Publications by authors named "Maile M"
Background: To determine if colonisation with drug resistant organisms is associated with worse outcomes in patients who subsequently develop sepsis.
Methods: Retrospective study of patients with sepsis employing logistic regression and linear regression to determine the independent association of colonisation with adverse outcomes.
Results: Mortality was higher in patients colonized with VRE [501 of 1937 (26%) v.
Article Synopsis
- Accurate diagnosis of heart failure (HF) before noncardiac surgery is difficult but important for patient outcomes.
- A study of 1018 surgical patients revealed that those with a correct HF diagnosis received significantly less intraoperative fluid and had a reduced risk of postoperative acute kidney injury compared to those misdiagnosed.
- Improving preoperative HF diagnostic accuracy could lead to better surgical results and fewer complications for patients undergoing major surgeries.
Background: Road traffic accidents (RTAs) are among the leading causes of injuries, fatalities, and the resulting increase in financial burdens worldwide. Every year, RTAs cause numerous serious injuries and fatalities in Ethiopia. it is important to understand how prevalent near-miss crash accidents are, and which by definition could have injured the victim but did not result in an actual accident.
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- A study on postdischarge mortality rates in sepsis survivors found that 42% of patients died within an average of 1.41 years after leaving the hospital.
- The mortality rate was highest shortly after discharge, decreasing over time, with 91% survival at 1 month compared to 48% at 10 years.
- Factors like organ dysfunction, elevated urea nitrogen levels, and older age increased the risk of mortality, whereas higher hemoglobin levels were linked to decreased mortality, with the significance of these factors changing over time post-discharge.
Article Synopsis
- The study aimed to assess how often physicians agree on preoperative heart failure (HF) diagnoses among patients undergoing major non-cardiac surgery and to identify characteristics of patients where disagreements occur.
- Conducted at an academic center, the research involved detailed chart reviews of 1,018 patients from a larger group of 40,659, with adjudications made by a team of specialized physicians.
- Results showed an overall high agreement rate of 91.1% among physicians, but disagreements were noted more frequently in patients with fewer guideline-defined HF diagnostic criteria, indicating potential areas for improved diagnosis standards.
Article Synopsis
- * A case is highlighted where a patient experienced severe respiratory failure after just 2 days of intubation during routine cardiac surgery.
- * It’s important for healthcare professionals to watch for signs of laryngeal injury, and quick surgical intervention can help minimize complications.
Background: Reliable diagnosis of heart failure during preoperative evaluation is important for perioperative management and long-term care. We aimed to quantify preoperative heart failure diagnostic accuracy and explore characteristics of patients with heart failure misdiagnoses.
Methods: We performed an observational cohort study of adults undergoing major noncardiac surgery at an academic hospital between 2015 and 2019.
Article Synopsis
- The study examines how patients with reduced left ventricular ejection fraction (LVEF) are managed during non-cardiac surgery compared to those with normal LVEF, focusing on intraoperative risks and treatment differences.
- A total of 9,420 patients were analyzed, revealing that those with reduced LVEF had less positive fluid balance and different medication usage, with remifentanil showing adverse effects specifically in this group.
- The findings indicate a higher risk of complications tied to the use of remifentanil in patients with reduced LVEF, highlighting the need for further research on adjusted treatment strategies for this population.
Article Synopsis
- The study aimed to create a polygenic risk score to better understand genetic factors associated with sepsis, a severe inflammatory response to infection.
- Researchers sequenced around 14 million genetic variants and compared patients with sepsis to controls, identifying numerous genetic variants linked to both Sepsis-2 and Sepsis-3.
- While most variants had minor individual effects, the cumulative polygenic risk scores effectively discriminated between those at risk for sepsis, highlighting both shared and distinct genetic influences for the two sepsis types.
Article Synopsis
- This study aimed to identify the factors contributing to endothelial dysfunction in COVID-19, which is linked to serious complications during the illness.
- Researchers tested the effects of serum and plasma from COVID-19 patients on human endothelial cells, comparing it with patients suffering from sepsis unrelated to COVID-19.
- The findings revealed that COVID-19 patient's serum increases cell adhesion molecules on endothelial cells, and certain antibodies present in their blood may drive this dysfunction, highlighting a connection between autoantibodies and severe COVID-19 outcomes.
Purpose: The difference between arterial and end-tidal partial pressure of carbon dioxide (ΔCO) is a measure of alveolar dead space, commonly evaluated intraoperatively. Given its relationship to ventilation and perfusion, ΔCO may provide prognostic information and guide clinical decisions. We hypothesized that higher ΔCO values are associated with occurrence of a composite outcome of re-intubation, postoperative mechanical ventilation, or 30-day mortality in patients undergoing non-cardiac surgery.
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- NPT520-34 is a small molecule in clinical development aimed at treating Parkinson's disease by promoting alpha-synuclein clearance and reducing inflammation.
- In animal studies, NPT520-34 showed significant benefits, including decreased alpha-synuclein pathology and improved motor function after daily administration.
- The compound appears to tackle two major issues in neurodegenerative diseases: enhancing the removal of harmful protein aggregates and lowering inflammation levels.
Purpose: To determine if earlier initiation of renal replacement therapy (RRT) is associated with improved survival in patients with severe acute kidney injury.
Methods: We performed a retrospective case-control study of propensity-matched groups with multivariable logistic regression using Akaike Information Criteria to adjust for non-matched variables in a surgical ICU in a tertiary care hospital.
Results: We matched 169 of 205 (82%) patients with new initiation of RRT (EARLY group) to 169 similar patients who did not initiate RRT on that day (DEFERRED group).
Objective: Despite advances in echocardiography and hemodynamic monitoring, limited progress has been made to effectively quantify left ventricular function during cardiac surgery. Traditional measures, including left ventricular ejection fraction (LVEF) and cardiac index, remain dependent on loading conditions; more complex measures remain impractical in a dynamic surgical setting. However, the Smith-Madigan Inotropy Index (SMII) and potential-to-kinetic energy ratio (PKR) offer promise as measures calculable during cardiac surgery and potentially predictive of outcomes.
View Article and Find Full Text PDFBackground: While reduced left ventricular ejection fraction (LVEF) is a known risk factor for complications after coronary artery bypass grafting (CABG), the relevance of higher LVEF values has not been established. Currently, most risk stratification tools consider LVEF values above a certain point as normal. However, since this does not account for insufficient ventricular filling or increased adrenergic tone, higher values may have clinical significance.
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- Endothelial dysfunction is linked to thrombo-inflammatory complications in COVID-19, but the underlying factors responsible for this dysfunction are still unclear.
- Researchers cultured human endothelial cells with serum from COVID-19 patients and found increased expression of cell adhesion molecules, which are indicators of endothelial activation.
- Elevated levels of specific antibodies in the serum of COVID-19 patients suggest that these may contribute to endotheliopathy, providing insight into the role of autoantibodies in the severe complications associated with the disease.
Objective: Weaning parameters are well studied in patients undergoing first time extubation. Fewer data exists to guide re-extubation of patients who failed their first extubation attempt. It is reasonable to postulate that improved weaning parameters between the first and second extubation attempt would lead to improved rates of re-extubation success.
View Article and Find Full Text PDFPurpose: To determine if left ventricular or inferior vena cava (IVC) measurements are easier to obtain on point-of-care ultrasound by anesthesiologists in preoperative patients, and to assess the relationship between preoperative cardiac dimensions and hypotension with the induction of general anesthesia.
Methods: This prospective observational study was conducted at a large academic medical center. Sixty-three patients undergoing noncardiac surgeries under general anesthesia were enrolled.
Objective: To assess whether patients prescribed four-factor prothrombin complex concentrate (4FPC) received less plasma during the following 24-hour period than those treated for the same indications who received only plasma.
Introduction: It is unclear whether 4FPC is associated with a reduction in subsequent plasma transfusion. This is important for minimising transfusion-associated risks and for inventory management.
Objectives: Recently, the definition of sepsis has changed from a physiologic derangement (Sepsis-1 and -2) to organ dysfunction (Sepsis-3) based. We sought to determine the concordance between the different sepsis phenotypes and how that affected mortality.
Design: Retrospective, multicenter study.
Background The use of extracorporeal life support (ECLS) has expanded to include unique populations such as peripartum women. This systematic review aims to (1) quantify the number of cases and indications for ECLS in women during the peripartum period reported in the literature and (2) report maternal and fetal complications and outcomes associated with peripartum ECLS. Methods and Results This review was registered in PROSPERO (CRD42018108142).
View Article and Find Full Text PDFBackground: Heart failure with reduced ejection fraction (HFrEF) is a condition imposing significant health care burden. Given its syndromic nature and often insidious onset, the diagnosis may not be made until clinical manifestations prompt further evaluation. Detecting HFrEF in precursor stages could allow for early initiation of treatments to modify disease progression.
View Article and Find Full Text PDFPurpose: To determine if baseline lipid levels contribute to the relationship between lipid levels during sepsis and outcomes.
Materials And Methods: We conducted a retrospective cohort study at a tertiary-care academic medical center. Multivariable logistic regression models were used to adjust for confounders.