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Intensive AND Care

William Gibson, Benedict M Wand, Catherine Meads, Mark J Catley, Neil E O'Connell
BACKGROUND: Chronic pain, considered to be pain lasting more than three months, is a common and often difficult to treat condition that can significantly impact upon function and quality of life. Treatment typically includes pharmacological and non-pharmacological approaches. Transcutaneous electrical nerve stimulation (TENS) is an adjunct non-pharmacological treatment commonly recommended by clinicians and often used by people with pain. OBJECTIVES: To provide an overview of evidence from Cochrane Reviews of the effectiveness of TENS to reduce pain in adults with chronic pain (excluding headache or migraine)...
February 19, 2019: Cochrane Database of Systematic Reviews
Elias Wagner, Georg Marckmann, Ralf J Jox
AIMS: In the case of acute brain injury, decision-making uncertainties can arise when both an advance decision to refuse treatment and a prior consent to post-mortem organ donation are present. It is yet unknown how the persons concerned view this potential conflict. The present study aims to investigate how frequent this situation is, whether the persons concerned are aware of the potential conflict and what they would prioritize. METHODS: Semi-quantitative cross-sectional survey of senior citizens of a metropolitan region in Germany using a literature-based questionnaire...
February 18, 2019: Das Gesundheitswesen
Dorothy M Wade, Paul R Mouncey, Alvin Richards-Belle, Jerome Wulff, David A Harrison, M Zia Sadique, Richard D Grieve, Lydia M Emerson, Alexina J Mason, David Aaronovitch, Nicole Als, Chris R Brewin, Sheila E Harvey, David C J Howell, Nicholas Hudson, Monty G Mythen, Deborah Smyth, John Weinman, John Welch, Chris Whitman, Kathryn M Rowan
Importance: A meta-analysis of outcomes during the 6 months after intensive care unit (ICU) discharge indicate a prevalence for clinically important posttraumatic stress disorder (PTSD) symptoms of 25%. Objective: To determine whether a nurse-led preventive, complex psychological intervention, initiated in the ICU, reduces patient-reported PTSD symptom severity at 6 months. Design, Setting, and Participants: A multicenter, parallel-group, cluster-randomized clinical trial with integrated economic and process evaluations conducted in 24 ICUs in the United Kingdom...
February 19, 2019: JAMA: the Journal of the American Medical Association
Ashley M Reilly, Michelle X Ding, Joseph E Rower, Tyree H Kiser
Concern for bacterial resistance and treatment failure with vancomycin trough concentrations < 10 μg/mL have led guidelines to increase goal concentrations. There is a paucity of data evaluating vancomycin dosage necessary to achieve goals in the neonatal intensive care unit (NICU). We aimed to evaluate the implementation of a new vancomycin dosing guideline in improving trough target attainment. This retrospective study evaluated neonates in the NICU treated with vancomycin between January 2009 and December 2015...
February 18, 2019: Journal of Clinical Pharmacology
Natasha Waterhouse, Gillian Nichol, Dusanka Kasapic
BACKGROUND: Urinalysis based on microbiological culture and manual microscopy requires expertise and is labor intensive. Automated screening could save time and improve patient management in clinical settings. METHODS: We evaluated the fully automated cobas u 701 analyzer for identifying infection-negative urine samples using 2,046 anonymized samples from a routine pathology laboratory. Samples containing ≥ 40 white blood cells (WBC)/µL and/or ≥ 100 bacteria/µL were considered positive...
January 1, 2019: Clinical Laboratory
Freda DeKeyser Ganz, Ilana Margalith, Julie Benbenishty, Miriam Hirschfeld, Nurit Wagner, Orly Toren
PURPOSE: The purpose of this study was to determine the willingness of Israeli registered nurses to work under threatening conditions, their perceived level of threat, and perceptions of peer willingness to report to work. DESIGN: This descriptive study was based on a convenience sample of registered nurses working in four hospitals throughout Israel from internal medicine, surgical, emergency, and intensive care units. METHODS: A questionnaire designed by the investigators was administered to registered nurses while on duty...
February 18, 2019: Journal of Nursing Scholarship
T Löbbing, S Carvalho Fernando, M Driessen, M Schulz, J Behrens, K K B Kobert
Background: In the recent years clinical ethics consultations (CEC) received an increasing attention not only in patients with medical conditions but also in those with mental disorders. However, the systematic and empirical knowledge is still small. The aim of this observational study was to investigate whether CECs differ between psychiatric and medical hospital inpatients regarding ethical issues, goals, characteristics, processes, and outcomes. Methods: This is a retrospective and in parts prospective analysis of a semi-structured CEC approach provided by the CEC service at a large German general hospital between January 2006 and June 2015...
January 2019: Heliyon
Supram Hosuru Subramanya, Rajesh Amberpet, Dinesh Chaudhary, Niranjan Nayak, Shashiraja Padukone, Indira Bairy, Shishir Gokhale
Background: Vancomycin-resistant enterococcal infections in the neonatal ICU are growing global problems. We report a case of neonatal septicemia by multidrug-resistant vancomycin-resistant Enterococcus faecium (VRE), the source of infection being the mother's gut. Case presentation: A newborn male child admitted to the neonatal intensive care unit (NICU) was diagnosed to have mild meconium aspiration syndrome, early onset neonatal septicemia, and bacteremia by multidrug and vancomycin-resistant Enterococcus faecium ...
2019: Antimicrobial Resistance and Infection Control
Fa-Ngam Charoenpol, Nuj Tontisirin, Borwornsom Leerapan, Rattaphol Seangrung, Roderick J Finlayson
Objective: Pain diaries are a valuable self-assessment tool; however, their use in chronic non-cancer pain has received limited attention. In this study, we examined the effect of pain diary use on pain intensity, interference, and intrapersonal change in patients with chronic non-cancer pain. Method: A convergent mixed-methods design was used to prospectively evaluate a cohort of 72 patients. Daily pain intensity and weekly pain-interference were self-reported using pain diaries for a 4-week period...
2019: Journal of Pain Research
Laleh Mahmoudi, Rahim Mohammadi, Ramin Niknam
Introduction: Stress-related mucosal damage (SRMD) is described as the damage of gastric mucosa due to physiological stress that is a very common complication in critically ill patients. SRMD prophylactic medications are widely prescribed all over the world, while numerous studies have revealed that a large percentage of patients admitted to non-intensive care unit (ICU) services do not need to receive these medications. The aim of this study was to determine the frequency and type of medication errors and the economic impact of clinical pharmacist intervention on stress ulcer prophylaxis (SUP)...
2019: ClinicoEconomics and Outcomes Research: CEOR
Pascale Peeters, Kellie Ryan, Sudeep Karve, Danielle Potter, Elisa Baelen, Sonia Rojas-Farreras, Jesús Rodríguez-Baño
Purpose: The RECOMMEND study (NCT02364284; D4280R00005) assessed the clinical management patterns and treatment outcomes associated with initial antibiotic therapy (IAT; antibiotics administered ≤48 hours post-initiation of antibiotic therapy) for health care-associated infections across five countries. Patients and methods: Data were collected from a retrospective chart review of patients aged ≥18 years with health care-associated complicated intra-abdominal infection (cIAI)...
2019: Infection and Drug Resistance
Asmaa A El-Madbouly, Asmaa A El Sehemawy, Noha A Eldesoky, Heba Mohammed Abd Elgalil, Amal M Ahmed
Background: Neonatal sepsis (NS) is an important cause of morbidity and mortality among newborns. Its diagnosis depends mainly on blood culture that takes at least 48 hours to give results. Therefore, searching for biomarkers for early diagnosis is of value. We aimed to assess presepsin, soluble triggering receptor expressed on myeloid cells (sTREM-1), and neutrophil CD64 (nCD64) as early diagnostic biomarkers in NS, and to compare them individually and in combination. Methods: This hospital-based case-control study has been conducted on 60 full-term neonates recruited from the neonatal intensive care unit, Al-Zahraa Hospital, Al-Azhar University, Cairo, Egypt...
2019: Infection and Drug Resistance
Karen Luyt, Sally Jary, Charlotte Lea, Grace J Young, David Odd, Helen Miller, Grazyna Kmita, Cathy Williams, Peter S Blair, Aída Moure Fernández, William Hollingworth, Michelle Morgan, Adam Smith-Collins, N Jade Thai, Steven Walker-Cox, Kristian Aquilina, Ian Pople, Andrew Whitelaw
BACKGROUND: The drainage, irrigation and fibrinolytic therapy (DRIFT) trial, conducted in 2003-6, showed a reduced rate of death or severe disability at 2 years in the DRIFT compared with the standard treatment group, among preterm infants with intraventricular haemorrhage (IVH) and post-haemorrhagic ventricular dilatation. OBJECTIVES: To compare cognitive function, visual and sensorimotor ability, emotional well-being, use of specialist health/rehabilitative and educational services, neuroimaging, and economic costs and benefits at school age...
February 2019: Health Technology Assessment: HTA
Riccardo Pravisani, Akihiko Soyama, Miriam Isola, Nariman Sadykov, Mitsuhisa Takatsuki, Masaaki Hidaka, Tomohiko Adachi, Shinichiro Ono, Takanobu Hara, Takashi Hamada, Umberto Baccarani, Andrea Risaliti, Susumu Eguchi
AIM: Sarcopenia is associated with high morbidity and mortality before and after liver transplantation(LT). The aim of the study was to evaluate the chronological changes in skeletal muscle mass(SMM) at different time points post-LT and to identify the risk factors for long-term low SMM. METHODS: The skeletal muscle index at L3 level(L3-SMI) was used for muscle mass measurement, and the recommended cut-off values of the Japanese Society of Hepatology guidelines were used as criteria for defining low muscularity...
February 17, 2019: Clinical Transplantation
J Xie, L Zhu, T Zhu, Y Jian, Y Ding, M Zhou, X Feng
BACKGROUND: The prevalence of Candida infections in paediatric intensive care units (PICUs) has dramatically increased as a result of resistance to conventional anti-fungal treatments. Because vitamin D has been shown to exhibit fungicidal activity against Candida infection in an in vitro antimicrobial screening, we aimed to investigate the effect of vitamin D on Candida infections in the PICU. METHODS: Four hundred sixteen eligible children aged between 12 months to 5 years old admitted to the PICU, who were on broad-spectrum antibiotic therapy, participated in the study...
February 18, 2019: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
Ryan Paul, Carissa Murugesh, Lynne Chepulis, Jade Tamatea, Louise Wolmarans
Babies born to mothers with gestational diabetes mellitus (GDM) are at a greater risk of developing respiratory complications and hypoglycaemia than those born to mothers without diabetes. However, there is currently insufficient evidence as to whether these risks are altered by antenatal corticosteroids after 37 weeks gestation. This retrospective study suggests that antenatal corticosteroids probably reduce respiratory admissions to the newborn intensive care unit with a mild increase in neonatal hypoglycaemia in women with GDM who deliver via caesarean section after 37 weeks gestation...
February 18, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Stephanie Ahrens, Margie A Ream, Laurel A Slaughter
PURPOSE OF REVIEW: The purpose of this review is to report recent advances in treatment of neonatal seizures, with a specific focus on new literature since a 2013 systematic review performed by this author (Slaughter) and others. There is a paucity of data with regard to well-defined status epilepticus (SE) in neonates, so treatment of recurrent seizures was also included in this inquiry. We aimed to summarize the efficacy and safety profiles of current therapeutic options as well as describe trends in medication selection in the neonatal intensive care unit (NICU) setting...
February 18, 2019: Current Treatment Options in Neurology
Soo Jin Na, Taek Kyu Park, Joo Myung Lee, Young Bin Song, Jin-Oh Choi, Joo-Yong Hahn, Jin-Ho Choi, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Chi Ryang Chung, Kyeongman Jeon, Gee Young Suh, Joong Hyun Ahn, Keumhee C Carriere, Jeong Hoon Yang
BACKGROUND: Data on the association between obesity and mortality in patients who require acute cardiac care are limited, so we investigated the effect of obesity on clinical outcomes in patients admitted to the cardiac intensive care unit (CICU). Methods and Results: We reviewed 2,429 eligible patients admitted to the CICU at Samsung Medical Center between January 2012 and December 2015. After excluding 197 patients with low body mass index (BMI) to adjust for the possibility of frailty, patients were divided into 3 categories: normal BMI (n=822), 18...
February 16, 2019: Circulation Journal: Official Journal of the Japanese Circulation Society
Maria Kapritsou, Maria Kalafati, Margarita Giannakopoulou, Dimitrios P Korkolis, Ioannis Kaklamanos, Tasoula Siskou, Evangelos A Konstantinou
PURPOSE: To determine the perception of postoperative pain intensity between nurses and oncology patients undergoing major abdominal surgery. DESIGN: A prospective cross-correlation study with 173 oncology patients undergoing major abdominal surgery, such as hepatectomy or pancreatectomy. METHODS: Postoperative pain intensity was evaluated by clinical pain assessment tools such as critical-care pain observation tool (CPOT) and behavioral pain scale (BPS) recorded by the researcher, whereas the visual analog scale was completed by patients...
February 14, 2019: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Ryusuke Miki, Masato Takeuchi, Takumi Imai, Tomotsugu Seki, Shiro Tanaka, Masaki Nakamura, Koji Kawakami
BACKGROUND: An admission to the intensive care unit (ICU) after developing acute myocardial infarction (AMI) has been the standard of care and is recommended by professional societies. However, evidence that justifies its use, such as a reduction in mortality, has never been shown despite the associated financial burden. This study aimed to investigate the association between ICU admission and a reduction in 30-day mortality in patients who developed AMI. METHODS: The multicenter retrospective cohort study was conducted using data from an administrative database between 2014 and 2016 in Japan...
February 14, 2019: Journal of Cardiology
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