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critical care of neurology

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https://www.readbyqxmd.com/read/29913994/patients-referred-from-a-multidisciplinary-pain-clinic-to-the-social-worker-their-general-health-pain-condition-treatment-and-outcome
#1
Heli Aho, Timo Kauppila, Maija Haanpää
Background and aims As far as we know, the range of issues particular to social work, when working with clients at a pain clinic has not been previously researched. Methods A retrospective study of referrals at the multidisciplinary Pain Clinic of Helsinki University Central Hospital was conducted based on medical records, focusing on pain conditions, treatments and patient flow. Variables used were age, gender, pain conditions, treatment interventions, pain duration and intensity, disruption in everyday life due to pain, psychiatric co-morbidities, referrals, outside care providers, post-treatment care and health habits...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29911901/patient-reported-experiences-of-using-community-rehabilitation-and-or-support-services-whilst-living-with-a-long-term-neurological-condition-a-qualitative-systematic-review-and-meta-aggregation
#2
Katherine Jackson, Sharon Hamilton, Susan Jones, Steven Barr
OBJECTIVES: The objective of this study is to identify patient reported experiences of using community rehabilitation and/or support services whilst living with a long-term neurological condition, and perceptions of their impact on quality of life. METHODS: Nine electronic databases were searched for peer-reviewed qualitative studies from 2005 to 2016, which met the inclusion criteria. Critical appraisal, data extraction, and quality assessment of 37 included papers were performed by three reviewers...
June 18, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29911033/association-between-glycemic-gap-and-adverse-outcomes-in-critically-ill-patients-with-diabetes
#3
Sandeep Donagaon, Mala Dharmalingam
Objectives: Glycemic excursions are commonly seen in patients admitted to the Intensive Care Unit (ICU) and are related to adverse outcomes. Glycemic gap is a marker of this excursion in patients with diabetes. It can be used to predict adverse outcomes in patients with diabetes admitted to the ICU. It is calculated by subtracting A1C-derived average glucose (ADAG) = ([28.7 × HbA1c]-46.7) from plasma glucose at admission. Objective of this study was to correlate glycemic gap and adverse outcomes in patients with type 2 diabetes mellitus (DM) admitted to the ICU...
March 2018: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29905575/ce-original-research-the-efficacy-and-safety-of-an-rn-driven-ketamine-protocol-for-adjunctive-analgesia-during-burn-wound-care
#4
Laura Baumgartner, Nicole Townsend, Katie Winkelman, Robert MacLaren
Findings indicate that adjunctive low-dose ketamine was safe and provided pain relief. ABSTRACT: Objectives: Traditional analgesic regimens often fail to control the severe pain patients experience during burn wound care, and the drugs are frequently administered at doses that can cause oversedation and respiratory depression. Ketamine may be an ideal agent for adjunctive analgesia in such patients because of its unique mechanism of action and lack of association with respiratory depression...
June 13, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29904451/thrombolysis-is-an-effective-and-safe-therapy-in-stuck-mitral-valves-with-delayed-presentation-as-well-as-hemodynamically-unstable-patients-a-single-centre-study
#5
Arun Shivajirao Bade, Shakil Sattar Ahmed Shaikh, Hemant Khemani, Gurkirat Singh, Narender Omprakash Bansal
Background: Thrombosis is a complication of prosthetic valves on oral anticoagulants which is associated with significant morbidity and mortality. A re-operation carries a substantial risk, with mortality rate from 10% to 15% in selected series, which may be 2- or 3-folds higher in critically ill patients. This study conducted in a tertiary care cardiology unit aimed to evaluate the effectiveness and safety of thrombolytic therapy in stuck mitral bileaflet heart valves. Methods: As a prospective observational study, clinical symptoms and fluoroscopy were the mainstay in diagnosis of stuck mitral valve...
June 2018: Cardiology Research
https://www.readbyqxmd.com/read/29903905/idiopathic-intracranial-hypertension-consensus-guidelines-on-management
#6
REVIEW
Susan P Mollan, Brendan Davies, Nick C Silver, Simon Shaw, Conor L Mallucci, Benjamin R Wakerley, Anita Krishnan, Swarupsinh V Chavda, Satheesh Ramalingam, Julie Edwards, Krystal Hemmings, Michelle Williamson, Michael A Burdon, Ghaniah Hassan-Smith, Kathleen Digre, Grant T Liu, Rigmor Højland Jensen, Alexandra J Sinclair
The aim was to capture interdisciplinary expertise from a large group of clinicians, reflecting practice from across the UK and further, to inform subsequent development of a national consensus guidance for optimal management of idiopathic intracranial hypertension (IIH). METHODS: Between September 2015 and October 2017, a specialist interest group including neurology, neurosurgery, neuroradiology, ophthalmology, nursing, primary care doctors and patient representatives met. An initial UK survey of attitudes and practice in IIH was sent to a wide group of physicians and surgeons who investigate and manage IIH regularly...
June 14, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29901487/a-core-set-of-outcome-measures-for-adults-with-neurologic-conditions-undergoing-rehabilitation-a-clinical-practice-guideline
#7
Jennifer L Moore, Kirsten Potter, Kathleen Blankshain, Sandra L Kaplan, Linda C OʼDwyer, Jane E Sullivan
BACKGROUND: Use of outcome measures (OMs) in adult neurologic physical therapy is essential for monitoring changes in a patient's status over time, quantifying observations and patient-reported function, enhancing communication, and increasing the efficiency of patient care. OMs also provide a mechanism to compare patient and organizational outcomes, examine intervention effectiveness, and generate new knowledge. This clinical practice guideline (CPG) examined the literature related to OMs of balance, gait, transfers, and patient-stated goals to identify a core set of OMs for use across adults with neurologic conditions and practice settings...
June 12, 2018: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/29891575/education-research-variation-in-priorities-for-neurocritical-care-education-expressed-across-role-groups
#8
Abigail S Cohen, Saef Izzy, Monisha A Kumar, Cara J Joyce, Stephen A Figueroa, Matthew B Maas, Christiana E Hall, David L McDonagh, David P Lerner, Paul M Vespa, Lori A Shutter, Eric S Rosenthal
OBJECTIVE: To define expectations for neurocritical care (NCC) core competencies vs competencies considered within the domain of other subspecialists. METHODS: An electronic survey was disseminated nationally to NCC nurses, physicians, fellows, and neurology residents through Accreditation Council for Graduate Medical Education neurology residency program directors, United Council for Neurologic Subspecialties neurocritical care fellowship program directors, and members of the Neurocritical Care Society...
June 12, 2018: Neurology
https://www.readbyqxmd.com/read/29891404/influenza-associated-neurological-complications-during-2014-2017-in-taiwan
#9
Li-Wen Chen, Chao-Ku Teng, Yi-Shan Tsai, Jieh-Neng Wang, Yi-Fang Tu, Ching-Fen Shen, Ching-Chuan Liu
INTRODUCTION: Seasonal influenza-associated neurological complications had high mortality and morbidity rates in recent studies. We reported influenza-associated encephalitis/encephalopathy in children during 2014-2017 in Taiwan, focusing on neurological presentations, neuroimaging correlations, and critical care managements. MATERIALS/SUBJECTS: During January 1st 2014 to June 30th 2017, pediatric patients reported to the Taiwan Centers for Disease Control surveillance system for severe complicated influenza infections in the hospital were retrospectively reviewed...
June 8, 2018: Brain & Development
https://www.readbyqxmd.com/read/29883819/evidences-in-neurological-surgery-and-a-cutting-edge-classification-of-the-trigeminocardiac-reflex-a-systematic-review
#10
REVIEW
Daniel S Leon-Ariza, Juan S Leon-Ariza, Jasvinder Nangiana, Gabriel Vargas Grau, Fidias E Leon-Sarmiento, Alfredo Quiñones-Hinojosa
BACKGROUND: The trigeminocardiac reflex (TCR) is characterized by bradycardia, decrease of main arterial blood pressure (MABP), and sometimes, asystole during surgery. We critically reviewed TCR studies and devised a novel classification scheme for assessing the reflex. MATERIAL: and Methods: A comprehensive systematic literature review was performed using PubMed, MEDLINE, Web of Science, EMBASE, and Scielo databases. Eligible studies were extracted based on stringent inclusion and exclusion criteria...
June 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29879852/predictors-of-extubation-failure-after-open-chest-cardiac-surgery-based-on-routinely-collected-data-the-importance-of-a-shared-interprofessional-clinical-assessment
#11
Gianfranco Sanson, Massimiliano Sartori, Lorella Dreas, Roberta Ciraolo, Adam Fabiani
BACKGROUND: Extubation failure (ExtF) is associated with prolonged hospital length of stay and mortality in adult cardiac surgery patients postoperatively. In this population, ExtF-related variables such as the arterial partial pressure of oxygen to fraction of inspired oxygen ratio (PaO2 /FiO2 ), rapid shallow breathing index, cough strength, endotracheal secretions and neurological function have been sparsely researched. AIM: To identify variables that are predictive of ExtF and related outcomes...
June 1, 2018: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29875116/evidence-based-review-of-clinical-trials-in-neurocritical-care
#12
Molly McNett, Cristina Moran, Halee Johnson
Neurocritical care is a rapidly growing specialty of complex care for the critically ill patient with neurological injury. This rapid growth has led to an increase in the number of important clinical trials to guide clinical practice and evidence-based care of the critically ill patient with neurological injury. Specialty-trained critical care nurses and advanced practice providers are integral members of neurocritical care teams and must remain informed about pivotal trials shaping practice recommendations...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29875114/critical-care-transport-of-patients-with-brain-injuries
#13
Rachel Zayas
Critical care transport began in the 1970s as a response to the growing need to be able to transport critically ill and injured patients to tertiary care centers for higher levels of care or specialized treatments. Patients in critical condition now are transported great distances to receive potentially lifesaving treatment and interventions. Modes of critical care transport include ambulances, helicopters, and airplanes. Critical care transport teams consist of highly skilled paramedics, registered nurses, respiratory therapists, nurse practitioners, and physicians...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29870491/caring-cards-preventing-patient-harm-through-the-heart-of-nursing
#14
Meredith Gould, Marci Mann, Heather Martin, Rachael Erwin, Ron Schultz, Kristen Swanson
The use of "Caring Cards" is a unique innovation, which builds on reliable Lean processes. It adds the way we emotionally care for people to a Lean methodology. This article describes how the foundational constructs of nursing theory are paired with aspects of universal fall precautions. In a pilot prioritizing Caring Cards, conversations between leaders and staff provide a way for the nurse to describe his or her critical thinking about fall prevention that is individualized to a patient. Leaders collect information on barriers to care and demonstrate follow-up actions to staff members who raise concerns...
July 2018: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/29867711/world-s-first-24-7-mobile-stroke-unit-initial-6-month-experience-at-mercy-health-in-toledo-ohio
#15
Eugene Lin, Victoria Calderon, Julie Goins-Whitmore, Vibhav Bansal, Osama Zaidat
Background and purpose: As the fourth mobile stroke unit (MSU) in the nation, and the first 24/7 unit worldwide, we review our initial experience with the Mercy Health MSU and institutional protocols implemented to facilitate rapid treatment of acute stroke patients and field triage for patients suffering other time-sensitive, acute neurologic emergencies in Lucas County, Ohio, and the greater Toledo metropolitan area. Methods: Data was prospectively collected for all patients transported and treated by the MSU during the first 6 months of service...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29857966/equine-manual-therapies-in-sport-horse-practice
#16
REVIEW
Kevin K Haussler
Manual therapies involve the application of the hands to the body, with a diagnostic or therapeutic intent. Touch therapies, massage, joint mobilization, and manipulation are all critical components in the management of muscular, articular, and neurologic components of select injuries in performance horses. Musculoskeletal conditions that are chronic or recurring, not readily diagnosed, or are not responding to conventional veterinary care may be indicators that manual therapy evaluation and treatment is needed...
May 29, 2018: Veterinary Clinics of North America. Equine Practice
https://www.readbyqxmd.com/read/29848152/voluntary-head-rotational-velocity-and-implications-for-brain-injury-risk-metrics
#17
Fidel Hernandez, David Benjamin Camarillo
We investigated whether humans could sustain high head rotational velocities without brain injury. Rotational velocity has long been implicated for predicting concussion risk, and has recently been used to develop the rotational velocity-based Brain Injury Criterion (BrIC). To assess the efficacy of rotational velocity and BrIC for predicting concussion risk, we instrumented 9 male subjects with sensor-laden mouthguards and measured six-degree-of-freedom head accelerations for 27 rapid voluntary head rotations...
May 31, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29845700/cough-response-to-aspiration-in-thin-and-thick-fluids-during-fees-in-hospitalized-inpatients
#18
Anna Miles, Mary McFarlane, Samantha Scott, Alexandra Hunting
BACKGROUND: The modifications of fluid viscosity and/or volume are common strategies in dysphagia management, with increased viscosity or reduced volume intended to reduce aspiration. Little attention has been given to whether cough response to aspiration varies across different viscosities and volumes. AIMS: This prospective observational study investigated aspiration prevalence and cough response to aspiration in thin and thick fluids of two different volumes in patients referred for flexible endoscopic evaluation of swallowing (FEES) in an acute hospital setting...
May 30, 2018: International Journal of Language & Communication Disorders
https://www.readbyqxmd.com/read/29782388/glasgow-coma-scale-score-fluctuations-are-inversely-associated-with-a-nirs-based-index-of-cerebral-autoregulation-in-acutely-comatose-patients
#19
Ryan J Healy, Andres Zorrilla-Vaca, Wendy Ziai, Marek A Mirski, Charles W Hogue, Romergryko Geocadin, Batya Radzik, Caitlin Palmisano, Lucia Rivera-Lara
BACKGROUND: The Glasgow Coma Scale (GCS) is an essential coma scale in critical care for determining the neurological status of patients and for estimating their long-term prognosis. Similarly, cerebral autoregulation (CA) monitoring has shown to be an accurate technique for predicting clinical outcomes. However, little is known about the relationship between CA measurements and GCS scores among neurological critically ill patients. This study aimed to explore the association between noninvasive CA multimodal monitoring measurements and GCS scores...
May 18, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29779827/zika-virus-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#20
Gisele Sampaio Silva, Guy A Richards, Tim Baker, Jorge Hidalgo, Juan Ignacio Silesky Jiménez, Pravin Amin
Zika fever is an acute infectious disease caused by the Zika virus (ZIKV), an RNA virus belonging to the genus Flavivirus. ZIKV can be transmitted by bites from Aedes aegypti and Aedes albopictus species, sexual activity, blood transfusion and from mother to fetus during pregnancy and delivery. A total of 50 territories and countries in the Americas had reported ZIKV infections. For those with symptoms, the presentation is similar to dengue fever with body aches, joint pain, fatigue, malaise, fever and conjunctivitis lasting up to seven days...
April 5, 2018: Journal of Critical Care
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