Articles: cations.
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Neurological conditions represent an important driver of paediatric disability burden worldwide. Measurement of serum neurofilament light chain (sNfL) concentrations, a specific marker of neuroaxonal injury, has the potential to contribute to the management of children with such conditions. In this context, the European Medicines Agency recently declared age-adjusted reference values for sNfL a top research priority. We aimed to establish an age-adjusted sNfL reference range database in a population of healthy children and adolescents, and to validate this database in paediatric patients with neurological conditions to affirm its clinical applicability. ⋯ Swiss National Science Foundation, US National Institutes of Health, and the National Multiple Sclerosis Society.
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There are numerous, well-established racial disparities in the management of pain. The degree to which these are evident at the stage of conducting clinical trials is unknown. To address this knowledge gap, we examined race-based reporting, participation of Black individuals, and the factors associated with reporting and participation in pain clinical trials in the United States. ⋯ Our results indicate that representation of Black participants in pain clinical trials generally aligns with national demographics in the United States. Increased representation corresponds with health conditions more prevalent among Black individuals (eg, cardiovascular disease) and with a diverse study team composition. Despite these encouraging results, less than half of pain trials reported race, which introduces potential publication bias and limits external validity.
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The International Classification of Diseases ( ICD ) is applied worldwide for public health data collection among other use cases. However, the current version of the ICD ( ICD-10 ), to which the reimbursement system is linked in many countries, does not represent chronic pain properly. This study aims to compare the ICD-10 with the ICD-11 in hospitalized patients in terms of specificity, clinical utility, and reimbursement for pain management. ⋯ The simulated reimbursement fee remained the same when adding 397 pain-related codings, even if the cost of pain management, such as cost of labor, existed. Compared with the ICD-10 version, the ICD-11 is more specific and makes pain diagnoses more visible. Thus, shifting from ICD-10 to ICD-11 has the potential to improve both the quality of care and the reimbursement for pain management.
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Objective: Respiratory infections or colonization of Acinetobacter baumannii (Ab) are common in clinical practice but are treated differently. Early identification of Ab infection and colonization reduces the risk of antibiotic mismatch but objective laboratory indicators to distinguish between bacterial infections and colonization are lacking. To distinguish infection and colonization of Ab, we tested the role of two biomarkers, triggering receptor expressed on myeloid cells-1 (TREM-1) and hemolysin coregulated protein. ⋯ No differences in hcp gene presence and transcript levels were found between two groups ( P > 0.05). Conclusions: Dynamic monitoring of sTREM-1 and PCT is valuable in identifying Ab infection and colonization. sTREM-1 can be improved by combination with multiple biomarkers in the early stage for identification of infection and colonization. The hcp gene was more likely to be present in the infection cohort.
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Minerva anestesiologica · Sep 2023
Enhanced extracorporeal carbon dioxide removal by acidification and metabolic control.
Extracorporeal carbon dioxide removal (ECCO
2 R) promotes protective ventilation in patients with acute respiratory failure, but devices with high CO2 extraction capacity are required for clinically relevant impact. This study evaluates three novel low-flow techniques based on dialysate acidification, also combined with renal replacement therapy, and metabolic control. ⋯ The three techniques achieved a significant extracorporeal CO2 removal allowing a relevant reduction in minute ventilation with a sufficient safety profile.