Search results for " Critical Care"

Retarder une épuration extrarénale dans l’insuffisance rénale aiguë : la nuit nous appartient

2019

Les indications de l’épuration extrarénale (EER) dans le contexte d’insuffisance rénale aiguë en réanimation sont débattues avec une certaine passion. Il est évident que les situations qui peuvent menacer immédiatement le pronostic vital (hyperkaliémie ou acidose métabolique réfractaire et sévère ou oedème pulmonaire de surcharge chez le patient anurique) nécessitent un recours urgent à l’EER. Hormis ces situations extrêmes, des études de haut niveau de preuve ont récemment montré que retarder l’indication de l’EER n’affecte pas la survie des patients et pourrait même favoriser la récupération de la fonction rénale par comparaison à une EER trop précoce. Cette mise au point se propose de di…

Organización de la asistencia y manejo inicial del traumatismo craneoencefálico grave en España: resultados de una encuesta nacional

2017

Resumen Objetivo El objetivo fundamental del estudio es conocer la organizacion de la asistencia al traumatismo craneoencefalico grave asi como el manejo inicial de estos pacientes en los servicios de neurocirugia de Espana. Material y metodo Se diseno un cuestionario de 22 preguntas que fue enviado a los 59 servicios de neurocirugia identificados. El objeto del cuestionario era conocer el perfil general de los pacientes con un trauma craneoencefalico grave, las caracteristicas generales de los hospitales, la atencion inicial de dichos pacientes, las tecnicas de monitorizacion empleadas y las medidas encaminadas a bajar la PIC. Resultados De los 59 servicios de neurocirugia identificados, 2…

Disaster E-Health Framework for Community Resilience

2018

Haemorrhagic Cerebrovascular Accident (CVA) Etiology and Case Report

2020

Abstract A haemorrhagic cerebrovascular accident refers to a spontaneous bleeding in the cerebral parenchyma, located either supratentorial or infratentorial, that occurs in the absence of a surgical or traumatic cause. The incidence is estimated at 12-15 new cases per 100.000 inhabitants per year. Intracranial haemorrhage is the third most frequent cause of stroke, the vast majority being represented by primary/hypertensive (spontaneous) intracerebral haemorrhage, ruptured saccular aneurysm, a vascular malformation or haemorrhage associated with the use of anticoagulants or thrombolytic agents. A cerebral tomography computer examination is the examination of choice in diagnosis of haemorrh…

Dos terapias conocidas podrían ser efectivas como adyuvantes en el paciente crítico infectado por COVID-19

2020

Resumen La neumonia causada por coronavirus, que se origino en Wuhan, China, a finales de 2019, se ha extendido por todo el mundo convirtiendose en una pandemia. Desafortunadamente, a dia de hoy no existe ninguna vacuna especifica para el virus COVID-19, y el tratamiento esta siendo de soporte con anadido de antivirales y otros farmacos, sin que hasta la fecha se haya evidenciado un beneficio claro. Muchos de estos pacientes se deterioran rapidamente y requieren ser intubados y ventilados mecanicamente, lo que esta provocando el colapso del sistema sanitario en muchos paises debido a la falta de ventiladores y de camas de criticos. En este documento revisamos dos terapias adyuvantes sencill…

From bedside to bench: The missing brick for patients with fungal sepsis

2016

We read with great interest the article by Spec et al. [1] investigating the immunophenotype of T cells from patients with Candida spp. sepsis. This is the first observational study describing the altered immune response of patients with candidemia. The authors included non-neutropenic critically ill patients with candidemia and non-septic controls, and excluded patients with human immunodeficiency virus infection, who had undergone solid or bone marrow transplantation or with other known causes of impaired immune response. The authors hypothesized that their findings may help explain why patients with fungal sepsis show a high mortality despite appropriate antifungal therapy. In our opinio…

Dying with or because of invasive fungal infection? The role of immunity exhaustion on patient outcome

2016

De Rosa et al. considered clinical scores, biomarkers and their combination as useful aids for an early antifungal treatment and advocated the adoption of de-escalation therapy in an antifungal stewardship approach as a possible key for a better management of these patients. Authors considered the high burden of invasive fungal infections in terms of patient outcomes and costs and focused on current strategies for their optimization.

Should we continue to use prediction tools to identify patients at risk of Candida spp. infection? If yes, why?

2016

Background Given the predominance of invasive fungal disease (IFD) amongst the non-immunocompromised adult critically ill population, the potential benefit of antifungal prophylaxis and the lack of generalisable tools to identify high risk patients, the aim of the current study was to describe the epidemiology of IFD in UK critical care units, and to develop and validate a clinical risk prediction tool to identify non-neutropenic, critically ill adult patients at high risk of IFD who would benefit from antifungal prophylaxis. Methods Data on risk factors for, and outcomes from, IFD were collected for consecutive admissions to adult, general critical care units in the UK participating in the…

Optimal doses of caspofungin during continuous venovenous hemodiafiltration in critically ill patients

2017

Plant polyphenols, chemoreception, taste receptors and taste management

2019

International audience; Purpose of review Polyphenols display beneficial health effects through chemopreventive actions on numerous chronic diseases including cancers, metabolic disorders, reproductive disorders and eating behaviour disorders. According to the principle of chemoreception, polyphenols bind cellular targets capable of accepting their stereochemistry, namely metabolizing enzymes and protein receptors, including taste receptors. The extraoral expression of taste receptors and their pharmacological interest in terms of novel drug therapies open up new perspectives on the potential use of these compounds and their interactions with other chemicals in cells. These new perspectives…