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Breast Surgery

Monday 13 October 2008

Translating and Implementing Evidence-Based Care in the ICU: It's Time to Value Family Communication.

Chest. 2008 Oct;134(4):676-8.
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Mularski RA.

Readmission to a surgical intensive care unit : incidence , outcome , and risk factors

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Axel Kaben ; Fabiano Correa ; Konrad Reinhart ; Utz Settmacher ; Jan Gummert ; Rolf Kalff and Yasser Sakr
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Page: R123 Vol/Issue: 2008 ; VOL 12 Date: 2008-06-18
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A Personal Reflection : Critical Care Family Communication

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Lilly , M .
EBSCO ( CINAHL with Full Text ) - via Athens (01/2001 - 08/2007)
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Page: 213-217 Vol/Issue: 2008 ; VOL 27 ; PART 5
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An Overview of Sepsis

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Latto , C .
EBSCO ( CINAHL with Full Text ) - via Athens (01/2001 - 08/2007)
Proquest NHS (01/1998 - 07/2002)
Page: 195-200 Vol/Issue: 2008 ; VOL 27 ; PART 5
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Journal of Advanced Nursing

October 2008, Volume 64, Issue 1
14–15
Hand washing for preventing diarrhoea
Yifan Xue, MBBS MPH

16–17
Role of MRSA reservoirs in the acute care setting
Yifan Xue, MBBS MPH

49–59
Diversity, attrition and transition into nursing
Jon Mulholland; Elizabeth N. Anionwu; Richard Atkins; Mike Tappern; Peter J. Franks

A new language of natriuretic peptides in sepsis ?

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Hoffmann , U . ; Brueckmann , M .
Ovid ( Journals @ Ovid ) via Athens Full Text (01/1995 - /)
Page: 2686-2687 Vol/Issue: 2008 ; VOL 36 ; PART 9
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Purpose of review: B-type natriuretic peptides are quantitative markers of heart failure (and/or cardiac stress) that summarize the extent of systolic and diastolic left ventricular dysfunction, valvular dysfunction, and right ventricular dysfunction. Based on the observation that heart failure is common albeit difficult to diagnose in the ICU, several studies have begun to evaluate the potential use of B-type natriuretic peptides in various ICU settings.

Recent findings: Previous pilot studies have examined the use of B-type natriuretic peptide in the differential diagnosis of hypoxemic respiratory failure, to differentiate cardiogenic from noncardiogenic shocks or to predict fluid responsiveness, to assess myocardial dysfunction and prognosis in patients with severe sepsis, and to predict ventilatory weaning failure.
Summary: Although previous studies were small, they highlight the potential of using B-type natriuretic peptides as a noninvasive easily available tool to quantify cardiac stress.
(C) 2008 Lippincott Williams & Wilkins, Inc.

Emotional outcome after intensive care: literature review

REVIEW PAPER
2–13
Emotional outcome after intensive care: literature review
Janice E. Rattray; Alastair M. Hull

End-of-Life Communication and Adjustment: Pre-Loss Communication as a Predictor of Bereavement-Related Outcomes.

Record: 1
End-of-Life Communication and Adjustment: Pre-Loss Communication as a Predictor of Bereavement-Related Outcomes.
Authors: Metzger, Patricia L.Gray, Matt J.
Source: Death Studies; Apr2008, Vol. 32 Issue 4, p301-325, 25p, 6 charts, 1 graph
Document Type: Article
Abstract: Although bereavement-related emotional distress usually remits on its own over time, approximately 20% of bereaved individuals experience chronic emotional difficulties following the loss (Prigerson & Jacobs, 2001). Although several factors have been shown to be associated with poor outcomes post-loss, few studies have examined the relationship between pre-loss communication and bereavement-related depression, and none have examined its relationship to complicated grief. The present study examined how pre-loss communication between the bereaved and the deceased is related to post-loss outcomes within a sample of 60 members of online bereavement support groups. Results indicated that developing acceptance of an expected loss is strongly associated with bereavement outcomes. This finding persists even after controlling for relationship closeness and time elapsed post-loss. [ABSTRACT FROM AUTHOR]
Copyright of Death Studies is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts)
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Record: 2
Influence of physicians' life stances on attitudes to end-of-life decisions and actual end-of-life decision-making in six countries.
Authors: Cohen, J.Van Delden, J.Mortier, F.Löfmark, R.Norup, M.Cartwright, C.Faisst, K.Canova, C.0nwuteaka-Philipsen, B.Bilsen, J.
Source: Journal of Medical Ethics; Apr2008, Vol. 34 Issue 4, p247-253, 7p, 5 charts

Abstract:
Aim: To examine how physicians' life stances affect their attitudes to end-of-life decisions and their actual end-of-life decision-making. Methods: Practising physicians from various specialties involved in the care of dying patients in Belgium, Denmark, The Netherlands, Sweden, Switzerland and Australia received structured questionnaires on end-of-life care, which included questions about their life stance. Response rates ranged from 53% in Australia to 68% in Denmark. General attitudes, intended behaviour with respect to two hypothetical patients, and actual behaviour were compared between all large life-stance groups in each country. Results: Only small differences in life stance were found in all countries in general attitudes and intended and actual behaviour with regard to various end-of-life decisions. However, with regard to the administration of drugs explicitly intended to hasten the patient's death (PAD), physicians with specific religious affiliations had significantly less accepting attitudes, and less willingness to perform it, than non-religious physicians. They had also actually performed PAD less often. However, in most countries, both Catholics (up to 15.7% in The Netherlands) and Protestants (up to 20.4% in The Netherlands) reported ever having made such a decision. Discussion: The results suggest that religious teachings influence to some extent end-of-life decision-making, but are certainly not blankly accepted by physicians, especially when dealing with real patients and circumstances. Physicians seem to embrace religious belief in a non-imperative way, allowing adaptation to particular situations. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Medical Ethics is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts)
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Record: 3
MANAGING INTENTIONS: THE END-OF-LIFE ADMINISTRATION OF ANALGESICS AND SEDATIVES, AND THE POSSIBILITY OF SLOW EUTHANASIA.
Authors: DOUGLAS, CHARLESKERRIDGE, IANANKENY, RACHEL
Source: Bioethics; Sep2008, Vol. 22 Issue 7, p388-396, 9p
Document Type:

Abstract:
There has been much debate regarding the ‘double-effect’ of sedatives and analgesics administered at the end-of-life, and the possibility that health professionals using these drugs are performing ‘slow euthanasia.’ On the one hand analgesics and sedatives can do much to relieve suffering in the terminally ill. On the other hand, they can hasten death. According to a standard view, the administration of analgesics and sedatives amounts to euthanasia when the drugs are given with an intention to hasten death. In this paper we report a small qualitative study based on interviews with 8 Australian general physicians regarding their understanding of intention in the context of questions about voluntary euthanasia, assisted suicide and particularly the use of analgesic and sedative infusions (including the possibility of voluntary or non-voluntary ‘slow euthanasia’). We found a striking ambiguity and uncertainty regarding intentions amongst doctors interviewed. Some were explicit in describing a ‘grey’ area between palliation and euthanasia, or a continuum between the two. Not one of the respondents was consistent in distinguishing between a foreseen death and an intended death. A major theme was that ‘slow euthanasia’ may be more psychologically acceptable to doctors than active voluntary euthanasia by bolus injection, partly because the former would usually only result in a small loss of ‘time’ for patients already very close to death, but also because of the desirable ambiguities surrounding causation and intention when an infusion of analgesics and sedatives is used. The empirical and philosophical implications of these findings are discussed. [ABSTRACT FROM AUTHOR]
Copyright of Bioethics is the property of Blackwell Publishing Limited and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts)

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Record: 4
The potential impact of decision role and patient age on end-of-life treatment decision making.
Authors: Zikmund-Fisher, B. J.Lacey, H. P.Fagerlin, A.
Source: Journal of Medical Ethics; May2008, Vol. 34 Issue 5, p327-331, 5p, 5 charts
Document Type:

Background: Recent research demonstrates that people sometimes make different medical decisions for others than they would make for themselves. This finding is particularly relevant to end-of-life decisions, which are often made by surrogates and require a trade-off between prolonging life and maintaining quality of life. We examine the impact of decision role, patient age, decision maker age and multiple individual differences on these treatment decisions.

Methods: Participants read a scenario about a terminally ill cancer patient faced with a choice
between an aggressive chemotherapy regimen that will extend life by two years and palliative treatments to control discomfort for one remaining month. Participants were randomly assigned to one of three decision roles (patient, physician, or an abstract other) and the scenario randomly varied whether the patient was described as 25 or 65-years old. Results: When deciding for a 65-year old patient, approximately 60% of participants selected aggressive chemotherapy regardless of decision role. When deciding for a 25-year old patient, however, participants were more likely to select chemotherapy for a patient (physician role) or another person (abstract other) than for themselves (70%, 67%, and 59%, respectively). In addition, confidence that powerful others (eg, physicians) control one's health, as well as respondents' age and race, consistently predicted treatment choices. Conclusions: Patient age appears to influence medical decisions made for others but not those that we make for ourselves. These findings may help to explain the discord that often occurs when younger cancer patients refuse life-extending treatments. [ABSTRACT FROM AUTHOR]
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Presentation: CRITICAL CARE WORKSTREAM

CRITICAL CARE WORKSTREAM Diane Campbell Patient Safety Development ...
NHS Greater Glasgow & Clyde

Aim: Reduce VAP rates to 0 or 300 days between by Jan 2011 by implementing
the VAP care bundle in Intensive care. Cycle 1a: Test sedation hold element
of ...

Go to: http://www.patientsafetyalliance.scot.nhs.uk/files/Criticalcare1DianeCampbellandMalcolmDaniel.ppt?fileid=411

Noninvasive Ventilation : Principles and Pitfalls

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DeGiorgi , A . ; White , M .
Proquest NHS (10/1998 - 02/2003)
Page: 10-15 Vol/Issue: 2008 ; VOL 40 ; PART 8
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Surviving Sepsis Campaign needed consensus to exclude selective decontamination of the digestive tract

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Silvestri , L . ; van Saene , H . K . F . ; de la Cal , M . A . ; Zandstra , D . F . ; Viviani , M . ; Peric , M . ; Gullo , A .
Ovid ( Journals @ Ovid ) via Athens Full Text (01/1995 - /)
Page: 2716-2717 Vol/Issue: 2008 ; VOL 36 ; PART 9
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Sepsis - induced myocardial depression and calcium mishandling : An acceptable unifying theory ?

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Fernandes , C . J . ; Campos , A . H .
Ovid ( Journals @ Ovid ) via Athens Full Text (01/1995 - /)
Page: 2695-2696 Vol/Issue: 2008 ; VOL 36 ; PART 9
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Intensive care unit costs : To infinity and beyond or not ?

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Stockwell , D . C . ; Slonim , A . D .
Ovid ( Journals @ Ovid ) via Athens Full Text (01/1995 - /)
Page: 2676-2677 Vol/Issue: 2008 ; VOL 36 ; PART 9
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Efficacy of red blood cell transfusion in the critically ill : A systematic review of the literature

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Marik , P . E . ; Corwin , H . L .
Ovid ( Journals @ Ovid ) via Athens Full Text (01/1995 - /)
Page: 2667-2674 Vol/Issue: 2008 ; VOL 36 ; PART 9
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Influence of ventilation strategies on survival in severe controlled hemorrhagic shock

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Herff , H . ; Paal , P . ; von Goedecke , A . ; Lindner , K . H . ; Severing , A . C . ; Wenzel , V .
Ovid ( Journals @ Ovid ) via Athens Full Text (01/1995 - /)
Page: 2613-2620 Vol/Issue: 2008 ; VOL 36 ; PART 9
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Malaria and bacterial sepsis : Similar mechanisms of endothelial apoptosis and its prevention in vitro

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Hemmer , C . J . ; Vogt , A . ; Unverricht , M . ; Krause , R . ; Lademann , M . ; Reisinger , E . C .
Ovid ( Journals @ Ovid ) via Athens Full Text (01/1995 - /)
Page: 2562-2568 Vol/Issue: 2008 ; VOL 36 ; PART 9
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The effect of tracheostomy timing during critical illness on long - term survival

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Scales , D . C . ; Thiruchelvam , D . ; Kiss , A . ; Redelmeier , D . A .
Ovid ( Journals @ Ovid ) via Athens Full Text (01/1995 - /)
Page: 2547-2557 Vol/Issue: 2008 ; VOL 36 ; PART 9
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Increased mortality of ventilated patients with endotracheal Pseudomonas aeruginosa without clinical signs of infection

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Zhuo , H . ; Yang , K . ; Lynch , S . V . ; Dotson , R . H . ; Glidden , D . V . ; Singh , G . ; Webb , W . R . ; Elicker , B . M . ; Garcia , O . ; Brown , R .
Ovid ( Journals @ Ovid ) via Athens Full Text (01/1995 - /)
Page: 2495-2503 Vol/Issue: 2008 ; VOL 36 ; PART 9
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Synthetic blood products : science fiction or coming to an ICU near you ?

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Holley , A . D .
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Page: 253-256 Vol/Issue: 2008 ; VOL 10 ; PART 3
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Elective fresh frozen plasma in the critically ill : what is the evidence ?
Verghese , S . G .
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Page: 264-268 Vol/Issue: 2008 ; VOL 10 ; PART 3
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Takotsubo cardiomyopathy associated with sepsis due to Streptococcus pneumoniae pneumonia

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Geng , S . ; Mullany , D . ; Fraser , J . F .
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Implementation and outcomes of a severe sepsis protocol in an Australian tertiary hospital

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Orford , N . R . ; Faulkner , C . ; Flintoff , W . ; Eddey , D . ; Lamb - Jenkins , J . ; Henry , M . ; Corke , C . ; Stow , P . ; Green , D .
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Can ICU stay be predicted accurately enough for fast - tracking cardiac surgical patients ?

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Salamonsen , M . R . ; Bailey , M . J . ; Salamonsen , R . F .
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Prospective observational study of levosimendan and weaning of difficult - to - wean ventilator - dependent intensive care patients

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Sterba , M . ; Banerjee , A . ; Mudaliar , Y .
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Which inotropic agent is best for intensive care patients ?

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Bellomo , R .

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Asthma , Atopy , and Airway Inflammation : What Does It Mean in Practice ?

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Saglani , S . ; Bush , A .
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Intensive care for the adult population in Ireland : a multicentre study of intensive care population demographics

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The Irish Critical Care Trials Group
BioMed Central PDF Abstract
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Entropy and Bispectral Index for the assessment of sedation analgesia and effects of unpleasant stimuli in critically ill patients an observational st

Matthias Haenggi ; Heidi Ypparila - Wolters ; Christine Bieri ; Carola Steiner ; Jukka Takala ; Ilkka Korhonen and Stephan M Jakob
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Pressure support ventilation attenuates ventilator induced protein modifications in the diaphragm

Emmanuel Futier ; Jean - Michel Constantin ; Lydie Combaret ; Laurent Mosoni ; Laurence Roszyk ; Vincent Sapin ; Didier Attaix ; Boris Jung ; Samir Jaber and Jean - etienne Bazin
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Influence of enrollment sequence effect on observed outcomes in the ADDRESS and PROWESS studies of drotrecogin alfa activated in patients with severe

Pierre - Francois Laterre ; William L Macias ; Jonathan Janes ; Mark D Williams ; David R Nelson ; Amand RJ Girbes ; Jean Francois Dhainaut and Edward Abraham
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Anion Gap Corrected for Albumin and Base Deficit Fail to Accurately Diagnose Clinically Significant Hyperlactatemia in Critically Ill Patients

Emmett , Michael
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Methicillin Resistant Staphylococcus aureus Infection With Intermediate Sensitivity to Vancomycin A Case Report and Literature Review

Schairer , Jason ; Sankri - Tarbichi , Abdul ; Fairfax , Marilynn ; Salimnia , Hossein ; Guzman , Jorge
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Argatroban Anticoagulation in Intensive Care Patients Effects of Heart Failure and Multiple Organ System Failure

Begelman , Susan ; Baghdasarian , Sarkis ; Singh , Inder ; Militello , Michael ; Hursting , Marcie ; Bartholomew , John
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Analytical Review Anemia of Inflammation in Critically Ill Patients

Sihler , Kristen ; Napolitano , Lena
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Emergency nurses require end of life care training

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Contribution of acquired meticillin-resistant Staphylococcus aureus bacteraemia to overall mortality in a general intensive care unit.

Thompson DS, Workman R, Strutt M.
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J Hosp Infect. 2008 Sep 15;
[Epub ahead of print] PMID: 18799233 [PubMed - as supplied by publisher]