Search results for "Critical Care"

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…

2021

Proteins play a crucial role in metabolism, in maintaining fluid and acid-base balance and antibody synthesis. Dietary proteins are important nutrients and are classified into: 1) animal proteins (meat, fish, poultry, eggs and dairy), and, 2) plant proteins (legumes, nuts and soy). Dietary modification is one of the most important lifestyle changes that has been shown to significantly decrease the risk of cardiovascular (CV) disease (CVD) by attenuating related risk factors. The CVD burden is reduced by optimum diet through replacement of unprocessed meat with low saturated fat, animal proteins and plant proteins. In view of the available evidence, it has become acceptable to emphasize the …

Nutritional status and all-cause mortality in older adults with acute coronary syndrome.

2020

Background & aims The present analysis investigated the prevalence and the prognostic implication of nutritional status in older adults hospitalized for acute coronary syndrome (ACS). Methods The analysis is based on older ACS patients included in the FRASER and LONGEVO SCA studies. The Global Risk of Acute Coronary Events (GRACE) risk score was computed in all patients. Nutritional status was assessed with the Mini Nutritional Assessment-Short Form (MNA-SF, normal for values between 12 and 14, at risk of malnutrition for values between 8 and 11, and malnutrition for values ≤ 7). Physical performance was assessed with the Short Physical Performance Battery (SPPB). Primary outcome was all-ca…

Impact of colonic fermentation on sterols after the intake of a plant sterol-enriched beverage: A randomized, double-blind crossover trial

2017

Summary Background Cholesterol microbial transformation has been widely studied using in vitro fermentation assays, but less information is available on the biotransformation of plant sterols (PS). The excretion percentage of animal sterols (AS) (67–73%) is considerably greater than that of PS (27–33%) in feces from healthy humans following a Western diet. However, a lower content of AS in feces from subjects following a vegetarian, vegan or low-fat animal diet has been seen when compared to omnivorous subjects. Although only one human study has reported fecal sterol excretion after the consumption of PS-enriched food (8.6 g PS/day), it was found that the target group showed an increase in …

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

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 …

Pharmacokinetics of anidulafungin during venovenous extracorporeal membrane oxygenation

2016

Echinocandins are currently considered the first-line treatment for invasive candidiasis (IC) in the intensive care unit (ICU) [1, 2]. However, extracorporeal membrane oxygenation (ECMO), a rescue therapy used in patients with severe acute respiratory distress syndrome (ARDS) [3], could alter the pharmacokinetics of certain drugs [4]. We prescribed anidulafungin for suspected IC in a patient with severe ARDS on ECMO and measured the plasma concentrations of the drug using high-performance liquid chromatography (HPLC).