592 research outputs found
Musculoskeletal ultrasound guiding shoulder injection when "one picture is worth ten thousand landmarks
No full text[No abstract available
Nosocomial Infection in MICU: An Observational Study
No full textIntroduction:
Nosocomial infections are infections; patients acquire while admitted to a health-care facility and generally develop 48 h or later after admission. These infections can lead to serious problems such as sepsis and even death.
Materials and Methods:
A prospective observational study was conducted for 6 months to estimate the incidence of nosocomial infections acquired in the medical intensive care unit (MICU), their risk factors, the causative pathogens, and the outcome. The patients admitted for more than 48 h to the MICU and willing to give consent were included in the study. Of 496 patients in MICU, 216 patients stayed 48 h and Acute Physiology and Chronic Health Evaluation II (APACHE II) score during the first 24 h of admission to the MICU.
Results:
The incidence of nosocomial infections in MICU was 14.9% (32 out of 216). Age, APACHE II score >13, MICU stay >7 days, and comorbidities such as peripheral venous line, central venous catheter, duration of urinary catheterization, duration of endotracheal intubation, nasogastric tube, and mechanical ventilator of >7 days were found to be independent risk factors of acquiring nosocomial infections (P < 0.05). Important causative organisms for nosocomial infections were Pseudomonas aeruginosa in 18 patients (32.72%), Escherichia coli in 11 (20.0%), Acinetobacter species in 8 (14.54%), and Klebsiella pneumoniae in seven patients (12.72%). Mortality among patients with nosocomial infections was 25% (8/32) and among those without nosocomial infections was 6.5% (12/184), P = 0.002. The length of ICU stay was higher in patients with nosocomial infections (15.42 ± 6.93 days) than in those without nosocomial infections (6.7 ± 5.14 days), P < 0.001.
Conclusion:
Nosocomial infections are common in ICU settings and contribute to significant mortality and morbidity. Infection control strategies are necessary to reduce nosocomial infection rates as well as ICU mortality and morbidity
Predictors of mortality among patients admitted to MICU.
No full textPredictors of mortality among patients admitted to MICU.</p
Demographic and admission characteristics of patients admitted to MICU.
No full textDemographic and admission characteristics of patients admitted to MICU.</p
The EF-hand Ca2+ binding protein MICU choreographs mitochondrial Ca2+ dynamics in Arabidopsis
No full textPlant organelle function must constantly adjust to environmental conditions, which requires dynamic coordination. Ca2+ signaling may play a central role in this process. Free Ca2+ dynamics are tightly regulated and differ markedly between the cytosol, plastid stroma, and mitochondrial matrix. The mechanistic basis of compartment-specific Ca2+ dynamics is poorly understood. Here, we studied the function of At-MICU, an EF-hand protein of Arabidopsis thaliana with homology to constituents of the mitochondrial Ca2+ uniporter machinery in mammals. MICU binds Ca2+ and localizes to the mitochondria in Arabidopsis. In vivo imaging of roots expressing a genetically encoded Ca2+ sensor in the mitochondrial matrix revealed that lack of MICU increased resting concentrations of free Ca2+ in the matrix. Furthermore, Ca2+ elevations triggered by auxin and extracellular ATP occurred more rapidly and reached higher maximal concentrations in the mitochondria of micu mutants, whereas cytosolic Ca2+ signatures remained unchanged. These findings support the idea that a conserved uniporter system, with composition and regulation distinct from the mammalian machinery, mediates mitochondrial Ca2+ uptake in plants under in vivo conditions. They further suggest that MICU acts as a throttle that controls Ca2+ uptake by moderating influx, thereby shaping Ca2+ signatures in the matrix and preserving mitochondrial homeostasis. Our results open the door to genetic dissection of mitochondrial Ca2+ signaling in plants
Restricted cubic spline predicted probability of 1-year MICU admission vs non-ARV medication count.
No full textRestricted cubic spline predicted probability of 1-year MICU admission vs non-ARV medication count.</p
Brane-world black holes and the scale of gravity
No full textA particle in four dimensions should behave like a classical black hole if the horizon radius is larger than the Compton wavelength or, equivalently, if its degeneracy (measured by entropy in units of the Planck scale) is large. For spherically symmetric black holes in 4 + d dimensions, both arguments again lead to a mass threshold M C and degeneracy scale M deg of the order of the fundamental scale of gravity M G. In the brane-world, deviations from the Schwarzschild metric induced by bulk effects alter the horizon radius and effective four-dimensional Euclidean action in such a way that M C ≃ M deg might be either larger or smaller than M G. This opens up the possibility that black holes exist with a mass smaller than M G and might be produced at the LHC even if M G ≳ 10 TeV, whereas effects due to bulk graviton exchanges remain undetectable because suppressed by inverse powers of M G. Conversely, even if black holes are not found at the LHC, it is still possible that M C ≫ M G and M G ≃ 1 TeV
Monthly analysis of admission versus death over three years in the MICU.
No full textMonthly analysis of admission versus death over three years in the MICU.</p
Risk factors for hospitalization and medical intensive care unit (MICU) admission among HIV-infected veterans
No full textObjectiveWith improved survival of HIV-infected persons on antiretroviral therapy and growing prevalence of non-AIDS diseases, we asked whether the VACS Index, a composite measure of HIV-associated and general organ dysfunction predictive of all-cause mortality, predicts hospitalization and medical intensive care unit (MICU) admission. We also asked whether AIDS and non-AIDS conditions increased risk after accounting for VACS Index score.MethodsWe analyzed data from the Veterans Aging Cohort Study (VACS), a prospective study of HIV-infected Veterans receiving care between 2002 and 2008. Data were obtained from the electronic medical record, VA administrative databases, and patient questionnaires and were used to identify comorbidities and calculate baseline VACS Index scores. The primary outcome was first hospitalization within 2 years of VACS enrollment. We used multivariable Cox regression to determine risk factors associated with hospitalization and logistic regression to determine risk factors for MICU admission, given hospitalization.ResultsOf 3410 patients, 1141 were hospitalized within 2 years; 203 (17.8%)/1141 patients included an MICU admission. Median VACS Index scores were 25 (no hospitalization), 34 (hospitalization only), and 51 (MICU). In adjusted analyses, a 5-point increment in VACS Index score was associated with 10% higher risk of hospitalization and MICU admission. In addition to VACS Index score, Hispanic ethnicity, current smoking, hazardous alcohol use, chronic obstructive pulmonary disease, hypertension, diabetes, and prior AIDS-defining event predicted hospitalization. Among those hospitalized, VACS Index score, cardiac disease, and prior cancer predicted MICU admission.ConclusionsThe VACS Index predicted hospitalization and MICU admission as did current smoking, hazardous alcohol use, and AIDS and certain non-AIDS diagnoses
Thermal BEC Black Holes
No full textWe review some features of Bose–Einstein condensate (BEC) models of black holes obtained by means of the horizon wave function formalism. We consider the Klein–Gordon equation for a toy graviton field coupled to a static matter current in a spherically-symmetric setup. The classical field reproduces the Newtonian potential generated by the matter source, while the corresponding quantum state is given by a coherent superposition of scalar modes with a continuous occupation number. An attractive self-interaction is needed for bound states to form, the case in which one finds that (approximately) one mode is allowed, and the system of N bosons can be self-confined in a volume of the size of the Schwarzschild radius. The horizon wave function formalism is then used to show that the radius of such a system corresponds to a proper horizon. The uncertainty in the size of the horizon is related to the typical energy of Hawking modes: it decreases with the increasing of the black hole mass (larger number of gravitons), resulting in agreement with the semiclassical calculations and which does not hold for a single very massive particle. The spectrum of these systems has two components: a discrete ground state of energy m (the bosons forming the black hole) and a continuous spectrum with energy ω > m (representing the Hawking radiation and modeled with a Planckian distribution at the expected Hawking temperature). Assuming the main effect of the internal scatterings is the Hawking radiation, the N-particle state can be collectively described by a single-particle wave-function given by a superposition of a total ground state with energy M = Nm and Entropy 2015, 17 6894 a Planckian distribution for E > M at the same Hawking temperature. This can be used to compute the partition function and to find the usual area law for the entropy, with a logarithmic correction related to the Hawking component. The backreaction of modes with ω > m is also shown to reduce the Hawking flux. The above corrections suggest that for black holes in this quantum state, the evaporation properly stops for a vanishing mass
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