Database : MEDLINE
Search on : Diabetic and Coma [Words]
References found : 2744 [refine]
Displaying: 1 .. 10   in format [Detailed]

page 1 of 275 go to page                         

  1 / 2744 MEDLINE  
              next record last record
select
to print
Photocopy
Full text

[PMID]: 29486630
[Au] Autor:Rougerie M; Czuzoj-Shulman N; Abenhaim HA
[Ad] Address:a Department of Obstetrics and Gynecology , Jewish General Hospital, McGill University , Montreal , Canada.
[Ti] Title:Diabetic ketoacidosis among pregnant and non-pregnant women: a comparison of morbidity and mortality.
[So] Source:J Matern Fetal Neonatal Med;:1-4, 2018 Feb 27.
[Is] ISSN:1476-4954
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:PURPOSE: Diabetic ketoacidosis (DKA) is a critical diagnosis that can cause severe morbidity and mortality in the diabetic population. Although it is rare in pregnancy, the aim of this study is to compare DKA in pregnant women with age-matched non-pregnant women to determine if outcomes are influenced by pregnancy. MATERIALS AND METHODS: A population-based age-matched retrospective cohort was carried out using data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from 1999 to 2013. Pregnant patients with DKA were age-matched with non-pregnant controls also admitted with DKA at a ratio of 1:10. Severe morbidities and mortality were compared among the two groups. Logistic regression was used to adjust for baseline characteristics and comorbidities. RESULTS: We identified 4661 cases of DKA in pregnancy during our study period, which were age-matched to 46,610 non-pregnant controls. Pregnant women with DKA were more likely to stay in hospital for >3 d (odds ratios (OR) 2.15, 95% CI 2.06-2.25) and had more associated renal failure (OR 2.86, 95% CI 1.76-4.55); however, they were less likely to require ventilation (OR 0.70, 95% CI 0.62-0.79), experience systemic inflammatory response syndrome (OR 0.53, 95% CI 0.38-0.73), or seizures (OR 0.49, 95% CI 0.42-0.57). Among pregnant women, rates of coma (0.04%) and death (0.17%, OR 0.23, 95% CI 0.14-0.39) were lower than previously reported and lower than non-pregnant women. CONCLUSION: Pregnant women with DKA are admitted to hospital for longer periods than non-pregnant controls and are at higher risk for renal failure but otherwise have better outcomes and less mortality than non-pregnant controls.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[St] Status:Publisher
[do] DOI:10.1080/14767058.2018.1443071

  2 / 2744 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 29484801
[Au] Autor:Çatli G; Anik A; Acar S; Küme T; Karabulut M; Çalan ÖG; Dündar BN; Abaci A
[Ad] Address:Department of Pediatric Endocrinology, Izmir Katip Celebi University, Faculty of Medicine, Izmir, Turkey.
[Ti] Title:Brain Injury Markers: S100 calcium-binding protein B, Neuron-Specific Enolase and Glial Fibrillary Acidic Protein in Children with Diabetic Ketoacidosis.
[So] Source:Pediatr Diabetes;, 2018 Feb 27.
[Is] ISSN:1399-5448
[Cp] Country of publication:Denmark
[La] Language:eng
[Ab] Abstract:AIM: To investigate serum levels of brain injury markers in diabetic ketoacidosis (DKA) and the relation of these markers with clinical and radiological findings of brain injury and laboratory results. METHODS: Twenty-nine patients with DKA, 30 with type 1 diabetes mellitus (T1DM), and 35 healthy children were included. Clinical and laboratory findings, and the Glasgow Coma Scale (GCS) were recorded. In the DKA group, Neuron-Specific Enolase (NSE), S100 calcium-binding protein B (S100B) and Glial Fibrillary Acidic Protein (GFAP) levels were measured at baseline and 6 and 12 hours after treatment. Magnetic resonance imaging was performed in the DKA group to demonstrate any brain injury. RESULTS: No clinical or radiological findings of brain injury were found in any of the patients with DKA. In the DKA group, S100B was significantly higher than the healthy control and T1DM groups, while GFAP and NSE levels were not different from controls and T1DM patients. No significant differences were found in GFAP, NSE and S100B levels according to severity of DKA, diabetes duration and GCS. CONCLUSION: NSE and GFAP levels do not increase in DKA patients without overt brain injury. Elevated levels of S100B, which is also synthesized from non-neuronal tissues, might arise from peripheral sources. A lack of concurrent increase in serum levels of these brain injury markers might result from the yet intact blood brain barrier or a true absence of neuronal damage. In order to reveal subclinical brain injury related to DKA, there is a need for studies concurrently assessing neurocognitive functions.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[St] Status:Publisher
[do] DOI:10.1111/pedi.12667

  3 / 2744 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 29396187
[Au] Autor:Wargny M; Gallini A; Hanaire H; Nourhashemi F; Andrieu S; Gardette V
[Ad] Address:Department of Epidemiology, University Hospital of Toulouse, Toulouse, France; INSERM, UMR 1027 Epidemiology and Analyses in Public Health, Toulouse, France; Clinical Investigation Center, Departement of Diabetology, Metabolic diseases and Nutrition, University Hospital of Nantes, Nantes, France. El
[Ti] Title:Diabetes Care and Dementia Among Older Adults: A Nationwide 3-Year Longitudinal Study.
[So] Source:J Am Med Dir Assoc;, 2018 Jan 25.
[Is] ISSN:1538-9375
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVES: To compare diabetes monitoring and the incidence of acute diabetic complications between patients with and without incident Alzheimer's Disease and Related Syndromes (ADRS). DESIGN: Longitudinal observational study from 2010 to 2014. SETTING: Data from the French national health system database. PARTICIPANTS: The France-Démence cohort: individuals aged 65 years or older suffering from incident ADRS, based on long-term disease registry, hospitalization for dementia, or antidementia drug delivery. They were matched (1:1) to a pair free of ADRS on age, sex, residence area, and insurance scheme. This study included France-Démence population with known diabetes for at least 2 years. MEASUREMENTS: Data related to diabetes control and complications: biological monitoring such as glycated hemoglobin A (HbA , ≥1/y, ≥2/y), lipid profile, microalbuminuria; eye examination; hospitalization for diabetes-related complications such as coma with ketoacidosis; and hospitalization for hypoglycemia were studied between the year prior to ADRS identification (Y ) and the 2 following years (Y ; Y ). Incidences between the 2 groups (ADRS/non-ADRS) were compared using age-standardized incidence ratios (SIR). RESULTS: The studied population included 87,816 individuals. HbA1c determination was less frequent in ADRS group, no matter the study period and the minimal annual threshold used. Respectively, 82.6% and 88.5% of ADRS and non-ADRS group had at least 1 HbA testing during Y [SIR = 0.94, 95% confidence interval (CI) 0.93-0.95], 73.4% and 89.0% during Y (SIR = 0.83, 95% CI 0.82-0.84), and 75.4% and 89.3% during Y (SIR = 0.85, 95% CI 0.83‒0.86). Subjects with ADRS were also consistently more hospitalized than non-ADRS peers. The gap was maximal in the year following the diagnosis, as observed for hospitalizations for any cause related to diabetes (SIR Y : 2.04, Y : 3.14, Y : 1.67), diabetes mellitus with coma (SIR Y : 3.84, Y : 9.30, Y : 3.06), and hypoglycemia (SIR Y : 4.20, Y : 5.25, Y : 2.27). CONCLUSIONS: Incident ADRS is associated with a less frequent diabetes monitoring and an increased risk of diabetes complications compared with older people without ADRS. Our study questions healthcare quality offered to participants with ADRS in comorbidity control. Further investigations are required to explain the mechanisms underlying our results and to propose actions to improve care of patients with ADRS.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180203
[Lr] Last revision date:180203
[St] Status:Publisher

  4 / 2744 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 29393753
[Au] Autor:Ramos-Estebanez C; Kohen M; Pace J; Bozorgi A; Manjila S; Alambyan V; Nwankwo I; DeGeorgia M; Bambakidis NC; Orge F
[Ad] Address:Neurological Institute, and.
[Ti] Title:Bedside optical coherence tomography for Terson's syndrome screening in acute subarachnoid hemorrhage: a pilot study.
[So] Source:J Neurosurg;:1-8, 2018 Feb 02.
[Is] ISSN:1933-0693
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE Approximately 10% of patients with subarachnoid hemorrhage (SAH) become permanently, legally blind. The average cost of lifetime support and unpaid taxes for each blind person amounts to approximately $900,000. This study evaluates the feasibility and potential role of bedside optical coherence tomography (OCT) in Terson's syndrome (TS) in patients with acute SAH (aSAH) and its potential role in blindness prevention. METHODS The authors conducted an open-label pilot study, in which 31 patients with an angiographic diagnosis of aSAH were first screened for TS with dilated funduscopy and then with OCT in the acute phase and at 6-week follow-up visits. Outpatient mood assessments (Patient Health Questionnaire-depression module, Hamilton Depression Scale), and quality of life general (NIH Patient-Reported Outcomes Measurement Information System) and visual scales (25-item National Eye Institute Visual Functioning Questionnaire) were measured at 1 and 6 weeks after discharge. Exclusion criteria included current or previous history of severe cataracts, severe diabetic retinopathy, severe macular degeneration, or glaucoma. RESULTS OCT identified 7 patients with TS, i.e., a 22.6% incidence in our aSAH sample: 7 in the acute phase, including a large retinal detachment that was initially missed by funduscopy and diagnosed by OCT in follow-up clinic. Dilated retinal funduscopy significantly failed to detect TS in 4 (57.1%) of these 7 cases. Intraventricular hemorrhage was significantly more common in TS cases (85.7% vs 25%). None of the participants experienced any complications from OCT examinations. Neither decreased quality of life visual scale scores nor a depressed mood correlated with objective OCT pathological findings at the 6-week follow-up after discharge. There were no significant mood differences between TS cases and controls. CONCLUSIONS OCT is the gold standard in retinal disease diagnosis. This pilot study shows that bedside OCT examination is feasible in aSAH. In this series, OCT was a safe procedure that enhanced TS detection by decreasing false-negative/inconclusive funduscopic examinations. It allows early diagnosis of macular holes and severe retinal detachments, which require acute surgical therapy to prevent legal blindness. In addition, OCT aids in ruling out potential false-positive visual deficits in individuals with a depressed mood at follow-up.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180202
[Lr] Last revision date:180202
[St] Status:Publisher
[do] DOI:10.3171/2017.7.JNS171302

  5 / 2744 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 29376579
[Au] Autor:Ostojic S; Vukovic R; Milenkovic T; Mitrovic K; Djuric M; Nikolic L
[Ad] Address:Department of Neurology, Mother and Child Health Care Institute of Serbia "Dr Vukan Cupic", Belgrade, Serbia.
[Ti] Title:Alpha coma in an adolescent with diabetic ketoacidosis.
[So] Source:Turk J Pediatr;59(3):318-321, 2017.
[Is] ISSN:0041-4301
[Cp] Country of publication:Turkey
[La] Language:eng
[Ab] Abstract:Ostojic S, Vukovic R, Milenkovic T, Mitrovic K, Djuric M, Nikolic L. Alpha coma in an adolescent with diabetic ketoacidosis. Turk J Pediatr 2017; 59: 318-321. This is the first report of alpha coma (AC) caused by brain edema in a patient with diabetic ketoacidosis (DKA). A previously healthy 15-year-old girl was admitted to the intensive care unit due to altered state of consciousness during the course of treatment for DKA. Patient was in a coma, intubated and had tachycardia with poor peripheral perfusion. Results of laboratory analyses indicated severe DKA and computed tomography scan indicated diffuse brain edema. The EEG pattern showed uniform alpha activity. Treatment with intravenous fluids, insulin and mannitol was started. Patient`s state of consciousness gradually improved and on the third day she was extubated. On the fifth day, her neurologic status and EEG findings were completely normal with no residual neurological deficits. In conclusion, although AC is associated with a high fatality rate, favorable outcome can be achieved with prompt recognition and treatment of cerebral edema in pediatric patients with DKA.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180129
[Lr] Last revision date:180129
[St] Status:In-Data-Review

  6 / 2744 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 29301583
[Au] Autor:Wang L; Qian X; Wang M; Tang X; Ao H
[Ad] Address:Department of Anesthesiology, Beijing Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Beilishi Road, West District of Beijing, Beijing, 100037, China.
[Ti] Title:Which factor is the most effective one in metabolic Sydrome on the outcomes after coronary artery bypass graft surgery? A cohort study of 5 Years.
[So] Source:J Cardiothorac Surg;13(1):1, 2018 Jan 04.
[Is] ISSN:1749-8090
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Metabolic Syndrome and diabetes mellitus are risk factors for cardiovascular disease. However, the effects of Metabolic Syndrome with or without diabetes on perioperative and long-term morbidity and mortality after Coronary Artery Bypass Graft remain unclear. METHODS: An retrospective study was performed on 1166 patients who received isolated primary Coronary Artery Bypass Graft in Fuwai hospital. They were divided into three groups: control, Metabolic Syndrome of three factors together with diabetes and Metabolic Syndrome of three factors without diabetes (n = 868, 76 and 222 respectively). Analysis of variance, Chi-rank test, Fisher's exact test, Log-rank test, Cox and Logistic regression models were used for data processing. Outcomes were postoperative and 5-year survival and morbidities. RESULTS: There were no significant differences between groups in in-hospital postoperative complications, epinephrine use, stroke, atrial fibrillation, renal failure, coma, myocardial infarction and repeated revascularization. Patients in the Metabolic Syndrome with diabetes, Metabolic Syndrome without diabetes and control groups, respectively, showed significant difference in perioperative Major Adverse Cerebral Cardiovascular Events (30.3% vs. 21.2%, 16.7%, P = 0.0071) and mortality (11.8% vs. 2.7%, 3.11%, P = 0.0003). The Metabolic Syndrome with diabetes group had higher rates of perioperative mortality than Metabolic Syndrome without diabetes (P = 0.0017, P of Fisher Test = 0.0039). Compared with non-diabetic patients with Metabolic Syndrome, those with Metabolic Syndrome and diabetes had increased long-term mortality (Adjusted HR: 4.3; 95% CI: 1.4-13.3; P = 0.0113) and Major Adverse Cerebral Cardiovascular Events (Adjusted OR: 1.7; 95% CI: 1.0-2.8; P = 0.048). Control and non-diabetic Metabolic Syndrome groups did not differ in long-term mortality but controls had lower rates of Major Adverse Cerebral Cardiovascular Events (Adjusted OR: 0.79; 95% CI: 0.64-0.98; P = 0.0329). CONCLUSIONS: There were significance differences between the three groups in perioperative Major Adverse Cerebral Cardiovascular Events and mortality after Coronary Artery Bypass Graft. Compared with non-diabetic Metabolic Syndrome patients, patients with Metabolic Syndrome and diabetes had higher long-term Major Adverse Cerebral Cardiovascular Events and mortality. While patients free of MetS and diabetes were associated with lower incidence of long-term Major Adverse Cerebral Cardiovascular Events after Coronary Artery Bypass Graft.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180107
[Lr] Last revision date:180107
[St] Status:In-Process
[do] DOI:10.1186/s13019-017-0682-5

  7 / 2744 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 29258472
[Au] Autor:Bai K; Fu Y; Liu C; Xu F; Zhu M
[Ad] Address:Intensive Care Unit, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Children Development and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing Key Labortory of Pediatrics, 136 Zh
[Ti] Title:Pediatric non-diabetic ketoacidosis: a case-series report.
[So] Source:BMC Pediatr;17(1):209, 2017 Dec 19.
[Is] ISSN:1471-2431
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: This study is to explore the clinical characteristics, laboratory diagnosis, and treatment outcomes in pediatric patients with non-diabetic ketoacidosis. METHODS: Retrospective patient chart review was performed between March 2009 to March 2015. Cases were included if they met the selection criteria for non-diabetic ketoacidosis, which were: 1) Age ≤ 18 years; 2) urine ketone positive ++ or >8.0 mmol/L; 3) blood ketone >3.1 mmol/L; 4) acidosis (pH < 7.3) and/or HCO < 15 mmol/L; 5) random blood glucose level < 11.1 mmol/L. Patients who met the criteria 1, 4, 5, plus either 2 or 3, were defined as non-diabetic ketoacidosis and were included in the report. RESULTS: Five patients with 7 episodes of non-diabetic ketoacidosis were identified. They all presented with dehydration, poor appetite, and Kussmaul breathing. Patients treated with insulin plus glucose supplementation had a quicker recovery from acidosis, in comparison to those treated with bicarbonate infusion and continuous renal replacement therapy. Two patients treated with bicarbonate infusion developed transient coma and seizures during the treatment. CONCLUSION: Despite normal or low blood glucose levels, patients with non-diabetic ketoacidosis should receive insulin administration with glucose supplementation to correct ketoacidosis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 171222
[Lr] Last revision date:171222
[St] Status:In-Process
[do] DOI:10.1186/s12887-017-0960-3

  8 / 2744 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy

[PMID]: 29180613
[Au] Autor:Lu Z; Liu J; He Q; Chakraborty A; Zhu T
[Ad] Address:Department of Endocrinology, General Hospital, Tianjin Medical University, Tianjin, China (mainland).
[Ti] Title:Analysis of Risk Factors for Hypoglycemic Coma in 194 Patients with Type 2 Diabetes.
[So] Source:Med Sci Monit;23:5662-5668, 2017 Nov 28.
[Is] ISSN:1643-3750
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND The present study was conducted to analyze possible risk factors in patients with type 2 diabetes who are in hypoglycemic coma. MATERIAL AND METHODS A total of 194 patients with type 2 diabetic hypoglycemic coma who were admitted to our hospital between January 2010 and January 2016 were included. The patients were all in coma on admission, and their blood glucose levels were lower than 2.8 mmol/L. None of the patients had type I diabetes, specific types of diabetes, or gestational diabetes. Multiple linear regression analysis was used to determine possible factors associated with hypoglycemic coma. RESULTS Among the patients, 82 were male and 112 were female (mean age, 66.88±10.62 years). In addition, 72 patients lived in urban areas and 122 lived in rural areas. Occurrence of hypoglycemic coma was correlated with difference between urban and rural residence, glycosylated hemoglobin (HbA1c) level, combined hypertension, and combined neural complications. Self-purchased drugs resulted in significantly lower blood glucose level at the onset of hypoglycemic coma than insulin, secretagogue, or non-secretagogue drugs. Blood glucose level at onset was correlated with season. Patients living in rural areas or with combined macrovascular or microvascular complications had prolonged hospital stay and poor prognosis. CONCLUSIONS Our results demonstrate that rural residence, higher HbA1c level, combined hypertension, and combined neural complications increase the incidence of hypoglycemic coma. Use of self-purchased drugs and colder seasons may result in lower blood glucose levels in patients with hypoglycemic coma.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171219
[Lr] Last revision date:171219
[St] Status:In-Process

  9 / 2744 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 29181767
[Au] Autor:Castrejón-Pérez RC; Aguilar-Salinas CA; Gutiérrez-Robledo LM; Cesari M; Pérez-Zepeda MU
[Ad] Address:Geriatric Epidemiology Research Department, National Institute of Geriatrics, Periférico Sur 2767, Colonia San Jerónimo Lídice, Delegación Magdalena Contreras, C.P. 10200, Mexico City, Mexico.
[Ti] Title:Frailty, diabetes, and the convergence of chronic disease in an age-related condition: a population-based nationwide cross-sectional analysis of the Mexican nutrition and health survey.
[So] Source:Aging Clin Exp Res;, 2017 Nov 27.
[Is] ISSN:1720-8319
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:AIMS: To describe the associations of frailty with diabetes mellitus and related conditions in older adults. METHODS: We conducted a cross-sectional analysis of a representative sample of older adults (n = 5379). We generated a 35-item frailty index (FI) and obtained information on diabetes and related conditions (peripheral neuropathy, lower limb amputation, diabetic coma, number of physician visits due to diabetes-related conditions, all-cause hospitalizations in the past year, years since diabetes diagnosis, and type of treatment). Logistic and Poisson regression models were used to determine the associations between frailty and diabetes and its complications. RESULTS: The mean age was 70.3 years (± 7.8); 54.7% were women. Those with an FI ≤ 0.082 composed the reference group. Multivariate analysis showed an OR of 2.32 (95% CI 1.93-2.73, p < 0.001) for the association between diabetes and frailty. People who were hospitalized for any cause during the previous year, those receiving both insulin and an oral compound to manage diabetes, and those with peripheral neuropathy showed ORs of 2.32 (95% CI 1.69-3.18, p < 0.001), 5.6 (95% CI 1.58-19.8, p = 0.008), and 2.02 (95% CI 1.42-2.86, p < 0.001), respectively, for being in the most frail group. CONCLUSIONS: People with diabetes have higher frailty scores. Furthermore, older adults with diabetes and higher burden of frailty have more diabetes-related complications.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171128
[Lr] Last revision date:171128
[St] Status:Publisher
[do] DOI:10.1007/s40520-017-0852-2

  10 / 2744 MEDLINE  
              first record previous record
select
to print
Photocopy
Full text

[PMID]: 28877108
[Au] Autor:Meyers T
[Ad] Address:Tina Meyers, MBA, BSN, CWOCN, Harris Health Systems, Landscape Court, Conroe, Texas.
[Ti] Title:Prevention of Heel Pressure Injuries and Plantar Flexion Contractures With Use of a Heel Protector in High-Risk Neurotrauma, Medical, and Surgical Intensive Care Units: A Randomized Controlled Trial.
[So] Source:J Wound Ostomy Continence Nurs;44(5):429-433, 2017 Sep/Oct.
[Is] ISSN:1528-3976
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: The purpose of this study was to compare the use of a heel protector to standard of care (pillows) in the prevention of hospital-acquired pressure injuries (HAPI) of the heels and prevention of plantar flexion contractures. DESIGN: Randomized controlled trial. SUBJECTS AND SETTING: The study took place on a surgical intensive care unit, medical intensive care unit, and neurotrauma intensive care unit. Inclusion criteria were a minimum of 5 days of sedation related to care for a critical illness, immobility for 6 to 8 hours before study initiation, a Braden Scale for Pressure Sore Risk score 18 or less, and a mobility subscale score 2 or less. Patients were included if they had preexisting heel pressure injury or plantar flexion contracture. The sample comprised 54 subjects; 37 were randomly allocated to the intervention group and 17 to the control group. Their average age-mean (standard deviation)-was 40.7 (14.96) years in the control group and 44.6 (17.15) years in the intervention group. METHODS: Data were collected from patients' electronic medical records. We recorded subject demographics, presence of diabetes mellitus or peripheral vascular disease, Glasgow Coma Scale scores (every shift), Braden Scale for Pressure Sore Risk scores (every shift), heel skin assessments (every shift), goniometric measurements (every other day), and adverse events (every shift). Assessments and measurements were continued until the patient was discharged from the study. RESULTS: None of the patients in the intervention group developed HAPI of the heels, as compared to 7 in the control group (0% vs 41%, P < .001). Patients in the intervention group had a significantly greater decrease in goniometric scores (mean decrease = 1.4 ± 2.25) compared to the control group by day 3 (mean decrease = 0.1 ± 0.52 P = .004) and the last study day (mean decrease = 2.0 ± 3.02 for the intervention group vs 0.07 ± 0.96 for the control group; P < .001). CONCLUSIONS: Study findings indicate that a heel protector that ensures off-loading and maintains the foot in a neutral position is more effective for prevention of HAPI of the heel and contractures as compared to standard care using pillows to position the heel and redistribute pressure.
[Mh] MeSH terms primary: Contracture/prevention & control
Pressure Ulcer/prevention & control
Skin Care/instrumentation
[Mh] MeSH terms secundary: Adult
Aged
Aged, 80 and over
Critical Care Nursing/methods
Diabetes Complications
Female
Heel/injuries
Humans
Injury Severity Score
Intensive Care Units/organization & administration
Intensive Care Units/statistics & numerical data
Male
Middle Aged
Peripheral Vascular Diseases/complications
Plantar Plate/injuries
Prospective Studies
[Pt] Publication type:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Entry month:1711
[Cu] Class update date: 171102
[Lr] Last revision date:171102
[Js] Journal subset:N
[Da] Date of entry for processing:170907
[St] Status:MEDLINE
[do] DOI:10.1097/WON.0000000000000355


page 1 of 275 go to page                         
   


Refine the search
  Database : MEDLINE Advanced form   

    Search in field  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/PAHO/WHO - Latin American and Caribbean Center on Health Sciences Information