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https://www.readbyqxmd.com/read/27915382/high-intensity-focused-ultrasound-treatment-in-patients-with-refractory-glaucoma
#1
Giuseppe Giannaccare, A Vagge, C Gizzi, A Bagnis, S Sebastiani, C Del Noce, M Fresina, C E Traverso, E C Campos
PURPOSE: To assess the safety and efficacy of ultrasound coagulation of the ciliary body in refractory glaucoma. METHODS: This prospective multicenter interventional study was conducted in two Italian university-affiliated glaucoma centers: St. Orsola-Malpighi Teaching Hospital (Bologna, Italy) and University Eye Clinic of Genoa (Genoa, Italy). The main inclusion criterion was the diagnosis of glaucoma with a baseline intraocular pressure (IOP) ≥ 21 mmHg while on maximum topical and systemic medical hypotensive treatment...
December 3, 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/27915328/critical-care-nephrology-a-multidisciplinary-approach
#2
Lilia Rizo-Topete, Claudio Ronco
Acute kidney injury (AKI) is a serious medical condition affecting millions of people. Patients in intensive care unit (ICU) who develop AKI have increased morbidity and mortality, prolonged length of stay in ICU and hospital and increased costs, especially when they require renal replacement therapy. In the latter case, morbidity and mortality increase further. In order to meet the needs of the critically ill patients, a multidisciplinary care team is required, combining the efforts of physicians and nurses from different disciplines as well as nephrologists and intensivists...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27915164/can-the-cerebral-regional-oxygen-saturation-be-a-perfusion-parameter-in-shock
#3
Ashraf Al Tayar, Amr Abouelela, Khaja Mohiuddeen
INTRODUCTION: Shock, defined as a state of tissue hypoperfusion and the tissues reperfusion, is the main goal of management of shock. Increase in central venous saturation (CvSo2) and decrease in blood lactate level are useful in assessment of adequacy of tissue perfusion. Near-infrared spectroscopy is a noninvasive way to observe real-time changes in regional cerebral saturation and has been used in patients with different brain diseases. There is a small body of literature suggesting that cerebral regional oxygen saturation (CrSo2) monitoring added a value in assessment and management of intensive care unit (ICU) patients...
November 10, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27914661/statin-discontinuation-and-mortality-in-an-older-adult-population-with-traumatic-brain-injury-a-four-year-multi-centre-observational-cohort-study
#4
Alessandro Orlando, Christine Thomas, Matthew Carrick, D Sue Slone, Charles W Mains, David Bar-Or
INTRODUCTION: Statin discontinuation has been investigated in a wide range of diseases and injuries, but there is a paucity of data in the older adult population with traumatic brain injury (TBI). The purpose of this study was to re-examine the extent to which early discontinuation of pre-injury statin (PIS) therapy increases the risk of poor patient outcomes in older adult patients suffering a TBI. METHODS: This was a retrospective observational cohort study of adult trauma patients with a blunt TBI across three trauma centres over four years...
November 25, 2016: Injury
https://www.readbyqxmd.com/read/27914127/impact-of-initial-vancomycin-trough-concentration-on-clinical-and-microbiological-outcomes-of-methicillin-resistant-staphylococcus-aureus-bacteremia-in-children
#5
Ree Nar Yoo, Seo Hee Kim, Jina Lee
It is important to use vancomycin in a proper manner to ensure optimal drug exposure. Despite extensive use of vancomycin in children, studies on its optimal trough concentration (Ctrough) in the pediatric population remained rare. This retrospective study included children < 18 years old with culture-confirmed methicillin-resistant Staphylococcus aureus (MRSA) bacteremia who were hospitalized in our institute from January 2010 to April 2014. Clinical characteristics, initial vancomycin dose, Ctrough and clinical/microbiological outcomes were retrospectively collected from medical records...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27913929/-inpatient-multimodal-pain-therapy-additive-value-of-neuromuscular-core-stability-exercises-for-chronic-back-pain
#6
F Giesche, H Streicher, M Maiwald, P Wagner
INTRODUCTION: The medical and healthcare economic burden caused by chronic lumbar back pain (CLBP) requires the use of interdisciplinary treatment approaches. The present study aimed to evaluate whether the effectiveness of inpatient multimodal pain therapy (MPT, operations and procedures (OPS) coding 8-918.02), can be increased by implementing additional neuromuscular core stability exercises (NCSE). MATERIAL AND METHODS: As part of a prospective controlled study, subjects with CLBP (n = 48, 17 males, 58...
December 2, 2016: Der Schmerz
https://www.readbyqxmd.com/read/27913873/impact-of-intensity-and-timing-of-integrated-home-palliative-cancer-care-on-end-of-life-hospitalization-in-northern-italy
#7
M Pellizzari, D Hui, E Pinato, M Lisiero, S Serpentini, L Gubian, F Figoli, M Cancian, C De Chirico, E Ferroni, F Avossa, M Saugo
PURPOSE: The Veneto Region implemented a novel integrated home-based palliative cancer care (HPCC) program embedded in primary care. We examined the impact of timing and intensity of this program on the quality of end-of-life (EOL) care. METHODS: We selected adult cancer patients died in the Veneto Region between March and December 2013, excluding those died from haematological malignancies as well as the very elderly (85+ years). We retrieved the claim-based data on hospitalization and homecare visits, and defined two observation windows: 90 to 16 days before death to examine intensity of HPCC exposure, and the last 15 days of life to examine EOL outcomes, including hospital death, any hospital stay for medical reasons and hospital stay ≥7 days for medical reasons...
December 2, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27913531/treatment-of-older-patients-with-acute-lymphoblastic-leukemia
#8
Nicola Gökbuget
The treatment of older patients with acute lymphoblastic leukemia (ALL) is an unmet medical need. With increasing age, ALL patients have a significantly lower clinical remission rate, higher early mortality, higher relapse rate, and poorer survival compared with younger patients. This is only partly explained by a higher incidence of poor prognostic factors in the older age group. Most importantly, intensive chemotherapy with or without stem cell transplantation (SCT) is less well tolerated in older patients...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913269/the-structure-organisation-and-perioperative-management-of-ambulatory-surgery-and-anaesthesia-in-france-methodology-of-the-sfar-opera-study
#9
Pierre Albaladejo, Frédéric Aubrun, Charles-Marc Samama, Laurent Jouffroy, Marc Beaussier, Dan Benhamou, Pauline Romegoux, Kristina Skaare, Jean Luc Bosson, Claude Ecoffey
The organization of health care establishments and perioperative care are essential for ensuring the quality of care and safety of patients undergoing outpatient surgery. In order to correctly inventory these organizations and practices, in 2013-2014, the French Society of Anaesthesia and Intensive Care organized an extensive practical survey in French ambulatory surgery units entitled the "OPERA" study (Organisation PERiopératoire de l'anesthésie en chirurgie Ambulatoire). From among all of the ambulatory surgery centres listed by the Agences Régionales de Santé [Regional Health Agencies, France], 206 public and private centres were randomly selected...
November 29, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27912730/homesick-residential-and-care-patterns-in-patients-with-severe-mental-illness
#10
Liselotte D de Mooij, Martijn Kikkert, Nick M Lommerse, Jan Theunissen, Mariken B de Koning, Lieuwe de Haan, Aartjan T F Beekman, Pim W R A Duurkoop, Jack J M Dekker
BACKGROUND: Changes in the residential and care settings of patients with severe mental illness (SMI) are a concern because of the large variety of possible negative consequences. This study describes patterns of changes in the residential and care settings of SMI patients and explores associations between these changes, sociodemographics, and clinical characteristics. METHODS: From January 2006 to January 2012, all data relating to changes in residential and/or care setting by SMI patients (N = 262) were collected from electronic case files...
December 3, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27908955/measuring-family-satisfaction-with-care-delivered-in-the-intensive-care-unit
#11
Kathleen Clark, Kerry A Milner, Marlene Beck, Virginia Mason
BACKGROUND: In our competitive health care environment, measuring the experience of family members of patients in the intensive care unit to ensure that health care providers are meeting families' needs is critical. Surveys from Press Ganey and the Centers for Medicare and Medicaid Services are unable to capture families' satisfaction with care in this setting. OBJECTIVE: To implement a sustainable measure for family satisfaction in a 12-bed medical and surgical intensive care unit...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27908954/chlorhexidine-impregnated-dressings-and-prevention-of-catheter-associated-bloodstream-infections-in-a-pediatric-intensive-care-unit
#12
Duygu Sönmez Düzkaya, Nejla Canbulat Sahiner, Gülzade Uysal, Tülay Yakut, Agop Çitak
BACKGROUND: Bloodstream infections related to use of catheters are associated with increased morbidity and mortality rates, prolonged hospital lengths of stay, and increased medical costs. OBJECTIVES: To compare the effectiveness of chlorhexidine-impregnated dressings with that of standard dressings in preventing catheter-related bloodstream infections. METHODS: A total of 100 children were randomly divided into 2 groups of 50 each: a chlorhexidine group and a standard group...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27907967/modern-approach-to-brain-death
#13
Panayiotis N Varelas, Ariane Lewis
People die either when their heart and respiration stop or when their brain irreversibly stops functioning. This latter mode of death by neurologic criteria (also called brain death) emerged after the development of ventilators and intensive care units in the late 1950s and 1960s. Brain death is universally accepted as a modern entity, but the complex process for declaring a patient brain dead is not uniformly followed across country and state lines or even hospital policies, creating unacceptable variability and risks for falsely pronouncing a patient dead...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907965/movement-disorders-in-the-intensive-care-unit
#14
Sara M Schaefer, Rezvan Rostami, David M Greer
Movement disorders are common; yet to those without subspecialty experience they can be difficult to recognize, categorize, and manage. Although most frequently encountered in an outpatient setting, patients with movement disorders are commonly hospitalized and often admitted to the intensive care unit, leading to possible confusion about their proper care. In addition, movement disorders can arise in critical care settings for several reasons, including medication side effects, substance withdrawal, or development of a new syndrome...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907964/critical-care-neurology-perspective-on-delirium
#15
Matthew B Maas, Andrew M Naidech
The evidence linking delirium to poor outcomes after critical illness is compelling, including higher mortality, prolonged mechanical ventilation, longer length of intensive care unit stay, and long-term cognitive impairments. The attitude toward delirium in the neurologic community is shifting away from viewing it as an unmodifiable, inevitable consequence of severe illness to treating it is as a neurologic emergency, akin to seizures or encephalitis. Delirium, like other manifestations of critical illness encephalopathy, is an organ dysfunction syndrome...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907963/optimizing-medication-outcomes-in-neurocritical-care-focus-on-clinical-pharmacology
#16
Denise H Rhoney, Kathryn Morbitzer, Jimmi Hatton-Kolpek
Drug dosing in neurocritically ill patients presents enormous challenges for clinicians due to the complex pathophysiological alterations. These alterations are dynamic both between and within patients. Unpredictable exposure from standard dosing regimens, which were extrapolated to intensive care unit patients from healthy volunteer studies, may influence medication outcomes. Knowledge of potential alterations in pharmacokinetics/pharmacodynamics in these patients could be applied to maximize the clinical response and minimize adverse effects...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907962/critical-care-of-traumatic-cervical-spinal-cord-injuries-preventing-secondary-injury
#17
Gary Schwartzbauer, Deborah Stein
The incidence of traumatic spinal cord injury (SCI) has not changed much over the years due to an aging population suffering falls, yet advances have been made in quality of life and survival time. In addition to initial medical and surgical stabilization, modern intensive care unit (ICU) care throughout the critical early period following SCI is essential to avoid continued secondary injury to the spinal cord. Cervical SCI patients are particularly prone and sensitive to periods of cardiovascular instability and respiratory failure directly resulting from their injuries...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27906716/infants-with-technology-dependence-facilitating-the-road-to-home
#18
Jennifer D Bowles, Amy J Jnah, Desi M Newberry, Carol A Hubbard, Tracey Roberston
BACKGROUND: The incidence of premature infants with complex medical needs, dependent upon medical technology at discharge, is on the rise in the United States. PURPOSE: Preparing the family for the hospital-to-home transition can be challenging due to the complex medical and emotional needs of the vulnerable infant and the volume of subspecialty services and equipment required. METHODS/SEARCH STRATEGY: Relevant articles from PubMed, Google Scholar, CINAHLFINDINGS/RESULTS:: There is an increasing incidence of technology dependent infants discharged from neonatal intensive care units in the United States...
December 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27906197/treatment-and-follow-up-of-venous-thrombosis-in-the-neonatal-intensive-care-unit-a-retrospective-study
#19
J C Bohnhoff, S A DiSilvio, R K Aneja, J R Shenk, Y A Domnina, B S Brozanski, M Good
OBJECTIVE: The critically ill, premature patients of neonatal intensive care units are susceptible to venous thrombosis, an adverse event associated with short- and long-term morbidity. Venous thrombosis is frequently treated with low-molecular-weight heparins (LMWHs) such as enoxaparin, but optimal dosing of LMWH must balance the morbidity of venous thrombosis with the potential adverse affects of anticoagulation. The optimal dosing of enoxaparin for premature infants is unclear. The objective of this study was to describe enoxaparin therapy and follow-up in critically ill neonates diagnosed with venous thrombosis...
December 1, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27905143/characterization-of-adverse-drug-reactions-causing-admission-to-an-intensive-care-unit
#20
Camilo Rojas-Velandia, Jair Ruiz-Garzón, Juan-Carlos Moscoso-Alcina, Álvaro Vallejos-Narvaéz, Jenny Castro-Canoa, Yuri Bustos-Martínez, Max Flórez-Cutiva, Mabel Contreras-Muñoz, Jully-Carolina Gómez-Gil, Carlos-Alberto Calderón-Ospina
AIM: This study aimed to determine the occurrence of adverse drug reactions (ADRs) that caused admission to the intensive care unit (ICU) of a university hospital. METHODS: Clinical records were reviewed for patients meeting the inclusion criteria who were admitted to the ICU between September and December 2012. Suspected cases of adverse drug reactions (ADR) were documented. Nine researchers later evaluated causality using the Naranjo Algorithm, preventability using the Schumock and Thornton criteria, and clinical classification based on the dose-time-susceptibility (DoTS) system...
December 1, 2016: British Journal of Clinical Pharmacology
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