Search results for " Emergency"

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.

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

2017

Airborne disease: a case of a Takotsubo cardiomyopathie as a consequence of nighttime aircraft noise exposure.

2016

Chronic noise exposure (in particular nighttime noise) leads to disturbances of activities, sleep, and communication. As a consequence, emotional responses or annoyance will lead to stress reactions characterized by an activation of the sympathetic nervous system and/or increased levels of circulating stress hormones. We report here a case of a patient, who was exposed to heavy …

Changes in the spatial distribution of the Purkinje network after acute myocardial infarction in the pig

2018

Purkinje cells (PCs) are more resistant to ischemia than myocardial cells, and are suspected to participate in ventricular arrhythmias following myocardial infarction (MI). Histological studies afford little evidence on the behavior and adaptation of PCs in the different stages of MI, especially in the chronic stage, and no quantitative data have been reported to date beyond subjective qualitative depictions. The present study uses a porcine model to present the first quantitative analysis of the distal cardiac conduction system and the first reported change in the spatial distribution of PCs in three representative stages of MI: an acute model both with and without reperfusion; a subacute …