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https://www.readbyqxmd.com/read/28821525/point-of-care-washing-of-allogeneic-red-blood-cells-for-the-prevention-of-transfusion-related-respiratory-complications-war-prc-a-protocol-for-a-multicenter-randomised-clinical-trial-in-patients-undergoing-cardiac-surgery
#1
Matthew A Warner, Ian J Welsby, Phillip J Norris, Christopher C Silliman, Sarah Armour, Erica D Wittwer, Paula J Santrach, Laurie A Meade, Lavonne M Liedl, Chelsea M Nieuwenkamp, Brian Douthit, Camille M van Buskirk, Phillip J Schulte, Rickey E Carter, Daryl J Kor
INTRODUCTION: The transfusion-related respiratory complications, transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO), are leading causes of transfusion-related morbidity and mortality. At present, there are no effective preventive strategies with red blood cell (RBC) transfusion. Although mechanisms remain incompletely defined, soluble biological response modifiers (BRMs) within the RBC storage solution may play an important role. Point-of-care (POC) washing of allogeneic RBCs may remove these BRMs, thereby mitigating their impact on post-transfusion respiratory complications...
August 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28821420/hyperglycemia-in-young-adults-seen-in-the-emergency-department-a-health-records-review
#2
Justin W Yan, Alexandra L Hamelin, Katherine M Gushulak, Kristine Van Aarsen, Melanie P Columbus, Ian G Stiell
Patients with diabetes who are in emerging adulthood, defined as the life stage between 18 and 29 years of age, have unique challenges in managing their illness and are at risk for acute complications and loss to follow up. This study's objective was to describe emergency department (ED) utilization because of hyperglycemia in emerging adults with diabetes and to characterize 30-day outcomes, including return visits and admission for hyperglycemia. This was a health-records review of emerging adults presenting over a 1-year period to 4 tertiary care EDs; the patients had known histories of diabetes and final diagnoses of hyperglycemia, diabetic ketoacidosis or hyperosmolar hyperglycemia...
August 15, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28820896/a-strategy-for-scaling-up-access-to-comprehensive-care-in-adults-with-chagas-disease-in-endemic-countries-the-bolivian-chagas-platform
#3
Maria-Jesus Pinazo, Jimy Pinto, Lourdes Ortiz, Jareth Sánchez, Wilson García, Ruth Saravia, Mirko-R Cortez, Silvia Moriana, Enric Grau, Daniel Lozano, Joaquim Gascon, Faustino Torrico
BACKGROUND: Bolivia has the highest prevalence of Chagas disease (CD) in the world (6.1%), with more than 607,186 people with Trypanosoma cruzi infection, most of them adults. In Bolivia CD has been declared a national priority. In 2009, the Chagas National Program (ChNP) had neither a protocol nor a clear directive for diagnosis and treatment of adults. Although programs had been implemented for congenital transmission and for acute cases, adults remained uncovered. Moreover, health professionals were not aware of treatment recommendations aimed at this population, and research on CD was limited; it was difficult to increase awareness of the disease, understand the challenges it presented, and adapt strategies to cope with it...
August 18, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28819204/prognostic-factors-and-outcomes-of-unplanned-extubation
#4
Chien-Ming Chao, Mei-I Sung, Kuo-Chen Cheng, Chih-Cheng Lai, Khee-Siang Chan, Ai-Chin Cheng, Shu-Chen Hsing, Chin-Ming Chen
This study investigated the prognostic factors and outcomes of unplanned extubation (UE) in patients in a medical center's 6 intensive care units (ICUs) and calculated their mortality risk. We retrospectively reviewed the medical records of all adult patients in Chi Mei Medical Center who underwent UE between 2009 and 2015. During the study period, there were 305 episodes of UE in 295 ICU patients (men: 199 [67.5%]; mean age: 65.7 years; age range: 18-94 years). The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 16...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28817952/professional-socialization-a-grounded-theory-of-the-clinical-reasoning-processes-that-rns-and-lpns-use-to-recognize-delirium
#5
Mohamed El Hussein, Sandra Hirst, Joseph Osuji
Delirium is an acute disorder of attention and cognition. It affects half of older adults in acute care settings and is a cause of increasing mortality and costs. Registered nurses (RNs) and licensed practical nurses (LPNs) frequently fail to recognize delirium. The goals of this research were to identify the reasoning processes that RNs and LPNs use to recognize delirium, to compare their reasoning processes, and to generate a theory that explains their clinical reasoning processes. Theoretical sampling was employed to elicit data from 28 participants using grounded theory methodology...
August 1, 2017: Clinical Nursing Research
https://www.readbyqxmd.com/read/28817481/incorporating-dynamic-assessment-of-fluid-responsiveness-into-goal-directed-therapy-a-systematic-review-and-meta-analysis
#6
Joseph M Bednarczyk, Jason A Fridfinnson, Anand Kumar, Laurie Blanchard, Rasheda Rabbani, Dean Bell, Duane Funk, Alexis F Turgeon, Ahmed M Abou-Setta, Ryan Zarychanski
OBJECTIVE: Dynamic tests of fluid responsiveness have been developed and investigated in clinical trials of goal-directed therapy. The impact of this approach on clinically relevant outcomes is unknown. We performed a systematic review and meta-analysis to evaluate whether fluid therapy guided by dynamic assessment of fluid responsiveness compared with standard care improves clinically relevant outcomes in adults admitted to the ICU. DATA SOURCES: Randomized controlled trials from MEDLINE, EMBASE, CENTRAL, clinicaltrials...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28816929/effectiveness-and-value-of-prophylactic-5-layer-foam-sacral-dressings-to-prevent-hospital-acquired-pressure-injuries-in-acute-care-hospitals-an-observational-cohort-study
#7
William V Padula
PURPOSE: The purpose of this study was to examine the effectiveness and value of prophylactic 5-layer foam sacral dressings to prevent hospital-acquired pressure injury rates in acute care settings. DESIGN: Retrospective observational cohort. SAMPLE AND SETTING: We reviewed records of adult patients 18 years or older who were hospitalized at least 5 days across 38 acute care hospitals of the University Health System Consortium (UHC) and had a pressure injury as identified by Patient Safety Indicator #3 (PSI-03)...
August 15, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28816594/consensus-statement-on-current-and-emerging-methods-for-the-diagnosis-and-evaluation-of-cerebrovascular-disease
#8
Manus J Donahue, Eric Achten, Petrice M Cogswell, Frank-Erik De Leeuw, Colin P Derdeyn, Rick M Dijkhuizen, Audrey P Fan, Rashid Ghaznawi, Jeremy J Heit, M Arfan Ikram, Peter Jezzard, Lori C Jordan, Eric Jouvent, Linda Knutsson, Richard Leigh, David S Liebeskind, Weili Lin, Thomas W Okell, Adnan I Qureshi, Charlotte J Stagg, Matthias Jp van Osch, Peter Cm van Zijl, Jennifer M Watchmaker, Max Wintermark, Ona Wu, Greg Zaharchuk, Jinyuan Zhou, Jeroen Hendrikse
Cerebrovascular disease (CVD) remains a leading cause of death and the leading cause of adult disability in most developed countries. This work summarizes state-of-the-art, and possible future, diagnostic and evaluation approaches in multiple stages of CVD, including (i) visualization of sub-clinical disease processes, (ii) acute stroke theranostics, and (iii) characterization of post-stroke recovery mechanisms. Underlying pathophysiology as it relates to large vessel steno-occlusive disease and the impact of this macrovascular disease on tissue-level viability, hemodynamics (cerebral blood flow, cerebral blood volume, and mean transit time), and metabolism (cerebral metabolic rate of oxygen consumption and pH) are also discussed in the context of emerging neuroimaging protocols with sensitivity to these factors...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28808752/return-to-work-and-work-related-disability-among-aml-survivors
#9
Osai Samadi, Henriette Breunis, Joanna Sandoval, Kosalan Akilan, Narhari Timilshina, Shabbir M H Alibhai
Acute myeloid leukemia (AML) is an aggressive, acute-onset hematological malignancy. Greater use of intensive chemotherapy (IC), supportive care, and stem cell transplantation have led to an increasing number of long-term survivors. Few studies have examined employment issues among AML survivors and to our knowledge, no study has examined the long-term effects of treatment on return to work. This study is the first to utilize a validated measure of work-related limitation and productivity (WLQ-16) to assess the long-term effects of AML treatment on employment rates, work-related limitations, and overall productivity...
August 14, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28808366/clinical-features-and-outcomes-of-patients-with-posterior-reversible-encephalopathy-syndrome
#10
M S Kalaiselvan, M K Renuka, A S Arunkumar
AIMS: The aim of this study was to study the clinical features and outcomes of patients with posterior reversible encephalopathy syndrome (PRES) admitted to the Intensive Care Unit (ICU). SUBJECTS AND METHODS: All adult patients admitted to our ICU with acute onset neurologic symptoms with focal vasogenic edema on magnetic resonance imaging (MRI) were included in the study. Data were collected on demography, coexisting illness, admission severity of illness, neurological symptoms, blood pressure, treatment initiated, and MRI findings...
July 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28808076/influence-of-the-duration-of-penicillin-prescriptions-on-outcomes-for-acute-sore-throat-in-adults-the-descarte-prospective-cohort-study-in-uk-general-practice
#11
Michael Moore, Beth Stuart, Fd Richard Hobbs, Chris C Butler, Alastair D Hay, John Campbell, Brendan C Delaney, Sue Broomfield, Paula Barratt, Kerenza Hood, Hazel Everitt, Mark Mullee, Ian Williamson, David Mant, Paul Little
BACKGROUND: Guidelines recommend 10-day treatment courses for acute sore throat, but shorter courses may be used in practice. AIM: To determine whether antibiotic duration predicts adverse outcome of acute sore throat in adults in routine care. DESIGN AND SETTING: A secondary analysis of the DESCARTE (Decision rule for the Symptoms and Complications of Acute Red Throat in Everyday practice) prospective cohort study of 12 829 adults presenting in UK general practice with acute sore throat...
August 14, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28808075/symptom-response-to-antibiotic-prescribing-strategies-in-acute-sore-throat-in-adults-the-descarte-prospective-cohort-study-in-uk-general-practice
#12
Michael Moore, Beth Stuart, Fd Richard Hobbs, Chris C Butler, Alastair D Hay, John Campbell, Brendan C Delaney, Sue Broomfield, Paula Barratt, Kerenza Hood, Hazel A Everitt, Mark Mullee, Ian Williamson, David Mant, Paul Little
BACKGROUND: A delayed or 'just in case' prescription has been identified as having potential to reduce antibiotic use in sore throat. AIM: To determine the symptomatic outcome of acute sore throat in adults according to antibiotic prescription strategy in routine care. DESIGN AND SETTING: A secondary analysis of the DESCARTE (Decision rule for the Symptoms and Complications of Acute Red Throat in Everyday practice) prospective cohort study comprising adults aged ≥16 years presenting with acute sore throat (≤2 weeks' duration) managed with treatment as usual in primary care in the UK...
August 14, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28807558/cost-of-asthma-in-portuguese-adults-a-population-based-cost-of-illness-study
#13
J P Barbosa, M Ferreira-Magalhães, A Sá-Sousa, L F Azevedo, J A Fonseca
INTRODUCTION: Asthma is one of the most frequent chronic diseases, putting a considerable economic burden on societies and individuals. We aimed to estimate the total cost of adult asthma in Portugal, as well as the extent to which direct and indirect costs are influenced by the level of asthma control. METHODS: A nationwide, prevalence-based, cost-of-illness study using a bottom-up approach to calculate direct and indirect costs of asthma was conducted, using participant data from the Portuguese National Asthma Survey (INAsma)...
August 11, 2017: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/28807140/acute-psychological-trauma-in-the-critically-ill-patient-and-family-perspectives
#14
Volha Dziadzko, Mikhail A Dziadzko, Margaret M Johnson, Ognjen Gajic, Lioudmila V Karnatovskaia
OBJECTIVE: Post-intensive care syndrome (PICS), which encompasses profound psychological morbidity, affects many survivors of critical illness. We hypothesize that acute psychological stress during the intensive care unit (ICU) confinement likely contributes to PICS. In order to develop strategies that mitigate PICS associated psychological morbidity, it is paramount to first characterize acute ICU psychological stress and begin to understand its causative and protective factors. METHODS: A structured interview study was administered to adult critical illness survivors who received ≥48h of mechanical ventilation in medical and surgical ICUs of a tertiary care center, and their families...
July 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28806860/patient-caregiver-and-provider-perceptions-of-pain-and-pain-management-in-adolescents-and-young-adults-with-bleeding-disorders
#15
Angela Lambing, Cynthia D Nichols, James E Munn, Terry L Anderson, Bartholomew J Tortella, Michelle L Witkop
INTRODUCTION: Recurrent bleeding and associated pain are critical components in the management of bleeding disorders, yet scant data describe perceptions of pain in this patient population. OBJECTIVE: This study assessed perceptions of pain and pain management in adolescents and young adults (AYAs) with haemophilia or von Willebrand disease (VWD) to determine agreement/disagreement between patients, caregivers and health care providers. METHODS: Using an online questionnaire, AYA patients (N=89), their caregivers (N=77), and providers (N=54) reported on pain perception, pain treatment and pain control...
August 14, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28806562/zika-virus-induced-neurological-critical-illness-in-latin-america-severe-guillain-barre-syndrome-and-encephalitis
#16
Sebastián U Ugarte, Angel Ricardo V Arenas, Bruno C Alvarez, Angela Cubides, Angélica F Luna, Max Arroyo-Parejo, Cayri E Acuña, Agamenón V Quintero, Orlando Ch Villareal, Oscar S Pinillos, Elías Vieda, Manuel Bello, Susana Peña, Carmelo Dueñas-Castell, Gloria M V Rodriguez, Jorge L M Ranero, Rosa L M López, Sandra G Olaya, José C Vergara, Ana Tandazo, Juan P S Ospina, Igor M Leyton Soto, R A Fowler, John C Marshall
Zika virus (ZIKAV) is classically described as causing minor symptoms in adult patients, however neurologic complications have been recognized. The recent outbreak in Central and South America has resulted in serious illness in some adult patients. We report adult patients in Latin America diagnosed with ZIKAV infection admitted to Intensive Care Units (ICUs). METHODS: Multicenter, prospective case series of adult patients with laboratory diagnosis of ZIKAV in 16 ICUs in 8 countries. RESULTS: Between December 1st 2015 and April 2nd 2016, 16 ICUs in 8 countries enrolled 49 critically ill patients with diagnosis of ZIKAV infection...
August 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28806453/neurologic-complications-associated-with-the-zika-virus-in-brazilian-adults
#17
Ivan Rocha Ferreira da Silva, Jennifer A Frontera, Ana Maria Bispo de Filippis, Osvaldo Jose Moreira do Nascimento
Importance: There are no prospective cohort studies assessing the incidence and spectrum of neurologic manifestations secondary to Zika virus (ZIKV) infection in adults. Objective: To evaluate the rates of acute ZIKV infection among patients hospitalized with Guillain-Barré syndrome (GBS), meningoencephalitis, or transverse myelitis. Design, Setting, and Participants: A prospective, observational cohort study was conducted at a tertiary referral center for neurological diseases in Rio de Janeiro, Brazil, between December 5, 2015, and May 10, 2016, among consecutive hospitalized adults (>18 years of age) with new-onset acute parainfectious or neuroinflammatory disease...
August 14, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28803772/perioperative-statins-do-not-prevent-acute-kidney-injury-after-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#18
Bing-Cheng Zhao, Pu Shen, Ke-Xuan Liu
OBJECTIVES: To evaluate whether perioperative statins reduce the risk of acute kidney injury (AKI) after cardiac surgery. DESIGN: Systematic review and meta-analysis of randomized trials. SETTING: Perioperative management in hospitals that perform cardiac surgery. PARTICIPANTS: Adult patients undergoing cardiac surgery. INTERVENTIONS: PubMed, EMBASE, and the Cochrane Library databases were searched for randomized trials...
April 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28802877/declining-mortality-in-critically-ill-patients-with-cirrhosis-in-australia-and-new-zealand-between-2000-and-2015
#19
Avik Majumdar, Michael Bailey, William M Kemp, Rinaldo Bellomo, Stuart K Roberts, David Pilcher
BACKGROUND AND AIMS: Few studies have described the outcomes of patients with cirrhosis receiving intensive care unit (ICU) admission at a population level. We aimed to describe trends in the mortality of such patients in Australia and New Zealand (ANZ), and to investigate the relationship with associated organ failures. METHODS: We studied patients admitted to 172 ICUs on a non-elective basis, with and without cirrhosis between January 1(st) 2000 and December 31(st) 2015 as recorded by the ANZ Intensive Care Society Centre for Outcome and Resource Evaluation Adult Patient Database...
August 9, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28802541/opioid-doses-and-acute-care-utilization-outcomes-for-adults-with-sickle-cell-disease-emergency-department-versus-acute-care-unit
#20
Robert E Molokie, Chariz Montminy, Corissa Dionisio, Muhammad Ahmen Farooqui, Michel Gowhari, Yingwei Yao, Marie L Suarez, Miriam O Ezenwa, Judith M Schlaeger, Zaijie J Wang, Diana J Wilkie
BACKGROUND: Acute care units (ACUs) with focused sickle cell disease (SCD) care have been shown to effectively address pain and limit hospitalizations compared to emergency departments (ED), the reason for differences in admission rates is understudied. Our aim was compare effects of usual care for adult SCD pain in ACU and ED on opioid doses and discharge pain ratings, hospital admission rates and lengths of stay. METHODS: In a retrospective, comparative cohort, single academic tertiary center study, 148 adults with sickle cell pain received care in the ED, ACU or both...
July 13, 2017: American Journal of Emergency Medicine
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