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https://www.readbyqxmd.com/read/29747562/early-ambulation-in-patients-with-external-ventricular-drains-results-of-a-quality-improvement-project
#1
Syed Omar Shah, Jacqueline Kraft, Nethra Ankam, Paula Bu, Kristen Stout, Sara Melnyk, Fred Rincon, M Kamran Athar
INTRODUCTION: Prolonged immobility in patients in the intensive care unit (ICU) can lead to muscle wasting and weakness, longer hospital stays, increased number of days in restraints, and hospital-acquired infections. Increasing evidence demonstrates the safety and feasibility of early mobilization in the ICU. However, there is a lack of evidence in the safety and feasibility of mobilizing patients with external ventricular drains (EVDs). The purpose of this study was to determine the safety and feasibility of early mobility in this patient population...
June 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29730622/early-rehabilitation-to-prevent-postintensive-care-syndrome-in-patients-with-critical-illness-a-systematic-review-and-meta-analysis
#2
Ryota Fuke, Toru Hifumi, Yutaka Kondo, Junji Hatakeyama, Tetsuhiro Takei, Kazuma Yamakawa, Shigeaki Inoue, Osamu Nishida
INTRODUCTION: We examined the effectiveness of early rehabilitation for the prevention of postintensive care syndrome (PICS), characterised by an impaired physical, cognitive or mental health status, among survivors of critical illness. METHODS: We performed a systematic literature search of several databases (Medline, Embase and Cochrane Central Register of Controlled Trials) and a manual search to identify randomised controlled trials (RCTs) comparing the effectiveness of early rehabilitation versus no early rehabilitation or standard care for the prevention of PICS...
May 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29670404/evaluation-of-vancomycin-therapy-in-the-adult-icus-of-a-teaching-hospital-in-southern-iran
#3
Afsaneh Vazin, Motahare Mahi Birjand, Masoud Darake
Background: Vancomycin resistance in intensive care units (ICUs) accounts for significant morbidity and excess costs. The objective of the present study was to determine the appropriateness of vancomycin use in the various ICUs of Nemazee Hospital, Shiraz, Iran. Methods: This prospective study was performed on 95 critically ill patients (48 males and 47 females) who were treated with vancomycin for at least 3 subsequent doses in 6 ICUs during 12 months. Required demographic, clinical, and paraclinical data were collected by a pharmacist...
2018: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/29663999/-analysis-of-high-risk-factors-of-intensive-care-unit-acquired-weakness-in-patients-with-sepsis
#4
Xiaofan Yu, Xiaohong Wan, Linjun Wan, Qingqing Huang
OBJECTIVE: To investigate high risk factors of intensive care unit-acquired weakness (ICUAW) in patients with sepsis. METHODS: A retrospective study was conducted. 164 patients with mechanical ventilation (MV) who were diagnosed sepsis and multiple organ dysfunction syndrome (MODS), admitted to intensive care unit (ICU) of the Second Affiliated Hospital of Kunming Medical University from January 1st, 2015 to September 30th, 2017 were enrolled. The general situation, the basic diseases (hypertension, diabetes), body mass index (BMI), protopathy diseases, the level of albumin before ICU admission, the MV time, whether to use glucocorticoid and continuous renal replacement therapy (CRRT) or not, nutrition supply (nutritional way, nutrition initiation time, amino acid/protein supply, nutritional status on ICU 3 days and 7 days), myoglobin, the length of ICU stay, the length of hospital stay, and acute physiology and chronic health evaluation II (APACHE II) score were collected...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29624594/a-systematic-scoping-review-on-the-consequences-of-stress-related-hyperglycaemia
#5
Elena Olariu, Nicholas Pooley, Aurélie Danel, Montserrat Miret, Jean-Charles Preiser
BACKGROUND: Stress-related hyperglycaemia (SHG) is commonly seen in acutely ill patients and has been associated with poor outcomes in many studies performed in different acute care settings. We aimed to review the available evidence describing the associations between SHG and different outcomes in acutely ill patients admitted to an ICU. Study designs, populations, and outcome measures used in observational studies were analysed. METHODS: We conducted a systematic scoping review of observational studies following the Joanna Briggs methodology...
2018: PloS One
https://www.readbyqxmd.com/read/29610592/predominant-upper-limb-chronic-demyelinating-polyneuropathy-associated-with-hbv-infection
#6
Ioan-Cristian Lupescu, Adriana Octaviana Dulamea
Chronic inflammatory demyelinating polyneuropathy is an acquired, presumably immune-mediated peripheral neuropathy, characterized by symmetric sensory-motor involvement. Although most often idiopathic, it has been described in association with several disorders, sometimes improving under treatment. We present the case of a 57-year-old male who was admitted to hospital for paresthesias and muscle weakness affecting both upper limbs, initially only the hands, but with worsening and ascending progression during the last three years...
December 2017: Mædica
https://www.readbyqxmd.com/read/29595563/one-year-outcomes-in-patients-with-acute-respiratory-distress-syndrome-enrolled-in-a-randomized-clinical-trial-of-helmet-versus-facemask-noninvasive-ventilation
#7
Bhakti K Patel, Krysta S Wolfe, Erica L MacKenzie, Dhafer Salem, Cheryl L Esbrook, Amy J Pawlik, Megan Stulberg, Crystal Kemple, Megan Teele, Erin Zeleny, Julia Macleod, Anne S Pohlman, Jesse B Hall, John P Kress
OBJECTIVES: Many survivors of acute respiratory distress syndrome have poor long-term outcomes possibly due to supportive care practices during "invasive" mechanical ventilation. Helmet noninvasive ventilation in acute respiratory distress syndrome may reduce intubation rates; however, it is unknown if avoiding intubation with helmet noninvasive ventilation alters the consequences of surviving acute respiratory distress syndrome. DESIGN: Long-term follow-up data from a previously published randomized controlled trial...
March 27, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29559814/a-rare-cause-of-fever-in-an-adult-a-case-of-familial-mediterranean-fever
#8
Ilknur Erdem, Fatih Saritas, Ritvan Karaali, Enes Ardic, Gaye Kubra Emeksiz, Sonat Pinar Kara, R Merve Yaniker, Oguzhan Bol
Background: Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease characterized by recurrent fever attacks and serositis. Nonspecific manifestations of the FMF can mimic many common acquired disorders such as infections and acute abdomen. This can delay recognition for many years and lead to comprehensive assessments and even unnecessary surgeries. Untreated FMF may lead to serious complications such as end-stage renal disease and malabsorption due to amyloid deposits in the kidneys and the digestive system...
2018: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/29475169/raoultella-planticola-associated-necrotizing-appendicitis-a-novel-case-report
#9
Gayathri Naganathan, Nalin Kumar Amin
INTRODUCTION: Raoultella Planticola is a gram negative, aerobic, rod bacteria found in water and soil and is rarely reported to cause infections in humans. This case study is the first of its kind in reporting R. planticola appendicitis. PRESENTATION OF CASE: We report a case of a woman presenting with a two-day history of increased weakness, fatigue and anorexia, localized pain to the right lower quadrant, and elevated white blood cell count. CT results demonstrated acute uncomplicated appendicitis which was managed via laparoscopic appendectomy...
2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29466947/stroke-as-an-atypical-initial-presentation-of-giant-cell-arteritis
#10
Tharsika Kuganesan, Allen R Huang
BACKGROUND: Giant cell arteritis (GCA) is an immune mediated inflammatory disease of medium and large arteries which afflicts older people. The classical presentation features include: headache, visual disturbances, and jaw claudication. Patients diagnosed with GCA have also been observed to be at higher risk for the subsequent development of strokes. CASE PRESENTATION: We describe a case of an 84-year old right-handed man who presented to hospital with dysarthria, dysphagia, right-sided facial drop, a history of generalized weakness and multiple falls...
February 21, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29430446/models-of-disuse-muscle-atrophy-therapeutic-implications-in-critically-ill-patients
#11
REVIEW
Esther Barreiro
Skeletal muscle weakness is common in the intensive care units (ICU). Approximately 50% of patients under mechanical ventilation for more than 7 days show signs of ICU-acquired muscle weakness. In these patients, muscle weakness may be the result of axonal polyneuropathy, myopathy or a combination of both. The commonest risk factors in patients with ICU-acquired weakness (AW) are the severity and duration of the systemic inflammatory response, duration of the stay in the ICU and of mechanical ventilation, hyperglycemia, hypoalbuminemia, parenteral nutrition, and administration of corticosteroids and of neuromuscular blocking agents...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29241382/causes-of-mortality-in-icu-acquired-weakness
#12
Linda van Wagenberg, Esther Witteveen, Luuk Wieske, Janneke Horn
BACKGROUND: Intensive care unit-acquired weakness (ICU-AW) is a common complication of critical illness and is associated with increased mortality, longer mechanical ventilation and longer hospital stay. Little is known about the causes of mortality in patients with ICU-AW. In this study, we aimed to give an overview of the causes of death in a population diagnosed with ICU-AW during hospital admission. METHODS: Data from a prospective cohort study in the mixed medical-surgical ICU of the Academic Medical Center in Amsterdam were used...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29074217/systematically-assessed-symptoms-as-outcome-predictors-in-emergency-patients
#13
R Bingisser, M Dietrich, R Nieves Ortega, A Malinovska, T Bosia, C H Nickel
INTRODUCTION: It is known that symptoms are predictive of mortality in "nonsurgical" emergency patients. It is unknown whether a prospective, systematic, and "unscreened" assessment of all symptoms is of any prognostic value. Therefore, we aimed to examine the association between symptoms and outcomes in an all-comer population. METHODS: Data were acquired during 6weeks at the ED of the University Hospital Basel, a tertiary hospital. Consecutive patients presenting to the ED were included...
November 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29061618/critical-care-cycling-study-cyclist-trial-protocol-a-randomised-controlled-trial-of-usual-care-plus-additional-in-bed-cycling-sessions-versus-usual-care-in-the-critically-ill
#14
Marc R Nickels, Leanne M Aitken, James Walsham, Adrian G Barnett, Steven M McPhail
INTRODUCTION: In-bed cycling with patients with critical illness has been shown to be safe and feasible, and improves physical function outcomes at hospital discharge. The effects of early in-bed cycling on reducing the rate of skeletal muscle atrophy, and associations with physical and cognitive function are unknown. METHODS AND ANALYSIS: A single-centre randomised controlled trial in a mixed medical-surgical intensive care unit (ICU) will be conducted. Adult patients (n=68) who are expected to be mechanically ventilated for more than 48 hours and remain in ICU for a further 48 hours from recruitment will be randomly allocated into either (1) a usual care group or (2) a group that receives usual care and additional in-bed cycling sessions...
October 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29026634/hiv-positive-patient-with-gbs-like-syndrome
#15
Samantha J Shepherd, Heather Black, Emma C Thomson, Rory N Gunson
Introduction. Guillain-Barré Syndrome (GBS) is an acute demyelinating polyneuropathy which can occur post-infection. Criteria of diagnosis of GBS include areflexia with progressive bilateral weakness in arms and legs. GBS can lead to severe respiratory and cardiac complications. The fatality rate can be up to 5 % in patients, depending on the severity of the symptoms. HIV can cause a range of neurological disorders including, on rare occasions, GBS. GBS can occur at any stage of HIV infection, highlighting the complexity of diagnosis of GBS within HIV patients...
August 2017: JMM Case Reports
https://www.readbyqxmd.com/read/28951846/effects-of-bu-zhong-yi-qi-tang-for-the-treatment-of-functional-dyspepsia-a-feasibility-study-protocol
#16
Jihye Kim, Hyunho Kim, Keun Ho Kim
BACKGROUND: Bu-Zhong-Yi-Qi-Tang (BZYQT) has long been used for the treatment of severe weakness caused by general fatigue, loss of appetite, or indigestion. The aim of this feasibility study is to assess the effectiveness and safety of BZYQT for the treatment of functional dyspepsia (FD) with spleen qi deficiency. METHODS: This study will be conducted at a single center as a prospective, nonrandomized, nonblinded, single-arm feasibility study. A total of 30 participants diagnosed with FD in accordance with the Rome III criteria will be enrolled...
September 2017: Integrative Medicine Research
https://www.readbyqxmd.com/read/28936613/chronic-inflammatory-demyelinating-polyradiculoneuropathy-and-anesthesia-a-case-series
#17
Andrew R Mortenson, Juraj Sprung, James C Watson, P James B Dyck, Toby N Weingarten
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired autoimmune demyelinating polyneuropathy characterized by symmetrical diffuse weakness that also can rarely affect bulbar and respiratory muscles. The study objective was to describe perioperative outcomes of patients with CIDP who received general anesthesia. This retrospective observational study evaluated patients with active (diagnosed or treated within the previous year) CIDP who underwent general anesthesia at our institution between January 1, 2010, and December 31, 2015...
September 21, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28868229/a-very-unlikely-finding-in-a-male-child-urethral-prolapse
#18
Çiğdem Ulukaya Durakbaşa, Gonca Gercel, Murat Huseyin Mutus, Burhan Aksu, Seyma Ozkanli
Urethral prolapse is a disease of prepubertal black girls and postmenopausal women with an unknown cause. It may be congenital in origin or an acquired condition. It has never been reported in males. We report a 10-year-old Caucasian boy who presented because of recurrent right undescended testis. He had been operated on for bilateral undescended testes 7 years ago in another hospital, and circumcision was done during the same operation. The boy complained of a weak urinary stream during voiding. The physical examination was consistent with recurrent right undescended testis...
January 2017: European Journal of Pediatric Surgery Reports
https://www.readbyqxmd.com/read/28790049/cor-triatriatum-and-stroke
#19
Jose Danilo Bengzon Diestro, Joseph Justin Hipolito Regaldo, Eddieson Masangcay Gonzales, Maria Kristina Casanova Dorotan, Adrian Isidro Espiritu, Jose Leonard Rivera Pascual
Cor triatriatum sinistrum (CTS) is a congenital anomaly where the left atrium is divided into two compartments by a fibromuscular membrane. This report aims to add to the literature on a rare cardiac condition that can cause neurological morbidity. We report a case of a 19-year-old female with an infarct in the right middle cerebral artery (MCA) territory initially maintained on aspirin. Eighteen months later, she had recurrence of weakness, for which repeat transthoracic echocardiography (TTE) and re-evaluation of the first TTE demonstrated a hyperechoic membrane spanning the width of the left atrium, clinching the diagnosis of CTS...
August 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28748673/neurological-complications-during-treatment-of-middle-east-respiratory-syndrome
#20
Jee Eun Kim, Jae Hyeok Heo, Hye Ok Kim, Sook Hee Song, Sang Soon Park, Tai Hwan Park, Jin Young Ahn, Min Ky Kim, Jae Phil Choi
BACKGROUND AND PURPOSE: Middle East respiratory syndrome (MERS) has a high mortality rate and pandemic potential. However, the neurological manifestations of MERS have rarely been reported since it first emerged in 2012. METHODS: We evaluated four patients with laboratory-confirmed MERS coronavirus (CoV) infections who showed neurological complications during MERS treatment. These 4 patients were from a cohort of 23 patients who were treated at a single designated hospital during the 2015 outbreak in the Republic of Korea...
July 2017: Journal of Clinical Neurology
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