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A clear case of diabetic ketoacidosis within a affected person together with COVID-19 along with fresh identified type 1 diabetes.
l practice are required. This will facilitate clinical decision-making and help define best practices for identification and management of elevated Lp(a) in adults and youth.
To describe the key features and epidemiology of traumatic brain injury (TBI) and how they may be changing, with an emphasis on how this may affect care in the intensive care unit.

TBI has been traditionally perceived as occurring mainly in a younger, predominantly male population injured in high velocity motor vehicle crashes or assaults. However, there are an increasing number of patients over 65 years who have sustained a TBI secondary to low velocity falls. Considering the effects of frailty, comorbidities and extracranial injuries is important when making management decisions. Mild TBI comprises a third of those admitted and as a significant proportion may have poor outcomes secondary to their TBI they should be assessed to ensure appropriate follow-up. Multimodal monitoring may offer a way in the future to offer more personalised management to this very complex and heterogeneous patient group.

This review highlights the urgent need to develop more age-inclusive TBI consensus management guidelines aimed at improving short- and long-term outcomes for the large and growing TBI population. Being elderly does not necessarily portend a poor outcome, and more research is needed to better triage, guide management and prognosticate on these patients.
This review highlights the urgent need to develop more age-inclusive TBI consensus management guidelines aimed at improving short- and long-term outcomes for the large and growing TBI population. Being elderly does not necessarily portend a poor outcome, and more research is needed to better triage, guide management and prognosticate on these patients.
To compare the agreement between whole-body (WB) magnetic resonance (MR) imaging, 18F-FDG PET/CT, and skeletal survey (SS) in patients with multiple myeloma (MM) for diagnosis, initial staging, response evaluation, and early detection of complications.

This is a retrospective cohort study including MM patients who were diagnosed, treated, and followed in 2 institutions. These patients were studied with SS, WB-MR, and/or 18F-FDG PET/CT. We studied bone lesions by anatomical locations and analyzed the concordance between SS and a tomographic technique (WB-MR or 18F-FDG PET/CT) and between both tomographic techniques (WB-MR and PET/CT).

Forty-four MM patients with a mean age of 62.6 years (range, 38-85 years) were included from January 2012 to February 2016. Whole-body MR and 18F-FDG PET/CT found more lesions than SS in every location except in the skull. Concordance between WB-MR and 18F-FDG PET/CT was either good or excellent in most of the locations and in plasmacytoma studies. However, WB-MR was better than 18F-FDG PET/CT in the study of complications (medullar compression and vascular necrosis).

Our results suggest the study of MM patients should include WB-MR and/or 18F-FDG PET/CT, whereas SS is only useful for the skull. Whole-body MR and 18F-FDG PET/CT are complementary techniques, because both of them show good concordance in almost every location. It is still necessary to individualize the indication of each technique according to patient characteristics.
Our results suggest the study of MM patients should include WB-MR and/or 18F-FDG PET/CT, whereas SS is only useful for the skull. Whole-body MR and 18F-FDG PET/CT are complementary techniques, because both of them show good concordance in almost every location. It is still necessary to individualize the indication of each technique according to patient characteristics.
The purpose of the project was to evaluate the impact of a clinical nurse specialist (CNS) collaborating with an established Midwestern community-based palliative care program on the following quality outcomes care coordination, 30-day readmissions, and emergency department (ED) utilization.

Palliative care services are evolving from the inpatient setting to community-based models to meet the needs of patients in their homes. As community-based programs develop, healthcare systems are examining the various models of care. The evidence-based practice project evaluated a collaborative practice model between a CNS and a community-based palliative care team. Quantitative analysis included 30-day readmissions and ED utilization in a preimplementation and postimplementation design. Qualitative data were obtained from a focus group of the community-based palliative care team to discuss the role of the CNS on the team.

The addition of a CNS did not significantly impact 30-day readmissions or ED visits. An unexpected outcome was that the CNS intervention was associated with an increase in social work visits. Results of the focus groups suggested that the CNS improved care coordination, nursing support, education, and medical management.

Both quantitative and qualitative analyses suggest that the CNS enhanced coordination of care and quality outcomes. Examining the CNS contribution over a longer period will further clarify the CNS's impact to the team.
Both quantitative and qualitative analyses suggest that the CNS enhanced coordination of care and quality outcomes. Selleckchem PDD00017273 Examining the CNS contribution over a longer period will further clarify the CNS's impact to the team.
The goal of this article is to describe how a high-functioning clinical nurse specialist (CNS) team rapidly responded to the needs of the patients, nursing staff, and organization as a whole to address the coronavirus disease 2019 (COVID-19) crisis.

Using the advanced practice knowledge and skills, each CNS moved effortlessly between the 3 spheres of influence, patient, nursing, and organization, to address the unique needs of the COVID-positive patient, as well as the routinely ill who still needed care during a pandemic. In addition to observing and addressing opportunities at the bedside, the CNS team was essential in the development of plans of care, crisis care standards, and a structure for critical care cross-training.

Five themes essential to success were identified a common motivation and goal, collaboration, the importance of communication in utilizing established groups to create rapid change, power of influence, and the availability of a vast number of resources including professional nursing roles.
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