Critical Care*

BACKGROUND: Catecholamines are commonly used as therapeutic drugs in intensive care medicine to maintain sufficient organ perfusion during shock. However, excessive or sustained adrenergic activation drives detrimental cardiac remodeling and may lead to heart failure. Whether catecholamine treatment in absence of heart failure causes persistent cardiac injury, is uncertain. In this experimental study, we assessed the course of cardiac remodeling and recovery during and after prolonged catecholamine treatment and investigated the molecular mechanisms involved...

BACKGROUND: Critical illness survival rates have improved, but patients frequently face prolonged new or worsened physical, cognitive and psychosocial impairments (Josepha op't Hoog et al., 2022, Aust Crit Care). These difficulties associated with critical care admission are known as post-intensive care syndrome (PICS). AIMS: The multidisciplinary InS:PIRE programme was developed to support patients in the recovery period from critical illness. During the COVID-19 pandemic, the psychology support offered by this service was adapted from an in-person group to individual remote review...

PURPOSE: This study sought to understand family functioning surrounding weight in Mexican American women with obesity. METHODS: Semi-structured in-depth interviews were conducted with mothers and adult daughters ( N  = 116). RESULTS: Thematic analysis identified five themes. 1) The communication process drives perception of supportive messages. Messages perceived as non-supportive consist of directives as interventions, confirmation of faults, and critical compliments whereas supportive consist of compliments, encouragement, empathetic listening, and disclosure...

Shoulder pain represents the most frequently reported musculoskeletal disorder, often leading to significant functional impairment and pain, impacting quality of life. Home-based rehabilitation programs offer a more accessible and convenient solution for an effective shoulder disorder treatment, addressing logistical and financial constraints associated with traditional physiotherapy. The aim of this systematic review is to report the monitoring devices currently proposed and tested for shoulder rehabilitation in home settings...

Wireless Sensor Networks (WSNs) are crucial in various fields including Health Care Monitoring, Battlefield Surveillance, and Smart Agriculture. However, WSNs are susceptible to malicious attacks due to the massive quantity of sensors within them. Hence, there is a demand for a trust evaluation framework within WSNs to function as a secure system, to identify and isolate malicious or faulty sensor nodes. This information can be leveraged by neighboring nodes, to prevent collaboration in tasks like data aggregation and forwarding...

This paper addresses the design of beam position monitor (BPM) devices suitable for fourth-generation diffraction-limited X-ray storage rings. Detailed investigations of the electromagnetic (EM) phenomena occurring inside the component under various working conditions are carried out by considering different BPM EM models defined by their geometry and materials. Moving from a theoretical characterization of the common round geometry, rhomboidal structures are studied through a careful numerical analysis relying on advanced computer-aided tools...

Enteral nutrition (EN) therapy in ICU patients requiring oxygen therapy with high-flow nasal cannula (HFNC) and/or noninvasive mechanical ventilation (NIMV) is controversial. A prospective, cohort, observational, and multicenter study was conducted in 10 ICUs in Spain to analyze the 90-day mortality, tolerance, side effects, and infectious complications of trophic EN in patients requiring HFNC therapy and/or NIVM. A total of 149 patients were enrolled. The mean age, severity scores, tracheobronchitis, bacteremia, and antimicrobial therapy were significantly higher in deceased than in living patients ( p < 0...

Sepsis-induced acute kidney injury (AKI) is a common complication in patients with severe illness and leads to increased risks of mortality and chronic kidney disease. We investigated the association between monocyte distribution width (MDW), red-blood-cell volume distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), sepsis-related organ-failure assessment (SOFA) score, mean arterial pressure (MAP), and other risk factors and sepsis-induced AKI in patients presenting to the emergency department (ED)...

D-bifunctional protein deficiency (D-BPD) is a rare, autosomal recessive peroxisomal disorder that affects the breakdown of long-chain fatty acids. Patients with D-BPD typically present during the neonatal period with hypotonia, seizures, and facial dysmorphism, followed by severe developmental delay and early mortality. While some patients have survived past two years of age, the detectable enzyme activity in these rare cases was likely a contributing factor. We report a D-BPD case and comment on challenges faced in diagnosis based on a narrative literature review...

Inspired by nature's remarkable ability to form intricate minerals, researchers have unlocked transformative strategies for creating next-generation biosensors with exceptional sensitivity, selectivity, and biocompatibility. By mimicking how organisms orchestrate mineral growth, biomimetic and bioinspired materials are significantly impacting biosensor design. Engineered bioinspired materials offer distinct advantages over their natural counterparts, boasting superior tunability, precise controllability, and the ability to integrate specific functionalities for enhanced sensing capabilities...

This study aimed to investigate how stakeholders in the United States beef industry incorporate animal welfare into their sustainability programs. A survey was administered online to the U.S. Roundtable for Sustainable Beef membership. Twenty-seven surveys were analyzed. Most respondents ( n = 26, 96%) had sustainability programs that incorporated animal welfare. Most respondents believed that welfare positively impacted environmental ( n = 25/26, 96%), economic ( n = 25/26, 96%), and social ( n = 26/26, 100%) sustainability...

The implantation of cardiac electronic devices (CIEDs), including pacemakers and defibrillators, has become increasingly prevalent in recent years and has been accompanied by a significant rise in cardiac device infections (CDIs), which pose a substantial clinical and economic burden. CDIs are associated with hospitalizations and prolonged antibiotic therapy and often necessitate device removal, leading to increased morbidity, mortality, and healthcare costs worldwide. Approximately 1-2% of CIED implants are associated with infections, making this a critical issue to address...

Nosocomial Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia results in a significant increase in morbidity and mortality in hospitalized patients. We aimed to analyze the impact of applying 10% povidone iodine (PI) twice daily to both nares in addition to chlorhexidine (CHG) bathing on nosocomial (MRSA) bacteremia in critically ill patients. A quality improvement study was completed with pre and post-design. The study period was from January 2018 until February 2020 and February 2021 and June 2021...

Veno-arterial (V-A) and Veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) support is increasingly utilized for acute cardiogenic shock and/or respiratory failure. Echocardiography and point-of-care ultrasonography (POCUS) play a critical role in the selection and management of these critically ill patients, however, there are limited guidelines regarding their application. This comprehensive review describes current and potential application of echocardiography and POCUS for pre-ECMO assessment and patient selection, cannulation guidance with emphasis on dual-lumen configurations, diagnosis of ECMO complications and trouble-shooting of cannula malposition, diagnosis of common cardiac or pulmonary pathologies, and assessment of ECMO weaning appropriateness including identification of the aortic mixing point in V-A ECMO...

Advanced respiratory monitoring encompasses a diverse range of mini- or noninvasive tools used to evaluate various aspects of respiratory function in patients experiencing acute respiratory failure, including those requiring extracorporeal membrane oxygenation (ECMO) support. Among these techniques, key modalities include esophageal pressure measurement (including derived pressures), lung and respiratory muscle ultrasounds, electrical impedance tomography, the monitoring of diaphragm electrical activity, and assessment of flow index...

Background: Artificial intelligence (AI) algorithms can be applied in breast cancer risk prediction and prevention by using patient history, scans, imaging information, and analysis of specific genes for cancer classification to reduce overdiagnosis and overtreatment. This scoping review aimed to identify the barriers encountered in applying innovative AI techniques and models in developing breast cancer risk prediction scores and promoting screening behaviors among adult females. Findings may inform and guide future global recommendations for AI application in breast cancer prevention and care for female populations...

Background: In hemodynamically unstable patients, the passive leg raise (PLR) test is recommended for use as a self-fluid challenge for predicting preload responsiveness. However, to interpret the hemodynamic effects and reliability of the PLR, the method of performing it is of the utmost importance. Our aim was to determine the current practice of the correct application and interpretation of the PLR in intensive care patients. Methods: After ethical approval, we designed a cross-sectional online survey with a short user-friendly online questionnaire...

Background : Though out-of-hospital CA (OHCA) is widely reported, data on in-hospital CA (IHCA) and especially cardiac arrest (CA) in the emergency department (CAED) are scarce. This study aimed to determine the frequency, prevalence, and clinical features of unexpected CAED and compare the data with those of expected CAED. Methods : We defined unexpected CAED as CA occurring in patients in non-critical ED-care areas; classified as not requiring strict monitoring. This classification was the modified Japanese Triage and Acuity Scale and physician assessment...

Clinical guidelines include monitoring blood test abnormalities to identify patients at increased risk of undiagnosed cancer. Noting blood test changes over time may improve cancer risk stratification by considering a patient's individual baseline and important changes within the normal range. We aimed to review the published literature to understand the association between blood test trends and undiagnosed cancer. MEDLINE and EMBASE were searched until 15 May 2023 for studies assessing the association between blood test trends and undiagnosed cancer...

Myeloproliferative neoplasms (MPNs), including Polycythemia Vera (PV), Essential Thrombocythemia (ET), and Primary Myelofibrosis (PMF), are characterized by the clonal proliferation of hematopoietic stem cells leading to an overproduction of hematopoietic cells. The last two decades have seen significant advances in our understanding of the molecular pathogenesis of these diseases, with the discovery of key mutations in the JAK2 , CALR , and MPL genes being pivotal. This review provides a comprehensive update on the molecular landscape of PV, ET, and PMF, highlighting the diagnostic, prognostic, and therapeutic implications of these genetic findings...