Tag: diagnosis
Sepsis Incidence and Mortality are Underestimated in Australian ICU Administrative Data
When compared with the reference standard — prospective clinical diagnosis — ANZICS CORE database criteria significantly underestimate the incidence of sepsis and overestimate the incidence of septic shock, and also result... read more
Overuse of troponin? A comprehensive evaluation of testing in a large hospital system
Troponin assays are integral to the diagnosis of acute myocardial infarction (AMI), but there is concern that testing is over utilized and may not conform to published guidelines. We reviewed all testing performed at 14 hospitals... read more
Procedure Eases Complications Related to Fluid Around Lungs
As people live longer with more advanced stages of cancer or chronic diseases, the longer their complications must be treated. That can include pleural effusions, an unusually large amount of fluid around a person’s lungs... read more
Insulin-Treated Diabetes Reduces Dysglycemia-Related Mortality in Sepsis
Patients with sepsis and a pre-existing diagnosis of insulin-treated diabetes (ITD) may show a different relationship between hospital mortality and highest glucose levels and glycemic variability in the first 24 hours than... read more
Are “Sniffer” Systems Effective in Detecting ARDS?
Acute respiratory distress syndrome (ARDS) results in substantial mortality but remains underdiagnosed in clinical practice. For this reason, automated "sniffer" systems that analyse electronic records have been developed... read more
Patient-tailored Triage Decisions by Anesthesiologist-staffed Prehospital Critical Care Teams
The primary objective was to estimate the incidence of patients in the Central Denmark Region triaged to bypass the local emergency department without being part of a predefined fast-track protocol. The secondary objective... read more
Effect of a Program Combining Transitional Care and Long-term Self-management Support on Outcomes of Hospitalized Patients With COPD
In a single-site randomized clinical trial of patients hospitalized due to Chronic obstructive pulmonary disease (COPD), a 3-month program that combined transition and long-term self-management support resulted in significantly... read more
New Sickle Cell Test Can Transform Screening
Sickle cell disease is common throughout much of sub-Saharan Africa. It affects up to 3% of births in some areas and is associated with very high mortality. Many cases go undiagnosed in regions where there are few resources,... read more
Seeing the Present Through the Past
As an MD-PhD candidate, now in the second year of a history of medicine PhD, I often reflect on the role of history in the medical school classroom and at the bedside. Medical history is a useful way to understand the roots... read more
The combination of procalcitonin and C-reactive protein or presepsin alone improves the accuracy of diagnosis of neonatal sepsis
The combination of PCT and CRP or presepsin alone improves the accuracy of diagnosis of neonatal sepsis. However, further studies are required to confirm these findings. A total of 28 studies enrolling 2661 patients were... read more
PET-CT in Critically Ill Patients: Diagnosing the Unsuspected
PET-CT precisely detected the deep foci of infection about 48 hours prior to the diagnosis of sepsis. The cases reports suggested the use of this image technique in ICU for patients with sepsis of unknown origin. We admitted... read more
Shared Decision Making – The Importance of Diagnosing Preferences
Shared decision making occurs when patients and clinicians reach a formulation about the presenting problem and discuss how to manage it. If there are several reasonable alternatives, the alternatives should be explicitly... read more
Implementing a bedside assessment of respiratory mechanics in patients with ARDS
Implementing a systematic respiratory mechanics test leads to frequent individual adaptations of ventilator settings and allows improvement in oxygenation indexes and reduction of the risk of overdistention at the same time.... read more
Policies That Limit Emergency Department Visits and Reimbursements Undermine the Emergency Care System
Emergency department (ED) visit rates in the United States have been rising over the past 2 decades, outpacing population growth.1 These visits are portrayed in the lay press as unnecessary visits that must be reduced or... read more
The Dreaded Acute Compartment Syndrome
When obtaining intracompartmental pressures, place the catheter within 5cm of the fracture level, with the transducer secured at the level of the measured compartment. Make sure to keep the catheter tip outside of the actual... read more
We Should Avoid the Term “Fluid Overload”
Using the right word or phrase to describe a specific pathologic process/patient diagnosis and/or status is important, not only within the intensive care unit team, but also when we communicate with external consultants.... read more
Sepsis: Learn the Signs and Document
Writing in the MJA, researchers have reported the findings of a prospective cohort study comparing estimates of the incidence and mortality of sepsis using clinical diagnosis or the Australian and New Zealand Intensive Care... read more
