8 research outputs found
Probiotic Bacterial Application in Pediatric Critical Illness as Coadjuvants of Therapy
No full textThe use of probiotics in critically ill adult and children patients has been growing exponentially over the last 20 years. Numerous factors in pediatriac intensive care unit (PICU) patients may contribute to intestinal dysbiosis, which subsequently promotes the pathobiota’s growth. Currently, lactobacillus and bifidobacterium species are mainly used to prevent the development of systemic diseases due to the subverted microbiome, followed by streptococcus, enterococcus, propionibacterium, bacillus and Escherichia coli, Lactobacillus rhamnosus GG, and Lactobacillus reuteri DSM 17938. The aim of this article is to review the scientific literature for further confirmation of the importance of the usage of probiotics in intensive care unit (ICU) patients, especially in the pediatric population. A progressive increase in nosocomial infections, especially nosocomial bloodstream infections, has been observed over the last 30 years. The World Health Organization (WHO) reported that the incidence of nosocomial infections in PICUs was still high and ranged between 5% and 10%. Petrof et al. was one of the first to demonstrate the efficacy of probiotics for preventing systemic diseases in ICU patients. Recently, however, the use of probiotics with different lactobacillus spp. has been shown to cause a decrease of pro-inflammatory cytokines and an increase in anti-inflammatory cytokines. In addition, in some studies, the use of probiotics, in particular the mix of Lactobacillus and Bifidobacterium reduces the incidence of ventilator-associated pneumonia (VAP) in PICU patients requiring mechanical ventilation. In abdominal infections, there is no doubt at all about the usefulness of using Lactobacillus spp probiotics, which help to treat ICU-acquired diarrhoea episodes as well as in positive blood culture for candida spp. Despite the importance of using probiotics being supported by various studies, their use is not yet part of the standard protocols to which all doctors must adhere. In the meantime, while waiting for protocols to be drawn up as soon as possible for use in PICUs, routine use could certainly stimulate the intestine’s immune defences. Though it is still too early to say, they could be considered the drugs of the future
Lock, Stock and Barrel: Role of Renin-Angiotensin-Aldosterone System in Coronavirus Disease 2019
No full textSince the end of 2019, the medical-scientific community has been facing a terrible pandemic caused by a new airborne viral agent known as SARS-CoV2. Already in the early stages of the pandemic, following the discovery that the virus uses the ACE2 cell receptor as a molecular target to infect the cells of our body, it was hypothesized that the renin-angiotensin-aldosterone system was involved in the pathogenesis of the disease. Since then, numerous studies have been published on the subject, but the exact role of the renin-angiotensin-aldosterone system in the pathogenesis of COVID-19 is still a matter of debate. RAAS represents an important protagonist in the pathogenesis of COVID-19, providing the virus with the receptor of entry into host cells and determining its organotropism. Furthermore, following infection, the virus is able to cause an increase in plasma ACE2 activity, compromising the normal function of the RAAS. This dysfunction could contribute to the establishment of the thrombo-inflammatory state characteristic of severe forms of COVID-19. Drugs targeting RAAS represent promising therapeutic options for COVID-19 sufferers
Cultural Diversity A Glimpse Over the Current Debate in Sweden
No full textA year and a half ago, the Swedish government decided 2006 to be The Year for Cultural Diversity (Agenda för Mångkultur, 2005). The general purpose, according to the directive, is to facilitate the possibilities for all citizens to participate in all aspects of the cultural life by enhancing appropriate arenas for different traditions (Agenda för Mångkultur, 2005). This policy decision was not a surprise to both observers and participants of the diversity debate. There has been a growing interest in the virtues of diversity for business effectiveness and success (mångfald.com), heightened scrutiny of institutional and organizational life by the mass media, and legitimizing debates by political parties which had always had some form of concern for diversity, if not for its own sake, at least for capitalizing on the legitimacy of diversity politics in the expectation of local and parliament elections next September. The proclamation of 2006 as a Year for Cultural diversity thus comes naturally from the broadened debates and organizational programs, each actor trying to get legitimacy by using the concept of cultural diversity to suit the demands of the times. Indeed, cultural diversity has become a priority agenda for any legitimate actor, at least in terms of programs and polices, if not in action. Moreover, the coordinator of the 2006 Cultural Year consistently promised in the mass media that this would be “the starting point”, and not merely a celebratory performance (VK, 28 October 2005; DN 3 January 2006). Already, what are called as the Cultural diversity consultants had worked since 2003 in eight counties as a partial preparation for this year, and to raise the consciousness of relevant actors in the field of culture and cultural institutions, especially those financed by state money. Private cultural associations, however, are invited to participate during the diversity year but they were not invited to co-design the contents of the diversity year. This paper is concerned with describing the concept of diversity as used by the different actors in this context, and also examines the background that has led to the decision of the Cultural Year. An implicit concern is scrutinizing whether in fact this year would be a starting point for more deeply engaged diversity programs and actions or a symbolic act of window dressing. The concerned actors base the paper on accounting the background to the Diversity debate in Sweden, and the different expected programs and agendas. As such, the paper is based on analysis of documents and agendas, interviews with different actors and two multicultural consultants at the county level. Additionally, the author also participated in a couple of seminars and conferences and video-filmed some of the speeches by different presenters to capture the patterns of the debate/discourse on Cultural diversity. Implicit discussion is whether the current interest on diversity may lead to its institutionalization in the Swedish society organizations (Scott 1995, Hamde, 2002), or it simply is a ‘traveling’ idea to appear occasionally and then occur in fashion-like manner as many management ideas (Czarniawska & Joerges, 1996). As pointed out in the sub-title this paper brings provides only a mere glimpse at the huge subject and the debate.: Actors, cultural diversity, institutionalization, multicultural consultants, multicultural year, Swedish debate
A Tale of Three Countries: Italian, Spanish and Swiss Manufacturing Operations in China
No full textIn this paper we investigate the choice of FDI versus joint-venture, made by Italian, Spanish and Swiss multinationals in China, as shaped by the risk of Dissipation of Intangible Assets. Probit estimates, based on an entirely new firm-level dataset, constructed by the author, show that FDI is more likely to emerge when know-how easily spills over - namely for firms endowed with more Intangible Assets or belonging to high tech sectors - in line with the theoretical expectations.Intangible Assets, Internalisation, FDI, Joint-venture, China
Why Worry About Climate Change? A Research Agenda
No full textEstimates of the marginal damage costs of carbon dioxide emissions suggest that, although climate change is a problem and some emission reduction is justified, very stringent abatement does not pass the cost-benefit test. However, current estimates of the economic impact of climate change are incomplete. Some of the missing impacts are likely to be positive and others negative, but overall the uncertainty seems to concentrate on the downside risks and current estimates of the damage costs may have a negative bias. The research effort on the economic impacts of climate change is minute, and should be strengthened, with a particular focus on the quantification of uncertainties; estimating missing impacts, interactions between impacts and higher-order effects; the valuation of biodiversity loss; the implications of extreme climate scenarios and violent conflict; and climate change in the very long term.Climate Change, Impacts, Valuation, Cost-benefit Analysis
Lack of SARS-CoV-2 RNA environmental contamination in a tertiary referral hospital for infectious diseases in Northern Italy
No full textN
Emergency Department and Out-of-Hospital Emergency System (112-AREU 118) integrated response to Coronavirus Disease 2019 in a Northern Italy centre
No full textSince December 2019, the world has been facing the life-threatening disease, named Coronavirus disease-19 (COVID-19), recognized as a pandemic by the World Health Organization. The response of the Emergency Medicine network, integrating "out-of-hospital" and "hospital" activation, is crucial whenever the health system has to face a medical emergency, being caused by natural or human-derived disasters as well as by a rapidly spreading epidemic outbreak. We here report the Pavia Emergency Medicine network response to the COVID-19 outbreak. The "out-of-hospital" response was analysed in terms of calls, rescues and missions, whereas the "hospital" response was detailed as number of admitted patients and subsequent hospitalisation or discharge. The data in the first 5 weeks of the Covid-19 outbreak (February 21-March 26, 2020) were compared with a reference time window referring to the previous 5 weeks (January 17-February 20, 2020) and with the corresponding historical average data from the previous 5 years (February 21-March 26). Since February 21, 2020, a sudden and sustained increase in the calls to the AREU 112 system was noted (+ 440%). After 5 weeks, the number of calls and missions was still higher as compared to both the reference pre-Covid-19 period (+ 48% and + 10%, respectively) and the historical control (+ 53% and + 22%, respectively). Owing to the overflow from the neighbouring hospitals, which rapidly became overwhelmed and had to temporarily close patient access, the population served by the Pavia system more than doubled (from 547.251 to 1.135.977 inhabitants, + 108%). To minimize the possibility of intra-hospital spreading of the infection, a separate "Emergency Department-Infective Disease" was created, which evaluated 1241 patients with suspected infection (38% of total ED admissions). Out of these 1241 patients, 58.0% (n = 720) were admitted in general wards (n = 629) or intensive care unit (n = 91). To allow this massive number of admissions, the hospital reshaped many general ward Units, which became Covid-19 Units (up to 270 beds) and increased the intensive care unit beds from 32 to 60. In the setting of a long-standing continuing emergency like the present Covid-19 outbreak, the integration, interaction and team work of the "out-of-hospital" and "in-hospital" systems have a pivotal role. The present study reports how the rapid and coordinated reorganization of both might help in facing such a disaster. AREU-112 and the Emergency Department should be ready to finely tune their usual cooperation to respond to a sudden and overwhelming increase in the healthcare needs brought about by a pandemia like the current one. This lesson should shape and reinforce the future
