Lung protective mechanical ventilation strategies in cardiothoracic critical care: a retrospective study.

A body of evidence supports the use of low tidal volumes in ventilated patients without lung pathology to slow progress to acute respiratory distress syndrome (ARDS) due to ventilator associated lung injury. We undertook a retrospective chart review and tested the hypothesis that tidal volume is a predictor of mortality in cardiothoracic (medical and surgical) critical care patients receiving invasive mechanical ventilation. Independent predictors of mortality in our study included: type of surgery, albumin, H, bilirubin, and fluid balance.

Use of a Structured Mirrors Intervention Does Not Reduce Delirium Incidence But May Improve Factual Memory Encoding in Cardiac Surgical ICU Patients Aged Over 70 Years: A Pilot Time-Cluster Randomized Controlled Trial.

Post-operative delirium remains a significant problem, particularly in the older surgical patient. Previous evidence suggests that the provision of supplementary visual feedback about ones environment via the use of a mirror may positively impact on mental status and attention (core delirium diagnostic domains). We aimed to explore whether use of an evidence-based mirrors intervention could be effective in reducing delirium and improving post-operative outcomes such as factual memory encoding of the Intensive Care Unit (ICU) environment in older cardiac surgical patients.

Evaluation of a novel in-line point-of-care blood gas analyser.

Point-of-care testing is becoming increasingly relevant to the practice of anaesthesia and critical care medicine, especially in terms of minimisation of sample volumes and decreased time to decision making. We performed a prospective observational study to evaluate a novel, in-line blood gas analysis device against a conventional benchtop model, and assessed it while placing the enrolled patients under extreme physiological conditions, specifically deep hypothermic circulatory arrest. Eight patients were studied, and had between seven and 11 samples analysed for seven variables (pH, pCO2 , pO2 , HCO3 (-) , base excess [BE], K(+) and haematocrit [Hct]), using the device during the process of cooling to 20 °C on cardiopulmonary bypass, and subsequent rewarming to normothermia.

Agreement between ACT and aPTT during extracorporeal membrane oxygenation shows intra- and inter-individual variation.

Aim: We explored the relationship between activated clotting time (ACT) and activated partial thromboplastin time (aPTT) when used to monitor anticoagulation in patients undergoing extracorporeal membrane oxygenation (ECMO) support.

Methods: Data obtained in patients undergoing ECMO support between October 2012 and August 2013 in a single centre were reviewed. Clinical data were extracted from our Clinical Information System and ECMO database.

Dyslexia.

Developmental dyslexia (DD) is a specific and persistent disability affecting the acquisition of written language. Prevalence is estimated to be between 5% and 17% of school-aged children; it therefore represents a major public health issue. Neurological in origin, its causes are unknown, although there is a clear genetic component.

[Predictive factors of acquired methicillin-resistant Staphylococcus aureus in a rehabilitation care unit].

Unlabelled: Controlling the diffusion of multiresistant bacteria is a priority in the campaign against nosocomial infections. Geriatric units seem to be reservoirs of methicillin-resistant Staphylococcus aureus (MRSA).

Objective: The first objective of this study was to determine if some characteristics identified on admission in a rehabilitation care unit could influence the colonization by the bacterium, and to define the rate of importation and acquired-infections.

[Factors of therapeutic imbalance of antivitamins K and their haemorrhagic consequences in elderly].

Objective. To determinate, for older subjects, specific factors of imbalance of the oral anticoagulant treatments. Method.

Asymmetry of voice onset time-processing in adult developmental dyslexics.

Objective: The human auditory cortex codes speech temporally according to sequential acoustico-phonetic cues like the voice onset time (VOT). This coding is predominantly left-lateralized in normal readers. We examined VOT-processing asymmetries in adults with a history of developmental dyslexia (DD-history+).

Pain in the elderly: Prospective study of hyperbaric CO2 cryotherapy (neurocryostimulation).

Objective: To evaluate the analgesic effects of hyperbaric CO(2) cryotherapy in elderly inpatients.

Methods: An open-label prospective study was conducted in two geriatrics departments in patients with a broad range of pain characteristics. Each patient underwent a physical evaluation followed by hyperbaric CO(2) cryotherapy sessions, whose spacing and number were at the discretion of the physiotherapist.

Is biolectrical impedance analysis a tool at bedside, during heat waves to assist geriatricians with discriminative diagnosis of hypertonic dehydration?

Objectives: To assess BIA data given by Analycor 3 and some bio-impedance equations to assist geriatricians with discriminative diagnosis of hypertonic dehydration, during heat waves.

Design: Prospective study: a dehydrated patients group has been compared with a randomised control group.

Setting: The study was carried out in a French geriatric department, in the Emile Roux geriatric hospital.

Hemispheric lateralization of voice onset time (VOT) comparison between depth and scalp EEG recordings.

Auditory-evoked potential (AEP)s elicited to French-language voiced stop consonant (/ba/) and voiceless stop consonant (/pa/) were studied in non-language-impaired epileptic patients and non-epileptic volunteers. First, depth AEPs recorded from the primary auditory cortex during pre-surgical exploration and scalp AEPs recordings using high resolution EEG (HR EEG-64 channels scalp EEG) were compared in the same patients. Both methods indicated that the processing of voiced and voiceless consonants was based on a temporal auditory coding.

Auditory evoked potential patterns to voiced and voiceless speech sounds in adult developmental dyslexics with persistent deficits.

Auditory evoked potentials (AEPs) were recorded from eight developmental dyslexic adults with persistent reading, spelling and phonological deficits, and 10 non-dyslexic controls to voiced (/ba/) and voiceless (/pa/) consonant-vowel syllables. Consistent with previous data, non-dyslexics coded these stimuli differentially according to the temporal cues that form the basis of the voiced/voiceless contrast: AEPs had time-locked components with latencies that were determined by the temporal structure of the stimuli. Dyslexics were characterized by one of two electrophysiological patterns: AEP pattern I dyslexics demonstrated a differential coding of stimuli on the basis of some temporal cues, but with an atypically large number of components and a considerable delay in AEP termination time; AEP pattern II dyslexics demonstrated no clear differential coding of stimuli on the basis of temporal cues.

[Impact of nasal colonization by methicillin-resistant Staphylococcus aureus among geriatric intermediate care facility patients].

Objective: To evaluate the impact of nasal carriage of Methicillin Resistant Staphylococcus aureus (MRSA) on antibiotic cost, infection morbidity, mortality and length of stay in a geriatric population.

Methods: 341 consecutive elderly patients (mean age 83.4 +/- 8.

[Resistance to linezolid in Staphylococcus aureus before its release].

Unlabelled: Resistance to antibiotics is a global problem in geriatric centres.

Objective: The aim of this study was to determine the frequency of the resistance to linezolid in Staphylococcus aureus strains before its release in a geriatric centre.

Method: From 03-01-01 to 03-04-30 linezolid was included in the panel of antibiotics tested in S.

[Headaches in the elderly].

ACCORDING TO AGE: It is generally thought that the prevalence of headaches decreases with ageing. However recent studies, with stricter epidemiology and methodology, clearly indicate that this decreases is less obvious than that perceived. PRIMARY AND SECONDARY HEADACHES: In elderly patients, primary headaches and notably migraine (often with altered presentation) are less frequent, even though new authentic cases may appear.

[Morning stiffness].

Unlabelled: STIFFNESS AND UNSTRETCHING: Morning stiffness in the elderly is a painful entity often ignored, but frequent in institutions. Unstretching in the morning is part of the criteria in the diagnosis of inflammatory pathologies, but morning stiffness in old patients appears different from that described in rheumatological diseases and arthrosis.

From An Aetiological Point Of View: Various affections can be accompanied by morning stiffness in an elderly patient: arthrosis, but also various consequential affections, static disorders, deformity.

Atrial fibrillation in the elderly: facts and management.

Although atrial fibrillation is not widely known by the general public, in developed countries it is the most common arrhythmia. The incidence increases markedly with advancing age. Thus, with the growing proportion of elderly individuals, atrial fibrillation will come to represent a significant medical and socioeconomic problem.

Interhemispheric sensorimotor integration in pointing movements: a study on dyslexic adults.

In addition to reading disorders, numerous deficits have been found to be associated with dyslexia, suggesting that various neurological factors might be involved in its etiology. In the present study, we focused on three of the deficits which have been thought to accompany and to a certain extent, to explain dyslexia: an abnormal pattern of hemispheric asymmetry, abnormal hemispheric communication, and abnormal motor control. The aim of the present study was to determine whether adults with reading difficulties perform differently from control subjects in a visuo-manual pointing task, in which the subject was required to point with the right or the left hand to targets appearing to the right or left of a central fixation point.

Intracerebral evoked potentials in pitch perception reveal a functional asymmetry of the human auditory cortex.

One acoustic feature that plays an important role in pitch perception is frequency. Studies on the processing of frequency in the human and animal brain have shown that the auditory cortex is tonotopically organized: low frequencies are represented laterally whereas high frequencies are represented medially. To date, the study of the functional organization of the human auditory cortex in the processing of frequency has been limited to the use of either scalp-recorded auditory evoked potentials (AEPs), which have relatively poor spatial resolving power, or functional imagery techniques, which have poor temporal resolving power.

[Oral anticoagulation in older patients. Establishment and validation of a new posologic warfarin regimen].

Objective: Warfarin is highly effective in preventing thromboembolism and more recent clinical trials have established that adjusted dosing is highly effective in reducing the risk of ischemic stroke in patients with nonvalvular atrial fibrillation. Fear of major hemorrhage frequently dissuades physicians from use of anticoagulants in older people. In addition, the time needed to reach the therapeutic range may be excessively long and delicate in this population.

Ictal asomatognosia with hemiparesis.

A 69-year-old woman presented with an ictal Anton-Babinski syndrome (asomatognosia with hemiparesis). Except for head and eye deviation to the side of the paralyzed limb, epileptic nystagmus, brief episodes of impaired consciousness, and automatisms, clinical symptomatology was identical to Anton-Babinski syndrome of vascular origin. Results of MRI imaging were normal.