Sepsis incidence and outcome: contrasting the intensive care unit with the hospital ward.

Objective: To describe the outcome of patients with sepsis according to location on a ward or in an intensive care unit.

Design: Prospective multicentered observational study.

Setting: Three academic hospitals in Madrid, Spain.

Joint symbolic dynamic analysis of cardiorespiratory interactions in patients on weaning trials.

Assessing autonomic control provides information about patho-physiological imbalances. Measures of variability of the cardiac interbeat duration RR(n) and the variability of the breath duration TTot(n) are sensitive to those changes. The interactions between RR(n) and TTot(n) are complex and strongly non-linear.

[Factors associated with the prognosis of mechanically ventilated infants and children. An international study].

Objective: Identify factors associated with the survival of pediatric patients who are submitted to mechanical ventilation (MV) for more than 12 hours.

Design: International prospective cohort study. It was performed between April 1 and May 31 1999.

Risk factors for extubation failure in patients following a successful spontaneous breathing trial.

Background: To assess the factors associated with reintubation in patients who had successfully passed a spontaneous breathing trial.

Methods: We used logistic regression and recursive partitioning analyses of prospectively collected clinical data from adults admitted to ICUs of 37 hospitals in eight countries, who had undergone invasive mechanical ventilation for > 48 h and were deemed ready for extubation.

Results: Extubation failure occurred in 121 of the 900 patients (13.

Pathology of acute lung injury and acute respiratory distress syndrome: a clinical-pathological correlation.

Clinical criteria cannot identify all patients who develop acute respiratory distress syndrome, which might indicate the need to develop new tools that improve reliability and diagnostic accuracy. Nevertheless, being conscious of the limitations of the American-European consensus conference criteria continues to be useful in clinical daily practice because these patients would benefit from treatments. This and other management strategies have been evaluated in patients who, fulfilling the clinical criteria of acute respiratory distress syndrome, could not have diffuse alveolar damage.

HCV-related advanced fibrosis/cirrhosis: randomized controlled trial of pegylated interferon alpha-2a and ribavirin.

In patients with hepatitis C virus (HCV)-related advanced fibrosis/cirrhosis, 30% of sustained HCV clearance has been reported with pegylated interferon alpha-2a (PEG-IFN) alone, but the efficacy and tolerability of the PEG-IFN/ribavirin (RBV) combination remain poorly defined. A total of 124 treatment-naïve patients with biopsy proved HCV-related advanced fibrosis/cirrhosis (Ishak score F4-F6, Child-Pugh score < or =7) were randomized to 48 weeks of PEG-IFN (180 microg sc weekly) and standard dose of RBV (1000/1200 mg po daily, STD) or PEG-IFN (180 microg sc weekly) and low-dose of RBV (600/800 mg po daily, LOW). Sustained virologic response (SVR) rates with PEG-IFN/STD RBV (52%) were higher--albeit not significantly--than that with PEG-IFN/LOW RBV (38%, P = 0.

Study of the effect of water activity and temperature on ochratoxin A production by Aspergillus carbonarius.

The effect of water activity (aw) (0.78-0.99) and temperature (15 and 30 degrees C) on growth and production of ochratoxin A (OTA) of six Aspergillus carbonarius strains was studied in two culture media: Czapek yeast autolysate (CYA) agar and yeast extract sucrose (YES) agar, during a period of 30 days.

[Validity of the diagnostic criteria of the acute respiratory distress syndrome].

Acute respiratory distress syndrome (ARDS) is defined according to the criteria of the 1994 consensus conference. These criteria aim to <>. However, the histological criteria that correspond to ARDS are the criteria of diffuse alveolar damage described in 1976 by Katzenstein et al.

Epidemiology of acute lung injury and acute respiratory distress syndrome.

Acute respiratory distress syndrome (ARDS) is a heterogeneous disorder that may be triggered by myriad etiologies (both pulmonary and extrapulmonary). Mortality rates for ARDS range from 30 to 75%, and most deaths are a consequence of multiorgan failure (MOF). Since the sentinel description of ARDS in 1967, criteria for the diagnosis of this entity were refined.

Effect of pH on ochratoxin A production by Aspergillus niger aggregate species.

The effect of pH (2-10) on growth and ochratoxin A (OTA) production by 12 Aspergillus niger aggregate strains was studied in two culture media: Czapek yeast autolysate agar (CYA) and yeast extract sucrose agar (YES), over 30 days. The strains were selected to include different sources, different reported abilities to produce OTA and different ITS-5.8S rDNA RFLP patterns.

Brain edema and inflammatory activation in bile duct ligated rats with diet-induced hyperammonemia: A model of hepatic encephalopathy in cirrhosis.

Studies of the pathogenesis of hepatic encephalopathy are hampered by the lack of a satisfactory animal model. We examined the neurological features of rats after bile duct ligation fed a hyperammonemic diet (BDL+HD). Six groups were studied: sham, sham pair-fed, hyperammonemic, bile duct ligation (BDL), BDL pair fed, and BDL+HD.

[Prognosis for acute exacerbation of chronic obstructive pulmonary disease in mechanically ventilated patients].

Objective: To determine the variables associated with prognosis for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in mechanically ventilated patients.

Design: Prospective cohort study with retrospective analysis.

Location: 361 Intensive Care Units (ICU) in 20 countries.

Outcome of older critically ill patients: a matched cohort study.

Background: Admission of older patients to intensive care units is a controversial issue.

Objective: To estimate age-associated mortality of critically ill patients.

Methods: A prospective matched cohort study in the Medical-Surgical Intensive Care Unit of a tertiary hospital was conducted.

Incidence, risk factors, and outcome of ventilator-associated pneumonia.

Objective: The purpose of this study is to determine the incidence, risk factors, and outcome of ventilator-associated pneumonia (VAP).

Design: Prospective cohort.

Setting: Three hundred sixty-one intensive care units (ICUs) from 20 countries.

Pulmonary tuberculosis due to Mycobacterium bovis in León.

In recent years, human infection due to Mycobacterium bovis has been considered almost eradicated in most industrialised countries. During the period 1998-2002, nine patients were diagnosed with pulmonary tuberculosis (TB) due to M. bovis in the Hospital Monte San Isidro, León, Spain.

Experimental and theoretical study of hyperconjugative interaction effects on NMR 1J(CH) scalar couplings.

Hyperconjugative and electrostatic interactions effects on 1J(CH) spin-spin coupling constants (SSCCs) are critically studied from both theoretical and experimental points of view. A qualitative model is used to predict how the former affect such SSCCs, while electrostatic interactions are modeled with a point charge placed in the vicinity of the corresponding sigma(CH) bond. Hyperconjugative interactions are calculated using the "natural bond orbital" approach, and using the point-charge model, it is shown how intertwined are both types of interactions.

Ventilation-induced lung injury in rats is associated with organ injury and systemic inflammation that is attenuated by dexamethasone.

Objective: To determine whether mechanical ventilation using high tidal volume is associated with nonpulmonary organ dysfunction that can be attenuated by dexamethasone.

Design: Prospective randomized animal intervention study.

Setting: Animal care facility in a university hospital.

Effect of water activity on ochratoxin A production by Aspergillus niger aggregate species.

The effect of water activity (a(w)) (0.82-0.99) on growth and ochratoxin A (OTA) production by twelve Aspergillus niger aggregate strains, cultured in Czapek Yeast Autolysate agar (CYA) and Yeast Extract Sucrose agar (YES), was studied for an incubation period of 30 days.

Large tidal volume mechanical ventilation induces vascular dysfunction in rats.

Background: Experimental studies have shown that mechanical ventilation using high tidal volumes (V(T)) damages the lungs, causing pulmonary edema. We tested the hypothesis that high V(T) ventilation in rats induces major vascular dysfunction.

Methods: Healthy Sprague-Dawley rats, weighing (mean +/- SD) 340 +/- 15 g, were ventilated with either V(T) = 9 mL/kg and positive end-expiratory pressure (PEEP) = 8 (n = 8) or V(T) = 35 mL/kg and PEEP = 0 (n = 8).

Prognosis factors and outcome of community-acquired pneumonia needing mechanical ventilation.

Purpose: To evaluate the variables associated with mortality of patients with community-acquired pneumonia who require mechanical ventilation and to determine the attributable morbidity and intensive care unit (ICU) mortality of community-acquired pneumonia.

Material And Methods: Retrospective cohort study carried out in 361 ICUs from 20 countries including 124 patients who required mechanical ventilation on the first day of admission to the hospital due to acute respiratory failure secondary to severe community-acquired pneumonia. To assess the factors associated with outcome, a forward stepwise logistic regression analysis was performed, and to determine the attributable mortality of community-acquired pneumonia, a matched study design was used.

Acute respiratory distress syndrome: underrecognition by clinicians and diagnostic accuracy of three clinical definitions.

Objective: To determine and compare the diagnostic accuracy of three clinical definitions of acute respiratory distress syndrome (ARDS): (1) the American-European consensus conference definition; (2) the lung injury score; and (3) a recently developed Delphi definition. A second objective was to determine the accuracy of clinical diagnoses of ARDS made in daily practice.

Design: Independent comparison of autopsy findings with the daily status of clinical definitions, constructed with data abstracted retrospectively from medical records.