Mitochondrial Homeostasis and Cellular Senescence

Cellular senescence refers to a stress response aiming to preserve cellular and, therefore, organismal homeostasis. Importantly, deregulation of mitochondrial homeostatic mechanisms, manifested as impaired mitochondrial biogenesis, metabolism and dynamics, has emerged as a hallmark of cellular senescence. On the other hand, impaired mitostasis has been suggested to induce cellular senescence. This review aims to provide an overview of homeostatic mechanisms operating within mitochondria and a comprehensive insight into the interplay between cellular senescence and mitochondrial dysfunction

Is prolonged infusion of piperacillin/tazobactam and meropenem in critically ill patients associated with improved pharmacokinetic/pharmacodynamic and patient outcomes? An observation from the Defining Antibiotic Levels in Intensive care unit patients (DALI) cohort

Objectives:We utilized the database of the Defining Antibiotic Levels in Intensive care unit patients (DALI) study to statistically compare the pharmacokinetic/pharmacodynamic and clinical outcomes between prolonged-infusion and intermittent-bolus dosing of piperacillin/tazobactam and meropenem in critically ill patients using inclusion criteria similar to those used in previous prospective studies.Methods: This was a post hoc analysis of a prospective, multicentre pharmacokinetic point-prevalence study (DALI), which recruited a large cohort of critically ill patients from 68 ICUs across 10 countries.Results: Of the 211 patients receiving piperacillin/tazobactam and meropenem in the DALI study, 182 met inclusion criteria. Overall, 89.0% (162/182) of patients achieved the most conservative target of 50% fT(> MIC) (time over which unbound or free drug concentration remains above the MIC). Decreasing creatinine clearance and the use of prolonged infusion significantly increased the PTA for most pharmacokinetic/pharmacodynamic targets. In the subgroup of patients who had respiratory infection, patients receiving beta-lactams via prolonged infusion demonstrated significantly better 30 day survival when compared with intermittent-bolus patients [86.2% (25/29) versus 56.7% (17/30); P=0.012]. Additionally, in patients with a SOFA score of >= 9, administration by prolonged infusion compared with intermittent-bolus dosing demonstrated significantly better clinical cure [73.3% (11/15) versus 35.0% (7/20); P=0.035] and survival rates [73.3% (11/15) versus 25.0% (5/20); P=0.025].Conclusions: Analysis of this large dataset has provided additional data on the niche benefits of administration of piperacillin/tazobactam and meropenem by prolonged infusion in critically ill patients, particularly for patients with respiratory infections

Reference values and prediction equations for FVC and FEV1 in the Greek elderly

Spirometry prediction equations obtained from middle-age adults, when extrapolated for the elderly, may lead to inaccurate interpretations. The purpose of this study was to determine prediction equations for forced vital capacity (FVC) and forced expiratory volume (FEV1) in the Greek elderly population. Spirometry prediction equations for normal FVC and FEV1 have been derived from tests on 71 healthy persons (38 men, 33 women) aged older than 60 years (range, 65-85 years), nonsmokers, white race, urban population using techniques and equipment that meet American Thoracic Society recommendations. Regression analysis using age, height, and weight as independent variables was used to provide prediction equations and values for both sexes. The FVC age coefficient in this healthy group was about 47.19 mL/y for elderly men and 34.27 mL/y for elderly women, and the FEV1 age coefficient was about 52.8 mL/y for elderly men and 46.4 mL/y for elderly women. Values from this study predicted equations were compared with those from some of the most commonly used sources of spirometry predicted equations. The FVC and FEV1 predicted values were found to be of less mean square error than that of other compared studies. Higher correlation is between FVC and FEV1 predicted values by the present model and FVC and FEV1 observed Values in both sexes. The higher correlation between FVC and FEV1 predicted and observed from this study allows the use of our model for predicting in a rather reliable way the FVC and FEV1 for elderly Creek individuals

Validity of St. George's respiratory questionnaire for greek patients with chronic obstructive pulmonary disease

The purpose of the present study was to examine the validity of St. George's Respiratory Questionnaire (SGRQ), a disease-specific survey of health-related quality of life, in adult Greek patients with chronic obstructive pulmonary disease (COPD). Questionnaire scores, dyspnea scores, spirometry values, and demographic data were collected from 72 patients with a diagnosis of COPD exacerbation. Follow-up visits were performed at 1-mo. intervals for the first 3 mo. after discharge and a final visit was performed 6 mo. after discharge. 27 (37.5%) patients were readmitted during the follow-up period. Recovery after exacerbation was prolonged and questionnaire scores were sensitive to the patients' health-status changes across time. The SGRQ discriminated COPD patients according to disease stage, and the SGRQ scores during the recovery course were related to readmission. Correlations between the SGRQ and %FEV1 were not significant during exacerbation but a significant negative correlation was observed during the stable phase of the disease. The SGRQ appeared to have acceptable discriminant and concurrent validities in Greek COPD patients who differed according to their exacerbation stage. © Perceptual and Motor Skills 2010

Investigation of the impact of extracting and exchanging health information by using internet and social networks

Introduction: Social networks (1) have been embedded in our daily life for a long time. They constitute a powerful tool used nowadays for both searching and exchanging information on different issues by using Internet searching engines (Google, Bing, etc.) and Social Networks (Facebook, Twitter etc.). In this paper, are presented the results of a research based on the frequency and the type of the usage of the Internet and the Social Networks by the general public and the health professionals. Objectives: The objectives of the research were focused on the investigation of the frequency of seeking and meticulously searching for health information in the social media by both individuals and health practitioners. The exchanging of information is a procedure that involves the issues of reliability and quality of information. Methods: In this research, by using advanced statistical techniques an effort is made to investigate the participant's profile in using social networks for searching and exchanging information on health issues. Results: Based on the answers 93 % of the people, use the Internet to find information on health-subjects. Considering principal component analysis, the most important health subjects were nutrition (0.719 %), respiratory issues (0.79 %), cardiological issues (0.777%), psychological issues (0.667%) and total (73.8%). Conclusions: The research results, based on different statistical techniques revealed that the 61.2% of the males and 56.4% of the females intended to use the social networks for searching medical information. Based on the principal components analysis, the most important sources that the participants mentioned, were the use of the Internet and social networks for exchanging information on health issues. These sources proved to be of paramount importance to the participants of the study. The same holds for nursing, medical and administrative staff in hospitals. © 2016 John Pistolis, Stelios Zimeras, Kostas Chardalias, Zoe Roupa, George Fildisis, and Marianna Diomidous

Ovarian hyperstimulation syndrome (OHSS): diagnosis and management

Objective: To present our experience and the current knowledge about pathophysiology, diagnosis, and management of the ovarian hyperstimulation syndrome (OHSS). Design: Retrospective study concerning clinical and laboratory findings of severe OHSS. Setting: General ICU at a maternity-surgical hospital. Patients: Ten patients suffering from severe OHSS. Interventions: Supportive and preventive therapeutic measures applied are described. Measurements and results: Admission and discharge data as well as worst values during disease course were recorded. Clinical and laboratory findings showed third space fluid shift leading to weight gain, generalized tissue edema, ascites, hydrothorax, abdominal distension and pain, chest discomfort, hypovolemia, dehydration, ovaries enlargement, electrolyte disturbances, hypoalbuminemia, high hematocrit, urea, and WBC. Conclusions: OHSS is an iatrogenic complication of assisted conception of unknown pathogenesis, with potentially life-threatening sequelae due to hemoconcentration such as circulatory shock, ARDS, hepatorenal failure, thromboembolic phenomena, and multi-organ dysfunction syndrome. Gynecologists and intensivists must be aware of the diagnosis and management of the syndrome because of the widely used reproductive techniques for assisted conception

Cross-transmission of multidrug-resistant Acinetobacter baumannii clonal strains causing episodes of sepsis in a trauma intensive care unit

OBJECTIVE. To investigate the mode of transmission of imipenem-resistant Acinetobacter baumannii strains causing episodes of sepsis. SETTING. A 7-bed trauma intensive care unit (ICU) in an orthopedic hospital in Greece. DESIGN. During a 14-week period (from January 10 to April 16, 2006), clinical specimens, along with samples taken on a weekly basis from the ICU environment and from the hands of health care workers (HCWs), were prospectively tested for imipenem-resistant A. baumannii. Pulsed-field gel electrophoresis was used to study the genetic relatedness of the isolates recovered from these specimens and samples. RESULTS. During the survey, imipenem-resistant A. baumannii was identified in 14 hospitalized patients, from whom 40 multidrug-resistant and imipenem-resistant A. baumanii isolates were recovered. These pathogens caused episodes of bacteremia and sepsis in all but one of the patients and contributed to the death of 3 patients. Samples for culture were obtained from the environment and from the hands of HCWs; 29 imipenem-resistant A. baumannii isolates were recovered from the environment, and 12 from HCWs. One predominant genotype and 2 less predominant genotypes were detected among the 81 imipenem-resistant A. baumannii isolates. All 3 of these genotypes were found among patients and HCWs and were recovered from environmental samples. INTERVENTIONS. Control measures consisted of the closure of the ICU and the transfer of the patients to other units. The ICU was disinfected, and adherence to proper hand hygiene protocol was reinforced. These same clonal isolates were not recovered from clinical or environmental samples during the month after the reopening of the ICU. CONCLUSIONS. The extensive dissemination of imipenem-resistant A. baumannii clonal strains causing episodes of bacteremia and/or sepsis resulted from modes of transmission via multiple contaminated surfaces and objects and transiently colonized HCWs' hands. Closure of the ICU and its meticulous environmental decontamination led to the successful control of the outbreak. © 2008 by The Society for Healthcare Epidemiology of America. All rights reserved