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Critical care

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https://read.qxmd.com/read/32227800/the-economic-and-public-health-impact-of-influenza-vaccinations-contributions-of-swiss-pharmacies-in-the-2016-17-and-2017-18-influenza-seasons-and-implications-for-vaccination-policy
#1
Isabelle Brunner, Karl Schmedders, Aline Wolfensberger, Peter W Schreiber, Stefan P Kuster
AIMS OF THE STUDY: Healthy adults have had the option to receive prescriptionless vaccination against influenza in pharmacies of several Swiss cantons since the 2015/16 influenza season. We aimed to assess in a cost-benefit analysis the resulting net benefits for the Swiss economy and public health, and the benefits that could be expected if an extension of the current vaccination recommendations was implemented. METHODS: The proportion of influenza vaccines administered in pharmacies was calculated from data provided by pharmacies entering information in phS-net...
December 16, 2019: Swiss Medical Weekly
https://read.qxmd.com/read/32227758/covid-19-in-critically-ill-patients-in-the-seattle-region-case-series
#2
Pavan K Bhatraju, Bijan J Ghassemieh, Michelle Nichols, Richard Kim, Keith R Jerome, Arun K Nalla, Alexander L Greninger, Sudhakar Pipavath, Mark M Wurfel, Laura Evans, Patricia A Kritek, T Eoin West, Andrew Luks, Anthony Gerbino, Chris R Dale, Jason D Goldman, Shane O'Mahony, Carmen Mikacenic
BACKGROUND: Community transmission of coronavirus 2019 (Covid-19) was detected in the state of Washington in February 2020. METHODS: We identified patients from nine Seattle-area hospitals who were admitted to the intensive care unit (ICU) with confirmed infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Clinical data were obtained through review of medical records. The data reported here are those available through March 23, 2020. Each patient had at least 14 days of follow-up...
March 30, 2020: New England Journal of Medicine
https://read.qxmd.com/read/32227294/guidelines-for-the-acute-treatment-of-cerebral-edema-in-neurocritical-care-patients
#3
Aaron M Cook, G Morgan Jones, Gregory W J Hawryluk, Patrick Mailloux, Diane McLaughlin, Alexander Papangelou, Sophie Samuel, Sheri Tokumaru, Chitra Venkatasubramanian, Christopher Zacko, Lara L Zimmermann, Karen Hirsch, Lori Shutter
BACKGROUND: Acute treatment of cerebral edema and elevated intracranial pressure is a common issue in patients with neurological injury. Practical recommendations regarding selection and monitoring of therapies for initial management of cerebral edema for optimal efficacy and safety are generally lacking. This guideline evaluates the role of hyperosmolar agents (mannitol, HTS), corticosteroids, and selected non-pharmacologic therapies in the acute treatment of cerebral edema. Clinicians must be able to select appropriate therapies for initial cerebral edema management based on available evidence while balancing efficacy and safety...
March 29, 2020: Neurocritical Care
https://read.qxmd.com/read/32227219/the-benefits-of-non-invasive-ventilation-for-community-acquired-pneumonia-a-meta-analysis
#4
Giovana Klefti, Adam T Hill
BACKGROUND: There is an observed international increase in NIV application as an alternative to endotracheal intubation in non-COPD patients admitted with community acquired pneumonia despite the lack of strong evidence for its use. The aim of this study is the meta-analysis of data from randomised-controlled trials on the effectiveness of non-invasive ventilation versus standard medical care in adults admitted with severe community-acquired pneumonia. METHODS: Monthly electronic searches on CENTRAL and MEDLINE were performed between September 2017 and October 2019...
March 30, 2020: QJM: Monthly Journal of the Association of Physicians
https://read.qxmd.com/read/32227151/empathy-in-medicinecultivating-an-empathetic-professional-identity-in-osteopathic-medical-students-through-service-learning-a-qualitative-analysis-of-reflective-essays
#5
Leanne M Chrisman-Khawam, Joel A Manzi
Context: The role of professional identity development has been established as a significant element of the "hidden curriculum" in medical education. While most programs do not contain explicit instruction on that topic, service learning initiatives are a popular trend in medical education that offer medical students early clinical experience and an opportunity to develop professional identity. Through intentional reflective practices, service learning can also promote empathy development, a critical component missing from current models...
April 1, 2020: Journal of the American Osteopathic Association
https://read.qxmd.com/read/32226961/response-to-letter-to-the-editor-acute-medicine-journal
#6
N Murch, C Chadwick, A Wijewardane
Editor- Thank you for giving us the opportunity to respond to the letter received regarding the Joint Royal College of Physicians Training Board (JRCPTB) curriculum for Acute Internal Medicine (AIM) that has previously been circulated for comment and consideration of implementation in August 2022. Dr Williamson is correct in asserting that the proposed curriculum hopes to produce doctors with generic professional and specialty specific capabilities needed to manage patients presenting with a wide range of medical symptoms and conditions...
2020: Acute Medicine
https://read.qxmd.com/read/32226960/letter-to-the-editor-acute-medicine-journal
#7
Adam Williamson
Editor- I note with interest that the Joint Royal College of Physicians Training Board curriculum for Acute Internal Medicine (AIM) has been reviewed and circulated for comment and consideration of implementation in August 2022. The proposed curriculum hopes to produce doctors with generic professional and specialty specific capabilities needed to manage patients presenting with a wide range of medical symptoms and conditions. It aims to produce a workforce that reflects the current trends of increasing patient attendances to both primary care and emergency departments- one that has a high level of diagnostic reasoning, the ability to manage uncertainty, deal with comorbidities and recognise when specialty input is require in a variety of settings, including ambulatory and critical care...
2020: Acute Medicine
https://read.qxmd.com/read/32226787/mesenchymal-stem-cell-derived-extracellular-vesicles-challenges-in-clinical-applications
#8
REVIEW
Austin Gowen, Farah Shahjin, Subhash Chand, Katherine E Odegaard, Sowmya V Yelamanchili
Stem cell therapy has garnered much attention and application in the past decades for the treatment of diseases and injuries. Mesenchymal stem cells (MSCs) are studied most extensively for their therapeutic roles, which appear to be derived from their paracrine activity. Recent studies suggest a critical therapeutic role for extracellular vesicles (EV) secreted by MSCs. EV are nano-sized membrane-bound vesicles that shuttle important biomolecules between cells to maintain physiological homeostasis. Studies show that EV from MSCs (MSC-EV) have regenerative and anti-inflammatory properties...
2020: Frontiers in Cell and Developmental Biology
https://read.qxmd.com/read/32226670/a-flare-up-of-systemic-lupus-erythematosus-with-unusual-enteric-predominance
#9
Joshua A Ronen, Armugam Mekala, Catherine Wiechmann, Sai Mungara
Enteritis associated with systemic lupus erythematosus (SLE) is a rare and unusual manifestation of the gastrointestinal (GI) consequences of SLE itself. Complications of the enteritis component include mesenteric vasculitis, intestinal pseudo-obstruction, and protein-losing enteropathy. Lupus enteritis is very responsive to treatment with pulse steroids in almost 70% of the patients, but it is critical to diagnose it early to prevent devastating organ damage. The case describes a 21-year-old Caucasian female with a past medical history of uncomplicated laparoscopic appendectomy (one month prior to the time of presentation), major depressive disorder, asthma, iron deficiency anemia, pelvic inflammatory disease secondary to sexually transmitted Chlamydia trachomatis infection, and SLE (diagnosed two weeks prior to presentation)...
February 21, 2020: Curēus
https://read.qxmd.com/read/32226649/imaging-in-chronic-wound-diagnostics
#10
REVIEW
Shuxin Li, Ali H Mohamedi, Jon Senkowsky, Ashwin Nair, Liping Tang
Significance: Chronic wounds affect millions of patients worldwide, placing a huge burden on health care resources. Although significant progress has been made in the development of wound treatments, very few advances have been made in wound diagnosis. Recent Advances: Standard imaging methods like computed tomography, single-photon emission computed tomography, magnetic resonance imaging, terahertz imaging, and ultrasound imaging have been widely employed in wound diagnostics. A number of noninvasive optical imaging modalities like optical coherence tomography, near-infrared spectroscopy, laser Doppler imaging, spatial frequency domain imaging, digital camera imaging, and thermal and fluorescence imaging have emerged over the years...
May 1, 2020: Advances in Wound Care
https://read.qxmd.com/read/32226647/inhibition-of-gkn2-attenuates-acute-gastric-lesions-through-the-nlrp3-inflammasome
#11
Ziqiang Zhang, Hongyuan Xue, Yuanqiang Dong, Jian Hu, Tao Jiang, Liubin Shi, Jianjun Du
Objective: Acute gastric lesions are commonly seen in critically ill patients in the intensive care unit and can result in significant upper gastrointestinal bleeding. However, the signaling mechanisms that regulate this severe disease are still unclear. In this study, we explored the involvement of gastrokine 2 (GKN2) in the development of acute gastric lesions in mice. Approach: We measured the degree of injury using the water immersion restraint stress mouse model. Inflammatory cells and factors were analyzed after gastric lesion induction...
May 1, 2020: Advances in Wound Care
https://read.qxmd.com/read/32226481/prevention-and-early-intervention-in-youth-mental-health-is-it-time-for-a-multidisciplinary-and-trans-diagnostic-model-for-care
#12
REVIEW
Marco Colizzi, Antonio Lasalvia, Mirella Ruggeri
Background: Similar to other health care sectors, mental health has moved towards the secondary prevention, with the effort to detect and treat mental disorders as early as possible. However, converging evidence sheds new light on the potential of primary preventive and promotion strategies for mental health of young people. We aimed to reappraise such evidence. Methods: We reviewed the current state of knowledge on delivering promotion and preventive interventions addressing youth mental health...
2020: International Journal of Mental Health Systems
https://read.qxmd.com/read/32226316/healing-health-care-from-sick-care-towards-salutogenic-healing-systems
#13
Christopher J Fries
Aaron Antonovsky's salutogenic model is starting to impact health promotion at the level of theory and research. However, the benefits of Antonovsky's theory for population health promotion practices and health care restructuring are unrealized. This analysis uses the definition of health derived from complexity science as a lifelong, multidimensional adaptive process comprised of intersecting biological, psychological, social, environmental, and spiritual systems as a starting point for a salutogenic analysis of formal healthcare...
2020: Social Theory & Health: STH
https://read.qxmd.com/read/32226310/is-intensive-glucose-control-bad-for-critically-ill-patients-a-systematic-review-and-meta-analysis
#14
Ren-Qi Yao, Chao Ren, Guo-Sheng Wu, Yi-Bing Zhu, Zhao-Fan Xia, Yong-Ming Yao
Background: The monitoring and management of blood glucose concentration are standard practices in critical settings as hyperglycaemia has been shown close association with poorer outcomes. Several meta-analyses have revealed that intensive glucose control has no benefit in decreasing short-term mortality among critically ill patients, while the studies these meta-analyses have incorporated have been largely divergent. We aim to perform a more comprehensive meta-analysis addressing this problem to provide stronger evidence...
2020: International Journal of Biological Sciences
https://read.qxmd.com/read/32226071/implementation-of-the-pharmacists-patient-care-process-in-a-medicinal-chemistry-course
#15
Naser Z Alsharif, Michele A Faulkner
Objective. To implement the Pharmacists' Patient Care Process (PPCP) in a medicinal chemistry course. Methods. Doctor of Pharmacy students in a medicinal chemistry course were challenged to apply the PPCP in a lesson on cholinesterase inhibitors and NMDA receptor antagonist in the treatment of Alzheimer's disease. A clinical faculty member with expertise in the topic reviewed the clinical information provided to ensure applicability to patient care. A pre- and post-course survey was administered to assess students' understanding of the PPCP and the effectiveness of the strategies used...
February 2020: American Journal of Pharmaceutical Education
https://read.qxmd.com/read/32226069/economic-contributions-of-a-college-of-pharmacy-to-the-surrounding-communities-and-state
#16
Marie Chisholm-Burns, Cyril F Chang, Shelia Cooper
Objective. To quantify the monetary value of economic contributions of a state-funded college of pharmacy as it pursues its missions of teaching, research, service, and patient care. Methods. An economic analysis was performed by applying the Impact Analysis for Planning (IMPLAN) Economic Input-Output Model to financial and enrollment data of the University of Tennessee Health Science Center College of Pharmacy. Results. A total of $94.1 million was attributed to the college in fiscal year 2018, which included $50...
February 2020: American Journal of Pharmaceutical Education
https://read.qxmd.com/read/32225424/terahertz-frequency-temporal-differentiator-enabled-by-a-high-q-resonator
#17
Jingya Xie, Xi Zhu, Hongxiang Zhang, Xiaofei Zang, Lin Chen, Alexey V Balakin, Alexander P Shkurinov, Yiming Zhu
Terahertz (THz) fundamental "building blocks" equivalent to those used in multi-functional electronic circuits are very helpful for actual applications in THz data-processing technology and communication. Here, we theoretically and experimentally demonstrate a THz temporal differentiator based on an on-chip high-quality (Q) factor resonator. The resonator is made of low-loss high-resistivity silicon material in a monolithic, integrated platform, which is carefully designed to operate near the critical coupling region...
March 16, 2020: Optics Express
https://read.qxmd.com/read/32225027/effectiveness-of-a-multifactorial-intervention-in-the-first-1000-days-of-life-to-prevent-obesity-and-overweight-in-childhood-study-protocol
#18
Mercedes Díaz-Rodríguez, Celia Pérez-Muñoz, José Manuel Lendínez-de la Cruz, Martina Fernández-Gutiérrez, Pilar Bas-Sarmiento, Bernardo C Ferriz-Mas
(1) Background : Obesity is a global health problem, and its prevention must be a priority goal of public health, especially considering the seriousness of the problem among children. It is known that fetal and early postnatal environments may favor the appearance of obesity in later life. In recent years, the impact of the programs to prevent obesity in childhood has been scarce. The aim of this research is to evaluate the effectiveness of an intervention based on the concept of early programming. (2) Methods : Non-randomized controlled trial design...
March 26, 2020: International Journal of Environmental Research and Public Health
https://read.qxmd.com/read/32224930/a-cecal-slurry-mouse-model-of-sepsis-leads-to-acute-consumption-of-vitamin-c-in-the-brain
#19
David C Consoli, Jordan J Jesse, Kelly R Klimo, Adriana A Tienda, Nathan D Putz, Julie A Bastarache, Fiona E Harrison
Vitamin C (ascorbate, ASC) is a critical antioxidant in the body with specific roles in the brain. Despite a recent interest in vitamin C therapies for critical care medicine, little is known about vitamin C regulation during acute inflammation and critical illnesses such as sepsis. Using a cecal slurry (CS) model of sepsis in mice, we determined ASC and inflammatory changes in the brain following the initial treatment. ASC levels in the brain were acutely decreased by approximately 10% at 4 and 24 h post CS treatment...
March 26, 2020: Nutrients
https://read.qxmd.com/read/32224830/efficacy-and-safety-of-dexmedetomidine-for-prolonged-sedation-in-the-picu-a-prospective-multicenter-study-prosdex
#20
Francesca Sperotto, Maria C Mondardini, Clara Dell'Oste, Francesca Vitale, Stefania Ferrario, Maria Lapi, Federica Ferrero, Maria P Dusio, Emanuele Rossetti, Marco Daverio, Angela Amigoni
OBJECTIVES: We sought to evaluate dexmedetomidine efficacy in assuring comfort and sparing conventional drugs when used for prolonged sedation (≥24 hr) in critically ill patients, by using validated clinical scores while systematically collecting drug dosages. We also evaluated the safety profile of dexmedetomidine and the risk factors associated with adverse events. DESIGN: Observational prospective study. SETTING: Nine tertiary-care PICUs...
March 12, 2020: Pediatric Critical Care Medicine
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