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https://www.readbyqxmd.com/read/29342203/biological-pathways-underlying-the-association-of-red-cell-distribution-width-and-adverse-clinical-outcome-results-of-a-prospective-cohort-study
#1
Giedre Zurauskaite, Marc Meier, Alaadin Voegeli, Daniel Koch, Sebastian Haubitz, Alexander Kutz, Luca Bernasconi, Andreas Huber, Mario Bargetzi, Beat Mueller, Philipp Schuetz
BACKGROUND: Red cell distribution width (RDW) predicts disease outcome in several patient populations, but its prognostic value in addition to other disease parameters in unselected medical inpatients remains unclear. Our aim was to investigate the association of admission RDW levels and mortality adjusted for several disease pathways in unselected medical patients from a previous multicenter study. METHODS: We included consecutive adult, medical patients at the time point of hospital admission through the emergency department into this observational, cohort study...
2018: PloS One
https://www.readbyqxmd.com/read/29340851/comparison-of-antibiotic-dosing-recommendations-for-neonatal-sepsis-from-established-reference-sources
#2
T B Y Liem, E M A Slob, J U M Termote, T F W Wolfs, A C G Egberts, C M A Rademaker
Background Incorrect dosing is the most frequent prescribing error in neonatology, with antibiotics being the most frequently prescribed medicines. Computer physician order entry and clinical decision support systems can create consistency contributing to a reduction of medication errors. Although evidence-based dosing recommendations should be included in such systems, the evidence is not always available and subsequently, dosing recommendations mentioned in guidelines and textbooks are often based on expert opinion...
January 16, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29340799/fully-automated-life-support-an-implementation-and-feasibility-pilot-study-in-healthy-pigs
#3
Wilfried Klingert, Jörg Peter, Christian Thiel, Karolin Thiel, Wolfgang Rosenstiel, Kathrin Klingert, Christian Grasshoff, Alfred Königsrainer, Martin Schenk
BACKGROUND: Automated systems are available in various application areas all over the world for the purpose of reducing workload and increasing safety. However, such support systems that would aid caregivers are still lacking in the medical sector. With respect to workload and safety, especially, the intensive care unit appears to be an important and challenging application field. Whereas many closed-loop subsystems for single applications already exist, no comprehensive system covering multiple therapeutic aspects and interactions is available yet...
January 16, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29338144/mortality-and-long-term-quality-of-life-after-percutaneous-tracheotomy-in-intensive-care-unit-a-prospective-observational-study
#4
Maria Vargas, Yuda Sutherasan, Iole Brunetti, Camilla Micalizzi, Angelo Insorsi, Lorenzo Ball, Marta Folentino, Rosanna Sileo, Arduino DE Lucia, Manuela Cerana, Alessandro Accattatis, Domenico DE Lisi, Angelo Gratarola, Francesco Mora, Giorgio Peretti, Giuseppe Servillo, Paolo Pelosi
BACKGROUND: Quality of life and mortality after percutaneous dilatational tracheotomy (PDT) has been poorly investigated. The aims of this study were to evaluate the independent risk factors for Intensive Care Unit (ICU) mortality and investigate quality of life over the first year after PDT in critically ill patients. METHODS: This was a prospective, single-center, cohort study performed in a tertiary care University Hospital, enrolling consecutive ICU patients requiring elective PDT, collecting data during the tracheotomy procedure and the ICU stay...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29337008/ice-pack-induced-perineal-analgesia-after-spontaneous-vaginal-birth-randomized-controlled-trial
#5
Adriana Amorim Francisco, Sonia Maria Junqueira Vasconcellos De Oliveira, Mary Steen, Moacyr Roberto Cuce Nobre, Eder Viana De Souza
BACKGROUND: Ice-pack is widely used for alleviating postpartum perineal pain sustained after birth related perineal trauma. However, it lacks robust evidence on timing and frequency of applications, to ensure the effective and safe use of this therapy. AIMS: To evaluate if a 10min ice-pack application relieved postpartum perineal pain and if the analgesic effect was maintained for up to 2h. METHODS: A randomised controlled trial conducted from December 2012 to February 2013 with 69 primiparous women ≥18 years old, 6-24h postpartum, with perineal pain ≥3, who had not received anti-inflammatory medication or analgesics after childbirth, who were randomised to a single ice-pack application on the perineum for 10min or standard care...
January 11, 2018: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/29336972/general-anesthesia-for-transcatheter-aortic-valve-replacement-total-intravenous-anesthesia-is-associated-with-less-delirium-as-compared-to-volatile-agent-technique
#6
Allie E Goins, Alan Smeltz, Cassandra Ramm, Paula D Strassle, Emily G Teeter, John P Vavalle, Lavinia Kolarczyk
OBJECTIVE: Investigate the effect of volatile anesthesia versus total intravenous anesthesia on the incidence of postoperative delirium and length of stay in patients undergoing transcatheter aortic valve replacement under general anesthesia. DESIGN: Retrospective study. SETTING: Single institution, academic medical center. PARTICIPANTS: Adult patients who underwent transcatheter aortic valve replacement under general anesthesia between November 2014 and February 2017...
December 11, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29336389/a-randomized-controlled-trial-comparing-the-myocardial-protective-effects-of-isoflurane-with-propofol-in-patients-undergoing-elective-coronary-artery-bypass-surgery-on-cardiopulmonary-bypass-assessed-by-changes-in-n-terminal-brain-natriuretic-peptide
#7
Balaji Kuppuswamy, Kirubakaran Davis, Raj Sahajanandan, Manickam Ponniah
OBJECTIVE: The objective of the study is to compare the myocardial protective effects of isoflurane with propofol in patients undergoing elective coronary artery bypass surgery on cardiopulmonary bypass (CPB), the cardio protection been assessed by changes in N-terminal brain natriuretic peptide (NT proBNP). Methodology and Design: This study is designed as a participant blinded, prospective randomized clinical trial. SETTING: Christian Medical College Hospital, Vellore, India...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29336274/controlling-diabetes-continuous-glucose-monitoring-for-the-older-adult
#8
Caren McHenry Martin, Catherine Travis
Obtaining and maintaining adequate blood glucose control in the older adult with diabetes offers unique challenges. Intensive blood glucose control can increase the risk of hypoglycemia, which can be particularly risky in the older adult. Adding and adjusting diabetes medications in elderly patients with multiple comorbidities and numerous other medications can also be challenging. The use of professional continuous glucose monitors-which are worn by the patient for up to two weeks and record blood sugars every 5 to 15 minutes-provides pharmacists and other health care professionals with valuable data for managing the care of the older adult with diabetes...
January 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29335393/peritoneal-metastases-of-colorectal-origin-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-hipec-the-financial-aspect
#9
Tomasz Jastrzębski, Marek Bębenek
The incidence of peritoneal carcinomatosis of colorectal cancer amounts to 5%-15% for synchronous metastases and as much as 40% in cases of local recurrence. Best results are obtained for cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC). This treatment offers much better outcomes, leading to 5-year survival rates of as much as 30%-50%. The procedures require significant experience in abdominal surgery, are time-consuming (mean duration of the procedure ranging from 6 to 8 hours) and are burdened by complications that are due not only to the procedure itself but also to the intraperitoneal administration of the cytostatic drug at elevated temperature (41...
December 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29335014/cost-effectiveness-study-of-early-versus-late-parenteral-nutrition-in-critically-ill-children-pepanic-preplanned-secondary-analysis-of-a-multicentre-randomised-controlled-trial
#10
Esther van Puffelen, Suzanne Polinder, Ilse Vanhorebeek, Pieter Jozef Wouters, Niek Bossche, Guido Peers, Sören Verstraete, Koen Felix Maria Joosten, Greet Van den Berghe, Sascha Cornelis Antonius Theodorus Verbruggen, Dieter Mesotten
BACKGROUND: The multicentre randomised controlled PEPaNIC trial showed that withholding parenteral nutrition (PN) during the first week of critical illness in children was clinically superior to providing early PN. This study describes the cost-effectiveness of this new nutritional strategy. METHODS: Direct medical costs were calculated with use of a micro-costing approach. We compared the costs of late versus early initiation of PN (n = 673 versus n = 670 patients) in the Belgian and Dutch study populations from a hospital perspective, using Student's t test with bootstrapping...
January 15, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29332427/serum-potassium-levels-and-outcomes-in-critically-ill-patients-in-the-medical-intensive-care-unit
#11
Surat Tongyoo, Tanuwong Viarasilpa, Chairat Permpikul
Objective To compare the outcomes of patients with and without a mean serum potassium (K+) level within the recommended range (3.5-4.5 mEq/L). Methods This prospective cohort study involved patients admitted to the medical intensive care unit (ICU) of Siriraj Hospital from May 2012 to February 2013. The patients' baseline characteristics, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, serum K+ level, and hospital outcomes were recorded. Patients with a mean K+ level of 3.5 to 4.5 mEq/L and with all individual K+ values of 3...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29331796/determination-of-meropenem-in-endotracheal-tubes-by-in-tube-solid-phase-microextraction-coupled-to-capillary-liquid-chromatography-with-diode-array-detection
#12
L Hakobyan, J Pla Tolos, Y Moliner-Martinez, C Molins-Legua, Jesús Ruiz Ramos, M Gordon, Paula Ramirez-Galleymore, P Campins-Falco
Meropenem is a widely used antimicrobial for the treatment of infections associated with the use of invasive medical devices in intensive care unit patients. These treatments are not always effective, in fact, in-vitro studies have demonstrated the difficulty of antimicrobials to penetrate into the biofilm, however in-vivo studies of the effect of these compounds is a trend, mostly because of the complexity of pulmonary samples extracted from ETTs. Therefore, the objective of this study was to evaluate in-tube solid phase microextraction (in-tube SPME) coupled to capillary liquid chromatography (CapLC) with DAD to determine meropenem in ETTs in order to estimate the penetration capability into the biofilm...
January 8, 2018: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29331713/repeated-attempted-homicide-by-administration-of-drugs-documented-by-hair-analysis
#13
Valérie Baillif-Couniou, Christophe Bartoli, Caroline Sastre, Marjorie Chèze, Marc Deveaux, Georges Léonetti, Anne-Laure Pélissier-Alicot
Attempted murder by repeated poisoning is quite rare. The authors describe the case of a 62-year-old man who was admitted to an intensive care unit (ICU) for neurological disturbances complicated by inhalation pneumopathy. He presented a loss of consciousness while his wife was visiting him at the ICU (H0). Forty-eight hours later (H48), police officers apprehended the patient's wife pouring a liquid into his fruit salad at the hospital. Toxicological analyses of a blood sample and the infusion equipment (H0), as well as the fruit salad and its container (H48), confirmed the attempted poisoning with cyamemazine (H0) and hydrochloric acid (H48)...
January 5, 2018: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/29331656/effect-of-a-wearable-patient-sensor-on-care-delivery-for-preventing-pressure-injuries-in-acutely-ill-adults-a-pragmatic-randomized-clinical-trial-ls-hapi-study
#14
David Pickham, Nic Berte, Mike Pihulic, Andre Valdez, Barbara Mayer, Manisha Desai
IMPORTANCE: Though theoretically sound, studies have failed to demonstrate the benefit of routine repositioning of at-risk patients for the prevention of hospital acquired pressure injuries. OBJECTIVE: To assess the clinical effectiveness of a wearable patient sensor to improve care delivery and patient outcomes by increasing the total time with turning compliance and preventing pressure injuries in acutely ill patients. DESIGN: Pragmatic, investigator initiated, open label, single site, randomized clinical trial...
December 30, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29331194/-specificities-of-nursing-care-in-neurological-intensive-care
#15
REVIEW
Christelle Garijo, Flavien Chabert, Cécile Armonia, Perrine Boucheix
In the acute phase of the treatment of patients with brain injuries, the management of secondary brain injuries of systemic origin is a priority. A neurosurgical intensive care paramedical team shares their experience of the care delivered and the constant monitoring carried out to optimise, with the medical team, the patient's outcome and to innovate practices.
January 2018: Revue de L'infirmière
https://www.readbyqxmd.com/read/29330241/primary-care-physician-involvement-in-shared-decision-making-for-critically-ill-patients-and-family-satisfaction-with-care
#16
Kevin B Huang, Urs Weber, Jennifer Johnson, Nathanial Anderson, Andrea K Knies, Belinda Nhundu, Cynthia Bautista, Kelly Poskus, Kevin N Sheth, David Y Hwang
PURPOSE: An intensive care unit (ICU) patient's primary care physician (PCP) may be able to assist family with certain ICU shared medical decisions. We explored whether families of patients in nonopen ICUs who nevertheless report involvement of a patient's PCP in medical decision making are more satisfied with ICU shared decision making than families who do not. METHODS: Between March 2013 and December 2015, we administered the Family Satisfaction in the ICU 24 survey to family members of adult neuroscience ICU patients...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330232/interventions-must-be-realistic-to-be-useful-and-completed-in-family-medicine
#17
EDITORIAL
Marjorie A Bowman, Dean A Seehusen, Anne Victoria Neale
Being realistic while helping our patients is this issue's theme. Given the volume of tasks required in family medicine, recommendations for improvements in direct care or care measurement cannot just be evidence-based but must also be realistic. On the list of realistic: ordering antipsychotics for symptoms of dementia in the elderly, despite recommendations to not do so; ordering antidepressants without fear that the patient could develop hypertension; mental health care providers in primary care offices; forced choice for opioid management; plus agenda setting for visit efficiency...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29329548/the-cost-of-a-pediatric-neurocritical-care-program-for-traumatic-brain-injury-a-retrospective-cohort-study
#18
Steven W Howard, Zidong Zhang, Paula Buchanan, Stephanie L Bernell, Christine Williams, Lindsey Pearson, Michael Huetsch, Jeff Gill, Jose A Pineda
BACKGROUND: Inpatient care for children with severe traumatic brain injury (sTBI) is expensive, with inpatient charges averaging over $70,000 per case (Hospital Inpatient, Children Only, National Statistics. Diagnoses- clinical classification software (CCS) principal diagnosis category 85 coma, stupor, and brain damage, and 233 intracranial injury. Diagnoses by Aggregate charges [ https://hcupnet.ahrq.gov/#setup ]). This ranks sTBI in the top quartile of pediatric conditions with the greatest inpatient costs (Hospital Inpatient, Children Only, National Statistics...
January 12, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29329456/designing-and-evaluating-an-automated-system-for-real-time-medication-administration-error-detection-in-a-neonatal-intensive-care-unit
#19
Yizhao Ni, Todd Lingren, Eric S Hall, Matthew Leonard, Kristin Melton, Eric S Kirkendall
Background: Timely identification of medication administration errors (MAEs) promises great benefits for mitigating medication errors and associated harm. Despite previous efforts utilizing computerized methods to monitor medication errors, sustaining effective and accurate detection of MAEs remains challenging. In this study, we developed a real-time MAE detection system and evaluated its performance prior to system integration into institutional workflows. Methods: Our prospective observational study included automated MAE detection of 10 high-risk medications and fluids for patients admitted to the neonatal intensive care unit at Cincinnati Children's Hospital Medical Center during a 4-month period...
January 10, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29329356/prognostic-factors-of-noninvasive-mechanical-ventilation-in-lung-cancer-patients-with-acute-respiratory-failure
#20
Wei-Chih Chen, Vincent Yi-Fong Su, Wen-Kuang Yu, Yen-Wen Chen, Kuang-Yao Yang
INTRODUCTION: Few studies have reported outcomes of lung cancer patients with acute respiratory failure (RF) using noninvasive positive pressure ventilation (NIPPV). The aim of this study was to investigate the prognostic factors in these patients. MATERIALS AND METHODS: This retrospective observational study included all hospitalized lung cancer patients who received NIPPV for acute RF. It was conducted at a tertiary medical center in Taiwan from 2005 to 2010. The primary outcome was all cause mortality at 28 days after the initiation of NIPPV...
2018: PloS One
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