A prospective emergency department-based study of pattern and outcome of neurologic and neurosurgical diseases in Haiti.

Objective: To perform the first prospective survey of neurologic and neurosurgical emergency department (ED) admissions in Haiti.

Methods: Data of all ED admissions at 3 Haitian hospitals for 90 consecutive days per site were collected prospectively. Patients who were given a diagnosis of a neurologic or neurosurgical disorder by the ED physician were entered in a deidentified database including demographics, presenting symptoms, brain imaging (when available), requests for neurosurgical consultation, and outcome.

Pulmonary hypertension in pregnancy: critical care management.

Pulmonary hypertension is common in critical care settings and in presence of right ventricular failure is challenging to manage. Pulmonary hypertension in pregnant patients carries a high mortality rates between 30-56%. In the past decade, new treatments for pulmonary hypertension have emerged.

Principles and practice of disaster relief: lessons from Haiti.

Disaster relief is an interdisciplinary field dealing with the organizational processes that help prepare for and carry out all emergency functions necessary to prevent, prepare for, respond to, and recover from emergencies and disasters caused by all hazards, whether natural, technological, or human-made. Although it is an important function of local and national governing in the developed countries, it is often wanting in resource-poor, developing countries where, increasingly, catastrophic disasters tend to occur and have the greatest adverse consequences. The devastating January 12, 2010, Haiti earthquake is a case study of the impact of an extreme cataclysm in one of the poorest and most unprepared settings imaginable.

Adult parenteral nutrition utilization at a tertiary care hospital.

Background: Guidelines from the American Society for Parenteral and Enteral Nutrition promote appropriate use of parenteral nutrition (PN). In addition, involvement of multidisciplinary nutrition support teams (NSTs) has led to a reduction of inappropriate PN administration. This study evaluated the effect of introducing hospital-wide PN guidelines and a PN review committee on PN prescription behavior of NSTs in the authors' hospital.

Sinus bradycardia associated with daclizumab in liver transplant recipients: report of 3 cases.

Daclizumab is a commonly used immunosuppressive agent for prophylaxis of solid organ rejection. Although rare, the cardiovascular adverse effects of daclizumab include sinus tachycardia, hypotension, and hypertension. Here, we report 3 patients who developed significant and prolonged sinus bradycardia after receiving daclizumab following orthotopic liver transplant.

Effect of lower limb compression devices on thermodilution cardiac output measurement.

Objective: The aim of this study was to determine whether lower limb (calf) sequential compression devices (SCDs) have a significant effect on thermodilution cardiac output measurements using a pulmonary artery catheter.

Design: Prospective clinical investigation.

Setting: Surgical and neurosurgical intensive care units in a university hospital.

Feasibility and potential clinical utility of goal-directed transthoracic echocardiography performed by noncardiologist intensivists using a small hand-carried device (SonoHeart) in critically ill patients.

Objective: This study was designed to assess the clinical applicability of a small, handheld, portable transthoracic echocardiography device by noncardiologist intensivists.

Design: Prospective, observational study. After 10 one-hour tutorials, intensivists performed a limited transthoracic echocardiography (TTE) (2-4 views, without Doppler or M-mode) examination with the 5.

Bronchiolitis obliterans organizing pneumonia after orthotopic liver transplantation.

Bronchiolitis obliterans organizing pneumonia (BOOP) has been described after bone marrow, lung, heart-lung, and renal transplantation, but rarely after orthotopic liver transplantation (OLT). We report a case of BOOP after OLT to emphasize BOOP as an under diagnosed and treatable cause of nonresolving pneumonia, which may not be preventable by maintenance low-dose prednisone. A 48-year-old man was hospitalized for dyspnea and cough one month after OLT.

Multicenter evaluation of a human monoclonal antibody to Enterobacteriaceae common antigen in patients with Gram-negative sepsis.

Objective: To evaluate in Gram-negative sepsis patients the human monoclonal immunoglobulin M antibody (MAB-T88) directed at the enterobacterial common antigen which is a specific surface antigen closely linked to lipopolysaccharide and shared by all members of the Enterobacteriaceae family of Gram-negative bacteria.

Design: Prospective, randomized, double-blinded, placebo-controlled, multicenter trial.

Setting: Thirty-three academic medical centers in the United States.

Intravenous iloprost increases mesenteric blood flow in experimental acute nonocclusive mesenteric ischemia.

Objective: To evaluate the effect of an intravenously administered synthetic epoprostenol analog, iloprost, in nonocclusive acute mesenteric ischemia induced by cardiac tamponade.

Design: Prospective, randomized, controlled experimental study.

Setting: Animal research laboratory at a university medical center.

Multicenter Experience Using a New Prototype Transnasal Transesophageal Echocardiography Probe.

Transesophageal echocardiography (TEE) is an invaluable diagnostic tool, particularly in patients with inadequate transthoracic echocardiographic examinations. In addition, continuous TEE has been used to monitor ventricular and valvular performance in the intensive care unit and the operating room. However, current generation transesophageal probes have limitations in the critical care setting due to their size.