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https://www.readbyqxmd.com/read/29773353/nurses-knowledge-and-attitudes-regarding-pediatric-pain-management-in-western-australia
#1
Deborah Peirce, Victoria Corkish, Margie Lane, Sally Wilson
Despite clinical guidelines, suboptimal pediatric pain management persists. A local audit found poor guideline compliance. Inadequate knowledge is a recognized barrier to the delivery of evidence-based care. The aim of the study was to investigate nurses' knowledge and attitudes regarding pain management at an Australian tertiary pediatric hospital. A cross-sectional, descriptive study using the Pediatric Pain Knowledge and Attitudes Questionnaire (Revised) was distributed to 590 nurses in an Australian pediatric hospital...
May 14, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29772538/targeting-fibroblast-activation-protein-in-cancer-prospects-and-caveats
#2
Petr Busek, Rosana Mateu, Michal Zubal, Lenka Kotackova, Aleksi Sedo
Fibroblast activation protein (FAP, seprase) is a serine protease with post-proline dipeptidyl peptidase and endopeptidase enzymatic activity. FAP is upregulated in several tumor types, while its expression in healthy adult tissues is scarce. FAP molecule itself and FAP+ stromal cells play an important although probably context-dependent and tumor type-specific pathogenetic role in tumor progression. We provide an overview of FAP expression under both physiological and pathological conditions with focus on human malignancies...
June 1, 2018: Frontiers in Bioscience (Landmark Edition)
https://www.readbyqxmd.com/read/29771700/the-effect-of-iv-amino-acid-supplementation-on-mortality-in-icu-patients-may-be-dependent-on-kidney-function-post-hoc-subgroup-analyses-of-a-multicenter-randomized-trial
#3
Ran Zhu, Matilde J Allingstrup, Anders Perner, Gordon S Doig
OBJECTIVES: We investigated whether preexisting kidney function determines if ICU patients may benefit from increased (2.0 g/kg/d) protein intake. DESIGN: Post hoc, hypothesis-generating, subgroup analysis of a multicenter, phase 2, randomized clinical trial. All analyses were conducted by intention to treat and maintained group allocation. Ninety-day mortality was the primary outcome. SETTING: ICUs of 16 hospitals throughout Australia and New Zealand...
May 15, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29769505/efficacy-of-0-5-hyperbaric-bupivacaine-with-dexamethasone-versus-0-5-hyperbaric-bupivacaine-alone-in-spinal-anaesthesia-for-patient-undergoing-lower-abdominal-urological-and-lower-limb-orthopedic-surgeries
#4
M M Haque, M A Aleem, F H Haque, A B Siddique, R Afrose
Spinal anaesthesia with local anaesthetics has limited duration. Different additives have been used to prolong spinal anaesthesia. The aim of this study was to determine the efficacy of adding dexamethasone to bupivacaine in spinal anaesthesia specially whether it would prolong the duration of sensory block/ surgical analgesia and post-operative analgesia/pain free period or not. This randomized, prospective, double-blind, clinical study was conducted in the Department of Anaesthesia, Analgesia and Critical Care of Combined Military Hospital, Chittagong from October 2016 to August 2017...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29768610/factors-associated-with-the-utilization-of-dental-health-services-by-the-pediatric-population-an-integrative-review
#5
Davi Silva Carvalho Curi, Andreia Cristina Leal Figueiredo, Silvia Regina Jamelli
This integrative literature review aimed to analyze studies about factors associated with the utilization of dental health services by the pediatric population between zero and 15 years old, published between 2006 and 2016 and available in Portuguese, English or Spanish. A survey of articles in the Lilacs and Medline databases was carried out, using the search strategy: ("dental care/utilization" OR "dental health services/utilization") AND ("child" OR "child, preschool") AND NOT adult...
May 2018: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/29767223/evaluation-of-renal-function-estimation-formulas-specific-to-dynamic-renal-function-for-drug-dosing-in-critically-ill-patients
#6
Lianjie Xiong, Z Kevin Lu, April Miller Quidley, Bebbyn S Alford, P Brandon Bookstaver
OBJECTIVES: The study compared estimated creatinine clearance (eCrCl) between the Cockcroft-Gault (CG) equation and the Jelliffe, Chiou, and Brater equations designed for estimation in dynamic renal function and resulting antimicrobial dosing concordance of five antimicrobials (cefepime, meropenem, piperacillin/tazobactam, vancomycin, and fluconazole) commonly used in the intensive care unit (ICU). METHODS: Electronic medical records were used to identify the target patient population...
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29766622/evaluating-the-implementation-of-confusion-assessment-method-intensive-care-unit-using-a-quality-improvement-approach
#7
C Stewart, S Bench
Quality improvement (QI) is a way through which health care delivery can be made safer and more effective. Various models of quality improvement methods exist in health care today. These models can help guide and manage the process of introducing changes into clinical practice. The aim of this project was to implement the use of a delirium assessment tool into three adult critical care units within the same hospital using a QI approach. The objective was to improve the identification and management of delirium...
May 15, 2018: Nursing in Critical Care
https://www.readbyqxmd.com/read/29766322/microdaimon-study-microcirculatory-daily-monitoring-in-critically-ill-patients-a-prospective-observational-study
#8
Claudia Scorcella, Elisa Damiani, Roberta Domizi, Silvia Pierantozzi, Stefania Tondi, Andrea Carsetti, Silvia Ciucani, Valentina Monaldi, Mara Rogani, Benedetto Marini, Erica Adrario, Rocco Romano, Can Ince, E Christiaan Boerma, Abele Donati
BACKGROUND: Until now, the prognostic value of microcirculatory alterations in critically ill patients has been mainly evaluated in highly selected subgroups. Aim of this study is to monitor the microcirculation daily in mixed group of Intensive Care Unit (ICU)-patients and to establish the association between (the evolution of) microcirculatory alterations and outcome. METHODS: This is a prospective longitudinal observational single-centre study in adult patients admitted to a 12-bed ICU in an Italian teaching hospital...
May 15, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29765435/mortality-of-adult-intensive-care-units-in-turkey-using-the-apache-ii-and-sofa-systems-outcome-assessment-in-turkish-intensive-care-units
#9
Cetin Kaymak, Irfan Sencan, Seval Izdes, Aydin Sari, Hatice Yagmurdur, Derya Karadas, Derya Oztuna
Introduction: The aim of this study was to evaluate intensive care unit (ICU) performance using risk-adjusted ICU mortality rates nationally, assessing patients who died or had been discharged from the ICU. For this purpose, this study analyzed the Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) databases, containing detailed clinical and physiological information and mortality of mixed critically ill patients in a medical ICU at secondary and tertiary referral ICUs in Turkey...
April 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29764554/-efficacy-and-safety-of-nalbuphine-on-analgesia-of-patients-in-intensive-care-unit
#10
Shaohua Liu, Youdong Wan, Yonggang Luo, Li Wan, Wenjing Yun, Haixu Wang, Zhenhua Wang, Xiaoguang Duan, Ruifang Zhang, Yingying Zhao, Hongwei Cui, Tongwen Sun
OBJECTIVE: To analyze the efficacy and safety of nalbuphine in patients with sedative analgesia in intensive care unit (ICU). METHODS: A prospective observation was conducted. The adult patients with mild and moderate analgesia in general ICU of the First Affiliated Hospital of Zhengzhou University from January to November in 2017 were enrolled, and they were divided into nalbuphine group and sufentanil group in proper order. The nabobrown group was given 40 mg nabobrown, the sufentanil group was given 0...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29763271/adults-with-developmental-disabilities-a-comprehensive-approach-to-medical-care
#11
Clarissa Kripke
Developmental disabilities are attributable to a cognitive impairment, physical impairment, or both. They manifest during the developmental period from birth to early adulthood, and are likely to continue indefinitely. The life expectancy of most persons with developmental disabilities now approaches that of the general population. According to the neurodiversity model of care, developmental disability is accepted as a valued part of human neurologic diversity. The social model focuses on improving participation in society with accommodations such as adaptive equipment or improvements to the social and physical environment...
May 15, 2018: American Family Physician
https://www.readbyqxmd.com/read/29762868/candidemia-in-children-epidemiology-prevention-and-management
#12
REVIEW
Elpis Mantadakis, Zoe Dorothea Pana, Theoklis Zaoutis
Candidemia is the leading cause of invasive fungal infections in hospitalized children. The highest rates of candidemia have been recorded in neonates and infants <1 year of age. Candidemia is more frequent in neonates and young infants than in adults, and is associated with better clinical outcomes, but higher inpatient costs. Over the last 10 years, a declining trend has been noted in the incidence of pediatric candidemia in the US and elsewhere due to the hospital-wide implementation of central-line insertion and maintenance bundles that emphasize full sterile barrier precautions, chlorhexidine skin preparation during line insertion, meticulous site and tubing care, and daily discussion of catheter necessity...
May 15, 2018: Mycoses
https://www.readbyqxmd.com/read/29762825/the-prognostic-role-of-platelet-to-lymphocyte-ratio-and-mean-platelet-volume-in-critically-ill-patients
#13
A Yildiz, A Yigit, A R Benli
OBJECTIVE: The aim of this study was to identify the relationship between complete blood count parameters, mean platelet volume (MPV), and platelet to lymphocyte ratio (PLR) with mortality and hospitalization duration in critically ill patients. PATIENTS AND METHODS: A retrospective analysis was made of patients admitted to our tertiary adult i̇ntensive Care Unit (ICU) between January 2015 and January 2016. Hemoglobin (Hb), white blood cell (WBC), lymphocyte and platelet counts were obtained from the complete blood count performed at the time of admission...
April 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#14
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29762304/effectiveness-and-harms-of-pharmacological-interventions-in-the-treatment-of-delirium-in-adults-in-intensive-care-units-post-cardiac-surgery-a-systematic-review-protocol
#15
Vivienne Leigh, Catalin Tufanaru, Rosalind Elliott
The review objective is to synthesize the best available evidence on the effectiveness and harms of pharmacological interventions in the treatment of delirium in adults in intensive care units (ICU) after cardiac surgery.The specific review question is: What is the effectiveness and what are the harms of pharmacological interventions in relation to the duration and severity of delirium episodes, length of stay in ICU, length of stay in hospital, functional capacity and quality of life and mortality for critically ill adult patients treated in intensive care after cardiac surgery?...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29762072/healthcare-users-experiences-of-communicating-with-healthcare-professionals-about-children-who-have-life-limiting-conditions-a-qualitative-systematic-review
#16
Stuart Ekberg, Natalie K Bradford, Anthony Herbert, Susan Danby, Patsy Yates
BACKGROUND: Globally, an estimated eight million children could benefit from palliative care each year. Effective communication about children with life-limiting conditions is well recognized as a critical component of high-quality pediatric palliative care. OBJECTIVE: To synthesize existing qualitative research exploring healthcare users' experiences of communicating with healthcare professionals about children with life-limiting conditions. DESIGN: The results of a systematic literature search were screened independently by two reviewers...
May 15, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29761482/timing-of-onset-of-gastrointestinal-bleeding-in-the-icu-protocol-for-a-preplanned-observational-study
#17
A Granholm, T Lange, C T Anthon, S Marker, M Krag, T S Meyhoff, M P Wise, M Borthwick, S Bendel, F Keus, A B Guttormsen, J C Schefold, J Wetterslev, A Perner, M H Møller
BACKGROUND: Critically ill patients are at risk of gastrointestinal bleeding, but clinically important gastrointestinal bleeding is rare. The majority of intensive care unit (ICU) patients receive stress ulcer prophylaxis (SUP), despite uncertainty concerning the balance between benefit and harm. For approximately half of ICU patients with gastrointestinal bleeding, onset is early, ie within the first two days of the ICU stay. The aetiology of gastrointestinal bleeding and consequently the balance between benefit and harm of SUP may differ between patients with early vs late gastrointestinal bleeding...
May 14, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29761372/outcomes-of-takotsubo-cardiomyopathy-in-hospitalized-cancer-patients
#18
Parijat Saurav Joy, Achuta Kumar Guddati, Iuliana Shapira
BACKGROUND: Chemotherapy-induced cardiomyopathy is a critical complication of treatment for cancer. The emotional stress of a cancer diagnosis, ongoing chemotherapy, abnormal cancer-related wasting syndrome may contribute to cardiac morbidity in these patients. The burden of Takotsubo Cardiomyopathy (TCM) in cancer patients is unknown. The incidence of TCM and related outcomes in cancer patients was investigated in this study. METHODS: The 2007-2013 National Inpatient Sample (NIS) was analyzed for patients with a prior and new diagnosis of TCM with and without malignancy...
May 14, 2018: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/29760848/code-help-can-this-unique-state-regulatory-intervention-improve-emergency-department-crowding
#19
Sean S Michael, John P Broach, Kevin A Kotkowski, D Eric Brush, Gregory A Volturo, Martin A Reznek
Introduction: Emergency department (ED) crowding adversely affects multiple facets of high-quality care. The Commonwealth of Massachusetts mandates specific, hospital action plans to reduce ED boarding via a mechanism termed "Code Help." Because implementation appears inconsistent even when hospital conditions should have triggered its activation, we hypothesized that compliance with the Code Help policy would be associated with reduction in ED boarding time and total ED length of stay (LOS) for admitted patients, compared to patients seen when the Code Help policy was not followed...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29759850/differences-in-prehospital-patient-assessments-for-pediatric-versus-adult-patients
#20
Sriram Ramgopal, Jonathan Elmer, Jeremiah Escajeda, Christian Martin-Gill
OBJECTIVE: To evaluate whether completion of vital signs assessments in pediatric transports by emergency medical services (EMS) differs by patient age. STUDY DESIGN: We reviewed records by 20 agencies in a regional EMS system in Southwestern Pennsylvania between April 1, 2013 and December 31, 2016. We abstracted demographics, vital signs (systolic blood pressure, heart rate, respiratory rate), clinical, and transport characteristics. We categorized age as neonates (≤30 days), infants (1 month to <1 year), toddler (1 to <2 years), early childhood (2 to <6 years), middle childhood (6 to <12 years), adolescent (12 to <18 years), and adult (≥18 years)...
May 11, 2018: Journal of Pediatrics
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