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https://www.readbyqxmd.com/read/28522901/transition-of-early-phase-treatment-for-acute-pancreatitis-an-analysis-of-nationwide-epidemiological-survey
#1
EDITORIAL
Shin Hamada, Atsushi Masamune, Tooru Shimosegawa
Treatment of acute pancreatitis (AP) is one of the critical challenges to the field of gastroenterology because of its high mortality rate and high medical costs associated with the treatment of severe cases. Early-phase treatments for AP have been optimized in Japan, and clinical guidelines have been provided. However, changes in early-phase treatments and the relationship between treatment strategy and clinical outcome remain unclear. Retrospective analysis of nationwide epidemiological data shows that time for AP diagnosis has shortened, and the amount of initial fluid resuscitation has increased over time, indicating the compliance with guidelines...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28521022/management-of-untreatable-ventricular-arrhythmias-during-pharmacologic-challenges-with-sodium-channel-blockers-for-suspected-brugada-syndrome
#2
Stefano Poli, Mauro Toniolo, Massimo Maiani, Davide Zanuttini, Luca Rebellato, Igor Vendramin, Ermanno Dametto, Guglielmo Bernardi, Flavio Bassi, Carlo Napolitano, Ugolino Livi, Alessandro Proclemer
Pharmacologic challenge with sodium channel blockers is part of the diagnostic workout in patients with suspected Brugada syndrome. The test is overall considered safe but both ajmaline and flecainide detain well known pro-arrhythmic properties. Moreover, the treatment of patients with life-threatening arrhythmias during these diagnostic procedures is not well defined. Current consensus guidelines suggest to adopt cautious protocols interrupting the sodium channel blockers as soon as any ECG alteration appears...
May 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28513531/who-should-lead-a-trauma-team-surgeon-or-non-surgeon-a-systematic-review-and-meta-analysis
#3
Shahab Hajibandeh, Shahin Hajibandeh
BACKGROUND: Presence of a trauma team leader (TTL) in the trauma team is associated with positive patient outcomes in major trauma. The TTL is traditionally a surgeon who coordinates the resuscitation and ensures adherence to Advanced Trauma Life Support (ATLS) guidelines. The necessity of routine surgical leadership in the resuscitative component of trauma care has been questioned by some authors. Therefore, it remains controversial who should lead the trauma team. We aimed to evaluate outcomes associated with surgeon versus non-surgeon TTLs in management of trauma patients...
June 1, 2017: Journal of Injury & Violence Research
https://www.readbyqxmd.com/read/28509730/american-college-of-critical-care-medicine-clinical-practice-parameters-for-hemodynamic-support-of-pediatric-and-neonatal-septic-shock
#4
Alan L Davis, Joseph A Carcillo, Rajesh K Aneja, Andreas J Deymann, John C Lin, Trung C Nguyen, Regina S Okhuysen-Cawley, Monica S Relvas, Ranna A Rozenfeld, Peter W Skippen, Bonnie J Stojadinovic, Eric A Williams, Tim S Yeh, Fran Balamuth, Joe Brierley, Allan R de Caen, Ira M Cheifetz, Karen Choong, Edward Conway, Timothy Cornell, Allan Doctor, Marc-Andre Dugas, Jonathan D Feldman, Julie C Fitzgerald, Heidi R Flori, James D Fortenberry, Ana Lia Graciano, Bruce M Greenwald, Mark W Hall, Yong Yun Han, Lynn J Hernan, Jose E Irazuzta, Elizabeth Iselin, Elise W van der Jagt, Howard E Jeffries, Saraswati Kache, Chhavi Katyal, Niranjan Tex Kissoon, Alexander A Kon, Martha C Kutko, Graeme MacLaren, Timothy Maul, Renuka Mehta, Fola Odetola, Kristine Parbuoni, Raina Paul, Mark J Peters, Suchitra Ranjit, Karin E Reuter-Rice, Eduardo J Schnitzler, Halden F Scott, Adalberto Torres, Jacki Weingarten-Abrams, Scott L Weiss, Jerry J Zimmerman, Aaron L Zuckerberg
OBJECTIVES: The American College of Critical Care Medicine provided 2002 and 2007 guidelines for hemodynamic support of newborn and pediatric septic shock. Provide the 2014 update of the 2007 American College of Critical Care Medicine "Clinical Guidelines for Hemodynamic Support of Neonates and Children with Septic Shock." DESIGN: Society of Critical Care Medicine members were identified from general solicitation at Society of Critical Care Medicine Educational and Scientific Symposia (2006-2014)...
June 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28508956/doctors-attitudes-towards-the-introduction-and-clinical-operation-of-do-not-resuscitate-orders-dnrs-in-ireland
#5
M O'Reilly, C M P O'Tuathaigh, K Doran
BACKGROUND: Do not resuscitate orders (DNRs) are documents which state that should a patient suffer from cardiopulmonary failure, resuscitation should not be attempted. Internationally, DNRs are often misunderstood and used inappropriately in a clinical setting. AIMS: The aim of this paper was to determine the current understanding of DNRs and their clinical operation among hospital doctors in Ireland. METHODS: A cross-sectional, questionnaire-based study was conducted involving doctors from the Cork teaching hospitals...
May 16, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28501220/7-8-hydroxy-2-deoxyguanosine-2-deoxiguanosine-ratio-determined-in-hydrolysates-of-brain-dna-by-ultrachromatrography-coupled-to-tandem-mass-spectrometry
#6
Isabel Torres-Cuevas, Miguel Aupi, Miguel Angel Asensi, Máximo Vento, Ángel Ortega, Javier Escobar
7,8-hydroxy-2'-deoxyguanosine (8-OHdG) is an abundant DNA lesion formed by oxidation of the nucleoside 2'-deoxyguanosine (2-dG) and one of the most studied and accepted oxidative stress biomarkers. 8-OHdG has a strong carcinogenic potential, and prolonged oxidative stress heightens pathological conditions and especially cancer risk. Our aim was to develop, validate and apply a reliable method to assess DNA oxidation in genomic cellular DNA of sensible target organs such as brain. A procedure to isolate and digest the DNA of brain tissue properly for further detection of 8-OHdG and 2-dG by Ultra Performance Liquid Chromatography-tandem Mass Spectrometry (UPLC-MS/MS) was optimized...
August 1, 2017: Talanta
https://www.readbyqxmd.com/read/28501114/evaluation-of-palliative-care-training-and-skills-retention-by-medical-students
#7
Priti P Parikh, Mary T White, Lynne Buckingham, Kathryn M Tchorz
BACKGROUND: Training in palliative and end-of-life care has been introduced in medical education; however, the impact of such training and the retention of skills and knowledge have not been studied in detail. This survey study examines long-term follow-up on end-of-life communication skills training, evaluation, and skills retention in medical students. MATERIALS AND METHODS: During the surgical clerkship, all third-year medical students received communication skills training in palliative care using simulated patients...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28499516/improving-cpr-performance
#8
REVIEW
Boulos S Nassar, Richard Kerber
Cardiac arrest continues to represent a public health burden with most patients having dismal outcomes. Cardiopulmonary resuscitation (CPR) is a complex set of interventions requiring leadership, coordination, and best practices. Despite the widespread adoption of new evidence in various guidelines, the provision of CPR remains variable with poor adherence to published recommendations. Key steps health care systems can take to enhance the quality of CPR and, potentially, to improve outcomes, include optimizing chest compressions; avoiding hyperventilation; encouraging intraosseus access, and monitoring capnography...
May 9, 2017: Chest
https://www.readbyqxmd.com/read/28492403/pediatric-in-hospital-acute-respiratory-compromise-a-report-from-the-american-heart-association-s-get-with-the-guidelines-resuscitation-registry
#9
Lars W Andersen, Mikael Vognsen, Alexis Topjian, Linda Brown, Robert A Berg, Vinay M Nadkarni, Hans Kirkegaard, Michael W Donnino
OBJECTIVES: The main objectives of this study were to describe in-hospital acute respiratory compromise among children (< 18 yr old), and its association with cardiac arrest and in-hospital mortality. DESIGN: Observational study using prospectively collected data. SETTING: U.S. hospitals reporting data to the "Get With The Guidelines-Resuscitation" registry. PATIENTS: Pediatric patients (< 18 yr old) with acute respiratory compromise...
May 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28490655/practice-guideline-summary-reducing-brain-injury-following-cardiopulmonary-resuscitation-report-of-the-guideline-development-dissemination-and-implementation-subcommittee-of-the-american-academy-of-neurology
#10
Romergryko G Geocadin, Eelco Wijdicks, Melissa J Armstrong, Maxwell Damian, Stephan A Mayer, Joseph P Ornato, Alejandro Rabinstein, José I Suarez, Michel T Torbey, Richard M Dubinsky, Jason Lazarou
OBJECTIVE: To assess the evidence and make evidence-based recommendations for acute interventions to reduce brain injury in adult patients who are comatose after successful cardiopulmonary resuscitation. METHODS: Published literature from 1966 to August 29, 2016, was reviewed with evidence-based classification of relevant articles. RESULTS AND RECOMMENDATIONS: For patients who are comatose in whom the initial cardiac rhythm is either pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF) after out-of-hospital cardiac arrest (OHCA), therapeutic hypothermia (TH; 32-34°C for 24 hours) is highly likely to be effective in improving functional neurologic outcome and survival compared with non-TH and should be offered (Level A)...
May 10, 2017: Neurology
https://www.readbyqxmd.com/read/28486899/a-survey-of-australian-and-new-zealand-anaesthetists-attitudes-towards-resuscitation-orders-in-the-perioperative-setting
#11
Z Keon-Cohen, P S Myles, D A Story
Not for resuscitation (NFR) orders are often suspended during anaesthesia, as perioperative care is believed to inherently involve the need for resuscitation including ventilation support. Recent legislative changes in Australia, New Zealand and the UK have enacted the binding nature of advance care directives (ACDs) in healthcare. National guidelines regarding codes of practice and government strategic plans for implementing advance care planning have reinforced the role for advance care planning in modern healthcare...
May 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28476474/the-association-between-aha-cpr-quality-guideline-compliance-and-clinical-outcomes-from-out-of-hospital-cardiac-arrest
#12
Sheldon Cheskes, Robert H Schmicker, Tom Rea, Laurie J Morrison, Brian Grunau, Ian R Drennan, Brian Leroux, Christian Vaillancourt, Terri A Schmidt, Allison C Koller, Peter Kudenchuk, Tom P Aufderheide, Heather Herren, Katharyn H Flickinger, Mark Charleston, Ron Straight, Jim Christenson
BACKGROUND: Measures of chest compression fraction (CCF), compression rate, compression depth and pre-shock pause have all been independently associated with improved outcomes from out-of-hospital (OHCA) cardiac arrest. However, it is unknown whether compliance with American Heart Association (AHA) guidelines incorporating all the aforementioned metrics, is associated with improved survival from OHCA. METHODS: We performed a secondary analysis of prospectively collected data from the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest database...
May 2, 2017: Resuscitation
https://www.readbyqxmd.com/read/28474598/neonatal-resuscitation-guidelines-india-specific-concerns
#13
Rhishikesh Thakre
No abstract text is available yet for this article.
April 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28472699/outcomes-of-patients-with-severe-infection-in-uganda-according-to-adherence-to-the-world-health-organization-s-integrated-management-of-adolescent-and-adult-illness-fluid-resuscitation-guidelines
#14
Abdallah Amir, Kacie J Saulters, Rose Muhindo, Christopher C Moore
PURPOSE: We determined outcomes in hospitalized patients in Uganda with World Health Organization's Integrated Management of Adolescent and Adult Illness (IMAI) defined septic shock (IMAI-shock) or severe respiratory distress without shock (IMAI-SRD) based on whether they received recommended fluid resuscitation according to IMAI guidelines. MATERIALS AND METHODS: We performed a secondary analysis of a prospective cohort of adult septic patients in Uganda that included the volume of fluids patients received during the first 6h of resuscitation...
April 26, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28471147/clinical-cardiac-imaging-in-cardiac-arrest-and-periarrest
#15
Antonio F Amico
Echocardiography during preresuscitation care, cardiopulmonary resuscitation and postresuscitation is suggested to be an important tool in critical care medicine. At present a structured process integrating advanced life support and transtoracic echocardiography is not included in guidelines of cardiac resuscitation. However identification and treatment of reversible causes or complicating factors during cardiopulmonary resuscitation is rational and aimed to improve the outcomes. Furthermore, echocardiography has the potential to define the efficiency of the chest compressions and the optimal duration of the resuscitation maneuvers and/or the right time to switch to extracorporeal resuscitation...
May 3, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28468633/myocardial-and-haemodynamic-responses-to-two-fluid-regimens-in-african-children-with-severe-malnutrition-and-hypovolaemic-shock-afrim-study
#16
Nchafatso Obonyo, Bernadette Brent, Peter Olupot-Olupot, Michael Boele van Hensbroek, Irene Kuipers, Sidney Wong, Kenji Shiino, Jonathan Chan, John Fraser, Job B M van Woensel, Kathryn Maitland
BACKGROUND: Fluid therapy in severely malnourished children is hypothesized to be deleterious owing to compromised cardiac function. We evaluated World Health Organization (WHO) fluid resuscitation guidelines for hypovolaemic shock using myocardial and haemodynamic function and safety endpoints. METHODS: A prospective observational study of two sequential fluid management strategies was conducted at two East African hospitals. Eligible participants were severely malnourished children, aged 6-60 months, with hypovolaemic shock secondary to gastroenteritis...
May 3, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28466799/-resuscitation-after-trauma-better-survival-chances-thanks-to-goal-oriented-treatment
#17
L Koers, J L van Schuppen, V A Viersen, F O Kooij, J C Goslings, M W Hollmann
- Recent literature shows increased survival for patients with traumatic cardiac arrest.- An early and aggressive approach to underlying causes and good integrated trauma care are probably responsible for this.- The new resuscitation guideline of the European Resuscitation Council emphasises that treatment of the underlying cause deserves more priority than performing chest compressions.- In addition to a structured approach with interventions focused on the causes of the arrest, standard operating procedures and protocols, regular scenario training and clinical governance are vital to improve survival chances for these patients...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28466294/-cardiac-support-and-replacement-systems
#18
REVIEW
T Graf, H Thiele
In recent years, the widespread use of partial mechanical cardiac support and even temporary complete replacement of cardiac function has been established in many intensive care units in the treatment of refractory cardiogenic shock. There is a difference between partial left-ventricular assist devices (LVAD) and the possibility of complete heart (and lung) replacement by extra corporeal life support (ECLS). Despite the use of mechanical support devices, the mortality of cardiogenic shock remains high. The consideration of using percutaneous LVAD and ECLS in cardiogenic shock should be considered in refractory cardiogenic shock patients in addition to support by catecholamines and after early revascularization in acute coronary syndromes...
May 2, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28463391/nya-nationella-riktlinjer-f%C3%A3-r-extremt-f%C3%A3-r-tidigt-f%C3%A3-dda-ett-viktigt-steg-fram%C3%A3-t-f%C3%A3-r-b%C3%A3-ttre-v%C3%A3-rd
#19
Mikael Norman
New Swedish guideline on periviable births A new national guideline on management of periviable births has been issued by the Swedish Neonatal and Obstetric Societies. The guideline focuses on management of deliveries at 22 to 25 weeks of gestation and five interventions are pin-pointed: centralization of care, use of antenatal corticosteroids, mode of delivery (use of C-section), neonatologist present in the delivery room and start of neonatal resuscitation. For each gestational week, a statement is made on whether or not the specific intervention is recommended...
April 25, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28456389/development-of-reliable-and-validated-tools-to-evaluate-technical-resuscitation-skills-in-a-pediatric-simulation-setting-resuscitation-and-emergency-simulation-checklist-for-assessment-in-pediatrics
#20
Camille Faudeux, Antoine Tran, Audrey Dupont, Jonathan Desmontils, Isabelle Montaudié, Jean Bréaud, Marc Braun, Jean-Paul Fournier, Etienne Bérard, Noémie Berlengi, Cyril Schweitzer, Hervé Haas, Hervé Caci, Amélie Gatin, Lisa Giovannini-Chami
OBJECTIVES: To develop a reliable and validated tool to evaluate technical resuscitation skills in a pediatric simulation setting. STUDY DESIGN: Four Resuscitation and Emergency Simulation Checklist for Assessment in Pediatrics (RESCAPE) evaluation tools were created, following international guidelines: intraosseous needle insertion, bag mask ventilation, endotracheal intubation, and cardiac massage. We applied a modified Delphi methodology evaluation to binary rating items...
April 26, 2017: Journal of Pediatrics
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