Identifying Patient Subgroups in the Heterogeneous Chronic Pain Population Using Cluster Analysis.

Chronic pain is an ill-defined disease with complex biopsychosocial aspects, posing treatment challenges. We hypothesized that treatment failure results, at least partly, from limited understanding of diverse patient subgroups. We aimed to identify subgroups using psychological variables, allowing for more tailored interventions.

Predicting a strongly positive fluid balance in critically ill patients with acute kidney injury: A multicentre, international study.

Background: In critically ill patients with acute kidney injury (AKI), a fluid balance (FB) > 2 L at 72 h after AKI diagnosis is associated with adverse outcomes. Identification of patients at high-risk for such fluid accumulation may help prevent it.

Methods: We used Australian electronic medical record (EMR)-based clinical data to develop the "AKI-FB risk score", validated it in a British cohort and used it to predict a positive FB >2 L at 72 h after AKI diagnosis.

Impact of attaining an aggressive PK/PD target with continuous infusion beta-lactams on the clinical efficacy of targeted therapy of early post-transplant Gram-negative infections in critically ill OLT recipients. An interim analysis of a 3-year prospective, observational, study.

Background: To assess the impact of attaining aggressive beta-lactam pharmacokinetic/pharmacodynamic (PK/PD) targets on clinical efficacy in critical orthotopic liver transplant (OLT) recipients with documented early Gram-negative infections.

Methods: OLT recipients admitted to the post-transplant ICU between June 2021 and May 2024 having documented Gram-negative infections treated with targeted therapy continuous infusion (CI) beta-lactams, and undergoing therapeutic drug monitoring (TDM)-guided beta-lactam dosing adjustment in the first 72 hours were prospectively enrolled. Free steady-state concentrations (fCss) of beta-lactams (BL) and/or of beta-lactamase inhibitors (BLI) were calculated, and aggressive PK/PD target attainment was measured.

Implementation of an Advance Directives Completion Protocol for Hospitalized Patients With Serious Illness: A Quality Improvement Initiative.

Despite mandates requiring hospitals to offer advance directives to all patients, many adults do not have advance directives in place at the end of life. This quality improvement project aimed to implement an evidence-based, standardized protocol to increase advance directive completion rates for hospitalized patients with serious illnesses. A preimplementation and postimplementation design was used to evaluate the impact of an educational intervention and advance directive completion protocol.

Oxidative stress in critically ill neonatal foals.

Background: Oxidative injury occurs in septic people, but the role of oxidative stress and antioxidants has rarely been evaluated in foals.

Objectives/hypothesis: To measure reactive oxygen species (ROS), biomarkers of oxidative injury, and antioxidants in neonatal foals. We hypothesized that ill foals would have higher blood concentrations of ROS and biomarkers of oxidative injury and lower concentrations of antioxidants compared to healthy foals.

Tracheobronchitis in Noncritically Ill Children With Tracheostomy: Can Quantitative Tracheal Cultures Assist in the Management?

Background And Objectives: Bacteria in tracheal aspirate samples from children with tracheostomy can indicate infection or colonization. Our study aimed to determine whether bacterial counts > 10 or > 10 CFU (colony forming units)/mL are more frequently associated with tracheobronchitis. Additionally, we aimed to examine the association between bacterial count and variables distinguishing colonization from infection in tracheobronchitis, along with clinical severity indicators.

Social support and online interaction and their links to psychosocial well-being among Nordic adolescents: Integrating variable-centered and person-centered approaches.

The Nordic countries are among the most digitally advanced societies in the world. Past research suggests that both social support offline and interaction online are linked to adolescent psychological adjustment. However, less is known regarding the complex implications of distinctive sources of social support offline and online interaction for a broader range of indices of adolescent psychosocial well-being, including its contemporary forms such as social media addiction.

Intensive Care Unit Memories and Trauma Triggers for Acute Respiratory Distress Syndrome Survivors Hospitalized During the COVID-19 Pandemic.

Background: Intensive care unit (ICU) admissions can be traumatic for critically ill, ventilated acute respiratory distress syndrome (ARDS) patients due to fear of death, an inability to verbally communicate, reliance on health care professionals, and invasive medical interventions. Adult ARDS patients hospitalized during the COVID-19 pandemic were strictly isolated and had limited to no visitation from loved ones, impacting their access to support systems.

Objective: To explore the memories and sensory triggers for them (if applicable) of adult ARDS survivors hospitalized during the COVID-19 pandemic.

Fluid accumulation in adult ICU patients - A protocol for a scoping review.

Introduction: Fluid accumulation in critically ill patients is associated with adverse outcomes. However, there is a substantial variability in the terminology and definitions used to describe fluid accumulation. We aim to provide an overview of evidence describing fluid accumulation in critically ill adult patients admitted to the intensive care unit (ICU), including how it is defined, patient characteristics associated with fluid accumulation, ICU population, and outcomes assessed.

Cost-effectiveness of data driven personalised antibiotic dosing in critically ill patients with sepsis or septic shock.

Purpose: This study provides an economic evaluation of bedside, data-driven, and model-informed precision dosing of antibiotics in comparison with usual care among critically ill patients with sepsis or septic shock.

Methods: This economic evaluation was conducted alongside an AutoKinetics randomized controlled trial. Effect measures included quality-adjusted life years (QALYs), mortality and pharmacokinetic target attainment.

Assessment of delirium in Indonesian pediatric intensive care unit: a psychometric evaluation of the Cornell Assessment of Pediatric Delirium.

Unlabelled: This study has the objective to translate the Cornell Assessment of Pediatric Delirium (CAPD) into Indonesian and evaluate the psychometric properties and diagnostic accuracy of the Indonesian version of the CAPD (I-CAPD) in identifying delirium in critically ill children. This prospective methodological study was conducted between January and April 2024 in a 6-bed pediatric intensive care unit (PICU). In total, 90 children aged 0-18 years hospitalized in the PICU were included.

Performance of Fluid Infusion Systems in the Changing Atmospheric Pressures Encountered in Aviation.

Introduction: With the increasing use of aeromedical transport for critically ill patients, it is essential to understand the impact of pressure changes on drug infusion delivery systems. As airplanes ascend and descend, gases/bubbles are released from solutions when ambient pressure decreases and dissolves when pressure increases. This may affect mechanical fluid delivery systems and cause clinically significant changes, especially within a critical care setting.

Multiplex Polymerase Chain Reaction Versus Standard Bacterial Culture in Critically Ill Children With Suspected Pneumonia.

Background: Bacterial lower respiratory tract infection, particularly ventilator-associated pneumonia (VAP), is a significant cause of morbidity and mortality in children who require mechanical ventilation (MV). Microbiologic diagnosis has relied on bacterial culture, but reverse transcriptase polymerase chain reaction (RT-PCR) with bacterial targets is now available for clinical use. We compared the diagnostic performance of tracheal aspirate (TA) multiplex RT-PCR to culture in children requiring MV with suspected lower respiratory tract infection.

A New Graphical Method for Displaying Two-Dimensional Echocardiography Results in Dogs: Comprehensive Analysis of Results of Diagnostic Imaging Organized in a BOX (CARDIOBOX).

Introduction And Objective: Rapid and efficient interpretation of echocardiographic findings is critical in clinical decision-making. This study aimed to design and validate a new graphical method, called CARDIOBOX, to represent echocardiographic findings in dogs.

Methods: A prospective, observational, exploratory cohort study was conducted over three years.

Sporadic Burkitt Lymphoma First Presenting as Painful Gingival Swellings and Tooth Hypermobility: A Life-Saving Referral.

Burkitt lymphoma (BL) is an aggressive non-Hodgkin lymphoma (NHL), subdivided into endemic, sporadic, and immunodeficiency-associated forms. While jaw lesions are common in endemic BL, they are infrequent in sporadic cases, only rarely constituting the first manifestation of the disease. The aim of this study is to present a rare pediatric case of sporadic BL first manifesting as gingival swellings and tooth hypermobility and provide a review of all the published sporadic BL case reports as the first sign of disease.

The pattern of cytokine profile in children received extracorporeal blood purification.

We reported the cytokine profile in children <18 years old who received extracorporeal blood purification (EBP) for sepsis, rhabdomyolysis, hyperbilirubinaemia, acute respiratory distress syndrome or cytokine storm, and determined the factors affecting the cytokine removal kinetics. Plasma levels of 38 types of cytokine/chemokine were measured at pre-EBP, 12 and 24 h after initiating EBP. Altogether there were 11 eligible episodes admitted between April 2021 and December 2023.

A Comprehensive Clinical Acumen Enhanced by Point-of-Care Ultrasonography in Managing Acute Life-Threatening Massive Pulmonary Thromboembolism in a Peripheral Setting: A Case Report.

Acute massive pulmonary thromboembolism (PTE) is a potentially life-threatening condition requiring urgent management to decrease mortality. However, in the peripheral setting, managing the emergency can be challenging. We report a case of massive PTE presenting with cardiopulmonary arrest, successfully managed with advanced cardiac life support, early initiation of anticoagulants (heparin), and thrombolytics.

The potential role of leukocytes cell population data (CPD) for diagnosing sepsis in adult patients admitted to the intensive care unit.

Objectives: The aim of the study was to evaluate the predictive value of cell population data (CPD) parameters in comparison with procalcitonin (PCT) and C-reactive protein (CRP) for an early diagnosis of sepsis in intensive care unit (ICU). The effect of renal function on CPD, PCT and CRP, in septic and non-septic patients was also investigated.

Methods: This is a retrospective, observational and single-center study, performed with data collected from patients consecutively admitted to the ICU of the Edoardo Bassini Hospital in Milan.

ACCREDIT: Validation of clinical score for progression of COVID-19 while hospitalized.

Unlabelled: COVID-19 is no longer a global health emergency, but it remains challenging to predict its prognosis.

Objective: To develop and validate an instrument to predict COVID-19 progression for critically ill hospitalized patients in a Brazilian population.

Methodology: Observational study with retrospective follow-up.

Phenotypic and genetic extended spectrum beta lactamase profiles of bacterial isolates from ICU in tertiary level hospital in Kenya.

Background: Bacterial infections in the Intensive Care Units are a threat to the lives of critically ill patients. Their vulnerable immunity predisposes them to developing bacteria-associated sepsis, deteriorating their already fragile health. In the face of increasing antibiotics resistance, the problem of bacterial infection in ICU is worsening.

Sex disparities in ICU care and outcomes after cardiac arrest: a Swiss nationwide analysis.

Background: Conflicting data exist regarding sex-specific outcomes after cardiac arrest. This study investigates sex disparities in the provision of critical care and outcomes of in-hospital (IHCA) and out-of-hospital cardiac arrest (OHCA) patients.

Methods: Analysis of adult cardiac arrest patients admitted to certified Swiss intensive care units (ICUs) (01/2008-12/2022) using the nationwide prospective ICU registry.

Developing a comprehensive inventory to define harm reduction housing.

Background: The City of Boston has faced unprecedented challenges with substance use amidst changes to the illicit drug supply and increased visibility of homelessness. Among its responses, Boston developed six low threshold harm reduction housing (HRH) sites geared towards supporting the housing needs of people who use drugs (PWUD) and addressing health and safety concerns around geographically concentrated tent encampments. HRH sites are transitional supportive housing that adhere to a "housing first" approach where abstinence is not required and harm reduction services and supports are co-located.