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https://www.readbyqxmd.com/read/29332427/serum-potassium-levels-and-outcomes-in-critically-ill-patients-in-the-medical-intensive-care-unit
#1
Surat Tongyoo, Tanuwong Viarasilpa, Chairat Permpikul
Objective To compare the outcomes of patients with and without a mean serum potassium (K+) level within the recommended range (3.5-4.5 mEq/L). Methods This prospective cohort study involved patients admitted to the medical intensive care unit (ICU) of Siriraj Hospital from May 2012 to February 2013. The patients' baseline characteristics, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, serum K+ level, and hospital outcomes were recorded. Patients with a mean K+ level of 3.5 to 4.5 mEq/L and with all individual K+ values of 3...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29332000/how-good-are-doctors-at-introducing-themselves-hellomynameis
#2
Peter Gillen, Sue Faye Sharifuddin, Muireann O'Sullivan, Alison Gordon, Eva M Doherty
BACKGROUND: This explorative study was triggered by the '#hellomynameis' campaign initiated by Dr Kate Granger in the UK. Our objectives were twofold: first, to measure rates of introduction in an Irish hospital setting by both consultant and non-consultant hospital doctors. Second to establish whether such practices were associated with patient perceptions of the doctor/patient interaction. METHOD: A patient 'exit' survey was undertaken following doctor-patient consultations in both acute (surgical and medical assessment units) and elective settings (outpatient clinics)...
January 13, 2018: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29331656/effect-of-a-wearable-patient-sensor-on-care-delivery-for-preventing-pressure-injuries-in-acutely-ill-adults-a-pragmatic-randomized-clinical-trial-ls-hapi-study
#3
David Pickham, Nic Berte, Mike Pihulic, Andre Valdez, Barbara Mayer, Manisha Desai
IMPORTANCE: Though theoretically sound, studies have failed to demonstrate the benefit of routine repositioning of at-risk patients for the prevention of hospital acquired pressure injuries. OBJECTIVE: To assess the clinical effectiveness of a wearable patient sensor to improve care delivery and patient outcomes by increasing the total time with turning compliance and preventing pressure injuries in acutely ill patients. DESIGN: Pragmatic, investigator initiated, open label, single site, randomized clinical trial...
December 30, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29329796/the-evolving-face-of-myocardial-reperfusion-in-acute-coronary-syndromes-a-primer-for-the-internist
#4
REVIEW
R Jay Widmer, Peter M Pollak, Malcolm R Bell, Bernard J Gersh, Nandan S Anavekar
Acute coronary syndromes (ACSs) account for a large proportion of disease burden in the United States and worldwide, and our understanding of ACS management continues to evolve. In this review we take a practical approach to evaluating and treating a patient with ACS, focusing on the optimal timing and methods of coronary reperfusion. Beginning with initial assessment and risk stratification, a provider managing the patient with ACS must be able to expeditiously decide on and implement the correct guideline-directed pathway to optimize outcomes...
January 9, 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29329356/prognostic-factors-of-noninvasive-mechanical-ventilation-in-lung-cancer-patients-with-acute-respiratory-failure
#5
Wei-Chih Chen, Vincent Yi-Fong Su, Wen-Kuang Yu, Yen-Wen Chen, Kuang-Yao Yang
INTRODUCTION: Few studies have reported outcomes of lung cancer patients with acute respiratory failure (RF) using noninvasive positive pressure ventilation (NIPPV). The aim of this study was to investigate the prognostic factors in these patients. MATERIALS AND METHODS: This retrospective observational study included all hospitalized lung cancer patients who received NIPPV for acute RF. It was conducted at a tertiary medical center in Taiwan from 2005 to 2010. The primary outcome was all cause mortality at 28 days after the initiation of NIPPV...
2018: PloS One
https://www.readbyqxmd.com/read/29326819/association-between-bullying-and-pediatric-psychiatric-hospitalizations
#6
Hadassa Leader, Jasmine Singh, Ayesha Ghaffar, Cheryl de Silva
Objectives: Bullying is a serious public health issue. We sought to demonstrate an association between bullying victimization and hospital admissions for acute psychiatric problems. We described the demographics and types of bullying in a sample of hospitalized patients in Staten Island, NY, and compared bullying victimization scores with psychiatric versus medical admissions. Methods: Patients in grades 3-12 were recruited from the Staten Island University Hospital Inpatient Pediatrics unit and emergency department...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29326340/rare-cause-of-pulmonary-cavitation-in-a-75-year-old-man
#7
Jaffar Al-Sheikhli, Hussein Taqi, John Drake, Ayaaz Habib
A 75-year-old man of Asian descent presented to the acute medical unit with signs and symptoms suggestive of a community-acquired pneumonia. He had multiple comorbidities and was relatively immunocompromised as a result. Initial investigations supported the diagnosis of community-acquired pneumonia complicated by a cavitating lung lesion, and the patient was treated as per hospital guidelines. He continued to deteriorate despite appropriate therapy and developed a hydropneumothorax, requiring the insertion of a chest drain...
January 10, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29321106/segway%C3%A2-personal-transporter-related-injuries-a-systematic-literature-review-and-implications-for-acute-and-emergency-care
#8
Ali Pourmand, Jen Liao, Jesse M Pines, Maryann Mazer-Amirshahi
BACKGROUND: The Segway® Personal Transporter™ (SPT) is used widely as a means of transport for city sightseeing tours, law enforcement, and professionals working in large facilities and factories. METHODS: We conducted a systematic review of the literature to assess SPT-related injuries. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, we queried PubMed from 1990 to 2017. The search terms Segway, personal transporter, and injury were used...
January 8, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29320313/acute-radiologic-manifestations-of-america-s-opioid-epidemic
#9
David D B Bates, Katherine Gallagher, HeiShun Yu, Jennifer Uyeda, Akira M Murakami, Bindu N Setty, Stephan W Anderson, Mariza O Clement
The United States is in the midst of an opioid use epidemic, which has severe medical, social, and economic consequences. Addictions to and abuse of prescription and illicit opioids are increasing, and emergency department radiologists are increasingly being faced with the task of examining patients who present with opioid-related complications. These complications may be the result of direct drug toxicity or nonsterile injection of the drugs. Neurologic, musculoskeletal, cardiopulmonary, genitourinary, and gastrointestinal complications may be evident at diagnostic imaging in emergent settings...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29319654/trauma-and-intensive-care-nursing-knowledge-and-attitude-of-foley-catheter-insertion-and-maintenance
#10
Brenda Shaver, Stephanie A Eyerly-Webb, Zoe Gibney, Linda Silverman, Candace Pineda, Rachele J Solomon
In the acute care setting, the majority of urinary tract infections are associated with indwelling urinary catheters. Despite guidelines for proper use, catheter-associated urinary tract infections (CAUTIs) continue to occur in critically ill/injured patients. There is a paucity of data on the translation between CAUTI prevention education and behavioral change. This project evaluated nurse's clinical knowledge and attitude toward Foley catheter insertion and maintenance to determine the benefits of addressing gaps in knowledge and inconsistencies in attitude through education...
January 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29319407/malpractice-litigation-in-acute-stroke-care-where-are-we-now
#11
Gilberto Kk Leung, Gerard Porter
Acute stroke care has undergone momentous changes in recent years with the introduction of intravenous thrombolysis, mechanical thrombectomy and integrated stroke services. While these are welcome developments, they also carry unique medico-legal challenges. In 2015, a patient from Greater Manchester was awarded over £1 million in compensation after ambulance paramedics failed to admit her to a specialist unit. This paper explores the medico-legal implications of this first but over looked thrombolysis-related claim in the United Kingdom...
January 1, 2018: Medico-legal Journal
https://www.readbyqxmd.com/read/29318698/nighttime-care-routine-interaction-and-sleep-disruption-in-adult-cardiac-surgery
#12
Jesus M Casida, Jean E Davis, Aaron Zalewski, James J Yang
AIMS AND OBJECTIVES: To explore the context and the influence of nighttime care routine interactions (NCRIs) on nighttime sleep effectiveness (NSE) and daytime sleepiness (DSS) of patients in the cardiac surgery critical-and progressive-care units of a hospital. BACKGROUND: There exists a paucity of empirical data regarding the influence of NCRIs on sleep and associated outcomes in hospitalized adult cardiac surgery patients. METHODS: An exploratory repeated measures research design was employed on the data provided by 38 elective cardiac surgery patients (mean age 60...
January 9, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29317976/postpartum-sudden-cardiac-death-after-spontaneous-coronary-artery-dissection-in-a-patient-with-fibromuscular-dysplasia
#13
Tannaz Shoja, Craig Basman, Suresh Jain, Aditya Mangla, Zoran Lasic
Spontaneous coronary artery dissection (SCAD) is a rare entity that can cause acute myocardial infarction and sudden cardiac death (SCD) which often goes unrecognized. We report a case of SCAD in a young postpartum female who presented with sudden cardiac arrest. The patient was managed medically and found to have fibromuscular dysplasia (FMD). After being stabilized in the critical care unit, coronary angiography was performed which showed dissection of the left main artery, intramural hematoma, and the culprit lesion...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29316937/estimate-of-incidence-and-cost-of-recreational-waterborne-illness-on-united-states-surface-waters
#14
Stephanie DeFlorio-Barker, Coady Wing, Rachael M Jones, Samuel Dorevitch
BACKGROUND: Activities such as swimming, paddling, motor-boating, and fishing are relatively common on US surface waters. Water recreators have a higher rate of acute gastrointestinal illness, along with other illnesses including respiratory, ear, eye, and skin symptoms, compared to non-water recreators. The quantity and costs of such illnesses are unknown on a national scale. METHODS: Recreational waterborne illness incidence and severity were estimated using data from prospective cohort studies of water recreation, reports of recreational waterborne disease outbreaks, and national water recreation statistics...
January 9, 2018: Environmental Health: a Global Access Science Source
https://www.readbyqxmd.com/read/29316845/rho-inhibitor-vx-210-in-acute-traumatic-subaxial-cervical-spinal-cord-injury-design-of-the-spinal-cord-injury-rho-inhibition-investigation-spring-clinical-trial
#15
Michael G Fehlings, Kee D Kim, Bizhan Aarabi, Marco Rizzo, Lisa M Bond, Lisa McKerracher, Alexander Vaccaro, David O Okonkwo
Traumatic spinal cord injury (SCI) is associated with a lifetime of disability stemming from loss of motor, sensory, and autonomic functions; these losses, along with increased comorbid sequelae, negatively impact health outcomes and quality of life. Early decompression surgery after SCI can enhance patient outcomes but does not directly facilitate neural repair and regeneration. Currently, there are no FDA-approved pharmacologic therapies to augment motor function and functional recovery in individuals with traumatic SCI...
January 9, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29313710/long-term-outcomes-after-protocolized-sedation-vs-usual-care-in-ventilated-pediatric-patients
#16
R Scott Watson, Lisa A Asaro, James H Hertzog, Lauren R Sorce, Alicia G Kachmar, Leslie A Dervan, Derek C Angus, David Wypij, Martha A Q Curley
RATIONALE: Whether a nurse-implemented goal-directed sedation protocol resulting in more awake yet calm intubated children affects post-discharge functional status, health-related quality of life, or risk for post-traumatic stress disorder is unknown. OBJECTIVES: To compare post-discharge outcomes in children with acute respiratory failure cluster randomized to a sedation protocol or usual care. METHODS: A stratified random sample of 1360 patients from 31 centers in the Randomized Evaluation of Sedation Titration for Respiratory Failure trial was assessed by mail, electronically, and/or telephone six months after intensive care unit discharge...
January 9, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29312837/recreational-marijuana-use-and-acute-myocardial-infarction-insights-from-nationwide-inpatient-sample-in-the-united-states
#17
Rupak Desai, Upenkumar Patel, Shobhit Sharma, Parth Amin, Rushikkumar Bhuva, Malav S Patel, Nitin Sharma, Manan Shah, Smit Patel, Sejal Savani, Neha Batra, Gautam Kumar
Background Marijuana is a widely used recreational substance. Few cases have been reported of acute myocardial infarction following marijuana use. To our knowledge, this is the first ever study analyzing the lifetime odds of acute myocardial infarction (AMI) with marijuana use and the outcomes in AMI patients with versus without marijuana use. Methods We queried the 2010-2014 National Inpatient Sample (NIS) database for 11-70-year-old AMI patients. Pearson Chi-square test for categorical variables and Student T-test for continuous variables were used to compare the baseline demographic and hospital characteristics between two groups (without vs...
November 3, 2017: Curēus
https://www.readbyqxmd.com/read/29310372/acute-kidney-injury-due-to-povidone-iodine-ingestion-a-case-report
#18
Chang Seong Kim, Sung Sun Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim
RATIONALE: Povidone-iodine is a broad-spectrum antiseptic applied topically to treat wounds and prevent their infection. There have been several case reports of acute kidney injury (AKI) in burn patients after povidone-iodine irrigation and in patients receiving the substance as a sclerotherapy agent for management of lymphocele after renal transplantation. However, biopsy-confirmed AKI after ingestion of povidone-iodine has not previously been described. PATIENT CONCERNS: A 47-year-old man who had apparently ingested povidone-iodine solution and presented with nausea, vomiting, and reduced urine output...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29304947/trading-bankruptcy-for-health-a-discrete-choice-experiment
#19
Mark G Shrime, Milton C Weinstein, James K Hammitt, Jessica L Cohen, Joshua A Salomon
BACKGROUND: Although nearly two-third of bankruptcy in the United States is medical in origin, a common assumption is that individuals facing a potentially lethal disease opt for cure at any cost. This assumption has never been tested, and knowledge of how the American population values a trade-off between cure and bankruptcy is unknown. OBJECTIVES: To determine the relative importance among the general American population of improved health versus improved financial risk protection, and to determine the impact of demographics on these preferences...
January 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29304923/potentially-modifiable-risk-factors-for-long-term-cognitive-impairment-after-critical-illness-a-systematic-review
#20
REVIEW
Amra Sakusic, John C O'Horo, Mikhail Dziadzko, Dziadzko Volha, Rashid Ali, Tarun D Singh, Rahul Kashyap, Ann M Farrell, John D Fryer, Ronald Petersen, Ognjen Gajic, Alejandro A Rabinstein
Long-term cognitive impairment is common in survivors of critical illness. Little is known about the etiology of this serious complication. We sought to summarize current scientific knowledge about potentially modifiable risk factors during intensive care unit (ICU) treatment that may play a substantial role in the development of long-term cognitive impairment. All searches were run on October 1, 2017. The search strategy included Ovid MEDLINE, Ovid Embase, Ovid CDR, Cochrane Central Register of Controlled Trials and Database of Abstracts of Reviews of Effect, Scopus, and Web of Science, and included MeSH headings and keywords related to intensive care, critical care, and cognitive disorders...
January 2018: Mayo Clinic Proceedings
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