scholarly journals Epileptic Seizures in Critically Ill Patients: Diagnosis, Management, and Outcomes

2020 ◽  
Vol 9 (7) ◽  
pp. 2218 ◽  
Author(s):  
Mathilde Holleville ◽  
Gwenaëlle Jacq ◽  
François Perier ◽  
Candice Fontaine ◽  
Stephane Legriel
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Epileptic Seizures ◽  
Research Articles ◽  
Original Research ◽  
Special Issue ◽  
Mortality And Morbidity ◽  
Global Epidemiology ◽  
High Degree ◽  
Significant Mortality

Epileptic seizures in critically ill patients represent a major source of concern, because they are associated with significant mortality and morbidity rates. Despite recent advances that have enabled a better understanding of the global epidemiology of this entity, epileptic seizures in critically ill patients remain associated with a high degree of uncertainty and numerous questions remain unanswered. The present Special Issue aims to invite authors to contribute original research articles as well as review articles related to all aspects of epileptic seizures in critically ill patients, diagnosis, management, and outcomes.

scholarly journals Effect of timing of intubation on clinical outcomes of critically ill patients with COVID-19: a systematic review and meta-analysis of non-randomized cohort studies

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Eleni Papoutsi ◽  
Vassilis G. Giannakoulis ◽  
Eleni Xourgia ◽  
Christina Routsi ◽  
Anastasia Kotanidou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Meta Analysis ◽  
Mortality And Morbidity ◽  
Icu Admission ◽  
All Cause Mortality ◽  
Detectable Difference

Abstract Background Although several international guidelines recommend early over late intubation of patients with severe coronavirus disease 2019 (COVID-19), this issue is still controversial. We aimed to investigate the effect (if any) of timing of intubation on clinical outcomes of critically ill patients with COVID-19 by carrying out a systematic review and meta-analysis. Methods PubMed and Scopus were systematically searched, while references and preprint servers were explored, for relevant articles up to December 26, 2020, to identify studies which reported on mortality and/or morbidity of patients with COVID-19 undergoing early versus late intubation. “Early” was defined as intubation within 24 h from intensive care unit (ICU) admission, while “late” as intubation at any time after 24 h of ICU admission. All-cause mortality and duration of mechanical ventilation (MV) were the primary outcomes of the meta-analysis. Pooled risk ratio (RR), pooled mean difference (MD) and 95% confidence intervals (CI) were calculated using a random effects model. The meta-analysis was registered with PROSPERO (CRD42020222147). Results A total of 12 studies, involving 8944 critically ill patients with COVID-19, were included. There was no statistically detectable difference on all-cause mortality between patients undergoing early versus late intubation (3981 deaths; 45.4% versus 39.1%; RR 1.07, 95% CI 0.99–1.15, p = 0.08). This was also the case for duration of MV (1892 patients; MD − 0.58 days, 95% CI − 3.06 to 1.89 days, p = 0.65). In a sensitivity analysis using an alternate definition of early/late intubation, intubation without versus with a prior trial of high-flow nasal cannula or noninvasive mechanical ventilation was still not associated with a statistically detectable difference on all-cause mortality (1128 deaths; 48.9% versus 42.5%; RR 1.11, 95% CI 0.99–1.25, p = 0.08). Conclusions The synthesized evidence suggests that timing of intubation may have no effect on mortality and morbidity of critically ill patients with COVID-19. These results might justify a wait-and-see approach, which may lead to fewer intubations. Relevant guidelines may therefore need to be updated.

scholarly journals Genetic and Epigenetic Modulation of Cell Functions by Physical Exercise

Genes ◽  
2019 ◽  
Vol 10 (12) ◽  
pp. 1043
Author(s):  
Italia Di Liegro
Keyword(s):  
Physical Exercise ◽  
Cognitive Processes ◽  
Sedentary Lifestyle ◽  
Research Articles ◽  
Original Research ◽  
Special Issue ◽  
Cell Functions ◽  
Ancient Times ◽  
Epigenetic Modulation ◽  
Molecular Bases

Since ancient times, the importance of physical activity (PA) and of a wholesome diet for human health has been clearly recognized. However, only recently, it has been acknowledged that PA can reverse at least some of the unwanted effects of a sedentary lifestyle, contributing to the treatment of pathologies such as hypertension and diabetes, to the delay of aging and neurodegeneration, and even to the improvement of immunity and cognitive processes. At the same time, the cellular and molecular bases of these effects are beginning to be uncovered. The original research articles and reviews published in this Special Issue on “Genetic and Epigenetic Modulation of Cell Functions by Physical Exercise” focus on different aspects of the genetics and molecular biology of PA effects on health and, in addition, on the effects of different genotypes on the ability to perform PA. All authors have read and agreed to the published version of the manuscript.

scholarly journals Embryo–Maternal Interactions Underlying Reproduction in Mammals

2020 ◽  
Vol 21 (14) ◽  
pp. 4872
Author(s):  
Stefan Bauersachs ◽  
Carmen Almiñana
Keyword(s):  
Current Knowledge ◽  
Mammalian Species ◽  
Stress Factors ◽  
Research Articles ◽  
Future Research ◽  
Original Research ◽  
Special Issue ◽  
New Findings ◽  
As Stress ◽  
The Impact

This Special Issue, “Embryo-Maternal Interactions Underlying Reproduction in Mammals”, gathers a collection of 23 articles, 16 original research articles and 7 up-to-date reviews, providing new findings or summarizing current knowledge on embryo–maternal interactions in seven different mammalian species including humans. Considering the different players involved in these embryo-maternal interactions, articles are mainly focused on one of these different players: the oviduct, the uterus, the embryo or the emergent extracellular vesicles. Additionally, a few articles bring up the impact of reproductive, but also non-reproductive, diseases, as well as stress factors, on the establishment of pregnancy. We hope the readers enjoy this collection of articles and that the knowledge assembled here will support and inspire current and future research investigations. We would like to thank all authors for their contributions to this Special Issue.

scholarly journals Muscle wasting in the critically ill patient: how to minimise subsequent disability

2020 ◽  
Vol 81 (4) ◽  
pp. 1-9
Author(s):  
Luke Flower ◽  
Zudin Puthucheary
Keyword(s):  
Critically Ill ◽  
Psychological Health ◽  
Critically Ill Patients ◽  
Muscle Wasting ◽  
Critically Ill Patient ◽  
Muscle Loss ◽  
Post Discharge ◽  
Mortality And Morbidity ◽  
Muscle Breakdown ◽  
Physical And Psychological Health

Muscle wasting in critically ill patients is the most common complication associated with critical care. It has significant effects on physical and psychological health, mortality and quality of life. It is most severe in the first few days of illness and in the most critically unwell patients, with muscle loss estimated to occur at 2–3% per day. This muscle loss is likely a result of a reduction in protein synthesis relative to muscle breakdown, resulting in altered protein homeostasis. The associated weakness is associated with in an increase in both short- and long-term mortality and morbidity, with these detrimental effects demonstrated up to 5 years post discharge. This article highlights the significant impact that muscle wasting has on critically ill patients' outcomes, how this can be reduced, and how this might change in the future.

scholarly journals Cytomegalovirus infection in non-immunosuppressed critically ill patients

2011 ◽  
Vol 5 (08) ◽  
pp. 571-579 ◽  
Author(s):  
Manisha Jain ◽  
Shalini Duggal ◽  
Tulsi Das Chugh
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Large Population ◽  
Severe Trauma ◽  
Transplant Recipients ◽  
Hematological Disease ◽  
Mortality And Morbidity ◽  
Multiple Organs ◽  
System A ◽  
Immunosuppressed Patients

Cytomegalovirus (CMV) is an important and common cause of mortality and morbidity in immunocompromised patients such as those with HIV/AIDS, transplant recipients on immunosuppressive therapy, and malignant hematological disease. After primary infection with CMV the virus becomes latent in multiple organs and can later be reactivated during severe dysregulation of the immune system. A large population carry dormant virus and are thus at risk for reactivation. However, reactivation of CMV has been reported in "non-immunosuppressed patients" such as severe trauma, sepsis, shock, burns, cirrhosis and other critically ill patients lying in the intensive care units. Therefore, the intensivists are increasingly facing a dilemma of identifying such patients to treat and there is a debate if there is a scientific justification for prophylaxis in such immunocompetent patients.

scholarly journals Multifunctional Nanomaterials: Synthesis, Properties and Applications

2021 ◽  
Vol 22 (21) ◽  
pp. 12073
Author(s):  
Raghvendra Singh Yadav
Keyword(s):  
Research Articles ◽  
Original Research ◽  
Special Issue ◽  
Synthesis Properties ◽  
Nanomaterials Synthesis ◽  
Multifunctional Nanomaterials

In this Special Issue “Multifunctional Nanomaterials: Synthesis, Properties and Applications”, we published three review papers and nine original research articles [...]

Insulin and oral anti-hyperglycaemic agents in critical illness

2016 ◽  
Author(s):  
Roosmarijn T. M. van Hooijdonk ◽  
Marcus J. Schultz
Keyword(s):  
Blood Glucose ◽  
Critical Illness ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Insulin Infusion ◽  
Venous Catheter ◽  
Glycaemic Variability ◽  
Mortality And Morbidity ◽  
Glucose Levels ◽  
Measuring Devices

Dysglycaemia is frequently seen in the intensive care unit (ICU). Hyperglycaemia, hypoglycaemia and glycaemic variability are all independently associated with mortality and morbidity in critically-ill patients. It is common practice to treat hypergycaemia in these patients, while at the same time preventing hypoglycaemia and glycaemic variability. Insulin infusion is preferred over oral anti–hyperglycaemic agents for glucose control in the ICU because of the highly unpredictable biological availability of oral anti-hyperglycaemic agents during critical illness. Many oral anti–hyperglycaemic agents are relatively contraindicated in critically-ill patients. Intravenously-administered insulin has a predictable effect on blood glucose levels, in particular because of its short half-life. Notably, effective and safe insulin titration requires frequent blood glucose measurements, a dedicated lumen of a central venous catheter for infusion of insulin, an accurate syringe pump, and trained nurses for delicate adoptions of the infusion rate. Insulin infusion increases the risk of hypoglycaemia, which should be prevented at all times. In addition, precautions should be taken against overcorrection of hypoglycaemia, using only small amounts of glucose. Whether glycaemic variability can be kept minimal is uncertain. Use of continuous glucose measuring devices has the potential to improve glycaemic control in critically-ill patients.

scholarly journals Novel Aspects of Toxicity Mechanisms of Dioxins and Related Compounds

2020 ◽  
Vol 21 (7) ◽  
pp. 2342 ◽  
Author(s):  
Raimo Pohjanvirta ◽  
Matti Viluksela
Keyword(s):  
Developmental Toxicity ◽  
Environmental Contaminants ◽  
Research Articles ◽  
Original Research ◽  
Special Issue ◽  
Aryl Hydrocarbon ◽  
Low Toxicity ◽  
Toxicity Mechanisms ◽  
Dioxin Toxicity ◽  
Related Compounds

Dioxins and related compounds are common environmental contaminants. Although their levels have gone down, they are still of concern, in particular regarding developmental toxicity. The adverse effects of these compounds are mediated by the aryl hydrocarbon receptor (AHR), whose canonical signaling pathway has been unveiled in fair detail. The alternative (non-genomic) pathways are much more obscure. AHR has also proven to be a master regulator of numerous physiological phenomena, which has led to the search of selective AHR modulators with low toxicity. Papers of this Special Issue address the developmental toxicity of dioxins and related compounds as well as selective modulators of AHR and both its canonical and alternative signaling pathways. In addition, new optical and stereoscopic methods for the detection of dioxins are presented. As a whole, this Special Issue provides an up-to-date view on a wide variety of aspects related to dioxin toxicity mechanisms from both original research articles and reviews.

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