Medicina
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Multicenter Study
Evaluation of Continuous Renal Replacement Therapy and Therapeutic Plasma Exchange, in Severe Sepsis or Septic Shock in Critically Ill Children.
Background and objective: Severe sepsis and septic shock are life-threatening organ dysfunctions and causes of death in critically ill patients. The therapeutic goal of the management of sepsis is restoring balance to the immune system and fluid balance. Continuous renal replacement therapy (CRRT) is recommended in septic patients, and it may improve outcomes in patients with severe sepsis or septic shock. ⋯ Conclusion: Our findings revealed that the requirement for CRRT in patients with severe sepsis is predictive of increased mortality. CRRT and TPE can be useful techniques in critically ill children with severe sepsis. However, our results did not show a decrease of mortality with CRRT and TPE.
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Background and objectives: Lumbar spine surgery may be considered if pharmacologic, rehabilitation and interventional approaches cannot provide sufficient recovery from low back-related pain. Postoperative physiotherapy treatment in England is often accompanied by patient information leaflets, which contain important rehabilitation advice. However, in order to be an effective instrument for patients, the information provided in these leaflets must be up to date and based on the best available evidence and clinical practice. ⋯ Return to normal activity advice was also wide ranging, with considerable variation in the recommendations and definitions provided. Conclusions: This study highlights a clear variation in the recommendations of exercise prescription, dosage and returning to normal activities following lumbar spine surgery. Future work should focus on providing a consistent and patient-centred approach to recovery.
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Background and Objectives: The purpose of the study was to determine the prevalence rate of potentially inappropriate prescribing (PIP), by using the Screening Tool of Older Person's potentially inappropriate Prescriptions (STOPP) criteria in older outpatients, and its association with potential clinically significant drug-drug interactions (csDDIs). Materials and Methods: A cross-sectional study included 248 outpatients ≥65 years old divided into two groups depending on the presence of csDDIs. For estimating the clinical significance of csDDIs we used Medscape's "Drug Interaction Checker". ⋯ There was a correlation between the number of medications prescribed and the number of PIMs (ρ = 0.297; p < 0.01) and between the number of PIPs and the number of potential csDDIs (ρ = 0.170; p < 0.01). Conclusions: Older outpatients with potential csDDIs in relation to those with no potential csDDIs had significantly more prescribed drugs in total as well as inappropriate drugs. Almost 30% of these PIMs were included in potential csDDIs.
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Randomized Controlled Trial
Experimental Effects of Acute Exercise in Attenuating Memory Interference: Considerations by Biological Sex.
Background and Objectives: The objective of this experiment was to evaluate the effects of acute exercise on memory interference and determine if this potential relationship is moderated by sex. Materials and Methods: A randomized controlled experiment was conducted (N = 40), involving young adult males (n = 20) and females (n = 20) completing two counterbalanced visits (exercise and no exercise). The exercise visit involved an acute (15 min), moderate-intensity bout of treadmill exercise, while the control visit involved a time-matched seated task. ⋯ Results: In a factorial ANOVA with the outcome being List B, there was a main effect for condition (F(1,38) = 5.75, P = 0.02, n2p = 0.13), but there was no main effect for sex (F(1,38) = 1.39, P = 0.24, n2p = 0.04) or sex by condition interaction (F(1,38) = 1.44, P = 0.23, n2p = 0.04). Conclusion: In conclusion, acute moderate-intensity exercise was effective in attenuating a proactive memory interference effect. This effect was not moderated by biological sex.
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Background and Objectives: The number of stillbirths has reduced more slowly than has maternal mortality or mortality in children younger than 5 years, which were explicitly targeted in the Millennium Development Goals. Placental pathologies and infection associated with preterm birth are linked to a substantial proportion of stillbirths. Appropriate preconception care and quality antenatal care that is accessible to all women has the potential to reduce stillbirth rates. ⋯ Abruption was associated with a 2.8 odds of stillbirth. Conclusions: Risk factors most significantly associated with stillbirth include maternal history of chronic hypertension and abruptio placenta which is a common cause of death in stillbirth. Early identification of potential risk factors and appropriate perinatal management are important issues in the prevention of adverse fetal outcomes and preventive strategies need to focus on improving antenatal detection of fetal growth restriction.