Randomized controlled clinical trial evaluating multiplex polymerase chain reaction for pathogen identification and therapy adaptation in critical care patients with pulmonary or abdominal sepsis.

Objective: To determine whether a multiplex polymerase chain reaction (PCR)-based test could reduce the time required for initial pathogen identification in patients in an intensive care unit (ICU) setting.

Methods: This double-blind, parallel-group randomized controlled trial** enrolled adults with suspected pulmonary or abdominal sepsis caused by an unknown pathogen. Both the intervention and control groups underwent the standard blood culture (BC) testing, but additional pathogen identification, based on the results of a LightCycler® SeptiFast PCR test, were provided in the intervention group.

[Prevention of ventilator-associated pneumonia: what's evidence-based treatment?].

Patients who suffer from a ventilator-associated pneumonia (VAP) are ventilated longer, stay longer in the ICU and in hospital and therefore lead to higher costs. Despite the therapeutic potential of the VAP nowadays there is about 10% additional mortality observed. Although the clinical VAP diagnosis is limited (sensitivity/specificity) rapid diagnosis promotes treatment (calculated antibiotic therapy) and improves the survival rate.

Gender-related outcome difference is related to course of sepsis on mixed ICUs: a prospective, observational clinical study.

Introduction: Impact of gender on severe infections is in highly controversial discussion with natural survival advantage of females described in animal studies but contradictory to those described human data. This study aims to describe the impact of gender on outcome in mixed intensive care units (ICUs) with a special focus on sepsis.

Methods: We performed a prospective, observational, clinical trial at Charité University Hospital in Berlin, Germany.

[Evidence-based anti-infective program "ABx" - Online-program for anti-infective therapy broadens functions for local adaptations].

National and international evidence based recommendations for anti-infective therapies in the intensive care unit are difficult to implement into daily clinical work. However, adequate and early applications of anti-infective therapies are important outcome factors for the clinical course of severe infections. With support of the German Society of Anaesthesiology and Intensive Care Medicine and the Association of German Anaesthesiologists (DGAI/BDA) a web based anti-infective program was developed to address these issues.

Low-dose oral metronomic chemotherapy prevents mobilization of endothelial progenitor cells into the blood of cancer patients.

Unlabelled: Circulating endothelial progenitor cells (EPCs) actively supply cells that may participate in tumor angiogenesis. The differing effects of low-dose metronomic trofosfamide as opposed to conventional dose-dense chemotherapy on plasma levels of vascular endothelial growth factor (VEGF) and the numbers of circulating EPC are reported.

Patients And Methods: Blood samples were obtained from cancer patients, 18 receiving oral metronomic chemotherapy of trofosfamide with or without celecoxib, and 24 receiving conventional dose-dense chemotherapy, eight of them in adjuvant intention.