Management of severe dehydration.

The presented case is one of severe dehydration and acute kidney injury with significant resultant complications that required considerable fluid and electrolyte replacement. Approaches to fluid resuscitation in the context of hypernatraemia and the hyperosmolar state were considered and then judiciously combined to manage a complex case with a successful outcome. Conflicting guidance in this domain is discussed with recommendations for a future management strategy that is tailored to individual patients.

Stream biomonitoring using macroinvertebrates around the globe: a comparison of large-scale programs.

Water quality agencies and scientists are increasingly adopting standardized sampling methodologies because of the challenges associated with interpreting data derived from dissimilar protocols. Here, we compare 13 protocols for monitoring streams from different regions and countries around the globe. Despite the spatially diverse range of countries assessed, many aspects of bioassessment structure and protocols were similar, thereby providing evidence of key characteristics that might be incorporated in a global sampling methodology.

Late HIV diagnosis is a major risk factor for intensive care unit admission in HIV-positive patients: a single centre observational cohort study.

Background: HIV positive patients are at risk of infectious and non-infectious complications that may necessitate intensive care unit (ICU) admission. While the characteristics of patients requiring ICU admission have been described previously, these studies did not include information on the denominator population from which these cases arose.

Methods: We conducted an observational cohort study of ICU admissions among 2751 HIV positive patients attending King's College Hospital, South London, UK.