Articles: outcome.
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Complicated intra-abdominal infections are an important cause of morbidity and are frequently associated with poor prognosis, particularly in higher risk patients. Well defined evidence-based recommendations for intra-abdominal infections treatment are partially lacking because of the limited number of randomized-controlled trials. Factors consistently associated with poor outcomes in patients with intra-abdominal infections include increased illness severity, failed source control, inadequate empiric antimicrobial therapy and healthcare-acquired infection. ⋯ A de escalation approach may be recommended in patients with specific risk factors for multidrug resistant infections such as immunodeficiency and prolonged antibacterial exposure. Therapy should focus on the obtainment of adequate source control and adequate use of antimicrobial therapy dictated by individual patient risk factors. Other critical issues remain debated and more controversies are still open mainly because of the limited number of randomized controlled trials.
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Transarticular screw (TAS) fixation is our preferred method for stable internal fixation of the atlantoaxial joint because of its excellent outcomes, versatility, and cost-effectiveness. ⋯ The placement of TASs is safe and effective for stabilizing the atlantoaxial articulation. Refinements in technique, such as 3-dimensional stereotactic workstation for trajectory planning, have reduced the rate of serious complications. Clinical outcomes are excellent, with nearly 100% of patients achieving stable bony union.
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To compare the effectiveness of supervised exercise therapy with usual care on self-reported recovery, pain, and function in persons with patellofemoral pain syndrome. ⋯ Supervised exercise therapy improved patients' pain at rest and during activity, and self-reported function improved faster than with no supervised intervention. The patients' perception of recovery from patellofemoral pain syndrome was not greater among the supervised exercise group.
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Decompressive craniectomy (DC) is often performed as an empirical lifesaving measure to protect the injured brain from the damaging effects of propagating oedema and intracranial hypertension. However, there are no clearly defined indications or specified guidelines for patient selection for the procedure. ⋯ Improving patient selection for DC may be expected to further improve the outcome following the procedure in severely brain-injured patients.
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HSR Proc Intensive Care Cardiovasc Anesth · Jan 2010
Volatile anaesthetic myocardial protection: a review of the current literature.
Ischaemic preconditioning is a powerful innate adaptive phenomenon whereby brief periods of sublethal ischaemia result in marked tolerance to subsequent lethal ischaemia. Halogenated anaesthetics have been shown to mimic ischaemic preconditioning, modifying and attenuating ischaemia reperfusion injury. ⋯ These volatile anaesthetics have been shown to improve clinical outcomes and health economics following cardiac surgery, reducing intensive care and hospital stay. The evidence for the benefit of volatile anaesthetics in non-cardiac surgery is less robust and further large randomized controlled trials are required to elucidate this question.