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https://www.readbyqxmd.com/read/28434210/changes-in-perinatal-hospital-deaths-occurring-outside-the-neonatal-intensive-care-unit-over-a-decade
#1
Amélie Du Pont-Thibodeau, Keith Barrington, Catherine Taillefer, Annie Janvier
AIM: Perinatal deaths occurring outside the neonatal intensive care unit (NICU) are rarely recorded in outcome studies, despite having a direct impact on perinatal statistics. Our aim was to investigate the timing and modes of perinatal deaths that occurred outside the NICU and changes over time. METHOD: We reviewed all perinatal deaths from 22 weeks of gestation onwards, without NICU admissions, during two periods in a Canadian tertiary mother and baby hospital and categorised deaths according to nine specific categories...
April 23, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28434116/activation-of-the-serotonin-pathway-is-associated-with-poor-outcome-in-copd-exacerbation-results-of-a-long-term-cohort-study
#2
Marc A Meier, Manuel Ottiger, Alaadin Vögeli, Christian Steuer, Luca Bernasconi, Robert Thomann, Mirjam Christ-Crain, Christoph Henzen, Claus Hoess, Werner Zimmerli, Andreas Huber, Beat Mueller, Philipp Schuetz
BACKGROUND/INTRODUCTION: Indoleamine 2,3-dioxygenase (IDO) metabolizes tryptophan to kynurenine. An increase of its activity is associated with severity in patients with pneumonia. In chronic obstructive pulmonary disease (COPD) patients, an elevation of serotonin has been reported. Experimental models showed that cigarette smoke inhibits monoamine oxidase (MAO) leading to higher levels of serotonin. We investigated the prognostic ability of tryptophan, serotonin, kynurenine, IDO, and tryptophan hydroxylase (TPH) to predict short- and long-term outcomes in patients with a COPD exacerbation...
April 22, 2017: Lung
https://www.readbyqxmd.com/read/28433979/lethal-high-acute-disseminated-encephalomyelitis-adem-triggered-by-toxic-effect-of-synthetic-cannabinoid-black-mamba
#3
Kiran Samra, Ian S Boon, Gregory Packer, Saiju Jacob
A previously well 25-year-old man presented with agitation, double incontinence and left-sided incoordination. His symptoms started after smoking a synthetic cannabinoid (black mamba) 5 days earlier. Over 48 hours, he developed aphasia, generalised hypertonia, hyper-reflexia and dense left hemiparesis. This progressed to profuse diaphoresis, fever, tachycardia, hypertension and a possible seizure necessitating admission to the intensive care unit. CT head and cerebrospinal fluid analysis were unremarkable...
April 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28433951/transesophageal-echocardiography-in-the-evaluation-of-the-trauma-patient-a-trauma-resuscitation-transesophageal-echocardiography-exam
#4
REVIEW
Stefan W Leichtle, Andrew Singleton, Mandeep Singh, Matthew J Griffee, Joshua M Tobin
The point-of-care ultrasound exam has become an essential tool for hemodynamic monitoring and resuscitation in the trauma bay as well as the intensive care unit. Transthoracic ultrasound provides a dynamic assessment of cardiac function, volume status, and fluid responsiveness that offers potential advantage over traditional methods of hemodynamic monitoring. More recently, a focused transthoracic echocardiography exam was described to improve immediate resuscitation of severely injured patients in the trauma bay...
April 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28433581/therapeutic-burst-suppression-coma-in-pediatric-febrile-refractory-status-epilepticus
#5
Jainn-Jim Lin, Cheng-Che Chou, Shih-Yun Lan, Hsiang-Ju Hsiao, Yu Wang, Oi-Wa Chan, Shao-Hsuan Hsia, Huei-Shyong Wang, Kuang-Lin Lin
BACKGROUND: Evidence for the beneficial effect of therapeutic burst-suppression coma in pediatric patients with febrile refractory status epilepticus is limited, and the clinical outcomes of this treatment strategy are largely unknown. Therefore, the aim of this study was to explore the outcomes of therapeutic burst-suppression coma in a series of children with febrile refractory status epilepticus. METHODS: We retrospectively reviewed consecutive pediatric patients with febrile refractory status epilepticus admitted to our pediatric intensive care unit between January 2000 and December 2013...
April 19, 2017: Brain & Development
https://www.readbyqxmd.com/read/28433509/transcutaneous-aortic-valve-implantation-using-the-carotid-artery-access-feasibility-and-clinical-outcomes
#6
Zacharenia Kallinikou, Alexandre Berger, Patrick Ruchat, Gregory Khatchatourov, Isabelle Fleisch, Branislav Korkodelovic, Emmanuel Henchoz, René-Andréas Marti, Stéphane Cook, Mario Togni, Jean-Jacques Goy
BACKGROUND: Transcarotid access is an alternative route for transcutaneous aortic valve implantation (TAVI) in patients with impossible transfemoral access. AIMS: We evaluated the safety, effectiveness and early and late clinical outcomes of CoreValve(®) implantation via the common carotid artery. METHODS: Eighteen patients (10 men, 8 women; mean age 84±5 years) at high surgical risk (mean EuroSCORE II 16±13%) with significant peripheral artery disease underwent TAVI via common carotid artery access under general anaesthesia...
April 19, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28433398/multi-state-survey-of-healthcare-associated-infections-in-acute-care-hospitals-in-brazil
#7
C Magno Castelo Branco Fortaleza, M C Padoveze, C R Veiga Kiffer, A L Barth, Irna C do Rosário Souza Carneiro, H I Garcia Giamberardino, J L Nobre Rodrigues, L Santos Filho, M J Gonçalves de Mello, M Severino Pereira, P Pinto Gontijo Filho, M Rocha, E A Servolo de Medeiros, A C Campos Pignatari
BACKGROUND: Healthcare-associated infections (HCAIs) challenge public health in developing countries such as Brazil, which harbour social inequalities and variations in the complexity of healthcare and regional development. AIM: To describe the prevalence of HCAIs in hospitals in a sample of hospitals in Brazil. METHODS: A prevalence survey conducted in 2011-13 enrolled 152 hospitals from the five macro-regions in Brazil. Hospitals were classified as large (≥200 beds), medium (50-199 beds) or small sized (<50 beds)...
March 23, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28433239/shame-feeling-in-the-intensive-care-unit-patient-s-family-members
#8
Vasilios Koulouras, Zoe Konstanti, Dimitra Lepida, Georgios Papathanakos, Mary Gouva
OBJECTIVE: To investigate the levels of internal and external shame among family members of critically ill patients. RESEARCH METHODOLOGY/ DESIGN: This prospective study was conducted in 2012/2013 on family members of Intensive Care Unit patients using the Others As Shamer Scale and the Experiential Shame Scale questionnaires. SETTING: Greek university hospital. RESULTS: Two hundred and twenty-three family members mean-aged (41...
April 19, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28433043/-complete-minimally-invasive-ivor-lewis-esophageal-resection
#9
P Zonča, M Peteja, V Richter, P Vávra, P Ostruszka, D Worek, J Stigler
INTRODUCTION: Minimally invasive esophagectomy is becoming a standard procedure in the treatment of esophageal cancer. We would like to present our experience with Ivor Lewis esophagectomy completed by minimally invasive technique. METHODS: The primary aim of the study was to analyse potential technical difficulties and intraoperative complications of thoracolaparoscopic Ivor Lewis esophagectomy with intrathoracic anastomosis. A secondary aim of the study was to evaluate postoperative complications according to the Clavien-Dindo classification...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28432612/evaluation-of-the-analgesia-nociception-index-ani-in-healthy-awake-volunteers
#10
Rami Issa, Marco Julien, Elizabeth Décary, Olivier Verdonck, Louis-Philippe Fortier, Pierre Drolet, Philippe Richebé
BACKGROUND: Analgesia might be evaluated with simple changes in vital signs, a non-specific and non-sensitive method. Heart rate variability (HRV) correlates with autonomous nervous system activity and can be used to evaluate painful stimuli. Heart rate variability is then transformed into a numeric scale called the analgesia nociception index (ANI), where higher values represent predominant parasympathetic tone, thus low nociception. Under general anesthesia, the ANI decreases following painful stimuli and increases after administration of analgesia, but significant interindividual variability is present...
April 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28432539/early-onset-ventilator-associated-pneumonia-in-patients-with-severe-traumatic-brain-injury-incidence-risk-factors-and-consequences-in-cerebral-oxygenation-and-outcome
#11
Pierre Esnault, Cédric Nguyen, Julien Bordes, Erwan D'Aranda, Ambroise Montcriol, Claire Contargyris, Jean Cotte, Philippe Goutorbe, Christophe Joubert, Arnaud Dagain, Henry Boret, Eric Meaudre
BACKGROUND: Early-onset ventilator-associated pneumonia (EOVAP) occurs frequently in severe traumatic brain-injured patients, but potential consequences on cerebral oxygenation and outcome have been poorly studied. The objective of this study was to describe the incidence, risk factors for, and consequences on cerebral oxygenation and outcome of EOVAP after severe traumatic brain injury (TBI). METHODS: We conducted a retrospective, observational study including all intubated TBI admitted in the trauma center...
April 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28431991/molecular-mechanisms-of-trauma-induced-acute-kidney-injury-inflammatory-and-metabolic-insights-from-animal-models
#12
David M Burmeister, Belinda I Gómez, Michael A Dubick
Trauma-induced acute kidney injury (AKI), such as after hemorrhagic shock (HS) or burn, remains a significant problem in the intensive care unit and is associated with increased mortality. The pathophysiology that drives AKI post-trauma is multi factorial, and includes both inflammatory and metabolic alterations. Identifying the systemic profile that contributes to AKI is crucial not only for early diagnosis, but also for identifying treatments that improve kidney function and maintaining long-term patient health...
April 18, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28431902/addressing-unmet-maternal-health-needs-at-a-pediatric-specialty-infant-care-clinic
#13
Matthew L Zerden, Anna Falkovich, Erin K McClain, Sarah Verbiest, Diane D Warner, Janice Kay Wereszczak, Alison Stuebe
OBJECTIVE: The objective of this intervention was to evaluate the feasibility of screening mothers of medically fragile infants in the domains of 1) depression, 2) tobacco exposure, and 3) family planning at a post-neonatal intensive care unit (NICU) developmental pediatric visit. Additionally, we sought to estimate the percentage who met criteria for further evaluation in the three domains assessed. METHODS: A cross-sectional questionnaire was administered to 100 caregivers of medically fragile infants at a specialty, post-NICU clinic visit...
April 18, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28431900/-quality-of-initial-trauma-care-in-paediatrics
#14
Vicente Ibáñez Pradas, Rut Pérez Montejano
INTRODUCTION: Trauma care in Spain is not provided in specific centres, which means that health professionals have limited contact to trauma patients. After the setting up of a training program in paediatric trauma, the aim of this study was to evaluate the quality of the initial care provided to these patients before they were admitted to the paediatric intensive care unit (PICU) of a third level hospital (trauma centre), as an indirect measurement of the increase in the number of health professionals trained in trauma...
April 18, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28431858/third-trimester-preterm-and-term-premature-rupture-of-membranes-is-there-any-difference-in-maternal-characteristics-and-pregnancy-outcomes
#15
Ivana Chandra, Lizhou Sun
BACKGROUND: The clinical significance and management of preterm premature rupture of membranes (PPROM) remains a topic of a controversy. Although PROM is associated with a low rate of complications, PPROM may lead to significant neonatal and maternal morbidity. METHODS: We performed a retrospective study of 714 women who presented to Jiangsu Province Hospital with third trimester PPROM or PROM between January and December 2015. The data were analyzed by SPSS; the significance of maternal characteristics, and maternal and neonatal outcomes were tested using Student's t test and the χ(2) test...
April 18, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28431848/epidemiology-of-device-associated-infections-in-an-intensive-care-unit-of-a-teaching-hospital-in-nepal-a-prospective-surveillance-study-from-a-developing-country
#16
Narayan Prasad Parajuli, Subhash Prasad Acharya, Santosh Dahal, Jaya Prasad Singh, Shyam Kumar Mishra, Hari Prasad Kattel, Basista Prasad Rijal, Bharat Mani Pokhrel
BACKGROUND: Device-associated health care-acquired infections (DA-HAIs) in intensive care unit patients are a major cause of morbidity, mortality, and increased health care costs. METHODS: A prospective, structured clinicomicrobiological surveillance was carried out for 3 common DA-HAIs: ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI) present in the patients of an intensive care unit of a teaching hospital in Nepal...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28431846/implementation-of-daily-chlorhexidine-bathing-to-reduce-colonization-by-multidrug-resistant-organisms-in-a-critical-care-unit
#17
Jackson S Musuuza, Ajay K Sethi, Tonya J Roberts, Nasia Safdar
BACKGROUND: Colonized patients are a reservoir for transmission of multidrug-resistant organisms (MDROs). Not many studies have examined the effectiveness of daily chlorhexidine gluconate (CHG) bathing under routine care conditions. We present a descriptive analysis of the trends of MDRO colonization following implementation of daily CHG bathing under routine clinical conditions in an intensive care unit (ICU). METHODS: From May 2010-January 2011, we screened patients admitted to a 24-bed ICU for and methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and fluoroquinolone-resistant gram-negative bacilli (FQRGNB)...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28431797/video-education-for-critical-care-nurses-to-assess-pain-with-a-behavioural-pain-assessment-tool-a-descriptive-comparative-study
#18
Annika Björn, Sanna-Mari Pudas-Tähkä, Sanna Salanterä, Anna Axelin
AIM: To evaluate the impact of video education on critical care nurses' knowledge and skills in using a behavioural pain assessment tool for intensive care patients and to explore the nurses' experiences with video education. METHODS: Forty-eight nurses in one intensive care unit watched an educational video on the use of the Critical-Care Pain Observation Tool, then assessed pain in two patients with the tool and took a knowledge test. The researcher made parallel pain assessments...
April 18, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28431426/anesthesiologists-and-disaster-medicine-a-needs-assessment-for-education-and-training-and-reported-willingness-to-respond
#19
Heather K Hayanga, Daniel J Barnett, Natasha R Shallow, Michael Roberts, Carol B Thompson, Itay Bentov, Gozde Demiralp, Bradford D Winters, Deborah A Schwengel
BACKGROUND: Anesthesiologists provide comprehensive health care across the emergency department, operating room, and intensive care unit. To date, anesthesiologists' perspectives regarding disaster medicine and public health preparedness have not been described. METHODS: Anesthesiologists' thoughts and attitudes were assessed via a Web-based survey at 3 major academic institutions. Frequencies, percentages, and odds ratios (ORs) were used to assess self-reported perceptions of knowledge and skills, as well as attitudes and beliefs regarding education and training, employee development, professional obligation, safety, psychological readiness, efficacy, personal preparedness, and willingness to respond (WTR)...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28431425/the-association-of-frailty-with-outcomes-and-resource-use-after-emergency-general-surgery-a-population-based-cohort-study
#20
Daniel I McIsaac, Husein Moloo, Gregory L Bryson, Carl van Walraven
BACKGROUND: Older patients undergoing emergency general surgery (EGS) experience high rates of postoperative morbidity and mortality. Studies focused primarily on elective surgery indicate that frailty is an important predictor of adverse outcomes in older surgical patients. The population-level effect of frailty on EGS is poorly described. Therefore, our objective was to measure the association of preoperative frailty with outcomes in a population of older patients undergoing EGS. METHODS: We created a population-based cohort study using linked administrative data in Ontario, Canada, that included community-dwelling individuals aged >65 years having EGS...
May 2017: Anesthesia and Analgesia
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