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https://www.readbyqxmd.com/read/27911489/palliative-care-interventions-in-advanced-dementia
#1
REVIEW
Edel Murphy, Katherine Froggatt, Sheelah Connolly, Eamon O'Shea, Elizabeth L Sampson, Dympna Casey, Declan Devane
BACKGROUND: Dementia is a chronic, progressive and ultimately fatal neurodegenerative disease. Advanced dementia is characterised by profound cognitive impairment, inability to communicate verbally and complete functional dependence. Usual care of people with advanced dementia is not underpinned universally by a palliative approach. Palliative care has focused traditionally on care of people with cancer but for more than a decade, there have been increased calls worldwide to extend palliative care services to include all people with life-limiting illnesses in need of specialist care, including people with dementia...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27911143/factors-predicting-life-threatening-infections-with-respiratory-syncytial-virus-in-adult-patients
#2
Se Yoon Park, Taeeun Kim, Young Rock Jang, Min-Chul Kim, Yong Pil Chong, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Jun Hee Woo, Sung-Han Kim
BACKGROUND: Respiratory syncytial virus (RSV) is a significant cause of acute respiratory illness with a clinical spectrum ranging from self-limiting upper respiratory infection to severe lower respiratory infection in elderly persons as well as young children. However, there are limited data on risk factors for life-threatening infections that could guide the appropriate use of antiviral agents in adult patients with RSV. METHODS: We conducted a retrospective cohort study from October 2013 to September 2015...
December 2, 2016: Infectious Diseases
https://www.readbyqxmd.com/read/27910090/spinal-fractures-in-older-adult-patients-admitted-after-low-level-falls-10-year-incidence-and-outcomes
#3
Randeep S Jawa, Adam J Singer, Daniel N Rutigliano, Jane E McCormack, Emily C Huang, Marc J Shapiro, Suzanne D Fields, Brian N Morelli, James A Vosswinkel
OBJECTIVES: To evaluate the incidence of spinal fractures and their outcomes in the elderly who fall from low-levels in a suburban county. DESIGN: Retrospective county-wide trauma registry review from 2004 to 2013. SETTING: Suburban county with regionalized trauma care consisting of 11 hospitals. PARTICIPANTS: Adult trauma patients aged ≥65 years who were admitted after falling from <3 feet. MEASUREMENTS: Demographic characteristics, comorbidities, and outcomes...
December 2, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27907205/household-air-pollution-and-acute-lower-respiratory-infections-in-adults-a-systematic-review
#4
Hannah Jary, Hope Simpson, Deborah Havens, Geoffrey Manda, Daniel Pope, Nigel Bruce, Kevin Mortimer
INTRODUCTION: Household air pollution from solid fuel burning kills over 4 million people every year including half a million children from acute lower respiratory infections. Although biologically plausible, it is not clear whether household air pollution is also associated with acute lower respiratory infections in adults. We systematically reviewed the literature on household air pollution and acute lower respiratory infection in adults to identify knowledge gaps and research opportunities...
2016: PloS One
https://www.readbyqxmd.com/read/27904748/patterns-of-medication-use-and-factors-associated-with-antibiotic-use-among-adult-fever-patients-at-singapore-primary-care-clinics
#5
Zaw Myo Tun, Mahesh Moorthy, Martin Linster, Yvonne C F Su, Richard James Coker, Eng Eong Ooi, Jenny Guek-Hong Low, Gavin J D Smith, Clarence C Tam
BACKGROUND: Antimicrobial resistance is a public health problem of global importance. In Singapore, much focus has been given to antibiotic usage patterns in hospital settings. Data on antibiotic use in primary care is lacking. We describe antibiotic usage patterns and assess factors contributing to antibiotic usage among adults presenting with acute febrile illness (AFI) in primary care settings in Singapore. METHODS: We analyzed data from the Early Dengue infection and outcome study...
2016: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/27903392/-resuscitation-efficacy-of-extracorporeal-membrane-oxygenation-in-non-postcardiotomy-adult-patients-with-cardiac-arrest
#6
L Huang, Y W Liu, T Li, X M Hu, D W Duan, P Wu
Objective: To evaluate the resuscitation efficacy of extracorporeal membrane oxygenation (ECMO) for non-postcardiotomy cardiac arrest adult patients post failed conventional cardiopulmonary resuscitation (CCPR). Methods: We retrospectively analyzed the clinical data of a total of 25 consecutive adults who suffered from non-postcardiotomy cardiac arrest and were treated with ECMO post failed CCPR in our hospital between January 2010 and January 2015. Inclusion criteria included: 18 to 75 years old; the duration from cardiac arrest to CCPR initiation<5 minutes; no recovery of spontaneous circulation within 10 min after implementation of standard CCPR, and the length of CCPR <90 minutes...
November 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/27903267/skeletal-muscle-quality-as-assessed-by-ct-derived-skeletal-muscle-density-is-associated-with-6-month-mortality-in-mechanically-ventilated-critically-ill-patients
#7
Wilhelmus G P M Looijaard, Ingeborg M Dekker, Sandra N Stapel, Armand R J Girbes, Jos W R Twisk, Heleen M Oudemans-van Straaten, Peter J M Weijs
BACKGROUND: Muscle quantity at intensive care unit (ICU) admission has been independently associated with mortality. In addition to quantity, muscle quality may be important for survival. Muscle quality is influenced by fatty infiltration or myosteatosis, which can be assessed on computed tomography (CT) scans by analysing skeletal muscle density (SMD) and the amount of intermuscular adipose tissue (IMAT). We investigated whether CT-derived low skeletal muscle quality at ICU admission is independently associated with 6-month mortality and other clinical outcomes...
December 1, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27902657/the-assessment-of-the-risk-of-unplanned-extubation-in-an-adult-intensive-care-unit
#8
Semine Aydoğan, Nurten Kaya
BACKGROUND: In order to plan and implement nursing intervention to reduce the incidence rate of unplanned extubation problem in the intensive care unit (ICU), it is necessary to determine the risk factors of unplanned extubation and the patients under risk. AIMS: This study was undertaken with the aim of evaluating the risk of unplanned extubation of endotracheal tube in adult ICU. DESIGN: This was a case-control study. METHODS: The population constituted patients hospitalized in the adult ICU during 1-year period in a university hospital...
January 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27902532/lean-six-sigma-to-reduce-intensive-care-unit-length-of-stay-and-costs-in-prolonged-mechanical-ventilation
#9
Stephen Trzeciak, Michael Mercincavage, Cory Angelini, William Cogliano, Emily Damuth, Brian W Roberts, Sergio Zanotti, Anthony J Mazzarelli
OBJECTIVE: Patients with prolonged mechanical ventilation (PMV) represent important "outliers" of hospital length of stay (LOS) and costs (∼$26 billion annually in the United States). We tested the hypothesis that a Lean Six Sigma (LSS) approach for process improvement could reduce hospital LOS and the associated costs of care for patients with PMV. DESIGN: Before-and-after cohort study. SETTING: Multidisciplinary intensive care unit (ICU) in an academic medical center...
November 29, 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27900652/mobile-based-mhgap-ig-depression-screening-in-kenya
#10
Christine W Musyimi, Victoria N Mutiso, Zahra R Haji, Erick S Nandoya, David M Ndetei
We aimed to determine the prevalence and determinants of depression using mobile based mental health Global Action Programme Intervention guide (mhGAP-IG) in remote health care settings where most priority mental health problems are managed by non-mental health specialists and evaluate the feasibility of the application. Adult patients were recruited from four rural public health facilities in Kenya using systematic random sampling and screened for depression. There were no missing items since the application prevented saving of data unless all the items were answered...
November 30, 2016: Community Mental Health Journal
https://www.readbyqxmd.com/read/27900227/urachal-cyst-causing-small-bowel-obstruction-in-an-adult-with-a-virgin-abdomen
#11
Michael P O'Leary, Zane W Ashman, David S Plurad, Dennis Y Kim
Introduction. A patent urachus is a rare congenital or acquired pathology, which can lead to complications later in life. We describe a case of urachal cystitis as the etiology of small bowel obstruction in an adult without prior intra-abdominal surgery. Case Report. A 64-year-old male presented to the acute care surgery team with a 5-day history of right lower quadrant abdominal pain, distention, nausea, and vomiting. He had a two-month history of urinary retention and his past medical history was significant for benign prostate hyperplasia...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27899470/i-trach-validating-a-tool-for-predicting-prolonged-mechanical-ventilation
#12
Paul A Clark, Ryan C Inocencio, Christopher J Lettieri
PURPOSE: We previously developed a bedside model (I-TRACH), which used commonly obtained data at the time of intubation to predict the duration of mechanical ventilation (MV). We now sought to validate this in a prospective trial. METHODS: A prospective, observational study of 225 consecutive adult medical intensive care unit patients requiring MV. Utilizing the original 6 variables used in the I-TRACH model (Intubation in the ICU, Tachycardia [heart rate > 110], Renal dysfunction [blood urea nitrogen > 25], Acidemia [pH < 7...
November 28, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27899357/a-phase-iii-randomized-trial-comparing-inolimomab-vs-usual-care-in-steroid-resistant-acute-gvhd
#13
Gérard Socié, Stéphane Vigouroux, Ibrahim Yakoub-Agha, Jacques-Olivier Bay, Sabine Fürst, Karin Bilger, Felipe Suarez, Mauricette Michallet, Dominique Bron, Philippe Gard, Zakaria Medeghri, Philippe Lehert, Chinglin Lai, Tim Corn, Jean-Paul Vernant
Treatment of steroid resistant (SR) aGVHD remains an unmet clinical need. Inolimomab, a monoclonal antibody to CD25, has shown encouraging results in phase II trials. This phase III randomized, open-label, multicenter compared Inolimomab vs. usual care in adult patients with steroid-refractory aGvHD. Patients were randomized to treatment with Inolimomab or usual care [control group were all treated with Anti Thymocyte Globulin (ATG)]. The primary objective was to evaluate overall survival at 1 year without changing baseline allocated therapy...
November 29, 2016: Blood
https://www.readbyqxmd.com/read/27899205/development-and-validation-of-the-new-icnarc-model-for-prediction-of-acute-hospital-mortality-in-adult-critical-care
#14
Paloma Ferrando-Vivas, Andrew Jones, Kathryn M Rowan, David A Harrison
PURPOSE: To develop and validate an improved risk model to predict acute hospital mortality for admissions to adult critical care units in the UK. MATERIALS AND METHODS: 155,239 admissions to 232 adult critical care units in England, Wales and Northern Ireland between January and December 2012 were used to develop a risk model from a set of 38 candidate predictors. The model was validated using 90,017 admissions between January and September 2013. RESULTS: The final model incorporated 15 physiological predictors (modelled with continuous nonlinear models), age, dependency prior to hospital admission, chronic liver disease, metastatic disease, haematological malignancy, CPR prior to admission, location prior to admission/urgency of admission, primary reason for admission and interaction terms...
November 21, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27898220/intensive-care-physiotherapy-during-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome
#15
Laveena Munshi, Tadahiro Kobayashi, Julian DeBacker, Ravi Doobay, Teagan Telesnicki, Vincent Lo, Nathalie Cote, Marcelo Cypel, Shaf Keshavjee, Niall D Ferguson, Eddy Fan
RATIONALE: There are limited data on physiotherapy during extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS). OBJECTIVES: We sought to characterize physiotherapy delivered to ARDS patients supported with ECMO, and to evaluate the association of this therapeutic modality with mortality. METHODS: We conducted a retrospective cohort study of all adult ARDS patients supported with ECMO at our institution from 2010-2015...
November 29, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27895058/diagnosis-and-management-of-aml-in-adults-2017-eln-recommendations-from-an-international-expert-panel
#16
Hartmut Döhner, Elihu Estey, David Grimwade, Sergio Amadori, Frederick R Appelbaum, Thomas Büchner, Hervé Dombret, Benjamin L Ebert, Pierre Fenaux, Richard A Larson, Ross L Levine, Francesco Lo-Coco, Tomoki Naoe, Dietger Niederwieser, Gert J Ossenkoppele, Miguel Sanz, Jorge Sierra, Martin S Tallman, Hwei-Fang Tien, Andrew H Wei, Bob Löwenberg, Clara D Bloomfield
The first edition of the European LeukemiaNet (ELN) recommendations for diagnosis and management of acute myeloid leukemia (AML) in adults published in 2010 has found broad acceptance by physicians and investigators caring for patients with AML. Recent advances, for example, in the discovery of the genomic landscape of the disease, in the development of assays for genetic testing and for detecting minimal residual disease, as well as in the development of novel anti-leukemic agents, prompted an international panel to provide updated evidence- and expert opinion-based recommendations...
November 28, 2016: Blood
https://www.readbyqxmd.com/read/27894558/helicopter-scene-response-for-stroke-patients-a-5-year-experience
#17
Andrew Hawk, Catherine Marco, Matt Huang, Bonnie Chow
OBJECTIVE: The purpose of this study was to examine the usefulness of an emergency medical service (EMS)-requested air medical helicopter response directly to the scene for a patient with clinical evidence of an ischemic cerebrovascular accident (CVA) and transport to a regional comprehensive CVA center. METHODS: CareFlight, an air medical critical care transportation service, is based in Dayton, OH. The 3 CareFlight helicopters are geographically located and provided transport to all CVA scene patients in this study...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27894271/effectiveness-of-a-physical-exercise-intervention-program-in-improving-functional-mobility-in-older-adults-after-hip-fracture-in-later-stage-rehabilitation-protocol-of-a-randomized-clinical-trial-reative-study
#18
Camila Astolphi Lima, Catherine Sherrington, Adriana Guaraldo, Suzana Albuquerque de Moraes, Renata Dos Ramos Varanda, Juliana de Araújo Melo, Kodi Edson Kojima, Monica Perracini
BACKGROUND: Hip fractures resulting from falls increase substantially with advancing age and less than half of older hip fracture survivors regain their former levels of mobility. There is increasing evidence that rehabilitation interventions with exercises that goes beyond the sub-acute phase or even in a later stage of care have a positive impact on various functional abilities. The purpose of this study is to determine if exercise program training for people who have suffered a fall-related hip fracture will improve functional mobility when compared with usual care...
November 29, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27893969/hospital-characteristics-and-favourable-neurological-outcome-among-patients-with-out-of-hospital-cardiac-arrest-in-osaka-japan
#19
Tasuku Matsuyama, Kosuke Kiyohara, Tetsuhisa Kitamura, Chika Nishiyama, Tatsuya Nishiuchi, Yasuyuki Hayashi, Takashi Kawamura, Bon Ohta, Taku Iwami
OBJECTIVE: To assess the association between favourable neurological outcome and hospital characteristics such as hospital volume and number of critical care centres (CCMCs) after out-of-hospital cardiac arrest (OHCA). METHODS: This retrospective, population-based observational study conducted in Osaka Prefecture, Japan included adult patients with OHCA, aged ≥18 years, before the arrival of the emergency medical service and who were transported to acute care hospitals between January 2005 and December 2012...
November 25, 2016: Resuscitation
https://www.readbyqxmd.com/read/27893070/contingent-valuation-analysis-of-an-otolaryngology-and-ophthalmology-emergency-department-the-value-of-acute-specialty-care
#20
Matthew R Naunheim, Elliot D Kozin, Rosh K Sethi, H G Ota, Stacey T Gray, Mark G Shrime
Importance: Specialty emergency departments (EDs) provide a unique mechanism of health care delivery, but the value that they add to the medical system is not known. Evaluation of patient preferences to determine value can have a direct impact on resource allocation and direct-to-specialist care. Objective: To assess the feasibility of contingent valuation (CV) methodology using a willingness-to-pay (WTP) survey to evaluate specialty emergency services, in the context of an ophthalmology- and otolaryngology-specific ED...
November 23, 2016: JAMA Otolaryngology—Head & Neck Surgery
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