ABSTRACT
Eosinophilia in not an uncommon findings in the intensive care unit (ICU); however, DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) syndrome, which is characterized by a hypersensitivity reaction to drugs and manifests as eosinophilia, systemic involvement and maculopapular erythematous rash 2-6 weeks after exposure to the offending drug, is an exceptional occurrence. We present the first case described in the literature of DRESS syndrome with pulmonary involvement in the form of interstitial pneumonitis and persistent adult respiratory distress syndrome (ARDS) secondary to proton pump inhibitors (PPI). The patient made a good recovery after withdrawal of the offending drug and long-term treatment with systemic corticosteroids. We also present a systematic review of all cases of DRESS with pulmonary involvement in the form of interstitial pneumonitis and cases of PPI-induced DRESS published to date; none of these describe pulmonary involvement.
ABSTRACT
Biobased tractable films consisting of blends of chitosan (CS) with polymer bearing carbazole derivatives as pendant groups and fluorene-thiophene as donor-acceptor units (referred to as DA) were prepared, and their optical, morphological and photocatalytic properties were studied. DA was dissolved in tetrahydrofuran (THF) and mixed with an acidified aqueous solution containing chitosan to obtain chitosan/DA (CS/DA) films by solution casting. The fabricated biobased films were characterized using spectroscopic techniques (FT-IR and UV-vis), thermogravimetry, mechanical assays, contact angle analysis, and atomic force microscopy (AFM). The effects of varying DA compositions and the results of exposure to visible-light irradiation of the films were also analyzed. The results indicated the existence of interactions between chitosan and DA and a potentially profitable light-driven response of these biobased films. This behavior was reflected in the optical, topographical, and contact angle properties of the films, which exhibited different characteristics before and after visible-light exposure. Finally, the photocatalytic performance of the biobased films was tested via the decomposition of methyl orange (MO), as a reaction model system. Our results revealed a significant photocatalytic activity (according to biobased film composition, approximately 64 % and 87 % of methyl orange were degraded under continuous visible-light irradiation for 120 min) of the films which is attributed to the combined presence and synergetic effects of the film-forming ability of chitosan and the photoproperties of DA.
Subject(s)
Azo Compounds/chemistry , Chitosan/chemistry , Polymers/chemistry , Light , Microscopy, Atomic Force , Spectroscopy, Fourier Transform Infrared , ThermogravimetryABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Aged , Aged, 80 and over , Decision Support Techniques , Life Support Systems/instrumentation , Intensive Care Units , Prospective Studies , Confidence Intervals , Statistics, NonparametricSubject(s)
Clinical Decision-Making , Intensive Care Units , Life Support Care , Patient Admission , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Prospective Studies , Refusal to TreatABSTRACT
OBJETIVO: Analizar qué factores clínicos influyen en la mortalidad de pacientes con cáncer que ingresan en UCI. DISEÑO: Estudio observacional retrospectivo. Ámbito: UCI de un hospital secundario. PACIENTES: Adultos ingresados en UCI con diagnóstico de cáncer (sólido o hematológico), excluyendo a aquellos ingresados en el postoperatorio de resección programada del tumor o con estancia inferior a 24 h en UCI. INTERVENCIONES: Revisión de datos clínicos. Variables de interés: Tipo de tumor, extensión, escala oncológica funcional Eastern Cooperative Oncology Group (ECOG), motivo de ingreso en UCI, gravedad (SOFA, APACHE-II, SAPS-II), terapia recibida y mortalidad hospitalaria. RESULTADOS: Se incluyó a 167 pacientes (edad media 71,1 años; 62,9% varones; el 79% con tumor sólido), de los cuales fallecieron 61 (36%) durante su estancia hospitalaria (35 en UCI). Los factores clínicos asociados a mayor riesgo de muerte hospitalaria fueron la puntuación 3-4 en la escala ECOG (OR 7,23; IC 95%: 1,95-26,87), extensión metastásica del tumor (OR 3,77; IC 95%: 1,70-8,36), insuficiencia renal (OR 3,66; IC 95%: 1,49-8,95) y puntuación SOFA al ingreso (OR 1,26; IC 95%: 1,10-1,43). El 60,3% de los supervivientes eran independientes al alta hospitalaria. CONCLUSIONES: En nuestra serie, solo un tercio de los pacientes con enfermedad oncológica grave que requieren ingreso en UCI fallecen durante el ingreso hospitalario y más de la mitad de los supervivientes presentan una situación de independencia al alta hospitalaria. Los factores clínicos asociados a la mortalidad hospitalaria fueron la mala situación funcional previa, el antecedente de tumor metastásico, la puntuación SOFA al ingreso en UCI y la presencia de insuficiencia renal aguda
OBJECTIVE: To analyze the factors influencing in-hospital mortality among cancer patients admitted to an Intensive Care Unit (ICU). DESIGN: A retrospective observational study was carried out. SETTING: The ICU of a community hospital. PATIENTS: Adults diagnosed with solid or hematological malignancies admitted to the ICU, excluding those admitted after scheduled surgery and those with an ICU stay of under 24h. INTERVENTIONS: Review of clinical data. Variables of interest: Referring ward and length of stay prior to admission to the ICU, type of tumor, extent, Eastern Cooperative Oncology Group (ECOG) score, reason for ICU admission, severity (SOFA, APACHE-II, SAPS-II), type of therapy received in the ICU, and in-hospital mortality. RESULTS: A total of 167 patients (mean age 71.1 years, 62.9% males; 79% solid tumors) were included, of which 61 (36%) died during their hospital stay (35 in the ICU). The factors associated to increased in-hospital mortality were ECOG scores 3-4 (OR 7.23, 95%CI: 1.95-26.87), metastatic disease (OR 3.77, 95%CI: 1.70-8.36), acute kidney injury (OR 3.66, 95%CI: 1.49-8.95) and SOFA score at ICU admission (OR 1.26, 95%CI: 1.10-1.43). A total of 60.3% of the survivors were independent at hospital discharge. CONCLUSIONS: In our series, only one-third of the critically ill cancer patients admitted to the ICU died during hospital admission, and more than 50% showed good performance status at hospital discharge. The clinical prognostic factors associated to in-hospital mortality were poor performance status, metastatic disease, SOFA score at ICU admission and acute kidney injury
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Neoplasms/mortality , Hospital Mortality , Intensive Care Units , Neoplasms/therapy , Patient Admission/statistics & numerical data , Prognosis , Retrospective Studies , Observational StudyABSTRACT
OBJECTIVE: To analyze the factors influencing in-hospital mortality among cancer patients admitted to an Intensive Care Unit (ICU). DESIGN: A retrospective observational study was carried out. SETTING: The ICU of a community hospital. PATIENTS: Adults diagnosed with solid or hematological malignancies admitted to the ICU, excluding those admitted after scheduled surgery and those with an ICU stay of under 24h. INTERVENTIONS: Review of clinical data. VARIABLES OF INTEREST: Referring ward and length of stay prior to admission to the ICU, type of tumor, extent, Eastern Cooperative Oncology Group (ECOG) score, reason for ICU admission, severity (SOFA, APACHE-II, SAPS-II), type of therapy received in the ICU, and in-hospital mortality. RESULTS: A total of 167 patients (mean age 71.1 years, 62.9% males; 79% solid tumors) were included, of which 61 (36%) died during their hospital stay (35 in the ICU). The factors associated to increased in-hospital mortality were ECOG scores 3-4 (OR 7.23, 95%CI: 1.95-26.87), metastatic disease (OR 3.77, 95%CI: 1.70-8.36), acute kidney injury (OR 3.66, 95%CI: 1.49-8.95) and SOFA score at ICU admission (OR 1.26, 95%CI: 1.10-1.43). A total of 60.3% of the survivors were independent at hospital discharge. CONCLUSIONS: In our series, only one-third of the critically ill cancer patients admitted to the ICU died during hospital admission, and more than 50% showed good performance status at hospital discharge. The clinical prognostic factors associated to in-hospital mortality were poor performance status, metastatic disease, SOFA score at ICU admission and acute kidney injury.
Subject(s)
Hospital Mortality , Neoplasms/mortality , Aged , Female , Humans , Intensive Care Units , Male , Neoplasms/therapy , Patient Admission/statistics & numerical data , Prognosis , Retrospective StudiesABSTRACT
No disponible
Subject(s)
Humans , Hypothermia, Induced , Heart Arrest/therapy , Cardiopulmonary Resuscitation , Risk Factors , Practice Patterns, Physicians' , Mortality/trendsSubject(s)
Hypothermia, Induced , Brain Damage, Chronic/prevention & control , Clinical Trials as Topic , Evidence-Based Medicine , Humans , Hypothermia, Induced/statistics & numerical data , Out-of-Hospital Cardiac Arrest/complications , Out-of-Hospital Cardiac Arrest/therapy , Recovery of Function , Therapeutic Equipoise , Treatment Failure , Treatment Outcome , UncertaintyABSTRACT
No disponible
