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chronic critical illness

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https://www.readbyqxmd.com/read/28709443/severity-of-acute-gastrointestinal-injury-grade-is-a-predictor-of-all-cause-mortality-in-critically-ill-patients-a-multicenter-prospective-observational-study
#1
Bangchuan Hu, Renhua Sun, Aiping Wu, Yin Ni, Jingquan Liu, Feng Guo, Lijun Ying, Guoping Ge, Aijun Ding, Yunchao Shi, Changwen Liu, Lei Xu, Ronglin Jiang, Jun Lu, Ronghai Lin, Yannan Zhu, Weidong Wu, Bo Xie
BACKGROUND: In 2012, the European Society of Intensive Care Medicine proposed a definition for acute gastrointestinal injury (AGI) based on current medical evidence and expert opinion. The aim of the present study was to evaluate the feasibility of using the current AGI grading system and to investigate the association between AGI severity grades with clinical outcome in critically ill patients. METHODS: Adult patients at 14 general intensive care units (ICUs) with an expected ICU stay ≥24 h were prospectively studied...
July 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28708677/repeated-critical-illness-and-unplanned-readmissions-within-1-year-to-picus
#2
Jeffrey D Edwards, Adam R Lucas, W John Boscardin, R Adams Dudley
OBJECTIVES: To determine the occurrence rate of unplanned readmissions to PICUs within 1 year and examine risk factors associated with repeated readmission. DESIGN: Retrospective cohort analysis. SETTING: Seventy-six North American PICUs that participated in the Virtual Pediatric Systems, LLC (VPS, LLC, Los Angeles, CA). PATIENTS: Ninety-three thousand three hundred seventy-nine PICU patients discharged between 2009 and 2010...
August 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28704229/treatment-of-hyponatremic-encephalopathy-in-the-critically-ill
#3
Steven G Achinger, Juan Carlos Ayus
OBJECTIVES: Hyponatremic encephalopathy, symptomatic cerebral edema due to a low osmolar state, is a medical emergency and often encountered in the ICU setting. This article provides a critical appraisal and review of the literature on identification of high-risk patients and the treatment of this life-threatening disorder. DATA SOURCES, STUDY SELECTION, AND DATA EXTRACTION: Online search of the PubMed database and manual review of articles involving risk factors for hyponatremic encephalopathy and treatment of hyponatremic encephalopathy in critical illness...
July 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28700476/peripheral-monocytosis-as-a-predictive-factor-for-adverse-outcome-in-the-emergency-department-survey-based-on-a-register-study
#4
Mathias Hensel, Lena Grädel, Alexander Kutz, Sebastian Haubitz, Andreas Huber, Beat Mueller, Philipp Schuetz, Thomas Hügle
Monocytosis is associated with chronic infections such as tuberculosis or endocarditis as well as rheumatic and myeloproliferative disorders. Monocytes are also involved in the pathogenesis of atherosclerosis, coronary artery disease, and stroke. The value of monocytosis as a prognostic marker in different diagnostic groups in the emergency setting, however, has not been investigated so far.The aim of the article is to study monocytosis as an outcome factor in the emergency setting.In a Swiss register study, we analyzed monocyte counts in 4238 patients aged >18 years who were admitted to the emergency department of a regional tertiary care hospital...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28698265/risk-factors-for-noninvasive-ventilation-failure-in-critically-ill-subjects-with-confirmed-influenza-infection
#5
Alejandro Rodríguez, Cristina Ferri, Ignacio Martin-Loeches, Emili Díaz, Joan R Masclans, Federico Gordo, Jordi Sole-Violán, María Bodí, Francesc X Avilés-Jurado, Sandra Trefler, Monica Magret, Gerard Moreno, Luis F Reyes, Judith Marin-Corral, Juan C Yebenes, Andres Esteban, Antonio Anzueto, Stefano Aliberti, Marcos I Restrepo
BACKGROUND: Despite wide use of noninvasive ventilation (NIV) in several clinical settings, the beneficial effects of NIV in patients with hypoxemic acute respiratory failure (ARF) due to influenza infection remain controversial. The aim of this study was to identify the profile of patients with risk factors for NIV failure using chi-square automatic interaction detection (CHAID) analysis and to determine whether NIV failure is associated with ICU mortality. METHODS: This work was a secondary analysis from prospective and observational multi-center analysis in critically ill subjects admitted to the ICU with ARF due to influenza infection requiring mechanical ventilation...
July 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28694703/secondary-sclerosing-cholangitis-in-critically-ill-patients-current-perspectives
#6
REVIEW
Hafsteinn O Gudnason, Einar S Björnsson
Secondary sclerosing cholangitis (SSC) is a term used for a group of chronic cholestatic disease affecting the intra- and/or extrahepatic biliary tree with inflammation and progressive stricture formation, which can lead to biliary cirrhosis. A newly recognized form of SSC is secondary sclerosing cholangitis in critically ill patients (SSC-CIP). Pathogenesis is believed to involve ischemic injury of intrahepatic bile ducts associated with prolonged hypotension, vasopressors administration, and/or mechanical ventilation in patients treated in the intensive care unit (ICU)...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28688338/pregnenolone-as-an-adjunct-to-risperidone-for-treatment-of-women-with-schizophrenia-a-randomized-double-blind-placebo-controlled-clinical-trial
#7
Ladan Kashani, Nazila Shams, Ehsan Moazen-Zadeh, Mohammad-Ali Karkhaneh-Yousefi, Gita Sadighi, Mohammad-Reza Khodaie-Ardakani, Farzin Rezaei, Fatemeh Rahiminejad, Shahin Akhondzadeh
There have been few studies of pregnenolone therapy in schizophrenia and those that exist have been subject to several critical limitations, thus yielding inconsistent results. We attempted to assess the therapeutic effect of pregnenolone in a patient sample as homogeneous as possible. In this randomized double-blind clinical trial, 82 female inpatients with chronic schizophrenia, who had discontinued their antipsychotic medications for at least one week in case of any oral antipsychotic medication or a month for any depot antipsychotic medication, received risperidone plus either pregnenolone (50 mg/day) or placebo for 8 weeks...
June 28, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28688155/critical-care-management-of-the-cirrhotic-patient-awaiting-liver-transplant-in-the-intensive-care-unit
#8
REVIEW
J C Olson, C J Karvellas
Patients with cirrhosis who are awaiting liver transplantation are at high risk for development of critical illness. Current liver allocation policies which dictate a "sickest first" approach coupled with a mismatch between need and availability of organs results in longer wait times and thus, patients are becoming increasingly ill while awaiting organ transplantation. Even patients with well compensated cirrhosis may suffer acute deterioration, the syndrome of acute-on-chronic liver failure (ACLF) results in multi-system organ dysfunction and a marked increase in associated short-term morbidity and mortality...
July 8, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28684104/acid-base-disorders-in-liver-disease
#9
REVIEW
Scheiner Bernhard, Lindner Gregor, Reiberger Thomas, Schneeweiss Bruno, Trauner Michael, Zauner Christian, Funk Georg-Christian
Next to the kidneys and lungs, the liver has been recognized as an important regulator of acid-base homeostasis. While respiratory alkalosis is the most common acid-base disorder in chronic liver disease, various complex metabolic acid-base disorders may occur with liver dysfunction. Although the standard variables of acid-base equilibrium, such as pH and overall base excess, often fail to unmask the underlying cause of acid-base disorders, the physical-chemical acid-base model allows a more in-depth pathophysiological understanding and clinical judgement of acid-base disorders in patients with liver diseases...
July 3, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28682981/risk-factors-of-delayed-onset-posttraumatic-stress-disorder-in-chronically-critically-ill-patients
#10
Gloria-Beatrice Wintermann, Jenny Rosendahl, Kerstin Weidner, Bernhard Strauß, Katja Petrowski
The main aim of this study was to investigate factors associated with a delayed-onset posttraumatic stress disorder (PTSD) after the intensive care unit (ICU) treatment of patients with a chronic critical illness (CCI). Patients (n = 97) with critical illness polyneuropathy or critical illness myopathy were interviewed via the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. The diagnosis of the acute stress disorder was assessed within 1 month (t1), the diagnosis of PTSD at 3 (t2) and 6 (t3) months after transfer from the acute care ICU to the post-acute ICU...
July 5, 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28682945/chronic-critical-illness-and-persistent-inflammation-what-can-we-learn-from-the-elderly-injured-septic-and-malnourished
#11
Vanessa Nomellini, Lewis J Kaplan, Carrie A Sims, Charles C Caldwell
Patients in the intensive care unit (ICU) who develop chronic critical illness significantly stress the clinical capacity and financial resources of healthcare systems. Although vast improvements have been made in critical care management, outcomes for this ICU subset remains poor. A hallmark for patients who progress to chronic critical illness is the development of persistent inflammation and immunosuppression. The risk factors associated with the development of chronic critical illness include increased age, medical comorbidities, severe injury, septic shock, and malnutrition...
July 4, 2017: Shock
https://www.readbyqxmd.com/read/28682734/families-living-well-with-chronic-illness-the-healing-process-of-moving-on
#12
Carole A Robinson
Chronic illness is a global issue of escalating importance. While prevention, control, and management of chronic disease are imperative, it is also critical to shift our focus away from illness and toward living. In particular, attention needs to focus on living well despite illness. This article reports a grounded theory study with 43 members from 17 families who perceived they were managing well with serious chronic illnesses. The theory that captures the circular, iterative healing process of moving on is comprised of five phases: the fight, accepting, living with the chronic illness, sharing the experience, and reconstructing life...
March 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28676896/the-impact-of-frailty-on-intensive-care-unit-outcomes-a-systematic-review-and-meta-analysis
#13
REVIEW
John Muscedere, Braden Waters, Aditya Varambally, Sean M Bagshaw, J Gordon Boyd, David Maslove, Stephanie Sibley, Kenneth Rockwood
PURPOSE: Functional status and chronic health status are important baseline characteristics of critically ill patients. The assessment of frailty on admission to the intensive care unit (ICU) may provide objective, prognostic information on baseline health. To determine the impact of frailty on the outcome of critically ill patients, we performed a systematic review and meta-analysis comparing clinical outcomes in frail and non-frail patients admitted to ICU. METHODS: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PubMed, CINAHL, and Clinicaltrials...
July 4, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28674176/effects-of-chronic-social-defeat-stress-on-sleep-and-circadian-rhythms-are-mitigated-by-kappa-opioid-receptor-antagonism
#14
Audrey M Wells, Elysia Ridener, Clinton A Bourbonais, Woori Kim, Harry Pantazopoulos, F Ivy Carroll, Kwang-Soo Kim, Bruce M Cohen, William A Carlezon
Stress plays a critical role in the neurobiology of mood and anxiety disorders. Sleep and circadian rhythms are affected in many of these conditions. Here we examined the effects of chronic social defeat stress (CSDS), an ethological form of stress, on sleep and circadian rhythms. We exposed male mice implanted with wireless telemetry transmitters to a 10-day CSDS regimen known to produce anhedonia (a depressive-like effect) and social avoidance (an anxiety-like effect). Electroencephalography (EEG), electromyography (EMG), body temperature, and locomotor activity data were collected continuously during the CSDS regimen and a 5-day recovery period...
July 3, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28674170/the-mnk-eif4e-signaling-axis-contributes-to-injury-induced-nociceptive-plasticity-and-the-development-of-chronic-pain
#15
Jamie K Moy, Arkady Khoutorsky, Marina N Asiedu, Bryan J Black, Jasper L Kuhn, Paulino Barragán-Iglesias, Salim Megat, Michael D Burton, Carolina C Burgos-Vega, Ohannes K Melemedjian, Scott Boitano, Josef Vagner, Christos G Gkogkas, Joseph J Pancrazio, Jeffrey S Mogil, Gregory Dussor, Nahum Sonenberg, Theodore J Price
Injury-induced sensitization of nociceptors contributes to pain states and the development of chronic pain. Inhibiting activity-dependent mRNA translation through mechanistic target of rapamycin (mTOR) and mitogen activated protein kinase (MAPK) pathways blocks the development of nociceptor sensitization. These pathways convergently signal to the eukaryotic translation initiation factor (eIF) 4F complex to regulate sensitization of nociceptors but the details of this process are ill-defined. Here we investigated the hypothesis that phosphorylation of the 5' cap-binding protein, eIF4E, by its specific kinase MAPK interacting kinase (MNK) 1/2 is a key factor in nociceptor sensitization and the development of chronic pain...
July 3, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28673010/rhubarb-vs-glycerin-enema-for-treatment-of-critically-ill-patients-with-intra-abdominal-hypertension
#16
Bing Wan, Hao Zhang, Jiangtao Yin, Haiyan Fu, Yikun Chen, Liping Yang, Dadong Liu, Tangfeng Lv, Yong Song
Rhubarb has been used as an evacuant for thousands of years. However, recent research has indicated that rhubarb inhibits inflammation and protects organ function. In the current study, the use of rhubarb was investigated in patients with intra-abdominal hypertension (IAH). Specifically, its dual role in attenuating lung and bowel injury by catharsis and inhibiting inflammation was evaluated. Patients in the glycerin group (n=56) received 110 ml of glycerin enema by coloclysis once daily for 7 to 9 days. Patients in the rhubarb group (n=56) were treated with a mixture of 0...
July 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28671859/being-underweight-is-an-independent-risk-factor-for-poor-outcomes-among-acutely-critically-ill-children
#17
Ming-Yin Chen, Yao-Jong Yang
BACKGROUND: Malnutrition is associated with impaired immune function; thus, nutrition status assessment is crucial in critical care medicine. We aimed to investigate the impact of being underweight or overweight on major sequelae and mortality among healthy children with an intensive care unit admission. METHODS: In this retrospective study, 282 patients aged 1 month to 18 years were enrolled on intensive care unit admission between 2011 and 2012. Children were excluded if they had underlying chronic diseases and were transferred to other hospitals or discharged against medical advice...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28664709/the-quality-of-life-of-farmers-with-chronic-obstructive-pulmonary-disease-copd
#18
Joanna Milanowska, Barbara Mackiewicz, Paweł Węgorowski, Janusz Milanowski, Piotr Milanowski, Marta Makara-Studzińska
<b>Introduction and objective.</b> COPD is a medical state characterized by chronically poor airflow, and typically worsens over time. Farmers have an increased risk of COPD because of being exposed to ammonia, hydrogen sulfide, inorganic dust, and organic dust. The quality of life of the ill depends on biomedical as well as psychosocial factors, the impact of which has not been a frequent subject of studies among COPD patients. The aim of the study was to indicate the factors that have negative and positive influence on the quality of life of farmers suffering from COPD...
June 9, 2017: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/28661307/policy-approaches-to-improving-housing-and-health
#19
William C Tilburg
Safe and healthy housing conditions are critical to improving population health, particularly for the most vulnerable - young children, senior citizens, and individuals with chronic illnesses and disabilities - who spend more time at home and are more susceptible to illness and injury. Across the country, millions of Americans are exposed to lead, radon, asbestos, volatile organic compounds, pests, mold, carbon monoxide, and tobacco smoke in the home, affecting the air they breathe and the water they drink...
March 2017: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/28661193/-you-want-to-show-you-re-a-valuable-employee-a-critical-discourse-analysis-of-multi-perspective-portrayals-of-employed-women-with-fibromyalgia
#20
Margaret Oldfield, Ellen MacEachen, Margaret MacNeill, Bonnie Kirsh
Background Advice on fibromyalgia, a chronic illness primarily affecting women, often presents it as incompatible with work and rarely covers how to remain employed. Yet many women do. Objectives We aimed to understand how these women, their family members, and workmates portrayed employees with fibromyalgia, and how these portrayals helped women retain employment. Methods We interviewed 22 participants, comprising five triads and three dyads of people who knew each other. Using the methodology of critical discourse analysis, we analysed the interview data within and across the triads/dyads through coding, narrative summaries, and relational mapping...
January 1, 2017: Chronic Illness
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