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https://www.readbyqxmd.com/read/28731599/does-eating-environment-have-an-impact-on-the-protein-and-energy-intake-in-the-hospitalised-elderly
#1
Karon Markovski, Aranka Nenov, Aurora Ottaway, Elizabeth Skinner
AIM: This pilot study aimed to examine the difference in energy and protein intake of the midday meal in two different eating environments-the communal dining room and patient bedside-and to obtain feedback on patient preference at each location. METHODS: Elderly patients in two rehabilitation wards were observed consuming the midday meal on two consecutive days: day 1 in the dining room and day 2 at the bedside. The patients' intake was recorded by a visual 5-point assessment scale and analysed for protein and energy content using the hospital food services nutrient analysis of the menu...
July 2017: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/28730574/mechanical-ventilation-guided-by-electrical-impedance-tomography-in-pediatric-acute-respiratory-distress-syndrome
#2
Jeffrey Dmytrowich, Tanya Holt, Karen Schmid, Gregory Hansen
Mechanical ventilation strategies in pediatric acute respiratory distress syndrome (pARDS) continue to advance. Optimizing positive end expiratory pressure (PEEP) and ventilation to recruitable lung can be difficult to clinically achieve. This is in part, due to disease evolution, unpredictable changes in lung compliance, and the inability to assess regional tidal volumes in real time at the bedside. Here we report the utilization of thoracic electrical impedance tomography to guide daily PEEP settings and recruitment maneuvers in a child with pARDS...
July 20, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28730554/bedside-selection-of-positive-end-expiratory-pressure-by-electrical-impedance-tomography-in-hypoxemic-patients-a-feasibility-study
#3
Nilde Eronia, Tommaso Mauri, Elisabetta Maffezzini, Stefano Gatti, Alfio Bronco, Laura Alban, Filippo Binda, Tommaso Sasso, Cristina Marenghi, Giacomo Grasselli, Giuseppe Foti, Antonio Pesenti, Giacomo Bellani
BACKGROUND: Positive end-expiratory pressure (PEEP) is a key element of mechanical ventilation. It should optimize recruitment, without causing excessive overdistension, but controversy exists on the best method to set it. The purpose of the study was to test the feasibility of setting PEEP with electrical impedance tomography in order to prevent lung de-recruitment following a recruitment maneuver. We enrolled 16 patients undergoing mechanical ventilation with PaO2/FiO2 <300 mmHg...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28729524/cardiac-arrest-following-drug-abuse-with-intravenous-tapentadol-case-report-and-literature-review
#4
Misbahuddin Khaja, George Lominadze, Konstantin Millerman
BACKGROUND Tapentadol is a centrally acting opioid analgesic, with a dual mode of action, as a norepinephrine reuptake inhibitor and an agonist of the μ-opioid receptor (MOR). Tapentadol is used for the management of musculoskeletal pain, and neuropathic pain associated with diabetic peripheral neuropathy. CASE REPORT A 32-year-old woman attended hospital for evaluation of an intractable headache. Computed tomography and magnetic resonance imaging of the brain were negative. She was found unresponsive in the bathroom on the day following hospital admission, and despite resuscitative measures, the patient died following cardiac arrest...
July 21, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28727889/clinical-assessment-of-uterine-contractions
#5
REVIEW
Wayne R Cohen
The assessment of uterine contractions is important in clinical decision-making, but the precise role for appraising contractions remains controversial. Four clinical approaches to assessing contractions are available: manual palpation; intrauterine pressure determination; external tocodynamometry; and electrohysterography. Palpation is inexpensive and harmless but requires the constant bedside presence of a trained observer. Intrauterine pressure measurement is considered the most sensitive and specific technique, and has become the standard by which other methods are judged; however, its quantitative measurements are not always precise or reproducible...
July 20, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28726333/the-auditory-oddball-paradigm-revised-to-improve-bedside-detection-of-consciousness-in-behaviorally-unresponsive-patients
#6
Dominique Morlet, Perrine Ruby, Nathalie André-Obadia, Catherine Fischer
Active paradigms requiring subjects to engage in a mental task on request have been developed to detect consciousness in behaviorally unresponsive patients. Using auditory ERPs, the active condition consists in orienting patient's attention toward oddball stimuli. In comparison with passive listening, larger P300 in the active condition identifies voluntary processes. However, contrast between these two conditions is usually too weak to be detected at the individual level. To improve test sensitivity, we propose as a control condition to actively divert the subject's attention from the auditory stimuli with a mental imagery task that has been demonstrated to be within the grasp of the targeted patients: navigate in one's home...
July 20, 2017: Psychophysiology
https://www.readbyqxmd.com/read/28725857/bedside-interprofessional-rounding-the-view-from-the-patient-s-side-of-the-bed
#7
Kailee Burdick, Areeba Kara, Patricia Ebright, Julie Meek
BACKGROUND: Bedside interprofessional rounding is gaining ground as a means to improve collaboration and patient outcomes, yet little is known regarding patients' perceptions of the practice. METHODS: This descriptive study used individual patient interviews to elicit views on interprofessional rounding from 35 patients at a large, urban hospital. RESULTS: The findings identified three major categories: 1) about the rounding process; 2) clinical information; and 3) the impact/value of bedside inter-professional rounding...
March 2017: Journal of patient experience
https://www.readbyqxmd.com/read/28724059/screening-tests-for-distal-symmetrical-polyneuropathy-in-latin-american-patients-with-type-2-diabetes-mellitus
#8
Nicolás Gómez-Banoy, Virginia Cuevas, Fernando Soler, Maria Fernanda Pineda, Ismena Mockus
Objective: This cross sectional study intended to evaluate two bedside tests (Neuropad and VibraTip) as screening tools for distal symmetrical polyneuropathy (DSPN) in Latin American patients with type 2 diabetes mellitus (T2D). Subjects and methods: Ninety-three Colombian patients diagnosed with T2D were recruited. Anthropometric variables, glycemic control parameters, lipid profile and renal function were assessed for each patient. DSPN was defined by a Michigan Neuropathy Screening Instrument (MNSI) clinical score greater than 2...
July 13, 2017: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28722298/development-of-a-bedside-viable-ultrasound-protocol-to-quantify-appendicular-lean-tissue-mass
#9
Michael T Paris, Benoit Lafleur, Joel A Dubin, Marina Mourtzakis
BACKGROUND: Ultrasound is a non-invasive and readily available tool that can be prospectively applied at the bedside to assess muscle mass in clinical settings. The four-site protocol, which images two anatomical sites on each quadriceps, may be a viable bedside method, but its ability to predict musculature has not been compared against whole-body reference methods. Our primary objectives were to (i) compare the four-site protocol's ability to predict appendicular lean tissue mass from dual-energy X-ray absorptiometry; (ii) optimize the predictability of the four-site protocol with additional anatomical muscle thicknesses and easily obtained covariates; and (iii) assess the ability of the optimized protocol to identify individuals with low lean tissue mass...
July 19, 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/28721951/recording-characteristics-of-electrical-impedance-myography-needle-electrodes
#10
Hyeuknam Kwon, Seward B Rutkove, Benjamin Sanchez
OBJECTIVE: The neurology and physiatry community need improved tools for the evaluation of skeletal muscle condition. Here, we evaluate needle electrical impedance myography (EIM), a new minimally invasive approach to determine muscle status that could ultimately become a bedside tool for the assessment of neuromuscular disorders. APPROACH: We design and study the recording characteristics of tetrapolar EIM needle electrodes combining theory and finite element model simulations...
July 19, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28721936/assessing-quantitative-eeg-spectrograms-to-identify-non-epileptic-events
#11
Ajay Goenka, Alexis Boro, Elissa Yozawitz
To evaluate the sensitivity and specificity of quantitative EEG (QEEG) spectrograms in order to distinguish epileptic from non-epileptic events. Seventeen patients with paroxysmal non-epileptic events, captured during EEG monitoring, were retrospectively assessed using QEEG spectrograms. These patients were compared to a control group of 13 consecutive patients (ages 25-60 years) with epileptic seizures of similar semiology. Assessment of raw EEG was employed as the gold standard against which epileptic and non-epileptic events were validated...
July 19, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28721826/clinical-uses-of-melatonin-in-neurological-diseases-and-mental-and-behavioural-disorders
#12
Emilio J Sánchez-Barceló, Noemi R Revilla, María D Mediavilla, Carmen Martínez-Cué, Russel J Reiter
Melatonin is a molecule with numerous properties applicable to the treatment of neurological diseases. Among these properties are the following: potent scavenger of oxygen and nitrogen reactive species, anti-inflammatory features, immuno-enhancing nature, and modulation of circadian rhythmicity. Furthermore, low concentrations of melatonin are usually found in patients with neurological diseases and mental disorders. The positive results obtained in experimental models of diverse pathologies, including diseases of the nervous system (e...
July 18, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28721646/non-invasive-measures-of-coronary-microcirculation-taking-the-long-road-to-the-clinic
#13
EDITORIAL
Kieran S Chung, Patricia K Nguyen
Although coronary microvascular disease is now a well-recognized entity that is associated with significant morbidity and mortality, current non-invasive strategies cannot differentiate between coronary microvascular disease (CMD) and obstructive epicardial stenosis. While the evaluation of intramyocardial blood volume as a surrogate measure for microvascular health may have limited sensitivity in early-stage disease, this strategy does enable the diagnosis of CMD in the presence of concurrent epicardial disease, bringing us one step further toward improving the management of this disease...
July 18, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28721309/retinal-pigment-epithelial-cells-are-a-potential-reservoir-for-ebola-virus-in-the-human-eye
#14
Justine R Smith, Shawn Todd, Liam M Ashander, Theodosia Charitou, Yuefang Ma, Steven Yeh, Ian Crozier, Michael Z Michael, Binoy Appukuttan, Keryn A Williams, David J Lynn, Glenn A Marsh
PURPOSE: Success of Ebola virus (EBOV) as a human pathogen relates at the molecular level primarily to blockade the host cell type I interferon (IFN) antiviral response. Most individuals who survive Ebola virus disease (EVD) develop a chronic disease syndrome: approximately one-quarter of survivors suffer from uveitis, which has been associated with presence of EBOV within the eye. Clinical observations of post-Ebola uveitis indicate involvement of retinal pigment epithelial cells. METHODS: We inoculated ARPE-19 human retinal pigment epithelial cells with EBOV, and followed course of infection by immunocytochemistry and measurement of titer in culture supernatant...
July 2017: Translational Vision Science & Technology
https://www.readbyqxmd.com/read/28721219/two-rare-manifestations-of-primary-hyperparathyroidism-paralysis-and-peptic-ulcer-bleeding
#15
Maryam Heidarpour, Mehdi Karami, Pegah Hedayat, Ashraf Aminorroaya
Primary hyperparathyroidism revealed by thoracic spine brown tumor and peptic ulcer bleeding is rare. We presented a case of 33-year-old male patient who was admitted with paraplegia. Thoracic spine magnetic resonance imaging (MRI) showed extradural lesion at T4 level. He underwent surgical decompression in T4. According to histopathologic finding and elevated serum parathormone (PTH) and hypercalcemia (total serum calcium 12.1 mg/dL), the diagnosis of brown tumor was down. Ultrasonography of his neck showed a well-defined lesion of 26 × 14 × 6 mm...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28720423/undergraduate-clinical-teaching-in-orthopedic-surgery-a-randomized-control-trial-comparing-the-effect-of-case-based-teaching-and-bedside-teaching-on-musculoskeletal-osce-performance
#16
Martin Kelly, Iain Feeley, Fiona Boland, John M O'Byrne
INTRODUCTION: Musculoskeletal (MSK) complaints are the second most common reason for a hospital outpatient appointment in the US, and account for 19.5% of general practice consultations. Previous studies have shown that passive teaching in medical school does not imbue students with an adequate degree of confidence in MSK evaluation. The aim of this study was to conduct a randomized control trial to compare the effect of the gold standard small group tutorial of bedside teaching against case-based teaching (CBT) in relation to orthopedic surgery in medical students...
July 15, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28719983/neonatal-lemierre-syndrome-youngest-reported-case-and-literature-review
#17
Blake S Raggio, Maria C Grant, Kimsey Rodriguez, Patrick J Cripe
A previously healthy 5-week-old female was admitted for sepsis secondary to methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. After several days of hospitalization, she experienced acute decompensation in mental status despite having received targeted antibiotic therapy. Imaging revealed left peritonsillar/parapharyngeal space abscess, left venous thrombophlebitis of the internal jugular vein, and septic emboli of the lungs and brain consistent with Lemierre syndrome. Bedside needle aspiration of the parapharyngeal abscess confirmed MRSA involvement...
July 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28719223/from-bench-to-bedside-converting-placebo-research-into-belief-activation
#18
Jen Green, Heather Wright
Research on the placebo effect contains important elements that can be harnessed to improve clinical care. This paper proposes a new term, "Belief Activation," to describe the deliberate use of placebo effect tools by both patients and clinicians to catalyze healing. Belief Activation includes, but is not limited to, maximizing patient and practitioner expectations, classical and social conditioning, spirituality and prayer/intention, therapeutic relationship, healing environments, and minimizing the nocebo effect...
July 18, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28717121/impact-of-doppler-ultrasound-on-diagnosis-and-therapy-control-of-lienalis-steal-syndrome-after-liver-transplantation
#19
Eva M Teegen, Timm Denecke, Rosa B Schmuck, Robert Öllinger, Dominik Geisel, Johann Pratschke, Sascha S Chopra
BACKGROUND Lienalis steal syndrome is a rare complication after orthotopic liver transplantation leading to severe complications. Routine duplex sonography allows early and safe detection of lienalis steal syndrome and secondarily helps to monitor the outcome by evaluating the hemodynamics. MATERIAL AND METHODS This analysis included eight patients who after orthotopic liver transplantation needed splenic artery embolization due to lienalis steal syndrome. Lienalis steal syndrome was assumed in case of elevated transaminases, bilirubinemia or persistent ascites, and the absence of further pathologies...
July 18, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28716980/early-dysphagia-screening-by-trained-nurses-reduces-pneumonia-rate-in-stroke-patients-a-clinical-intervention-study
#20
Christoph Palli, Simon Fandler, Kathrin Doppelhofer, Kurt Niederkorn, Christian Enzinger, Christian Vetta, Esther Trampusch, Reinhold Schmidt, Franz Fazekas, Thomas Gattringer
BACKGROUND AND PURPOSE: Dysphagia is a common stroke symptom and leads to serious complications such as aspiration and pneumonia. Early dysphagia screening can reduce these complications. In many hospitals, dysphagia screening is performed by speech-language therapists who are often not available on weekends/holidays, which results in delayed dysphagia assessment. METHODS: We trained the nurses of our neurological department to perform formal dysphagia screening in every acute stroke patient by using the Gugging Swallowing Screen...
July 17, 2017: Stroke; a Journal of Cerebral Circulation
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