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Young Hwan Choi, Jong Ho Lee, Jae Jun Shin, Young Soon Cho
OBJECTIVE: Most of the literature about Curling's ulcer was published from 1960 through 1980. Therefore, an updated study of Curling's ulcer is needed. We analyzed the risk factors affecting ulcer incidence in burn patients. METHODS: We retrospectively analyzed the medical records of burn patients who were admitted to two burn centers. We collected information about the general characteristics of patients, burn area size, abbreviated burn severity index, whether surgery was performed, endoscopy results, and the total body surface area (TBSA)...
December 2015: Clin Exp Emerg Med
Lourdes A Blanco Esquivel, Jorge Macia Urbina, Hugo Mendieta Zerón
BACKGROUND: Severe obstetric morbidity constitutes a serious problem worldwide; however, an effective obstetrical prognosis scale is still missing. OBJECTIVE: To propose a modified Sequential Organ Failure Assessment Score (SOFA) score based on time before reaching specialized medical attention. METHOD: This was an ambispective, descriptive study, including all women treated at the Obstetrical Intensive Care Unit (OICU) of the "Mónica Pretelini Sáenz" Maternal-Perinatal Hospital (HMPMPS), Toluca, Mexico, from June 2009 to June 2013...
September 2016: Ghana Medical Journal
Angel Paternina-Caicedo, Jezid Miranda, Ghada Bourjeily, Andrew Levinson, Carmelo Dueñas, Camilo Bello Muñoz, José A Rojas-Suarez
BACKGROUND: Every day, about 830 women die worldwide from preventable causes related to pregnancy and childbirth. Obstetric early-warning scores have been proposed as a potential tool to reduce maternal morbidity and mortality, based upon the identification of predetermined abnormal values in the vital signs or laboratory parameters, to generate a rapid and effective medical response. Several early-warning scores have been developed for obstetrical patients, but the majority are the result of a clinical consensus rather than statistical analyses of clinical outcome measures (i...
October 14, 2016: American Journal of Obstetrics and Gynecology
Xiang Kong, Yan Kong, Fangyuan Zhang, Tingting Wang, Jin Yan
BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is a specific pregnancy-related disorder without standard medical therapies. Ursodeoxycholic acid (UDCA) is the most used medicine, but the efficacy and safety of UDCA remain uncertain. Several meta-analyses had been made to assess the effects of UDCA in ICP. However, the samples were not large enough to convince obstetricians to use UDCA. We conducted a meta-analysis to evaluate the effects and safety of UDCA in patients with ICP, which included only randomized controlled trials (RCTs)...
October 2016: Medicine (Baltimore)
Alladi Mohan, G Sivaram Naik, J Harikrishna, D Prabath Kumar, M H Rao, Kvs Sarma, K K Guntupalli
BACKGROUND & OBJECTIVES: Ingestion of Cleistanthus collinus causes hypokalemia and cardiac arrhythmias leading to mortality in most cases. We undertook this retrospective study to evaluate the clinical presentation and predictors of outcome in critically ill patients admitted with C. collinus poisoning. METHODS: The case records of 56 patients admitted to the medical intensive care unit (MICU) of a tertiary care teaching hospital in south India (2000-2014) with C...
June 2016: Indian Journal of Medical Research
Surendra K Sharma, Anunay Gupta, Ashutosh Biswas, Abhishek Sharma, Atul Malhotra, K T Prasad, Sreenivas Vishnubhatla, Sajal Ajmani, Hridesh Mishra, Manish Soneja, Shobha Broor
BACKGROUND & OBJECTIVES: Acute respiratory distress syndrome (ARDS) is a common disorder in critically ill patients and is associated with high mortality. There is a paucity of literature on this condition from developing countries. This prospective observational study was designed to find out the aetiology, outcomes and predictors of mortality in ARDS. METHODS: Sixty four consecutive patients who satisfied American-European Consensus Conference (AECC) definition of ARDS from medical Intensive Care Unit (ICU) of a tertiary care centre in New Delhi, India, were enrolled in the study...
June 2016: Indian Journal of Medical Research
Patrick J van der Geest, Mostafa Mohseni, Daan Nieboer, Servet Duran, A B Johan Groeneveld
OBJECTIVES: We aimed to study the safety and efficacy of PCT in guiding blood culture taking in critically ill patients with suspected infection. METHODS: We performed a cluster-randomized, multi-center, single-blinded, cross-over trial. Patients suspected of infection in whom taking blood for culture was indicated were included. The participating ICU's were stratified and randomized by treatment regimen into a control group and PCT-guided group. All patients included into this trial followed the regimen which was allocated to the ICU for that period...
October 13, 2016: Clinical Microbiology and Infection
Chih-Cheng Lai, Chin-Ming Chen, Shyh-Ren Chiang, Wei-Lun Liu, Shih-Feng Weng, Mei-I Sung, Shu-Chen Hsing, Kuo-Chen Cheng
The aim of this study was to establish predictors for successfully planned extubation, which can be followed by medical personnel. The patients who were admitted to the adult intensive care unit of a tertiary hospital and met the following criteria between January 2005 and December 2014 were collected retrospectively: intubation > 48 hours; and candidate for extubation. The patient characteristics, including disease severity, rapid shallow breath index (RSBI), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), cuff leak test (CLT) before extubation, and outcome, were recorded...
October 2016: Medicine (Baltimore)
Anthony T Gerlach, Danielle M Blais, G Morgan Jones, Pamela K Burcham, Stanislaw P Stawicki, Charles H Cook, Claire V Murphy
BACKGROUND: Dexmedetomidine is commonly used for sedation in the Intensive Care Unit (ICU), and its use may be associated with hypotension. We sought to determine predictors of dexmedetomidine-associated hypotension. METHODS: Retrospective, single-center study of 283 ICU patients in four adults ICUs over a 12 month period. Univariate analyses were performed to determine factors associated with dexmedetomidine-related hypotension. Risk factors significant at the 0...
July 2016: International Journal of Critical Illness and Injury Science
Ignacio Martin-Loeches, Marcus J Schultz, Jean-Louis Vincent, Francisco Alvarez-Lerma, Lieuwe D Bos, Jordi Solé-Violán, Antoni Torres, Alejandro Rodriguez
BACKGROUND: Co-infection is frequently seen in critically ill patients with influenza, although the exact rate is unknown. We determined the rate of co-infection, the risk factors and the outcomes associated with co-infection in critically ill patients with influenza over a 7-year period in 148 Spanish intensive care units (ICUs). METHODS: This was a prospective, observational, multicentre study. Influenza was diagnosed using the polymerase chain reaction. Co-infection had to be confirmed using standard bacteriological tests...
October 5, 2016: Intensive Care Medicine
Jacob Calvert, Qingqing Mao, Jana L Hoffman, Melissa Jay, Thomas Desautels, Hamid Mohamadlou, Uli Chettipally, Ritankar Das
BACKGROUND: Clinical decision support systems are used to help predict patient stability and mortality in the Intensive Care Unit (ICU). Accurate patient information can assist clinicians with patient management and in allocating finite resources. However, systems currently in common use have limited predictive value in the clinical setting. The increasing availability of Electronic Health Records (EHR) provides an opportunity to use medical information for more accurate patient stability and mortality prediction in the ICU...
November 2016: Annals of Medicine and Surgery
L McLean House, Khensani N Marolen, Paul J St Jacques, Matthew D McEvoy, Jesse M Ehrenfeld
STUDY OBJECTIVE: To assess the impact of intraoperative hemodynamics in the development of perioperative myocardial infarction (MI) and myocardial ischemia after noncardiac surgery. DESIGN: Single-center retrospective cohort study of surgical patients from 2007 to 2012. SETTING: Postanesthesia care unit, intensive care unit, and medical-surgical ward at an academic tertiary medical center. PATIENTS: A total of 46,799 adult noncardiac, nonthoracic surgery patients, for which 2290 peak cardiac troponin (cTn) levels were available...
November 2016: Journal of Clinical Anesthesia
Fernando G Zampieri, Fernando A Bozza, Giulliana M Moralez, Débora D S Mazza, Alexandre V Scotti, Marcelo S Santino, Rubens A B Ribeiro, Edison M Rodrigues Filho, Maurício M Cabral, Marcelo O Maia, Patrícia S D'Alessandro, Sandro V Oliveira, Márcia A M Menezes, Eliana B Caser, Roberto S Lannes, Meton S Alencar Neto, Maristela M Machado, Marcelo F Sousa, Jorge I F Salluh, Marcio Soares
PURPOSE: To assess the impact of performance status (PS) impairment 1 week before hospital admission on the outcomes in patients admitted to intensive care units (ICU). METHODS: Retrospective cohort study in 59,693 patients (medical admissions, 67 %) admitted to 78 ICUs during 2013. We classified PS impairment according to the Eastern Cooperative Oncology Group (ECOG) scale in absent/minor (PS = 0-1), moderate (PS = 2) or severe (PS = 3-4). We used univariate and multivariate logistic regression analyses to investigate the association between PS impairment and hospital mortality...
September 29, 2016: Intensive Care Medicine
Li Weng, Xu Huang, Lie Chen, Li-Qin Feng, Wei Jiang, Xiao-Yun Hu, Jin-Min Peng, Chun-Yao Wang, Qing-Yuan Zhan, Bin Du
BACKGROUND: Pneumocystis jiroveci pneumonia (PJP) in non-HIV patients is still a challenge for intensivists. The aim of our study was to evaluate mortality predictors of PJP patients requiring Intensive care unit (ICU) admission. METHODS: Retrospectively review medical records of patients with diagnosis of PJP admitted to four ICUs of two academic medical centers from October 2012 to October 2015. RESULTS: Eighty-two patients were enrolled in the study...
September 29, 2016: BMC Infectious Diseases
Chun-Chieh Yeh, Chien-Chang Liao, Chun-Chuan Shih, Long-Bin Jeng, Ta-Liang Chen
Outcomes after surgeries involving physicians as patients have not been researched. This study compares postoperative adverse events between physicians as surgical patients and nonhealth professional controls.Using reimbursement claims data from Taiwan's National Health Insurance Program, we conducted a matched retrospective cohort study of 7973 physicians as surgical patients and 7973 propensity score-matched nonphysician controls receiving in-hospital major surgeries between 2004 and 2010. We compared postoperative major complications, length of hospital stay, intensive care unit (ICU), medical expenditure, and 30-day mortality...
September 2016: Medicine (Baltimore)
Archana Hinduja, Kenneth Habetz, Sunil Kumar Raina, Ryan T Fitzgerald
Posterior reversible encephalopathy syndrome (PRES) is an acute neurological syndrome that requires prompt, aggressive management to improve outcomes. Our aim was to identify factors that would necessitate care in the intensive care unit (ICU) in patients with PRES and the outcomes on discharge following ICU stay. We retrospectively reviewed the medical records and radiological data of adult PRES patients admitted to our tertiary care medical center. We dichotomized them into two groups based on their need for ICU care and compared their clinical, laboratory, imaging characteristics and discharge outcomes...
September 28, 2016: Acta Neurologica Belgica
Simone Thomas, Wolfgang Sauter, Ulrike Starrost, Marcus Pohl, Jan Mehrholz
BACKGROUND: Treatment of critical illness on intensive-care-units (ICU) results often in persistent invasive endotracheal intubation which might delay rehabilitation and increases the risk of mortality. Recent longitudinal studies have described the recovery of critically ill people, but the detailed time course of decannulation in patients with chronic critical illness with ICU- acquired muscle weakness (ICUAW) is not well known. AIM: The aim of our study was therefore to describe the decannulation times and associated risk factors in patients who are chronic critically ill with ICU acquired weakness...
September 27, 2016: European Journal of Physical and Rehabilitation Medicine
Hirotake Okazaki, Akihiro Shirakabe, Nobuaki Kobayashi, Noritake Hata, Takuro Shinada, Masato Matsushita, Yoshiya Yamamoto, Yusaku Shibata, Junsuke Shibuya, Reiko Shiomura, Suguru Nishigoori, Kuniya Asai, Wataru Shimizu
Atherosclerosis induces the elevation of uric acid (UA), and an elevated UA level is well known to lead to a poor prognosis in patients with acute heart failure (AHF). However, the prognostic value of atherosclerotic risk factors in hyperuricemic AHF patients remains to be elucidated. The data from 928 patients who were admitted to the intensive care unit (ICU) at Nippon Medical School Chiba Hokusoh Hospital between January 2001 and December 2014, and whose serum UA levels were measured were screened. A total of 394 AHF patients with hyperuricemia were enrolled in this study...
September 26, 2016: Heart and Vessels
Christian S Scheer, Christian Fuchs, Sven-Olaf Kuhn, Marcus Vollmer, Sebastian Rehberg, Sigrun Friesecke, Peter Abel, Veronika Balau, Christoph Bandt, Konrad Meissner, Klaus Hahnenkamp, Matthias Gründling
OBJECTIVE: To investigate the impact of a quality improvement initiative for severe sepsis and septic shock focused on the resuscitation bundle on 90-day mortality. Furthermore, effects on compliance rates for antiinfective therapy within the recommended 1-hour interval are evaluated. DESIGN: Prospective observational before-after cohort study. SETTING: Tertiary university hospital in Germany. PATIENTS: All adult medical and surgical ICU patients with severe sepsis and septic shock...
September 22, 2016: Critical Care Medicine
Veerapong Vattanavanit, Rungsun Bhurayanontachai
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is one of the leading causes of intensive care unit admission, which results in high hospital mortality. Targeted temperature management (TTM) was introduced several years ago and is considered to improve neurological and mortality outcomes. This management process was implemented in our hospital in 2012, which was expected to improve the standard of care in OHCA patients. PURPOSE: We aimed to report the clinical and mortality outcomes after TTM was introduced to our hospital in 2012...
2016: Open Access Emergency Medicine: OAEM
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