[Fatal crossbow injury in an adolescent].

The authors present the case of a 14-year-old boy who died while handling a crossbow, which was a gift from a friend's mother. The bolt passed through the right nostril, penetrated the sinus sphenoidalis, the brain stem, the left occipital lobe and the occipital calvaria. Immediately after the accident, the victim was taken to a maximum care hospital.

The neurological syndrome in adults during the 2011 northern German E. coli serotype O104:H4 outbreak.

The aim of this study was to describe the neurological syndrome in the largest cohort of adult patients with a complicated Shiga toxin-producing Escherichia coli infection. The recent outbreak of Shiga toxin-producing E. coli serotype O104:H4 in northern Germany affected more than 3842 patients, 22% of whom developed haemolytic uraemic syndrome.

[Communication in intensive care medicine].

Communication plays a crucial role in the intensive care unit. Posttraumatic stress syndromes develop in a significant number of patients and their relatives after being in an intensive care unit. The syndromes may persist for several years.

Use of a weighted, automated analysis of the differential blood count to differentiate sepsis from non-infectious systemic inflammation: the intensive care infection score (ICIS).

Introduction: Rapid and accurate diagnosis and immediate treatment of sepsis are of crucial importance. However, differentiating sepsis from Systemic Inflammatory Response Syndrome (SIRS) is a difficult challenge. Many diagnostic approaches based on clinical chemistry surrogate markers have not improved the situation.

Virtual autopsy as an alternative to traditional medical autopsy in the intensive care unit: a prospective cohort study.

Background: Autopsy is an important educational and quality-control tool in the intensive care unit (ICU), but rates of traditional medical autopsies have declined worldwide. "Virtual" autopsy involving only advanced radiographic techniques might provide an alternative approach to postmortem examinations.

Objective: To assess the value of postmortem multidetector computed tomography as an alternative to medical autopsy.

Diagnostic value of positron emission tomography combined with computed tomography for evaluating patients with septic shock of unknown origin.

Purpose: (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) combined with computed tomography (CT) is a promising new tool for the identification of infectious foci. The aim of our work was to evaluate the diagnostic value of FDG-PET/CT in critically ill patients with septic shock of unknown origin.

Methods: We performed a single-center, 6-year retrospective evaluation of the value of FDG-PET/CT in critically ill patients with severe sepsis or septic shock of unknown origin.

Arabidopsis long-chain acyl-CoA synthetase 1 (LACS1), LACS2, and LACS3 facilitate fatty acid uptake in yeast.

The plant cuticle is a lipid-based barrier on the aerial surfaces of plants that plays a variety of protective roles. The cuticle is comprised largely of long-chain and very-long-chain fatty acids and their derivatives. In Arabidopsis, LONG-CHAIN ACYL-COA SYNTHETASE1 (LACS1), LACS2, and LACS3 are known or suspected cuticle biosynthetic genes.

Characterization of Enterobacter cloacae pneumonia: a single-center retrospective analysis.

Objectives: Enterobacter cloacae (E. cloacae) is a Gram-negative rod commonly found on intensive care units (ICU) causing severe infections with high mortality. Specific characteristics of E.

Fiber optic bronchoscopy in patients with acute hypoxemic respiratory failure requiring noninvasive ventilation--a feasibility study.

Introduction: Noninvasive ventilation (NIV) is a standard procedure in selected patients with acute respiratory failure. Previous studies have used noninvasive ventilation to ensure adequate gas exchange during fiberoptic bronchoscopy in spontaneously breathing hypoxemic patients, thus avoiding endotracheal intubation. However, it is unknown whether bronchoscopy can be performed safely in patients with acute hypoxemic respiratory failure already in need of NIV prior to the decision for bronchoscopy.

Rescue therapy with a pumpless extracorporeal lung assist device in a patient with acute interstitial lung disease and severe refractory hypercapnia.

Idiopathic interstitial pneumonia frequently causes severe pulmonary restriction that in turn makes mechanical ventilation difficult. We report the case of a 44-year-old woman who developed a refractory severe hypercapnic respiratory failure (P(aCO(2)) 281 mm Hg, pH 6.77) despite mechanical ventilation with high inspiratory pressure and PEEP.

Interventional lung assist enables lung protective mechanical ventilation in acute respiratory distress syndrome.

Background: The feasibility and safety of a pumpless arteriovenous extracorporeal lung assist system (pECLA) has been demonstrated in previous studies of patients with severe respiratory insufficiency. The aim of this report was to examine whether pECLA is feasible in a center that is new to the technology and to determine the positive and adverse effects associated with its use.

Methods: This was a retrospective case series of 13 consecutive patients with established acute respiratory distress syndrome (ICU patients with ARDS or ALI) at a university hospital.

Coronary angiography and intervention during hypothermia can be performed safely without cardiac arrhythmia or vasospasm.

Purpose: Mild therapeutic hypothermia is a neuroprotective procedure after cardiac arrest. Therefore, it is increasingly used. Likewise, there is a growing demand for coronary angiography and percutaneous coronary interventions under hypothermia.

Multi tyrosine kinase inhibitor dasatinib as novel cause of severe pre-capillary pulmonary hypertension?

Background: Pulmonary hypertension (PH) is a life-threatening disease with poor prognosis. Encouraging efforts have been made to target the main vasoproliferative aspects of the disease. Promising emerging therapeutics are tyrosine kinase inhibitors such as imatinib.

Do centrally pre-prepared solutions achieve more reliable drug concentrations than solutions prepared on the ward?

Purpose: To compare the concentration conformity of infusion solutions manually prepared on intensive care units (ICU) with solutions from pharmacy-based, automated production.

Methods: A prospective observational study conducted in a university hospital in Germany. Drug concentrations of 100 standardised infusion solutions manually prepared in the ICU and 100 matching solutions from automated production containing amiodarone, noradrenaline or hydrocortisone were measured by high-performance liquid chromatography analysis.

[Current approaches to the treatment of severe hypoxic respiratory insufficiency (acute lung injury; acute respiratory distress syndrome)].

Lung-protective ventilation with a low tidal volume, plateau pressure < 30 cm H(2)O. oxygen saturation > 90% and permissive hypercapnia results in reduction of the mortality rate in patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). The level of the positive end-expiratory pressure (PEEP) must be chosen in relation to oxygen requirement.

Twelfth biannual report of the Cochrane Haematological Malignancies Group--focus on tyrosine kinase inhibitors.

This 12th biannual report of the Cochrane Haematological Malignancies Group highlights recently published randomized controlled trials in the field of hemato-oncology, covering the publication period from September 1, 2009, through June 30, 2010. Implication for clinical practice and methodological aspects are the main principles used to select trials for this report. Studies on tyrosine kinase inhibitors for patients with chronic myeloid leukemia were identified through electronic search of MEDLINE with a broad search filter that covered all topics in hemato-oncology combined with a highly sensitive search filter for randomized studies as described in the Cochrane Handbook for Systematic Reviews of Interventions.

[Ultrasonic and radiographic quantification of palmar angulation in metacarpal IV and V neck fractures].

Purpose/background: Therapy of metacarpal neck fractures depending on radiographically measured palmar angulation is discussed controversially in the literature. Some authors describe normal hand function of malunited metacarpal neck fractures with a palmar angulation up to 70°; others define 30° as the uppermost limit to maintain normal hand function. However, the methods of measuring palmar angulation are not clearly defined.

Bioprocess control in microscale: scalable fermentations in disposable and user-friendly microfluidic systems.

Background: The efficiency of biotechnological production processes depends on selecting the best performing microbial strain and the optimal cultivation conditions. Thus, many experiments have to be conducted, which conflicts with the demand to speed up drug development processes. Consequently, there is a great need for high-throughput devices that allow rapid and reliable bioprocess development.

[Tracheostomy in the intensive care unit].

Indication, timing and technique of tracheostomy have undergone considerable changes during the past years. Percutaneous tracheostomy has become a standard procedure in modern intensive care. It can be performed by the intensive medicine specialists themselves with low complication rates.

Differences in clinical manifestations of imported versus autochthonous leptospirosis in Austria and Germany.

Leptospirosis, a zoonosis occurring worldwide, has a broad spectrum of clinical manifestations. Recently, various countries observed an increase of severe anicteric cases. In Austria and Germany, growing numbers of imported cases are notified in addition to autochthonous infections.

[28-year old female patient with respiratory insufficiency, elevated liver enzymes, pancytopenia and fever].

We report on a 28-year old female patient with fever and severe respiratory insufficiency requiring mechanical ventilation. Cytomegalovirus pneumonia was diagnosed by bronchoalveolar lavage, and antiviral therapy was initiated. However fever persisted and laboratory workup showed pancytopenia and elevated liver enzymes.

Pulmonary hypertension after ventriculoatrial shunt implantation.

Object: Ventriculoatrial (VA) shunts inserted for the treatment of hydrocephalus are known to be a risk factor for pulmonary hypertension. The aim of this study was to evaluate the incidence of pulmonary hypertension among adult patients with VA shunts.

Methods: All patients who had received a VA shunt at one of two institutions between 1985 and 2000 were invited for a cardiopulmonary evaluation.