The objective of this study was to evaluate the use of social media among healthcare workers in an attempt to identify how it affects the quality of patient care.
An anonymous survey of 35 questions ...was conducted in South Texas, on 366 healthcare workers. Of the 97% of people who reported owning electronic devices, 87.9% indicated that they used social media. These healthcare workers indicated that they spent approximately 1 h on social media every day. The healthcare workers below the age of 40 were more involved in social media compared to those above 40 (p < 0.05). The use of social media among physicians and nurses was noted to be identical (88% for each group), and both groups encouraged their patients to research their clinical conditions on social media (p < 0.05). A higher number of physicians reported awareness of a social media policy in their hospital compared to nurses (p < 0.05). However, a large proportion of healthcare workers (40%) were unaware of their workplace policy, which could potentially cause a privacy breach of confidential medical information. Further studies are required to evaluate specific effects of these findings on the quality of patient care.
Morbid obesity is a highly serious condition that significantly impairs health worldwide. This is especially prominent during the COVID-19 pandemic, as lockdowns and reduced physical activity ...contributed to the problem. Overweight and obese adults are at a higher risk of various acute and chronic medical conditions, including hypertension, heart disease, diabetes, respiratory problems, certain cancers, gout, and arthritis. While some individuals may have higher muscle or bone mass accounting for excess weight, the majority of those exceeding 20% of their ideal body weight have excessive fat. Disturbingly, obesity rates in the USA have been progressively increasing since the first survey conducted in 1960. Recent data shows that obesity prevalence in the USA is three times higher than in France and one-and-a-half times higher than in England. Given the widespread nature of obesity and its association with numerous diseases, it is not surprising that many obese patients require treatment in the intensive care unit (ICU).
Extreme obesity in the ICU Varon, Joseph; Husaini, Najia
World nutrition journal,
10/2022, Letnik:
6, Številka:
S1
Journal Article
Recenzirano
Odprti dostop
Morbid obesity remains an extremely serious disorder resulting in significant impairment of health all over the World. This is particularly true especially now in the setting of lockdowns and people ...not exercising due to the recent COVID-19 pandemic. In general, overweight and obese adults are at in increased risk of morbidity and mortality from many acute and chronic medical conditions, including hypertension, dyslipidemia, coronary heart disease, diabetes mellitus, gallbladder disease, respiratory disease, some types of cancer, gout and arthritis. Although body weight that exceeds ideal standards as determined by age, sex and height may be accounted for by a greater muscle mass or bone mass, the majority of individuals who weigh more than 20% over their calculated ideal body weight (IBW) have excessive adipose mass. What is even more alarming is the fact that the incidence of obesity in the USA has increased progressively since 1960, when the first survey was conducted. More recent data has demonstrated that the prevalence of obesity is three times higher in the USA than France, and one-and-a-half times that of England. As obesity is such a pervasive disorder in our society, and because obesity is an important risk factor for many diseases, it is not surprising that many obese patients are treated in the intensive care unit (ICU).
Extended work hours, interrupted sleep, and shift work are integral parts of medical training among all specialties. The need for 24-hour patient care coverage and economic factors have resulted in ...prolonged work hours for resident physicians. This has traditionally been thought to enhance medical educational experience. These long and erratic work hours lead to acute and chronic sleep deprivation and poor sleep quality, resulting in numerous adverse consequences. Impairments may occur in several domains, including attention, cognition, motor skills, and mood. Resident performance, professionalism, safety, and well-being are affected by sleep deprivation, causing potentially adverse implications for patient care. Studies have shown adverse health consequences, motor vehicle accidents, increased alcohol and medication use, and serious medical errors to occur in association with both sleep deprivation and shift work. Resident work hour limitations have been mandated by the Accreditation Council for Graduate Medical Education in response to patient safety concerns. Studies evaluating the impact of these regulations on resident physicians have generated conflicting reports on patient outcomes, demonstrating only a modest increase in sleep duration for resident physicians, along with negative perceptions regarding their education. This literature review summarizes research on the effects of sleep deprivation and shift work, and examines current literature on the impact of recent work hour limitations on resident physicians and patient-related outcomes.
Perioperative hypertension management Varon, Joseph; Marik, Paul E
Vascular health and risk management,
06/2008, Letnik:
4, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Perioperative hypertension is commonly encountered in patients that undergo surgery. While attempts have been made to standardize the method to characterize the intraoperative hemodynamics, these ...methods still vary widely. In addition, there is a lack of consensus concerning treatment thresholds and appropriate therapeutic targets, making absolute recommendations about treatment difficult. Nevertheless, perioperative hypertension requires careful management. When treatment is necessary, therapy should be individualized for the patient. This paper reviews the pharmacologic agents and strategies commonly used in the management of perioperative hypertension.
Coagulopathy is common in patients with COVID-19. The ideal approach to anticoagulation remains under debate. There is a significant variability in existing protocols for anticoagulation, and these ...are mostly based on sporadic reports, small studies, and expert opinion.
This multicenter retrospective cohort study evaluated the association between anticoagulation dose and inpatient mortality among critically ill COVID-19 patients admitted to the intensive care units (ICUs) or step-down units (SDUs) of eight Beaumont Healthcare hospitals in Michigan, USA from March 10th to April 15th, 2020.
Included were 578 patients with a median age of 64 years; among whom, 57.8% were males. Most patients (n = 447, 77.3%) received high dose and one in four (n = 131, 22.7%) received low dose anticoagulation. Overall mortality rate was 41.9% (n = 242). After adjusting for potential confounders (age, sex, race, BMI, ferritin level at hospital admission, intubation, comorbidities, mSOFA, and Padua score), administration of high anticoagulation doses at the time of ICU/SDU admission was associated with decreased inpatient mortality (OR 0.564, 95% CI 0.333-0.953, p = 0.032) compared to low dose.
Treatment with high dose anticoagulation at the time of ICU/SDU admission was associated with decreased adjusted mortality among critically ill adult patients with COVID-19.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background The relationship between computed tomography (CT) and prognosis of patients with COVID-19 pneumonia remains unclear. We hypothesized that the Ichikado CT score, obtained in the first 24 h ...of hospital admission, is an independent predictor for all-cause mortality during hospitalization in patients with COVID-19 pneumonia. Methods Single-center retrospective cohort study of patients with confirmed COVID-19 pneumonia admitted at our institution between March 20th, 2020 and October 31st, 2020. Patients were enrolled if, within 24 h of admission, a chest CT scan, an arterial blood gas, a complete blood count, and a basic metabolic panel were performed. Two independent radiologists, who were blinded to clinical data, retrospectively evaluated the chest CT scans following a previously described qualitative and quantitative CT scoring system. The primary outcome was all-cause in-hospital mortality or survival to hospital discharge. Secondary outcomes were new requirements for invasive mechanical ventilation and hospital length of stay. Cox regression models were used to test the association between potential independent predictors and all-cause mortality. Results Two hundred thirty-five patients, 197 survivors and 38 nonsurvivors, were studied. The median Ichikado CT score for nonsurvivors was significantly higher than survivors (P < 0.001). An Ichikado CT score of more than 172 enabled prediction of mortality, with a sensitivity of 84.2% and a specificity of 79.7%. Multivariate analysis identified Ichikado CT score (HR, 7.772; 95% CI, 3.164-19.095; P < 0.001), together with age (HR, 1.030; 95% CI, 1.030-1.060; P = 0.043), as independent predictors of all-cause in-hospital mortality. Conclusions Ichikado CT score is an independent predictor of both requiring invasive mechanical ventilation and all-cause mortality in patients hospitalized with COVID-19 pneumonia. Further prospective evaluation is necessary to confirm these findings. Trial registration: The WCG institutional review board approved this retrospective study and patient consent was waived due to its non-interventional nature (Identifier: 20210799). Keywords: Coronavirus disease 2019, COVID-19, CT score, Ichikado CT score, COVID-19 prognostic factor, Tomography
The author found that, in those animals that were allocated to receive Shenfu injections, a variety of inflammatory markers, such as the levels of tumor necrosis factor α and interleukin 10, ...decreased in a dose-dependent manner. ...more important, is if Western clinicians are ready to implement Shenfu in their daily practice of emergency medicine when confronted with patients with sepsis.
Pulmonary complications of hepatic diseases Surani, Salim R; Mendez, Yamely; Anjum, Humayun ...
World journal of gastroenterology,
07/2016, Letnik:
22, Številka:
26
Journal Article
Odprti dostop
Severe chronic liver disease(CLD) may result from portal hypertension, hepatocellular failure or the combination of both. Some of these patients may develop pulmonary complications independent from ...any pulmonary pathology that they may have. Among them the hepatopulmonary syndrome(HPS), portopulmonary hypertension(PPH) and hepatic hydrothorax(HH) are described in detail in this literature review. HPS is encountered in approximately 15% to 30% of the patients and its presence is associated with increase in mortality and also requires liver transplantation in many cases. PPH has been reported among 4%-8% of the patient with CLD who have undergone liver transplantation. The HH is another entity, which has the prevalence rate of 5% to 6% and is associated in the absence of cardiopulmonary disease. These clinical syndromes occur in similar pathophysiologic environments. Most treatment modalities work as temporizing measures. The ultimate treatment of choice is liver transplant. This clinical review provides basic concepts; pathophysiology and clinical presentation that will allow the clinician to better understand these potentially life-threatening complications. This article will review up-to-date information on the pathophysiology, clinical features and the treatment of the pulmonary complications among liver disease patients.
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