The International journal of artificial organs
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Early renal replacement therapy (RRT) initiation should theoretically influence many physiological disorders related to acute kidney injury (AKI). Currently, there is no consensus about RRT timing in intensive care unit (ICU) patients. ⋯ Early RRT in ICU patients with acute kidney injury or failure was associated with increased survival.
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Candida species have two distinct lifestyles: planktonic, and surface-attached communities called biofilms. Mature C. albicans biofilms show a complex three-dimensional architecture with extensive spatial heterogeneity, and consist of a dense network of yeast, hyphae, and pseudohyphae encased within a matrix of exopolymeric material. Several key processes are likely to play vital roles at the different stages of biofilm development, such as cell-substrate and cell-cell adherence, hyphal development, and quorum sensing. ⋯ The traditional approach to the management of these infections has been to explant the affected device. There is a strong medical but also economical motivation for the development of novel anti-fungal biofilm strategies due to the constantly increasing resistance of Candida biofilms to conventional antifungals, and the high mortality caused by related infections. A better description of the extent and role of yeast in biofilms may be critical for developing novel therapeutic strategies in the clinical setting.
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Indwelling vascular catheters are the most common cause of nosocomial bloodstream infections. One approach to infection prevention is the use of antimicrobial catheter lock solutions, although their widespread use is limited due to concern regarding the emergence of antimicrobial resistance. The primary purpose of this study was to determine the efficacy of N-acetylcysteine (NAC) lock solution in preventing peripheral bacteremia using an in vivo model of catheter-associated infection. ⋯ These promising data encourage further clinical evaluation of an NAC lock solution for prevention of catheter-associated bacteremia in patients.
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Multicenter Study
The Sorin freedom stentless pericardial valve: clinical and echocardiographic performance at 10 years.
The Sorin Pericarbon Freedom (SPF) is a stentless valve made of pericardium clinically available in 1990. We report the clinical and hemodynamic performance of the SPF at 10 years. ⋯ The SPF has demonstrated overall good results in terms of valve durability and freedom from valve-related complications up to 10 years, with excellent hemodynamic performance.
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Multicenter Study Comparative Study
Low-dose continuous renal replacement therapy for acute kidney injury.
Continuous renal replacement therapy (CRRT) is used increasingly to treat acute kidney injury (AKI), which is a common condition in the intensive care unit (ICU). However, the optimal CRRT dose for the treatment of AKI is still a matter of controversy. This study was conducted to ascertain the minimal dose of CRRT that can be effective on AKI patient outcomes. ⋯ We found that low-dose CRRT did not increase mortality in critically ill patients with AKI. We also found that AKI patients treated with lower-dose CRRT non-significantly but numerically lower hospital mortality compared to higher-dose CRRT.