Minerva anestesiologica
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Minerva anestesiologica · Oct 2011
Case ReportsHyperlipidemic acute pancreatitis: a possible role of antiretroviral therapy with entecavir.
In most cases clinical profile of acute hyperlipidemic pancreatitis is a preexisting lipoprotein abnormality associated to second risk factors such as alcohol abuse, diabetes mellitus or medications that can induce hypertrygliceridemia. We report a case of a young male affected by chronic hepatitis B virus infection admitted to Emergency Department due to acute abdominal pain, vomiting and fever. ⋯ Considering its possible role in the pathogenesis of pancreatitis, entecavir was interrupted and total of 3 sections of plasmapheresis were performed, allowing clinical resolution and prevention of pancreatic damage. The possible pathogenetic role of entecavir is discussed.
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Minerva anestesiologica · Oct 2011
Superinfections in Pseudomonas aeruginosa ventilator-associated pneumonia.
Data on superinfections in patients with ventilator-associated pneumonia vary, but different pathogens are typically studied as a single category. We studied the incidence of superinfections and the outcomes of patients with superinfections in Pseudomonas aeruginosa ventilator-associated pneumonia. ⋯ For Pseudomonas aeruginosa ventilator-associated pneumonia, superinfections are not uncommon as early as day three, but they do not increase mortality.
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Minerva anestesiologica · Sep 2011
ReviewWhen, where and how to initiate hypothermia after adult cardiac arrest.
Therapeutich hypothermia (TH) has been shown to improve neurological outcome and survival after witnessed cardiac arrest (CA) that is due to ventricular fibrillation. Although TH is widely used following witnessed CA as well as all forms of initial rhythm, the mortality rate after CA remains unacceptably high, and additional study is needed to understand when and how to implement hypothermia in the post-resuscitation phase. ⋯ Thus, hypothermia use should not be limited to the Intensive Care Unit but can be initiated in the field/ambulance or in the Emergency Department, then continued after hospital admission- even during specific procedures such as coronary angiography-as part of the global management of CA patients. Various methods (both non-invasive and invasive) are available to achieve and maintain the target temperature; however, only some of these methods-which include cold fluids, ice packs, iced pads and helmet and trans-nasal cooling- are easily deployed in the pre-hospital setting.