Infections and Multidrug-Resistant Pathogens in ICU Patients

This chapter aims to highlight the main types of infections in the ICU, in order to improve diagnostic and therapeutic management. Risk factors for patients hospitalised in the ICU will be raised: the increasing use of invasive devices and procedures, aggressive antimicrobial therapies, surgical interventions, immunosuppressive treatments or co-morbidities responsible for immune deficiencies. Starting from the rising mortality risk among patients with hospital-acquired infections (HAI), in the case of failure to control the pathogen in the first 24–48 h, we will tackle about the prevention, reduction and control of the emergence of resistant pathogens. The rational administration of antibiotics will also be addressed, with the aim of reducing adverse reactions, including secondary infections, decreasing the mortality rate, length of hospital stay and costs of health care

Fossil CO2 and GHG emissions of all world countries

The Paris Agreement plans global stocktakes, to which the UNFCCC GHG emission inventories are the primary input. To complete this picture, the Emissions Database for Global Atmospheric Research provides for all world countries emission timeseries from 1970 until 2016 for CO2 and until 2012 for the other GHGs.JRC.C.5-Air and Climat

Impact evaluation of biomass used in small combustion activities sector on air emissions: Analyses of emissions from Alpine, Adriatic-Ionian and Danube EU macro-regions by using the EDGAR emissions inventory

The emissions from small stationary combustion activities sector, in particular from the energy needs for residential buildings, have significant shares in total emissions of EU28. Therefore, measures to mitigate the emissions from this less regulated sector related to implementation checking are needed. In this study, we analysed the changes in fuel mix for this sector over 1990-2012 period, the emissions and their distribution over the areas covered by European Union Strategy for Alpine macro-region (EUSALP), European Union Strategy for Adriatic and Ionian macro-region (EUSAIR) and European Union Strategy for Danube macro-region (EUSDR). The emissions gridmaps of fine particulate matter (PM2.5), black carbon (BC) and benzo(a)pyren (BaP) are presented for the year 2010; in specific circumstances, these pollutants are known to produce negative effects on health. For this research, we used the data and information of the Emissions Database for Global Atmospheric Research (EDGAR) versions v4.3.2 and v4.tox3. Accurate emissions estimates are important to evaluate the impacts of fuel combustion in small stationary combustion activities sector on air quality, human health and crops. Inventories of GHGs, air pollutants and toxic pollutants included in EDGAR are developed by using, as input, fuel consumption from IEA (2014) and emissions factors from scientific literature and official guidebooks such as EMEP/EEA (2013). Working together with emissions inventory experts from selected countries in these macro-regions, the effects of improvements of fuel consumption statistics, biomass in particular, on emissions in the latest years have been quantified by comparing EDGAR data with national data. Besides sectorial emissions estimation, the emissions distribution is also important in the inventory development process. In order to distribute emissions consistently for all countries included in Alpine, Adriatic-Ionian and Danube macro-regions, the EDGAR team upgraded the WEB-based gridding tool with a module for small stationary combustion activities. Emissions estimation and distribution are key elements in preparing a complete input for chemical transport models and further evaluate the impacts of these emissions on air quality, health and crops. This report aims to provide the policy makers and scientists insights on the representativeness and uncertainty of local emissions from the residential sector that play an important role on air quality. These datasets can be used as input for the atmospheric chemical transport models for air pollutants and can illustrate the importance of emission inventory uncertainties and discrepancies.JRC.C.5-Air and Climat

Climate change in a changing world: Socio-economic and technological transitions, regulatory frameworks and trends on global greenhouse gas emissions from EDGAR v.5.0

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Fossil CO2 emissions of all world countries - 2018 Report

The Emissions Database for Global Atmospheric Research provides time series of CO2 emissions for all world countries from 1970 until 2017. In this report, fossil CO2 emissions are presented for the period 1990-2017 as well as the per capita and per GDP trends.JRC.C.5-Air and Climat

Possible algorithms for determining adverse reactions caused by food supplements in Romania

George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, Romania, Richter Pharmacy no 7, Cluj-Napoca, RomaniaIntroduction. The advertising of food supplements on various media channels or in specialty stores with natural products and other stores, as well as the lack of informative and educational programs for the population on side effects and the interaction of food supplements with food and drugs, have led to the development of uncontrolled marketing of these products. Through this paper we want to present the algorithms that can be applied to determine the side effects caused by food supplements in Romania, the need to initiate a legislative project on reporting these side effects and educating the population on the consumption of food supplements. Material and methods. PubMed, ResearchGate and EUR-Lex databases (online portal providing access to EU legislation) were analyzed between 2015-2021, based on search criteria: adverse reactions, ingredient new food, food supplements, algorithms. Results. Dietary supplements concentrated sources of nutrients or other substances with a beneficial nutritional or physiological effect intended to supplement a normal diet. They can be sold as capsules, dragees, tablets, sachets or in bottles. Certain dietary supplements can cause multiple side effects, such as: impaired platelet function by decreased platelet aggregation, gastrointestinal side effects (diarrhea, vomiting), decreased wound healing/epithelialization, bacterial or fungal sepsis, most common in patients older. Probiotics that can cause human sepsis, generally in elderly patients and those suffering from chronic diseases, are Lactobacilli (strains of L. rhamnosis, due to its high translocation potential), Lactobacillus sp. bacteremia which is sometimes fatal, infectious endocarditis caused by L. rhamnosus, L. casei, L. acidophilus, L. jensenii, L. plantarum and L. paracasei. They can cause anaphylactic response in patients who have undergone cardiovascular surgery or localized infection in diabetes associated with old age and liver transplantation. Side effects have also been found with mineral supplements, omega 3 / fish oil, soy protein, soy protein, plant nutrients, antioxidants, anti-inflammatory, supplements for weight loss or bodybuilding, various botanical supplements. Multi-skeletal distortion, fatigue, pain and gastrointestinal symptoms and hepatic adverse events have been reported with the nutraceutical ingredient RYR (red rice yeast) at the doses recommended by EFSA (European Food Safety Authority). With the exception of "classic" foods (hazelnuts, nuts, eggs, etc.) known to cause certain side effects such as allergies, the development of the food industry has led to the emergence of foods eaten especially by teenagers, such as energy drinks. Frequent consumption of this type of drink was significantly associated with asthma, allergic rhinitis and atopic dermatitis, high stress, lack of sleep, poor school performance and suicide attempts in Korean adolescents. Conclusions. It is imperative to legislate the reporting of adverse reactions caused by food supplements, including their interaction with food or medicine. The veracity of the practical applicability of the legislation and the existence of an educational program of the population, make this action not to become null and void. Using the algorithms applied to analyze the severity - causality of adverse reactions caused by drugs, in Romania, nutrivigilence can be implemented for the health and safety of the population

Algoritmi posibili pentru determinarea reacțiilor adverse cauzate de suplimentele alimentare în România

Introduction. The advertising of food supplements on various media channels or in specialty stores with natural products and other places, as well as the lack of informative and educational programs for the population upon side effects and the interaction of food supplements with food and drugs, have led to the development of uncontrolled marketing of these products. Material and methods. PubMed, ResearchGate and EUR-Lex databases were analyzed during 2015-2021, based on search criteria based on: adverse reactions, ingredient new food, food supplements, algorithms. Results. Certain dietary supplements can cause multiple side effects, such as: impaired platelet function by decreased platelet aggregation, gastrointestinal side effects (diarrhea, vomiting), decreased wound healing/epithelialization, bacterial or fungal sepsis, most common in patients older. Herbal resources such as Aloe vera, Matricaria recutita, Taraxacum officinale and others, can cause dermatological side effects and inhibit the elimination of dermatological drugs metabolised by cytochrome P-450 (e.g. terbinafine). Matricaria recutita, Allium sativum, Mentha piperita L. and others, inhibit the enzyme CYP2C9. Another enzyme with a role in the metabolism of dermatological drugs and which is inhibited by plant resources is CYP3A4. Conclusions. It is imperative to legislate the reporting of adverse reactions caused by food supplements, including their interaction with food or drugs.Introducere. Promovarea suplimentelor alimentare în diverse surse media sau de către unele magazine, în special de cele specializate în comercializarea produselor naturale, precum și lipsa programelor informative și educaționale pentru populație cu privire la efectele secundare și interacțiunea suplimentelor alimentare cu alimentele și medicamentele, au dus la dezvoltarea comercializării necontrolate a acestor produse. Material si metode. Bazele de date PubMed, Research Gate și EUR-Lex au fost analizate în perioada 2015-2021, pe baza criteriilor de căutare: reacții adverse, ingrediente alimentare noi, suplimente alimentare, algoritmi. Rezultate. Anumite suplimente alimentare pot provoca efecte secundare multiple, cum ar fi: afectarea funcției trombocitelor prin scăderea agregării plachetare, efecte secundare gastrointestinale (diaree, vărsături), scăderea vindecării/epitelizării rănilor, sepsis bacterian sau fungic, atestate cel mai frecvent la pacienții cu vârstă înaintată. Resursele vegetale precum Aloe vera, Matricaria recutita, Taraxacum officinale și altele, pot provoca reacții adverse dermatologice și inhiba eliminarea medicamentelor dermatologice metabolizate de citocromul P-450 (de exemplu terbinafină). Matricaria recutita, Allium sativum, Mentha piperita L. și altele, inhibă enzima CYP2C9. O altă enzimă cu rol în metabolismul medicamentelor dermatologice și care este inhibată de resursele vegetale este CYP3A4. Concluzii. Este imperativ să se reglementeze raportarea reacțiilor adverse cauzate de suplimentele alimentare, inclusiv interacțiunea acestora cu alimentele sau medicamentele