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https://www.readbyqxmd.com/read/28817114/trauma-informed-care-in-the-newborn-intensive-care-unit-promoting-safety-security-and-connectedness
#1
M R Sanders, S L Hall
Both babies and their parents may experience a stay in the newborn intensive care unit (NICU) as a traumatic or a 'toxic stress,' which can lead to dysregulation of the hypothalamic-pituitary-adrenal axis and ultimately to poorly controlled cortisol secretion. Toxic stresses in childhood or adverse childhood experiences (ACEs) are strongly linked to poor health outcomes across the lifespan and trauma-informed care is an approach to caregiving based on the recognition of this relationship. Practitioners of trauma-informed care seek to understand clients' or patients' behaviors in light of previous traumas they have experienced, including ACEs...
August 17, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28816834/effect-of-amantadine-on-agitation-in-critically-ill-patients-with-traumatic-brain-injury
#2
Jawaher A Gramish, Brian J Kopp, Asad E Patanwala
OBJECTIVE: This study aimed to compare the presence of agitation in traumatic brain injury patients treated with amantadine with those not treated with amantadine in the intensive care unit (ICU). METHODS: This was a retrospective cohort study conduced in a trauma ICU of a tertiary care institution in the United States. Patients who received amantadine were compared with patients who did not receive amantadine. The primary outcome measure was the presence of agitation, defined as the Richmond Agitation Sedation Scale score of +2 or higher...
August 14, 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28815080/mckeown-or-ivor-lewis-totally-minimally-invasive-esophagectomy-for-cancer-of-the-esophagus-and-gastroesophageal-junction-systematic-review-and-meta-analysis
#3
Frans van Workum, Gijs H Berkelmans, Bastiaan R Klarenbeek, Grard A P Nieuwenhuijzen, Misha D P Luyer, Camiel Rosman
BACKGROUND: Minimally invasive esophagectomy (MIE) has consistently been associated with improved perioperative outcome and similar oncological safety compared to open esophagectomy. However, it is currently unclear what type of MIE is preferred for patients with resectable esophageal cancer. METHODS: Literature was searched in Medline, Embase and the Cochrane library combining relevant search terms. Articles that included patients undergoing totally minimally invasive esophagectomy (TMIE) or hybrid minimally invasive esophagectomy (HMIE) and compared McKeown with Ivor Lewis procedures were included...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28810921/the-role-of-whole-body-computed-tomography-in-the-diagnosis-of-thoracic-injuries-in-severely-injured-patients-a-retrospective-multi-centre-study-based-on-the-trauma-registry-of-the-german-trauma-society-traumaregister-dgu-%C3%A2
#4
Patricia Lang, Martin Kulla, Fabian Kerwagen, Rolf Lefering, Benedikt Friemert, Hans-Georg Palm
BACKGROUND: Thoracic injuries are a leading cause of death in polytrauma patients. Early diagnosis and treatment are of paramount importance. Whole-body computed tomography (WBCT) has largely replaced traditional imaging techniques such as conventional radiographs and focused computed tomography (CT) as diagnostic tools in severely injured patients. It is still unclear whether WBCT has led to higher rates of diagnosis of thoracic injuries and thus to a change in outcomes. METHODS: In a retrospective study based on the trauma registry of the German Trauma Society (TraumaRegister DGU(®)), we analysed data from 16,545 patients who underwent treatment in 59 hospitals between 2002 and 2012 (ISS ≥ 9)...
August 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28807196/trauma-patients-meeting-both-centers-for-disease-control-and-prevention-s-definitions-for-ventilator-associated-pneumonia-had-worse-outcomes-than-those-meeting-only-one
#5
Duraid Younan, Russell Griffin, Thomas Swain, Jean-Francois Pittet, Bernard Camins
BACKGROUND: The Centers for Disease Control and Prevention's National Healthcare Safety Network (NHSN) replaced its old definition for ventilator-associated pneumonia (VAP) with the ventilator-associated events algorithm in 2013. We sought to compare the outcome of trauma patients meeting the definitions for VAP in the two modules. METHODS: Trauma patients with blunt or penetrating injuries and with at least 2 d of ventilator support were identified from the trauma registry from 2013 to 2014...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28807140/acute-psychological-trauma-in-the-critically-ill-patient-and-family-perspectives
#6
Volha Dziadzko, Mikhail A Dziadzko, Margaret M Johnson, Ognjen Gajic, Lioudmila V Karnatovskaia
OBJECTIVE: Post-intensive care syndrome (PICS), which encompasses profound psychological morbidity, affects many survivors of critical illness. We hypothesize that acute psychological stress during the intensive care unit (ICU) confinement likely contributes to PICS. In order to develop strategies that mitigate PICS associated psychological morbidity, it is paramount to first characterize acute ICU psychological stress and begin to understand its causative and protective factors. METHODS: A structured interview study was administered to adult critical illness survivors who received ≥48h of mechanical ventilation in medical and surgical ICUs of a tertiary care center, and their families...
July 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28805782/-blunt-chest-trauma-possibilities-to-stabilize-multiple-and-floating-ribs-fractures
#7
A S Benyan
AIM: To improve surgical treatment of patients with multiple and flotating ribs fractures. MATERIAL AND METHODS: A comparative analysis of two groups of victims with rib fractures was carried out. 148 patients of the control group underwent conservative treatment, mechanical ventilation, skeletal traction. In 167 patients of the main group we used advanced surgical tactics based on differentiated, stepwise and combined chest stabilization including osteosynthesis of ribs and thoracoscopy...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28803574/retrospective-evaluation-of-the-big-score-to-predict-mortality-in-pediatric-blunt-trauma
#8
Charlotte Grandjean-Blanchet, Guillaume Emeriaud, Marianne Beaudin, Jocelyn Gravel
OBJECTIVES: This study's objective was to measure the criterion validity of the BIG score (a new pediatric trauma score composed of the initial base deficit [BD], international normalized ratio [INR], and Glasgow Coma Scale [GCS]) to predict in-hospital mortality among children admitted to the emergency department with blunt trauma requiring an admission to the intensive care unit, knowing that a score <16 identifies children with a high probability of survival. METHODS: This was a retrospective cohort study performed in a single tertiary care pediatric hospital between 2008 and 2016...
August 14, 2017: CJEM
https://www.readbyqxmd.com/read/28803441/thermoregulation-disorders-of-central-origin-how-to-diagnose-and-treat
#9
Marta Zawadzka, Marta Szmuda, Maria Mazurkiewicz-Bełdzińska
Fever is a common symptom in the Intensive Care Unit. At least half of febrile episodes are caused by infection. Excluding infectious etiology and other non-infectious causes of fever, especially in patients with central nervous system (CNS) disorders, attention should be paid to disturbances of thermoregulatory centre. In particular, subarachnoid haemorrhage, cerebral trauma, along with ischaemic or haemorrhagic stroke are strongly associated with the development of central fever. Proper, speedy diagnosis of the cause of fever makes it possible to implement preventive measures against the harmful effects of hyperthermia on the CNS and to avoid the consequences of inappropriate treatment...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28792355/factors-related-to-parent-attendance-at-a-follow-up-meeting-with-an-intensivist-after-a-child-s-death-in-the-pediatric-intensive-care-unit
#10
Markita L Suttle, Cynthia A Gerhardt, Marci Z Fults
Parents who experience the death of a child are at high risk for psychopathology. Because a large percentage of pediatric deaths occur in the pediatric intensive care unit each year, a follow-up meeting between bereaved parents and intensivists could provide essential emotional support, although some parents may not attend. The aim of this study was to explore demographic and medical factors that may distinguish between bereaved parents who attend a follow-up meeting with their child's pediatric intensivist and those who do not...
January 1, 2017: Omega
https://www.readbyqxmd.com/read/28791433/prevalence-and-main-determinants-of-early-post-traumatic-thromboembolism-in-patients-requiring-icu-admission
#11
F Kazemi Darabadi, M A Jafari Zare, Z Torabi Goodarzi, P Namdar
BACKGROUND: Post-traumatic thromboembolism (PE) is now a common challenging particularly in critically ill patients referred to emergency wards. We aimed to identify main factors associated with PE within 72 h of admission after trauma among patients referred to emergency ward. METHODS: In this retrospective study, the database records of 240 patients, with the primary diagnosis of trauma requiring ICU admission and with a final diagnosis of pulmonary embolism, were reviewed...
August 8, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28790042/multicentre-randomised-controlled-trial-to-investigate-the-usefulness-of-continuous-pneumatic-regulation-of-tracheal-cuff-pressure-for-reducing-ventilator-associated-pneumonia-in-mechanically-ventilated-severe-trauma-patients-the-agate-study-protocol
#12
Nicolas Marjanovic, Denis Frasca, Karim Asehnoune, Catherine Paugam, Sigismond Lasocki, Carole Ichai, Jean-Yves Lefrant, Marc Leone, Claire Dahyot-Fizelier, Julien Pottecher, Dominique Falcon, Benoit Veber, Jean-Michel Constantin, Sabrina Seguin, Jérémy Guénézan, Olivier Mimoz
INTRODUCTION: Severe trauma represents the leading cause of mortality worldwide. While 80% of deaths occur within the first 24 hours after trauma, 20% occur later and are mainly due to healthcare-associated infections, including ventilator-associated pneumonia (VAP). Preventing underinflation of the tracheal cuff is recommended to reduce microaspiration, which plays a major role in the pathogenesis of VAP. Automatic devices facilitate the regulation of tracheal cuff pressure, and their implementation has the potential to reduce VAP...
August 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28779880/investigation-of-a-nosocomial-outbreak-of%C3%A2-fungemia-caused-by-candida-pelliculosa-pichia-anomala-in-a-korean-tertiary-care-center
#13
Jiwon Jung, Young Sook Moon, Jung A Yoo, Ji-Hun Lim, Joseph Jeong, Jae-Bum Jun
BACKGROUND: Candida pelliculosa is a rare pathogen of fungemia. There have been a few nosocomial outbreaks of C. pelliculosa fungemia in nurseries and pediatric intensive care units (ICU), hematologic units, and surgical ICU. We describe an epidemiologic outbreak investigation, including case findings of C. pelliculosa fungemia in South Korea. METHODS: This outbreak investigation conducted in a 940-bed, tertiary referral center, Ulsan, South Korea and included active microbial surveillance and a case-control study...
June 28, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28778037/comparison-of-midwife-led-care-and-obstetrician-led-care-on-maternal-and-neonatal-outcomes-in-singapore-a-retrospective-cohort-study
#14
Shi Tian Voon, Julie Tay Suan Lay, Wilson Tam Wai San, Shefaly Shorey, Serena Koh Siew Lin
OBJECTIVES: to examine the maternal and neonatal outcomes of low-risk women receiving midwife-led care and obstetrician-led care. DESIGN, SETTING,&PARTICIPANTS: a retrospective cohort study design was used. Data were collected from a large tertiary maternity hospital in Singapore. This involved a medical record review of 368 women who had singleton, normal to low-risk, term pregnancy, and received midwife-led care and obstetrician-led care between 2013 to 2014. MEASUREMENTS: a data extraction tool was used to solicit information on the outcome measures, including duration of labour, mode of delivery, episiotomy, and 5-minutes Apgar score (<7)...
July 18, 2017: Midwifery
https://www.readbyqxmd.com/read/28769999/non-operative-management-for-penetrating-splenic-trauma-how-far-can-we-go-to-save-splenic-function
#15
Roy Spijkerman, Michel Paul Johan Teuben, Fatima Hoosain, Liezel Phyllis Taylor, Timothy Craig Hardcastle, Taco Johan Blokhuis, Brian Leigh Warren, Luke Petrus Hendrikus Leenen
BACKGROUND: Selective non-operative management (NOM) for the treatment of blunt splenic trauma is safe. Currently, the feasibility of selective NOM for penetrating splenic injury (PSI) is unclear. Unfortunately, little is known about the success rate of spleen-preserving surgical procedures. The aim of this study was to investigate the outcome of selective NOM for penetrating splenic injuries. METHODS: A dual-centre study is performed in two level-one trauma centres...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28767796/mortality-predictors-in-patients-with-pelvic-fractures-from-blunt-trauma
#16
Wagner Oséas Corrêa, Vinícius Guilherme Rocha Batista, Erisvaldo Ferreira Cavalcante, Michael Pereira Fernandes, Rafael Fortes, Gabriela Zamunaro Lopes Ruiz, Carla Jorge Machado, Mario Pastore
Objective: to analyze the association of mortality with sociodemographic and clinical variables, as well as lesions and complication in patients with pelvic trauma due to blunt trauma. Methods: we conducted a retrospective, observational study with five-year trauma record data. Death was considered as the main stratification variable for the analyzes. We used the Student t test to compare means, the Chi-Square or Fisher exact test for proportions, and the Wilcoxon-Mann Whitney test for medians...
May 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28764996/coagulopathy-as-a-predictor-of-mortality-after-penetrating-traumatic-brain-injury
#17
Lindley E Folkerson, Duncan Sloan, Elizabeth Davis, Ryan S Kitagawa, Bryan A Cotton, John B Holcomb, Jeffrey S Tomasek, Charles E Wade
STUDY HYPOTHESIS: Traumatic brain injury (TBI) is a leading cause of mortality with penetrating TBI (p-TBI) patients having worse outcomes. These patients are more likely to be coagulopathic than blunt TBI (b-TBI) patients, thus we hypothesize that coagulopathy would be an early predictor of mortality. METHODS: We identified highest-level trauma activation patients who underwent an admission head CT and had ICU admission orders from August 2009-May 2013, excluding those with polytrauma and anticoagulant use...
July 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28755869/maternal-exposure-to-childhood-maltreatment-and-risk-of-stillbirth
#18
Alexa A Freedman, Alison L Cammack, Jeff R Temple, Robert M Silver, Donald J Dudley, Barbara J Stoll, Michael W Varner, George R Saade, Deborah Conway, Robert L Goldenberg, Carol J Hogue
PURPOSE: To determine the association between maternal exposure to childhood maltreatment (CM) and risk of stillbirth (fetal death at or after 20 weeks' gestation). METHODS: Population-based case-control study from the Stillbirth Collaborative Research Network (SCRN) conducted in 2006-2008, and the follow-up study, SCRN-Outcomes after Study Index Stillbirth (SCRN-OASIS), conducted in 2009 in the United States. Cases (n = 133) included women who experienced a stillbirth, excluding stillbirths attributed to genetic/structural or umbilical cord abnormalities and intrapartum stillbirths...
July 13, 2017: Annals of Epidemiology
https://www.readbyqxmd.com/read/28755271/multiclassifier-systems-for-predicting-neurological-outcome-of-patients-with-severe-trauma-and-polytrauma-in-intensive-care-units
#19
Javier González-Robledo, Félix Martín-González, Mercedes Sánchez-Barba, Fernando Sánchez-Hernández, María N Moreno-García
This paper presents an ensemble based classification proposal for predicting neurological outcome of severely traumatized patients. The study comprises both the whole group of patients and a subgroup containing those patients suffering traumatic brain injury (TBI). Data was gathered from patients hospitalized in the Intensive Care Unit (ICU) of the University Hospital in Salamanca. Predictive models were induced from both epidemiologic and clinical variables taken at the emergency room and along the stay in the ICU...
September 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28752438/-blunt-and-penetrating-thoracic-trauma
#20
B Mühling
In most cases blunt chest trauma leads to fractures of the bony thorax, i. e. ribs. In the case of accompanying hemothorax or pneumothorax initial management consists of chest tube drainage by mini-thoracotomy. Subsequently patients with blunt chest trauma have to be transferred to the intensive care unit as these patients are at risk of pulmonary insufficiency or persistent blood loss via the chest tube. Injury to the great vessels or heart requires trauma care in specialized centers. Penetrating trauma is always surgically treated and the foreign body is removed in the operating room (OR)...
July 27, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
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