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https://www.readbyqxmd.com/read/29331668/earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-a-feasibility-randomised-controlled-trial
#1
David McWilliams, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, Emma Reeves, Lauren Cooper, Catherine Snelson
BACKGROUND: Systematic reviews of early rehabilitation within intensive care units have highlighted the need for robust multi-centre randomised controlled trials with longer term follow up. This trial aims to explore the feasibility of earlier and enhanced rehabilitation for patients mechanically ventilated for ≥5days and to assess the impact on possible long term outcome measures for use in a definitive trial. METHODS: Patients admitted to a large UK based intensive care unit and invasively ventilated for ≥5days were randomised to the rehabilitation intervention or standard care on a 1:1 basis, stratified by age and SOFA score...
January 4, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29325276/-a-clinical-study-of-antiviral-therapy-for-patients-with-compensated-hepatitis-c-cirrhosis
#2
Z W Xie, J P Li, Y J Guan, X Y Zhang, F X Guo, B B Chen, Calvin Q Pan
Objective: To investigate the effect of antiviral therapy on the progression of liver cirrhosis and related predictive factors through a retrospective analysis of patients with compensated hepatitis C cirrhosis. Methods: The patients with compensated hepatitis C cirrhosis who were treated in our hospital from 2004 to 2015 were divided into sustained virologic response (SVR) group, non-SVR (NSVR) group, and untreated group. The baseline features of patients with or without liver cirrhosis were compared to identify the predictive factors for the progression of liver cirrhosis...
November 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29320362/predictive-value-of-serum-gelsolin-and-gc-globulin-in-sepsis-a-pilot-study
#3
Zoltán Horváth-Szalai, Péter Kustán, Balázs Szirmay, Ágnes Lakatos, Per Hjort Christensen, Tamás Huber, Beáta Bugyi, Diána Mühl, Andrea Ludány, Attila Miseta, Gábor L Kovács, Tamás Kőszegi
BACKGROUND: Simultaneous determination of the two main actin scavenger proteins in sepsis has not been investigated until now. In our pilot study, we elucidated the predictive values of Gc globulin and gelsolin (GSN) in sepsis by comparing them to classic laboratory and clinical parameters. METHODS: A 5-day follow-up was performed, including 46 septic patients, 28 non-septic patients and 35 outpatients as controls. Serum Gc globulin and GSN levels were determined by automated immune turbidimetric assay on a Cobas 8000/c502 analyzer...
January 10, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29319770/factors-associated-with-hospital-mortality-in-renal-transplant-patients-admitted-to-the-intensive-care-unit-with-acute-respiratory-failure
#4
Rafael Mendes da Silva, Flavio Geraldo Rezende de Freitas, Antonio Tonete Bafi, Hélio Tedesco Silva Junior, Bartira de Aguiar Roza
INTRODUCTION: The lungs are often involved in a variety of complications after kidney transplantation. Acute respiratory failure (ARF) is one of the most serious manifestations of pulmonary involvement. OBJECTIVE: To describe the main causes of ARF in kidney transplant patients who require intensive care and identify the factors associated with mortality. METHODS: This retrospective study evaluated adult patients with ARF admitted to the intensive care unit of a center with high volume of transplants from August 2013 to August 2015...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29319365/the-prognostic-value-of-mid-regional-pro-adrenomedullin-in-the-evaluation-of-acute-dyspnea
#5
Justin J Choi, Matthew W McCarthy
Acute dyspnea is a common chief complaint among patients who visit an emergency room and presents diagnostic challenges for clinicians in both identifying the etiology and determining the clinical severity. The study of biomarkers in the prognostication and risk stratification of these patients has been increasing, including the investigation of the prognostic value for mid-regional pro-adrenomedullin (MR-proADM). Areas Covered: In this review, the authors cover what is known about MR-proADM testing in patients presenting with acute dyspnea and the supporting evidence of its prognostic value in common conditions in medical patients with acute dyspnea, including acute heart failure, community acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease, and acute pulmonary embolism...
January 10, 2018: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/29317824/selection-of-piperacillin-tazobactam-infusion-mode-guided-by-sofa-score-in-cancer-patients-with-hospital-acquired-pneumonia-a-randomized-controlled-study
#6
Yang Lyu, Yang Yang, Xin Li, Min Peng, Xin He, Peng Zhang, Shangwen Dong, Wanhua Wang, Donghao Wang
Background: This study aimed to select piperacillin/tazobactam (TZP) infusion mode guided by Sequential Organ Failure Assessment (SOFA) score in cancer patients with hospital-acquired pneumonia (HAP) postoperation. Patients and methods: A total of 120 cancer patients with postoperative HAP were divided into two groups: improved administration group (L group) and conventional treatment group (Con group). The Con group received traditional infusion of TZP and the L group received it as prolonged infusion...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29316571/validation-of-three-postoperative-risk-prediction-models-for-intensive-care-unit-mortality-after-cardiac-surgery
#7
Samuel Henry Howitt, Camila Caiado, Charles McCollum, Michael Goldstein, Ignacio Malagon, Rajamiyer Venkateswaran, Stuart William Grant
BACKGROUND:  Several cardiac surgery risk prediction models based on postoperative data have been developed. However, unlike preoperative cardiac surgery risk prediction models, postoperative models are rarely externally validated or utilized by clinicians. The objective of this study was to externally validate three postoperative risk prediction models for intensive care unit (ICU) mortality after cardiac surgery. METHODS:  The logistic Cardiac Surgery Scores (logCASUS), Rapid Clinical Evaluation (RACE), and Sequential Organ Failure Assessment (SOFA) scores were calculated over the first 7 postoperative days for consecutive adult cardiac surgery patients between January 2013 and May 2015...
January 9, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29303209/point-of-care-gastrointestinal-and-urinary-tract-sonography-in-daily-evaluation-of-gastrointestinal-dysfunction-in-critically-ill-patients-guts-protocol
#8
Angel Augusto Perez-Calatayud, Raul Carrillo-Esper, Eduardo Daniel Anica-Malagon, Jesus Carlos Briones-Garduño, Emilio Arch-Tirado, Robert Wise, Manu L N G Malbrain
PURPOSE: There is currently a lack of universally accepted criteria for gastrointestinal (GI) failure or dysfunction in critical care. Also, the clinical assessment of intestinal function is notoriously difficult and thus often goes unrecognized, contributing to poor outcomes. A recent grading system has been proposed to define acute gastrointestinal injury (AGI) in conjunction with other organ function scores (e.g., SOFA). Ultrasonography has become widely accepted as a diagnostic tool for GI problems and pathology...
January 5, 2018: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29291417/performance-of-qsofa-and-sofa-for-predicting-mortality-in-patients-with-acute-pyelonephritis-associated-with-upper-urinary-tract-calculi
#9
Hiroshi Fukushima, Masaki Kobayashi, Keizo Kawano, Shinji Morimoto
PURPOSE: The Sepsis-3 Task Force proposed a new definition of sepsis based on SOFA and introduced a novel scoring system, qSOFA, for screening high-risk patients for sepsis. Their clinical usefulness, however, is unclear. Therefore, we investigated their predictive performance for mortality in APN-UTC patients. MATERIALS AND METHODS: This retrospective study included 141 consecutive patients clinically diagnosed with APN-UTC outside the ICU. We evaluated the performance of qSOFA, SOFA, and SIRS in predicting in-hospital mortality and ICU admission using the AUC of the ROC curve, NRI, IDI, and decision curve analysis...
December 29, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29290034/pharmacokinetics-of-dexmedetomidine-during-analgosedation-in-icu-patients
#10
Piotr Smuszkiewicz, Paweł Wiczling, Justyna Ber, Justyna Warzybok, Tomasz Małkiewicz, Jan Matysiak, Agnieszka Klupczyńska, Iwona Trojanowska, Zenon Kokot, Edmund Grześkowiak, Wojciech Krzyzanski, Agnieszka Bienert
Dexmedetomidine (DEX) is a fairly new alfa2-agonist which has been increasingly used in recent years for analgosedation, mostly because it offers a unique ability of providing both moderate level of sedation and analgesia without respiratory depression. Despite of many papers published, there are still only a few concerning the PK of the drug given as long-term infusion in ICU patients. The aim of this work was to characterize the population pharmacokinetics of dexmedetomidine and to investigate the potential benefits of individualization of drug dosing based on patient characteristics in the heterogeneous group of medical and surgical patients staying in intensive care unit...
December 30, 2017: Journal of Pharmacokinetics and Pharmacodynamics
https://www.readbyqxmd.com/read/29282483/soluble-trem-1-serum-level-can-early-predict-mortality-of-patients-with-sepsis-severe-sepsis-and-septic-shock
#11
Monika Jedynak, Andrzej Siemiatkowski, Barbara Mroczko, Magdalena Groblewska, Robert Milewski, Maciej Szmitkowski
Early prognostic prediction of sepsis is essential in adjusting therapeutic protocols to prevent deterioration and reduce mortality. We compared the predictive value of the serum concentration of the soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) for 28-day mortality and for the development of severe sepsis or septic shock on the third day with the levels of interleukin (IL)-6, C-reactive protein (CRP) and procalcitonin (PCT). The study was conducted on 85 patients with sepsis. sTREM-1, CRP, PCT and IL-6 concentrations were measured upon study inclusion (day 0) and on days 1, 2, 3 and 5...
December 27, 2017: Archivum Immunologiae et Therapiae Experimentalis
https://www.readbyqxmd.com/read/29275503/subjective-and-objective-measures-of-function-and-return-to-work-an-observational-study-with-a-clinical-psychiatric-cohort
#12
Tanja Laukkala, Susanne Heikinheimo, Aki Vuokko, Ilkka S Junttila, Katinka Tuisku
PURPOSE: To evaluate the association between two measurement tools (Social and Occupational Functioning Assessment Scale, SOFAS and Sheehan Disability Scale, SDS), returning to work (RTW) and their inter-correlation. METHODS: 132 psychiatric patients referred to assessment of work ability participated. The association between SOFAS and SDS Work to RTW were assessed by logistic regression. Inter-correlations between SOFAS and SDS were assessed with the Spearman's rho correlation coefficient...
December 23, 2017: Social Psychiatry and Psychiatric Epidemiology
https://www.readbyqxmd.com/read/29273833/prospective-observational-study-on-the-association-between-serum-mannose-binding-lectin-levels-and-severe-outcome-in-critically-ill-patients-with-pandemic-influenza-type-a-h1n1-infection
#13
Elie Zogheib, Remy Nyga, Marjorie Cornu, Boualem Sendid, Julien Monconduit, Vincent Jounieaux, Julien Maizel, Christine Segard, Taïeb Chouaki, Hervé Dupont
BACKGROUND: Mannose-binding lectin (MBL) plays an important role in the innate immune response. In addition to activating the complement, MBL can induce cytokine production and contribute to a deleterious inflammatory response with severe A(H1N1)pdm09 virus infection. Our aim was to determine if serum MBL levels correlate with the risk of mortality in intensive care units (ICU) patients with A(H1N1)pdm09 infection. METHODS: Prospective observational study was performed in ICU patients with acute respiratory distress syndrome due to influenza A(H1N1)pdm09 virus...
December 22, 2017: Lung
https://www.readbyqxmd.com/read/29258809/could-qsofa-and-sofa-score-be-correctly-estimating-the-severity-of-healthcare-associated-pneumonia
#14
Nobuhiro Asai, Hiroki Watanabe, Arufumi Shiota, Hideo Kato, Daisuke Sakanashi, Mao Hagihara, Yusuke Koizumi, Yuka Yamagishi, Hiroyuki Suematsu, Hiroshige Mikamo
The Japanese Respiratory Society newly updated the prognostic guidelines for pneumonia in 2017. Quick Sequential Organ Failure Assessment (qSOFA) and Sequential Organ Failure Assessment (SOFA) score are used to evaluate the severity of pneumonia and to select the therapy for pneumonia. This is a retrospective study at Aichi Medical University hospital from January to December of 2016 to investigate the accuracy and usefulness of qSOFA and SOFA score in evaluating the severity and prognosis of healthcare-associated pneumonia (HCAP)...
December 16, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29251709/benchmarking-clinical-outcomes-and-the-immunocatabolic-phenotype-of-chronic-critical-illness-after-sepsis-in-surgical-intensive-care-unit-patients
#15
Julie A Stortz, Juan C Mira, Steven L Raymond, Tyler J Loftus, Tezcan Ozrazgat-Baslanti, Zhongkai Wang, Gabriela L Ghita, Christiaan Leeuwenburgh, Mark S Segal, Azra Bihorac, Babette A Brumback, Alicia M Mohr, Philip A Efron, Lyle L Moldawer, Frederick A Moore, Scott C Brakenridge
BACKGROUND: A growing number of patients survive sepsis but remain chronically critically ill. We sought to define clinical outcomes and incidence of chronic critical illness (CCI) after sepsis and to determine whether selected biomarkers of inflammation, immunosuppression, and catabolism differ between these patients and those that rapidly recover (RAP). METHODS: This three-year prospective observational cohort study (NCT02276417) evaluated 145 surgical intensive care unit patients with sepsis for the development of CCI (≥14 days of ICU resource utilization with persistent organ dysfunction)...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29246637/usefulness-of-midregional-pro-adrenomedullin-as-a-marker-of-organ-damage-and-predictor-of-mortality-in-patients-with-sepsis
#16
Enrique Bernal-Morell, Eva García-Villalba, Maricarmen Vera, Blanca Medina, Monica Martinez, Victoria Callejo, Salvador Valero, Cesar Cinesi, Pascual Piñera, Antonia Alcaraz, Irene Marin, Angeles Muñoz, Alfredo Cano
BACKGROUND: Midregional proadrenomedullin (MR-proADM) is a prognostic biomarker in patients with community-acquired pneumonia (CAP) and sepsis. In this paper, we examined the ability of MR-proADM to predict organ damage and long-term mortality in sepsis patients, compared to that of procalcitonin, C-reactive protein and lactate. METHODS: This was a prospective observational cohort, enrolling severe sepsis or septic shock patients admitted to internal service department...
December 12, 2017: Journal of Infection
https://www.readbyqxmd.com/read/29242524/clinical-implications-of-the-plasma-epha2-receptor-level-in-critically-ill-patients-with-septic-shock
#17
Su Hwan Lee, Ju Hye Shin, Joo Han Song, Ah Young Leem, Moo Suk Park, Young Sam Kim, Joon Chang, Kyung Soo Chung
The Eph/ephrin receptor ligand system is known to play a role in inflammation induced by infection, injury, and inflammatory diseases. The present study aimed to evaluate plasma EphA2 receptor levels in critically ill patients with sepsis. This study was a prospective cohort study evaluating samples and clinical data from the medical intensive care unit (MICU) of a 2000-bed university tertiary referral hospital in South Korea. Positive correlations of the plasma EphA2 receptor level with the acute physiology and chronic health evaluation (APACHE) II score and the sequential organ failure assessment (SOFA) score were observed...
December 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29242031/prognosis-and-predictors-of-mortality-in-critically-ill-elderly-patients
#18
A Suarez-de-la-Rica, C Castro-Arias, J Latorre, F Gilsanz, E Maseda
OBJECTIVES: to evaluate mortality of patients≥80 years admitted to the Surgical Intensive Care Unit (SICU), global hospital mortality and factors related to it. MATERIAL AND METHODS: observational retrospective study of patients≥80 years admitted to SICU between June 2012 and June 2015. RESULTS: a total of 299 patients were included, 54 of them died in the SICU (18.1%) and 80 patients (26.8%) died during their hospital stay. SICU mortality was independently related to age (OR=1...
December 11, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29237497/hyaluronic-acid-is-associated-with-organ-dysfunction-in-acute-respiratory-distress-syndrome
#19
Anthony J Esposito, Pavan K Bhatraju, Renee D Stapleton, Mark M Wurfel, Carmen Mikacenic
BACKGROUND: Hyaluronic acid (HA), an extracellular matrix component, is degraded in response to local tissue injury or stress. In various animal models of lung injury, HA has been shown to play a mechanistic role in modulating inflammation and injury. While HA is present in the lungs of patients with acute respiratory distress syndrome (ARDS), its relationship to patient outcomes is unknown. METHODS: We studied 86 patients with ARDS previously enrolled in the Phase II Randomized Trial of Fish Oil in Patients with Acute Lung Injury (NCT00351533) at five North American medical centers...
December 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29228380/elderly-versus-nonelderly-patients-with-invasive-aspergillosis-in-the-icu-a-comparison-and-risk-factor-analysis-for-mortality-from-the-aspicu-cohort
#20
D K Matthaiou, G Dimopoulos, F S Taccone, P Bulpa, A M Van den Abeele, B Misset, W Meersseman, H Spapen, T Cardoso, P E Charles, D Vogelaers, S Blot
Data regarding the epidemiology and diagnosis of invasive aspergillosis in the critically ill population are limited, with data regarding elderly patients (≥75 years old) even scarcer. We aimed to further compare the epidemiology, characteristics and outcome of elderly versus nonelderly critically ill patients with invasive aspergillosis (IA) Prospective, international, multicenter observational study (AspICU) including adult intensive care unit (ICU) patients, with a culture and/or direct examination and/or histopathological sample positive for Aspergillus spp...
December 8, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
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