Articles: critical-care.
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To describe how nurses assess and manage pain in critically ill children. ⋯ Pain assessment of critically ill children includes unique indicators, as compared to less sick children, and must take into account the child's decreased ability to communicate pain.
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After acute brain injury there may be increased intracranial production of cytokines, with activation of inflammatory cascades. We have sought to determine if a transcranial cytokine gradient was demonstrable in paired sera of 32 patients requiring intensive care after acute brain injury. ⋯ This suggests that there is significant production of IL-6 by intracranial cells after acute brain injury. Therapy directed towards combatting the negative effects of IL-6 may potentially benefit patients who have sustained an acute brain injury.
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Nosocomial infection remains a pressing problem of surgery and intensive care. The authors analyze the sources of infection, the factors predisposing to it, and the pathogenetic aspects. ⋯ Microbiological and pharmacological studies helped the authors develop the protocols of the initial and alternative antibiotic therapy of various nosocomial complications of wound infection, abdominal sepsis, nosocomial pneumonia, and infectious toxic shock. Experience gained by the authors permitted them to recommend preventive measures decreasing the risk of exo- and endogenous infection and improving the mechanisms of patients' immunity.