1,720,970 research outputs found
Intravenous Amino-acid Infusion to Prevent Acute Kidney Injury after Cardiac Surgery: A Review of the Evidence
No full textBackground: Acute kidney injury (AKI) is a frequent and important complication of cardiac surgery. Decreased perfusion is a key mechanism. This decreased perfusion may be attenuated by intravenous amino acids (AAs) through recruitment of renal functional reserve. Methods: The study investigators performed a PubMed search of all articles published from 1980 to August 30, 2024, with combined search criteria of “renal functional reserve,” “amino acids,” “cardiac surgery,” and “cardiopulmonary bypass” by using MEDLINE (PubMed), Embase, and the Cochrane Central Register of Clinical Trials. Included were studies describing the effect of AAs on renal functional reserve and studies of adult cardiac surgery patients with information on renal function. A narrative review was developed. Results: Multiple experimental and human studies over >40 years have recurrently and consistently shown that the administration of an oral protein load or intravenous AAs increase renal blood flow and glomerular filtration rate by >30%. Moreover, several pilot investigations in cardiac surgery with cardiopulmonary bypass consistently showed renal benefits with intravenous AAs. Finally, a pivotal trial of 3511 cardiac surgery patients (the PROTECTION trial) recently confirmed such beneficial effects in a double-blind multicenter international setting. Conclusions: Intravenous AAs consistently recruit renal functional reserve and improve kidney function in cardiac surgery patients. These findings have been confirmed by the PROTECTION (Intravenous Amino Acid Therapy for Kidney Protection in Cardiac Surgery) trial. Intravenous AA therapy is the only proven treatment to prevent and/or attenuate the severity of cardiac surgery−associated AKI
Amino Acid Infusion and Renal Protection: Beyond Hemodynamic Optimization in Cardiac Surgery
No full textNon-Invasive Ventilation in the Prehospital Emergency Setting: A Systematic Review and Meta-Analysis
No full textIntroduction: Noninvasive ventilation is a well-established treatment for acute respiratory failure, being increasingly applied in the prehospital setting. This systematic review and meta-analysis aims to investigate whether early prehospital initiation of noninvasive ventilation reduces mortality compared to standard oxygen therapy. Methods: We searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials from inception to February 7th, 2022, for studies comparing prehospital noninvasive ventilation performed by emergency medical services versus standard oxygen therapy in patients with acute respiratory failure. The primary outcome was mortality at the longest follow-up available. Results: We included ten randomized studies and two quasi-randomized studies for a total of 1485 patients. Prehospital treatment with noninvasive ventilation compared with standard oxygen therapy did not significantly reduce mortality at the longest follow-up available (107/810 [13%] vs 114/772 [15%]; RR = 0.89; 95% CI, 0.70–1.13; P = 0.34; I2=24%). The endotracheal intubation rate was reduced when receiving prehospital noninvasive ventilation (38/776 [4.9%] vs 81/743 [11%]; RR = 0.44; 95% CI, 0.31–0.63; P < 0.001; I2=0%; number needed to treat 17). The intensive care admission rate (114/532 [21%] vs 129/507 [25%]; RR = 0.85; 95% CI, 0.69–1.04; P = 0.11; I2=0%) and length of hospital stay (mean difference=-1.29 days; 95% CI, −3.35–0.77; P = 0.21; I2=82%) were similar between groups. Conclusions: Adults with acute respiratory failure treated in the prehospital setting with noninvasive ventilation had a lower risk of intubation than those managed with standard oxygen therapy, with similar risk of death, intensive care admission, and length of hospital stay. Review registration: PROSPERO CRD42021284947
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
The renal effects of amino acids infusion
No full textAcute kidney injury (AKI) frequently affects surgical and critically ill patients [1-3]. AKI is associated with increased morbidity and mortality [4], as well as the requirement for additional resources [5]. Patients with severe AKI often need renal-replacement therapy (RRT), a treatment that doubles hospitalization costs [6] and has repercussions on long-term mortality and quality of life [7]. Until June 2024, the only to highlight their possible mechanisms of action
Serious complications associated with nasogastric, orogastric or enteral tube misplacement over the decades: a systematic review
Full text linkBackground: Gastrointestinal tube (GIT) insertion is common in surgical, medical and intensive care unit settings, with approximately 170,000 annual insertions in the UK alone. Despite its apparent simplicity, GIT placement can lead to acute complications, ranging from mucosal lesions to life-threatening conditions. Methods: We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching on PubMed, Cochrane, EMBASE and Scopus, all case reports and series describing harm from nasogastic, orogastric, or enteral tube placement. Results: A total of 148 studies reported acute GIT complications in 168 patients (70 patients received an enteral feeding tube). The number of publications increased over time. Half (91 patients, 52%) of the displacements involved the respiratory tract, but other organs were also affected, including the brain (33 patients, 20%), gastrointestinal tract (23 patients, 14%) and intravascular system (6 patients, 4%). Brain misplacement had the highest mortality (60.6%), while for respiratory tract misplacement mortality was 20.9%. Mortality was high in emergency department procedures and acute trauma, while it was low when enteral feeding tubes were involved. Only 30% of the manuscripts reported adherence to guidelines, which was associated with a trend towards decreased mortality. Conclusions: Our findings identify an increasing reporting of GIT misplacement complications and emphasize a variety of involved anatomical sites, from the well-known brain, respiratory tract, and pleural space mispositioning, to gastrointestinal and abdomen perforation, to the extremely uncommon spleen and intravascular mispositioning. The importance of implementing standardized protocols and maintaining heightened clinical vigilance is crucial to mitigate complications related to GIT misplacement. The PROSPERO Registration: PROSPERO CRD42024491074
Gender gap in bibliometric indices of academic and non-academic italian ICU physicians
Full text linkHirsch-index, better known as, H-index is an important bibliometric index for Italian critical care physi-cians. Aim of our study was to collect the H-index of all Italian critical care academic physicians and compare it with the Italian Ministry of University and Research thresholds necessary to be eligible as Professor, and to investigate potential gender disparities in such bibliometric indices. Materials and Methods. We collected all the names of academic ICU physicians on June 24th, 2023 from the official Italian Ministry of University and Research website. We added non-academic ICU physicians searching on Scopus or among academic physicians’ collaborators. Minimum thresholds to be eligible as Professor were identified through the official Italian Ministry of University and Research website. Median H-index of men and women were compared. Results. The total number of included physicians was 237 (46 Full Professors, 88 Associate Professors, 79 Researchers and 22 Non-academic physicians). Minimum threshold to be eligible as Associate Professor was 6 and to be eligible as Full Professor was 13. The median H-index in men versus women in every subgroup was: Full Professors (38 [27–49] vs 29 [21–34]), Associate Professors (25 [18–32] vs 22 [18–28]), Researchers (12 [7–21] vs 9 [6–16]) and Non-academic physicians (27 [25–37] vs 26 [25–29]). Conclusion. Current median H-index of Italian academic ICU physicians is considerably greater than minimum thresholds released by the Italian Ministry of University and Research to be eligible as Professor. Gender gap in bibliometric indices of academic ICU physicians remains
The renal effects of amino acids infusion
No full textAcute kidney injury (AKI) frequently affects surgical and critically ill patients [1-3]. AKI is associated with increased morbidity and mortality [4], as well as the requirement for additional resources [5]. Patients with severe AKI often need renal-replacement therapy (RRT), a treatment that doubles hospitalization costs [6] and has repercussions on long-term mortality and quality of life [7]. Until June 2024, the only to highlight their possible mechanisms of action
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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