Search results for " Emergency"

Bio-inspired security analysis for IoT scenarios

2020

Computer security has recently become more and more important as the world economy dependency from data has kept growing. The complexity of the systems that need to be kept secure calls for new models capable of abstracting the interdependencies among heterogeneous components that cooperate at providing the desired service. A promising approach is attack graph analysis, however, the manual analysis of attack graphs is tedious and error prone. In this paper we propose to apply the metabolic network model to attack graph analysis, using three interacting bio-inspired algorithms: topological analysis, flux balance analysis, and extreme pathway analysis. A developed framework for graph building…

Ambulatory Glucose Profile Applied to Flash Glucose Monitoring in Real Life: An Expert Opinion.

2016

The clinical benefits of real time continuous glucose monitoring (rtCGM) use have been well demonstrated in both CSII- and MDI-treated individuals in large clinical trials. However, recommendations for patient use of rtCGM in everyday life situations are lacking. This article provides guidance to clinicians and patients with type 1 diabetes (T1D) in effective use of rtCGM data, including glucose rate of change (ROC) arrows, for insulin dosing adjustments and other treatment decisions. The recommendations presented here are based on our own clinical experiences as endocrinologists, our personal experiences living with T1D using rtCGM, and findings from a recent survey of T1D patients who hav…

Sure he's dead? Be wise.

2013

Sedation and analgesia during noninvasive ventilation (NIV)

2017

The use of noninvasive ventilation (NIV) has increased significantly in patients with acute respiratory failure (ARF) in order to prevent tracheal intubation and its complications. Unfortunately, NIV failure represents a frequent event, with rates that in some cases reach 40%. Mask intolerance, agitation, and delirium may lead to NIV failure, thus requiring endotracheal intubation. NIV failure rates are higher in patients without chronic obstructive pulmonary disease (COPD), and, when used in acute hypoxemic failure, its failure is associated with an increased mortality rate. The practice of sedation during NIV could be a valuable option for patients at risk of intubation. Sedation may decr…

The Impact of the COVID-19 Emergency on the Quality of Life of the General Population

2022

COVID-19 is a pandemic that has forced many states to declare restrictive measures in order to prevent its wider spread. These measures are necessary to protect the health of adults, children, and people with disabilities. Long quarantine periods could cause an increase in anxiety crises, fear of contagion, and post-traumatic stress disorder (frustration, boredom, isolation, fear, insomnia, difficulty concentrating). Post-traumatic stress disorder (PTSD) is a condition that can develop in subjects who have been or have witnessed a traumatic, catastrophic, or violent event, or who have become aware of a traumatic experience that happened to a loved one. In fact, from current cases, it emerge…

Covid-19, documento SIAARTI e gerarchie di cura: cambiamenti e comportamenti sanitari in Italia

2021

In periodi segnati da pandemie sanitarie e crisi economiche profonde, l’incertezza rende ansiosi, influenzando comportamenti singoli, collettivi. Il Covid-19 ha già provocato e comporterà una serie di mutamenti che in Italia toccano diversi aspetti e tra questi sicuramente si annovera il principio della cura, per cui l’uso delle risorse e le politiche sanitarie necessitano di un processo di analisi e approfondimento ad oggi non maturo. L’articolo pone sotto i riflettori un tema lasciato nell’ombra: il diritto alla cura e il principio di gerarchia che è stato applicato durante la pandemia (1). Pietra miliare è il documento della Società Italiana di Anestesia, Analgesia, Rianimazione e Terapi…

Mr-Proadm Elevation Upon Icu Admission Predicts the Outcome of Septic Patients and is Correlated with Upcoming Fluid Overload.

2017

IF 3.113; International audience; Background: Among septic patients admitted to the intensive care unit (ICU), early recognition of those with the highest risk of death is of paramount importance. We evaluated the prognostic value of Procalcitonin (PCT), mid regional-proadrenomedullin (MR-proADM), copeptine and CT-proendothelin 1 (CT-ProET 1) concentrations. Methods: This was a prospective cohort study, which included 173 septic patient admitted to one ICU. Blood samples for biomarker measure-ments were obtained upon admission and on day 5. The predictive value of each biomarker regarding the risk of death at day 28 was assessed. The fluid balance was evaluated from admission to day 5. Resu…

Palliative Care in Advanced Cancer Patients: How and When? And Where?

2012

Eduardo Bruera et al. [1] recently published an exhaustive paper in which they underscore the importance of the integration between oncology and palliative care, suggesting how and when to provide palliative care in advanced cancer patients. We agree that this integrative model allows prompt evaluation and treatment of symptoms, a reduction in costs resulting from inappropriate hospitalization, and better survival outcomes. In their conclusion, Bruera et al. [1] affirm that the two most important resources for palliative care delivery are outpatient palliative care centers and inpatient palliative care units. Although we are on the same wavelength as Bruera et al. [1], we would like to poin…

Prognostic significance of central venous-to-arterial carbon dioxide difference during the first 24 hours of septic shock in patients with and withou…

2017

IF 6.238; International audience; Objective: To investigate the prognostic significance of central venous-to-arterial carbon dioxide difference (cv-art CO2 gap) during septic shock in patients with and without impaired cardiac function.Methods: We performed a prospective cohort study in 10 French intensive care units. Patients suffering from septic shock were assigned to the impaired cardiac function group (‘cardiac group’, n=123) if they had atrial fibrillation (AF) and/or left ventricular ejection fraction (LVEF) 0.9 kPa at 12 h had a higher risk of day 28 mortality (hazard ratio=3.18; P=0.0049). Among the 59 patients in the cardiac group with mean arterial pressure (MAP) ≥65 mm Hg, centr…

Comparison between doppler-echocardiography and uncalibrated pulse contour method for cardiac output measurement. a multicenter observational study

2016

Objectives: Echocardiography and pulse contour methods allow, respectively, noninvasive and less invasive cardiac output estimation. The aim of the present study was to compare Doppler echocardiography with the pulse contour method MostCare for cardiac output estimation in a large and nonselected critically ill population. Design: A prospective multicenter observational comparison study. Setting: The study was conducted in 15 European medicosurgical ICUs. Patients: We assessed cardiac output in 400 patients in whom an echocardiographic evaluation was performed as a routine need or for cardiocirculatory assessment. Interventions: None. Measurements and Main Results: One echocardiographic car…