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Physiology critical care

Murad Megjhani, Kalijah Terilli, Hans-Peter Frey, Angela G Velazquez, Kevin William Doyle, Edward Sander Connolly, David Jinou Roh, Sachin Agarwal, Jan Claassen, Noemie Elhadad, Soojin Park
Purpose: Accurate prediction of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) can be critical for planning interventions to prevent poor neurological outcome. This paper presents a model using convolution dictionary learning to extract features from physiological data available from bedside monitors. We develop and validate a prediction model for DCI after SAH, demonstrating improved precision over standard methods alone. Methods: 488 consecutive SAH admissions from 2006 to 2014 to a tertiary care hospital were included...
2018: Frontiers in Neurology
Cornelia Wiegand, Andrea Völpel, Andrea Ewald, Markko Remesch, Jan Kuever, Janine Bauer, Stefanie Griesheim, Carolin Hauser, Julian Thielmann, Silke Tonndorf-Martini, Bernd W Sigusch, Jürgen Weisser, Ralf Wyrwa, Peter Elsner, Uta-Christina Hipler, Martin Roth, Carolin Dewald, Claudia Lüdecke-Beyer, Jörg Bossert
Bactericidal materials gained interest in the health care sector as they are capable of preventing material surfaces from microbial colonization and subsequent spread of infections. However, commercialization of antimicrobial materials requires proof of their efficacy, which is usually done using in vitro methods. The ISO 22196 standard (Japanese test method JIS Z 2801) is a method for measuring the antibacterial activity of daily goods. As it was found reliable for testing the biocidal activity of antimicrobially active materials and surface coatings most of the laboratories participating in this study used this protocol...
2018: PloS One
Piotr Czempik, Daniel Cieśla, Piotr Knapik, Łukasz Krzych
BACKGROUND: Acute kidney injury (AKI) in critically ill patients has a deleterious impact on the prognosis, especially when renal replacement therapy (RRT) is required. This issue has not yet been investigated in the intensive care setting in Poland. OBJECTIVES: The aim of the study was to evaluate the short-term outcomes of AKI-RRT subjects, based on a large registry population. MATERIAL AND METHODS: This observational multicenter study covered 100 demographic and clinical variables from the Silesian Registry of ICUs regarding 15,030 adult patients hospitalized between October 2011 and December 2014...
March 16, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Anna Maria Orani, Aurélie Barats, Wendy Zitte, Christine Morrow, Olivier P Thomas
The bioaccumulation and biotransformation of arsenic (As) were studied in six representative marine sponges from the French Mediterranean and Irish Atlantic coasts. Methodologies were carefully optimized in one of the species on Haliclona fulva sponges for two critical steps: the sample mineralization for total As analysis by ICP-MS and the extraction of As species for HPLC-ICP-MS analysis. During the optimization, extractions performed with 0.6 mol L-1 H3 PO4 were shown to be the most efficient. Extraction recovery of 81% was obtained which represents the best results obtained until now in sponge samples...
March 12, 2018: Chemosphere
Horng-Ruey Chua, Weng-Kin Wong, Venetia Huiling Ong, Dipika Agrawal, Anantharaman Vathsala, Hui-Ming Tay, Amartya Mukhopadhyay
PURPOSE: To evaluate 1-year mortality in patients with septic acute kidney injury (AKI) and to determine association between initial AKI recovery patterns ( reversal within 5 days, beyond 5 days but recovery, or nonrecovery) and chronic kidney disease (CKD) progression. METHODS: Prospective observational study, with retrospective evaluation of initial nonconsenters, of critically ill patients with septic AKI. RESULTS: We studied 207 patients (age, mean [SD]: 64 [16] years, 39% males), of which 56 (27%), 18 (9%), and 9 (4%) died in intensive care unit (ICU), post-ICU in hospital, and posthospitalization, respectively...
January 1, 2018: Journal of Intensive Care Medicine
Carol L Wagner, John E Baatz, Danforth Newton, Bruce W Hollis
In this review, we will discuss the changes that occur in the mammary gland from pregnancy to lactation and the issues surrounding the analysis of circulating and milk hormones during the stages of lactogenesis. There is a cascade of events that must occur to achieve milk synthesis, milk ejection, and successful transfer to the breastfeeding infant. The adequacy and success of this process is no small measure and the assessment of milk production, the hormones involved in this process and the ability to properly diagnose conditions and causes of low milk supply are critical for the health and well-being of the mother-infant breastfeeding dyad...
January 2018: Best Practice & Research. Clinical Endocrinology & Metabolism
Alice G Vassiliou, Anastasia Kotanidou, Zafeiria Mastora, Carlo Tascini, Gianluigi Cardinali, Stylianos E Orfanos
INTRODUCTION: A soluble (s) form of the endothelial protein C receptor (EPCR) circulates in plasma and inhibits activated protein C (APC) activities. The clinical impact of sEPCR and its involvement in the septic process is under investigation. This study determined the frequencies of EPCR haplotypes H1 and H3 to investigate possible associations with plasma admission levels of sEPCR in an intensive care unit (ICU) cohort of septic patients. METHODS: Three polymorphisms in the EPCR gene were genotyped in 239 Caucasian critically ill patients, and their plasma sEPCR levels were also measured at the time of admission to the ICU...
March 2018: Infectious Diseases and Therapy
Kurt F Heiss, Mehul V Raval
For over 20 years enhanced recovery protocols (ERPs) have been used to decrease the physiologic stress and inflammation of surgery using evidence-based principles. ERPs include optimizing patient preparation, creating less trauma using minimally invasive anesthetic and surgical techniques, and regular audit of outcomes. A critical aspect of ERPs is patient engagement in all phases of care, which facilitates effective team function and focused oversight of patient flow through the system. Counseling extends beyond traditional review of surgical risks and benefits, by creating clear daily patient goals, establishing pain management plans, optimizing nutrition, and defining criteria for discharge...
April 2018: Seminars in Pediatric Surgery
Marcus Eng Hock Ong, Gavin D Perkins, Alain Cariou
Sudden out-of-hospital cardiac arrest is the most time-critical medical emergency. In the second paper of this Series on out-of-hospital cardiac arrest, we considered important issues in the prehospital management of cardiac arrest. Successful resuscitation relies on a strong chain of survival with the community, dispatch centre, ambulance, and hospital working together. Early cardiopulmonary resuscitation and defibrillation has the greatest impact on survival. If the community response does not restart the heart, resuscitation is continued by emergency medical services' staff...
March 10, 2018: Lancet
Livio Provenzi, Sara Broso, Rosario Montirosso
Preterm infants are hospitalized in the Neonatal Intensive Care Unit (NICU) and are precociously separated from their mothers. Although developmental care interventions are meant to facilitate mother-infant bonding, physical contact is not always possible. Maternal voice exposure has been proposed as a way to foster maternal closeness and support postnatal bonding. Here we present a systematic review on maternal voice effects on preterm infants' development. Literature search occurred on 4 databases (PubMed, Scopus, Web of Science and CINAHL)...
March 10, 2018: Neuroscience and Biobehavioral Reviews
Valliappan Muthu, Sahajal Dhooria, Ritesh Agarwal, Kuruswamy Thurai Prasad, Ashutosh N Aggarwal, Digambar Behera, Inderpaul Singh Sehgal
Background: There is a paucity of literature regarding outcome of critically ill patients with tuberculosis (TB) from India. Herein, we describe our experience of patients with active TB admitted to a Respiratory Intensive Care Unit (RICU) of a tertiary care hospital. Methods: This was a retrospective analysis of all the patients admitted with active TB. The baseline clinical, demographic, ICU parameters and mortality were recorded. A multivariate logistic regression analysis was performed to identify factors predicting mortality...
February 2018: Indian Journal of Critical Care Medicine
Christopher J Miller, Bruce A Doepker, Andrew N Springer, Matthew C Exline, Gary Phillips, Claire V Murphy
BACKGROUND: Hypo- and hyperphosphatemia are common in severe sepsis and septic shock. Published outcome data in patients with phosphate derangements primarily focus on hypophosphatemia and the general critically ill population. This study aimed to determine the impact of serum phosphate on clinical outcomes in patients with severe sepsis and septic shock. METHODS: A retrospective cohort analysis of adult mechanically ventilated patients with severe sepsis or septic shock was performed...
January 1, 2018: Journal of Intensive Care Medicine
W Philip T James
BACKGROUND: This analysis sets out an overview of an IUNS presentation of a European clinician's assessment of the challenges of coping with immediate critical clinical problems and how to use metabolic and a mechanistic understanding of disease when developing nutritional policies. SUMMARY: Critically ill malnourished children prove very sensitive to both mineral and general nutritional overload, but after careful metabolic control they can cope with a high-quality, energy-rich diet provided their initial lactase deficiency and intestinal atrophy are taken into account...
March 8, 2018: Annals of Nutrition & Metabolism
Bart Morlion, Flaminia Coluzzi, Dominic Aldington, Magdalena Kocot-Kepska, Joseph Pergolizzi, Ana Cristina Mangas, Karsten Ahlbeck, Eija Kalso
OBJECTIVE: Pain is one of the most common reasons for an individual to consult their primary care physician, with the majority of chronic pain being treated in the primary care setting. However, many primary care physicians/non-pain medicine specialists lack enough awareness, education and skills to manage pain patients appropriately, and there is currently no clear, common consensus/formal definition of `pain chronification'. METHODS: This article, based on an international Change Pain Chronic Advisory Board meeting which was held in Wiesbaden, Germany, in October 2016, provides primary care physicians/non-pain medicine specialists with a narrative overview of pain chronification, including underlying physiological and psychosocial processes, predictive factors for pain chronification, a brief summary of preventive strategies, and the role of primary care physicians and non-pain medicine specialists in the holistic management of pain chronification...
March 7, 2018: Current Medical Research and Opinion
D Dante Yeh, Eva Fuentes, Sadeq A Quraishi, Jarone Lee, Haytham M A Kaafarani, Peter Fagenholz, Kathryn Butler, Marc DeMoya, Yuchiao Chang, George Velmahos
BACKGROUND: Failure to provide adequate nutrition in the intensive care unit (ICU) may be particularly harmful for patients with prolonged critical illness. We hypothesized that early nutrition inadequacy is more influential for those requiring a longer ICU stay versus those requiring a shorter stay. METHODS: We enrolled 280 adult patients with prolonged surgical ICU stay who were receiving enteral nutrition for >72 hours. Subjects were divided into 2 groups: shortICU (<14 days) and longICU (≥14 days)...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Wolf B Kratzert, Eva K Boyd, Johanna C Schwarzenberger
Survival of adults with congenital heart disease (CHD) has improved significantly over the last 2 decades, leading to an increase in hospital and intensive care unit (ICU) admissions of these patients. Whereas most of the ICU admissions in the past were related to perioperative management, the incidence of medical emergencies from long-term sequelae of palliative or corrective surgical treatment of these patients is rising. Intensivists now are confronted with patients who not only have complex anatomy after congenital cardiac surgery, but also complex pathophysiology due to decades of living with abnormal cardiac anatomy and diseases of advanced age...
November 16, 2017: Journal of Cardiothoracic and Vascular Anesthesia
Yahya Shehabi, Rinaldo Bellomo, Suhaini Kadiman, Lian Kah Ti, Belinda Howe, Michael C Reade, Tien Meng Khoo, Anita Alias, Yu-Lin Wong, Amartya Mukhopadhyay, Colin McArthur, Ian Seppelt, Steven A Webb, Maja Green, Michael J Bailey
OBJECTIVES: In the absence of a universal definition of light or deep sedation, the level of sedation that conveys favorable outcomes is unknown. We quantified the relationship between escalating intensity of sedation in the first 48 hours of mechanical ventilation and 180-day survival, time to extubation, and delirium. DESIGN: Harmonized data from prospective multicenter international longitudinal cohort studies SETTING:: Diverse mix of ICUs. PATIENTS: Critically ill patients expected to be ventilated for longer than 24 hours...
March 1, 2018: Critical Care Medicine
X H Gao, P J Li, W Cao
Objective: To investigate the prognostic significance of central venous-arterial carbon dioxide tension to arterial-venous oxygen content ratio (Pcv-aCO(2)/Ca-cvO(2)) combined with lactate clearance rate (LCR) as early resuscitation goals of septic shock. Methods: One hundred and forty-five septic shock patients admitted to Second Department of Critical Care Medicine of Lanzhou University Second Hospital from March 2013 to May 2017 were enrolled in this study.All septic shock patients received an initial resuscitation therapy according to early goal-directed therapy...
February 13, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Anna Clebone
PURPOSE OF REVIEW: Trauma is the most common cause of pediatric mortality. Much of the research that led to life-saving interventions in adults, however, has not been replicated in the pediatric population. Children have important physiologic and anatomic differences from adults, which impact hemostasis and transfusion. Hemorrhage is a leading cause of death in trauma, and children have important differences in their coagulation profiles. Transfusion strategies, including the massive transfusion protocol and use of antifibrinolytics, are still controversial...
April 2018: Current Opinion in Anaesthesiology
Ping Yan, Yi Yang, Li Zhang, Fuye Li, Amei Huang, Yanan Wang, Yali Dai, Hua Yao
We aim to analyze the correlated influential factors between work-related musculoskeletal disorders (WMSDs) and nursing practice environment and quality of life and social support.From January 2015 to October 2015, cluster sampling was performed on the nurses from 12 hospitals in the 6 areas in Xinjiang. The questionnaires including the modified Nordic Musculoskeletal Questionnaire, Practice Environment Scale (PES), the Mos 36-item Short Form Health Survey, and Social Support Rating Scale were used to investigate...
March 2018: Medicine (Baltimore)
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