219,489 results match your criteria acute care


Plasma levels of bigEndothelin-1 are associated with renal insufficiency and in-hospital mortality of immune thrombotic thrombocytopenic purpura.

Thromb Haemost 2021 May 13. Epub 2021 May 13.

Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, United States.

Immune thrombotic thrombocytopenic purpura (iTTP) is caused by severe deficiency of plasma ADAMTS13 activity. Despite advances in early diagnosis and management, the mortality rate of acute iTTP remains high in a large part of world where access to some of the most novel therapies is limited. To determine the role of plasma bigEndothelin-1 (bigET-1) or its bioactive product ET-1 as a biomarker and/or a pathogenic factor in acute iTTP, plasma levels of bigET-1 were determined using an immunoassay in patients with iTTP on admission and during remission, as well as in healthy controls; moreover, the biological effect of ET-1 in thrombus formation was determined by a microfluidic assay. Read More

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Agreement between wireless and standard measurements of vital signs in acute exacerbation of chronic obstructive pulmonary disease: a clinical validation study.

Physiol Meas 2021 May 13. Epub 2021 May 13.

Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital, Copenhagen, DENMARK.

Objective: Wireless sensors for continuous monitoring of vital signs have potential to improve patient care by earlier detection of deterioration in general ward patients. We aimed to assess agreement between wireless and standard (wired) monitoring devices in patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

Approach: Paired measurements of vital signs were recorded with 15 minutes intervals for two hours. Read More

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Increased Incidence of COVID-19 Infections Amongst Interpersonal Violence Patients.

J Surg Res 2021 Apr 30;266:62-68. Epub 2021 Apr 30.

Division of Acute Care Surgery, University of Southern California, Los Angeles, California.

Objective: To investigate whether any specific acute care surgery patient populations are associated with a higher incidence of COVID-19 infection.

Background: Acute care providers may be exposed to an increased risk of contracting the COVID-19 infection since many patients present to the emergency department without complete screening measures. However, it is not known which patients present with the highest incidence. Read More

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Trends in Pediatric Primary Care Visits during the COVID-19 Pandemic.

Acad Pediatr 2021 May 10. Epub 2021 May 10.

Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA. Electronic address:

Objective: Months after the declaration of the COVID-19 national emergency, visits among children remained suppressed for unclear reasons, which we sought to understand by examining child visit rates.

Methods: Using de-identified claims data for children <18 years old from OptumLabs® Data Warehouse, a large commercial claims database, we compared monthly primary care visit and vaccination rates from January-October 2020 to January-October 2018 and 2019. Visit rates were analyzed by visit reason and by the month after (e. Read More

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Compassion inequities and opioid use disorder: A matched case-control analysis examining inpatient management of cancer-related pain for patients with opioid use disorder.

J Pain Symptom Manage 2021 May 10. Epub 2021 May 10.

Department of Hematology and Oncology, West Virginia University, Morgantown, West Virginia, USA.

Context: The opioid epidemic spurred guidelines intended to reduce inappropriate prescribing. Although acute cancer-related pain was excluded from these recommendations, studies demonstrate reduced opioid prescribing for patients hospitalized with advanced cancer.

Objectives: We performed a matched case-control analysis to determine how a history of opioid use disorder (OUD) affects inpatient management of cancer pain. Read More

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Bacterial Infection Related Acute on Chronic Liver Failure: the standpoint matters!

J Hepatol 2021 May 10. Epub 2021 May 10.

Regional Institute of Gastroenterology and Hepatology "Prof. Dr. Octavian Fodor," Anesthesia and Intensive Care Department, Cluj-Napoca, Romania; University of Medicine and Pharmacy "Iuliu Hatieganu," Department of Anesthesia and Intensive Care I, Cluj-Napoca, Romania.

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Development of an immunochromatographic kit to detect severe acute respiratory syndrome coronavirus 2.

J Virol Methods 2021 May 10:114183. Epub 2021 May 10.

Department of Microbiology, Juntendo University School of Medicine, Tokyo, Japan. Electronic address:

Background: The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for the worldwide coronavirus disease-19 (COVID-19) pandemic, starting in late 2019. The standard diagnostic methods to detect SARS-CoV-2 are PCR-based genetic assays. Antigen-antibody-based immunochromatographic assays are alternative methods of detecting this virus. Read More

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Neuropsychiatric sequelae of acute carbon monoxide poisoning: The predictive role of neuron specific enolase and glial fibrillary acidic protein.

Neurotoxicology 2021 May 10. Epub 2021 May 10.

Department of neuropsychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Background: Acute carbon monoxide (CO) poisoning is one of the most common poisons worldwide and neuropsychiatric sequelae (NS) are the most frequent form of its morbidity.

Objectives: This study aimed to measure the percentage of patients liable to NS, to evaluate the cognitive profile of patients with NS and to assess the role of neuron specific enolase (NSE) and glial fibrillary acidic protein (GFAP) in predicting the development of NS after acute CO poisoning.

Methods: This prospective study included 50 patients with acute CO poisoning presented to the Poison Control Center, Ain Shams University Hospitals during the period from beginning of November 2015 till the end of January 2017. Read More

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Rationale and Design of the Comparison of Outcomes and Access to Care for Heart Failure (COACH) Trial: A Stepped Wedge Cluster Randomized Trial.

Am Heart J 2021 May 10. Epub 2021 May 10.

Peter Munk Cardiac Centre of the University Health Network, Toronto, Canada; Ted Rogers Centre for Heart Research, Toronto, Canada; University of Toronto, Toronto, Canada.

Background: Heart failure (HF) is an ambulatory care sensitive condition and a leading reason for emergency department (ED) visits and hospitalizations. Improved decision-making and care may enhance safety and efficiency for patients presenting to the ED with acute HF.

Objectives: We will evaluate an intervention comprised of two complementary components: i) the Emergency Heart Failure Mortality Risk Grade simultaneous 7- and 30-day (EHMRG30-ST) risk scores, which will inform admission-discharge decisions, and ii) a rapid outpatient follow-up (RAPID-HF) clinic for low-to-intermediate risk patients on cardiovascular readmissions or death. Read More

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An investment case for the prevention and management of rheumatic heart disease in the African Union 2021-30: a modelling study.

Lancet Glob Health 2021 May 10. Epub 2021 May 10.

Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA; Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA; Program in Global Noncommunicable Disease and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Partners In Health, Boston, MA, USA. Electronic address:

Background: Despite declines in deaths from rheumatic heart disease (RHD) in Africa over the past 30 years, it remains a major cause of cardiovascular morbidity and mortality on the continent. We present an investment case for interventions to prevent and manage RHD in the African Union (AU).

Methods: We created a cohort state-transition model to estimate key outcomes in the disease process, including cases of pharyngitis from group A streptococcus, episodes of acute rheumatic fever (ARF), cases of RHD, heart failure, and deaths. Read More

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Variation in 30-Day Readmission Rates from Inpatient Rehabilitation Facilities to Acute Care Hospitals.

J Am Med Dir Assoc 2021 May 10. Epub 2021 May 10.

Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Research Institute, Charlestown, MA, USA. Electronic address:

Objectives: To quantify the rate of readmission from inpatient rehabilitation facilities (IRFs) to acute care hospitals (ACHs) during the first 30 days of rehabilitation stay. To measure variation in 30-day readmission rate across IRFs, and the extent that patient and facility characteristics contribute to this variation.

Design: Retrospective analysis of an administrative database. Read More

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Post-acute conditions of patients with COVID-19 not requiring hospital admission.

Authors:
Lixue Huang Bin Cao

Lancet Infect Dis 2021 May 10. Epub 2021 May 10.

Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China; Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China. Electronic address:

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Post-acute effects of SARS-CoV-2 infection in individuals not requiring hospital admission: a Danish population-based cohort study.

Lancet Infect Dis 2021 May 10. Epub 2021 May 10.

Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark. Electronic address:

Background: Individuals admitted to hospital for COVID-19 might have persisting symptoms (so-called long COVID) and delayed complications after discharge. However, little is known regarding the risk for those not admitted to hospital. We therefore examined prescription drug and health-care use after SARS-CoV-2 infection not requiring hospital admission. Read More

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Functional Outcomes, Goals, and Goal Attainment Amongst Chronically Critically Ill Long-Term Acute Care Hospital Patients.

Ann Am Thorac Soc 2021 May 13. Epub 2021 May 13.

University of Pennsylvania Perelman School of Medicine, 14640, Philadelphia, Pennsylvania, United States.

Rationale: Chronically critically ill patients admitted to a long-term acute care hospital (LTACH) setting are a vulnerable population of intensive care unit survivors. Little is known of the goals and functional outcomes achieved by patients after rehabilitation in the LTACH setting.

Objectives: We sought to examine patient goals and functional outcomes, including swallowing function, amongst ICU survivors admitted to an LTACH with a tracheostomy. Read More

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Neurologic Compromise in COVID-19: A Literature Review.

J Neurol Res 2020 Oct 4;10(5):164-172. Epub 2020 Sep 4.

Department of Neurosurgery, University of Texas Health at San Antonio, San Antonio, TX, USA.

Coronavirus disease 2019 (COVID-19) disease caused by a new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been associated with many neurological symptoms. The purpose of this article is to describe the neurological manifestations so far reported and their probable pathogenesis. We conducted a literature review on EMBASE, MEDLINE and SCIELO databases using the terms "COVID-19", "COVID", "neurological", "neurologic", "manifestations", "implications", "Guillain-Barre syndrome", "encephalopathy". Read More

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October 2020

Fewer Hospital Visits for Acute Stroke and Acute Coronary Syndrome During the COVID-19 Pandemic: A Reality or a Myth?

J Neurol Res 2020 Jun 1;10(3):53-55. Epub 2020 Jun 1.

Stroke Program, Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.

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Rhinocerebral Mucormycosis and COVID-19 Pneumonia.

J Med Cases 2021 Mar 19;12(3):85-89. Epub 2021 Jan 19.

Christiana Care Health System, 4755 Ogletown Stanton Road, Newark, DE 19718, USA.

As the coronavirus disease 2019 (COVID-19) pandemic is evolving, more complications associated with COVID-19 are emerging. In this case report, we present a case of rhinocerebral mucormycosis concurrent with COVID-19 pneumonia in a 41-year-old man with a history of type 1 diabetes mellitus (T1DM). COVID-19 pneumonia was diagnosed with reverse transcription-polymerase chain reaction (RT-PCR). Read More

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Anesthetic Management of a Child With Propionic Acidemia Complicated by Bacteremia and Severe Acute Respiratory Syndrome Coronavirus 2.

J Med Cases 2021 Apr 8;12(4):152-156. Epub 2021 Feb 8.

Department of Anesthesiology and Critical Care, Saint Louis University Hospital, 1201 S. Grand Boulevard, St. Louis, MO 63104, USA.

Propionic acidemia (PA) is a rare, multi-systemic inborn error of metabolism. PA results from an impaired activity of the mitochondrial enzyme, propionyl-CoA carboxylase (PCC). PCC holds an essential role in the catabolic pathways for odd-chain fatty acids, cholesterol side-chains and branched-chain amino acids. Read More

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A Case of COVID-19 Failed in Viral Identification but Showed Consistent Host Responses to Severe Acute Respiratory Syndrome Coronavirus 2.

J Med Cases 2020 Oct 28;11(10):330-335. Epub 2020 Aug 28.

Infection Control Team, Department of Internal Medicine, JA Toride Medical Center, Toride, Ibaraki 302-0022, Japan.

In a 75-year-old hemodialysis patient, pneumonia manifested with computed tomography (CT) images suggestive of coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ribonucleic acid (RNA) was not detected with repeated polymerase chain reaction (PCR) tests, but serum immunoglobulin G (IgG) and IgM antibodies against SARS-CoV-2 turned positive with two different assay kits. The patient was thus treated as a probable COVID-19 case, and then recovered through the intensive care including ciclesonide, favipiravir, and methyl prednisolone. Read More

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October 2020

Macrophage Activation in COVID-19 Patients in Intensive Care Unit.

J Med Cases 2020 Jul 29;11(7):211-214. Epub 2020 Jun 29.

Service de Reanimation Medicale, Groupe Hospitalier de la Region Mulhouse Sud Alsace, Mulhouse, France.

We report six cases of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, admitted to intensive care unit (ICU), for whom bone marrow aspirate revealed hemophagocytosis. We compared their clinical presentation and laboratory findings to those that can be encountered during a hemophagocytic lymphohistiocytosis. These observations might evoke a macrophage activation mechanism different from the one encountered in the hemophagocytic lymphohistiocytosis (HLH). Read More

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Intra-abdominal hypertension and abdominal compartment syndrome in the critically ill liver cirrhotic patient-prevalence and clinical outcomes. A multicentric retrospective cohort study in intensive care.

PLoS One 2021 13;16(5):e0251498. Epub 2021 May 13.

University of Tartu, Tartu University Hospital, Tartu, Estonia.

Background: Liver cirrhosis and ascites are risk factors for intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS); however, data is scarce. We aimed to determine the prevalence of IAH/ACS in a population of critically ill cirrhotic patients with acute medical illness in intensive care and to assess for risk factors and clinical outcomes.

Methods: This was a multicentric retrospective cohort study including two general ICUs and pooled data from a multicentric study between January 2009 and October 2019. Read More

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Predicting Acute Respiratory Distress Syndrome in Severe Blunt Trauma: The Utility of Interleukin-18.

Surg Infect (Larchmt) 2021 May 13. Epub 2021 May 13.

Department of Surgery, University of California San Francisco-East Bay, Oakland, California, USA.

In trauma, direct pulmonary injury and innate immune response activation primes the lungs for acute respiratory distress syndrome (ARDS). The inflammasome-dependent release of interleukin-18 (IL-18) was recently identified as a key mediator in ARDS pathogenesis, leading us to hypothesize that plasma IL-18 is a diagnostic predictor of ARDS in severe blunt trauma. Secondary analysis of the Inflammation and Host Response to Injury database was performed on plasma cytokines collected within 12 hours of severe blunt trauma. Read More

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Delirium in adult patients in intensive care: nursing interventions.

Br J Nurs 2021 May;30(9):534-538

Assistent Professor, Universidade Católica Portuguesa, Lisbon, Portugal.

Background: Delirium is a neuropsychiatric syndrome of high incidence in the critically ill patient. It is characterised by changes in acute attention and cognition, has a multifactorial aetiology and has a negative impact on the patient's clinical situation and future quality of life. Prevention of delirium and early identification can reduce associated morbidity and mortality. Read More

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Exploration of current dietetic practices for patients with gynaecological cancers undergoing radiotherapy in Australia: a cross-sectional survey.

Support Care Cancer 2021 May 13. Epub 2021 May 13.

School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building, St Lucia, Brisbane, QLD, 4072, Australia.

Purpose: Radiotherapy for gynaecological cancers often causes gastrointestinal (GI) toxicities such as diarrhoea. Evidence for the potential benefits of dietary interventions on the management of acute GI toxicities is inconclusive and of low quality, with no clear evidence-based guidelines to inform clinical practice. This study aims to provide an overview of current opinions and clinical practice of dietitians treating this cohort and to examine existing models of nutrition care in Australian cancer centres. Read More

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Implementation of the Uniformed Services University Pain Registry Biobank: A Military and Veteran Population Focused Biobank and Registry.

Pain Med 2021 May 13. Epub 2021 May 13.

Defense and Veterans Center for Integrative Pain Management, Uniformed Services University, 11300 Rockville Pike, Rockville, MD.

Objective: The objective of this overview is to discuss the development, implementation, data content, and structure of the Uniformed Services University Pain Registry Biobank. Additionally, procedures and policies for accessing samples for pain-related research purposes are detailed.

Design: Cross-sectional overview. Read More

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Screening for Cognitive Dysfunction Using the Rowland Universal Dementia Assessment Scale in Adults With Sickle Cell Disease.

JAMA Netw Open 2021 May 3;4(5):e217039. Epub 2021 May 3.

Division of Medical Oncology and Hematology, Department of Medicine, University Health Network (UHN), Toronto, Ontario, Canada.

Importance: Adults with sickle cell disease (SCD) disproportionally experience early cognitive decline; however, guidance on the optimal screening strategy for cognitive dysfunction is lacking, and several available tools are biased by language, educational level, socioeconomic status, and race/ethnicity. The Rowland Universal Dementia Assessment Scale (RUDAS) was specifically designed for cognitive screening in multicultural populations.

Objective: To ascertain the prevalence of suspected dementia in adults with SCD using the RUDAS, and to identify whether age, sex, educational level, several biological variables, and SCD complications were associated with RUDAS scores. Read More

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Efficacy of Reduced-Intensity Chemotherapy With Oxaliplatin and Capecitabine on Quality of Life and Cancer Control Among Older and Frail Patients With Advanced Gastroesophageal Cancer: The GO2 Phase 3 Randomized Clinical Trial.

JAMA Oncol 2021 May 13. Epub 2021 May 13.

University of Leeds, Leeds, United Kingdom.

Importance: Older and/or frail patients are underrepresented in landmark cancer trials. Tailored research is needed to address this evidence gap.

Objective: The GO2 randomized clinical trial sought to optimize chemotherapy dosing in older and/or frail patients with advanced gastroesophageal cancer, and explored baseline geriatric assessment (GA) as a tool for treatment decision-making. Read More

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Presenteeism Among Nurses in Switzerland and Portugal and Its Impact on Patient Safety and Quality of Care: Protocol for a Qualitative Study.

JMIR Res Protoc 2021 May 13;10(5):e27963. Epub 2021 May 13.

School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal.

Background: Nurses dispense direct care in a wide variety of settings and are considered the backbone of the health care system. They often work long hours, face emotional stress, and are at a high risk of psychosocial and somatic illnesses. Nurses sometimes fall sick but work regardless, leading to presenteeism and subsequent risks to quality of care and patient safety due to the increased likelihood of patients falling, medication errors, and staff-to-patient disease transmission. Read More

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Contemporary use of guideline-based higher potency P2Y12 receptor inhibitor therapy in patients with moderate-to-high risk non-ST-segment elevation myocardial infarction: Results from the Canadian ACS reflective II cross-sectional study.

Clin Cardiol 2021 May 13. Epub 2021 May 13.

Terrence Donnelly Heart Centre, St Michael's Hospital, University of Toronto, Toronto, Canada.

Background: After myocardial infarction, guidelines recommend higher-potency P2Y12 receptor inhibitors, namely ticagrelor and prasugrel, over clopidogrel.

Hypothesis: We aimed to determine the contemporary use of higher-potency antiplatelet therapy in Canadian patients with non-ST-elevation myocardial infarction (NSTEMI).

Methods: A total of 684 moderate-to-high risk NSTEMI patients were enrolled in the prospective Canadian ACS Reflective II registry at 12 Canadian hospitals and three clinics in five provinces between July 2016 and May 2018. Read More

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Arachidonic Acid Metabolites in Neurologic Disorders.

CNS Neurol Disord Drug Targets 2021 May 11. Epub 2021 May 11.

Selcuk University Faculty of Medicine Neurology, Turkey.

Background & Objective: Arachidonic acid (ARA) is essential for the fluidity, selective permeability, and flexibility of the cell membrane. It is an important factor for the function of all cells, particularly in the nervous system, immune system, and vascular endothelium. ARA, after docosahexaenoic acid, is the second most common polyunsaturated fatty acid in the phospholipids of the nerve cell membrane. Read More

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