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https://www.readbyqxmd.com/read/28530332/-treatment-of-mechanically-ventilated-patients-in-an-internal-medicine-department-overview-2013
#1
Jacov Kogan, Alex Rodnitsky, Ornit Cohen, Svetlana Turkot, Yevgenia Tziba, Boris Golzman
BACKGROUND: Over recent years the number of mechanically ventilated patients in internal medicine departments has grown. These patients are elderly, mostly disabled and suffer from many chronic illnesses. Most of them require prolonged mechanical ventilation. OBJECTIVES: The study aimed to evaluate the population of mechanically ventilated patients in an internal department, the treatment and outcomes, particularly the morbidity in hospitalization and to identify the prognostic causes of death...
August 2016: Harefuah
https://www.readbyqxmd.com/read/28530312/-the-second-victim-treating-the-health-care-providers
#2
REVIEW
Shimrit Shor, Orna Tal, Ron Maymon
During their professional careers, physicians and other health care providers are repeatedly exposed to emotional stress. This is usually secondary to coping with the results of a medical error or complicated medical event. Generally, in the above cases, the patient and his/her family are in the center of the medical system, being "the first victim" of such an event, while the involved caregiver, who provided the medical service, is categorized as the "second victim". "Second victims" may feel anxiety, fear, guilt or anger and experience social withdrawal, which may lead to troubling memories, depression and insomnia...
January 2017: Harefuah
https://www.readbyqxmd.com/read/28530085/-long-term-treatment-with-macrolides-in-chronic-lung-diseases
#3
REVIEW
Michal Shteinberg, Sonia Schneer, Ophir Lavon, Yochai Adir
Macrolide agents have both antibacterial properties as well as various effects on the inflammatory system. In recent years there is growing evidence regarding the favourable effects of macrolides in a range of chronic respiratory conditions. Historically, erythromycin and clarithromycin were found to stabilize pulmonary deterioration in diffuse panbronchiolitis. In cystic fibrosis patients colonized with pseudomonas aeruginosa, long term treatment with azithromycin reduces exacerbations and presents improved lung function...
September 2016: Harefuah
https://www.readbyqxmd.com/read/28529813/difficult-management-of-a-double-lumen-endotracheal-tube-and-difficult-ventilation-during-robotic-thymectomy-with-carbon-dioxide-insufflation
#4
Yuki Sugiyama, Kunihiro Mitsuzawa, Yuki Yoshiyama, Fumiko Shimizu, Satoshi Fuseya, Takashi Ichino, Hiroyuki Agatsuma, Takayuki Shiina, Ken-Ichi Ito, Mikito Kawamata
Robotic surgery with carbon dioxide (CO2) insufflation to the thorax is frequently performed to gain a better operative field of view, although its intraoperative complications have not yet been discussed in detail. We treated two patients with difficult ventilation caused by distal migration of a double-lumen endotracheal tube (DLT) during robotic thymectomy. In the first case, migration of the DLT during one-lung ventilation (OLV) occurred after CO2 insufflation to the bilateral thoraxes was started. Oxygenation rapidly deteriorated because dependent lung expansion was restricted by CO2 insufflation...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28529753/assessment-of-xerostomia-and-its-impact-on-quality-of-life-in-head-and-neck-cancer-patients-undergoing-radiation-therapy
#5
Pinelopi-Theopisti Memtsa, Maria Tolia, Ioannis Tzitzikas, John Bizakis, Kyriaki Pistevou-Gombaki, Martha Charalambidou, Chrysoula Iliopoulou, George Kyrgias
Xerostomia in head and neck (H&N) cancer patients significantly affects their quality of life (QoL). The aim of the present study was to investigate the associations among QoL, xerostomia and quantity of saliva in a sample of H&N cancer patients who had received conventional radiotherapy (RT). A total of 60 H&N adult patients were enrolled in this prospective study. The patients completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30), the Quality of Life Questionnaire Head and Neck Module (QLQ-H&N35) and the Greek version of the XQ questionnaire at 4 timepoints: At the beginning of RT, at the end of RT, 6 months after RT completion and 1 year after RT completion...
May 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28528623/organizational-perspectives-of-nurse-executives-in-15-hospitals-on-the-impact-and-effectiveness-of-rapid-response-teams
#6
Patricia L Smith, Jean McSweeney
BACKGROUND: Many hospitals use rapid response teams (RRTs) to respond to deteriorating patients, but it remains unclear what organizations actually monitor. Understanding what organizations value in an RRT may help clarify measurement choices. Interviews were conducted to determine how organizational leaders perceived and evaluated their hospitals' RRTs. METHODS: The study used a descriptive, qualitative design. Participants were nurse executives and key informants in 300- to 500-bed hospitals in the south-central United States and were recruited using purposive and snowball sampling...
June 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28528586/white-matter-connectivity-disruptions-in-early-and-chronic-schizophrenia
#7
M A Di Biase, V L Cropley, B T Baune, J Olver, G P Amminger, C Phassouliotis, C Bousman, P D McGorry, I Everall, C Pantelis, A Zalesky
BACKGROUND: White matter disruptions in schizophrenia have been widely reported, but it remains unclear whether these abnormalities differ between illness stages. We mapped the connectome in patients with recently diagnosed and chronic schizophrenia and investigated the extent and overlap of white matter connectivity disruptions between these illness stages. METHODS: Diffusion-weighted magnetic resonance images were acquired in recent-onset (n = 19) and chronic patients (n = 45) with schizophrenia, as well as age-matched controls (n = 87)...
May 22, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28528280/aortic-involvement-in-relapsing-polychondritis
#8
Maëlle Le Besnerais, Laurent Arnaud, Jonathan Boutémy, Boris Bienvenu, Hervé Lévesque, Zahir Amoura, Isabelle Marie
OBJECTIVE: To assess prevalence of aortic involvement in relapsing polychondritis (RP) patients; to evaluate clinical features and long-term outcome of RP patients exhibiting aortitis, aortic ectasia and/or aneurysm. METHODS: 172 RP patients underwent aortic computed tomography (CT)-scan; they were seen in 3 medical centers. RESULTS: 11 patients (6.4%) had aortic involvement, occurring within a median time of 2 years after RP diagnosis. CT-scan showed isolated aortitis (n=2); the 9 other patients exhibited: aortitis and aortic aneurysm (n=2) or ectasia (n=1), isolated aortic aneurysm (n=4) or ectasia (n=2); aortic localizations were as follows: thoracic (n=6), abdominal (n=2), thoracic and abdominal (n=4) aorta...
May 17, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28528140/maternal-and-neonatal-outcomes-of-respiratory-failure-during-pregnancy
#9
Chen-Yiu Hung, Han-Chung Hu, Li-Chung Chiu, Chih-Hao Chang, Li-Fu Li, Chung-Chi Huang, Chuan-Chi Kao, Po-Jen Cheng, Kuo-Chin Kao
BACKGROUND: Obstetric patients comprise a limited portion of intensive care unit patients, but they often present with unfamiliar conditions and exhibit the potential for catastrophic deterioration. This study evaluated the maternal and neonatal outcomes of respiratory failure during pregnancy. METHODS: Information on 71 patients at >25 weeks gestation in the ICU with respiratory failure was recorded between 2009 and 2013. The characteristics and outcomes of mothers and fetuses were determined through a retrospective chart review and evaluated using Student's t test, chi-square test, and Fisher's exact test...
May 17, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28527831/different-efficacy-of-inhaled-and-oral-medications-in-pulmonary-hypertension
#10
Batool J AbuHalimeh, Joseph G Parambil, Adriano R Tonelli
Pulmonary arterial hypertension (PAH) is progressive disorder characterized by elevated pulmonary vascular resistance that can lead to right heart failure and death. One of the main therapeutic options for PAH are medications targeting the prostacyclin pathway. Treprostinil is a prostacyclin analogue and selexipag is a selective IP receptor agonist. Treprostinil can be delivered by a variety of routes including oral, inhaled, subcutaneous and intravenous. Selexipag is currently approved as an oral formulation...
May 17, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28527102/studies-of-environmental-risk-factors-in-amyotrophic-lateral-sclerosis-als-and-a-phase-i-clinical-trial-of-l-serine
#11
Walter G Bradley, R X Miller, T D Levine, E W Stommel, P A Cox
β-N-Methylamino-L-alanine (BMAA) has been linked to Guam ALS/PDC and shown to produce neurodegeneration in vitro and in vivo (Drosophila, mice, rats, primates). BMAA misincorporation into neuroproteins produces protein misfolding and is inhibited by L-serine. Case-control studies in Northern New England indicate that living near to water-bodies with cyanobacterial blooms increases the risk of developing amyotrophic lateral sclerosis (ALS). The distribution of addresses of ALS cases in New Hampshire, Vermont, and Florida was compared to that of controls...
May 19, 2017: Neurotoxicity Research
https://www.readbyqxmd.com/read/28526645/carotid-falciform-optic-neuropathy-microsurgical-treatment
#12
M Neil Woodall, Cargill H Alleyne
BACKGROUND: Several recent reports have implicated vascular ectasia and vessel contact with dysfunction of the visual apparatus. A subset of patients with pre-chiasmatic visual deterioration have an ectatic internal carotid artery (ICA) that displaces and flattens the optic nerve (ON) rostrally as the ON exits the skull base. We will offer a proposed pathophysiological mechanism and describe a straightforward surgical technique for dealing with this interesting problem. METHODS: Via an ipsilateral pterional craniotomy, the bony roof of the optic canal is removed...
May 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28526597/slow-ventricular-tachycardia-in-a-91-year-old-man-with-implantable-cardioverter-defibrillator-and-acute-respiratory-failure
#13
Nicola Vargas, Loredana Tibullo, Cesare A E Landi, Giovanni Carifi, Emanuela Landi, Elisa Salsano, Francesco Di Grezia, Fiore Candelmo
Slow ventricular tachycardia (VT) in patients with devices such as an implantable cardioverter - defibrillator (ICD) is more common than in the rest of the population. The incidence in elderly patients with an ICD remains largely unknown. In younger patients, slow VT is generally asymptomatic or associated with limited clinical relevance. It may be efficiently and safely terminated by anti-tachycardia pacing. We present a case of slow VT in a 91-year-old man with ICD with type 1 acute respiratory failure and drowsiness...
May 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28526141/total-parenteral-and-enteral-nutrition-in-the-icu-evolving-concepts
#14
REVIEW
Amir O Elhassan, Lien B Tran, Richard C Clarke, Sumit Singh, Alan D Kaye
Appropriate nutrition in the hospital setting, particularly in critically ill patients, has long been tied to improving clinical outcomes. During critical illness, inflammatory mediators and cytokines lead to the creation of a catabolic state to facilitate the use of endogenous energy sources to meet increased energy demands. This process results in increasing the likelihood of overfeeding. The literature has revealed exponential advances in understanding the molecular basis of nutritional support and evolution of clinical protocols aimed at treating artificial nutritional support as a therapeutic intervention, preventing loss of lean body mass and metabolic deterioration to improve clinical outcomes in the critically ill...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28525972/association-of-fibrinogen-level-with-early-neurological-deterioration-among-acute-ischemic-stroke-patients-with-diabetes
#15
Seong-Joon Lee, Ji Man Hong, Sung Eun Lee, Dae Ryong Kang, Bruce Ovbiagele, Andrew M Demchuk, Jin Soo Lee
BACKGROUND: Diabetes mellitus (DM) is a risk factor for early neurological deterioration (END) in acute ischemic stroke. The prothrombotic protein fibrinogen is frequently elevated in patients with diabetes, and may be associated with poorer prognoses. We evaluated whether fibrinogen is associated with END in patients with diabetes after acute ischemic stroke. METHODS: We included 3814 patients from a single hospital database admitted within 72 h of onset of ischemic stroke...
May 19, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28525489/minimum-5-year-follow-up-results-for-occipitocervical-fusion-using-the-screw-rod-system-in-craniocervical-instability
#16
Kei Ando, Shiro Imagama, Zenya Ito, Kazuyoshi Kobayashi, Hideki Yagi, Ryuichi Shinjo, Tetsuro Hida, Kenyu Ito, Yoshimoto Ishikawa, Naoki Ishiguro
STUDY DESIGN: Retrospective clinical study. OBJECTIVE: To evaluate the clinical outcome of patients who had undergone occipitocervical (OC) fusion using pedicle screws and rods over a minimum 5-year follow-up. SUMMARY OF BACKGROUND DATA: Few studies have evaluated occipitocervical (OC) fusion using pedicle screws and rods for long-term follow-up. METHODS: Twenty-seven consecutive patients treated underwent posterior OC fusion using pedicle screws and rods over a minimum 5-year follow-up...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525416/is-there-a-preinterventional-mechanical-ventilation-time-limit-for-candidates-of-adult-respiratory-extracorporeal-membrane-oxygenation
#17
Meng-Yu Wu, Chung-Chi Huang, Tzu-I Wu, Yu-Sheng Chang, Chin-Liang Wang, Pyng-Jing Lin
Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a useful life support in severe acute respiratory distress syndrome (ARDS). Although prolonged mechanical ventilation (MV) before institution of ECMO is known to be a poor prognostic factor for outcomes of VV-ECMO, a reasonable deadline for this period has not been defined yet. To discover the answer, we reviewed a 9 year institutional experience of adult respiratory ECMO in VV configuration and investigate the relationship between the MV time before ECMO and in-hospital mortality...
May 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28524382/an-observational-study-of-patient-care-outcomes-sensitive-to-handover-quality-in-the-post-anaesthetic-care-unit
#18
Nichole Lillibridge, Mari Botti, Beverley Wood, Bernice Redley
AIMS AND OBJECTIVES: To identify patient care outcome indicators sensitive to the quality of interprofessional handover between the anaesthetist and the Post-Anaesthetic Care Unit nurse. BACKGROUND: The relationship between interprofessional clinical handover when patients are transferred from the operating theatre to the Post-Anaesthetic Care Unit and patient outcomes of subsequent patient care delivery is not well understood. DESIGN: Naturalistic, exploratory descriptive design using observation...
May 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28524380/family-members-experiences-with-intensive-care-unit-diaries-when-the-patient-does-not-survive
#19
Maria Johansson, Ingrid Wåhlin, Lennart Magnusson, Ingrid Runeson, Elizabeth Hanson
OBJECTIVE: The aim of the study was to explore how family members experienced the use of a diary when a relative does not survive the stay in the intensive care unit (ICU). METHOD: A qualitative method with a hermeneutic approach was used. Nine participants who read/wrote eight diaries in total were interviewed. The collected data were analysed using a hermeneutic technique inspired by Geanellos. FINDINGS: The analysis revealed an overall theme 'the diary was experienced as a bridge connecting the past with the future', which was a metaphor referring to the temporal aspect where there was the period with the diary up until the patient's death and then the postbereavement period...
May 19, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28524135/-selective-symptomatic-therapy-of-macular-edema-due-to-occlusive-processes-in-retinal-venous-system
#20
M M Bikbov, R R Fayzrakhmanov, T R Gil'manshin
AIM: to evaluate the effect of dexamethasone intravitreal implant on the functional state of the eye in macular edema associated with central retinal vein occlusion. MATERIAL AND METHODS: The study included two groups of patients: group 1 (control group) - 8 patients (16 eyes) without ocular pathology and group 2 (study group) - 8 patients (8 eyes) with macular edema on the background of newly diagnosed thrombosis of the central retinal vein. All the patients from the study group underwent insertion of an intravitreal dexamethasone implant - Ozurdex...
2017: Vestnik Oftalmologii
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