Articles: adult.
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Critical care medicine · Dec 2015
Systemic Corticosteroids and Transition to Delirium in Critically Ill Patients.
Corticosteroids are frequently used in critically ill patients. We investigated whether systemic corticosteroid use increases the probability of transitioning to delirium in a large population of mixed medical-surgical ICU patients. ⋯ In a large population of mixed medical-surgical ICU patients, systemic corticosteroid use was not associated with an increased probability of transitioning to delirium.
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Sudden cardiac arrest (SCA) or sudden cardiac death (SCD) in children and adolescents is a devastating event. Although the true incidence is unclear, the etiologies are not. Strategies for prevention include both primary as well as secondary prevention strategies, and these strategies are not mutually exclusive. ⋯ It is critically important to promote and advocate for cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) education for everyone, including all students prior to graduation from high school. CPR and AEDs save the lives of children, adolescents, and adults. A society that is able and willing to perform CPR will result in an increase in the incidence of lay-rescuer CPR and will undoubtedly save more lives.
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This study was performed to determine a landmark for chest compression depth for adult cardiopulmonary resuscitation (CPR) using chest computed tomography and to evaluate the validity of the landmark. ⋯ The SN may have value as a functional landmark for chest compression depth in adult CPR. Our findings combined with the simulated one-fourth chest compressions were more consistent with the depth between 50 and 60 mm recommended by the 2015 CPR guidelines.
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Pertussis is a potentially severe respiratory disease, which affects all age groups from young infants to older adults and is responsible for an estimated 195,000 deaths occurred globally in 2008. Active research is ongoing to better understand the pathogenesis, immunology, and diagnosis of pertussis. For diagnosis, molecular assays (e.g., polymerase chain reaction) for detection of Bordetella pertussis have become more widely available and support improved outbreak detection. ⋯ Continued surveillance for pertussis will be important to identify opportunities for reducing young infants' exposure and reducing the impact of outbreaks among school-aged children. Laboratory-based surveillance for newly emerging strains of B. pertussis will be important to identify strains that may evade protection elicited by currently available vaccines. Efforts to develop new-generation pertussis vaccines should be considered now in anticipation of vaccine development programs, which may require ten or more years to deliver a licensed vaccine.
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Catheter Cardiovasc Interv · Dec 2015
Case ReportsPercutaneous tricuspid valve-In-ring replacement for the treatment of recurrent severe tricuspid regurgitation.
Percutaneous tricuspid valve-in-ring replacement can be an alternative to surgery for high-risk patients with symptomatic severe tricuspid regurgitation that recurs after surgical ring repair. Practitioners must pay attention to the specific technical details associated with this procedure that include: using the ring as a fluoroscopic landmark, sizing the valve area with multi-modality imaging, choosing the appropriate device based on the patients anatomy, and dealing with the inevitable paravalvular leak (created by the ring deformation in the absence of valve-specific devices). Our case demonstrates that percutaneous tricuspid valve-in-ring replacement is a feasible treatment that can result in both hemodynamic and symptomatic improvement.