The Silent Threat of Human Metapneumovirus: Clinical Challenges and Diagnostic Insights from a Severe Pneumonia Case.

Background: Human metapneumovirus (hMPV) is a respiratory pathogen that has gained increasing recognition due to advancements in molecular diagnostic tools, which have improved its detection and characterization. While severe disease manifestations are traditionally associated with pediatric, elderly, or immunocompromised patients, hMPV-related pneumonia in immunocompetent adults remains underexplored.

Methods: This case report describes a 68-year-old male who developed severe community-acquired pneumonia (CAP) caused by hMPV despite being immunocompetent and having no significant comorbidities.

Understanding and addressing a 'difficult' family in ICU.

Conflicts between ICU staff and patient/relatives are common and are a source of additional stress in an already tense environment. These conflicts vary from disagreements to serious controversies, which may lead to legal process or even violence. Unsuccessful communication is recognised as a common denominator for such disagreements.

Peripheral Intravenous Catheter Insertion: Professionals' Performance and Implications for Patient Safety: A Cross-Sectional Study.

This study evaluated peripheral intravenous catheter insertion by licensed practical nurses in a simulated scenario. This cross-sectional and descriptive study was performed in a general hospital's simulation center located in Brazil, from January to October 2020. The authors developed a tool from the leading guidelines to measure peripheral intravenous catheter insertion performance in 60 licensed practical nurses.

Effect of rapid cycle deliberate practice in peripheral intravenous catheters insertion training: A simulation experimental study.

Aim: to compare the effect of rapid cycle deliberate practice simulation training with skill-training simulation on peripheral intravenous catheter insertion for Licensed Practical Nurses.

Background: The use of peripheral intravenous catheters is associated with high rates of complications, although it is widely used in clinical practice. Training strategies to ensure good performance can minimize the risks inherent to this procedure.

Can support surfaces characteristics influence high-quality chest compression? manikin experiment with a mechanical device.

Background: Support surfaces variables, such as size, material, and density, can determine chest compression depth in cardiopulmonary resuscitation.

Objective: to analyze the force required to do a high-quality chest compression concerning different surfaces in CPR.

Method: This experimental study was developed using a Little Anne manikin and a mechanical device to perform chest compressions.

A Natural History of Disease Framework for Improving the Prevention, Management, and Research on Post-viral Fatigue Syndrome and Other Forms of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

We propose a framework for the treatment, rehabilitation, and research into Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) using a natural history of disease approach to outline the distinct disease stages, with an emphasis on cases following infection to provide insights into prevention. Moving away from the method of subtyping patients based on the various phenotypic presentations and instead reframing along the lines of disease progression could help with defining the distinct stages of disease, each of which would benefit from large prospective cohort studies to accurately describe the pathological mechanisms taking place therein. With a better understanding of these mechanisms, management and research can be tailored specifically for each disease stage.

Impact of different frequencies of controlled breath and pressure-support levels during biphasic positive airway pressure ventilation on the lung and diaphragm in experimental mild acute respiratory distress syndrome.

Background: We hypothesized that a decrease in frequency of controlled breaths during biphasic positive airway pressure (BIVENT), associated with an increase in spontaneous breaths, whether pressure support (PSV)-assisted or not, would mitigate lung and diaphragm damage in mild experimental acute respiratory distress syndrome (ARDS).

Materials And Methods: Wistar rats received Escherichia coli lipopolysaccharide intratracheally. After 24 hours, animals were randomly assigned to: 1) BIVENT-100+PSV0%: airway pressure (Phigh) adjusted to VT = 6 mL/kg and frequency of controlled breaths (f) = 100 bpm; 2) BIVENT-50+PSV0%: Phigh adjusted to VT = 6 mL/kg and f = 50 bpm; 3) BIVENT-50+PSV50% (PSV set to half the Phigh reference value, i.

Intra-abdominal hypertension, fluid balance, and adverse outcomes after orthotopic liver transplantation.

Background: Intra-abdominal hypertension (IAH) is frequently encountered in critically ill surgical patients. We aimed to evaluate the incidence of IAH after orthotopic liver transplant (OLT) and its impact on organ function, hospital length-of-stay (LOS), and death.

Methods: This prospective, observational, cohort study evaluated consecutive adult patients admitted in the ICU after undergoing OLT.

How Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Progresses: The Natural History of ME/CFS.

We propose a framework for understanding and interpreting the pathophysiology of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) that considers wider determinants of health and long-term temporal variation in pathophysiological features and disease phenotype throughout the natural history of the disease. As in other chronic diseases, ME/CFS evolves through different stages, from asymptomatic predisposition, progressing to a prodromal stage, and then to symptomatic disease. Disease incidence depends on genetic makeup and environment factors, the exposure to singular or repeated insults, and the nature of the host response.

Are there normal values of phase analysis parameters for left ventricular dyssynchrony in patients with no structural cardiomyopathy?: a systematic review.

Background: ECG-gated single photon emission computed tomography (SPECT) myocardial perfusion scintigraphy combined with phase analysis allows for the assessment of left ventricular dyssynchrony. However, there are several software programs available thereby introducing variability in outcome and normal values. The aim of this systematic review was to evaluate the variability between different programs as currently available in literature with a focus on normal values.

Accessory Mitral Valve Tissue: An Unusual Echocardiographic Finding.

• AMVT is a rare congenital cardiac malformation. • AMVT can be an incidental finding. • Endocarditis and embolic events are known complications.

Low-molecular-weight heparin venous thromboprophylaxis in critically ill patients with renal dysfunction: A subgroup analysis of the PROTECT trial.

Introduction: There is concern about excessive bleeding when low-molecular-weight heparins (LMWHs) are used for venous thromboembolism (VTE) prophylaxis in renal dysfunction. Our objective was to evaluate whether LMWH VTE prophylaxis was safe and effective in critically ill patients with renal dysfunction by conducting a subgroup analysis of PROTECT, a randomized blinded trial.

Methods: We studied intensive care unit (ICU) patients with pre-ICU dialysis-dependent end-stage renal disease (ESRD; pre-specified subgroup; n = 118), or severe renal dysfunction at ICU admission (defined as ESRD or non-dialysis dependent with creatinine clearance [CrCl] <30 ml/min; post hoc subgroup; n = 590).

Mental Stress-Induced Myocardial Ischemia Related to Generalized Anxiety Disorder in a Patient With Acute Coronary Syndrome and Normal Coronary Arteries.

Mental stress-induced myocardial ischemia (MSIMI) has been described in patients with acute coronary syndrome (ACS). We reported the case of a patient admitted with ACS and MSIMI related to generalized anxiety disorder (GAD). Myocardial perfusion imaging (MPI) after exercise stress and computed tomography coronary angiography showed normal results.

Subcortical Vascular Cognitive Impairment staged through cdr's functional subsum (cdr-func): Preliminary results from an outpatient sample.

Background: Staging vascular cognitive impairment (VCI) might be useful for sample selection in clinical trials and for guiding clinical decision-making. Clinical dementia rating (CDR) has been applied for staging cognitive impairments of different etiologies, but it may underestimate severity of non-Alzheimer's disease cognitive deficits.

Methods: Out of a total of 147 elderly subjects, 23 (mean age: 72.

Obesity, Insulin Resistance, and Incident Small Vessel Disease on Magnetic Resonance Imaging: Atherosclerosis Risk in Communities Study.

Background And Purpose: The term metabolic syndrome describes the clustering of risk factors found in many individuals with obesity. Because of their pathophysiology, we hypothesized that 2 features of metabolic syndrome, central obesity and insulin resistance (IR), would be associated with cerebrovascular changes on magnetic resonance imaging, and specifically with incident lacunar disease and not white matter hyperintensity (WMH) progression.

Methods: Risk factors were defined at study baseline in 934 participants in the Atherosclerosis Risk in Communities (ARIC) study, who completed 2 brain magnetic resonance imagings≈10 years apart.

Is robotic mitral valve surgery more expensive than its conventional counterpart?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'Is robotic mitral valve surgery more expensive than its conventional counterpart?' Altogether 19 papers were found using the reported search, of which 5 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated.

Myocardial perfusion imaging study of CO(2)-induced panic attack.

Chest pain is often seen alongside with panic attacks. Moreover, panic disorder has been suggested as a risk factor for cardiovascular disease and even a trigger for acute coronary syndrome. Patients with coronary artery disease may have myocardial ischemia in response to mental stress, in which panic attack is a strong component, by an increase in coronary vasomotor tone or sympathetic hyperactivity setting off an increase in myocardial oxygen consumption.

The total face mask is more comfortable than the oronasal mask in noninvasive ventilation but is not associated with improved outcome.

Background: Noninvasive positive-pressure ventilation (NPPV) is commonly used to improve ventilation and oxygenation and avoid endotracheal intubation and mechanical ventilation. Although clinically indicated, most patients fail to use NPPV due to mask intolerance. A total face mask was designed to increase compliance, but whether this translates into better outcome (improvement in clinical and blood gas parameters and less intubation) is unknown.

The brain subcortical white matter and aging: A quantitative fractional anisotropy analysis.

Unlabelled: To study the integrity of hemispheric subcortical white matter by comparing normal young and elderly subjects using quantitative fractional anisotropy (DTI-FA).

Methods: Subjects of two different age groups (young=12, elderly=12) were included. MR - GE Signa Horizon - 1.

Surgical treatment of anomalous coronary artery arising from the pulmonary artery.

Anomalous coronary arteries arising from the pulmonary trunk is a rare but potentially fatal condition. We report the clinical presentation, surgical treatment and long-term follow-up of seven surgical cases of anomalous left coronary and one case of anomalous right coronary artery arising from the pulmonary artery. Age ranged from 7 months to 13 years (average: 5.