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https://www.readbyqxmd.com/read/27913962/bathing-and-associated-treatments-in-atopic-dermatitis
#1
REVIEW
Julia K Gittler, Jason F Wang, Seth J Orlow
Atopic dermatitis is one of the most common complaints presenting to dermatologists, and patients typically inquire as to appropriate bathing recommendations. Although many dermatologists, allergists, and primary-care practitioners provide explicit bathing instructions, recommendations regarding frequency of bathing, duration of bathing, and timing related to emollient and medication application relative to bathing vary widely. Conflicting and vague guidelines stem from knowledge related to the disparate effects of water on skin, as well as a dearth of studies, especially randomized controlled trials, evaluating the effects of water and bathing on the skin of patients with atopic dermatitis...
December 3, 2016: American Journal of Clinical Dermatology
https://www.readbyqxmd.com/read/27913539/prevention-of-central-nervous-system-sequelae-in-sickle-cell-disease-without-evidence-from-randomized-controlled-trials-the-case-for-a-team-based-learning-collaborative
#2
Michael R DeBaun, Allison A King
Since 1998, the National Institutes of Health has funded 5 randomized controlled trials (RCTs) for primary and secondary prevention of strokes in children with sickle cell anemia (SCA). In a systematic fashion, these trials have significantly advanced the care of children with SCA. In the absence of an RCT, clinicians are often compelled to make decisions at the bedside, based on experience, observational studies, and principles of hematology. We will provide an initial example that describes how a team-based, learning collaborative developed a multisite standard care protocol with a low budget (<$10 000 per year) to overcome the intrinsic limitations of advancing the care of neurologic complications in sickle cell disease (SCD)...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27912161/a-prospective-randomized-trial-of-tapered-cuff-endotracheal-tubes-with-intermittent-subglottic-suctioning-in-preventing-ventilator-associated-pneumonia-in-critically-ill-patients
#3
Ata Mahmoodpoor, Hadi Hamishehkar, Masoud Hamidi, Kamran Shadvar, Sarvin Sanaie, Samad Ej Golzari, Zahid Hussain Khan, Nader D Nader
BACKGROUND: Endotracheal tube placement is necessary for the control of the airway in patients who are mechanically ventilated. However, prolonged duration of endotracheal tube placement contributes to the development of ventilator-associated pneumonias (VAPs). The aim of this study was to evaluate whether subglottic suctioning using TaperGuard EVAC tubes was effective in decreasing the frequency of VAP. METHODS: A total of 276 mechanically ventilated patients for more than 72 hours were randomly assigned to group E (EVAC tube) and group C (conventional tube)...
November 14, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27907898/obstetrical-and-perinatal-outcomes-following-blastocyst-transfer-compared-to-cleavage-transfer-a-systematic-review-and-meta-analysis
#4
W P Martins, C O Nastri, L Rienzi, S Z van der Poel, C R Gracia, C Racowsky
STUDY QUESTION: Is blastocyst transfer safe when compared to cleavage stage embryo transfer regarding obstetric and perinatal outcomes? SUMMARY ANSWER: The clinical equipoise between blastocyst and cleavage stage embryo transfer remains as the evidence associating blastocyst transfer with some adverse perinatal outcomes is of low/very low quality. WHAT IS KNOWN ALREADY: Extended embryo culture to the blastocyst stage provides some theoretical advantages and disadvantages...
November 2016: Human Reproduction
https://www.readbyqxmd.com/read/27904643/effects-of-nesting-and-swaddling-on-the-sleep-duration-of-premature-infants-hospitalized-in-neonatal-intensive-care-units
#5
Zahra Abdeyazdan, Maryam Mohammadian-Ghahfarokhi, Zohreh Ghazavi, Majid Mohammadizadeh
BACKGROUND: In neonatal intensive care unit (NICU), neonatal sleep is disrupted due to different factors. Due to the critical role of sleep in premature infants' brain development, this study aimed to investigate the effect of nesting and swaddling on the sleep duration of premature infants hospitalized in NICUs. MATERIALS AND METHODS: In a crossover clinical trial, 42 preterm infants who met the inclusion criteria were enrolled. They were randomly assigned to two groups of nest-swaddle and swaddle-nest...
September 2016: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/27904641/the-effect-of-daily-sedation-interruption-protocol-on-early-incidence-of-ventilator-associated-pneumonia-among-patients-hospitalized-in-critical-care-units-receiving-mechanical-ventilation
#6
Mehdi Shahabi, Hojatollah Yousefi, Ahmad Reza Yazdannik, Babak Alikiaii
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common side effect in patients who receive intravenous sedation infusion. In routine care, after starting sedation infusion for patients who receive mechanical ventilation, interruption of sedation starts without protocol. This study aimed to evaluate the effect of daily sedation vacation protocol on the incidence of VAP in mechanically ventilated patients. MATERIALS AND METHODS: In this clinical trial study, 80 patients with intravenous sedation infusion were selected and randomly allocated to intervention and control groups...
September 2016: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/27900749/-efficacy-of-ultrasound-guided-peripheral-intravenous-access-a-systematic-review-and-meta-analysis
#7
Chia-Chi Kuo, Chen-Yun Wu, I-Jung Feng, Wei-Jing Lee
BACKGROUND: Peripheral intravenous access is a common, invasive procedure that is performed in clinical practice. Difficult intravenous access may not only jeopardize patient safety but also increase staff stress, nursing hours, and material costs. PURPOSE: To explore the efficacy of ultrasound-guided peripheral intravenous access in difficult intravenous-access patients and in the two subgroups of adult patients and pediatric patients using systematic review and meta-analysis...
December 2016: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/27899338/high-touch-and-high-tech-ht2-proposal-transforming-patient-engagement-throughout-the-continuum-of-care-by-engaging-patients-with-portal-technology-at-the-bedside
#8
Ann Scheck McAlearney, Cynthia J Sieck, Jennifer L Hefner, Alison M Aldrich, Daniel M Walker, Milisa K Rizer, Susan D Moffatt-Bruce, Timothy R Huerta
BACKGROUND: For patients with complex care needs, engagement in disease management activities is critical. Chronic illnesses touch almost every person in the United States. The costs are real, personal, and pervasive. In response, patients often seek tools to help them manage their health. Patient portals, personal health records tethered to an electronic health record, show promise as tools that patients value and that can improve health. Although patient portals currently focus on the outpatient experience, the Ohio State University Wexner Medical Center (OSUWMC) has deployed a portal designed specifically for the inpatient experience that is connected to the ambulatory patient portal available after discharge...
November 29, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27891297/exercise-rehabilitation-following-intensive-care-unit-discharge-for-recovery-from-critical-illness-executive-summary-of-a-cochrane-collaboration-systematic-review
#9
REVIEW
Bronwen Connolly, Lisa Salisbury, Brenda O'Neill, Louise Geneen, Abdel Douiri, Michael P W Grocott, Nicholas Hart, Timothy S Walsh, Bronagh Blackwood
Skeletal muscle wasting and weakness are major complications of critical illness and underlie the profound physical and functional impairments experienced by survivors after discharge from the intensive care unit (ICU). Exercise-based rehabilitation has been shown to be beneficial when delivered during ICU admission. This review aimed to determine the effectiveness of exercise rehabilitation initiated after ICU discharge on primary outcomes of functional exercise capacity and health-related quality of life...
December 2016: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/27883968/vitamin-d-and-outcomes-in-adult-critically-ill-patients-a-systematic-review-and-meta-analysis-of-randomized-trials
#10
REVIEW
Alessandro Putzu, Alessandro Belletti, Tiziano Cassina, Sara Clivio, Giacomo Monti, Alberto Zangrillo, Giovanni Landoni
PURPOSE: Low vitamin D blood levels are associated with high mortality in critically ill patients. There is controversy about vitamin D supplementation in this population. The objective of this meta-analysis was to evaluate if vitamin D administration reduces mortality in critically ill patients. MATERIALS AND METHODS: Online databases were searched up to September 1(st), 2016 for randomized placebo-controlled trials on the use of vitamin D in adult patients with critical illness...
November 9, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27881152/fitness-and-mobility-training-in-patients-with-intensive-care-unit-acquired-muscle-weakness-fitonicu-study-protocol-for-a-randomised-controlled-trial
#11
Jan Mehrholz, Simone Thomas, Jane H Burridge, André Schmidt, Bettina Scheffler, Ralph Schellin, Stefan Rückriem, Daniel Meißner, Katja Mehrholz, Wolfgang Sauter, Ulf Bodechtel, Bernhard Elsner
BACKGROUND: Critical illness myopathy (CIM) and polyneuropathy (CIP) are a common complication of critical illness. Both cause intensive-care-unit-acquired (ICU-acquired) muscle weakness (ICUAW) which increases morbidity and delays rehabilitation and recovery of activities of daily living such as walking ability. Focused physical rehabilitation of people with ICUAW is, therefore, of great importance at both an individual and a societal level. A recent systematic Cochrane review found no randomised controlled trials (RCT), and thus no supporting evidence, for physical rehabilitation interventions for people with defined CIP and CIM to improve activities of daily living...
November 24, 2016: Trials
https://www.readbyqxmd.com/read/27876084/a-trial-to-determine-whether-septic-shock-reversal-is-quicker-in-pediatric-patients-randomized-to-an-early-goal-directed-fluid-sparing-strategy-versus-usual-care-squeeze-study-protocol-for-a-pilot-randomized-controlled-trial
#12
Melissa J Parker, Lehana Thabane, Alison Fox-Robichaud, Patricia Liaw, Karen Choong
BACKGROUND: Current pediatric septic shock resuscitation guidelines from the American College of Critical Care Medicine focus on the early and goal-directed administration of intravascular fluid followed by vasoactive medication infusions for persistent and fluid-refractory shock. However, accumulating adult and pediatric data suggest that excessive fluid administration is associated with worse patient outcomes and even increased risk of death. The optimal amount of intravascular fluid required in early pediatric septic shock resuscitation prior to the initiation of vasoactive support remains unanswered...
November 22, 2016: Trials
https://www.readbyqxmd.com/read/27876082/evaluating-data-abstraction-assistant-a-novel-software-application-for-data-abstraction-during-systematic-reviews-protocol-for-a-randomized-controlled-trial
#13
Ian J Saldanha, Christopher H Schmid, Joseph Lau, Kay Dickersin, Jesse A Berlin, Jens Jap, Bryant T Smith, Simona Carini, Wiley Chan, Berry De Bruijn, Byron C Wallace, Susan M Hutfless, Ida Sim, M Hassan Murad, Sandra A Walsh, Elizabeth J Whamond, Tianjing Li
BACKGROUND: Data abstraction, a critical systematic review step, is time-consuming and prone to errors. Current standards for approaches to data abstraction rest on a weak evidence base. We developed the Data Abstraction Assistant (DAA), a novel software application designed to facilitate the abstraction process by allowing users to (1) view study article PDFs juxtaposed to electronic data abstraction forms linked to a data abstraction system, (2) highlight (or "pin") the location of the text in the PDF, and (3) copy relevant text from the PDF into the form...
November 22, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27867308/effect-of-n-methyl-d-aspartate-receptor-antagonist-dextromethorphan-on-opioid-analgesia-in-pediatric-intensive-care-unit
#14
Mohammed Naeem, Hala Al Alem, Ali Al Shehri, Majed Al-Jeraisy
Objective. Pain control is an essential goal in the management of critical children. Narcotics are the mainstay for pain control. Patients frequently need escalating doses of narcotics. In such cases an adjunctive therapy may be beneficial. Dextromethorphan (DM) is NMDA receptor antagonist and may prevent tolerance to narcotics; however, its definitive role is still unclear. We sought whether dextromethorphan addition could decrease the requirements of fentanyl to control pain in critical children. Design. Double-blind, randomized control trial (RCT)...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/27861516/the-mcme-project-a-randomized-controlled-trial-of-an-sms-based-continuing-medical-education-intervention-for-improving-medical-knowledge-among-vietnamese-community-based-physicians-assistants
#15
Christopher J Gill, Bao Le Ngoc, Nafisa Halim, Ha Nguyen Viet, Anna Larson Williams, Tan Nguyen Van, Marion McNabb, Lien Tran Thi Ngoc, Ariel Falconer, Hai An Phan Ha, Julia Rohr, Hai Hoang, James Michiel, Tam Nguyen Thi Thanh, Liat Bird, Hoang Pham Vu, Mahlet Yeshitla, Nhu Ha Van, Lora Sabin
BACKGROUND: Community health workers (CHWs) provide critical services to underserved populations in low and middle-income countries, but maintaining CHW's clinical knowledge through formal continuing medical education (CME) activities is challenging and rarely occurs. We tested whether a Short Message Service (SMS)-based mobile CME (mCME) intervention could improve medical knowledge among a cadre of Vietnamese CHWs (Community Based Physician's Assistants-CBPAs) who are the leading providers of primary medical care for rural underserved populations...
2016: PloS One
https://www.readbyqxmd.com/read/27861388/early-initiation-of-renal-replacement-treatment-in-patients-with-acute-kidney-injury-a-systematic-review-and-meta-analysis
#16
Hongwei Wang, Liwei Li, Qinjun Chu, Yong Wang, Zhisong Li, Wei Zhang, Lanlan Li, Long He, Yanqiu Ai
BACKGROUND: Acute kidney injury (AKI) is associated with a substantially increased risk of mortality for many hospitalized patients. It has been suggested that early initiation of renal replacement treatment has a favorable outcome in critically ill patients complicated with AKI. However, results of studies evaluating the effect of early initiation strategy of renal replacement treatment on AKI have been controversial and contradictory. The aim of this meta-analysis is to examine the effect of early initiation of renal replacement treatment on patients with AKI...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27849653/the-role-of-aspirin-desensitization-in-the-management-of-aspirin-exacerbated-respiratory-disease
#17
Bobby A Tajudeen, Joseph S Schwartz, John V Bosso
PURPOSE OF REVIEW: Aspirin-exacerbated respiratory disease (AERD) is a progressive inflammatory disease of the upper and lower airways characterized by marked eosinophilic nasal polyposis, asthma, and respiratory reactions to medications that inhibit the cyclooxygenase pathway. Aspirin desensitization has proven to be an effective tool in the management of this disease when used in a multidisciplinary setting. The purpose of this article is to review the current literature regarding AERD, aspirin desensitization, and share our opinion regarding the most optimal multidisciplinary approach to these complex patients...
November 15, 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27849239/importance-of-the-use-of-protocols-for-the-management-of-analgesia-and-sedation-in-pediatric-intensive-care-unit
#18
Emiliana Motta, Michele Luglio, Artur Figueiredo Delgado, Werther Brunow de Carvalho
Introduction: Analgesia and sedation are essential elements in patient care in the intensive care unit (ICU), in order to promote the control of pain, anxiety and agitation, prevent the loss of devices, accidental extubation, and improve the synchrony of the patient with mechanical ventilation. However, excess of these medications leads to rise in morbidity and mortality. The ideal management will depend on the adoption of clinical and pharmacological measures, guided by scales and protocols...
September 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27846124/effectiveness-and-experiences-of-families-and-support-workers-participating-in-peer-led-parenting-support-programs-delivered-as-home-visiting-programs-a-comprehensive-systematic-review
#19
Ailsa Munns, Robin Watts, Desley Hegney, Roz Walker
BACKGROUND: Designing child and family health services to meet the diverse needs of contemporary families is intended to minimize impacts of early disadvantage and subsequent lifelong health and social issues. Innovative programs to engage families with child and family support services have led to interest in the potential value of peer-led home visiting from parents in local communities. There is a range of benefits and challenges identified in a limited number of studies associated with home visiting peer support...
October 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27846030/efficacy-of-monitoring-devices-in-support-of-prevention-of-pressure-injuries-systematic-review-and-meta-analysis
#20
Gurjot S Walia, Alison L Wong, Andrea Y Lo, Gina A Mackert, Hannah M Carl, Rachel A Pedreira, Ricardo Bello, Carla S Aquino, William V Padula, Justin M Sacks
GENERAL PURPOSE: To present a systematic review of the literature assessing the efficacy of monitoring devices for reducing the risk of developing pressure injuries. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1...
December 2016: Advances in Skin & Wound Care
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