Home hospitalization for palliative cancer care: factors associated with unplanned hospital admissions and death in hospital.

Background: Home hospitalization at the end of life can sometimes be perturbed by unplanned hospital admissions (UHAs, defined as any admission that is not part of a preplanned care procedure), which increase the likelihood of death in hospital. The objectives were to describe the occurrence and causes of UHAs in cancer patients receiving end-of-life care at home, and to identify factors associated with UHAs and death in hospital.

Methods: A retrospective, single-center study (performed at a regional cancer center in the city of Lille, northern France) of advanced cancer patients discharged to home hospitalization between January 2014 and December 2017.

Factors Associated with Alzheimer's Disease: An Overview of Reviews.

Alzheimer's disease (AD) is a frequent pathology, with a poor prognosis, for which no curative treatment is available in 2018. AD prevention is an important issue, and is an important research topic. In this manuscript, we have synthesized the literature reviews and meta-analyses relating to modifiable risk factors associated with AD.

A prospective, randomized, study comparing early percutaneous dilational tracheotomy to prolonged translaryngeal intubation (delayed tracheotomy) in critically ill medical patients.

Objective: The timing of tracheotomy in patients requiring mechanical ventilation is unknown. The effects of early percutaneous dilational tracheotomy compared with delayed tracheotomy in critically ill medical patients needing prolonged mechanical ventilation were assessed.

Design: Prospective, randomized study.

Posterior tracheal wall perforation during percutaneous dilational tracheostomy: an investigation into its mechanism and prevention.

Objectives: Part 1: To describe the complication of posterior tracheal wall injury and perforation associated with the percutaneous dilational tracheostomy (PDT). Part 2: To determine the mechanism of posterior tracheal wall injury during PDT.

Design: Prospective observational study.

Safety of thoracentesis in mechanically ventilated patients.

As practicing intensivists, we frequently diagnose pleural effusions in mechanically ventilated patients and routinely perform thoracentesis even when the patient is on positive end-expiratory pressure (PEEP). In light of a recent report, we have reviewed our experience. It is of interest that all thoracenteses were performed with patients in the lateral decubitus position.

Comparative clinical trial of standard operative tracheostomy with percutaneous tracheostomy.

Objective: To compare percutaneous tracheostomy with conventional operative tracheostomy.

Design: Randomized clinical trial.

Setting: The medical and surgical critical care units of a large, tertiary-care, private hospital.

Bedside percutaneous tracheostomy: experience with 55 elective procedures.

Over a 24-month period, tracheostomy was performed in 55 patients using a percutaneous, wire-guided, dilatational technique. All such procedures were undertaken at the patient's bedside in the intensive care unit, with the patient under local anesthesia and mechanically ventilated through an oral endotracheal tube. A variety of wire-guides, dilators, and tracheal tubes were used as experience and proficiency were gained with the approach, and eventually, a simple modification of a standard low-pressure cuffed endotracheal tube was found to facilitate the procedure.

Flail chest injury in a patient with surgical absence of the sternum.

Although pulmonary disability is usually minimal following total sternectomy, the potential for remote complications exists. We present a case of severe respiratory failure resulting from simple rib fractures occurring two years after sternectomy for sternal osteomyelitis. Respiratory failure resulted from flail chest due to the combination of acute rib fracture and the lack of anterior fixation of the thoracic cage.

Verapamil in multifocal atrial tachycardia. Hemodynamic and respiratory changes.

The hemodynamic and gas exchange alterations resulting from treatment of multifocal atrial tachycardia (MAT) with intravenous verapamil were monitored in 13 critically ill patients. Administration of verapamil (mean dose 12.9 +/- 1.

Treatment of multifocal atrial tachycardia with metoprolol.

We used metoprolol orally or iv in 25 patients with multifocal atrial tachycardia that was complicating severe cardiopulmonary illness, and we observed its effect on heart rate and rhythm, BP, and arterial blood gases. All patients showed a dramatic slowing of heart rate, averaging 54.0 +/- 4.

Calculation of sodium bicarbonate requirement in metabolic acidosis.

Despite the host of complications which may be associated with intravenous sodium bicarbonate infusion, the use of this agent is a frequent necessity in patients with metabolic acidosis. No satisfactory formula for calculating bicarbonate dose had previously been described, although such an approach might be expected to reduce the incidence of these complications. The authors have devised a simple formula for bedside calculation of bicarbonate requirement in metabolic acidosis, designed to elevate th pH to the region about 7.

Transvenous cardiac pacing in cardiopulmonary resuscitation.

Despite widespread application of cardiac pacing to a wide variety of circumstances with minimal morbidity are remarkable success, the possible role of transvenous pacing in the acute setting of cardiac resuscitation has not been adequately evaluated. The authors report their experience with the use of transvenous pacemakers in 26 patients undergoing cardiopulmonary resuscitation (CPR). Although electrical activity was induced by pacing in nearly one-third of those whose primary disturbance was asystole, electromechanical dissociation followed and survival was not improved.