719 research outputs found
Length of remdesivir treatment in patients with severe covid-19
No full textIn severe COVID-19, a 5-day remdesivir regimen seems as effective as a 10-day course of treatment and it may be safer. To date, the drug has no clearly proven efficacy over time
Exploring Associations Between Respiratory Mechanics and Survival in Immunocompromised Patients With ARDS
No full textThanks to improvements in organ support strategies and to advances in the treatment of solid and hematological
tumors, outcome of immunocompromised patients requiring ICU admission has improved impressively over the last decade . For this reason, the number of immunocompromised patients admitted to the ICU and deemed candidates for invasive therapies is steadily increasing. Acute respiratory failure (ARF) is the leading cause of hospital and ICU admission, but the optimal first-line
reatment of respiratory failure in these patients remains to be determine
Empirical decision-making for antimicrobial therapy in critically ill patients
No full textL'articolo non ha abstrac
Predatory journals and conferences: why fake counts
No full textPURPOSE OF REVIEW: Predatory publishing poses a serious educational end ethical threat to the credibility of science. The aim of this review is to discuss the main features of this deceptive open-access model, its potential consequences and relevance for the whole scientific community. RECENT FINDINGS: Recent reports showed that scholars and clinicians from all research fields, including anesthesiology, are facing an alarming invasion of predatory journals and, more recently, fake conferences. This review discusses key elements of these phenomena and proposes countermeasures to tackle the problem. SUMMARY: Predatory journals and conferences are two sides of the same coin. As here reviewed, their deceptive practices have negative implications for scientists and clinicians, both educational and ethical. These range from publication of experimental data that are unreliable and poorly verified to inflated curricula and 'doped' academic careers. Because clinical practice is heavily based on research data, a solution is needed to ultimately ensure patients' safety
Neutrophil CD64 as a marker of infection in patients admitted to the emergency department with acute respiratory failure
No full textAndrea Cortegiani, Vincenzo Russotto, Francesca Montalto, Grazia Foresta, Pasquale Iozzo, Santi Maurizio Raineri, Antonino Giarratano Department of Biopathology and Medical and Forensic Biotechnologies (DIBIMEF), Section of Anesthesiology, Analgesia, Emergency and Intensive Care, Policlinico “P Giaccone”, University of Palermo, Palermo, Italy Introduction: Cluster of differentiation 64 (CD64) is expressed on neutrophils during bacterial infections and sepsis. The aim of our study was to assess the CD64 expression in patients admitted to the emergency department (ED) with a triage diagnosis of acute respiratory failure (ARF) and/or dyspnea and to verify a relationship between its value and the presence of infection. Methods: We assessed neutrophil CD64 expression in peripheral blood of patients admitted to the ED with a diagnosis of ARF and/or dyspnea from September 2012 to April 2013. We measured CD64 index by flow cytometry (Leuko64™ kit) and classified patients as infected within 12 hours from admission, without an infection within 12 hours but infected within 72 hours from admission, and not infected. The primary outcome was differentiating CD64 values of patients with a diagnosis of infection within 12 hours and 72 hours from admission, from those of patients without a diagnosis of infection. The secondary outcome was verifying a relationship between CD64 values and patients' characteristics, Sequential Organ Failure Assessment score, and intensive care unit admission. Results: Of 212 patients included in the study, 40.1% were classified as infected within 12 hours from admission, 20.3% were without an infection 12 hours after admission but were infected within 72 hours, and 39.6% were not infected. The median CD64 index was higher in patients with an infection on admission (CD64 index: 3.58) than in those not considered infected (CD64 index: 1.37), P<0.0001. Among patients not infected at admission, the CD64 index was higher in those with an infection detected during the following hours of observation (CD64 index: 2.75) than in patients without a diagnosis of infection (CD64 index: 1.28), P<0.0001. A CD64 index >3.65 showed a sensitivity of 94.6%, a specificity of 86.8%, and an area under the receiver-operating characteristic curve of 0.952 for prediction of intensive care unit admission. Conclusion: CD64 index could represent a useful diagnostic tool for differential diagnosis of ARF in the ED. Keywords: acute respiratory failure, CD64, CD64 index, infectio
Physiopathological rationale of using high-flow nasal therapy in the acute and chronic setting: A narrative review
No full textChronic lung disease and admissions due to acute respiratory failure (ARF) are becoming increasingly common. Consequently, there is a growing focus on optimizing respiratory support, particularly non-invasive respiratory support, to manage these conditions. High flow nasal therapy (HFNT) is a noninvasive technique where humidified and heated gas is delivered through the nose to the airways via small dedicated nasal prongs at flows that are higher than the rates usually applied during conventional oxygen therapy. HFNT enables to deliver different inspired oxygen fractions ranging from 0.21 to 1. Despite having only recently become available, the use of HFNT in the adult population is quite widespread in several clinical settings. The respiratory effects of HNFT in patients with respiratory failure may be particularly relevant for clinicians. In this narrative review, we discuss the main pathophysiological mechanism and rationale for using HFNT in the acute and chronic setting
Rationale and evidence on the use of tocilizumab in COVID-19: A systematic review. Authors’ reply
No full textIntramuscular tranexamic acid: a real-world application of pharmacokinetics
No full textFor many anaesthetists around the world, the mere mention of the word ‘pharmacokinetics’ is sufficient to make their eyes glaze over and their attention wander. Pharmacokinetics is seen as an art that is as obscure and esoteric as the art of divination (prediction) practiced by the likes of Professor Sybille Trelawny 1 but that has varying and mostly limited relevance to clinical practice. Although this hyperbole may have elements of truth, it is a fact that pharmacokinetic data are the essential foundation upon which rational drug dosing guidelines are developed for all drugs
Obstructive sleep apnoea syndrome: What the anesthesiologist should know
No full textObstructive sleep apnoea syndrome (OSAS) is a rather common sleep disorder and
constitutes a risk or an aggravating factor for various underlying diseases. OSAS is
characterised by repeated upper airway collapse during sleep causing fragmented
sleep, hypoxemia and hypercapnia. It may also cause considerable changes in intrathoracic
pressure and an increase in sympathetic nervous activity, which represent
the basis of associated pathologies such as arterial hypertension, ischaemic heart
disease, diabetes mellitus, stroke and sudden death [1]. Moreover, there is a wellestablished
association between OSAS and postoperative complications [2, 3].
Nevertheless, a significant proportion of patients affected by OSAS undergo surgery
without diagnosis and, consequently, without therapy [4]. Therefore, it is crucial for
the anaesthesiologist to identify patients at risk of OSAS before surgery for a correct
definition of a perioperative strategy to reduce the risk of perioperative complication.
This process should be done independently and regardless of whether the
patient undergoes general or locoregional anaesthesia
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