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chronic critical illness

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https://www.readbyqxmd.com/read/29444446/pathophysiological-changes-after-lipopolysaccharide-induced-acute-inflammation-in-a-type-2-diabetic-rat-model-versus-normal-controls
#1
Tingting Han, Xingxing Ren, Dongdong Jiang, Shuang Zheng, Yawen Chen, Huiying Qiu, Peter C Hou, Wei Liu, Yaomin Hu
AIMS: The present study aimed to explore the mechanism of a potential beneficial effect of pre-existing diabetes in acute hyperglycemia during critical illness. METHODS: Pathophysiological changes including blood glucose variability, changes of inflammatory and oxidative stress responses after lipopolysaccharide (LPS)-induced acute infection were compared between type 2 diabetic rat model (GK rats) and normal controls (Wistar rats). RESULTS: After LPS injection, Wistar rats showed serious infective symptoms while GK rats did not...
February 11, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29438924/chemotherapy-is-administered-to-a-minority-of-hospitalized-patients-with-diffuse-large-b-cell-lymphoma-and-is-associated-with-less-likelihood-of-death-during-hospitalization
#2
Anita J Kumar, Tobi Henzer, Angie Mae Rodday, Susan K Parsons
BACKGROUND: While treatment of DLBCL is largely outpatient, some patients require planned or unplanned admissions for chemotherapy, new diagnosis, relapse, or toxicity. We examined risk factors for receipt of inpatient chemotherapy and death during hospitalization. METHODS: We analyzed data from the 2012-2013 HCUP-NIS. We identified patient and hospital characteristics that were associated with chemotherapy administration and death. RESULTS: Chemotherapy was given in 3260/11,150 (29...
February 10, 2018: Cancer Epidemiology
https://www.readbyqxmd.com/read/29438222/high-crp-levels-after-critical-illness-are-associated-with-an-increased-risk-of-re-hospitalization
#3
Wilhelm Grander, Bernhard Koller, Christine Ludwig, Martin W Dünser, Ilse Gradwohl-Matis
PURPOSE: Chronic inflammation, even at subclinical levels, is associated with adverse long-term outcome. MATERIALS AND METHODS: In this prospective, observational study, sixty-six critically ill patients surviving to hospital discharge were included. CRP levels were determined at hospital discharge, one, two and six weeks after hospital discharge. All patients were repeatedly screened for adverse events resulting into re-hospitalization or death for 1.5 years. RESULTS: After hospital discharge, over two thirds of patients exhibited elevated CRP levels (> 2...
February 12, 2018: Shock
https://www.readbyqxmd.com/read/29433841/relationship-between-acute-kidney-injury-and-serum-procalcitonin-pct-concentration-in-critically-ill-patients-with-influenza-infection
#4
A Rodríguez, L F Reyes, J Monclou, B Suberviola, M Bodí, G Sirgo, J Solé-Violán, J Guardiola, D Barahona, E Díaz, I Martín-Loeches, M I Restrepo
INTRODUCTION: Serum procalcitonin (PCT) concentration could be increased in patients with renal dysfunction in the absence of bacterial infection. OBJECTIVE: To determine the interactions among serum renal biomarkers of acute kidney injury (AKI) and serum PCT concentration, in patients admitted to the intensive care unit (ICU) due to lung influenza infection. DESIGN: Secondary analysis of a prospective multicentre observational study. SETTING: 148 Spanish ICUs...
February 9, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29431918/examining-the-psychological-and-emotional-mechanisms-of-mindfulness-that-reduce-stress-to-enhance-healthy-behaviours
#5
Sara J Sagui-Henson, Sara M Levens, Cara L Blevins
Engagement in modifiable health behaviours plays a critical role in the development of chronic illnesses. Research suggests that mindfulness facilitates health-enhancing behaviour, yet the influence of mindfulness on different health behaviours and the mechanisms underlying this association are unclear. This study investigated a mediation model that explores psychological and emotional coping processes (reappraisal, suppression, and psychological flexibility) as mechanisms connecting mindfulness to reduced stress perceptions and reactions, which then predict physical activity, fruit and vegetable consumption, and sleep quality...
February 12, 2018: Stress and Health: Journal of the International Society for the Investigation of Stress
https://www.readbyqxmd.com/read/29426304/rationale-design-and-methodology-of-a-trial-evaluating-three-models-of-care-for-hcv-treatment-among-injection-drug-users-on-opioid-agonist-therapy
#6
Matthew J Akiyama, Linda Agyemang, Julia H Arnsten, Moonseong Heo, Brianna L Norton, Bruce R Schackman, Benjamin P Linas, Alain H Litwin
BACKGROUND: People who inject drugs (PWID) constitute 60% of the approximately 5 million people in the U.S. infected with hepatitis C virus (HCV). Treatment of PWID is complex due to addiction, mental illness, poverty, homelessness, lack of positive social support, poor adherence-related skills, low motivation and knowledge, and poor access to and trust in the health care system. New direct-acting antiviral medications are available for HCV with high cure rates and few side effects. The life expectancy and economic benefits of new HCV treatments will not be realized unless we determine optimal models of care for the majority of HCV-infected patients...
February 9, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29425283/development-of-a-dosing-nomogram-for-continuous-infusion-meropenem-in-critically-ill-patients-based-on-a-validated-population-pharmacokinetic-model
#7
Iris K Minichmayr, Jason A Roberts, Otto R Frey, Anka C Roehr, Charlotte Kloft, Alexander Brinkmann
Background: Optimal antibiotic exposure is a vital but challenging prerequisite for achieving clinical success in ICU patients. Objectives: To develop and externally validate a population pharmacokinetic model for continuous-infusion meropenem in critically ill patients and to establish a nomogram based on a routinely available marker of renal function. Methods: A population pharmacokinetic model was developed in NONMEM® 7.3 based on steady-state meropenem concentrations (CSS) collected during therapeutic drug monitoring...
February 7, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29423967/suvorexant-is-associated-with-a-low-incidence-of-delirium-in-critically-ill-patients-a-retrospective-cohort-study
#8
Tomoyuki Masuyama, Masamitsu Sanui, Naoto Yoshida, Yusuke Iizuka, Kunio Ogi, Satoko Yagihashi, Kanae Nagatomo, Yusuke Sasabuchi, Alan K Lefor
BACKGROUND: Benzodiazepine use is a risk factor for the development of delirium in adult intensive care unit (ICU) patients. Suvorexant is an alternative to benzodiazepines to induce sleep, but the incidence of delirium in critically ill patients is unknown. We undertook this retrospective study to investigate the incidence of delirium in patients who receive suvorexant in the ICU. METHODS: This retrospective cohort study was conducted in a closed 12-bed ICU at a tertiary teaching hospital...
February 8, 2018: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
https://www.readbyqxmd.com/read/29422291/a-case-control-study-on-the-clinical-impact-of-ventilator-associated-tracheobronchitis-in-adult-patients-who-did-not-develop-ventilator-associated-pneumonia
#9
María Luisa Cantón-Bulnes, María Ascensión González-García, Manuela García-Sánchez, Ángel Arenzana-Seisdedos, José Garnacho-Montero
OBJECTIVES: The main objective was to determine whether ventilator-associated tracheobronchitis (VAT) is related to increased length of ICU stay. Secondary endpoints included prolongation of hospital stay, as well as, ICU and hospital mortality. DESIGN: A retrospective matched case-control study. Each case was matched with a control for duration of ventilation (± 2 days until development of ventilator-associated tracheobronchitis), disease severity (Acute Physiology and Chronic Health Evaluation II) at admission ± 3, diagnostic category and age ±10 years...
February 5, 2018: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/29420543/does-the-chronic-care-model-meet-the-emerging-needs-of-people-living-with-multimorbidity-a-systematic-review-and-thematic-synthesis
#10
Kasey R Boehmer, Abd Moain Abu Dabrh, Michael R Gionfriddo, Patricia Erwin, Victor M Montori
BACKGROUND: The Chronic Care Model (CCM) emerged in the 1990s as an approach to re-organize primary care and implement critical elements that enable it to proactively attend to patients with chronic conditions. The chronic care landscape has evolved further, as most patients now present with multiple chronic conditions and increasing psychosocial complexity. These patients face accumulating and overwhelming complexity resulting from the sum of uncoordinated responses to each of their problems...
2018: PloS One
https://www.readbyqxmd.com/read/29416200/hyperlactatemia-and-the-importance-of-repeated-lactate-measurements-in-critically-ill-patients
#11
Amina Godinjak, Selma Jusufovic, Admir Rama, Amer Iglica, Faris Zvizdic, Adis Kukuljac, Ira Tancica, Sejla Rozajac
Objective: The aim of the study was to describe the prevalence of hyperlactatemia and emphasis on repeated lactate measurements in critically ill patients, and the associated mortality. Materials and methods: The study included 70 patients admitted in the Medical Intensive Care Unit at the Clinical Center, University of Sarajevo, in a 6-month period (July - December 2015). The following data were obtained: age, gender, reason for admission, Simplified Acute Physiology Score II, Acute Physiology and Chronic Health Evaluation, lactate concentrations upon admission, after 24 and 48 hours, and outcome (discharge from hospital or death)...
December 2017: Medical Archives
https://www.readbyqxmd.com/read/29415760/mobile-critical-care-recovery-program-m-ccrp-for-acute-respiratory-failure-survivors-study-protocol-for-a-randomized-controlled-trial
#12
Sikandar Khan, Ashok Biju, Sophia Wang, Sujuan Gao, Omar Irfan, Amanda Harrawood, Stephanie Martinez, Emily Brewer, Anthony Perkins, Frederick W Unverzagt, Sue Lasiter, Ben Zarzaur, Omar Rahman, Malaz Boustani, Babar Khan
BACKGROUND: Patients admitted to intensive care units (ICU) with acute respiratory failure (ARF) face chronic complications that can impede return to normal daily function. A mobile, collaborative critical care model may enhance the recovery of ARF survivors. METHODS: The Mobile Critical Care Recovery Program (m-CCRP) study is a two arm, randomized clinical trial. We will randomize 620 patients admitted to the ICU with acute respiratory failure requiring mechanical ventilation in a 1:1 ratio to one of two arms (310 patients per arm) - m-CCRP intervention versus attention control...
February 7, 2018: Trials
https://www.readbyqxmd.com/read/29415048/phosphate-is-a-potential-biomarker-of-disease-severity-and-predicts-adverse-outcomes-in-acute-kidney-injury-patients-undergoing-continuous-renal-replacement-therapy
#13
Su-Young Jung, Jaeyeol Kwon, Seohyun Park, Jong Hyun Jhee, Hae-Ryong Yun, HyoungNae Kim, Youn Kyung Kee, Chang-Yun Yoon, Tae-Ik Chang, Ea Wha Kang, Jung Tak Park, Tae-Hyun Yoo, Shin-Wook Kang, Seung Hyeok Han
Hyperphosphatemia is associated with mortality in patients with chronic kidney disease, and is common in critically ill patients with acute kidney injury (AKI); however, its clinical implication in these patients is unknown. We conducted an observational study in 1144 patients (mean age, 63.2 years; male, 705 [61.6%]) with AKI who received continuous renal replacement therapy (CRRT) between January 2009 and September 2016. Phosphate levels were measured before (0 h) and 24 h after CRRT initiation. We assessed disease severity using various clinical parameters...
2018: PloS One
https://www.readbyqxmd.com/read/29412394/biographical-ruptures-and-flows-in-the-family-experience-and-trajectory-of-children-with-cystic-fibrosis
#14
Marcelo Eduardo Pfeiffer Castellanos, Nelson Filice de Barros, Sandra Straccialano Coelho
Biographical disruption (BD) became a core concept of sociological studies on the chronic illness experience by showing how this event can be strongly affected by ruptures in the ways of living and organizing the biographical trajectory through narratives. Critical reviews have pointed out that the widespread use of this concept was not sufficiently attentive to its analytical limits, e.g. addressing experiences of children with genetic diseases, when biographic flows (BF) rather than BD would be probably found...
February 2018: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/29402368/-efficacy-and-safety-of-simulated-artificial-pancreas-in-modulating-stress-hyperglycemia-in-critically-ill-patients-a-prospective-randomized-controlled-study
#15
Zhongliang Yang, Guoqiang Tao, Meifeng Guo, Baoling Sun, Liang Gong, Yong Ding, Shuming Ye, Weidong Liu, Xiuyun Yang
OBJECTIVE: To explore efficacy and safety of simulated artificial pancreas in modulating stress hyperglycemia in critically ill patients. METHODS: A prospective randomized controlled study was performed. Seventy-two critically ill patients with stress hyperglycemia, aged 18-85 years, acute physiology and chronic health evaluation II (APACHE II) score over 15, two consecutive random blood glucose 11.1 mmol/L or higher, glycated hemoglobin (HbA1C) below 0.065, unable to eat food for 3 days after inclusion, or only accepting parenteral nutrition, admitted to intensive care unit (ICU) in Shanghai Punan Hospital of Pudong New District from January 1st, 2015 to June 30th, 2017 were enrolled...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29396136/renal-replacement-therapy-in-the-neonatal-intensive-care-unit
#16
Tze Yee Diane Mok, Min-Hua Tseng, Ming-Chou Chiang, Ju-Li Lin, Shih Ming Chu, Jen-Fu Hsu, Reyin Lien
BACKGROUND: Renal replacement therapy (RRT) is becoming increasingly necessary for supporting critically ill neonates. Few studies have reported the use of RRT in the neonatal intensive care unit (NICU). Therefore, we performed a retrospective study to describe the use of RRT in our NICU and its associated efficacy, complications, and outcomes. METHODS: We identified patients requiring RRT between January 2009 and January 2017. Demographic data, mode of RRT, and associated factors were recorded...
December 21, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29393202/quantification-of-adipose-tissue-and-muscle-mass-based-on-computed-tomography-scans-comparison-of-eight-planimetric-and-diametric-techniques-including-a-step-by-step-guide
#17
Thomas Irlbeck, Silke Janitza, Balázs Poros, Monika Golebiewski, Lorenz Frey, Philipp M Paprottka, Teresa da Silva, Michael Irlbeck, Wolfgang Böcker, Thomas Weig
BACKGROUND: Recent scientific work proved that knowledge about body composition beyond the body mass index is essential. Both adipose tissue and muscular status are determining risk factors of morbidity and mortality. Analysis of single cross-sectional computed tomography (CT) images, acquired during routine care only to prevent additional radiation exposure, provide a detailed insight into the body composition of chronically and critically ill patients. METHODS: This retrospective study included 490 trauma patients of whom a whole-body multiple detector CT scan was acquired at admission...
January 23, 2018: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
https://www.readbyqxmd.com/read/29389682/is-acute-kidney-injury-a-harbinger-for-chronic-kidney-disease
#18
David T Selewski, Dylan M Hyatt, Kevin M Bennett, Jennifer R Charlton
PURPOSE OF REVIEW: Despite abundant evidence in adults, the relationship between acute kidney injury (AKI) and chronic kidney disease (CKD) remains unanswered in pediatrics. Obstacles to overcome include the challenges defining these entities and the lack of long-term follow-up studies. This review focuses on pediatric populations at high-risk for AKI, the evidence of the long-term effect of AKI on renal health, and biomarkers to detect renal disease. RECENT FINDINGS: AKI in critically ill children and neonates is common and independently associated with adverse outcomes...
January 31, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29387913/the-ten-tips-to-manage-critically-ill-patients-with-acute-on-chronic-liver-failure
#19
Valentin Fuhrmann, Tony Whitehouse, Julia Wendon
No abstract text is available yet for this article.
January 31, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29384315/the-efficacy-of-parenteral-fish-oil-in-critical-illness-patients-with-sepsis-a-prospective-non-randomized-observational-study
#20
Wen-Si Li, Zhang-Zhang Chen, Yi-Jun Zheng, Ming Zhong, Jie-Fei Ma, Li-Zhen Xuan, Jie-Qiong Song, Qian-Zhou Lv, Du-Ming Zhu
BACKGROUND AND OBJECTIVES: To investigate the clinical outcomes in septic patients receiving parenteral fish oil. METHODS AND STUDY DESIGN: A prospective, non-randomized, observational clinical study was carried out in 112 patients with sepsis from March, 2013 to May, 2015 in the surgical intensive care unit (SICU) of a tertiaryreferral hospital. The patients were put into one of two groups; either the control or the study group. Patients received the standard treatment of sepsis based on guidelines in the control group...
2018: Asia Pacific Journal of Clinical Nutrition
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