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30 papers 0 to 25 followers
Jeffrey L Saver, Mayank Goyal, Aad van der Lugt, Bijoy K Menon, Charles B L M Majoie, Diederik W Dippel, Bruce C Campbell, Raul G Nogueira, Andrew M Demchuk, Alejandro Tomasello, Pere Cardona, Thomas G Devlin, Donald F Frei, Richard du Mesnil de Rochemont, Olvert A Berkhemer, Tudor G Jovin, Adnan H Siddiqui, Wim H van Zwam, Stephen M Davis, Carlos Castaño, Biggya L Sapkota, Puck S Fransen, Carlos Molina, Robert J van Oostenbrugge, Ángel Chamorro, Hester Lingsma, Frank L Silver, Geoffrey A Donnan, Ashfaq Shuaib, Scott Brown, Bruce Stouch, Peter J Mitchell, Antoni Davalos, Yvo B W E M Roos, Michael D Hill
IMPORTANCE: Endovascular thrombectomy with second-generation devices is beneficial for patients with ischemic stroke due to intracranial large-vessel occlusions. Delineation of the association of treatment time with outcomes would help to guide implementation. OBJECTIVE: To characterize the period in which endovascular thrombectomy is associated with benefit, and the extent to which treatment delay is related to functional outcomes, mortality, and symptomatic intracranial hemorrhage...
September 27, 2016: JAMA: the Journal of the American Medical Association
Jason Phua, Nathan C Dean, Qi Guo, Win Sen Kuan, Hui Fang Lim, Tow Keang Lim
Mortality rates for severe community-acquired pneumonia (CAP) range from 17 to 48 % in published studies.In this review, we searched PubMed for relevant papers published between 1981 and June 2016 and relevant files. We explored how early and aggressive management measures, implemented within 24 hours of recognition of severe CAP and carried out both in the emergency department and in the ICU, decrease mortality in severe CAP.These measures begin with the use of severity assessment tools and the application of care bundles via clinical decision support tools...
August 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
Sandra L Peake, Michael Bailey, Rinaldo Bellomo, Peter A Cameron, Anthony Cross, Anthony Delaney, Simon Finfer, Alisa Higgins, Daryl A Jones, John A Myburgh, Gillian A Syres, Steven A R Webb, Patricia Williams
AIM: Determine current resuscitation practices and outcomes in patients presenting to the emergency department (ED) with sepsis and hypoperfusion or septic shock in Australia and New Zealand (ANZ). METHODS: Three-month prospective, multi-centre, observational study of all adult patients with sepsis and hypoperfusion or septic shock in the ED of 32 ANZ tertiary-referral, metropolitan and rural hospitals. RESULTS: 324 patients were enrolled (mean [SD] age 63...
July 2009: Resuscitation
Giles J Peek, Miranda Mugford, Ravindranath Tiruvoipati, Andrew Wilson, Elizabeth Allen, Mariamma M Thalanany, Clare L Hibbert, Ann Truesdale, Felicity Clemens, Nicola Cooper, Richard K Firmin, Diana Elbourne
BACKGROUND: Severe acute respiratory failure in adults causes high mortality despite improvements in ventilation techniques and other treatments (eg, steroids, prone positioning, bronchoscopy, and inhaled nitric oxide). We aimed to delineate the safety, clinical efficacy, and cost-effectiveness of extracorporeal membrane oxygenation (ECMO) compared with conventional ventilation support. METHODS: In this UK-based multicentre trial, we used an independent central randomisation service to randomly assign 180 adults in a 1:1 ratio to receive continued conventional management or referral to consideration for treatment by ECMO...
October 17, 2009: Lancet
Keith Wheatley, Natalie Ives, Richard Gray, Philip A Kalra, Jonathan G Moss, Colin Baigent, Susan Carr, Nicholas Chalmers, David Eadington, George Hamilton, Graham Lipkin, Anthony Nicholson, John Scoble
BACKGROUND: Percutaneous revascularization of the renal arteries improves patency in atherosclerotic renovascular disease, yet evidence of a clinical benefit is limited. METHODS: In a randomized, unblinded trial, we assigned 806 patients with atherosclerotic renovascular disease either to undergo revascularization in addition to receiving medical therapy or to receive medical therapy alone. The primary outcome was renal function, as measured by the reciprocal of the serum creatinine level (a measure that has a linear relationship with creatinine clearance)...
November 12, 2009: New England Journal of Medicine
Zhengming Chen, Richard Peto, Maigeng Zhou, Andri Iona, Margaret Smith, Ling Yang, Yu Guo, Yiping Chen, Zheng Bian, Garry Lancaster, Paul Sherliker, Shutao Pang, Hao Wang, Hua Su, Ming Wu, Xianping Wu, Junshi Chen, Rory Collins, Liming Li
BACKGROUND: Chinese men now smoke more than a third of the world's cigarettes, following a large increase in urban then rural usage. Conversely, Chinese women now smoke far less than in previous generations. We assess the oppositely changing effects of tobacco on male and female mortality. METHODS: Two nationwide prospective studies 15 years apart recruited 220,000 men in about 1991 at ages 40-79 years (first study) and 210,000 men and 300,000 women in about 2006 at ages 35-74 years (second study), with follow-up during 1991-99 (mid-year 1995) and 2006-14 (mid-year 2010), respectively...
October 10, 2015: Lancet
Derek J Hausenloy, Luciano Candilio, Richard Evans, Cono Ariti, David P Jenkins, Shyam Kolvekar, Rosemary Knight, Gudrun Kunst, Christopher Laing, Jennifer Nicholas, John Pepper, Steven Robertson, Maria Xenou, Tim Clayton, Derek M Yellon
BACKGROUND: Whether remote ischemic preconditioning (transient ischemia and reperfusion of the arm) can improve clinical outcomes in patients undergoing coronary-artery bypass graft (CABG) surgery is not known. We investigated this question in a randomized trial. METHODS: We conducted a multicenter, sham-controlled trial involving adults at increased surgical risk who were undergoing on-pump CABG (with or without valve surgery) with blood cardioplegia. After anesthesia induction and before surgical incision, patients were randomly assigned to remote ischemic preconditioning (four 5-minute inflations and deflations of a standard blood-pressure cuff on the upper arm) or sham conditioning (control group)...
October 8, 2015: New England Journal of Medicine
Sean D Levy, Jehan W Alladina, Kathryn A Hibbert, R Scott Harris, Ednan K Bajwa, Dean R Hess
In this Series paper, we review the current evidence for the use of high-flow oxygen therapy, inhaled gases, and aerosols in the care of critically ill patients. The available evidence supports the use of high-flow nasal cannulae for selected patients with acute hypoxaemic respiratory failure. Heliox might prevent intubation or improve gas flow in mechanically ventilated patients with severe asthma. Additionally, it might improve the delivery of aerosolised bronchodilators in obstructive lung disease in general...
April 30, 2016: Lancet
Betty Yu, Soo-Young Kang, Ariya Akthakul, Nithin Ramadurai, Morgan Pilkenton, Alpesh Patel, Amir Nashat, Daniel G Anderson, Fernanda H Sakamoto, Barbara A Gilchrest, R Rox Anderson, Robert Langer
We report the synthesis and application of an elastic, wearable crosslinked polymer layer (XPL) that mimics the properties of normal, youthful skin. XPL is made of a tunable polysiloxane-based material that can be engineered with specific elasticity, contractility, adhesion, tensile strength and occlusivity. XPL can be topically applied, rapidly curing at the skin interface without the need for heat- or light-mediated activation. In a pilot human study, we examined the performance of a prototype XPL that has a tensile modulus matching normal skin responses at low strain (<40%), and that withstands elongations exceeding 250%, elastically recoiling with minimal strain-energy loss on repeated deformation...
August 2016: Nature Materials
Graeme J Hankey
No abstract text is available yet for this article.
June 21, 2016: Annals of Internal Medicine
Mathias Johansen, Anne Wikkelsø, Jens Lunde, Jørn Wetterslev, Arash Afshari
BACKGROUND: Treatment with vitamin K antagonists is associated with increased morbidity and mortality. Reversal therapy with prothrombin complex concentrate (PCC) is used increasingly and is recommended in the treatment of patients with bleeding complications undertaking surgical interventions, as well as patients at high risk of bleeding. Evidence is lacking regarding indication, dosing, efficacy and safety. OBJECTIVES: We assessed the benefits and harms of PCC compared with fresh frozen plasma in the acute medical and surgical setting involving vitamin K antagonist-treated bleeding and non-bleeding patients...
2015: Cochrane Database of Systematic Reviews
Adnan I Qureshi, Yuko Y Palesch, William G Barsan, Daniel F Hanley, Chung Y Hsu, Renee L Martin, Claudia S Moy, Robert Silbergleit, Thorsten Steiner, Jose I Suarez, Kazunori Toyoda, Yongjun Wang, Haruko Yamamoto, Byung-Woo Yoon
Background Limited data are available to guide the choice of a target for the systolic blood-pressure level when treating acute hypertensive response in patients with intracerebral hemorrhage. Methods We randomly assigned eligible participants with intracerebral hemorrhage (volume, <60 cm(3)) and a Glasgow Coma Scale (GCS) score of 5 or more (on a scale from 3 to 15, with lower scores indicating worse condition) to a systolic blood-pressure target of 110 to 139 mm Hg (intensive treatment) or a target of 140 to 179 mm Hg (standard treatment) in order to test the superiority of intensive reduction of systolic blood pressure to standard reduction; intravenous nicardipine to lower blood pressure was administered within 4...
September 15, 2016: New England Journal of Medicine
Evelien de Jong, Jos A van Oers, Albertus Beishuizen, Piet Vos, Wytze J Vermeijden, Lenneke E Haas, Bert G Loef, Tom Dormans, Gertrude C van Melsen, Yvette C Kluiters, Hans Kemperman, Maarten J van den Elsen, Jeroen A Schouten, Jörn O Streefkerk, Hans G Krabbe, Hans Kieft, Georg H Kluge, Veerle C van Dam, Joost van Pelt, Laura Bormans, Martine Bokelman Otten, Auke C Reidinga, Henrik Endeman, Jos W Twisk, Ewoudt M W van de Garde, Anne Marie G A de Smet, Jozef Kesecioglu, Armand R Girbes, Maarten W Nijsten, Dylan W de Lange
BACKGROUND: In critically ill patients, antibiotic therapy is of great importance but long duration of treatment is associated with the development of antimicrobial resistance. Procalcitonin is a marker used to guide antibacterial therapy and reduce its duration, but data about safety of this reduction are scarce. We assessed the efficacy and safety of procalcitonin-guided antibiotic treatment in patients in intensive care units (ICUs) in a health-care system with a comparatively low use of antibiotics...
July 2016: Lancet Infectious Diseases
Dong Liu, Bing-Xiang Wu, Na Sun, Yi Yan, Ping Yuan, Jie-Ming Qu, Zhi-Cheng Jing
BACKGROUND: This study aimed to show whether circulating bone morphogenetic proteins (BMPs) levels are associated with increased risk of mortality in patients with pulmonary arterial hypertension (PAH). METHODS: A total of 156 patients with PAH including 43 with heritable PAH (HPAH) and 113 with idiopathic PAH (IPAH) diagnosed by gene screening were enrolled in the study. Circulating BMPs were measured by ELISA in plasma samples from patients with HPAH (n = 43) and IPAH (n = 113) and from control subjects (n = 51)...
August 2016: Chest
Sanghoon Park, Eun Joo Lee
The concept on idiopathic pulmonary fibrosis (IPF) pathogenesis has progressed from chronic inflammation to aberrant wounding healing and even more to the current paradigms of a multifactorial and heterogeneous disease process. Despite the growth of clinical trials for IPF, most of the results, including N-acetylcysteine combination, warfarin, and bosentan, were disappointing. On the other hand, there have been a number of important developments; the foremost is the licensing of pirfenidone in Europe and Asia...
January 2013: Tuberculosis and Respiratory Diseases
Joachim Müller-Quernheim, Athol Wells
No abstract text is available yet for this article.
July 1, 2012: American Journal of Respiratory and Critical Care Medicine
Khuder Alagha, Veronique Secq, Laurie Pahus, Tunde Sofalvi, Alain Palot, Arnaud Bourdin, Pascal Chanez
No abstract text is available yet for this article.
April 15, 2015: American Journal of Respiratory and Critical Care Medicine
Imre Noth, Kevin J Anstrom, Sara Bristol Calvert, Joao de Andrade, Kevin R Flaherty, Craig Glazer, Robert J Kaner, Mitchell A Olman
RATIONALE: Animal and human studies support the importance of the coagulation cascade in pulmonary fibrosis. OBJECTIVES: In a cohort of subjects with progressive idiopathic pulmonary fibrosis (IPF), we tested the hypothesis that treatment with warfarin at recognized therapeutic doses would reduce rates of mortality, hospitalization, and declines in FVC. METHODS: This was a double-blind, randomized, placebo-controlled trial of warfarin targeting an international normalized ratio of 2...
July 1, 2012: American Journal of Respiratory and Critical Care Medicine
Alberto Corona, Riccardo Colombo, Emanuele Catena
No abstract text is available yet for this article.
March 2016: Critical Care Medicine
Laura Amado-Rodríguez, Teresa Bernal, Inés López-Alonso, Jorge Blázquez-Prieto, Emilio García-Prieto, Guillermo M Albaiceta
OBJECTIVE: Acute respiratory failure in hematological patients is related to a high mortality. Noninvasive mechanical ventilation may benefit a subset of these patients, but the overall effect on mortality and the risks derived from its failure are unclear. Our objective was to review the impact of initial ventilatory strategy on mortality and the risks related to noninvasive mechanical ventilation failure in this group of patients. DATA SOURCES: Data sources, including PubMed and conference proceedings, were searched from the year 2000 to January 2015...
July 2016: Critical Care Medicine
2016-03-03 01:50:16
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