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https://www.readbyqxmd.com/read/28716775/acute-rehabilitation-after-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-major-trauma
#1
Jessica Anne Rich, Julia Coleman, Camille Devaux, Karen Hoffman
We report a 23-year-old woman admitted post cyclist versus heavy goods vehicle accident in December 2014. This was the second case the life-saving procedure, that is, resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed on at the roadside. This advanced procedure was performed due to the extensive haemorrhage from this patient's complex pelvic fracture . As a result of REBOA, the patient consequently lost her left lower limb and underwent a variety of complex pelvic and lower limb surgeries...
July 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28711963/transfer-of-neonates-with-critical-congenital-heart-disease-within-a-regionalized-network
#2
Michael F Swartz, Jill M Cholette, Jennifer M Orie, Marshall L Jacobs, Jeffrey P Jacobs, George M Alfieris
Regionalization of pediatric cardiac surgical care varies between and within states. In most geographic regions, at least some neonates with critical heart disease are transferred from their birth hospital to a different hospital for surgery. The impact of neonatal transfer for surgery, particularly over a considerable distance (>10 miles), has been largely unexplored. We sought to examine the impact of transferring neonates for cardiac surgery. We queried the New York State Cardiac Surgery database (2005-2014) from a single institution to identify neonates born within the cardiac surgery center and those transferred for surgery...
July 15, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28702263/factors-associated-with-the-incidence-and-severity-of-new-onset-atrial-fibrillation-in-adult-critically-ill-patients
#3
Péricles A D Duarte, Gustavo Elias Leichtweis, Luiza Andriolo, Yasmim A Delevatti, Amaury C Jorge, Andreia C Fumagalli, Luiz Claudio Santos, Cecilia K Miura, Sergio K Saito
BACKGROUND: Acute Atrial Fibrillation (AF) is common in critically ill patients, with significant morbidity and mortality; however, its incidence and severity in Intensive Care Units (ICUs) from low-income countries are poorly studied. Additionally, impact of vasoactive drugs on its incidence and severity is still not understood. This study aimed to assess epidemiology and risk factors for acute new-onset AF in critically ill adult patients and the role of vasoactive drugs. METHOD: Cohort performed in seven general ICUs (including cardiac surgery) in three cities in Paraná State (southern Brazil) for 45 days...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/28697317/management-of-malignant-bowel-obstruction-associated-with-gi-cancers
#4
Aaron J Franke, Atif Iqbal, Jason S Starr, Rajesh M Nair, Thomas J George
For many patients with GI malignancies, the seeding of the abdominal cavity with tumor cells, called peritoneal carcinomatosis, is a common mode of metastases and disease progression. Prognosis for patients with this aspect of their disease remains poor, with high disease-related morbidity and complications. Uniform and proven practices that provide optimal palliative care and quality of life for these patients are needed. The objective of this review is to critically assess the current literature regarding palliative strategies in the management of peritoneal carcinomatosis and associated symptoms in patients with advanced GI cancers...
July 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28696880/performance-of-pediatric-risk-of-mortality-score-among-critically-ill-children-with-heart-disease
#5
Rebecca A Russell, Mallikarjuna Rettiganti, Nancy Brundage, Howard E Jeffries, Punkaj Gupta
OBJECTIVE: To evaluate the performance of the Pediatric Risk of Mortality 3 (PRISM-3) score in critically ill children with heart disease. METHODS: Patients <18 years of age admitted with cardiac diagnoses (cardiac medical and cardiac surgical) to one of the participating pediatric intensive care units in the Virtual Pediatric Systems, LLC, database were included. Performance of PRISM-3 was evaluated with discrimination and calibration measures among both cardiac surgical and cardiac medical patients...
July 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28695239/occurrence-of-clinical-bone-fracture-following-a-prolonged-stay-in-intensive-care-unit-a-retrospective-controlled-study
#6
Anne-Françoise Rousseau, Etienne Cavalier, Jean-Yves Reginster, Pierre Damas, Olivier Bruyère
Clinical consequences of critical illness and critical care (CC) on bone health remain largely unexplored. This retrospective study aimed to assess the number of new bone fractures (BF) following a prolonged length of stay (LOS) in intensive care unit (ICU). Adults admitted in our tertiary ICU during 2013 with a stay >7 days were included (CC group). Patients who died in ICU or lost to follow-up were excluded. For each CC patient still alive after 2 years of follow-up, 2 control patients, scheduled for surgery during 2013, were recruited and matched for gender and age...
July 10, 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/28694703/secondary-sclerosing-cholangitis-in-critically-ill-patients-current-perspectives
#7
REVIEW
Hafsteinn O Gudnason, Einar S Björnsson
Secondary sclerosing cholangitis (SSC) is a term used for a group of chronic cholestatic disease affecting the intra- and/or extrahepatic biliary tree with inflammation and progressive stricture formation, which can lead to biliary cirrhosis. A newly recognized form of SSC is secondary sclerosing cholangitis in critically ill patients (SSC-CIP). Pathogenesis is believed to involve ischemic injury of intrahepatic bile ducts associated with prolonged hypotension, vasopressors administration, and/or mechanical ventilation in patients treated in the intensive care unit (ICU)...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28694568/the-role-of-routine-measurement-of-intra-abdominal-pressure-in-preventing-abdominal-compartment-syndrome
#8
G Raghavendra Prasad, J V Subba Rao, Amtul Aziz, T M Rashmi
INTRODUCTION: Abdomen, a closed compartment, is prone to raised intra-abdominal pressure (IAP) in the postoperative period. After a critical value of ≥ 15 cm of water, IAP produces abdominal compartment syndrome (ACS). ACS leads to reduced venous return, reduced cardiac output, and domino effect of organ dysfunction, leading to death. Hence, it is the need of hour to monitor IAP to pick up intra-abdominal hypertension (IAH) and ACS. This routine facilitates early institution of treatment measures...
July 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28692951/identifying-critical-steps-towards-improved-access-to-innovation-in-cancer-care-a-european-cancer-organisation-position-paper
#9
Matti Aapro, Alain Astier, Riccardo Audisio, Ian Banks, Pierre Bedossa, Etienne Brain, David Cameron, Paolo Casali, Arturo Chiti, Leticia De Mattos-Arruda, Daniel Kelly, Denis Lacombe, Per J Nilsson, Martine Piccart, Philip Poortmans, Katrine Riklund, Gunnar Saeter, Martin Schrappe, Riccardo Soffietti, Luzia Travado, Hein van Poppel, Suzanne Wait, Peter Naredi
In recent decades cancer care has seen improvements in the speed and accuracy of diagnostic procedures; the effectiveness of surgery, radiation therapy and medical treatments; the power of information technology; and the development of multidisciplinary, specialist-led approaches to care. Such innovations are essential if we are to continue improving the lives of cancer patients across Europe despite financial pressures on our healthcare systems. Investment in innovation must be balanced with the need to ensure the sustainability of healthcare budgets, and all health professionals have a responsibility to help achieve this balance...
July 7, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28691631/web-review-risky-business
#10
(no author information available yet)
Risky Business In the early 2000s, a quality improvement project brought together a group of healthcare professionals with experts from the world of motor racing. They compared handovers of critically ill infants and children from operating theatre to intensive care team after complex heart surgery with the processes of a Formula 1 pitstop.
July 10, 2017: Nursing Children and Young People
https://www.readbyqxmd.com/read/28688556/pediatric-langerhans-cell-histiocytosis-of-the-lateral-skull-base
#11
Ananya Majumder, Cameron C Wick, Rebecca Collins, Timothy N Booth, Brandon Isaacson, J Walter Kutz
OBJECTIVE: Describe the presentation, imaging characteristics, management, and outcomes of pediatric patients with Langerhans cell histiocytosis (LCH) of the temporal bone. METHODS: A retrospective chart review was performed between 2000 and 2014 at a single tertiary care children's hospital. Fourteen patients were identified with a diagnosis of LCH and involvement of the temporal bone. RESULTS: Ten patients were female and ten were Caucasian...
August 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28688155/critical-care-management-of-the-cirrhotic-patient-awaiting-liver-transplant-in-the-intensive-care-unit
#12
REVIEW
J C Olson, C J Karvellas
Patients with cirrhosis who are awaiting liver transplantation are at high risk for development of critical illness. Current liver allocation policies which dictate a "sickest first" approach coupled with a mismatch between need and availability of organs results in longer wait times and thus, patients are becoming increasingly ill while awaiting organ transplantation. Even patients with well compensated cirrhosis may suffer acute deterioration, the syndrome of acute-on-chronic liver failure (ACLF) results in multi-system organ dysfunction and a marked increase in associated short-term morbidity and mortality...
July 8, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28682128/the-effects-of-centralisation-of-vascular-surgical-services-in-the-bath-bristol-and-weston-area-on-the-carotid-endarterectomy-pathway
#13
E Partridge, M Brooks, C Curd, V Davis, C Oates, D McGeeney
Introduction Patients who experience a transient ischaemic attack are at the highest risk of having a subsequent stroke immediately after their symptoms. A carotid endarterectomy should be performed on symptomatic, surgically suitable patients who present with a greater than 50% North American Symptomatic Carotid Endarterectomy Trial stenosis of the internal carotid artery within 2 weeks of their symptoms. This study aimed to determine whether the effectiveness of the carotid endarterectomy pathway has been impacted by the centralisation of vascular surgical services in the Bath, Bristol and Weston area...
July 6, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28681208/surgical-considerations-in-the-optimal-management-of-patients-with-malignant-brain-tumors
#14
REVIEW
Jaclyn J Renfrow, Roy E Strowd, Adrian W Laxton, Stephen B Tatter, Carol P Geer, Glenn J Lesser
Advances in technology are revolutionizing medicine and the limits of what we can offer to our patients. In neurosurgery, technology continues to reduce morbidity, increase surgical accuracy, facilitate tissue acquisition, and promote novel techniques for prolonging survival in patients with neuro-oncologic disease. Surgery has been the backbone of glioma diagnosis and treatment by providing adequate, high quality material for precise histologic diagnosis, and genomic characterization in the setting of significant intratumoral heterogeneity, thus allowing personalized treatment selection in the clinic...
August 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28678122/all-cause-versus-complication-specific-readmission-following-total-knee-arthroplasty
#15
Michele D'Apuzzo, Geoffrey Westrich, Chisa Hidaka, Ting Jung Pan, Stephen Lyman
BACKGROUND: Unplanned readmissions have become an important quality indicator, particularly for reimbursement; thus, accurate assessment of readmission frequency and risk factors for readmission is critical. The purpose of this study was to determine (1) the frequency of and (2) risk factors for readmissions for all causes or procedure-specific complications within 30 days after total knee arthroplasty (TKA) as well as (3) the association between hospital volume and readmission rate. METHODS: The Statewide Planning and Research Cooperative System (SPARCS) database from the New York State Department of Health was used to identify 377,705 patients who had undergone primary TKA in the period from 1997 to 2014...
July 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28677871/well-leg-compartment-syndrome-after-laparoscopic-low-anterior-resection-for-lower-rectal-cancer-in-the-lithotomy-position-a-case-report
#16
Masaya Nishino, Miho Okano, Junji Kawada, Yongkook Kim, Mami Yamada, Toshimasa Tsujinaka
A 64-year-old man underwent laparoscopic low anterior resection for lower rectal cancer. Because he was overweight (BMI, 28.1 kg/m(2) ) with rich visceral fat and a narrow pelvic cavity, the operation was technically difficult and the operation time was 686 min. Postoperatively, the patient immediately complained of pain and swelling of the left lower limb. Laboratory examination showed that serum creatinine kinase was markedly increased and urine myoglobin was positive on postoperative day 1. He was diagnosed with well-leg compartment syndrome and was transported to the trauma and critical care center for emergency fasciotomy...
July 5, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28669430/complications-after-gynecologic-and-obstetric-procedures-a-pictorial-review
#17
REVIEW
Richard Tsai, Demetrios Raptis, Constantine Raptis, Vincent M Mellnick
Gynecologic and obstetric procedures require careful dissection in to high real-estate regions in the pelvis and abdomen where many structures lie in close proximity: the urinary bladder, ureter, and bowel. Damage to one of these structures can cause significant morbidity. Recognition of the patient who has an acute complication of gynecologic or obstetric surgery on imaging can precipitate quick and effective medical management. Imaging can appropriately diagnose the underlying problem and provide critical information for the clinical team...
June 7, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28666290/-venous-paravasation-after-augmentation-of-pedicle-screws-an-underestimated-risk
#18
Axel Prokop, Manuela Sagerer, Wolfgang Rupp, Marc Chmielnicki
Cement-augmented pedicle screws can increase the stability of fixators for unstable vertebral fractures in the elderly. Fixators can be inserted quickly and with minimally invasive techniques, reducing surgical risks. From March 2012 until July 2014, we treated 40 patients with percutaneous augmented fixators for unstable vertebral fractures. Average age was 77.5 years. During the six month observation period, no patients died. There were no neurological deficits. On VAS, average pain decreased from 8.5 to 4...
June 30, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28662926/defining-the-burden-scope-and-future-of-vascular-acute-care-surgery
#19
Donald G Harris, Anthony Herrera, Charles B Drucker, Richa Kalsi, Nandakumar Menon, Shahab Toursavadkohi, Jose J Diaz, Robert S Crawford
OBJECTIVE: The paradigm of acute care surgery has revolutionized nonelective general surgery. Similarly, nonelective vascular surgery may benefit from specific management and resource capabilities. To establish the burden and scope of vascular acute care surgery, we analyzed the characteristics and outcomes of patients hospitalized for vascular surgical procedures in Maryland. METHODS: A retrospective analysis of a statewide inpatient database was performed to identify patients undergoing noncardiac vascular procedures in Maryland from 2009 to 2013...
June 26, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28662377/a-multifactor-model-for-predicting-mortality-in-critically-ill-patients-a-multicenter-prospective-cohort-study
#20
Zhongwang Li, Baoli Cheng, Jingya Wang, Guohao Xie, Xiaobo Yu, Man Huang, Zhijun Xu, Zhongqiu Lu, Huaqin Sun, Jian Zhang, Zhiyi Wang, Haiya Wu, Xu Liu, Lihua Chu, Jialian Zhao, Xiangming Fang
PURPOSE: The objective of this study was to develop a model using a combination of routine clinical variables to predict mortality in critically ill patients. METHODS: A cohort of 500 patients recruited from eight university hospital intensive care units (ICUs) was used to develop a model via logistic regression analyses. Discrimination and calibration analyses were performed to assess the model. RESULTS: The model included the lactate level (odds ratio [OR]=1...
June 16, 2017: Journal of Critical Care
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