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https://www.readbyqxmd.com/read/28634768/futile-treatment-a-review
#1
Lenko Šarić, Ivana Prkić, Marko Jukić
The main goal of intensive care medicine is helping patients survive acute threats to their lives, while preserving and restoring life quality. Because of medical advancements, it is now possible to sustain life to an extent that would previously have been difficult to imagine. However, the goals of medicine are not to preserve organ function or physiological activity but to treat and improve the health of a person as a whole. When dealing with medical futilities, physicians and other members of the care team should be aware of some ethical principles...
June 20, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28634133/acute-severe-gastrointestinal-tract-bleeding-is-associated-with-an-increased-risk-of-thromboembolism-and-death
#2
Naoyoshi Nagata, Toshiyuki Sakurai, Takuro Shimbo, Shiori Moriyasu, Hidetaka Okubo, Kazuhiro Watanabe, Chizu Yokoi, Mikio Yanase, Junichi Akiyama, Naomi Uemura
BACKGROUND & AIMS: We performed a retrospective cohort study of patients with and without gastrointestinal bleeding (GIB) to determine whether GIB increases the risks of thromboembolism and death. METHODS: We collected data from 522 patients with acute severe GIB and 1044 patients without GIB (controls, matched for age, sex, year of diagnosis, history of thromboembolism, and use of antithrombotic drugs) who underwent endoscopy at the National Center for Global Health and Medicine in Japan from January 2009 through December 2014...
June 17, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28633904/clinical-characteristics-of-type-a-acute-aortic-dissection-with-symptom-of-the-central-nervous-system
#3
Yuji Shono, Tomohiko Akahoshi, Satomi Mezuki, Kenta Momii, Noriyuki Kaku, Jun Maki, Kentaro Tokuda, Tetsuro Ago, Takanari Kitazono, Yoshihiko Maehara
BACKGROUND AND PURPOSE: Accurate diagnosis of acute aortic dissection (AAD) is sometimes difficult because of accompanying central nervous system (CNS) symptoms. The purpose of this study was to investigate the clinical characteristics of Type A AAD (TAAAD) with CNS symptoms. METHODS: We retrospectively reviewed the medical records of 8403 patients ambulanced to our emergency and critical care center between April 2009 and May 2014. RESULTS: We identified 59 TAAAD patients for the analysis (mean age, 67...
June 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28633144/standardized-renal-endpoints-for-perioperative-clinical-trials-the-standardized-endpoints-in-perioperative-medicine-initiative
#4
David R McIlroy, Andrew D Shaw, Paul S Myles
Perioperative acute kidney injury is a common problem. While clinical trials seek to evaluate the impact of interventions on a variety of primary and secondary endpoints with the aim of implementing this knowledge to improve perioperative outcomes, the use of valid and relevant endpoints within clinical trials is of critical importance to achieving this goal. Suitable endpoints must be validated for the study population and in light of the clinical context under investigation while also considering regulatory requirements that govern the licensing of new therapeutic agents as well as the values of patients whose outcomes we seek to improve...
June 21, 2017: Nephron
https://www.readbyqxmd.com/read/28632246/declines-noted-in-cognitive-processes-and-association-with-achievement-among-children-with-leukemia
#5
Kathleen C Insel, Marilyn J Hockenberry, Lynette L Harris, Kari M Koerner, Zhenqiang Lu, Kristin B Adkins, Olga A Taylor, Patricia M Gundy, Ida M Moore
PURPOSE/OBJECTIVES: To assess change in specific cognitive processes during treatment with chemotherapy only among children with acute lymphoblastic leukemia (ALL). 
. DESIGN: A prospective, repeated measures design.
. SETTING: Pediatric oncology treatment centers at Banner-University Medical Center Tucson/Banner Children's-Diamond Medical Center (University of Arizona) and Texas Children's Cancer and Hematology centers (Baylor College of Medicine) in Houston...
July 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28632196/drug-hypersensitivity-and-desensitizations-mechanisms-and-new-approaches
#6
REVIEW
Leticia de Las Vecillas Sánchez, Leila A Alenazy, Marlene Garcia-Neuer, Mariana C Castells
Drug hypersensitivity reactions (HSRs) are increasing in the 21st Century with the ever expanding availability of new therapeutic agents. Patients with cancer, chronic inflammatory diseases, cystic fibrosis, or diabetes can become allergic to their first line therapy after repeated exposures or through cross reactivity with environmental allergens. Avoidance of the offending allergenic drug may impact disease management, quality of life, and life expectancy. Precision medicine provides new tools for the understanding and management of hypersensitivity reactions (HSRs), as well as a personalized treatment approach for IgE (Immunoglobuline E) and non-IgE mediated HSRs with drug desensitization (DS)...
June 20, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28632194/a-mind-body-approach-to-pediatric-pain-management
#7
REVIEW
Melanie L Brown, Enrique Rojas, Suzanne Gouda
Pain is a significant public health problem that affects all populations and has significant financial, physical and psychological impact. Opioid medications, once the mainstay of pain therapy across the spectrum, can be associated with significant morbidity and mortality. Centers for Disease and Control (CDC) guidelines recommend that non-opioid pain medications are preferred for chronic pain outside of certain indications (cancer, palliative and end of life care). Mindfulness, hypnosis, acupuncture and yoga are four examples of mind-body techniques that are often used in the adult population for pain and symptom management...
June 20, 2017: Children
https://www.readbyqxmd.com/read/28631761/-management-of-outpatients-with-cardiac-disease-follow-up-timing-and-modalities
#8
Roberta Rossini, Daniela Lina, Marco Ferlini, Giuseppina Belotti, Salvatore Ivan Caico, Fabrizio Caravati, Pompilio Faggiano, Annamaria Iorio, Davide Lauri, Corrado Lettieri, Emanuela Teresa Locati, Antonio Maggi, Ferdinando Massari, Andrea Mortara, Luigi Moschini, Giuseppe Musumeci, Daniele Nassiacos, Fabrizio Negri, Domenico Pecora, Simona Pierini, Roberto Pedretti, Pierfranco Ravizza, Michele Romano, Fabrizio Oliva
The increasing rate of cardiovascular diseases, the improved survival after the acute phase, the aging of the population and the implementation of primary prevention caused an exponential increase in outpatient cardiac performance, thereby making it difficult to maintain a balance between the citizen-patient request and the economic sustainability of the healthcare system. On the other side, the prescription of many diagnostic tests with a view to defensive medicine and the related growth of patients' expectations, has led several scientific societies to educational campaigns highlighting the concept that "less is more"...
June 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28631044/-personalized-treatment-of-viral-hepatitis-of-the-present-and-the-future-hepatitis%C3%A2-b-c-delta-and-e
#9
REVIEW
R Bartenschlager, M Cornberg, T Pietschmann
Precision medicine is also possible for infectious diseases as shown for the treatment of chronic viral hepatitis, especially if different options are available. In hepatitis B virus (HBV) infection, treatment indication as well as the choice of treatment and the decisions to stop treatment are based on viral markers and alanine aminotransferase (ALT) level. Future therapies for HBV infection aiming for functional cure or even virus elimination may be even more personalized and have to take into account the immune status of a given patient...
June 19, 2017: Der Internist
https://www.readbyqxmd.com/read/28630871/a-systematic-review-and-meta-analysis-on-the-treatment-of-cerebral-hemorrhage-with-naoxueshu-oral-liquid
#10
REVIEW
Lijun Wu, Yanda Li, Xiaofeng Wang, Xiaomeng Ren, Haiyan Zhu, Yikun Sun, Yanwei Xing, Lingqun Zhu, Yonghong Gao, Hongcai Shang
NaoXueShu oral liquid invigorates Qi and promotes blood circulation, which is mainly used for treating the acute stage of the meridian of hemorrhagic apoplexy and acute blood stasis syndrome during early convalescence. Its main clinical manifestations include hemiplegia, mouth askew, hemianesthesia, and inarticulateness. It is used mainly in patients with lobar hemorrhage, basal ganglia, and thalamus of the small amount of bleeding without disturbing consciousness of hypertensive cerebral. The purpose of this study was to evaluate the efficacy and adverse effects of NaoXueShu oral liquid on the treatment of cerebral hemorrhage...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28630774/lead-poisoning-can-be-easily-misdiagnosed-as-acute-porphyria-and-nonspecific-abdominal-pain
#11
Ming-Ta Tsai, Shi-Yu Huang, Shih-Yu Cheng
Lead poisoning (LP) is less commonly encountered in emergency departments (ED). However, lead exposure still occurs, and new sources of poisoning have emerged. LP often goes unrecognized due to a low index of suspicion and nonspecific symptoms. We present a case of a 48-year-old man who had recurring abdominal pain with anemia that was misdiagnosed. His condition was initially diagnosed as nonspecific abdominal pain and acute porphyria. Acute porphyria-like symptoms with a positive urine porphyrin test result led to the misdiagnosis; testing for heme precursors in urine is the key to the differential diagnosis between LP and acute porphyria...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28630605/xinfuli-granule-improves-post-myocardial-infarction-ventricular-remodeling-and-myocardial-fibrosis-in-rats-by-regulating-tgf-%C3%AE-smads-signaling-pathway
#12
Jie Ma, Zhi-Yuan Li, Xiao-Peng Liang, Cai-Xia Guo, Pei-Pei Lu, Li-Hong Ma
BACKGROUND: Recent clinical and experimental studies have confirmed the effects of Xinfuli Granule (XG), a compound Chinese medicine in the prevention and treatment of heart failure (HF). This study aimed to investigate the effects and the mechanisms of XG on ventricular reconstruction in rats with acute myocardial infarction (AMI). METHODS: Sprague-Dawley rats were subjected to left anterior descending branch ligation. The rats that survived 24 h were randomly assigned to five groups: medium-dose of XG group (MI+XGM), high-dose of XG group (MI+XGH), carvedilol group (MI+C), medium-dose of XG + carvedilol group (MI+C+XGM)...
May 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28629581/impact-of-a-teamstepps-trauma-nurse-academy-at-a-level-1-trauma-center
#13
V Kristen Peters, Ellen M Harvey, Andi Wright, Jennifer Bath, Dan Freeman, Bryan Collier
PROBLEM: Nurses are crucial members of the team caring for the acutely injured trauma patient. Until recently, nurses and physicians gained an understanding of leadership and supportive roles separately. With the advent of a multidisciplinary team approach to trauma care, formal team training and simulation has transpired. METHODS: Since 2007, our Level I trauma system has integrated TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety; Agency for Healthcare Research and Quality, Rockville, MD) into our clinical care, joint training of nurses and physicians, using simulations with participation of all health care providers...
June 16, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28629285/acute-movement-disorders-in-the-medical-setting
#14
Ifrah Zawar, Mario A Caro, Lara Feldman, Xavier F Jimenez
Objective Psychosomatic medicine psychiatrists are often tasked with the evaluation and treatment of complex neuropsychiatric states which may be motoric in phenotype. Little energy has been dedicated to understanding acute movement disorders in the hospital environment. Method Recognizing the importance of frontal-subcortical (corticostriatothalamocortical) circuitry and basal ganglia structures, we present a case series of acute movement disorder phenotypes resulting from underlying medical conditions, commonly-administered medications, or the interaction of both...
July 2016: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28628498/earlier-physical-therapy-input-is-associated-with-a-reduced-length-of-hospital-stay-and-reduced-care-needs-on-discharge-in-frail-older-inpatients-an-observational-study
#15
Peter J Hartley, Victoria L Keevil, Ledia Alushi, Rebecca L Charles, Eimear B Conroy, Patricia M Costello, Becki Dixon, Aida M Dolinska-Grzybek, Diana Vajda, Roman Romero-Ortuno
BACKGROUND AND PURPOSE: Pressures on hospital bed occupancy in the English National Health Service have focused attention on enhanced service delivery models and methods by which physical therapists might contribute to effective cost savings, while retaining a patient-centered approach. Earlier access to physical therapy may lead to better outcomes in frail older inpatients, but this has not been well studied in acute National Health Service hospitals. Our aim was to retrospectively study the associations between early physical therapy input and length of hospital stay (LOS), functional outcomes, and care needs on discharge...
June 16, 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/28628030/a-novel-flexible-cuff-like-microelectrode-for-dual-purpose-acute-and-chronic-electrical-interfacing-with-the-mouse-cervical-vagus-nerve
#16
April Shawn Caravaca, Téa Tsaava, Laura Goldman, Harold Silverman, Gary Riggott, Sangeeta Chavan, Chad Bouton, Kevin J Tracey, Robert Desimone, Ed Boyden, Harbaljit Singh Sohal, Peder S Olofsson
OBJECTIVE: Neural reflexes establish homeostasis and regulate the immune system. Advances in bioelectronic medicine indicate that electrical stimulation of the vagus nerve can be used to treat inflammatory disease, yet the understanding of neural signals that regulate inflammation is incomplete. Current interfaces with the vagus nerve do not permit effective chronic stimulation or recording in mouse models, which is vital to studying the molecular and neurophysiological mechanisms that control inflammation homeostasis in health and disease...
June 19, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/28625256/-comparison-of-effect-of-norepinephrine-and-terlipressin-on-patients-with-ards-combined-with-septic-shock-a-prospective-single-blind-randomized-controlled-trial
#17
Zhi Chen, Ping Zhou, Yuanhua Lu, Chunli Yang
OBJECTIVE: To approach the effect of different vasopressor on hemodynamics, volume responsiveness, fluid volume balance, renal function and prognosis in patients with acute respiratory distress syndrome (ARDS) complicated with septic shock. METHODS: A prospective single-blind randomized controlled trial was conducted. ARDS patients with septic shock admitted to the Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2015 to May 1st, 2016 were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625248/-core-knowledge-and-skill-based-approach-to-subspecialty-construction-in-critical-intensive-care-medicine-with-distinct-chinese-peculiarity
#18
Lijun Wang, Fang Tian
With the rapid development of critical care medicine (CCM) in China, there are increases in the number of intensive care units (ICUs), the scale of one center ICU and the team. Subspecialty construction of CCM is of great concerns for personnel training as well as discipline development, and is currently one of the urgent problems that need to be resolved. Experience of CCM subspecialty construction from Europe and the United States is lacking and it is necessary to propose some opinions on innovation to construct CCM subspecialties with Chinese characteristics...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625240/-dynamic-changes-of-complement-level-in-patients-with-acute-coronary-syndrome-and-its-relationships-with-myocardial-injury
#19
Aihong Shao, Xin Qi, Qi Li, Wenjun Jia, Liping Wei, Wenguang Hou, Yanfang Qi, Yue Liu
OBJECTIVE: To study relationships between myocardial injury and the levels of serum complement C3, C4 and C5b-9 in patients with acute coronary syndrome (ACS). METHODS: A retrospectively analysis was conducted. 170 ACS patients [including 110 cases of ST-segment elevation myocardial infarction (STEMI) and 60 cases of non-ST-segment elevation acute coronary syndrome (NSTE-ACS)] with ischemic chest pain or chest discomfort onset within the prior 12 hours admitted to the cardiology department of Tianjin Union Medicine Center from January 2014 to July 2016 were enrolled...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625235/-pharmacokinetics-of-vancomycin-in-patients-with-severe-acute-pancreatitis-and-its-influencing-factors-analysis-of-7-years-data
#20
Juan He, Enqiang Mao, Feng Jing, Huiting Jiang, Wanhua Yang, Erzhen Chen
OBJECTIVE: To observe the change of the serum trough concentration and its pharmacokinetics of vancomycin in patients with severe acute pancreatitis (SAP), and to analyze the factors influencing vancomycin concentration. METHODS: A retrospective analysis was conducted. Steady-state trough concentrations of vancomycin from patients (18-80 years old) with SAP concomitantly with G(+) infection admitted to Intensive Care Unit (ICU) of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2010 to December 2016 were enrolled...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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