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https://www.readbyqxmd.com/read/29159958/evaluation-of-a-low-risk-mild-traumatic-brain-injury-and-intracranial-hemorrhage-emergency-department-observation-protocol
#1
Brian J Yun, Pierre Borczuk, Lulu Wang, Stephen Dorner, Benjamin A White, Ali S Raja
OBJECTIVES: Among emergency physicians, there is wide variation in admitting practices for patients who suffered a mild traumatic brain injury (TBI) with an intracranial hemorrhage (ICH). The purpose of this study was to evaluate the effects of implementing a protocol in the emergency department (ED) observation unit for patients with mild TBI and ICH. METHODS: This retrospective cohort study was approved by the Institutional Review Board. Study subjects were patients ≥18 years of age with an International Classification of Diseases (ICD) code corresponding to a traumatic IC, and admitted to an ED observation unit (EDOU) of an urban, academic level 1 trauma center between February 1, 2015 and January 31, 2017...
November 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29159719/effect-of-a-real-time-electronic-dashboard-on-a-rapid-response-system
#2
Grant S Fletcher, Barry A Aaronson, Andrew A White, Reena Julka
A rapid response system (RRS) may have limited effectiveness when inpatient providers fail to recognize signs of early patient decompensation. We evaluated the impact of an electronic medical record (EMR)-based alerting dashboard on outcomes associated with RRS activation. We used a repeated treatment study in which the dashboard display was successively turned on and off each week for ten 2-week cycles over a 20-week period on the inpatient acute care wards of an academic medical center. The Rapid Response Team (RRT) dashboard displayed all hospital patients in a single view ranked by severity score, updated in real time...
November 20, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29153063/-investigation-of-various-virulence-factors-of-klebsiella-pneumoniae-strains-isolated-from-nosocomial-infections
#3
Halit Kuş, Uğur Arslan, Hatice Türk Dağı, Duygu Fındık
Klebsiella pneumoniae is an opportunistic pathogen that commonly affects immunosuppressed patients and causes nosocomial infections. K.pneumoniae has a variety of virulence factors, especially capsule polysaccharide, hypermucoviscosity (HV), fimbriae, toxins and determinants for iron acquisition. The aim of this study was to detect the virulence factors in K.pneumoniae strains isolated from nosocomial infections in two years. Fifty three K.pneumoniae strains isolated from the samples of patients with nosocomial infections in the Medical Microbiology Laboratory of Selcuk University Faculty of Medicine Hospital between 2011 and 2013 were included in the study...
October 2017: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/29140969/risk-factors-for-ventilator-associated-events-in-a-picu
#4
Raeley Guess, Jarin Vaewpanich, Jorge A Coss-Bu, Siriporn Phongjitsiri, Curtis Kennedy, Jeffrey Starke, Satid Thammasitboon
OBJECTIVE: The term ventilator-associated events includes ventilator-associated condition, infection-related ventilator-associated complication, and ventilator-associated pneumonia. We sought to identify potential new risk factors for ventilator-associated condition and infection-related ventilator-associated complication in the PICU population. DESIGN: Matched case control study. SETTING: Children's hospital at a tertiary care academic medical center...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29138955/the-impact-of-palliative-care-training-for-oncologists-and-integrative-palliative-service-in-a-public-funded-hospital-cluster-a-retrospective-cohort-study
#5
Pak-Lun Lam, Tai-Chung Lam, Cheuk-Wai Choi, Anne Wing-Mui Lee, Kwok-Keung Yuen, To-Wai Leung
PURPOSE: Oncological care of advanced cancer patients was provided by multiple departments in Hong Kong. One of these departments, the clinical oncology department (COD), introduced systematic palliative care training for its oncologists since 2002. The COD was recognized as a European Society for Medical Oncology (ESMO) Designated Centre of Integrated Oncology and Palliative Care since 2009. This retrospective cohort study aims to review the impact of integrative training and service on palliative care coverage and outcome...
November 14, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29138206/monitor-ic-study-a-mixed-methods-prospective-multicentre-controlled-cohort-study-assessing-5-year-outcomes-of-icu-survivors-and-related-healthcare-costs-a-study-protocol
#6
Wytske Geense, Marieke Zegers, Hester Vermeulen, Mark van den Boogaard, Johannes van der Hoeven
INTRODUCTION: Due to advances in critical care medicine, more patients survive their critical illness. However, intensive care unit (ICU) survivors often experience long-term physical, cognitive and mental problems, summarised as post-intensive care syndrome (PICS), impacting their health-related quality of life (HRQoL). In what frequency PICS occurs, and to what extent this influences ICU survivors' HRQoL, is mostly unknown. The aims of this study are therefore to study the: (1) 5-year patient outcomes, (2) predictors for PICS, (3) ratio between HRQoL of ICU survivors and healthcare-related costs, and (4) care and support needs...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29131022/an-echocardiographic-screening-program-helps-to-identify-pulmonary-hypertension-in-extremely-low-birthweight-infants-with-and-without-bronchopulmonary-dysplasia-a-single-center-experience
#7
Katrin Mehler, Floris E Udink Ten Cate, Titus Keller, Ursula Bangen, Angela Kribs, André Oberthuer
BACKGROUND: Pulmonary hypertension (PH) affects 1 in 6 infants with a birthweight <1,000 g (extremely low birthweight; ELBW) and is frequently associated with bronchopulmonary dysplasia (BPD). If untreated, the mortality rates of the disease are high. OBJECTIVES: The aim of this study was to characterize risk factors for PH in ELBW infants and to describe the timing of onset of the disease by setting up a screening program. METHODS: ELBW infants treated at the Department of Neonatology (level III neonatal intensive care unit at the University of Cologne Medical Centre, Germany) between January 2010 and March 2015 were included...
November 8, 2017: Neonatology
https://www.readbyqxmd.com/read/29128962/good-response-to-tolvaptan-shortens-hospitalization-in-patients-with-congestive-heart-failure
#8
Tomohito Kogure, Kentaro Jujo, Kazuyuki Hamada, Katsumi Saito, Nobuhisa Hagiwara
Tolvaptan has been gradually spread to use as a potent diuretic for congestive heart failure in the limited country. However, the response to this aquaretic drug still is unpredictable. A total of 92 patients urgently hospitalized due to congestive heart failure and treated with tolvaptan in addition to standard treatment was retrospectively analyzed. Responder of tolvaptan treatment was defined as a patient with peak negative fluid balance greater than 500 mL/day, and clinical profiles were compared between 76 responders and 16 non-responders...
November 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29118858/characteristics-and-predictors-of-mortality-of-patients-with-hematologic-malignancies-requiring-invasive-mechanical-ventilation
#9
Hasan M Al-Dorzi, Haya Al Orainni, Faten Al Eid, Haytham Tlayjeh, Abedalrahman Itani, Ayman Al Hejazi, Yaseen M Arabi
RATIONALE: Acute respiratory failure (ARF) may complicate the course of hematologic malignancies (HMs). Our objective was to study the characteristics, outcomes and predictors of mortality of patients with HMs who required intubation for ARF. METHODS: This retrospective cohort study evaluated all patients with HMs who were admitted to the Intensive Care Unit (ICU) of King Abdul-Aziz Medical City-Riyadh between 2008 and 2013 and required invasive mechanical ventilation...
October 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/29116972/low-cardiac-output-syndrome-after-adult-cardiac-surgery-predictive-value-of-peak-systolic-global-longitudinal-strain
#10
Philippe Amabili, Sabeha Benbouchta, Laurence Roediger, Marc Senard, Marie Bernard Hubert, Anne-Françoise Donneau, Jean-François Brichant, Gregory A Hans
BACKGROUND: Peak systolic global longitudinal strain (GLS) is increasingly used to quantify left ventricular systolic function. The primary objective of this study was to assess whether GLS obtained during intraoperative transesophageal echocardiogram, performed before cardiopulmonary bypass, improves the prediction of postoperative low cardiac output syndrome (LCOS) after adult cardiac surgery. METHODS: GLS from 275 patients undergoing on-pump cardiac surgery was calculated retrospectively using two-dimensional- speckle tracking echocardiography (aCMQ module from Qlab software version 10...
November 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29114700/invasive-candidiasis-in-pediatric-patients-at-king-fahad-medical-city-in-central-saudi-arabia-a-5-year-retrospective-study
#11
Zainab Almooosa, Gasmelseed Y Ahmed, Abeer Omran, Ayah AlSarheed, Afnan Alturki, Abdulaziz Alaqeel, Mohammed Alshehri, Tariq Alfawaz, Dayel AlShahrani
To identify predisposing factors, species distribution, antifungal susceptibility, and outcome. Methods: This study is a retrospective chart review that was conducted at a children's hospital at King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia. One hundred twenty-nine children with invasive candidiasis who were admitted between January 2010 and January 2015. Results: The statistical analysis results have revealed a group of risk factors; prematurity in 37 (28.7%) of patients, low birth weight in 42 (32...
November 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/29112468/the-effects-of-on-pump-and-off-pump-coronary-artery-bypass-surgery-on-respiratory-function-in-the-early-postoperative-period
#12
Federica Chiarenza, Theodoros Tsoutsouras, Cesare Cassisi, Cristina Santonocito, Stephen Gerry, Marinella Astuto, Shane George, Filippo Sanfilippo
BACKGROUND: Respiratory complications are common after cardiac surgery and the use of extracorporeal circulation is one of the main causes of lung injury. We hypothesized a better postoperative respiratory function in off-pump coronary artery bypass grafting (OPCABG) as compared with "on-pump coronary artery bypass grafting" (ONCABG). METHODS: This is a retrospective, single-center study at a cardiothoracic intensive care unit (ICU) in a tertiary university hospital...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29112079/acute-physiologic-stress-and-subsequent-anxiety-among-family-members-of-icu-patients
#13
Sarah J Beesley, Ramona O Hopkins, Julianne Holt-Lunstad, Emily L Wilson, Jorie Butler, Kathryn G Kuttler, James Orme, Samuel M Brown, Eliotte L Hirshberg
OBJECTIVES: The ICU is a complex and stressful environment and is associated with significant psychologic morbidity for patients and their families. We sought to determine whether salivary cortisol, a physiologic measure of acute stress, was associated with subsequent psychologic distress among family members of ICU patients. DESIGN: This is a prospective, observational study of family members of adult ICU patients. SETTING: Adult medical and surgical ICU in a tertiary care center...
November 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29108378/preoperative-risk-factors-for-massive-blood-loss-in-adrenalectomy-for-pheochromocytoma
#14
Hongju Liu, Bin Li, Xuerong Yu, Yuguang Huang
Background: This retrospective analysis of patients who underwent adrenalectomy for pheochromocytoma aimed to determine preoperative risk factors for intraoperative massive blood loss. Preoperative identification of patients at high-risk of massive blood loss may be helpful in anesthesia management and preoperative preparation. Materials and Methods: The study involved data of 268 patients who had undergone pheochromocytoma surgery at the Peking Union Medical College Hospital between January 1, 2013 and October 31, 2016...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29107951/the-effect-of-tranexamic-acid-on-blood-loss-and-maternal-outcome-in-the-treatment-of-persistent-postpartum-hemorrhage-a-nationwide-retrospective-cohort-study
#15
Ada Gillissen, Dacia D C A Henriquez, Thomas van den Akker, Camila Caram-Deelder, Merlijn Wind, Joost J Zwart, Jos van Roosmalen, Jeroen Eikenboom, Kitty W M Bloemenkamp, Johanna G van der Bom
BACKGROUND: Recent results show a protective effect of tranexamic acid on death due to bleeding in patients with postpartum hemorrhage in low- and middle-resource countries. We quantify the association between early administration of tranexamic acid compared to late or no administration and severe acute maternal morbidity and blood loss among women suffering from persistent severe postpartum hemorrhage in a high-income country. METHODS AND FINDINGS: We performed a nationwide retrospective cohort study in 61 hospitals in the Netherlands...
2017: PloS One
https://www.readbyqxmd.com/read/29100227/utility-of-the-shock-index-for-risk-stratification-in-patients-with-acute-upper-gastrointestinal-bleeding
#16
Supannee Rassameehiran, Jirapat Teerakanok, Sakolwan Suchartlikitwong, Kenneth Nugent
OBJECTIVES: Patients with upper gastrointestinal bleeding (UGIB) frequently require hospitalization, and a small but significant percentage of these patients have adverse outcomes. Risk-scoring tools can help clinicians organize care and make predictions about outcomes. The shock index (heart rate divided by systolic blood pressure) has been used in multiple acute disorders and has the potential to identify patients with UGIB who are at risk for adverse outcomes. METHODS: We retrospectively reviewed the electronic medical records of patients admitted with UGIB between January 1, 2012 and December 31, 2015...
November 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/29095203/acute-respiratory-distress-syndrome-cases-volume-and-icu-mortality-in-medical-patients
#17
Martin Dres, Peter C Austin, Tài Pham, Philippe Aegerter, Bertrand Guidet, Alexandre Demoule, Antoine Vieillard-Baron, Laurent Brochard, Guillaume Géri
OBJECTIVES: To determine whether ICUs caring for higher volumes of acute respiratory distress syndrome patients would be associated with lower ICU mortality. DESIGN: A 9-year multicenter retrospective cohort study of prospectively collected data. SETTING: French medical ICUs. PATIENTS: From 2004 to 2012, acute respiratory distress syndrome cases were identified from a coding system through a regional database (Collège des Utilisateurs de Données en Réanimation)...
October 31, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29092656/effect-of-anemia-on-mortality-in-mechanically-ventilated-patients-with-chronic-obstructive-pulmonary-disease
#18
Shruti K Gadre, Aravdeep Singh Jhand, Sami Abuqayyas, Xiaofeng Wang, Jorge Guzman, Abhijit Duggal
RATIONALE: The effect of anemia on patients with chronic obstructive pulmonary disease (COPD) requiring invasive mechanical ventilation for acute respiratory failure is unknown. OBJECTIVES: To examine the association between anemia (hemoglobin <12 g/dL) and 90-day and overall mortality in patients with COPD having acute respiratory failure requiring invasive mechanical ventilation. METHODS: Retrospective study of patients admitted to a quaternary referral medical intensive care unit (ICU) between October 2007 and December 2012 with a diagnosis of COPD and requiring invasive mechanical ventilation for acute respiratory failure of any cause...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29089038/the-impact-of-n-acetylcysteine-and-ascorbic-acid-in-contrast-induced-nephropathy-in-critical-care-patients-an-open-label-randomized-controlled-study
#19
Eleni Palli, Demosthenes Makris, John Papanikolaou, Grigorios Garoufalis, Irini Tsilioni, Paris Zygoulis, Epaminondas Zakynthinos
BACKGROUND: The aim was to investigate whether the use of N-acetylcysteine and ascorbic acid reduce contrast-induced nephropathy incidence in critical care patients. METHODS: This was a one-center, two-arm, prospective, randomized, open-label, controlled trial in the Intensive Care Unit of the University Hospital of Larissa, Greece. Patients with stable renal function, who underwent non urgent contrast-enhanced computed tomography for diagnostic purposes, were included in the study...
October 31, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29088994/a-generic-simulation-model-of-the-relative-cost-effectiveness-of-icu-versus-step-down-imcu-expansion
#20
Amin Mahmoudian-Dehkordi, Somayeh Sadat
BACKGROUND: Many jurisdictions are facing increased demand for intensive care. There are two long-term investment options: intensive care unit (ICU) versus step-down or intermediate care unit (IMCU) capacity expansion. Relative cost-effectiveness of the two investment strategies with regard to patient lives saved has not been studied to date. METHODS: We expand a generic system dynamics simulation model of emergency patient flow in a typical hospital, populated with empirical evidence found in the medical and hospital administration literature, to estimate the long-term effects of expanding ICU versus IMCU beds on patient lives saved under a common assumption of 2...
January 1, 2017: Journal of Intensive Care Medicine
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