Critical care medicine
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Critical care medicine · Apr 2012
Case ReportsHerpes simplex virus encephalitis despite normal cell count in the cerebrospinal fluid.
To describe herpes simplex virus encephalitis despite normal cell count in the cerebrospinal fluid in patients with malignoma after whole brain irradiation. ⋯ In patients with impaired consciousness, epileptic seizure, or temporal lobe symptoms of new onset and a recent history of brain irradiation with normal cerebrospinal fluid, an atypical anergic course of herpes simplex virus encephalitis should be considered. Herpes simplex virus polymerase chain reaction should be used as method of choice to detect herpes simplex virus genomes as early as possible rather than relying on routine cerebrospinal fluid parameters. Importantly, antiviral therapy should be started without delay in any case of faint suspicion and should be continued until herpes simplex virus encephalitis is clearly ruled out.
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Critical care medicine · Apr 2012
Critical care physicians' approaches to negotiating with surrogate decision makers: a qualitative study.
To describe how critical care physicians manage conflicts with surrogates about withdrawing or withholding patients' life support. ⋯ Physicians reported using a tailored approach to resolve decisional conflicts about life support and attempted to change surrogates' decisions in accordance with what the physician thought was in the patients' best interests. Although physicians acknowledged their efforts to change surrogates' decisions, many physicians did not perceive these efforts as persuasive.
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Critical care medicine · Apr 2012
Statins and outcomes in patients with bloodstream infection: a propensity-matched analysis.
The pleiotropic effects of statins, 3-hydroxy-3 methylglutaryl coenzyme A reductase inhibitor, have been shown to modify inflammatory cell signaling on the immune response to infection. It was postulated that statins may be a good candidate as novel therapeutic agents for the treatment of sepsis. We investigated whether ongoing statin therapy is associated with mortality in patients with bloodstream infection. ⋯ After adjusting for the propensity to receive statin therapy, no statistically significant association between statin therapy before bloodstream infection and survival was identified.
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Critical care medicine · Apr 2012
A mathematical model for simulating daily bed occupancy in an intensive care unit.
To develop a mathematical model for simulating the daily bed occupancy in an intensive care unit. ⋯ It is possible to develop simulation models that can be used to predict future intensive care unit resource needs.
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Critical care medicine · Apr 2012
Systemic administration of autologous adipose-derived mesenchymal stem cells alleviates hepatic ischemia-reperfusion injury in rats.
Mesenchymal stem cells have previously been shown to offer significant therapeutic benefit in ischemic organ injuries. This study aimed at investigating the therapeutic role of adipose tissue-derived mesenchymal stem cells in hepatic ischemia-reperfusion injury and the underlying mechanisms. ⋯ The results showed that systemic adipose tissue-derived mesenchymal stem cell administration significantly preserved hepatocyte integrity and suppressed inflammatory responses, oxidative stress, and apoptosis in a rodent model of hepatic ischemia-reperfusion injury.