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https://www.readbyqxmd.com/read/28813495/establishing-failure-predictors-for-the-planned-extubation-of-overweight-and-obese-patients
#1
Chien-Ming Chao, Chih-Cheng Lai, Ai-Chin Cheng, Shyh-Ren Chiang, Wei-Lun Liu, Chung-Han Ho, Shu-Chen Hsing, Chin-Ming Chen, Kuo-Chen Cheng
We investigated failure predictors for the planned extubation of overweight (body mass index [BMI] = 25.0-29.9) and obese (BMI ≥ 30) patients. All patients admitted to the adult intensive care unit (ICU) of a tertiary hospital in Taiwan were identified. They had all undergone endotracheal intubation for > 48 h and were candidates for extubation. During the study, 595 patients (overweight = 458 [77%]); obese = 137 [23%]) with planned extubation after weaning were included in the analysis; extubation failed in 34 patients (5...
2017: PloS One
https://www.readbyqxmd.com/read/28813492/point-prevalence-survey-of-healthcare-facility-onset-healthcare-associated-clostridium-difficile-infection-in-greek-hospitals-outside-the-intensive-care-unit-the-c-define-study
#2
Athanasios Skoutelis, Angelos Pefanis, Sotirios Tsiodras, Nikolaos V Sipsas, Moyssis Lelekis, Marios C Lazanas, Panagiotis Gargalianos, George N Dalekos, Emmanuel Roilides, George Samonis, Efstratios Maltezos, Dimitrios Hatzigeorgiou, Malvina Lada, Symeon Metallidis, Athena Stoupis, Georgios Chrysos, Lazaros Karnesis, Styliani Symbardi, Chariclia V Loupa, Helen Giamarellou, Ioannis Kioumis, Helen Sambatakou, Epameinondas Tsianos, Maria Kotsopoulou, Areti Georgopali, Klairi Liakou, Stavroula Perlorentzou, Stamatina Levidiotou, Marina Giotsa-Toutouza, Helen Tsorlini-Christoforidou, Ilias Karaiskos, Georgia Kouppari, Eleftheria Trikka-Graphakos, Maria-Anna Ntrivala, Kate Themeli-Digalaki, Anastasia Pangalis, Melina Kachrimanidou, Maria Martsoukou, Stergios Karapsias, Maria Panopoulou, Sofia Maraki, Anagnostina Orfanou, Efthymia Petinaki, Maria Orfanidou, Vasiliki Baka, Antonios Stylianakis, Iris Spiliopoulou, Stavroula Smilakou, Loukia Zerva, Evangelos Vogiatzakis, Eleni Belesiotou, Charalambos A Gogos
BACKGROUND: The correlation of Clostridium difficile infection (CDI) with in-hospital morbidity is important in hospital settings where broad-spectrum antimicrobial agents are routinely used, such as in Greece. The C. DEFINE study aimed to assess point-prevalence of CDI in Greece during two study periods in 2013. METHODS: There were two study periods consisting of a single day in March and another in October 2013. Stool samples from all patients hospitalized outside the ICU aged ≥18 years old with diarrhea on each day in 21 and 25 hospitals, respectively, were tested for CDI...
2017: PloS One
https://www.readbyqxmd.com/read/28813449/influenza-virus-infections-among-patients-attending-emergency-department-according-to-main-reason-to-presenting-to-ed-a-3-year-prospective-observational-study-during-seasonal-epidemic-periods
#3
Enrique Casalino, Stephanie Antoniol, Nadhira Fidouh, Christophe Choquet, Jean-Christophe Lucet, Xavier Duval, Benoit Visseaux, Laurent Pereira
OBJECTIVE: The role of influenza virus in patients presenting at ED during seasonal-epidemic periods has not previously been specified. Our objective was to determine its frequency according to clinical presentation. METHODS: This is a prospective observational study conducted during three-consecutive seasonal Influenza epidemics (2013-2015), including patients presenting i) community-acquired pneumonia (CAP); ii) severe acute symptoms (SAS): respiratory failure (RF), hemodynamic failure (HF), cardiac failure (CF), and miscellaneous symptoms (M); iii) symptoms suggesting influenza (PSSI)...
2017: PloS One
https://www.readbyqxmd.com/read/28813205/combining-2-commonly-adopted-nutrition-instruments-in-the-critical-care-setting-is-superior-to-administering-either-one-alone
#4
Charles Chin Han Lew, Ka Po Cheung, Mary Foong Fong Chong, Ai Ping Chua, Robert J L Fraser, Michelle Miller
BACKGROUND: This study aimed to determine the agreement between the modified Nutrition Risk in Critically ill Score (mNUTRIC) and the Subjective Global Assessment (SGA) and compare their ability in discriminating and quantifying mortality risk independently and in combination. METHODS: Between August 2015 and October 2016, all patients in a Singaporean hospital received the SGA within 48 hours of intensive care unit admission. Nutrition status was dichotomized into presence or absence of malnutrition...
August 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28813053/copper-ii-benzimidazole-complexes-as-efficient-fluorescent-probes-for-l-cysteine-in-water
#5
Duraiyarasu Maheshwaran, Selvarasu Priyanga, Ramasamy Mayilmurugan
Copper(ii) complexes [Cu(L1)(H2O)2](SO3CF3)21 and [Cu(L2)(H2O)2](SO3CF3)22 based on 2,6-bis(benzimidazolyl)pyridine were synthesized and are reported herein as highly selective "turn-on" optical probes for l-cysteine. The Cu(ii)/Cu(i) redox potential of probe 1 (0.14 V vs. NHE) was lower than that of 2 (0.233 V vs. NHE) in water. The molecular structure of 2 adopted a square pyramidal geometry (τ = 0.2545), with the Cu-Npy bond (1.958 Å) of its middle pyridine unit being shorter than the other two Cu-Nbenzim bonds (Cu-N, 1...
August 16, 2017: Dalton Transactions: An International Journal of Inorganic Chemistry
https://www.readbyqxmd.com/read/28811766/prognostic-factors-determining-morbidity-and-mortality-in-organophosphate-poisoning
#6
Ayca Acikalin, Nezihat Rana Dişel, Selcuk Matyar, Ahmet Sebe, Zeynep Kekec, Yuksel Gokel, Emre Karakoc
OBJECTIVE: Our aim in this retrospective study was to determine the factors affecting poor prognosis and mortality of organophosphate (OP) poisoning by reviewing patient data. We also reviewed present knowledge to make conclusions on certain longstanding debates in light of the literature. METHODS: In this retrospective descriptive study, patients who were admitted to and hospitalized in the emergency department (ED) or intensive care unit (ICU) of a university hospital with the diagnosis of OP poisoning between December 2010 and December 2015 were evaluated...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28811237/the-in-validity-of-volatile-poct-parameters-from-patients-beyond-normothermia
#7
Michael A Gruber, Stefan Felbermeir, Regina Lindner, Martin Kieninger
BACKGROUND: A common characteristic of all blood gas analyzers on the market is that measurements are processed at 37°C, not at the real patients´ temperature. Subsequently temperature-sensitive parameters can be mathematically corrected (alpha-stat method) or used directly (pH-stat method). National rules in Germany (Rili-BAEK) demand defined accuracy and precision without any restriction to samples´ temperatures or corrections. As consequence in the investigation at hand we tried to find out whether blood gas analyzers can fulfill the regulations for pCO2 and pO2 when normothermia of the matrix is not given...
August 12, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28811085/the-use-of-phenobarbital-and-other-anti-seizure-drugs-in-newborns
#8
REVIEW
Mohamed El-Dib, Janet S Soul
Neonatal seizures constitute the most frequent presenting neurologic sign encountered in the neonatal intensive care unit. Despite limited efficacy and safety data, phenobarbital continues to be used near-universally as the first-line anti-seizure drug (ASD) in neonates. The choice of second-line ASDs varies by provider and institution, and is still not supported by sufficient scientific evidence. In this review, we discuss the available evidence supporting the efficacy, mechanism of action, potential adverse effects, key pharmacokinetic characteristics such as interaction with therapeutic hypothermia, logistical issues, and rationale for use of neonatal ASDs...
August 12, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28811051/patient-blood-management-in-the-intensive-care-unit
#9
REVIEW
Aryeh Shander, Mazyar Javidroozi, Gregg Lobel
Patient Blood Management underscores a fundamental shift from a product-centered approach to a patient-centric approach through timely application of evidence-based medical and surgical concepts designed to maintain hemoglobin concentration, optimize hemostasis, and minimize blood loss in an effort to improve patient outcome. In this concept, allogeneic blood transfusion is not viewed as the treatment of default for anemic patients, but one among many treatment modalities that should be weighed based on its merits-potentials risks and benefits-for the individual patient in the context of other alternatives...
July 31, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28810921/the-role-of-whole-body-computed-tomography-in-the-diagnosis-of-thoracic-injuries-in-severely-injured-patients-a-retrospective-multi-centre-study-based-on-the-trauma-registry-of-the-german-trauma-society-traumaregister-dgu-%C3%A2
#10
Patricia Lang, Martin Kulla, Fabian Kerwagen, Rolf Lefering, Benedikt Friemert, Hans-Georg Palm
BACKGROUND: Thoracic injuries are a leading cause of death in polytrauma patients. Early diagnosis and treatment are of paramount importance. Whole-body computed tomography (WBCT) has largely replaced traditional imaging techniques such as conventional radiographs and focused computed tomography (CT) as diagnostic tools in severely injured patients. It is still unclear whether WBCT has led to higher rates of diagnosis of thoracic injuries and thus to a change in outcomes. METHODS: In a retrospective study based on the trauma registry of the German Trauma Society (TraumaRegister DGU(®)), we analysed data from 16,545 patients who underwent treatment in 59 hospitals between 2002 and 2012 (ISS ≥ 9)...
August 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28810817/struggles-over-antibiotics-physicians-stance-taking-toward-a-nonconforming-policy-in-an-intensive-care-unit
#11
Letizia Caronia, Marzia Saglietti
One of the most pressing contemporary health care challenges consists in rethinking antibiotic use to contrast the increase of multidrug resistant bacteria. Drawing on an ethnographic fieldwork in an Intensive Care Unit that adopts a nonconforming policy of antibiotic stewardship, this article analyzes doctor-doctor interaction concerning infectious disease diagnosis and antibiotic treatment. By analyzing examples of medical decision-making from a corpus of video-recorded morning briefings, we focus on physicians' stance-taking toward the ward's nonconforming policy and illustrate how it is contingently situated along a continuum from strong commitment to overt resistance...
August 1, 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28810610/microbial-investigations-in-throat-swab-and-tracheal-aspirate-specimens-are-beneficial-to-predict-the-corresponding-endotracheal-tube-biofilm-flora-among-intubated-neonates-with-ventilator-associated-pneumonia
#12
Yun Pan, Lizhong Du, Qing Ai, Sijie Song, Xiaoli Tang, Danping Zhu, Jialin Yu
Ventilator-associated pneumonia (VAP) is a common nosocomial infection in neonatal intensive care units with high morbidity and mortality. Bacterial biofilm in the endotracheal tube (ET) provides a notable and persistent source of pathogens that may cause VAP, and thus is important for VAP detection. However, during intubation microbial investigations in ET, samples are unavailable due to the infeasibility of collecting ET samples during intubation of neonates. It is therefore of great importance to find alternative sources of samples that can help identify the ET biofilm flora...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28810239/the-prevalence-of-and-factors-related-to-vascular-hyperintensity-on-t1-weighted-imaging-in-acute-ischemic-stroke
#13
Yuki Sakamoto, Seiji Okubo, Chikako Nito, Satoshi Suda, Noriko Matsumoto, Arata Abe, Junya Aoki, Takashi Shimoyama, Kanako Muraga, Takuya Kanamaru, Kentaro Suzuki, Yuki Go, Masahiro Mishina, Kazumi Kimura
BACKGROUND: Thrombus visualization in patients with acute ischemic stroke has been detected and reported using various imaging modalities. T1-weighted imaging (T1-WI) can depict thrombi as hyperintense signals within vessels. Moreover, in addition to thrombi, T1-WI hyperintensities in arteries may suggest arterial dissection. However, the frequency of and factors related to the T1-hyperintense vessel sign (T1-HVS) are not fully known. The aim of this study was to clarify the prevalence of and related factors for the T1-HVS in patients with acute ischemic stroke...
August 16, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28810207/intermediate-care-to-intensive-care-triage-a-quality-improvement-project-to-reduce-mortality
#14
David N Hager, Pranav Chandrashekar, Robert W Bradsher, Ali M Abdel-Halim, Souvik Chatterjee, Melinda Sawyer, Roy G Brower, Dale M Needham
PURPOSE: Medical patients whose care needs exceed what is feasible on a general ward, but who do not clearly require critical care, may be admitted to an intermediate care unit (IMCU). Some IMCU patients deteriorate and require medical intensive care unit (MICU) admission. In 2012, staff in the Johns Hopkins IMCU expressed concern that patient acuity and the threshold for MICU admission were too high. Further, shared triage decision-making between residents and supervising physicians did not consistently occur...
August 3, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28809518/mir-542-promotes-mitochondrial-dysfunction-and-smad-activity-and-is-raised-in-icu-acquired-weakness
#15
Roser Farre Garros, Richard Paul, Martin Connolly, Amy Lewis, Benjamin E Garfield, S Amanda Natanek, Susannah Bloch, Vincent Mouly, Mark J Griffiths, Michael I Polkey, Paul R Kemp
RATIONALE: Loss of skeletal muscle mass and function is a common consequence of critical illness and a range of chronic diseases but the mechanisms by which this occurs are unclear. OBJECTIVES: We aimed to identify miRNAs that were increased in the quadriceps of patients with muscle wasting and to determine the molecular pathways by which they contributed to muscle dysfunction. METHODS: miR-542-3p/-5p were quantified in the quadriceps of patients with COPD and intensive care unit acquired weakness (ICUAW)...
August 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28808927/lymphopaenia-in-cardiac-arrest-patients
#16
Paola Villois, David Grimaldi, Savino Spadaro, Claudia Righy Shinotsuka, Vito Fontana, Sabino Scolletta, Federico Franchi, Jean-Louis Vincent, Jacques Creteur, Fabio Silvio Taccone
BACKGROUND: A decrease in circulating lymphocytes has been described as a marker of poor prognosis after septic shock; however, scarce data are available after cardiac arrest (CA). The aim of this study was to evaluate the impact of lymphopaenia after successful cardiopulmonary resuscitation. METHODS: This is a retrospective analysis of an institutional database including all adult CA patients admitted to the intensive care unit (ICU) between January 2007 and December 2014 who survived for at least 24 h...
August 14, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28808901/the-utility-of-routine-intensive-care-admission-for-patients-undergoing-intracranial-neurosurgical-procedures-a-systematic-review
#17
Cesar Cimonari de Almeida, M Dustin Boone, Yosef Laviv, Burkhard S Kasper, Clark C Chen, Ekkehard M Kasper
BACKGROUND: Patients who have undergone intracranial neurosurgical procedures have traditionally been admitted to an intensive care unit (ICU) for close postoperative neurological observation. The purpose of this study was to systematically review the evidence for routine ICU admission in patients undergoing intracranial neurosurgical procedures and to evaluate the safety of alternative postoperative pathways. METHODS: We were interested in identifying studies that examined selected patients who presented for elective, non-emergent intracranial surgery whose postoperative outcomes were compared as a function of ICU versus non-ICU admission...
August 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28808879/influence-of-ignited-sediments-on-external-phosphorus-adsorption-and-sedimentary-phosphorus-forms
#18
PeiYing Zhu, DaPeng Li, Yong Huang, Yong Li
Phosphorus (P) adsorpted by sediments, when covered by and mixed with ignited sediments from Meiliang Bay in Tai Lake, was analyzed in the laboratory. Potassium dihydrogen phosphate (KH2PO4) was added to the parallel experimental units to simulate periodic external P input. Based on the Langmuir model, the sediments after ignition had a greater Smax (maximum P adsorption), a lower equilibrium phosphorus concentration at zero adsorption (EPC0), and a lower degree of phosphorus saturation in comparison with sediments without ignition...
August 15, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28808668/physician-preferences-for-aggressive-treatment-at-the-end-of-life-and-area-level-health-care-spending-the-johns-hopkins-precursors-study
#19
Joseph J Gallo, Martin S Andersen, Seungyoung Hwang, Lucy Meoni, Ravishankar Jayadevappa
Objective: To determine whether physician preferences for end-of-life care were associated with variation in health care spending. Method: We studied 737 physicians who completed the life-sustaining treatment questionnaire in 1999 and were linked to end-of-life care data for the years 1999 to 2009 from Medicare-eligible beneficiaries from the Dartmouth Atlas of Health Care (in hospital-related regions [HRRs]). Using latent class analysis to group physician preferences for end-of-life treatment into most, intermediate, and least aggressive categories, we examined how physician preferences were associated with health care spending over a 7-year period...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/28808508/new-onset-acute-thrombocytopenia-in-hospitalized-patients-pathophysiology-and-diagnostic-approach
#20
REVIEW
Naveed Ali, Herbert E Auerbach
Thrombocytopenia is a hematological finding commonly encountered in daily clinical practice from asymptomatic clinic patients to critically ill intensive care unit patients. A broad spectrum of etiologies and variation in clinical presentation often present a diagnostic challenge. Furthermore, concomitant presence of thrombosis and thrombocytopenia, as in cases of thrombotic thrombocytopenia, complicates the management. In hospitalized patients, new-onset thrombocytopenia is an important reason for hematology consultation...
July 2017: Journal of Community Hospital Internal Medicine Perspectives
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