubkov, Allan Doctor, J Michael Dean, Tammara L Jenkins, Carol E Nicholson
OBJECTIVES: Although pediatric intensivists philosophically embrace lung protective ventilation for acute lung injury and acute respiratory distress syndrome, we hypothesized that ventilator management varies. We assessed ventilator management by evaluating changes to ventilator settings in response to blood gases, pulse oximetry, or end-tidal CO2. We also assessed the potential impact that a pediatric mechanical ventilation protocol adapted from National Heart Lung and Blood Institute acute respiratory distress syndrome network protocols could have on reducing variability by comparing actual changes in ventilator settings to those recommended by the protocol...
September 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28930814/neurologic-and-functional-morbidity-in-critically-ill-children-with-bronchiolitis
#10
Steven L Shein, Katherine N Slain, Jason A Clayton, Bryan McKee, Alexandre T Rotta, Deanne Wilson-Costello
OBJECTIVES: Neurologic and functional morbidity occurs in ~30% of PICU survivors, and young children may be at particular risk. Bronchiolitis is a common indication for PICU admission among children less than 2 years old. Two single-center studies suggest that greater than 10-25% of critical bronchiolitis survivors have neurologic and functional morbidity but those estimates are 20 years old. We aimed to estimate the burden of neurologic and functional morbidity among more recent bronchiolitis patients using two large, multicenter databases...
September 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28930813/temporal-changes-in-prescription-of-neuropharmacologic-drugs-and-utilization-of-resources-related-to-neurologic-morbidity-in-mechanically-ventilated-children-with-bronchiolitis
#11
Steven L Shein, Katherine Slain, Deanne Wilson-Costello, Bryan McKee, Alexandre T Rotta
OBJECTIVES: Critically ill children with bronchiolitis may require neuropharmacologic medications and support for neuro-functional sequelae, but current practices are not well described. We aimed to describe recent trends in neuropharmacology and utilization of neuro-rehabilitation resources in mechanically ventilated children with bronchiolitis. DESIGN: Analysis of the multicenter Pediatric Health Information System database. SETTING: Forty-seven U...
September 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28930639/50-years-of-research-in-ards-tidal-volume-selection-in-the-acute-respiratory-distress-syndrome
#12
Sarina K Sahetya, Jordi Mancebo, Roy G Brower
Mechanical ventilation (MV) is critical in the management of many patients with the acute respiratory distress syndrome (ARDS). However, MV can also cause ventilator-induced lung injury (VILI). The selection of an appropriate tidal volume is an essential part of a lung-protective MV strategy. Since the publication of a large randomized clinical trial demonstrating the benefit of lower tidal volumes, the use of tidal volumes of 6 mL/kg predicted body weight (PBW, based on sex and height) has been recommended in clinical practice guidelines...
September 20, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28930627/fitness-body-composition-and-vascular-health-in-adolescent-and-young-adult-survivors-of-paediatric-brain-cancer-and-cranial-radiotherapy
#13
Treya M Long, Shoshana R Rath, Tessa D Maroni, Karen E Wallman, Helen C Atkinson, Nicholas G Gottardo, Catherine H Cole, Catherine S Choong, Louise H Naylor
Background Survivors of paediatric brain cancer and/or cranial radiotherapy (CRT) are at an increased risk of developing serious comorbidities. Established risk factors for chronic disease include central obesity, endothelial abnormalities and diminished fitness. Objectives Here we characterised anthropometry, body composition, bone mineral density (BMD), heart rate (HR), blood pressure (BP), endothelial function, muscular strength and endurance and aerobic fitness in adolescent and young adult (AYA) survivors...
September 20, 2017: International Journal of Adolescent Medicine and Health
https://www.readbyqxmd.com/read/28930478/mechanical-ventilation-induced-diaphragm-atrophy-strongly-impacts-clinical-outcomes
#14
Ewan C Goligher, Martin Dres, Eddy Fan, Gordon D Rubenfeld, Damon C Scales, Margaret S Herridge, Stefannie Vorona, Michael C Sklar, Nuttapol Rittayamai, Ashley Lanys, Alistair Murray, Deborah Brace, Cristian Urrea, W Darlene Reid, George Tomlinson, Arthur S Slutsky, Brian P Kavanagh, Laurent J Brochard, Niall D Ferguson
Rationale Diaphragm dysfunction worsens outcomes in mechanically ventilated patients but the clinical impact of potentially preventable changes in diaphragm structure and function due to mechanical ventilation is unknown. Objectives To determine whether diaphragm atrophy developing during mechanical ventilation leads to prolonged ventilation. Methods Diaphragm thickness was measured daily by ultrasound in adults requiring invasive mechanical ventilation; inspiratory effort was assessed by thickening fraction...
September 20, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28930178/diagnostic-value-of-endotracheal-aspirates-sonication-on-ventilator-associated-pneumonia-microbiologic-diagnosis
#15
Laia Fernández-Barat, Ana Motos, Otavio T Ranzani, Gianluigi Li Bassi, Elisabet Aguilera Xiol, Tarek Senussi, Chiara Travierso, Chiara Chiurazzi, Francesco Idone, Laura Muñoz, Jordi Vila, Miquel Ferrer, Paolo Pelosi, Francesco Blasi, Massimo Antonelli, Antoni Torres
Microorganisms are able to form biofilms within respiratory secretions. Methods to disaggregate such biofilms before utilizing standard, rapid, or high throughput diagnostic technologies may aid in pathogen detection during ventilator associated pneumonia (VAP) diagnosis. Our aim was to determine if sonication of endotracheal aspirates (ETA) would increase the sensitivity of qualitative, semi-quantitative, and quantitative bacterial cultures in an animal model of pneumonia caused by Pseudomonasaeruginosa or by methicillin resistant Staphylococcusaureus (MRSA)...
September 20, 2017: Microorganisms
https://www.readbyqxmd.com/read/28930049/experience-with-the-syncardia-total-artificial-heart-in-a-canadian-centre
#16
Anthony Nguyen, Michel Pellerin, Louis P Perrault, Michel White, Anique Ducharme, Normand Racine, Michel Carrier
BACKGROUND: The SynCardia total artificial heart (TAH) provides complete circulatory support by replacing both native ventricles. Accepted indications include bridge to transplantation and destination therapy. We review our experience with TAH implantation during a period when axial flow pump became available. METHODS: We retrospectively analyzed the demographics, clinical characteristics and survival of all patients receiving the TAH. RESULTS: From September 2004 to November 2016, 13 patients (12 men, mean age 45 ± 13 yr) received the TAH for refractory cardiogenic shock secondary to idiopathic (56%) or ischemic (17%) cardiomyopathy and to other various causes (33%)...
October 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28929966/-a-case-with-scalp-pruritus-caused-by-dermanysus-gallinae-order-mesostigmata
#17
Mustafa Şengül, Nida Kaçar, Mehmet Karaca, Sedef Zeliha Öner, Çağrı Ergin
Dermanyssus gallinae is one of the important hematophagous ectoparasite species of poultry like chicken, pigeon and wild bird species. These ectoparasites in the form of nymphs or adults who can not find their hosts are also seen in mammals and even in humans. For this reason, they are considered as important for public health. The ectoparasite causes a clinical condition named gamasoidosis among pet owners and people who live or work close to animal shelters, barns and chicken farms. Pruritus dermatitis is also caused by D...
July 2017: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28929237/underground-anemotactic-orientation-in-leaf-cutting-ants-perception-of-airflow-and-experience-dependent-choice-of-airflow-direction-during-digging
#18
Florian Halboth, Flavio Roces
Air exchange between the large nests of Atta vollenweideri leaf-cutting ants and the environment strongly relies on a passive, wind-induced ventilation mechanism. Air moves through nest tunnels and airflow direction depends on the location of the tunnel openings on the nest mound. We hypothesized that ants might use the direction of airflow along nest tunnels as orientation cue in the context of climate control, as digging workers might prefer to broaden or to close tunnels with inflowing or outflowing air in order to regulate nest ventilation...
September 19, 2017: Die Naturwissenschaften
https://www.readbyqxmd.com/read/28928610/does-heart-type-fatty-acid-binding-protein-predict-clinical-outcomes-after-pediatric-cardiac-surgery
#19
Egmond S Evers, Varsha Walavalkar, Suresh Pujar, Latha Balasubramanian, Frits W Prinzen, Tammo Delhaas, Ward Y Vanagt, Shreesha Maiya
INTRODUCTION: The early identification of vulnerable pediatric cardiac surgery patients can help clinicians provide them with timely support. Heart-type fatty acid-binding protein. (H-FABP) is an early biomarker of myocardial injury in acute myocardial infarction in adults. In this study, we evaluated the correlations between postoperative H-FABP, creatine kinase-myocardial band (CK-MB), troponin-I, total bypass time, and clinical outcomes. METHODS: In 32 pediatric patients that underwent ventricular septal defect...
September 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28928596/ease-in-bag-and-mask-ventilation-is-ankyloglossia-in-a-child-with-micrognathia-a-blessing-in-disguise
#20
Vansh Priya, Rameez Riaz, Sanjay Dhiraaj, Puneet Goyal
No abstract text is available yet for this article.
July 2017: Anesthesia, Essays and Researches
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