Intensive care medicine
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Intensive care medicine · Nov 2007
Leptospirosis in Reunion Island (Indian Ocean): analysis of factors associated with severity in 147 confirmed cases.
Analysis of risk factors associated with severity in patients with confirmed leptospirosis. ⋯ Pulmonary involvement is a major feature in leptospirosis disease but is not associated with poor outcome. Identification of clinical and laboratory findings on admission may help to better characterize severe cases.
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Intensive care medicine · Nov 2007
Relative safety of hyperinsulinaemia/euglycaemia therapy in the management of calcium channel blocker overdose: a prospective observational study.
To examine the clinical safety of hyperinsulinaemia/euglycaemia therapy (HIET) in calcium channel blocker (CCB) poisoning. ⋯ HIET used to treat CCB-induced cardiovascular toxicity is a safe intervention when administered in a critical care setting. Maximal HIET efficacy may be obtained when HIET is administered in conjunction with conventional therapy relatively early in the course of severe CCB poisoning when insulin resistance is high.
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Intensive care medicine · Nov 2007
The views of patients and relatives of what makes a good intensivist: a European survey.
This study examined the views of adult patients and relatives about desirable characteristics of specialists in intensive care medicine (ICM) to incorporate these into an international competency-based training programme, CoBaTrICE. ⋯ Patients and relatives with experience of intensive care in different European countries share similar views on the importance of knowledge, skills, decision making and communication in the training of intensive care specialists. These generic patient-centred components of training have been incorporated into the international competency-based ICM training programme, CoBaTrICE.
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Intensive care medicine · Nov 2007
Neuronal nitric oxide synthase deficiency decreases survival in bacterial peritonitis and sepsis.
To investigate the role of neuronal nitric oxide synthase (NOS1) in murine polymicrobial peritonitis and sepsis. ⋯ Deficiency and inhibition of NOS1 increases mortality, possibly by increasing proinflammatory cytokine response and impairing bacterial clearance after CLP. These data suggest that NOS1 is important for survival, bacterial clearance, and regulation of cytokine response during infection and sepsis.
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Intensive care medicine · Nov 2007
Light and darkness fail to regulate melatonin release in critically ill humans.
Pineal dysfunction has been associated with morbidity and mortality in various animal models of severe illness, and low melatonin plasma concentrations have recently been reported in patients on the ICU. However, it is not known whether the physiological response of the pineal gland to light and darkness is preserved in critical illness. ⋯ The physiological regulation of melatonin secretion by darkness and light is abolished in severely ill patients.