85 research outputs found
Assessment of Economic Growth of the Republic of Moldova in the Context of Global Economic Crisis
No full textThe world economic crisis has had a negative impact on the economic development of Moldova, but recent trends show that in 2010 we were able to forecast a small economic growth. The author examines the problems faced by the Moldavian economy which shackle its strong recovery. The current evolutions of the Moldavian economy are analyzed in the paper as well.remittances, foreign trade, competitiveness, structural reforms, macroeconomic environment
Cardiac Follow-Up in Patients with COVID-19
No full textAlthough major clinical manifestations of coronavirus disease (COVID-19) is related with respiratory system, major cardiac complications such as myocardial injury, arrhyth 2019 mias are reported in many publications. Another remarkable finding related with COVID-19 is the relation between hypertension and disease severity and mortality
Approach to the Elderly Patient with Delirium: The Intensive Care Specialist’s Perspective
No full text
A fatal case of severe serotonin syndrome accompanied by moclobemide and paroxetine overdose
No full textAim: To present a fatal case of serotonin syndrome accompanied by
moclobemide and paroxetine overdose. Case presentation: A 34-year-old
married woman was presented following intentional ingestion of 3.5 g
moclobemide and 2.6 g paroxetine. She was drowsy, agitated, and having
rigor. In 1 h she developed myoclonus and diffuse muscle rigidity
prominent in lower extremities. All laboratory tests were unremarkable
except hyperglycemia (160 mg/dl), sinus tachycardia (103/min), and
metabolic acidosis (7.051 pH, 52 mmHg pO2, 74.7 mmHg pCO2, 15% HCO3,
77% SaO2). Despite oxygen supplementation, her respiratory acidosis got
worse and the SaO2 concentration decreased to 72%. Endotracheal
intubation and paralysis were decided to control muscle hyperactivity
followed by hyperthermia (max. 42.3°C) unresponsive to
benzodiazepine. Even aggressive supportive treatment (mechanical
ventilation, buffer replacement, cyproheptadine, and dantrolene) were
applied, the patient could not recover and suffered cardiopulmonary
arrest 20 h after presentation. Conclusion: Physicians working in the
emergency departments and intensive care units, managing patients
presenting with acute ingestion of selective serotonin reuptake
inhibitors combined with monoamine oxidase inhibitors, should be aware
of recognizing and treating serotonin stndrome. This is because many of
these patients may require intensive care monitoring as well as
tracheal intubation and ventilatory support
IMPACT OF TIME TO ANTIBIOTICS ON MORTALITY IN SEVERE SEPSIS AND SEPTIC SHOCK
No full textIntroduction: Severe sepsis and septic shock are associated with high mortality. Antibiotherapy must be started as early as possible since it seems to be the most important factor determining survival. In this study, we aimed to evaluate the time intervals between diagnosis and first dose of antibiotherapy and its impact on mortality in severe sepsis and septic shock patients
Impact of factors at admittance predicting intensive care unit mortality in critically ill cancer patients
No full textBackground: The aim of this study is to evaluate the prognostic factors at medical ICU admittance predicting intensive care unit (ICU) mortality in cancer patients.Methods: Retrospectively data of adult patients admitted to medical ICU of a 1200-bed university hospital during January 2012-December 2013 interval were analysed. The patients were divided into three groups; patients with solid tumor, patients with hematologic malignancy and patients without cancer. The study end point was ICU mortality.Results: 512 patients were identified; 374 patients without cancer, 89 patients with solid tumor and 49 patients with hematologic malignancy. Overall mortality rate in intensive care unit was 46% (n=236). The ICU mortality rate of patients with hematologic malignancy was significantly higher than patients with solid tumors (68.6% vs 53%; p<0.001) and patients without cancer (68.6% vs 39.8%; p<0.001). Logistic regression analysis showed high APACHE II score and the requirement for invasive mechanical ventilation (odds ratio [OR], 5.52; 95% confidence interval [CI], 2.10-14.53; p<0.001) at the time of intensive care unit admittance as independent risk factors for increased mortality. In addition, the requirement of renal replacement therapy(OR, 2.34; [CI: 1.44-3.80]; p<0.002) and vasopressors(OR, 1.67; [CI: 1.10-2.54]; p<0.02) at the time of intensive care unit admittance were detected as independent risk factors for increased mortality in cancer free group.Conclusions: In critically ill cancer patients; high APACHE II score and the requirement of invasive mechanical ventilation should be evaluated at the time of intensive care unit admittance, for these are strong predictors of increased mortality
Evaluation of Hyperkalemia Associated with Trimethoprim-Sulfamethoxazole in the Intensive Care Unit
No full textAim: The objective of this study was to determine the incidence and risk factors of hyperkalemia associated with trimethoprim-sulfamethoxazole (TMP-SMX) in the intensive care unit (ICU)
Risk factors for resistant gram negative infections in intensive care unit
No full textObjective: The most common resistant gram negative bacteria isolated in hospital-acquired blood stream infections are Pseudomonas aeruginosa, Acinetobacter species and Klebsiella pneumoniae. These infections are associated with increased mortality rates. In this study, we aimed to identify the risk factors for emerging resistant gram negative bacterial infections. Methods: Data of 280 patients hospitalized in Medical Intensive Care Unit (ICU) between September 1st, 2013 and September 30th, 2014 were reviewed retrospectively. Results: Resistant gram negative bacterial infections were detected in 80 patients. Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa were the most resistant strains, respectively. APACHE II score, duration of mechanical ventilation, length of ICU stay and length of hospital stay were independent risk factors for resistant gram negative bacteria isolation. Mechanical ventilation and central venous catheterization were related with increased mortality rates. Length of ICU stay was an independent risk factor for resistant A.baumannii isolation. Prolonged mechanical ventilation, hospital and ICU stay were common risk factors for resistant K.pneumoniae and P.aeruginosa isolation. Total parenteral nutrition was an additional risk factor for resistant K.pneumoniae isolation and mortality rates for K.pneumoniae were higher than the other bacteriae. Conclusion: In the management of critical patients; prolonged ICU and hospital stays should be avoided as much as possible and central venous catheterization should only be used for appropriate indications and removed as soon as possible to prevent resistant gram negative bacterial infections. In addition, mechanically ventilated patients should be weaned from the ventilator as soon as possible, parenteral nutrition products should not be used instead of enteral nutrition if it’s not necessary and antibiotics must be used appropriately. © 2020 by Turkish Society of Medical and Surgical Intensive Care Medicine
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