Bretislav Lipovy, Martin Hladik, Katerina Vyklicka, Iva Kocmanova, Martina Lengerova, Leos Kren, Michal Srnik, Jan Bohm, Petr Andrla, Petra Borilova Linhartova
Patients with burn injury and inhalation injury are highly susceptible to infectious complications, including opportunistic pathogens, due to the loss of skin cover and mucosal damage of respiratory tract as well as the disruption of homeostasis. This case report, a 34-year-old man suffered critical burns, provides the first literature description of triple-impact immunoparalysis (critical burns, inhalation injury, and SARS-CoV-2 infection), leading to a lethal multifocal infection caused by several fungi including very rare environmental representatives Metschnikowia pulcherrima and Wickerhamomyces anomalus...
April 22, 2024: Folia Microbiologica
Minghao Liang, Yifei Xu, Xiuhong Ren, Di Huang, Minyan Jin, Zhanjun Qiu
BACKGROUND: Sepsis is a recognized global health challenge that places a considerable disease burden on countries. Although there has been some progress in the study of sepsis, the mortality rate of sepsis remains high. The relationship between serum osmolality and the prognosis of patients with sepsis is unclear. METHOD: Patients with sepsis who met the criteria in the Medical Information Mart for Intensive Care IV database were included in the study. Hazard ratios (HRs) and 95% confidence intervals (CIs) were determined using multivariable Cox regression...
April 22, 2024: Infection
Emilie Gregers, Peter H Frederiksen, Nanna L J Udesen, Louise Linde, Ann Banke, Amalie L Povlsen, Jeppe P Larsen, Christian Hassager, Lisette O Jensen, Jens F Lassen, Henrik Schmidt, Hanne B Ravn, Peter M H Heegaard, Jacob E Møller
BACKGROUND: In selected cases of cardiogenic shock, veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is combined with trans valvular micro axial flow pumps (ECMELLA). Observational studies indicate that ECMELLA may reduce mortality but exposing the patient to two advanced mechanical support devices may affect the early inflammatory response. We aimed to explore inflammatory biomarkers in a porcine cardiogenic shock model managed with V-A ECMO or ECMELLA. METHODS: Fourteen landrace pigs had acute myocardial infarction-induced cardiogenic shock with minimal arterial pulsatility by microsphere embolization and were afterwards managed 1:1 with either V-A ECMO or ECMELLA for 4 h...
April 22, 2024: Intensive Care Medicine Experimental
Nathan E Brummel, Christopher G Hughes, J Brennan McNeil, Pratik P Pandharipande, Jennifer L Thompson, Onur M Orun, Rameela Raman, Lorraine B Ware, Gordon R Bernard, Fiona E Harrison, E Wesley Ely, Timothy D Girard
PURPOSE: The purpose of this study was to determine associations between markers of inflammation and endogenous anticoagulant activity with delirium and coma during critical illness. METHODS: In this prospective cohort study, we enrolled adults with respiratory failure and/or shock treated in medical or surgical intensive care units (ICUs) at 5 centers. Twice per day in the ICU, and daily thereafter, we assessed mental status using the Richmond Agitation Sedation Scale (RASS) and the Confusion Assessment Method-Intensive Care Unit (CAM-ICU)...
April 22, 2024: Intensive Care Medicine
Soufiane El Megdar, Lahbib Fayzi, Raja Elkheloui, Asma Laktib, Mohamed Bourouache, Abdellah El Boulani, Hicham Abou Oualid, Khalil Cherifi, Fouad Msanda, Mohamed Hassi, Rachida Mimouni, Fatima Hamadi
Hospital-acquired infections involving carbapenem-resistant Acinetobacter baumannii (A. baumannii) and extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae pose significant challenges in the intensive care units. The lack of novel antimicrobial drugs amplifies the urgency to explore innovative management strategies. Nanotechnology, with its ability to generate nanoparticles possessing specific properties beneficial in drug delivery and nanomedicine, stands as a pivotal research domain. The objective of this study was to synthesize, for the first time, biologically silver nanoparticles (Ag-NPs) from Lavandula mairei Humbert (L...
April 22, 2024: Current Microbiology
Ziqi Ni, Jiaqi Cao, Meiling Shan, Yanyan Zhang, Lijun Shi
The developmental origins of health and disease concept highlights the impact of early environments on chronic non-communicable diseases like diabetes, cardiovascular disease, and cancer. Studies using animal models have investigated how maternal factors such as undernutrition, overnutrition, obesity, and exposure to chemicals or hypoxia affect fetal development and offspring health, leading to issues like low birth weight, high blood pressure, dyslipidemia, and insulin resistance. Given the increasing prevalence of overweight and obesity among reproductive-age women, effective interventions are critical...
April 5, 2024: Journal of Visualized Experiments: JoVE
Violette Suc, Julie Starck, Yael Levy, Yohan Soreze, Jerome Rambaud, Pierre-Louis Léger
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is widely used for children treated for refractory respiratory failures or refractory cardiogenic shock. Its duration depends on organ functions recovery. Weaning is decided using macro-circulatory tools, but microcirculation is not well evaluated. Sidestream dark-field video imaging is used to assess the perfusion of the sublingual microvascular vessels. The aim of this study was to assess the predictive value of microcirculatory indices in ECMO weaning...
April 22, 2024: Artificial Organs
Silvia Manea, Marco Pinato, Laura Salmaso, Silvia Vittorii, Michela Biasio, Matteo Rigoni, Vinicio Manfrin, Elisabetta Bertocco, Mirko Zanatta, Mario Saia
BACKGROUND: During COVID-19 pandemic, health professionals have been working in an extreme uncertainty context. Affected patients needed to be cared at home as long as possible to avoid virus spreading and hospital resources saturation. The Veneto Regional Administration (North-east of Italy) released Regional guidelines about it. The Western Healthcare District of the Local Health Authority of the city of Vicenza (180,000 inhabitants) implemented a healthcare pathway following them. Aim of the study is to describe the results and outcomes of such implementation...
April 12, 2024: Annali di Igiene: Medicina Preventiva e di Comunità
Agnieszka Żyłka, Katarzyna Dobruch-Sobczak, Hanna Piotrzkowska-Wróblewska, Maciej Jędrzejczyk, Piotr Góralski, Jacek Gałczyński, Elwira Bakuła-Zalewska, Marek Dedecjus
INTRODUCTION: The latest World Health Organization (WHO) classification from 2022 distinguishes the division of low-risk thyroid neoplasms such as non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP), follicular tumour of uncertain malignant potential (FT-UMP), and well-differentiated tumour of uncertain malignant potential (WDT-UMP). The final diagnosis is made postoperatively according to histopathologic results. The aim of the study was the assessment of ultrasonographic and cytopathological features of borderline lesions to predict low-risk tumours preoperatively and plan the optimal treatment for that group of patients...
April 22, 2024: Endokrynologia Polska
Steven W Rayburn, Sidney Anderson, Yamile C Jackson
This research explores parents' experiences in the NICU to inform design and implementation of processes that motivate and direct parent participation in healthcare processes for their children. Qualitative methods were employed combining elements of grounded theory and phenomenology. Findings reveal that despite known benefits, parent participation does not always occur in NICUs due to difficulties NICUs face while balancing technologically complex care that increases survival rates with parent-participation models that provides holistic wellbeing...
April 22, 2024: Health Marketing Quarterly
Qi Li, Dominique Lafrance, Moishe Liberman, Charles Leduc, Emmanuel Charbonney, Polina Titova, Hélène Manganas, Michaël Chassé
IMPORTANCE: Lung biopsies are sometimes performed in mechanically ventilated patients with acute hypoxemic respiratory failure (AHRF) of unknown etiology to guide patient management. While surgical lung biopsies (SLB) offer high diagnostic rates, they may also cause significant complications. Transbronchial forceps lung biopsies (TBLB) are less invasive but often produce non-contributive specimens. Transbronchial lung cryobiopsies (TBLC) yield specimens of potentially better quality than TBLB, but due to their novel implementation in the intensive care unit (ICU), their accuracy and safety are still unclear...
April 22, 2024: Journal of Intensive Care Medicine
Limin Peng, Yan Gao, Chengkun Yuan, Hongying Kuang
BACKGROUND: Vaginal progesterone in preterm birth and adverse outcomes caused by cervical insufficiency remains controversial. To address it, the effect of vaginal progesterone on preterm delivery and perinatal outcome of single pregnancy women with short cervix (less than 25 mm) was systematically evaluated by meta-analysis. METHODS: "Vaginal progesterone," "placebo," "ultrasound," "cervix," "singleton pregnancy," "preterm birth," and "antenatal outcomes" were entered to screen clinical studies PubMed, Embase, and the Chinese Biomedical Literature Database (CBM)...
2024: Frontiers in Medicine
Zhang Junqi, Cai Jie, Wang Jinglin, Lu Jinmiao, Lu Guoping, Wang Yi, Li Zhiping
OBJECTIVES: Levofloxacin is widely used because of its broad-spectrum antimicrobial activity and convenient dosing schedule. However, the relevance of its use in children remains to be investigated. The purpose of this study is to investigate the efficacy and safety of levofloxacin use in children with severe infections. METHODS: We conducted a retrospective observational study of patients <18 years of age who received levofloxacin intravenously in the Pediatric Intensive Care Unit (PICU) of our hospital during the period between 2021 and 2022...
2024: Frontiers in Pediatrics
Krishna Revanna Gopagondanahalli, Abdul Alim Abdul Haium, Shrenik Jitendrakumar Vora, Sreekanthan Sundararaghavan, Wei Di Ng, Tze Liang Jonathan Choo, Wai Lin Ang, Nur Qaiyimah Binte Mohamad Taib, Nishanthi Han Ying Wijedasa, Victor Samuel Rajadurai, Kee Thai Yeo, Teng Hong Tan
OBJECTIVES: To evaluate serial tissue Doppler cardiac imaging (TDI) in the evolution of bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) among extremely preterm infants. DESIGN: Prospective observational study. SETTING: Single-center, tertiary-level neonatal intensive care unit. PATIENTS: Infant born <28 weeks gestation. MAIN OUTCOME MEASURES: Utility of TDI in the early diagnosis and prediction of BPD-PH and optimal timing for screening of BPD-PH...
2024: Frontiers in Pediatrics
Joseph Bonanno, Timothy Grannell, Gregory Maves, Joseph D Tobias
In pediatric-aged patients, hyperthyroidism generally results from the autoimmune disorder, Graves' disease (GD). Excessive levels of thyroid hormones (triiodothyronine and thyroxine) result in irritability, emotional lability, nervousness, tremors, palpitations, tachycardia, and arrhythmias. The risk of morbidity and mortality is increased when surgical intervention is required in patients with hyperthyroidism due to the potential for the development of thyroid storm (TS). A 3-year, 1-month-old child with a past medical history of GD presented for total thyroidectomy when pharmacologic control with methimazole was not feasible due to intolerance following development of a serum sickness-like illness...
April 2024: Journal of Medical Cases
Ghadeer Al Ghareeb, Duoaa Abdoh, Mostafa Kofi, Ayman Afify Konswa
Obesity is a growing global health concern. Saudi Arabia is experiencing a higher prevalence of obesity compared to the globe. This case report focuses on a 38-year-old female with a body mass index (BMI) of 90.5 kg/m2 , prediabetes, and obstructive sleep apnea who successfully underwent a lifestyle modification process resulting in remarkable weight loss. The patient's past unsuccessful attempts at weight loss had left her with a reluctance to try again initially. A multidisciplinary team collaborated to develop a management plan starting with an intensive lifestyle intervention...
April 2024: Journal of Medical Cases
Shiji Chalipat, Jyothsna Sree Madala, Sanjay Chavan, Sudhir Malwade, Shilpa Baviskar
Critical illness polyneuropathy (CIP) and myopathy (CIM) are underreported conditions in critically ill children with prolonged intensive care unit stays and mechanical ventilation. We report a case of a 10-year-old boy with pneumococcal meningoencephalitis with severe sepsis and multiorgan dysfunction. The child required prolonged ventilation, sedation, and inotropic support. He had repeated extubation failures and the development of quadriparesis with areflexia. Electrophysiology studies were consistent with CIP with acute motor and sensory axonal polyneuropathy and elevated muscle enzymes...
March 2024: Curēus
Moshumi Godbole, Samantha Olafson, Ryan B Cohen, Candace L Ward, Stephanie Sailes, Mia Sharlin, Afshin Parsikia, Benjamin J Moran, Pak Shan P Leung
Background Resuscitative thoracotomy (RT) is performed in severe trauma cases as a final lifesaving effort. Prominent, yet differing, practice management guidelines exist from Eastern Association for the Surgery of Trauma (EAST) and Western Trauma Association (WTA). This study evaluates all RTs performed from 2012 to 2019 at an urban Level 1 trauma center for management guideline indication and subsequent outcomes. Methods Our trauma registry was queried to identify RT cases from 2012 to 2019. Data was collected on patient demographics, prehospital presentation, cardiopulmonary resuscitation (CPR) requirements, and resuscitation provided...
March 2024: Curēus
Nga N Tran, Sydney Hutto, James Liu, Tyler Bullock, Richard Virgilio, David L Flowers
This case report describes necrotizing enterocolitis (NEC) in an infant with a history of twin-twin transfusion syndrome (TTTS). TTTS is a volume imbalance where the anastomosis at the vascular equator between the two placentae shifts from the donor to the recipient twin. This causes a higher risk for NEC, a marked inflammation caused by bacterial infection into the intestinal wall, from prematurity and intestinal hypoperfusion. Complications include sepsis, bowel necrosis, perforation, peritonitis, and death...
March 2024: Curēus
Tong Ren, Shaikh Afaq, Ali Vaziri, Olu Oyesanmi, Salman Muddassir
Ogilvie's syndrome, also known as acute colonic pseudo-obstruction, is often encountered in post-surgical patients or those with serious comorbidities requiring intensive care. For this reason, it has rarely been reported in patients younger than 50 years without any predisposing risk factors. Our case report highlights a unique case of Ogilvie's syndrome in a young female with no recent trauma or surgical history. To that extent, we discuss risk factors that predisposed her to this condition, including her history of chronic constipation...
March 2024: Curēus
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