Antibiotic Therapy Strategies for Treating Gram-Negative Severe Infections in the Critically Ill: A Narrative Review.

Introduction: Not enough data exist to inform the optimal duration and type of antimicrobial therapy against GN infections in critically ill patients.

Methods: Narrative review based on a literature search through PubMed and Cochrane using the following keywords: "multi-drug resistant (MDR)", "extensively drug resistant (XDR)", "pan-drug-resistant (PDR)", "difficult-to-treat (DTR) Gram-negative infection," "antibiotic duration therapy", "antibiotic combination therapy" "antibiotic monotherapy" "Gram-negative bacteremia", "Gram-negative pneumonia", and "Gram-negative intra-abdominal infection".

Results: Current literature data suggest adopting longer (≥10-14 days) courses of synergistic combination therapy due to the high global prevalence of ESBL-producing (45-50%), MDR (35%), XDR (15-20%), PDR (5.

Tracheostomy in critically ill patients with SARS 2 COVID-19 infection: a prospective observational multi-center study of short- and long-term outcomes.

Background: We report the characteristics, timing, and factors related to the decision to perform a tracheostomy in patients with confirmed COVID-19 infection admitted to eight Italian intensive care units (ICUs).

Materials And Methods: Prospective observational cohort study of patients with COVID-19 disease on mechanical ventilation. Long-term functional impairment (up to 180 days' post-hospital discharge) was assessed using the Karnofsky scale.

Description, Organization, and Individual Postgraduate Perspectives of One Italian School of Anesthesia and Intensive Care.

Introduction: The study aims to describe the organization of one accredited school of Anesthesia and Intensive Care of University of Modena and Reggio Emilia, Italy. The analysis of the post-graduation period aims to measure the time-to-first job, the perceived challenges, what postgraduate residents choose as first employ, and the overall satisfaction rating of a cohort of residents completing their training until 2017 with the usual and standard training program.

Methods: We collected organization and administrative records of the five-year program of the A-IC School of 4 cohorts of residents who joined from 2009 to 2012 and we performed a survey.

Malignant Gastric Outlet Obstruction Caused by Duodenal Cervix Metastasis in a Young Woman: Rendezvous Technique.

: Malignant gastric outlet obstruction (MGOD) is an extremely rare expression of advanced extra-gastrointestinal cancer, such as squamous cell carcinoma (SCC) of the cervix, and only sixcases are described in the literature.Because of the short life expectancyand the high surgical risk involving these patients, less invasive approaches have been developed over time, such asthe use of an enteral stent or less invasive surgical techniques (i.e.

How Artificial Intelligence and New Technologies Can Help the Management of the COVID-19 Pandemic.

The COVID-19 pandemic has worked as a catalyst, pushing governments, private companies, and healthcare facilities to design, develop, and adopt innovative solutions to control it, as is often the case when people are driven by necessity. After 18 months since the first case, it is time to think about the pros and cons of such technologies, including artificial intelligence-which is probably the most complex and misunderstood by non-specialists-in order to get the most out of them, and to suggest future improvements and proper adoption. The aim of this narrative review was to select the relevant papers that directly address the adoption of artificial intelligence and new technologies in the management of pandemics and communicable diseases such as SARS-CoV-2: environmental measures; acquisition and sharing of knowledge in the general population and among clinicians; development and management of drugs and vaccines; remote psychological support of patients; remote monitoring, diagnosis, and follow-up; and maximization and rationalization of human and material resources in the hospital environment.

Bacterial infections in critically ill patients with SARS-2-COVID-19 infection: results of a prospective observational multicenter study.

Purpose: To investigate the prevalence, incidence and characteristics of bacterial infections and their impact on outcome in critically ill patients infected with COVID-19.

Methods: We conducted a prospective observational study in eight Italian ICUs from February to May 2020; data were collected through an interactive electronic database. Kaplan-Meier analysis (limit product method) was used to identify the occurrence of infections and risk of acquisition.

A new sensitive and accurate model to predict moderate to severe obstructive sleep apnea in patients with obesity.

Obstructive sleep apnea (OSA) has a high prevalence in patients with obesity. Only patients with clinical symptoms of OSA are admitted to polysomnography; however, many patients with OSA are asymptomatic. We aimed to create and validate a population-based risk score that predicts the severity of OSA in patients with obesity.

Prevention and Treatment of Postoperative Pain after Lumbar Spine Procedures: A Systematic Review.

Background And Objective: In the past 2 decades, in developed countries, spine procedures (surgical and percutaneous) had the highest absolute increase in case volume trend. The optimal approach to prevent and treat postoperative pain is continuously evolving. This systematic literature review presents evidence on safety and efficacy of pharmacological and nonpharmacological therapies to prevent and treat postoperative pain after lumbar spine procedures.

The societal burden of chronic liver diseases: results from the COME study.

Objective: Chronic liver diseases (CLDs) impose a significant socioeconomic burden on patients and the healthcare system, but to what extent remains underexplored. We estimated costs and health-related-quality-of-life (HRQoL) among patients with CLDs at different stages and with different aetiologies.

Design: A cost-of-illness study was conducted.

Focus on emerging drugs for the treatment of patients with non-alcoholic fatty liver disease.

Non-alcoholic fatty liver disease (NAFLD) has become the most common liver disorder in Western countries and is increasingly being recognized in developing nations. Fatty liver disease encompasses a spectrum of hepatic pathology, ranging from simple steatosis to non-alcoholic steatohepatitis, cirrhosis, hepatocellular carcinoma and end-stage liver disease. Moreover, NAFLD is often associated with other metabolic conditions, such as diabetes mellitus type 2, dyslipidemia and visceral obesity.

Optimized contrast-enhanced ultrasonography for characterization of focal liver lesions in cirrhosis: A single-center retrospective study.

Background: Hepatocellular carcinoma (HCC) is the leading cause of death amongst cirrhotic patients. Its diagnosis and discrimination from non-HCC malignant lesions in cirrhosis includes contrast enhanced computed tomography (CECT), contrast enhanced magnetic resonance imaging (CEMRI), or, in selected cases, liver biopsy. The role of contrast-enhanced ultrasonography (CEUS) is still controversial.

Salivary biomarkers of obstructive sleep apnea syndrome in children.

Objectives: The present pilot study was performed to evaluate the HPA axis and ANS activity by measuring salivary cortisol and α-amylase diurnal trajectory and production, respectively, in mild or moderate-to-severe (MS) OSA-affected, but otherwise healthy, children. Moreover, a correlative analysis was performed between the salivary biomarker concentrations and the PSG variables characterizing the OSA severity.

Methods: We studied 27 consecutive OSA patients (13 mild OSA; 14 MS OSA) and seven healthy children who were enrolled as controls by collecting salivary samples and measuring cortisol and α-amylase levels using enzyme-linked bioassays.

Liver failure in an obese middle-aged woman after biliointestinal bypass.

Obesity is considered an emerging epidemic that is often associated with non-alcoholic fatty liver disease. Among the therapeutic options for morbid obesity, bariatric surgery plays an important role when conventional therapies fail. The effects of bariatric surgery on liver function and morphology are controversial in the literature.

Comparing the performance of the standard EQ-5D 3L with the new version EQ-5D 5L in patients with chronic hepatic diseases.

Purpose: To assess the performance of the EQ-5D-5L version compared with the standard EQ-5D-3L in a clinical setting targeted at patients with chronic hepatic diseases (CHDs).

Methods: We introduced the 5L descriptive system into a cost-of-illness study involving patients with different CHDs. The patients completed a questionnaire including the two versions of the EQ-5D, together with other questions related to their condition.

Herbal products: benefits, limits, and applications in chronic liver disease.

Complementary and alternative medicine soughts and encompasses a wide range of approaches; its use begun in ancient China at the time of Xia dynasty and in India during the Vedic period, but thanks to its long-lasting curative effect, easy availability, natural way of healing, and poor side-effects it is gaining importance throughout the world in clinical practice. We conducted a review describing the effects and the limits of using herbal products in chronic liver disease, focusing our attention on those most known, such as quercetin or curcumin. We tried to describe their pharmacokinetics, biological properties, and their beneficial effects (as antioxidant role) in metabolic, alcoholic, and viral hepatitis (considering that oxidative stress is the common pathway of chronic liver diseases of different etiology).

The role of gut hormones in controlling the food intake: what is their role in emerging diseases?

Central nervous system (CNS) receives peripheral relevant information that are able to regulate individual's energy balance through metabolic, neural, and endocrine signals. Ingested nutrients come into contact with multiple sites in the gastrointestinal tract that have the potential to alter peptide and neural signaling. There is a strong relationship between CNS and those peripheral signals (as gastrointestinal hormones) in the control of food intake.

Rifaximin in the treatment of hepatic encephalopathy.

Hepatic encephalopathy is a challenging complication in patients with advanced liver disease. It can be defined as a neuropsychiatric syndrome caused by portosystemic venous shunting, ranging from minimal to overt hepatic encephalopathy or coma. Its pathophysiology is still unclear, although increased levels of ammonia play a key role.

Gut microbiota and probiotics in chronic liver diseases.

There is a strong relationship between liver and gut: the portal system receives blood from the gut, and intestinal blood content activates liver functions. The liver, in turn, affects intestinal functions through bile secretion into the intestinal lumen. Alterations of intestinal microbiota seem to play an important role in induction and promotion of liver damage progression, in addition to direct injury resulting from different causal agents.