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https://www.readbyqxmd.com/read/28932559/pupillary-abnormalities-in-non-selected-critically-ill-patients-an-observational-study
#1
Philippe Portran, Martin Cour, Romain Hernu, Sylvie de la Salle, Laurent Argaud
BACKGROUND: Repeated pupillary examination is a key element of neurologic surveillance in intensive care units (ICU). However, in non-selected critically ill patients, the clinical interest of monitoring pupillary diameter and light reflex is poorly documented. We aimed to determine the prevalence and the etiologies of pupillary abnormalities (PAs) in this ICU patient population. METHODS: We performed a prospective, observational study in a medical university affiliated ICU over a 6-month period...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28932408/golden-hour-of-neonatal-life-need-of-the-hour
#2
REVIEW
Deepak Sharma
"Golden Hour" of neonatal life is defined as the first hour of post-natal life in both preterm and term neonates. This concept in neonatology has been adopted from adult trauma where the initial first hour of trauma management is considered as golden hour. The "Golden hour" concept includes practicing all the evidence based intervention for term and preterm neonates, in the initial sixty minutes of postnatal life for better long-term outcome. Although the current evidence supports the concept of golden hour in preterm and still there is no evidence seeking the benefit of golden hour approach in term neonates, but neonatologist around the globe feel the importance of golden hour concept equally in both preterm and term neonates...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28928588/patient-with-persistent-low-oxygen-saturation-for-emergency-cesarean-section
#3
Shivali Panwar, Kirti Nath Saxena, Prachi Gaba
A 24-year-old woman with previous undiagnosed congenital methemoglobinemia presented for the emergency cesarean section in view of fetal distress. The patient had a persistent low oxygen saturation on pulse oximetry with normal heart rate and blood pressure. Arterial blood gas values were normal. The patient was asymptomatic and respiratory and cardiovascular system examination was normal. The patient underwent cesarean section under general anesthesia and was shifted to the Intensive Care Unit postoperatively...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28925473/chronic-obstructive-pulmonary-disease-copd-exacerbation-impact-of-comorbidities-on-length-and-costs-during-hospitalization
#4
C Terzano, V Colamesta, B Unim, S Romani, A Meneghini, G Volpe, G La Torre
OBJECTIVE: A retrospective cohort study was performed, using administrative database of the Local Health Unit Roma-A (LHU RM-A). The included subjects were residing in one of the four districts and were hospitalized for COPD exacerbation in healthcare facilities of the LHU during years 2010-2012. PATIENTS AND METHODS: The aim of the present study is to evaluate the impact of comorbidities, length and costs of hospital stay in patients with COPD exacerbations. Chronic obstructive pulmonary disease (COPD) is often associated with other diseases (cardiovascular diseases, diabetes, metabolic syndrome, chronic renal failure, depression) that can increase risk of mortality and hospitalization...
August 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28923811/coronary-artery-calcium-progression-is-associated-with-cardiovascular-events-among-asymptomatic-individuals-from-the-north-texas-primary-care-practice-based-research-network-nortex-pbrn
#5
Roberto Cardarelli, Alexandria Hall, Wade Rankin
BACKGROUND: Although incidental coronary artery calcium (CAC) has been established as a surrogate measure for atherosclerotic plaque burden, little is known about its progression and the associated risks. This study looks at the association of select cardiovascular risk factors with the progression of CAC over a 2-year period and the relationship between CAC progression and experiencing a composite cardiovascular disease (CVD) event. METHODS: Repeated CAC measurements were obtained for 311 asymptomatic participants aged >44 years, who were recruited from a collaborative network of primary care clinics...
September 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28917226/energy-intake-in-the-first-week-in-an-emergency-intensive-care-unit-may-not-influence-clinical-outcomes-in-critically-ill-overweight-japanese-patients
#6
Satomi Ichimaru, Maren Sono, Ryutaro Seo, Koichi Ariyoshi, Teruyoshi Amagai
BACKGROUND AND OBJECTIVES: The American Society for Parenteral and Enteral Nutrition recommends hypocaloric feeding for critically ill patients with a BMI of >=30.0 kg/m2. However, the cut-off value of obesity in Japan is BMI >25.0 kg/m2, due to the higher prevalence of type 2 diabetes mellitus, and cardiovascular risk factors, even at a lower BMI than in Western populations. Thus, the optimal energy intake for critically ill, overweight Asian patients is unknown. METHODS AND STUDY DESIGN: A retrospective chart review was conducted in patients with BMI of >=25...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28913483/the-prevalence-of-perioperative-complications-in-patients-with-and-without-obstructive-sleep-apnoea-a-prospective-cohort-study
#7
Tatiana Ambrosii, Serghei Şandru, Adrian Belîi
BACKGROUND AND AIMS: Patients with obstructive sleep apnoea (OSA) have a high risk of postoperative complications. The purpose of the study was to record the spectrum and frequency of postoperative complications in patients with OSA versus (vs.) without OSA depending on the type of surgery and type of anaesthesia in a large cohort of patients. METHODS: We conducted a prospective, descriptive study (n = 400). Ethics Committee approval was obtained and written informed consent was signed...
October 2016: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28910267/surveillance-for-certain-health-behaviors-and-conditions-among-states-and-selected-local-areas-behavioral-risk-factor-surveillance-system-united-states-2013-and-2014
#8
Sonya Gamble, Tebitha Mawokomatanda, Fang Xu, Pranesh P Chowdhury, Carol Pierannunzi, David Flegel, William Garvin, Machell Town
PROBLEM: Chronic diseases and conditions (e.g., heart diseases, stroke, arthritis, and diabetes) are the leading causes of morbidity and mortality in the United States. These conditions are costly to the U.S. economy, yet they are often preventable or controllable. Behavioral risk factors (e.g., excessive alcohol consumption, tobacco use, poor diet, frequent mental distress, and insufficient sleep) are linked to the leading causes of morbidity and mortality. Adopting positive health behaviors (e...
September 15, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/28904548/effect-of-family-patient-communication-on-the-incidence-of-delirium-in-hospitalized-patients-in-cardiovascular-surgery-icu
#9
Maryam Eghbali-Babadi, Nasrin Shokrollahi, Tayebe Mehrabi
BACKGROUND: Cardiovascular diseases are the most important causes of morbidity and mortality in the world, and cardiac surgery is one of the treatments that have complication for patients. One of the most important current psychological complications after cardiac surgery is delirium. For its prevention and treatment, considerable attention should be paid to the role of family. This study has been conducted for assessing the effect of the relationship between the family and patient on the incidence of delirium in hospitalized patients in cardiovascular surgery intensive care unit (ICU) of Isfahan Shahid Chamran hospital...
July 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28900356/humidifiers-for-oxygen-therapy-what-risk-for-reusable-and-disposable-devices
#10
REVIEW
V La Fauci, G B Costa, A Facciolà, A Conti, R Riso, R Squeri
INTRODUCTION: Nosocomial pneumonia accounts for the vast majority of healthcare-associated infections (HAI). Although numerous medical devices have been discussed as potential vehicles for microorganisms, very little is known about the role played by oxygen humidifiers as potential sources of nosocomial pathogens. The purpose of this research was to evaluate the safety of the reuse of humidifiers by analysing the rate of microbial contamination in reusable and disposable oxygen humidifiers used during therapy, and then discuss their potential role in the transmission of respiratory pathogens...
June 2017: Journal of Preventive Medicine and Hygiene
https://www.readbyqxmd.com/read/28895231/software-related-recalls-of-health-information-technology-and-other-medical-devices-implications-for-fda-regulation-of-digital-health
#11
Jay G Ronquillo, Diana M Zuckerman
Policy Points: Medical software has become an increasingly critical component of health care, yet the regulation of these devices is inconsistent and controversial. No studies of medical devices and software assess the impact on patient safety of the FDA's current regulatory safeguards and new legislative changes to those standards. Our analysis quantifies the impact of software problems in regulated medical devices and indicates that current regulations are necessary but not sufficient for ensuring patient safety by identifying and eliminating dangerous defects in software currently on the market...
September 2017: Milbank Quarterly
https://www.readbyqxmd.com/read/28889825/enhancement-of-diuresis-with-metolazone-in-infant-paediatric-cardiac-intensive-care-patients
#12
Russell T Wise, Brady S Moffett, Ayse Akcan-Arikan, Marianne Galati, Natasha Afonso, Paul A Checchia
BACKGROUND: Few data are available regarding the use of metolazone in infants in cardiac intensive care. Researchers need to carry out further evaluation to characterise the effects of this treatment in this population. METHODS: This is a descriptive, retrospective study carried out in patients less than a year old. These infants had received metolazone over a 2-year period in the paediatric cardiac intensive care unit at our institution. The primary goal was to measure the change in urine output from 24 hours before the start of metolazone therapy to 24 hours after...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28883982/assessment-of-the-agreement-between-the-framingham-and-dad-risk-equations-for-estimating-cardiovascular-risk-in-adult-africans-living-with-hiv-infection-a-cross-sectional-study
#13
Steve Raoul Noumegni, Vicky Jocelyne Moor Ama, Felix K Assah, Jean Joel Bigna, Jobert Richie Nansseu, Jenny Arielle M Kameni, Jean-Claude Katte, Mesmin Y Dehayem, Andre Pascal Kengne, Eugene Sobngwi
BACKGROUND: The Absolute cardiovascular disease (CVD) risk evaluation using multivariable CVD risk models is increasingly advocated in people with HIV, in whom existing models remain largely untested. We assessed the agreement between the general population derived Framingham CVD risk equation and the HIV-specific Data collection on Adverse effects of anti-HIV Drugs (DAD) CVD risk equation in HIV-infected adult Cameroonians. METHODS: This cross-sectional study involved 452 HIV infected adults recruited at the HIV day-care unit of the Yaoundé Central Hospital, Cameroon...
2017: Tropical Diseases, Travel Medicine and Vaccines
https://www.readbyqxmd.com/read/28882655/brief-psychological-intervention-in-phase-i-of-cardiac-rehabilitation-after-acute-coronary-syndrome
#14
Ana Cláudia Fernandes, Teresa McIntyre, Rui Coelho, Joana Prata, Maria Júlia Maciel
INTRODUCTION: Acute coronary syndrome (ACS) is an important cause of mortality and significant personal and financial costs. Cardiac rehabilitation (CR) programs have shown positive effects in reducing cardiovascular mortality and improving functional capacity. However, adherence is low and appears to be influenced by psychosocial factors, such as patients' cognitions and emotional state. The objective was to evaluate the efficacy of a brief in-hospital psychological intervention to promote cognitive and emotional adaptation after ACS...
September 4, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28882638/delayed-onset-of-atrial-fibrillation-and-ventricular-tachycardia-after-an-automobile-lightning-strike
#15
Dorian Drigalla, Shannon E Essler, C Keith Stone
BACKGROUND: Lightning strike is a rare medical emergency. The primary cause of death in lightning strike victims is immediate cardiac arrest. The mortality rate from lightning exposure can be as high as 30%, with up to 70% of patients left with significant morbidity. CASE REPORT: An 86-year-old male was struck by lightning while driving his vehicle and crashed. On initial emergency medical services evaluation, he was asymptomatic with normal vital signs. During his transport, he lost consciousness several times and was found to be in atrial fibrillation with intermittent runs of ventricular tachycardia during the unconscious periods...
September 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28876376/pre-frailty-increases-the-risk-of-adverse-events-in-older-patients-undergoing-cardiovascular-surgery
#16
Miguel K Rodrigues, Artur Marques, Denise M L Lobo, Iracema I K Umeda, Mayron F Oliveira
BACKGROUND: Frailty is identified as a major predictor of adverse outcomes in older surgical patients. However, the outcomes in pre-frail patients after cardiovascular surgery remain unknown. OBJECTIVE: To investigate the main outcomes (length of stay, mechanical ventilation time, stroke and in-hospital death) in pre-frail patients in comparison with no-frail patients after cardiovascular surgery. METHODS: 221 patients over 65 years old, with established diagnosis of myocardial infarction or valve disease were enrolled...
September 4, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28871657/seasonality-of-mortality-and-graft-failure-among-kidney-transplant-recipients-in-the-us
#17
Brad C Astor, M L Melamed, D A Mandelbrot, Arjang Djamali
Mortality in the general population and in patients on chronic hemodialysis is significantly higher in winter than summer. It is unknown whether such a seasonal difference exists for mortality or graft failure among kidney transplant recipients. We analyzed United Network for Organ Sharing (UNOS) data to assess whether the annual distribution of deaths and graft failures differed significantly from expected. There was significant annual variation in both deaths (n=52,523) and graft failures (n=50,301; both p<0...
September 4, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28867172/untreated-unruptured-aneurysm-natural-history-at-long-term
#18
V Gilard, L Terrier, O Langlois, S Derrey, S Curey, F Proust
BACKGROUND AND OBJECTIVES: Although the diagnosis of unruptured intracranial aneurysm (IA) has become more frequent, its natural history and management still remain controversial. A better comprehension of its evolution could optimize our therapeutic strategies. The aim of our study was to evaluate, in a cohort of patients with untreated unruptured IA based on the proposition of multidisciplinary staff meetings, the proportion of bleeding, death and cardiovascular events during a long-term prospective follow-up...
August 31, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28865067/predictors-of-cpap-compliance-in-different-clinical-settings-primary-care-versus-sleep-unit
#19
Núria Nadal, Jordi de Batlle, Ferran Barbé, Josep Ramon Marsal, Alicia Sánchez-de-la-Torre, Nuria Tarraubella, Merce Lavega, Manuel Sánchez-de-la-Torre
BACKGROUND: Good adherence to continuous positive airway pressure (CPAP) treatment improves the patient's quality of life and decreases the risk of cardiovascular disease. Previous studies that have analyzed the adherence to CPAP were performed in a sleep unit (SU) setting. The involvement of primary care (PC) in the management of obstructive sleep apnea (OSA) patients receiving CPAP treatment could introduce factors related to the adherence to treatment. OBJECTIVES: The objective was to compare the baseline predictors of CPAP compliance in SU and PC settings...
September 1, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28862933/quality-of-care-of-the-initial-patient-cohort-of-the-diabetes-collaborative-registry-%C3%A2
#20
Suzanne V Arnold, Abhinav Goyal, Silvio E Inzucchi, Darren K McGuire, Fengming Tang, Sanjeev N Mehta, Laurence S Sperling, Thomas M Maddox, Daniel Einhorn, Nathan D Wong, Niklas Hammar, Peter Fenici, Kamlesh Khunti, Carolyn S P Lam, Mikhail Kosiborod
BACKGROUND: Although guidelines and performance measures exist for patients with diabetes mellitus, achievement of these metrics is not well known. The Diabetes Collaborative Registry(®) (DCR) was formed to understand the quality of diabetes mellitus care across the primary and specialty care continuum in the United States. METHODS AND RESULTS: We assessed the frequency of achievement of 7 diabetes mellitus-related quality metrics and variability across the Diabetes Collaborative Registry(®) sites...
August 11, 2017: Journal of the American Heart Association
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