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https://www.readbyqxmd.com/read/28231633/barriers-to-regaining-control-within-a-constructivist-grounded-theory-of-family-resilience-in-icu-living-with-uncertainty
#1
Pauline Wong, Pranee Liamputtong, Susan Koch, Helen Rawson
This paper discusses families' experiences of their interactions when a relative is admitted unexpectedly to an Australian intensive care unit BACKGROUND: The overwhelming emotions associated with the unexpected admission of a relative to an intensive care unit (ICU) are often due to the uncertainty surrounding the condition of their critically ill relative. There is limited in-depth understanding of the nature of uncertainty experienced by families in ICU, and interventions perceived by families to minimise their uncertainty are not well documented...
February 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28231631/commentary-response-frailty-not-just-about-old-people-reply-to-smith-gd-kydd-a-2017-getting-care-of-older-people-right-the-need-for-appropriate-frailty-assessment
#2
Sunita R Jha, Julee Mcdonagh, Caleb Ferguson, Peter S Macdonald, Phillip J Newton
As highlighted in a recent editorial, the ageing population and burden of frailty amongst those aged 60 years and older represents an impending challenge for individuals and health care systems globally (Smith & Kydd 2017). As frailty is largely considered a geriatric syndrome, research has primarily occurred within elderly community dwelling populations (Fried et al. 2001). However, it is important to highlight that not all older people are frail; and conversely not all younger people are non-frail. With frailty research expanding its scope beyond geriatrics over the last 2 decades, our understanding of this syndrome and its complexities has progressed...
February 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28231475/the-use-and-yield-of-continuous-eeg-in-critically-ill-patients-a-comparative-study-of-three-centers
#3
Vincent Alvarez, Andres A Rodriguez Ruiz, Suzette LaRoche, Lawrence J Hirsch, Christopher Parres, Paula E Voinescu, Andres Fernandez, Ognen A Petroff, Nishi Rampal, Hiba Arif Haider, Jong Woo Lee
OBJECTIVE: Continuous EEG (cEEG) monitoring of critically ill patients has gained widespread use, but there is substantial reported variability in its use. We analyzed cEEG and antiseizure drug (ASD) usage at three high volume centers. METHODS: We utilized a multicenter cEEG database used daily as a clinical reporting tool in three tertiary care sites (Emory Hospital, Brigham and Women's Hospital and Yale - New Haven Hospital). We compared the cEEG usage patterns, seizure frequency, detection of rhythmic/periodic patterns (RPP), and ASD use between the sites...
January 17, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28231442/ethnomethodological-studies-of-nurse-patient-and-nurse-relative-interactions-a-scoping-review
#4
REVIEW
Eric Mayor, Lucas Bietti
OBJECTIVES: Researchers in nursing science interested in the study of nurse-patient and nurse-relative interactions have displayed an ever increasing interest in ethnomethodology and conversation analysis. This review assesses the scope of this literature. We categorize the papers in thematic categories determined both inductively and deductively and synthesize the main findings of this literature within category. Finally we discuss the interactional determinants of the lack patient participation, the limitations of the field, and focus on implications...
February 9, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28231398/living-with-melanoma-%C3%A2-for-a-day-a-phenomenological-analysis-of-medical-students-simulated-experiences
#5
M Corr, G Roulston, N King, T Dornan, C Blease, G J Gormley
BACKGROUND: Despite the rising incidence of melanoma, medical students have progressively fewer opportunities to encounter patients with this important condition. Curricula tend to attach the greatest value to intellectual forms of learning. Compared to intellectual learning, however, experiential learning affords students deep insights about a condition. Doctors who experience ill health are more empathic towards patients. However opportunities to learn about cancer experientially are limited...
February 23, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28230634/platelet-dysfunction-in-critically-ill-patients
#6
Travis Hase, Sarah Sirajuddin, Patrick Maluso, Raksha Bangalore, Louis DePalma, Babak Sarani
Thrombelastography Platelet Mapping (TEG-PM) allows for measurement of maximal potential clot strength (MA) and strength from stimulation of arachidonic acid (MA-AA) and adenosine disphosphate (MA-ADP) receptors. This study was conducted to assess degree of platelet dysfunction in critically ill adult patients. A retrospective study of critically ill, adult, nontrauma patients in a medical/surgical ICU was conducted from August 2013 to September 2014. All patients who underwent TEG-PM were enrolled. Patients with intracerebral hemorrhage, following cardiac surgery, or without an APACHE II score were excluded...
February 21, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28229129/sphincterotomy-with-endoscopic-biliary-drainage-for-severe-acute-cholangitis-a-meta-analysis
#7
Tarek Sawas, Noura Arwani, Shadi Al Halabi, John Vargo
Aims To investigate the role of endoscopic sphincterotomy (ES) with endoscopic biliary drainage (EBD) in acute severe obstructive cholangitis management by performing a meta-analysis of controlled trials. Method We searched PubMed and Embase for controlled studies that compared endoscopic drainage with ES versus Non-ES in acute obstructive cholangitis. Two reviewers selected the studies and extracted the data. Disagreement was addressed by a third reviewer. Heterogeneity of the studies was analyzed by Cochran's Q statistics...
February 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28228057/intravenous-chlorothiazide-versus-enteral-metolazone-to-augment-loop-diuretic-therapy-in-the-intensive-care-unit
#8
Christopher J Michaud, Kendall C Mintus
BACKGROUND: In cases of loop diuretic resistance in the intensive care unit (ICU), recommendations for a specific second-line thiazide agent are lacking. OBJECTIVE: To compare the effects of intravenous chlorothiazide (CTZ) and enteral metolazone (MET) on urine output (UOP) when added to furosemide monotherapy therapy in critically ill adults. METHODS: This was a retrospective cohort study conducted in the medical, surgical, and cardiothoracic ICUs of a quaternary medical center...
April 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28227158/interventional-placement-of-thin-coil-shaped-implants-powered-wirelessly-for-monitoring-vital-signals-and-controlling-abnormal-activities-by-electro-stimulation
#9
Hidetoshi Ohta, Masanobu Honda, Makoto Takamiya, Hidetoshi Ohta, Masanobu Honda, Makoto Takamiya, Masanobu Honda, Hidetoshi Ohta, Makoto Takamiya
Various types of implants are being commonly used for monitoring vital signals and controlling the critically ill patient's condition such as arrhythmia, sick sinus syndrome, etc. For implanting these medical devices under the skin, surgery is inevitable. These days many patients are more willing to accept interventional therapies that are less invasive, especially inserting a catheter into a blood vessel or endoscopy through a natural orifice. To be able to use interventional therapy for implanting medical devices, they will need to be small enough to fit them through a catheter or the forceps channel of an endoscope...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227082/long-term-quasi-continuous-oxygen-saturation-levels-obtained-from-sternal-photoplethysmography-on-patients-with-obstructive-lung-diseases
#10
Shadi S Chreiteh, Dorthe B Saadi, Bo Belhage, Nassim Nabipour, Karsten Hoppe, Erik V Thomsen, Shadi S Chreiteh, Dorthe B Saadi, Bo Belhage, Nassim Nabipour, Karsten Hoppe, Erik V Thomsen, Bo Belhage, Karsten Hoppe, Shadi S Chreiteh, Nassim Nabipour, Erik V Thomsen, Dorthe B Saadi
Calculation of long-term quasi-continuous oxygen saturation (SpO2) levels is highly relevant for critically ill patients. The purpose of this study is therefore to conduct a preliminary investigation of the clinical reliability of long-term photoplethysmography (PPG) recordings obtained from the sternum of patients admitted to the hospital with obstructive lung diseases. Due to the lack of a gold standard reference that is suitable for long-term monitoring without interfering with the patient's activity level, we extracted reliable segments based on knowledge from the basic pulse oximeter theory as well as knowledge about the inherent physiological regulation of the SpO2 levels...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227079/a-clinical-study-of-short-term-sternal-photoplethysmography-recordings-from-patients-with-obstructive-airways-diseases
#11
Shadi S Chreiteh, Dorthe B Saadi, Bo Belhage, Nassim Nabipour, Karsten Hoppe, Erik V Thomsen, Shadi S Chreiteh, Dorthe B Saadi, Bo Belhage, Nassim Nabipour, Karsten Hoppe, Erik V Thomsen, Bo Belhage, Karsten Hoppe, Shadi S Chreiteh, Nassim Nabipour, Erik V Thomsen, Dorthe B Saadi
Traditionally, measurements of the oxygen saturation (SpO2) has been confound to the extremities. In this study, we therefore investigated the possibility for reliable estimation of clinically relevant SpO2 levels from photoplethysmography (PPG) obtained on the sternum of patients with obstructive airway diseases. We initiated the study with a calibration of a prototype sternal PPG sensor. In accordance with the ISO 80601-2-61:2011 guidelines, the calibration was conducted as a controlled desaturation study...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226980/gastric-mucosa-injury-quantification-in-an-ischemia-reperfusion-experimental-model
#12
E Pena-Mercado, M Garcia-Lorenzana, E Arechaga, C H Gonzalez-de la Rosa, N E Beltran, E Pena-Mercado, M Garcia-Lorenzana, E Arechaga, C H Gonzalez-de la Rosa, N E Beltran, E Arechaga, E Pena-Mercado, M Garcia Lorenzana, N E Beltran
Gastric ischemia - reperfusion (I/R) injury is an important clinical problem, which is developed in more than 80% of critically ill patients. I/R is caused by interruption of blood supply to an organ or tissue followed by blood reflow into the exposed area, leading to multiple organ failure and death. Gastric reactance has been proposed to measure tissue injury caused by ischemia. The present study evaluates a new method to quantify gastric tissue damage due to I/R, and assess its relation to gastric reactance changes...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226967/nonlinear-model-predictive-glycemic-control-of-critically-ill-patients-using-online-identification-of-insulin-sensitivity
#13
Sha Wu, Eiko Furutani, Sha Wu, Eiko Furutani, Eiko Furutani, Sha Wu
In critically ill patients suffering from hyperglycemia, it has been recently shown that mortality and morbidity can be reduced by keeping blood glucose within the range of 80-110 mg/dL. However, maintaining glycemia within such range is difficult due to the time variability in insulin sensitivity in critically ill patients. In this paper, we propose a novel glycometabolism model of critically ill patients with an insulin sensitivity parameter and develop a nonlinear model predictive glycemic control system with online identification of insulin sensitivity at one-hour intervals...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226029/predictive-value-of-c-reactive-protein-in-critically-ill-patients-after-abdominal-surgery
#14
Frédéric Sapin, Patrick Biston, Michael Piagnerelli
OBJECTIVES: The development of sepsis after abdominal surgery is associated with high morbidity and mortality. Due to inflammation, it may be difficult to diagnose infection when it occurs, but measurement of C-reactive protein could facilitate this diagnosis. In the present study, we evaluated the predictive value and time course of C-reactive protein in relation to outcome in patients admitted to the intensive care unit (ICU) after abdominal surgery. METHODS: We included patients admitted to the ICU after abdominal surgery over a period of two years...
January 1, 2017: Clinics
https://www.readbyqxmd.com/read/28225376/a-qualitative-analysis-of-general-emergency-medicine-providers-perceptions-on-pediatric-emergency-telemedicine
#15
Ji Won Kim, Gunjan Tiyyagura, Melissa Langhan
OBJECTIVE: Most children in the United States are evaluated in general emergency departments (ED), which are staffed by practitioners who care for both adults and children and may have limited pediatric resources. The application of telemedicine in pediatrics is growing and has been shown to be effective in outpatient as well as critical care settings. Telemedicine has the potential to address disparities in access to pediatric emergency care. The objective of this study was to explore experiences of general ED providers with telemedicine and their perception about a potential video telemedicine program with pediatric ED providers...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28224107/risk-factors-for-mortality-in-postoperative-peritonitis-in-critically-ill-patients
#16
Yoann Launey, Benjamin Duteurtre, Raphaëlle Larmet, Nicolas Nesseler, Audrey Tawa, Yannick Mallédant, Philippe Seguin
AIM: To identify the risk factors for mortality in intensive care patients with postoperative peritonitis (POP). METHODS: This was a retrospective analysis using a prospective database that includes all patients hospitalized in a surgical intensive care unit for POP from September 2006 to August 2011. The data collected included demographics, comorbidities, postoperative severity parameters, bacteriological findings, adequacy of antimicrobial therapy and surgical treatments...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224105/nutrient-stimulation-of-mesenteric-blood-flow-implications-for-older-critically-ill-patients
#17
REVIEW
Thu An Nguyen, Yasmine Ali Abdelhamid, Liza K Phillips, Leeanne S Chapple, Michael Horowitz, Karen L Jones, Adam M Deane
Nutrient ingestion induces a substantial increase in mesenteric blood flow. In older persons (aged ≥ 65 years), particularly those with chronic medical conditions, the cardiovascular compensatory response may be inadequate to maintain systemic blood pressure during mesenteric blood pooling, leading to postprandial hypotension. In older ambulatory persons, postprandial hypotension is an important pathophysiological condition associated with an increased propensity for syncope, falls, coronary vascular events, stroke and death...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224103/management-of-parenteral-nutrition-in-critically-ill-patients
#18
REVIEW
Paolo Cotogni
Artificial nutrition (AN) is necessary to meet the nutritional requirements of critically ill patients at nutrition risk because undernutrition determines a poorer prognosis in these patients. There is debate over which route of delivery of AN provides better outcomes and lesser complications. This review describes the management of parenteral nutrition (PN) in critically ill patients. The first aim is to discuss what should be done in order that the PN is safe. The second aim is to dispel "myths" about PN-related complications and show how prevention and monitoring are able to reach the goal of "near zero" PN complications...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28222898/strategies-for-the-optimal-timing-to-start-renal-replacement-therapy-in-critically-ill-patients-with-acute-kidney-injury
#19
REVIEW
Sean M Bagshaw, Ron Wald
Renal replacement therapy (RRT) is increasingly utilized to support critically ill patients with severe acute kidney injury (AKI). The question of whether and when to start RRT for a critically ill patient with AKI has long troubled clinicians. When severe complications of AKI develop, the need to commence RRT is unambiguous. In the absence of such complications but in the presence of severe AKI, the optimal time and thresholds for starting RRT are uncertain. The majority of existing data have largely been derived from observational studies...
February 17, 2017: Kidney International
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#20
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
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