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https://www.readbyqxmd.com/read/28548696/the-roles-of-continuous-renal-replacement-therapy-in-septic-acute-kidney-injury
#1
Takuya Ueno
Despite hundreds of clinical and basic studies that have led to a better mechanistic understanding of sepsis, the number of cases with sepsis in the United States is still rising. Sepsis is a common cause of acute kidney injury (AKI) and may explain long-term complications and mortality. In the current article, a new therapeutic concept using continuous renal replacement therapy to prevent and manage long-term sequelae in septic AKI is described.
May 26, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28548592/intracranial-pressure-monitoring-in-severe-blunt-head-trauma-does-the-type-of-monitoring-device-matter
#2
Alberto Aiolfi, Desmond Khor, Jayun Cho, Elizabeth Benjamin, Kenji Inaba, Demetrios Demetriades
OBJECTIVE Intracranial pressure (ICP) monitoring has become the standard of care in the management of severe head trauma. Intraventricular devices (IVDs) and intraparenchymal devices (IPDs) are the 2 most commonly used techniques for ICP monitoring. Despite the widespread use of these devices, very few studies have investigated the effect of device type on outcomes. The purpose of the present study was to compare outcomes between 2 types of ICP monitoring devices in patients with isolated severe blunt head trauma...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28547751/education-and-process-change-to-improve-skin-health-in%C3%A2-a%C3%A2-residential-aged-care-facility
#3
Kay Price, Kate J Kennedy, Tabatha L Rando, Anthony R Dyer, Jo Boylan
We report on an intervention and evaluation in relation to changes in staff knowledge, time spent on healing and wound prevention and proportion of wounds in the facilities before and after. A rapid review of recent peer-reviewed literature (2006-2016) found 14 education-based intervention articles and provided the background and context for this intervention. A cohort of 164 nurses and personal care workers and 261 residents at two aged care-approved facilities contributed to this intervention on the effect of education, mentoring and practice change on staff knowledge and wound prevalence between 2015 and 2016...
May 26, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28547587/new-quantitative-radiographic-parameters-for-vertical-and-horizontal-instability-in-acromioclavicular-joint-dislocations
#4
Matthias A Zumstein, Philippe Schiessl, Benedikt Ambuehl, Lilianna Bolliger, Johannes Weihs, Martin H Maurer, Beat K Moor, Michael Schaer, Sumit Raniga
PURPOSE: The aim of this study was to identify the most accurate and reliable quantitative radiographic parameters for assessing vertical and horizontal instability in different Rockwood grades of acromioclavicular joint (ACJ) separations. Furthermore, the effect of projectional variation on these parameters was investigated in obtaining lateral Alexander view radiographs. METHODS: A Sawbone model of a scapula with clavicle was mounted on a holding device, and acromioclavicular dislocations as per the Rockwood classification system were simulated with the addition of horizontal posterior displacement...
May 25, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28546764/optimal-management-of-primary-focal-segmental-glomerulosclerosis-in-adults
#5
REVIEW
Séverine Beaudreuil, Hans Kristian Lorenzo, Michele Elias, Erika Nnang Obada, Bernard Charpentier, Antoine Durrbach
Focal segmental glomerulosclerosis (FSGS) is a frequent glomerular kidney disease that is revealed by proteinuria or even nephrotic syndrome. A diagnosis can be established from a kidney biopsy that shows focal and segmental glomerulosclerosis. This histopathological lesion may be caused by a primary podocyte injury (idiopathic FSGS) but is also associated with other pathologies (secondary FSGS). The first-line treatment for idiopathic FSGS with nephrotic syndrome is a prolonged course of corticosteroids. However, steroid resistance or steroid dependence is frequent, and despite intensified immunosuppressive treatment, FSGS can lead to end-stage renal failure...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28546718/brachial-plexus-injury-after-right-hepatectomy
#6
Garima Daga, Prashant Balwant Kerkar
Iatrogenic nerve palsies due to faulty positioning on the operating table are commonly seen over the elbow and popliteal fossa. However, injury to the brachial plexus (BP) is rarely encountered and is a recently reported phenomenon due to the increasing number of complex surgeries including hepatobiliary surgical procedures. Brachial plexus injury (BPI) needs to be recognized as a potential complication of prolonged abdominal surgery. The present case report highlights the potential for BPI and its early recognition, management, and prevention in complex prolonged abdominal surgical procedures...
June 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28546377/respiratory-care-considerations-in-the-childhood-cancer-patient
#7
Lama Elbahlawan, K Jason Rains, Dennis C Stokes
This article reviews the common pulmonary complications seen in the pediatric oncology population and our approach to diagnosis, management, and therapy considerations in this specialized population, including patients receiving chemotherapy, radiation, and hematopoietic stem cell transplantation. Although infections cause the most significant complications in this population, non-infectious complications, including acute lung injury from chemotherapy or radiation, idiopathic interstitial pneumonia, diffuse alveolar hemorrhage, bronchiolitis obliterans, and cryptogenic organizing pneumonia, also occur commonly...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28546375/extracorporeal-membrane-oxygenation-for-severe-pediatric-respiratory-failure
#8
John C Lin
Extracorporeal membrane oxygenation (ECMO) was developed initially in the 1960s to support refractory respiratory failure in addition to the cardiac support inherent in a venoarterial bypass circuit. Early successes occurred predominantly in the neonatal population with subsequent randomized controlled trials and comprehensive reviews concluding therapeutic efficacy for ECMO in neonatal respiratory failure. In contrast, the evidence supporting ECMO for respiratory failure in children is less definitive. However, although pediatric randomized controlled trials have not been completed, sufficient evidence in support of ECMO as a beneficial therapy for pediatric respiratory failure exists...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28546374/pediatric-ards
#9
Ira M Cheifetz
The Pediatric Acute Lung Injury Consensus Conference (PALICC) has provided the critical care community with the first pediatric-focused definition for ARDS. The PALICC recommendations provide guidance on conventional ventilator management, gas exchange goals, use of high-frequency ventilation, adjunct management approaches, and the application of extracorporeal membrane oxygenation for pediatric ARDS (PARDS). Although outcomes for PARDS have improved over the past decade, mortality and morbidity remain significant...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28546049/gunshot-induced-injuries-in-orthopaedic-trauma-research-a-bibliometric-analysis-of-the-most-influential-literature
#10
REVIEW
Michael Held, Esmee Engelmann, Robert Dunn, Sufian S Ahmad, Maritz Laubscher, Marius J B Keel, Sithombo Maqungo, Sven Hoppe
INTRODUCTION: A growing burden of gunshot injuries demands evidence-based ballistic trauma management. No comprehensive systematic overview of the current knowledge is available to date. This study aims to identify and analyze the most influential publications in the field of orthopedic ballistic trauma research. MATERIAL AND METHODS: All databases available in the Thomson Reuters Web of Knowledge were searched to conduct this bibliometrical study. The most cited orthopedic ballistic trauma articles published between 1950 and 2015 were identified by use of a multi-step approach...
May 22, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28545727/postoperative-weight-bearing-and-patient-reported-outcomes-at-one-year-following-tibial-plateau-fractures
#11
Dominic Thewlis, Francois Fraysse, Stuart A Callary, Viju Daniel Verghese, Claire F Jones, David M Findlay, Gerald J Atkins, Mark Rickman, Lucian B Solomon
Tibial plateau fractures are complex and the current evidence for postoperative rehabilitation is weak, especially related to the recommended postoperative weight bearing. The primary aim of this study was to investigate if loading in the first 12 weeks of recovery is associated with patient reported outcome measures at 26 and 52 weeks postoperative. We hypothesized that there would be no association between loading and patient reported outcome measures. Seventeen patients, with a minimum of 52-week follow-up following fragment-specific open reduction and internal fixation for tibial plateau fracture, were selected for this retrospective analysis...
May 17, 2017: Injury
https://www.readbyqxmd.com/read/28545379/tissue-engineering-in-achilles-tendon-reconstruction-the-role-of-stem-cells-growth-factors-and-scaffolds
#12
D S Pillai, Bal S Dhinsa, Wasim Khan
Achilles tendon injuries are common, and present a challenge in the acute and chronic setting. There is significant morbidity associated with the injury and the numerous management strategies, as well as financial implications to the patient and the health service. To date, repair tissue from all methods of management fail to achieve the same functional and biomechanical properties as the native tendon. The use of tissue engineering technology may reduce morbidity, improve the biomechanical properties of repair tissue and reduce the financial burden...
May 23, 2017: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28545316/lower-extremity-fractures-in-patients-with-spinal-cord-injury-characteristics-outcome-and-risk-factors-for-non-unions
#13
Lukas Grassner, Barbara Klein, Doris Maier, Volker Bühren, Matthias Vogel
CONTEXT: Sublesional osteoporosis is an important sequel after spinal cord injury (SCI) resulting in a high incidence of fractures and impaired osseous healing due to altered bone metabolism. The following study aims to identify demographic characteristics and outcome of patients with SCI with lower extremity fractures. DESIGN: Retrospective observational study. SETTING: Level-I cross-regional trauma center. PARTICIPANTS: All patients with SCI suffering from osteoporotic/pathologic fractures during an 11-year-period (01/2003-12/2013) at the Center for Spinal Cord Injuries (Trauma Center Murnau) were analyzed via a chart review...
May 25, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28543428/health-workforce-characteristics-quality-of-life-and-intention-to-leave-the-fit-for-the-future-survey-of-australian-nurses-and-midwives
#14
Lin Perry, Xiaoyue Xu, Christine Duffield, Robyn Gallagher, Rachel Nicholls, David Sibbritt
AIM: To examine the quality of life of nurses and midwives in New South Wales, Australia and compare values with those of the Australian general population; to determine the influence of workforce, health and work life characteristics on quality of life and its effect on workforce intention to leave. BACKGROUND: Few studies have examined nurses' and midwives' quality of life and little is known of its effects on workforce longevity. DESIGN: This was a cross-sectional survey conducted in 2014-2015...
May 24, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28542894/risk-factors-of-falls-among-inpatients-with-cancer
#15
M D Jun, K M Lee, S A Park
AIM: To investigate the risk factors and predictors of falls according to the general characteristics, conscious state, physical condition and treatment of hospitalized patients with cancer. BACKGROUND: Inpatients with cancer experience falls more frequently than those without cancer, and the degree of injuries is more severe among inpatients with cancer. A specific fall prevention strategy is needed for each patient. Prevention of falls in patients with cancer is very important for improving the quality of nursing care...
May 25, 2017: International Nursing Review
https://www.readbyqxmd.com/read/28542848/change-of-transfusion-and-treatment-paradigm-in-major-trauma-patients
#16
P Stein, A Kaserer, K Sprengel, G A Wanner, B Seifert, O M Theusinger, D R Spahn
Trauma promotes trauma-induced coagulopathy, which requires urgent treatment with fixed-ratio transfusions of red blood cells, fresh frozen plasma and platelet concentrates, or goal-directed administration of coagulation factors based on viscoelastic testing. This retrospective observational study compared two time periods before (2005-2007) and after (2012-2014) the implementation of changes in trauma management protocols which included: use of goal-directed coagulation management; admission of patients to designated trauma centres; whole-body computed tomography scanning on admission; damage control surgery; permissive hypotension; restrictive fluid resuscitation; and administration of tranexamic acid...
May 23, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28542719/ibuprofen-and-diclofenac-treatments-reduce-proliferation-of-pancreatic-acinar-cells-upon-inflammatory-injury-and-mitogenic-stimulation
#17
Marta Bombardo, Ermanno Malagola, Rong Chen, Alina Rudnicka, Rolf Graf, Sabrina Sonda
BACKGROUND AND PURPOSE: Nonsteroidal anti-inflammatory drugs (NSAIDs) are administered to manage pain typically found in patients suffering from pancreatitis. NSAIDs also display anti-proliferative activity against cancer cells, however their effects in normal, untransformed cells is poorly understood. Here we evaluated whether NSAIDs inhibit proliferation of pancreatic acinar cells during the development of acute pancreatitis. EXPERIMENTAL APPROACH: The NSAIDs ibuprofen and diclofenac were administered to C57BL/6 mice after induction of pancreatitis with serial injection of cerulein...
May 19, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28542336/does-ngal-reduce-costs-a-cost-analysis-of-urine-ngal-ungal-serum-creatinine-scr-for-acute-kidney-injury-aki-diagnosis
#18
Amay Parikh, John A Rizzo, Pietro Canetta, Catherine Forster, Meghan Sise, Omar Maarouf, Eugenia Singer, Antje Elger, Saban Elitok, Kai Schmidt-Ott, Jonathon Barasch, Thomas L Nickolas
INTRODUCTION: Urine neutrophil gelatinase-associated lipocalin (uNGAL) is a sensitive and specific diagnostic test for acute kidney injury (AKI) in the Emergency Department (ED), but its economic impact has not been investigated. We hypothesized that uNGAL used in combination with serum creatinine (sCr) would reduce costs in the management of AKI in patients presenting to the ED in comparison to using sCr alone. MATERIALS AND METHODS: A cost simulation model was developed for clinical algorithms to diagnose AKI based on sCr alone vs...
2017: PloS One
https://www.readbyqxmd.com/read/28542281/gait-asymmetry-ankle-spasticity-and-depression-as-independent-predictors-of-falls-in-ambulatory-stroke-patients
#19
Ta-Sen Wei, Peng-Ta Liu, Liang-Wey Chang, Sen-Yung Liu
BACKGROUND: Falls are the leading cause of injury in stroke patients. However, the cause of a fall is complicated, and several types of risk factors are involved. Therefore, a comprehensive model to predict falls with high sensitivity and specificity is needed. METHODS: This study was a prospective study of 112 inpatients in a rehabilitation ward with follow-up interviews in patients' homes. Evaluations were performed 1 month after stroke and included the following factors: (1) status of cognition, depression, fear of fall and limb spasticity; (2) functional assessments [walking velocity and the Functional Independence Measure (FIM)]; and (3) objective, computerized gait and balance analyses...
2017: PloS One
https://www.readbyqxmd.com/read/28541862/nonoperative-management-of-the-damaged-spleen-a-community-surgeon-looks-back
#20
Mark L Walker
Blunt spleen injury is usually managed nonoperatively. An 8-year retrospective analysis by one community surgeon was done to provide an overview of the role of CT, angiography, and transfusion in the management algorithm. A total of 2750 patients were screened and 125 patients were identified with spleen injury. Of these 125 patients, 72 were managed without surgery. These were young (mean age 32 ± 16 years) patients with mean Injury Severity Score of 16 ± 8. Angiography was used in 14 patients. These patients received more blood (5 ± 6 vs 2 ± units of packed red blood cells) than their nonangiogram counterparts...
May 1, 2017: American Surgeon
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