Journal of critical care
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Journal of critical care · Feb 2018
ReviewEbola virus disease: Report from the task force on tropical diseases by the World Federation of Societies of Intensive and Critical Care Medicine.
Ebola virus is a filovirus that can cause fatal hemorrhagic fever (HF) and five distinct species exist that vary in terms of geographical distribution and virulence. Once the more virulent forms enter the human population, transmission occurs primarily through direct contact with infected body fluids and may result in significant outbreaks. The devastating has been the recent West African outbreak. ⋯ Real time reverse transcription-PCR (RT-PCR) techniques on blood specimens are the gold standard for diagnosis [6]. Management is discussed and is essentially supportive with strict attention to infection control and prevention. None of the pharmacological interventions have shown conclusive benefit and future management of epidemics should centre around prevention and containment, specifically isolation, hygiene, and vaccination.
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Journal of critical care · Feb 2018
ReviewDengue fever: Report from the task force on tropical diseases by the World Federation of Societies of Intensive and Critical Care Medicine.
Dengue is an arbovirus affecting humans and spread by mosquitoes. Severe dengue follows a secondary infection with a different virus serotype. The problem is truly global as it is endemic in over 100 countries. ⋯ Commercial rapid tests and ELISA kits are freely available, ensuring early diagnosis. The basis of management of severe dengue is effective fluid replacement. Future directions in management will involve vector control and development of effective vaccination.
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Journal of critical care · Feb 2018
ReviewOvercoming the Warburg Effect: Is it the key to survival in sepsis?
Sepsis is a leading cause of mortality in the U. S. and Europe. Sepsis and septic shock are the results of severe metabolic abnormalities following infection. ⋯ Although the initial pathways of cancer and sepsis may be different, the mechanisms which allow aerobic glycolysis to occur, even in the presence of oxygen, are similar. This review provides some evidence that reversing these steps reverses the Warburg Effect in model systems and some pathological consequences of this effect. Therefore, this implies that these steps might be modifiable in sepsis to reverse the Warburg Effect and possibly lead to better outcomes.
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Journal of critical care · Feb 2018
Multicenter StudyUntreated hypertension as predictor of in-hospital mortality in intracerebral hemorrhage: A multi-center study.
Hypertension is a significant risk factor for intracerebral hemorrhage (ICH). The importance of managing blood pressure to reduce the risk of ICH has been recognized. However, few studies have focused on ICH outcomes due to untreated hypertension. ⋯ Subjects with untreated-hypertension were younger and had fewer comorbidities when compared with treated-hypertension and were similar when compared to normotensive individuals. Once demographic and in-hospital factors were accounted for, untreated-hypertension subjects demonstrated significantly increased in-hospital mortality following ICH when compared with normotensive individuals.
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Journal of critical care · Feb 2018
Multicenter Study Observational StudyAssociation between strained capacity and mortality among patients admitted to intensive care: A path-analysis modeling strategy.
To evaluate the associations between strained ICU capacity and patient outcomes. ⋯ Strained capacity was associated with increased ICU mortality, partly mediated through greater illness acuity. Future work should consider both the direct and indirect relationships of strain on outcomes.