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https://www.readbyqxmd.com/read/28822384/clinical-characteristics-of-trauma-patients-requiring-hydrocortisone-treatment-for-refractory-hypotension
#1
Gina Kim, Jeffrey Young
Corticosteroids play an important role in responding to physiologic stress in the human body. However, its application in critical care remains heavily debated. The purpose of this study was to identify patient characteristics associated with receiving stress-dose steroids during the intensive care unit stay after traumatic injury and its effect on in-hospital mortality. Patients admitted to the University of Virginia trauma center between January 1, 2011, and December 31, 2015, were identified using our Trauma Registry...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28808942/primary-care-providers-opening-of-time-sensitive-alerts-sent-to-commercial-electronic-health-record-inbaskets
#2
Sarah L Cutrona, Hassan Fouayzi, Laura Burns, Rajani S Sadasivam, Kathleen M Mazor, Jerry H Gurwitz, Lawrence Garber, Devi Sundaresan, Thomas K Houston, Terry S Field
BACKGROUND: Time-sensitive alerts are among the many types of clinical notifications delivered to physicians' secure InBaskets within commercial electronic health records (EHRs). A delayed alert review can impact patient safety and compromise care. OBJECTIVE: To characterize factors associated with opening of non-interruptive time-sensitive alerts delivered into primary care provider (PCP) InBaskets. DESIGN AND PARTICIPANTS: We analyzed data for 799 automated alerts...
August 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28807206/graft-loss-review-of-a-single-burn-center-s-experience-and-proposal-of-a-graft-loss-grading-scale
#3
Lauren B Nosanov, Melissa M McLawhorn, Lamisa Hassan, Taryn E Travis, Shawn Tejiram, Laura S Johnson, Lauren T Moffatt, Jeffrey W Shupp
BACKGROUND: There exists neither a consensus definition of burn "graft loss" nor a scale with which to grade severity. We introduced an institutional scale in 2014 for quality improvement. MATERIALS AND METHODS: We reviewed all burned patients with graft loss on departmental Morbidity and Mortality reports between July 2014 and July 2016. Graft loss grades were assigned during the course of clinical care per institutional scale. Chronic nonhealing wounds and nonburn wounds were excluded...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28803752/optimal-dose-timing-and-ratio-of-blood-products-in-massive-transfusion-results-from-a-systematic-review
#4
REVIEW
Zoe K McQuilten, Gemma Crighton, Susan Brunskill, Jessica K Morison, Tania H Richter, Neil Waters, Michael F Murphy, Erica M Wood
Optimal dose, timing and ratio to red blood cells (RBC) of blood component therapy (fresh frozen plasma [FFP], platelets, cryoprecipitate or fibrinogen concentrate) to reduce morbidity and mortality in critically bleeding patients requiring massive transfusion is unknown. We performed a systematic review for randomized controlled trials (RCT) in MEDLINE, The Cochrane Library, Embase, CINAHL, PubMed the Transfusion Evidence Library and using multiple clinical trials registries to 21 February 2017. Sixteen RCTs were identified: six completed (five in adult trauma patients, one pediatric burn patients) and ten ongoing trials...
July 6, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28803724/implementation-and-outcomes-of-an-evidence-based-precepting-program-for-burn-nurses
#5
Johnnie R Robbins, Krystal K Valdez-Delgado, Nicole W Caldwell, Linda H Yoder, Elizabeth J Hayes, Michaèl G Barba, Hope L Greeley, Colleen Mitchell, Elizabeth A Mann-Salinas
INTRODUCTION: There is significant nationwide interest in transitioning new and new-to-specialty nurses into practice, especially in burn care. Lack of a structured transition program in our Burn Center was recognized as a contributing factor for nursing dissatisfaction and increased turnover compared to other hospital units. Employee evaluations exposed a need for more didactic instruction, hands-on learning, and preceptor support. The goal of this project was to implement an evidence-based transition to practice program specific to the burn specialty...
August 10, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28803723/perceived-social-support-among-patients-with-burn-injuries-a-perspective-from-the-developing-world
#6
Ahmed Waqas, Marvee Turk, Sadiq Naveed, Atif Amin, Harriet Kiwanuka, Neha Shafique, Muhammad Ashraf Chaudhry
BACKGROUND: Social support is among the most well-established predictors of post-burn psychopathology after burn. Despite a disproportionately large burden of burns in the developing world, the nature of social support among burn patients in this context remains elusive. We, therefore, seek to investigate social support and its biopsychosocial determinants among patients with burn injuries in Pakistan. METHODS: A cross-sectional study of 343 patients presenting with burn injuries at four teaching hospitals in the Punjab province of Pakistan was conducted...
August 10, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28802983/systemic-and-local-management-of-burn-wounds
#7
REVIEW
Alessio Vigani, Christine A Culler
Management of severe burn injury (SBI) requires prompt, complex, and aggressive care. Despite major advances in the management of SBI-including patient-targeted resuscitation, management of inhalation injuries, specific nutritional support, enhanced wound therapy, and infection control-the consequences of SBI often result in complex, multiorgan metabolic changes. Consensus guidelines and clinical evidence regarding specific management of small animal burn patients are lacking. This article aims to review updated therapeutic consideration for the systemic and local management of SBI that are proven effective to optimize outcomes in human burn patients and may translate to small animal patients...
August 9, 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28801148/assessing-and-addressing-the-problem-of-pain-and-distress-during-wound-care-procedures-in-paediatric-patients-with-burns
#8
Marianne J E van der Heijden, Alette de Jong, Heinz Rode, Roux Martinez, Monique van Dijk
OBJECTIVE: While the prevalence of burns in children is highest in low and middle-income countries, most research on burn-related pain intensity and distress is carried out in high-income countries. In this study we assessed pain intensity and distress in paediatric patients with burns undergoing wound care procedures without distraction and parental presence in a South-African children's hospital and sought to identify predictors for the outcomes. METHODS: This observational study, carried out as part of a randomized controlled trial, took place at a burns unit in Cape Town, South Africa and included patients between the ages of 0 and 13 years undergoing their first or second wound care procedure...
August 8, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28797571/epidemiology-of-burn-patients-presenting-to-a-tertiary-hospital-emergency-department-in-lebanon
#9
Abou Dagher Gilbert, Eva Rajha, Christopher El Khuri, Ralph Bou Chebl, Aurelie Mailhac, Maha Makki, Mazen El Sayed
BACKGROUND: The epidemiology of burns is well described in the United States, Europe and Asia. However, few studies address this topic in the Levant region. This study aims to describe characteristics of burn victims treated at the emergency department of a tertiary care center in Beirut, Lebanon and to report on factors that affect ED disposition. METHODS: A retrospective cohort study was conducted in the ED of a tertiary care hospital, in Beirut, Lebanon, between 2009 and 2013...
August 7, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28795063/determinants-of-mortality-and-the-lethal-area-50-index-la50-in-burn-patients-admitted-to-a-large-burn-center-a-single-center-experience
#10
Shahab Shahabi Shahmiri, Mohsen Kolahdouzan, Ara Omrani, Mehdi Khazaei, Hamid Salehi, Abbas Motavalian, Rastin Mohammadi Mofrad, Mohammad Taghi Rezaei, Helia Hemasian
OBJECTIVES: To investigate the determinants of mortality and the lethal area 50 (LA50) in large series of Iranian burn patients admitted to a single burn center. METHODS: This cross-sectional study was conducted in Shahid Motahari burn center of Tehran, Iran during a 1-year period from 2011 to 2012. We included all the burn patients who were admitted to our center during the study period. Those with incomplete medical records and those referred to other centers were excluded from the study...
July 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28794620/spreading-improvements-for-advanced-copd-care-through-a-canadian-collaborative
#11
Graeme M Rocker, Claudia Amar, Wendy L Laframboise, Jane Burns, Jennifer Y Verma
BACKGROUND: A year-long pan-Canadian quality improvement collaborative (QIC) led by the Canadian Foundation for Healthcare Improvement (CFHI) supported the spread of the successful Halifax, Nova Scotia-based INSPIRED COPD Outreach Program™ to 19 teams in the 10 Canadian provinces. We describe QIC results, addressing two main questions: 1) Can the results of the Nova Scotia INSPIRED model be replicated elsewhere in Canada? 2) How did the teams implement and evaluate their versions of the INSPIRED program? METHODS: Collaborative faculty selected measures that were evidence-based, relatively simple to collect, and relevant to local context...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28792686/viral-surveillance-using-pcr-during-treatment-of-aml-and-all
#12
Stephanie B Dixon, Adam Lane, Maureen M O'Brien, Karen C Burns, Jennifer L Mangino, Erin H Breese, Michael J Absalon, John P Perentesis, Christine L Phillips
BACKGROUND: While viral surveillance of cytomegalovirus (CMV), Epstein-Barr virus (EBV), and adenovirus using PCR is routine in patients undergoing hematopoetic stem cell transplant and solid organ transplant, the utility in the nontransplant pediatric leukemia population is unknown. Our institution screens patients with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) for viral DNAemia by PCR as part of clinical care. PROCEDURE: This retrospective chart review included patients treated for newly diagnosed or relapsed AML or ALL between April 2010 and September 2014...
August 9, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28792620/cut-point-levels-of-phosphatidylethanol-to-identify-alcohol-misuse-in-a-mixed-cohort-including-critically-ill-patients
#13
Majid Afshar, Ellen L Burnham, Cara Joyce, Brendan J Clark, Meagan Yong, Jeannette Gaydos, Richard S Cooper, Gordon S Smith, Elizabeth J Kovacs, Erin M Lowery
BACKGROUND: Although alcohol misuse is associated with deleterious outcomes in critically ill patients, its detection by either self-report or examination of biomarkers is difficult to obtain consistently. Phosphatidylethanol (PEth) is a direct alcohol biomarker that can characterize alcohol consumption patterns; however, its diagnostic accuracy in identifying misuse in critically ill patients is unknown. METHODS: PEth values were obtained in a mixed cohort comprised of 122 individuals from medical and burn intensive care units (n=33), alcohol detoxification unit (n=51), and healthy volunteers (n=38)...
August 9, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28789820/hepatitis-c-testing-in-general-practice-settings-a-cross-sectional-study-of-people-who-inject-drugs-in-australia
#14
Kerryn Butler, Carolyn Day, Rachel Sutherland, Joe van Buskirk, Courtney Breen, Lucinda Burns, Sarah Larney
BACKGROUND: People who inject drugs (PWID) often do not receive confirmatory RNA testing following positive HCV antibody testing. Expanding access to adequate testing and assessment will improve the progression of patients through the HCV care cascade with the potential to improve diagnosis as well as linkage to treatment. We aimed to determine current utilisation of general practitioners (GPs) by PWID in Australia compared to other settings for HCV testing and post-test discussions. METHODS: A national sample (n=888) of people who had injected drugs regularly in the past 6 months was interviewed about HCV antibody, RNA testing, and post-test discussions, and the settings where these took place...
August 5, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28783893/delayed-treatment-of-frostbite-with-hyperbaric-oxygen-a-report-of-two-cases
#15
Corine A Lansdorp, Gert R Roukema, Onno Boonstra, Jan Dokter
Frostbite is an injury caused by the freezing of tissue, causing varied levels of tissue damage and necrosis. Case reports have shown a positive effect of hyperbaric oxygen (HBO₂) in such injuries, in acute cases as well as delayed (up to 21 days) presentation with complications. In this case report we present the course of hyperbaric treatment of two patients (a brother and sister, age 58 and 62) who sustained frostbite injuries to both feet 28 days earlier while hiking in the Himalayas. They were initially treated in Nepal following local protocol; afterward their primary care in the Netherlands was managed by the Burn Centre at Maasstad Hospital in Rotterdam...
July 2017: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/28782599/ascertainment-of-unmet-needs-and-participation-in-health-maintenance-and-screening-of-adult-hematopoietic-cell-transplantation-hct-survivors-followed-in-a-formal-survivorship-program
#16
Theresa Hahn, Pamela Paplham, Tammy Austin-Ketch, Yali Zhang, Jennifer Grimmer, Michael Burns, Sophia Balderman, Maureen Ross, Philip L McCarthy
This study aimed to ascertain unmet needs in autologous and allogeneic HCT recipients actively followed in an established long-term survivorship clinic at Roswell Park Cancer Institute from 2006-2012. The Survivor Unmet Needs Survey (SUNS) was mailed to 209 eligible patients and returned by 110 (53% participation rate). SUNS includes 89-items covering 5 domains: Emotional Health, Access and Continuity of Care, Relationships, Financial Concerns, and Information. The top five specific unmet needs for autologous HCT patients were: inability to set future goals/long-term plans; changes in appearance; bad memory/lacking focus; losing confidence in abilities; paying household or other bills...
August 4, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28781135/five-year-epidemiology-of-liquefied-petroleum-gas-related-burns
#17
Ronghua Jin, Pan Wu, Jon Kee Ho, Xingang Wang, Chunmao Han
BACKGROUND: The incidence of liquefied petroleum gas (LPG)-related burns has increased over recent years, and it has become a serious public health issue in developing countries such as India and Turkey. This paper aims to investigate the epidemiological characteristics of LPG-related burns to provide assistance and suggestions for planning prevention strategies. METHODS: A 5-year retrospective study was conducted in patients with LPG-related burns admitted to the Department of Burns & Wound Care Center, Second Affiliated Hospital of Zhejiang University, College of Medicine, between 1st January 2011 and 31st December 2015...
August 3, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28777823/two-new-risk-factors-for-heterotopic-ossification-development-after-severe-burns
#18
Laurent Thefenne, Gratiane de Brier, Thomas Leclerc, Claire Jourdan, Claire Nicolas, Stéphanie Truffaut, Eric Lapeyre, Francois Genet
OBJECTIVES: Life after severe burns is conditioned by the remaining sequelae. The pathophysiology and risk factors of Heterotopic Ossification (HO) after burns are still poorly understood. The aim of this study was to determine: 1) the incidence of HO after burns and 2) the risk factors associated with HO development, in a large retrospective study. METHODS: A case-control study of patients admitted to the burns intensive care unit of Percy Hospital, Paris, from the 1st January 2009 to the 31st December 2013 and then admitted to one of three centres specialised in the rehabilitation of patients with burns...
2017: PloS One
https://www.readbyqxmd.com/read/28777112/the-relationship-between-professional-quality-of-life-and-caring-ability-in-critical-care-nurses
#19
Marzieh Mohammadi, Hamid Peyrovi, Mahmood Mahmoodi
BACKGROUND: Critical care nursing has some features that may affect the ability of critical care nurses to provide care. Professionals as critical care nurses who deal with peoples' health and life often experience some levels of stress that affects their quality of life. OBJECTIVE: This study examined the relationship between professional quality of life and caring ability of critical care nurses. METHOD: In this descriptive correlational study, 253 critical care nurses working in the medical and surgical intensive care units of Tehran University of Medical Sciences were recruited by convenience sampling method...
September 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28770591/phased-implementation-of-spaced-clinic-visits-for-stable-hiv-positive-patients-in-rwanda-to-support-treat-all
#20
REVIEW
Sabin Nsanzimana, Eric Remera, Muhayimpundu Ribakare, Tracy Burns, Sibongile Dludlu, Edward J Mills, Jeanine Condo, Heiner C Bucher, Nathan Ford
INTRODUCTION: In 2016, Rwanda implemented "Treat All," requiring the national HIV programme to increase antiretroviral (ART) treatment coverage to all people living with HIV. Approximately half of the 164,262 patients on ART have been on treatment for more than five years, and long-term retention of patients in care is an increasing concern. To address these challenges, the Ministry of Health has introduced a differentiated service delivery approach to reduce the frequency of clinical visits and medication dispensing for eligible patients...
July 21, 2017: Journal of the International AIDS Society
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