95 research outputs found
Study on lipid fractions of Streptococcus thermophilus by TLC, GC and GC/MS techniques
In this research the lipid fraction of two strains of Streptococcus thermophilus was studied. Lipids were extracted by applying Folch method and fractioned by thin layer chromatography (TLC). Fatty acid composition was determined both before TLC, on the total fat extracted, and after TLC on diacylglycerol and apolar fractions. Gas chromatographic analysis was performed by using both flame ionization (FID) and mass spectrometer (MS) detector. The main difference between the two strains was the presence of short and medium chain fatty acids in food-born S. thermophilus. Moreover one of the most important bacterial fatty acids, C19 cyclopropane, was detected only in diacylglycerols, which, as reported in literature, are formed transiently as intermediates in the biosynthesis of glycerophospholipids
Neurologic outcome of postanoxic refractory status epilepticus after aggressive treatment
OBJECTIVE:
To investigate neurologic outcome of patients with cardiac arrest with refractory status epilepticus (RSE) treated with a standardized aggressive protocol with antiepileptic drugs and anesthetics compared to patients with other EEG patterns.
METHODS:
In the prospective cohort study, 166 consecutive patients with cardiac arrest in coma were stratified according to 4 independent EEG patterns (benign, RSE, generalized periodic discharges [GPDs], malignant nonepileptiform) and multimodal prognostic indicators. Primary outcomes were survival and cerebral performance category (CPC) at 6 months.
RESULTS:
RSE occurred in 36 patients (21.7%) and was treated with an aggressive standardized protocol as long as multimodal prognostic indicators were not unfavorable. RSE started after 3 \ub1 2.3 days after cardiac arrest and lasted 4.7 \ub1 4.3 days. A benign EEG pattern was recorded in 76 patients (45.8%); a periodic pattern (GPDs) was seen in 13 patients (7.8%); and a malignant nonepileptiform EEG pattern was recorded in 41 patients (24.7%). The 4 EEG patterns were highly associated with different prognostic indicators (low-flow time, clinical motor seizures, N20 responses, neuron-specific enolase, neuroimaging). Survival and good neurologic outcome (CPC 1 or 2) at 6 months were 72.4% and 71.1% for benign EEG pattern, 54.3% and 44.4% for RSE, 15.4% and 0% for GPDs, and 2.4% and 0% for malignant nonepileptiform EEG pattern, respectively.
CONCLUSIONS:
Aggressive and prolonged treatment of RSE may be justified in patients with cardiac arrest with favorable multimodal prognostic indicators
The role of the intensive care unit in real-time surveillance of emerging pandemics: The Italian GiViTI experience
Communication and visiting policies in Italian intensive care units during the first COVID-19 pandemic wave and lockdown: a nationwide survey
Background: During the first coronavirus disease 2019 (COVID-19) pandemic wave, an unprecedented number of patients with respiratory failure due to a new, highly contagious virus needed hospitalization and intensive care unit (ICU) admission. The aim of the present study was to describe the communication and visiting policies of Italian intensive care units (ICUs) during the first COVID-19 pandemic wave and national lockdown and compare these data with prepandemic conditions. Methods: A national web-based survey was conducted among 290 Italian hospitals. Each ICU (active between February 24 and May 31, 2020) was encouraged to complete an individual questionnaire inquiring the hospital/ICU structure/organization, communication/visiting habits and the role of clinical psychology prior to, and during the first COVID-19 pandemic wave. Results: Two hundred and nine ICUs from 154 hospitals (53% of the contacted hospitals) completed the survey (202 adult and 7 pediatric ICUs). Among adult ICUs, 60% were dedicated to COVID-19 patients, 21% were dedicated to patients without COVID-19 and 19% were dedicated to both categories (Mixed). A total of 11,102 adult patients were admitted to the participating ICUs during the study period and only approximately 6% of patients received at least one visit. Communication with family members was guaranteed daily through an increased use of electronic devices and was preferentially addressed to the same family member. Compared to the prepandemic period, clinical psychologists supported physicians more often regarding communication with family members. Fewer patients received at least one visit from family members in COVID and mixed-ICUs than in non-COVID ICUs, l (0 [0–6]%, 0 [0–4]% and 11 [2–25]%, respectively, p < 0.001). Habits of pediatric ICUs were less affected by the pandemic. Conclusions: Visiting policies of Italian ICUs dedicated to adult patients were markedly altered during the first COVID-19 wave. Remote communication was widely adopted as a surrogate for family meetings. New strategies to favor a family-centered approach during the current and future pandemics are warranted
ECMO for COVID-19 patients in Europe and Israel
Since March 15th, 2020, 177 centres from Europe and Israel have joined the study, routinely reporting on the ECMO support they provide to COVID-19 patients. The mean annual number of cases treated with ECMO in the participating centres before the pandemic (2019) was 55. The number of COVID-19 patients has increased rapidly each week reaching 1531 treated patients as of September 14th. The greatest number of cases has been reported from France (n = 385), UK (n = 193), Germany (n = 176), Spain (n = 166), and Italy (n = 136) .The mean age of treated patients was 52.6 years (range 16–80), 79% were male. The ECMO configuration used was VV in 91% of cases, VA in 5% and other in 4%. The mean PaO2 before ECMO implantation was 65 mmHg. The mean duration of ECMO support thus far has been 18 days and the mean ICU length of stay of these patients was 33 days. As of the 14th September, overall 841 patients have been weaned from ECMO
support, 601 died during ECMO support, 71 died after withdrawal of ECMO, 79 are still receiving ECMO support and for 10 patients status n.a. . Our preliminary data suggest that patients placed
on ECMO with severe refractory respiratory or cardiac failure secondary to COVID-19 have a reasonable (55%) chance of survival. Further extensive data analysis is expected to provide invaluable information on the demographics, severity of illness, indications and different ECMO management strategies in these patients
Echocardiography for adult patients supported with extracorporeal membrane oxygenation
Valutazione del reclutamento alveolare mediante analisi della curva pressione-volume del sistema respiratorio
Uso della saturazione venosa mista (SvO2) e della saturazione capillare percutanea (Sap) per la determinazione del livello di PEEP
Goat\u2019s and sheep\u2019s milk fat : characterization of triglycerides by Ag+SPE/GC/MS
Multimodal neurological approach can lead the treatment in postcardiac arrest persistent refractory status epilepticus
Refractory status epilepticus (RSE) is a common challenge in the setting of post resuscitation care. We describe how multimodal neurological approach can lead treatment and improve the prognosis. We report on three survivors of cardiac arrest (CA) who had good neurological outcomes after mild hypothermia (TH), despite exhibiting persisting RSE requiring treatment with several antiepileptic (AED) and anesthetic drugs, including barbiturate-induced coma. No evidence-based data exist to guide management of RSE in the setting of anoxic brain injury. Our cases emphasize the need for continuous active treatment led by a multimodal approach in order to improve neurological outcome
- …