Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

THE FIRST EXPERIENCE WITH INGARON TREATMENT FOR CONJUNCTIVAL MELANOMA

The paper describes the first experience with the Russian drug Ingaron from an interferon-group in the treatment of patients with conjunctival melanoma. The positive result obtained during 5-to-62-month follow-ups allows its therapeutic action to be positively appreciated

Вплив гіпернатріевої дієти i діуретиків на елементний статус у щурів

A comparative study of the effect of furosemide, indapamide, hydrochlorothiazide and a hypersodium diet on the element status of the whole blood and the renal excretion of chemical elements based on the findings of mass spectrometry has been carried out in a chronic experiment on rats. Diuretics and a surplus intake of sodium chloride have been found to induce dyselementosis. Changes of the blood content of elements are often due to changes of their renal excretion.В хроническом эксперименте на крысах проведено сравнительное изучение влияния фуросемида, индапамида, гидрохлортиазида и гипернатриевой диеты на элементный состав цельной крови и почечную экскрецию химических элементов по данным массспектрометрии. Установлено, что диуретики и избыточное потребление натрия хлорида вызывают дисэлементоз. Изменения содержания элементов в крови часто обусловлены изменениями их почечной экскреции.У хронічному експерименті на щурах проведено порівняльне вивчення впливу фуросеміду, індапаміду, гідрохлортіазиду і гіпернатрієвої дієти на елементний склад цільної крові та ниркову екскрецію хімічних елементів за даними мас-спектрометрії. Встановлено, що діуретики і надлишкове споживання натрію хлориду викликають диелементоз. Зміни вмісту елементів у крові часто зумовлені змінами їх ниркової екскреції

New plant agents with cerebroprotective effect

The meadowsweet (Filipendula vulgaris) extract in a greater degree, than valerian extract improves in albino rat's brain the kinetic characteristics of mitochondrion respiratory activity, increases the association of substrate oxidation with ADP phosphorylation in experimental posthypoxic encephalopathy. The nettle (Urtica dioica) extract increases in albino rat's brain the rate of cycle Krebs substrate utilization and oxidative phosphorylation coupling in experimental inhibition of fatty acids p-oxidation caused with 4-pentenoic acid. The meadowsweet and nettle extracts posses the expressed antioxidant effect

Новые фитопрепараты с церебропротективным эффектом

The meadowsweet (Filipendula vulgaris) extract in a greater degree, than valerian extract improves in albino rat's brain the kinetic characteristics of mitochondrion respiratory activity, increases the association of substrate oxidation with ADP phosphorylation in experimental posthypoxic encephalopathy. The nettle (Urtica dioica) extract increases in albino rat's brain the rate of cycle Krebs substrate utilization and oxidative phosphorylation coupling in experimental inhibition of fatty acids p-oxidation caused with 4-pentenoic acid. The meadowsweet and nettle extracts posses the expressed antioxidant effect.Экстракт лабазника обыкновенного в большей степени, чем экстракт валерианы, улучшает в головном мозге белых крыс кинетические характеристики дыхательной активности митохондрий, увеличивает сопряженность субстратного окисления с фосфорилированием при экспериментальной постгипоксической энцефалопатии. Экстракт крапивы двудомной эффективнее силибинина повышает в головном мозге белых крыс скорость утилизации субстратов цикла Кребса, сопряженность окислительного фосфорилирования при модели ингибирования р-окисления жирных кислот, вызванного 4-пентеноевой кислотой. Экстракты лабазника и крапивы оказывают выраженное антиоксидантное действие

Histidine switch controlling pH-dependent protein folding and DNA binding in a transcription factor at the core of synthetic network devices

Therapeutic strategies have been reported that depend on synthetic network devices in which a urate-sensing transcriptional regulator detects pathological levels of urate and triggers production or release of urate oxidase. The transcription factor involved, HucR, is a member of the multiple antibiotic resistance (MarR) protein family. We show that protonation of stacked histidine residues at the pivot point of long helices that form the scaffold of the dimer interface leads to reversible formation of a molten globule state and significantly attenuated DNA binding at physiological temperatures. We also show that binding of urate to symmetrical sites in each protein lobe is communicated via the dimer interface. This is the first demonstration of regulation of a MarR family transcription factor by pH-dependent interconversion between a molten globule and a compact folded state. Our data further suggest that HucR may be utilized in synthetic devices that depend on detection of pH changes