Kian Niknam, Jason Nesbitt, Tsuyoshi Mitarai, Matthew J R Nudelman, Alexandra June Gordon, Jennifer G Wilson, Michael A Kohn
BACKGROUND: Boarding of ICU patients in the ED is increasing. Illness severity scores may help emergency physicians stratify risk to guide earlier transfer to the ICU and assess pre-ICU interventions by adjusting for baseline mortality risk. Most existing illness severity scores are based on data that is not available at the time of the hospital admission decision or cannot be extracted from the electronic health record (EHR). We adapted the SOFA score to create a new illness severity score (eccSOFA) that can be calculated at the time of ICU admission order entry in the ED using EHR data...
December 14, 2020: American Journal of Emergency Medicine
Furkhan Ali, Vanteemar S Sreeraj, Ravi Kumar Nadella, Bharath Holla, Jayant Mahadevan, Dhruva Ithal, Srinivas Balachander, Biju Viswanath, Ganesan Venkatasubramanian, John P John, Y C Janardhan Reddy, Sanjeev Jain
A history of psychiatric illnesses in family members of those diagnosed to have an illness has been of significant interest both in research and in clinical practice. Almost all of the major psychiatric illnesses have a familial component to them, perhaps influenced by genetics and a shared environment or their combination. Systematic attempts have been made to quantify these familial risks, as obtained from family history (FH) of psychiatric illnesses. The methods range from a simple dichotomous or count scores to those quantifying as weighted risks such as the Family history density (FHD) measures...
January 10, 2021: Asian Journal of Psychiatry
Anthony Cyr, Yanjun Zhong, Steven E Reis, Rami A Namas, Andrew Amoscato, Brian Zuckerbraun, Jason Sperry, Ruben Zamora, Yoram Vodovotz, Timothy R Billiar
BACKGROUND: Trauma is the leading cause of death and disability for individuals under age 55. Many severely injured trauma patients experience complicated clinical courses despite appropriate initial therapy. We sought to identify novel circulating metabolomic signatures associated with clinical outcomes following trauma. STUDY DESIGN: Untargeted metabolomics and circulating plasma immune mediator analysis was performed on plasma collected during three post-injury time periods (<6h, 6h-24h, D2-D5) in critically ill trauma patients enrolled between April 2004 and May 2013 at UPMC Presbyterian Hospital in Pittsburgh, PA...
January 13, 2021: Journal of the American College of Surgeons
Zili Zhang, Tao Wang, Fei Liu, Airu Zhu, Guoping Gu, Jieping Luo, Jingyi Xu, Jincun Zhao, Yiming Li, Yuanyuan Li, Xiaoqing Liu, Nanshan Zhong, Wenju Lu
BACKGROUND: The pandemic of the coronavirus disease 2019 (COVID-19) has brought a global public health crisis. However, the pathogenesis underlying COVID-19 are barely understood. METHODS: In this study, we performed proteomic analyses of airway mucus obtained by bronchoscopy from severe COVID-19 patients. In total, 2351 and 2073 proteins were identified and quantified in COVID-19 patients and healthy controls, respectively. RESULTS: Among them, 92 differentiated expressed proteins (DEPs) (46 up-regulated and 46 down-regulated) were found with a fold change >1...
January 13, 2021: Life Sciences
Prateek Lohia, Shweta Kapur, Sindhuri Benjaram, Abhilasha Pandey, Tanveer Mir, Berhane Seyoum
BACKGROUND: Metabolic Syndrome (MetS) is highly prevalent worldwide and its individual components obesity, diabetes and hypertension have been identified as risk factors to develop severe COVID-19 illness, however data on MetS and clinical outcomes in COVID-19 is scarce. This study aims to determine association between MetS and severe disease outcomes, i.e. mortality, need for mechanical ventilation and ICU requirement among COVID-19 patients. METHODS: A retrospective multi-hospital cohort study on 1871 patients with confirmed COVID-19 diagnosis...
January 16, 2021: Journal of Diabetes
Chunmei Zhang, Xi Chen, Chao Wang, Yu Ran, Kai Sheng
Cardiomyocytes injury caused by sepsis is a complication of common clinical critical illness and an important cause of high mortality in intensive care unit (ICU) patients. Therefore, lipopolysaccharide (LPS)-induced H9c2 cells were used to simulate the cardiomyocytes injury in vitro. The aim of this study was to investigate whether X-box binding protein 1 (XBP1) exacerbated LPS-induced cardiomyocytes injury by downregulating Xlinked inhibitor of apoptosis protein (XIAP) through activating the NF-κB signaling pathway...
January 16, 2021: Inflammation
Oddgeir Synnes, Kristin Lie Romm, Hilde Bondevik
There is a growing interest in the application of creative writing in the treatment of mental illness. Nonpharmacological approaches have shown that access to poetic, creative language can allow for the verbalisation of illness experiences, as well as for self-expressions that can include other facets of the subject outside of the disease. In particular, creative writing in a safe group context has proven to be of particular importance. In this article, we present a pilot on a creative writing group for young adults in treatment for psychosis...
January 16, 2021: Medicine, Health Care, and Philosophy
Thomas M Donaldson
Time-limited trials of intensive care have arisen in response to the increasing demand for intensive care treatment for patients with a low chance of surviving their critical illness, and the clinical uncertainty inherent in intensive care decision-making. Intensive care treatment is reported by most patients to be a significantly unpleasant experience. Therefore, patients who do not survive intensive care treatment are exposed to a negative dying experience. Time-limited trials of intensive care treatment in patients with a low chance of surviving have both a small chance of benefiting this patient group and a high chance of harming them by depriving them of a good death...
January 15, 2021: Medicine, Health Care, and Philosophy
Hyunmin Kim, Asos Mahmood, Joy V Goldsmith, HyukJae Chang, Satish Kedia, Cyril F Chang
Informal caregivers provide unpaid care to their physically or mentally ill loved ones and play a critical role in the healthcare delivery. eHealth tools, including the broadband internet, can facilitate care processes and impact the caregiving burden through seeking health information and health communication. This study examines the predictors of access to broadband internet and the factors associated with health information seeking and health communication among informal caregivers with broadband internet...
January 15, 2021: Journal of Medical Systems
Nahed Abdel-Haq, Basim I Asmar, Maria P Deza Leon, Eric J McGrath, Harbir S Arora, Katherine Cashen, Bradley Tilford, Ahmad Charaf Eddine, Usha Sethuraman, Jocelyn Y Ang
This study was conducted to assess the clinical spectrum, management, and outcome of SARS-CoV-2-related multisystem inflammatory syndrome in children (MIS-C). We reviewed medical records of children with MIS-C diagnosis seen at the Children's Hospital of Michigan in Detroit between April and June 2020. Thirty-three children were identified including 22 who required critical care (group 1) and 11 with less intense inflammation (group 2). Children in group 1 were older (median 7.0 years) than those in group 2 (median 2...
January 16, 2021: European Journal of Pediatrics
Loren Gaudet
Dominant understandings of genre-as-form have limited our abilities to perceive health awareness: we recognise, and expect, health awareness campaigns from governmental and non-profit agencies. Inversely, we often fail to recognise, or name, health awareness as such when it comes from other sources, such as commercial marketing or advertisements for products. However, rhetorical genre theory centres attention on action brought about by form and, as such, rhetorical genre provides tools for recognising instances of health awareness often escape our notice...
January 15, 2021: Medical Humanities
Anna L Funk, Todd A Florin, Stuart R Dalziel, Santiago Mintegi, Marina I Salvadori, Daniel Joseph Tancredi, Mark I Neuman, Daniel C Payne, Amy C Plint, Terry P Klassen, Richard Malley, Lilliam Ambroggio, Kelly Kim, Nathan Kuppermann, Stephen B Freedman
INTRODUCTION: Relatively limited data are available regarding paediatric COVID-19. Although most children appear to have mild or asymptomatic infections, infants and those with comorbidities are at increased risk of experiencing more severe illness and requiring hospitalisation due to COVID-19. The recent but uncommon association of SARS-CoV-2 infection with development of a multisystem inflammatory syndrome has heightened the importance of understanding paediatric SARS-CoV-2 infection...
January 15, 2021: BMJ Open
Shaista Meghani
BACKGROUND: The advance in the practice of resuscitation is globally recognised and fully sanctioned in scientific world. However, practicing family presence during resuscitation, also known as witnessed resuscitation, is yet to be endorsed by healthcare professionals. Many professional nursing and physician organisations have endorsed the practice of witnessed resuscitation by issuing guidelines. These organisations support family presence during resuscitation due to the research proving its benefit for patients and families...
January 12, 2021: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Elisabeth De Waele, Julie Roth Jakubowski, Reto Stocker, Paul E Wischmeyer
Nutrition therapy, by enteral, parenteral, or both routes combined, is a key component of the management of critically ill, surgical, burns, and oncology patients. Established evidence indicates overfeeding (provision of excessive calories) results in increased risk of infection, morbidity, and mortality. This has led to the practice of "permissive underfeeding" of calories; however, this can often lead to inadequate provision of guideline-recommended protein intakes. Acutely ill patients requiring nutritional therapy have high protein requirements, and studies demonstrate that provision of adequate protein can result in reduced mortality and improvement in quality of life...
December 29, 2020: Clinical Nutrition
Yi-Han Lin, Maryann P Platt, Haiyan Fu, Yuan Gui, Yanlin Wang, Norberto Gonzalez-Juarbe, Dong Zhou, Yanbao Yu
Sepsis-induced acute kidney injury (S-AKI) is the most common complication in hospitalized and critically ill patients, highlighted by a rapid decline of kidney function occurring a few hours or days after sepsis onset. Systemic inflammation elicited by microbial infections is believed to lead to kidney damage under immunocompromised conditions. However, although AKI has been recognized as a disease with long-term sequelae, partly because of the associated higher risk of chronic kidney disease (CKD), the understanding of kidney pathophysiology at the molecular level and the global view of dynamic regulations in situ after S-AKI, including the transition to CKD, remains limited...
December 2020: Molecular & Cellular Proteomics: MCP
Isadore Budnick, Jessica Davis, Anirudh Sundararaghavan, Samuel Konkol, Chelsea Lau, James Alsobrooks, Matthew Stotts, Nicolas Intagliata, Ton Lisman, Patrick Northup
BACKGROUND: Fibrinogen (FIB) levels less than 150 mg/dL have been associated with increased rates of bleeding and lower survival in critically ill cirrhosis patients. OBJECTIVE: We aimed to determine if treatment with cryoprecipitate (CRYO) for low FIB levels were associated with bleeding complications or survival. Patients / Methods: 237 cirrhosis patients admitted to an intensive care unit at a tertiary care liver transplant center with initial FIB levels less than 150 mg/dL were retrospectively assessed for CRYO transfusion, bleeding events, and survival outcomes...
January 15, 2021: Thrombosis and Haemostasis
Jothydev Kesavadev, Anoop Misra, Banshi Saboo, S R Aravind, Akhtar Hussain, Leszek Czupryniak, Itamar Raz
BACKGROUND AND AIMS: The measurement of vital signs is an important part of clinical work up. Presently, measurement of blood glucose is a factor for concern mostly when treating individuals with diabetes. Significance of blood glucose measurement in prognosis of non-diabetic and hospitalized patients is not clear. METHODS: A systematic search of literature published in the Electronic databases, PubMed and Google Scholar was performed using following keywords; blood glucose, hospital admissions, critical illness, hospitalizations, cardiovascular disease (CVD), morbidity, and mortality...
January 2, 2021: Diabetes & Metabolic Syndrome
Tirsa M Ferrer Marrero, Mark Barash, Besma Jaber, Meghan Nothem, Kumar Shah, Matthew W Weber, Stephanie Zellner Jones, Patrick Kennedy, Jeanette Graf, Shannon Broaddrick, Zhuping Garacci, Anjishnu Banerjee, Jennifer Kryworuchko, Jayshil Patel
PURPOSE: To test the primary hypothesis that a CPR video will reduce ICU patients' surrogates' anxiety when deciding code status, as measured by the Hamilton Anxiety Rating (HAM-A) Scale, as compared to the no video group. MATERIALS AND METHODS: This is a prospective randomized control trial. Twenty-seven ICU patients' surrogates were enrolled in the study after receiving an ICU team-led code status discussion. After the enrollment, twelve surrogates were randomized to the video group and fifteen to the no video group...
December 3, 2020: Journal of Critical Care
Yugeesh R Lankadeva, Yahya Shehabi, Adam M Deane, Mark P Plummer, Rinaldo Bellomo, Clive N May
Alpha2 -adrenoceptor agonists are increasingly being used for the provision of comfort, sedation and the management of delirium in critically ill patients with and without sepsis. In this context, increased sympathetic and inflammatory activity are common pathophysiological features linked to multi-organ dysfunction, particularly in patients with sepsis or those undergoing cardiac surgery requiring cardiopulmonary bypass. Experimental and clinical studies support the notion that the alpha2 -adrenoceptor agonists, dexmedetomidine and clonidine, mitigate sympathetic and inflammatory overactivity in sepsis and cardiac surgery requiring cardiopulmonary bypass...
January 15, 2021: British Journal of Pharmacology
Anand V Kulkarni, Lovkesh Anand, Ashish Kumar Vyas, Madhumita Premkumar, Ashok K Choudhury, Nirupama Trehanpati, Jaya Benjamin, Guresh Kumar, Yogendra Kumar Joshi, Shiv Kumar Sarin
BACKGROUND AND AIM: Sepsis is an important determinant of the outcome of acute-on-chronic liver failure (ACLF) patients. Omega-3 fatty acids (FAs) are known to suppress inflammation, reduce morbidity, and mortality in postoperative and critically ill patients. We aimed to evaluate the effect of intravenous omega-6 and omega-3 FA lipid emulsions in ACLF patients. METHODS: Ninety ACLF patients were randomly allocated to 3 groups- Gr. A- received no lipid emulsions, Gr...
January 15, 2021: Journal of Gastroenterology and Hepatology
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