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https://www.readbyqxmd.com/read/28110487/the-use-of-bilateral-internal-mammary-artery-grafting-in-different-degrees-of-obesity
#1
Yasser Y Hegazy, Wael Hassanein, Jürgen Ennker, Noha Keshk, Stefan Bauer, Ralf Sodian
Background Obesity is a limiting factor for the use of bilateral internal mammary arteries (BIMAs). Therefore, we assessed the safety of their use in different degrees of obesity. Patients and Methods We studied two groups of patients with obesity using propensity matching. The first group received single internal mammary artery and saphenous vein grafts (SIMA group, 526 patients) and the second group received bilateral internal mammary arteries (BIMA group, 526 patients). Patients were classified further according to their body mass index (BMI) into overweight (BMI = 25-29...
January 22, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28110410/neurophysiological-assessment-of-brain-dysfunction-in-critically-ill-patients-an-update
#2
REVIEW
Eric Azabou, Catherine Fischer, Jean Michel Guerit, Djillali Annane, François Mauguiere, Fréderic Lofaso, Tarek Sharshar
The aim of this review was to provide up-to-date information about the usefulness of clinical neurophysiology testing in the management of critically ill patients. Evoked potentials (EPs) and electroencephalogram (EEG) are non-invasive clinical neurophysiology tools that allow an objective assessment of the central nervous system's function at the bedside in intensive care unit (ICU). These tests are quite useful in diagnosing cerebral complications, and establishing the vital and functional prognosis in ICU...
January 21, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28110287/aspirin-to-inhibit-sepsis-antisepsis-randomised-controlled-trial-protocol
#3
Damon P Eisen, Elizabeth M Moore, Karin Leder, Jessica Lockery, Emma S McBryde, John J McNeil, David Pilcher, Rory Wolfe, Robyn L Woods
INTRODUCTION: Sepsis is a leading global cause of morbidity and mortality, and is more common at the extremes of age. Moreover, the cost of in-hospital care for elderly patients with sepsis is significant. There are indications from experimental and observational studies that aspirin may reduce inflammation associated with infection. This paper describes the rationale and design of the AspiriN To Inhibit SEPSIS (ANTISEPSIS) trial, a substudy of ASPirin in Reducing Events in the Elderly (ASPREE)...
January 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28110270/assessment-of-neonatal-pain-during-heel-prick-lancet-vs-needle-a-randomized-controlled-study
#4
Carl Britto, Suman P N Rao
BACKGROUND: Heel prick is a frequent painful procedure in newborns. A lancet or a 26-gauge needle is used for a heel prick in India. OBJECTIVE: To compare the pain caused by heel prick with a lancet or a 26-gauge needle in newborns admitted in the neonatal intensive care unit (NICU) using the preterm infant pain profile (PIPP). METHODS: This randomized controlled trial was conducted over 2 months in a Level III NICU with a sample size of 40 subjects (20 in each group), which was required for the study to have a power of 80% with an alpha error of 0...
January 21, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28110095/prophylaxis-for-stress-ulcers-with-proton-pump-inhibitors-is-not-associated-with-increased-risk-of-bloodstream-infections-in-the-intensive-care-unit
#5
Margot E Cohen, Joanne M Hathway, Hojjat Salmasian, Jianfang Liu, Melissa Terry, Julian A Abrams, Daniel E Freedberg
BACKGROUND & AIMS: Proton pump inhibitors (PPIs) have been associated with increased risk of infection, likely due to changes in intestinal epithelial permeability and the gastrointestinal microbiome. PPIs are frequently given to patients in the intensive care unit (ICU) to prevent stress ulcers. These patients are at risk for bloodstream infections (BSIs), so we investigated the relationship between PPI use and BSIs among patients in the ICU. METHODS: We performed a retrospective cohort study of adults (≥18 years) admitted to 1 of 14 ICUs within a hospital network of 3 large hospitals from 2008 through 2014...
January 18, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28110055/adverse-and-hypersensitivity-reactions-to-prescription-nonsteroidal-anti-inflammatory-agents-in-a-large-health-care-system
#6
Kimberly G Blumenthal, Kenneth H Lai, Mingshu Huang, Zachary S Wallace, Paige G Wickner, Li Zhou
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most frequently used medications in the United States. NSAID use can be limited by adverse drug reactions (ADRs), including hypersensitivity reactions (HSRs). OBJECTIVE: We aimed to use electronic health record data to determine the incidence and predictors of HSRs to prescription NSAIDs. METHODS: We performed a retrospective cohort study of all adult outpatients in a large health care system prescribed diclofenac, indomethacin, nabumetone, or piroxicam between January 1, 2004, and September 30, 2012...
January 18, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28109962/endothelial-permeability-and-hemostasis-in-septic-shock-results-from-the-process-trial
#7
Peter Hou, Michael Filbin, Henry Wang, Long Ngo, David T Huang, William C Aird, Donald M Yealy, Derek C Angus, John A Kellum, Nathan I Shapiro
BACKGROUND: We studied patients from the Protocolized Care in Early Septic Shock (ProCESS) trial to determine: the effects of alternative resuscitation strategies on circulating markers of endothelial cell permeability and hemostasis, and; the association between biomarkers and mortality. METHODS: Prospective study of biomarkers of endothelial cell permeability (vegf, sflt-1, ang-2) and hemostasis (vwf, thrombomodulin, tpa) in 605 of the 1341 ProCESS participants in a derivation cohort and 305 in validation...
January 18, 2017: Chest
https://www.readbyqxmd.com/read/28109938/forced-vital-capacity-assessment-for-risk-stratification-of-blunt-chest-trauma-patients-in-emergency-settings-a-preliminary-study
#8
C Carrie, L Stecken, M Scotto, M Durand, F Masson, P Revel, M Biais
OBJECTIVE: The aim of this study was to assess the performance of Forced Vital Capacity (FCV) for prediction of secondary pulmonary complications in blunt-chest trauma patients. METHODS: During a 15-month period, all consecutive blunt chest trauma patients admitted in our emergency intensive care unit with more than 3 rib fractures were eligible, unless they required mechanical ventilation in the prehospital or emergency settings. FVC was measured at enrolment and at emergency discharge after therapeutic interventions...
January 18, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28109735/implementation-and-evaluation-of-two-educational-strategies-to-improve-screening-for-eating-disorders-in-pediatric-primary-care
#9
Holly C Gooding, Elizabeth Cheever, Sara F Forman, Jonathan Hatoun, Farah Jooma, Currie Touloumtzis, Louis Vernacchio
PURPOSE: Routine screening for disordered eating or body image concerns is recommended by the American Academy of Pediatrics. We evaluated the ability of two educational interventions to increase screening for eating disorders in pediatric primary care practice, predicting that the "active-learning" group would have an increase in documented screening after intervention. METHODS: We studied 303 practitioners in a large independent practice association located in the northeastern United States...
January 18, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28109689/-intensity-of-interprofessional-collaboration-among-intensive-care-nurses-at-a-tertiary-hospital
#10
G Serrano-Gemes, M Rich-Ruiz
OBJECTIVES: To measure the intensity of interprofessional collaboration (IPC) in nurses of an intensive care unit (ICU) at a tertiary hospital, to check differences between the dimensions of the Intensity of Interprofessional Collaboration Questionnaire, and to identify the influence of personal variables. METHOD: A cross-sectional descriptive study was conducted with 63 intensive care nurses selected by simple random sampling. Explanatory variables: age, sex, years of experience in nursing, years of experience in critical care, workday type and work shift type; variable of outcome: IPC...
January 18, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28109683/incidence-and-risk-factors-of-delirium-in-patients-after-type-a-aortic-dissection-surgery
#11
Zhengqin Liu, Xinyan Pang, Xiquan Zhang, Guangqing Cao, Changcun Fang, Shuming Wu
OBJECTIVE: To study the incidence and related risk factors for postoperative delirium after type-A aortic dissection in patients who underwent Sun's procedure (total arch replacement using a tetrafurcate graft with stented elephant trunk implantation). DESIGN: A retrospective study. SETTING: A cardiac surgical intensive care unit. PARTICIPANTS: The study comprised 100 patients admitted to the intensive care unit for type-A aortic dissection...
November 3, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28109560/etiologies-trends-and-predictors-of-30-day-readmission-in-patients-with-heart-failure
#12
Shilpkumar Arora, Prashant Patel, Sopan Lahewala, Nilay Patel, Nileshkumar J Patel, Kosha Thakore, Aditi Amin, Byomesh Tripathi, Varun Kumar, Harshil Shah, Mahek Shah, Sidakpal Panaich, Abhishek Deshmukh, Apurva Badheka, Umesh Gidwani, Radha Gopalan
Heart failure (HF) is the most common discharge diagnosis across the United States, and these patients are particularly vulnerable to readmissions, increasing attention to potential ways to address the problem. The study cohort was derived from the Healthcare Cost and Utilization Project's National Readmission Data 2013, sponsored by the Agency for Healthcare Research and Quality. HF was identified using appropriate International Classification of Diseases, Ninth Revision, Clinical Modification codes. Readmission was defined as a subsequent hospital admission within 30 days after discharge day of index admission...
December 14, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28109537/clinical-factors-associated-with-cerebral-metabolism-in-term-neonates-with-congenital-heart-disease
#13
Anna Lonyai Harbison, Jodie K Votava-Smith, Sylvia Del Castillo, S Ram Kumar, Vince Lee, Vincent Schmithorst, Hollie A Lai, Sharon O'Neil, Stefan Bluml, Lisa Paquette, Ashok Panigrahy
OBJECTIVE: To determine associations between patient and clinical factors with postnatal brain metabolism in term neonates with congenital heart disease (CHD) via the use of quantitative magnetic resonance spectroscopy. STUDY DESIGN: Neonates with CHD were enrolled prospectively to undergo pre- and postoperative 3T brain magnetic resonance imaging. Short-echo single-voxel magnetic resonance spectroscopy of parietal white matter was used to quantify metabolites related to brain maturation (n-acetyl aspartate, choline, myo- inositol), neurotransmitters (glutamate and gamma-aminobutyric acid), energy metabolism (glutamine, citrate, glucose, and phosphocreatine), and injury/apoptosis (lactate and lipids)...
January 19, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28109467/dexamethasone-in-head-and-neck-cancer-patients-with-microvascular-reconstruction-no-benefit-more-complications
#14
S Kainulainen, J Törnwall, A M Koivusalo, A L Suominen, P Lassus
OBJECTIVES: Glucocorticoids are widely used in association with major surgery of the head and neck to improve postoperative rehabilitation, shorten intensive care unit and hospital stay, and reduce neck swelling. This study aimed to clarify whether peri- and postoperative use of dexamethasone in reconstructive head and neck cancer surgery is associated with any advantages or disadvantages. MATERIALS AND METHODS: This prospective double-blind randomized controlled trial comprised 93 patients...
February 2017: Oral Oncology
https://www.readbyqxmd.com/read/28109409/ecco-essential-requirements-for-quality-cancer-care-soft-tissue-sarcoma-in-adults-and-bone-sarcoma-a-critical-review
#15
REVIEW
Elisabeth Andritsch, Marc Beishon, Stefan Bielack, Sylvie Bonvalot, Paolo Casali, Mirjam Crul, Roberto Delgado- Bolton, Davide Maria Donati, Hassan Douis, Rick Haas, Pancras Hogendoorn, Olga Kozhaeva, Verna Lavender, Jozsef Lovey, Anastassia Negrouk, Philippe Pereira, Pierre Roca, Godelieve Rochette de Lempdes, Tiina Saarto, Bert van Berck, Gilles Vassal, Markus Wartenberg, Wendy Yared, Alberto Costa, Peter Naredi
BACKGROUND: ECCO essential requirements for quality cancer care (ERQCC) are checklists and explanations of organisation and actions that are necessary to give high-quality care to patients who have a specific tumour type. They are written by European experts representing all disciplines involved in cancer care. ERQCC papers give oncology teams, patients, policymakers and managers an overview of the elements needed in any healthcare system to provide high quality of care throughout the patient journey...
February 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28109408/ecco-essential-requirements-for-quality-cancer-care-colorectal-cancer-a-critical-review
#16
REVIEW
Geerard Beets, David Sebag-Montefiore, Elisabeth Andritsch, Dirk Arnold, Marc Beishon, Mirjam Crul, Jan Willem Dekker, Roberto Delgado-Bolton, Jean-François Fléjou, Wolfgang Grisold, Geoffrey Henning, Andrea Laghi, Jozsef Lovey, Anastassia Negrouk, Philippe Pereira, Pierre Roca, Tiina Saarto, Thomas Seufferlein, Claire Taylor, Giampaolo Ugolini, Cornelis van de Velde, Bert van Herck, Wendy Yared, Alberto Costa, Peter Naredi
ECCO essential requirements for quality cancer care (ERQCC) are checklists and explanations of organisation and actions that are necessary to give high-quality care to patients who have a specific tumour type. They are written by European experts representing all disciplines involved in cancer care. ERQCC papers give oncology teams, patients, policymakers and managers an overview of the elements needed in any healthcare system to provide high quality of care throughout the patient journey. References are made to clinical guidelines and other resources where appropriate, and the focus is on care in Europe...
February 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28109347/how-is-physician-work-valued
#17
Jeffrey P Jacobs, Stephen J Lahey, Francis C Nichols, James M Levett, George Gilbert Johnston, Richard K Freeman, James D St Louis, Julie Painter, Courtney Yohe, Cameron D Wright, Kirk R Kanter, John E Mayer, Keith S Naunheim, Jeffrey B Rich, Joseph E Bavaria
Strategies to value physician work continue to evolve. The Society of Thoracic Surgeons and The Society of Thoracic Surgeons National Database have an increasingly important role in this evolution. An understanding of the Current Procedural Terminology (CPT) system (American Medical Association [AMA], Chicago, IL) and the Relative Value Scale Update Committee (RUC) is necessary to comprehend how physician work is valued. In 1965, with the dawn of increasingly complex medical care, immense innovation, and the rollout of Medicare, the need for a common language describing medical services and procedures was recognized as being of critical importance...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28109296/design-of-simulation-based-medical-education-and-advantages-and-disadvantages-of-in-situ-simulation-versus-off-site-simulation
#18
EDITORIAL
Jette Led Sørensen, Doris Østergaard, Vicki LeBlanc, Bent Ottesen, Lars Konge, Peter Dieckmann, Cees Van der Vleuten
BACKGROUND: Simulation-based medical education (SBME) has traditionally been conducted as off-site simulation in simulation centres. Some hospital departments also provide off-site simulation using in-house training room(s) set up for simulation away from the clinical setting, and these activities are called in-house training. In-house training facilities can be part of hospital departments and resemble to some extent simulation centres but often have less technical equipment. In situ simulation, introduced over the past decade, mainly comprises of team-based activities and occurs in patient care units with healthcare professionals in their own working environment...
January 21, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28109276/introduction-of-microsystems-in-a-level-3-neonatal-intensive-care-unit-an-interprofessional-approach
#19
Salhab El Helou, Samira Samiee-Zafarghandy, Gerhard Fusch, Muzafar Gani Abdul Wahab, Lynda Aliberti, Ahmad Bakry, Deborah Barnard, Joanne Doucette, Enas El Gouhary, Michael Marrin, Carrie-Lynn Meyer, Amit Mukerji, Anne Nwebube, David Pogorzelski, Edward Pugh, Karen Schattauer, Jay Shah, Sandesh Shivananda, Sumesh Thomas, Jennifer Twiss, Connie Williams, Sourabh Dutta, Christoph Fusch
BACKGROUND: Growth of neonatal intensive care units in number and size has raised questions towards ability to maintain continuity and quality of care. Structural organization of intensive care units is known as a key element for maintaining the quality of care of these fragile patients. The reconstruction of megaunits of intensive care to smaller care units within a single operational service might help with provision of safe and effective care. METHODS/DESIGN: The clinical team and patient distribution lay out, admission and discharge criteria and interdisciplinary round model was reorganized to follow the microstructure philosophy...
January 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28109272/opinions-about-the-new-law-on-end-of-life-issues-in-a-sample-of-french-patients-receiving-palliative-care
#20
Augustin Boulanger, Théo Chabal, Marie Fichaux, Mireille Destandau, Jean Marc La Piana, Pascal Auquier, Karine Baumstarck, Sébastien Salas
BACKGROUND: In February 2nd 2016, the French government enacted the Claeys-Leonetti law that forbade euthanasia and established the right to deep and continuous sedation for end-of-life patients. Moreover, the law also obliges clinicians to abide by any advance directives regarding treatment and investigation, except in cases where they are "obviously inappropriate" in a given medical situation, or in cases of emergency, in order to allow medical staff to take time to assess the patient's situation...
January 21, 2017: BMC Palliative Care
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