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https://www.readbyqxmd.com/read/29168941/causes-assessment-and-management-of-fatigue-in-critically-ill-patients
#1
Ruff Jm Cajanding
Fatigue is a common complaint among hospitalised patients and is one of the most prevalent and distressing symptoms reported by critically ill patients in the intensive care unit (ICU). Fatigue comes in many forms, is associated with a wide range of aetiologies, and is aggravated and intensified by a multitude of environmental and situational factors present in the intensive care environment. While assessing and evaluating fatigue is key to the effective management of this distressing symptom, reports have shown that fatigue assessment in the ICU is suboptimal and patients are often left suffering from its untoward consequences...
November 23, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29168937/managing-the-nutritional-needs-of-palliative-care-patients
#2
Teresa Day
The nutritional needs of patients receiving palliative care should be routinely assessed, taking into account disease trajectory and nutrition-related symptoms. The social and emotional aspects of eating and drinking should also be acknowledged; as should the distress that weight loss and anorexia engenders in patients and their families. Practical strategies to optimise nutritional intake are discussed. Open and sensitive communication of patients' needs and wishes is essential, especially when discussing complementary nutrition approaches...
November 23, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29168896/healing-of-self-inflicted-thermal-injury-of-palatal-mucosa-by-low-level-laser-therapy
#3
Abdul Ahad, Shazra Tasneem, Arundeep Kaur Lamba, Saif Khan
Self-inflicted injury to oral mucosa is a rare entity. These injuries can be premeditated, accidental, or can result from an abnormal habit. These uncommon gingival injuries can sometimes test the clinician's diagnostic abilities as well as treatment planning skills. In conventional treatment, removal of etiology and application of topical drugs is usually sufficient for healing. However, some cases require alternative or adjunctive wound healing methods. Low-level laser therapy (LLLT) has been reported to be effective in pain management and improvement in wound healing through promotion, fortification, and commissioning of cellular cycle to generate productive and substitute cells...
November 23, 2017: Special Care in Dentistry
https://www.readbyqxmd.com/read/29168239/evaluation-of-a-diagnostic-therapeutic-educational-pathway-for-asthma-management-in-youth
#4
Sebastiano Guarnaccia, Cristina Quecchia, Andrea Festa, Michele Magoni, Marco Moneda, Valeria Gretter, Carmelo Scarcella, Ada Pluda, Cinzia Gasparotti, Malica Frassine, Luigi Vitale, Emanuele D'Agata, Rosa Maria Limina, Francesco Donato
BACKGROUND: In spite of some evidence for positive effects of patient's education to asthma self-management by randomized clinical trials, there are few studies on the impact of patient' s educational programs in the real world. We aimed to assess the impact of a diagnostic therapeutic educational pathway (DTEP) on asthma control of children and adolescents by comparing frequency of outcomes indicative of asthma control before and after attending the pathway. METHODS: This is a retrospective cohort study including all patients aged 6-11 and 12-17 years who attended the DTEP in 2007-2014...
November 23, 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/29168217/prevalence-management-and-prognosis-of-bladder-cancer-in-patients-with-neurogenic-bladder-a-systematic-review
#5
Salima Ismail, Gilles Karsenty, Emmanuel Chartier-Kastler, Olivier Cussenot, Eva Compérat, Morgan Rouprêt, Véronique Phé
AIM: To perform a systematic review of the literature regarding epidemiology, diagnosis, management and prognosis of bladder cancer in the neuro-urological patient population, in order to serve as a basis for future recommendations and research. METHODS: A systematic review was performed according to the PRISMA-Preferred Reporting Items for Systematic Reviews and Meta-Analyzes Statement. Embase was searched for studies providing data on epidemiology, diagnosis, management and prognosis of bladder cancer in neuro-urological patients...
November 23, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29168157/perioperative-implications-of-sodium-glucose-cotransporter-2-inhibitors-a-case-series-of-euglycemic-diabetic-ketoacidosis-in-three-patients-after-cardiac-surgery
#6
Aaron Lau, Simon Bruce, Erica Wang, Ron Ree, Kevin Rondi, Anthony Chau
PURPOSE: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) comprise the newest class of oral hypoglycemic agents approved for treating type II diabetes mellitus (DM-II). Their use, however, has been associated with the rare development of euglycemic diabetic ketoacidosis (euDKA). We present three cases of euDKA that occurred following elective coronary artery bypass grafting surgery. The role of the anesthesiologist in the prevention, diagnosis, and management of this complication is also discussed...
November 22, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29168013/clinical-features-and-treatment-of-pediatric-patients-with-drug-induced-anaphylaxis-a-study-based-on-pharmacovigilance-data
#7
Yan Xing, Hua Zhang, Shusen Sun, Xiang Ma, Roy A Pleasants, Huilin Tang, Hangci Zheng, Suodi Zhai, Tiansheng Wang
We assessed the clinical features and treatment of pediatric patients with drug-induced anaphylaxis in clinical settings. Pediatric drug-induced anaphylaxis cases collected by the Beijing Pharmacovigilance Database from 2004 to 2014 were analyzed. A total of 91 cases were identified. Drug-induced anaphylaxis was primarily caused by antibiotics (53%). Children of 0-5 years were more likely to develop cyanosis symptoms than children of 13-17 years (OR = 5.14, 95%CI [1.74, 15.20], P = 0.002). Children of 13-17 years were more likely to develop hypotension than children of 6-12 years (OR = 11...
November 22, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29167954/no-implant-migration-and-good-subjective-outcome-of-a-novel-customized-femoral-resurfacing-metal-implant-for-focal-chondral-lesions
#8
Anders Stålman, Olof Sköldenberg, Nicolas Martinez-Carranza, David Roberts, Magnus Högström, Leif Ryd
PURPOSE: Managing focal cartilage injuries in the middle-aged patient poses a challenge. Focal prosthetic inlay resurfacing has been proposed to be a bridge between biologics and conventional joint arthroplasty. Patient selection and accurate implant positioning is crucial to avoid increased contact pressure to the opposite cartilage surface. A customized femoral condyle implant for focal cartilage injuries was designed to precisely fit each patient's individual size and location of damage...
November 22, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29167952/growth-of-focal-nodular-hyperplasia-is-not-a-reason-for-surgical-intervention-but-patients-should-be-referred-to-a-tertiary-referral-centre
#9
Mirelle E E Bröker, Anne J Klompenhouwer, Marcia P Gaspersz, Annick M E Alleleyn, Roy S Dwarkasing, Indra C Pieters, Robert A de Man, Jan N M IJzermans
BACKGROUND: When a liver lesion diagnosed as focal nodular hyperplasia (FNH) increases in size, it may cause doubt about the initial diagnosis. In many cases, additional investigations will follow to exclude hepatocellular adenoma or malignancy. This retrospective cohort study addresses the implications of growth of FNH for clinical management. METHODS: We included patients diagnosed with FNH based on ≥2 imaging modalities between 2002 and 2015. Characteristics of patients with growing FNH with sequential imaging in a 6-month interval were compared to non-growing FNH...
November 22, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29167908/a-pilot-single-centre-cross-sectional-study-to-determine-the-knowledge-and-management-of-sports-concussion-by-emergency-physicians-an-experience-from-singapore
#10
Dinesh Sirisena, Joy Walter, Joo Haw Ong, Joanne Probert
INTRODUCTION: Sports concussion remains a challenging condition to manage despite changes to policy and practice since the 2012 Concussion in Sport Group consensus meeting. Emergency physicians (EPs) are often the first line of medical care for athletes in amateur and youth collision sports. This single-centre cross-sectional study aimed to establish the understanding and management of concussion by EPs in Singapore. METHODS: An anonymised 17-item online questionnaire was sent out to EPs using the Google Forms application, requesting information on clinical experience, training, exposure to concussion cases in the emergency department (ED) and assessed knowledge of the condition...
November 13, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/29167795/managing-rheumatoid-arthritis-with-dietary-interventions
#11
REVIEW
Shweta Khanna, Kumar Sagar Jaiswal, Bhawna Gupta
Self-help by means of dietary interventions can help in management of various disorders including rheumatoid arthritis (RA), a debilitating autoimmune disease. Dietary interventions necessitate a widespread appeal for both patients as well as clinicians due to factors including affordability, accessibility, and presence of scientific evidences that demonstrate substantial benefits in reducing disease symptoms such as pain, joint stiffness, swelling, tenderness and associated disability with disease progression...
2017: Frontiers in Nutrition
https://www.readbyqxmd.com/read/29167387/prehospital-systolic-blood-pressure-is-related-to-intracerebral-hemorrhage-volume-on-admission
#12
David Rodriguez-Luna, Noelia Rodriguez-Villatoro, Jesús M Juega, Sandra Boned, Marián Muchada, Estela Sanjuan, Jorge Pagola, Marta Rubiera, Marc Ribo, Pilar Coscojuela, Carlos A Molina
BACKGROUND AND PURPOSE: Ultra-early blood pressure (BP) management in the prehospital setting could improve the efficacy of this treatment on attenuating intracerebral hemorrhage (ICH) expansion. We aimed to determine the association of prehospital systolic BP (SBP) with ICH volume, ultra-early hematoma growth, and the spot sign on admission. METHODS: We conducted a retrospective study of a prospective database of 219 consecutive patients with spontaneous ICH admitted to the emergency department of a tertiary stroke center during a 3-year period...
November 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29167232/identification-of-ifn-%C3%AE-and-il-27-as-critical-regulators-of-respiratory-syncytial-virus-induced-exacerbation-of-allergic-airways-disease-in-a-mouse-model
#13
Thi Hiep Nguyen, Steven Maltby, Hock L Tay, Fiona Eyers, Paul S Foster, Ming Yang
Respiratory syncytial virus (RSV) infection induces asthma exacerbations, which leads to worsening of clinical symptoms and may result in a sustained decline in lung function. Exacerbations are the main cause of morbidity and mortality associated with asthma, and significantly contribute to asthma-associated healthcare costs. Although glucocorticoids are used to manage exacerbations, some patients respond to them poorly. The underlying mechanisms associated with steroid-resistant exacerbations remain largely unknown...
November 22, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/29167218/concomitant-aids-cholangiopathy-and-fanconi-syndrome-as-complications-of-hiv-in-a-single-patient
#14
Robert Maweni, Jins Kallampallil, Szewai Leong, Srikanth Akunuri
We describe the case of a 50-year-old woman presenting to our acute medicine department with generalised non-specific symptoms on a background of HIV managed on triple therapy (tenofovir, lamivudine and zidovudine). On admission, she was noted to be acidotic with proteinuria, glycosuria, hypophosphataemia and generalised body pain, and was diagnosed with Fanconi's renotubular syndrome secondary to tenofovir. It was also noted that she had elevated liver dysfunction markers, and an MRI of the liver revealed a focal stricture near the ampulla of Vater, resulting in a diagnosis of AIDS cholangiopathy...
November 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29167188/severe-panniculitis-and-polyarthritis-caused-by-acinar-cell-carcinoma-arising-from-an-ectopic-pancreas
#15
Marc Plier, Patrick Durez, Mina Komuta, Alexandros Raptis
The pancreatitis, panniculitis and polyarthritis (PPP) syndrome is a rare condition caused by pancreatic diseases, such as acute or chronic pancreatitis or pancreatic carcinoma. We report the first case of PPP syndrome caused by metastatic acinar cell carcinoma from an ectopic pancreas. The symptoms were successfully managed by the treatment of the metastatic carcinoma. Pancreatic cytosteatonecrosis should be always considered in a patient who is showing symptoms of panniculitis and polyarthritis.
November 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29167065/a-systematic-review-of-practice-guidelines-and-recommendations-for-discontinuation-of-cholinesterase-inhibitors-in-dementia
#16
REVIEW
Brenna N Renn, Ali Abbas Asghar-Ali, Stephen Thielke, Angela Catic, Sharyl R Martini, Brian G Mitchell, Mark E Kunik
Cholinesterase inhibitors (ChEIs) are the primary pharmacological treatment for symptom management of Alzheimer disease (AD), but they carry known risks during long-term use, and do not guarantee clinical effects over time. The balance of risks and benefits may warrant discontinuation at different points during the disease course. Indeed, although there is limited scientific study of deprescribing ChEIs, clinicians routinely face practical decisions about whether to continue or stop medications. This review examined published practice recommendations for discontinuation of ChEIs in AD...
October 10, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/29167039/psychological-and-psychiatric-symptoms-of-terminally-ill-patients-with-cancer-and-their-family-caregivers-in-the-home-care-setting-a-nation-wide-survey-from-the-perspective-of-bereaved-family-members-in-japan
#17
Makoto Kobayakawa, Asao Ogawa, Michiko Konno, Akiko Kurata, Jun Hamano, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Maho Aoyama, Mitsunori Miyashita
OBJECTIVE: The psychological and psychiatric symptoms of terminally ill cancer patients are highly problematic and have been associated with greater burden among caregivers. Until now, the extent of these problems in the home care setting was unclear. METHODS: This retrospective study was conducted as part of a nationwide survey from the perspective of bereaved family members in Japan (J-HOPE3). The bereaved family members rated the symptoms of delirium and suicidal ideation of patients with cancer, and the sleeplessness and depressed mood of family caregivers utilizing home care services in the one month before the patients' deaths...
December 2017: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/29166989/use-of-a-patient-specific-outcome-measure-and-a-movement-classification-system-to-guide-nonsurgical-management-of-a-circus-performer-with-low-back-pain-a-case-report
#18
Ruth L Chimenti, Linda R Van Dillen, Lynnette Khoo-Summers
Low back pain (LBP) can be detrimental to the career of a circus arts performer, yet there is minimal population-specific literature to guide care. Moreover, reluctance to discontinue training and the need to resume end-range lumbar motion can impede the success of conservative care. The purpose of this case report is to describe the use of a patient-specific outcome measure and a movement classification system to structure a home exercise program (HEP) for an adolescent training to be a circus performer. The patient was a 16-year-old female with a 10-month history of LBP...
December 15, 2017: Journal of Dance Medicine & Science
https://www.readbyqxmd.com/read/29166877/a-prospective-study-examining-the-role-of-myocardial-fibrosis-in-outcome-following-mitral-valve-repair-in-degenerative-mitral-regurgitation-rationale-and-design-of-the-mitral-finder-study
#19
Boyang Liu, Nicola C Edwards, Desley A H Neal, Christopher Weston, Gerard Nash, Nicolas Nikolaidis, Thomas Barker, Ramesh Patel, Moninder Bhabra, Richard P Steeds
BACKGROUND: The optimal management of chronic severe primary degenerative mitral regurgitation (MR) is to repair the valve but identification of the optimal timing of surgery remains challenging. Current guidelines suggest 'watchful waiting' until the onset of symptoms or left ventricular (LV) dysfunction but these have been challenged as promoting 'rescue surgery'. Better predictors are required to inform decision-making in relation to the necessity and timing of surgery. Chronic volume overload is a stimulus for adverse adaptive LV remodelling...
November 22, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29166810/anesthetic-management-of-amniotic-fluid-embolism-a-multi-center-prospective-cohort-study
#20
Shiri Skolnik, Alexander Ioscovich, Leonid A Eidelman, Atara Davis, Anat Shmueli, Amir Aviram, Sharon Orbach-Zinger
INTRODUCTION: Amniotic fluid embolism (AFE) is a rare and potentially lethal obstetric complication, commonly occurring during labor, delivery, or immediately postpartum. There is a paucity of data regarding incidence, risk factors, and clinical management. Our primary objective in this study was to evaluate clinical presentation of AFE and delineate anesthesia management of these cases. METHODS: This 10 years retrospective multi-center cohort study was performed in five tertiary university-affiliated medical centers, between the years 2005 and 2015...
November 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
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