Publications by authors named "Heming N"
The Rio Doce Hydrographic Basin (RDB) lies almost completely in the Brazilian Atlantic Forest, a highly threatened tropical rainforest. The RDB has suffered dramatic anthropogenic impacts during the last two centuries and is currently one of the most degraded regions in southeastern Brazil. In this paper, we gathered 140,742 bird records collected since the early 19th by more than two thousand naturalists, professional scientists, and citizen scientists.
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- Mechanical ventilation for myasthenic crisis lacks standardization and is prone to failure; a study investigated using prolonged spontaneous breathing trials (SBT) and pulmonary function tests (PFT) to improve weaning outcomes.
- Of the 126 analyzed cases, the weaning failure rate was 14.3%, notably lower when the cause of the crisis was identified, although factors like mechanical ventilation duration and infection risk influenced prolonged weaning.
- The study suggests that implementing standardized protocols could enhance extubation success, emphasizing the need for further research to validate these findings in larger trials.
Article Synopsis
- * Early treatment involves controlling the source of infection, using antibiotics, and supporting organ function, while later care addresses metabolic, nutritional, and immune needs.
- * Effective management includes moderate glucose control, careful nutritional support to prevent muscle loss, and using corticosteroids to help patients with shock and organ dysfunction, emphasizing a personalized approach for better recovery.
Background: The COVID-19 pandemic related to SARS-CoV-2 virus was responsible for global pandemic. The severe form of the disease was linked to excessive activation of immune pathways together with a systemic cytokine storm response and thrombotic venous or arterial complications. Factors predicting severe outcomes including venous and/or pulmonary thrombosis (VT) and death were identified, but the prognostic role of their combination was not addressed extensively.
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- A study was conducted across 49 ICUs in France to investigate the clinical outcomes and severity of severe Pneumocystis jirovecii pneumonia (PJP), focusing on how delayed antibiotic treatment and corticosteroid therapy affect patient survival.
- The study included 158 patients, mainly admitted due to acute respiratory failure, and found high mortality rates (31.6% in ICU, 40.5% at 6 months), with delayed antibiotic treatment beyond 96 hours linked to a significantly higher risk of death.
- The results indicate that most patients did not receive preventive antibiotic therapy before needing intensive care, and both delayed antibiotic treatment and the use of corticosteroids worsened mortality rates in those with severe PJP.
Article Synopsis
- This study investigates COVID-19-associated pulmonary aspergillosis (CAPA) among critically ill patients during the Omicron variant wave, finding it affects 5.1% of patients and 9.1% of those on invasive mechanical ventilation.
- CAPA patients showed higher rates of immunosuppression and required more intensive care measures, like vasopressors and renal therapy, compared to non-CAPA patients.
- While CAPA did not significantly impact day-28 mortality, it was linked to longer mechanical ventilation and ICU stays, suggesting a shift in outcomes with emerging SARS-CoV-2 variants.
Article Synopsis
- Patients with COVID-19 requiring mechanical ventilation have a high risk of developing ventilator-associated pneumonia (VAP), particularly caused by Enterobacterales, with limited data on extended-spectrum beta-lactamase producing Enterobacterales (ESBL-E).
- In a study involving 591 patients with Enterobacterales related VAP, 19% developed ESBL-E infections, primarily from Enterobacter sp, K. pneumoniae, and E. coli, while a very small percentage experienced carbapenem-resistant Enterobacterales (CRE) infections.
- Key risk factors for ESBL-E related VAP included African origin, time between intubation and VAP development, the patient's oxygenation status, and prior exposure to trimethopr
Article Synopsis
- - The STROMA-CoV-2 study evaluated the effects of umbilical cord-derived mesenchymal stromal cells (UC-MSCs) on patients with severe respiratory issues from SARS-CoV-2, finding no significant effectiveness despite good safety results after 28 days.
- - An extended follow-up assessed the long-term safety and health outcomes of UC-MSC administration in the same patient cohort at 6 and 12 months post-hospital discharge, focusing on various health metrics.
- - Results indicated a favorable safety profile with no significant differences between UC-MSC and placebo groups, although some patients experienced lingering lung issues and declines in quality of life over the year.
This article describes the structures and processes involved in healthcare delivery for sepsis, from the prehospital setting until rehabilitation. Quality improvement initiatives in sepsis may reduce both morbidity and mortality. Positive outcomes are more likely when the following steps are optimized: early recognition, severity assessment, prehospital emergency medical system activation when available, early therapy (antimicrobials and hemodynamic optimization), early orientation to an adequate facility (emergency room, operating theater or intensive care unit), in-hospital organ failure resuscitation associated with source control, and finally a comprehensive rehabilitation program.
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- The study explores the effectiveness of hydrocortisone and fludrocortisone treatments in patients with septic shock caused by community-acquired pneumonia (CAP) compared to non-CAP cases.
- It includes data from the phase 3 APROCCHSS trial, which initially tested these treatments across multiple centers in France, focusing specifically on how they impact mortality outcomes.
- Results indicate that patients with CAP may respond differently to these treatments, and various mortality rates and recovery metrics were analyzed to determine the overall benefit of the steroid regimen.
Two centuries of ornithological exploration of the Rio Doce basin, southeastern Brazil. Part IA history of the landscape, its explorers, and their collections.
Zootaxa
September 2023
The Rio Doce Hydrographic Basin (RDB) was once covered by magnificent tropical forest, which remained untouched by Europeans for three centuries after the arrival of the Portuguese colonists in the Brazilian coast in 1500. Nevertheless, a dramatic change in land use occurred throughout the entire RDB after the turn of the 19th century. Currently, the RDB is one of the most degraded regions in southeastern Brazil and, recently, it was the scenario of the worst environmental disaster in Brazilian history.
View Article and Find Full Text PDFObjectives: To determine the perceived barriers to the implementation of research findings in clinical practice among critical care nurses and allied health professionals.
Methods: A cross-sectional study was conducted using an online questionnaire sent to critical care nurses and allied health professionals in French-speaking countries. The primary objective was the identification and grading of perceived barriers to implementation of research findings into clinical practice, using a previously validated tool (French version of the BARRIERS scale).
The crested capuchin monkey (Sapajus robustus) is endemic to the Atlantic Forest and its transition areas within Cerrado in Brazil. The species is currently threatened by habitat loss and has been classified as endangered by the IUCN Red List of Threatened Species since 2015. We used ecological niche models built with MaxEnt to predict the potential impact of climate change on the distribution of this species.
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- A study was conducted on 158 adult patients with acute respiratory failure due to SARS-CoV-2, focusing on the impact of various Omicron sublineages, including BA.2, BA.4/BA.5, and BQ.1.1.
- Patients infected with the recent BQ.1.1 variant displayed a higher rate of obesity and a lower rate of immunosuppression compared to those with earlier sublineages.
- Despite these differences in patient characteristics, there was no significant variation in disease severity at ICU admission, organ support needs, or 28-day mortality across the different sublineage groups.
Article Synopsis
- ARDS often occurs alongside sepsis, both driven by excessive inflammation in the body.
- Corticosteroids, known for their anti-inflammatory properties, are now being explored for their potential benefits in treating ARDS, especially after showing reduced mortality in severe pneumonia cases.
- The review emphasizes the need for high-quality research to clarify how corticosteroids can best be used in ARDS treatment, focusing on timing, dosing, and length of therapy.
Article Synopsis
- The study focused on determining the best type of anticoagulation therapy for COVID-19 pneumonia patients to reduce mortality and disease duration, comparing therapeutic anticoagulation (TA), high-dose prophylactic anticoagulation (HD-PA), and standard-dose prophylactic anticoagulation (SD-PA).
- Conducted in France, the ANTICOVID trial involved 334 patients with hypoxemic COVID-19 pneumonia, all requiring supplemental oxygen, and aimed to understand the effects of these treatments over a 14-day period.
- Results indicated that HD-PA and SD-PA had similar outcomes, as did TA when compared to SD-PA, suggesting no significant advantage for either anticoagulation strategy in improving patient outcomes by day
Article Synopsis
- A phase 3 clinical trial investigated if intravenous hydrocortisone could reduce mortality in patients with severe community-acquired pneumonia compared to a placebo.
- The study involved 800 patients, and results showed that those receiving hydrocortisone had a significantly lower death rate (6.2%) at 28 days versus 11.9% in the placebo group.
- Additionally, patients on hydrocortisone required less mechanical ventilation and vasopressors compared to those on placebo, with similar rates of hospital-acquired infections and bleeding risks.
Objectives: Respiratory syncytial virus (RSV) is a common agent of viral respiratory infections with significant morbidity and mortality in adults. The objective of this study was to determine risk factors for mortality and invasive mechanical ventilation and to describe the characteristics of patients who received ribavirin.
Methods: A retrospective multicentre observational cohort study was conducted in Great Paris area hospitals, including patients hospitalised between 1 January 2015 and 31 December 2019 for documented RSV infection.
Article Synopsis
- The RECORDS trial investigates how different adult patients with sepsis respond to corticosteroids by categorizing them into distinct groups based on their likelihood of responding to treatment.
- It is a large, placebo-controlled study that includes 1800 adults with conditions like pneumonia and septic shock, randomly assigning them to receive either corticosteroids or placebo for 7 to 10 days.
- The primary goal is to assess the impact of corticosteroids on mortality and organ dysfunction after 90 days, with the findings expected to be shared at conferences and published in scientific journals.
Characterization of the microbiota dynamics associated with , causal agent of cocoa frosty pod rot disease, reveals new viral species.
Front Microbiol
February 2023
Article Synopsis
- Cacao trees are vulnerable to a variety of pathogens, especially fungi, with some specific to certain regions, while others, like CSP, are expanding geographically and causing significant economic loss.
- RNA sequencing of spores from cacao pods was conducted to assess the diversity and activity of microorganisms involved in the sporulation of a major cacao pathogen, revealing a rich variety of fungi and bacteria whose dynamics fluctuate with culture time.
- This study marks the first report of viruses infecting fungi of the genus investigated and highlights the potential for viral spread, particularly in samples from Ecuador, revealing new dimensions in understanding cacao pathogens.
Article Synopsis
- COVID-19 patients on mechanical ventilation face a significant risk of developing ventilator-associated pneumonia (VAP), with about 45.5% of the analyzed patients experiencing VAP after around 7 days of ventilation.!* -
- Key risk factors for developing VAP include male gender, pre-existing bacterial pneumonia, certain ventilation parameters, and the use of corticosteroids. VAP notably increases the risk of 90-day mortality, especially when it occurs later during ventilation.!* -
- The study highlights the need to explore modifiable risk factors further, as VAP substantially impacts survival rates among COVID-19 patients who require prolonged mechanical ventilation, particularly during the second and third weeks of care.!*
Background: A defining feature of prolonged critical illness is muscle wasting, leading to impaired recovery. Supplementation with a tailored blend of amino acids may bolster the innate gut defence, promote intestinal mucosa repair and limit muscle loss.
Methods: This was a monocentric, randomized, double-blind, placebo-controlled study that included patients with sepsis or acute respiratory distress syndrome.