Two scales are in common use, the Confusion Assessment Method for the ICU (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC).
Of the sedation scales described, the Riker Sedation–Agitation Scale and the Richmond Agitation–Sedation Scale are the most commonly reported, but in head-to-head comparison, neither is demonstrably superior Sedation Scales for Patients in the intensive care unit (ICU).
Recent guidelines published by the American College of Gastroenterology suggest that urgent endoscopic retrograde cholangiopancreatography (ERCP) (within 24 hours after admission) is indicated in patients with biliary pancreatitis who have concurrent acute cholangitis, but it is not needed in most patients who do not have evidence of ongoing biliary obstruction.
Although the use of resuscitation fluids is one of the most common interventions in medicine, no currently available resuscitation fluid can be considered to be ideal. In light of recent high quality evidence, a reappraisal of how resuscitation fluids are used in acutely ill patients is now required. The selection, timing, and doses of intravenous fluids should be evaluated as carefully as they are in the case of any other intravenous drug, with the aim of maximizing efficacy and minimizing iatrogenic toxicity.
Primary infection with varicella–zoster virus (VZV) results in chickenpox, characterized by viremia with a diffuse rash and seeding of multiple sensory ganglia, where the virus establishes lifelong latency. Herpes zoster is caused by reactivation of latent VZV in cranial-nerve or dorsal-root ganglia, with spread of the virus along the sensory nerve to the dermatome.
As defined by the American Thyroid Association’s task force on the management of thyroid nodules and differentiated thyroid cancer, a thyroid nodule is a discrete lesion within the thyroid gland that is radiologically distinct from the surrounding thyroid parenchyma.
Anaemia is a frequent finding in cancer patients and should be carefully assessed. Additional causes of anaemia such as iron deficiency, bleeding, nutritional defects or haemolysis should be corrected prior to erythropoietic protein therapy. The following recommendations are related to adult cancer patients with solid tumours or haematological malignancies:
In contrast to macroadenomas, for which therapy is routinely indicated, microadenomas do not always require treatment. For patients with microadenomas who do not have these indications, symptoms and prolactin levels can be monitored, and MRI can be used to follow the size of the tumor.
Scoring system for risk of complications among febrile neutropenic patients, based on the Multinational Association for Supportive Care in Cancer (MASCC) predictive model.
4 = eyelids open or opened, tracking, or blinking to command
3 = eyelids open but not tracking
2 = eyelids closed but open to loud voice
1 = eyelids closed but open to pain
0 = eyelids remain closed with pain