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https://www.readbyqxmd.com/read/29028742/intraoperative-esmolol-as-an-adjunct-for-perioperative-opioid-and-postoperative-pain-reduction-a-systematic-review-meta-analysis-and-meta-regression
#1
Amanda M Gelineau, Michael R King, Karim S Ladha, Sara M Burns, Timothy Houle, T Anthony Anderson
BACKGROUND: Esmolol is an ultrashort β-1 receptor antagonist. Recent studies suggest a role for esmolol in pain response modulation. The authors performed a meta-analysis to determine if the intraoperative use of esmolol reduces opioid consumption or pain scores. METHODS: PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, pubget, and Google Scholar were searched. Studies were included if they were randomized, placebo- or opioid-controlled trials written in English, and performed on patients 18 years of age or older...
October 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29028413/initial-assessment-treatment-and-follow-up-of-minor-pediatric-burn-wounds-in-four-patients-remotely-a-preliminary-communication
#2
Marek A Paul, Parisa Kamali, Ahmed M S Ibrahim, Caroline Medin, Bernard T Lee, Samuel J Lin
BACKGROUND: Close, multidisciplinary collaboration with burn experts is the essential strategy to achieve the best functional and esthetic outcomes in burn wound treatment. Management of minor burn injuries, where no specialized care is available, might be challenging. One concept to achieve a fast and timely result is the application of telemedicine. The objective of this study was to assess and develop a simple telemedicine protocol, which can be applied globally. MATERIAL AND METHODS: We present a pilot study based on a pediatric population of four patients with minor burns...
October 13, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29026812/medical-student-perception-of-plastic-surgery-and-the-impact-of-mainstream-media
#3
S J Fraser, S Al Youha, P J Rasmussen, J G Williams
BACKGROUND: Plastic surgery as a discipline is poorly understood by many, including primary care physicians, nurses, medical students, and the public. These misconceptions affect the specialty in a number of ways, including referral patterns and recruitment of medical students into residency programs. The reason for these commonly held misconceptions has not yet been addressed in the plastic surgery literature. As such, we assessed medical students' knowledge and perceptions of plastic surgery as a discipline and explored factors influencing these opinions...
February 2017: Plastic Surgery
https://www.readbyqxmd.com/read/29023905/cholangiopathy-in-critically-ill-patients-surviving-beyond-the-intensive-care-period-a-multicentre-survey-in-liver-units
#4
L Laurent, C Lemaitre, A Minello, A Plessier, G Lamblin, A Poujol-Robert, A Gervais-Hasenknopf, E-A Pariente, P Belenotti, N Mostefa-Kara, P Sogni, M Legrand, J-M Cournac, F Tamion, G Savoye, P Bedossa, D-C Valla, V Vilgrain, O Goria
BACKGROUND: The outcome of cholangiopathy developing in intensive care unit (ICU) is not known in patients surviving their ICU stay. AIM: To perform a survey in liver units, in order to clarify the course of cholangiopathy after surviving ICU stay. METHODS: The files of the liver units affiliated to the French network for vascular liver disease were screened for cases of ICU cholangiopathy developing in patients with normal liver function tests on ICU admission, and no prior history of liver disease...
October 11, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29022204/the-relationship-between-single-and-two-dimensional-indices-of-left-ventricular-size-using-hemodynamic-transesophageal-echocardiography-in-trauma-and-burn-patients
#5
Duraid Younan, T Mark Beasley, David C Pigott, C Blayke Gibson, John P Gullett, Jeffrey Richey, Jean-Francois Pittet, Ahmed Zaky
BACKGROUND: Conventional echocardiographic technique for assessment of volume status and cardiac contractility utilizes left ventricular end-diastolic area (LVEDA) and fractional area of change (FAC), respectively. Our goal was to find a technically reliable yet faster technique to evaluate volume status and contractility by measuring left ventricular end-diastolic diameter (LVEDD) and fractional shortening (FS) in a cohort of mechanically ventilated trauma and burn patients using hemodynamic transesophageal echocardiographic (hTEE) monitoring...
October 11, 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29022064/proinflammatory-switch-from-g%C3%AE-s-to-g%C3%AE-i-signaling-by-glucagon-like-peptide-1-receptor-in-murine-splenic-monocyte-following-burn-injury
#6
Qing-Hong Zhang, Ji-Wei Hao, Guang-Lei Li, Xiao-Jing Ji, Xu-Dong Yao, Ning Dong, Yong-Ming Yao
OBJECTIVE: Glucagon-like peptide-1 (GLP-1)-based therapy via G protein-coupled receptor (GPCR) GLP-1R, to attenuate hyperglycemia in critical care has attracted great attention. However, the exaggerated inflammation by GLP-1R agonist, Exendin-4, in a mouse model of burn injury was quite unexpected. Recent studies found that GPCR might elicit proinflammatory effects by switching from Gαs to Gαi signaling in the immune system. Thus, we aimed to investigate the possible Gαs to Gαi switch in GLP-1R signaling in monocyte following burn injury...
October 11, 2017: Inflammation Research: Official Journal of the European Histamine Research Society ... [et Al.]
https://www.readbyqxmd.com/read/29021727/analgesia-sedation-and-arousal-status-in-burn-patients-the-gap-between-recommendations-and-current-practices
#7
A Lavrentieva, N Depetris, I Rodini
Assessment and treatment of pain, agitation and delirium are integral parts of the management of critically ill patients. The purpose of this review is to describe how pain, delirium and agitation are managed in general intensive care units and in burn units, and to address whether management of these issues is compatible with internationally accepted recommendations. A substantial gap exists between the conception of the guidelines, clinical practice and physicians' statements regarding pain, sedation and delirium management...
June 30, 2017: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/29021724/inhalation-injury-in-a-burn-unit-a-retrospective-review-of-prognostic-factors
#8
D Monteiro, I Silva, P Egipto, A Magalhães, R Filipe, A Silva, A Rodrigues, J Costa
Inhalation injury (InI) is known to seriously affect the prognosis of burn patients, as it is strongly associated with high morbidity and mortality. Despite major advances in the treatment of burn patients in the past years, advances in the treatment of smoke InI have been somewhat limited; mortality reduction mostly results from improvements in critical care. It is difficult to separate the contribution of InI from other mechanisms that also affect respiratory tract and lungs. The aim of this study was to compare patients with and without InI and to identify prognostic factors among patients with smoke InI...
June 30, 2017: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/29021723/bacterial-infections-in-burn-wound-patients-at-a-tertiary-teaching-hospital-in-accra-ghana
#9
O A Forson, E Ayanka, M Olu-Taiwo, P J Pappoe-Ashong, P J Ayeh-Kumi
Intact human skin surface is essential for protection against infection, preservation of body fluid homeostasis and thermoregulation. Burn injury compromises the skin barrier and enables bacterial infection, hence delaying burn wound healing. This study aimed to determine the microbial profile of burn wounds, and resistance patterns of microbes with respect to the source of the injured patient's wound. Fifty wound swab samples were collected from fifty burn patients at the Korle-Bu Teaching Hospital, Accra (KBTH)...
June 30, 2017: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/29021720/burn-injury-review-of-pathophysiology-and-therapeutic-modalities-in-major-burns
#10
I Kaddoura, G Abu-Sittah, A Ibrahim, R Karamanoukian, N Papazian
Despite a considerable decrease in their incidence worldwide, burn injuries remain one of the commonest forms of trauma and account for a weighty proportion of trauma cases in health-care emergencies around the globe. Although the latest data reveal a substantial decline in burn-related mortality and hospital admissions in the US over the past three decades, severe thermal injuries continue to trigger devastating morbidity and significant mortality while their management remains a dynamic challenge for the entire medical and paramedical community...
June 30, 2017: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/29016490/neonatal-morbidity-and-maternal-complication-rates-in-women-with-a-delivery-body-mass-index-of-60-or-higher
#11
Tana Kim, Sabrina C Burn, Ananta Bangdiwala, Samantha Pace, Phillip Rauk
OBJECTIVE: To investigate neonatal morbidity and maternal complication rates with delivery body mass index (BMI) 60 or greater. METHODS: This retrospective, multicenter cohort study included singleton pregnancies between 23 and 42 weeks of gestation from January 2005 to April 2016. Women with BMI 60 or greater were compared with a random sample of women with BMI 30-59. The primary outcome, composite neonatal morbidity, was defined as 5-minute Apgar score less than 7, hypoglycemia, respiratory distress syndrome, sepsis, hospital stay greater than 5 days, neonatal intensive care unit admission, or neonatal death...
October 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28993173/role-of-mexab-oprm-and-mexxy-oprm-efflux-pumps-and-class-1-integrons-in-resistance-to-antibiotics-in-burn-and-intensive-care-unit-isolates-of-pseudomonas-aeruginosa
#12
Hamid Reza Goli, Mohammad Reza Nahaei, Mohammad Ahangarzadeh Rezaee, Alka Hasani, Hossein Samadi Kafil, Mohammad Aghazadeh, Mojtaba Nikbakht, Younes Khalili
BACKGROUND: The overexpression of efflux pumps and existence of class 1 integrons are the most important mechanisms that contribute to antimicrobial resistance in Pseudomonas aeruginosa especially in burn and Intensive Care Units (ICUs). The present study evaluated the role of MexAB-OprM and MexXY-OprM efflux pumps and class 1 integrons in resistance to antibiotics in burn and ICU isolates of P. aeruginosa. METHODS: Fifteen burn and forty-two ICU isolates were obtained from four hospitals in Northwest Iran...
October 6, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28992770/influence-of-demographic-and-utilization-of-physical-therapy-interventions-on-clinical-outcomes-and-revision-rates-following-anterior-cruciate-ligament-reconstruction
#13
Caitlin J Miller, Jesse C Christensen, Ryan D Burns
Study Design Retrospective cohort from Intermountain Healthcare system Jan 2007-Dec 2014. Background Recent evolutions in healthcare delivery are putting physical therapists in the forefront to be more responsible for providing high-quality rehabilitation care within a more cost-effective manner. Studies investigating the association between physical therapy (PT) visit utilization and outcomes in vulnerable patient populations following anterior cruciate ligament reconstruction (ACLR) may provide useful insights...
October 9, 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28992156/what-works-in-implementation-of-integrated-care-programs-for-older-adults-with-complex-needs-a-realist-review
#14
Maritt Kirst, Jennifer Im, Tim Burns, G Ross Baker, Jodeme Goldhar, Patricia O'Campo, Anne Wojtak, Walter P Wodchis
Purpose: A realist review of the evaluative evidence was conducted on integrated care (IC) programs for older adults to identify key processes that lead to the success or failure of these programs in achieving outcomes such as reduced healthcare utilization, improved patient health, and improved patient and caregiver experience. Data sources: International academic literature was searched in 12 indexed, electronic databases and gray literature through internet searches, to identify evaluative studies...
October 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28991940/posttraumatic-stress-disorder-often-missed-in-primary-care
#15
Adrienne A Williams
DeSean W, a 47-year-old man, returned to his primary care clinic with a new complaint of epigastric burning that had been bothering him for the past 4 months. He had tried several over-the-counter remedies, which provided no relief. He also remained concerned--despite assurances to the contrary at previous clinic visits--that he had contracted a sexually-transmitted disease (STD) after going to a bar one night 4 to 5 months ago. At 2 other clinic visits since that time, STD test results were negative. At this current visit, symptoms and details of sexual history were unchanged since the last visit, with the exception of the epigastric pain...
October 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28991317/-incidence-and-risk-factors-for-bacteremia-on-pediatric-patients-with-burns-in-a-specialized-care-center-in-mexico
#16
Teresa de J Chávez-Velarde, Juan C Lona-Reyes, Alejandra Riebeling-Dueñas, Luis G Orozco-Alatorre
BACKGROUND: Bacteremia events are frequent cause of mortality in burn patients and may originate from infected wounds, by bacterial translocation of endogenous microorganisms, from invasive devices or contaminated intravenous solutions. OBJECTIVE: To quantify the incidence of bacteremia in pediatric patients with burns and to identify risk factors. MATERIAL AND METHODS: A prospective cohort study was performed in pediatric patients with burns of Hospital Civil de Guadalajara "Dr...
June 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28989039/first-line-osimertinib-in-patients-with-treatment-na%C3%A3-ve-somatic-or-germline-egfr-t790m-mutant-metastatic-nsclc
#17
Katerina Ancevski Hunter, David M Friedland, Liza C Villaruz, Timothy F Burns
INTRODUCTION: In rare cases, patients present with baseline (somatic or germline) Epidermal Growth Factor Receptor (EGFR) Thr790Met (T790M) mutations prior to EGFR tyrosine kinase inhibitor (TKI) treatment. This mutation confers resistance to first and second generation TKIs. Osimertinib is a third generation TKI that is FDA approved for use in patients with the EGFR T790M mutation and who have progressed on TKI treatment. To date, the only presented but unpublished experience with first-line osimertinib treatment in 5 patients with baseline T790M mutations who received osimertinib on an expansion cohort of the phase 1 AURA trial...
October 5, 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/28984652/an-outcomes-study-on-the-effects-of-the-singapore-general-hospital-burns-protocol
#18
Weihao Liang, Yee Onn Kok, Bien Keem Tan, Si Jack Chong
INTRODUCTION: The Singapore General Hospital Burns Protocol was implemented in May 2014 to standardize treatment for all burns patients, incorporate new techniques and materials, and streamline the processes and workflow of burns management. This study aims to analyze the effects of the Burns Protocol 2 years after its implementation. METHODS: Using a REDCap electronic database, all burns patients admitted from May 2013 to April 2016 were included in the study. The historical preimplementation control group composed of patients admitted from May 2013 to April 2014 (n = 96)...
October 3, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28979916/addressing-the-physicians-shortage-in-developing-countries-by-accelerating-and-reforming-the-medical-education-is-it-possible
#19
Mustafa Al-Shamsi
INTRODUCTION: Doctors' shortage has remained a concern worldwide. The developed countries started aids to recruit international medical graduates (IMG) to cope with the defects that the health care system suffers from; however, this solution may not work in developing countries that have a limited resource and poor budget to spend on the health care system. This study aims to present an alternative way to approach the physicians' shortage by accelerating undergraduate medical education and reform some post-graduate courses in order to cope with this problem...
October 2017: Journal of Advances in Medical Education & Professionalism
https://www.readbyqxmd.com/read/28970179/creation-and-efficacy-of-a-cadaver-based-prosection-anatomical-course-for-critical-care-advanced-practice-providers
#20
Melissa K Stewart, Stephen Gondek, Roslyn Green, Jason Young, Raeanna C Adams, Timothy Nunez
OBJECTIVE: Intensive care units (ICUs) increasingly rely on advanced practice providers (APPs) to care for critically ill patients. Our institutional APPs perceived functional anatomical knowledge deficits. To meet this need, a cadaver-based prosection course was developed. The purpose of our study was to describe and evaluate the learner-perceived course efficacy. DESIGN: A precourse survey collected participant demographics. Precourse and postcourse surveys assessed perceived confidence in 13 anatomical areas...
September 29, 2017: Journal of Surgical Education
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