Evaluation of the Modified Early Warning Score (MEWS) in In-Hospital Cardiac Arrest in a Tertiary Healthcare Facility.

: In-hospital cardiac arrest has high incidence and poor survival rates, posing a significant healthcare challenge. It is important to intervene in the hours before the cardiac arrest to prevent poor outcomes. The modified early warning score (MEWS) is a validated tool for identifying a deteriorating patient.

Overview and management of hepatorenal syndrome.

Purpose Of Review: Hepatorenal syndrome (HRS) is an acute kidney injury (AKI) syndrome commonly encountered in critically ill patients with a history of cirrhosis with ascites. Given the complexity of diagnosing and managing this condition, this review aims to highlight the key features of disease pathophysiology along with prevention and treatment modalities to improve patient outcomes.

Recent Findings: Recent meetings between the acute disease quality initiative and the internal club of ascites have renamed HRS from HRS-1 and HRS-2 to HRS-AKI and HRS-chronic kidney disease.

Sepsis Care: Cardiovascular Challenges and Solutions for Nurses.

Sepsis and septic shock are two of the most prevalent disease states in today's medical intensive care units. Sepsis is a multi-system inflammatory response to infection that affects multiple organ systems, with the cardiovascular system being one of the most profoundly affected. Inflammatory mediators cause dilatation of the venous system, local tissue perfusion defects cause vasoconstriction of arterioles, and catecholamines cause increases in heart rate.

Racial Disparities in Septic Shock Outcomes: A Nationwide Analysis (2016-2020).

Background: The mortality rate and outcomes of septic shock can vary, depending on the patient's race. The most comprehensive national study on these racial disparities is dated, and recent studies have reported mixed findings.

Objective: To gain insight into racial variation in outcomes of septic shock and understand underlying factors.

COVID-19-related Pneumonitis in Immunocompromised Patients: Reviewing Clinical Features and Management Approaches.

In this case series, we explore persistent SARS-CoV-2 infection and its resultant pneumonitis within a cohort of immunocompromised patients. We elucidate the complex interplay between immunosuppression and COVID-19 by examining four patients who experienced prolonged viral shedding and recurrent respiratory failure due to their compromised immune systems. This series elucidates the clinical presentation, diagnostic challenges, and therapeutic strategies.

Impact of COVID-19 on pregnancy outcomes during delivery admissions: a nationwide analysis with clinical implications.

Background: The available literature indicates a link between SARS-CoV-2 infection during pregnancy and a heightened probability of experiencing negative outcomes for both the pregnant patient and the developing fetus. We compared clinical outcomes of pregnant patients with or without COVID-19 hospitalized during delivery.

Methods: Multivariate logistic regression analysis was used to compare outcomes and was adjusted for patient-related, hospital-related, and illness severity indicators.

Effects of pulmonary rehabilitation on functional and psychological parameters in post-acute sequelae of SARS-CoV-2 infection (PASC) patients.

Background: COVID-19 survivors may develop long-term symptoms of fatigue, dyspnea, mental health issues, and functional limitations: a condition termed post-acute sequelae of COVID-19 (PASC). Pulmonary rehabilitation (PR) is a recommended treatment for PASC; however, there is a lack of data regarding PR's effect on multiple health indices and the factors that influence patient outcomes. The aim of our study is to evaluate the impact of pulmonary rehabilitation on functional and psychological parameters in patients diagnosed with Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), thereby offering insights into the efficacy of such interventions in improving the quality of life and clinical outcomes for these individuals.

Idiopathic Bilateral Pulmonary Vein Thrombosis.

Unlabelled: A 52-year-old female with a history of chronic lymphoedema and untreated deep vein thrombosis, presented with non-specific right-sided chest pain. A CT angiogram confirmed bilateral inferior pulmonary vein thromboses (PVT). A comprehensive hypercoagulable workup and age-appropriate cancer screening were unremarkable; the lack of associated risk factors confirmed idiopathic PVT.

Efficacy of bronchial thermoplasty in a patient panel with uncontrolled severe persistent asthma.

Background: Bronchial thermoplasty (BT) is an approved procedure to manage uncontrolled severe persistent asthma. Many insurance providers are reluctant to pay for BT without proven benefit among their specific patient panel.

Objective: Determine if BT is effective in a panel patient panel with uncontrolled severe persistent asthma.

Extracorporeal Carbon Dioxide Removal to Avoid Invasive Ventilation During Exacerbations of Chronic Obstructive Pulmonary Disease: VENT-AVOID Trial - A Randomized Clinical Trial.

It is unclear whether extracorporeal CO removal (ECCOR) can reduce the rate of intubation or the total time on invasive mechanical ventilation (IMV) in adults experiencing an exacerbation of chronic obstructive pulmonary disease (COPD). To determine whether ECCOR increases the number of ventilator-free days within the first 5 days postrandomization (VFD-5) in exacerbation of COPD in patients who are either failing noninvasive ventilation (NIV) or who are failing to wean from IMV. This randomized clinical trial was conducted in 41 U.

Impact of COVID-19 on Pregnancy Outcomes across Trimesters in the United States.

Background: Current knowledge regarding the association between trimester-specific changes during pregnancy and COVID-19 infection is limited. We utilized the National Inpatient Sample (NIS) database to investigate trimester-specific outcomes among hospitalized pregnant women diagnosed with COVID-19.

Results: Out of 3,447,771 pregnant women identified, those with COVID-19 exhibited higher in-hospital mortality rates in their third trimester compared with those without the virus.

Asthma in Pregnancy.

Asthma is a common chronic respiratory condition that affects approximately 10% of adult women in the United States. Pregnancy can present unique challenges for women with asthma, as changes in the body can alter the severity and management of asthma-related respiratory symptoms. In this article, we review the current understanding of asthma during pregnancy, including the direct effects of the disease state on the pregnant woman and fetus, risk factors for poor control of disease, as well as current treatment recommendations.

Learning Clinical Concepts for Predicting Risk of Progression to Severe COVID-19.

With COVID-19 now pervasive, identification of high-risk individuals is crucial. Using data from a major healthcare provider in Southwestern Pennsylvania, we develop survival models predicting severe COVID-19 progression. In this endeavor, we face a tradeoff between more accurate models relying on many features and less accurate models relying on a few features aligned with clinician intuition.

Comparing Clinical Outcomes of COVID-19 and Influenza-Induced Acute Respiratory Distress Syndrome: A Propensity-Matched Analysis.

Acute respiratory distress syndrome (ARDS) is one the leading causes of mortality and morbidity in patients with COVID-19 and Influenza, with only small number of studies comparing these two viral illnesses in the setting of ARDS. Given the pathogenic differences in the two viruses, this study shows trends in national hospitalization and outcomes associated with COVID-19- and Influenza-related ARDS. To evaluate and compare the risk factors and rates of the adverse clinical outcomes in patients with COVID-19 associated ARDS (C-ARDS) relative to Influenza-related ARDS (I-ARDS), we utilized the National Inpatient Sample (NIS) database 2020.

Gastrointestinal Emergencies in the ICU.

Gastrointestinal (GI) emergencies and disorders are among the most common reasons to be admitted to an intensive care unit (ICU). In addition, critically ill patients admitted to the ICU for non-GI-related diseases are frequently at risk of developing GI complications during their hospitalization. This article details the epidemiology/etiology, clinical presentation, diagnostic assessment, and management of the following GI emergencies: upper and lower GI bleed, acute pancreatitis, and ascending cholangitis.

Effect of Recent Exacerbation History on the Efficacy of Once-Daily Single-Inhaler Fluticasone Furoate/Umeclidinium/Vilanterol Triple Therapy in Patients with Chronic Obstructive Pulmonary Disease in the FULFIL Trial.

Background: In the FULFIL trial, once-daily single-inhaler triple therapy with fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) resulted in reduced moderate/severe exacerbation rates and conferred significant improvements in lung function and health status in patients with chronic obstructive pulmonary disease (COPD) versus twice-daily budesonide/formoterol (BUD/FOR) dual therapy.

Methods: FULFIL was a Phase III, randomized, double-blind, double-dummy, parallel-group study. Patients ≥40 years of age with symptomatic COPD were randomized 1:1 to FF/UMEC/VI 100/62.

Acute Cardiac Emergencies.

Acute cardiac emergencies are life threatening. The initial responses to acute cardiac emergencies must be rapid, efficient, skillful, and well-planned. The goal of this article is to provide information that can be used to facilitate the prompt recognition and treatment of the most common acute cardiac emergencies.

Lemierre's Syndrome: A Case Series.

Lemierre's syndrome (LS) is a potentially fatal complication of oropharyngeal infection, resulting in contiguous suppurative thrombosis of the internal jugular vein (IJV) and septic emboli. It is most commonly associated with , though other pathogens have also been implicated in its pathogenesis. The incidence of LS had so significantly decreased that it was referred to as "the forgotten disease.

COVID-19: An Update on the Epidemiological, Clinical, Preventive, and Therapeutic Management of 2019 Novel Coronavirus Disease.

The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) remains a serious issue for global health, given widespread infectivity and a high contagion rate. A tremendous amount of data has been generated since it was first identified in December 2019. It is vital to keep up with these data from across the world at a time of uncertainty and continuously evolving guidelines and clinical practice.

Developing a Multidisciplinary Approach to the COPD Care Pathway.

Chronic obstructive pulmonary disease (COPD) is characterized as a predominately preventable and treatable inflammatory lung disease caused by progressive obstructed airflow from the lungs. In the United States and worldwide, it is becoming a major cause in hospital admissions as well as an increase in morbidity and mortality. The rising total cost of care for COPD is concerning for all health care industries.

The Role of Palliative Care in COPD.

Chronic obstructive pulmonary disease is a highly symptomatic disease that may lead to significant morbidity. Even with optimal therapy, the patient's quality of life can be severely affected. These symptoms include dyspnea, anxiety, depression, and malnourishment.