Can fuzzy logic make things more clear?

Intensive care is a complex environment involving many signals, data and observations. Clinical decision support and artificial intelligence using fuzzy logic and closed loop techniques are methods that might help us to handle this complexity in a safe, effective and efficient way. Merouani and colleagues have performed a study using fuzzy logic and closed loop techniques to more effectively wean patients with sepsis from norepinephrine infusion

Levels of protein C and activated protein C: what do they mean?

Acute pancreatitis is a local inflammatory process that leads to a systemic inflammatory response in the majority of cases, and sometimes leads to multiple organ failure. It is obvious that coagulation and especially the protein C system are involved in this disease. The present commentary is related to a study in patients with pancreatitis with and without multiple organ failure in which protein C and activated protein C levels were studied. The protein C system and other studies analyzing (activated) protein C levels are discussed

Septic Shock with Purpura in Children: an experimental and clinical approach

Septic shock with purpura is a rapidly evolving clinical picture characterized by sepsis (tachycardia, tachypnea, fever), shock (hypotension or signs of end-organ failure) and a spectrum of coagulation disorders (ranging from petechiae, purpura to ecchymoses). It is mainly (80 %) caused by N. meningitidis (group A, B or C). However, occasionally other micro-organisms such as Haemophilus influenzae, Haemophilus aegyptius, Streptococcus group A, group B streptococcus, streptococcus pneumoniae, Staphylococcus aureus, Pseudomonas species and Capnocytophagus canimorsus can be detected as a causative agent. Even viruses can under certain conditions cause a comparable clinical picture. Approximately 80 % of the patients is below the age of 18 years, and 50 % below the age of 5 years. The development of the disease in older patients is partly due to the presence of a deficiency in the immune system (complement deficiency, spleen extirpation, diabetes mellitus). The occurrence in children is related to the absence of antibodies, although it is assumed that these children are healthy except for an agerelated immaturity oftheir immune system. The mortality ranges from 15 - 40 %, depending on the selection of the patients

Bench-to-bedside review: genetic influences on meningococcal disease

This review discusses the possible involvement of a variety of genetic polymorphisms on the course of meningococcal disease. It has been shown that several common genetic polymorphisms can either influence the susceptibility to meningococcal disease or can account for a higher mortality rate in patients. Gene polymorphisms concerning antibody receptors, lipopolysaccharide (LPS) binding receptors or proteins, innate complement proteins as well as cytokines and hemostatic proteins are described. The study of genetic polymorphisms might provide important insights in the pathogenesis of meningococcal disease and could make it possible to identify individuals who are at risk of either contracting or dying from meningococcal disease

A patient perspective on information provision during the care path of Lentigo Maligna

Patients sometimes experience complex diagnostic and treatment procedures. During these processes, they need to rely on the information provided by the care providers. In particular, if they would like to play an active role in the shared decision-making process, it is important that this information is accessible, complete and understandable. A patient with Lentigo Maligna on the nose has been followed during the process of diagnosis, shared decision-making and treatment. Using the autoethnographical methodology, it was evaluated which sources of information available to the patient contributed to a better understanding, a more active role in the treatment process and a positive experience. Possible improvements are suggested. Experience Framework This article is associated with the Quality & Clinical Excellence lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens