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Fluid Management in Critical Care: New Insights Into Optimal Fluid Therapy.
Cureus
December 2024
Critical Care Medicine, Star Care Multispeciality Hospital, Kozhikode, IND.
Background: Fluid management is a crucial critical care component, influencing outcomes such as organ function, renal integrity, and survival in critically ill patients. Recent evidence suggests that balanced crystalloids may offer advantages over isotonic saline, particularly in reducing the risk of acute kidney injury (AKI) and other complications. This study aimed to evaluate the impact of balanced crystalloids versus isotonic saline on clinical outcomes in the intensive care unit (ICU), focusing on AKI, renal replacement therapy (RRT), and mortality.
View Article and Find Full Text PDFIncreased respiratory syncytial virus-associated hospitalizations and ambulatory visits in very preterm infants in the first year of life following discontinuation of access to palivizumab.
Am J Perinatol
January 2025
Pediatrics, Dalhousie University, Halifax, Canada.
Background: From 2002 to 2023, palivizumab was the only intervention to reduce RSV-associated hospitalizations in high-risk infants in Canada, but advances in RSV prevention are drastically changing this landscape. Eligibility criteria for this monoclonal antibody for preterm infants varied over time across each of 10 Canadian provinces and 3 territories. The national professional pediatric association (Canadian Paediatric Society) revised its eligibility recommendations in 2015, removing access for preterm infants 30 to 32 weeks gestation (WG).
View Article and Find Full Text PDFUse and limitations of clinical data in the identification and classification of low molecular weight chemicals (LMWCs) as respiratory sensitizers: recommendations for improvement.
Crit Rev Toxicol
January 2025
Syngenta, Bracknell, United Kingdom.
While progress has been made in recent years, there are still no suitable and accepted , or models that can be used to accurately predict whether a chemical substance has the intrinsic property to cause immune-mediated chemical respiratory allergy, typically manifested as allergic asthma or allergic rhinitis which represents a severe health hazard. Regulatory authorities have relied primarily on clinical evidence (case reports, clinical databases, worker exposure studies) to classify substances as respiratory sensitizers, but this evidence can lack a proven immunological mechanism which is necessary to identify substances which can cause life-long sensitization and clinically relevant allergic symptoms in the respiratory tract in an exposed population (such respiratory allergens may be considered as "true" sensitizers, in analogy to the definition of skin sensitization, and in contrast to respiratory irritants). In light of this, the European Center for Ecotoxicology and Toxicology of Chemicals convened a Task Force to evaluate the types of clinical methods and data sources and the implications of relying on such data for regulatory decision making from a scientific perspective.
View Article and Find Full Text PDFRespiratory manifestations of sickle cell disease in children: a comprehensive review for the pediatrician.
Expert Rev Respir Med
January 2025
Department of Surgery, Dentistry, Pediatrics and Gynaecology, Pediatric Division, University of Verona, Verona, Italy.
Introduction: Sickle cell disease (SCD) is an inherited hemoglobinopathy characterized by the production of sickle hemoglobin, leading to red blood cells sickling and hemolysis in hypoxic conditions. The resulting acute and chronic endothelial inflammation leads to chronic organ damage. Respiratory manifestations in SCD usually start from childhood and represent the leading causes of morbidity and mortality.
View Article and Find Full Text PDFDementia Care Practice.
Alzheimers Dement
December 2024
University of São Paulo Medical School, São Paulo, Brazil.
Introduction: Patients with severe cognitive impairment, with the progression of the disease, show behavioral impairments, loss of functionality and, in many cases, swallowing changes (dysphagia). Dysphagia comes with serious complications that can cause health damage, such as malnutrition, dehydration and serious lung damage secondary to aspirations. Eating process goes beyond nutritional intake, as it has a social, cultural, behavioral, physical and cognitive component.
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