Articles: adult.
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Obese patients seem to have worse outcomes and more complications during intensive care unit (ICU) stay. This study describes the clinical course, complications and prognostic factors of obese patients admitted to an intensive care unit compared to a control group of nonobese patients. ⋯ Obesity did not increase the mortality rate, but improved intensive care unit length of stay. The current prognostic scoring systems do not include BMI, possibly underestimating the risk of death, and other quality of care indexes in obese patients. New studies could be useful to clarify how body mass index impacts the mortality rate.
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To determine if a sensitive D-dimer assay can exclude progression to organ dysfunction, death, and intensive care unit (ICU) admission in patients presenting to the emergency department (ED) with suspected infection, and if increasing levels of D-dimer are predictive of those end points. ⋯ This study was limited by its nonconsecutive patient recruitment and sample size. A normal D-dimer may exclude progression to organ dysfunction, ICU admission, and death and, at higher cutoff levels, could help risk stratify patients presenting to the ED with signs of sepsis.
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Intussusception is a condition found primarily in the pediatric population. In the adult population, however, intussusception is usually due to a pathological process, with a higher risk of bowel obstruction, vascular compromise, inflammatory changes, ischemia, and necrosis. Radiographic and sonographic evidence can aid in the diagnosis. Surgical intervention involving resection of affected bowel is the standard of care in adult cases of intussusception. ⋯ In the adult population, intussusception is usually caused by a lead point, with subsequent telescoping of one part of the bowel into an adjacent segment. While intussusception can occur in any part of the bowel, it usually occurs between a freely moving segment and either a retroperitoneal or an adhesion-fixed segment. The etiology may be associated with pathological processes such as carcinoma or iatrogenic causes, such as scars or adhesions from prior surgeries. The cases presented here demonstrate important etiologies of abdominal pain in adult patients. Along with gynecological etiologies of lower quadrant abdominal pain in female patients, it is important for the emergency physician to expand the differential diagnosis to include other causes, such as intussusceptions, especially given the symptoms that could be associated with bowel obstruction.
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Biological psychiatry · Apr 2010
Attentional control activation relates to working memory in attention-deficit/hyperactivity disorder.
Attentional control difficulties in individuals with attention-deficit/hyperactivity disorder (ADHD) might reflect poor working memory (WM) ability, especially because WM ability and attentional control rely on similar brain regions. The current study examined whether WM ability might explain group differences in brain activation between adults with ADHD and normal control subjects during attentional demand. ⋯ The inability to maintain an appropriate task set in young adults with combined type ADHD, associated with decreased activity in left DLPFC, might in part be due to poor WM ability. Furthermore, in individuals with ADHD, higher WM ability might relate to increased recruitment of stimulus-driven attention and response selection processes, perhaps as a compensatory strategy.
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Rev Bras Ter Intensiva · Mar 2010
Comparison and effects of two different airway occlusion times during measurement of maximal inspiratory pressure in adult intensive care unit neurological patients.
To verify if the maximal inspiratory pressure values with 40 seconds occlusion time are greater than with the 20 seconds occlusion time, and the impacts on the following patient's physiological variables: respiratory rate, pulse oxygen saturation, heart rate and blood pressure, before and after the measurements. ⋯ The measurement of maximal inspiratory pressure using a longer occlusion (40 seconds) produced higher values, without triggering clinically significant stress according to the selected variables.