Therapy Unit (therapy + unit)

Distribution by Scientific Domains

Kinds of Therapy Unit

  • intensive therapy unit

  • Selected Abstracts

    Techniques for liver parenchymal transection: a meta-analysis of randomized controlled trials

    HPB, Issue 4 2009
    Viniyendra Pamecha
    Abstract Background:, Different techniques of liver parenchymal transection have been described, including the finger fracture, sharp dissection, clamp,crush methods and, more recently, the Cavitron ultrasonic surgical aspirator (CUSA), the hydrojet and the radiofrequency dissection sealer (RFDS). This review assesses the benefits and risks associated with the various techniques. Methods:, Randomized clinical trials were identified from the Cochrane Library Trials Register, MEDLINE, EMBASE, Science Citation Index Expanded and reference lists. Odds ratio (ORs), mean difference (MDs) and standardized mean differences (SMDs) were calculated with 95% confidence intervals based on intention-to-treat analysis or available-case analysis. Results:, We identified seven trials including a total of 556 patients. Blood transfusion requirements were lower with the clamp,crush technique than with the CUSA or hydrojet. The clamp,crush technique was quicker than the CUSA, hydrojet or RFDS. Infective complications and transection blood loss were greater with the RFDS than with the clamp,crush method. There was no significant difference between techniques in mortality, morbidity, liver dysfunction or intensive therapy unit and hospital stay. Conclusions:, The clamp,crush technique is more rapid and is associated with lower rates of blood loss and otherwise similar outcomes when compared with other methods of parenchymal transection. It represents the reference standard against which new methods may be compared. [source]

    Utilizing audit to evaluate improvements in continuous veno-venous haemofiltration practices in intensive therapy unit

    Annette Richardson
    Abstract Continuous veno-venous haemofiltration (CVVH) is used regularly in the management of acute renal failure in intensive therapy unit (ITU). A three-staged approach was undertaken involving two audits of practice to improve CVVH record keeping in a 15-bedded cardiac ITU. An initial baseline audit identified a number of areas for improvement in practice. The areas for improvement were implemented then a second audit was repeated. The improvements and practice changes included the dissemination of audit findings to the multidisciplinary team, redesigning the prescription chart to a more user-friendly format and the development of a competency-based CVVH workbook. This nurse-led project demonstrated how positive outcomes and improvements could be achieved with record keeping across the multidisciplinary ITU team. [source]

    Continuous Coronary Sinus Perfusion Reverses Ongoing Myocardial Damage in Acute Ischemia

    ARTIFICIAL ORGANS, Issue 10 2009
    Francesco Onorati
    Abstract Acute cardiogenic shock or cardiac arrest (CS/CA) before cardiopulmonary bypass (CPB) installation are life-threatening events in acute coronary syndromes. We evaluated whether continuous retrograde warm-blood perfusion (CRWBP) before aortic cross-clamping (ACC), with immediate CPB installation may improve hospital results in these dreadful events. Hospital outcome of 18 coronary artery bypass grafting (CABG) (Group A) with CS/CA before CPB, with immediate CPB installation and CRWBP, has been compared with 24 CABG (Group B) with CS/CA undergoing only immediate CPB installation. No differences have been detected in the mean time to establish CPB (P = 0.655). Electrocardiography normalized in a significantly higher number of CRWBP (P = 0.0001). Group B showed longer CPB (116.2 21.2 min vs. 157.8 32.4; P = 0.0001) and postoperative intra-aortic balloon pumping time course (36.2 5.9 h vs. 77.8 13.2; P = 0.0001). CRWBP reduced postoperative acute myocardial infarction (P = 0.004) and damage (P = 0.033), death (P = 0.026), and need for high inotropic support (0% vs. 37.5%; P = 0.003). Troponin I was significantly lower in Group A (P = 0.013 from coronary sinus; P , 0.0001 at 12, 24, and 48 h postoperatively; P = 0.008 at 72 h), never reaching values suggestive of acute myocardial infarction. Group A had also lower lactate release from aortic declamping to 48 h postoperatively (P , 0.0001). CRWBP improved postoperative left ventricular ejection fraction (EF) (P = 0.017) and wall motion score index (P = 0.041), whereas Group B showed a significant worsening of EF (P = 0.0001) and wall motion score index (P = 0.002). Patients in Group A had shorter intubation time (P = 0.0001), intensive therapy unit (ITU) stay (P = 0.001), and hospital stay (P = 0.0001). CRWBP reverses myocardial damage in patients with CS/CA during acute coronary syndromes, adding a straightforward benefit to hospital survival. [source]

    Hospital-based industrial therapy units and the people who work within them , an Irish case analysis using a soft-systems approach

    J. S. G. WELLS phd msc ba(hons) pgdip(ed.) rpn rnt
    Occupational training and employment is seen as a central concern in the delivery of community-orientated mental health services aimed at enhancing the quality of life of people with enduring mental illness. A range of schemes from sheltered to open employment now operates in a number of countries, with a concomitant growth of interest in their evaluation. At the same time, hospital-based workshops, often referred to as industrial therapy units (ITUs), have steadily declined because they are seen as outdated and less efficacious compared with community-located training and employment. However, whether the total disappearance of the traditional ITU is a positive development may be open to question. This paper reports on a study of five mental health hospital-based sheltered workshops located in one Health Board area in Ireland, which catered for the needs of people with enduring mental health problems. Utilizing a soft-systems methodological approach, it examined their role and significance to ,users' who spent occupational time in them, the staff who worked in them and the clinicians who referred users to them. [source]

    Self-poisoning with lamotrigine and pregabalin

    ANAESTHESIA, Issue 5 2007
    A. J. Braga
    Summary We report a case of intentional overdose in a 29-year-old male with two of the newer anti-epileptic agents, lamotrigine and pregabalin. To our knowledge, this case report details the highest plasma levels of lamotrigine ever recorded in the literature. The patient presented with seizures and a reduced level of consciousness. Management of these and subsequent complications centres on supportive care in the high dependency and intensive therapy units. [source]