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https://www.readbyqxmd.com/read/28092280/challenges-and-opportunities-to-enhance-global-drug-development-in-neonates
#1
Alexandra M Smith, Jonathan M Davis
PURPOSE OF REVIEW: This study reviews the history of neonatal drug development, recent legislative efforts designed to facilitate the study of therapeutic agents in neonates, and future steps necessary to advance drug development. RECENT FINDINGS: Although many federal regulations have been introduced over the past 15 years to encourage pediatric and neonatal drug development, the majority of medications that are used in the Neonatal Intensive Care Unit are not approved by the Food and Drug Administration (FDA) for use in neonates...
January 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28079529/leveraging-the-skills-of-nurses-and-the-power-of-language-nutrition-to-ensure-a-better-future-for-children
#2
Ashley Darcy Mahoney, Lauren Head Zauche, Sunny Hallowell, Arianne Weldon, Jennifer Stapel-Wax
BACKGROUND: Early language exposure is critical for language acquisition and significantly influences a child's literacy skills. However, preterm infants may experience language deprivation in the neonatal intensive care unit. Nurses are vital to helping parents understand their critical role in early language development. PURPOSE: To discuss the impact of language-rich interactions and interventions that promote early language exposure, or Language Nutrition, by parents and caregivers on the long-term developmental, language, and educational outcomes of high-risk infants...
January 11, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28076671/a-randomized-trial-of-collaborative-care-for-perinatal-depression-in-socioeconomically-disadvantaged-women-the-impact-of-comorbid-posttraumatic-stress-disorder
#3
Nancy K Grote, Wayne J Katon, Joan E Russo, Mary Jane Lohr, Mary Curran, Erin Galvin, Kathy Carson
OBJECTIVE: The comorbidity of posttraumatic stress disorder (PTSD) with antenatal depression poses increased risks for postpartum depression and may delay or diminish response to evidence-based depression care. In a secondary analysis of an 18-month study of collaborative care for perinatal depression, the authors hypothesized that pregnant, depressed, socioeconomically disadvantaged women with comorbid PTSD would show more improvement in the MOMCare intervention providing Brief Interpersonal Psychotherapy and/or antidepressants, compared to intensive public health Maternity Support Services (MSS-Plus)...
November 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28076304/the-use-of-liquid-chromatography-tandem-mass-spectrometry-for-therapeutic-drug-monitoring-of-antibiotics-in-cancer-patients
#4
Nahed El-Najjar, Jonathan Jantsch, André Gessner
Cancer remains a leading cause of mortality and morbidity worldwide. In addition to organ failure, the most frequent reasons for admission of cancer patients to intensive care units (ICU) are: infections and sepsis. As critically ill, the complexity of the health situation of cancer patients renders the standard antimicrobial regimen more complex and even inadequate which results in increased mortality rates. This is due to pathophysiological changes in the volume of distribution, increased clearance, as well as to organ dysfunction...
January 11, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28069789/hypotension-induced-by-the-concomitant-use-of-a-calcium-channel-blocker-and-clarithromycin
#5
Sayako Takeuchi, Yuki Kotani, Toshihide Tsujimoto
In the elderly, calcium-channel blockers are the first-line treatment for hypertension, and macrolides are commonly prescribed antibiotics. Here we report a 78-year-old man taking nifedipine, diltiazem and carvedilol who presented with persistent hypotension and bradycardia after clarithromycin was prescribed. He was diagnosed with drug-induced hypotension and treated with fluid resuscitation and vasoactive agents. His symptoms gradually improved. He was transferred out of the intensive care unit 3 days after hospitalisation...
January 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28062188/a-comprehensive-analysis-and-immunobiology-of-autoimmune-neurological-syndromes-during-the-zika-virus-outbreak-in-c%C3%A3%C2%BAcuta-colombia
#6
Juan-Manuel Anaya, Yhojan Rodríguez, Diana M Monsalve, Daniel Vega, Ernesto Ojeda, Diana González-Bravo, Mónica Rodríguez-Jiménez, Carlos A Pinto-Díaz, Pablo Chaparro, María L Gunturiz, Aftab A Ansari, M Eric Gershwin, Nicolás Molano-González, Carolina Ramírez-Santana, Yeny Acosta-Ampudia
We have focused on the epidemiology and immunobiology of Zika virus (ZIKV) infection and factors associated with the development of Guillain-Barré syndrome (GBS) and other neurological syndromes in Cúcuta, the capital of North Santander department, Colombia. Data of patients with ZIKV disease reported to the national population-based surveillance system were used to calculate the basic reproduction number (R0) and the attack rates (ARs) as well as to develop epidemiological maps. Patients with neurological syndromes were contacted and their diagnoses were confirmed...
January 3, 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28057949/impact-of-targeted-educational-interventions-on-clostridium-difficile-infection-treatment-in-critically-ill-adults
#7
Drayton A Hammond, Catherine A Hughes, Jacob T Painter, Rose E Pennick, Kshitij Chatterjee, Bradley Boye, Nikhil Meena
Background: Clostridium difficile infection (CDI) is a growing clinical and economic burden throughout the world. Pharmacists often are members of the primary care team in the intensive care unit (ICU) setting; however, the impact of pharmacists educating other health care providers on appropriateness of CDI treatment has not been previously examined. Objective: This study was performed to determine the impact of structured educational interventions on CDI treatment on appropriateness of CDI treatment and clinical outcomes...
December 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/28052047/mechanical-ventilatory-modes-and-cardioventilatory-phase-synchronization-in-acute-respiratory-failure-patients
#8
Claudio Enrico Mazzucco, Andrea Marchi, Vlasta Bari, Beatrice De Maria, Stefano Guzzetti, Ferdinando Raimondi, Emanuele Catena, Davide Ottolina, Carla Amadio, Silvio Cravero, Tommaso Fossali, Riccardo Colombo, Alberto Porta
Cardioventilatory phase synchronization was studied in ten critically ill patients admitted in intensive care unit (ICU) for acute respiratory failure under two mechanical ventilatory modes: i) pressure controlled ventilation (PCV); ii) pressure support ventilation (PSV). The two modalities were administered to the same patient in different times in a random order. Cardioventilatory phase interactions were typified by plotting the relative position of a heartbeat, detected from the electrocardiogram and collected in n groups, within m ventilatory cycles as a function of the progressive cardiac beat number via the synchrogram...
January 4, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28051772/characterizing-teamwork-in-cardiovascular-care-outcomes-a-network-analytics-approach
#9
Matthew B Carson, Denise M Scholtens, Conor N Frailey, Stephanie J Gravenor, Emilie S Powell, Amy Y Wang, Gayle Shier Kricke, Faraz S Ahmad, R Kannan Mutharasan, Nicholas D Soulakis
BACKGROUND: The nature of teamwork in healthcare is complex and interdisciplinary, and provider collaboration based on shared patient encounters is crucial to its success. Characterizing the intensity of working relationships with risk-adjusted patient outcomes supplies insight into provider interactions in a hospital environment. METHODS AND RESULTS: We extracted 4 years of patient, provider, and activity data for encounters in an inpatient cardiology unit from Northwestern Medicine's Enterprise Data Warehouse...
November 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28049028/morphine-exposure-during-early-life-alters-thermal-and-mechanical-thresholds-in-rats
#10
Ellen A Nunes, Liciane Fernandes Medeiros, Joice Soares de Freitas, Isabel Cristina Macedo, Jonnsin Kuo, Andressa de Souza, Joanna Rippol Rozisky, Wolnei Caumo, Iraci L S Torres
BACKGROUND: Morphine is an opioid analgesic used to relieve moderate-to-severe pain, including pain in neonates at the intensive care unit. In our previous study, we showed that repeated morphine exposure during early life could trigger long-lasting implications on the developing nervous system, such as long-term neurochemical and behavioral alterations in adult rats. AIMS: The aim of our study was to determine the short-, intermediate-, and long-term effects of repeated morphine administration during early life on the thermal and mechanical thresholds and on the central levels (cerebral cortex and brainstem) of neurotrophins (brain-derived neurotrophic factor [BDNF] and nerve growth factor [NGF]) and cytokines (interleukin-6 [IL-6] and IL-10)...
December 31, 2016: International Journal of Developmental Neuroscience
https://www.readbyqxmd.com/read/28025061/understanding-resident-performance-mindfulness-and-communication-in-critical-care-rotations
#11
Kevin Real, Katelyn Fields-Elswick, Andrew C Bernard
OBJECTIVE: Evidence from the medical literature suggests that surgical trainees can benefit from mindful practices. Surgical educators are challenged with the need to address resident core competencies, some of which may be facilitated by higher levels of mindfulness. This study explores whether mindful residents perform better than their peers as members of the health care team. DESIGN: This study employed a multiphase, multimethod design to assess resident mindfulness, communication, and clinical performance...
December 23, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/28011233/septic-shock-prediction-for-icu-patients-via-coupled-hmm-walking-on-sequential-contrast-patterns
#12
Shameek Ghosh, Jinyan Li, Longbing Cao, Kotagiri Ramamohanarao
BACKGROUND AND OBJECTIVE: Critical care patient events like sepsis or septic shock in intensive care units (ICUs) are dangerous complications which can cause multiple organ failures and eventual death. Preventive prediction of such events will allow clinicians to stage effective interventions for averting these critical complications. METHODS: It is widely understood that physiological conditions of patients on variables such as blood pressure and heart rate are suggestive to gradual changes over a certain period of time, prior to the occurrence of a septic shock...
December 20, 2016: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28001143/vital-signs-and-their-cross-correlation-in-sepsis-and-nec-a-study-of-1-065-very-low-birth-weight-infants-in-two-nicus
#13
Karen D Fairchild, Douglas E Lake, John Kattwinkel, J Randall Moorman, David A Bateman, Philip G Grieve, Joseph R Isler, Rakesh Sahni
BACKGROUND: Subtle changes in vital signs and their interactions occur in preterm infants prior to overt deterioration from late-onset septicemia (LOS) or necrotizing enterocolitis (NEC). Optimizing predictive algorithms may lead to earlier treatment. METHODS: For 1,065 very-low-birth-weight (VLBW) infants in two neonatal intensive care units (NICUs), mean, SD, and cross-correlation of respiratory rate, heart rate (HR), and oxygen saturation (SpO2) were analyzed hourly (131 infant-years' data)...
December 21, 2016: Pediatric Research
https://www.readbyqxmd.com/read/28000127/intensive-care-unit-admission-for-patients-in-the-interact2-ich-blood-pressure-treatment-trial-characteristics-predictors-and-outcomes
#14
Katja E Wartenberg, Xia Wang, Paula Muñoz-Venturelli, Alejandro A Rabinstein, Pablo M Lavados, Craig S Anderson, Thompson Robinson
BACKGROUND: Wide variation exists in criteria for accessing intensive care unit (ICU) facilities for managing patients with critical illnesses such as acute intracerebral hemorrhage (ICH). We aimed to determine the predictors of admission, length of stay, and outcome for ICU among participants of the main Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2). METHODS: INTERACT2 was an international, open, blinded endpoint, randomized controlled trial of 2839 ICH patients (<6 h) and elevated systolic blood pressure (SBP) allocated to receive intensive (target SBP <140 mmHg within 1 h) or guideline-recommended (target SBP <180 mmHg) BP-lowering treatment...
December 20, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27993215/anti-pd-l1-peptide-improves-survival-in-sepsis
#15
Yuichiro Shindo, Jacquelyn S McDonough, Katherine C Chang, Murali Ramachandra, Pottayil G Sasikumar, Richard S Hotchkiss
BACKGROUND: Sepsis remains a leading cause of death in most intensive care units. Many deaths in sepsis are due to nosocomial infections in patients who have entered the immunosuppressive phase of the disorder. One cause of immunosuppression in sepsis is T-cell exhaustion mediated by programmed cell death-1 (PD-1) interaction with its ligand (PD-L1). Studies demonstrated that blocking the interaction of PD-1 with PD-L1 with knockout mice or inhibitory antibodies reversed T-cell dysfunction and improved sepsis survival...
February 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27979477/maximizing-efficiency-on-trauma-surgeon-rounds
#16
Aliaksandr Ramaniuk, Barbara J Dickson, Sean Mahoney, Michael S O'Mara
BACKGROUND: Rounding by trauma surgeons is a complex multidisciplinary team-based process in the inpatient setting. Implementation of lean methodology aims to increase understanding of the value stream and eliminate nonvalue-added (NVA) components. We hypothesized that analysis of trauma rounds with education and intervention would improve surgeon efficacy. MATERIALS AND METHODS: Level 1 trauma center with 4300 admissions per year. Average non-intensive care unit census was 55...
January 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27927037/clinical-hepatotoxicity-associated-with-antifungal-agents
#17
Ioannis Kyriakidis, Athanasios Tragiannidis, Silke Munchen, Andreas H Groll
Invasive fungal diseases (IFDs) are a leading cause of morbidity and mortality among immunocompromised patients with bone marrow failure syndromes, hematological malignancies, hematopoietic stem cell transplantation (HSCT), those admitted in intensive care units (ICUs) and those with prolonged febrile neutropenia. IFDs occur in a setting of multiple morbidities and are associated with case fatality rates between 30 and 70%. Along with the development of classes and compounds, the last two decades have seen substantial improvements in the prevention and management of these infections and an overall increased use of antifungal agents...
December 16, 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27924651/caffeine-combined-with-sedative-anesthetic-drugs-triggers-widespread-neuroapoptosis-in-a-mouse-model-of-prematurity
#18
Omar Hoseá Cabrera, Shawn David O'Connor, Brant Stephen Swiney, Patricia Salinas-Contreras, Francesca Maria Manzella, George Townsend Taylor, Kevin Kiyoshi Noguchi
OBJECTIVES: Caffeine (CAF) and sedative/anesthetic drugs (SADs) are often coadministered to premature infants in the neonatal intensive care unit (NICU). While SAD neurotoxicity in the developing brain is well established, it is not fully clear whether CAF interacts with SADs and whether this interaction is detrimental. Using a mouse model of prematurity, we hypothesized that CAF would increase apoptotic neurotoxicity when coadministered with SADs. METHODS: Postnatal day 3 mice were treated with vehicle or 80 mg/kg CAF prior to challenge with 6 mg/kg midazolam, 40 mg/kg ketamine, or 40 μg/kg fentanyl...
December 7, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27923376/immunomodulation-after-ischemic-stroke-potential-mechanisms-and-implications-for-therapy
#19
REVIEW
Cynthia Santos Samary, Paolo Pelosi, Pedro Leme Silva, Patricia Rieken Macedo Rocco
Brain injuries are often associated with intensive care admissions, and carry high morbidity and mortality rates. Ischemic stroke is one of the most frequent causes of injury to the central nervous system. It is now increasingly clear that human stroke causes multi-organ systemic disease. Brain inflammation may lead to opposing local and systemic effects. Suppression of systemic immunity by the nervous system could protect the brain from additional inflammatory damage; however, it may increase the susceptibility to infection...
December 7, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27898697/risk-of-death-influences-regional-variation-in-intensive-care-unit-admission-rates-among-the-elderly-in-the-united-states
#20
Colin R Cooke
RATIONALE: The extent to which geographic variability in ICU admission across the United States is driven by patients with lower risk of death is unknown. OBJECTIVES: To determine whether patients at low to moderate risk of death contribute to geographic variation in ICU admission. METHODS: Retrospective cohort of hospitalizations among Medicare beneficiaries (age > 64 years) admitted for ten common medical and surgical diagnoses (2004 to 2009)...
2016: PloS One
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