118 results match your criteria: "Critical Care Centre[Affiliation]"

Background: Lung cancer surgery is associated with a high incidence of chronic postsurgical pain (CPSP), which necessitates long-term analgesic prescriptions. However, while essential for managing pain, these have shown various adverse effects. Current guidelines recommend using peripheral nerve blocks over epidural anaesthesia for perioperative analgesia in minimally invasive thoracic surgery (MITS).

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Letter to the editor: "Platelet dysfunction in heatstroke-induced coagulopathy: A retrospective observational study".

J Crit Care

December 2024

Department of Emergency Medicine and Critical Care Medicine, Tochigi Prefectural Emergency and Critical Care Centre, Imperial Foundation Saiseikai Utsunomiya Hospital, 911-1 Takebayashimachi, Utsunomiya, 321-0974 Tochigi, Japan.

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Fungal infection-related conditions and outcomes in severe COVID-19: a nationwide case-control study.

BMC Infect Dis

December 2024

Department of Emergency and Critical Care Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan.

Background: Fungal infections are significant complications of severe coronavirus disease 2019 (COVID-19). Although various risk factors for poor outcomes in patients with COVID-19 have been identified, clinical and treatment factors associated with fungal infections in patients with severe COVID-19 remain unclear. This study aimed to elucidate clinical factors associated with fungal infections during severe COVID-19 treatment.

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Torsemide in the Management of Pulmonary Edema.

J Assoc Physicians India

September 2024

Country Head, Medical Affairs, Cipla Ltd., Mumbai, Maharashtra, India.

Article Synopsis
  • - Pulmonary edema occurs when fluid builds up in the lungs' alveoli, and can be classified as either cardiogenic (related to heart issues) or noncardiogenic (not related to heart problems).
  • - Cardiogenic pulmonary edema is often linked to congestive heart failure (CHF) and is typically treated with loop diuretics, with torsemide and furosemide being effective options due to their ability to reduce heart pressure levels.
  • - Torsemide may be preferable over furosemide because it has better absorption and efficacy, showing good results when given intravenously for cardiogenic pulmonary edema, but further studies are necessary to evaluate its effectiveness in non-cardiogenic cases.
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ISCCM Position Statement for Improving Gender Balance in Critical Care Medicine.

Indian J Crit Care Med

August 2024

Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.

Unlabelled: Gender disparity in Critical Care Medicine (CCM) persists globally, with women being underrepresented. Female Intensivists remain a minority, facing challenges in academic and leadership positions at the workplace and within academic societies. The Indian Society of Critical Care Medicine (ISCCM) recognized the need for addressing issues related to gender parity and constituted its first Diversity Equity and Inclusion (DEI) Committee in 2023.

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Aim: Extracorporeal cardiopulmonary resuscitation (ECPR) is used to resuscitate patients with cardiac arrest; however, its effect in treating hypothermic cardiac arrest has not been well studied. Therefore, in this study, we aimed to examine the characteristics and outcomes of patients with hypothermic cardiac arrest who underwent ECPR, using a multicenter out-of-hospital cardiac arrest (OHCA) registry in Japan.

Methods: Baseline characteristics of patients with hypothermic OHCA and body temperature below 32 °C were assessed.

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Introduction: This pooled analysis was conducted to assess the clinical safety and performance of the Supra family (Sahajanand Medical Technologies Ltd., Surat, India) of sirolimus-eluting stents (SES) in patients with acute coronary syndromes (ACSs) including ST-segment elevation myocardial infarction (STEMI) from two real-world all-comers Indian registries at 1 year.

Methods: We evaluated 1,824 patients with ACS who underwent percutaneous coronary intervention with the Supra family of SES from two real-world Indian registries (891 patients from T-Flex registry and 933 patients from Tetriflex real-world registry).

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Article Synopsis
  • This study compared the effectiveness of high-flow nasal cannula (HFNC) oxygen therapy versus low-flow oxygen support (LFOS) in children under 5 with acute hypoxemic respiratory failure from severe pneumonia in low-middle-income countries.
  • An open-label randomized trial involved 244 children, analyzing the failure rates of treatment within 72 hours, where HFNC displayed a significantly lower failure rate (7.3%) compared to LFOS (20%).
  • The conclusion indicated that early use of HFNC resulted in better outcomes and fewer necessary intubations, highlighting its potential as a preferred treatment for young children with this condition.
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Background: Coronavirus disease 2019 (COVID-19) has exposed critical care supply shortages worldwide. This study aimed to investigate the association between regional critical care capacity and the incidence of invasive mechanical ventilation following novel COVID-19 during the pandemic in Japan, a country with a limited intensive care unit (ICU) bed capacity of a median of 5.1 ICU beds per 100,000 individuals.

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Article Synopsis
  • Inhaled corticosteroids like ciclesonide were examined for their effectiveness in treating non-critically ill hospitalized patients with COVID-19, as their role remains unclear.
  • A study of 3,638 patients across 64 Japanese hospitals analyzed mortality rates between those using ciclesonide and a control group.
  • The findings indicated no significant difference in 28-day or in-hospital mortality rates between the two groups, suggesting that inhaled ciclesonide does not provide a mortality benefit in this patient population, warranting further research.
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Background: We examined the association between body mass index (BMI) and outcomes in patients with out-of-hospital cardiac arrest (OHCA) undergoing extracorporeal cardiopulmonary resuscitation (ECPR).

Methods: We retrospectively analyzed the database of an observational multicenter cohort in Japan. Adult patients with OHCA of cardiac etiology who received ECPR between 2013 and 2018 were categorized as follows: underweight, BMI < 18.

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Background: The organ dysfunction that is associated with death in COVID-19 patients has not been determined in multicenter epidemiologic studies. In this study, we evaluated the major association with death, concomitant organ dysfunction, and proportion of multiple organ failure in deaths in patients with COVID-19, along with information on organ support.

Methods: We performed an observational cohort study using the Japanese multicenter research of COVID-19 by assembling a real-world data (J-RECOVER) study database.

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Background: We aimed to synthesize published data on and identify factors associated with healthcare providers' satisfaction with end-of-life care for critically ill adults.

Methods: Electronic databases were searched from inception to January 23, 2023. We included trials involving adults admitted to intensive care units (ICUs) or high-dependency units to evaluate palliative care interventions.

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Article Synopsis
  • This study compared the effects of early versus delayed feeding in patients with acute lower gastrointestinal bleeding (ALGIB) after their bleeding was controlled.
  • Researchers analyzed data from 5,910 patients across Japan, dividing them into early (feeding within 1 day) and delayed (feeding after 2-3 days) groups.
  • Results showed no significant differences in rebleeding rates or need for further treatments between the groups, but the early feeding group had a shorter hospital stay, suggesting it is a safe and beneficial practice.
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Background Despite significant evolution in stent technology, female gender, and patients with diabetes mellitus, multivessel disease, total occlusions, long lesions, and small vessels represent the "Achilles' heel" of contemporary percutaneous coronary intervention (PCI). We performed a pooled analysis of high-risk subgroup on patient-level data from the T-Flex registry (1,203 patients) and a real-world Indian registry (1,269 patients), with the aim of assessing one-year safety and clinical performance of ultrathin strut biodegradable polymer-coated Supra family of sirolimus-eluting stents (SES) (Sahajanand Medical Technologies Limited, Surat, India) in the real-world, all-comer population. Method We pooled the following high-risk subgroups data from two all-comer registries: female gender (n=678), diabetes mellitus (n=852), multivessel disease (n=406), total occlusions (n=420), long lesions (≥28 mm) (n=1241), and small vessels (≤2.

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  • This study evaluated the effectiveness of restrictive versus liberal red blood cell transfusion strategies in patients with severe trauma to see which approach led to better survival rates during the acute post-injury phase.
  • Conducted in Japan, the trial involved 22 hospitals and compared transfusion target hemoglobin levels of 7-9 g/dL in the restrictive group to 10-12 g/dL in the liberal group, measuring outcomes like 28-day survival, transfusion volume, and complications.
  • Results showed no significant difference in 28-day survival rates (92.1% for restrictive vs. 91.3% for liberal), nor in complication rates, but the restrictive group required lower transfusion
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Background: The volume-outcome relationship in patients with severe Coronavirus disease 2019 (COVID-19) is unclear and is important for establishing a system for the medical care of severe COVID-19. This study aimed to evaluate the association between institutional case volume and outcomes in patients with ventilated COVID-19.

Methods: We analyzed patients with severe COVID-19 on ventilatory control aged > 17 years who were enrolled in the J-RECOVER study, which is a retrospective multicenter observational study conducted between January 2020 and September 2020 in Japan.

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Retrospective study of feline tracheal mass lesions.

J Feline Med Surg

May 2023

Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan.

Objectives: This multicentre, retrospective observational study aimed to describe the clinical presentation, diagnostic methods, treatment and outcomes of cats with tracheal masses.

Methods: Eighteen cats from five academic or secondary/tertiary animal hospitals were included.

Results: The median age at diagnosis was 10.

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Combined advances in haematopoietic cell transplantation (HCT) and intensive care management have improved the survival of patients with haematological malignancies admitted to the intensive care unit. In cases of refractory respiratory failure or refractory cardiac failure, these advances have led to a renewed interest in advanced life support therapies, such as extracorporeal membrane oxygenation (ECMO), previously considered inappropriate for these patients due to their poor prognosis. Given the scarcity of evidence-based guidelines on the use of ECMO in patients receiving HCT and the need to provide equitable and sustainable access to ECMO, the European Society of Intensive Care Medicine, the Extracorporeal Life Support Organization, and the International ECMO Network aimed to develop an expert consensus statement on the use of ECMO in adult patients receiving HCT.

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Article Synopsis
  • Significant healthcare challenges are posed by rare diseases in underserved areas like the Middle East, which lack genomic diagnostic services.
  • A clinical genomics facility was established in the UAE to diagnose and manage rare disease patients, utilizing methods like exome sequencing and chromosomal microarrays, demonstrating a cumulative diagnostic yield of 32.5%.
  • The majority of diagnosed Mendelian disorders were identified in young patients, with many receiving delayed diagnoses due to limited access to genetic testing, highlighting the importance of local genomic services for timely management.
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  • This study evaluated how effective ECG findings, specifically STEMI equivalents, are in diagnosing acute coronary syndrome in patients who experienced out-of-hospital cardiac arrest (OHCA).
  • Researchers analyzed data from a registry between 2012 and 2017, focusing on patients who had specific ECG patterns upon achieving return of spontaneous circulation (ROSC).
  • The results indicated that while certain ECG signs like isolated T-wave inversion and Wellens' signs had high specificity for ACS, their overall diagnostic accuracy was low, suggesting that more research is needed to understand the timing of ECG assessments after ROSC.
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Current Role of Intra-Articular Injections of Platelet-Rich Plasma in Adhesive Capsulitis of Shoulder: A Systematic Review.

Bioengineering (Basel)

December 2022

Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, Republic of Korea.

Adhesive capsulitis shoulder is a common problem of patients presenting with shoulder pain and disability. The approach to such patients includes a variety of modalities. This systematic review evaluates the efficacy of intra-articular injections of platelet-rich plasma (PRP) in the treatment.

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The benefits of introducing a systematic lung-protective protocol for coronavirus disease 2019 (COVID-19) pneumonia requiring invasive ventilation in the intensive care unit (ICU) are unknown. Herein, we aimed to evaluate the clinical effects of introducing such a protocol in terms of mortality, duration of ventilation, and length of ICU stay. In this single-centre, retrospective, quality comparison study, we identified patients with COVID-19 pneumonia who received invasive ventilation in our ICU between February 2020 and October 2021.

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Background: In the early COVID-19 pandemic concerns about the correct choice of analgesics in patients with COVID-19 were raised. Little data was available on potential usefulness or harmfulness of prescription free analgesics, such as paracetamol. This international multicentre study addresses that lack of evidence regarding the usefulness or potential harm of paracetamol intake prior to ICU admission in a setting of COVID-19 disease within a large, prospectively enrolled cohort of critically ill and frail intensive care unit (ICU) patients.

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We aimed to evaluate the association between ICU patient volume before the COVID-19 pandemic and the outcomes of ventilated COVID-19 patients. We analyzed ventilated patients with COVID-19 aged > 17 years and enrolled in the J-RECOVER study, a retrospective multicenter observational study conducted in Japan between January and September 2020. Based on the number of patients admitted to the ICU between January and December 2019, the top third institutions were defined as high-volume centers, the middle third ones as middle-volume centers, and the bottom third ones as low-volume centers.

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