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https://www.readbyqxmd.com/read/28219190/-efficacy-and-safety-of-procalcitonin-guidance-in-reducing-the-duration-of-antibiotic-treatment-of-sepsis-patients
#1
X L Xu, F D Yan, J Q Yu, Q H Chen, H Lin, R Q Zheng
Objective: To assesse the efficacy and safety of procalcitonin-guided antibiotic treatment of sepsis patients in intensive care units (ICU). Methods: A prospective, randomised, controlled trial was gone in ICU of Northern Jiangsu People's Hospital.Between January 2013 and December 2015.One hundred and fifty-six patients assessed for eligibility were randomly assigned to the procalcitonin-guided group (PCT group, 79) or to regular antibiotic group (RAT group, 77). Patients who received antibiotics for presumed infection according to principle of antimicrobial usage...
February 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28215127/characteristics-and-outcomes-of-critically-ill-patients-with-drug-overdose-in-australia-and-new-zealand
#2
Luca Cioccari, Nora Luethi, Michael Bailey, David Pilcher, Rinaldo Bellomo
OBJECTIVE: The epidemiology of patients admitted to the intensive care unit after a drug overdose (OD) is poorly defined. We aimed to study the incidence, characteristics and outcomes of patients admitted to the ICU because of OD in Australia and New Zealand. DESIGN, SETTING AND PATIENTS: Retrospective study of data from the Australian and New Zealand Intensive Care Society Adult Patient Database, including all patients admitted to an ICU with OD from 2005 to 2013...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28204902/-medical-rehabilitation-from-a%C3%A2-lifespan-perspective
#3
Michael Linden, Sebastian Bernert, Ariane Funke, Karsten E Dreinhöfer, Michael Jöbges, Ernst von Kardorff, Steffi G Riedel-Heller, Karla Spyra, Heinz Völler, Petra Warschburger, Pia-Maria Wippert
Lifespan research investigates the development of individuals over the course of life. As medical rehabilitation deals with primary and secondary prophylaxis, treatment, and compensation of chronic illnesses, a lifespan perspective is needed for the classification and diagnosis of chronic disorders, the assessment of course modifying factors, the identification of vulnerable life periods and critical incidents, the implementation of preventive measures, the development of methods for the evaluation of prior treatments, the selection and prioritization of interventions, including specialized inpatient rehabilitation, the coordination of therapies and therapists, and for evaluations in social and forensic medicine...
February 15, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/28198758/medication-reconciliation-failures-in-children-and-young-adults-with-chronic-disease-during-intensive-and-intermediate-care
#4
Danielle D DeCourcey, Melanie Silverman, Esther Chang, Al Ozonoff, Carolyn Stickney, Darla Pichoff, Alexandra Oldershaw, Jonathan A Finkelstein
OBJECTIVES: Although medication reconciliation has become standard during hospital admission, rates of unintentional medication discrepancies during intensive care of pediatric patients with chronic disease are unknown. Such discrepancies are an important cause of adverse drug events in adults with chronic illness and are associated with unintentional discontinuation of chronic medications. We sought to determine the rate, type, timing, and predictors of potentially harmful unintentional medication discrepancies in children and young adults with chronic disease...
February 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28191008/the-nlrp3-and-pyrin-inflammasomes-implications-in-the-pathophysiology-of-autoinflammatory-diseases
#5
REVIEW
Carlos de Torre-Minguela, Pablo Mesa Del Castillo, Pablo Pelegrín
Inflammasomes are multiprotein complexes that critically control different aspects of innate and adaptive immunity. Among them we could highlight the release of pro-inflammatory cytokines that induce and maintain the inflammatory response. Usually, inflammasomes result from oligomerization of a nucleotide-binding domain-like receptor (NLR) after sensing different pathogenic or endogenous sterile dangerous signals; however, other proteins such as absent in melanoma 2, retinoic acid-inducible gene I, or pyrin could also form inflammasome platforms...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28162841/adherence-to-attention-deficit-hyperactivity-disorder-medication-during-the-transition-to-college
#6
Megan R Schaefer, Alana Resmini Rawlinson, Scott T Wagoner, Steven K Shapiro, Jan Kavookjian, Wendy N Gray
PURPOSE: The present study explores the medication self-management experiences of adolescents with attention-deficit/hyperactivity disorder (ADHD) during their transition to young adulthood in college. METHODS: Participants were college freshmen with ADHD prescribed daily medication for their condition. Ten individual interviews were conducted using a semistructured interview script. Measures related to ADHD medication management were also completed. Qualitative data were analyzed via directed content analysis and quantitative data via descriptive statistics...
February 2, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28160956/the-role-of-liver-function-in-the-setting-of-cirrhosis-with-chronic-infection-and-critical-illness
#7
REVIEW
Susan Lee, Latanja Divens, Leanne H Fowler
The patient with sepsis in the setting of hepatitis C virus (HCV)-related cirrhosis can have a more rapid decline in other organ dysfunction during critical illness and faces further increase in the risk for death. This article discusses the role of liver function in the patient with a systemic critical illness in contrast to the worsened pathophysiology of the patient with cirrhosis secondary to chronic HCV infection and critical illness, inpatient and posthospitalization management of the critically ill patient with chronic HCV-related cirrhosis, and the nursing implications and recommendations for future research for this population...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28153190/acute-pd-evidence-guidelines-and-controversies-%C3%A2
#8
REVIEW
Daniela Ponce, Andre Balbi, Brett Cullis
Peritoneal dialysis (PD) may be a feasible, safe, and complementary alternative to hemodialysis not only in the chronic setting, but also in the acute setting. It previously was widely accepted for acute kidney injury (AKI) treatment, but its practice decreased in favor of other types of extracorporeal therapies. The interest in PD to manage AKI patients has been reignited and PD now frequently is used in developing countries because of its lower cost and minimal infrastructural requirements. Studies from these countries have shown that, with careful thought and planning, critically ill patients can be treated successfully using PD...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28152732/reducing-pain-agitation-and-delirium-to-optimize-outcomes-in-mechanically-ventilated-critically-ill-oncology-patients
#9
Dana Bullick, Sharon Barniak, Joanne McGovern, Trisha Patel, Jeffrey Hoag
: 233 Background: Greater than 60% of cancer patients experience chronic pain which is heightened in critical illness. Optimal pain assessment is challenging in the critically ill leading to under treatment due to sedation during mechanical ventilation (MV). The Society of Critical Care Medicine (SCCM) favors treating pain with intermittent boluses rather than continuous infusions; however,appropriate analgesic doses and means of titration are elusive leading to over sedation, prolonged ventilation, and delirium...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152666/provision-of-critical-care-services-to-hiv-infected-children-in-an-era-of-advanced-intensive-care-and-availability-of-combined-antiretroviral-therapy
#10
Prakash M Jeena, Miriam Adhikari
Intensive care facilities are always in demand in the public sector and there is constant competition for beds. Appropriate allocation of children to these resources is based on the ethical principles of distributive justice and beneficence that is determined on the presumed short-term outcome of the acute illness, long-term outcome of the underlying chronic disease and the overall demand for these facilities. At the onset of the HIV epidemic in South Africa, HIV-infected children were refused admission to the paediatric intensive care unit (PICU) on the basis of poor ICU outcomes and the lack of provision of combined antiretroviral therapy (cART) for survivors...
February 3, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28149825/correlations-between-pulmonary-artery-pressures-and-inferior-vena-cava-collapsibility-in-critically-ill-surgical-patients-an-exploratory-study
#11
Stanislaw P Stawicki, Thomas J Papadimos, David P Bahner, David C Evans, Christian Jones
INTRODUCTION: As pulmonary artery catheter (PAC) use declines, search continues for reliable and readily accessible minimally invasive hemodynamic monitoring alternatives. Although the correlation between inferior vena cava collapsibility index (IVC-CI) and central venous pressures (CVP) has been described previously, little information exists regarding the relationship between IVC-CI and pulmonary artery pressures (PAPs). The goal of this study is to bridge this important knowledge gap...
October 2016: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28144827/biomarkers-for-musculoskeletal-pain-conditions-use-of-brain-imaging-and-machine-learning
#12
REVIEW
Jeff Boissoneault, Landrew Sevel, Janelle Letzen, Michael Robinson, Roland Staud
Chronic musculoskeletal pain condition often shows poor correlations between tissue abnormalities and clinical pain. Therefore, classification of pain conditions like chronic low back pain, osteoarthritis, and fibromyalgia depends mostly on self report and less on objective findings like X-ray or magnetic resonance imaging (MRI) changes. However, recent advances in structural and functional brain imaging have identified brain abnormalities in chronic pain conditions that can be used for illness classification...
January 2017: Current Rheumatology Reports
https://www.readbyqxmd.com/read/28144059/epidemiological-profile-of-acute-respiratory-distress-syndrome-patients-a-tertiary-care-experience
#13
Rahul Magazine, Shobitha Rao, Bharti Chogtu, Ramkumar Venkateswaran, Hameed Aboobackar Shahul, Umesh Goneppanavar
BACKGROUND: Acute respiratory distress syndrome (ARDS) is seen in critically ill patients. Its etiological spectrum in India is expected to be different from that seen in western countries due to the high prevalence of tropical infections. AIM: To study the epidemiological profile of ARDS patients. SETTING: A tertiary care hospital in Karnataka, India. MATERIALS AND METHODS: Retrospective analysis of 150 out of the 169 ARDS patients diagnosed during 2010-2012...
January 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28142264/annals-express-neutrophil-gelatinase-associated-lipocalin-is-a-better-biomarker-than-cystatin-c-for-predicting-imminent-acute-kidney-injury-in-critically-ill-patients
#14
Itir Yegenaga, Fatih Kamis, Canan Baydemir, Elizade Erdem, Koray Celebi, Necmi Eren, Nur Baykara
AIMS: The prevention of acute kidney injury (AKI) can be lifesaving for intensive care unit (ICU) patients. However, conventional methods are not sufficient for predicting the risk for approaching AKI. In this study, the promising biomarker NGAL(neutrophil gelatinase-associated lipocalin) was compared to CysC (Cystatin C ) for indicating risk of future AKI. METHODS: One hundred eighty-three adult patients without chronic kidney disease or renal replacement therapy were included in this study...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/28139396/heme-oxygenase-1-as-a-therapeutic-target-in-acute-kidney-injury
#15
Subhashini Bolisetty, Abolfazl Zarjou, Anupam Agarwal
A common clinical condition, acute kidney injury (AKI) significantly influences morbidity and mortality, particularly in critically ill patients. The pathophysiology of AKI is complex and involves multiple pathways, including inflammation, autophagy, cell-cycle progression, and oxidative stress. Recent evidence suggests that a single insult to the kidney significantly enhances the propensity to develop chronic kidney disease. Therefore, the generation of effective therapies against AKI is timely. In this context, the cytoprotective effects of heme oxygenase 1 (HO-1) in animal models of AKI are well documented...
January 27, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28133685/impact-of-acute-kidney-injury-on-long-term-mortality-and-progression-to-chronic-kidney-disease-among-critically-ill-children
#16
Najlaa G Al-Otaibi, Maryam Zeinelabdin, Mohamed A Shalaby, Norah Khathlan, Ghadi D Mashat, Amal A Zahrani, Sundus Mw NoorSaeed, Nora M Shalabi, Khalid A Alhasan, Sara N Sharief, Amr S Albanna, Jameela A Kari
To determine the 2-year outcome of acute kidney injury (AKI) following admission to pediatric critical care units (PICU). Methods: A retrospective cohort study was conducted between January 2012 and December 2013. We followed 131 children admitted to PICU, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia with a diagnosis of AKI, based on pRIFLE (pediatric risk, injury, failure, loss, and end-stage renal disease), for 2 years. During the study period, 46 children died and 38 of survivors completed the follow-up...
February 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28131530/cystatin-c-guided-vancomycin-dosing-in-critically-ill-patients-a%C3%A2-quality-improvement-project
#17
Erin Frazee, Andrew D Rule, John C Lieske, Kianoush B Kashani, Jason N Barreto, Abinash Virk, Philip J Kuper, Ross A Dierkhising, Nelson Leung
BACKGROUND: The aim of the study was to determine whether a vancomycin dosing algorithm based on estimated glomerular filtration rate from creatinine and cystatin C levels (eGFRcr-cys) improves target trough concentration achievement compared to an algorithm based on estimated creatinine clearance (eCLcr) in critically ill patients. STUDY DESIGN: This prospective quality improvement project evaluated intensive care unit (ICU) patients started on intravenous vancomycin using one of 2 different strategies...
January 25, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28130203/ehealth-literacy-predictors-in-a-population-with-moderate-to-high-cardiovascular-risk
#18
Sarah S Richtering, Karice Hyun, Lis Neubeck, Genevieve Coorey, John Chalmers, Tim Usherwood, David Peiris, Clara K Chow, Julie Redfern
BACKGROUND: Electronic health (eHealth) literacy is a growing area of research parallel to the ongoing development of eHealth interventions. There is, however, little and conflicting information regarding the factors that influence eHealth literacy, notably in chronic disease. We are similarly ill-informed about the relationship between eHealth and health literacy, 2 related yet distinct health-related literacies. OBJECTIVE: The aim of our study was to investigate the demographic, socioeconomic, technology use, and health literacy predictors of eHealth literacy in a population with moderate-to-high cardiovascular risk...
January 27, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28128746/no-relationship-between-red-blood-cell-distribution-width-and-microcirculatory-alterations-in-septic-patients
#19
Vito Fontana, Savino Spadaro, Ottavia Bond, Federica Zama Cavicchi, Filippo Annoni, Katia Donadello, Jean-Louis Vincent, Daniel De Backer, Fabio Silvio Taccone
BACKGROUND: Increased red cell distribution width (RDW), a quantitative measure of erythrocyte size variability, has been associated with increased mortality in critically ill patients. METHODS: In this post-hoc analysis of prospectively collected data, we studied 122 septic patients with and without shock who had undergone sublingual microcirculatory assessment using Sidestream Dark Field (SDF) videomicroscopy. Patient demographics, comorbidities, the Acute Physiology and Chronic Health Evaluation (APACHE) II score on admission and the Sequential Organ Failure Assessment (SOFA) score on the day of the microcirculatory assessment were collected...
January 27, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28127124/optimizing-laboratory-test-utilization-in-long-term-acute-care-hospitals
#20
Adan Mora, Brian S Krug, Antony M Grigonis, Amanda Dawson, Yuqing Jing, Samuel I Hammerman
Laboratory tests can be considered inappropriate if overused or when repeated, unnecessary "routine" testing occurs. For chronically critically ill patients treated in long-term acute care hospitals (LTACHs), inappropriate testing may result in unnecessary blood draws that could potentially harm patients or increase infections. A quality improvement initiative was designed to increase physician awareness of their patterns of lab utilization in the LTACH environment. Within a large network of LTACHs, 9 hospitals were identified as having higher patterns of lab utilization than other LTACHs...
January 2017: Proceedings of the Baylor University Medical Center
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