Critical care medicine
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Critical care medicine · Dec 2013
Observational StudyIndependent External Validation of the Status Epilepticus Severity Score.
A clinical scoring system for patients with status epilepticus was developed for predicting outcome, planning the level of monitoring needed, and guiding treatment. The aim was to confirm the external validity and transportability of the Status Epilepticus Severity Score prediction functions for outcome in adult patients with status epilepticus. ⋯ This study is the first independent external validation of the predictive accuracy of the Status Epilepticus Severity Score and its transportability to ICU patients with status epilepticus. Measures of discrimination and calibration indicated that Status Epilepticus Severity Score performed reasonably well on our cohort of ICU patients with status epilepticus. However, the specific optimal cutoff point for survival versus death in our cohort was different than proposed.
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Critical care medicine · Dec 2013
Mild Hypothermia Attenuates Circulatory and Pulmonary Dysfunction During Experimental Endotoxemia.
We tested whether mild hypothermia impacts on circulatory and respiratory dysfunction during experimental endotoxemia. ⋯ The induction of mild hypothermia attenuates cardiac and respiratory dysfunction and counteracts sympathetic activation during experimental endotoxemia. This was not associated with lower plasma cytokine levels, indicating a reduction of cytokine responsiveness by mild hypothermia.
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The therapeutic approach to sepsis is following an evolutionary process of scientific discovery as articulated in the landmark work by Kuhn, The Structure of Scientific Revolutions, first published 50 years ago. ⋯ A sustained paradigm shift in the approach to treating sepsis has yet to emerge, but recent data suggest that an open-minded posture informed by novel pathobiologic findings may eventually bear fruit.
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Critical care medicine · Dec 2013
P2X7 Receptor Antagonism Inhibits p38 Mitogen-Activated Protein Kinase Activation and Ameliorates Neuronal Apoptosis After Subarachnoid Hemorrhage in Rats.
Brilliant blue G, a selective P2X7 receptor antagonist, exhibits neuroprotective properties. This study examined whether brilliant blue G treatment ameliorates early brain injury after experimental subarachnoid hemorrhage, specifically via inhibiting p38 mitogen-activated protein kinase-related proapoptotic pathways. ⋯ Inhibition of P2X7 receptor by brilliant blue G or P2X7 receptor small interfering RNA can prevent early brain injury via p38 mitogen-activated protein kinase after subarachnoid hemorrhage.