Antibiotic dose optimisation in the critically ill: targets, evidence and future strategies.

Purpose Of Review: To highlight the recent evidence for antibiotic pharmacokinetics and pharmacodynamics (PK/PD) in enhancing patient outcomes in sepsis and septic shock. We also summarise the limitations of available data and describe future directions for research to support translation of antibiotic dose optimisation to the clinical setting.

Recent Findings: Sepsis and septic shock are associated with poor outcomes and require antibiotic dose optimisation, mostly due to significantly altered pharmacokinetics.

Correction: Comparison of Four Active SARS-CoV-2 Surveillance Strategies in Representative Population Sample Points: Two-Factor Factorial Randomized Controlled Trial.

[This corrects the article DOI: 10.2196/44204.].

Comparison of Four Active SARS-CoV-2 Surveillance Strategies in Representative Population Sample Points: Two-Factor Factorial Randomized Controlled Trial.

Background: The COVID-19 pandemic is characterized by rapid increases in infection burden owing to the emergence of new variants with higher transmissibility and immune escape. To date, monitoring the COVID-19 pandemic has mainly relied on passive surveillance, yielding biased epidemiological measures owing to the disproportionate number of undetected asymptomatic cases. Active surveillance could provide accurate estimates of the true prevalence to forecast the evolution of the pandemic, enabling evidence-based decision-making.

Lung health in older adults.

One in five people in the UK live with lung disease. The National Taskforce for Lung Health, supported by 29 organisations, published its report in December 2018 with 43 recommendations for the UK, most of which are highly relevant to older adults. Prevention is key, especially relating to the introduction of clean air zones and air pollution alerts.

A Community-Based Nutrition and Physical Activity Intervention for Children Who Are Overweight or Obese and Their Caregivers.

There is a need for efficacious interventions to reduce the prevalence of childhood obesity, and a limited body of research suggests that collaborative community-based programs designed for children and their caregivers may be effective in reducing obesity rates. This paper reports the results of a community-based obesity intervention, South County Food, Fitness and Fun (SCFFF), designed for preadolescent children who are overweight or obese and their caregivers. SCFFF was developed in response to community concerns.

Microwave Enhancement of Autocatalytic Growth of Nanometals.

The desire for designing efficient synthetic methods that lead to industrially important nanomaterials has led a desire to more fully understand the mechanism of growth and how modern synthetic techniques can be employed. Microwave (MW) synthesis is one such technique that has attracted attention as a green, sustainable method. The reports of enhancement of formation rates and improved quality for MW driven reactions are intriguing, but the lack of understanding of the reaction mechanism and how coupling to the MW field leads to these observations is concerning.

Safety and tolerability of paricalcitol in patients with chronic kidney disease.

Introduction: Secondary hyperparathyroidism (SHPT) is a complication of chronic kidney disease (CKD). Beyond skeletal complications, uncontrolled SHPT is associated with cardiovascular mortality. Vitamin D receptor activators (VDRAs) are a mainstay of therapy for SHPT; however, use is limited by hypercalcemia, though less so with calcitriol analogs such as paricalcitol and there is emerging experience with oral formulations for non-SHPT indications.

The interaction of ageing and lung disease.

This article explores the structural and physiological changes that occur in the ageing lung, and the impact that lung disease and other co-morbidities may have on it. The major changes associated with ageing are reduced lung elasticity, respiratory muscle strength and chest wall compliance, all of which may be influenced by impaired lung growth in early childhood and adolescence. The resultant reduction in diffusing capacity may not be relevant in a fit older adult, but co-morbidities may interact to cause breathlessness and impairments in quality of life.

Effects of immobilization stress and hormonal treatment on nociception.

The purpose of this study was to evaluate the effects of stress and estradiol (E2) on pain tolerance. Ovariectomized rats were assigned to treatment groups based on a 2 x 4 factorial design comprising stress (nonstress x stress) and hormone treatment vehicle x E2 [0.25 mg/kg/d]) x estrogen receptor alpha (ERalpha)-selective agonist propyl pyrazole triol (1 mg/kg/d) x estrogen receptor beta (ERbeta)-selective agonist diarylpropionitrile (1 mg/kg/d).

Effects of guided imagery on postoperative outcomes in patients undergoing same-day surgical procedures: a randomized, single-blind study.

The purpose of this investigation was to evaluate the effects of guided imagery on postoperative outcomes in patients undergoing same-day surgical procedures. Forty-four adults scheduled for head and neck procedures were randomly assigned into 2 groups for this single-blind investigation. Anxiety and baseline pain levels were documented preoperatively.

What are the needs of patients following discharge from hospital after an acute exacerbation of chronic obstructive pulmonary disease (COPD)?

Aim: To identify patient needs following discharge from hospital after an exacerbation of COPD.

Methods: Qualitative and semi-quantitative study using home-based structured interviews and focus groups involving 25 COPD patients after hospital discharge. Interviews were performed seven days and three months post-discharge.

Long-term outcome of deceased donor renal transplants correlates with the 30-day creatinine reduction ratio.

A simplified model to correlate early allograft function with long-term allograft survival in recipients of deceased donor renal transplants (DDRT) remains challenging. We propose here a novel approach, using the change from the pretransplant creatinine to the 30-day posttransplant creatinine. The outcomes of 153 consecutive DDRT performed at our center between January 1998 and March 2001 were reviewed.

Falls prevention in residential care homes: a randomised controlled trial.

Objective: to determine the effect of risk factor modification and balance exercise on falls rates in residential care homes.

Design: cluster randomised controlled trial.

Participants: 196 residents (aged 60 years or over) in 20 residential care homes were enrolled (38% response rate).

Unexpectedly, induction of cytotoxic T lymphocytes enhances the humoral response after DNA immunization.

Although there are many examples (eg, immune deviation) in which enhanced cellular responses correspond with lower humoral responses, here we demonstrate for the first time 2 models in which cytotoxic T-lymphocyte (CTL) activity is associated with an enhanced antibody response. First, C57BL/6 mice generate a stronger antibody response to ovalbumin DNA immunization than congenic bm1 mice. The latter differ from C57BL/6 mice in that the H-2Kb molecule is mutated so that the immunodominant CTL epitope of ovalbumin is no longer presented.

Antigen targeted to secondary lymphoid organs via vascular cell adhesion molecule (VCAM) enhances an immune response.

The localisation of antigen within secondary lymphoid organs can significantly increase the immune response. Using the monoclonal antibody M/K 2.7, which recognises murine vascular cell adhesion molecule (VCAM), we have shown antigen accumulation within organs of the secondary lymph such as the draining lymph nodes and spleen.