SARS-CoV-2 on Ocular Surfaces in a Cohort of Patients With COVID-19 From the Lombardy Region, Italy.

Importance: Since February 2020, coronavirus disease 2019 (COVID-19) has spread rapidly all over the world, with an epidemiological cluster in Lombardy, Italy. The viral communicability may be mediated by various body fluids, but insufficient information is available on the presence of the virus in human tears.

Objectives: To investigate the rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in tears collected from patients with COVID-19 by means of real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) assay and to assess the association of virus presence with concomitant clinical conditions.

"If an acute event occurs, what should we do?" Diverse ethical approaches to decision-making in the ICU.

The aim of this paper is to analyze an Intensive Care Unit case that required ethics consultation at a University Hospital in Northern Italy. After the case was resolved, a retrospective ethical analysis was performed by four clinical ethicists who work in different healthcare contexts (Italy, the United States, and Switzerland). Each ethicist used a different method to analyze the case; the four general approaches provide insight into how these ethicists conduct ethics consultations at their respective hospitals.

Hyperinfection in an HIV-Infected Patient Successfully Treated with Subcutaneous Ivermectin.

A 39-year-old Ethiopian HIV-positive man with peripheral T-cell lymphoma developed hyperinfection. The patient was initially treated with oral ivermectin for three weeks without response, most likely due to malabsorption because of concomitant paralytic ileus. Given the persistence of larvae in the body fluids, the worsening respiratory status and clinical malabsorption, veterinary parenteral formulation of ivermectin was administered.

Tracking Nosocomial Klebsiella pneumoniae Infections and Outbreaks by Whole-Genome Analysis: Small-Scale Italian Scenario within a Single Hospital.

Multidrug-resistant (MDR) Klebsiella pneumoniae is one of the most important causes of nosocomial infections worldwide. After the spread of strains resistant to beta-lactams at the end of the previous century, the diffusion of isolates resistant to carbapenems and colistin is now reducing treatment options and the containment of infections. Carbapenem-resistant K.

Ethical issues associated with in-hospital emergency from the Medical Emergency Team's perspective: a national survey.

Background: Medical Emergency Teams (METs) are frequently involved in ethical issues associated to in-hospital emergencies, like decisions about end-of-life care and intensive care unit (ICU) admission. MET involvement offers both advantages and disadvantages, especially when an immediate decision must be made. We performed a survey among Italian intensivists/anesthesiologists evaluating MET's perspective on the most relevant ethical aspects faced in daily practice.

Open abdomen management of intra-abdominal infections: analysis of a twenty-year experience.

Background: No conclusive results on the efficacy and timing of open abdomen (OA) are available, particularly in the setting of intra-abdominal infections. We analyzed outcomes and risk factors retrospectively in a large series of patients managed with an OA during the past 20 y in an effort to clarify this issue.

Methods: We reviewed the records of 133 patients who underwent treatment with an OA, considering factors related to patient, disease, medical management, and surgical treatment.

Fascia-to-fascia closure with abdominal topical negative pressure for severe abdominal infections: preliminary results in a department of general surgery and intensive care unit.

Background: Vacuum-assisted fascial closure (VAFC-KCI(®)) of an open abdomen is one of the latest methods.

Methods: A prospective observational study was performed with medical records of nine patients who had been treated by abdominal VAFC-KCI(®) from March 2006 to October 2007 in the Department of Surgical Sciences, University of Insubria. The mean Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores were 22.

Treatment of high output entero-cutaneous fistulae associated with large abdominal wall defects: single center experience.

Background And Aim: Enteric fistulas are defined by their sites of origin, communication and flow. We evaluate the treatment of complex patients with entero-cutaneous fistulae with large abdominal wall defects.

Materials And Methods: Retrospective case note review of 19 patients (15 males, median age 46 years) treated at the Department of Surgical Sciences, University of Insubria, Varese, Italy.

Successful use of the new high-dose mannitol treatment in patients with Glasgow Coma Scale scores of 3 and bilateral abnormal pupillary widening: a randomized trial.

Object: The authors evaluated long-term clinical outcomes in selected acutely comatose patients with severe diffuse brain swelling and recent clinical signs of impending brain death who received a novel high-dose mannitol treatment compared with those who received conventional-dose mannitol in the emergency room.

Methods: Forty-four adult patients with traumatic, nonmissile-inflicted, acute, severe diffuse brain swelling were prospectively and randomly evaluated. All patients were selected based on the presence of recent clinical signs of impending brain death on the first emergency room evaluation.

Major clinical and physiological benefits of early high doses of mannitol for intraparenchymal temporal lobe hemorrhages with abnormal pupillary widening: a randomized trial.

Objective: We evaluated long-term clinical outcomes and postoperative physiological findings in acutely comatose patients with nonmissile surgical intraparenchymal temporal lobe hemorrhages and abnormal pupillary widening who received early preoperative high-dose mannitol (HDM) versus conventional dose mannitol treatment in the emergency room.

Methods: One hundred forty-one adult patients with traumatic, nonmissile, acute, intraparenchymal temporal lobe hemorrhages associated with early abnormal pupillary widening were prospectively and randomly assigned to receive emergency preoperative intravenous HDM treatment (approximately 1.4 g/kg; 72 patients) and were compared with a control group that was treated with a lower preoperative mannitol dose (approximately 0.

Use and nursing of the helmet in delivering non invasive ventilation.

Continuous positive end-expiratory pressure (CPAP) and Pressure Support Ventilation (PSV) are commonly used for the therapy of several forms of respiratory failure. CPAP and PSV can be delivered both during invasive respiratory treatment, by means of an endotracheal tube or tracheostomy, and during non invasive respiratory treatment. Non Invasive Ventilation (NIV) is commonly used for the therapy of several forms of respiratory failure (COPD, Weaning period from Invasive Mechanical Ventilation, Cardiogenic Edema,.

The abdominal compartment syndrome. Clinical relevance.

Increased intra-abdominal pressure (IAP) may occur in a number of different situations encountered by intensivists, such as tense ascites, abdominal hemorrhage, use of military antishock trousers, abdominal obstruction, during laparoscopy, large abdominal tumors and peritoneal dialysis.1-3 Both clinical and experimental evidence indicate that increased IAP may adversely affect cardiac, renal, respiratory and metabolic functions.1-5 Despite this, increased IAP is rarely recognized and treated in Intensive Care Unit (ICU) settings.

Improving clinical outcomes from acute subdural hematomas with the emergency preoperative administration of high doses of mannitol: a randomized trial.

Objective: To evaluate clinical outcomes and postoperative physiological findings for comatose patients with acute subdural hematomas who received preoperative high-dose mannitol (HDM) versus conventional-dose mannitol treatment.

Methods: One hundred seventy-eight adult patients with non-missile, traumatic, acute, subdural hematomas were prospectively and randomly assigned to receive emergency, preoperative, intravenous HDM treatment (91 patients), compared with a control group treated with a lower preoperative mannitol dose (87 patients).

Results: Preoperative improvement of abnormal pupillary widening was significantly more frequent in the study group than in the control group of patients (P < 0.

The clinical use of 99m-Tc-labeled WBC scintigraphy in critically ill surgical and trauma patients with occult sepsis.

Objective: To evaluate the clinical use of radionuclide-labeled white blood cell scintigraphy in the detection of focal sepsis.

Design: Prospective clinical study.

Setting: A medical/surgical 12-bed intensive care unit (ICU) in a university hospital.

Effect of recombinant IL-1 beta and recombinant gamma interferon on septic acute lung injury in mice.

The effect of recombinant human interleukin 1B (IL-1B) and recombinant human gamma interferon (IFN-g), when given prophylactically, in a mouse model of septic acute lung injury was studied. Mice were treated with various doses of IL-1B and IFN-g for 3 consecutive days prior to administration of lipopolysaccharide of Escherichia coli (1 mg/kg given intraperitoneally). To determine the histologic changes occurring after prophylactic administration of such cytokines, a scoring system was assessed.

Use of heat and moisture exchanging (HME) filters in mechanically ventilated ICU patients: influence on airway flow-resistance.

Objective: To investigate the flow-resistance of a new generation of Heat Moisture Exchanging Filters (HME filters) during 24 h of clinical use.

Design: Before-after trial.

Setting: A general Intensive Care Unit of a university hospital.

Effectiveness of ibopamine in the management of ascitic liver cirrhosis--a controlled study v placebo and frusemide.

1 Thirty in-patients of both sexes suffering from ascitic liver cirrhosis were divided into three groups treated with (a) a placebo, (b) ibopamine (SB 7505, a new oral dopaminergic drug) and (c) frusemide, for 10 days. 2 Body weight decreased with both frusemide and ibopamine, diuresis and urinary excretion of Na+ and Cl- increased with both drugs; whereas urinary excretion of K+ increased only with frusemide. 3 An important difference between the frusemide and ibopamine treatment was encountered in creatinine clearance, which increased only with ibopamine, and in blood uric acid which increased only with frusemide.

Renal effect of SB 7505: a double-blind study.

Two groups of 20 patients with no evidence of cardiovascular, hepatic, renal or gastrointestinal failure were treated orally for five days with placebo or SB 7505 100 mg/day. No change was observed in heart rate or blood pressure. Urine output, the excretion of Na, K and Cl, and creatinine clearance were significantly increased.