7 research outputs found
Acute intestinal failure: international multicenter point-of-prevalence study
Background & aims: Intestinal failure (IF) is defined from a requirement or intravenous supplementation due to failing capacity to absorb nutrients and fluids. Acute IF is an acute, potentially reversible form of IF. We aimed to identify the prevalence, underlying causes and outcomes of acute IF. Methods: This point-of-prevalence study included all adult patients hospitalized in acute care hospitals and receiving parenteral nutrition (PN) on a study day. The reason for PN and the mechanism of IF (if present) were documented by local investigators and reviewed by an expert panel. Results: Twenty-three hospitals (19 university, 4 regional) with a total capacity of 16,356 acute care beds and 1237 intensive care unit (ICU) beds participated in this study. On the study day, 338 patients received PN (21 patients/1000 acute care beds) and 206 (13/1000) were categorized as acute IF. The categorization of reason for PN was revised in 64 cases (18.9% of total) in consensus between the expert panel and investigators. Hospital mortality of all study patients was 21.5%; the median hospital stay was 36 days. Patients with acute IF had a hospital mortality of 20.5% and median hospital stay of 38 days (P > 0.05 for both outcomes). Disordered gut motility (e.g. ileus) was the most common mechanism of acute IF, and 71.5% of patients with acute IF had undergone abdominal surgery. Duration of PN of ≥42 days was identified as being the best cut-off predicting hospital mortality within 90 days. PN ≥ 42 days, age, sepsis and ICU admission were independently associated with 90-day hospital mortality. Conclusions: Around 2% of adult patients in acute care hospitals received PN, 60% of them due to acute IF. High 90-day hospital mortality and long hospital stay were observed in patients receiving PN, whereas presence of acute IF did not additionally influence these outcomes. Duration of PN was associated with increased 90-day hospital mortality
BiTiB \ue8 un\u2019emanazione del Gruppo Thyplo & Tactus, che da 7 anni organizza il primo Concorso Europeo di letteratura adattata, nato per stimolare la creazione, la ricerca e la produzione di bozze di libri e album tattili illustrati per bambini con disabilit\ue0 visiva dai 5 anni in poi. Le bozze risultate vincenti vengono pubblicate fruendo dei finanziamenti della Comunit\ue0 Economica Europea, giungendo quindi ai bambini ad un prezzo accessibile.
La consapevolezza delle esigenze e delle carenze dei libri tattili per bambini ciechi e ipovedenti ha portato, nel luglio del 2007, alla nascita in Francia del gruppo di lavoro , formato da: Anneke Blok (Nederland), Nathalie Caffier (France), Roberta Caldin (Italia), Philippe Claudet (France), Louise Comtois (Qc, Canada), Alessandro Fanan (Italia), Paul Giovanetti (France), Evelyne Justin-Joseph (France), Claudette Kraemer (France), Jos\ue9e Lanners (Italia), Enrica Polato (Italia), Patricia Richard (France), Joanne Thibaudeau (QcCanada), Jana Vachulova (Cz. Republic), Pietro Vecchiarelli (Italia).
BiTiB \ue8 un\u2019emanazione del Gruppo Thyplo & Tactus, che da 7 anni organizza il primo Concorso Europeo di letteratura adattata, nato per stimolare la creazione, la ricerca e la produzione di bozze di libri e album tattili illustrati per bambini con disabilit\ue0 visiva dai 5 anni in poi. Le bozze risultate vincenti vengono pubblicate fruendo dei finanziamenti della Comunit\ue0 Economica Europea, giungendo quindi ai bambini ad un prezzo accessibile.
La composizione di BiTiB \ue8 quanto mai varia e, al contempo, funzionale al compito che il gruppo si \ue8 prefisso: i membri sono esperti riabilitatori, docenti universitari ed editori di libri tattili.
Il gruppo ha sin da subito assunto il compito di affrontare la tematica della lettura di albi illustrati in et\ue0 prescolare nella sua complessit\ue0 partendo dall\u2019approfondimento teorico sull\u2019alfabetizzazione emergente, per trattare poi la tematica delle illustrazioni tattili efficaci ed arrivando infine ai problemi legati alla stampa di testo ed illustrazioni tattili ed ai finanziamenti necessari per la produzione.
Si veda:
http://www.libritattili.prociechi.it/lt/index.php?module=documents&JAS_DocumentManager_op=downloadFile&JAS_File_id=3
BiTiB \ue8 un\u2019emanazione del Gruppo Thyplo & Tactus, che dal 2000organizza il primo Concorso Europeo di letteratura adattata, nato per stimolare la creazione, la ricerca e la produzione di bozze di libri e album tattili illustrati per bambini con disabilit\ue0 visiva ora anche dagli 0 ai 5 anni e dai 5 anni in poi. Le bozze risultate vincenti vengono pubblicate fruendo dei finanziamenti della Comunit\ue0 Economica Europea, giungendo quindi ai bambini ad un prezzo accessibile.
La consapevolezza delle esigenze e delle carenze dei libri tattili per bambini ciechi e ipovedenti ha portato, nel luglio del 2007, alla nascita in Francia del gruppo di lavoro , formato da: Anneke Blok (Nederland), Nathalie Caffier (France), Roberta Caldin (Italia), Philippe Claudet (France), Louise Comtois (Qc, Canada), Alessandro Fanan (Italia), Paul Giovanetti (France), Evelyne Justin-Joseph (France), Claudette Kraemer (France), Jos\ue9e Lanners (Italia), Enrica Polato (Italia), Patricia Richard (France), Joanne Thibaudeau (QcCanada), Jana Vachulova (Cz. Republic), Pietro Vecchiarelli (Italia).
BiTiB \ue8 un\u2019emanazione del Gruppo Thyplo & Tactus, che dal 2000 organizza il primo Concorso Europeo di letteratura adattata, nato per stimolare la creazione, la ricerca e la produzione di bozze di libri e album tattili illustrati per bambini con disabilit\ue0 visiva ora dagli 0 ai 5 anni e dai 5 anni in poi. Le bozze risultate vincenti vengono pubblicate fruendo dei finanziamenti della Comunit\ue0 Economica Europea, giungendo quindi ai bambini ad un prezzo accessibile.
La composizione di BiTiB \ue8 quanto mai varia e, al contempo, funzionale al compito che il gruppo si \ue8 prefisso: i membri sono esperti riabilitatori, docenti universitari ed editori di libri tattili.
Il gruppo ha sin da subito assunto il compito di affrontare la tematica della lettura di albi illustrati in et\ue0 prescolare nella sua complessit\ue0 partendo dall\u2019approfondimento teorico sull\u2019alfabetizzazione emergente, per trattare poi la tematica delle illustrazioni tattili efficaci ed arrivando infine ai problemi legati alla stampa di testo ed illustrazioni tattili ed ai finanziamenti necessari per la produzione.
Si veda:
http://www.libritattili.prociechi.it/lt/index.php?module=documents&JAS_DocumentManager_op=downloadFile&JAS_File_id=35
Allegati (documentazione utile ai fini della valutazione) Allegato 1. (File PDF)
http://www.erickson.it/erickson/repository/attach/EmyBeseghi.pd
Polymyxin B Hemoperfusion in Clinical Practice: The Picture from an Unbound Collaborative Registry The Early Use of Polymyxin B Hemoperfusion in the Abdominal Sepsis 2 (EUPHAS2) Collaborative Group
Polymyxin-B hemoperfusion in septic patients: analysis of a multicenter registry
Background: In 2010, the EUPHAS 2 collaborative group created a registry with the purpose of recording data from critically ill patients suffering from severe sepsis and septic shock treated with polymyxin-B hemoperfusion (PMX-HP) for endotoxin removal. The aim of the registry was to verify the application of PMX-HP in the daily clinical practice. Methods: The EUPHAS 2 registry involved 57 centers between January 2010 and December 2014, collecting retrospective data of 357 patients (297 in Europe and 60 in Asia) suffering from severe sepsis and septic shock caused by proved or suspected infection related to Gram negative bacteria. All patients received atleast one cycle of extracorporeal endotoxin removal by PMX-HP. Results: Septic shock was diagnosed in 305 (85.4 %) patients. The most common source of infection was abdominal (44.0 %) followed by pulmonary (17.6 %). Gram negative bacteria represented 60.6 % of the pathogens responsible of infection. After 72 h from the first cycle of PMX-HP, some of the SOFA score components significantly improved with respect to baseline: cardiovascular (2.16 \ub1 1.77 from 3.32 \ub1 1.29, p < 0.0001), respiratory (1.95 \ub1 0.95 from 2.40 \ub1 1.06, p < 0.001) and renal (1.84 \ub1 1.77 from 2.23 \ub1 1.62, p = 0.013). Overall 28-day survival rate was 54.5 % (60.4 % in abdominal and 47.5 % in pulmonary infection). Patients with abdominal infection treated with PMX-HP within 24 h from the diagnosis of septic shock had a 28-day survival rate of 64.5 %. Patients showing a significantly cardiovascular improvement after PMX-HP had a 28-survival rate of 75 % in comparison to the 39 % of patients who did not (p < 0.001). Cox regression analysis found the variation of cardiovascular, respiratory and coagulation SOFA to be independent covariates for 28-day survival. In European patients were observed a higher 28-day (58.8 vs. 34.5 %, p = 0.003), ICU (59 vs. 36.7 %, p = 0.006) and hospital survival rate (53.2 vs. 35 %, p = 0.02) than in Asian patients. However, the two populations were highly heterogeneous in terms of source of infection and severity scores at admission. Conclusion: The EUPHAS 2 is the largest registry conducted outside Japan on the clinical use of PMX-HP in septic patients. Data analysis confirmed the feasibility of PMX-HP to treat septic patients in daily clinical practice, showing clinical benefits associated with endotoxin removal without significant adverse events related to the extracorporeal technique
Prosafe: a european endeavor to improve quality of critical care medicine in seven countries
BACKGROUND: long-lasting shared research databases are an important source of epidemiological information and can promote comparison between different healthcare services. Here we present ProsaFe, an advanced international research network in intensive care medicine, with the focus on assessing and improving the quality of care. the project involved 343 icUs in seven countries. all patients admitted to the icU were eligible for data collection. MetHoDs: the ProsaFe network collected data using the same electronic case report form translated into the corresponding languages. a complex, multidimensional validation system was implemented to ensure maximum data quality. individual and aggregate reports by country, region, and icU type were prepared annually. a web-based data-sharing system allowed participants to autonomously perform different analyses on both own data and the entire database. RESULTS: The final analysis was restricted to 262 general ICUs and 432,223 adult patients, mostly admitted to Italian units, where a research network had been active since 1991. organization of critical care medicine in the seven countries was relatively similar, in terms of staffing, case mix and procedures, suggesting a common understanding of the role of critical care medicine. conversely, icU equipment differed, and patient outcomes showed wide variations among countries. coNclUsioNs: ProsaFe is a permanent, stable, open access, multilingual database for clinical benchmarking, icU self-evaluation and research within and across countries, which offers a unique opportunity to improve the quality of critical care. its entry into routine clinical practice on a voluntary basis is testimony to the success and viability of the endeavor