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corticosteroids in icu

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https://www.readbyqxmd.com/read/27836209/-extracorporeal-co2-removal-as-life-support-system-for-a-severe-organizing-pneumonia
#1
G Rival, O Millet, G Capellier
INTRODUCTION: Acute lung injuries are usually found in intensive care unit. The diffuse alveolar damage (DAD) is the associated histological pattern and the most severe end-stage of the disease. Organizing pneumonia (OP), for which corticosteroids are the reference therapy, can mimic DAD. While postponing the response to treatment, to limit mechanical ventilation side effects, extracorporeal membrane oxygene can be proposed. We present a case of a severe OP for which extracorporeal CO2 removal (ECCO2R) is used as a bridge to recovery under corticosteroid therapy...
November 8, 2016: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/27833765/plasma-exchange-in-the-management-of-catastrophic-antiphospholipid-syndrome
#2
Dimitri Titeca-Beauport, Valery Salle, Loay Kontar, Julien Maizel, Gabriel Choukroun
: Objective. Report of a case of catastrophic antiphospholipid syndrome (CAPS) with multiple organ involvement leading to a life-threatening condition despite early combination corticosteroid and heparin therapy. Initiation of plasma exchange led to rapid improvement of the patient's general condition. Design. CASE REPORT: Setting. University teaching hospital medical intensive care unit. Patient. Single case: 52-year-old man hospitalized for catastrophic antiphospholipid syndrome (CAPS) with cardiac, renal, and cutaneous involvement...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27816734/sex-based-differences-in-adults-with-community-acquired-bacterial-meningitis-a-prospective-cohort-study
#3
Sara P Dias, Matthijs C Brouwer, Merijn W Bijlsma, Arie van der Ende, Diederik van de Beek
OBJECTIVES: To investigate sex-based differences in clinical features, causative pathogens, outcome and treatment of adult community-acquired meningitis. METHODS: From January 2006 to July 2014, adults with community-acquired bacterial meningitis were prospectively evaluated in a nationwide cohort study in the Netherlands. Sex was analysed along with known predictors of unfavourable outcome using logistic regression. RESULTS: We evaluated 1412 episodes of meningitis, 707 (50%) in males...
November 2, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27812050/clinical-outcomes-of-pneumocystis-pneumonia-from-a-tertiary-care-centre-in-pakistan
#4
Ali Bin Sarwar Zubairi, Hira Shahzad, Afia Zafar
OBJECTIVE: To assess the predisposing immunocompromised states, administration of pneumocystis jirovecii pneumonia prophylaxis, the disease course and outcomes of patients with pneumocystis jirovecii pneumonia. METHODS: The retrospective study was conducted at the Aga Khan University Hospital in Karachi. The medical records of patients diagnosed with pneumocystis jirovecii pneumonia from January 1995 to October 2015 were retrieved. Baseline characteristics, clinical course, treatment, and mortality rates were noted...
November 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27807817/neutrophil-expression-of-glucocorticoid-induced-leucine-zipper-gilz-anti-inflammatory-protein-is-associated-with-acute-respiratory-distress-syndrome-severity
#5
Marie-Alix Espinasse, David Hajage, Philippe Montravers, Pascale Piednoir, Guillaume Dufour, Florence Tubach, Vanessa Granger, Luc de Chaisemartin, Benoît Noël, Marc Pallardy, Sylvie Chollet-Martin, Armelle Biola-Vidamment
BACKGROUND: Glucocorticoid-induced leucine zipper (GILZ) is a potent anti-inflammatory protein involved in neutrophil apoptosis and the resolution of inflammation. Given the numerous pathophysiologic roles of neutrophils in the acute respiratory distress syndrome (ARDS), we postulated that neutrophil GILZ expression might be induced during ARDS, to modulate the inflammatory process and participate in lung repair. METHODS: This single-center, prospective, observational cohort study took place in the surgical intensive care unit of Bichat Hospital (Paris, France) and involved 17 ARDS patients meeting the Berlin criteria at inclusion, and 14 ventilated controls without ARDS...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27784445/-clinical-features-of-acute-respiratory-failure-due-to-pneumocystis-pneumonia-in-non-hiv-immunocompromised-patients
#6
X Huang, L Weng, L Yi, M Li, Y Y Feng, Y Tian, J G Xia, Q Y Zhan, B Du
Objective: To examine the clinical features of patients with acute respiratory failure (ARF) caused by pneumocystis pneumonia (PCP) admitted into two medical intensive care units (ICU) in non- human immunodeficiency virus (HIV) infected immunocompromised patients. Methods: A retrospective review was conducted among 92 non-HIV patients with ARF caused by PCP in medical ICU of Peking Union Medical College Hospital and China-Japan Friendship Hospital between Jan 2010 and Dec 2015. Patient characteristics, clinical presentation, laboratory and radiological findings, complications, as well as therapy and mortality were included in the analysis...
October 18, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27746415/2016-guidelines-for-the-management-of-thyroid-storm-from-the-japan-thyroid-association-and-japan-endocrine-society-first-edition
#7
Tetsurou Satoh, Osamu Isozaki, Atsushi Suzuki, Shu Wakino, Tadao Iburi, Kumiko Tsuboi, Naotetsu Kanamoto, Hajime Otani, Yasushi Furukawa, Satoshi Teramukai, Takashi Akamizu
Thyroid storm is an endocrine emergency which is characterized by multiple organ failure due to severe thyrotoxicosis, often associated with triggering illnesses. Early suspicion, prompt diagnosis and intensive treatment will improve survival in thyroid storm patients. Because of its rarity and high mortality, prospective intervention studies for the treatment of thyroid storm are difficult to carry out. We, the Japan Thyroid Association and Japan Endocrine Society taskforce committee, previously developed new diagnostic criteria and conducted nationwide surveys for thyroid storm in Japan...
October 15, 2016: Endocrine Journal
https://www.readbyqxmd.com/read/27736708/corticosteroids-and-neuromuscular-blockers-in-development-of-critical-illness-neuromuscular-abnormalities-a-historical-review
#8
Susan R Wilcox
Weakness is common in critically ill patients, associated with prolonged mechanical ventilation and increased mortality. Corticosteroids and neuromuscular blockade (NMB) administration have been implicated as etiologies of acquired weakness in the intensive care unit. Medical literature since the 1970s is replete with case reports and small case series of patients with weakness after receiving high-dose corticosteroids, prolonged NMB, or both. Several risk factors for weakness appear in the early literature, including large doses of steroids, the dose and duration of NMB, hyperglycemia, and the duration of mechanical ventilation...
September 26, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27733360/antenatal-corticosteroids-for-maturity-of-term-or-near-term-fetuses-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#9
Gabriele Saccone, Vincenzo Berghella
OBJECTIVE:  To evaluate the effectiveness of antenatal corticosteroids given at ≥34 weeks' gestation. DESIGN:  Systematic review with meta-analysis. DATA SOURCES:  Electronic databases were searched from their inception to February 2016. ELIGIBILITY CRITERIA FOR STUDY SELECTION:  Randomized clinical trials comparing antenatal corticosteroids with placebo or no treatment in women with a singleton pregnancy at ≥34 weeks' gestation...
October 12, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27724931/positive-impact-of-a-clinical-goal-directed-protocol-on-reducing-cardiac-arrests-during-potential-brain-dead-donor-maintenance
#10
Glauco A Westphal, Elisabeth Coll, Rafael L de Souza, Silvana Wagner, Artur Montemezzo, Fernanda Carolina Cani de Souza, Gabriel Torres, Stefan Halla, Tiago C Carnin, Míriam C Machado, Eduardo Berbigier, Fernando Busetto, Ivonei Bittencourt, Karine Gerent, Bruno S de Souza, Manoel Tassinari, Joel de Andrade
BACKGROUND: The disproportion between the large organ demand and the low number of transplantations performed represents a serious public health problem worldwide. Reducing the loss of transplantable organs from deceased potential donors as a function of cardiac arrest (CA) may contribute to an increase in organ donations. Our purpose was to test the hypothesis that a goal-directed protocol to guide the management of deceased donors may reduce the losses of potential brain-dead donors (PBDDs) due to CA...
October 11, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27721666/intermittent-courses-of-corticosteroids-also-present-a-risk-for-pneumocystis-pneumonia-in-non-hiv-patients
#11
Maria L Calero-Bernal, Isabel Martin-Garrido, Mikel Donazar-Ezcurra, Andrew H Limper, Eva M Carmona
Introduction. Pneumocystis pneumonia (PCP) is rising in the non-HIV population and associates with higher morbidity and mortality. The aggressive immunosuppressive regimens, as well as the lack of stablished guidelines for chemoprophylaxis, are likely contributors to this increased incidence. Herein, we have explored the underlying conditions, immunosuppressive therapies, and clinical outcomes of PCP in HIV-negative patients. Methods. Retrospective analysis of PCP in HIV-negative patients at Mayo Clinic from 2006-2010...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/27670947/piperacillin-tazobactam-induced-immune-mediated-thrombocytopenia-in-the-intensive-care-unit
#12
K Boyce, H Brar, S N Stabler
WHAT IS KNOWN AND OBJECTIVE: Drug-induced immune-mediated thrombocytopenia is a rare adverse event that remains a diagnostic challenge, especially in the critically ill population. There are only two previously reported cases of rapid and profound thrombocytopenia after administration of piperacillin/tazobactam. CASE SUMMARY: A 64-year-old man experienced several episodes of isolated thrombocytopenia after receiving piperacillin/tazobactam. Interestingly, the degree of thrombocytopenia varied with the amount of corticosteroid therapy the patient was receiving...
September 27, 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27664106/diagnostic-values-and-limitations-of-1-3-%C3%AE-d-glucans-and-galactomannan-assays-for-invasive-fungal-infection-in-patients-admitted-to-pediatric-intensive-care-unit
#13
Fang Zheng, Hui Zha, Dandan Yang, Jun Deng, Zhiquan Zhang
The relationship among (1,3)-β-D-glucans (BG), galactomannan (GM), and the risk of developing invasive fungal infections (IFI) has been observed in adult ICU and in children with hematological malignancies. Only scant data evaluated the value of BG/GM assays for diagnosis of IFI in patients with nonhematological diseases in pediatric intensive care unit (PICU). In this study, we assessed the diagnostic value of these markers for IFI in PICU. The records of 230 patients were retrospectively evaluated. Out of 117 patients (7 proven, 23 probable, and 87 cases without evidence of IFI) performed GM and BG assays...
September 23, 2016: Mycopathologia
https://www.readbyqxmd.com/read/27646108/assessment-and-predictors-of-physical-functioning-post-hospital-discharge-in-survivors-of-critical-illness
#14
Kevin J Solverson, Christopher Grant, Christopher J Doig
BACKGROUND: Prior studies of physical functioning after critical illness have been mostly limited to survivors of acute respiratory distress syndrome. The purpose of this study was to objectively assess muscle strength and physical functioning in survivors of critical illness from a general ICU and the associations of these measures to health-related quality of life (HRQL), mental health and critical illness variables. METHODS: This was a prospective cohort study of 56 patients admitted to a medical ICU (length of stay ≥4 days) from April 1, 2009, and March 31, 2010...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27609755/effects-of-corticosteroids-on-critically-ill-pulmonary-tuberculosis-patients-with-acute-respiratory-failure-a-propensity-analysis-of-mortality
#15
Ji Young Yang, Minkyu Han, Younsuck Koh, Woo-Sung Kim, Jin-Woo Song, Yeon-Mok Oh, Sang-Do Lee, Sei Won Lee, Jae-Seung Lee, Chae-Man Lim, Chang-Min Choi, Jin-Won Huh, Sang-Bum Hong, Tae Sun Shim, Kyung-Wook Jo
BACKGROUND:  We investigated the effects of corticosteroids on the 90-day mortality outcomes in patients with pulmonary tuberculosis who were admitted to the intensive care unit (ICU) because of acute respiratory failure (ARF). METHODS:  The medical records of 124 patients who had pulmonary tuberculosis with ARF and were admitted to the ICU at our tertiary referral center in South Korea between March 1989 and December 2014 were retrospectively analyzed. The 90-day mortality rate in this population was analyzed after adjustments with the inverse probability of treatment weighted (IPTW) method...
September 8, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27583588/community-acquired-pneumonia-still-a-major-burden-of-disease
#16
Charles Feldman, Ronald Anderson
PURPOSE OF REVIEW: Describe recent studies that may impact on the management of community-acquired pneumonia (CAP). RECENT FINDINGS: CAP continues to be associated with a considerable burden of disease. Diagnosis remains problematic, and various biomarkers are neither accurate in the diagnosis of the presence of CAP nor superior to standard severity of illness scores in predicting outcome. Current evidence indicates that patients with nonsevere CAP can be effectively treated with antibiotic monotherapy, whereas those with severe infection, particularly ICU cases, do best with early initiation of combination antibiotic therapy...
October 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27579483/what-is-the-role-of-corticosteroids-in-the-management-of-sepsis
#17
Joaquín Jerez, Ricardo Castro
During an episode of sepsis, the systemic inflammatory response phenomenon triggers a deficit in the action and/or secretion of cortisol. It has been suggested that the use of corticosteroids may have a role in the management of sepsis, but there is no consensus. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified 16 systematic reviews including 66 randomized controlled trials addressing the question of this article. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach...
2016: Medwave
https://www.readbyqxmd.com/read/27566463/recovery-from-a-possible-cytomegalovirus-meningoencephalitis-induced-apparent-brain-stem-death-in-an-immunocompetent-man-a-case-report
#18
Theresia Monica Rahardjo, Tinni Trihartini Maskoen, Ike Sri Redjeki
BACKGROUND: Recovery from cytomegalovirus meningoencephalitis with brain stem death in an immunocompetent patient is almost impossible. We present a remarkable recovery from a possible cytomegalovirus infection in an immunocompetent man who had severe neurological syndromes, suggesting brain stem death complicated by pneumonia and pleural effusion. CASE PRESENTATION: A 19-year-old Asian man presented at our hospital's emergency department with reduced consciousness and seizures following high fever, headache, confusion, and vomitus within a week before arrival...
2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27564785/the-application-of-adult-traumatic-brain-injury-models-in-a-pediatric-cohort
#19
Adam M H Young, Mathew R Guilfoyle, Helen Fernandes, Matthew R Garnett, Shruti Agrawal, Peter J Hutchinson
OBJECTIVE There is increasing interest in the use of predictive models of outcome in adult head injury. Two international models have been identified to be reliable modalities for predicting outcome: the Corticosteroid Randomisation After Significant Head Injury (CRASH) model, and the International Mission on Prognosis and Analysis of randomized Controlled Trials in TBI (IMPACT) model. However, these models are designed only to identify outcomes in adult populations. METHODS A retrospective analysis was performed on pediatric patients with severe traumatic brain injury (TBI) admitted to the pediatric intensive care unit (PICU) of Addenbrooke's Hospital between January 2009 and December 2013...
August 26, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27513261/potential-drug-drug-interactions-in-a-medical-intensive-care-unit-of-a-university-hospital
#20
Medine Gülçebi İdriz Oğlu, Esra Küçükibrahimoğlu, Atila Karaalp, Özlem Sarikaya, Mahluga Demirkapu, Filiz Onat, Mehmet Zafer Gören
BACKGROUND/AIM: Drug-drug interactions (DDIs) can impact patient safety. Occurrence of clinically important DDIs is higher for intensive care unit (ICU) patients. This observational study aimed to evaluate the potential DDIs in medical ICU patients of a university hospital. MATERIALS AND METHODS: The Medical Pharmacology Department organized consultation reports for ICU patients in order to detect the DDIs. To focus on clinically important DDIs, interactions in the C, D, or X risk rating categories of the Lexi-Interact online database were analyzed...
2016: Turkish Journal of Medical Sciences
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