Publications by authors named "A Charles-Nelson"
Objective: Extracorporeal membrane oxygenation (ECMO) is a high-risk procedure with significant morbidity and mortality and there is an uncertain volume-outcome relationship, especially regarding long-term functional outcomes. The aim of this study was to examine the association between ECMO centre volume and long-term death and disability outcomes.
Design Setting And Participants: This is a registry-embedded observational cohort study.
Background: In patients with multivessel disease with successful primary percutaneous coronary intervention for ST-segment-elevation myocardial infarction, the FLOWER-MI trial (Flow Evaluation to Guide Revascularization in Multivessel ST-Elevation Myocardial Infarction) showed that a fractional flow reserve (FFR)-guided strategy was not superior to an angiography-guided strategy for treatment of noninfarct-related artery lesions regarding the 1-year risk of death from any cause, myocardial infarction, or unplanned hospitalization leading to urgent revascularization. The extension phase of the trial was planned using the same primary outcome to determine whether a difference in outcomes would be observed with a longer follow-up.
Methods: In this multicenter trial, we randomly assigned patients with ST-segment-elevation myocardial infarction and multivessel disease with successful percutaneous coronary intervention of the infarct-related artery to receive complete revascularization guided by either FFR (n=586) or angiography (n=577).
Ventilator-associated pneumonia related to extended-spectrum beta-lactamase producing Enterobacterales during severe acute respiratory syndrome coronavirus 2 infection: risk factors and prognosis.
Crit Care
April 2024
Article Synopsis
- Patients with COVID-19 requiring mechanical ventilation have a high risk of developing ventilator-associated pneumonia (VAP), particularly caused by Enterobacterales, with limited data on extended-spectrum beta-lactamase producing Enterobacterales (ESBL-E).
- In a study involving 591 patients with Enterobacterales related VAP, 19% developed ESBL-E infections, primarily from Enterobacter sp, K. pneumoniae, and E. coli, while a very small percentage experienced carbapenem-resistant Enterobacterales (CRE) infections.
- Key risk factors for ESBL-E related VAP included African origin, time between intubation and VAP development, the patient's oxygenation status, and prior exposure to trimethopr
Randomized controlled trials can be used to generate evidence on the efficacy and safety of new treatments in eating disorders research. Many of the trials previously conducted in this area have been deemed to be of low quality, in part due to a number of practical constraints. This article provides an overview of established and more innovative clinical trial designs, accompanied by pertinent examples, to highlight how design choices can enhance flexibility and improve efficiency of both resource allocation and participant involvement.
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- The study aimed to identify risk factors for arterial and venous thromboses (AVT) in COVID-19 pneumonia patients requiring oxygen while hospitalized.
- During a 3-month follow-up of 388 patients, 10% experienced AVT, with diabetes and high C-reactive protein (CRP) levels linked to increased risk, while obesity showed no significant association.
- The findings suggest that monitoring diabetes and CRP levels in hospitalized COVID-19 patients is crucial, and higher anticoagulant doses might be beneficial for those identified as high-risk.