Swiss medical weekly
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Swiss medical weekly · Jan 2012
Multicenter Study Clinical TrialEvaluation of a novel in-vitro diagnostic device for the detection of urinary tract infections in diaper wearing children.
Is the novel in-vitro diagnostic device U-Test(®) reliable and secure for urine collection in diaper-wearing children and simultaneous evaluation of the urine collected for the presence of leucocytes and nitrite? ⋯ The evaluation shows that U-Test(®) is a safe and reliable device of high functionality and diagnostic performance for the detection of leucocytes and nitrite directly and without time delay in a child's diaper. This statement is based on a comprehensive comparison of the novel device with accepted diagnostic test systems and procedures based on the same dry chemistry technology. Due to its simplicity of use, U-Test(®) can be considered an alternative to the cumbersome procedures of urine collection by the bag-method or clean-catch followed by dipstick analysis for the presence of leucocytes and nitrite.
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Swiss medical weekly · Jan 2012
Randomized Controlled TrialEffect of bispectral index monitoring on extubation time and analgesic consumption in abdominal surgery: a randomised clinical trial.
The aim of this study was to investigate the effect of bispectral index (BIS) monitoring on intra-operative anaesthesia consumption and extubation time. ⋯ Guiding anaesthesia according to BIS level will result in significantly faster recovery after anaesthesia. The investigation was registered on ClinicalTrials.gov (NCT01470898).
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Malignant hyperthermia (MH) is a subclinical myopathy, usually triggered by volatile anaesthetics and depolarising muscle relaxants. Clinical symptoms are variable, and the condition is sometimes difficult to identify. Nevertheless, rapid recognition and specific as well as symptomatic treatment are crucial to avoid a lethal outcome. ⋯ There is no screening method to test for MH, as current tests are invasive (open muscle biopsy) or restricted to MH families with known MH-associated mutations (molecular genetic testing). The prevalence of the MH trait is unknown, because the clinical penetrance after contact with triggering agents is very variable. More recently, MH mutations have been associated with rhabdomyolysis following statin therapy or with non-pharmacological triggering, such as exertional heat stroke.
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Swiss medical weekly · Jan 2012
Comparative StudyPrognostic value of proadrenomedullin in severe sepsis and septic shock patients with community-acquired pneumonia.
Midregional proadrenomedullin (proADM) is a novel biomarker with potential prognostic utility in patients with community-acquired pneumonia. The aim of this study was to investigate the value of proADM levels for severity assessment and outcome prediction in severe sepsis and septic shock due to CAP. ⋯ In our study MR-proADM levels correlate with increasing severity of illness and death. High MR-proADM levels offer additional risk stratification in high-risk CAP patients.
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Swiss medical weekly · Jan 2012
ReviewPrognosis and quality of life of elderly patients after intensive care.
Ageing of the world's population raises important questions about the utilisation of the health care system. It is not clear how much should be invested in the last years of life whereas the costs are known to increase in parallel. Since intensive care units (ICU) are costly with highly specialised personnel, it seems of paramount importance that they would be used efficiently. ⋯ The fundamental questions are actually "Do they go back to life?" "What is life for elderly people?" These questions lead to more basic questions such as "Are they able to go back home or are they institutionalised? How is their quality of life and functional status after ICU?". We tried to address these questions through the existing literature and our experience while caring for these particular patients. Some clues on the prognostic factors related to their outcome are reported.