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https://www.readbyqxmd.com/read/27924651/caffeine-combined-with-sedative-anesthetic-drugs-triggers-widespread-neuroapoptosis-in-a-mouse-model-of-prematurity
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/27886650/the-relationship-between-gestational-age-and-the-severity-of-neonatal-abstinence-syndrome
#4
Kelly S Gibson, Ms Sydney Stark, Deepak Kumar, Jennifer L Bailit
BACKGROUND AND AIMS: The relationship between gestational age at delivery and the severity of neonatal abstinence syndrome (NAS) is poorly understood. Our objective was to compare the length of pharmacotherapy and hospital stay among opioid exposed infants born during the late preterm, early term, full term, and late term periods. DESIGN: Retrospective cohort study of infants affected by NAS SETTING: MetroHealth Medical Center in Cleveland, Ohio, USA: an urban tertiary care hospital serving as the referral center for opioid dependency in pregnancy with a level III neonatal intensive care unit PARTICIPANTS: All deliveries complicated by maternal opioid exposure from January 2000 to October 2014; 403 were eligible to be included (n = 102 Late Preterm, 34-36weeks (LP), n = 158 Early Term, 37-38weeks (ET), n = 122 Full Term, 39-40weeks (FT), n = 21 Late Term, ≥41 weeks (LT))...
November 25, 2016: Addiction
https://www.readbyqxmd.com/read/27883969/drug-drug-interactions-in-the-intensive-care-unit-do-they-really-matter
#5
D Vanham, A Spinewine, Ph Hantson, X Wittebole, D Wouters, B Sneyers
PURPOSE: To describe prevalence and patterns of potential drug-drug interactions (pDDIs) in the intensive care unit (ICU), occurrence of adverse drug events (ADEs), and agreement between different compendia and intensivists' perceptions. METHODS: A cross-sectional study. Drug profiles of all adult patients from 2 academic ICUs were screened on day 3 upon admission. We identified pDDIs using 3 compendia (Stockley's, Micromedex, and Epocrates) and documented their mechanism of action, clinical consequences, severity, level of evidence, and management...
October 4, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27874844/making-visible-the-invisible-and-vice-versa-bodies-and-organisational-arrangements-in-the-intensive-care-unit
#6
Roberto Lusardi
BACKGROUND AND AIMS: The effectiveness of the treatments carried out in the Intensive Care Unit (ICU) is guaranteed by a socio-technical ensemble where material resources, scientific knowledge, technological artefacts, social norms, spatial dispositions, and professional practices coexist and constantly interact. This paper intends to penetrate such an ensemble for analysing the moral order produced and maintained in everyday medical practice. METHOD: The results of a case study, carried out in the ICU of a hospital in the north of Italy between 2006 and 2007 are reported...
November 22, 2016: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/27867655/veno-arterial-extracorporeal-membrane-oxygenation-va-ecmo-in-postcardiotomy-cardiogenic-shock-how-much-pump-flow-is-enough
#7
COMMENT
Federico Pappalardo, Andrea Montisci
Post-cardiotomy cardiogenic shock (PCCS) is a complication of heart surgery associated with a poor prognosis: veno-arterial extracorporeal membrane oxygenation (VA ECMO) ensures end-organ perfusion while fully replacing heart and lung function, though it is associated with unsatisfactory results. Few studies have identified reliable predictors of poor prognosis early in the course of extracorporeal support. A recent study showed the strong prognostic power of urine output in the first 24 hours of VA ECMO in predicting early and late mortality of PCCS...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27861506/chronic-alcohol-ingestion-delays-t-cell-activation-and-effector-function-in-sepsis
#8
Lindsay M Margoles, Rohit Mittal, Nathan J Klingensmith, John D Lyons, Zhe Liang, Mara A Serbanescu, Maylene E Wagener, Craig M Coopersmith, Mandy L Ford
Sepsis is the leading cause of death in intensive care units in the US, and it is known that chronic alcohol use is associated with higher incidence of sepsis, longer ICU stays, and higher mortality from sepsis. Both sepsis and chronic alcohol use are associated with immune deficits such as decreased lymphocyte numbers, impaired innate immunity, delayed-type hypersensitivity reactions, and susceptibility to infections; however, understanding of specific pathways of interaction or synergy between these two states of immune dysregulation is lacking...
2016: PloS One
https://www.readbyqxmd.com/read/27853969/preventable-medical-errors-driven-modeling-of-medical-best-practice-guidance-systems
#9
Andrew Y-Z Ou, Yu Jiang, Po-Liang Wu, Lui Sha, Richard B Berlin
In a medical environment such as Intensive Care Unit, there are many possible reasons to cause errors, and one important reason is the effect of human intellectual tasks. When designing an interactive healthcare system such as medical Cyber-Physical-Human Systems (CPHSystems), it is important to consider whether the system design can mitigate the errors caused by these tasks or not. In this paper, we first introduce five categories of generic intellectual tasks of humans, where tasks among each category may lead to potential medical errors...
January 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/27846827/nurses-perceptions-acceptance-and-use-of-a-novel-in-room-pediatric-icu-technology-testing-an-expanded-technology-acceptance-model
#10
Richard J Holden, Onur Asan, Erica M Wozniak, Kathryn E Flynn, Matthew C Scanlon
BACKGROUND: The value of health information technology (IT) ultimately depends on end users accepting and appropriately using it for patient care. This study examined pediatric intensive care unit nurses' perceptions, acceptance, and use of a novel health IT, the Large Customizable Interactive Monitor. METHODS: An expanded technology acceptance model was tested by applying stepwise linear regression to data from a standardized survey of 167 nurses. RESULTS: Nurses reported low-moderate ratings of the novel IT's ease of use and low to very low ratings of usefulness, social influence, and training...
November 15, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27835799/a-nursing-perspective-of-interprofessional-work-in-critical-care-findings-from-a-secondary-analysis
#11
Deborah Kendall-Gallagher, Scott Reeves, Janet A Alexanian, Simon Kitto
PURPOSE: This article presents a secondary analysis of nurse interviews from a 2-year comparative ethnographic study exploring cultures of collaboration across intensive care units (ICU). Critically ill patients rely on their interprofessional health care team to communicate and problem-solve quickly to give patients the best outcome available. Critical care nurses function at the hub of patient care giving them a distinct perspective of how interprofessional interactions impact collaborative practice...
October 19, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27825699/implementation-of-a-standardized-electronic-tool-improves-compliance-accuracy-and-efficiency-of-trainee-to-trainee-patient-care-handoffs-after-complex-general-surgical-oncology-procedures
#12
Callisia N Clarke, Sameer H Patel, Ryan W Day, Sobha George, Colin Sweeney, Georgina Avaloa Monetes De Oca, Mohamed Ait Aiss, Elizabeth G Grubbs, Brian K Bednarski, Jeffery E Lee, Diane C Bodurka, John M Skibber, Thomas A Aloia
BACKGROUND: Duty-hour regulations have increased the frequency of trainee-trainee patient handoffs. Each handoff creates a potential source for communication errors that can lead to near-miss and patient-harm events. We investigated the utility, efficacy, and trainee experience associated with implementation of a novel, standardized, electronic handoff system. METHODS: We conducted a prospective intervention study of trainee-trainee handoffs of inpatients undergoing complex general surgical oncology procedures at a large tertiary institution...
November 5, 2016: Surgery
https://www.readbyqxmd.com/read/27816734/sex-based-differences-in-adults-with-community-acquired-bacterial-meningitis-a-prospective-cohort-study
#13
Sara P Dias, Matthijs C Brouwer, Merijn W Bijlsma, Arie van der Ende, Diederik van de Beek
OBJECTIVES: To investigate sex-based differences in clinical features, causative pathogens, outcome and treatment of adult community-acquired meningitis. METHODS: From January 2006 to July 2014, adults with community-acquired bacterial meningitis were prospectively evaluated in a nationwide cohort study in the Netherlands. Sex was analysed along with known predictors of unfavourable outcome using logistic regression. RESULTS: We evaluated 1412 episodes of meningitis, 707 (50%) in males...
November 2, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27806171/intensive-care-unit-utilization-and-mortality-among-medicare-patients-hospitalized-with-non-st-segment-elevation-myocardial-infarction
#14
Alexander C Fanaroff, Eric D Peterson, Anita Y Chen, Laine Thomas, Jacob A Doll, Christopher B Fordyce, L Kristin Newby, Ezra A Amsterdam, Mikhail N Kosiborod, James A de Lemos, Tracy Y Wang
Importance: Intensive care unit (ICU) utilization may have important implications for the care and outcomes of patients with non-ST-segment elevation myocardial infarction (NSTEMI). Objectives: To examine interhospital variation in ICU utilization in the United States for older adults with hemodynamically stable NSTEMI and outcomes associated with ICU utilization among patients with low, moderate, or high mortality risk. Design, Setting, and Participants: This study was a retrospective analysis of 28 018 Medicare patients 65 years or older admitted with NSTEMI to 346 hospitals participating in the Acute Coronary Treatment and Intervention Outcomes Network (ACTION)-Get With the Guidelines from April 1, 2011, through December 31, 2012...
November 2, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27797086/risk-factors-for-new-onset-delirium-in-patients-with-bloodstream-infections-independent-and-quantitative-effect-of-catheters-and-drainages-a-four-year-cohort-study
#15
Tolga Dittrich, Sarah Tschudin-Sutter, Andreas F Widmer, Stephan Rüegg, Stephan Marsch, Raoul Sutter
BACKGROUND: Bloodstream infections (BSI) and delirium are frequent in critically ill patients. During systemic inflammatory response to BSI, cytokines may interact with neurotransmitters and neuronal receptors driving acute brain dysfunction. However, prospectively collected data on incidence, prediction and impact of delirium in association with BSI are lacking. This study aimed to determine the incidence and predictors of new-onset delirium and its impact on outcome in critically ill adult patients with BSI...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27785087/adiponectin-treatment-attenuates-inflammatory-response-during-early-sepsis-in-obese-mice
#16
XianFeng Wang, Nancy L Buechler, Barbara K Yoza, Charles E McCall, Vidula Vachharajani
BACKGROUND: Morbid obesity increases the cost of care in critically ill patients. Sepsis is the leading cause of death in noncoronary intensive care units. Circulating cell-endothelial cell interactions in microcirculation are the rate-determining factors in any inflammation; obesity increases these interactions further. Adiponectin deficiency is implicated in increased cardiovascular risk in obese patients. We have shown that adiponectin deficiency increases microvascular dysfunction in early sepsis...
2016: Journal of Inflammation Research
https://www.readbyqxmd.com/read/27784322/spontaneous-breathing-trial-and-post-extubation-work-of-breathing-in-morbidly-obese-critically-ill-patients
#17
Martin Mahul, Boris Jung, Fabrice Galia, Nicolas Molinari, Audrey de Jong, Yannaël Coisel, Rosanna Vaschetto, Stefan Matecki, Gérald Chanques, Laurent Brochard, Samir Jaber
BACKGROUND: Predicting whether an obese critically ill patient can be successfully extubated may be specially challenging. Several weaning tests have been described but no physiological study has evaluated the weaning test that would best reflect the post-extubation inspiratory effort. METHODS: This was a physiological randomized crossover study in a medical and surgical single-center Intensive Care Unit, in patients with body mass index (BMI) >35 kg/m(2) who were mechanically ventilated for more than 24 h and underwent a weaning test...
October 27, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27782503/intermolecular-modulation-of-ir-intensities-in-the-solid-state-the-role-of-weak-interactions-in-polyethylene-crystal-a-computational-dft-study
#18
Daria Galimberti, Alberto Milani, Lorenzo Maschio, Chiara Castiglioni
Density functional theory calculations with periodic boundary conditions are exploited to study the infrared spectrum of crystalline polyethylene. Spectral changes lead by the intermolecular packing in the orthorhombic three-dimensional crystal are discussed by means of a careful comparison with calculations carried out for an isolated polymer chain in the all-trans conformation, described as an ideal one-dimensional crystal. The results are analyzed in the framework of the "oligomer approach" through the modelling of the IR spectrum of n-alkanes of different lengths...
October 14, 2016: Journal of Chemical Physics
https://www.readbyqxmd.com/read/27779495/exploring-nicu-nurses-affective-responses-to-end-of-life-care
#19
Stephanie Lacefield Lewis
BACKGROUND: The survival rate for infants born with life-threatening problems has improved greatly over the last few decades. Nevertheless, infants still die in neonatal intensive care units (NICUs) every day. Despite existing standards of care, some aspects of end-of-life care (EOLC) are still not delivered consistently. Little is known about how NICU nurses' individual experiences affect EOLC. PURPOSE: The purpose of this study was to explore, through lived and told stories, the affective, interactional, and meaning-related responses that NICU nurses have while caring for dying infants and their families...
October 24, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27774929/neuropsychological-functioning-in-preterm-born-twins-and-singletons-at-preschool-age
#20
Sarah Raz, Jamie C Piercy, Andrew M Heitzer, Brittany N Peters, Julie Bapp Newman, Angela K DeBastos, Noa Ofen, Beau Batton, Daniel G Batton
OBJECTIVES: A limited body of research is available on the relationships between multiplicity of birth and neuropsychological functioning in preterm children who were conceived in the age of assisted reproductive technology and served by the modern neonatal intensive care unit. Our chief objective was to evaluate whether, after adjustment for sociodemographic factors and perinatal complications, twin birth accounted for a unique portion of developmental outcome variance in children born at-risk in the surfactant era...
October 2016: Journal of the International Neuropsychological Society: JINS
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