Aisha Al Balushi, David Smart
INTRODUCTION: Critically ill patients require continuation of their care when receiving hyperbaric oxygen treatment. This care may be facilitated via portable electrically powered devices such as intravenous (IV) infusion pumps and syringe drivers, which may create risks in the absence of a comprehensive safety evaluation. We reviewed published safety data for IV infusion pumps and powered syringe drivers in hyperbaric environments and compared the evaluation processes to key requirements documented in safety standards and guidelines...
March 31, 2023: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Mukesh Mann, Rakesh P Badoni, Harsh Soni, Mohammed Al-Shehri, Aman Chandra Kaushik, Dong-Qing Wei
Chest radiography is a widely used diagnostic imaging procedure in medical practice, which involves prompt reporting of future imaging tests and diagnosis of diseases in the images. In this study, a critical phase in the radiology workflow is automated using the three convolutional neural network (CNN) models, viz. DenseNet121, ResNet50, and EfficientNetB1 for fast and accurate detection of 14 class labels of thoracic pathology diseases based on chest radiography. These models were evaluated on an AUC score for normal versus abnormal chest radiographs using 112120 chest X-ray14 datasets containing various class labels of thoracic pathology diseases to predict the probability of individual diseases and warn clinicians of potential suspicious findings...
March 26, 2023: Interdisciplinary Sciences, Computational Life Sciences
Benedict Rogers, Juan Paolo Legaspi, Tarun Bastiampillai
No abstract text is available yet for this article.
March 26, 2023: Medical Journal of Australia
Gyula Tövisházi, Katalin Csordás, Balázs Hauser
Our aim is to summarize the new European Resuscitation Council (ERC) 2021 guidelines on paediatric life support. In children, exhaustion of compensatory mechanisms in respiratory or circulatory failure leads to cardiac arrest. Recognition and treatment of children in critical condition are the most important element of its prevention. With the ABCDE approach, life-threatening problems can be identified and treated using simple interventions (bag-mask ventilation, intraosseous access, fluid bolus, etc.). Important new recommendations: 4-hand ventilation during bag-mask ventilation, target saturation of 94-98% during oxygen therapy, and fluid bolus of 10 ml/kg...
March 26, 2023: Orvosi Hetilap
Dénes Kiss, Ádám Pál-Jakab, Boldizsár Kiss, Dávid Pilecky, Endre Zima
Cardiovascular mortality has declined significantly in recent years, however, sudden cardiac death remains the leading cause of death in a range of different mortality indicators, very often caused by cardiac arrhythmias. The electrophysiological causes of sudden cardiac death include ventricular tachycardia, ventricular fibrillation, asystole and pulseless electrical activity. In addition, other cardiac arrhythmias may also trigger sudden cardiac death, periarrest arrhytmias. The rapid and accurate recognition of the various arrhythmias and their appropriate management are major challenges at both prehospital and hospital care levels...
April 2, 2023: Orvosi Hetilap
Razi Paracha, David K H Lo, Ursula Montgomery, Louise Ryan, Vivek Varakantam, Erol A Gaillard
Poor adherence to asthma preventer medication is associated with life-threatening asthma attacks. The quality and outcomes framework mandated primary care annual asthma review does not include adherence monitoring and the effect of poor adherence on lung function in paediatric primary care patients is unknown. The aim was to investigate the link between inhaled corticosteroid (ICS) adherence and spirometry, fraction of exhaled nitric oxide (FeNO) and asthma control in asthmatic school-age children in this cross-sectional observational study involving three Leicestershire general practices...
March 25, 2023: NPJ Primary Care Respiratory Medicine
Aaron S Wilson, Thu Pham, Daniel Mbusa, Parth Patel, Soumya Chennupati, Sybil Crawford, Alok Kapoor
BACKGROUND: High adherence to direct-acting oral anticoagulant (DOAC) is critical to treat and prevent thromboembolic disease. The Anticoagulation Forum recently endorsed a checklist (DOAC checklist) that recommends care processes that may improve adherence. OBJECTIVES: This study aimed to determine whether checklist-driven care from a clinical pharmacist improves adherence in ambulatory patients starting a DOAC or resuming it after a setback. METHODS: This study included ambulatory patients starting a DOAC or resuming it after setback (thromboembolic event or bleeding) in an ambulatory setting...
February 27, 2023: Journal of the American Pharmacists Association: JAPhA
Neil Bodagh, Michelle C Williams, Keeran Vickneson, Ali Gharaviri, Steven Niederer, Steven E Williams
The clinical spectrum of atrial fibrillation means that a patient-individualised approach is required to ensure optimal treatment. Cardiac computed tomography can accurately delineate atrial structure and function and could contribute to a personalised care pathway for atrial fibrillation patients. The imaging modality offers excellent spatial resolution and has been utilised in pre-, peri- and post-procedural care for patients with atrial fibrillation. Advances in temporal resolution, acquisition times and analysis techniques suggest potential expanding roles for cardiac computed tomography in the future management of patients with atrial fibrillation...
March 23, 2023: Journal of Cardiovascular Computed Tomography
Andre Nel
The purpose of this review is to elucidate how dimensional and durability characteristics of high aspect ratio nanomaterials (HARN), including carbon nanotubes (CNT) and metal nanowires (MeNW), contribute to understanding the fiber pathogenicity paradigm (FPP), including by explaining the structure-activity relationships (SAR) of a diverse range of natural and synthetic elongate materials that may or may not contribute to mesothelioma development in the lung. While the FPP was originally developed to explain the critical importance of asbestos and synthetic vitreous fiber length, width, aspect ratio and biopersistence in mesothelioma development, there are a vast number of additional inhalable materials that need to be considered in terms of pathogenic features that may contribute to mesothelioma or lack thereof...
November 10, 2022: Environmental Research
Marie-Claude Beaulieu, Joel Neves Briard, Michaël Chassé
It is challenging in COVID-19 patients to determine if the virus is the primary cause of their symptoms, or if it is exacerbating an underlying condition. When the virus is a significant contributing factor, drug therapies must be tailored to the severity of the clinical presentation. We aimed to summarize the indications of drug therapies for SARS-CoV-2 infected patients.
March 23, 2023: Canadian Journal of Cardiology
Estevão Bassi, Bruno Martins Tomazini, Bárbara Vieira Carneiro, Amanda Rodrigues de Oliveira Siqueira, Sara Rodrigues de Oliveira Siqueira, Thais Guimarães, Fernando da Costa Ferreira Novo, Edivaldo Massazo Utiyama, Paolo Pelosi, Luiz Marcelo Sá Malbouisson
BACKGROUND: Systemic inflammatory responses mimicking infectious complications are often present in surgical patients. METHODS: The objective was to assess the association between withholding early antimicrobial therapy while investigating alternative diagnoses and worse outcomes in nonseptic patients with suspected nosocomial infection in a retrospective cohort of critically ill surgical patients. The initiation of antibiotic therapy within 24h of the suspicion of infection was defined as the Early Empirical Antibiotic strategy (EEA) group and the initiation after 24h of suspicion or not prescribed was defined as the Conservative Antibiotic strategy (CA) group...
March 23, 2023: Brazilian Journal of Anesthesiology
Q Q Feng, Y B Ao, S Z Chen, I Martek
OBJECTIVES: Evaluating the efficiency of health resource allocations is critical to improving China's rural three-level health service network. STUDY DESIGN: This was a prospective panel data study. METHODS: Based on panel data of the medical and health resources of 31 provinces within rural China, collected from 2003 to 2020, this study uses a three-stage Data Envelopment Analysis-Malmquist index to analyze the evolution of efficiency and productivity...
March 23, 2023: Public Health
Huan Yang, Dong Huang, Jian Luo, Zongan Liang, Jie Li
BACKGROUND: High-flow nasal cannula (HFNC) has been increasingly utilized in patients with chronic obstructive pulmonary disease (COPD); however, the effects on reducing the need for intubation or reintubation remain unclear. OBJECTIVES: We aimed to investigate whether HFNC therapy was superior to conventional oxygen therapy (COT) or noninvasive ventilation (NIV) in patients with COPD. METHODS: A literature search was performed in electronic databases until October 1st, 2022...
March 23, 2023: Heart & Lung: the Journal of Critical Care
Kerina J Denny, Rodney A Lea, Ross Lindell-Innes, Larisa M Haupt, Aaron J Heffernan, Nicholas R Harvey, Oliver Hughes, Van T Cao, Janine Stuart, David L Paterson, John F McNamara, Jacobus P J Ungerer, Carel J Pretorius, Lyn R Griffiths, Jeffrey Lipman
PURPOSE: We aimed to identify a gene signature that discriminates between sepsis and aseptic inflammation in patients administered antibiotics in the intensive care unit and compare it to commonly utilised sepsis biomarkers. METHODS: 91 patients commenced on antibiotics were retrospectively diagnosed as having: (i) blood culture positive sepsis; (ii) blood culture negative sepsis; or (iii) aseptic inflammation. Bloods were collected after <24 h of antibiotic commencement for both gene expression sequencing analysis and measurement of previously identified biomarkers...
March 23, 2023: Journal of Critical Care
Elizabeth K Baker, Faris N Al Gharaibeh, Kevin Bove, Maria A Calvo-Garcia, Amelle Shillington, Katherine VandenHeuvel, DonnaMaria E Cortezzo
Ryanodine receptor type 1-related disorder (RYR1-RD) is the most common subgroup of congenital myopathies with a wide phenotypic spectrum ranging from mild hypotonia to lethal fetal akinesia. Genetic testing for myopathies is imperative as the diagnosis informs counseling regarding prognosis and recurrence risk, treatment options, monitoring, and clinical management. However, diagnostic challenges exist as current options are limited to clinical suspicion prompting testing including: single gene sequencing or familial variant testing, multi-gene panels, exome, genome sequencing, and invasive testing including muscle biopsy...
March 25, 2023: American Journal of Medical Genetics. Part A
Michael Nurok, Mark E Nunnally, Michael O'Connor, Richard N Pierson, David A Baran, Michael D Harper, Darren Malinoski, Aly El Banayosy, Abiodun Orija, Shelley Hall, Jeffrey D Edelman, Thoralf M Sundt, Deborah Levine, Jon Kobashigawa, David Nelson
Heart and lung transplant recipients require care provided by clinicians from multiple different specialties, each contributing unique expertise and perspective. The period the patient spends in the intensive care unit is one of the most critical times in the perioperative trajectory. Various organizational models of intensive care exist, including those led by intensivists, surgeons, transplant cardiologists, and pulmonologists. Coordinating timely efficient intensive care is an essential and logistically difficult goal...
March 25, 2023: Clinical Transplantation
Vincenzo Damico, Liana Murano, Alberto Dal Molin
AIM: To investigate the prevalence and characteristics of chronic postICU pain in survivors of critical illness and to examine the association between pain and psychological disorders. METHODS: The study was carried out in an Italian ICU. Six months after ICU discharge, patients were called back for an interview for assessed chronic pain (CP), pain intensity, pain location and interference of pain with activities of daily living. During the interview a battery of psychometric test was administered for evaluate anxiety, depression, insomnia, fatigue and posttraumatic stress disorder (PTSD)...
July 1, 2022: Professioni Infermieristiche
Maria Luisa Asta, Salvatore Lo Presti, Paolo Pasetti, Vincenzo Bonazza
INTRODUCTION: Nurses who work at night often experience high levels of sleepiness, which are the biological consequence of the circadian rhythm, which induces sleep at particular hours of the night, increasing the risk of errors and accidents. OBJECTIVE: According to the latest data declared by the World Organization of Healthcare (WHO), at least 134 million patients are victims every year adverse events that occur due to the lack of safety in the health care and and 2...
July 1, 2022: Professioni Infermieristiche
Samantha Fernandez Hernandez, Brooke Barlow, Vera Pertsovskaya, Carolina B Maciel
Cardiac arrest (CA) is a critical public health issue affecting more than half a million Americans annually. The main determinant of outcome post-CA is hypoxic-ischemic brain injury (HIBI), and temperature control is currently the only evidence-based, guideline-recommended intervention targeting secondary brain injury. Temperature control is a key component of a post-CA care bundle; however, conflicting evidence challenges its wide implementation across the vastly heterogeneous population of CA survivors. Here, we critically appraise the available literature on temperature control in HIBI, detail how the evidence has been integrated into clinical practice, and highlight the complications associated with its use and the timing of neuroprognostication after CA...
March 25, 2023: Advances in Therapy
Ximu Kuang, Guojian Jian, Desheng Xie, Xiaolin Chen, Haoyuan Liu
PURPOSE: There is no specific literature on the best implantation position of the Femoral Neck System (FNS) for treating Pauwels type III femoral neck fracture in young adults. METHODS: Use finite-element analysis to compare the mechanical properties of implantation positions: FNS in the central position, FNS in the low position, and FNS in the low position combined with cannulated screw (CS). The CT data of the femur were imported into the mimics20.0 to obtain the three-dimensional model of the femur; imported into geomagic2017 and SolidWorks 2017 for optimizations; models of FNS and CS are built on the basis of the device manuals...
March 25, 2023: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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