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https://www.readbyqxmd.com/read/28412028/-effectiveness-of-erlotinib-in-critical-care-unit-in-patients-with-non-small-cell-lung-cancer-with-egfr-mutation
#1
M Dewolf, C Dayen, C Garoute, W Khamis, M Fourrier, F Rousselle, M Sadki, F Le Meunier, R Suguenot, E Lecuyer, H Bentayeb, Y Douadi, P Berna
INTRODUCTION: The search for mutations epidermal growth factor receptor (EGFR) has changed the therapeutic approach and prognosis of non-small cell lung cancer (NSCLC). The effectiveness of tyrosine kinase inhibitors (TKI) has been demonstrated orally in patients with EGFR mutation. We report the case of a patient for whom treatment with TKI was started effectively in a Critical Care Unit. OBSERVATION: A patient of 59 years is followed for a stage IV lung adenocarcinoma with metastases in liver, brain, adrenal, lung and pleura...
April 12, 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/28393340/-development-of-the-oral-assessment-scale-for-post-operational-patients-with-oral-cancer
#2
Yi-Chen Lee, Ya-Chuan Hsu, Hui-Ying Chiang
BACKGROUND: Current oral assessment scales are designed to assess the severity of oral health in cancer patients who have undergone radiotherapy or chemotherapy. Currently, no scale is available that assesses the overall oral health situation of patients. However, this type of scale is critical for guiding nursing staff to understand the oral status of postoperative patients and for facilitating the development of patient-centered oral nursing treatments. PURPOSE: To develop the oral assessment scale for post-operational patients with oral cancer (OASPOCa) and establish its psychometric properties...
April 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28368352/melatonin-pharmacological-blood-levels-increase-total-antioxidant-capacity-in-critically-ill-patients
#3
Giovanni Mistraletti, Rita Paroni, Michele Umbrello, Lara D'Amato, Giovanni Sabbatini, Martina Taverna, Paolo Formenti, Elena Finati, Gaia Favero, Francesca Bonomini, Rita Rezzani, Russel J Reiter, Gaetano Iapichino
In this study, the aim was to test the biochemical effects of melatonin supplementation in Intensive Care Unit (ICU) patients, since their blood levels are decreased. Sixty-four patients were enrolled in the study. From the evening of the 3rd ICU day, patients were randomized to receive oral melatonin (3 mg, group M) or placebo (group P) twice daily, at 20:00 and 24:00, until discharged. Blood was taken (at 00:00 and 14:00), on the 3rd ICU day to assess basal nocturnal melatonin values, and then during the treatment period on the 4th and 8th ICU days...
April 3, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28362659/neuroleptic-malignant-syndrome-secondary-to-metoclopramide-use-in-an-elderly-gastroenterologic-surgery-patient
#4
Richard Breeden, Heath Ford, Carey Chrisman, Charles Mascioli
An 84-year-old African American woman was admitted to the hospital secondary to severe abdominal pain accompanied by septic shock. She underwent exploratory laparotomy, which revealed extensive small bowel necrosis likely due to small bowel torsion. A small bowel resection was performed with primary anastomoses and the patient was subsequently transferred to the intensive care unit (ICU). She recovered from shock but had a persistent gastroparesis interfering with enteral feeding, for which metoclopramide was prescribed...
March 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/28327122/midodrine-as-adjunctive-support-for-treatment-of-refractory-hypotension-in-the-intensive-care-unit-a-multicenter-randomized-placebo-controlled-trial-the-midas-trial
#5
Matthew H Anstey, Bradley Wibrow, Tharusan Thevathasan, Brigit Roberts, Khushi Chhangani, Pauline Yeung Ng, Alexander Levine, Alan DiBiasio, Todd Sarge, Matthias Eikermann
BACKGROUND: Patients admitted to intensive care units (ICU) are often treated with intravenous (IV) vasopressors. Persistent hypotension and dependence on IV vasopressors in otherwise resuscitated patients lead to delay in discharge from ICU. Midodrine is an oral alpha-1 adrenergic agonist approved for treatment of symptomatic orthostatic hypotension. This trial aims to evaluate whether oral administration of midodrine is an effective adjunct to standard therapy to reduce the duration of IV vasopressor treatment, and allow earlier discharge from ICU and hospital...
March 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28325798/management-of-inpatient-hyperglycemia-and-diabetes-in-older-adults
#6
Guillermo E Umpierrez, Francisco J Pasquel
Adults aged 65 years and older are the fastest growing segment of the U.S. population, and their number is expected to double to 89 million between 2010 and 2050. The prevalence of diabetes in hospitalized adults aged 65-75 years and over 80 years of age has been estimated to be 20% and 40%, respectively. Similar to general populations, the presence of hyperglycemia and diabetes in elderly patients is associated with increased risk of hospital complications, longer length of stay, and increased mortality compared with subjects with normoglycemia...
April 2017: Diabetes Care
https://www.readbyqxmd.com/read/28320561/the-effects-of-oral-rinse-with-0-2-and-2-chlorhexidine-on-oropharyngeal-colonization-and-ventilator-associated-pneumonia-in-adults-intensive-care-units
#7
Farid Zand, Leili Zahed, Parisa Mansouri, Freshte Dehghanrad, Maryam Bahrani, Mohammad Ghorbani
BACKGROUND: Ventilator Associated Pneumonia (VAP) is the most common nosocomial infection in Intensive Care Units (ICUs) which increases the length of ICU stay, duration of mechanical ventilation, and mortality. The present study used an oral care protocol and compared the effects of two different concentrations of chlorhexidine on reduction of oropharyngeal colonization and VAP. MATERIALS AND METHODS: This study was performed on 114 patients from trauma, surgery, neurosurgery, and general ICUs randomly allocated to two groups under oral care with 0...
March 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28216018/prospective-randomised-controlled-study-evaluating-early-modification-of-oral-microbiota-following-admission-to-the-intensive-care-unit-and-oral-hygiene-with-chlorhexidine
#8
Felipe Francisco Tuon, Oleg Gavrilko, Saulo de Almeida, Eigi Ricardo Sumi, Thiago Alberto, Jaime Luis Rocha, Edvaldo Antonio Rosa
OBJECTIVES: Chlorhexidine (CHX) is the most commonly used oral hygiene product for the prevention of ventilator-associated pneumonia (VAP) in patients undergoing mechanical ventilation (MV). The change in dental plaque (DP) microbiota following CHX use in patients under MV has not been described previously. The aim of this study was to evaluate the incidence of pathogenic bacteria associated with VAP and the coverage of DP within the oral cavity in patients administered CHX. METHODS: This was a prospective, randomised, controlled, double-blind study in patients (n=16) under MV who were mouth-rinsed with either CHX or placebo...
February 18, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28215171/oral-colonization-by-nosocomial-pathogens-during-hospitalization-in-invasive-care-unit-and-prevention-strategies
#9
Hossein Kazemian, Samane Bourbour, Maryam Beheshti, Abbas Bahador
BACKGROUND: Critically ill patients are very susceptible to a variety of disorders and infections during hospitalization in Intensive Care Units (ICU). Among these problems, nosocomial infections are major causes of morbidity and mortality. METHODS: Nosocomial pneumonias, specifically ventilator associated pneumonias have become a major health care issue. The implication of oral care in hospital presents challenges that can prevent or reduce the risk of nosocomial pneumonias in ICU...
February 15, 2017: Recent Patents on Anti-infective Drug Discovery
https://www.readbyqxmd.com/read/28180003/ventilator-associated-pneumonia-and-the-importance-of-education-of-icu-nurses-on-prevention-preliminary-results
#10
REVIEW
Bence Mogyoródi, Erzsébet Dunai, János Gál, Zsolt Iványi
BACKGROUND AND AIMS: Ventilator-associated pneumonia (VAP) increases intensive care unit (ICU) length of stay, ICU mortality, the number of ventilator days, and costs. We implemented a VAP bundle and investigated its efficacy on prevention. MATERIALS AND METHODS: A prospective observational study was conducted between January 1, 2015 and December 31, 2015 in a 12-bed multidisciplinary ICU. The bundle was implemented on July 02, 2015. Comparative analysis was performed before and after the implementation of the bundle...
December 2016: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28152740/understanding-efficiency-of-chemotherapy-delivery-for-planned-chemotherapy-admission-at-columbia-university-medical-center
#11
Jason Dennis Wright, Sowmya Vasan, Alfred I Neugut, Jim Hu, Dawn L Hershman
206 Background: Delays in administration of planned in-patient chemotherapy can lead to prolonged length of stay (LOS), resulting in increased cost and risk of nosocomial infections and other complications. METHODS: We conducted a retrospective analysis of cancer patients admitted to Columbia University Medical Center, a tertiary care center, for planned chemotherapy from January 1, 2014 through December 31, 2014. Eligible patients were identified as cancer patients (via ICD9 codes) who were admitted directly to the inpatient hematology/oncology service with intravenous chemotherapy orders submitted within 24 hours of the admission...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152386/no-difference-in-mechanical-ventilation-free-hours-in-critically-ill-patients-who-received-intravenous-oral-or-enteral-phosphate-replacement
#12
Stephen J Lemon, Stephanie D Zack, Stacy A Voils
PURPOSE: To determine the impact on duration of mechanical ventilation (MV) and the need for reintubation after changing from intravenous (IV) to oral phosphate formulations, in response to a national shortage of IV phosphate. METHODS: A retrospective study was performed in adult patients who required MV for at least 48 hours. RESULTS: A total of 136 patients were included, with 68 patients in both the restricted phosphate group and unrestricted phosphate groups...
January 19, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28144465/incidence-rate-of-post-intubation-tracheal-stenosis-in-patients-admitted-to-five-intensive-care-units-in-iran
#13
Roya Farzanegan, Behrooz Farzanegan, Mahdi Zangi, Majid Golestani Eraghi, Shahram Noorbakhsh, Neda Doozandeh Tabarestani, Mohammad Behgam Shadmehr
BACKGROUND: Tracheal stenosis is one of the worst complications associated with endotracheal intubation and it is the most common reason for reconstructive airway surgeries. Due to various local risk factors, the incidence rate of tracheal stenosis may vary in different countries. In order to estimate the incidence rate of post-intubation tracheal stenosis (PITS) in patients admitted to an intensive care unit (ICU), a follow-up study was planned. As there was no similar methodological model in the literature, a feasibility step was also designed to examine the whole project and to enhance the follow-up rate...
September 2016: Iranian Red Crescent Medical Journal
https://www.readbyqxmd.com/read/28143414/impact-of-oral-hygiene-involving-toothbrushing-versus-chlorhexidine-in-the-prevention-of-ventilator-associated-pneumonia-a-randomized-study
#14
Claudia Fernanda de Lacerda Vidal, Aurora Karla de Lacerda Vidal, José Gildo de Moura Monteiro, Aracele Cavalcanti, Ana Paula Trindade Henriques, Márcia Oliveira, Michele Godoy, Mirella Coutinho, Pollyanna Dutra Sobral, Claudia Ângela Vilela, Bárbara Gomes, Marta Amorim Leandro, Ulisses Montarroyos, Ricardo de Alencar Ximenes, Heloísa Ramos Lacerda
BACKGROUND: Nosocomial pneumonia has correlated to dental plaque and to oropharynx colonization in patients receiving mechanical ventilation. The interruption of this process, by preventing colonization of pathogenic bacteria, represents a potential procedure for the prevention of ventilator-associated pneumonia (VAP). METHODS: The study design was a prospective, randomized trial to verify if oral hygiene through toothbrushing plus chlorhexidine in gel at 0.12% reduces the incidence of ventilatior-associated pneumonia, the duration of mechanical ventilation, the length of hospital stay and the mortality rate in ICUs, when compared to oral hygiene only with chlorhexidine, solution of 0...
January 31, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28110639/amitraz-poisoning-a-case-report-of-an-unusual-pesticide-poisoning-in-sri-lanka-and-literature-review
#15
H M M T B Herath, S P Pahalagamage, Nilukshana Yogendranathan, M D M S Wijayabandara, Aruna Kulatunga
BACKGROUND: Amitraz is a pesticide used worldwide on animals and in agriculture. It contains triazapentadiene, which is a centrally acting alpha-2 adrenergic agonist. Amitraz poisoning is fairly uncommon in humans and occurs via oral, dermal or inhalational routes. Only a limited number of case reports of human intoxication have been published and most of them are of accidental ingestion by children. CASE PRESENTATION: A twenty-year-old Sri Lankan female presented following self-ingestion of 20 ml of amitraz resulting in 37...
January 23, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28064542/antibiotic-treatment-patterns-costs-and-resource-utilization-among-patients-with-community-acquired-pneumonia-a-us-cohort-study
#16
Christopher J Llop, Edward Tuttle, Glenn S Tillotson, Kerry LaPlante, Thomas M File
OBJECTIVES: The current treatment options for patients with community-acquired pneumonia (CAP) often present a trade-off between the potential for treatment failure and safety concerns. We set out to investigate real-world outcomes associated with the use of currently available antimicrobial treatment options for CAP in both the outpatient and inpatient (non-intensive care unit [ICU]) settings. METHODS: This claims-based retrospective study included adult patients diagnosed with CAP and treated with antibiotic therapies, including any oral fluoroquinolone, macrolide, or beta-lactam monotherapy in the outpatient setting, and intravenous (IV) levofloxacin or IV azithromycin/ceftriaxone in the inpatient setting...
February 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28054290/treatment-of-hyponatremia-in-patients-with-acute-neurological-injury
#17
Theresa Human, Aaron M Cook, Brian Anger, Kathleen Bledsoe, Amber Castle, David Deen, Haley Gibbs, Christine Lesch, Norah Liang, Karen McAllen, Christopher Morrison, Dennis Parker, A Shaun Rowe, Denise Rhoney, Kiranpal Sangha, Elena Santayana, Scott Taylor, Eljim Tesoro, Gretchen Brophy
BACKGROUND: Little data exist regarding the practice of sodium management in acute neurologically injured patients. This study describes the practice variations, thresholds for treatment, and effectiveness of treatment in this population. METHODS: This retrospective, multicenter, observational study identified 400 ICU patients, from 17 centers, admitted for ≥48 h with subarachnoid hemorrhage (SAH), traumatic brain injury (TBI), intraparenchymal hemorrhage, or intracranial tumors between January 1, 2011 and July 31, 2012...
January 4, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28000150/atrial-fibrillation-following-aortic-valve-replacement-impact-of-perioperative-use-of-intravenous-%C3%AE-blocker
#18
Junki Yokota, Hiroyuki Nishi, Naosumi Sekiya, Mitsutomo Yamada, Toshiki Takahashi
OBJECTIVES: Despite recent advances in perioperative management, postoperative atrial fibrillation/flutter (POAF) remains the most common complication after cardiac surgery. Therefore, it is important to determine related risk factors to establish effective management. However, most studies have focused on patients undergoing coronary artery bypass grafting and little is known about POAF in those who receive aortic valve replacement (AVR). We investigated the relationship of clinical predictors with POAF in patients undergoing AVR...
April 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27999970/oral-30-glucose-provides-sufficient-sedation-in-newborns-during-mri
#19
H Evren Eker, Oya Yalcin Cok, Bilin Çetinkaya, Anis Aribogan
PURPOSE: Newborns are often sedated during MRI but sedation itself creates adverse events and management is more challenging in this environment. Oral glucose/sucrose administration has been studied in newborns during painful procedures; however, its effectiveness in keeping newborns sleepy and motionlessness during painless procedures has not been demonstrated. The objective of this study was to describe effectiveness of oral 30% glucose administration by comparing with intravenous midazolam sedation for newborns during MRI...
December 20, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27983872/recovery-from-dysphagia-symptoms-after-oral-endotracheal-intubation-in-acute-respiratory-distress-syndrome-survivors-a-5-year-longitudinal-study
#20
Martin B Brodsky, Minxuan Huang, Carl Shanholtz, Pedro A Mendez-Tellez, Jeffrey B Palmer, Elizabeth Colantuoni, Dale M Needham
RATIONALE: Nearly 60% of patients who are intubated in intensive care units (ICUs) experience dysphagia after extubation, and approximately 50% of them aspirate. Little is known about dysphagia recovery time after patients are discharged from the hospital. OBJECTIVES: To determine factors associated with recovery from dysphagia symptoms after hospital discharge for acute respiratory distress syndrome (ARDS) survivors who received oral intubation with mechanical ventilation...
March 2017: Annals of the American Thoracic Society
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