Post-Intensive Care Syndrome: Recognizing the Critical Need for Psychiatric Care

Post-intensive care syndrome (PICS) is a rapidly growing phenomenon in older adults. As survival rates from ICU hospitalizations have increased over the past few decades, the long-term cognitive, psychological, and physical sequelae of the illness have become a major challenge in critical care medicine. More than half of all ICU survivors suffer from at least one PICS-related impairment, and these effects can persist as long as 5 or more years

Nutritional management of chronic renal failure by dietitians - the South African experience

Objective: The objective of this descriptive study was to assess the practices of South African dietitians regarding the dietary treatment of patients with chronic renal failure.Subjects and design: A questionnaire was mailed to 600 randomly selected dietitians registered with the Health Professions Council of South Africa. Practices were compared to international standards for pre-dialysis, haemodialysis (HD) and peritoneal dialysis (PD) patients.Results: A 26% response rate was obtained, with only 28% of these dietitians indicating that they counsel renal patients. The majority of dietitians met the international dietary recommendations, but a substantial number deviated from them. This was especially evident in PD patients, where the deviation ranged from 20% (4 dietitians) in the case of energy and phosphate, to 55% (11 dietitians) in the case of calcium. Parameters used for the assessment of nutritional status included body mass index (45% of dietitians), serum albumin (44%), clinical examinations (43%), bioelectrical impedance (37%) and diet history (36%). Methods used to monitor dietary compliance included biochemistry, dietary history, anthropometric measurements and clinical investigation. The most frequently used approaches in the management of protein-energy malnutrition included supplemental drinks (86%) and dietary enrichment at household level (76%).Conclusion: Although the majority of dietitians met international standards for most nutrients, there was some variation and uncertainty. Ongoing education will enable South African dietitians to treat renal patients competently and with confidence.South African Journal of Clinical Nutrition Vol. 18(2) 2005: 60-6

Bacterial colony counting could be rapid, adaptive and automated

© 2022 PECS.Although many attempts have been made to automate bacterial colony counting, little has tackled the counting of clustered colonies and adaptations to handle different bacteria species. In this work, we explore the counting by density estimation method via few-shot learning. We have avoided the difficult localisation and detection of clustered colonies by estimating a density map from the input image. We have also exploited exemplars provided by users to make the method agnostic and adaptive to different bacteria species. Our experiments show that using the counting by density estimation method via few-shot learning results in a promising accuracy from the data set provided by Synoptics Ltd.Peer reviewe

2-(1H-Benzotriazol-1-yl)-1-(2-chloro­benzo­yl)ethyl 4-methyl­benzoate

In the mol­ecule of the title compound, C23H18ClN3O3, the essentially planar benzotriazole ring makes dihedral angles of 52.93 (1) and 85.21 (1)°, respectively, with the chloro­phenyl and tolyl rings. The crystal packing is stabilized by π–π [centroid-to-centroid distance 3.830 (2) Å, interplanar distance 3.705 Å, slippage 0.968 Å]; C—H⋯π⋯tolyl ring inter­actions are also present

Aging and Post-Intensive Care Syndrome (PICS): A Critical Need for Geriatric Psychiatry

Due to the aging of the intensive care unit (ICU) population and an improvement in survival rates after ICU hospitalization, an increasing number of older adults are suffering from long-term impairments due to critical illness, known as post-intensive care syndrome (PICS). This paper focuses on PICS-related cognitive, psychological, and physical impairments, and the impact of ICU hospitalization on families and caregivers. The authors also describe innovative models of care for PICS, and what roles geriatric psychiatrists could play in the future of this rapidly growing population

TGF-beta 1 induces human alveolar epithelial to mesenchymal cell transition (EMT)

Background: Fibroblastic foci are characteristic features in lung parenchyma of patients with idiopathic pulmonary fibrosis (IPF). They comprise aggregates of mesenchymal cells which underlie sites of unresolved epithelial injury and are associated with progression of fibrosis. However, the cellular origins of these mesenchymal phenotypes remain unclear. We examined whether the potent fibrogenic cytokine TGF-β1 could induce epithelial mesenchymal transition (EMT) in the human alveolar epithelial cell line, A549, and investigated the signaling pathway of TGF-β1-mediated EMT. Methods: A549 cells were examined for evidence of EMT after treatment with TGF-β1. EMT was assessed by: morphology under phase-contrast microscopy; Western analysis of cell lysates for expression of mesenchymal phenotypic markers including fibronectin EDA (Fn-EDA), and expression of epithelial phenotypic markers including E-cadherin (E-cad). Markers of fibrogenesis, including collagens and connective tissue growth factor (CTGF) were also evaluated by measuring mRNA level using RT-PCR, and protein by immunofluorescence or Western blotting. Signaling pathways for EMT were characterized by Western analysis of cell lysates using monoclonal antibodies to detect phosphorylated Erk1/2 and Smad2 after TGF-β1 treatment in the presence or absence of MEK inhibitors. The role of Smad2 in TGF-β1-mediated EMT was investigated using siRNA. Results: The data showed that TGF-β1, but not TNF-α or IL-1β, induced A549 cells with an alveolar epithelial type II cell phenotype to undergo EMT in a time-and concentration-dependent manner. The process of EMT was accompanied by morphological alteration and expression of the fibroblast phenotypic markers Fn-EDA and vimentin, concomitant with a downregulation of the epithelial phenotype marker E-cad. Furthermore, cells that had undergone EMT showed enhanced expression of markers of fibrogenesis including collagens type I and III and CTGF. MMP-2 expression was also evidenced. TGF-β1-induced EMT occurred through phosphorylation of Smad2 and was inhibited by Smad2 gene silencing; MEK inhibitors failed to attenuate either EMT-associated Smad2 phosphorylation or the observed phenotypic changes. Conclusion: Our study shows that TGF-β1 induces A549 alveolar epithelial cells to undergo EMT via Smad2 activation. Our data support the concept of EMT in lung epithelial cells, and suggest the need for further studies to investigate the phenomenon

Di-μ-chlorido-bis­[chlorido(N,N-di­methyl­ethylenediamine-κ2 N,N′)zinc(II)]

The centrosymmetric dinuclear title compound, [Zn2Cl4(C4H12N2)2], is isostructural with its previously reported CuII analogue [Phelps, Goodman & Hodgson (1976 ▶). Inorg. Chem. 15, 2266–2270]. In the title compound, each of the ZnII ions is coordinated by two N atoms from a chelating N,N-dimethyl­ethylenediamine ligand, two bridging Cl atoms and one terminal Cl atom. The coordination environment is distorted square-pyramidal. The Zn—Cl bond distances of the two bridging Cl atoms are distinctly different: the equatorial Cl atom exbibits a Zn—Cl distance of 2.318 (1) Å and the axial Cl atom exbibits a Zn—Cl distance of 2.747 (2) Å, which is significantly longer. The mol­ecule can thus be seen as a dimer of two nearly square-planar monomeric units which are related to each other by an inversion center located in the middle of the dimer. Within one monomeric unit, the Zn atom, the two N atoms and the two Cl atoms are almost coplanar, with a mean deviation of only 0.05 (1) Å from the associated least-squares plane. The Zn⋯Zn distance within the dimer is 3.472 (3) Å. N—H⋯Cl and C—H⋯Cl hydrogen-bond inter­actions connect neighboring mol­ecules with each other

2-[2-(4-Nitro­phenyl)hy­dra­zin­yl­idene]malononitrile

The title compound, C10H8N8, is close to planar (r.m.s. deviation from the mean plane = 0.118 Å). In the crystal, inversion dimers linked by pairs of N—H⋯N hydrogen bonds generate R 2 2(12) loops