Medical science monitor : international medical journal of experimental and clinical research
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Blood glucose control aiming at normoglycemia, frequently referred to as "strict glycemic control", decreases mortality and morbidity of critically ill patients. We searched the medical literature for export opinions, surveys, and clinical reports on blood glucose control in intensive care medicine. While strict glycemic control has been recommended standard of care for critically ill patients, the risk of severe hypoglycemia with strict glycemic control is frequently mentioned by experts. ⋯ Implementation of strict glycemic control is far from complete, at least in part because of the feared risks of hypoglycemia. The preference for hyperglycemia over intermittent hypoglycemia is irrational, however, because there is causal evidence of harm for the former but only associative evidence of harm for the latter. For several reasons it is wise to have strict glycemic control being a nurse-based strategy.
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Fat embolization and fat embolism syndrome are poorly understood complications of skeletal trauma. Fat embolism syndrome is a clinical diagnosis, and patients typically present with a classic triad of petechial rash, pulmonary distress, and neurologic dysfunction. The incomplete form of the syndrome (i.e., cerebral fat embolism) is a more challenging clinical diagnosis in which brain magnetic resonance imaging may be a valuable tool. Fat embolism syndrome can be a life-threatening condition, but the latent form that occurs 24 to 72 hours after the trauma is frequently described as a self-limiting condition. ⋯ The pathogenesis and treatment options of fat embolism syndrome are reviewed based on available literature, and the usefulness of brain magnetic resonance imaging is discussed.
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This study aimed to decrease the massive problem of cataract-related blindness and visual disability in rural areas of Yemen and reach more visually impaired and blind people to provide them with an improved standard of visual rehabilitation. ⋯ The "eye camps" involved a comprehensive cooperative relief effort on a large scale to combat the widespread prevalence of cataract and chronic shortages of ophthalmic facilities and medical personnel as it affects residents of rural areas in Yemen. Until primary and secondary care facilities are optimal for cataract screening and surgery in Yemen, such eye camps are recommended to reduce the backlog of curable blindness resulting from cataract. This project will continue until enough eye hospitals are built in Yemen.