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https://www.readbyqxmd.com/read/29049042/atrial-fibrillation-occurring-transiently-with-stress
#1
William F McIntyre, Stuart J Connolly, Jeff S Healey
PURPOSE OF REVIEW: Atrial fibrillation may be detected in the setting of an acute stressor, such as medical illness or surgery. It is uncertain if atrial fibrillation detected in these settings (AFOTS: atrial fibrillation occurring transiently with stress) is secondary to a reversible trigger or is simply paroxysmal atrial fibrillation. This distinction is critical for clinicians, who must decide if AFOTS can be dismissed as a reversible phenomenon, or if it signals the need for chronic therapy; in particular, anticoagulation...
October 18, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29046107/determinants-of-endotracheal-intubation-in-critically-ill-patients-undergoing-gastrointestinal-endoscopy-under-conscious-sedation
#2
Nathan J Smischney, Mohamed O Seisa, Mukesh Kumar, Jillian Deangelis, Darrell R Schroeder, Daniel A Diedrich
OBJECTIVES: Our primary aim was to determine the factors leading to prophylactic endotracheal intubation in intensive care unit (ICU) patients undergoing gastrointestinal endoscopy. Secondary aims were to determine the rate of unplanned endotracheal intubations during endoscopy and to determine the rate of aspiration following endoscopy for patients admitted to the ICU. METHODS: Critically ill adult (≥18 years) patients who underwent upper and lower endoscopic procedures from January 2012 to July 2016 in a medical/surgical ICU were included...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29044341/the-use-of-antimicrobials-in-septic-patients-with-acute-kidney-injury
#3
Fernanda Moreira de Freitas, Welder Zamoner, Durval Sampaio de Souza Garms, Mariele Gobo de Oliveira, André Luis Balbi, Daniela Ponce
Sepsis is the most common cause of death in critically ill patients and it may be associated with multiorgan failure, including acute kidney injury (AKI). This situation can require acute renal support and increase mortality. Therefore, it is essential to administrate antimicrobials in dosis to achieve adequate serum levels, preventing overdosis and drug toxicity or underdosing and risk for resistance to antibiotics and higher mortality. To date, there aren't validated guidelines on antibiotic dosis adjustment in septic patients with AKI and the recommendations are extrapolated from studies conducted in non-critical patients with chronic kidney disease in end stage receiving chronic renal replacement therapy...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29041985/simplified-prognostic-model-for-critically-ill-patients-in-resource-limited-settings-in-south-asia
#4
Rashan Haniffa, Mavuto Mukaka, Sithum Bandara Munasinghe, Ambepitiyawaduge Pubudu De Silva, Kosala Saroj Amarasiri Jayasinghe, Abi Beane, Nicolette de Keizer, Arjen M Dondorp
BACKGROUND: Current critical care prognostic models are predominantly developed in high-income countries (HICs) and may not be feasible in intensive care units (ICUs) in lower- and middle-income countries (LMICs). Existing prognostic models cannot be applied without validation in LMICs as the different disease profiles, resource availability, and heterogeneity of the population may limit the transferability of such scores. A major shortcoming in using such models in LMICs is the unavailability of required measurements...
October 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29038667/predicting-mortality-of-patients-with-sepsis-a-comparison-of-apache-ii-and-apache-iii-scoring-systems
#5
Farid Sadaka, Cheikh EthmaneAbouElMaali, Margaret A Cytron, Kimberly Fowler, Victoria M Javaux, Jacklyn O'Brien
BACKGROUND: Acute Physiology, Age and Chronic Health Evaluation (APACHE) II and III scores were developed in 1985 and 1991, respectively, and are used mainly for critically ill patients of all disease categories admitted to the intensive care unit (ICU). They differ in how chronic health status is assessed, in the number of physiologic variables included (12 vs. 17), and in the total score. These two scoring systems have not been compared in predicting hospital mortality in patients with sepsis...
November 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29035909/dysregulated-myelopoiesis-and-hematopoietic-function-following-acute-physiologic-insult
#6
Tyler J Loftus, Alicia M Mohr, Lyle L Moldawer
PURPOSE OF REVIEW: The purpose of this review is to describe recent findings in the context of previous work regarding dysregulated myelopoiesis and hematopoietic function following an acute physiologic insult, focusing on the expansion and persistence of myeloid-deriver suppressor cells, the deterioration of lymphocyte number and function, and the inadequacy of stress erythropoiesis. RECENT FINDINGS: Persistent myeloid-derived suppressor cell (MDSC) expansion among critically ill septic patients is associated with T-cell suppression, vulnerability to nosocomial infection, chronic critical illness, and poor long-term functional status...
October 13, 2017: Current Opinion in Hematology
https://www.readbyqxmd.com/read/29032639/long-term-mental-well-being-of-adolescents-and-young-adults-diagnosed-with-venous-thromboembolism-results-from-a-multistage-mixed-methods-study
#7
Anette Arbjerg Højen, Erik Elgaard Sørensen, Pia Sander Dreyer, Mette Søgaard, Torben Bjerregaard Larsen
BACKGROUND: Critical and chronic illness in youth can lead to impaired mental well-being. Venous thromboembolism (VTE) is a potentially traumatic and life-threatening condition. Nonetheless, the long-term mental well-being of adolescents and young adults (AYAS) with VTE is unclear. OBJECTIVES: To investigate the long-term mental well-being of AYAS (13-33 years) diagnosed with VTE. METHODS: We performed a multistage mixed method study based on data from the Danish nationwide health registries, and semi-structured interviews with 12 AYAS diagnosed with VTE...
October 15, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29028707/icu-acquired-weakness-chronic-critical-illness-and-the-persistent-inflammation-immunosuppression-and-catabolism-syndrome
#8
Tyler John Loftus, Frederick Allen Moore, Lyle L Moldawer
No abstract text is available yet for this article.
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29024974/functional-recovery-in-major-depressive-disorder-providing-early-optimal-treatment-for-the-individual-patient
#9
Oloruntoba J Oluboka, Martin A Katzman, Jeffrey Habert, Diane McIntosh, Glenda M MacQueen, Roumen V Milev, Roger S McIntyre, Pierre Blier
Major depressive disorder (MDD) is an often chronic and recurring illness. Left untreated, MDD may result in progressive alterations in brain morphometry and circuit function. Recent findings, however, suggest that pharmacotherapy may halt and possibly reverse those effects. These findings, together with evidence that a delay in treatment is associated with poorer clinical outcomes, underscore the urgency of rapidly treating depression to full recovery. Early optimized treatment, using measurement-based care and customizing treatment to the individual patient, may afford the best possible outcomes for each patient...
September 8, 2017: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29023260/dysphagia-in-mechanically-ventilated-icu-patients-dynamics-a-prospective-observational-trial
#10
Joerg C Schefold, David Berger, Patrick Zürcher, Michael Lensch, Andrea Perren, Stephan M Jakob, Ilkka Parviainen, Jukka Takala
OBJECTIVES: Swallowing disorders may be associated with adverse clinical outcomes in patients following invasive mechanical ventilation. We investigated the incidence of dysphagia, its time course, and association with clinically relevant outcomes in extubated critically ill patients. DESIGN: Prospective observational trial with systematic dysphagia screening and follow-up until 90 days or death. SETTINGS: ICU of a tertiary care academic center...
October 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29016348/parp-1-and-parp-2-activity-in-cancer-induced-cachexia-potential-therapeutic-implications
#11
Esther Barreiro, Joaquim Gea
Skeletal muscle dysfunction and mass loss is a characteristic feature in patients with chronic diseases including cancer and acute conditions such as critical illness. Maintenance of an adequate muscle mass is crucial for the patients' prognosis irrespective of the underlying condition. Moreover, aging-related sarcopenia may further aggravate the muscle wasting process associated with chronic diseases and cancer. Poly(adenosine diphosphate-ribose) polymerase (PARP) activation has been demonstrated to contribute to the pathophysiology of muscle mass loss and dysfunction in animal models of cancer-induced cachexia...
October 26, 2017: Biological Chemistry
https://www.readbyqxmd.com/read/28990418/redox-mechanisms-in-migraine-novel-therapeutics-and-dietary-interventions
#12
Patrizia Ferroni, Piero Barbanti, David Della-Morte, Raffaele Palmirotta, Emilio Jirillo, Fiorella Guadagni
Significance Migraine represents the third most prevalent and the seventh most disabling human disorder. Approximately 30% of migraine patients experience transient, fully reversible, focal neurological symptoms (aura) preceding the attack. Recent advances Awareness of the hypothesis that migraine actually embodies a spectrum of illnesses - ranging from episodic to chronic forms - is progressively increasing and poses novel challenges for clarifying the underlying pathophysiological mechanisms of migraine as well as for the development of novel therapeutic interventions...
October 7, 2017: Antioxidants & Redox Signaling
https://www.readbyqxmd.com/read/28987256/liver-disease-in-patients-on-total-parenteral-nutrition
#13
REVIEW
Arnab Mitra, Joseph Ahn
Parenteral nutrition-associated liver disease (PNALD) spectrum ranges from liver enzyme abnormalities to steatosis to fibrosis, and, eventually, cirrhosis from total parenteral nutrition (TPN). The pathophysiology is postulated to be multifactorial. Diagnosis in adults is primarily by exclusion, eliminating other causes of chronic liver disease or cirrhosis, and other factors seen in critically ill or postoperative patients on TPN. Principal treatment is avoiding TPN. If this is not feasible, research supports fish oil-based lipid emulsions in TPN formulations to reduce risk and progression of PNALD...
November 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28981515/the-heuristics-of-nurse-responsiveness-to-critical-patient-monitor-and-ventilator-alarms-in-a-private-room-neonatal-intensive-care-unit
#14
Rohan Joshi, Heidi van de Mortel, Loe Feijs, Peter Andriessen, Carola van Pul
AIM: Alarm fatigue is a well-recognized patient safety concern in intensive care settings. Decreased nurse responsiveness and slow response times to alarms are the potentially dangerous consequences of alarm fatigue. The aim of this study was to determine the factors that modulate nurse responsiveness to critical patient monitor and ventilator alarms in the context of a private room neonatal intensive care setting. METHODS: The study design comprised of both a questionnaire and video monitoring of nurse-responsiveness to critical alarms...
2017: PloS One
https://www.readbyqxmd.com/read/28976827/exploring-pressures-tissue-reperfusion-and-body-positioning-a-pilot-evaluation
#15
F Coyer, M Clark, P Slattery, P Thomas, G McNamara, C Edwards, J Ingleman, J Stephenson, K Ousey
OBJECTIVE: To assess the relationship in healthy adults and critically ill patients between: patient position, body mass index (BMI), patient body temperature, interface pressure (IP) and tissue reperfusion (TR). Also to determine the relationship in critically ill patients between: Sequential Organ Failure Assessment (SOFA) score, Braden Scale score for predicting pressure injury risk, Acute Physiology and Chronic Health Evaluation II (APACHE II) severity of disease classification score, IP and TR...
October 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28974430/predictive-value-of-low-interleukin-33-in-critically-ill-patients
#16
Konstantin A Krychtiuk, Stefan Stojkovic, Max Lenz, Mira Brekalo, Kurt Huber, Johann Wojta, Gottfried Heinz, Svitlana Demyanets, Walter S Speidl
Patients admitted to a medical intensive care unit (ICU) are characterized by an activated immune system and exhibit a high mortality rate irrespective of the underlying cause of admission. Interleukin (IL)-33 has been shown to be protective in experimental sepsis models and it has been demonstrated that circulating levels of its "decoy" receptor soluble ST2 (sST2) are associated with outcome in critically ill patients. The aim of the present study was to investigate whether circulating IL-33 is associated with 30-day mortality in patients admitted to a medical ICU...
September 30, 2017: Cytokine
https://www.readbyqxmd.com/read/28970659/prognostic-value-of-venous-to-arterial-carbon-dioxide-difference-during-early-resuscitation-in-critically-ill-patients-with-septic-shock
#17
Tamer Abdallah Helmy, Ehab Mahmoud El-Reweny, Farahat Gomaa Ghazy
CONTEXT: The partial pressure of venous to arterial carbon dioxide gradient (PCO2 gap) is considered as an alternative marker of tissue hypoperfusion and has been used to guide treatment for shock. AIMS: The aim of this study was to investigate the prognostic value of venous-to-arterial carbon dioxide difference during early resuscitation of patients with septic shock and compared it with that of lactate clearance and Acute Physiology and Chronic Health Evaluation II (APACHE-II) score...
September 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28961483/chronic-obstructive-pulmonary-disease-copd-illness-narratives-and-elias-s-sociology-of-knowledge
#18
Dominic Malcolm, Mark W Orme, Mike D Morgan, Lauren B Sherar
This paper draws on Elias's sociology of knowledge to provide a critical assessment of illness narratives. Focusing on a cohort of chronic obstructive pulmonary disease (COPD) patients (n = 26), the paper employs a comparative analysis of mixed method data derived from qualitative interviews, quantitative questionnaires, and physiological and accelerometer testing. The article firstly compares four narratives conveyed in interviews with the broader paradigmatic approach to illness narratives and existing COPD-specific studies...
September 18, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28960213/impaired-polyfunctionality-of-cd8-t-cells-in-severe-sepsis-patients-with-human-cytomegalovirus-reactivation
#19
Young Joon Choi, Sun Bean Kim, Jong Hoon Kim, Su-Hyung Park, Moo Suk Park, June Myung Kim, Sang Hoon Han, Eui-Cheol Shin
Human cytomegalovirus (HCMV) establishes a lifelong chronic latent infection and often reactivates in immunocompromised patients. In addition, HCMV reactivates in patients with sepsis or other critical illnesses, particularly in patients with poor prognoses. However, the immunological characteristics of sepsis patients with HCMV reactivation have not been elucidated. In the present study, we examined T-cell responses in severe sepsis patients with and without HCMV reactivation. First, HCMV pp65-specific T-cell functions were assessed by intracellular cytokine staining (ICS) for IFN-γ, TNF-α, and MIP-1β and by CD107a staining...
September 29, 2017: Experimental & Molecular Medicine
https://www.readbyqxmd.com/read/28957481/lower-fragmentation-of-coordination-in-primary-care-is-associated-with-lower-prescribing-drug-costs-lessons-from-chronic-illness-care-in-hungary
#20
Ágnes Lublóy, Judit Lilla Keresztúri, Gábor Benedek
Improving patient care coordination is critical for achieving better health outcome measures at reduced cost. However, assessing the results of patient care coordination at system level is lacking. In this report, based on administrative healthcare data, a provider-level care coordination measure is developed to assess the function of primary care at system level. In a sample of 31 070 patients with diabetes we find that the type of collaborative relationship general practitioners build up with specialists is associated with prescription drug costs...
October 1, 2017: European Journal of Public Health
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