Revue médicale suisse
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Vitamin D deficiency , defined by a 25-OH vitamin D3 plasma level < 30 ng/ml, is highly prevalent in the population. Several observational studies have suggested that such a deficiency increases the risk of hypertension development. Vitamin D seems to have an inhibitory effect on renin secretion and might by this mechanism exert an antihypertensive effect. Recent randomized trials have failed however to demonstrate a blood pressure lowering effect of vitamin D supplementation.
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Revue médicale suisse · Jan 2011
[Pediatrics. Fecal calprotectin in children: use and interpretation].
Fecal calprotectin is a small protein released mainly by neutrophils. It is recognized as a reliable, easy and non-invasive biomarker of gastro-intestinal inflammation. ⋯ It is not a specific marker of IBD but is increased in other situations of gastro-intestinal inflammation. In patients with IBD, fecal calprotectin is used to monitor treatment response.
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Revue médicale suisse · Dec 2010
[Neurally adjusted ventilatory assist: a revolution of mechanical ventilation?].
Neurally adjusted ventilatory assist or NAVA is a new assisted ventilatory mode which, in comparison with pressure support, leads to improved patient-ventilator synchrony and a more variable ventilatory pattern. It also improves arterial oxygenation. ⋯ With NAVA, the patient's respiratory pattern controls the ventilator's timing of triggering and cycling as well as the magnitude of pressurization, which is proportional to inspiratory demand. The effect of NAVA on patient outcome remains to be determined through well-designed prospective studies.
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The process of health care delivery in Intensive Care Units (ICUs) is subject to significant workload fluctuations and unpredictable events. Medical and nursing staff, while relying on protocols, must adjust to these "out of the routine" disturbances by displaying initiative and innovation. ⋯ The assumption is that this resilience ability may be intentionally built by a specific work organization. The theoretical framework of "resilience engineering" described here could be a powerful tool in organizational designing suited to the ICUs.