Multivalent assembly of a pyrene functionalized thio-N-acetylglucosamine: Synthesis, spectroscopic and WGA binding studies.

We introduce here a new fluorescent derivative of 1-thio-β-N-acetylglucosamine linked to a pyrene system through a triazolylpentyl spacer, designed to self-assemble into a multivalent glycocluster. The synthesis was achieved by efficient CuAAC click reaction between a pyrene functionalized with an azide group and a suitable alkynyl thiomonosaccharide. Spectroscopic studies by fluorometry indicated that the self-assembly in aqueous medium is modulated by concentration and pH changes, the latter due to the presence of the amino group close to the π system.

The mechanism of the photochromic transformation of spirorhodamines.

We investigate the equilibrium, kinetics, and mechanism of the photochromic transformation of a series of amido spirorhodamine compounds-differing in the nature of the substituents of the amido group and in the rhodamine chromophore-in ethanol at room temperature in the presence of trifluoroacetic acid. A proton participates in the equilibrium between the spiro form and the open rhodamine form. The relaxation times in the dark or under continuous irradiation show a linear dependence on the proton concentration.

Composite outcomes of chronically critically ill patients 4 months after hospital discharge.

Background: Data on likely postdischarge outcomes are important for decision making about chronically critically ill patients. It seems reasonable to categorize outcomes into "better" or overall desirable states and "worse" or generally undesirable states. Survival, being at home, and being cognitively intact are commonly identified as important to quality of life and thus may be combined to describe composite outcome states.

Age differences in survival outcomes and resource use for chronically critically ill patients.

Purpose: Chronically critically ill (CCI) patients use a disproportionate amount of resources, yet little research has examined outcomes for older CCI patients. The purpose of this study was to compare outcomes (mortality, disposition, posthospital resource use) between older (> or =65 years) and middle-aged (45-64 years) patients who require more than 96 hours of mechanical ventilation while in the intensive care unit.

Methods: Data from 2 prospective studies were combined for the present examination.

Chronically critically ill patients: health-related quality of life and resource use after a disease management intervention.

Background: Chronically critically ill patients often have high costs of care and poor outcomes and thus might benefit from a disease management program.

Objectives: To evaluate how adding a disease management program to the usual care system affects outcomes after discharge from the hospital (mortality, health-related quality of life, resource use) in chronically critically ill patients.

Methods: In a prospective experimental design, 335 intensive care patients who received more than 3 days of mechanical ventilation at a university medical center were recruited.

Arthroscopic management of traumatic anterior shoulder instability in collision athletes: analysis of 204 cases with a 4- to 9-year follow-up and results with the suture anchor technique.

Purpose: The purpose of this study was to determine the effectiveness of arthroscopy in the selection of surgical procedure and treatment of both acute and recurrent traumatic anterior shoulder instability in rugby players by use of pre-established selection criteria. We describe the injury mechanisms, analyze the pathologic lesions and treatment indications based on surgical findings, and assess the results in patients treated with the arthroscopic suture anchor technique.

Methods: From November 1996 to November 2001, 204 rugby players with acute or recurrent traumatic anterior instability underwent an initial arthroscopic examination.

Impact of a disease management program upon caregivers of chronically critically ill patients.

Objectives: Few studies have examined the effects of caregiving on the caregivers of chronically critically ill (CCI) patients, and no one has examined the impact of a disease management program (DMP) on physical and psychological outcomes for the caregivers of CCI patients. The purposes of this study of caregivers of CCI patients were as follows: (1) to describe the characteristics of CCI patients and caregivers and to examine the frequency of depression, subjective burden, and physical health; (2) to examine factors related to depression after hospital discharge; and (3) to examine the effects of a DMP on the physical health, depression, and burden of caregivers 2 months post-hospital discharge.

Design: Prospective experimental design.

Beyond the intensive care unit: a review of interventions aimed at anticipating and preventing in-hospital cardiopulmonary arrest.

Despite more than four decades of experience with in-hospital cardiopulmonary arrest, outcomes have remained poor. Numerous studies have documented the physiological instability leading to clinical deterioration, which often precedes cardiopulmonary arrest. These physiological changes often go unrecognized or are acted upon inadequately.

Trial of a disease management program to reduce hospital readmissions of the chronically critically ill.

Background: Patients requiring prolonged periods of intensive care and mechanical ventilation are termed chronically critically ill. They are prone to continued morbidity and mortality after hospital discharge and are at high risk for hospital readmission. Disease management (DM) programs have been shown to be effective in improving both coordination and efficiency of care after hospital discharge for populations with single-disease diagnoses, but have not been tested with patients with multiple-disease diagnoses, such as the chronically critically ill.