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Children who are hospitalized have the potential for experiencing clinical deterioration during the treatment period. Nurses who recognize abnormal physiological parameters and implement appropriate, integrated, multidisciplinary interventions can prevent a child's condition from worsening. However, communication problems may delay the required decision-making. The present study assessed the effectiveness of monitoring physiological changes in children via the modified Pediatric Early Warning System (mPEWS)-InPro mobile-based application in determining the risk of clinical deterioration and in providing appropriate intervention. This initial validation study consisted of three stages: literature search, instrument development, and instrument application. The study involved 108 pediatric patients from March to April 2018. Data were collected via a mobile-based demographic field. Eight physiological parameters were observed, inputted, and automatically computed. The writing of this manuscript follows TRIPOD Checklist for Prediction Model Validation. The mPEWS-InPro mobile-based application obtained an AUC value of 0.942 (95%, CI: 0.865 to 1.000; p = 0.001), indicating very strong degrees of accuracy and significance in predicting a child's clinical deterioration. With a cut value of 4, the mPEWS-InPro has a sensitivity of 92.3% and a specificity of 80%. The mPEWS-InPro mobile-based application is effective for predicting and monitoring a child's clinical deterioration. Its application can be integrated with any hospital's electronic health record system. This form of nursing informatics can be considered a strategy for detecting the clinical deterioration of pediatric patients. Its user-friendly application and automatic parameter scoring allow nurses to take care the patients while maintaining the human touch, which is essential in nursing care. Key Words: Deteriorating child, monitoring, mPEWS-InPro mobile-based, nursing informatics., The clinical deterioration of inpatients is usually characterized by physiological disorders. Some key issues related to deteriorating conditions of children in hospitals include the failure of nursing staff to monitor [...]

2021 NOV 11 (NewsRx) -- By a News Reporter-Staff News Editor at Women's Health Weekly -- Fresh data on heart attack are presented in a new report. According to news [...]

Background: Implantable defibrillators are recommended for the prevention of sudden cardiac death in patients with heart failure. However, criteria to identify those who would benefit most from this therapy are lacking. We assessed the maximum potential benefit of preventing sudden death in patients with repeated hospital admissions because of heart failure. Methods: Using a cohort assembled from an administrative database, we identified 14 374 patients admitted to hospital for the first time because of heart failure between Jan. 1, 2000, and Dec. 31, 2004. We followed subsequent admissions related to heart failure as well as mortality and causes of death to Mar. 31, 2006. We regarded all out-of-hospital cardiac deaths as sudden deaths. We calculated the maximum potential benefit of preventing sudden death by subtracting the observed survival after each hospital admission from the hypothetical survival whereby all out-of-hospital cardiac deaths were assumed to be preventable. Results: The mean age of the cohort was 77 years, 45% were women, 11% had cerebrovascular disease, and 21% had chronic kidney disease. Out-of-hospital cardiac deaths constituted 13.7% (1226/8967) of all deaths during 32 055 person-years of follow-up. The median survival declined with each subsequent hospital admission related to heart failure. The hypothetical prevention of all out-of-hospital deaths prolonged life by 0.63 (95% confidence interval [CI] 0.49 to 0.77) years after the first hospital admission. This potential benefit dropped to 0.28 (95% CI 0.10 to 0.46) years after 3 hospital admissions related to heart failure. Among patients less than 65 years old, and older patients without kidney disease, dementia or cancer, more than 50% survived longer than 2 years until they had 2 or 3 hospital admissions related to heart failure. Interpretation: The use of implantable defibrillators to prevent sudden death would provide limited benefit among older patients with comorbidities and among patients with multiple hospital admissions related to heart failure. Une version francaise de ce resume est disponible a l'adresse www.cmaj.ca/cgi/content/full/180/6/611/DC1, The burden of heart failure is substantial, accounting for 106 130 related hospital admissions and 1.38 million days in hospital in 2001 in Canada. (1) In the United States it [...]

Background: The associations of different components of body mass with disease outcomes are not well defined. Objective: We investigated the effects of body composition on risk of death from cardiac causes and cancer in adult men. Design: Middle-aged men (n = 7608) in the Paris Prospective Study were followed up for 15 y. At study entry, the following measurements were obtained: sagittal diameter, sum of midarm and midthigh circumferences, sum of 3 trunk skinfold thicknesses (estimate of trunk subcutaneous fat), and sum of 3 extremity skinfold thicknesses (estimate of extremity subcutaneous fat). To assess their relative contributions to cardiac and cancer mortality, we used multivariate Cox models in which the sagittal diameter adjusted for trunk skinfold thicknesses was used as an estimate of intraabdominal fat and the sum of midarm and midthigh circumferences adjusted for extremity skinfold thicknesses was used as an estimate of muscle mass. Results: In multivariate analyses in both smokers and nonsmokers, the sagittal diameter was the only significant predictor of cardiac death. The sum of midarm and midthigh circumferences was negatively associated and sagittal diameter was positively associated with cancer death, whereas extremity skinfold thicknesses exhibited a U-shape relation. Exclusion of subjects who died from cancer in the first 5 y of follow-up did not change these results. Conclusions: Intraabdominal fat appears to be the main body compartment involved in risk of cardiac death, whereas increased risk of cancer death is associated with lower muscle mass and lower subcutaneous fat, independent of smoking and after the exclusion of early mortality. Increased central fat distribution may confer additional risk of death from cancer. Am J Clin Nutr 2002;75:1107-13. KEY WORDS Body composition, fat distribution, body fat, muscle mass, mortality, cardiovascular disease, cardiac death, heart disease, cancer, prospective study

EVIDENCE-BASED ANSWER Patients with atypical chest pain and no history of cardiovascular events coronary artery disease, unstable angina, or history of percutaneous transthoracic coronary angioplasty [PTCA]) and a negative stress [...]

Sudden deaths during half-marathons and marathons make big headlines, which may make you think racing is risky. But a new study published in The New England Journal of Medicine reveals [...]

A 3-month-old boy was diagnosed with severe respiratory syncytial virus infection at a North Carolina hospital in 2009. The infant was intubated, and a transfer to another hospital that had [...]

"Losing weight saved my life." Vitals Jennifer Powell, 36, Lebanon, OH Occupation Stay-at-home mom Height 5'8" Time it took to reach her goal 3 years, 1 month Weight before 312 [...]

The exercise-induced hemodynamic loads in spinal cord injured athletes are different to those in able-bodied counterparts. According to a study, the heart of the spinal cord injured athlete may adapt moderately to athletic training.

AT THE AHA SCIENTIFIC SESSIONS ORLANDO -- A second, confirmatory major study has shown that chronic obstructive pulmonary disease independently increases the risk of sudden cardiac death severalfold. COPD was [...]

WASHINGTON -- Incorporating preparticipation screening into routine health supervision visits for all youth-not just those playing competitive sports--is one of the recommendations in an updated monograph being published by the [...]