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https://www.readbyqxmd.com/read/29149961/practice-variation-in-the-immediate-postoperative-care-of-pediatric-kidney-transplantation-a-national-survey
#1
S Abu-Sultaneh, M J Hobson, A C Wilson, W C Goggins, M E Nitu, R Lutfi
INTRODUCTION: Advances in organ allocation, surgical technique, immunosuppression, and long-term follow-up have led to a significant improvement in kidney transplant outcomes. Although there are clear recommendations for several aspects of kidney transplant management, there are no pediatric-specific guidelines for immediate postoperative care. The aim of this survey is to examine practice variations in the immediate postoperative care of pediatric kidney transplant patients. METHODS: We surveyed medical directors of Pediatric Acute Lung Injury and Sepsis Investigators (PALISI)-affiliated pediatric intensive care units regarding center-specific immediate postoperative management of pediatric kidney transplantation...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29147805/can-clinical-practice-indicator-relating-to-long-acting-benzodiazepine-use-in-the-elderly-be-easily-generated-in-a-hospital-setting
#2
Badria Kadri, Antonio Teixeira, Christelle Duteil, Annabelle Tan, Hélène Barreteau, Christophe Segouin, Pénélope Troude
BACKGROUND: To improve the appropriate use of long-acting benzodiazepine (la.bzd) prescriptions in the elderly, the Haute Autorité de Santé (HAS) has developed clinical practice indicators (CPI). The alert indicator (AI) evaluates the prevalence of la.bzd prescription among older people. The mastering indicator (MI) corresponds to the prevalence of elderly with a justified, i.e., appropriate, la.bzd prescription among all the elderly with la.bzd prescriptions. OBJECTIVE: The objective of this study was to test the feasibility of routine generation of CPI regarding la...
November 16, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29146420/extracorporeal-membrane-oxygenation-used-successfully-in-a-near-fatal-case-of-opioid-induced-acute-respiratory-distress-syndrome
#3
Karen Greenberg, Benjamin Kohl
Acute Respiratory Distress Syndrome (ARDS) was first recognized during the 1960s. It is a distinct type of hypoxemic respiratory failure characterized by acute abnormality of both lungs. Extracorporeal membrane oxygenation (ECMO) is being increasingly used for patients with severe ARDS refractory to otherwise conventional management. A 29year old male arrived with Emergency Medical Services (EMS) status post presumed heroin overdose. He was administered Naloxone 2mg intravenously prior to arrival in the emergency department...
November 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29144720/cost-effectiveness-of-gammacore-non-invasive-vagus-nerve-stimulation-for-acute-treatment-of-episodic-cluster-headache
#4
Mkaya Mwamburi, Eric J Liebler, Andrew T Tenaglia
Cluster headache is a debilitating disease characterized by excruciatingly painful attacks that affects 0.15% to 0.4% of the US population. Episodic cluster headache manifests as circadian and circannual seasonal bouts of attacks, each lasting 15 to 180 minutes, with periods of remission. In chronic cluster headache, the attacks occur throughout the year with no periods of remission. While existing treatments are effective for some patients, many patients continue to suffer. There are only 2 FDA-approved medications for episodic cluster headache in the United States, while others, such as high-flow oxygen, are used off-label...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29142632/delayed-burr-hole-surgery-in-patients-with-acute-subdural-hematoma-clinical-analysis
#5
Yoon Heuck Choi, Seong Rok Han, Chang Hyun Lee, Chan Young Choi, Moon Jun Sohn, Chae Heuck Lee
Objective: To evaluate the effectiveness and efficacy of delayed burr hole surgery in relation to the reduction of postoperative subdural hematoma (SDH) volume in patients with acute SDH. Methods: We retrospectively analyzed patients with acute SDH who received delayed burr hole surgery at our institute. Age, sex, Glasgow coma scale, maximal SDH thickness, volume of SDH, midline shifts, hounsfield unit (HU), and medical history of anticoagulant agent usage were recorded...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29141658/thioredoxin-mitigates-radiation-induced-hematopoietic-stem-cell-injury-in-mice
#6
Pasupathi Sundaramoorthy, Qinhong Wang, Zhihong Zheng, Yiqun Jiao, Benny J Chen, Phuong L Doan, Nelson J Chao, Yubin Kang
BACKGROUND: Radiation exposure poses a significant threat to public health. Hematopoietic injury is one of the major manifestations of acute radiation sickness. Protection and/or mitigation of hematopoietic stem cells (HSCs) from radiation injury is an important goal in the development of medical countermeasure agents (MCM). We recently identified thioredoxin (TXN) as a novel molecule that has marked protective and proliferative effects on HSCs. In the current study, we investigated the effectiveness of TXN in rescuing mice from a lethal dose of total body radiation (TBI) and in enhancing hematopoietic reconstitution following a lethal dose of irradiation...
November 15, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/29141183/functional-outcomes-of-acute-inpatient-rehabilitation-in-patients-with-chronic-graft-versus-host-disease
#7
Jason Leung, Sean Smith, Claire Kalpakjian
BACKGROUND: Growing numbers of allogeneic stem cell transplants (HSCT) and improved post-transplant care have led to an increase of individuals with chronic graft versus host disease (cGVHD). Although cGVHD leads to functional impairment for many, there is limited literature regarding the benefits of acute inpatient rehabilitation for cGVHD patients. OBJECTIVE: To assess Functional Independence Measure (FIM) outcomes of cGVHD patients during acute inpatient rehabilitation, and to compare inpatient rehabilitation outcomes to burn patients, a rehabilitation patient population with similar co-morbidities...
November 12, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29138849/elevated-serum-levels-of-lipoprotein%C3%A2-associated-phospholipase%C3%A2-a2-predict-mortality-rates-in-patients-with-sepsis
#8
Zhongwei Huang, Haiyan Jiang, Xiaohui Cui, Guiwen Liang, Yu Chen, Ting Wang, Zhichao Sun, Lei Qi
Sepsis remains one of the leading contributors to mortality rates in the intensive care unit (ICU) and emergency intensive care unit (EICU). Therefore, any treatments against the agents which produce sepsis in a medical emergency, are welcome. Elevated serum levels of lipoprotein‑associated phospholipase A2 (Lp‑PLA2) have been reported in a small cohort of patients with inflammation. The present study evaluated serum levels of Lp‑PLA2 in patients with sepsis and investigated the role of Lp‑PLA2 in sepsis...
November 13, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29137820/does-acute-care-for-the-elderly-ace-unit-decrease-the-incidence-of-falls
#9
Ahmed Abdalla, Mehul Adhaduk, Raad A Haddad, Yanal Alnimer, Carlos F Ríos-Bedoya, Ghassan Bachuwa
To determine whether acute care for the elderly (ACE) units decrease the incidence of patient falls compared to general medical and surgical (GMS) units, a non-concurrent prospective study included individuals aged 65 and older admitted to ACE or GMS units over a 2-year span was done. There were 7069 admissions corresponded to 28,401 patient-days. A total of 149 falls were reported for an overall incidence rate (IR) of 5.2 falls per 1000 patient-days, 95% CI, 4.4/1000-6.1/1000 patient-days. The falls IR ratio for patients in ACE unit compared to those in non-ACE units after adjusting for age, sex, prescribed psychotropics and hypnotics, and Morse Fall Score was 0...
November 11, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/29137693/another-chance-at-life-jordanian-patients-experience-of-going-through-a-myocardial-infarction
#10
Ali Ahmad Ammouri, Joy Kabasindi Kamanyire, Ahmad H Abu Raddaha, Susan Achora, Arwa Atef Obeidat
BACKGROUND AND PURPOSE: Myocardial infarction (MI) is a life-threatening health condition that has physical, spiritual, emotional, and social changes. Understanding feelings and thoughts of patients who suffered MI attacks is essential to recovery. Among Jordanian patients who suffered an acute attack of MI, the aim of the study was to describe the experiences and the varied meanings that they assign to their experiences. METHODS: A qualitative hermeneutic phenomenological research design was used...
November 1, 2017: Research and Theory for Nursing Practice
https://www.readbyqxmd.com/read/29137585/association-of-positive-fluid-balance-and-mortality-in-sepsis-and-septic-shock-in-an-australian-cohort
#11
M G Pittard, S J Huang, A S McLean, S R Orde
In patients with septic shock, a correlation between positive fluid balance and worsened outcomes has been reported in multiple observational studies worldwide. No published data exists in an Australasian cohort. We set out to explore this association in our institution. We conducted a retrospective audit of patient records from August 2012 to May 2015 in a single-centre, 24-bed surgical and medical intensive care unit (ICU) in Sydney, Australia. All patients with septic shock were included. Exclusion criteria included length of stay less than 24 hours or vasopressors needed for less than six hours...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29136301/ketamine-for-the-acute-management-of-excited-delirium-and-agitation-in-the-prehospital-setting
#12
Kyle A Weant, Lauren M Linder, Clint A Ross
BACKGROUND: Traditional first-line therapy in the prehospital setting for the acutely agitated patient includes an antipsychotic in combination with a benzodiazepine. Recently, interest has grown regarding the use of ketamine in the prehospital setting as an attempt to overcome the limitations of the traditional medications and provide a more safe and effective therapy. This review provides an overview of the pharmacology of ketamine, evaluates the literature regarding ketamine use for prehospital agitation, and proposes an algorithm that may be used within the prehospital setting...
November 14, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29135754/implementation-of-a-pediatric-behavioral-staffing-algorithm-in-an-acute-hospital-a-best-practice-implementation-project
#13
Tamara O'Connor
BACKGROUND: A progressive decline in acute psychiatric facility beds has led to a steadily increasing number of pediatric psychiatric patients hospitalized on acute care medical-surgical units. Clinical nurses in this environment feel ill-equipped to provide quality behavioral health care. AIMS/OBJECTIVES: This project aimed to improve continuity of care as well as staff and patient safety in pediatric acute and transitional care units. The specific objectives related to implementation of a resource allocation algorithm for staffing behavioral health admissions and consistent use of an interdisciplinary psychiatric huddle...
November 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29134926/influence-of-stroke-coordinators-on-delivery-of-acute-stroke-care-and-hospital-outcomes-an-observational-study
#14
Tara Purvis, Monique F Kilkenny, Sandy Middleton, Dominique A Cadilhac
Background Stroke coordinators have been inconsistently used in various countries to support stroke care in hospital. Aim To investigate the association between stroke coordinators and the provision of evidence-based care and patient outcomes in hospitals with acute stroke units. Methods Observational study using cross-sectional data from the 2015 National Acute Services Audit Program (Australia): including a retrospective medical record audit (40 records from each hospital) and a self-reported survey of organizational resources for stroke...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29132321/the-role-of-the-specialized-team-in-the-operation-of-continuous-renal-replacement-therapy-a-single-center-experience
#15
Harin Rhee, Gum Sook Jang, Miyeun Han, In Seong Park, Il Young Kim, Sang Heon Song, Eun Young Seong, Dong Won Lee, Soo Bong Lee, Ihm Soo Kwak
BACKGROUND: The requirement of continuous renal replacement therapy (CRRT) is increasing with the growing incidence of acute kidney injury (AKI). The decision to initiate CRRT is not difficult if an adequate medical history is obtained. However, the handling and maintenance of CRRT constitute a labor-intensive intervention that requires specialized skills. For these reasons, our center organized a specialized CRRT team in March 2013. The aim of this study is to report on the role of a specialized CRRT team and to evaluate the team's outcome...
November 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29132090/the-potential-use-of-transdermal-drug-delivery-for-the-prophylaxis-and-management-of-stroke-and-coronary-artery-disease
#16
REVIEW
Kevin Ita
In 2013, cardiovascular disease was responsible for 30.8% (800,937) of all 2,596,993 deaths, or approximately 1 of every 3 deaths while stroke caused about 1 of every 20 deaths in the United States [1]. To put it in context, about 795,000 people continue to have a new or recurrent stroke (ischemic or hemorrhagic) [1] in the USA. Mechanical vascular recanalization and thrombolysis with tissue plasminogen activator are the only clinically useful approaches available now for the management of ischemic stroke [2]...
June 4, 2017: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/29127768/diabetic-ketoacidosis-hyperuricemia-and-encephalopathy-intractable-to-regular-dose-insulin
#17
Jillian Gregory, Sonali Basu
BACKGROUND: Diabetic ketoacidosis (DKA) in children less than 1 year of age is a rare occurrence. Typical presentation includes a prodrome of weight loss and polyuria with subsequent presentation to medical care when acidosis becomes symptomatic. CASE PRESENTATION: We describe an unusual case of a previously healthy infant with a 3 days' history of constipation, presenting acutely with abdominal pain, lethargy, and dehydration. On initial evaluation, our patient had profound encephalopathy, with marked tachypnea and work of breathing...
November 11, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/29126895/extracorporeal-membrane-oxygenation-in-circulatory-and-respiratory-failure-a-single-center-experience
#18
Marisa Passos Silva, Daniel Caeiro, Paula Fernandes, Cláudio Guerreiro, Eduardo Vilela, Marta Ponte, Adelaide Dias, Fernando Alves, Jorge Morais, Andreza Mello, Lino Santos, Paula Castelões, Vasco Gama
INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) provides mechanical pulmonary and circulatory support for patients with shock refractory to conventional medical therapy. In this study we aim to describe the indications, clinical characteristics, complications and mortality associated with use of ECMO in a single tertiary hospital. METHODS: We conducted a retrospective observational cohort study of all patients supported with ECMO in two different intensive care units (general and cardiac), from the first patient cannulated in April 2011 up to October 2016...
November 7, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29126197/impaired-insulin-action-is-associated-with-increased-glucagon-concentrations-in-non-diabetic-humans
#19
Anu Sharma, Ron T Varghese, Meera Shah, Chiara Dalla Man, Claudio Cobelli, Robert A Rizza, Kent R Bailey, Adrian Vella
Context: Abnormal glucagon concentrations contribute to hyperglycemia but the mechanism(s) of α-cell dysfunction in prediabetes are unclear. Objective: We sought to determine the relative contributions of insulin secretion and action to α-cell dysfunction in non-diabetic subjects across the spectrum of glucose tolerance. Design: This was a cross-sectional study. A subset of subjects (n = 120) was studied in the presence and absence of free fatty acid (FFA) elevation, achieved by infusion of intralipid + heparin, to cause insulin resistance...
November 6, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29125033/medical-costs-in-patients-with-heart-failure-after-acute-heart-failure-events-one-year-follow-up-study
#20
Eugene Kim, Hye-Young Kwon, Sang Hong Baek, Haeyoung Lee, Byung-Su Yoo, Seok-Min Kang, Youngkeun Ahn, Bongmin Yang
AIMS: This study investigated annual medical costs using real-world data focusing on acute heart failure. METHODS: The data were retrospectively collected from 6 tertiary hospitals in South Korea. Overall, about 330 patients who were hospitalized for acute heart failure between January 2011 and July 2012 were selected. We collected data on their follow-up medical visits for one year, including medical costs incurred toward treatment. Those who died within the observational period or who had no records of follow-up visits were excluded...
November 10, 2017: Journal of Medical Economics
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