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Physiology critical care

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https://www.readbyqxmd.com/read/28915335/ecm-related-myopathies-and-muscular-dystrophies-pros-and-cons-of-protein-therapies
#1
Pam M Van Ry, Tatiana M Fontelonga, Pamela Barraza-Flores, Apurva Sarathy, Andreia M Nunes, Dean J Burkin
Extracellular matrix (ECM) myopathies and muscular dystrophies are a group of genetic diseases caused by mutations in genes encoding proteins that provide critical links between muscle cells and the extracellular matrix. These include structural proteins of the ECM, muscle cell receptors, enzymes, and intracellular proteins. Loss of adhesion within the myomatrix results in progressive muscle weakness. For many ECM muscular dystrophies, symptoms can occur any time after birth and often result in reduced life expectancy...
September 12, 2017: Comprehensive Physiology
https://www.readbyqxmd.com/read/28912057/apnoeic-oxygenation-during-intubation-in-the-intensive-care-unit-a-systematic-review-and-meta-analysis
#2
REVIEW
Matthew J Binks, Rhys S Holyoak, Thomas M Melhuish, Ruan Vlok, Anthony Hodge, Thomas Ryan, Leigh D White
Hypoxaemia increases the risk of cardiac arrest and mortality during intubation. The reduced physiological reserve and reduced efficacy of pre-oxygenation in intensive care patients makes their intubation particularly dangerous. Apnoeic oxygenation is a promising means of preventing hypoxaemia in this setting. We sought to ascertain whether apnoeic oxygenation reduces the incidence of hypoxaemia when used during endotracheal intubation in the intensive care unit (ICU). A systematic review of five databases for all relevant studies published up to November 2016 was performed...
September 11, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28911290/outcomes-of-telemedicine-intervention-in-a-regional-intensive-care-unit-a-before-and-after-study
#3
O M Panlaqui, E Broadfield, R Champion, J P Edington, S Kennedy
Telemedicine consultations in remote intensive care units (ICUs) overseas were found to be effective in reducing mortality and hospital length of stay (LOS). In Australia, there were anecdotal reports of these clinical outcomes. This retrospective before and after study assessed the improvement in patient outcomes with the implementation of a telemedicine program in a regional high dependency unit. Daily virtual consultations were conducted between the rural facility and the intensivists at the regional centre...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28905701/outcomes-of-patients-with-severe-influenza-infection-admitted-to-intensive-care-units-a-retrospective-study-in-a-medical-centre
#4
Chien-Ming Chao, Chih-Cheng Lai, Khee-Siang Chan, Kuo-Chen Cheng, Willy Chou, Kuo-Shu Yuan, Chin-Ming Chen
PURPOSE: This study assessed clinical manifestations and prognostic factors of critically ill patients with severe influenza admitted to the intensive care unit (ICU) in Taiwan's recent outbreak. METHODOLOGY: Patients admitted to ICU for severe influenza between January 1, 2015, and March 31, 2016, were identified and their medical records were retrospectively reviewed. The primary endpoints were outcomes and predictors of in-hospital mortality. RESULTS: There were 125 patients with an average Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 20...
September 14, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28904523/music-listening-among-postoperative-patients-in-the-intensive-care-unit-a-randomized-controlled-trial-with-mixed-methods-analysis
#5
Nancy Ames, Rebecca Shuford, Li Yang, Brad Moriyama, Meredith Frey, Florencia Wilson, Thiruppavai Sundaramurthi, Danelle Gori, Andrew Mannes, Alexandra Ranucci, Deloris Koziol, Gwenyth R Wallen
BACKGROUND: Music listening may reduce the physiological, emotional, and mental effects of distress and anxiety. It is unclear whether music listening may reduce the amount of opioids used for pain management in critical care, postoperative patients or whether music may improve patient experience in the intensive care unit (ICU). METHODS: A total of 41 surgical patients were randomized to either music listening or controlled non-music listening groups on ICU admission...
2017: Integrative Medicine Insights
https://www.readbyqxmd.com/read/28904478/how-useful-is-extravascular-lung-water-measurement-in-managing-lung-injury-in-intensive-care-unit
#6
Anirban Bhattacharjee, Debasis Pradhan, Prithwis Bhattacharyya, Samarjit Dey, Daniala Chhunthang, Akash Handique, Angkita Barman, Mohd Yunus
CONTEXT: The primary goal of septic shock management is optimization of organ perfusion, often at the risk of overloading the interstitium and causing pulmonary edema. The conventionally used end points of resuscitation do not generally include volumetric parameters such as extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI). AIMS: This study aimed to assess the prognostic value of EVLWI and PVPI by calculating their correlation with the severity of lung injury...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28895696/b-type-natriuretic-peptide-usefulness-in-the-management-of-critically-ill-neonates
#7
Gisela L Salas, Mariela Jozefkowicz, Gustavo S Goldsmit, Gabriela Disa, Alejandra Rodiño, Susana Rodríguez, Diana Fariña
INTRODUCTION: B-type natriuretic peptide (BNP) is responsible for changes in the heart organogenesis and is associated with transition to extrauterine life. In the first week of life, BNP levels are high and return to normal with the physiological loss in weight. High BNP levels are associated with different conditions. OBJETIVE: To establish the relationship between BNP levels and criticality and the short-term clinical course among patients hospitalized in the neonatal intensive care unit...
October 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28877877/acute-blood-loss-stimulates-fibroblast-growth-factor-23-production
#8
Seham Rabadi, Ikemesit Udo, David Evan Leaf, Sushrut Waikar, Marta Christov
Fibroblast growth factor 23 (FGF23) production is upregulated by iron deficiency and hypoxia. However, the influence of acute blood loss, and the resulting increases in circulating erythropoietin, on FGF23 production is unknown. Using wild-type C57BL/6 mice, we show that acute loss of 10% total blood volume leads to an increase in plasma C-terminal FGF23 (cFGF23) levels within six hours, while plasma levels of intact FGF23, phosphate, calcium, parathyroid hormone, iron, and ferritin remain similar to control mice without acute blood loss...
September 6, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28877753/weekends-affect-mortality-risk-and-chance-of-discharge-in-critically-ill-patients-a-retrospective-study-in-the-austrian-registry-for-intensive-care
#9
Paul Zajic, Peter Bauer, Andrew Rhodes, Rui Moreno, Tobias Fellinger, Barbara Metnitz, Faidra Stavropoulou, Martin Posch, Philipp G H Metnitz
BACKGROUND: In this study, we primarily investigated whether ICU admission or ICU stay at weekends (Saturday and Sunday) is associated with a different risk of ICU mortality or chance of ICU discharge than ICU admission or ICU stay on weekdays (Monday to Friday). Secondarily, we analysed whether weekend ICU admission or ICU stay influences risk of hospital mortality or chance of hospital discharge. METHODS: A retrospective study was performed for all adult patients admitted to 119 ICUs participating in the benchmarking project of the Austrian Centre for Documentation and Quality Assurance in Intensive Care (ASDI) between 2012 and 2015...
September 7, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28876970/responding-to-ten-common-delirium-misconceptions-with-best-evidence-an-educational-review-for-clinicians
#10
Mark A Oldham, Nina M Flanagan, Ariba Khan, Olga Boukrina, Edward R Marcantonio
Delirium (acute confusion) is a serious, common health condition, and it predicts poor outcomes, including greater rates of mortality, institutionalization, prolonged hospitalization, and cognitive impairment. Expedient diagnosis and management are critical to address modifiable delirium causes and improve both quality of care and outcomes. Moreover, more than a third of delirium is preventable. Despite the clear significance of delirium and our increasingly sophisticated understanding of the condition, the gap between evidence and practice persists...
September 6, 2017: Journal of Neuropsychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28867295/asthma-outcomes-and-management-during-pregnancy
#11
REVIEW
Catherine A Bonham, Karen C Patterson, Mary E Strek
Asthma during pregnancy poses a common, increasingly prevalent threat to the health of women and their children. We review recent insights gained from the epidemiology of asthma during pregnancy, demonstrating the many short and long-term risks to mother and fetus incurred by poorly controlled maternal asthma. We further discuss emerging evidence that active asthma management during pregnancy can positively influence and perhaps completely mitigate these poor outcomes. Recent high-quality trials examining best methods for asthma treatment are reviewed and synthesized to offer an evidence-based pathway for comprehensive treatment of asthma in the outpatient setting...
August 31, 2017: Chest
https://www.readbyqxmd.com/read/28851498/point-of-care-ultrasound-leads-to-diagnostic-shifts-in-patients-with-undifferentiated-hypotension
#12
Hamid Shokoohi, Keith S Boniface, Michelle Zaragoza, Ali Pourmand, James P Earls
OBJECTIVE: To assess the impact of an ultrasound hypotension protocol in identifying life-threatening diagnoses that were missed in the initial evaluation of patients with hypotension and shock. METHODS: A subset of cases from a previously published prospective study of hypotensive patients who presented at the Emergency Department in a single, academic tertiary care hospital is described. An ultrasound-trained emergency physician performed an ultrasound on each patient using a standardized hypotension protocol...
August 26, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28845902/persistence-of-delirium-after-cessation-of-sedatives-and-analgesics-and-impact-on-clinical-outcomes-in-critically-ill-patients
#13
Michael T Kenes, Joanna L Stollings, Li Wang, Timothy D Girard, E Wesley Ely, Pratik P Pandharipande
STUDY OBJECTIVE: As delirium is a common manifestation in critically ill patients and is associated with worse clinical outcomes, we sought to characterize the reversibility of delirium after discontinuation of sedation and to determine whether sedation-associated delirium that rapidly reverses impacts clinical outcomes. DESIGN: Post hoc subgroup analysis of prospectively collected data from a previously published study. PATIENTS: Seventy adults admitted to a medical intensive care unit (ICU) between March and July 2012 who required mechanical ventilation with continuous analgesia and/or sedation and underwent a spontaneous awakening trial (SAT)...
August 28, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28843112/bio-behavioral-synchrony-promotes-the-development-of-conceptualized-emotions
#14
REVIEW
Shir Atzil, Maria Gendron
As adults, we have structured conceptual representations of our emotions that help us to make sense of and regulate our ongoing affective experience. The ability to use emotion concepts is critical to make predictions about the world and choose appropriate action, such as 'I am afraid, and going to run away' or 'I am hungry and going to eat'. Thus, emotion concepts have an important role in helping us maintain our ongoing physiological balance, or allostasis. We will suggest here that infants can learn emotion concepts for the purpose of allostasis regulation, and that conceptualization is key component in emotional development...
July 17, 2017: Current Opinion in Psychology
https://www.readbyqxmd.com/read/28831330/impact-of-traumatic-lower-extremity-injuries-beyond-acute-care-movement-based-considerations-for-resultant-longer-term-secondary-health-conditions
#15
REVIEW
Courtney M Butowicz, Christopher L Dearth, Brad D Hendershot
Significance: Advances in field-based trauma care, surgical techniques, and protective equipment have collectively facilitated the survival of a historically large number of service members (SMs) following combat trauma, although many sustained significant composite tissue injuries to the extremities, including limb loss (LL) and limb salvage (LS). Beyond the acute surgical and rehabilitative efforts that focus primarily on wound care and restoring mobility, traumatic LL and LS are associated with several debilitating longer term secondary health conditions (e...
August 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28826408/the-association-of-early-combined-lactate-and-glucose-levels-with-subsequent-renal-and-liver-dysfunction-and-hospital-mortality-in-critically-ill-patients
#16
Pedro Freire Jorge, Nienke Wieringa, Eva de Felice, Iwan C C van der Horst, Annemieke Oude Lansink, Maarten W Nijsten
BACKGROUND: The development of renal and liver dysfunction may be accompanied by initially subtle derangements in the gluconeogenetic function. Discrepantly low glucose levels combined with high lactate levels might indicate an impaired Cori cycle. Our objective was to examine the relation between early lactate and glucose levels with subsequent renal and liver dysfunction and hospital mortality in critically ill patients. METHODS: Over a 4-year period (2011 to 2014), all adult patients admitted to our adult 48-bed teaching hospital intensive care unit (ICU) for at least 12 h were retrospectively analyzed...
August 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28822384/clinical-characteristics-of-trauma-patients-requiring-hydrocortisone-treatment-for-refractory-hypotension
#17
Gina Kim, Jeffrey Young
Corticosteroids play an important role in responding to physiologic stress in the human body. However, its application in critical care remains heavily debated. The purpose of this study was to identify patient characteristics associated with receiving stress-dose steroids during the intensive care unit stay after traumatic injury and its effect on in-hospital mortality. Patients admitted to the University of Virginia trauma center between January 1, 2011, and December 31, 2015, were identified using our Trauma Registry...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28820040/effect-of-interhospital-icu-relocation-on-patient-physiology-and-clinical-outcomes
#18
David R Janz, Yasin A Khan, Jennifer L Mooney, Matthew W Semler, Todd W Rice, Jessica L Johnson, Bennett P deBoisblanc
Relocation of large numbers of critically ill patients between hospitals is sometimes necessary and the risks associated with relocation may be high. In the setting of adherence to an interhospital intensive care unit (ICU) relocation protocol, we aimed to determine whether the interhospital relocation of all ICU patients in a single day is associated with changes in vital signs, device removal, and worse clinical outcomes. We conducted a prospective, observational, cohort study of all critically ill adults admitted to a tertiary medical center's ICUs on the day of a planned hospital relocation and exposed to interhospital ICU relocation compared with unexposed critically ill adults...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28818213/the-natural-history-and-outcomes-of-line-associated-upper-extremity-deep-venous-thromboses-in-critically-ill-patients
#19
Joshua Underhill, Matthew A Sherman, Ryan Howard, Anthony Hage, Andrea Obi, Lena Napolitano, Dawn M Coleman
OBJECTIVE: Anticoagulation remains the standard of care for line-associated upper extremity deep venous thrombosis (UEDVT). This treatment carries the risk of hemorrhagic complications, possibly more so in surgical patients. Considering the low-risk profile of UEDVT-which is associated with fewer, less severe pulmonary emboli than lower extremity deep venous thrombosis-current UEDVT treatment guidelines may be overly aggressive. The goal of this study was to review outcomes of line-associated UEDVT in critically ill patients and to define the efficacy of current treatment protocols in pulmonary embolism (PE) prevention while avoiding hemorrhagic complications...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28815849/molecular-aspects-of-uterine-diseases-in-dogs
#20
REVIEW
R Hagman
Uterine diseases are common in dogs, particularly in countries where elective spaying is not usually performed. The associated clinical illnesses may be of varying degree ranging from merely decreased fertility to a critical pyometra requiring intensive care to survive. The diagnosis of some uterine diseases is generally uncomplicated, such as in a classic pyometra presenting with enlarged, fluid-filled uterus, purulent vaginal discharge and characteristic signs of illness or in other disorders associated with uterine enlargement...
August 2017: Reproduction in Domestic Animals, Zuchthygiene
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