Knockout of the longevity gene Klotho perturbs aging and Alzheimer's disease-linked brain microRNAs and tRNA fragments.

Overexpression of the longevity gene Klotho prolongs lifespan, while its knockout shortens lifespan and impairs cognition via perturbation of myelination and synapse formation. However, comprehensive analysis of Klotho knockout effects on mammalian brain transcriptomics is lacking. Here, we report that Klotho knockout alters the levels of aging- and cognition related mRNAs, long non-coding RNAs, microRNAs and tRNA fragments.

In-Hospital Violence and Its Impact on Critical Care Practitioners.

Objectives: To provide a narrative review of hospital violence (HV) and its impact on critical care clinicians.

Data Sources: Detailed search strategy using PubMed and OVID Medline for English language articles describing HV, risk factors, precipitating events, consequences, and mitigation strategies.

Study Selection: Studies that specifically addressed HV involving critical care medicine clinicians or their practice settings were selected.

Antimicrobial resistance and outcome in the critically ill patient: An opinion paper.

Antimicrobial resistance (AMR) is associated with increased mortality and resources consumption in critically ill patients. However, the causality of AMR in this mortality remains unclear. This opinion paper aims to overview the effects of multidrug resistant (MDR) pathogens on the outcomes of critically ill patients, considering different variables as appropriateness of empirical antimicrobial therapy, severity of sepsis, comorbid conditions and frailty.

Distribution of Aeration and Pulmonary Blood Volume in Healthy, ARDS and COVID-19 Lungs: A Dual-Energy Computed Tomography Retrospective Cohort Study.

Rationale And Objectives: Few reports have studied lung aeration and perfusion in normal lungs, COVID-19, and ARDS from other causes (NC-ARDS) using dual-energy computed tomography pulmonary angiograms (DE-CTPA). To describe lung aeration and blood-volume distribution using DE-CTPAs of patients with NC-ARDS, COVID-19, and controls with a normal DE-CTPA ("healthy lungs"). We hypothesized that each of these conditions has unique ranges of aeration and pulmonary blood volumes.

Effect of maternal age on neonatal outcomes in very low birth weight singleton infants: a population-based study.

Background: Little is known on the impact of maternal age (MA) on very low birth weight (VLBW) infants' outcomes. We tested the hypothesis that at both ends of MA there are increased adverse neonatal outcomes in VLBW infants.

Methods: We used the Israel National Neonatal Network VLBW (≤1500 g) database.

Sepsis and antibiotics: When should we deploy a parachute?

In sepsis and septic shock, guidelines recommend administering antimicrobial therapy within the first hour following diagnosis. This recommendation is based on observational studies suggesting that early antimicrobial therapy is associated with improved outcomes. Consequently, front-line physicians are under pressure to quickly decide on the need for antibiotics in patients for whom the diagnosis of sepsis remains uncertain.

Fluid balance following laparotomy for hollow viscus perforation: A study of morbidity and mortality.

Background: In critically unwell patients requiring emergency abdominal surgery, the relationship between the volume of intravenous fluid given, the subsequent fluid balance and morbidity or mortality is poorly delineated. This study aimed to elucidate this relationship.

Materials And Methods: Retrospective analysis of data from a single medical center.

Decompressive Laparotomy for Veno-Venous Extracorporeal Membrane Oxygenation Failure due to Intra-Abdominal Hypertension in Critically Ill COVID-19 Patient.

The use of extracorporeal membrane oxygenation (ECMO) has increased over the course of the SARS-CoV-2 pandemic. Intra-abdominal hypertension resulting in abdominal compartment syndrome (ACS) during ECMO support is a rare but life-threatening complication, with previous case series describing mortality rates of 44%-100%. Bleeding complications, linked to both patient-related and device-related factors, also characterize prolonged ECMO support and have been reported in up to 60% of ECMO patients.

Nipple/Areola Dimensions in Early Breastfeeding.

Nipple dimensions may be an important factor in breastfeeding (BF) initiation success. To establish standards of nipple/areola dimensions in early BF and to determine whether maternal age, gestational age (GA), parity, cup size, previous BF experience, and early (<2 hours) BF affect nipple dimensions (assessed on the second day of BF). A total of 205 consecutive BF women were enrolled.

Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave: the global UNITE-COVID study.

Purpose: To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients.

Methods: Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020.

The time is now: addressing the need for training in maternal critical care medicine.

Amongst many high-income countries, indirect medical conditions (e.g. cardiovascular disease, sepsis) now account for the majority of maternal deaths.

Dual Therapy vs. Monotherapy for the Patent Ductus Arteriosus: A Systematic Review.

To evaluate the efficacy of dual patent ductus arteriosus (PDA) pharmacotherapy compared to monotherapy we searched Medline, Embase, Cochrane Library, and references of relevant articles through October 20, 2021 for randomized clinical trials (RCTs) and cohort studies comparing dual PDA treatment vs. monotherapy. Data were analyzed using a fixed effects model.

Performance of non-invasive stroke volume variation during passive leg raising as a predictor of hypotension following induction of spinal anesthesia for elective cesarean delivery: a single cohort study.

Background: Spinal anesthesia for cesarean delivery is accompanied by hypotension in up to 70% of cases. To date, there is no gold standard for predicting hypotension after spinal anesthesia for cesarean delivery. The Clearsight™ device is a non-invasive system that uses a digital cuff to calculate stroke volume.

An international survey of adherence to Surviving Sepsis Campaign Guidelines 2016 regarding fluid resuscitation and vasopressors in the initial management of septic shock.

Background: Our survey aimed to evaluate adherence to Surviving Sepsis Campaign (SSC) Guidelines 2016 among intensive care practitioners and to identify issues that remain controversial or lack clarity.

Methods: Members of the European Society of Intensive Care Medicine (ESICM) were surveyed using an anonymous web-based survey written by an international group of experts. The primary outcome measure was the rate of adherence to specific recommendations.

Expert consensus statements for the management of COVID-19-related acute respiratory failure using a Delphi method.

Background: Coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented pressure on healthcare system globally. Lack of high-quality evidence on the respiratory management of COVID-19-related acute respiratory failure (C-ARF) has resulted in wide variation in clinical practice.

Methods: Using a Delphi process, an international panel of 39 experts developed clinical practice statements on the respiratory management of C-ARF in areas where evidence is absent or limited.

Short-term outcomes of Jewish and Arab preterms: a population-based comparison.

Objective: To compare short-term outcomes of Arabs versus Jewish infants in Israel.

Methods: We used the Israel national VLBW infant database to compare adjusted mortality and major morbidities rates of Arabs versus Jewish infants delivered between January 1995 and December 2016. Multivariable logistic regression analyses were performed to study the association of ethnicity with the odds for mortality and neonatal morbidities.

Noninvasive respiratory support in the hypoxaemic peri-operative/periprocedural patient: A joint ESA/ESICM guideline.

: Hypoxaemia is a potential life-threatening yet common complication in the peri-operative and periprocedural patient (e.g. during an invasive procedure with risk of deterioration of gas exchange, such as bronchoscopy).

From the ICU to the operating room: how to manage the patient?

Purpose Of Review: To outline key points for perioperative ICU optimization of nutrition, airway management, blood product preparation and transfusion, antibiotic prophylaxis and transport.

Recent Findings: Optimization entails glycemic control for all, with specific attention to type-1 diabetic patients. Transport-related adverse events may be averted with surgery in the ICU.

Comparative Study of Meshed and Nonmeshed Acellular Dermal Matrix in Immediate Breast Reconstruction.

Background: Acellular dermal matrices are commonly used to support implant-based breast reconstruction. Meshing may enhance integration, reduce drain time and seroma, and decrease surgical costs.

Methods: This was a retrospective, single-center analysis of 83 adult women (115 breasts) undergoing one-stage (84.

Maternal cardiac arrest.

Purpose Of Review: The review is intended to serve as a practical clinical aid for the clinician called to maternal cardiac arrest.

Recent Findings: Anesthesia complications comprise an important cause of maternal cardiac arrest in developed countries Also predominant are hemorrhage and infections. Recent in-depth reports highlight fractionated care for pregnant women with cardiac and also probably neurological comorbidities.