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https://www.readbyqxmd.com/read/28781312/the-prehospital-predictors-of-tracheal-intubation-for-in-patients-who-experience-convulsive-seizures-in-the-emergency-department
#1
Kenichiro Sato, Noritoshi Arai, Aki Omori-Mitsue, Ayumi Hida, Akio Kimura, Sousuke Takeuchi
Objective To identify the prehospital factors predicting the performance of tracheal intubation (TI) at the emergency department (ED) in patients with convulsive seizure or epilepsy. Methods We performed a retrospective analysis of seizure patients who underwent TI at the ED soon after arrival. The clinical variables obtained in the prehospital setting were reviewed. Patients The study population included consecutive adult patients who were transported to an urban tertiary care ED due to convulsive seizure between August 2010 and September 2015...
August 15, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28754457/impact-of-electronic-acute-kidney-injury-aki-alerts-with-automated-nephrologist-consultation-on-detection-and-severity%C3%A2-of-aki-a-quality-improvement-study
#2
Sehoon Park, Seon Ha Baek, Soyeon Ahn, Kee-Hyuk Lee, Hee Hwang, Jiwon Ryu, Shin Young Ahn, Ho Jun Chin, Ki Young Na, Dong-Wan Chae, Sejoong Kim
BACKGROUND: Several electronic alert systems for acute kidney injury (AKI) have been introduced. However, their clinical benefits require further investigation. STUDY DESIGN: Before-and-after quality improvement study. SETTING & PARTICIPANTS: A tertiary teaching hospital in Korea, which adopted an AKI alert system on June 1, 2014. Before and after launch of the alert system, 1,884 and 1,309 patients with AKI were included in the usual-care and alert groups, respectively...
July 25, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28751970/service-evaluation-of-the-implementation-of-a-digitally-enabled-care-pathway-for-the-recognition-and-management-of-acute-kidney-injury
#3
Alistair Connell, Hugh Montgomery, Stephen Morris, Claire Nightingale, Sarah Stanley, Mary Emerson, Gareth Jones, Omid Sadeghi-Alavijeh, Charles Merrick, Dominic King, Alan Karthikesalingam, Cian Hughes, Joseph Ledsam, Trevor Back, Geraint Rees, Rosalind Raine, Christopher Laing
Acute Kidney Injury (AKI), an abrupt deterioration in kidney function, is defined by changes in urine output or serum creatinine. AKI is common (affecting up to 20% of acute hospital admissions in the United Kingdom), associated with significant morbidity and mortality, and expensive (excess costs to the National Health Service in England alone may exceed £1 billion per year). NHS England has mandated the implementation of an automated algorithm to detect AKI based on changes in serum creatinine, and to alert clinicians...
2017: F1000Research
https://www.readbyqxmd.com/read/28709596/be-on-alert-for-pediatric-aki
#4
Nicholas M Selby, Rachel Lennon
Acute kidney injury in children is associated with adverse outcomes, although much of our current understanding originates from studies in intensive care units. Holmes et al. used an automated acute kidney injury detection method to obtain epidemiologic data on pediatric acute kidney injury at a national level in outpatient, inpatient, and intensive care unit settings. We discuss the impact of these important results and the considerations needed with this approach.
August 2017: Kidney International
https://www.readbyqxmd.com/read/28693548/using-a-linked-database-for-epidemiology-across-the-primary-and-secondary-care-divide-acute-kidney-injury
#5
M Johnson, H Hounkpatin, S Fraser, D Culliford, M Uniacke, P Roderick
BACKGROUND: NHS England has mandated the use in hospital laboratories of an automated early warning algorithm to create a consistent method for the detection of acute kidney injury (AKI). It generates an 'alert' based on changes in serum creatinine level to notify attending clinicians of a possible incident case of the condition, and to provide an assessment of its severity. We aimed to explore the feasibility of secondary data analysis to reproduce the algorithm outside of the hospital laboratory, and to describe the epidemiology of AKI across primary and secondary care within a region...
July 11, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28607684/a-multifaceted-quality-improvement-programme-to-improve-acute-kidney-injury-care-and-outcomes-in-a-large-teaching-hospital
#6
Leonard Ebah, Prasanna Hanumapura, Deryn Waring, Rachael Challiner, Katharine Hayden, Jill Alexander, Robert Henney, Rachel Royston, Cassian Butterworth, Marc Vincent, Susan Heatley, Ged Terriere, Robert Pearson, Alastair Hutchison
Acute kidney injury (AKI) is now widely recognised as a serious health care issue, occurring in up to 25% of hospital in-patients, often with worsening of outcomes. There have been several reports of substandard care in AKI. This quality improvement (QI) programme aimed to improve AKI care and outcomes in a large teaching hospital. Areas of documented poor AKI care were identified and specific improvement activities implemented through sequential Plan-Do-Study-Act (PDSA) cycles. An electronic alert system (e-alert) for AKI was developed, a Priority Care Checklist (PCC) was tested with the aid of specialist nurses whilst targeted education activities were carried out and data on care processes and outcomes monitored...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28553762/evaluation-of-serum-neutrophil-gelatinase-associated-lipocalin-in-predicting-acute-kidney-injury-in-critically-ill-patients
#7
Chen-Chen Hang, Jun Yang, Shuo Wang, Chun-Sheng Li, Zi-Ren Tang
Objective This investigation evaluated the real-time point-of-care testing (RT-POCT) of neutrophil gelatinase-associated lipocalin (NGAL) for detecting acute kidney injury (AKI) and prognosis of critically ill patients. Methods A total of 249 critically ill patients in the emergency department (ED), who were diagnosed with acute decompensated heart failure, sepsis or diabetic ketoacidosis were enrolled in this study. All enrolled patients were followed up for 28 days or to death and the mortalities were recorded...
June 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28548639/rai1-frees-mice-from-the-repression-of-active-wake-behaviors-by-light
#8
Shanaz Diessler, Corinne Kostic, Yvan Arsenijevic, Aki Kawasaki, Paul Franken
Besides its role in vision, light impacts physiology and behavior through circadian and direct (aka 'masking') mechanisms. In Smith-Magenis syndrome (SMS), the dysregulation of both sleep-wake behavior and melatonin production strongly suggests impaired non-visual light perception. We discovered that mice haploinsufficient for the SMS causal gene, Retinoic acid induced-1 (Rai1), were hypersensitive to light such that light eliminated alert and active-wake behaviors, while leaving time-spent-awake unaffected...
May 26, 2017: ELife
https://www.readbyqxmd.com/read/28521019/a-whole-system-approach-to-improving-mortality-associated-with-acute-kidney-injury
#9
Thangavelu Chandrasekar, Asheesh Sharma, Lucinda Tennent, Christopher Wong, Peter Chamberlain, Kottarathil A Abraham
BACKGROUND: Acute kidney injury (AKI) is in the main managed by non-nephrologists, many who feel challenged by or lack awareness of the complexity that the renal element adds to their patients' care. National reports have raised major concerns about the quality of care and have predicted that mortality reductions of 30% are achievable with good medical practice. AIM: This quality improvement project evaluated whether a whole system approach could improve outcomes for patients with AKI...
May 18, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28483379/the-incidence-of-pediatric-acute-kidney-injury-is-increased-when-identified-by-a-change-in-a%C3%A2-creatinine-based-electronic-alert
#10
Jennifer Holmes, Gethin Roberts, Kate May, Kay Tyerman, John Geen, John D Williams, Aled O Phillips
A prospective national cohort study was undertaken to collect data on all cases of pediatric (under 18 yrs of age) acute kidney injury (AKI) identified by a biochemistry-based electronic alert using the Welsh National electronic AKI reporting system. Herein we describe the utility and limitation of using this modification of the KDIGO creatinine-based system data set to characterize pediatric AKI. Of 1,343 incident episodes over a 30-month period, 34.5% occurred in neonates of which 83.8% were AKI stage 1. Neonatal 30-day mortality was 4...
August 2017: Kidney International
https://www.readbyqxmd.com/read/28402560/acute-kidney-injury-electronic-alerts-in-primary-care-findings-from-a-large-population-cohort
#11
Jennifer Holmes, Nicholas Allen, Gethin Roberts, John Geen, John D Williams, Aled O Phillips
Background: Electronic reporting of AKI has been used to aid early AKI recognition although its relevance to CA-AKI and primary care has not been described. Aims: We described the characteristics and clinical outcomes of patients with CA-AKI, and AKI identified in primary care (PC-AKI) through AKI e-Alerts. Design: A prospective national cohort study was undertaken to collect data on all e-alerts representing adult CA-AKI. Method: The study utilised the biochemistry based AKI electronic (e)-alert system that is established across the Welsh National Health Service...
April 11, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28343224/the-evidence-of-acute-kidney-injury-in-the-community-and-for-primary-care-interventions
#12
Lauren Emmett, James Tollitt, Sheila McCorkindale, Smeeta Sinha, Dimitrios Poulikakos
BACKGROUND: Almost two-thirds of patients with acute kidney injury (AKI) damage their kidneys whilst in the community. This paper aims to review existing data on incidence, mortality, and morbidity of AKI within the community and explore the evidence base for primary care strategies aimed at reducing incidence and improving early detection and management of AKI. METHODS: A literature search was carried out using PubMed; key words including AKI, primary care, community acquired, and electronic alerts (e-alerts) were used to capture relevant data...
2017: Nephron
https://www.readbyqxmd.com/read/28282296/herbal-and-dietary-supplements-related-to-diarrhea-and-acute-kidney-injury-a-case-report
#13
Suphamat Wanitsriphinyo, Mayuree Tangkiatkumjai
Background There is very little evidence relating to the association of herbal medicine with diarrhea and the development of acute kidney injury (AKI). This study reports a case of diarrhea-induced AKI, possibly related to an individual ingesting copious amounts of homemade mixed fruit and herb puree. Case presentation A 45-year-old Thai man with diabetes had diarrhea for 2 days, as a result of taking high amounts of a puree made up of eight mixed fruits and herbs over a 3-day period. He developed dehydration and stage 2 AKI, with a doubling of his serum creatinine...
March 1, 2017: Journal of Complementary & Integrative Medicine
https://www.readbyqxmd.com/read/28268210/leveraging-big-data-and-electronic-health-records-to-enhance-novel-approaches-to-acute-kidney-injury-research-and-care
#14
REVIEW
Scott M Sutherland, Stuart L Goldstein, Sean M Bagshaw
While acute kidney injury (AKI) has been poorly defined historically, a decade of effort has culminated in a standardized, consensus definition. In parallel, electronic health records (EHRs) have been adopted with greater regularity, clinical informatics approaches have been refined, and the field of EHR-enabled care improvement and research has burgeoned. Although both fields have matured in isolation, uniting the 2 has the capacity to redefine AKI-related care and research. This article describes how the application of a consistent AKI definition to the EHR dataset can accurately and rapidly diagnose and identify AKI events...
2017: Blood Purification
https://www.readbyqxmd.com/read/28143633/electronic-alerts-for-acute-kidney-injury
#15
Michael Haase, Andreas Kribben, Walter Zidek, Jürgen Floege, Christian Albert, Berend Isermann, Bernt-Peter Robra, Anja Haase-Fielitz
BACKGROUND: Acute kidney injury (AKI) often takes a complicated course if diagnosed late and undertreated. Electronic alerts that provide an early warning of AKI are intended to support treating physicians in making the diagnosis of AKI and treating it appropriately. The available evidence on the effects of such alert systems is inconsistent. METHODS: We employed the PRISMA recommendations for systematic literature reviews to identify relevant articles in the PubMed, Scopus, and Web of Science databases...
January 9, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28122032/approaches-to-predicting-outcomes-in-patients-with-acute-kidney-injury
#16
Danielle Saly, Alina Yang, Corey Triebwasser, Janice Oh, Qisi Sun, Jeffrey Testani, Chirag R Parikh, Joshua Bia, Aditya Biswas, Chess Stetson, Kris Chaisanguanthum, F Perry Wilson
Despite recognition that Acute Kidney Injury (AKI) leads to substantial increases in morbidity, mortality, and length of stay, accurate prognostication of these clinical events remains difficult. It remains unclear which approaches to variable selection and model building are most robust. We used data from a randomized trial of AKI alerting to develop time-updated prognostic models using stepwise regression compared to more advanced variable selection techniques. We randomly split data into training and validation cohorts...
2017: PloS One
https://www.readbyqxmd.com/read/28088774/association-between-e-alert-implementation-for-detection-of-acute-kidney-injury-and-outcomes-a-systematic-review
#17
Philippe Lachance, Pierre-Marc Villeneuve, Oleksa G Rewa, Francis P Wilson, Nicholas M Selby, Robin M Featherstone, Sean M Bagshaw
Background.: Electronic alerts (e-alerts) for acute kidney injury (AKI) in hospitalized patients are increasingly being implemented; however, their impact on outcomes remains uncertain. Methods.: We performed a systematic review. Electronic databases and grey literature were searched for original studies published between 1990 and 2016. Randomized, quasi-randomized, observational and before-and-after studies that included hospitalized patients, implemented e-alerts for AKI and described their impact on one of care processes, patient-centred outcomes or resource utilization measures were included...
February 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28074790/incidence-and-progression-of-cardiac-surgery-associated-acute-kidney-injury-and-its-relationship-with-bypass-and-cross-clamp-time
#18
Habib Md Reazaul Karim, Mohd Yunus, Manuj Kumar Saikia, Jyoti Prasad Kalita, Mrinal Mandal
INTRODUCTION: Cardiac surgery-associated kidney injury (CSA-AKI) is common but relatively less is known about its progression. The present study is aimed at evaluating the incidence and course of CSA-AKI and its relationship with the different durations of cardiopulmonary bypass (CPB) and cross clamp times. MATERIALS AND METHODS: Occurrences of CSA-AKI are evaluated as per the Akin Kidney Injury Network (AKIN) criteria over the course of 5 postoperative day (POD) in 100 patients...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28061831/acute-kidney-injury-as-an-independent-risk-factor-for-unplanned-90-day-hospital-readmissions
#19
Simon Sawhney, Angharad Marks, Nick Fluck, David J McLernon, Gordon J Prescott, Corri Black
BACKGROUND: Reducing readmissions is an international priority in healthcare. Acute kidney injury (AKI) is common, serious and also a global concern. This analysis evaluates AKI as a candidate risk factor for unplanned readmissions and determines the reasons for readmissions. METHODS: GLOMMS-II is a large population cohort from one health authority in Scotland, combining hospital episode data and complete serial biochemistry results through data-linkage. 16453 people (2623 with AKI and 13830 without AKI) from GLOMMS-II who survived an index hospital admission in 2003 were used to identify the causes of and predict readmissions...
January 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28030868/implementation-of-an-automated-primary-care-acute-kidney-injury-warning-system-a-quantitative-and-qualitative-review-of-2-years-of-experience
#20
REVIEW
Omid Sadeghi Alavijeh, Jas Bansal, Katie Hadfield, Christopher Laing, Anne Dawnay
BACKGROUND: Acute kidney injury (AKI) is often detected late, leading to worse clinical outcomes. In 2012, we pioneered an AKI-alerting system for primary care clinicians (PCCs). We retrospectively analysed the alerts and evaluated PCC satisfaction to assess the feasibility of the system. METHODS: The study used a 2-pronged approach. AKI alerts, generated by an algorithm designed by University College London Hospital biochemistry department between June 2012 and June 2014, were analysed to reveal the demographics and outcomes of each patient generating an alert...
2017: Nephron
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