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Rodolfo Espinoza, José Roberto Lapa E Silva, Anke Bergmann, Ulisses de Oliveira Melo, Flávio Elias Calil, Robson Correa Santos, Jorge I F Salluh
OBJECTIVE: Describe characteristics and outcomes of CAP admitted to public ICUs in Brazil. METHODS: Retrospective cohort study in 4 Tertiary Public Hospitals in Rio de Janeiro, Brazil during 2016. Patients admitted to ICUs with a diagnosis of community-acquired pneumonia were included. Clinical and outcomes data were collected from Epimed Monitor System. RESULTS: From 7902 admissions, 802 patients (10, 1%) were included and analyzed. Main source of admission was the emergency department (78, 3%)...
November 22, 2018: Journal of Critical Care
Gilcilene Oliveira Gadelha, Hémilly Caroline da Silva Paixão, Patricia Rezende do Prado, Renata Andréa Pietro Pereira Viana, Thatiana Lameira Maciel Amaral
OBJETIVE: to identify risk factors for death in patients who have suffered non-infectious adverse events. METHOD: a retrospective cohort study with patients who had non-infectious Adverse Events (AE) in an Intensive Care Unit. The Kaplan Meier method was used to estimate the conditional probability of death (log-rank test 95%) and the risk factors associated with death through the Cox regression. RESULTS: patients over 50 years old presented a risk 1...
July 16, 2018: Revista Latino-americana de Enfermagem
Stéphane Gaudry, David Hajage, Frédérique Schortgen, Laurent Martin-Lefevre, Charles Verney, Bertrand Pons, Eric Boulet, Alexandre Boyer, Guillaume Chevrel, Nicolas Lerolle, Dorothée Carpentier, Nicolas de Prost, Alexandre Lautrette, Anne Bretagnol, Julien Mayaux, Saad Nseir, Bruno Megarbane, Marina Thirion, Jean-Marie Forel, Julien Maizel, Hodane Yonis, Philippe Markowicz, Guillaume Thiery, Florence Tubach, Jean-Damien Ricard, Didier Dreyfuss
RATIONALE: The optimal strategy for initiation of renal replacement therapy (RRT) in patients with severe acute kidney injury in the context of septic shock and acute respiratory distress syndrome (ARDS) is unknown. OBJECTIVES: To examine the effect of an early compared with a delayed RRT initiation strategy on 60-day mortality according to baseline sepsis status, ARDS status, and severity. METHODS: Post hoc analysis of the AKIKI (Artificial Kidney Initiation in Kidney Injury) trial...
July 1, 2018: American Journal of Respiratory and Critical Care Medicine
Rafael Mendes da Silva, Flavio Geraldo Rezende de Freitas, Antonio Tonete Bafi, Hélio Tedesco Silva Junior, Bartira de Aguiar Roza
INTRODUCTION: The lungs are often involved in a variety of complications after kidney transplantation. Acute respiratory failure (ARF) is one of the most serious manifestations of pulmonary involvement. OBJECTIVE: To describe the main causes of ARF in kidney transplant patients who require intensive care and identify the factors associated with mortality. METHODS: This retrospective study evaluated adult patients with ARF admitted to the intensive care unit of a center with high volume of transplants from August 2013 to August 2015...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Kyo Won Lee, Chan Woo Cho, Nuri Lee, Gyu-Seong Choi, Yang Hyun Cho, Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh
PURPOSE: This study was designed to assess the outcome of the extracorporeal membrane oxygenation (ECMO) in liver transplantation (LT) recipients with refractory septic shock and predict the prognosis of those cases. METHODS: From February 2005 to October 2012, ECMO was used in 8 cases of refractory septic shock. Laboratory values including lactate and total bilirubin level just before starting ECMO were obtained and sepsis-related organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACH) II score and simplified acute physiology score (SAPS) 3 were calculated...
September 2017: Annals of Surgical Treatment and Research
Jong Wan Kim, Jun Ho Park, Doo Jin Kim, Won Hyuk Choi, Jin Cheol Cheong, Jeong Yeon Kim
INTRODUCTION: The delta neutrophil index (DNI) represents the fraction of circulating immature granulocytes and is a marker of infection and sepsis. Our objective was to evaluate the usefulness of DNI for predicting in-hospital mortality within 30 days after surgery in patients with sepsis caused by peritonitis by means of comparing DNI, white blood cell (WBC) count, neutrophil percentage, and C-reactive protein (CRP) before and after surgery. MATERIALS AND METHODS: We performed a retrospective analysis of demographic, clinical, and laboratory data...
2017: PloS One
Mohammed Hamid, Dandan Liu, Yassin Abdulrahim, Alamzeb Khan, Gang Qian, Kehe Huang
Selenizing astragalus polysaccharides-3 (sAPS3 ) was prepared by nitric acid-sodium selenite method. The effects of sAPS3 on carbon tetrachloride (CCl4 ) induced hepatocellular necrosis, and its underlying mechanisms were studied in male Wistar rats. Hepatic damage was induced by intraperitoneal injection of CCl4 twice a week, for 3 weeks. Meanwhile, the rats in addition to CCl4 were also exposed to sodium selenite (SS), astragalus polysaccharides (APS), SS + APS or sAPS3 , in parallel by oral gavage once a day for 3 weeks...
October 2017: Biological Trace Element Research
Daniere Yurie Vieira Tomotani, Antônio Tonete Bafi, Eduardo Souza Pacheco, Tainá Veras de Sandes-Freitas, Laila Almeida Viana, Edgar Porto de Oliveira Pontes, Nikkei Tamura, Hélio Tedesco-Silva, Flavia Ribeiro Machado, Flávio Geraldo Rezende Freitas
BACKGROUND: The purpose of this study was to assess the efficacy of open lung biopsy (OLB) in determining the specific diagnosis and the related complications in patients with undiagnosed diffuse pulmonary infiltrates. METHODS: This single center, retrospective study included adult kidney transplant patients who underwent OLB. The patients had diffuse pulmonary infiltrates without definitive diagnoses and failed to respond to empiric antibiotic treatment. We analyzed the number of specific diagnoses, changes in treatment and the occurrence of complications in these patients...
January 2017: Journal of Thoracic Disease
Norman Ertych, Ailine Stolz, Oliver Valerius, Gerhard H Braus, Holger Bastians
BRCA1 (breast cancer type 1 susceptibility protein) is a multifunctional tumor suppressor involved in DNA damage response, DNA repair, chromatin regulation, and mitotic chromosome segregation. Although the nuclear functions of BRCA1 have been investigated in detail, its role during mitosis is little understood. It is clear, however, that loss of BRCA1 in human cancer cells leads to chromosomal instability (CIN), which is defined as a perpetual gain or loss of whole chromosomes during mitosis. Moreover, our recent work has revealed that the mitotic function of BRCA1 depends on its phosphorylation by the tumor-suppressor kinase Chk2 (checkpoint kinase 2) and that this regulation is required to ensure normal microtubule plus end assembly rates within mitotic spindles...
February 16, 2016: Proceedings of the National Academy of Sciences of the United States of America
Sofie Van Ackerbroeck, Tom Schepens, Karolien Janssens, Philippe G Jorens, Walter Verbrugghe, Sandra Collet, Viviane Van Hoof, Luc Van Gaal, Christophe De Block
INTRODUCTION: Elevated blood glucose levels during intensive care unit (ICU) stay, so-called stress hyperglycaemia (SH), is a common finding. Its relation with a future diabetes risk is unclear. Our objective was to determine the incidence of disturbed glucose metabolism (DGM) post ICU admission and to identify predictors for future diabetes risk with a focus on stress hyperglycaemia. METHODS: This single center prospective cohort trial (DIAFIC trial) had a study period between September 2011 and March 2013, with follow-up until December 2013...
October 2, 2015: Critical Care: the Official Journal of the Critical Care Forum
Fernando Godinho Zampieri, Fernando Colombari
OBJECTIVE: To evaluate the impact of body mass index on the short-term prognosis of non-surgical critically ill patients while controlling for performance status and comorbidities. METHODS: We performed a retrospective analysis on a two-year single-center database including 1943 patients. We evaluated the impact of body mass index on hospital mortality using a gradient-boosted model that also included comorbidities and was assessed by Charlson's comorbidity index, performance status and illness severity, which was measured by the SAPS3 score...
April 2015: Revista Brasileira de Terapia Intensiva
Elena López-Knowles, Paul M Wilkerson, Ricardo Ribas, Helen Anderson, Alan Mackay, Zara Ghazoui, Aradhana Rani, Peter Osin, Ash Nerurkar, Lorna Renshaw, Alexey Larionov, William R Miller, J Michael Dixon, Jorge S Reis-Filho, Anita K Dunbier, Lesley-Ann Martin, Mitch Dowsett
INTRODUCTION: Aromatase inhibitors (AIs) are a vital component of estrogen receptor positive (ER+) breast cancer treatment. De novo and acquired resistance, however, is common. The aims of this study were to relate patterns of copy number aberrations to molecular and proliferative response to AIs, to study differences in the patterns of copy number aberrations between breast cancer samples pre- and post-AI neoadjuvant therapy, and to identify putative biomarkers for resistance to neoadjuvant AI therapy using an integrative analysis approach...
2015: Breast Cancer Research: BCR
Fernando G Zampieri, Fernando Colombari
BACKGROUND: Patients ≥80 years of age are increasingly being admitted to the intensive care unit (ICU). The impact of relevant variables, such comorbidities and performance status, on short-term outcomes in the very elderly is largely unknown. Few studies address the calibration of illness severity scores (SAPS3 score) within this population. We investigated the risk factors for hospital mortality in critically ill patients ≥80 years old, emphasizing performance status and comorbidities, and assessed the calibration of SAPS3 scores in this population...
2014: BMC Anesthesiology
Edvaldo Vieira de Campos, Marcelo Park, David Souza Gomez, Marcus Castro Ferreira, Luciano Cesar Pontes Azevedo
INTRODUCTION: To characterize the evolution of clinical and physiological variables in severe adult burn patients admitted to a Brazilian burn ICU, we hypothesized that characteristics of survivors are different from non-survivors after ICU admission. METHODS: A five-year observational study was carried out. The clinical characteristics, physiological variables, and outcomes were collected during this period. RESULTS: A total of 163 patients required ICU support and were analyzed...
December 2014: Burns: Journal of the International Society for Burn Injuries
Pedro V Mendes, Bruno N Rodrigues, Leandro C Miranda, Fernando G Zampieri, Eduardo L Queiroz, Guilherme Schettino, Luciano C Azevedo, Marcelo Park, Leandro U Taniguchi
BACKGROUND: Dynamic parameters for fluid responsiveness obtained from heart-lung interaction during invasive mechanical ventilation require specific conditions not always present in intensive care unit (ICU) patients. The aim of this study was to examine the prevalence of these conditions in critically ill patients. METHODS: We conducted a prospective observational study in 2 medical-surgical ICUs. We evaluated whether it would be possible to measure dynamic indices of fluid responsiveness when fluid expansion was administered...
May 2016: Journal of Intensive Care Medicine
Fabian Doerr, Akmal M A Badreldin, Ferzen Can, Ole Bayer, Thorsten Wahlers, Khosro Hekmat
OBJECTIVES: Cardiac surgery patients are excluded from SAPS2 but included in SAPS3. Neither score is evaluated for this exclusive population; however, they are used daily. We hypothesized that SAPS3 may be superior to SAPS2 in outcome prediction in cardiac surgery patients. DESIGN: All consecutive patients undergoing cardiac surgery between January 2007 and December 2010 were included in our prospective study. Both models were tested with calibration and discrimination statistics...
April 2014: Scandinavian Cardiovascular Journal: SCJ
Ruy Camargo Pires-Neto, Yurika Maria Fogaça Kawaguchi, Adriana Sayuri Hirota, Carolina Fu, Clarice Tanaka, Pedro Caruso, Marcelo Park, Carlos Roberto Ribeiro Carvalho
INTRODUCTION: Early mobilization can be performed in critically ill patients and improves outcomes. A daily cycling exercise started from day 5 after ICU admission is feasible and can enhance functional capacity after hospital discharge. In the present study we verified the physiological changes and safety of an earlier cycling intervention (< 72 hrs of mechanical ventilation) in critical ill patients. METHODS: Nineteen hemodynamically stable and deeply sedated patients within the first 72 hrs of mechanical ventilation were enrolled in a single 20 minute passive leg cycling exercise using an electric cycle ergometer...
2013: PloS One
So Yeon Lim, Shin Ok Koh, Kyeongman Jeon, Sungwon Na, Chae-Man Lim, Won-Il Choi, Young-Joo Lee, Seok Chan Kim, Gyu Rak Chon, Je Hyeong Kim, Jae Yeol Kim, Jaemin Lim, Chin Kook Rhee, Sunghoon Park, Ho Cheol Kim, Jin Hwa Lee, Ji Hyun Lee, Jisook Park, Younsuck Koh, Gee Young Suh
BACKGROUND AND OBJECTIVE: To externally validate the simplified acute physiology score 3 (SAPS3) and to customize it for use in Korean intensive care unit (ICU) patients. METHODS: This is a prospective multicentre cohort study involving 22 ICUs from 15 centres throughout Korea. The study population comprised patients who were consecutively admitted to participating ICUs from 1 July 2010 to 31 January 2011. RESULTS: A total of 4617 patients were enrolled...
August 2013: Respirology: Official Journal of the Asian Pacific Society of Respirology
Ranistha Ratanarat, Peenida Skulratanasak, Nattakarn Tangkawattanakul, Chattree Hantaweepant
BACKGROUND: The Acute Dialysis Quality Initiative (ADQI) group developed RIFLE criteria and the Acute Kidney Injury Network published AKIN classification that modified form RIFLE criteria. OBJECTIVE: The authors aimed to compare the ability of RIFLE and AKIN criteria to measure the incidence of acute kidney injury (AKI) and to predict clinical outcomes in critically illpatients. MATERIAL AND METHOD: A retrospective cohort study, in Siriraj Hospital, Bangkok...
February 2013: Journal of the Medical Association of Thailand
Marcelo Park, Luciano Cesar Pontes Azevedo, Pedro Vitale Mendes, Carlos Roberto Ribeiro Carvalho, Marcelo Brito Passos Amato, Guilherme Paula Pinto Schettino, Mauro Tucci, Alexandre Toledo Maciel, Leandro Utino Taniguchi, Edzangela Vasconcelos Santos Barbosa, Raquel Oliveira Nardi, Michelle de Nardi Ignácio, Cláudio Cerqueira Machtans, Wellington Alves Neves, Adriana Sayuri Hirota, Eduardo Leite Vieira Costa
OBJECTIVES: The aim of this manuscript is to describe the first year of our experience using extracorporeal membrane oxygenation support. METHODS: Ten patients with severe refractory hypoxemia, two with associated severe cardiovascular failure, were supported using venous-venous extracorporeal membrane oxygenation (eight patients) or veno-arterial extracorporeal membrane oxygenation (two patients). RESULTS: The median age of the patients was 31 yr (range 14-71 yr)...
October 2012: Clinics
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