Clinician views on selective decontamination of the digestive tract in mechanically ventilated patients in intensive care units: A survey.

Objective: Selective decontamination of the digestive tract (SDD) has been investigated as a strategy to reduce the incidence of ventilator-associated pneumonia (VAP) and other healthcare-associated infections in intensive care unit (ICU) patients receiving mechanical ventilation. There is some evidence to suggest that the use of SDD is associated with a reduction in healthcare-associated infection and mortality; however, the uptake of SDD in ICUs in Australia and New Zealand (ANZ) remains low. To better understand the potential reasons, we designed a questionnaire to gather views from specialists in intensive care medicine, infectious diseases, and medical microbiology.

Attributable Risk and Consequences of Bone Mineral Density Deficits in Childhood Cancer Survivors.

Importance: Data characterizing the severity and changing prevalence of bone mineral density (BMD) deficits and associated nonfracture consequences among childhood cancer survivors decades after treatment are lacking.

Objective: To evaluate risk for moderate and severe BMD deficits in survivors and to identify long-term consequences of BMD deficits.

Design, Setting, And Participants: This cohort study used cross-sectional and longitudinal data from the St Jude Lifetime (SJLIFE) cohort, a retrospectively constructed cohort with prospective follow-up.

Anticoagulation and associated complications in veno-arterial extracorporeal membrane oxygenation in adult patients: A systematic review and meta-analysis.

Objective: To describe the incidence of bleeding and thrombotic complications in VA-ECMO according to anticoagulation strategy.

Design: This systematic review and meta-analysis included randomised controlled trials (RCTs) and observational studies reporting bleeding and thrombotic complications in VA-ECMO. The incidence of primary outcomes according to anticoagulation drug and monitoring test was described.

Liberal or Restrictive Transfusion Strategy in Aneurysmal Subarachnoid Hemorrhage.

Background: The effect of a liberal red-cell transfusion strategy as compared with a restrictive strategy in patients during the critical care period after an aneurysmal subarachnoid hemorrhage is unclear.

Methods: We randomly assigned critically ill adults with acute aneurysmal subarachnoid hemorrhage and anemia to a liberal strategy (mandatory transfusion at a hemoglobin level of ≤10 g per deciliter) or a restrictive strategy (optional transfusion at a hemoglobin level of ≤8 g per deciliter). The primary outcome was an unfavorable neurologic outcome, defined as a score of 4 or higher on the modified Rankin scale (range, 0 to 6, with higher scores indicating greater disability) at 12 months.

Characteristics and outcomes of adults with acute brain injuries admitted to intensive care units in Australia and New Zealand from 2013 to 2022.

Background: The characteristics and outcomes of patients with acute brain injuries admitted to the intensive care unit (ICU) in Australia and New Zealand (ANZ) are insufficiently described.

Objective: This study aimed to describe the epidemiology of acute brain injury in ICU patients in ANZ.

Methods: A binational retrospective cohort study was conducted using the ANZ Intensive Care Society Adult Patient Database.

Expert consensus on serratus anterior plane block education and credentialing: A modified-Delphi study.

Objective: The serratus anterior plane block (SAPB) is a regional anaesthesia technique with increasing use as an analgesic adjunct in patients with rib fractures. The present study aimed to generate consensus of the requirements of education, training and credentialing for the use of a 'single shot' SAPB in the management of rib fractures.

Methods: A modified Delphi process was designed using online questionnaires.

American Football-associated Whiplash Maculopathy Presenting With Bilateral Bacillary Detachments: Case Report and Review of Literature.

Ocular trauma is a rare cause of bacillary layer detachments (BALAD). A case report was evaluated and a literature review was performed. A 15-year-old boy presented with bilateral scotomas after a routine American football tackle and was found to have bilateral BALADs.

Sexual dysfunction among long-term survivors of Hodgkin lymphoma.

Background: Survival rates from childhood cancer continue to increase, with an ongoing interest in long-term survivorship. Although infertility and gonadal failure are well recognized in Hodgkin lymphoma (HL) survivors, sexual dysfunction is less studied. The objective of this study was to compare the prevalence of sexual dysfunction in HL survivors with that in matched community controls.

Reducing unnecessary use of intermittent pneumatic compression in intensive care: A before-and-after pilot study with environmental perspective.

Background: The healthcare sector in Australia has committed to reducing carbon emissions associated with care delivery. Thirty percent of care delivered in the Australian hospital sector is considered low-value care. Intensive care uses chemical prophylaxis to reduce risk of venous thromboembolism (VTE).

Prophylactic Antibiotics in Adults With Acute Brain Injury Who Are Invasively Ventilated in the ICU: A Systematic Review and Meta-Analysis.

Background: Lower respiratory tract infections are common in patients receiving invasive mechanical ventilation in an ICU after an acute brain injury and may have deleterious consequences.

Research Question: In adults with acute brain injury receiving invasive mechanical ventilation in an ICU, is the administration of prophylactic parenteral antibiotics, compared with placebo or usual care, associated with reduced mortality?

Study Design And Methods: We conducted a systematic review and meta-analysis. We searched for randomized clinical trials (RCTs) in electronic databases, as well as unpublished trials.

Methods of functional outcome assessment in neurocritical care trials: A systematic review and meta-analysis.

Background: Acute brain injury due to conditions such as subarachnoid haemorrhage and traumatic brain injury are associated with physical, psychological, cognitive, emotional, and social deficits. Despite reductions in morbidity and mortality, there have been few significant changes in clinical practice. It has been suggested that heterogeneity in outcome assessment in studies has contributed to this limited progress.

Rational Function-Based Approach for Integrating Tableting Reduced-Order Models with Upstream Unit Operations: Dry Granulation Case Study.

We present a systematic and automatic approach for integrating tableting reduced-order models with upstream unit operations. The approach not only identifies the upstream critical material attributes and process parameters that describe the coupling to the first order and, possibly, the second order, but it also selects the mathematical form of such coupling and estimates its parameters. Specifically, we propose that the coupling can be generally described by normalized bivariate rational functions.

High-Fidelity Bleeding Control Simulation Scenario During Medical Student Orientation Improves Students' Self-Reported Ability to Identify and Treat Life-Threatening Bleeding with 3-year Follow-up.

Objective: Increasingly, medical schools integrate clinical skills into early didactic coursework. The Stop the Bleed® Campaign emphasizes prehospital hemorrhage control to reduce preventable deaths; however, this course overlooks team interactions. We assessed the impact of high-fidelity simulation during medical student orientation on identification and treatment of life-threatening hemorrhage in a team setting.

Development and Evaluation of a Framework for Authentic Online Co-Design: Partnership-Focussed Principles-Driven Online Co-Design.

Introduction: Co-design in health research involves patient and public involvement and engagement (PPIE) in intervention or service design. Traditionally, co-design is undertaken in-person; however, exploring online delivery is warranted. PPIE in co-design must be considered carefully, and assumptions that in-person approaches will transition automatically to an online environment should be avoided.

Brexucabtagene autoleucel for relapsed or refractory mantle cell lymphoma in the United Kingdom: A real-world intention-to-treat analysis.

Brexucabtagene autoleucel (brexu-cel) is an autologous CD19 CAR T-cell product, approved for relapsed/refractory (r/r) mantle cell lymphoma (MCL). In ZUMA-2, brexu-cel demonstrated impressive responses in patients failing ≥2 lines, including a bruton's tyrosine kinase inhibitor, with an overall and complete response rate of 93% and 67%, respectively. Here, we report our real-world intention-to-treat (ITT) outcomes for brexu-cel in consecutive, prospectively approved patients, from 12 institutions in the United Kingdom between February 2021 and June 2023, with a focus on feasibility, efficacy, and tolerability.

A Patient-Level Meta-Analysis of Intensive Glucose Control in Critically Ill Adults.

Background: Whether intensive glucose control reduces mortality in critically ill patients remains uncertain. Patient-level meta-analyses can provide more precise estimates of treatment effects than are currently available.

Methods: We pooled individual patient data from randomized trials investigating intensive glucose control in critically ill adults.

Prolonged vs Intermittent Infusions of β-Lactam Antibiotics in Adults With Sepsis or Septic Shock: A Systematic Review and Meta-Analysis.

Importance: There is uncertainty about whether prolonged infusions of β-lactam antibiotics improve clinically important outcomes in critically ill adults with sepsis or septic shock.

Objective: To determine whether prolonged β-lactam antibiotic infusions are associated with a reduced risk of death in critically ill adults with sepsis or septic shock compared with intermittent infusions.

Data Sources: The primary search was conducted with MEDLINE (via PubMed), CINAHL, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.

The incidence of ventriculostomy-related infections as diagnosed by 16S rRNA polymerase chain reaction: A prospective observational study.

Background: Ventriculostomy-related infections (VRIs) are reported in about 10 % of patients with external ventricular drains (EVDs). VRIs are difficult to diagnose due to clinical and laboratory abnormalities caused by the primary neurological injury which led to insertion of the EVD. Polymerase chain reaction (PCR) of the cerebrospinal fluid (CSF) may enable more accurate diagnosis of VRI.

Preparedness of Speech Language Pathologists and Occupational Therapists to Treat Pediatric Feeding Disorder: A Cross-Sectional Survey.

Background: Pediatric feeding disorder (PFD) is increasingly common and is often treated by speech language pathologists (SLPs) and occupational therapists (OTs) in the community setting. However, the preparedness of these disciplines to effectively address PFD is relatively unknown.

Methods: A national (US), online survey was disseminated to providers who assess and treat PFD.