Laboratory alerts to guide early intensive care team review in surgical patients: A feasibility, safety, and efficacy pilot randomized controlled trial.

Aim: Common blood tests can help identify patients at risk of death, unplanned intensive care unit (ICU) admission, or rapid response team (RRT) call. We aimed to test whether early ICU-team review triggered by such laboratory tests (lab alert) is feasible, safe, and can alter physiological variables, clinical management, and clinical outcomes.

Methods: In prospective pilot randomized controlled trial in surgical wards of a tertiary hospital, we studied patients admitted for >24 h.

Liberal Glucose Control in ICU Patients With Diabetes: A Before-and-After Study.

Objectives: To assess the feasibility, biochemical efficacy, and safety of liberal versus conventional glucose control in ICU patients with diabetes.

Design: Prospective, open-label, sequential period study.

Setting: A 22-bed mixed ICU of a tertiary hospital in Australia.

Use of evidence-based recommendations in an antibiotic care bundle for the intensive care unit.

Purpose: To drive decisions on antibiotic therapy in the intensive care unit (ICU), we developed an antibiotic care bundle (ABC-Bundle) with evidence-based recommendations (EBRs) for antibiotic prescriptions.

Methods: We conducted a three-step prospective study. First, a systematic review was performed of the literature reporting EBRs for antibiotic usage in the ICU.

Liberal Versus Conventional Glucose Targets in Critically Ill Diabetic Patients: An Exploratory Safety Cohort Assessment.

Objectives: To assess the feasibility, safety, and impact on relative hypoglycemia of liberal versus conventional blood glucose concentration targets in critically ill diabetic patients.

Design: Prospective, open-label, sequential-period exploratory study.

Setting: A 22-bed multidisciplinary ICU of a tertiary care hospital in Australia.

Clinical impact of pulmonary sampling site in the diagnosis of ventilator-associated pneumonia: A prospective study using bronchoscopic bronchoalveolar lavage.

Purpose: It is unclear whether ventilator-associated pneumonia (VAP) is actually a bilateral and multifocal process. In addition, the diagnostic role of chest x-ray is under debate. Assuming a low microbiologic concordance between the left and right lungs, the reliability of a single pulmonary sampling becomes questionable.

The role of arthroscopy in articular fracture management: the lower limb.

The management of articular fracture is always a matter of concern. While each articular fracture is different from one another, besides the classification system used and the surgical or non-surgical indication given by the specialist, main goals remain the same: anatomical reduction, stable fixation, loose body removal, and minimal invasiveness. Open procedures are the actual compromise, but unfortunately, it is not always possible to perfectly meet every treatment goal, associated lesions could pass unnoticed or delayed in treatment, and even in a best-case scenario, there could be several complications developing in the long term.

Photoinduced dermatitis and oral lichenoid reaction in a chronic myeloid leukemia patient treated with imatinib mesylate.

Background: Imatinib mesylate (IM) is a phenylaminopyrimidine that represents the first-line treatment for chronic myeloid leukemia (CML), Philadelphia chromosome-positive. It acts as a potent and selective inhibitor of the bcr-abl fusion protein by a competitive inhibition at the adenosine triphosphate-binding site of the enzyme, which leads to the inhibition of tyrosine phosphorylation of the proteins involved in bcr-abl signal transduction. IM is generally well tolerated and usually provokes only mild side effects consisting of nausea, myalgia, edema and muscle cramps.

Acquired ichthyosis in a child with autoimmune thyroiditis.

Acquired ichthyosis is a rare cutaneous disorder characterized by dry, rough skin with prominent scaling, that involves symmetrically the trunk and limbs and especially on the extensor surfaces. It appears most commonly in adults in association with malignant, autoimmune, metabolic, endocrine, and infectious diseases. We describe a child with acquired ichthyosis in whom an autoimmune hypothyroidism was detected; furthermore, replacement therapy with L-thyroxine resulted in complete remission of ichthyosis.

Zosteriform connective tissue nevus in a pediatric patient.

We report an 8-year-old girl affected by hypochromic, asymptomatic, acquired lesions with a paving-stone aspect on the right lumbosacral area and proximal right leg. The results of serum and urine biochemical screening were normal, as was the bone survey A biopsy was performed. The clinical and histologic aspects led to the diagnosis of connective tissue nevus with zosteriform distribution.