Articles: function.
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Observational Study
Re-admission to Level 2 unit after hip-fracture surgery - Risk factors, reasons and outcome.
Hip fractures are common geriatric fractures with increasing incidence. Treatment of these fractures is still associated with high rates of complications and poor outcome. Data concerning unexpected re-admission to a Level 2 unit after an initial inconspicuous postoperative course are limited. We aimed to identify causes and associated risk factors for admission as well as impact of re-admission on acute care and short-term outcome. ⋯ Unexpected admission to the Level 2 unit in the post-surgical period is a frequent phenomenon in geriatric hip-fracture patients. Males and femoral neck fracture patients seem to be especially endangered. Although the majority of reasons for admissions were not immediately life-threatening illnesses, they had a substantial negative impact on patients' outcome. This emphasises the importance of careful handling of this frail patient population.
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Physicians are constantly navigating the overwhelming body of medical literature available on the Internet. Although early citation managers were capable of limited searching of index databases and tedious bibliography production, modern versions of citation managers such as EndNote, Zotero, and Mendeley are powerful web-based tools for searching, organizing, and sharing medical literature. ⋯ In addition to easily creating manuscript bibliographies, various citation managers allow physicians to readily access medical literature, share references for teaching purposes, collaborate with colleagues, and even participate in social networking. If physicians are willing to invest the time to familiarize themselves with modern citation managers, they will reap great benefits in the future.
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Curr Opin Crit Care · Dec 2013
ReviewCauses and consequences of disproportionate care in intensive care medicine.
Increased use of advanced life-sustaining measures in patients with poor long-term expectations secondary to more chronic organ dysfunctions, comorbidities and/or a poor quality of life has become a worrying trend over the last decade. This can lead to futile, disproportionate or inappropriate care in the ICU. This review summarizes the causes and consequences of disproportionate care in the ICU. ⋯ Disproportionate care is common in western ICUs. It can lead to violation of basic bioethical principles, suffering of patients and relatives and compassion fatigue and moral distress in healthcare providers. Avoiding inappropriate use of ICU resources and disproportionate care in the ICU should have high priority for ICU managers but also for every healthcare provider taking care of patients at the bedside.
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We present 2 cases of patients with septic shock and discuss changes in B-type natriuretic peptide (BNP) levels. While previous increases in BNP in septic shock were attributed to the accompanying myocardial depression, recent work claims that high levels of BNP in sepsis are related to an alteration in the BNP clearance pathway. We postulate from these cases that increased BNP should not automatically be associated with cardiac dysfunction and may assist in an early, difficult diagnosis of septic shock.
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Arch Phys Med Rehabil · Nov 2013
Randomized Controlled Trial Comparative StudyMuscle energy technique versus corticosteroid injection for management of chronic lateral epicondylitis: randomized controlled trial with 1-year follow-up.
To determine the short- and long-term effectiveness of the muscle energy technique (MET) compared with corticosteroid injections (CSIs) for chronic lateral epicondylitis (LE). ⋯ This study showed that while both MET and CSI improved measures of strength, pain, and function compared with baseline, subjects receiving MET had better scores at 52 weeks for PFGS and the VAS for pain. We conclude that MET appears to be an effective intervention in the treatment of LE.