A scoping study of pulmonary paracoccidioidomycosis: severity classification based on radiographic and tomographic evaluation.

The lungs have great importance in patients with paracoccidioidomycosis since they are the portal of entry for the infecting fungi, the site of quiescent foci, and one of the most frequently affected organs. Although they have been the subject of many studies with different approaches, the severity classification of the pulmonary involvement, using imaging procedures, has not been carried out yet. This study aimed to classify the active and the residual pulmonary damage using radiographic and tomographic evaluations, according to the area involved and types of lesions.

A scoping study of pulmonary paracoccidioidomycosis: severity classification based on radiographic and tomographic evaluation

The lungs have great importance in patients with paracoccidioidomycosis since they are the portal of entry for the infecting fungi, the site of quiescent foci, and one of the most frequently affected organs. Although they have been the subject of many studies with different approaches, the severity classification of the pulmonary involvement, using imaging procedures, has not been carried out yet. This study aimed to classify the active and the residual pulmonary damage using radiographic and tomographic evaluations, according to the area involved and types of lesions.

Predictors of mortality of trauma patients admitted to the ICU: a retrospective observational study☆.

BACKGROUND AND OBJECTIVES: Worldwide, trauma is one of the leading causes of morbidity and mortality. The aim of the present study is to identify the predictors of mortality of trauma patients requiring Intensive Care Unit (ICU) admission. METHODS: This retrospective study was conducted in the ICU of our institution in Greece during a six-year period (2010-215). RESULTS: Among 326 patients, trauma was caused by road traffic accidents in .5%, followed by falls (21.1%) and violence (7.4%). Thirty-day mortality was 27.3%. Multivariate analysis showed that higher New Injury Severity Score (NISS), severe head/neck injury, acute kidney injury, septic shock and hemorrhagic shock were significantly associated with mortality while higher Revised Injury Severity Classification, version II (RISC II) and the administration of enteral nutrition were associated with survival. NISS showed the higher accuracy in predicting 30-day mortality followed by RISC II, while scores based only in physiological variables had lower predictive ability. CONCLUSIONS: Increased mortality was strongly associated with the severity of the injury upon admission. Traumatic brain injury, septic shock and acute kidney injury have also been found among the strongest predictors of mortality. NISS can be considered as a statistically superior score in predicting mortality of severely injured patients.

Provision of intensive care to severely ill pregnant women is associated with reduced mortality: Results from the WHO Multicountry Survey on Maternal and Newborn Health.

OBJECTIVE: To estimate the impact of the use of Intensive Care Units (ICU) in maternal mortality. METHODS: A secondary analysis of the WHO Multicountry Survey on Maternal and Newborn Health, a multicenter cross-sectional study conducted in maternity hospitals in 29 countries. Women who had severe maternal outcome (maternal death or maternal near-miss) and the availability and use of ICU beds were included. The women were categorized according to availability of ICU, and multivariate logistic regression analyses were performed to determine the risk of maternal death. To rate the severity of complications, the Maternal Severity Score (MSS) and the Maternal Severity Index (MSI) were used. RESULTS: Of 314 623 women observed, 24 396 had severe complications. Of those, 16 981 (69.6%) were in facilities with ICUs; 1573 women were admitted to ICUs (6.4% of women with maternal complications and 0.5% of total). There is a significant protective effect for maternal mortality for patients with more severe conditions using ICUs (odds ratio 0.16, 95% confidence interval 0.07-0.33). CONCLUSION: The use of ICU was associated with significantly reduced odds of maternal death in obstetric patients with severe clinical conditions. The availability and appropriate use of good-quality ICUs are therefore crucial to reduce maternal mortality.