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https://www.readbyqxmd.com/read/27907964/critical-care-neurology-perspective-on-delirium
#1
Matthew B Maas, Andrew M Naidech
The evidence linking delirium to poor outcomes after critical illness is compelling, including higher mortality, prolonged mechanical ventilation, longer length of intensive care unit stay, and long-term cognitive impairments. The attitude toward delirium in the neurologic community is shifting away from viewing it as an unmodifiable, inevitable consequence of severe illness to treating it is as a neurologic emergency, akin to seizures or encephalitis. Delirium, like other manifestations of critical illness encephalopathy, is an organ dysfunction syndrome...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27898136/pharmacological-approaches-for-the-management-of-persistent-pain-in-older-adults-what-nurses-need-to-know
#2
Fabio Guerriero, Ruth Bolier, Janet H Van Cleave, M Cary Reid
HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.4 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27886697/nonsurgical-management-of-osteoarthritis-knee-pain-in-the-older-adult
#3
REVIEW
Nora Taylor
Symptomatic knee osteoarthritis is a common complaint of many elderly patients in primary care offices. For those unable or unwilling to undergo knee replacement, the primary practitioners' understanding of the strengths and weaknesses of the available treatment modalities for pain relief is critical to successful in-office counseling and expectation management. Treatment requires a multimodal approach of nonpharmacologic and pharmacologic therapies to achieve a maximal clinical benefit. The focus of this review is on the nonsurgical options for treatment of knee osteoarthritis in patients aged 65 and older...
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27886604/a-low-cost-and-palm-size-analyzer-for-rapid-and-sensitive-protein-detection-by-ac-electrokinetics-capacitive-sensing
#4
Xiaozhu Liu, Cheng Cheng, Jayne Wu, Shigetoshi Eda, Yongcai Guo
Specific detection of protein biomarkers has a wide range of applications in areas such as medical science, diagnostics, and pharmacology. Quantitative detection of protein biomarkers in biological media, such as serum, is critically important in detecting disease or physiological malfunction, or tracking disease progression. Among various detection methods, electrical detection is particularly well suited for point-of-care (POC) specific protein detection, being of low cost, light weight and small form factor...
November 11, 2016: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/27878605/-special-medical-problems-in-end-of-life-care-crisis-at-the-end-of-life-which-therapy-is-adequate-and-when-is-redefining-treatment-goals-appropriate
#5
Gesine Benze, Bernd Alt-Epping, Friedemann Nauck
Crisis at the end of life are exceptional challenges for patients, relatives and therapists. With respect to the individual treatment goals and the patients' autonomy, therapeutic action should be commenced in an adequate manner in order to preserve the patients' quality of life as much as possible. Advance care planning for specific critical scenarios may be helpful in order to treat patients according to their wishes and values even if they are not capable to express themselves. Furthermore, a crisis plan can define the scope of action for therapists in emergency situations...
November 23, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27854224/can-human-pluripotent-stem-cell-derived-cardiomyocytes-advance-understanding-of-muscular-dystrophies
#6
Spandan Kalra, Federica Montanaro, Chris Denning
Muscular dystrophies (MDs) are clinically and molecularly a highly heterogeneous group of single-gene disorders that primarily affect striated muscles. Cardiac disease is present in several MDs where it is an important contributor to morbidity and mortality. Careful monitoring of cardiac issues is necessary but current management of cardiac involvement does not effectively protect from disease progression and cardiac failure. There is a critical need to gain new knowledge on the diverse molecular underpinnings of cardiac disease in MDs in order to guide cardiac treatment development and assist in reaching a clearer consensus on cardiac disease management in the clinic...
August 30, 2016: Journal of Neuromuscular Diseases
https://www.readbyqxmd.com/read/27849239/importance-of-the-use-of-protocols-for-the-management-of-analgesia-and-sedation-in-pediatric-intensive-care-unit
#7
Emiliana Motta, Michele Luglio, Artur Figueiredo Delgado, Werther Brunow de Carvalho
Introduction: Analgesia and sedation are essential elements in patient care in the intensive care unit (ICU), in order to promote the control of pain, anxiety and agitation, prevent the loss of devices, accidental extubation, and improve the synchrony of the patient with mechanical ventilation. However, excess of these medications leads to rise in morbidity and mortality. The ideal management will depend on the adoption of clinical and pharmacological measures, guided by scales and protocols...
September 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27846856/ethno-medicinal-survey-of-important-plants-practiced-by-indigenous-community-at-ladha-subdivision-south-waziristan-agency-pakistan
#8
Muhammad Abdul Aziz, Muhammad Adnan, Amir Hasan Khan, Atiq Ur Rehman, Rahmatullah Jan, Jafar Khan
BACKGROUND: Medicinal flora plays a vital role in treating various types of ailments in living beings. The present study was planned to investigate and document systematically the indigenous knowledge in a scientifically little explored area of Ladha sub-division, South Waziristan agency, Pakistan. Hence, this study would contribute positively to the field of ethnopharmacology. METHODS: Prior to ethnomedicinal data collection, regular field visits were conducted during the month of May and June 2015 to locate the sites and respondents from where the traditional knowledge was to be recorded...
November 15, 2016: Journal of Ethnobiology and Ethnomedicine
https://www.readbyqxmd.com/read/27818334/neuromuscular-blockade-in-the-21-st-century-management-of-the-critically-ill-patient
#9
REVIEW
Julian deBacker, Nicholas Hart, Eddy Fan
Neuromuscular blockings agents (NMBAs) have a controversial role in the ventilatory and medical management of critical illness. The clinical concern surrounding NMBA-induced complications stems from evidence presented in the 2002 clinical practice guidelines, but new evidence from subsequent randomized trials and studies provides a more optimistic outlook about the application of NMBAs in the intensive care unit (ICU). Furthermore, changes in the delivery of critical care such as protocolized care pathways, minimizing or interrupting sedation, increased monitoring techniques, and overall improvements in reducing immobility have created a modern, 21st century ICU environment whereby NMBAs may be administered safely...
November 3, 2016: Chest
https://www.readbyqxmd.com/read/27812994/a-review-of-adverse-outcomes-associated-with-psychoactive-drug-use-in-nursing-home-residents-with-dementia
#10
REVIEW
Maryse Lapeyre-Mestre
Treatment guidelines generally recommend careful assessment and non-pharmacological treatment approaches for behavioural and psychological symptoms of dementia. However, the inappropriate use of psychoactive drugs in patients with dementia in nursing homes is still prevalent. The aim of this narrative review is to summarise and criticize the most recent data investigating the adverse outcomes related to psychoactive drug use, specifically antipsychotics, antidepressants and benzodiazepines, in patients with dementia living in nursing homes...
November 4, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27807201/molecular-pathophysiology-of-congenital-long-qt-syndrome
#11
REVIEW
M S Bohnen, G Peng, S H Robey, C Terrenoire, V Iyer, K J Sampson, R S Kass
Ion channels represent the molecular entities that give rise to the cardiac action potential, the fundamental cellular electrical event in the heart. The concerted function of these channels leads to normal cyclical excitation and resultant contraction of cardiac muscle. Research into cardiac ion channel regulation and mutations that underlie disease pathogenesis has greatly enhanced our knowledge of the causes and clinical management of cardiac arrhythmia. Here we review the molecular determinants, pathogenesis, and pharmacology of congenital Long QT Syndrome...
January 2017: Physiological Reviews
https://www.readbyqxmd.com/read/27800591/unmet-needs-and-current-and-future-approaches-for-osteoporotic-patients-at-high-risk-of-hip-fracture
#12
REVIEW
Serge Ferrari, Jean-Yves Reginster, Maria Luisa Brandi, John A Kanis, Jean-Pierre Devogelaer, Jean-Marc Kaufman, Jean-Marc Féron, Andreas Kurth, René Rizzoli
: This review provides a critical analysis of currently available approaches to increase bone mass, structure and strength through drug therapy and of possible direct intra-osseous interventions for the management of patients at imminent risk of hip fracture. PURPOSE: Osteoporotic hip fractures represent a particularly high burden in morbidity-, mortality- and health care-related costs. There are challenges and unmet needs in the early prevention of hip fractures, opening the perspective of new developments for the management of osteoporotic patients at imminent and/or at very high risk of hip fracture...
December 2016: Archives of Osteoporosis
https://www.readbyqxmd.com/read/27792072/unique-educational-needs-of-emergency-nurse-practitioners
#13
Vicki A Keough, Dina Tell, Colleen Andreoni, Paula Tanabe
The purpose of this study is to identify the unique educational needs of emergency nurse practitioners (ENPs). A survey from 167 nurse practitioners (NPs) practicing in the emergency department (ED) settings was analyzed. A variety of certified NPs practice in EDs: family NPs (30%), adult NPs (18%), acute care NPs (40%), and some with 2 or more certifications (12%). NPs come with a variety of basic educational preparations. The top educational needs specific to ENP preparation identified were managing critically ill patients, pharmacology, interpretation of laboratory tests, electrocardiograms, radiographs, and computed tomographic scans, suturing superficial lacerations, and mentoring by MDs and NPs...
October 2016: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/27791223/non-pharmacological-interventions-to-prevent-or-treat-delirium-in-older-patients-clinical-practice-recommendations-the-senator-ontop-series
#14
I Abraha, J M Rimland, F Trotta, V Pierini, A Cruz-Jentoft, R Soiza, D O'Mahony, A Cherubini
DESCRIPTION: The ONTOP project aims to undertake a literature search of systematic reviews concerning evidence-based non-pharmacological interventions of prevalent medical conditions affecting older people, including delirium. OBJECTIVES: To develop explicit and transparent recommendations for non-pharmacological interventions in older subjects at risk of developing delirium, as well as in older subjects with delirium, based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to rating the quality of evidence and the strength of recommendations...
2016: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/27777355/analgesia-in-the-surgical-intensive-care-unit
#15
REVIEW
Eric Ehieli, Suraj Yalamuri, Charles S Brudney, Srinivas Pyati
Critically ill patients are a heterogeneous group with diverse comorbidities and physiological derangements. The management of pain in the critically ill population is emerging as a standard of care in the intensive care unit (ICU). Pain control of critically ill patients in the ICU presents numerous challenges to intensivists. Inconsistencies in pain assessment, analgesic prescription and variation in monitoring sedation and analgesia result in suboptimal pain management. Inadequate pain control can have deleterious effects on several organ systems in critically ill patients...
October 24, 2016: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/27754761/a-novel-pink1-and-park2-dependent-protective-neuroimmune-pathway-in-lethal-sepsis
#16
Rui Kang, Ling Zeng, Yangchun Xie, Zhengwen Yan, Borong Zhou, Lizhi Cao, Daniel J Klionsky, Kevin J Tracey, Jianhua Li, Haichao Wang, Timothy R Billiar, Jianxin Jiang, Daolin Tang
Although the PINK1-PARK2 pathway contributes to the pathogenesis of Parkinson disease, its roles in sepsis (a major challenge for critical care) were previously unknown. Here, we show that pink1(-/-) and park2(-/-) mice are more sensitive to polymicrobial sepsis-induced multiple organ failure and death. The decrease in the circulating level of the neurotransmitter dopamine in pink1(-/-) and park2(-/-) mice accelerates the release of a late sepsis mediator, HMGB1, via HIF1A-dependent anaerobic glycolysis and subsequent NLRP3-dependent inflammasome activation...
October 18, 2016: Autophagy
https://www.readbyqxmd.com/read/27729950/prevention-of-post-operative-delirium-in-the-elderly-using-pharmacological-agents
#17
Patrice Tremblay, Susan Gold
INTRODUCTION: Post-operative delirium (POD) is a serious surgical complication that can cause significant morbidity and mortality. It is associated with prolonged hospital stay, delayed admission to rehabilitation programs, persistent cognitive deficits, marked health-care costs, and more. The pathophysiology is multi-factorial and not completely understood, which complicates the optimal management. Non-pharmacological measures have been the mainstay of treatment, but there has been an ongoing interest in the medical literature on the prevention of post-operative delirium using medications...
September 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/27720664/pharmacological-management-of-acute-kidney-injury-and-chronic-kidney-disease-in-neonates
#18
Jennifer G Jetton, Mark Sorenson
Both acute kidney injury (AKI) and chronic kidney disease (CKD) are seen more frequently in the neonatal intensive care unit (NICU) as advances in supportive care improve the survival of critically ill infants as well as those with severe, congenital kidney and urinary tract anomalies. Many aspects of the infant's care, including fluid balance, electrolyte and mineral homeostasis, acid-base balance, and growth and nutrition require close monitoring by and collaboration among neonatologists, nephrologists, dieticians, and pharmacologists...
October 6, 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27705988/missing-messages-of-clinical-pharmacologic-survey-on-inotropic-drug-use-in-neonatal-critical-care
#19
Yun Cao, Ying Dong, Bo Sun
No abstract text is available yet for this article.
October 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27703398/cystic-fibrosis-transmembrane-conductance-regulator-modulators-in-cystic-fibrosis-current-perspectives
#20
Béla Z Schmidt, Jérémy B Haaf, Teresinha Leal, Sabrina Noel
Mutations of the CFTR gene cause cystic fibrosis (CF), the most common recessive monogenic disease worldwide. These mutations alter the synthesis, processing, function, or half-life of CFTR, the main chloride channel expressed in the apical membrane of epithelial cells in the airway, intestine, pancreas, and reproductive tract. Lung disease is the most critical manifestation of CF. It is characterized by airway obstruction, infection, and inflammation that lead to fatal tissue destruction. In spite of great advances in early and multidisciplinary medical care, and in our understanding of the pathophysiology, CF is still considerably reducing the life expectancy of patients...
2016: Clinical Pharmacology: Advances and Applications
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