MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Journal of Critical Care' source. Thu, 09 Feb 2012 10:59:51 +0100 http://www.medworm.com/index.php?rid=5654935&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111005168%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654935 Wed, 01 Feb 2012 05:00:00 +0100 5654935 http://www.medworm.com/index.php?rid=5654934&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111005156%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654934 Wed, 01 Feb 2012 05:00:00 +0100 5654934 http://www.medworm.com/index.php?rid=5654930&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111004941%2Fabstract%3Frss%3Dyes Abstract: An intensive care unit (ICU) is for critically ill patients who are likely to benefit from the expertise care provided. The outcome is dependent on the available human and material resources. The University of Calabar Teaching Hospital is a 410-bed hospital. It has a 3-bed general ICU consisting of 2 adult and 1 pediatric beds. A retrospective analysis of all ICU admissions as well as the mortality rate during a 12-month period that spans April 2009 and March 2010 was done. The data were collected from the ICU admissions and nurses' report books. The data extracted were the patients ages, stratified to pediatric (0-18 years) and adult (>18 years); the source of admission, primary diagnosis, the duration of admission, and the patients who were ventilated were also noted. The outco... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654930 Wed, 01 Feb 2012 05:00:00 +0100 5654930 http://www.medworm.com/index.php?rid=5654923&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111005090%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654923 Wed, 01 Feb 2012 05:00:00 +0100 5654923 http://www.medworm.com/index.php?rid=5654908&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111005351%2Fabstract%3Frss%3Dyes The year 2011 marked the first year the Journal of Critical Care published on a bimonthly schedule. This, coupled with an increased page allocation and accelerated submission rate, has created a robust and increasingly visible publication that depends upon its volunteer reviewers to succeed. Therefore, it is not only appropriate and fitting but also a pleasure and responsibility to thank the Journal's nine hundred fifty-eight completed reviews (out of 2024 invitations) 2011 reviewers for their expert commentaries, unstinting commitment to excellence, and selfless dedication to the concept that peer review is one of the highest forms of academic commitment and a bastion of journalistic integrity. This year has seen a number of challenges to the reputation of the process, but despite several... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654908 Wed, 01 Feb 2012 05:00:00 +0100 5654908 http://www.medworm.com/index.php?rid=5609932&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611003576%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609932 Fri, 20 Jan 2012 21:08:15 +0100 5609932 http://www.medworm.com/index.php?rid=5609931&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611003370%2Fabstract%3Frss%3Dyes The Publisher regrets that an error occurred in the last 4 lines of the Table (just before the references) of the EC-IBD centres and members. The correction is as follows: (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609931 Fri, 20 Jan 2012 21:08:15 +0100 5609931 http://www.medworm.com/index.php?rid=5609914&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611003564%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609914 Fri, 20 Jan 2012 21:08:15 +0100 5609914 http://www.medworm.com/index.php?rid=5446529&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111004539%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5446529 Sat, 26 Nov 2011 04:24:25 +0100 5446529 http://www.medworm.com/index.php?rid=5446528&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111004527%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5446528 Sat, 26 Nov 2011 04:24:25 +0100 5446528 http://www.medworm.com/index.php?rid=5446519&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111004400%2Fabstract%3Frss%3Dyes “Whoever saves one life it is as he or she had saved the entire world” is the sentence from the Talmud's book that inspired Dr Max Harry Weil throughout his life as man, clinician, scientist, teacher, and friend. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5446519 Sat, 26 Nov 2011 04:24:25 +0100 5446519 http://www.medworm.com/index.php?rid=5446505&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111004485%2Fabstract%3Frss%3Dyes The December issue marks the end of the Journal of Critical Care's first year of bimonthly publication schedule, and I am happy to report that the year noted not only continued strength in the journal's impact factor but also a significant increase in the number of submitted abstracts from all areas of the world. The journal is on track to receive approximately 600 submissions. The processing of the material depends on the work of multiple volunteers, and the February issue will provide further details of the individuals whose academic dedication and volunteer support make an endeavor of this magnitude possible. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5446505 Sat, 26 Nov 2011 04:24:25 +0100 5446505 http://www.medworm.com/index.php?rid=5441970&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611002856%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441970 Fri, 25 Nov 2011 09:32:44 +0100 5441970 http://www.medworm.com/index.php?rid=5441945&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611002844%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441945 Fri, 25 Nov 2011 09:32:44 +0100 5441945 http://www.medworm.com/index.php?rid=5654916&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111003911%2Fabstract%3Frss%3Dyes Conclusions: In this large cohort study, nosocomial/health care–associated infections were common in ICU patients with HIV and severe sepsis. Hospital mortality was associated with acute illness severity, but not clearly associated with variables related to HIV infection. Interventions that aim to prevent or more effectively treat nosocomial infections in critically ill patients with HIV may favorably impact clinical outcomes. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654916 Fri, 28 Oct 2011 04:00:00 +0100 5654916 http://www.medworm.com/index.php?rid=5609930&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611002595%2Fabstract%3Frss%3Dyes Conclusions: The answers to 10 key questions were based on available evidence and clinical experience of programme participants. It is hoped they will be of practical use in everyday gastroenterology practice. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609930 Thu, 20 Oct 2011 04:00:00 +0100 5609930 http://www.medworm.com/index.php?rid=5609915&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS187399461100256X%2Fabstract%3Frss%3Dyes Abstract: Epidemiological evidence demonstrates that smoking is the most important environmental risk factor in Crohn's disease while it positively interferes with the disease course of ulcerative colitis. However, the underlying mechanisms through which smoking exerts this divergent effect and affects pathogenesis of inflammatory bowel disease are largely unknown. Animal smoke models are good models to investigate the impact of cigarette smoke on intestinal physiology and inflammation. They enable one to explore the interaction of smoke components and the gut on cellular and molecular level, clarifying how smoking interferes with normal gut function and with disease course in inflammatory conditions. This review describes the currently used animal models for studying the impact of cigaret... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609915 Thu, 13 Oct 2011 04:00:00 +0100 5609915 http://www.medworm.com/index.php?rid=5280221&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111003996%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280221 Sat, 01 Oct 2011 04:00:00 +0100 5280221 http://www.medworm.com/index.php?rid=5280220&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111003984%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280220 Sat, 01 Oct 2011 04:00:00 +0100 5280220 http://www.medworm.com/index.php?rid=5280210&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002395%2Fabstract%3Frss%3Dyes The aim of this study is to examine the bacterial contamination of computer user interface (keyboard and mouse) of physician workstation at different intensive care units (ICUs) in Jeddah City, in 2011. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280210 Sat, 01 Oct 2011 04:00:00 +0100 5280210 http://www.medworm.com/index.php?rid=5280209&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002383%2Fabstract%3Frss%3Dyes This study examined the biopsychosocial impact of laughter yoga and therapy on stroke patients in South Africa. A quasiexperimental research design was used involving 2 groups. The laughter group participated in movement exercises using laughter yoga and therapy, whereas the control group participated in the same exercises without the laughter yoga and therapy. Physiologic tests were performed to measure the respondent's blood sugar levels as well as their blood pressure during the pretest and posttest. A pretest and posttest relating to the psychosocial functioning of the respondent's using the PANAS scale as well as a self-reported symptom checklist were administered. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280209 Sat, 01 Oct 2011 04:00:00 +0100 5280209 http://www.medworm.com/index.php?rid=5280208&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002371%2Fabstract%3Frss%3Dyes Ventilator-associated pneumonia (VAP) is a very serious hospital-acquired infection that increases mortality, morbidity, hospital length of stay, and costs. An organized approach toward VAP prevention includes education and training of the ICU team, followed by regular monitoring and feedback on VAP prevention. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280208 Sat, 01 Oct 2011 04:00:00 +0100 5280208 http://www.medworm.com/index.php?rid=5280207&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS088394411100236X%2Fabstract%3Frss%3Dyes A protocol that paired spontaneous awakening trials (SATs) and spontaneous breathing trials (SBTs) decreased the duration of mechanical ventilation, the intensive care unit (ICU) length of stay (LOS), and mortality . We studied the efficacy of multifaceted implementation strategies of an evidence-based protocol at a tertiary academic center . (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280207 Sat, 01 Oct 2011 04:00:00 +0100 5280207 http://www.medworm.com/index.php?rid=5280206&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002358%2Fabstract%3Frss%3Dyes Sepsis is associated with cell necrosis and apoptosis. Indeed, plasma DNA levels have been shown to be increased in patient with sepsis . So, we investigated the prognostic value of circulating levels of cell-free DNA in critically ill septic patients regarding the clinical course and final outcome. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280206 Sat, 01 Oct 2011 04:00:00 +0100 5280206 http://www.medworm.com/index.php?rid=5280205&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002346%2Fabstract%3Frss%3Dyes The objective of this study is to determine the incidence, characteristics, and preventability of adverse drug events (ADEs) in critically ill patients with cancer. This was a 5-month prospective observational study conducted in a 12-bed intensive care unit (ICU) at a comprehensive cancer medical center. All patients admitted to the ICU were evaluated for any ADEs upon admission and during their ICU stay. Adverse drug events were identified using a modified version of the trigger tool developed by the Institute of Health Improvement. The ADEs were classified based on the system involved, management, outcomes, and preventability. The results were presented as counts and percentages. A comparison for the number of ADEs and several patient factors was conducted using the Kruskal-Wallis test ... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280205 Sat, 01 Oct 2011 04:00:00 +0100 5280205 http://www.medworm.com/index.php?rid=5280203&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS088394411100390X%2Fabstract%3Frss%3Dyes Tracheostomy has become the method of choice in managing patients requiring long-term mechanical ventilation and is required in nearly 10% of patients receiving mechanical ventilation . Late complications after decannulation occur in up to 65% of these patients and include granulation tissue formation, tracheal stenosis, tracheomalacia, fistula formation, infection, and aspiration . The clinical presentations in these cases range from an asymptomatic status to serious clinical events. Some patients also have complications secondary to scar formation during stoma closure. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280203 Sat, 01 Oct 2011 04:00:00 +0100 5280203 http://www.medworm.com/index.php?rid=5280202&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002942%2Fabstract%3Frss%3Dyes We thank the authors of the letter entitled “Characterization of temporal evolution of metabolic acidosis in adult patients with severe diabetic ketoacidosis admitted to the intensive care unit: not quite done” for the attention in reading our article and for the considerations. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280202 Sat, 01 Oct 2011 04:00:00 +0100 5280202 http://www.medworm.com/index.php?rid=5280201&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002930%2Fabstract%3Frss%3Dyes We read with great interest the article by Lopes et al describing, in a retrospective study, the characterization of temporal evolution of metabolic acidosis in adult patients with severe diabetic ketoacidosis (DKA) admitted to the intensive care unit by using the quantitative approach. We have some remarks regarding this article. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280201 Sat, 01 Oct 2011 04:00:00 +0100 5280201 http://www.medworm.com/index.php?rid=5280200&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111003960%2Fabstract%3Frss%3Dyes We read, with interest, the remarks of Dr Tan et al regarding our study on the clinical course of Acinetobacter baumannii infection in patients with hematologic malignancy in the intensive care unit (ICU) . (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280200 Sat, 01 Oct 2011 04:00:00 +0100 5280200 http://www.medworm.com/index.php?rid=5280199&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111003844%2Fabstract%3Frss%3Dyes In this study, they investigated the clinical manifestations of Acinetobacter baumannii infection in patients with hematologic cancer in the intensive care unit (ICU). Despite that the ICU mortality was higher in 35 patients with A baumannii infection than in 87 patients without A baumannii infection (83% vs 56%, P = .006), the presence of A baumannii infection was not found to be independently associated with mortality in multivariate analysis. However, no molecular method is used to identify the different genospecies of the Acinetobacter spp in this study to investigate the clinical impact of different A baumannii infections. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280199 Sat, 01 Oct 2011 04:00:00 +0100 5280199 http://www.medworm.com/index.php?rid=5280186&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111004229%2Fabstract%3Frss%3Dyes The critical care world lost one of its founders and most influential advocates with the death of Max Harry (Hal) Weil in Rancho Mirage, California, on July 29. Founding president of the Society of Critical Care Medicine (1970-1972), Hal had a profound influence on the specialty he named “critical care” not only as a brilliant clinician scientist, translational researcher, and inventor but also as a mentor and stalwart friend to former fellows who are today's worldwide critical care leaders. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280186 Sat, 01 Oct 2011 04:00:00 +0100 5280186 http://www.medworm.com/index.php?rid=5280185&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111004217%2Fabstract%3Frss%3Dyes Hal Weil's death makes us conscious of not only the debt critical care practitioners owe their visionary founder but also of the potential loss of some of the hallmarks of the master physician and clinician who followed his intuition and created a new order of things. Without indefatigable energy and consummate clinical skill, it is unlikely that prescience alone would have led to the changes Weil's vision entailed. It will be important for all of us moving forward to recognize that the new will have to be invented and that although recycling may provide increased safety and incremental change, it is unlikely to create insight unless new patterns are observed, articulated, investigated, and described. The articles in this edition of the Journal provide a new look at several different topic... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280185 Sat, 01 Oct 2011 04:00:00 +0100 5280185 http://www.medworm.com/index.php?rid=5654924&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111003765%2Fabstract%3Frss%3Dyes Conclusions: The finding of a low plasma zinc concentration in Intensive Therapy Unit patients is often misinterpreted as indicating zinc deficiency and inappropriately prompts zinc supplementation. There is no evidence base to support high-dose zinc supplementation in ICU patients. This practice is justifiable only if future randomized trials demonstrate a benefit. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654924 Thu, 29 Sep 2011 04:00:00 +0100 5654924 http://www.medworm.com/index.php?rid=5654921&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS088394411100373X%2Fabstract%3Frss%3Dyes Conclusions: Significant exercise limitation is evident in patients who have had critical illness. Etiology of exercise limitation appears multifactorial, with general deconditioning and muscle weakness as major contributory factors. Early CPET appears a practical method of assessing exercise capacity in ICU survivors. Cardiopulmonary exercise testing could be used to select patients who may benefit most from a targeted physical rehabilitation program, aid in exercise prescription, and help assess the response to intervention. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654921 Thu, 29 Sep 2011 04:00:00 +0100 5654921 http://www.medworm.com/index.php?rid=5654917&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002929%2Fabstract%3Frss%3Dyes Conclusions: Patients in the ED with indicators of high trauma severity have a reduced EDt but a higher mortality rate. Advanced age increases both mortality and EDt. With the factors included in the model, EDt was not an independent factor for mortality in STPs. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654917 Thu, 29 Sep 2011 04:00:00 +0100 5654917 http://www.medworm.com/index.php?rid=5654910&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111003716%2Fabstract%3Frss%3Dyes Conclusion: Differences in perceptions between staff in larger and smaller ICUs highlight the importance of teamwork across units in larger ICUs. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654910 Thu, 29 Sep 2011 04:00:00 +0100 5654910 http://www.medworm.com/index.php?rid=5441969&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611002480%2Fabstract%3Frss%3Dyes Moderate to severe form of Crohn'sdisease (CD) and acrodermatitis continua of Hallopeau (ACH), a rare form of pustular psoriasis, can be successfully treated with adalimumab, a fully human anti-TNF-α antibody. So far, there are no data regarding the use of adalimumab for a co-existing condition of CD and ACH. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441969 Fri, 23 Sep 2011 04:00:00 +0100 5441969 http://www.medworm.com/index.php?rid=5238919&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS187399461100239X%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5238919 Thu, 22 Sep 2011 10:25:51 +0100 5238919 http://www.medworm.com/index.php?rid=5238895&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611002388%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5238895 Thu, 22 Sep 2011 10:25:50 +0100 5238895 http://www.medworm.com/index.php?rid=5441948&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001231%2Fabstract%3Frss%3Dyes Conclusion: In our study sample, high endotoxin levels were inversely related to case status. Whether endotoxin is a marker of hygiene or causal needs further investigation. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441948 Mon, 19 Sep 2011 04:00:00 +0100 5441948 http://www.medworm.com/index.php?rid=5609929&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611002133%2Fabstract%3Frss%3Dyes We report a case of primary rectal SCC combined with adenocarcinoma arising in left-sided UC. Immunohistochemically, tumor cells were positive for chromogranin A, synaptophysin, and CD56 in the SCC but not in the adenocarcinoma. The patient simultaneously developed multiple lesions of adenocarcinoma and high-grade dysplasia in the sigmoid colon and rectum. To elucidate whether SCC might evolve from multipotential cells in dysplasia and/or adenocarcinoma, we examined the mutational status of TP53 and KRAS. The same clonality of these lesions including SCC was confirmed by the presence of an identical single nucleotide point mutation in TP53. KRAS mutation was not observed in these lesions. Thus, these lesions seem to have developed from the same origin. Long-standing inflammation leading to... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609929 Mon, 12 Sep 2011 04:00:00 +0100 5609929 http://www.medworm.com/index.php?rid=5609924&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001954%2Fabstract%3Frss%3Dyes Conclusions: Based on common willingness to pay thresholds, ant-TNF-α drugs would not be perceived as a cost effective treatment for refractory CD.Highlights: ► We assess the cost-effectiveness of infliximab and adalimumab for chrohn’s disease. ► A 5 year probabilistic Markov model used. ► Adalimumab costs $193,305 per quality adjusted life year (QALY)versus to usual care. ► Infliximab costs $451,165 per QALY compared to adalimumab. ► Infliximab and adalimumabmay be poor value for money for Chron’s disease. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609924 Mon, 12 Sep 2011 04:00:00 +0100 5609924 http://www.medworm.com/index.php?rid=5609923&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001942%2Fabstract%3Frss%3Dyes Abstract: Background and aims: Inflammatory Bowel Disease (IBD) patients with anxiety and/or depressive symptoms may not receive the care they need. Provision of care requires insight into the factors affecting these psychiatric symptoms. The study was designed to examine the extent to which: (1) IBD patients with anxiety and/or depressive symptoms receive mental treatment and (2) clinical and socio-demographic variables are associated with these symptoms.Methods: 231 adult IBD patients (79% response rate), attending a tertiary care center, completed standardized measures on anxiety and depressive symptoms (HADS), quality of life (SF-12) and mental health care use (TIC-P). Diagnosis and disease activity were determined by the gastroenterologist.Results: 43% had high levels of anxiety and/o... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609923 Mon, 12 Sep 2011 04:00:00 +0100 5609923 http://www.medworm.com/index.php?rid=5441968&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611002091%2Fabstract%3Frss%3Dyes Meckel's diverticulum (MD) is a congenital alteration (found in about 2% of the population) due to incomplete involution of the omphalomesenteric tract, appearing as an outpouching of the intestine located approximately 60cm from the ileocecal valve. Its prevalence among Crohn's disease (CD) patients is debated: Andreyev reported a three-fold higher prevalence in pathology specimens after 294 ileocolic resections, while Freeman more recently refuted this assertion reporting a 1% prevalence of MD among 877 patients with CD. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441968 Mon, 12 Sep 2011 04:00:00 +0100 5441968 http://www.medworm.com/index.php?rid=5441966&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS187399461100208X%2Fabstract%3Frss%3Dyes The lack of support for a common etiology in Johne's disease (JD) of animals and Crohn's disease (CD) of man was last reviewed 12years ago. In light of new literature, the failure to establish an etiologic connection between Mycobacterium paratuberculosis (MPTB) and CD is reiterated. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441966 Mon, 12 Sep 2011 04:00:00 +0100 5441966 http://www.medworm.com/index.php?rid=5609928&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611002054%2Fabstract%3Frss%3Dyes In conclusion, immunogenicity to infliximab and adalimumab may be associated with both acute anaphylactoid reactions and delayed hypersensitivity reactions. Reactions may be precipitated by newly induced specific anti-drug antibodies rather than by cross-reactivity of previously generated antibodies. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609928 Fri, 02 Sep 2011 04:00:00 +0100 5609928 http://www.medworm.com/index.php?rid=5441967&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611002042%2Fabstract%3Frss%3Dyes A 41-year old Caucasian man with a 25-year history of ileocolonic Crohn's and 15 pack-year smoking history was noted to have a rapidly growing non-tender swelling on the left thigh. He was treated with Azathioprine for 5–6years previously and Methotrexate for 2years, both stopped due to perceived lack of efficacy and deemed steroid dependant on Prednisolone 15mg daily for 15years. He was on a 5-ASA (2.4g), calcium and vitamin D and B12 supplements. A single infusion of Infliximab in 2002 resulted in a partial clinical response. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441967 Mon, 29 Aug 2011 04:00:00 +0100 5441967 http://www.medworm.com/index.php?rid=5441965&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611002029%2Fabstract%3Frss%3Dyes Conclusions: Cyclophosphamide therapy was highly effective in steroid-refractory Crohn's colitis accompanied by Sweet's syndrome for induction of remission. Furthermore, apoptosis of mononuclear cells in the colon mucosa, including CD68+ macrophages as well as CD4+ and CD8+ cells, appears to be a component of the anti-inflammatory effect of cyclophosphamide in Crohn's disease. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441965 Mon, 29 Aug 2011 04:00:00 +0100 5441965 http://www.medworm.com/index.php?rid=5609925&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001966%2Fabstract%3Frss%3Dyes Conclusions: There was a high frequency of UGI involvement in children with CD and UC. One third of CD patients showed significant lesions at upper endoscopy and one patient out of ten had real diagnostic help from EGD.Highlights: ► Upper gastrointestinal involvement is common in paediatric patients with IBD. ► Characteristic findings were noted in one third of patients with CD. ► Abnormalities observed in UC were unspecific and did not provide diagnostic help. ► EGD helped to establish the final diagnosis in 9% of CD patients (diagnostic yield). (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609925 Thu, 25 Aug 2011 04:00:00 +0100 5609925 http://www.medworm.com/index.php?rid=5609922&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001930%2Fabstract%3Frss%3Dyes Conclusions: A high proportion of patients whose dose of infliximab is increased due to loss of efficacy respond initially. However, nearly half lose the response after one year. The safety profile of an intensified infliximab regimen is good. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609922 Mon, 22 Aug 2011 04:00:00 +0100 5609922 http://www.medworm.com/index.php?rid=5280204&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002309%2Fabstract%3Frss%3Dyes On April 21-23, 2011, the ECCC Dubai 2011 hosted the Seventh Emirates Critical Care Conference, Thirds Asia-Africa World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM) conference and the Seventh International Pan Arab Critical Care Congress. This year's theme “Critical care without boarders: towards a new era of collaboration” is a major step toward better partnership in an effort to improve the critical care medicine around the globe. Leaders from WFSICCM, ESICM, NCC, SCCM, EICS, and IPACCMS with representatives of 30 countries in the region participated in this successful event. In our forth consecutive year, the partnership of IPACCMS and WFSICCM grows in the field of education and research, especially in Asia and Africa. The 2011 awards were judged by an ... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280204 Mon, 22 Aug 2011 04:00:00 +0100 5280204 http://www.medworm.com/index.php?rid=5609927&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS187399461100198X%2Fabstract%3Frss%3Dyes Conclusions: Serum ADA levels were found to be elevated in UC patients in active state suggesting a partial role of activated T-cell response in the disease pathophysiology. Further randomized controlled studies are warranted to demonstrate the role of ADA in UC patients, with a special interest in specifically targeted therapies against ADA for achieving disease remission. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609927 Fri, 19 Aug 2011 04:00:00 +0100 5609927 http://www.medworm.com/index.php?rid=5609926&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001978%2Fabstract%3Frss%3Dyes Abstract: Background and aims: High concentrations of methylated thiopurine metabolites, such as 6-methyl mercaptopurine, are associated with hepatotoxicity during administration of the conventional thiopurines azathioprine or 6-mercaptopurine in IBD patients. Metabolization of the non-conventional thiopurine 6-thioguanine does not generate 6-methyl mercaptopurine. Hence, the aim of our study was to evaluate hepatotoxicity during 6-thioguanine in IBD patients who previously failed conventional thiopurines due to 6-methyl mercaptopurine associated hepatotoxicity.Methods: A retrospective single center intercept cohort study was performed of IBD patients using 6-thioguanine between January 2006 and July 2010 after failing conventional thiopurine therapy due to 6-methyl mercaptopurine associat... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609926 Fri, 19 Aug 2011 04:00:00 +0100 5609926 http://www.medworm.com/index.php?rid=5609918&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001826%2Fabstract%3Frss%3Dyes Conclusions: This study reinforced the association of life style events, in particular a specific dietary and infections history, with IBD. Alteration of gut flora or alterations of the mucosal immune system in reactivity to the flora could be an important factor to explain the relationship between life-style and disease. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609918 Fri, 19 Aug 2011 04:00:00 +0100 5609918 http://www.medworm.com/index.php?rid=5609921&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001929%2Fabstract%3Frss%3Dyes Abstract: Aim of the study: To describe our 15-year experience on the patients' response and safety to the use of EPO in IBD patients with refractory anemia.Patients–Methods: Single center retrospective chart analysis of all IBD patients receiving EPO for the period 1994–2009. Patients with resistant anemia not responding to I.V. iron therapy were enrolled. Concommitant medication, medical and laboratory data on short and long-term patients' responses and safety were recorded.Results: In total 820 IBD files were reviewed and among 78 patients treated with I.V. iron we identified 26 patients who received EPO in concordance to our inclusion criteria. Azathioprine or methotrexate was administered in 17 patients and 7 patients received concomitant Infliximab. After EPO, 22/26 patients (84.... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609921 Thu, 18 Aug 2011 04:00:00 +0100 5609921 http://www.medworm.com/index.php?rid=5441964&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001905%2Fabstract%3Frss%3Dyes Abstract: Plasmablastic lymphoma is a very rare and recently-described subtype of diffuse large B-cell lymphoma. It has a poor prognosis despite intensive chemotherapy treatment. A 57-year old woman with perianal Crohn's disease receiving azathioprine and infliximab developed this type of lymphoma after a short period of time on the treatment. She also had a hepatitis C virus chronic infection which had not been diagnosed or treated before. There is no solid scientific evidence that either immunomodulators or anti-TNF drugs have a definitive role in the appearance of malignancies, and therefore there are no clear recommendations to limit their use. In these patients, there are some other factors we have to take into account, like the inflammatory bowel disease in itself and its behaviour o... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441964 Tue, 16 Aug 2011 04:00:00 +0100 5441964 http://www.medworm.com/index.php?rid=5238912&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001917%2Fabstract%3Frss%3Dyes Abstract: The healing of the intestine is becoming an important objective in the management of inflammatory bowel diseases. It is associated with improved disease outcome. Therefore the assessment of this healing both in clinical studies and routine practice is a key issue. Endoscopy for the colon and terminal ileum and computerized tomography or magnetic resonance imaging for the small bowel are the most direct ways to evaluate intestinal healing. However, there are many unsolved questions about the definition and the precise assessment of intestinal healing using these endoscopic and imaging techniques. Furthermore, these are relatively invasive and expensive procedures that may be inadequate for regular patients' monitoring. Therefore, biomarkers such as C-reactive protein and fecal cal... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5238912 Fri, 12 Aug 2011 04:00:00 +0100 5238912 http://www.medworm.com/index.php?rid=5238911&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS187399461100184X%2Fabstract%3Frss%3Dyes Abstract: Over the past years, mucosal healing has emerged as a major therapeutic goal in clinical trials in inflammatory bowel diseases. Accumulating evidence indicates that mucosal healing may change the natural course of the disease by decreasing the need for surgery and reducing hospitalization rates in both ulcerative colitis and Crohn's disease. Mucosal healing may also prevent the development of long-term disease complications, such as bowel damage in Crohn's disease and colorectal cancer in ulcerative colitis. Histologic healing may be the ultimate therapeutic goal in ulcerative colitis, whereas its impact on the course of Crohn's disease is unknown. Complete mucosal healing may be required before considering drug withdrawal. Targeting early Crohn's disease is more effective than a... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5238911 Thu, 04 Aug 2011 04:00:00 +0100 5238911 http://www.medworm.com/index.php?rid=5238918&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001875%2Fabstract%3Frss%3Dyes The overall incidence of Clostridium difficile infection is increasing over the decades and super-infection with C. difficile is also known to exacerbate the underlying inflammatory bowel disease (IBD). IBD patients with C. difficile infection have longer hospital stay, consume more healthcare resources and also have higher mortality rates than the patients with C. difficile infection alone. Here, we discuss an IBD patient represented with C. difficile infection who took the exact diagnosis via colonoscopic procedure even after a negative stool examination for C. difficile. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5238918 Wed, 03 Aug 2011 04:00:00 +0100 5238918 http://www.medworm.com/index.php?rid=5609920&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001887%2Fabstract%3Frss%3Dyes Abstract: Background and aims: Our study evaluated the prevalence, the characteristics and implications of the upper gastrointestinal localisation (UGI+) in paediatric Crohn's Disease (CD) patients.Methods: This prospective study evaluated 45 newly diagnosed CD patients at diagnosis and follow up with respect to CD localisation.Results: All patients presented CD at the colon and/or ileum. In 24/45 patients (53.3%, 12 F and 12 M) an UGI+ involvement was also found. UGI+ patients had a younger age of onset (10.9years versus 12.6years; P (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609920 Mon, 01 Aug 2011 04:00:00 +0100 5609920 http://www.medworm.com/index.php?rid=5441962&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001851%2Fabstract%3Frss%3Dyes Abstract: Anti-tumor necrosis factor alpha antibodies have been used with increasing frequency despite the number of reported adverse effects. Further new information is still emerging. Here we report the case of a 71-years-old patient affected by Crohn's disease and HCV-positive who developed Guillain–Barrè syndrome after four injections of fully human anti-tumor necrosis factor alpha antibodies (adalimumab). Indication for the treatment was severe clinical recurrence of Crohn's disease following intestinal resection. Guillain–Barrè syndrome was treated by intravenous immunoglobulins, and methylprednisolone and plasmapheresis were started with a progressive partial resolution of neurological symptoms. To date, Crohn's disease was maintained in clinical remission with low dose steroi... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441962 Fri, 29 Jul 2011 04:00:00 +0100 5441962 http://www.medworm.com/index.php?rid=5654922&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002449%2Fabstract%3Frss%3Dyes This article highlights the increasing importance of palliative care throughout the spectrum of medical care offered to patients, regardless of age. The authors recognize and highlight that palliation in the NICU is an understudied area. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654922 Thu, 28 Jul 2011 04:00:00 +0100 5654922 http://www.medworm.com/index.php?rid=5654918&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002437%2Fabstract%3Frss%3Dyes Abstract: Background: The utility of postoperative troponins as an independent predictor of long-term mortality after vascular surgery is unknown.Methods: One hundred sixty-four consecutive patients underwent vascular surgery and postoperative mortality was determined at 2.5 years. Troponins were drawn within 48 hours postsurgery and the peak levels, defined by the upper reference limit (URL), were categorized as negative ( (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654918 Thu, 28 Jul 2011 04:00:00 +0100 5654918 http://www.medworm.com/index.php?rid=5654915&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002279%2Fabstract%3Frss%3Dyes Conclusions: The use of an AA significantly improves the adequacy of empiric antimicrobial therapy. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654915 Thu, 28 Jul 2011 04:00:00 +0100 5654915 http://www.medworm.com/index.php?rid=5654914&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002139%2Fabstract%3Frss%3Dyes Conclusions: Manual compression of the abdomen provides a simple, rapid, and safe bedside reliable maneuver to detect and quantify EFL during mechanical ventilation. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654914 Thu, 28 Jul 2011 04:00:00 +0100 5654914 http://www.medworm.com/index.php?rid=5446522&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002164%2Fabstract%3Frss%3Dyes Conclusions: The prognosis of ICU patients with AKI depended on the total number and types of associated failed organ systems. Respiratory failure was the most common associated organ failure, but neurologic and hepatic failures were associated with the worst prognosis. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5446522 Thu, 28 Jul 2011 04:00:00 +0100 5446522 http://www.medworm.com/index.php?rid=5067727&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002747%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5067727 Wed, 27 Jul 2011 14:40:19 +0100 5067727 http://www.medworm.com/index.php?rid=5067726&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002735%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5067726 Wed, 27 Jul 2011 14:38:56 +0100 5067726 http://www.medworm.com/index.php?rid=5067724&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002048%2Fabstract%3Frss%3Dyes On page 219 of the printed article, “Ronco et al [6], who observed a mortality in sepsis of 47% at a prescribed dose of 20 ml/kg/h and of 18% at a dose of 35 ml/kg/h” should have been “Ronco et al [6], who observed a mortality in sepsis of 75% at a prescribed CVVH dose of 20 mL kg−1 h−1 and 53% at a dose of 45 mL kg−1 h−1.” (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5067724 Wed, 27 Jul 2011 14:38:50 +0100 5067724 http://www.medworm.com/index.php?rid=5067704&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002255%2Fabstract%3Frss%3Dyes Thank you for your interest in our work in dysphagia for the trauma patient. As I am sure you are aware, almost all dysphagia research has been conducted with stroke patients, which is a dramatically different population than trauma patients. Overall, trauma patients are younger, healthier, and exhibit fewer medical comorbidities than stroke patients. Recovery from neurologic events is typically more rapid and complete than those of stroke patients. In addition, trauma patients may have no neurologic impairment at all, which is not the case in stroke patients. Our purpose is to contribute to the body of research to establish evidence-based practice guidelines specific to trauma patients. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5067704 Wed, 27 Jul 2011 14:35:02 +0100 5067704 http://www.medworm.com/index.php?rid=5067685&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002516%2Fabstract%3Frss%3Dyes This issue of the Journal features a number of articles, all of which have a common theme, and each contains a conflict of interest statement. However, the very nature of a conflict of interest is questioned by 2 Italian authors in an included Letter to the Editor. Recent charges of publishing scandals and retractions create uncertainty in the scientific community, and it is incumbent on all peer reviewers and editors to understand the responsibility inherent in the decision to accept or reject a manuscript. Certainly, content is important, but so too are the veracity and integrity of authorship. The Journal of Critical Care will soon require all authors to submit evidence that they have performed a plagiarism check on their submission before transmittal; this will include self-plagiarism ... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5067685 Wed, 27 Jul 2011 14:18:17 +0100 5067685 http://www.medworm.com/index.php?rid=5441963&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001863%2Fabstract%3Frss%3Dyes Conclusions: Awareness of this rare condition in patients receiving immunosuppressive treatment is important to prevent poor outcomes for patients. The increasing number of these cases recognised in patients receiving Infliximab should be kept under close clinical surveillance due to the possibility of a link between the two.Highlights: ► Posterior reversible encephalopathy syndrome(PRES) is a multifactorial disorder. ► This is the 4th published case of PRES in IBD patients treated with infliximab. ► PRES cases and infliximab have been described more in children. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441963 Thu, 21 Jul 2011 04:00:00 +0100 5441963 http://www.medworm.com/index.php?rid=5609917&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001814%2Fabstract%3Frss%3Dyes Conclusions: The simple clinical items age at diagnosis, gender, and need for systemic steroid therapy can predict a progressive disease course in early CD. Our model based on these parameters allows an individualized estimation of each patient's risk to develop a progressive disease course. Thereby, our model can help in deciding if patients will need immunosuppressive drugs early in the disease course or if a careful watch and wait strategy is justified.Highlights: ► Retrospective analysis from 6 German tertiary IBD centers involving 353 patients. ► Age, gender and effect of steroids are associated with necessity of immunosuppressors. ► A prognostic model predicts the patient's risk for a progressive disease course. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609917 Mon, 18 Jul 2011 04:00:00 +0100 5609917 http://www.medworm.com/index.php?rid=5609919&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001838%2Fabstract%3Frss%3Dyes Conclusion: These findings suggest that granuloma formation is a marker of a more aggressive disease course, and that variants in autophagy genes ATG4A, ATG2A, FNBP1L and ATG4D, may contribute to granuloma formation.Highlights: ► Granulomas are a marker of aggressive clinical behavior. ► Young patients develop granulomas more frequently with more granulomas in the bowel wall. ► Smokers are more likely to develop granulomas. ► Autophagy genes ATG4A, FNBP1L and ATG4D are associated with granuloma formation. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609919 Fri, 15 Jul 2011 04:00:00 +0100 5609919 http://www.medworm.com/index.php?rid=5609916&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001802%2Fabstract%3Frss%3Dyes Conclusions: This study is the first to show that TAFIa is increased in CD patients compared with UC and its levels are associated with inflammatory markers in both forms of IBD. These findings fit in the hypothesis that TAFIa may be a marker of active IBD, and in particular of active UC.Highlights: ► Thrombin activatable fibrinolysis inhibitor (TAFI) has been reported to be involved in the pathogenesis and progression of inflammatory bowel disease. ► This study is the first to show that TAFIa is increased in CD patients compared with UC and its levels are associated with inflammatory markers in both forms of IBD. ► TAFIa may be considered as a marker of exacerbated UC, but not CD. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5609916 Fri, 15 Jul 2011 04:00:00 +0100 5609916 http://www.medworm.com/index.php?rid=5441957&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS187399461100170X%2Fabstract%3Frss%3Dyes Conclusions: PST and SFT both positively affect the fatigue and QoL scores in patients with Crohn's disease. SFT seems most feasible with fewer dropouts and is therefore a promising new tool in the management of fatigue in Crohn's disease patients. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441957 Mon, 11 Jul 2011 04:00:00 +0100 5441957 http://www.medworm.com/index.php?rid=5238917&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001723%2Fabstract%3Frss%3Dyes Cigarette smokers are twice as likely to develop Crohn's Disease (CD) as non-smokers. Furthermore, cigarette smokers are more likely to have a complicated course of disease than non-smokers. Cessation of smoking has also been shown to have important protective effects in reduction of activity of CD (by up to 65%). Current estimates are that approximately 50% of CD patients in Europe smoke. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5238917 Mon, 11 Jul 2011 04:00:00 +0100 5238917 http://www.medworm.com/index.php?rid=5654933&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002152%2Fabstract%3Frss%3Dyes Conclusion: In CHF, the use of CVVHDF effectively and safely produced greater weight and fluid loss and decreased LOS in the ICU more than the intravenous furosemide with no hemodynamic instability. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654933 Thu, 07 Jul 2011 04:00:00 +0100 5654933 http://www.medworm.com/index.php?rid=5654932&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002188%2Fabstract%3Frss%3Dyes Conclusion: In our cohort of severe P(H1N1)2009v infection, myocardial injury and dysfunction was frequent and associated with high mortality. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654932 Thu, 07 Jul 2011 04:00:00 +0100 5654932 http://www.medworm.com/index.php?rid=5654931&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002206%2Fabstract%3Frss%3Dyes Conclusions: Most DA-HAI rates are lower in Poland than in INICC, but higher than in the National Healthcare Safety Network, expressing the feasibility of lowering infection rates and increasing patient safety. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654931 Thu, 07 Jul 2011 04:00:00 +0100 5654931 http://www.medworm.com/index.php?rid=5654927&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS088394411100222X%2Fabstract%3Frss%3Dyes Conclusion: Individuals' attachment styles should be taken into consideration when planning and implementing the nursing care and treatment of individuals hospitalized in an ICU. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654927 Thu, 07 Jul 2011 04:00:00 +0100 5654927 http://www.medworm.com/index.php?rid=5654919&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS088394411100219X%2Fabstract%3Frss%3Dyes Conclusion: Prolonged duration of invasive ventilation but not of renal replacement therapy is inversely related to short-term survival. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654919 Thu, 07 Jul 2011 04:00:00 +0100 5654919 http://www.medworm.com/index.php?rid=5654912&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002218%2Fabstract%3Frss%3Dyes Conclusions: During comparisons of VAP rate between institutions, a zero VAP rate needs to be considered in the context of overall ventilator days, mean durations of ventilator stay and ICU mortality. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654912 Thu, 07 Jul 2011 04:00:00 +0100 5654912 http://www.medworm.com/index.php?rid=5446520&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002115%2Fabstract%3Frss%3Dyes Conclusion: Intensive care unit severity of illness was not associated with patients' retrospectively recalled baseline physical function. Patients with a lower level of education may be more influenced by ICU severity of illness, but the magnitude of this effect may not be clinically meaningful. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5446520 Thu, 07 Jul 2011 04:00:00 +0100 5446520 http://www.medworm.com/index.php?rid=5446514&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002127%2Fabstract%3Frss%3Dyes Conclusions: Even if incidence varied greatly depending on the definition, CIN appeared frequent in our critically ill patients. The AKIN definition, independently associated with ICU mortality, may allow unifying diagnostic criteria to further evaluate this condition that impacts morbidity and mortality. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5446514 Thu, 07 Jul 2011 04:00:00 +0100 5446514 http://www.medworm.com/index.php?rid=5446506&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002085%2Fabstract%3Frss%3Dyes Conclusions: Severe protein C deficiency in patients with severe sepsis is associated with both the incidence and severity of organ dysfunction and subsequent worsening of organ function and may be a useful predictor of organ failure in severe sepsis. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5446506 Thu, 07 Jul 2011 04:00:00 +0100 5446506 http://www.medworm.com/index.php?rid=5280188&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002097%2Fabstract%3Frss%3Dyes Conclusions: Patients with dengue fever may require ICU admission for organ failure. Outcome is good if appropriate aggressive care and organ support are instituted. Admission APACHE II score may predict patients at higher risk of death. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280188 Thu, 07 Jul 2011 04:00:00 +0100 5280188 http://www.medworm.com/index.php?rid=5280187&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002103%2Fabstract%3Frss%3Dyes Conclusions: In our cohort, outcome from severe dengue was primarily related to nonhematological organ failure. Low serum albumin concentration on ICU admission and a more positive fluid balance at 72 hours were also associated with worse outcomes. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280187 Thu, 07 Jul 2011 04:00:00 +0100 5280187 http://www.medworm.com/index.php?rid=5441959&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001735%2Fabstract%3Frss%3Dyes Conclusion: Surgical repair and immunomodulator therapy with infliximab could be an option in incontinent patients with Crohn's disease involving both a sphincter defect and severe or refractory fistulas.Research highlights: ► Complex surgical procedures have traditionally been avoided in severe Crohn’s disease. ► Infliximab could change expectations achievable with surgical treatment. ► Sphincter defects and fistulas can be simultaneously addressed in incontinence. ► Combined biological therapy and surgery improved the Wexner and solved incontinence. ► Benefits of sphincteroplasty with antiTNF were stable after 48 months. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441959 Mon, 04 Jul 2011 04:00:00 +0100 5441959 http://www.medworm.com/index.php?rid=5441958&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001711%2Fabstract%3Frss%3Dyes Conclusions: In the present study, a risk factor for developing CD complication was male gender. Further studies are warranted to assess additional risk factors and how such findings should affect therapy.Research highlights: ► The aim of our study was to indentify predictive factors for complications of Crohn's disease. ► Genetic and phenotypic information on presentation were analyzed. ► Risk factors for developing CD complication were male gender and smoking status. ► No predictive genetic markers were indetified. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441958 Mon, 04 Jul 2011 04:00:00 +0100 5441958 http://www.medworm.com/index.php?rid=5441947&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001632%2Fabstract%3Frss%3Dyes Abstract: Not fully defined pathophysiologic mechanisms of inflammatory bowel disease (IBD) involve an array of genetic, epigenetic, infectious, physiological and immunological factors. Nowadays, an inadequate activation of the innate immune system to a luminal factor occurring in genetically predisposed subjects is the most widely accepted today. Micro-autoimmune diseases, a group of small, single-stranded, non-coding RNA molecules act as potent negative gene regulators. Beyond cancer and various autoimmune diseases, their impact on IBD has recently been the focus of research. Differential expression of various micro-RNAs has been documented in active and inactive ulcerative colitis, while micro-RNA profile appears to differ between ileal and colonic Crohn's disease. Except for tissue sam... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441947 Mon, 04 Jul 2011 04:00:00 +0100 5441947 http://www.medworm.com/index.php?rid=5654928&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001973%2Fabstract%3Frss%3Dyes Conclusions: Progression of RIFLE class and newly developed AKI after hospital admission were better able to predict 28-day mortality than RIFLE criteria on the first day of admission in patients with severe sepsis and septic shock. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654928 Wed, 29 Jun 2011 04:00:00 +0100 5654928 http://www.medworm.com/index.php?rid=5654909&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001985%2Fabstract%3Frss%3Dyes Conclusions: Among surrogates in the ICU, the Health Care System Distrust Scale has high internal consistency and convergent validity. There was substantial variability in surrogates' trust in the health-care system. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654909 Wed, 29 Jun 2011 04:00:00 +0100 5654909 http://www.medworm.com/index.php?rid=5446521&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS088394411100205X%2Fabstract%3Frss%3Dyes Conclusion: The EMR-based automatic tool accurately calculates SWIFT score and can facilitate ICU discharge decisions without the need for manual data collection. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5446521 Wed, 29 Jun 2011 04:00:00 +0100 5446521 http://www.medworm.com/index.php?rid=5446513&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111002012%2Fabstract%3Frss%3Dyes Conclusions: Acute kidney injury on MV initiation day is an independent risk factor for PMV of more than 21 days, which may be helpful for clinicians to refine their management of these ICU patients early. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5446513 Wed, 29 Jun 2011 04:00:00 +0100 5446513 http://www.medworm.com/index.php?rid=5441956&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001668%2Fabstract%3Frss%3Dyes Conclusion: Among Danish patients with CD and UC belonging to an unselected cohort, disease occurrence was found to be associated both with well-known factors such as smoking and appendectomy, and with more debated factors including breastfeeding, tonsillectomy, childhood vaccinations, childhood infections, and dietary intake of fibres and sugar.Highlights: ► The aetiology of inflammatory bowel diseases remains uncertain. ► Smoking was positively associated with CD and negatively associated with UC. ► Low consumption of dietary fibres and high consumption of sugar increased the risk for IBD. ► Appendectomy decreased the risk for UC. Tonsillectomy decreased the risk for both UC and CD. ► Childhood infections and vaccinations may also play an aetiological role in IBD. (Source: Jour... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441956 Wed, 29 Jun 2011 04:00:00 +0100 5441956 http://www.medworm.com/index.php?rid=5280190&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001997%2Fabstract%3Frss%3Dyes Conclusions: Despite the high mortality rate in critically ill patients with hematologic malignancies, presence of A baumannii infection was not an independent risk factor for mortality. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5280190 Wed, 29 Jun 2011 04:00:00 +0100 5280190 http://www.medworm.com/index.php?rid=5067705&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS088394411100164X%2Fabstract%3Frss%3Dyes At a recent intensive care medicine congress, we had the occasion to read this formally perfect disclosure before one of the (nonsponsored) talks commenced: “Dr. X has made interventions related to Y that are patent. The licenses for these patents belong to Y. Future commercial uses of this technology may provide financial benefit to Dr. X through royalties. Dr. X owns Z% of Y.” After this slide, we thought the room would have emptied; but nobody moved. This kind of conflict of interest (COI) disclosure is more and more frequent at the beginning of meeting talks and at the end of manuscript texts. The oblige of COI disclosure is a fundamental process of modern research and an important index of authors' and editors' loyalty toward their readers: in theory, the listener/reader is aware ... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5067705 Tue, 28 Jun 2011 23:00:00 +0100 5067705 http://www.medworm.com/index.php?rid=5441955&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS187399461100167X%2Fabstract%3Frss%3Dyes Conclusions: Increased IgG4+ plasma cells were found in 1/4 of IPAA patients with persistent symptoms. The presence of tissue infiltration of IgG4+ plasma cells appeared to be associated with chronic pouch inflammation and concurrent autoimmune disorders.Highlights: ► IgG4+ plasma cells were found in 1/4 of IPAA patients with persistent symptoms. ► IgG4+ plasma cells were associated with concurrent autoimmune disorders. ► IgG4+ plasma cells were associated with worse pouch inflammation. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441955 Mon, 27 Jun 2011 04:00:00 +0100 5441955 http://www.medworm.com/index.php?rid=5654929&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001535%2Fabstract%3Frss%3Dyes Conclusions: Nonteaching ICUs discharge patients earlier than do teaching ICUs, but the effect of it remains to be clarified with further studies addressing questions as what happens after ICU discharge. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654929 Fri, 24 Jun 2011 04:00:00 +0100 5654929 http://www.medworm.com/index.php?rid=5654920&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001961%2Fabstract%3Frss%3Dyes Conclusion: The L/P ratio and CPP were found to be related to patient outcome. In addition, a CPP greater than 75.46 mm Hg and an L/P ratio lower than 37.40 mm Hg were related to a favorable outcome. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5654920 Fri, 24 Jun 2011 04:00:00 +0100 5654920 http://www.medworm.com/index.php?rid=5446523&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001626%2Fabstract%3Frss%3Dyes Conclusions: Significant delays in responding to acute deterioration persist despite strategies to facilitate the functioning of the RRT system. Simple strategies such as policy directives are not sufficient to effect change in complex health care systems. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5446523 Fri, 24 Jun 2011 04:00:00 +0100 5446523 http://www.medworm.com/index.php?rid=5238916&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001693%2Fabstract%3Frss%3Dyes This study enrolled 30 patients with suspected Crohn's Disease (CD), in whom conventional techniques had been nondiagnostic. Small bowel capsule endoscopy (SBCE) detected lesions compatible with CD in almost one third of those patients. The results from this study support the role of SBCE in the detection of superficial small bowel lesions missed by conventional procedures, which can be useful to establish the diagnosis in patients with a clinical presentation that is highly suggestive of CD. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5238916 Thu, 23 Jun 2011 04:00:00 +0100 5238916 http://www.medworm.com/index.php?rid=5441954&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001656%2Fabstract%3Frss%3Dyes Abstract: Background: A higher incidence of inflammatory bowel disease (IBD) in industrialized areas has been previously reported, but the effect of emigrating to western industrialized countries for a period of time and returning to the country of origin is unknown. Aim of the study was to evaluate the effect of emigrating to another country and returning to the place of origin on the risk of IBD.Methods: A prospective case-control study was performed. Inclusion criteria were all patients >18years diagnosed with Crohn's disease (CD) or ulcerative colitis (UC) in the last 10years. Healthy, unrelated controls, matched by sex, age and smoking habits, with no family history of IBD were included. All patients and controls were interviewed and emigration was defined as living for at least one y... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441954 Wed, 22 Jun 2011 04:00:00 +0100 5441954 http://www.medworm.com/index.php?rid=5441953&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001644%2Fabstract%3Frss%3Dyes Conclusion: Chronic nonspecific multiple ulcer of the small intestine seems to segregate in offspring from consanguineous marriage.Highlights: ► Chronic nonspecific multiple ulcer of the small intestine is characterized by protein and blood loss from the small bowel. ► Parental consanguineous marriage and enteropathy in the siblings are frequent in patients with the disease. ► The disease may be a condition with an autosomal recessive hereditary trait. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441953 Wed, 22 Jun 2011 04:00:00 +0100 5441953 http://www.medworm.com/index.php?rid=5441952&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001620%2Fabstract%3Frss%3Dyes Conclusions: In contrast with prior reports, infliximab can be detected in the breast milk of nursing mothers. The miniscule amounts of infliximab transferred in breast milk are unlikely to result in systemic immune-suppression of the infant. Nonetheless, local effects of this exposure on the neonates' intestine and potential immune sensitization or tolerization towards the drug can not be excluded and merit further investigations.Research Highlights: ► Current available data indicate that infliximab is not transferred in breast milk. ► The present study shows that infliximab can be detected in the breast milk of nursing mothers. ► The level of infliximab in breast milk is low, at 1/200th of its level in maternal serum. ► The clinical and immunological impact of the newborn's expos... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441952 Mon, 20 Jun 2011 04:00:00 +0100 5441952 http://www.medworm.com/index.php?rid=4938564&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001590%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4938564 Sat, 18 Jun 2011 17:30:49 +0100 4938564 http://www.medworm.com/index.php?rid=4938544&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001589%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4938544 Sat, 18 Jun 2011 17:30:46 +0100 4938544 http://www.medworm.com/index.php?rid=5446515&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001523%2Fabstract%3Frss%3Dyes Conclusion: The present study demonstrates that the need for RRT had a negative impact on weaning and mortality in PMV patients compared with patients without RRT. Patients who had RRT initiated at the RCC had a significantly lower weaning rate compared with ESRD patients. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5446515 Fri, 10 Jun 2011 04:00:00 +0100 5446515 http://www.medworm.com/index.php?rid=5441951&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001401%2Fabstract%3Frss%3Dyes Abstract: Background and aims: To determine the real-world dosage pattern of adalimumab and predictors for weekly dosing in Crohn's disease (CD).Methods: Patients with CD receiving adalimumab maintenance therapy (≥3 dispensing events within 1year) were identified from a large specialty pharmacy database in the United States (March 2007–July 2008). Weekly dosing rates (≥2 consecutive weekly doses after the first dispensing event) for a 12-month period were estimated with Kaplan–Meier methods. Predictors for weekly dosing were identified using Cox proportional-hazards regression.Results: The overall adalimumab weekly dosing rate was 11.3% (151 of 1335 patients). The 12-month cumulative risk of weekly dosing was 15.5%. Patients who received a 160-/80-mg induction regimen had half the ... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441951 Fri, 10 Jun 2011 04:00:00 +0100 5441951 http://www.medworm.com/index.php?rid=5441950&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001395%2Fabstract%3Frss%3Dyes Conclusion: Autologous HSCT appears to be safe and can be an alternative strategy for Crohn's disease patients with severe and therapy resistant disease. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441950 Fri, 10 Jun 2011 04:00:00 +0100 5441950 http://www.medworm.com/index.php?rid=5441961&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001309%2Fabstract%3Frss%3Dyes Conclusions: Microscopic colitis with severe symptoms refractory to standard medical therapy including immunosuppressives is uncommon. In this setting, anti-TNF therapies may be a good option to avoid colectomy. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441961 Mon, 06 Jun 2011 04:00:00 +0100 5441961 http://www.medworm.com/index.php?rid=5441949&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001371%2Fabstract%3Frss%3Dyes Conclusions: These results indicate P-gp expression may contribute to the resistance of potential bacterial toxicity, by preventing them adhering to human enterocytes cells in the gastrointestinal tract, which may reduce the risk or intensity of gastrointestinal disorders. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5441949 Mon, 06 Jun 2011 04:00:00 +0100 5441949 http://www.medworm.com/index.php?rid=5238902&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001383%2Fabstract%3Frss%3Dyes Abstract: Background: There has not been an extensive comparison of CRP and ESR in ulcerative colitis (UC), and thus, we aimed to explore their utility in UC.Methods: Four previously enrolled cohorts of 451 children with UC were utilized, all including laboratory, clinical and endoscopic data. A longitudinal analysis was performed on prospectively collected data of 75 children. Disease activity was captured by both global assessment and pediatric UC activity index (PUCAI).Results: The best thresholds to differentiate quiescent, mild, moderate and severe disease activity, were 37mm/h for ESR, and 9mg/L for CRP (area under the ROC curves 0.70–0.81). Correlation of endoscopic appearance with CRP and ESR were 0.55 and 0.41, respectively (P (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5238902 Fri, 03 Jun 2011 04:00:00 +0100 5238902 http://www.medworm.com/index.php?rid=5238914&cid=s_33231_17_f&fid=38417&url=http%3A%2F%2Fwww.ecco-jccjournal.org%2Farticle%2FPIIS1873994611001292%2Fabstract%3Frss%3Dyes We appreciate the opportunity to respond to Dr. Kruis' letter with respect to our abstract and poster. We stand by the results of the experiments we conducted. However, we discovered an inadvertent error in the description of the methods. The poster and abstract incorrectly indicate that all formulations were tested using USP apparatus II (paddle). In fact, all capsule and granule formulations in our experiments were tested using USP apparatus I (basket) in order to minimize the risk of loss of the test product during media replacement. We believe that the choice of apparatus I for all capsule and granule formulations, and apparatus II for all tablet formulations was appropriate. We acknowledge that dissolution methodology (including apparatus type, dissolution media, and rotational mixed... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=5238914 Mon, 30 May 2011 04:00:00 +0100 5238914 http://www.medworm.com/index.php?rid=4869666&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001675%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869666 Fri, 27 May 2011 21:43:25 +0100 4869666 http://www.medworm.com/index.php?rid=4869665&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001663%2Fabstract%3Frss%3Dyes (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869665 Fri, 27 May 2011 21:43:25 +0100 4869665 http://www.medworm.com/index.php?rid=4869657&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001493%2Fabstract%3Frss%3Dyes Our goal is to develop predictive monitoring for early diagnosis of subacute, potentially catastrophic illness. To date, our major focus has been on premature infants in an intensive care unit. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869657 Fri, 27 May 2011 21:43:21 +0100 4869657 http://www.medworm.com/index.php?rid=4869656&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001481%2Fabstract%3Frss%3Dyes The automatic, continuous capture of EKG waveform data from hospital patients is increasingly common. Once only within the purview of a few centers, vast quantities of data can now be amassed using commercial software compatible with major brands of bedside physiologic monitors. These repositories provide novel opportunities for scientific discovery and improved patient care. At the same time, efficiently interpreting such data and applying findings to clinical practice presents a host of technical and conceptual challenges. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869656 Fri, 27 May 2011 21:43:21 +0100 4869656 http://www.medworm.com/index.php?rid=4869655&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS088394411100147X%2Fabstract%3Frss%3Dyes Research for 3 decades has largely focused on (1) identifying different methodologies to characterize variability and (2) evaluating the association between altered variability and illness. In an attempt to bring this research methodology to the bedside to assist patients, several investigators are pioneering the utility of variability analysis by performing longitudinal studies in both critically ill patients and patients at risk for developing critical illness. The following discussion represents a summary of lessons learned from performing the following research projects: (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869655 Fri, 27 May 2011 21:43:21 +0100 4869655 http://www.medworm.com/index.php?rid=4869654&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001468%2Fabstract%3Frss%3Dyes Severe sepsis is a challenging and elusive entity with a high mortality rate. As a syndrome, clinicians are challenged to distinguish individuals with systemic infection warranting further interventions and monitoring from lower severity patients. Recent data have shown that in-hospital disease progression from sepsis to septic shock is associated with a higher risk of morbidity and mortality than those with shock on initial presentation. Yet, even when identified, despite early and aggressive interventions, the presence of shock is still associated with a mortality rate of 25% to 40%. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869654 Fri, 27 May 2011 21:43:20 +0100 4869654 http://www.medworm.com/index.php?rid=4869653&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001456%2Fabstract%3Frss%3Dyes EEG phase synchrony, entropy, and variability are being used to evaluate brain function and predict neurologic outcome in both adults and children. Increased EEG phase synchrony has been associated with pathologies such as epilepsy and Parkinson disease. Phase synchrony among brain regions also increases during normal physiologic events (eg, slow-wave sleep or during cognitive tasks). EEG phase synchrony in both normal and pathologic conditions may have a common underlying mechanism. Understanding the mechanisms producing EEG phase synchrony in the brain will impact the clinical interpretation and significance of this phenomenon. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869653 Fri, 27 May 2011 21:43:20 +0100 4869653 http://www.medworm.com/index.php?rid=4869652&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001444%2Fabstract%3Frss%3Dyes Intensive care units (ICUs) worldwide offer support for patients in need of critical care. They boast a range of state of the art medical monitoring devices to monitor patient's physiologic parameters such as blood oxygen, blood pressure, electrocardiograms, and electroencephalograms. Although these monitoring systems aim at improving patient care and staff productivity, they clearly have the potential of introducing a data overload problem. In fact, most of data collected by these monitoring systems in ICUs is transient, and the typical practice is for physicians to eyeball representative readings and manually record summaries of these readings in the patient record once every 30 to 60 minutes. The rest of the data remains on the device's buffers typically for up to 96 hours before it tim... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869652 Fri, 27 May 2011 21:43:20 +0100 4869652 http://www.medworm.com/index.php?rid=4869651&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001432%2Fabstract%3Frss%3Dyes Valuable physiologic information is being wasted across the enterprise. We hypothesize that continuous physiologic data, densely collected, and analyzed and distributed in real time can be linked to clinical databases (medication, laboratory, microbiology, and genetics) to create new bedside biomarkers (new vital signs). These biomarkers can be used to stratify individual patient risk, reflect patient trajectory (improvement or deterioration), and may ultimately illuminate underlying mechanisms of disease. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869651 Fri, 27 May 2011 21:43:20 +0100 4869651 http://www.medworm.com/index.php?rid=4869650&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001420%2Fabstract%3Frss%3Dyes For the past 3 decades, research concerning physiologic variability has largely focused on (1) identifying different methodologies to characterize variability and (2) evaluating the association between altered variability and illness. Theories regarding the physiology and pathophysiology of variability have understandably been guided by data obtained from using the techniques of measurement available. For example, in keeping with the rich tradition of experimental research, a large body of investigation documents the relationship between frequency domain measures of heart rate variability and autonomic nervous system function. In this exploratory discussion, we will pursue a distinct approach to the question of understanding of the underlying physiology and pathophysiology of variability. ... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869650 Fri, 27 May 2011 21:43:20 +0100 4869650 http://www.medworm.com/index.php?rid=4869649&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001419%2Fabstract%3Frss%3Dyes Many biologic entities, from cells to whole organs, display quasi-periodic events. Once tagged, each event can be classified according to instantaneous frequency and some measures of the event itself (such as a peak voltage, the rate of rise of a reactant concentration, and so on). For example, secretion of insulin from a pancreatic β cell has an intrinsic period of 3 to 7 minutes. The beat of the human heart has a quasi period of 0.5 to 1 seconds. Until the last third of the 20th century, biologists generally (and physicians specifically) opined that the variability—that is, the “quasi” in quasi periodic—were aberrancies attributable to illness, aging, or failure to maintain stationary conditions during data collection. More recent studies suggest that variability is not only cha... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869649 Fri, 27 May 2011 21:43:19 +0100 4869649 http://www.medworm.com/index.php?rid=4869648&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001407%2Fabstract%3Frss%3Dyes Sepsis remains a leading cause of death worldwide. In the United States, over 650 000 cases are diagnosed each year with mortality rates of 20% to 50%. The recognition of key molecules such as endotoxin and tumor necrosis factor led to a series of unsuccessful antimediator trials in the 1980s and 1990s, often with paradoxical results and more recently with only modest success with recombinant human activated protein C (Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis [PROWESS] trial). The most successful advances in the treatment of sepsis in recent years have actually come from process improvements such as early goal-directed therapy (N Engl J Med. 2001;345[19]:1368-77). Underlying antimediator efforts is a flawed scientific paradigm that considers singular cau... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869648 Fri, 27 May 2011 21:43:19 +0100 4869648 http://www.medworm.com/index.php?rid=4869647&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001390%2Fabstract%3Frss%3Dyes At first glance, the human ventilatory flow resembles a cyclic, repetitive, monotonously regular phenomenon. Actually, it is not. In normal subjects, the ventilatory pattern varies from breath to breath. Ventilatory variability decreases in pathologic conditions, such as restrictive lung diseases . It can also provide prognostic indexes. For example, its diminution predicts a poor outcome of weaning from mechanical ventilation in critically sick patients . (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869647 Fri, 27 May 2011 21:43:19 +0100 4869647 http://www.medworm.com/index.php?rid=4869646&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001389%2Fabstract%3Frss%3Dyes Antenatal brain injury remains a major cause of long-term neurodevelopmental sequelae in children and adults . Fetal inflammation and acidemia play a major role in the etiology of antenatal brain injury . These pathologic conditions are difficult to diagnose and new early and noninvasive indicators are urgently needed . Variations in fetal vagal activity can be measured noninvasively by monitoring the fetal heart rate (FHR) variability (fHRV). Fetal heart rate variability holds promise as a noninvasive, continuous, sensitive, and specific measure that may identify fetuses at risk for adverse outcomes and requiring intervention. Increased vagal activity via cholinergic anti-inflammatory pathway (CAP) reduces systemic levels of proinflammatory cytokines . Enhancement of fetal CAP activity ma... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869646 Fri, 27 May 2011 21:43:17 +0100 4869646 http://www.medworm.com/index.php?rid=4869645&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001377%2Fabstract%3Frss%3Dyes The tracheobronchial tree is a complex transport and distribution system in charge of delivering oxygen to the pulmonary exchange units and clearing the carbon dioxide. Its geometric structure is that of a space-filling dichotomous branching tree. From the point of view of ventilation, this tree can be modeled as an arrangement of pipes that has to simultaneously satisfy several constraints: its aerodynamic resistance must be low to minimize the energy dissipation of the system, which implies large airway diameters. On the other hand, its volume must be as small as possible because it does not participate in gas exchange ; it must transport the oxygen to the terminal units in a limited time defined by the duration of the inspiratory phase. The compliant structure must be able to exhale all... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869645 Fri, 27 May 2011 21:43:17 +0100 4869645 http://www.medworm.com/index.php?rid=4869644&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001365%2Fabstract%3Frss%3Dyes The nonlinear dynamical systems theory is reputed to consider aperiodic behaviors that are deterministic, that is, chaos. If these behaviors provide very interesting examples to determine the ability of any technique to extract some characteristics, to state whether the dynamics underlying given biologic or biomedical data is chaotic or not, is not the most useful task we may have . This is mainly due to the difficulty encountered for proving the existence of determinism underlying the data investigated. Typically, the issue can only be reliably addressed using a global modeling technique . Physicians, for instance, do not care to know if their patients present a chaotic dynamics, but they are deeply interested to know if a technique is able to reliably discriminate patients from healthy s... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869644 Fri, 27 May 2011 21:43:16 +0100 4869644 http://www.medworm.com/index.php?rid=4869643&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001353%2Fabstract%3Frss%3Dyes Recently, Cohen et al offered a new approach to identifying and describing states of critical illness. The work followed a path launched by John Siegel almost 2 decades ago toward letting the data themselves define densely populated regions of physiologic state space that collectively represent a clinical condition . Areas of densely and of sparsely populated regions of the state space arise spontaneously from interconnections among various organ systems and their constituent tissues . (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869643 Fri, 27 May 2011 21:43:16 +0100 4869643 http://www.medworm.com/index.php?rid=4869642&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001341%2Fabstract%3Frss%3Dyes Human ventilation is characterized by chaoslike complexity and breath-by-breath variability. The latter is influenced by the chemical drive to breathe and the mechanical load imposed on the respiratory system. This forms the basis of the growing medical interest in ventilatory variability and complexity as diagnostic and prognostic indicators. Within this frame, and to answer the title question, the following postulates will be taken as truisms, keeping in mind that they are open to challenge. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869642 Fri, 27 May 2011 21:43:16 +0100 4869642 http://www.medworm.com/index.php?rid=4869641&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS088394411100133X%2Fabstract%3Frss%3Dyes Asthma is an increasing health problem worldwide, but the long-term temporal pattern of clinical symptoms is not well understood, and predicting asthma episodes has not been successful. Previously, we analyzed the time series of peak expiratory flows assessed twice daily in a large asthmatic population during a long-term crossover clinical trial. We introduced an approach to predict the risk of worsening airflow obstruction by calculating the conditional probability that, given the current airway condition, a severe obstruction will occur within a certain period. We found that the time series of peak expiratory flows show long-range correlations that change significantly with disease severity, approaching a random process with increased variability in the most severe cases. Using a nonline... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869641 Fri, 27 May 2011 21:43:16 +0100 4869641 http://www.medworm.com/index.php?rid=4869640&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001328%2Fabstract%3Frss%3Dyes The lung does not inflate and deflate perfectly, uniformly, and isotropically. In fact, the sudden opening of collapsed lung regions (recruitment) during inspiration and its reverse (derecruitment) during expiration are normal events even in the healthy lung. In the injured lung, recruitment and derecruitment are typically greatly exaggerated to the point that they may become the dominant mechanisms by which the lung changes volume during respiration. It is common to view recruitment and derecruitment as being functions simply of pressure; regions of the lung have critical opening and closing pressures that are the sole determinants of whether the region opens during inflation or closes during deflation. However, experimental evidence shows that recruitment and derecruitment are also stron... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869640 Fri, 27 May 2011 21:43:15 +0100 4869640 http://www.medworm.com/index.php?rid=4869639&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001316%2Fabstract%3Frss%3Dyes Physiologic monitoring of the human is based on outdated single-sensor, single-indicator principles and relies on intermittent assessment of large quantities of descriptive data by medical providers. Face-to-face contact with the patient is diminishing. Not infrequently, the patient is completely invisible behind monitors, sensors, and displays. Available sensors compartmentalize display of physiology, and the already overloaded provider is tasked with integration of displayed data and their interpretation on the fly. How can we visualize a congruent picture of the patient from multiple discretely sampled strings of monitoring data? Automatic computational assessment of high-granularity physiologic data using machine-learning technology may be the answer. I will present several multivariat... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869639 Fri, 27 May 2011 21:43:15 +0100 4869639 http://www.medworm.com/index.php?rid=4869638&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001304%2Fabstract%3Frss%3Dyes Schrodinger wrote that “the essential thing in metabolism is that the organism succeeds in freeing itself from all the entropy it cannot help producing while alive.” This is usually interpreted as exportation of entropy, a measure of disorder, via the gastrointestinal and urinary tracts, the lungs, and the skin. This is wrong. The production of entropy is tightly linked to heat, which is molecular motion. Metabolic combustion increases the internal energy (E) in the body, which is partially used to perform work (W) with the remainder exported as heat (H) to the environment: E = W + H, and H is the amount of wasted energy that is not used to perform work. Entropy production (ΔS) is H divided by body temperature in kelvin (T): ΔS = H/T = (E − W)/T. At constant T, ΔS is directly prop... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869638 Fri, 27 May 2011 21:43:15 +0100 4869638 http://www.medworm.com/index.php?rid=4869637&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001298%2Fabstract%3Frss%3Dyes Autonomic nervous system (ANS) dysfunction has been implicated in several gastrointestinal (GI) disorders such as irritable bowel syndrome (IBS), inflammatory bowel disease, and gastrointestinal reflux disease. We evaluated the autonomic function using indices derived from the heart rate variability such as power spectra and baroreceptor sensitivity in patients with IBS and inflammatory bowel disease. This abstract summarizes the research conducted in our laboratory on patients with above pathologies of the GI system. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869637 Fri, 27 May 2011 21:43:15 +0100 4869637 http://www.medworm.com/index.php?rid=4869636&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001286%2Fabstract%3Frss%3Dyes Asthma is a chronic disease with features of intermittent shortness of breath and cough. Symptoms come and go, and most objective measures, such as forced expired volume in 1 second, peak expired flow, and airway resistance (Rrs) by forced oscillations, are more variable. From measurements of Rrs using the forced oscillation technique, the distributions of Rrs are more log-normal than normal, and time series analysis using detrended fluctuation analysis reveals long-term memory and correlative properties, indicating that the origins of the variation in Rrs could be described by theories of complex systems. Although the origin of the fluctuations in Rrs have been attributed to fluctuations in the diameters among the hundreds of thousands of airways in the lung, just how the fluctuations cou... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869636 Fri, 27 May 2011 21:43:15 +0100 4869636 http://www.medworm.com/index.php?rid=4869635&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001274%2Fabstract%3Frss%3Dyes Critical care has traditionally been one of the most resource intensive and costly areas of health care. Although patients are surrounded by state-of-the-art medical devices, information extraction, analysis, and synthesis are in most cases manual or e-charting in real time. There have been no integrated approaches to provide a platform for implementing extraction, analysis, and synthesis of information for clinical applications to support complex care at the bedside. Health information technology is expected to improve patient care through increased accuracy through improved information flows, time savings, and reduced documentation . For this reason, the United States plan to invest approximately US $19.1 billion into implementing electronic health records and other health information te... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869635 Fri, 27 May 2011 21:43:14 +0100 4869635 http://www.medworm.com/index.php?rid=4869634&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001262%2Fabstract%3Frss%3Dyes In 2003, Sutter Health, a 26-hospital health system in northern California, initiated a program in tele-critical care (the electronic ICU [ICU]) across all its intensive care unit (ICU) beds. Now that the program has been in place for 7 years, Sutter senior executives are grappling with the question: has tele-critical care improved ICU outcomes? (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869634 Fri, 27 May 2011 21:43:14 +0100 4869634 http://www.medworm.com/index.php?rid=4869633&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001250%2Fabstract%3Frss%3Dyes This talk will address the question of the possible upper and lower bounds to the fluctuations in brain-coordinated activity, normally assessed as synchronization, that are needed for efficient, adaptive information processing. Some main empirical findings will be briefly reviewed, related to the variability in neural synchrony in autism, trauma, and epilepsy. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869633 Fri, 27 May 2011 21:43:14 +0100 4869633 http://www.medworm.com/index.php?rid=4869632&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001249%2Fabstract%3Frss%3Dyes Complexity science is storming into all aspects of life, and medicine is about to witness a paradigm shift in the way human physiology is understood, studied, and how illness and recovery are monitored. I will argue that the human is the quintessential complex system with all of the features and forms of complexity from the smallest composing elements to organs and organ systems manifesting self-organization and emergent properties along multiple scales. We will discuss a definition of a complex system and how it applies and translates to the human. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869632 Fri, 27 May 2011 21:43:13 +0100 4869632 http://www.medworm.com/index.php?rid=4869631&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001237%2Fabstract%3Frss%3Dyes Critical illness is an inherently iatrogenic state. It only arises in patients who, in the absence of medical intervention, would have died to an otherwise lethal insult. Before the past century, simple interventions such as fluid resuscitation, blood transfusion, antibiotics, and surgical repair of major injuries were unavailable, and the response to infection or injury was either death or a relatively rapid recovery. The emergence of intensive care unit (ICU) technologies over the past half century added a further layer of possibility to the process of resuscitation, by sustaining life during a time of otherwise lethal vital organ insufficiency. But ICU technologies also challenged fundamental concepts regarding clinical biology and spawned an unprecedented group of new disorders. There ... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869631 Fri, 27 May 2011 21:43:13 +0100 4869631 http://www.medworm.com/index.php?rid=4869630&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001225%2Fabstract%3Frss%3Dyes In this short talk, I will review about 50 years' history of work on the origin of life, experimental and theoretical. I will discuss the famous Miller Urey experiments that fostered prebiotic chemistry; debates about the extraterrestrial and terrestrial origins of organic compounds; Leslie Orgel's heroic efforts, unsuccessful, to obtain a single-stranded RNA that template replicated with free nucleotides but no enzymes; the onset of the RNA world view, perhaps now fading; work on self-reproducing liposomes; chemical network catalysis; and my own and now others' works on collectively autocatalytic sets, realized experimentally and theoretically as a “complexity” phase transition in complex reaction networks. In addition, I will point out that real cells link exergonic and endergonic re... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869630 Fri, 27 May 2011 21:43:13 +0100 4869630 http://www.medworm.com/index.php?rid=4869629&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001213%2Fabstract%3Frss%3Dyes Perhaps, the most complex phenomenon known to us is life itself. Indeed, the evolution of life and the evolution of biologic complexity are stunning. Many attempts have been aimed at understanding the origin of life and biologic complexity, both at the experimental and theoretical levels, but neither is fully explained yet. In this presentation, I will propose that network phenomena played an important role in the evolution of complexity. First, I will define networks in general terms and explain what I mean by emergent network phenomena. Next, I will argue that emergent network phenomena must have played an important enabling role in the major transitions of life including the transition from nonliving to living; the functioning of the genetic mechanism; the evolution of eukaryotic cells;... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869629 Fri, 27 May 2011 21:43:13 +0100 4869629 http://www.medworm.com/index.php?rid=4869628&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001201%2Fabstract%3Frss%3Dyes Life is an open thermodynamic system that imports energy from the environment and regulates the production of entropy. Entropy is often defined as a measure of disorder. Regulating its production rate combined with the importation of energy allows the development of the high degree of order in living things. This seems to violate the second law of thermodynamics, which states that the entropy of closed systems tends to increase spontaneously. No work is required to do this, but work is required to decrease entropy and create order. To do so, there must be an energy source that generates heat and maintains body temperature. In us, this is provided by metabolic combustion, which consumes oxygen and produces carbon dioxide. In addition, there must be a colder heat sink to take up the heat tha... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869628 Fri, 27 May 2011 21:43:12 +0100 4869628 http://www.medworm.com/index.php?rid=4869627&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001195%2Fabstract%3Frss%3Dyes It is widely held that living organisms are complex dynamic systems. Their dynamic aspects are self-evident; life is a process for which evolution through time is fundamental, the absence of which is the very definition of death. The notion of complexity with respect to living systems arises because we currently cannot imagine how to make one from scratch, in contradistinction to things such as computers and nuclear submarines that are certainly complicated and not easily constructed but which are, nevertheless, based on well-understood principles. In searching for the fundamental characteristics of life, we seek to move the living system from its current location in the realm of the mysterious and have it join the computer and the nuclear submarine. To do this, we need to find those funda... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869627 Fri, 27 May 2011 21:43:10 +0100 4869627 http://www.medworm.com/index.php?rid=4869626&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001183%2Fabstract%3Frss%3Dyes CH Waddington, famous evolutionary and developmental biologist, invented the idea of the “epigenetic landscape” to think metaphorically about the process of cell differentiation from the zygote to the adult. “Wad” thought of a landscape with hills and downhill branching valleys. The zygote had daughter cells, which rolled down the valleys into final resting “wells” that were the terminal cell types of the newborn or adult. Mutations and/or environmental alterations could warp this landscape leading to developmental errors. (Source: Journal of Critical Care) Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869626 Fri, 27 May 2011 21:43:10 +0100 4869626 http://www.medworm.com/index.php?rid=4869625&cid=s_33231_53_f&fid=33231&url=http%3A%2F%2Fwww.jccjournal.org%2Farticle%2FPIIS0883944111001882%2Fabstract%3Frss%3Dyes September 28–October 1 2010. Montebello, Quebec: Scientists, mathematicians, and physicians from across Canada, United States, and France were invited to participate in the second round table discussion on Complexity and Variability at the Bedside to present research, discuss, methodology, and promote applications of “variability analysis”—a novel method for continuous monitoring of variations in physiological systems at the bedside of patients. Recent advancements in research and technology of variability analysis may significantly improve the care provided to patients afflicted with acute and critical illness. Using mathematical models to analyze data harvested from heart, respiratory, and brain monitors at the bedside of adults and children, preliminary findings show that doctor... Journal of Critical Care journals http://www.medworm.com/rss/comments.php?id=4869625 Fri, 27 May 2011 21:43:10 +0100 4869625