Burnout in the intensive care unit professionals.

Background: Professional burnout has been widely explored in health care. We conducted this study in our hospital intensive care unit (ICU) in United States to explore the burnout among nurses and respiratory therapists (RT).

Materials And Methods: A survey consisting of two parts was used to assess burnout.

Comparison of anxiety, depression, and post-traumatic stress symptoms in relatives of ICU patients in an American and an Indian public hospital.

Context: An intensive care unit (ICU) admission of a patient causes considerable stress among relatives. Whether this impact differs among populations with differing sociocultural factors is unknown.

Aims: The aim was to compare the psychological impact of an ICU admission on relatives of patients in an American and Indian public hospital.

Nutrition management for the patient requiring prolonged mechanical ventilation.

Patients requiring prolonged mechanical ventilation are often medically complex and present with a wide range of pulmonary conditions, including neuromuscular diseases, chronic pulmonary diseases, and chronic critical illness. These patients present the nutrition support professional with many challenges. However, accurate nutrition assessment, timely and effective nutrition interventions, and careful monitoring will help patients meet their medical and nutrition goals.

Managing TB in the 21st century: existing and novel drug therapies.

With an estimated one-third of the world's population infected with Mycobacterium tuberculosis (MTB) and approximately 1.6 million deaths in 2006 attributed to tuberculosis (TB) world-wide, TB remains a major public health concern today. Considerable advances have been made in the effective treatment of TB, in particular with the adoption of directly observed therapy short course (DOTS), in national TB control programs, but in spite of this the currently available regimens are suboptimal.

Smoking and systemic disease.

Cigarette smoking is associated with a number of adverse health effects, including well-established links to cardiopulmonary disease and several cancers. Some of the other important systemic diseases associated with smoking are the subjects of this article, such as diabetes mellitus and insulin resistance, and thyroid diseases. Also reviewed here is the impact of smoking on male and female infertility, on selected dermatologic conditions, and on gastrointestinal diseases including peptic ulcer and inflammatory bowel diseases.

Cardiac arrest in pregnancy and somatic support after brain death.

Objective: To review the important causes of cardiopulmonary arrest during pregnancy and the recommended modifications to resuscitation protocols when applied to pregnant patients, including the indications for perimortem cesarean section and the expected fetal outcomes, and to review the literature regarding extended somatic support after brain death during pregnancy.

Data Sources: MEDLINE review of publications relating to cardiac arrest and resuscitation in pregnancy, physiologic changes after brain death, and attempted somatic support of brain-dead pregnant women.

Conclusions: Cardiac arrest during pregnancy is rare, but it is important to recognize the causes, which may be either unrelated to pregnancy or unique to the pregnant woman.

Nutritional management of the patient with chronic obstructive pulmonary disease.

The prevalence and prognostic importance of malnutrition in chronic obstructive pulmonary disease (COPD), the factors that contribute to development of nutritional depletion, and the available evidence regarding effects of nutrition support in these patients are the subjects of this review. Nutritional depletion, as indicated by weight loss and loss of lean body mass, is a common complication of advanced COPD (particularly, but not limited to, the emphysematous type). Low body weight or recent weight loss and in particular depleted lean body mass in patients with COPD have been shown to be independent predictors of mortality, outcomes after acute exacerbations, hospital admission rates, and need for mechanical ventilation.

Smoking and systemic disease.

Cigarette smoking is associated with a number of adverse health effects, including well-established links to cardiopulmonary disease and several cancers. Some of the other important systemic diseases associated with smoking are the subjects of this article, such as diabetes mellitus and insulin resistance and thyroid diseases. Also reviewed here is the negative impact of smoking on male and female infertility, on selected dermatologic conditions, and on gastrointestinal diseases including peptic ulcer and inflammatory bowel diseases.

Cardiopulmonary resuscitation and somatic support of the pregnant patient.

Cardiopulmonary arrest during pregnancy is a rare event that critical care clinicians must be prepared to manage. The causes of cardiopulmonary arrest during pregnancy, recommended modifications to cardiopulmonary resuscitation protocols that are specific to pregnancy, indications for and timing of perimortem cesarean delivery, and the expected fetal outcomes are reviewed. Rarely, brain death of a pregnant patient may occur in which continued support of the mother is possible to prolong the pregnancy and improve fetal outcome.