Detecting acute distress and risk of future psychological morbidity in critically ill patients: validation of the intensive care psychological assessment tool.

Introduction: The psychological impact of critical illness on a patient can be severe, and frequently results in acute distress as well as psychological morbidity after leaving hospital. A UK guideline states that patients should be assessed in critical care units, both for acute distress and risk of future psychological morbidity; but no suitable method for carrying out this assessment exists. The Intensive care psychological assessment tool (IPAT) was developed as a simple, quick screening tool to be used routinely to detect acute distress, and the risk of future psychological morbidity, in critical care units.

Intrusive memories of hallucinations and delusions in traumatized intensive care patients: An interview study.

Objective: Psychological morbidity, including post-traumatic stress disorder (PTSD), is common in survivors of intensive care. Intrusive memories of trauma are important symptoms of PTSD. Research has not established which aspects of intensive care are most traumatizing; invasive medical procedures, fear of dying from life-threatening illness or injury, or effects of psychoactive drugs, including hallucinations and delusions.

The effect of intravenous interferon-beta-1a (FP-1201) on lung CD73 expression and on acute respiratory distress syndrome mortality: an open-label study.

Background: Pulmonary vascular leakage occurs early in acute respiratory distress syndrome (ARDS). Mortality is high (35-45%), but no effective pharmacotherapy exists. Production of anti-inflammatory adenosine by ecto-5'-nucleotidase (CD73) helps maintain endothelial barrier function.

Improved intensive care unit survival for critically ill allogeneic haematopoietic stem cell transplant recipients following reduced intensity conditioning.

The use of allogeneic haematopoietic stem cell transplantation (Allo-HSCT) is a standard treatment option for many patients with haematological malignancies. Historically, patients requiring intensive care unit (ICU) admission for transplant-related toxicities have fared extremely poorly, with high ICU mortality rates. Little is known about the impact of reduced intensity Allo-HSCT conditioning regimens in older patients on the ICU and subsequent long-term outcomes.

Investigating risk factors for psychological morbidity three months after intensive care: a prospective cohort study.

Introduction: There is growing evidence of poor mental health and quality of life among survivors of intensive care. However, it is not yet clear to what extent the trauma of life-threatening illness, associated drugs and treatments, or patients' psychological reactions during intensive care contribute to poor psychosocial outcomes. Our aim was to investigate the relative contributions of a broader set of risk factors and outcomes than had previously been considered in a single study.

A multidisciplinary team approach to weaning from prolonged mechanical ventilation.

Objective: To establish whether multidisciplinary team-led strategies to maintain continuity across the weaning process result in an increase in the proportion of patients surviving prolonged mechanical ventilation and reduce the length of time patients are ventilated.

Design: A quality improvement programme was conceived and implemented for patients receiving mechanical ventilation for >21 days.

Setting: University teaching hospital general intensive care unit.

Medication issues experienced by patients and carers after discharge from the intensive care unit.

Purpose: Medication-related problems (MRPs) frequently occur at the interfaces of care settings. We examined this further because little has been published about MRPs experienced by patients/carers after discharge from the intensive care unit (ICU).

Methods And Materials: Medication history data were collected before, during, and after ICU admission and by face-to-face semistructured interviews with 21 patients and 13 carers attending the ICU Follow-up Clinic (FC) of our 35-bed adult ICU.

On comparing a single case with a control sample: an alternative perspective.

Corballis [Corballis, M. C. (2009).

Pulmonary epithelium is a prominent source of proteinase-activated receptor-1-inducible CCL2 in pulmonary fibrosis.

Rationale: Studies in patients and experimental animals provide compelling evidence of the involvement of the major thrombin receptor, proteinase-activated receptor-1 (PAR(1)), and the potent chemokine, chemokine (CC motif) ligand-2 (CCL2)/monocyte chemotactic protein-1, in the pathogenesis of idiopathic pulmonary fibrosis (IPF). PAR(1) knockout mice are protected from bleomycin-induced lung inflammation and fibrosis and this protection is associated with marked attenuation in CCL2 induction.

Objectives: The aim of this study was to determine which cell types represent the major source of PAR(1)-inducible CCL2 in the fibrotic lung.

Testing for a deficit in single-case studies: effects of departures from normality.

In neuropsychological single-case research inferences concerning a patient's cognitive status are often based on referring the patient's test score to those obtained from a modestly sized control sample. Two methods of testing for a deficit (z and a method proposed by Crawford and Howell [Crawford, J. R.

Absence of proteinase-activated receptor-1 signaling affords protection from bleomycin-induced lung inflammation and fibrosis.

Activation of the coagulation cascade is commonly observed in the lungs of patients with both acute and chronic inflammatory and fibrotic lung disorders, as well as in animal models of these disorders. The aim of this study was to examine the contribution of the major thrombin receptor, proteinase-activated receptor-1 (PAR-1), during the acute inflammatory and chronic fibrotic phases of lung injury induced by intratracheal instillation of bleomycin in mice. Inflammatory cell recruitment and increases in bronchoalveolar lavage fluid (BALF) protein were attenuated by 56 +/- 10% (P < 0.

Inferential methods for comparing a single case with a control sample: modified t-tests versus mycroft et al.'s (2002) modified anova.

Mycroft, Mitchell, and Kay (2002) have criticised existing inferential methods (e.g., Crawford & Howell, 1998) for comparing a single case with a control sample and propose that such comparisons be made using a modified ANOVA.

Intra-individual measures of association in neuropsychology: inferential methods for comparing a single case with a control or normative sample.

Performance on some neuropsychological tests is best expressed as an intra-individual measure of association (such as a parametric or non-parametric correlation coefficient or the slope of a regression line). Examples of the use of intra-individual measures of association (IIMAs) include the quantification of performance on tests designed to assess temporal order memory or the accuracy of time estimation. The present paper presents methods for comparing a patient's performance with a control or normative sample when performance is expressed as an IIMA.

Angiotensin II and the fibroproliferative response to acute lung injury.

Angiotensin II (ANG II), generated by activation of local renin-angiotensin systems, is believed to play an important role in tissue repair and remodeling, in part via transforming growth factor-beta (TGF-beta). Angiotensin-converting enzyme (ACE) inhibitors have been shown to abrogate experimental lung injury via a number of potential mechanisms; however, the potentially fibroproliferative role for ANG II in the lung has not been characterized. We hypothesized that, after lung injury, ANG II would stimulate fibroblast procollagen synthesis and promote lung collagen deposition in rats.