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https://www.readbyqxmd.com/read/28110388/venovenous-extracorporeal-membrane-oxygenation-in-two-morbidly-obese-patients
#1
Sagar Kadakia, Vishnu Ambur, Ryan Moore, Yoshiya Toyoda, Akira Shiose
Case studies on the use of venovenous extracorporeal membrane oxygenation in the obese patient have been infrequently reported. We report the successful utilization of venovenous extracorporeal membrane oxygenation in two obese patients with acute respiratory distress syndrome. The first patient had a body mass index of 93 and developed acute respiratory distress syndrome in the setting of pneumonia and aspiration while the second patient had a body mass index of 47 and developed acute respiratory distress syndrome in the setting of gastrografin aspiration...
January 21, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28110286/exploring-the-role-of-pain-as-an-early-predictor-of-category-2-pressure-ulcers-a-prospective-cohort-study
#2
Isabelle L Smith, Sarah Brown, Elizabeth McGinnis, Michelle Briggs, Susanne Coleman, Carol Dealey, Delia Muir, E Andrea Nelson, Rebecca Stevenson, Nikki Stubbs, Lyn Wilson, Julia M Brown, Jane Nixon
OBJECTIVE: To explore pressure area related pain as a predictor of category ≥2 pressure ulcer (PU) development. DESIGN: Multicentre prospective cohort study. SETTING: UK hospital and community settings. PARTICIPANTS INCLUSION: Consenting acutely ill patients aged ≥18 years, defined as high risk (Braden bedfast/chairfast AND completely immobile/very limited mobility; pressure area related pain or; category 1 PU)...
January 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28109895/pilot-study-of-the-mirabilis-system-prototype-for-rapid-noninvasive-uterine-fibroid-treatment-using-an-ultrasound-guided-volumetric-shell-ablation-technique
#3
Jessica E Parsons, Michael P H Lau, Patrick J Martin, Joel J Islas Lagos, Juan M Aguilar Aguirre, José G Garza Leal
STUDY OBJECTIVE: The primary objective of this pilot study was to evaluate the safety and acute tissue ablation efficacy of a transabdominal high-intensity focused ultrasound (HIFU) prototype device that uses ultrasound imaging guidance for rapid noninvasive ablation of uterine fibroids. The secondary objective was to assess preliminary fibroid-related symptom improvement and fibroid volume reduction at 3 - 6 months post-treatment in subsets of patients. DESIGN: Multi-center prospective single-arm pilot study (Canadian Task Force Classification II-2) SETTING: University-affiliated teaching hospital and private community hospital PATIENTS: Women with a diagnosis of symptomatic uterine fibroids planning to undergo hysterectomy INTERVENTIONS: Seventy-three (73) women underwent transabdominal ultrasound-guided HIFU treatment using a volumetric ablation technique referred to as 'shell ablation,' in which the HIFU energy is deposited in patterns that partially encapsulate the peripheral region of the targeted fibroid(s)...
January 18, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28109741/eight-unexpected-cases-of-vancomycin-associated-acute-kidney-injury-with-contemporary-dosing
#4
J Nicholas O'Donnell, Cybele Ghossein, Nathaniel J Rhodes, Jessica Peng, Tina Lertharakul, C Kim Pham, Marc H Scheetz
Vancomycin is one of the most commonly utilized antibiotics in US hospitals. It remains the drug of choice for the treatment of serious infections caused by methicillin-resistant Staphylococcus aureus. For many of these deep-seated infections, guidelines recommend achieving troughs of 15-20 mg/L for treatment efficacy. At our institution we observed a number of cases of presumed vancomycin-induced acute tubular necrosis clinically diagnosed by the nephrology service. We report eight cases of presumed vancomycin-induced acute tubular necrosis, three of which required hemodialysis before resolution of nephrotoxicity...
January 18, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28109578/liver-fibrogenesis-marker-7s-domain-of-collagen-type-iv-in-patients-with-acutely-decompensated-heart-failure-correlates-prognostic-value-and-time-course
#5
Kazuya Nagao, Akinori Tamura, Takeshi Morimoto, Kiyotaka Shimamura, Hiroshi Yukawa, Haruyasu Ito, Fujio Hayashi, Toshinori Makita, Genzou Takemura, Yukihito Sato, Tsukasa Inada, Takeshi Kimura, Masaru Tanaka
BACKGROUND: Congestion in heart failure (HF) induces multiple organ injury, which may cause remodeling of extracellular matrix. We hypothesized that liver fibrogenesis marker, 7S domain of collagen type IV (P4NP 7S) was correlated with congestion and liver injury in HF. METHODS AND RESULTS: We measured serum P4NP 7S in two cohorts. Cohort 1 included 70 patients undergoing catheterization. P4NP 7S was correlated with pulmonary capillary wedge pressure, right ventricular and atrial pressure (r=0...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28109466/definitive-proton-beam-therapy-for-adenoid-cystic-carcinoma-of-the-nasopharynx-involving-the-base-of-skull
#6
Michelle S Gentile, Darwin Yip, Norbert J Liebsch, Judith A Adams, Paul M Busse, Annie W Chan
OBJECTIVES: Management of unresectable adenocystic carcinoma (ACC) of the nasopharynx is challenging given the high dose required for tumor control while respecting dose constraints. We evaluated long-term outcomes and toxicity in patients with unresectable ACC of the nasopharynx treated with definitive proton beam therapy. METHODS: Between 2000 and 2013, 14 patients with ACC of the nasopharynx were treated. Ninety-three percent had T4 disease. All had involvement of the skull base...
February 2017: Oral Oncology
https://www.readbyqxmd.com/read/28109282/does-a-biomedical-research-centre-affect-patient-care-in-local-hospitals
#7
Catherine A Lichten, Grace Marsden, Alexandra Pollitt, Vasiliki Kiparoglou, Keith M Channon, Jon Sussex
BACKGROUND: Biomedical research can have impacts on patient care at research-active hospitals. We qualitatively evaluated the impact of the Oxford Biomedical Research Centre (Oxford BRC), a university-hospital partnership, on the effectiveness and efficiency of healthcare in local hospitals. Effectiveness and efficiency are conceptualised in terms of impacts perceived by clinicians on the quality, quantity and costs of patient care they deliver. METHODS: First, we reviewed documentation from Oxford BRC and literature on the impact of research activity on patient care...
January 21, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28109263/common-and-uncommon-neurological-manifestations-of-neuroborreliosis-leading-to-hospitalization
#8
Philipp Schwenkenbecher, Refik Pul, Ulrich Wurster, Josef Conzen, Kaweh Pars, Hans Hartmann, Kurt-Wolfram Sühs, Ludwig Sedlacek, Martin Stangel, Corinna Trebst, Thomas Skripuletz
BACKGROUND: Neuroborreliosis represents a relevant infectious disease and can cause a variety of neurological manifestations. Different stages and syndromes are described and atypical symptoms can result in diagnostic delay or misdiagnosis. The aim of this retrospective study was to define the pivotal neurological deficits in patients with neuroborreliosis that were the reason for admission in a hospital. METHODS: We retrospectively evaluated data of patients with neuroborreliosis...
January 21, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28109108/-brachiocephalic-artery-sparing-aortic-arch-repair-combined-with-stent-graft-elephant-trunk-technique-for-stanford-type-a-aortic-dissection-analysis-of-23-cases
#9
Song-Lin DU, Jun Wan, Wu-Jun Wang, Kai-Can Cai, Ya-Xiang Liu, Xiang-Hui Mao
OBJECTIVE: To assess the clinical outcomes of brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique for treatment of Stanford type A aortic dissection. METHODS: Twenty-three patients with Stanford type A aortic dissection requiring arch replacement underwent brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique. The operations were performed within 72 h (20 cases) or 3-14 days (3 cases) after the onset of aortic dissection...
January 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28109104/-clinical-significance-of-peripheral-blood-neutrophil-lymphocyte-ratio-and-platelet-lymphocyte-ratio-in-patients-with-asthma
#10
Guang Shi, Jun-Wei Zhao, Liang Ming
OBJECTIVE: To investigate the changes of peripheral blood neutrophil-lymphocyte ratio (NLR) and platelet- lymphocyte ratio (PLR) in patients in acute stage of bronchial asthma and their clinical significance. METHODS: A total of 262 patients with acute asthma, including 97 critical and 175 non-critical patients, were recruited from our hospital between January, 2013 and May, 2016, with 130 healthy individuals as the control group. The absolute neutrophil count, absolute lymphocyte count, platelet, NLR and PLR were compared among different groups, and their diagnostic values were evaluated using the area under the receiver-operating characteristic (ROC) curve...
January 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28108793/effective-cerebrovascular-thrombectomy-requires-well-organized-structures-real-world-experiences-of-a%C3%A2-regional-stroke-network-between-2012-2015
#11
Maria Sophie Stockinger, Johannes Trenkler, Tim von Oertzen, Karin Nussbaumer, Michael Sonnberger, Wolfgang Schimetta, Anthony C Pereira, Gerhard Traxler, Claudia Dorninger, Hans-Peter Haring
BACKGROUND: The objective of this study was to analyse the Neurothrombectomy Network registry of the Neuromed Campus (NMC) of the Kepler University Hospital in Linz (Austria). The data were compared to the results of recently published thrombectomy trials (MR CLEAN, ESCAPE, EXTEND-IA, SWIFT-PRIME, REVASCAT and THRACE). METHODS: We retrospectively studied 246 patients with acute ischemic stroke who underwent thrombectomy between January 2012 and December 2015 at the NMC in Upper Austria...
January 20, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28108566/total-aortic-arch-replacement-with-the-frozen-elephant-trunk-procedure-in-acute-debakey-type-i-aortic-dissections
#12
Malakh Shrestha, Axel Haverich, Andreas Martens
OBJECTIVES: In patients with acute aortic dissection involving the arch and the descending aorta (AADA DeBakey type I), performing a total aortic arch replacement with the frozen elephant trunk (FET) procedure for supposedly better long-term results is still controversial. METHODS: From February 2004 to April 2016, 94 patients with AADA DeBakey type I had an FET procedure (80% men, age 58 ± 12 years). During the early period (Group 1, 2004-10), the FET technique was performed using non-branched grafts...
January 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28108465/outcomes-of-women-and-men-with-acute-coronary-syndrome-treated-with-and-without-percutaneous-coronary-revascularization
#13
Jacob A Udell, Maria Koh, Feng Qiu, Peter C Austin, Harindra C Wijeysundera, Akshay Bagai, Andrew T Yan, Shaun G Goodman, Jack V Tu, Dennis T Ko
BACKGROUND: Women hospitalized with a non-ST segment elevation acute coronary syndrome (ACS) have worse clinical outcomes compared with men. An early invasive strategy with prompt coronary revascularization may mitigate sex differences in outcomes. However, few contemporary studies have evaluated whether clinical outcomes differ between women and men presenting with ACS treated with an early invasive strategy. METHODS AND RESULTS: A population-based cohort of hospitalized ACS patients who received prompt cardiac catheterization from 2008 to 2011 in Ontario, Canada and followed for up to 2 years was studied...
January 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28108374/strategies-to-reduce-hospitalizations-of-children-with-medical-complexity-through-complex-care-expert-perspectives
#14
Ryan J Coller, Bergen B Nelson, Thomas S Klitzner, Adrianna A Saenz, Paul G Shekelle, Carlos F Lerner, Paul J Chung
OBJECTIVES: Interventions to reduce disproportionate hospital use among children with medical complexity (CMC) are needed. Our objective was to conduct a rigorous, structured process to develop intervention strategies aiming to reduce hospitalizations within a complex care program population. METHODS: A complex care medical home program used 1) semi-structured interviews of caregivers of CMC experiencing acute, unscheduled hospitalizations, and 2) literature review on preventing hospitalizations among CMC, to develop key drivers for lowering hospital utilization and link them with intervention strategies...
January 17, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28108054/acute-respiratory-compromise-in-the-emergency-department-a-description-and-analysis-of-3571-events-from-the-get-with-the-guidelines-resuscitation%C3%A2-registry
#15
Carl Mathias Karlsson, Michael W Donnino, Hans Kirkegaard, Michael N Cocchi, Maureen Chase, Lars W Andersen
BACKGROUND: Respiratory events requiring the use of assisted ventilation are relatively common in the emergency department (ED), and can be associated with substantial morbidity and mortality. OBJECTIVE: The aim of this study was to describe and elucidate patient and event characteristics associated with mortality and progression to cardiac arrest in ED patients with acute respiratory compromise. METHODS: Data were obtained from the multicenter Get With the Guidelines-Resuscitation® registry...
January 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28107859/dengue-fever-may-mislead-the-surgeons-when-it-presents-as-an-acute-abdomen
#16
Bingumal Jayasundara, Lalith Perera, Ajith de Silva
OBJECTIVE: To review the management experience of a consecutive series of patients presenting as acute surgical abdomen whom were ultimately diagnosed to have DF (Dengue fever)/DHF (Dengue hemorrhagic fever). METHODS: Clinical data of all cases of apparent acute abdomen (AA) which were later confirmed as having DF/DHF reviewed by two surgical units from December 2012 to December 2013 were analyzed. Initially confirmed patients with DF/DHF who developed abdominal symptoms were not considered...
January 2017: Asian Pacific Journal of Tropical Medicine
https://www.readbyqxmd.com/read/28107437/hyperventilation-with-maintenance-of-isocapnia-an-old-new-method-in-carbon-monoxide-intoxication
#17
Jacek Sein Anand, Daria Schetz, Wojciech Waldman, Marek Wiśniewski
INTRODUCTION: Exposure to carbon monoxide (CO) is among the most common causes of acute and chronic poisonings worldwide. The crucial point of treatment of such acute poisonings is to eliminate CO from the body as fast as possible. There are currently two approaches to the management of the CO intoxication: hyperbaric oxygen therapy (HOT) and normobaric oxygen therapy (NOT). HOT is highly effective and capable of achieving the CO elimination half-time (T½) as low as 15 minutes. Unfortunately this method is expensive and not always readily available...
2017: PloS One
https://www.readbyqxmd.com/read/28107311/performance-of-international-classification-of-diseases-based-injury-severity-measures-used-to-predict-in-hospital-mortality-and-intensive-care-admission-among-traumatic-brain-injured-patients
#18
Mathieu Gagné, Lynne Moore, Marie-Josée Sirois, Marc Simard, Claudia Beaudoin, Brice Lionel Batomen Kuimi
BACKGROUND: The International Classification of Diseases (ICD) is the main classification system used for population-based traumatic brain injury (TBI) surveillance activities but does not contain direct information on injury severity. International Classification of Diseases-based injury severity measures can be empirically derived or mapped to the Abbreviated Injury Scale, but no single approach has been formally recommended for TBI. OBJECTIVE: The aim of this study was to compare the accuracy of different ICD-based injury severity measures for predicting in-hospital mortality and intensive care unit (ICU) admission in TBI patients...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28107297/nursing-care-management-influence-on-bundled-payments
#19
Shaynie Lentz, Brenda Luther
Fragmented and uncoordinated care is the third highest driver of U.S. healthcare costs. Although less than 10% of patients experience uncoordinated care, these patients represent 36% of total healthcare costs; care management interaction makes a significant impact on the utilization of healthcare dollars. A literature search was conducted to construct a model of care coordination for elective surgical procedures by collecting best practices for acute, transitions, and post-acute care periods. A case study was used to demonstrate the model developed...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28107264/readmission-and-late-mortality-after-critical-illness-in-childhood
#20
Mary E Hartman, Mohammed J Saeed, Tellen Bennett, Katri Typpo, Renee Matos, Margaret A Olsen
OBJECTIVES: Little is known about the ongoing mortality risk and healthcare utilization among U.S. children after discharge from a hospitalization involving ICU care. We sought to understand risks for hospital readmission and trends in mortality during the year following ICU discharge. DESIGN: Retrospective observational cohort study. SETTING: This study was performed using administrative claims data from 2006-2013 obtained from the Truven Health Analytics MarketScan Database...
January 19, 2017: Pediatric Critical Care Medicine
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