Tag: treatment

Upvote Story 5
This case report shows that junctional rhythm can cause deterioration of SAM, LVOTO, and MR, and can lead to unstable hemodynamics in a patient with right ventricular failure after MVR. Atrial pacing can resolve SAM, LVOTO, and MR and can improve hemodynamics in a patient with unstable normal sinus rhythm. TEE in the ICU can play a pivotal role in clinical decision-making. Given that there... Read More | Comment
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Hospitals are increasingly facing the challenge of cutting costs while also improving clinical outcomes. This is certainly true in the infectious disease sector, as unrecognized or ineffectively treated bacterial infections can lead to sepsis, which can be life-threatening. Sepsis is relatively common: each year in the United States, more than 1.6 million adults develop sepsis and approximately 270,000 people die from it. In fact, sepsis... Read More | Comment
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Statistically significant results in anesthesia and critical care randomized controlled trials are often fragile, and study conclusions are frequently affected by spin. Routine calculation of the Fragility Index in medical literature may allow for better understanding of trials and therefore enhance the quality of reporting. We identified 166 eligible randomized controlled trials with a median sample size of 207 patients (interquartile range, 109–497). The median... Read More | Comment
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This JAMA Clinical Guidelines Synopsis summarizes the American College of Chest Physicians' 2016 recommendations on antithrombotic therapy for venous thromboembolism (VTE). The estimated annual incidence of VTE, defined as DVT of the leg or PE, ranges from 104 to 183 per 100 000 person-years. Compared with those without VTE, the 30-year mortality risk is increased for survivors of an episode of VTE and for survivors of... Read More | Comment
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Pediatric critical care nephrology is a complex and highly specialized field, presenting challenges and management strategies that are often quite distinct from those seen in adult practice. Therefore, it is high time to address all the topics in the field of critical care nephrology in children in a unique book which is the first of its kind. This book covers the basics as well as... Read More | Comment
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In this study, antipsychotics were used to treat nearly half of all antipsychotic-naïve ICU patients and were prescribed at discharge to 24% of antipsychotic-treated patients. Treatment with an atypical antipsychotic greatly increased the odds of discharge with an antipsychotic prescription, a practice that should be examined carefully during medication reconciliation since these drugs carry “black box warnings” regarding long-term use. After excluding 18 patients due... Read More | Comment
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There is great variability in end-of-life care and the legal context may interfere with decisions on limitation of medical treatment. In Brazil, end-of-life care was initially regulated in 2006, but legal controversies still continue. Even though physicians do not need authorization from the Judiciary system to act, those controversies may cause uncertainty regarding seemingly competing professional duties (caring for patients’ best interests versus maintenance of... Read More | Comment
Upvote Story 15
It seems like every week there’s another publicized instance of our impending replacement by artificial intelligence. Big Data, they say, is going to free us of the cognitive burdens of complex thought while maximizing healthcare outcomes. This latest entry is the “AI Clinician”, which has been created as a demonstration for the treatment of sepsis. Or, rather more narrowly, the AI Clinician tries to prescribe... Read More | Comment
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What do doctors and religious leaders have in common? At least a couple of big things: individuals in both professions engage with people at some of the most critical moments in their lives and require a high degree of empathy to truly succeed in all of their endeavors. Last year, I worked with the Rev. Professor Jane Shaw, at the time Stanford’s Dean of Religious... Read More | Comment
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A novel drug is showing promise for helping improve cognition in patients with mild to moderate Alzheimer’s disease (AD), according to new topline results. A phase 3 trial of more than 800 patients showed that those who were randomly assigned to receive oral GV-971 (Green Valley Pharmaceutical Co, China) met the primary endpoint of significant change from baseline to week 36 on the 12-item cognitive... Read More | Comment
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Bedside procedures are exceedingly common. Data regarding the severity of procedural pain and strategies to mitigate it are important for the informed consent process and patient satisfaction. Overall, pain reported from common bedside procedures is low, but pain can be further reduced with the addition of lidocaine onto the skin surface to modulate pain perception. A total of 481 patients provided consent and were randomized... Read More | Comment
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Changes in lactate levels after ECMO implantation is an important tool to assess effective circulatory support and it is found superior to single lactate measurements as a prognostic sign of mortality in our study. Based on our results, an early insertion of ECMO before lactate gets high was suggested. Serial changes on lactate levels and calculation of its clearance may be superior to single lactate... Read More | Comment
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This book collects and synthesizes the latest thinking on the condition in its variety of cognitive and behavioral presentations, matched by a variety of clinical responses. Acknowledging the continuum of injury and the multi-stage nature of recovery, expert contributors review salient research data and offer clinical guidelines for the neuropsychologist working with TBI patients, detailing key areas of impairment, brief and comprehensive assessment methods and... Read More | Comment
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In this randomized, double-blind, placebo-controlled, dose-finding adaptive phase 2a/2b trial enrolling 301 adults, the optimal therapeutic dose of recombinant alkaline phosphatase was 1.6 mg/kg. Treatment with this dose for 3 days when added to standard care resulted in a median increase in endogenous creatinine clearance of 27.6 mL/min vs 14.7 mL/min for placebo in the first 7 days, a difference that was not statistically significant.... Read More | Comment
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Among adults with COPD at high risk of exacerbation treated with inhaled corticosteroids, the addition of low-dose theophylline, compared with placebo, did not reduce the number COPD exacerbations over a 1-year period. The findings do not support the use of low-dose theophylline as adjunctive therapy to inhaled corticosteroids for the prevention of COPD exacerbations. Of the 1567 participants analyzed, mean (SD) age was 68.4 (8.4)... Read More | Comment