Author: "E. Salas" / Topic: business - Searchworks@Jio Institute Digital Library Search Results

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177 results on '"E. Salas"'

1. A scoping review of new implementations of interprofessional bedside rounding models to improve teamwork, care, and outcomes in hospitals

Author: Nicole Summerside, Danielle C. Lavallee, Erin Abu-Rish Blakeney, Elizabeth Ibby Tanner, Bryan J. Weiner, Rachel E. Salas, Brenda K. Zierler, Deborah Dang, Frances Chu, Andrew A. White, Kyla F. Woodward, Mayumi A. Willgerodt, Kevin D. O'Brien, Genevieve Beaird, G. Randy Smith, and John M. Dent
Subjects: Teamwork, business.industry, Clinical study design, media_common.quotation_subject, Psychological intervention, General Medicine, PsycINFO, CINAHL, Article, Terminology, Patient safety, Nursing, Health care, business, Psychology, media_common
Abstract: Poor communication within healthcare teams occurs commonly, contributing to inefficiency, medical errors, conflict, and other adverse outcomes. Interprofessional bedside rounds (IBR) are a promising model that brings two or more health professions together with patients and families as part of a consistent, team-based routine to share information and collaboratively arrive at a daily plan of care. The purpose of this systematic scoping review was to investigate the breadth and quality of IBR literature to identify and describe gaps and opportunities for future research. We followed an adapted Arksey and O'Malley Framework and PRISMA scoping review guidelines. PubMed, CINAHL, PsycINFO, and Embase were systematically searched for key IBR words and concepts through June 2020. Seventy-nine articles met inclusion criteria and underwent data abstraction. Study quality was assessed using the Mixed Methods Assessment Tool. Publications in this field have increased since 2014, and the majority of studies reported positive impacts of IBR implementation across an array of team, patient, and care quality/delivery outcomes. Despite the preponderance of positive findings, great heterogeneity, and a reliance on quantitative non-randomized study designs remain in the extant research. A growing number of interventions to improve safety, quality, and care experiences in hospital settings focus on redesigning daily inpatient rounds. Limited information on IBR characteristics and implementation strategies coupled with widespread variation in terminology, study quality, and design create challenges in assessing the effectiveness of models of rounds and optimal implementation strategies. This scoping review highlights the need for additional studies of rounding models, implementation strategies, and outcomes that facilitate comparative research.
Published: 2023

2. Use of a structured approach and virtual simulation practice to improve diagnostic reasoning

Author: Amber T. Pincavage, Judy Kalinyak, Nancy Weigle, Saumil M. Chudgar, Jillian Zavodnick, Rachel E. Salas, Khadeja Johnson, Kelly Bossenbroek Fedoriw, Fred Sanfilippo, Scott Stern, Craig F Knoche, Michael Dekhtyar, Yoon Soo Park, Lisa C. Martinez, Stephen M. Sozio, Nina Mingioni, and Sarah K. Wood
Subjects: Abdominal pain, medicine.medical_specialty, Students, Medical, 020205 medical informatics, Clinical Biochemistry, Medicine (miscellaneous), Diagnostic reasoning, 02 engineering and technology, Post-intervention, 03 medical and health sciences, 0302 clinical medicine, Virtual patient, 0202 electrical engineering, electronic engineering, information engineering, medicine, Humans, Computer Simulation, 030212 general & internal medicine, Medical diagnosis, Problem Solving, business.industry, Health Policy, Biochemistry (medical), Public Health, Environmental and Occupational Health, Internship and Residency, Repeated measures design, Physical therapy, Diagnostic assessment, Clinical Competence, medicine.symptom, Differential diagnosis, business
Abstract: Objectives In 2015, the National Academy of Medicine IOM estimated that 12 million patients were misdiagnosed annually. This suggests that despite prolonged training in medical school and residency there remains a need to improve diagnostic reasoning education. This study evaluates a new approach. Methods A total of 285 medical students were enrolled in this 8 center, IRB approved trial. Students were randomized to receive training in either abdominal pain (AP) or loss of consciousness (LOC). Baseline diagnostic accuracy of the two different symptoms was assessed by completing a multiple-choice question (MCQ) examination and virtual patient encounters. Following a structured educational intervention, including a lecture on the diagnostic approach to that symptom and three virtual patient practice cases, each student was re-assessed. Results The change in diagnostic accuracy on virtual patient encounters was compared between (1) baseline and post intervention and (2) post intervention students trained in the prescribed symptom vs. the alternate symptom (controls). The completeness of the student’s differential diagnosis was also compared. Comparison of proportions were conducted using χ 2-tests. Mixed-effects regressions were used to examine differences accounting for case and repeated measures. Compared with baseline, both the AP and LOC groups had marked post-intervention improvements in obtaining a correct final diagnosis; a 27% absolute improvement in the AP group (p Conclusions The study showed that a virtual patient platform combined with a diagnostic reasoning framework could be used for education and diagnostic assessment and improved correct diagnosis compared with baseline performance in a simulated platform.
Published: 2021

3. Outcome of acute hypoxaemic respiratory failure: insights from the LUNG SAFE Study

Author: Pham, Tài, Pesenti, Antonio, Bellani, Giacomo, Rubenfeld, Gordon, Fan, Eddy, Bugedo, Guillermo, Lorente, José Angel, Fernandes, Antero do Vale, Van Haren, Frank, Bruhn, Alejandro, Rios, Fernando, Esteban, Andres, Gattinoni, Luciano, Larsson, Anders, McAuley, Daniel F., Ranieri, Marco, Thompson, B. Taylor, Wrigge, Hermann, Brochard, Laurent J., Laffey, John G, Antonio Pesenti, John G Laffey, Laurent Brochard, Andres Esteban, Luciano Gattinoni, Frank van Haren, Anders Larsson, Daniel F McAuley, Marco Ranieri, Gordon Rubenfeld, B Taylor Thompson, Hermann Wrigge, Arthur S Slutsky, Giacomo Bellani, Tài Pham, Eddy Fan, Fernando Rios, Thierry Sottiaux, Pieter Depuydt, Fredy S Lora, Luciano Cesar Azevedo, Guillermo Bugedo, Haibo Qiu, Marcos Gonzalez, Juan Silesky, Vladimir Cerny, Jonas Nielsen, Manuel Jibaja, Dimitrios Matamis, Jorge Luis Ranero, Pravin Amin, S M Hashemian, Kevin Clarkson, Kiyoyasu Kurahashi, Asisclo Villagomez, Amine Ali Zeggwagh, Leo M Heunks, Jon Henrik Laake, Jose Emmanuel Palo, Antero do Vale Fernandes, Dorel Sandesc, Yaasen Arabi, Vesna Bumbasierevic, Nicolas Nin, Jose A Lorente, Lise Piquilloud, Fekri Abroug, Lia McNamee, Javier Hurtado, Ed Bajwa, Gabriel Démpaire, Hektor Sula, Lordian Nunci, Alma Cani, Alan Zazu, Christian Dellera, Carolina S Insaurralde, Risso V Alejandro, Julio Daldin, Mauricio Vinzio, Ruben O Fernandez, Luis P Cardonnet, Lisandro R Bettini, Mariano Carboni Bisso, Emilio M Osman, Mariano G Setten, Pablo Lovazzano, Javier Alvarez, Veronica Villar, Norberto C Pozo, Nicolas Grubissich, Gustavo A Plotnikow, Daniela N Vasquez, Santiago Ilutovich, Norberto Tiribelli, Ariel Chena, Carlos A Pellegrini, María G Saenz, Elisa Estenssoro, Matias Brizuela, Hernan Gianinetto, Pablo E Gomez, Valeria I Cerrato, Marco G Bezzi, Silvina A Borello, Flavia A Loiacono, Adriana M Fernandez, Serena Knowles, Claire Reynolds, Deborah M Inskip, Jennene J Miller, Jing Kong, Christina Whitehead, Shailesh Bihari, Aylin Seven, Amanda Krstevski, Helen J Rodgers, Rebecca T Millar, Toni E McKenna, Irene M Bailey, Gabrielle C Hanlon, Anders Aneman, Joan M Lynch, Raman Azad, John Neal, Paul W Woods, Brigit L Roberts, Mark R Kol, Helen S Wong, Katharina C Riss, Thomas Staudinger, Xavier Wittebole, Caroline Berghe, Pierre A Bulpa, Alain M Dive, Rik Verstraete, Herve Lebbinck, Joris Vermassen, Philippe Meersseman, Helga Ceunen, Jonas I Rosa, Daniel O Beraldo, Claudio Piras, Adenilton M Rampinelli, Antonio P Nassar Jr, Sergio Mataloun, Marcelo Moock, Marlus M Thompson, Claudio H Gonçalves, Ana Carolina P Antônio, Aline Ascoli, Rodrigo S Biondi, Danielle C Fontenele, Danielle Nobrega, Vanessa M Sales, Ahmad Yazid Bin Hj Abul Wahab, Maizatul Ismail, Suresh Shindhe, John Laffey, Francois Beloncle, Kyle G Davies, Rob Cirone, Venika Manoharan, Mehvish Ismail, Ewan C Goligher, Mandeep Jassal, Erin Nishikawa, Areej Javeed, Gerard Curley, Nuttapol Rittayamai, Matteo Parotto, Niall D Ferguson, Sangeeta Mehta, Jenny Knoll, Antoine Pronovost, Sergio Canestrini, Alejandro R Bruhn, Patricio H Garcia, Felipe A Aliaga, Pamela A Farías, Jacob S Yumha, Claudia A Ortiz, Javier E Salas, Alejandro A Saez, Luis D Vega, Eduardo F Labarca, Felipe T Martinez, Nicolás G Carreño, Pilar Lora, Haitao Liu, Ling Liu, Rui Tang, Xiaoming Luo, Youzhong An, Huiying Zhao, Yan Gao, Zhe Zhai, Zheng L Ye, Wei Wang, Wenwen Li, Qingdong Li, Ruiqiang Zheng, Wenkui Yu, Juanhong Shen, Xinyu Li, Tao Yu, Weihua Lu, Ya Q Wu, Xiao B Huang, Zhenyang He, Yuanhua Lu, Hui Han, Fan Zhang, Renhua Sun, Hua X Wang, Shu H Qin, Bao H Zhu, Jun Zhao, Jian Liu, Bin Li, Jing L Liu, Fa C Zhou, Qiong J Li, Xing Y Zhang, Zhou Li-Xin, Qiang Xin-Hua, Liangyan Jiang, Yuan N Gao, Xian Y Zhao, Yuan Y Li, Xiao L Li, Chunting Wang, Qingchun Yao, Rongguo Yu, Kai Chen, Huanzhang Shao, Bingyu Qin, Qing Q Huang, Wei H Zhu, Ai Y Hang, Ma X Hua, Yimin Li, Yonghao Xu, Yu D Di, Long L Ling, Tie H Qin, Shou H Wang, Junping Qin, Yi Han, Suming Zhou, Monica P Vargas, Juan I Silesky Jimenez, Manuel A González Rojas, Jaime E SolisQuesada, Christian M Ramirez-Alfaro, Jan Máca, Peter Sklienka, Jakob Gjedsted, Aage Christiansen, Boris G Villamagua, Iguel Llano, Philippe Burtin, Gautier Buzancais, Pascal Beuret, Nicolas Pelletier, Satar Mortaza, Alain Mercat, Jonathan Chelly, Sébastien Jochmans, Nicolas Terzi, Cédric Daubin, Guillaume Carteaux, Nicolas de Prost, Jean-Daniel Chiche, Fabrice Daviaud, Muriel Fartoukh, Guillaume Barberet, Jerome Biehler, Jean Dellamonica, Denis Doyen, Jean-Michel Arnal, Anais Briquet, Sami Hraiech, Laurent Papazian, Arnaud Follin, Damien Roux, Jonathan Messika, Evangelos Kalaitzis, Laurence Dangers, Alain Combes, Siu-Ming Au, Gaetan Béduneau, Dorothée Carpentier, Elie H Zogheib, Herve Dupont, Sylvie Ricome, Francesco L Santoli, Sebastien L Besset, Philippe Michel, Bruno Gelée, Pierre-Eric Danin, Bernard Goubaux, Philippe J Crova, Nga T Phan, Frantz Berkelmans, Julio C Badie, Romain Tapponnier, Josette Gally, Samy Khebbeb, Jean-Etienne Herbrecht, Francis Schneider, PierreLouis M Declercq, Jean-Philippe Rigaud, Jacques Duranteau, Anatole Harrois, Russell Chabanne, Julien Marin, Charlene Bigot, Sandrine Thibault, Mohammed Ghazi, Messabi Boukhazna, Salem Ould Zein, Jack R Richecoeur, Daniele M Combaux, Fabien Grelon, Charlene Le Moal, Elise P Sauvadet, Adrien Robine, Virginie Lemiale, Danielle Reuter, Martin Dres, Alexandre Demoule, Dany Goldgran-Toledano, Loredana Baboi, Claude Guérin, Ralph Lohner, Jens Kraßler, Susanne Schäfer, Kai D Zacharowski, Patrick Meybohm, Andreas W Reske, Philipp Simon, HansBernd F Hopf, Michael Schuetz, Thomas Baltus, Metaxia N Papanikolaou, Theonymfi G Papavasilopoulou, Giannis A Zacharas, Vasilis Ourailogloy, Eleni K Mouloudi, Eleni V Massa, Eva O Nagy, Electra E Stamou, Ellada V Kiourtzieva, Marina A Oikonomou, Luis E Avila, Cesar A Cortez, Johanna E Citalán, Sameer A Jog, Safal D Sable, Bhagyesh Shah, Mohan Gurjar, Arvind K Baronia, Mohammedfaruk Memon, Radhakrishnan Muthuchellappan, Venkatapura J Ramesh, Anitha Shenoy, Ramesh Unnikrishnan, Subhal B Dixit, Rachana V Rhayakar, Nagarajan Ramakrishnan, Vallish K Bhardwaj, Heera L Mahto, Sudha V Sagar, Vijayanand Palaniswamy, Deeban Ganesan, Seyed Mohammadreza Hashemian, Hamidreza Jamaati, Farshad Heidari, Edel A Meaney, Alistair Nichol, Karl M Knapman, Donall O'Croinin, Eimhin S Dunne, Dorothy M Breen, Kevin P Clarkson, Rola F Jaafar, Rory Dwyer, Fahd Amir, Olaitan O Ajetunmobi, Aogan C O'Muircheartaigh, Colin S Black, Nuala Treanor, Daniel V Collins, Wahid Altaf, Gianluca Zani, Maurizio Fusari, Savino Spadaro, Carlo A Volta, Romano Graziani, Barbara Brunettini, Salvatore Palmese, Paolo Formenti, Michele Umbrello, Andrea Lombardo, Elisabetta Pecci, Marco Botteri, Monica Savioli, Alessandro Protti, Alessia Mattei, Lorenzo Schiavoni, Andrea Tinnirello, Manuel Todeschini, Antonino Giarratano, Andrea Cortegiani, Massimo M Antonelli, Luca M Montini, Paolo Casalena, Sergio Scafetti, Giovanna Panarello, Giovanna Occhipinti, Nicolò Patroniti, Matteo Pozzi, Roberto R Biscione, Michela M Poli, Ferdinando Raimondi, Daniela Albiero, Giulia Crapelli, Eduardo Beck, Vincenzo Pota, Vincenzo Schiavone, Alexandre Molin, Fabio Tarantino, Giacomo Monti, Elena Frati, Lucia Mirabella, Gilda Cinnella, Tommaso Fossali, Riccardo Colombo, Pierpaolo Terragni, Ilaria Pattarino, Francesco Mojoli, Antonio Braschi, Erika E Borotto, Andrea N Cracchiolo, Daniela M Palma, Francesco Raponi, Giuseppe Foti, Ettore R Vascotto, Andrea Coppadoro, Luca Brazzi, Leda Floris, Giorgio A Iotti, Aaron Venti, Osamu Yamaguchi, Shunsuke Takagi, Hiroki N Maeyama, Eizo Watanabe, Yoshihiro Yamaji, Kazuyoshi Shimizu, Kyoko Shiozaki, Satoru Futami, Sekine Ryosuke, Koji Saito, Yoshinobu Kameyama, Keiko Ueno, Masayo Izawa, Nao Okuda, Hiroyuki Suzuki, Tomofumi Harasawa, Michitaka Nasu, Tadaaki Takada, Fumihito Ito, Shin Nunomiya, Kansuke Koyama, Toshikazu Abe, Kohkichi Andoh, Kohei Kusumoto, Akira Hirata, Akihiro Takaba, Hiroyasu Kimura, Shuhei Matsumoto, Ushio Higashijima, Hiroyuki Honda, Nobumasa Aoki, Hiroshi Imai, Yasuaki Ogino, Ichiko Mizuguchi, Kazuya Ichikado, Kenichi Nitta, Katsunori Mochizuki, Tomoaki Hashida, Hiroyuki Tanaka, Tomoyuki Nakamura, Daisuke Niimi, Takeshi Ueda, Yozo Kashiwa, Akinori Uchiyama, Olegs Sabelnikovs, Peteris Oss, Youssef Haddad, Kong Y Liew, Silvio A Ñamendys-Silva, Yves D Jarquin-Badiola, Luis A Sanchez-Hurtado, Saira S Gomez-Flores, Maria C Marin, Asisclo J Villagomez, Jordana S Lemus, Jonathan M Fierro, Mavy Ramirez Cervantes, Francisco Javier Flores Mejia, Dulce Dector, Alejandro Rojas, Daniel R Gonzalez, Claudia R Estrella, Jorge R Sanchez-Medina, Alvaro Ramirez-Gutierrez, Fernando G George, Janet S Aguirre, Juan A Buensuseso, Manuel Poblano, Tarek Dendane, Hicham Balkhi, Mina Elkhayari, Nacer Samkaoui, Hanane Ezzouine, Abdellatif Benslama, Mourad Amor, Wajdi Maazouzi, Nedim Cimic, Oliver Beck, Monique M Bruns, Jeroen A Schouten, Myra Rinia, Monique Raaijmakers, Hellen M van Wezel, Serge J Heines, Ulrich Strauch, Marc P Buise, Fabienne D Simonis, Marcus J Schultz, Jennifer C Goodson, Troy S Browne, Leanlove Navarra, Anna Hunt, Robyn A Hutchison, Mathew B Bailey, Lynette Newby, Colin McArthur, Michael Kalkoff, Alex Mcleod, Jonathan Casement, Danielle J Hacking, Finn H Andersen, Merete S Dolva, Jon H Laake, Andreas Barratt-Due, Kim Andre L Noremark, Eldar Søreide, Brit Å Sjøbø, Anne B Guttormsen, Hector H Leon Yoshido, Ronald Zumaran Aguilar, Fredy A Montes Oscanoa, Alain U Alisasis, Joanne B Robles, Rossini Abbie B Pasanting-Lim, Beatriz C Tan, Pawel Andruszkiewicz, Karina Jakubowska, Cristina M Coxo, António M Alvarez, Bruno S Oliveira, Gustavo M Montanha, Nelson C Barros, Carlos S Pereira, António M Messias, Jorge M Monteiro, Ana M Araujo, Nuno T Catorze, Susan M Marum, Maria J Bouw, Rui M Gomes, Vania A Brito, Silvia Castro, Joana M Estilita, Filipa M Barros, Isabel M Serra, Aurelia M Martinho, Dana R Tomescu, Alexandra Marcu, Ovidiu H Bedreag, Marius Papurica, Dan E Corneci, Silvius Ioan Negoita, Evgeny Grigoriev, Alexey I Gritsan, Andrey A Gazenkampf, Ghaleb Almekhlafi, Mohamad M Albarrak, Ghanem M Mustafa, Khalid A Maghrabi, Nawal Salahuddin, Tharwat M Aisa, Ahmed S Al Jabbary, Edgardo Tabhan, Yaseen M Arabi, Olivia A Trinidad, Hasan M Al Dorzi, Edgardo E Tabhan, Vesna Bumbasirevic, Bojan Jovanovic, Stefan Bolon, Oliver Smith, Jordi Mancebo, Hernan Aguirre-Bermeo, Juan C Lopez-Delgado, Francisco Esteve, Gemma Rialp, Catalina Forteza, Candelaria De Haro, Antonio Artigas, Guillermo M Albaiceta, Sara De Cima-Iglesias, Leticia Seoane-Quiroga, Alexandra Ceniceros-Barros, Antonio L RuizAguilar, Luis M Claraco-Vega, Juan Alfonso Soler, Maria Del Carmen Lorente, Cecilia Hermosa, Federico Gordo, Miryam PrietoGonzález, Juan B López-Messa, Manuel P Perez, Cesar P Perez, Raquel Montoiro Allue, Ferran RocheCampo, Marcos Ibañez-Santacruz, Susana TempranoSusana, Maria C Pintado, Raul De Pablo, Pilar Ricart Aroa Gómez, Silvia Rodriguez Ruiz, Silvia Iglesias Moles, Mª Teresa Jurado, Alfons Arizmendi, Enrique A Piacentini, Nieves Franco, Teresa Honrubia, Meisy Perez Cheng, Elena Perez Losada, Javier Blanco, Luis J Yuste, Cecilia Carbayo-Gorriz, Francisca G Cazorla-Barranquero, Javier G Alonso, Rosa S Alda, Ángela Algaba, Gonzalo Navarro, Enrique Cereijo, Esther Diaz-Rodriguez, Diego Pastor Marcos, Laura Alvarez Montero, Luis Herrera Para, Roberto Jimenez Sanchez, Miguel Angel Blasco Navalpotro, Ricardo Diaz Abad, Raquel Montiel González, Dácil Parrilla Toribio, Alejandro G Castro, Maria Jose D Artiga, Oscar Penuelas, Tomas P Roser, Moreno F Olga, Elena Gallego Curto, Rocío Manzano Sánchez, Vallverdu P Imma, Garcia M Elisabet, Laura Claverias, Monica Magret, Ana M Pellicer, Lucia L Rodriguez, Jesús Sánchez-Ballesteros, Ángela González-Salamanca, Antonio G Jimenez, Francisco P Huerta, Juan Carlos J Sotillo Diaz, Esther Bermejo Lopez, David D Llinares Moya, Alec A Tallet Alfonso, Palazon Sanchez Eugenio Luis, Palazon Sanchez Cesar, Sánchez I Rafael, Corcoles G Virgilio, Noelia N Recio, Christian C Rylander, Bernhard Holzgraefe, Lars M Broman, Joanna Wessbergh, Linnea Persson, Fredrik Schiöler, Hans Kedelv, Anna Oscarsson Tibblin, Henrik Appelberg, Lars Hedlund, Johan Helleberg, Karin E Eriksson, Rita Glietsch, Niklas Larsson, Ingela Nygren, Silvia L Nunes, Anna-Karin Morin, Thomas Kander, Anne Adolfsson, Hervé O Zender, Corinne Leemann-Refondini, Souheil Elatrous, Slaheddine Bouchoucha, Imed Chouchene, Islem Ouanes, Asma Ben Souissi, Salma Kamoun, Oktay Demirkiran, Mustafa Aker, Emre Erbabacan, Ilkay Ceylan, Nermin Kelebek Girgin, Menekse Ozcelik, Necmettin Ünal, Basak Ceyda Meco, Onat O Akyol, Suleyman S Derman, Barry Kennedy, Ken Parhar, Latha Srinivasa, Danny McAuley, Phil Hopkins, Clare Mellis, Vivek Kakar, Dan Hadfield, Andre Vercueil, Kaushik Bhowmick, Sally K Humphreys, Andrew Ferguson, Raymond Mckee, Ashok S Raj, Danielle A Fawkes, Philip Watt, Linda Twohey, Rajeev R Jha, Matthew Thomas, Alex Morton, Varsha Kadaba, Mark J Smith, Anil P Hormis, Santhana G Kannan, Miriam Namih, Henrik Reschreiter, Julie Camsooksai, Alek Kumar, Szabolcs Rugonfalvi, Christopher Nutt, Orla Oneill, Colette Seasman, Ged Dempsey, Christopher J Scott, Helen E Ellis, Stuart Mckechnie, Paula J Hutton, Nora N Di Tomasso, Michela N Vitale, Ruth O Griffin, Michael N Dean, Julius H Cranshaw, Emma L Willett, Nicholas Ioannou, Sarah Gillis, Peter Csabi, Rosaleen Macfadyen, Heidi Dawson, Pieter D Preez, Alexandra J Williams, Owen Boyd, Laura Ortiz-Ruiz de Gordoa, Jon Bramall, Sophie Symmonds, Simon K Chau, Tim Wenham, Tamas Szakmany, Piroska Toth-Tarsoly, Katie H McCalman, Peter Alexander, Lorraine Stephenson, Thomas Collyer, Rhiannon Chapman, Raphael Cooper, Russell M Allan, Malcolm Sim, David W Wrathall, Donald A Irvine, Kim S Zantua, John C Adams, Andrew J Burtenshaw, Gareth P Sellors, Ingeborg D Welters, Karen E Williams, Robert J Hessell, Matthew G Oldroyd, Ceri E Battle, Suresh Pillai, Istvan Kajtor, Mageswaran Sivashanmugavel, Sinead C Okane, Adrian Donnelly, Aniko D Frigyik, Jon P Careless, Martin M May, Richard Stewart, T John Trinder, Samantha J Hagan, Jade M Cole, Caroline C MacFie, Anna T Dowling, Nicolás Nin, Edgardo Nuñez, Gustavo Pittini, Ruben Rodriguez, María C Imperio, Cristina Santos, Ana G França, Alejandro Ebeid, Alberto Deicas, Carolina Serra, Aditya Uppalapati, Ghassan Kamel, Valerie M Banner-Goodspeed, Jeremy R Beitler, Satyanarayana Reddy Mukkera, Shreedhar Kulkarni, John O Shinn Iii, Dina Gomaa, Christopher Tainter, Jarone Lee, Tomaz MesarJarone Lee, Dale J Yeatts, Jessica Warren, Michael J Lanspa, Russel R Miller, Colin K Grissom, Samuel M Brown, Philippe R Bauer, Ryan J Gosselin, Barrett T Kitch, Jason E Cohen, Scott H Beegle, Shazia Choudry, Renaud M Gueret, Aiman Tulaimat, William Stigler, Hitesh Batra, Nidhi G Huff, Keith D Lamb, Trevor W Oetting, Nicholas M Mohr, Claine Judy, Shigeki Saito, Fayez M Kheir, Fayez Kheir, Adam B Schlichting, Angela Delsing, Daniel R Crouch, Mary Elmasri, Dina Ismail, Kyle R Dreyer, Thomas C Blakeman, Rebecca M Baro, Carolina Quintana Grijalba, Peter C Hou, Raghu Seethala, Imo Aisiku, Galen Henderson, Gyorgy Frendl, Sen-Kuang Hou, Robert L Owens, Ashley Schomer, Pham, Tài, Pesenti, Antonio, Bellani, Giacomo, Rubenfeld, Gordon, Fan, Eddy, Bugedo, Guillermo, Lorente, José Angel, Fernandes, Antero do Vale, Van Haren, Frank, Bruhn, Alejandro, Rios, Fernando, Esteban, Andre, Gattinoni, Luciano, Larsson, Ander, McAuley, Daniel F., Ranieri, Marco, Thompson, B. Taylor, Wrigge, Hermann, Brochard, Laurent J., Laffey, John G, Antonio Pesenti, John G Laffey, Laurent Brochard, Andres Esteban, Luciano Gattinoni, Frank van Haren, Anders Larsson, Daniel F McAuley, Marco Ranieri, Gordon Rubenfeld, B Taylor Thompson, Hermann Wrigge, Arthur S Slutsky, John G Laffey, Giacomo Bellani, Tài Pham, Eddy Fan, Fernando Rios, Frank van Haren, Thierry Sottiaux, Pieter Depuydt, Fredy S Lora, Luciano Cesar Azevedo, Eddy Fan, Guillermo Bugedo, Haibo Qiu, Marcos Gonzalez, Juan Silesky, Vladimir Cerny, Jonas Nielsen, Manuel Jibaja, Tài Pham, Hermann Wrigge, Dimitrios Matamis, Jorge Luis Ranero, Pravin Amin, S M Hashemian, Kevin Clarkson, Giacomo Bellani, Kiyoyasu Kurahashi, Asisclo Villagomez, Amine Ali Zeggwagh, Leo M Heunks, Jon Henrik Laake, Jose Emmanuel Palo, Antero do Vale Fernandes, Dorel Sandesc, Yaasen Arabi, Vesna Bumbasierevic, Nicolas Nin, Jose A Lorente, Anders Larsson, Lise Piquilloud, Fekri Abroug, Daniel F McAuley, Lia McNamee, Javier Hurtado, Ed Bajwa, Gabriel Démpaire, Hektor Sula, Lordian Nunci, Alma Cani, Alan Zazu, Christian Dellera, Carolina S Insaurralde, Risso V Alejandro, Julio Daldin, Mauricio Vinzio, Ruben O Fernandez, Luis P Cardonnet, Lisandro R Bettini, Mariano Carboni Bisso, Emilio M Osman, Mariano G Setten, Pablo Lovazzano, Javier Alvarez, Veronica Villar, Norberto C Pozo, Nicolas Grubissich, Gustavo A Plotnikow, Daniela N Vasquez, Santiago Ilutovich, Norberto Tiribelli, Ariel Chena, Carlos A Pellegrini, María G Saenz, Elisa Estenssoro, Matias Brizuela, Hernan Gianinetto, Pablo E Gomez, Valeria I Cerrato, Marco G Bezzi, Silvina A Borello, Flavia A Loiacono, Adriana M Fernandez, Serena Knowles, Claire Reynolds, Deborah M Inskip, Jennene J Miller, Jing Kong, Christina Whitehead, Shailesh Bihari, Aylin Seven, Amanda Krstevski, Helen J Rodgers, Rebecca T Millar, Toni E McKenna, Irene M Bailey, Gabrielle C Hanlon, Anders Aneman, Joan M Lynch, Raman Azad, John Neal, Paul W Woods, Brigit L Roberts, Mark R Kol, Helen S Wong, Katharina C Riss, Thomas Staudinger, Xavier Wittebole, Caroline Berghe, Pierre A Bulpa, Alain M Dive, Rik Verstraete, Herve Lebbinck, Pieter Depuydt, Joris Vermassen, Philippe Meersseman, Helga Ceunen, Jonas I Rosa, Daniel O Beraldo, Claudio Piras, Adenilton M Rampinelli, Antonio P Nassar Jr, Sergio Mataloun, Marcelo Moock, Marlus M Thompson, Claudio H Gonçalves, Ana Carolina P Antônio, Aline Ascoli, Rodrigo S Biondi, Danielle C Fontenele, Danielle Nobrega, Vanessa M Sales, Ahmad Yazid Bin Hj Abul Wahab, Maizatul Ismail, Suresh Shindhe, John Laffey, Francois Beloncle, Kyle G Davies, Rob Cirone, Venika Manoharan, Mehvish Ismail, Ewan C Goligher, Mandeep Jassal, Erin Nishikawa, Areej Javeed, Gerard Curley, Nuttapol Rittayamai, Matteo Parotto, Niall D Ferguson, Sangeeta Mehta, Jenny Knoll, Antoine Pronovost, Sergio Canestrini, Alejandro R Bruhn, Patricio H Garcia, Felipe A Aliaga, Pamela A Farías, Jacob S Yumha, Claudia A Ortiz, Javier E Salas, Alejandro A Saez, Luis D Vega, Eduardo F Labarca, Felipe T Martinez, Nicolás G Carreño, Pilar Lora, Haitao Liu, Haibo Qiu, Ling Liu, Rui Tang, Xiaoming Luo, Youzhong An, Huiying Zhao, Yan Gao, Zhe Zhai, Zheng L Ye, Wei Wang, Wenwen Li, Qingdong Li, Ruiqiang Zheng, Wenkui Yu, Juanhong Shen, Xinyu Li, Tao Yu, Weihua Lu, Ya Q Wu, Xiao B Huang, Zhenyang He, Yuanhua Lu, Hui Han, Fan Zhang, Renhua Sun, Hua X Wang, Shu H Qin, Bao H Zhu, Jun Zhao, Jian Liu, Bin Li, Jing L Liu, Fa C Zhou, Qiong J Li, Xing Y Zhang, Zhou Li-Xin, Qiang Xin-Hua, Liangyan Jiang, Yuan N Gao, Xian Y Zhao, Yuan Y Li, Xiao L Li, Chunting Wang, Qingchun Yao, Rongguo Yu, Kai Chen, Huanzhang Shao, Bingyu Qin, Qing Q Huang, Wei H Zhu, Ai Y Hang, Ma X Hua, Yimin Li, Yonghao Xu, Yu D Di, Long L Ling, Tie H Qin, Shou H Wang, Junping Qin, Yi Han, Suming Zhou, Monica P Vargas, Juan I Silesky Jimenez, Manuel A González Rojas, Jaime E SolisQuesada, Christian M Ramirez-Alfaro, Jan Máca, Peter Sklienka, Jakob Gjedsted, Aage Christiansen, Jonas Nielsen, Boris G 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Charlene Bigot, Sandrine Thibault, Mohammed Ghazi, Messabi Boukhazna, Salem Ould Zein, Jack R Richecoeur, Daniele M Combaux, Fabien Grelon, Charlene Le Moal, Elise P Sauvadet, Adrien Robine, Virginie Lemiale, Danielle Reuter, Martin Dres, Alexandre Demoule, Dany Goldgran-Toledano, Loredana Baboi, Claude Guérin, Ralph Lohner, Jens Kraßler, Susanne Schäfer, Kai D Zacharowski, Patrick Meybohm, Andreas W Reske, Philipp Simon, HansBernd F Hopf, Michael Schuetz, Thomas Baltus, Metaxia N Papanikolaou, Theonymfi G Papavasilopoulou, Giannis A Zacharas, Vasilis Ourailogloy, Eleni K Mouloudi, Eleni V Massa, Eva O Nagy, Electra E Stamou, Ellada V Kiourtzieva, Marina A Oikonomou, Luis E Avila, Cesar A Cortez, Johanna E Citalán, Sameer A Jog, Safal D Sable, Bhagyesh Shah, Mohan Gurjar, Arvind K Baronia, Mohammedfaruk Memon, Radhakrishnan Muthuchellappan, Venkatapura J Ramesh, Anitha Shenoy, Ramesh Unnikrishnan, Subhal B Dixit, Rachana V Rhayakar, Nagarajan Ramakrishnan, Vallish K Bhardwaj, Heera L 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Gazenkampf, Ghaleb Almekhlafi, Mohamad M Albarrak, Ghanem M Mustafa, Khalid A Maghrabi, Nawal Salahuddin, Tharwat M Aisa, Ahmed S Al Jabbary, Edgardo Tabhan, Yaseen M Arabi, Yaseen M Arabi, Olivia A Trinidad, Hasan M Al Dorzi, Edgardo E Tabhan, Vesna Bumbasirevic, Bojan Jovanovic, Stefan Bolon, Oliver Smith, Jordi Mancebo, Hernan Aguirre-Bermeo, Juan C Lopez-Delgado, Francisco Esteve, Gemma Rialp, Catalina Forteza, Candelaria De Haro, Antonio Artigas, Guillermo M Albaiceta, Sara De Cima-Iglesias, Leticia Seoane-Quiroga, Alexandra Ceniceros-Barros, Antonio L RuizAguilar, Luis M Claraco-Vega, Juan Alfonso Soler, Maria Del Carmen Lorente, Cecilia Hermosa, Federico Gordo, Miryam PrietoGonzález, Juan B López-Messa, Manuel P Perez, Cesar P Perez, Raquel Montoiro Allue, Ferran RocheCampo, Marcos Ibañez-Santacruz, Susana TempranoSusana, Maria C Pintado, Raul De Pablo, Pilar Ricart Aroa Gómez, Silvia Rodriguez Ruiz, Silvia Iglesias Moles, Mª Teresa Jurado, Alfons Arizmendi, Enrique A 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Hormis, Santhana G Kannan, Miriam Namih, Henrik Reschreiter, Julie Camsooksai, Alek Kumar, Szabolcs Rugonfalvi, Christopher Nutt, Orla Oneill, Colette Seasman, Ged Dempsey, Christopher J Scott, Helen E Ellis, Stuart Mckechnie, Paula J Hutton, Nora N Di Tomasso, Michela N Vitale, Ruth O Griffin, Michael N Dean, Julius H Cranshaw, Emma L Willett, Nicholas Ioannou, Sarah Gillis, Peter Csabi, Rosaleen Macfadyen, Heidi Dawson, Pieter D Preez, Alexandra J Williams, Owen Boyd, Laura Ortiz-Ruiz de Gordoa, Jon Bramall, Sophie Symmonds, Simon K Chau, Tim Wenham, Tamas Szakmany, Piroska Toth-Tarsoly, Katie H McCalman, Peter Alexander, Lorraine Stephenson, Thomas Collyer, Rhiannon Chapman, Raphael Cooper, Russell M Allan, Malcolm Sim, David W Wrathall, Donald A Irvine, Kim S Zantua, John C Adams, Andrew J Burtenshaw, Gareth P Sellors, Ingeborg D Welters, Karen E Williams, Robert J Hessell, Matthew G Oldroyd, Ceri E Battle, Suresh Pillai, Istvan Kajtor, Mageswaran Sivashanmugavel, Sinead C Okane, Adrian Donnelly, Aniko D Frigyik, Jon P Careless, Martin M May, Richard Stewart, T John Trinder, Samantha J Hagan, Jade M Cole, Caroline C MacFie, Anna T Dowling, Javier Hurtado, Nicolás Nin, Javier Hurtado, Edgardo Nuñez, Gustavo Pittini, Ruben Rodriguez, María C Imperio, Cristina Santos, Ana G França, Alejandro Ebeid, Alberto Deicas, Carolina Serra, Aditya Uppalapati, Ghassan Kamel, Valerie M Banner-Goodspeed, Jeremy R Beitler, Satyanarayana Reddy Mukkera, Shreedhar Kulkarni, John O Shinn Iii, Dina Gomaa, Christopher Tainter, Jarone Lee, Tomaz MesarJarone Lee, Dale J Yeatts, Jessica Warren, Michael J Lanspa, Russel R Miller, Colin K Grissom, Samuel M Brown, Philippe R Bauer, Ryan J Gosselin, Barrett T Kitch, Jason E Cohen, Scott H Beegle, Shazia Choudry, Renaud M Gueret, Aiman Tulaimat, William Stigler, Hitesh Batra, Nidhi G Huff, Keith D Lamb, Trevor W Oetting, Nicholas M Mohr, Claine Judy, Shigeki Saito, Fayez M Kheir, Fayez Kheir, Adam B Schlichting, Angela Delsing, Daniel R Crouch, Mary Elmasri, Daniel R Crouch, Dina Ismail, Kyle R Dreyer, Thomas C Blakeman, Dina Gomaa, Rebecca M Baro, Carolina Quintana Grijalba, Peter C Hou, Raghu Seethala, Imo Aisiku, Galen Henderson, Gyorgy Frendl, Sen-Kuang Hou, Robert L Owens, Ashley Schomer, Intensive Care Medicine, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, Pham, T, Pesenti, A, Bellani, G, Rubenfeld, G, Fan, E, Bugedo, G, Lorente, J, Fernandes, A, Van Haren, F, Bruhn, A, Rios, F, Esteban, A, Gattinoni, L, Larsson, A, Mcauley, D, Ranieri, M, Thompson, B, Wrigge, H, Brochard, L, Laffey, J, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), St. Michael's Hospital, University of Toronto, Groupe de recherche clinique CARMAS, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Università degli Studi di Milano [Milano] (UNIMI), University of Milan, San Gerardo Hospital, Sunnybrook Health Sciences Center, Mount Sinai Hospital [Toronto, Canada] (MSH), Pontificia Universidad Católica de Chile (UC), University Hospital of Getafe, CIBER Enfermedades Respiratorias (CIBERES), Universidad Europea de Madrid, Hospital Garcia de Orta (EPE), Canberra Hospital, Medical School [Australian National University - ANU], Australian National University (ANU), University of Canberra, Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), University of Göttingen - Georg-August-Universität Göttingen, Uppsala University, Queen's University [Belfast] (QUB), Royal Victoria Hospital, McGill University Health Center [Montreal] (MUHC), Università degli Studi di Bologna, Massachusetts General Hospital [Boston], University Hospital Leipzig, Department of Anaesthesiology, Intensive Care and Emergency Medicine, Pain Therapy, Bergmannstrost Hospital Halle, 06112, Halle, National University of Ireland [Galway] (NUI Galway), Bayer GlaxoSmithKline, GSK Baxter International Boehringer Ingelheim Wellcome Trust, WT National Institute for Health Research, NIHR Queen's University Belfast, QUB Medical Research Council Canada, MRC European Society of Intensive Care Medicine, ESICM, Support statement: This work was supported by the European Society of Intensive Care Medicine. Funding information for this article has been deposited with the Crossref Funder Registry., Conflict of interest: T. Pham has nothing to disclose. A. Pesenti reports personal fees from Maquet, Novalung/Xenios, Baxter, Gilead and Boehringer Ingelheim, outside the submitted work. G. Bellani reports grants and personal fees from Draeger Medical, personal fees from Getinge, Hamilton, GE Healthcare, Dimar SRL, Intersurgical and Flowmeter SPA, outside the submitted work. G. Rubenfeld has nothing to disclose. E. Fan reports personal fees from ALung Technologies, Getinge and MC3 Cardiopulmonary, grants, personal fees and non-financial support from Fresenius Medical Care, outside the submitted work. G. Bugedo has nothing to disclose. J.A. Lorente has nothing to disclose. A.D. V. Fernandes has nothing to disclose. F. Van Haren has nothing to disclose. A. Bruhn has nothing to disclose. F. Rios has nothing to disclose. A. Esteban has nothing to disclose. L. Gattinoni has nothing to disclose. A. Larsson reports grants from the Swedish Heart and Lung Foundation, during the conduct of the study. D.F. McAuley reports personal fees from consultancy for GlaxoSmithKline, Boehringer Ingelheim and Bayer, outside the submitted work, in addition, his institution has received funds from grants from the UK NIHR, Wellcome Trust, Innovate UK, NI HSC R&D Division, NI Chest Heart and Stroke, and MRC, is one of four named inventors on a patent US8962032 covering the use of sialic acid-bearing nanoparticles as anti-inflammatory agents issued to his institution, The Queen’s University of Belfast (http://www.google.com/patents/US8962032), and is a Director of Research for the Intensive Care Society and NIHR EME Programme Director. M. Ranieri has nothing to disclose. B.T. Thompson reports personal fees from Bayer, Thetis and Novartis, outside the submitted work. H. Wrigge reports personal fees for consultancy from Dräger Medical, personal fees for advisory board work from Liberate Medical, grants and personal fees for lectures from InfectoPharm, personal fees for lectures from MSD and GE, outside the submitted work. L.J. Brochard reports grants from Medtronic Covidien, grants and non-financial support from Fisher Paykel, non-financial support from Air Liquide, Sentec and Philips, other (patent) from General Electric, outside the submitted work. J.G. Laffey reports grants and personal fees from Baxter, grants and non-financial support from Aerogen and Factor Biosciences, outside the submitted work., LUNG SAFE Investigators and the European Society of Intensive Care Medicine Trials Group: Antonio Pesenti, John G Laffey, Laurent Brochard, Andres Esteban, Luciano Gattinoni, Frank van Haren, Anders Larsson, Daniel F McAuley, Marco Ranieri, Gordon Rubenfeld, B Taylor Thompson, Hermann Wrigge, Arthur S Slutsky, John G Laffey, Giacomo Bellani, Tài Pham, Eddy Fan, Fernando Rios, Frank van Haren, Thierry Sottiaux, Pieter Depuydt, Fredy S Lora, Luciano Cesar Azevedo, Eddy Fan, Guillermo Bugedo, Haibo Qiu, Marcos Gonzalez, Juan Silesky, Vladimir Cerny, Jonas Nielsen, Manuel Jibaja, Tài Pham, Hermann Wrigge, Dimitrios Matamis, Jorge Luis Ranero, Pravin Amin, S M Hashemian, Kevin Clarkson, Giacomo Bellani, Kiyoyasu Kurahashi, Asisclo Villagomez, Amine Ali Zeggwagh, Leo M Heunks, Jon Henrik Laake, Jose Emmanuel Palo, Antero do Vale Fernandes, Dorel Sandesc, Yaasen Arabi, Vesna Bumbasierevic, Nicolas Nin, Jose A Lorente, Anders Larsson, Lise Piquilloud, Fekri Abroug, Daniel F McAuley, Lia McNamee, Javier Hurtado, Ed Bajwa, Gabriel Démpaire, Hektor Sula, Lordian Nunci, Alma Cani, Alan Zazu, Christian Dellera, Carolina S Insaurralde, Risso V Alejandro, Julio Daldin, Mauricio Vinzio, Ruben O Fernandez, Luis P Cardonnet, Lisandro R Bettini, Mariano Carboni Bisso, Emilio M Osman, Mariano G Setten, Pablo Lovazzano, Javier Alvarez, Veronica Villar, Norberto C Pozo, Nicolas Grubissich, Gustavo A Plotnikow, Daniela N Vasquez, Santiago Ilutovich, Norberto Tiribelli, Ariel Chena, Carlos A Pellegrini, María G Saenz, Elisa Estenssoro, Matias Brizuela, Hernan Gianinetto, Pablo E Gomez, Valeria I Cerrato, Marco G Bezzi, Silvina A Borello, Flavia A Loiacono, Adriana M Fernandez, Serena Knowles, Claire Reynolds, Deborah M Inskip, Jennene J Miller, Jing Kong, Christina Whitehead, Shailesh Bihari, Aylin Seven, Amanda Krstevski, Helen J Rodgers, Rebecca T Millar, Toni E McKenna, Irene M Bailey, Gabrielle C Hanlon, Anders Aneman, Joan M Lynch, Raman Azad, John Neal, Paul W Woods, Brigit L Roberts, Mark R Kol, Helen S Wong, Katharina C Riss, Thomas Staudinger, Xavier Wittebole, Caroline Berghe, Pierre A Bulpa, Alain M Dive, Rik Verstraete, Herve Lebbinck, Pieter Depuydt, Joris Vermassen, Philippe Meersseman, Helga Ceunen, Jonas I Rosa, Daniel O Beraldo, Claudio Piras, Adenilton M Rampinelli, Antonio P Nassar Jr, Sergio Mataloun, Marcelo Moock, Marlus M Thompson, Claudio H Gonçalves, Ana Carolina P Antônio, Aline Ascoli, Rodrigo S Biondi, Danielle C Fontenele, Danielle Nobrega, Vanessa M Sales, Ahmad Yazid Bin Hj Abul Wahab, Maizatul Ismail, Suresh Shindhe, John Laffey, Francois Beloncle, Kyle G Davies, Rob Cirone, Venika Manoharan, Mehvish Ismail, Ewan C Goligher, Mandeep Jassal, Erin Nishikawa, Areej Javeed, Gerard Curley, Nuttapol Rittayamai, Matteo Parotto, Niall D Ferguson, Sangeeta Mehta, Jenny Knoll, Antoine Pronovost, Sergio Canestrini, Alejandro R Bruhn, Patricio H Garcia, Felipe A Aliaga, Pamela A Farías, Jacob S Yumha, Claudia A Ortiz, Javier E Salas, Alejandro A Saez, Luis D Vega, Eduardo F Labarca, Felipe T Martinez, Nicolás G Carreño, Pilar Lora, Haitao Liu, Haibo Qiu, Ling Liu, Rui Tang, Xiaoming Luo, Youzhong An, Huiying Zhao, Yan Gao, Zhe Zhai, Zheng L Ye, Wei Wang, Wenwen Li, Qingdong Li, Ruiqiang Zheng, Wenkui Yu, Juanhong Shen, Xinyu Li, Tao Yu, Weihua Lu, Ya Q Wu, Xiao B Huang, Zhenyang He, Yuanhua Lu, Hui Han, Fan Zhang, Renhua Sun, Hua X Wang, Shu H Qin, Bao H Zhu, Jun Zhao, Jian Liu, Bin Li, Jing L Liu, Fa C Zhou, Qiong J Li, Xing Y Zhang, Zhou Li-Xin, Qiang Xin-Hua, Liangyan Jiang, Yuan N Gao, Xian Y Zhao, Yuan Y Li, Xiao L Li, Chunting Wang, Qingchun Yao, Rongguo Yu, Kai Chen, Huanzhang Shao, Bingyu Qin, Qing Q Huang, Wei H Zhu, Ai Y Hang, Ma X Hua, Yimin Li, Yonghao Xu, Yu D Di, Long L Ling, Tie H Qin, Shou H Wang, Junping Qin, Yi Han, Suming Zhou, Monica P Vargas, Juan I Silesky Jimenez, Manuel A González Rojas, Jaime E SolisQuesada, Christian M Ramirez-Alfaro, Jan Máca, Peter Sklienka, Jakob Gjedsted, Aage Christiansen, Jonas Nielsen, Boris G Villamagua, Iguel Llano, Philippe Burtin, Gautier Buzancais, Pascal Beuret, Nicolas Pelletier, Satar Mortaza, Alain Mercat, Jonathan Chelly, Sébastien Jochmans, Nicolas Terzi, Cédric Daubin, Guillaume Carteaux, Nicolas de Prost, Jean-Daniel Chiche, Fabrice Daviaud, Tài Pham, Muriel Fartoukh, Guillaume Barberet, Jerome Biehler, Jean Dellamonica, Denis Doyen, Jean-Michel Arnal, Anais Briquet, Sami Hraiech, Laurent Papazian, Arnaud Follin, Damien Roux, Jonathan Messika, Evangelos Kalaitzis, Laurence Dangers, Alain Combes, Siu-Ming Au, Gaetan Béduneau, Dorothée Carpentier, Elie H Zogheib, Herve Dupont, Sylvie Ricome, Francesco L Santoli, Sebastien L Besset, Philippe Michel, Bruno Gelée, Pierre-Eric Danin, Bernard Goubaux, Philippe J Crova, Nga T Phan, Frantz Berkelmans, Julio C Badie, Romain Tapponnier, Josette Gally, Samy Khebbeb, Jean-Etienne Herbrecht, Francis Schneider, PierreLouis M Declercq, Jean-Philippe Rigaud, Jacques Duranteau, Anatole Harrois, Russell Chabanne, Julien Marin, Charlene Bigot, Sandrine Thibault, Mohammed Ghazi, Messabi Boukhazna, Salem Ould Zein, Jack R Richecoeur, Daniele M Combaux, Fabien Grelon, Charlene Le Moal, Elise P Sauvadet, Adrien Robine, Virginie Lemiale, Danielle Reuter, Martin Dres, Alexandre Demoule, Dany Goldgran-Toledano, Loredana Baboi, Claude Guérin, Ralph Lohner, Jens Kraßler, Susanne Schäfer, Kai D Zacharowski, Patrick Meybohm, Andreas W Reske, Philipp Simon, HansBernd F Hopf, Michael Schuetz, Thomas Baltus, Metaxia N Papanikolaou, Theonymfi G Papavasilopoulou, Giannis A Zacharas, Vasilis Ourailogloy, Eleni K Mouloudi, Eleni V Massa, Eva O Nagy, Electra E Stamou, Ellada V Kiourtzieva, Marina A Oikonomou, Luis E Avila, Cesar A Cortez, Johanna E Citalán, Sameer A Jog, Safal D Sable, Bhagyesh Shah, Mohan Gurjar, Arvind K Baronia, Mohammedfaruk Memon, Radhakrishnan Muthuchellappan, Venkatapura J Ramesh, Anitha Shenoy, Ramesh Unnikrishnan, Subhal B Dixit, Rachana V Rhayakar, Nagarajan Ramakrishnan, Vallish K Bhardwaj, Heera L Mahto, Sudha V Sagar, Vijayanand Palaniswamy, Deeban Ganesan, Seyed Mohammadreza Hashemian, Hamidreza Jamaati, Farshad Heidari, Edel A Meaney, Alistair Nichol, Karl M Knapman, Donall O'Croinin, Eimhin S Dunne, Dorothy M Breen, Kevin P Clarkson, Rola F Jaafar, Rory Dwyer, Fahd Amir, Olaitan O Ajetunmobi, Aogan C O'Muircheartaigh, Colin S Black, Nuala Treanor, Daniel V Collins, Wahid Altaf, Gianluca Zani, Maurizio Fusari, Savino Spadaro, Carlo A Volta, Romano Graziani, Barbara Brunettini, Salvatore Palmese, Paolo Formenti, Michele Umbrello, Andrea Lombardo, Elisabetta Pecci, Marco Botteri, Monica Savioli, Alessandro Protti, Alessia Mattei, Lorenzo Schiavoni, Andrea Tinnirello, Manuel Todeschini, Antonino Giarratano, Andrea Cortegiani, Antonino Giarratano, Andrea Cortegiani, Massimo M Antonelli, Luca M Montini, Paolo Casalena, Sergio Scafetti, Giovanna Panarello, Giovanna Occhipinti, Nicolò Patroniti, Matteo Pozzi, Roberto R Biscione, Michela M Poli, Ferdinando Raimondi, Daniela Albiero, Giulia Crapelli, Eduardo Beck, Vincenzo Pota, Vincenzo Schiavone, Alexandre Molin, Fabio Tarantino, Giacomo Monti, Elena Frati, Lucia Mirabella, Gilda Cinnella, Tommaso Fossali, Riccardo Colombo, Pierpaolo Terragni, Ilaria Pattarino, Francesco Mojoli, Antonio Braschi, Erika E Borotto, Andrea N Cracchiolo, Daniela M Palma, Francesco Raponi, Giuseppe Foti, Ettore R Vascotto, Andrea Coppadoro, Luca Brazzi, Leda Floris, Giorgio A Iotti, Aaron Venti, Osamu Yamaguchi, Shunsuke Takagi, Hiroki N Maeyama, Eizo Watanabe, Yoshihiro Yamaji, Kazuyoshi Shimizu, Kyoko Shiozaki, Satoru Futami, Sekine Ryosuke, Koji Saito, Yoshinobu Kameyama, Keiko Ueno, Masayo Izawa, Nao Okuda, Hiroyuki Suzuki, Tomofumi Harasawa, Michitaka Nasu, Tadaaki Takada, Fumihito Ito, Shin Nunomiya, Kansuke Koyama, Toshikazu Abe, Kohkichi Andoh, Kohei Kusumoto, Akira Hirata, Akihiro Takaba, Hiroyasu Kimura, Shuhei Matsumoto, Ushio Higashijima, Hiroyuki Honda, Nobumasa Aoki, Hiroshi Imai, Yasuaki Ogino, Ichiko Mizuguchi, Kazuya Ichikado, Kenichi Nitta, Katsunori Mochizuki, Tomoaki Hashida, Hiroyuki Tanaka, Tomoyuki Nakamura, Daisuke Niimi, Takeshi Ueda, Yozo Kashiwa, Akinori Uchiyama, Olegs Sabelnikovs, Peteris Oss, Youssef Haddad, Kong Y Liew, Silvio A Ñamendys-Silva, Yves D Jarquin-Badiola, Luis A Sanchez-Hurtado, Saira S Gomez-Flores, Maria C Marin, Asisclo J Villagomez, Jordana S Lemus, Jonathan M Fierro, Mavy Ramirez Cervantes, Francisco Javier Flores Mejia, Dulce Dector, Alejandro Rojas, Daniel R Gonzalez, Claudia R Estrella, Jorge R Sanchez-Medina, Alvaro Ramirez-Gutierrez, Fernando G George, Janet S Aguirre, Juan A Buensuseso, Manuel Poblano, Juan A Buensuseso, Manuel Poblano, Tarek Dendane, Amine Ali Zeggwagh, Hicham Balkhi, Mina Elkhayari, Nacer Samkaoui, Hanane Ezzouine, Abdellatif Benslama, Mourad Amor, Wajdi Maazouzi, Nedim Cimic, Oliver Beck, Monique M Bruns, Jeroen A Schouten, Myra Rinia, Monique Raaijmakers, Leo M Heunks, Hellen M van Wezel, Serge J Heines, Ulrich Strauch, Marc P Buise, Fabienne D Simonis, Marcus J Schultz, Jennifer C Goodson, Troy S Browne, Leanlove Navarra, Anna Hunt, Robyn A Hutchison, Mathew B Bailey, Lynette Newby, Colin McArthur, Michael Kalkoff, Alex Mcleod, Jonathan Casement, Danielle J Hacking, Finn H Andersen, Merete S Dolva, Jon H Laake, Andreas Barratt-Due, Kim Andre L Noremark, Eldar Søreide, Brit Å Sjøbø, Anne B Guttormsen, Hector H Leon Yoshido, Ronald Zumaran Aguilar, Fredy A Montes Oscanoa, Alain U Alisasis, Joanne B Robles, Rossini Abbie B Pasanting-Lim, Beatriz C Tan, Pawel Andruszkiewicz, Karina Jakubowska, Cristina M Coxo, António M Alvarez, Bruno S Oliveira, Gustavo M Montanha, Nelson C Barros, Carlos S Pereira, António M Messias, Jorge M Monteiro, Ana M Araujo, Nuno T Catorze, Susan M Marum, Maria J Bouw, Rui M Gomes, Vania A Brito, Silvia Castro, Joana M Estilita, Filipa M Barros, Isabel M Serra, Aurelia M Martinho, Dana R Tomescu, Alexandra Marcu, Ovidiu H Bedreag, Marius Papurica, Dan E Corneci, Silvius Ioan Negoita, Evgeny Grigoriev, Alexey I Gritsan, Andrey A Gazenkampf, Ghaleb Almekhlafi, Mohamad M Albarrak, Ghanem M Mustafa, Khalid A Maghrabi, Nawal Salahuddin, Tharwat M Aisa, Ahmed S Al Jabbary, Edgardo Tabhan, Yaseen M Arabi, Yaseen M Arabi, Olivia A Trinidad, Hasan M Al Dorzi, Edgardo E Tabhan, Vesna Bumbasirevic, Bojan Jovanovic, Stefan Bolon, Oliver Smith, Jordi Mancebo, Hernan Aguirre-Bermeo, Juan C Lopez-Delgado, Francisco Esteve, Gemma Rialp, Catalina Forteza, Candelaria De Haro, Antonio Artigas, Guillermo M Albaiceta, Sara De Cima-Iglesias, Leticia Seoane-Quiroga, Alexandra Ceniceros-Barros, Antonio L RuizAguilar, Luis M Claraco-Vega, Juan Alfonso Soler, Maria Del Carmen Lorente, Cecilia Hermosa, Federico Gordo, Miryam PrietoGonzález, Juan B López-Messa, Manuel P Perez, Cesar P Perez, Raquel Montoiro Allue, Ferran RocheCampo, Marcos Ibañez-Santacruz, Susana TempranoSusana, Maria C Pintado, Raul De Pablo, Pilar Ricart Aroa Gómez, Silvia Rodriguez Ruiz, Silvia Iglesias Moles, Mª Teresa Jurado, Alfons Arizmendi, Enrique A Piacentini, Nieves Franco, Teresa Honrubia, Meisy Perez Cheng, Elena Perez Losada, Javier Blanco, Luis J Yuste, Cecilia Carbayo-Gorriz, Francisca G Cazorla-Barranquero, Javier G Alonso, Rosa S Alda, Ángela Algaba, Gonzalo Navarro, Enrique Cereijo, Esther Diaz-Rodriguez, Diego Pastor Marcos, Laura Alvarez Montero, Luis Herrera Para, Roberto Jimenez Sanchez, Miguel Angel Blasco Navalpotro, Ricardo Diaz Abad, Raquel Montiel González, Dácil Parrilla Toribio, Alejandro G Castro, Maria Jose D Artiga, Oscar Penuelas, Tomas P Roser, Moreno F Olga, Elena Gallego Curto, Rocío Manzano Sánchez, Vallverdu P Imma, Garcia M Elisabet, Laura Claverias, Monica Magret, Ana M Pellicer, Lucia L Rodriguez, Jesús Sánchez-Ballesteros, Ángela González-Salamanca, Antonio G Jimenez, Francisco P Huerta, Juan Carlos J Sotillo Diaz, Esther Bermejo Lopez, David D Llinares Moya, Alec A Tallet Alfonso, Palazon Sanchez Eugenio Luis, Palazon Sanchez Cesar, Sánchez I Rafael, Corcoles G Virgilio, Noelia N Recio, Christian C Rylander, Bernhard Holzgraefe, Lars M Broman, Joanna Wessbergh, Linnea Persson, Fredrik Schiöler, Hans Kedelv, Anna Oscarsson Tibblin, Henrik Appelberg, Lars Hedlund, Johan Helleberg, Karin E Eriksson, Rita Glietsch, Niklas Larsson, Ingela Nygren, Silvia L Nunes, Anna-Karin Morin, Thomas Kander, Anne Adolfsson, Lise Piquilloud, Hervé O Zender, Corinne Leemann-Refondini, Souheil Elatrous, Slaheddine Bouchoucha, Imed Chouchene, Islem Ouanes, Asma Ben Souissi, Salma Kamoun, Oktay Demirkiran, Mustafa Aker, Emre Erbabacan, Ilkay Ceylan, Nermin Kelebek Girgin, Menekse Ozcelik, Necmettin Ünal, Basak Ceyda Meco, Onat O Akyol, Suleyman S Derman, Barry Kennedy, Ken Parhar, Latha Srinivasa, Lia McNamee, Danny McAuley, Phil Hopkins, Clare Mellis, Vivek Kakar, Dan Hadfield, Andre Vercueil, Kaushik Bhowmick, Sally K Humphreys, Andrew Ferguson, Raymond Mckee, Ashok S Raj, Danielle A Fawkes, Philip Watt, Linda Twohey, Rajeev R Jha, Matthew Thomas, Alex Morton, Varsha Kadaba, Mark J Smith, Anil P Hormis, Santhana G Kannan, Miriam Namih, Henrik Reschreiter, Julie Camsooksai, Alek Kumar, Szabolcs Rugonfalvi, Christopher Nutt, Orla Oneill, Colette Seasman, Ged Dempsey, Christopher J Scott, Helen E Ellis, Stuart Mckechnie, Paula J Hutton, Nora N Di Tomasso, Michela N Vitale, Ruth O Griffin, Michael N Dean, Julius H Cranshaw, Emma L Willett, Nicholas Ioannou, Sarah Gillis, Peter Csabi, Rosaleen Macfadyen, Heidi Dawson, Pieter D Preez, Alexandra J Williams, Owen Boyd, Laura Ortiz-Ruiz de Gordoa, Jon Bramall, Sophie Symmonds, Simon K Chau, Tim Wenham, Tamas Szakmany, Piroska Toth-Tarsoly, Katie H McCalman, Peter Alexander, Lorraine Stephenson, Thomas Collyer, Rhiannon Chapman, Raphael Cooper, Russell M Allan, Malcolm Sim, David W Wrathall, Donald A Irvine, Kim S Zantua, John C Adams, Andrew J Burtenshaw, Gareth P Sellors, Ingeborg D Welters, Karen E Williams, Robert J Hessell, Matthew G Oldroyd, Ceri E Battle, Suresh Pillai, Istvan Kajtor, Mageswaran Sivashanmugavel, Sinead C Okane, Adrian Donnelly, Aniko D Frigyik, Jon P Careless, Martin M May, Richard Stewart, T John Trinder, Samantha J Hagan, Jade M Cole, Caroline C MacFie, Anna T Dowling, Javier Hurtado, Nicolás Nin, Javier Hurtado, Edgardo Nuñez, Gustavo Pittini, Ruben Rodriguez, María C Imperio, Cristina Santos, Ana G França, Alejandro Ebeid, Alberto Deicas, Carolina Serra, Aditya Uppalapati, Ghassan Kamel, Valerie M Banner-Goodspeed, Jeremy R Beitler, Satyanarayana Reddy Mukkera, Shreedhar Kulkarni, John O Shinn Iii, Dina Gomaa, Christopher Tainter, Jarone Lee, Tomaz MesarJarone Lee, Dale J Yeatts, Jessica Warren, Michael J Lanspa, Russel R Miller, Colin K Grissom, Samuel M Brown, Philippe R Bauer, Ryan J Gosselin, Barrett T Kitch, Jason E Cohen, Scott H Beegle, Shazia Choudry, Renaud M Gueret, Aiman Tulaimat, William Stigler, Hitesh Batra, Nidhi G Huff, Keith D Lamb, Trevor W Oetting, Nicholas M Mohr, Claine Judy, Shigeki Saito, Fayez M Kheir, Fayez Kheir, Adam B Schlichting, Angela Delsing, Daniel R Crouch, Mary Elmasri, Daniel R Crouch, Dina Ismail, Kyle R Dreyer, Thomas C Blakeman, Dina Gomaa, Rebecca M Baro, Carolina Quintana Grijalba, Peter C Hou, Raghu Seethala, Imo Aisiku, Galen Henderson, Gyorgy Frendl, Sen-Kuang Hou, Robert L Owens, Ashley Schomer, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (MGD) Services des soins intensifs, and UCL - (SLuc) Service de soins intensifs
Subjects: Pulmonary and Respiratory Medicine, ARDS, Unidades de cuidados intensivos, [SDV]Life Sciences [q-bio], medicine.medical_treatment, mechanical ventilation, NO, law.invention, 03 medical and health sciences, Tratamiento médico, 0302 clinical medicine, law, Settore MED/41 - ANESTESIOLOGIA, Insuficiencia respiratoria, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Lung, Mechanical ventilation, Respiratory Distress Syndrome, business.industry, Respiration, Incidence (epidemiology), medicine.disease, Intensive care unit, Respiration, Artificial, 3. Good health, Intensive Care Units, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], medicine.anatomical_structure, 030228 respiratory system, Respiratory failure, Heart failure, Anesthesia, Artificial, ards, business, Respiratory Insufficiency, Enfermedad
Abstract: BackgroundCurrent incidence and outcome of patients with acute hypoxaemic respiratory failure requiring mechanical ventilation in the intensive care unit (ICU) are unknown, especially for patients not meeting criteria for acute respiratory distress syndrome (ARDS).MethodsAn international, multicentre, prospective cohort study of patients presenting with hypoxaemia early in the course of mechanical ventilation, conducted during four consecutive weeks in the winter of 2014 in 459 ICUs from 50 countries (LUNG SAFE). Patients were enrolled with arterial oxygen tension/inspiratory oxygen fraction ratio ≤300 mmHg, new pulmonary infiltrates and need for mechanical ventilation with a positive end-expiratory pressure of ≥5 cmH2O. ICU prevalence, causes of hypoxaemia, hospital survival and factors associated with hospital mortality were measured. Patients with unilateral versus bilateral opacities were compared.Findings12 906 critically ill patients received mechanical ventilation and 34.9% with hypoxaemia and new infiltrates were enrolled, separated into ARDS (69.0%), unilateral infiltrate (22.7%) and congestive heart failure (CHF; 8.2%). The global hospital mortality was 38.6%. CHF patients had a mortality comparable to ARDS (44.1% versus 40.4%). Patients with unilateral-infiltrate had lower unadjusted mortality, but similar adjusted mortality compared to those with ARDS. The number of quadrants on chest imaging was associated with an increased risk of death. There was no difference in mortality comparing patients with unilateral-infiltrate and ARDS with only two quadrants involved.InterpretationMore than one-third of patients receiving mechanical ventilation have hypoxaemia and new infiltrates with a hospital mortality of 38.6%. Survival is dependent on the degree of pulmonary involvement whether or not ARDS criteria are reached.
Published: 2021

4. The proteolytic fraction from Vasconcellea cundinamarcensis accelerates wound healing after corneal chemical burn in rabbits

Author: Carlos E. Salas, Alfredo M. Goes, Flavia Rodrigues da Silva, Miriam Teresa Paz Lopes, Thaís Maria da Mata Martins, Bruna Lopes da Costa, Rummenigge Oliveira Silva, Lays Fernanda Nunes Dourado, Carolina Nunes da Silva, and Armando Silva-Cunha
Subjects: Latex, genetic structures, Cell Survival, Chemical burn, Administration, Ophthalmic, In Vitro Techniques, Pharmacology, Critical Care and Intensive Care Medicine, medicine.disease_cause, Cornea, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Re-Epithelialization, Stroma, Burns, Chemical, Animals, Humans, Medicine, Cells, Cultured, Cell Proliferation, Inflammation, Wound Healing, Dose-Response Relationship, Drug, Ethanol, business.industry, Proteolytic enzymes, Caricaceae, 030208 emergency & critical care medicine, General Medicine, Fibroblasts, Corneal perforation, medicine.disease, eye diseases, Ocular toxicity, Eye Burns, Superinfection, Solvents, Emergency Medicine, Vasconcellea cundinamarcensis, Surgery, Collagen, Rabbits, sense organs, business, Wound healing, Corneal Injuries, Peptide Hydrolases
Abstract: Introduction Chemical ocular burns are among the most frequently eye-related injuries, which require immediate and intensive evaluation and care since they may lead to potential complications such as superinfection, corneal perforation, and blindness.Vasconcellea cundinamarcensis, a species from Caricaceae family, contains highly active proteolytic enzymes in its latex that show healing activity in animal models bearing lesions of different etiologies. Methods We evaluate the ocular toxicity of the proteolytic fraction from V. cundinamarcensis (P1G10) by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and Hen’s Egg Test-Chorioallantoic Membrane test. The corneal healing property of P1G10 was studied by the ethanol-chemical burn in the rabbit’s eyes. Results P1G10 is safe for ocular administration, except when administrated at 10 μg/mL. P1G10 at 1 μg/mL accelerates the corneal re-epithelization achieving complete wound closure after 72 h of chemical burn. Also, P1G10 modulated the inflammatory response and controlled the arrangement of collagen fibers in the stroma, demonstrating its potential corneal healing properties. Conclusions Our work was the first one to evaluate the ophthalmic application of P1G10. Here we demonstrated that P1G10 is suitable for ocular administration and it has a promising corneal healing activity which may emerge as a new pharmacological tool to the development of a new drug for ocular surface chemical injuries in the future.
Published: 2020

5. Education Research: The medical student perspective on challenging conversations

Author: Roy E. Strowd, Mary Carol Barks, Charlene E. Gamaldo, Rachel E. Salas, Monica E. Lemmon, and Rheaya Willis
Subjects: Resident & Fellow Section, Medical education, business.industry, Perspective (graphical), Qualitative property, Focus group, Clinical communication, Content analysis, Health care, Neurology (clinical), Communication skills, Psychology, business, Curriculum
Abstract: ObjectiveMedical students experience difficult conversations with patients during clinical clerkships. This study aimed to characterize barriers to and opportunities for learning in the setting of challenging conversations.MethodsNeurology clerkship medical students were enrolled prospectively in a concurrent nested mixed methods study. Qualitative data were collected using a postclerkship survey and semi-structured focus groups. Students were asked to reflect on challenging conversations they experienced with patients and to identify the top reasons why conversations were challenging. Responses were analyzed using directed content analysis.ResultsA total of 159 medical students were enrolled (MS2: n = 35 [22%]; MS3: n = 97 [61%]; MS4: n = 27 [17%]). Three themes of difficulty were identified in survey and focus group data: (1) tough clinical realities: how the clinical environment makes conversations challenging; (2) communication skill needs: the difficulty of finding the words to say; and (3) navigating emotions: of patients, clinicians, and students themselves. Tough clinical realities were cited by over two-thirds of students in all years (MS2: n = 30 [86%]; MS3: n = 74 [76%]; MS4: n = 23 [85%]). Communication skills needs were cited most frequently by third-year students (MS2: n = 15 [43%]; MS3: n = 55 [57%]; MS4: n = 10 [37%]). Students early in training were more likely to cite difficulty navigating emotions (MS2: n = 28 [80%]; MS3: n = 71 [73%]; MS4: n = 19 [70%]).ConclusionsMedical students frequently observe and participate in challenging conversations with patients. Here, students identified what makes these conversations most difficult. Communication curricula should leverage clinical communication encounters, prepare students for inherent clinical realities, and help students navigate emotions in the health care setting.
Published: 2020

6. The Proteolytic Fraction From Vasconcellea cundinamarcensis Latex Displays Anti-Inflammatory Effect in A Mouse Model of Acute TNBS-Induced Colitis

Author: Marina Passos Pizzitola, Carlos E. Salas, Miriam T. P. Lopes, Ana Cândida Araújo e Silva, Enio Ferreira, Ronniel Morais Albuquerque, Kátia M. Freitas, and Dalton Dittz
Subjects: 0301 basic medicine, medicine.medical_specialty, Latex, medicine.drug_class, Colon, Anti-Inflammatory Agents, lcsh:Medicine, Body weight, Gastroenterology, Anti-inflammatory, Article, Lesion, 03 medical and health sciences, Mice, 0302 clinical medicine, Internal medicine, Cell density, Weight Loss, medicine, Murine colitis, Animals, Humans, Colitis, lcsh:Science, Tnbs colitis, Peroxidase, Multidisciplinary, business.industry, lcsh:R, Caricaceae, Proteases, medicine.disease, Disease Models, Animal, 030104 developmental biology, Hexosaminidases, Matrix Metalloproteinase 9, Trinitrobenzenesulfonic Acid, Pharmacodynamics, Cyclooxygenase 2, 030220 oncology & carcinogenesis, Proteolysis, Vasconcellea cundinamarcensis, Cytokines, Matrix Metalloproteinase 2, lcsh:Q, medicine.symptom, Inflammation Mediators, business
Abstract: The proteolytic fraction (P1G10) from Vasconcellea cundinamarcensis, displays gastric protective and healing activities in different skin lesions in mice and human. In an excisional model, this fraction accelerates resolution of lesions and modulates inflammatory mediators. Based on these data, we assessed its anti-inflammatory activity in murine colitis model, induced by 2,4,6-trinitrobenzenesulfonic acid (TNBS) adopted by its physiopathological similarity with human colitis. Twenty four hours after colitis induction followed by three days of treatment, P1G10 at 0.3 and 3.0 mg/Kg induced 30% increase in body weight (p
Published: 2020

7. Approach to Common Sleep Disorders

Author: Yujie Wang and Rachel E. Salas
Subjects: Multiple Sleep Latency Test, Sleep Wake Disorders, medicine.medical_specialty, Sleep hygiene, medicine.diagnostic_test, business.industry, Polysomnography, Excessive daytime sleepiness, Sleep apnea, Actigraphy, Disorders of Excessive Somnolence, medicine.disease, Sleep in non-human animals, Physical medicine and rehabilitation, Neurology, Insomnia, Quality of Life, Medicine, Humans, Neurology (clinical), medicine.symptom, business, Child
Abstract: Sleep disorders are highly relevant in clinical practice given their prevalence as well as their impact on health outcomes and quality of life. The most common concerns are excessive daytime sleepiness, insomnia, disordered breathing, and abnormal movements or behaviors during sleep. A detailed but targeted history is vital, particularly from the sleep partner/witness. In-laboratory sleep testing (polysomnography and multiple sleep latency test) remains vital in the diagnosis of certain sleep disorders (such as sleep-disordered breathing and central hypersomnia) and in specific populations (such as in children and individuals with comorbid medical disorders). Advances in technology have allowed for a variety of methods in assessing a patient's sleep, from compact devices to evaluate for sleep apnea, wrist actigraphy, and mobile device-based applications. As the pathophysiology of various sleep disorders becomes better elucidated, disease-specific medications have been developed for these conditions. Nonetheless, a multidisciplinary approach to management is necessary, including improving sleep hygiene and cognitive behavioral therapy.
Published: 2021

8. Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome: Insights from the LUNG SAFE study

Author: Madotto F, Rezoagli E, Pham T, Schmidt M, McNicholas B, Protti A, Panwar R, Bellani G, Fan E, van Haren F, Brochard L, Laffey JG, Antonio Pesenti, John G Laffey, Laurent Brochard, Andres Esteban, Luciano Gattinoni, Frank van Haren, Anders Larsson, Daniel F McAuley, Marco Ranieri, Gordon Rubenfeld, B Taylor Thompson, Hermann Wrigge, Arthur S Slutsky, Fernando Rios, T Sottiaux, P Depuydt, Fredy S Lora, Luciano Cesar Azevedo, Eddy Fan, Guillermo Bugedo, Haibo Qiu, Marcos Gonzalez, Juan Silesky, Vladimir Cerny, Jonas Nielsen, Manuel Jibaja, Tài Pham, Dimitrios Matamis, Jorge Luis Ranero, Pravin Amin, S M Hashemian, Kevin Clarkson, Giacomo Bellani, Kiyoyasu Kurahashi, Asisclo Villagomez, Amine Ali Zeggwagh, Leo M Heunks, Jon Henrik Laake, Jose Emmanuel Palo, Antero do Vale Fernandes, Dorel Sandesc, Yaasen Arabi, Vesna Bumbasierevic, Nicolas Nin, Jose A Lorente, Lise Piquilloud, Fekri Abroug, Lia McNamee, Javier Hurtado, Ed Bajwa, Gabriel Démpaire, Uhc Mother Theresa, Hektor Sula, Lordian Nunci, Alma Cani, Villa Maria, Alan Zazu, Christian Dellera, Carolina S Insaurralde, Risso V Alejandro, Julio Daldin, Mauricio Vinzio, Ruben O Fernandez, Luis P Cardonnet, Lisandro R Bettini, Mariano Carboni Bisso, Emilio M Osman, Mariano G Setten, Pablo Lovazzano, Javier Alvarez, Veronica Villar, Norberto C Pozo, Nicolas Grubissich, Gustavo A Plotnikow, Daniela N Vasquez, Santiago Ilutovich, Norberto Tiribelli, Ariel Chena, Carlos A Pellegrini, María G Saenz, Elisa Estenssoro, Matias Brizuela, Hernan Gianinetto, Pablo E Gomez, Valeria I Cerrato, Marco G Bezzi, Silvina A Borello, Flavia A Loiacono, Adriana M Fernandez, Serena Knowles, Claire Reynolds, Deborah M Inskip, Jennene J Miller, Jing Kong, Christina Whitehead, Shailesh Bihari, Aylin Seven, Amanda Krstevski, Helen J Rodgers, Rebecca T Millar, Toni E Mckenna, Irene M Bailey, Gabrielle C Hanlon, Anders Aneman, Joan M Lynch, Raman Azad, John Neal, Paul W Woods, Brigit L Roberts, Mark R Kol, Helen S Wong, Katharina C Riss, Thomas Staudinger, Xavier Wittebole, Caroline Berghe, Pierre A Bulpa, Alain M Dive, Rik Verstraete, Herve Lebbinck, Pieter Depuydt, Joris Vermassen, Philippe Meersseman, Helga Ceunen, Jonas I Rosa, Daniel O Beraldo, Claudio Piras, Adenilton M Rampinelli, Antonio P Nassar Jr, Sergio Mataloun, Marcelo Moock, Marlus M Thompson, Claudio H Gonçalves, Ana Carolina P Antônio, Aline Ascoli, Rodrigo S Biondi, Danielle C Fontenele, Danielle Nobrega, Vanessa M Sales, Suresh Shindhe, Dk Maizatul Aiman B Pg Hj Ismail, John Laffey, Francois Beloncle, Kyle G Davies, Rob Cirone, Venika Manoharan, Mehvish Ismail, Ewan C Goligher, Mandeep Jassal, Erin Nishikawa, Areej Javeed, Gerard Curley, Nuttapol Rittayamai, Matteo Parotto, Niall D Ferguson, Sangeeta Mehta, Jenny Knoll, Antoine Pronovost, Sergio Canestrini, Alejandro R Bruhn, Patricio H Garcia, Felipe A Aliaga, Pamela A Farías, Jacob S Yumha, Claudia A Ortiz, Javier E Salas, Alejandro A Saez, Luis D Vega, Eduardo F Labarca, Felipe T Martinez, Nicolás G Carreño, Pilar Lora, Haitao Liu, Ling Liu, Rui Tang, Xiaoming Luo, Youzhong An, Huiying Zhao, Yan Gao, Zhe Zhai, Zheng L Ye, Wei Wang, Wenwen Li, Qingdong Li, Ruiqiang Zheng, Wenkui Yu, Juanhong Shen, Xinyu Li, Tao Yu, Weihua Lu, Ya Q Wu, Xiao B Huang, Zhenyang He, Yuanhua Lu, Hui Han, Fan Zhang, Renhua Sun, Hua X Wang, Shu H Qin, Bao H Zhu, Jun Zhao, Jian Liu, Bin Li, Jing L Liu, Fa C Zhou, Qiong J Li, Xing Y Zhang, Zhou Li-Xin, Qiang Xin-Hua, Liangyan Jiang, Yuan N Gao, Xian Y Zhao, Yuan Y Li, Xiao L Li, Chunting Wang, Qingchun Yao, Rongguo Yu, Kai Chen, Huanzhang Shao, Bingyu Qin, Qing Q Huang, Wei H Zhu, Ai Y Hang, Ma X Hua, Yimin Li, Yonghao Xu, Yu D Di, Long L Ling, Tie H Qin, Shou H Wang, Junping Qin, Yi Han, Suming Zhou, Monica P Vargas, Juan I Silesky Jimenez, Manuel A González Rojas, Jaime E Solis-Quesada, Christian M Ramirez-Alfaro, Jan Máca, Peter Sklienka, Jakob Gjedsted, Aage Christiansen, Boris G Villamagua, Miguel Llano, Philippe Burtin, Gautier Buzancais, Pascal 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Mohammadreza Hashemian, Hamidreza Jamaati, Farshad Heidari, Edel A Meaney, Alistair Nichol, Karl M Knapman, Donall O'Croinin, Eimhin S Dunne, Dorothy M Breen, Kevin P Clarkson, Rola F Jaafar, Rory Dwyer, Fahd Amir, Olaitan O Ajetunmobi, Aogan C O'Muircheartaigh, Colin S Black, Nuala Treanor, Daniel V Collins, Wahid Altaf, Gianluca Zani, Maurizio Fusari, Savino Spadaro, Carlo A Volta, Romano Graziani, Barbara Brunettini, Salvatore Palmese, Paolo Formenti, Michele Umbrello, Andrea Lombardo, Elisabetta Pecci, Marco Botteri, Monica Savioli, Alessandro Protti, Alessia Mattei, Lorenzo Schiavoni, Andrea Tinnirello, Manuel Todeschini, Antonino Giarratano, Andrea Cortegiani, Sara Sher, Anna Rossi, Massimo M Antonelli, Luca M Montini, Paolo Casalena, Sergio Scafetti, Giovanna Panarello, Giovanna Occhipinti, Nicolò Patroniti, Matteo Pozzi, Roberto R Biscione, Michela M Poli, Ferdinando Raimondi, Daniela Albiero, Giulia Crapelli, Eduardo Beck, Vincenzo Pota, Vincenzo Schiavone, Alexandre Molin, Fabio Tarantino, Giacomo Monti, Elena Frati, Lucia Mirabella, Gilda Cinnella, Tommaso Fossali, Riccardo Colombo, Pierpaolo Terragni Ilaria Pattarino, Francesco Mojoli, Antonio Braschi, Erika E Borotto, Andrea N Cracchiolo, Daniela M Palma, Francesco Raponi, Giuseppe Foti, Ettore R Vascotto, Andrea Coppadoro, Luca Brazzi, Leda Floris, Giorgio A Iotti, Aaron Venti, Osamu Yamaguchi, Shunsuke Takagi, Hiroki N Maeyama, Eizo Watanabe, Yoshihiro Yamaji, Kazuyoshi Shimizu, Kyoko Shiozaki, Satoru Futami, Sekine Ryosuke, Koji Saito, Yoshinobu Kameyama, Keiko Ueno, Masayo Izawa, Nao Okuda, Hiroyuki Suzuki, Tomofumi Harasawa, Michitaka Nasu, Tadaaki Takada, Fumihito Ito, Shin-Nunomiya Kansuke-Koyama, Toshikazu Abe, Kohkichi Andoh, Kohei Kusumoto, Akira Hirata, Akihiro Takaba, Hiroyasu Kimura, Shuhei Matsumoto, Ushio Higashijima, Hiroyuki Honda, Nobumasa Aoki, Hiroshi Imai, Yasuaki Ogino, Ichiko Mizuguchi, Kazuya Ichikado, Kenichi Nitta, Katsunori Mochizuki, Tomoaki Hashida, Hiroyuki Tanaka, Tomoyuki Nakamura, Daisuke Niimi, Takeshi Ueda, Yozo Kashiwa, Akinori Uchiyama, Olegs Sabelnikovs, Peteris Oss, Youssef Haddad, Kong Y Liew, Silvio A Ñamendys-Silva, Yves D Jarquin-Badiola, Luis A Sanchez-Hurtado, Saira S Gomez-Flores, Maria C Marin, Asisclo J Villagomez, Jordana S Lemus, Jonathan M Fierro, Mavy Ramirez Cervantes, Francisco Javier Flores Mejia, Dulce Dector, Dulce M Dector, Daniel R Gonzalez, Claudia R Estrella, Jorge R Sanchez-Medina, Alvaro Ramirez-Gutierrez, Fernando G George, Janet S Aguirre, Juan A Buensuseso, Manuel Poblano, Tarek Dendane, Hicham Balkhi, Mina Elkhayari, Nacer Samkaoui, Hanane Ezzouine, Abdellatif Benslama Mourad Amor, Wajdi Maazouzi, Nedim Cimic, Oliver Beck, Monique M Bruns, Jeroen A Schouten, Myra-Rinia, Monique Raaijmakers, Hellen M Van Wezel, Serge J Heines, Ulrich Strauch, Marc P Buise, Fabienne D Simonis, Marcus J Schultz, Jennifer C Goodson, Troy S Browne, Leanlove Navarra, Anna Hunt, Robyn A Hutchison, Mathew B Bailey, Lynette Newby, 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Alonso, Rosa S Alda, Ángela Algaba, Gonzalo Navarro, Enrique Cereijo, Esther Diaz-Rodriguez, Diego Pastor Marcos, Laura Alvarez Montero, Luis Herrera Para, Roberto Jimenez Sanchez, Miguel Angel Blasco Navalpotro, Ricardo Diaz Abad, Raquel Montiel Gonz Á Lez, D Á Cil Parrilla Toribio, Alejandro G Castro, Maria Jose D Artiga, Oscar Penuelas, Tomas P Roser, Moreno F Olga, Elena Gallego Curto, Rocío Manzano Sánchez, Vallverdu P Imma, Garcia M Elisabet, Laura Claverias, Monica Magret, Ana M Pellicer, Lucia L Rodriguez, Jesús Sánchez-Ballesteros, Ángela González-Salamanca, Antonio G Jimenez, Francisco P Huerta, Juan Carlos J Sotillo Diaz, Esther Bermejo Lopez, David D Llinares Moya, Alec A Tallet Alfonso, Palazon Sanchez Eugenio Luis, Palazon Sanchez Cesar, Sánchez I Rafael, Corcoles G Virgilio, Noelia N Recio, Richard O Adamsson, Christian C Rylander, Bernhard Holzgraefe, Lars M Broman, Joanna Wessbergh, Linnea Persson, Fredrik Schiöler, Hans Kedelv, Anna Oscarsson Tibblin, Henrik Appelberg, Lars Hedlund, Johan Helleberg, Karin E Eriksson, Rita Glietsch, Niklas Larsson, Ingela Nygren, Silvia L Nunes, Anna-Karin Morin, Thomas Kander, Anne Adolfsson, Hervé O Zender, Corinne Leemann-Refondini, Souheil Elatrous, Slaheddine Bouchoucha, Imed Chouchene, Islem Ouanes, Asma Ben Souissi, Salma Kamoun, Oktay Demirkiran, Mustafa Aker, Emre Erbabacan, Ilkay Ceylan, Nermin Kelebek Girgin, Menekse Ozcelik, Necmettin Ünal, Basak Ceyda Meco, Onat O Akyol, Suleyman S Derman, Barry Kennedy, Ken Parhar, Latha Srinivasa, Danny McAuley, Phil Hopkins, Clare Mellis, Vivek Kakar, Dan Hadfield, Andre Vercueil, Kaushik Bhowmick, Sally K Humphreys, Andrew Ferguson, Raymond Mckee, Ashok S Raj, Danielle A Fawkes, Philip Watt, Linda Twohey, Rajeev R JhaMatthew Thomas, Alex Morton, Varsha Kadaba, Mark J Smith, Anil P Hormis, Santhana G Kannan, Miriam Namih, Henrik Reschreiter, Julie Camsooksai, Alek Kumar, Szabolcs Rugonfalvi, Christopher Nutt, Orla O'Neill, Colette Seasman, Ged Dempsey, Christopher J Scott, Helen E Ellis, Stuart Mckechnie, Paula J Hutton, Nora N Di Tomasso, Michela N Vitale, Ruth O Griffin, Michael N Dean, Julius H Cranshaw, Emma L Willett, Nicholas Ioannou, Sarah Gillis, Peter Csabi, Rosaleen Macfadyen, Heidi Dawson, Pieter D Preez, Alexandra J Williams, Owen Boyd, Laura Ortiz-Ruiz De Gordoa, Jon Bramall, Sophie Symmonds, Simon K Chau, Tim Wenham, Tamas Szakmany, Piroska Toth-Tarsoly, Katie H McCalman, Peter Alexander, Lorraine Stephenson, Thomas Collyer, Rhiannon Chapman, Raphael Cooper, Russell M Allan, Malcolm Sim, David W Wrathall, Donald A Irvine, Kim S Zantua, John C Adams, Andrew J Burtenshaw, Gareth P Sellors, Ingeborg D Welters, Karen E Williams, Robert J Hessell, Matthew G Oldroyd, Ceri E Battle, Suresh Pillai, Istvan Kajtor, Mageswaran Sivashanmugavel, Sinead C O'Kane, Adrian Donnelly, Aniko D Frigyik, Jon P Careless, Martin M May, Richard Stewart, T John Trinder, Samantha J Hagan, Matt P Wise, Jade M Cole, Caroline C MacFie, Anna T Dowling, Nicolás Nin, Edgardo Nuñez, Gustavo Pittini, Ruben Rodriguez, María C Imperio, Cristina Santos, Ana G França, Alejandro Ebeid, Alberto Deicas, Carolina Serra, Aditya Uppalapati, Ghassan Kamel, Valerie M Banner-Goodspeed, Jeremy R Beitler, Satyanarayana Reddy Mukkera, Shreedhar Kulkarni, Jarone Lee, Tomaz Mesar, John O Shinn 3rd, Dina Gomaa, Christopher Tainter, Dale J Yeatts, Jessica Warren, Michael J Lanspa, Russel R Miller, Colin K Grissom, LUNG SAFE Investigators and the ESICM Trials Group, Samuel M Brown, Philippe R Bauer, Ryan J Gosselin, Barrett T Kitch, Jason E Cohen, Scott H Beegle, Renaud M Gueret, Aiman Tulaimat, Shazia Choudry, William Stigler, Hitesh Batra, Nidhi G Huff, Keith D Lamb, Trevor W Oetting, Nicholas M Mohr, Claine Judy, Shigeki Saito, Fayez M Kheir, Fayez Kheir, Adam B Schlichting, Angela Delsing, Daniel R Crouch, Mary Elmasri, Dina Ismail, Kyle R Dreyer, Thomas C Blakeman, Rebecca M Baron, Carolina Quintana Grijalba, Peter C Hou, Raghu Seethala, Imo Aisiku, Galen Henderson, Gyorgy Frendl, Sen-Kuang Hou, Robert L Owens, Ashley Schomer, Vesna Bumbasirevic, Bojan Jovanovic, Maja Surbatovic, Milic Veljovic, Madotto, F., Rezoagli, E., Pham, T., Schmidt, M., Mcnicholas, B., Protti, A., Panwar, R., Bellani, G., Fan, E., Van Haren, F., Brochard, L., Laffey, J. 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N., Ilutovich, S., Tiribelli, N., Chena, A., Pellegrini, C. A., Saenz, M. G., Estenssoro, E., Brizuela, M., Gianinetto, H., Gomez, P. E., Cerrato, V. I., Bezzi, M. G., Borello, S. A., Loiacono, F. A., Fernandez, A. M., Knowles, S., Reynolds, C., Inskip, D. M., Miller, J. J., Kong, J., Whitehead, C., Bihari, S., Seven, A., Krstevski, A., Rodgers, H. J., Millar, R. T., Mckenna, T. E., Bailey, I. M., Hanlon, G. C., Aneman, A., Lynch, J. M., Azad, R., Neal, J., Woods, P. W., Roberts, B. L., Kol, M. R., Wong, H. S., Riss, K. C., Staudinger, T., Wittebole, X., Berghe, C., Bulpa, P. A., Dive, A. M., Verstraete, R., Lebbinck, H., Vermassen, J., Meersseman, P., Ceunen, H., Rosa, J. I., Beraldo, D. O., Piras, C., Rampinelli, A. M., Nassar, A. P., Mataloun, S., Moock, M., Thompson, M. M., Goncalves, C. H., Antonio, A. C. P., Ascoli, A., Biondi, R. S., Fontenele, D. C., Nobrega, D., Sales, V. M., Shindhe, S., Pg Hj Ismail, D. M. A. B., Laffey, J., Beloncle, F., Davies, K. G., Cirone, R., Manoharan, V., Ismail, M., Goligher, E. C., Jassal, M., Nishikawa, E., Javeed, A., Curley, G., Rittayamai, N., Parotto, M., Ferguson, N. D., Mehta, S., Knoll, J., Pronovost, A., Canestrini, S., Bruhn, A. R., Garcia, P. H., Aliaga, F. A., Farias, P. A., Yumha, J. S., Ortiz, C. A., Salas, J. E., Saez, A. A., Vega, L. D., Labarca, E. F., Martinez, F. T., Carreno, N. G., Lora, P., Liu, H., Liu, L., Tang, R., Luo, X., An, Y., Zhao, H., Gao, Y., Zhai, Z., Ye, Z. L., Wang, W., Li, W., Li, Q., Zheng, R., Yu, W., Shen, J., Li, X., Yu, T., Lu, W., Wu, Y. Q., Huang, X. B., He, Z., Lu, Y., Han, H., Zhang, F., Sun, R., Wang, H. X., Qin, S. H., Zhu, B. H., Zhao, J., Liu, J., Li, B., Liu, J. L., Zhou, F. C., Li, Q. J., Zhang, X. Y., Li-Xin, Z., Xin-Hua, Q., Jiang, L., Gao, Y. N., Zhao, X. Y., Li, Y. Y., Li, X. L., Wang, C., Yao, Q., Yu, R., Chen, K., Shao, H., Qin, B., Huang, Q. Q., Zhu, W. H., Hang, A. Y., Hua, M. X., Li, Y., Xu, Y., Di, Y. D., Ling, L. L., Qin, T. H., Wang, S. 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M., Rigaud, J. -P., Duranteau, J., Harrois, A., Chabanne, R., Marin, J., Bigot, C., Thibault, S., Ghazi, M., Boukhazna, M., Zein, S. O., Richecoeur, J. R., Combaux, D. M., Grelon, F., Le Moal, C., Sauvadet, E. P., Robine, A., Lemiale, V., Reuter, D., Dres, M., Demoule, A., Goldgran-Toledano, D., Baboi, L., Guerin, C., Lohner, R., Krassler, J., Schafer, S., Zacharowski, K. D., Meybohm, P., Reske, A. W., Simon, P., Hopf, H. -B. F., Schuetz, M., Baltus, T., Papanikolaou, M. N., Papavasilopoulou, T. G., Zacharas, G. A., Ourailogloy, V., Mouloudi, E. K., Massa, E. V., Nagy, E. O., Stamou, E. E., Kiourtzieva, E. V., Oikonomou, M. A., Avila, L. E., Cortez, C. A., Citalan, J. E., Jog, S. A., Sable, S. D., Shah, B., Gurjar, M., Baronia, A. K., Memon, M., Muthuchellappan, R., Ramesh, V. J., Shenoy, A., Unnikrishnan, R., Dixit, S. B., Rhayakar, R. V., Ramakrishnan, N., Bhardwaj, V. K., Mahto, H. L., Sagar, S. V., Palaniswamy, V., Ganesan, D., Jamaati, H., Heidari, F., Meaney, E. A., Nichol, A., Knapman, K. M., O'Croinin, D., Dunne, E. S., Breen, D. M., Clarkson, K. P., Jaafar, R. F., Dwyer, R., Amir, F., Ajetunmobi, O. O., O'Muircheartaigh, A. C., Black, C. S., Treanor, N., Collins, D. V., Altaf, W., Zani, G., Fusari, M., Spadaro, S., Volta, C. A., Graziani, R., Brunettini, B., Palmese, S., Formenti, P., Umbrello, M., Lombardo, A., Pecci, E., Botteri, M., Savioli, M., Mattei, A., Schiavoni, L., Tinnirello, A., Todeschini, M., Giarratano, A., Cortegiani, A., Sher, S., Rossi, A., Antonelli, M. M., Montini, L. M., Casalena, P., Scafetti, S., Panarello, G., Occhipinti, G., Patroniti, N., Pozzi, M., Biscione, R. R., Poli, M. M., Raimondi, F., Albiero, D., Crapelli, G., Beck, E., Pota, V., Schiavone, V., Molin, A., Tarantino, F., Monti, G., Frati, E., Mirabella, L., Cinnella, G., Fossali, T., Colombo, R., Pattarino, P. T. I., Mojoli, F., Braschi, A., Borotto, E. E., Cracchiolo, A. N., Palma, D. M., Raponi, F., Foti, G., Vascotto, E. R., Coppadoro, A., Brazzi, L., Floris, L., Iotti, G. A., Venti, A., Yamaguchi, O., Takagi, S., Maeyama, H. N., Watanabe, E., Yamaji, Y., Shimizu, K., Shiozaki, K., Futami, S., Ryosuke, S., Saito, K., Kameyama, Y., Ueno, K., Izawa, M., Okuda, N., Suzuki, H., Harasawa, T., Nasu, M., Takada, T., Ito, F., Shin-Nunomiya, Andoh, K., Kusumoto, K., Hirata, A., Takaba, A., Kimura, H., Kansuke-Koyama, Abe, T., Honda, H., Aoki, N., Imai, H., Ogino, Y., Mizuguchi, I., Ichikado, K., Nitta, K., Mochizuki, K., Hashida, T., Tanaka, H., Nakamura, T., Niimi, D., Ueda, T., Kashiwa, Y., Uchiyama, A., Sabelnikovs, O., Oss, P., Haddad, Y., Liew, K. Y., Namendys-Silva, S. A., Jarquin-Badiola, Y. D., Sanchez-Hurtado, L. A., Gomez-Flores, S. S., Marin, M. C., Villagomez, A. J., Lemus, J. S., Fierro, J. M., Cervantes, M. R., Mejia, F. J. F., Dector, D., Dector, D. M., Gonzalez, D. R., Estrella, C. R., Sanchez-Medina, J. R., Ramirez-Gutierrez, A., George, F. G., Aguirre, J. S., Buensuseso, J. A., Poblano, M., Dendane, T., Balkhi, H., Elkhayari, M., Samkaoui, N., Ezzouine, H., Amor, A. B. M., Maazouzi, W., Cimic, N., Beck, O., Bruns, M. M., Schouten, J. A., Myra-Rinia, Van Wezel, H. M., Heines, S. J., Strauch, U., Buise, M. P., Simonis, F. D., Schultz, M. J., Goodson, J. C., Browne, T. S., Raaijmakers, M., Hunt, A., Hutchison, R. A., Bailey, M. B., Newby, L., Mcarthur, C., Kalkoff, M., Mcleod, A., Casement, J., Hacking, D. J., Andersen, F. H., Dolva, M. S., Barratt-Due, A., Noremark, K. A. L., Soreide, E., Sjobo, B. A., Guttormsen, A. B., Leon Yoshido, H. H., Aguilar, R. Z., Montes Oscanoa, F. A., Alisasis, A. U., Robles, J. B., Pasanting-Lim, R. A. B., Tan, B. C., Andruszkiewicz, P., Jakubowska, K., Coxo, C. M., Alvarez, A. M., Oliveira, B. S., Montanha, G. M., Barros, N. C., Pereira, C. S., Messias, A. M., Monteiro, J. M., Araujo, A. M., Catorze, N. T., Marum, S. M., Bouw, M. J., Gomes, R. M., Brito, V. A., Castro, S., Estilita, J. M., Barros, F. M., Serra, I. M., Martinho, A. M., Tomescu, D. R., Marcu, A., Bedreag, O. H., Papurica, M., Corneci, D. E., Negoita, S. I., Grigoriev, E., Gritsan, A. I., Gazenkampf, A. A., Almekhlafi, G., Albarrak, M. M., Mustafa, G. M., Maghrabi, K. A., Salahuddin, N., Aisa, T. M., Al Jabbary, A. S., Tabhan, E., Arabi, Y. M., Trinidad, O. A., Al Dorzi, H. M., Tabhan, E. E., Bolon, S., Smith, O., Mancebo, J., Aguirre-Bermeo, H., Lopez-Delgado, J. C., Esteve, F., Rialp, G., Forteza, C., De Haro, C., Artigas, A., Albaiceta, G. M., De Cima-Iglesias, S., Seoane-Quiroga, L., Ceniceros-Barros, A., Ruiz-Aguilar, A. L., Claraco-Vega, L. M., Soler, J. A., Del Carmen Lorente, M., Hermosa, C., Gordo, F., Miryam-Prieto-Gonzalez, Perez, M. P., Perez, C. P., Allue, R. M., Roche-Campo, F., Ibanez-Santacruz, M., Susana-Temprano, De Pablo, R., Gomez, P. R. A., Ruiz, S. R., Moles, S. I., Jurado, Mª. T., Arizmendi, A., Piacentini, E. A., Franco, N., Honrubia, T., Cheng, M. P., Losada, E. P., Javier-Blanco, Pintado, M. C., Cazorla-Barranquero, F. G., Alonso, J. G., Alda, R. S., Algaba, A., Navarro, G., Cereijo, E., Diaz-Rodriguez, E., Marcos, D. P., Montero, L. A., Para, L. H., Sanchez, R. J., Navalpotro, M. A. B., Abad, R. D., Gonz A Lez, R. M., Toribio, D. A. C. P., Castro, A. G., Artiga, M. J. D., Penuelas, O., Roser, T. P., Olga, M. F., Curto, E. G., Sanchez, R. M., Imma, V. P., Elisabet, G. M., Claverias, L., Magret, M., Pellicer, A. M., Rodriguez, L. L., Sanchez-Ballesteros, J., Gonzalez-Salamanca, A., Jimenez, A. G., Huerta, F. P., Sotillo Diaz, J. C. J., Lopez, E. B., Llinares Moya, D. D., Tallet Alfonso, A. A., Luis, P. S. E., Cesar, P. S., Rafael, S. I., Virgilio, C. G., Recio, N. N., Adamsson, R. O., Rylander, C. C., Holzgraefe, B., Broman, L. M., Wessbergh, J., Persson, L., Schioler, F., Kedelv, H., Tibblin, A. O., Appelberg, H., Hedlund, L., Helleberg, J., Eriksson, K. E., Glietsch, R., Larsson, N., Nygren, I., Nunes, S. L., Morin, A. -K., Kander, T., Adolfsson, A., Zender, H. O., Leemann-Refondini, C., Elatrous, S., Bouchoucha, S., Chouchene, I., Ouanes, I., Souissi, A. B., Kamoun, S., Demirkiran, O., Aker, M., Erbabacan, E., Ceylan, I., Girgin, N. K., Ozcelik, M., Unal, N., Meco, B. C., Akyol, O. O., Derman, S. S., Kennedy, B., Parhar, K., Srinivasa, L., Hopkins, P., Mellis, C., Kakar, V., Hadfield, D., Vercueil, A., Bhowmick, K., Humphreys, S. K., Ferguson, A., Mckee, R., Raj, A. S., Fawkes, D. A., Watt, P., Twohey, L., Jhamatthew Thomas, R. R., Morton, A., Kadaba, V., Smith, M. J., Hormis, A. P., Kannan, S. G., Namih, M., Reschreiter, H., Camsooksai, J., Kumar, A., Rugonfalvi, S., Nutt, C., O'Neill, O., Seasman, C., Dempsey, G., Scott, C. J., Ellis, H. E., Mckechnie, S., Hutton, P. J., Di Tomasso, N. N., Vitale, M. N., Griffin, R. O., Dean, M. N., Cranshaw, J. H., Willett, E. L., Ioannou, N., Gillis, S., Csabi, P., Macfadyen, R., Dawson, H., Preez, P. D., Williams, A. J., Boyd, O., De Gordoa, L. O. -R., Bramall, J., Symmonds, S., Chau, S. K., Wenham, T., Szakmany, T., Toth-Tarsoly, P., Mccalman, K. H., Alexander, P., Stephenson, L., Collyer, T., Chapman, R., Cooper, R., Allan, R. M., Sim, M., Wrathall, D. W., Irvine, D. A., Zantua, K. S., Adams, J. C., Burtenshaw, A. J., Sellors, G. P., Welters, I. D., Williams, K. E., Hessell, R. J., Oldroyd, M. G., Battle, C. E., Pillai, S., Kajtor, I., Sivashanmugavel, M., O'Kane, S. C., Donnelly, A., Frigyik, A. D., Careless, J. P., May, M. M., Stewart, R., Trinder, T. J., Hagan, S. J., Wise, M. P., Cole, J. M., Macfie, C. C., Dowling, A. T., Nunez, E., Pittini, G., Rodriguez, R., Imperio, M. C., Santos, C., Franca, A. G., Ebeid, A., Deicas, A., Serra, C., Uppalapati, A., Kamel, G., Banner-Goodspeed, V. M., Beitler, J. R., Mukkera, S. R., Kulkarni, S., Lee, J., Mesar, T., Shinn, J. O., Gomaa, D., Tainter, C., Yeatts, D. J., Warren, J., Lanspa, M. J., Miller, R. R., Grissom, C. K., Brown, S. M., Bauer, P. R., Gosselin, R. J., Kitch, B. T., Cohen, J. E., Beegle, S. H., Gueret, R. M., Tulaimat, A., Choudry, S., Stigler, W., Batra, H., Huff, N. G., Lamb, K. D., Oetting, T. W., Mohr, N. M., Judy, C., Saito, S., Kheir, F. M., Kheir, F., Schlichting, A. B., Delsing, A., Crouch, D. R., Elmasri, M., Ismail, D., Dreyer, K. R., Blakeman, T. C., Baron, R. M., Grijalba, C. Q., Hou, P. C., Seethala, R., Aisiku, I., Henderson, G., Frendl, G., Hou, S. -K., Owens, R. L., Schomer, A., Bumbasirevic, V., Jovanovic, B., Surbatovic, M., Veljovic, M., UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (MGD) Services des soins intensifs, UCL - (SLuc) Service de soins intensifs, Graduate School, Intensive Care Medicine, ACS - Heart failure & arrhythmias, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, Madotto, F, Rezoagli, E, Pham, T, Schmidt, M, Mcnicholas, B, Protti, A, Panwar, R, Bellani, G, Fan, E, Van Haren, F, Brochard, L, Laffey, J, Pesenti, A, Esteban, A, Gattinoni, L, Larsson, A, Mcauley, D, Ranieri, M, Rubenfeld, G, Thompson, B, Wrigge, H, Slutsky, A, Rios, F, Sottiaux, T, Depuydt, P, Lora, F, Azevedo, L, Bugedo, G, Qiu, H, Gonzalez, M, Silesky, J, Cerny, V, Nielsen, J, Jibaja, M, Matamis, D, Ranero, J, Amin, P, Hashemian, S, Clarkson, K, Kurahashi, K, Villagomez, A, Zeggwagh, A, Heunks, L, Laake, J, Palo, J, Do Vale Fernandes, A, Sandesc, D, Arabi, Y, Bumbasierevic, V, Nin, N, Lorente, J, Piquilloud, L, Abroug, F, Mcnamee, L, Hurtado, J, Bajwa, E, Dempaire, G, Theresa, U, Sula, H, Nunci, L, Cani, A, Maria, V, Zazu, A, Dellera, C, Insaurralde, C, Alejandro, R, Daldin, J, Vinzio, M, Fernandez, R, Cardonnet, L, Bettini, L, Bisso, M, Osman, E, Setten, M, Lovazzano, P, Alvarez, J, Villar, V, Pozo, N, Grubissich, N, Plotnikow, G, Vasquez, D, Ilutovich, S, Tiribelli, N, Chena, A, Pellegrini, C, Saenz, M, Estenssoro, E, Brizuela, M, Gianinetto, H, Gomez, P, Cerrato, V, Bezzi, M, Borello, S, Loiacono, F, Fernandez, A, Knowles, S, Reynolds, C, Inskip, D, Miller, J, Kong, J, Whitehead, C, Bihari, S, Seven, A, Krstevski, A, Rodgers, H, Millar, R, Mckenna, T, Bailey, I, Hanlon, G, Aneman, A, Lynch, J, Azad, R, Neal, J, Woods, P, Roberts, B, Kol, M, Wong, H, Riss, K, Staudinger, T, Wittebole, X, Berghe, C, Bulpa, P, Dive, A, Verstraete, R, Lebbinck, H, Vermassen, J, Meersseman, P, Ceunen, H, Rosa, J, Beraldo, D, Piras, C, Rampinelli, A, Nassar, A, Mataloun, S, Moock, M, Thompson, M, Goncalves, C, Antonio, A, Ascoli, A, Biondi, R, Fontenele, D, Nobrega, D, Sales, V, Shindhe, S, Pg Hj Ismail, D, Beloncle, F, Davies, K, Cirone, R, Manoharan, V, Ismail, M, Goligher, E, Jassal, M, Nishikawa, E, Javeed, A, Curley, G, Rittayamai, N, Parotto, M, Ferguson, N, Mehta, S, Knoll, J, Pronovost, A, Canestrini, S, Bruhn, A, Garcia, P, Aliaga, F, Farias, P, Yumha, J, Ortiz, C, Salas, J, Saez, A, Vega, L, Labarca, E, Martinez, F, Carreno, N, Lora, P, Liu, H, Liu, L, Tang, R, Luo, X, An, Y, Zhao, H, Gao, Y, Zhai, Z, Ye, Z, Wang, W, Li, W, Li, Q, Zheng, R, Yu, W, Shen, J, Li, X, Yu, T, Lu, W, Wu, Y, Huang, X, He, Z, Lu, Y, Han, H, Zhang, F, Sun, R, Wang, H, Qin, S, Zhu, B, Zhao, J, Liu, J, Li, B, Zhou, F, Zhang, X, Li-Xin, Z, Xin-Hua, Q, Jiang, L, Zhao, X, Li, Y, Wang, C, Yao, Q, Yu, R, Chen, K, Shao, H, Qin, B, Huang, Q, Zhu, W, Hang, A, Hua, M, Xu, Y, Di, Y, Ling, L, Qin, T, Wang, S, Qin, J, Han, Y, Zhou, S, Vargas, M, Silesky Jimenez, J, Gonzalez Rojas, M, Solis-Quesada, J, Ramirez-Alfaro, C, Maca, J, Sklienka, P, Gjedsted, J, Christiansen, A, Villamagua, B, Llano, M, Burtin, P, Buzancais, G, Beuret, P, Pelletier, N, Mortaza, S, Mercat, A, Chelly, J, Jochmans, S, Terzi, N, Daubin, C, Carteaux, G, De Prost, N, Chiche, J, Daviaud, F, Fartoukh, M, Barberet, G, Biehler, J, Dellamonica, J, Doyen, D, Arnal, J, Briquet, A, Hraiech, S, Papazian, L, Follin, A, Roux, D, Messika, J, Kalaitzis, E, Dangers, L, Combes, A, Au, S, Beduneau, G, Carpentier, D, Zogheib, E, Dupont, H, Ricome, S, Santoli, F, Besset, S, Michel, P, Gelee, B, Danin, P, Goubaux, B, Crova, P, Phan, N, Berkelmans, F, Badie, J, Tapponnier, R, Gally, J, Khebbeb, S, Herbrecht, J, Schneider, F, Declercq, P, Rigaud, J, Duranteau, J, Harrois, A, Chabanne, R, Marin, J, Bigot, C, Thibault, S, Ghazi, M, Boukhazna, M, Zein, S, Richecoeur, J, Combaux, D, Grelon, F, Le Moal, C, Sauvadet, E, Robine, A, Lemiale, V, Reuter, D, Dres, M, Demoule, A, Goldgran-Toledano, D, Baboi, L, Guerin, C, Lohner, R, Krassler, J, Schafer, S, Zacharowski, K, Meybohm, P, Reske, A, Simon, P, Hopf, H, Schuetz, M, Baltus, T, Papanikolaou, M, Papavasilopoulou, T, Zacharas, G, Ourailogloy, V, Mouloudi, E, Massa, E, Nagy, E, Stamou, E, Kiourtzieva, E, Oikonomou, M, Avila, L, Cortez, C, Citalan, J, Jog, S, Sable, S, Shah, B, Gurjar, M, Baronia, A, Memon, M, Muthuchellappan, R, Ramesh, V, Shenoy, A, Unnikrishnan, R, Dixit, S, Rhayakar, R, Ramakrishnan, N, Bhardwaj, V, Mahto, H, Sagar, S, Palaniswamy, V, Ganesan, D, Jamaati, H, Heidari, F, Meaney, E, Nichol, A, Knapman, K, O'Croinin, D, Dunne, E, Breen, D, Jaafar, R, Dwyer, R, Amir, F, Ajetunmobi, O, O'Muircheartaigh, A, Black, C, Treanor, N, Collins, D, Altaf, W, Zani, G, Fusari, M, Spadaro, S, Volta, C, Graziani, R, Brunettini, B, Palmese, S, Formenti, P, Umbrello, M, Lombardo, A, Pecci, E, Botteri, M, Savioli, M, Mattei, A, Schiavoni, L, Tinnirello, A, Todeschini, M, Giarratano, A, Cortegiani, A, Sher, S, Rossi, A, Antonelli, M, Montini, L, Casalena, P, Scafetti, S, Panarello, G, Occhipinti, G, Patroniti, N, Pozzi, M, Biscione, R, Poli, M, Raimondi, F, Albiero, D, Crapelli, G, Beck, E, Pota, V, Schiavone, V, Molin, A, Tarantino, F, Monti, G, Frati, E, Mirabella, L, Cinnella, G, Fossali, T, Colombo, R, Pattarino, P, Mojoli, F, Braschi, A, Borotto, E, Cracchiolo, A, Palma, D, Raponi, F, Foti, G, Vascotto, E, Coppadoro, A, Brazzi, L, Floris, L, Iotti, G, Venti, A, Yamaguchi, O, Takagi, S, Maeyama, H, Watanabe, E, Yamaji, Y, Shimizu, K, Shiozaki, K, Futami, S, Ryosuke, S, Saito, K, Kameyama, Y, Ueno, K, Izawa, M, Okuda, N, Suzuki, H, Harasawa, T, Nasu, M, Takada, T, Ito, F, Shin-Nunomiya, K, Abe, T, Andoh, K, Kusumoto, K, Hirata, A, Takaba, A, Kimura, H, Matsumoto, S, Higashijima, U, Honda, H, Aoki, N, Imai, H, Ogino, Y, Mizuguchi, I, Ichikado, K, Nitta, K, Mochizuki, K, Hashida, T, Tanaka, H, Nakamura, T, Niimi, D, Ueda, T, Kashiwa, Y, Uchiyama, A, Sabelnikovs, O, Oss, P, Haddad, Y, Liew, K, Namendys-Silva, S, Jarquin-Badiola, Y, Sanchez-Hurtado, L, Gomez-Flores, S, Marin, M, Lemus, J, Fierro, J, Cervantes, M, Mejia, F, Dector, D, Gonzalez, D, Estrella, C, Sanchez-Medina, J, Ramirez-Gutierrez, A, George, F, Aguirre, J, Buensuseso, J, Poblano, M, Dendane, T, Balkhi, H, Elkhayari, M, Samkaoui, N, Ezzouine, H, Amor, A, Maazouzi, W, Cimic, N, Beck, O, Bruns, M, Schouten, J, Raaijmakers, M, Van Wezel, H, Heines, S, Strauch, U, Buise, M, Simonis, F, Schultz, M, Goodson, J, Browne, T, Navarra, L, Hunt, A, Hutchison, R, Bailey, M, Newby, L, Mcarthur, C, Kalkoff, M, Mcleod, A, Casement, J, Hacking, D, Andersen, F, Dolva, M, Barratt-Due, A, Noremark, K, Soreide, E, Sjobo, B, Guttormsen, A, Leon Yoshido, H, Aguilar, R, Montes Oscanoa, F, Alisasis, A, Robles, J, Pasanting-Lim, R, Tan, B, Andruszkiewicz, P, Jakubowska, K, Coxo, C, Alvarez, A, Oliveira, B, Montanha, G, Barros, N, Pereira, C, Messias, A, Monteiro, J, Araujo, A, Catorze, N, Marum, S, Bouw, M, Gomes, R, Brito, V, Castro, S, Estilita, J, Barros, F, Serra, I, Martinho, A, Tomescu, D, Marcu, A, Bedreag, O, Papurica, M, Corneci, D, Negoita, S, Grigoriev, E, Gritsan, A, Gazenkampf, A, Almekhlafi, G, Albarrak, M, Mustafa, G, Maghrabi, K, Salahuddin, N, Aisa, T, Al Jabbary, A, Tabhan, E, Trinidad, O, Al Dorzi, H, Bolon, S, Smith, O, Mancebo, J, Aguirre-Bermeo, H, Lopez-Delgado, J, Esteve, F, Rialp, G, Forteza, C, De Haro, C, Artigas, A, Albaiceta, G, De Cima-Iglesias, S, Seoane-Quiroga, L, Ceniceros-Barros, A, Ruiz-Aguilar, A, Claraco-Vega, L, Soler, J, Del Carmen Lorente, M, Hermosa, C, Gordo, F, Lopez-Messa, J, Perez, M, Perez, C, Allue, R, Roche-Campo, F, Ibanez-Santacruz, M, Pintado, M, De Pablo, R, Ruiz, S, Moles, S, Jurado, M, Arizmendi, A, Piacentini, E, Franco, N, Honrubia, T, Cheng, M, Losada, E, Yuste, L, Carbayo-Gorriz, C, Cazorla-Barranquero, F, Alonso, J, Alda, R, Algaba, A, Navarro, G, Cereijo, E, Diaz-Rodriguez, E, Marcos, D, Montero, L, Para, L, Sanchez, R, Navalpotro, M, Abad, R, Gonz A Lez, R, Toribio, D, Castro, A, Artiga, M, Penuelas, O, Roser, T, Olga, M, Curto, E, Imma, V, Elisabet, G, Claverias, L, Magret, M, Pellicer, A, Rodriguez, L, Sanchez-Ballesteros, J, Gonzalez-Salamanca, A, Jimenez, A, Huerta, F, Sotillo Diaz, J, Lopez, E, Llinares Moya, D, Tallet Alfonso, A, Luis, P, Cesar, P, Rafael, S, Virgilio, C, Recio, N, Adamsson, R, Rylander, C, Holzgraefe, B, Broman, L, Wessbergh, J, Persson, L, Schioler, F, Kedelv, H, Tibblin, A, Appelberg, H, Hedlund, L, Helleberg, J, Eriksson, K, Glietsch, R, Larsson, N, Nygren, I, Nunes, S, Morin, A, Kander, T, Adolfsson, A, Zender, H, Leemann-Refondini, C, Elatrous, S, Bouchoucha, S, Chouchene, I, Ouanes, I, Souissi, A, Kamoun, S, Demirkiran, O, Aker, M, Erbabacan, E, Ceylan, I, Girgin, N, Ozcelik, M, Unal, N, Meco, B, Akyol, O, Derman, S, Kennedy, B, Parhar, K, Srinivasa, L, Hopkins, P, Mellis, C, Kakar, V, Hadfield, D, Vercueil, A, Bhowmick, K, Humphreys, S, Ferguson, A, Mckee, R, Raj, A, Fawkes, D, Watt, P, Twohey, L, Jhamatthew Thomas, R, Morton, A, Kadaba, V, Smith, M, Hormis, A, Kannan, S, Namih, M, Reschreiter, H, Camsooksai, J, Kumar, A, Rugonfalvi, S, Nutt, C, O'Neill, O, Seasman, C, Dempsey, G, Scott, C, Ellis, H, Mckechnie, S, Hutton, P, Di Tomasso, N, Vitale, M, Griffin, R, Dean, M, Cranshaw, J, Willett, E, Ioannou, N, Gillis, S, Csabi, P, Macfadyen, R, Dawson, H, Preez, P, Williams, A, Boyd, O, De Gordoa, L, Bramall, J, Symmonds, S, Chau, S, Wenham, T, Szakmany, T, Toth-Tarsoly, P, Mccalman, K, Alexander, P, Stephenson, L, Collyer, T, Chapman, R, Cooper, R, Allan, R, Sim, M, Wrathall, D, Irvine, D, Zantua, K, Adams, J, Burtenshaw, A, Sellors, G, Welters, I, Williams, K, Hessell, R, Oldroyd, M, Battle, C, Pillai, S, Kajtor, I, Sivashanmugavel, M, O'Kane, S, Donnelly, A, Frigyik, A, Careless, J, May, M, Stewart, R, Trinder, T, Hagan, S, Wise, M, Cole, J, Macfie, C, Dowling, A, Nunez, E, Pittini, G, Rodriguez, R, Imperio, M, Santos, C, Franca, A, Ebeid, A, Deicas, A, Serra, C, Uppalapati, A, Kamel, G, Banner-Goodspeed, V, Beitler, J, Mukkera, S, Kulkarni, S, Lee, J, Mesar, T, Shinn, J, Gomaa, D, Tainter, C, Yeatts, D, Warren, J, Lanspa, M, Miller, R, Grissom, C, Brown, S, Bauer, P, Gosselin, R, Kitch, B, Cohen, J, Beegle, S, Gueret, R, Tulaimat, A, Choudry, S, Stigler, W, Batra, H, Huff, N, Lamb, K, Oetting, T, Mohr, N, Judy, C, Saito, S, Kheir, F, Schlichting, A, Delsing, A, Crouch, D, Elmasri, M, Ismail, D, Dreyer, K, Blakeman, T, Baron, R, Grijalba, C, Hou, P, Seethala, R, Aisiku, I, Henderson, G, Frendl, G, Hou, S, Owens, R, Schomer, A, Bumbasirevic, V, Jovanovic, B, Surbatovic, M, Veljovic, M, Madotto F, Rezoagli E, Pham T, Schmidt M, McNicholas B, Protti A, Panwar R, Bellani G, Fan E, van Haren F, Brochard L, Laffey JG, Antonio Pesenti, John G Laffey, Laurent Brochard, Andres Esteban, Luciano Gattinoni, Frank van Haren, Anders Larsson, Daniel F McAuley, Marco Ranieri, Gordon Rubenfeld, B Taylor Thompson, Hermann Wrigge, Arthur S Slutsky, Fernando Rios, T Sottiaux, P Depuydt, Fredy S Lora, Luciano Cesar Azevedo, Eddy Fan, Guillermo Bugedo, Haibo Qiu, Marcos Gonzalez, Juan Silesky, Vladimir Cerny, Jonas Nielsen, Manuel Jibaja, Tài Pham, Dimitrios Matamis, Jorge Luis Ranero, Pravin Amin, S M Hashemian, Kevin Clarkson, Giacomo Bellani, Kiyoyasu Kurahashi, Asisclo Villagomez, Amine Ali Zeggwagh, Leo M Heunks, Jon Henrik Laake, Jose Emmanuel Palo, Antero do Vale Fernandes, Dorel Sandesc, Yaasen Arabi, Vesna Bumbasierevic, Nicolas Nin, Jose A Lorente, Lise Piquilloud, Fekri Abroug, Daniel F McAuley, Lia McNamee, Javier Hurtado, Ed Bajwa, Gabriel Démpaire, Uhc Mother Theresa, Hektor Sula, Lordian Nunci, Alma Cani, Villa Maria, Alan Zazu, Christian Dellera, Carolina S Insaurralde, Risso V Alejandro, Julio Daldin, Mauricio Vinzio, Ruben O Fernandez, Luis P Cardonnet, Lisandro R Bettini, Mariano Carboni Bisso, Emilio M Osman, Mariano G Setten, Pablo Lovazzano, Javier Alvarez, Veronica Villar, Norberto C Pozo, Nicolas Grubissich, Gustavo A Plotnikow, Daniela N Vasquez, Santiago Ilutovich, Norberto Tiribelli, Ariel Chena, Carlos A Pellegrini, María G Saenz, Elisa Estenssoro, Matias Brizuela, Hernan Gianinetto, Pablo E Gomez, Valeria I Cerrato, Marco G Bezzi, Silvina A Borello, Flavia A Loiacono, Adriana M Fernandez, Serena Knowles, Claire Reynolds, Deborah M Inskip, Jennene J Miller, Jing Kong, Christina Whitehead, Shailesh Bihari, Aylin Seven, Amanda Krstevski, Helen J Rodgers, Rebecca T Millar, Toni E Mckenna, Irene M Bailey, Gabrielle C Hanlon, Anders Aneman, Joan M Lynch, Raman Azad, John Neal, Paul W Woods, Brigit L Roberts, Mark R Kol, Helen S Wong, Katharina C Riss, Thomas Staudinger, Xavier Wittebole, Caroline Berghe, Pierre A Bulpa, Alain M Dive, Rik Verstraete, Herve Lebbinck, Pieter Depuydt, Joris Vermassen, Philippe Meersseman, Helga Ceunen, Jonas I Rosa, Daniel O Beraldo, Claudio Piras, Adenilton M Rampinelli, Antonio P Nassar Jr, Sergio Mataloun, Marcelo Moock, Marlus M Thompson, Claudio H Gonçalves, Ana Carolina P Antônio, Aline Ascoli, Rodrigo S Biondi, Danielle C Fontenele, Danielle Nobrega, Vanessa M Sales, Suresh Shindhe, Dk Maizatul Aiman B Pg Hj Ismail, John Laffey, Francois Beloncle, Kyle G Davies, Rob Cirone, Venika Manoharan, Mehvish Ismail, Ewan C Goligher, Mandeep Jassal, Erin Nishikawa, Areej Javeed, Gerard Curley, Nuttapol Rittayamai, Matteo Parotto, Niall D Ferguson, Sangeeta Mehta, Jenny Knoll, Antoine Pronovost, Sergio Canestrini, Alejandro R Bruhn, Patricio H Garcia, Felipe A Aliaga, Pamela A Farías, Jacob S Yumha, Claudia A Ortiz, Javier E Salas, Alejandro A Saez, Luis D Vega, Eduardo F Labarca, Felipe T Martinez, Nicolás G Carreño, Pilar Lora, Haitao Liu, Ling Liu, Rui Tang, Xiaoming Luo, Youzhong An, Huiying Zhao, Yan Gao, Zhe Zhai, Zheng L Ye, Wei Wang, Wenwen Li, Qingdong Li, Ruiqiang Zheng, Wenkui Yu, Juanhong Shen, Xinyu Li, Tao Yu, Weihua Lu, Ya Q Wu, Xiao B Huang, Zhenyang He, Yuanhua Lu, Hui Han, Fan Zhang, Renhua Sun, Hua X Wang, Shu H Qin, Bao H Zhu, Jun Zhao, Jian Liu, Bin Li, Jing L Liu, Fa C Zhou, Qiong J Li, Xing Y Zhang, Zhou Li-Xin, Qiang Xin-Hua, Liangyan Jiang, Yuan N Gao, Xian Y Zhao, Yuan Y Li, Xiao L Li, Chunting Wang, Qingchun Yao, Rongguo Yu, Kai Chen, Huanzhang Shao, Bingyu Qin, Qing Q Huang, Wei H Zhu, Ai Y Hang, Ma X Hua, Yimin Li, Yonghao Xu, Yu D Di, Long L Ling, Tie H Qin, Shou H Wang, Junping Qin, Yi Han, Suming Zhou, Monica P Vargas, Juan I Silesky Jimenez, Manuel A González Rojas, Jaime E Solis-Quesada, Christian M Ramirez-Alfaro, Jan Máca, Peter Sklienka, Jakob Gjedsted, Aage Christiansen, Boris G Villamagua, Miguel Llano, Philippe Burtin, Gautier Buzancais, Pascal Beuret, Nicolas Pelletier, Satar Mortaza, Alain Mercat, Jonathan Chelly, Sébastien Jochmans, Nicolas Terzi, Cédric Daubin, Guillaume Carteaux, Nicolas de Prost, Jean-Daniel Chiche, Fabrice Daviaud, Tai Pham, Muriel Fartoukh, Guillaume Barberet, Jerome Biehler, Jean Dellamonica, Denis Doyen, Jean-Michel Arnal, Anais Briquet, Sami Hraiech, Laurent Papazian, Arnaud Follin, Damien Roux, Jonathan Messika, Evangelos Kalaitzis, Laurence Dangers, Alain Combes, Siu-Ming Au, Gaetan Béduneau, Dorothée Carpentier, Elie H Zogheib, Herve Dupont, Sylvie Ricome, Francesco L Santoli, Sebastien L Besset, Philippe Michel, Bruno Gelée, Pierre-Eric Danin, Bernard Goubaux, Philippe J Crova, Nga T Phan, Frantz Berkelmans, Julio C Badie, Romain Tapponnier, Josette Gally, Samy Khebbeb, Jean-Etienne Herbrecht, Francis Schneider, Pierre-Louis M Declercq, Jean-Philippe Rigaud, Jacques Duranteau, Anatole Harrois, Russell Chabanne, Julien Marin, Charlene Bigot, Sandrine Thibault, Mohammed Ghazi, Messabi Boukhazna, Salem Ould Zein, Jack R Richecoeur, Daniele M Combaux, Fabien Grelon, Charlene Le Moal, Elise P Sauvadet, Adrien Robine, Virginie Lemiale, Danielle Reuter, Martin Dres, Alexandre Demoule, Dany Goldgran-Toledano, Loredana Baboi, Claude Guérin, Ralph Lohner, Jens Kraßler, Susanne Schäfer, Kai D Zacharowski, Patrick Meybohm, Andreas W Reske, Philipp Simon, Hans-Bernd F Hopf, Michael Schuetz, Thomas Baltus, Metaxia N Papanikolaou, Theonymfi G Papavasilopoulou, Giannis A Zacharas, Vasilis Ourailogloy, Eleni K Mouloudi, Eleni V Massa, Eva O Nagy, Electra E Stamou, Ellada V Kiourtzieva, Marina A Oikonomou, Luis E Avila, Cesar A Cortez, Johanna E Citalán, Sameer A Jog, Safal D Sable, Bhagyesh Shah, Mohan Gurjar, Arvind K Baronia, Mohammedfaruk Memon, Radhakrishnan Muthuchellappan, Venkatapura J Ramesh, Anitha Shenoy, Ramesh Unnikrishnan, Subhal B Dixit, Rachana V Rhayakar, Nagarajan Ramakrishnan, Vallish K Bhardwaj, Heera L Mahto, Sudha V Sagar, Vijayanand Palaniswamy, Deeban Ganesan, Seyed Mohammadreza Hashemian, Hamidreza Jamaati, Farshad Heidari, Edel A Meaney, Alistair Nichol, Karl M Knapman, Donall O'Croinin, Eimhin S Dunne, Dorothy M Breen, Kevin P Clarkson, Rola F Jaafar, Rory Dwyer, Fahd Amir, Olaitan O Ajetunmobi, Aogan C O'Muircheartaigh, Colin S Black, Nuala Treanor, Daniel V Collins, Wahid Altaf, Gianluca Zani, Maurizio Fusari, Savino Spadaro, Carlo A Volta, Romano Graziani, Barbara Brunettini, Salvatore Palmese, Paolo Formenti, Michele Umbrello, Andrea Lombardo, Elisabetta Pecci, Marco Botteri, Monica Savioli, Alessandro Protti, Alessia Mattei, Lorenzo Schiavoni, Andrea Tinnirello, Manuel Todeschini, Antonino Giarratano, Andrea Cortegiani, Sara Sher, Anna Rossi, Massimo M Antonelli, Luca M Montini, Paolo Casalena, Sergio Scafetti, Giovanna Panarello, Giovanna Occhipinti, Nicolò Patroniti, Matteo Pozzi, Roberto R Biscione, Michela M Poli, Ferdinando Raimondi, Daniela Albiero, Giulia Crapelli, Eduardo Beck, Vincenzo Pota, Vincenzo Schiavone, Alexandre Molin, Fabio Tarantino, Giacomo Monti, Elena Frati, Lucia Mirabella, Gilda Cinnella, Tommaso Fossali, Riccardo Colombo, Pierpaolo Terragni Ilaria Pattarino, Francesco Mojoli, Antonio Braschi, Erika E Borotto, Andrea N Cracchiolo, Daniela M Palma, Francesco Raponi, Giuseppe Foti, Ettore R Vascotto, Andrea Coppadoro, Luca Brazzi, Leda Floris, Giorgio A Iotti, Aaron Venti, Osamu Yamaguchi, Shunsuke Takagi, Hiroki N Maeyama, Eizo Watanabe, Yoshihiro Yamaji, Kazuyoshi Shimizu, Kyoko Shiozaki, Satoru Futami, Sekine Ryosuke, Koji Saito, Yoshinobu Kameyama, Keiko Ueno, Masayo Izawa, Nao Okuda, Hiroyuki Suzuki, Tomofumi Harasawa, Michitaka Nasu, Tadaaki Takada, Fumihito Ito, Shin-Nunomiya, Kansuke-Koyama, Toshikazu Abe, Kohkichi Andoh, Kohei Kusumoto, Akira Hirata, Akihiro Takaba, Hiroyasu Kimura, Shuhei Matsumoto, Ushio Higashijima, Hiroyuki Honda, Nobumasa Aoki, Hiroshi Imai, Yasuaki Ogino, Ichiko Mizuguchi, Kazuya Ichikado, Kenichi Nitta, Katsunori Mochizuki, Tomoaki Hashida, Hiroyuki Tanaka, Tomoyuki Nakamura, Daisuke Niimi, Takeshi Ueda, Yozo Kashiwa, Akinori Uchiyama, Olegs Sabelnikovs, Peteris Oss, Youssef Haddad, Kong Y Liew, Silvio A Ñamendys-Silva, Yves D Jarquin-Badiola, Luis A Sanchez-Hurtado, Saira S Gomez-Flores, Maria C Marin, Asisclo J Villagomez, Jordana S Lemus, Jonathan M Fierro, Mavy Ramirez Cervantes, Francisco Javier Flores Mejia, Dulce Dector, Dulce M Dector, Daniel R Gonzalez, Claudia R Estrella, Jorge R Sanchez-Medina, Alvaro Ramirez-Gutierrez, Fernando G George, Janet S Aguirre, Juan A Buensuseso, Manuel Poblano, Tarek Dendane, Hicham Balkhi, Mina Elkhayari, Nacer Samkaoui, Hanane Ezzouine, Abdellatif Benslama Mourad Amor, Wajdi Maazouzi, Nedim Cimic, Oliver Beck, Monique M Bruns, Jeroen A Schouten, Myra-Rinia, Monique Raaijmakers, Hellen M Van Wezel, Serge J Heines, Ulrich Strauch, Marc P Buise, Fabienne D Simonis, Marcus J Schultz, Jennifer C Goodson, Troy S Browne, Leanlove Navarra, Anna Hunt, Robyn A Hutchison, Mathew B Bailey, Lynette Newby, Colin Mcarthur, Michael Kalkoff, Alex Mcleod, Jonathan Casement, Danielle J Hacking, Finn H Andersen, Merete S Dolva, Jon H Laake, Andreas Barratt-Due, Kim Andre L Noremark, Eldar Søreide, Brit Å Sjøbø, Anne B Guttormsen, Hector H Leon Yoshido, Ronald Zumaran Aguilar, Fredy A Montes Oscanoa, Alain U Alisasis, Joanne B Robles, Rossini Abbie B Pasanting-Lim, Beatriz C Tan, Pawel Andruszkiewicz, Karina Jakubowska, Cristina M Coxo, António M Alvarez, Bruno S Oliveira, Gustavo M Montanha, Nelson C Barros, Carlos S Pereira, António M Messias, Jorge M Monteiro, Ana M Araujo, Nuno T Catorze, Susan M Marum, Maria J Bouw, Rui M Gomes, Vania A Brito, Silvia Castro, Joana M Estilita, Filipa M Barros, Isabel M Serra, Aurelia M Martinho, Dana R Tomescu, Alexandra Marcu, Ovidiu H Bedreag, Marius Papurica, Dan E Corneci, Silvius Ioan Negoita, Evgeny Grigoriev, Alexey I Gritsan, Andrey A Gazenkampf, Ghaleb Almekhlafi, Mohamad M Albarrak, Ghanem M Mustafa, Khalid A Maghrabi, Nawal Salahuddin, Tharwat M Aisa, Ahmed S Al Jabbary, Edgardo Tabhan, Yaseen M Arabi, Olivia A Trinidad, Hasan M Al Dorzi, Edgardo E Tabhan, Stefan Bolon, Oliver Smith, Jordi Mancebo, Hernan Aguirre-Bermeo, Juan C Lopez-Delgado, Francisco Esteve, Gemma Rialp, Catalina Forteza, Candelaria De Haro, Antonio Artigas, Guillermo M Albaiceta, Sara De Cima-Iglesias, Leticia Seoane-Quiroga, Alexandra Ceniceros-Barros, Antonio L Ruiz-Aguilar, Luis M Claraco-Vega, Juan Alfonso Soler, Maria Del Carmen Lorente, Cecilia Hermosa, Federico Gordo, Miryam-Prieto-González, Juan B López-Messa, Manuel P Perez, Cesar P Perez, Raquel Montoiro Allue, Ferran Roche-Campo, Marcos Ibañez-Santacruz, Susana-Temprano, Maria C Pintado, Raul De Pablo, Pilar Ricart Aroa Gómez, Silvia Rodriguez Ruiz, Silvia Iglesias Moles, Mª Teresa Jurado, Alfons Arizmendi, Enrique A Piacentini, Nieves Franco, Teresa Honrubia, Meisy Perez Cheng, Elena Perez Losada, Javier-Blanco, Luis J Yuste, Cecilia Carbayo-Gorriz, Francisca G Cazorla-Barranquero, Javier G Alonso, Rosa S Alda, Ángela Algaba, Gonzalo Navarro, Enrique Cereijo, Esther Diaz-Rodriguez, Diego Pastor Marcos, Laura Alvarez Montero, Luis Herrera Para, Roberto Jimenez Sanchez, Miguel Angel Blasco Navalpotro, Ricardo Diaz Abad, Raquel Montiel Gonz Á Lez, D Á Cil Parrilla Toribio, Alejandro G Castro, Maria Jose D Artiga, Oscar Penuelas, Tomas P Roser, Moreno F Olga, Elena Gallego Curto, Rocío Manzano Sánchez, Vallverdu P Imma, Garcia M Elisabet, Laura Claverias, Monica Magret, Ana M Pellicer, Lucia L Rodriguez, Jesús Sánchez-Ballesteros, Ángela González-Salamanca, Antonio G Jimenez, Francisco P Huerta, Juan Carlos J Sotillo Diaz, Esther Bermejo Lopez, David D Llinares Moya, Alec A Tallet Alfonso, Palazon Sanchez Eugenio Luis, Palazon Sanchez Cesar, Sánchez I Rafael, Corcoles G Virgilio, Noelia N Recio, Richard O Adamsson, Christian C Rylander, Bernhard Holzgraefe, Lars M Broman, Joanna Wessbergh, Linnea Persson, Fredrik Schiöler, Hans Kedelv, Anna Oscarsson Tibblin, Henrik Appelberg, Lars Hedlund, Johan Helleberg, Karin E Eriksson, Rita Glietsch, Niklas Larsson, Ingela Nygren, Silvia L Nunes, Anna-Karin Morin, Thomas Kander, Anne Adolfsson, Hervé O Zender, Corinne Leemann-Refondini, Souheil Elatrous, Slaheddine Bouchoucha, Imed Chouchene, Islem Ouanes, Asma Ben Souissi, Salma Kamoun, Oktay Demirkiran, Mustafa Aker, Emre Erbabacan, Ilkay Ceylan, Nermin Kelebek Girgin, Menekse Ozcelik, Necmettin Ünal, Basak Ceyda Meco, Onat O Akyol, Suleyman S Derman, Barry Kennedy, Ken Parhar, Latha Srinivasa, Danny McAuley, Phil Hopkins, Clare Mellis, Vivek Kakar, Dan Hadfield, Andre Vercueil, Kaushik Bhowmick, Sally K Humphreys, Andrew Ferguson, Raymond Mckee, Ashok S Raj, Danielle A Fawkes, Philip Watt, Linda Twohey, Rajeev R JhaMatthew Thomas, Alex Morton, Varsha Kadaba, Mark J Smith, Anil P Hormis, Santhana G Kannan, Miriam Namih, Henrik Reschreiter, Julie Camsooksai, Alek Kumar, Szabolcs Rugonfalvi, Christopher Nutt, Orla O'Neill, Colette Seasman, Ged Dempsey, Christopher J Scott, Helen E Ellis, Stuart Mckechnie, Paula J Hutton, Nora N Di Tomasso, Michela N Vitale, Ruth O Griffin, Michael N Dean, Julius H Cranshaw, Emma L Willett, Nicholas Ioannou, Sarah Gillis, Peter Csabi, Rosaleen Macfadyen, Heidi Dawson, Pieter D Preez, Alexandra J Williams, Owen Boyd, Laura Ortiz-Ruiz De Gordoa, Jon Bramall, Sophie Symmonds, Simon K Chau, Tim Wenham, Tamas Szakmany, Piroska Toth-Tarsoly, Katie H McCalman, Peter Alexander, Lorraine Stephenson, Thomas Collyer, Rhiannon Chapman, Raphael Cooper, Russell M Allan, Malcolm Sim, David W Wrathall, Donald A Irvine, Kim S Zantua, John C Adams, Andrew J Burtenshaw, Gareth P Sellors, Ingeborg D Welters, Karen E Williams, Robert J Hessell, Matthew G Oldroyd, Ceri E Battle, Suresh Pillai, Istvan Kajtor, Mageswaran Sivashanmugavel, Sinead C O'Kane, Adrian Donnelly, Aniko D Frigyik, Jon P Careless, Martin M May, Richard Stewart, T John Trinder, Samantha J Hagan, Matt P Wise, Jade M Cole, Caroline C MacFie, Anna T Dowling, Nicolás Nin, Edgardo Nuñez, Gustavo Pittini, Ruben Rodriguez, María C Imperio, Cristina Santos, Ana G França, Alejandro Ebeid, Alberto Deicas, Carolina Serra, Aditya Uppalapati, Ghassan Kamel, Valerie M Banner-Goodspeed, Jeremy R Beitler, Satyanarayana Reddy Mukkera, Shreedhar Kulkarni, Jarone Lee, Tomaz Mesar, John O Shinn 3rd, Dina Gomaa, Christopher Tainter, Dale J Yeatts, Jessica Warren, Michael J Lanspa, Russel R Miller, Colin K Grissom, Madotto F, Rezoagli E, Pham T, Schmidt M, McNicholas B, Protti A, Panwar R, Bellani G, Fan E, van Haren F, Brochard L, Laffey JG, and LUNG SAFE Investigators and the ESICM Trials Group, Samuel M Brown, Philippe R Bauer, Ryan J Gosselin, Barrett T Kitch, Jason E Cohen, Scott H Beegle, Renaud M Gueret, Aiman Tulaimat, Shazia Choudry, William Stigler, Hitesh Batra, Nidhi G Huff, Keith D Lamb, Trevor W Oetting, Nicholas M Mohr, Claine Judy, Shigeki Saito, Fayez M Kheir, Fayez Kheir, Adam B Schlichting, Angela Delsing, Daniel R Crouch, Mary Elmasri, Dina Ismail, Kyle R Dreyer, Thomas C Blakeman, Rebecca M Baron, Carolina Quintana Grijalba, Peter C Hou, Raghu Seethala, Imo Aisiku, Galen Henderson, Gyorgy Frendl, Sen-Kuang Hou, Robert L Owens, Ashley Schomer, Vesna Bumbasirevic, Bojan Jovanovic, Maja Surbatovic, Milic Veljovic
Subjects: ARDS, medicine.medical_treatment, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Hyperoxemia, Hypoxemia, law.invention, 0302 clinical medicine, law, Fraction of inspired oxygen, Oxygen therapy, Prevalence, Medicine, Hypoxia, Acute respiratory distress syndrome, Hyperoxia, Invasive mechanical ventilation, Mortality, Respiratory Distress Syndrome, Hyperbaric Oxygenation, Respiration, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Intensive care unit, Intensive Care Units, Anesthesia, Artificial, medicine.symptom, Human, Artificial ventilation, Intensive Care Unit, NO, 03 medical and health sciences, Intensive care, Settore MED/41 - ANESTESIOLOGIA, Humans, business.industry, Research, Respiratory Distress Syndrome, Adult, lcsh:RC86-88.9, medicine.disease, Respiration, Artificial, respiratory tract diseases, Oxygen, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], 030228 respiratory system, business
Abstract: Background Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55–100 mmHg) patients (P = 0.47). Conclusions Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073
Published: 2020

9. Optimal Design of Hot-Dip Galvanized DP Steels via Artificial Neural Networks and Multi-Objective Genetic Optimization

Author: Frank Goodwin, Edgar O. Reséndiz-Flores, Patricia Sheilla Costa, Armando Salinas-Rodríguez, Gerardo Altamirano-Guerrero, and Antonio E. Salas-Reyes
Subjects: Optimal design, lcsh:TN1-997, Materials science, 02 engineering and technology, 01 natural sciences, symbols.namesake, multi-objective genetic optimization, 0103 physical sciences, Ultimate tensile strength, Genetic algorithm, General Materials Science, optimal design, lcsh:Mining engineering. Metallurgy, Holding time, 010302 applied physics, Artificial neural network, Manufacturing process, business.industry, DP steels, Metals and Alloys, Structural engineering, 021001 nanoscience & nanotechnology, Galvanization, symbols, Fracture (geology), 0210 nano-technology, business, artificial neural networks
Abstract: This modeling and optimization study applies a non-linear back-propagation artificial neural network, commonly denoted as BPNN, to model the most important mechanical properties such as yield strength (YS), ultimate tensile strength (UTS) and elongation at fracture (EL) during the experimental processing of hot-dip galvanized dual-phase (GDP) steels. Once the non-linear BPNN is properly trained, the most important variables of the continuous galvanizing process, including initial/first cooling rate (CR1), holding time at the galvanizing temperature of 460 °C (tg) and the final/second cooling rate (CR2), are obtained in an optimal way using an evolutionary approach. The experimental development of GDP steels in continuous processing lines with outstanding mechanical properties (550 &lt, YS &lt, 750 MPa, 1100 MPa &lt, UTS and 10% &lt, EL) is possible by using a combined hybrid approach based in BPNN and multi-objective genetic algorithm (GA). The proposed computational method is applied to the specific design of an actual manufacturing process for the first time.
Published: 2021

10. Assessing Sleep Concerns in Individuals With Acquired Brain Injury: The Feasibility of a Smartpad Sleep Tool

Author: Peter Dziedzic, Luis F. Buenaver, Moon Jeong Lee, Rachel E. Salas, Matthew E. Peters, Alyssa A. Gamaldo, Marcela Sierra-Arce, Charlene E. Gamaldo, Irene Vargas, Durga Roy, and Amanda Chow
Subjects: Male, Sleep Wake Disorders, medicine.medical_specialty, Disrupted sleep, Cohort Studies, Physical medicine and rehabilitation, Restless Legs Syndrome, Sleep Initiation and Maintenance Disorders, Surveys and Questionnaires, Prevalence, Medicine, Humans, Acquired brain injury, Brain trauma, Referral and Consultation, business.industry, Diagnostic test, Middle Aged, medicine.disease, Sleep in non-human animals, United States, Psychiatry and Mental health, Health program, Cross-Sectional Studies, Brain Injuries, Computers, Handheld, Feasibility Studies, Female, Neurology (clinical), business
Abstract: The investigators examined the presence of disrupted sleep in acquired brain injury (ABI) and the utility of a mobile health program, MySleepScript, as an effective clinical tool to detect sleep disturbances.A cross-sectional pilot study of MySleepScript, a customizable electronic battery of validated sleep questionnaires, was conducted. Participants were recruited at the Acquired Brain Injury Clinic at Johns Hopkins Bayview Medical Center.Sixty-eight adults with ABI (mean age, 46.3 years [SD=14.8]) participated in the study, with a mean completion time of 16.6 minutes (SD=5.4). Time to completion did not differ on individual completion or staff assistance. The mean score on the Pittsburgh Sleep Quality Index was 9.2 (SD=4.7); 83.9% of individuals had poor sleep quality (defined as a score5). Insomnia Severity Index scores indicated moderate to severe insomnia in 45% of participants; 36.5% of participants screened positive for symptoms concerning sleep apnea, while 39.3% of individuals screened positive for restless legs syndrome.Poor sleep quality was highly prevalent in this ABI cohort. MySleepScript may be an effective method of assessing for sleep disturbance in ABI. Further efforts to identify sleep disorders in this patient population should be pursued to optimize ABI management.
Published: 2021

11. Impact of non-formulary drugs on pharmacological prescription in hospitalised patients

Author: Marta Riu, Santiago Grau, Olivia Ferrández, Xavier Duran-Jordan, X Fernández-Sala, Jaime Barceló-Vidal, and E. Salas
Subjects: Drug, medicine.medical_specialty, media_common.quotation_subject, Pharmacists, 030226 pharmacology & pharmacy, Health informatics, Drug Prescriptions, 03 medical and health sciences, 0302 clinical medicine, Physicians, Medicine, Humans, 030212 general & internal medicine, General Pharmacology, Toxicology and Pharmaceutics, Medical prescription, Formulary, media_common, Original Research, Retrospective Studies, business.industry, Clinical course, Retrospective cohort study, University hospital, Clinical pharmacy, Emergency medicine, business
Abstract: Objectives The growing number of drugs on the market makes it necessary to adapt hospital formularies in order to ensure consistent drug coverage. The aim of this study was to evaluate the impact of the prescription of non-formulary drugs (NFD) on the therapeutic management of admitted patients. Methods This retrospective observational study included NFD prescriptions in patients hospitalised in a tertiary university hospital during the period 2012–2015. NFD prescriptions are displayed on the computerised medical order as a pending alert to be reviewed by the clinical pharmacists, who make a notation to the clinical course that includes a recommendation for an available therapeutic alternative when available in the hospital formulary. The degree of acceptance of the recommendation by physicians is recorded. Results Approximately 0.5% of patients hospitalised during the study period were affected by an NFD prescription. A total of 52 (9.5%) NFD were of doubtful therapeutic efficacy, five (0.9%) were non-replaceable drugs and 490 (89.4%) were prescriptions for drugs with an alternative available in the hospital formulary. The acceptance rate for the recommended alternative was 34.9% in the evaluable NFD prescriptions. No correlation was observed between the number of NFD prescriptions or the number of NFD and the availability index (drugs included in the hospital formulary in relation to the total number of drugs marketed). Conclusions The number of patients with a NFD prescription was very low. The lack of correlation between the number of NFD or NFD prescriptions and the availability index demonstrated that the hospital formulary covers practically all therapeutic needs.
Published: 2020

12. Identifying Sleep Biomarkers to Evaluate Cognition in HIV

Author: Sridevi V. Sarma, Rachel E. Salas, Hilda Azimi, Kristin M. Gunnarsdottir, Charlene E. Gamaldo, and Alyssa A. Gamaldo
Subjects: Male, medicine.medical_specialty, HIV Infections, Polysomnography, 030312 virology, Electroencephalography, Article, 03 medical and health sciences, Cognition, 0302 clinical medicine, Physical medicine and rehabilitation, medicine, Humans, 030212 general & internal medicine, Set (psychology), 0303 health sciences, Sleep Stages, Sleep disorder, Framingham Risk Score, medicine.diagnostic_test, business.industry, medicine.disease, Sleep in non-human animals, Sleep, business, Biomarkers
Abstract: Sleep disturbance and cognitive impairment now represent two of the most common and debilitating conditions facing seropositive (HIV+) individuals who are otherwise well controlled with antiretroviral therapy. Sleep-assessment-based biomarkers represent an important step towards improving understanding the unique mechanistic features that may link sleep disruption and cognition in HIV+ individuals and can ultimately advance early detection and treatment opportunities in this cohort. In this study, a risk score was computed via a generalized linear model (GLM), which optimally combines polysomnography (PSG) features extracted from EEG, EMG, and EOG signals, to distinguish 18 HIV+ Black male individuals with and without cognitive impairment. The optimal set of features was identified via the least absolute shrinkage and selection operator (LASSO) approach, and the risk separation between the two groups, i.e., cognitively normal and cognitive impaired, was significant (and has a P-value < .001). Interestingly, the optimal set of features were all EEG derived and sleep stage-specific. These preliminary findings suggest that sleep-based EEG markers may be used as a diagnostic and prognostic for cognition in HIV+ patients.
Published: 2020

13. Procedures for Standard Evaluation and Data Management of Advanced Potato Clones. Summary Guide to Selecting Potato Clones for Drought Tolerance under Field Conditions

Author: D. Cevallos, J. De Souza, E. Salas, M. Bonierbale, and Raul Eyzaguirre
Subjects: Drought stress, Agronomy, business.industry, Data management, Drought tolerance, Biology, business, Field conditions
Published: 2020

14. When a private community neurology practice executes home sleep apnea testing: benefits identified and lessons learned in a retrospective observational study

Author: Maya Carter, Molly Price, Rachel E. Salas, Charlene E. Gamaldo, Daniel Hexter, Aadi Kalloo, Laurence T. Hou, Brian Salter, and Alyssa A. Gamaldo
Subjects: Adult, Male, medicine.medical_specialty, Neurology, Adolescent, Private Practice, Risk Assessment, Young Adult, 03 medical and health sciences, Behavioral Neuroscience, 0302 clinical medicine, medicine, Humans, Community Health Services, Young adult, Aged, Retrospective Studies, Aged, 80 and over, Sleep Apnea, Obstructive, business.industry, Sleep apnea, Retrospective cohort study, Middle Aged, medicine.disease, Home Care Services, respiratory tract diseases, Obstructive sleep apnea, 030228 respiratory system, Private practice, Physical therapy, Feasibility Studies, Female, Observational study, Risk assessment, business, 030217 neurology & neurosurgery
Abstract: Objective To investigate the feasibility and utility of a private community neurology practice–initiated home sleep apnea testing (HSAT) program. Methods A private community neurology practice conducted HSAT on patients clinically identified as high risk for obstructive sleep apnea (OSA). An academic board-certified sleep specialist performed all study interpretations. The presence and severity of OSA and its association with patient demographics (eg, sex, age) and comorbid health conditions relevant to OSA were evaluated. Results During 2011-2014, 147 consecutive patients clinically identified as highly “at risk for OSA” during their neurological visit underwent HSAT. Sixty-one percent (n = 89) of patients had a “positive” study with evidence of an apnea-hypopnea index of greater than 5 events per hour. Of those, 37% (n = 54) had mild OSA and 24% (n = 35) had moderate-severe OSA. OSA was more common among men (54%, n = 48) and in individuals with a previous documented history of depression (33%, n = 48) and hypertension 44% (n = 64). OSA treatment was ordered in 44% (n = 39) of patients by the neurologists or by a sleep specialist. Twenty-four percent (n = 21) of all patients studied were referred to a sleep specialist. Conclusion Implementation of HSAT in a (nonsleep) private community neurology practice in collaboration with an academic sleep program is recommended. Based on this observational study, community-based neurological practices and board-certified sleep specialists should consider teaming up to develop HSAT collaborative programs to open new sleep care access pathways for neurological patients often at risk for sleep apnea.
Published: 2018

15. The Proteolytic Fraction from Latex of Vasconcellea cundinamarcensis (P1G10) Enhances Wound Healing of Diabetic Foot Ulcers: A Double-Blind Randomized Pilot Study

Author: Gustavo Velasquez-Melendez, Luís Antônio Batista Tonaco, Miriam T. P. Lopes, Carlos E. Salas, and Flávia Sampaio Latini Gomes
Subjects: Male, medicine.medical_specialty, Latex, Pilot Projects, 030209 endocrinology & metabolism, Type 2 diabetes, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Internal medicine, Diabetes mellitus, medicine, Humans, Diabetic Nephropathies, Pharmacology (medical), Prospective Studies, Wound Healing, Intention-to-treat analysis, business.industry, Incidence (epidemiology), Caricaceae, General Medicine, Middle Aged, medicine.disease, Diabetic foot, Diabetic Foot, Rheumatology, Clinical trial, Diabetes Mellitus, Type 2, Chronic Disease, Female, Wound healing, business
Abstract: The aim of the study was to investigate the role of the proteolytic fraction from Vasconcellea cundinamarcensis, designated as P1G10, on the healing of chronic foot ulcers in neuropathic patients with diabetes 2. Fifty patients were enrolled in a prospective, randomized, double-blind trial, to verify the efficacy and safety of a topical dressing formulated with 0.1% P1G10, intended for wound healing, versus a hydrogel (control) protocol. Upon completion of the intervention, the outcome evaluated the number of patients attaining full epithelization (100%), or at least 80% healing. Statistical analysis compared the data on each group for the significance of the differences. Collection of data was finished in week 16, and the results were analyzed by intention to treat. The results showed that, in the control group, 5 patients attained 100% ulcer healing, 3 patients ≥ 80% healing and 11 experienced ulcer changes ≤ 80%, and the remainder showed no changes or their wounds became worse. Meanwhile, in the P1G10 group, 11 patients experienced full healing, 4 had healing ≥ 80% and 5 had ulcer changes ≤ lower than 80%, and the remainder showed no changes or their wounds became worse. The healing incidence for the first endpoint (100% healing) showed that the P1G10 group was 2.95-fold more efficacious than the control group (CI 95%) and 2.52-fold (CI, 95%) higher than its control for the second endpoint (80% healing). These data support the hypothesis that topical application of the proteolytic fraction identified as P1G10 significantly enhances foot ulcer healing compared to hydrogel treatment.
Published: 2018

16. Education Research: Difficult conversations in neurology

Author: Charlene E. Gamaldo, Renee D. Boss, Rachel E. Salas, Roy E. Strowd, Ankita Saxena, Monica E. Lemmon, and Tiana E. Cruz
Subjects: Medical education, Medical psychology, Debriefing, media_common.quotation_subject, Communication skills training, Focus group, 03 medical and health sciences, 0302 clinical medicine, business.product_line, Conversation, 030212 general & internal medicine, Neurology (clinical), Psychology, business, Curriculum, Health communication, 030217 neurology & neurosurgery, Qualitative research, media_common
Abstract: ObjectiveTo characterize features of medical student exposure to difficult conversations during a neurology core clerkship.MethodsThis was a cross-sectional concurrent nested mixed methods study, and all students rotating through a required neurology clerkship between 2014 and 2015 were enrolled. Data collection included an electronic communication tracker, baseline and end-of-clerkship surveys, and 4 facilitated focus groups. Students were asked to log exposure to patient–clinician conversations about (1) new disability, (2) poor prognosis, (3) prognostic uncertainty (4), terminal diagnosis, and (5) end-of-life care.ResultsA total of 159 students were enrolled and 276 conversations were tracked. Most (70%) students observed at least 1 difficult conversation, and conversations about poor prognosis, new disability, and prognostic uncertainty were most commonly logged. At clerkship end, most students (87%) desired additional bedside training in communication skills. Exposure to one of the predefined conversation types did not improve student perceived preparedness to lead difficult conversations in the future. In focus groups, students noted that the educational value of observation of a difficult conversation could be optimized with preconversation planning and postconversation debriefing.ConclusionsDifficult conversations are common in neurology, and represent a valuable opportunity to provide communication skills training on the wards. Future curricula should consider ways to leverage these existing opportunities to enhance communication skills training.
Published: 2018

17. The Critical Role of the Neurology Diversity Officer in Serving Our Patients, Profession, and the Neurology Pipeline

Author: Rachel E. Salas and Charlene E. Gamaldo
Subjects: Equity (economics), business.industry, media_common.quotation_subject, education, Identity (social science), Public relations, Audience measurement, Officer, 03 medical and health sciences, 0302 clinical medicine, Health care, 030212 general & internal medicine, Neurology (clinical), Sociology, Justice (ethics), business, Inclusion (education), 030217 neurology & neurosurgery, Diversity (politics), media_common
Abstract: We write this editorial after experiencing a 10-month global pandemic that has disproportionately affected marginalized racial and ethnic communities. We write this editorial with heightened focus on the historical impact that structurally racist policies have had on justice, housing, education, and (most applicably to this readership) health care systems. We write this editorial after this last year also revealed some hard truth(s) regarding the direct and historic connections between the institution of slavery and current medical research,1 medical education,2 and the traditions and practices of some of our most respected academic medical centers.3 This contextual lens placed even greater relevance to the article by Mohile et al.,4 “Developing the Neurology Diversity Officer: A Roadmap for Academic Neurology Departments,” in this issue of Neurology ®. The authors present various roles and unique challenges that the neurology diversity officer or equity, diversity, inclusion (EDI) equivalent officers (NDOE) and the academic community must consider to create inclusive academic neurology communities. Arguably, the events and experiences over the last year provide the most substantial evidence for the requisite role of the NDOE in our effort to fulfill the oath to serve the following stakeholders: (1) our patients (who are becoming increasingly diverse as noted in the article),4 (2) ourselves and our pipeline (who are not only expecting but increasingly demanding a greater focus on EDI in the interprofessional healthcare environment),5 and (3) our research (which increasingly requires the inclusion of a diverse participant enrollment in all clinical and therapeutic research protocols).6,7 Dating back to 1957, Merton spoke of the critical role of the medical education experience in cultivating the professional identity of a physician.8 More recently, the Carnegie Foundation developed this concept further by citing professional identity formation as 1 of the 4 primary concepts to target in medical curricular reform.9 Professional identity formation is defined as the process by which the learner is shepherded through his or her transformation into a “physician with the values, disposition, and aspirations of the physician community.”8 A strong professional identity has been linked to training physicians who deliver higher-quality care.10 Progress toward fulfilling the oath to serve our 3 aforementioned stakeholders makes it increasingly apparent that the presence of NDOE is paramount to both the transformation and maintenance of the neurologist's professional identity.9
Published: 2021

18. Finding Time for Sleep: Identifying Sleep Concerns in Non-Sleep Specialty Clinics using the MySleepScript App

Author: Alyssa A. Gamaldo, Anthony B. Kwan, Aadi Kalloo, Peter Dziedzic, Charlene E. Gamaldo, Rachel E. Salas, Ankur A. Doshi, Luis F. Buenaver, Seulah Choi, and Annette Wang
Subjects: medicine.medical_specialty, business.industry, Specialty, Medicine, Sleep (system call), business, Psychiatry
Published: 2017

19. Computerized pharmacy surveillance and alert system for drug-related problems

Author: J. Portabella, O. Urbina, S. Mojal, E. Salas, Santiago Grau, M Marín-Casino, J. Mateu-de-Antonio, M. Riu, and O. Ferrández
Subjects: Male, Drug, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, media_common.quotation_subject, Pharmacy, Pharmacists, 030226 pharmacology & pharmacy, Clinical decision support system, Medical Order Entry Systems, 03 medical and health sciences, 0302 clinical medicine, Pharmacotherapy, medicine, Humans, Medication Errors, Drug Interactions, Pharmacology (medical), In patient, 030212 general & internal medicine, Medical prescription, Intensive care medicine, Alert system, media_common, Pharmacology, business.industry, Electronic medical record, nutritional and metabolic diseases, Emergency medicine, Female, Patient Safety, business
Abstract: SummaryWhat is known and objective Because of the impact of drug-related problems (DRPs) on morbidity and mortality, there is a need for computerized strategies to increase drug safety. The detection and identification of the causes of potential DRPs can be facilitated by the incorporation of a pharmacy warning system (PWS) in the computerized prescriber order entry (CPOE) and its application in the routine validation of inpatient drug therapy. A limited number of studies have evaluated a clinical decision support system to monitor drug treatment. Most of these applications have utilized a small range of drugs with alerts and/or types of alert. The objective of this study was to describe the implementation of a PWS integrated in the electronic medical record (EMR). Methods The PWS was developed in 2003–2004. Pharmacological information to generate drug alerts was entered on demographic data, drug dosage, laboratory tests related to the prescribed drug and drug combinations (interactions, duplications and necessary combinations). The PWS was applied in the prescription reviews conducted in patients admitted to the hospital in 2012. Results and discussion Information on 83% of the drugs included in the pharmacopeia was introduced into the PWS, allowing detection of 2808 potential DRPs, representing 79·1% of all potential DRPs detected during the study period. Twenty per cent of PWS DRPs were clinically relevant, requiring pharmacist intervention. What is new and conclusion The PWS detected most potential DRPs, thus increasing inpatient safety. The detection ability of the PWS was higher than that reported for other tools described in the literature.
Published: 2017

20. PO-87 Comparison of different clinical risk assessment models (RAMs) in ambulatory cancer patients receiving chemotherapy from the Oncothromb-02 study

Author: V. Pachón Olmos, M. Salgado, I. Fernández Pérez, A. Muñoz Martín, A. Martínez-Pérez, J. Rubio Pérez, C. Font-Puig, V. Rubio Castellón, M. Ruiz Zamorano, J.M. Soria Fernández, E. Martínez de Castro, A.I. Ferrer Pérez, A. Cárdenas Yebra, J. Martínez-Galán, A.B. Ruperez Blanco, L. Ortega Morán, Elia Seguí, E. Salas Pérez-Rasilla, Sheila Lopez, T. Quintanar Verdúgez, and X. García Escobar
Subjects: medicine.medical_specialty, Chemotherapy, business.industry, Internal medicine, medicine.medical_treatment, Ambulatory, medicine, Cancer, Hematology, business, medicine.disease, Clinical risk factor
Published: 2021

21. Validation of a Wireless, Self-Application, Ambulatory Electroencephalographic Sleep Monitoring Device in Healthy Volunteers

Author: Jessica M. Richards, Jeannie Marie S. Leoutsakos, Rachel E. Salas, Patrick H. Finan, Dingfen Han, Michael R. Irwin, Charlene E. Gamaldo, and Michael T. Smith
Subjects: Male, Polysomnography, Audiology, Electroencephalography, Sleep medicine, 0302 clinical medicine, Reference Values, Psychology, Medicine, validation, medicine.diagnostic_test, Scientific Investigations, Neurology, ambulatory EEG, Anesthesia, Ambulatory, Female, Sleep (system call), Sleep onset, Sleep Research, Wireless Technology, psychological phenomena and processes, Adult, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Monitoring, Clinical Sciences, Monitoring, Ambulatory, Sensitivity and Specificity, Young Adult, 03 medical and health sciences, Clinical Research, Humans, sleep, Other Medical and Health Sciences, Neurology & Neurosurgery, business.industry, Neurosciences, Reproducibility of Results, 030228 respiratory system, Ambulatory EEG, Neurology (clinical), Sleep onset latency, Sleep, business, 030217 neurology & neurosurgery
Abstract: STUDY OBJECTIVES To evaluate the validity of an ambulatory electroencephalographic (EEG) monitor for the estimation of sleep continuity and architecture in healthy adults. METHODS Healthy, good sleeping participants (n = 14) were fit with both an ambulatory EEG monitor (Sleep Profiler) and a full polysomnography (PSG) montage. EEG recordings were gathered from both devices on the same night, during which sleep was permitted uninterrupted for eight hours. The study was set in an inpatient clinical research suite. PSG and Sleep Profiler records were scored by a neurologist board certified in sleep medicine, blinded to record identification. Agreement between the scored PSG record, the physician-scored Sleep Profiler record, and the Sleep Profiler record scored by an automatic algorithm was evaluated for each sleep stage, with the PSG record serving as the reference. RESULTS Results indicated strong percent agreement across stages. Kappa was strongest for Stage N3 and REM. Specificity was high for all stages; sensitivity was low for Wake and Stage N1, and high for Stage N2, Stage N3, and REM. Agreement indices improved for the manually scored Sleep Profiler record relative to the autoscore record. CONCLUSIONS Overall, the Sleep Profiler yields an EEG record with comparable sleep architecture estimates to PSG. Future studies should evaluate agreement between devices with a clinical sample that has greater periods of wake in order to better understand utility of this device for estimating sleep continuity indices, such as sleep onset latency and wake after sleep onset.
Published: 2016

22. Relationship between Physical Function and Sleep Quality in African Americans

Author: Roland J. Thorpe, Rachel E. Salas, Keith E. Whitfield, Alyssa A. Gamaldo, and Charlene E. Gamaldo
Subjects: Male, Sleep Wake Disorders, Pulmonary and Respiratory Medicine, Gerontology, Physical function, 03 medical and health sciences, 0302 clinical medicine, Physical functioning, Activities of Daily Living, Humans, Medicine, 030212 general & internal medicine, Geriatric Assessment, Aged, Sleep quality, business.industry, Scientific Investigations, Sleep in non-human animals, Black or African American, Neurology, Baltimore, Female, Neurology (clinical), Sleep, business, 030217 neurology & neurosurgery
Abstract: There is a growing body of research examining the relationship between sleep and functional outcomes. However, little is known about sleep and physical functioning in older African Americans.Data for this project included 450 community-dwelling older African Americans (71.4 ± 9.2 years of age) who participated in the Baltimore Study of Black Aging. Overall sleep pattern and quality was measured by the Pittsburgh Sleep Quality Index (PSQI). Physical functioning was measured by the number of activities of daily living that each participant reported difficulty (ADL; e.g. eating, dressing, and bathing). Negative binomial regression models were conducted to estimate the association between sleep quality and physical functioning.Seventy-two percent of the participants reported poor sleep quality. African Americans who reported poor sleep quality had a greater likelihood of an increase in the number of difficulties in ADLs that they reported even after accounting for demographic characteristics and health conditions. The relationship between sleep quality and physical functioning did not vary by gender.Sleep may be an important factor to consider when seeking to improve physical functioning among community-dwelling older African Americans.
Published: 2016

23. Evaluating and managing sleep disorders in the parkinson’s disease clinic

Author: Charlene E. Gamaldo, Zoltan Mari, Seema Gulyani, Abhimanyu Mahajan, S. Choi, and Rachel E. Salas
Subjects: 0301 basic medicine, medicine.medical_specialty, business.industry, Cognition, Disease, Sleep in non-human animals, Article, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Neurology, Medicine, Neurology (clinical), business, Psychiatry, 030217 neurology & neurosurgery, Specific population, Parkinson's disease clinic
Abstract: Parkinson's disease is a multi-systems neurodegenerative disorder that is characterized by a combination of motor and non-motor symptoms. Non-motor symptoms of Parkinson's disease comprise a variety of cognitive, neuropsychiatric, autonomic, sensory, and sleep complaints. Although sleep disruption represents one of the most common non-motor symptom complaints among Parkinson's disease patients, recommendations regarding effective evaluation and management strategies for this specific population remain limited. This review gives an evidence based summary of the available treatment options and management strategies for the sleep complaints commonly encountered by patients with Parkinson's disease.
Published: 2016

24. Speaking the same language

Author: Roland J. Thorpe, Roy E. Strowd, Charlene E. Gamaldo, Tiana E. Cruz, Deanna Saylor, and Rachel E. Salas
Subjects: medicine.medical_specialty, business.industry, Research, Professional behavior, media_common.quotation_subject, education, Likert scale, Family medicine, Perception, Health care, Academic Training, medicine, Medical training, Neurology (clinical), Single institution, business, Psychology, Social responsibility, Social psychology, media_common
Abstract: Background: Professionalism is integral to medical training and practice. Recent studies suggest generational differences in perceptions of professionalism, which have not been adequately explored in academic neurology. Methods: A cross-sectional study was performed to describe perceptions of professionalism among representative physicians across the academic training spectrum of neurology. A self-report questionnaire adapted from a published instrument was distributed to students, residents, fellows, and faculty in neurology at a single institution. Responders rated 4 domains of professionalism: Personal Characteristics, Interactions with Patients, Social Responsibility, and Interactions with the Health Care Team (5-point Likert scale, not at all important to very important), and selected the “top 2” characteristics critical to professional behavior in each domain. Results: A total of 296 of 312 (95%) responded, including 228 students, 24 residents, 19 fellows, and 25 faculty. Respondents ranked the following components to be important/very important contributors to the expression of professional behavior: Personal Characteristics (98%, mean rating 4.6 ± 0.3), Interactions with Patients (97%, 4.6 ± 0.4), and Interactions with the Health Care Team (96%, 4.6 ± 0.5). Although mean ratings were high for Social Responsibility (4.3 ± 0.6), only 82% indicated that this was important/very important in the expression of professionalism, with a gradual decline from students (4.4 ± 0.6) to residents (3.99 ± 0.8, p = 0.02). The “top 2” contributors to each domain were similar across responders. Conclusions: Professionalism was perceived as critically important across the academic training spectrum in neurology, and the view regarding the top contributors to the expression of professionalism remained consistent among the respondents.
Published: 2016

25. Epidemiology and prognostic factors in severe sepsis/septic shock. Evolution over six years

Author: I. Elósegui, G. Choperena, R. Sebastián, G. Lara, E. Salas, R. Salaberria, I. Eguibar, I. Azkárate, and L. Barrutia
Subjects: education.field_of_study, medicine.medical_specialty, business.industry, Septic shock, Incidence (epidemiology), Population, 030208 emergency & critical care medicine, Emergency department, medicine.disease, Intensive care unit, Procalcitonin, law.invention, Sepsis, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, law, Emergency medicine, Epidemiology, medicine, education, Intensive care medicine, business
Abstract: Objective To determine the clinical characteristics and prognostic factors of patients with severe sepsis/septic shock admitted to the Intensive Care Unit of Donostia University Hospital (Guipuzcoa, Spain). Design A prospective, observational study was carried out during a consecutive 6-year period (1st February 2008–31st December 2013). Setting The Intensive Care Unit of Donostia University Hospital, the only third level hospital in the province of Guipuzcoa, with a recruitment population of 700,000 inhabitants. Results Number of patients with severe sepsis/septic shock has progressively increased over the last years to reach 1136 patients, yet significant changes in age, sex, Acute Physiology and Chronic Health Evaluation II, procalcitonin and lactate values could not be observed. In the last years, admission rate from Emergency Department has increased in comparison to admissions from hospitalization ward, with a higher incidence of urological sepsis. Hemodynamic and renal dysfunctions have been the most prevalent disorders, respiratory involvement and thrombocytopenia have gone down while coagulopathy has increased significantly. Mortality has decreased significantly. We have performed a multivariate analysis of the early prognostic factors. Type, origin, sepsis etiology, lactate and the presence of organ dysfunction–except for hyperbilirubinemia and hypotension–were the most important mortality factors. Conclusions Severe sepsis and septic shock result in growing ICU admissions. Although clinical features have barely changed over the last years, we have observed a decrease in mortality. We find important knowing these early prognostic factors to improve the management of these patients.
Published: 2016

26. Applying Lean Thinking: The Assessment of Professional Conduct of Medical Students

Author: Laurence Hou, Roy E. Strowd, Charlene E. Gamaldo, Alyssa A. Gamaldo, Rachel E. Salas, Mark A. Sanchez, and Aadi Kalloo
Subjects: Professional conduct, Physician burnout, Medical education, business.industry, education, Specialty, Core competency, General Medicine, Lean manufacturing, 03 medical and health sciences, 0302 clinical medicine, Medicine, 030212 general & internal medicine, business, Clinical evaluation, 030217 neurology & neurosurgery
Abstract: Methods of incorporating the evaluation of professional conduct have varied widely by specialty, institution, and level of training. Medical educators now are tasked with developing more operationally-defined evaluative tools while balancing the ongoing need to reduce administrative load and survey fatigue that have been linked with physician burnout. Our aim was to investigate the value of a single question to measure the professional conduct of a medical student. Responses to the single question, “please rate this student’s potential as a resident on YOUR team”, were correlated with the individual core competency domains (17 questions with six questions targeted towards professional conduct), overall clinical evaluation score, final grade, and shelf examination score. Resident and faculty ratings across the 17 questions, overall clinical evaluation scores, and final grades were significantly associated with ratings on the single “Housestaff Potential” question. While this score was also significantly associated with the shelf score for resident evaluators only, it was a significant unique predictor for the overall clinical evaluation score for both evaluators. Our findings suggest that a single question designed to rate the professional conduct of medical students can be efficiently incorporated into the clerkship clinical evaluation.
Published: 2016

27. Epidemiología y factores pronósticos de la sepsis grave/shock séptico. Seis años de evolución

Author: I. Elósegui, R. Sebastián, G. Lara, E. Salas, G. Choperena, R. Salaberria, I. Eguibar, I. Azkárate, and L. Barrutia
Subjects: 03 medical and health sciences, 0302 clinical medicine, business.industry, Medicine, 030208 emergency & critical care medicine, 030212 general & internal medicine, Critical Care and Intensive Care Medicine, business, Humanities
Abstract: Resumen Objetivo Examinar las caracteristicas clinicas y los factores pronosticos de los pacientes ingresados por sepsis grave/shock septico en la Unidad de Cuidados Intensivos del Hospital Universitario Donostia. Diseno Estudio observacional prospectivo durante un periodo consecutivo de 6 anos (1-2-2008 a 31-12-2013). Ambito Servicio de Medicina Intensiva del Hospital Universitario Donostia, unico hospital terciario de Guipuzcoa. Resultados El numero de pacientes con sepsis grave/shock septico ha aumentado progresivamente hasta un total de 1.136, sin observarse cambios significativos en la edad, el sexo, la puntuacion del Acute Physiology and Chronic Health Evaluation II, los valores de procalcitonina ni en los de lactato serico. En los ultimos anos ha habido un aumento significativo de los ingresos desde Urgencias respecto a los procedentes de planta, con una mayor incidencia de la sepsis urologica. La afectacion hemodinamica y renal han sido las disfunciones mas prevalentes, descendiendo la afectacion respiratoria y la trombocitopenia y aumentando la coagulopatia. La mortalidad ha descendido significativamente. Mediante un analisis multivariante analizamos factores pronosticos precoces: el tipo de paciente, su procedencia, la etiologia de la sepsis, la cifra de lactato y la presencia de disfunciones organicas, exceptuando la hiperbilirrubinemia y la hipotension, fueron las variables mas influyentes en la mortalidad. Conclusiones La sepsis grave/shock septico genera un creciente numero de ingresos. A pesar de que las caracteristicas clinicas han variado poco en los ultimos anos, hemos observado un descenso de la mortalidad. Consideramos importante el conocimiento de los factores pronosticos precoces para mejorar el abordaje de estos pacientes.
Published: 2016

28. A Novel Sleep Stage Scoring System: Combining Expert-Based Rules with a Decision Tree Classifier

Author: Sridevi V. Sarma, Rachel E. Salas, Kristin M. Gunnarsdottir, Joshua B. Ewen, Charlene E. Gamaldo, and Richard P. Allen
Subjects: Sleep Wake Disorders, medicine.medical_specialty, Computer science, Polysomnography, 0206 medical engineering, 02 engineering and technology, Electroencephalography, Sleep medicine, Article, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Sleep Stages, medicine.diagnostic_test, business.industry, Decision tree learning, Decision Trees, Pattern recognition, 020601 biomedical engineering, Artificial intelligence, business, psychological phenomena and processes, 030217 neurology & neurosurgery
Abstract: Overnight polysomnography (PSG) is the gold standard tool used to characterize sleep and for diagnosing sleep disorders. PSG is a non-invasive procedure that collects various physiological data which is then scored by sleep specialists who assign a sleep stage to every 30-second window of the data according to predefined scoring rules. In this study, we aimed to automate the process of sleep stage scoring of overnight PSG data while adhering to expert-based rules. We developed an algorithm utilizing a likelihood ratio decision tree classifier and extracted features from EEG, EMG and EOG signals based on predefined rules of the American Academy of Sleep Medicine Manual. Specifically, features were computed in 30-second epochs in the time and the frequency domains of the signals and used as inputs to the classifier which assigned each epoch to one of five possible stages: N3, N2, N1, REM or Wake. The algorithm was trained and tested on PSG data from 38 healthy individuals with no reported sleep disturbances. The overall scoring accuracy was 80.70% on the test set, which was comparable to the training set. Our results imply that the automatic classification is highly robust, fast, consistent with visual scoring and is highly interpretable.
Published: 2018

29. AB1413-HPR Advantages of rheumatology nursing vaccination of patients with inflammatory rheumatic diseases of autoimmune origin. analysis of the first 3 years

Author: A. Pons-Bas, M.A. Lorente, E. Ivars, G. Santos-Soler, Clímaco Cano, E. Salas, Xavier Barber, José Miguel Senabre-Gallego, and José Rosas
Subjects: Hepatitis B virus, medicine.medical_specialty, business.industry, Medical record, Booster dose, medicine.disease_cause, medicine.disease, Rheumatology, Vaccination, Psoriatic arthritis, Nursing, Internal medicine, Rheumatoid arthritis, Epidemiology, medicine, business
Abstract: Background Patients with systemic autoimmune diseases (SAD) have higher incidence of infections. In our Service, until 2014 about 50% of patients did not complete vaccination for pneumococcus or hepatitis B virus (HBV). Objectives To know the characteristics of vaccinated patients and advantages of vaccination by Rheumatology nurse (Nurse-RHEU). Methods Observational study of patients in follow-up in rheumatology, vaccinated from 2015–2017, by SAD in treatment with biological therapy and/or immunosuppressive, by Nurse-RHEU, following the recommendations from SVR and the Valencian Society of Preventive Medicine and Public Health Consensus Document for the vaccination of patients with SAD, published in 2014. Nurse-RHEU, assumed from 2015 the vaccination of all rheumatology patients with SAD. The vaccines to be administered were: pneumococcal (13 V and/or 23 V) and hepatitis B virus (HBV). Pneumococcal vaccination should be initiated with the conjugate/13 V type and at least 8 weeks later with a dose of polysaccharide/23 V vaccine. A single 23 V booster dose is recommended 5 years after the first dose. Only if patient have received a previous dose of 23 V, it is advisable to administer type 13 V, one year later. For the HBV vaccine, it is necessary previously check the immune status of the subject. If it is not immune, 3 doses will be administered (0–1–6 months). Since 2015, our Section has: refrigerator, electronic access to the Vaccinated Nominal Registry of the Valencian Community (it collects data of the patient, date, type, batch of vaccine administered), specific database (epidemiological data of the patients, future dose programming, access to electronic medical records) and Nurse-RHEU trained. Previously, the nurse details possible side effects, and how to act or contact. Results Of the 261 patients vaccinated during 2015 to 2017, 65% were women, with mean age 53.57±15.50 years (10–81 years). The diagnosis was: rheumatoid arthritis: 48%, ankylosing spondylitis: 23%, psoriatic arthritis: 13%, systemic lupus erythematosus: 7%, uveitis: 4%, and others 5%. The reason for vaccination was: initiation treatment with a biological drug (51%), or immunosuppressive (49%). A total of 621 vaccines were administered, which were: 13-valent conjugate antineumotococcal: 259 (42%), 1 st VHB dose: 94 (15%), 2nd VHB dose: 85 (14%), 3rd VHB dose: 72 (12%), pneumococcal 23-valent polysaccharide: 111 (17%). All vaccines were registered in the Vaccinated Nominal Register of the Valencian Community. Conclusions 1. Patients with SAD in biological treatment and/or immunosuppressant, vaccinated by Nurse-RHEU, achieve a completeness of all doses of vaccination, close to 100%. 2. In a large part of the patients, vaccination is scheduled at the beginning of the diagnosis of the disease, at the first consultation or immunosuppressive treatment, the same day of the visit to the Rheumatologist, avoiding unnecessary visits to the patient. 3. An adequate electronic registry allows immediate access to information from any point in the Valencian Community, through access to the computer program of the Health department. Acknowledgements The study was supported with a research grant from the Association for Research in Rheumatology of Marina Baixa (AIRE-MB). Disclosure of Interest None declared
Published: 2018

30. THU0479 The antiosteoporotic treatment is scarce among patients with vertebral fracture reflected in the radiological report: data from a fracture unit-fls

Author: Mariano Hernández, G. Santos-Soler, B. Statti, JD Alvarado, José Rosas, Xavier Barber, V. Miñanos, M. López, A. Pons-Bas, J. Monteagudo, José Miguel Senabre-Gallego, José Carlos Hernández, Jorge Jimenez, E. Salas, M.A. Lorente, Antonio García, E. Ivars, H. Arcos, C. Cano, AM Molinos, and Cataixa López
Subjects: medicine.medical_specialty, business.industry, Osteoporosis, Traumatology, Emergency department, medicine.disease, Rheumatology, Surgery, Denosumab, Lumbar, Internal medicine, Radiological weapon, Ambulatory, medicine, business, medicine.drug
Abstract: Background A relevant number of patients with vertebral fracture (VF) do not receive specific treatment for osteoporosis and remain as invisible fractures. The objective of the Fracture Units-FLS is to detect patients with fracture, to perform an adequate diagnostic evaluation, initiate treatment and try to prevent new fractures. Objectives To know the characteristics of the patients and attitude of the referring service, in which the radiological report identifies the presence of VF. Methods Observational study carried out from January 1 to June 30, 2017, of consecutive patients in which the radiological report after performing simple radiology or CT, reflects the presence of dorsal, lumbar or both VF. The attitude of the service requesting the radiological test was reviewed 3 months after the radiological report. The following variables were collected: general data of the patients (age, gender), the service requesting the imaging test (specialty, request from hospitalisation or ambulant, diagnosis and/or previous treatment for osteoporosis, attitude towards the FV) and the radiological test (type of test and location of the VF). Results 91 patients were included, of which 62% were women, with a mean age of 72±11.56 years. In 46% of the patients, the image test was requested by one of the Internal Medicine Services (gastroenterology: 31%, oncology-haematology: 17%, rheumatology: 14%, neumology: 12%, cardiology: 10%), 36% by Primary Care Physicians, 15% from the Emergency Department of the Hospital and the remaining 2% from a Surgical Service. In 77%, the radiological test was given to ambulatory patients. In 56%, the imaging test was simple radiology (chest X-ray: 56%, dorsal-lumbar spine: 41% and the remaining 4% bone series study) and 44% CT. In 61%, the fracture was located in dorsal spine, in 28% in lumbar spine and the remaining 11% in the dorsal and lumbar spine. Previously, 44% were diagnosed with osteoporosis and 38% were undergoing specific treatment (oral bisphosphonate: 23%, bisphosphonate iv: 20%, denosumab: 20%, SERM: 8%, PTH: 6% and only calcium +vitamin supplements D: 23%). Three months after the identification of the VF, 66% did not receive specific treatment for osteoporosis, 11% were referred to Rheumatology (initiating treatment in all) and 3% to Traumatology. Three (3%) of the patients had died and 2 (2%) had moved away. Conclusions Despite being reflected in the radiological report, a significant number of patients with vertebral fracture do not receive antiosteoporotic treatment, 3 months later. Acknowledgements The study was supported with a research grant from the Association for Research in Rheumatology of Marina Baixa (AIRE-MB). Disclosure of Interest None declared
Published: 2018

31. SAT0401 Risk of hospital admission due to severe infection in patients under treatment with anti-tnf drugs: data from a local registry

Author: G. Santos-Soler, Xavier Barber, E. Salas, José Alberto García-Gómez, J. Ena, José Miguel Senabre-Gallego, M. Pucciarelli, E. Ivars, José Rosas, A. Pons-Bas, M.A. Lorente, and Clímaco Cano
Subjects: medicine.medical_specialty, business.industry, Septic shock, Arthritis, medicine.disease, Infliximab, Etanercept, Sepsis, Psoriatic arthritis, Internal medicine, medicine, Adalimumab, Septic arthritis, business, medicine.drug
Abstract: Objectives To Know characteristics of patients treated with anti-TNF, who suffered infections that forced hospital admission. Methods Prospective observational study in patients treated with anti-TNF, during 1/1/2000 to 12/31/2017, followed up in the Rheumatology Section. General data of patients (age, gender), of disease (diagnosis and time of evolution, type of anti-TNF, time in anti-TNF, concomitant treatment with DMARD), regarding the presence of severe infection, defined as infection that required hospital admission (time in anti-TNF to infection, location of infection, days of admission, mantoux/IGRAS and vaccinations prior to the start anti-TNF treatment) was collected. The admission decision was made by Emergency Department of centre or Rheumatology. Results Of 442 patients with anti-TNF, 44 (9.6%) patients had at least one hospital admission due to severe infection. 59% were women, with mean age 64±16.72 years,22–88 21.25±4.02 years of disease evolution. A mantoux/IGRAS was performed prior anti-TNF. Diagnosis was: rheumatoid arthritis (RA): 25 (57%), ankylosing spondylitis (AS): 12 (27%), psoriatic arthritis (PSA): 5 (11%) and juvenile idiopathic arthritis (JIA): 2 (5%). The mean time of treatment with anti-TNF is 5.6±4.5 years. Adalimumab received 24 (55%) patient, infliximab 8 (18%) patients, etanercept 6 (14%) patients, golimumab 5 (11%) and 1 (2%) certolizumab. Of the 55 confirmed infections: non-pneumonic infection in 13 (24%) patients, pneumonia: 10 (18%), septic arthritis: 6 (11%), septic shock and/or bacteremia: 6 (11%), abscess: 4 (7%), urinary infections: 4 (7%), cellulitis: 3 (5%), cutaneous leishmaniasis: 3 (5%), acute gastroenteritis: 2 (4%), surgical wound infection: 1 (2%), cutaneous infection: 1 (2%), Septic bursitis: 1 (2%), gonorrhoea: 1 (2%). The mean time of hospital admission was 9.76 days. Three (7%) patients presented the infection within a year of starting treatment. The rate of severe infection x100 patients/year of exposure is 2.01 (1.47–2.67). The odd ratio of admission for infection of 3.67 (1.11–4.87, p=0.03). The risk of admission for infection in patients with peripheral arthritis (RA, PSA, JIA) is 2.42 (1.21–3.11) times higher than in patients with AS (p=0.012). In the table 1, the Odd ratio of income for infection distributed by anti-TNF drug is shown. Conclusions 1. The severe infection rate x100 patients/year of exposure is 2.01 and the prevalence is 9.6%. 2. The majority of severe infection occurred late, after more than 1 year of treatment. 3. The most frequent infection were those of respiratory origin, followed by sepsis or bacteremia and septic arthritis. 4. Etarnecept has presented the lowest rate of severe infection. 5. Patients with AS have a lower risk of severe infection than patients with chronic peripheral arthritis. Acknowledgements The study was supported with a research grant from the Association for Research in Rheumatology of Marina Baixa (AIRE-MB). Disclosure of Interest None declared
Published: 2018

32. 4CPS-043 Evaluation of non-formulary drugs prescription and acceptance of an alternative drug

Author: N Carballo, Santiago Grau, M De Antonio-Cuscó, Olivia Ferrández, Jaime Barceló-Vidal, E González-Colominas, X Fernandez Sala, and E. Salas
Subjects: Drug, medicine.medical_specialty, business.industry, media_common.quotation_subject, Retrospective cohort study, University hospital, Clinical pharmacy, Internal medicine, Concomitant, medicine, In patient, Formulary, Medical prescription, business, Section 4: Clinical pharmacy services, media_common
Abstract: Background Hospitals cannot include all marketed drugs in their formularies. Those drugs not included in the formulary (NFD) need an alternative drug available (ALT) in order to cover all patient requirements. Purpose To assess the prevalence of NFD prescriptions and factors associated with the acceptance recommendation on an ALT. Material and methods Retrospective study performed in a tertiary university hospital from 2012 to 2015. Data collected: drug-related problems (DRP); DRP-related NFD prescription (DRP-NFD); admissions; and admissions with prescription of NFD. NFD classification: NFD with ALT (NFD-ALT) (drug able to present the same clinical effect and safety profile than NFD); non-replaceable NFD (NFD-NR) (drug for which no therapeutic alternative is available); or NFD of doubtful therapeutic efficacy (NFD-DTE) (drug with limited evidence on its effectiveness). Clinical pharmacists made an annotation in the electronic medical record, offering an ALT when it was available, proceeding to its acquisition when it was NFD-NR and recommending withdrawal when it was NFD-DTE. Admissions data collected: demographic; Charlson comorbidity index; urgent/scheduled admission; surgical/medical service; number of concomitant drugs; and ATC-group. Acceptance of ALT recommendation was evaluated. Results Total admissions: 69,686; DRP: 10,480; admissions affected by DRP-NFD: 441 (0.6%). DRP-NFD: 557 (5.1%), where: NFD-ALT: 496 (89%); NFD-NR: 5 (0.9%); NFD-DTE: 56 (10.1%). Most commonly involved ATC groups: urological preparations (G04):71 (16.1%); renin-angiotensin system (C09): 47 (10.7%); agents against obstructive airway diseases (R03): 47 (10.7%); ophthalmologic (S01): 43 (9.8%); hypolipidaemic (C10): 25 (5.7%); systemic antihistamines (R06): 20 (4.5%); systemic corticosteroids (H02): 17 (3.9%); diuretics (C03): 16 (3.6%); laxatives (A06): 12 (2.7%); anti-inflammatory/antirheumatic (M01): 11 (2.5%); others: 132 (29.9%). From 496 NFD-ALT, 154 (31%) recommended ALT were accepted, 287 (57.9%) not accepted and 55 (11.1%) were non-evaluable. Conclusion Most drugs not included in the formulary are substitutable for an available alternative (99.1%). Although no factors are significantly associated, there is a trend towards acceptance of the recommended therapeutic alternative in patients with prescription of a higher number of concomitant drugs. Acceptance was less than 30% when the ATC involved were systemic antihistamines, ophthalmologic preparations and agents used against obstructive airway diseases. No conflict of interest
Published: 2018

33. 4CPS-072 Are we properly dosing antibiotics in enterococcus faecium bacteraemia?

Author: J Barcelo, Luisa Sorlí, Daniel Echeverría-Esnal, J.P. Horcajada, Mónica Marín-Casino, X Fernandez, Santiago Grau, Clara Martín-Ontiyuelo, E. Salas, and S Luque Pardos
Subjects: medicine.medical_specialty, medicine.diagnostic_test, biology, business.industry, medicine.drug_class, Incidence (epidemiology), Antibiotics, Retrospective cohort study, Antimicrobial, biology.organism_classification, Therapeutic drug monitoring, Internal medicine, Medicine, Dosing, Medical prescription, business, Section 4: Clinical pharmacy services, Enterococcus faecium
Abstract: Background The incidence of Enterococcus faecium infections has increased over the past years and is currently the third major microorganism implicated in nosocomial bacteraemia. Nevertheless, the best treatment available is yet to be established, especially in vancomycin-susceptible E. faecium . In this setting, a correct dosage is essential, as inappropriate dosage has been associated with a higher risk of treatment failure. Purpose Our objective was to describe the dosage adequacy of antibiotics used in the treatment of E. faecium bacteraemia. Material and methods Retrospective observational study performed in a 400-bed university teaching hospital from June 2011 to June 2016. Patients with E. faecium isolation from at least one positive blood culture were included. Dosage adequacy was assessed by infectious-diseases-trained pharmacists, who reviewed antimicrobial prescriptions daily and recommended an appropriate dose adjustment in the first 24 to 72 hours of treatment. Inappropriate dosage was considered if it was out of therapeutic range according to plasmatic levels when available, or if an adjustment was needed according to weight or renal function (based on John Hopkins antibiotic guide and data sheet). Categorical variables were presented as percentages and continuous variables as mean (±SD). Results Seventy patients were included Sixty (85.7%) males, 17 (24.3%) critically ill, mean age 69.8 (±13.5) years. Thirty (42.3%) patients received an inappropriate dosage, 19 (63.3%) of them were underdosed. Conclusion Almost 43% of patients were inappropriately dosed in E. faecium bacteraemia, mainly because of underdosing. These data demonstrate the large proportion of inappropriate doses, which highlights the importance of an adequate review of medication and therapeutic drug monitoring in order to assure efficacy and prevent toxicities. No conflict of interest
Published: 2018

34. Connecting clinical aspects to corticomotor excitability in restless legs syndrome: a TMS study

Author: Keyana Foster, Gabriela Cantarero, Richard P. Allen, Christopher J. Earley, Pablo Celnik, Aadi Kalloo, Tiana E. Cruz, and Rachel E. Salas
Subjects: 0301 basic medicine, Male, medicine.medical_specialty, medicine.medical_treatment, Polysomnography, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Disease severity, Restless Legs Syndrome, mental disorders, Medicine, Humans, In patient, Restless legs syndrome, medicine.diagnostic_test, business.industry, Motor Cortex, General Medicine, Middle Aged, medicine.disease, Transcranial Magnetic Stimulation, Transcranial magnetic stimulation, 030104 developmental biology, Intracortical facilitation, Cortical Excitability, Intracortical inhibition, Female, Primary motor cortex, business, 030217 neurology & neurosurgery
Abstract: We assessed corticomotor excitability in the primary motor cortex (M1) of participants with moderate-to-severe restless legs syndrome (RLS) symptoms using transcranial magnetic stimulation (TMS) in relation to the clinical and sleep aspects of the disease. Thirty-five participants (20 F; mean age: 59.23 ± 1.66 years; range: 42–78 years) affected by primary RLS (off medications) and 31 age-matched controls (19 F; mean age: 57.90 ± 1.50 years; range: 43–79 years) underwent TMS following two nights of polysomnography (PSG). Paired-pulse TMS measures [short-interval intracortical inhibition (SICI), long-interval intracortical inhibition (LICI), and intracortical facilitation (ICF)] of the dominant M1hand and M1leg muscles were collected and analyzed in relation to clinical features of RLS and PSG. We found decreased corticomotor excitability in M1hand, whereas it was increased in M1leg, which was greater in patients with more severe RLS. Participants with RLS with a history of dopamine-agonist–induced symptom augmentation showed decreased LICI (reduced inhibition) compared to nonaugmented participants with RLS for M1leg. None of the TMS measures (M1hand or M1leg) correlated with the PSG parameters. This study shows hyperexcitability in M1leg, and this appears related to RLS disease severity and decreased excitability in M1hand. The results provide new insight into the complex neurobiology of RLS, particularly in more advanced stages of the disease.
Published: 2018

35. Validation of a score to identify inpatients at risk of a drug-related problem during a 4-year period

Author: M. Riu, O. Ferrández, Santiago Grau, E. Salas, S. Mojal, and O. Urbina
Subjects: medicine.medical_specialty, Computerized medical record system, Pharmaceutical Science, Pharmacy, Drug-related problems, 030226 pharmacology & pharmacy, Article, 03 medical and health sciences, 0302 clinical medicine, Pharmacotherapy, Computerized physician order entry, Medicine, 030212 general & internal medicine, Medical prescription, Pharmacology, Framingham Risk Score, business.industry, lcsh:RM1-950, Area under the curve, medicine.disease, Comorbidity, Patient safety, lcsh:Therapeutics. Pharmacology, Emergency medicine, Risk score, Major Diagnostic Category, business
Abstract: Objective: Drug-related problems (DRP) produce high morbidity and mortality. It is therefore essential to identify patients at higher risk of these events. This study aimed to validate a DRP risk score in a large number of inpatients. Material and methods: Validation of a previously designed score to identify inpatients at risk of experiencing at least one DRP in a tertiary university hospital from 2010 to 2013. DRP were detected by a pharmacy warning system integrated in the electronic medical record. The score included the following variables associated with a higher risk of DRP: prescription of a higher number of drugs, greater comorbidity, advanced age, specific ATC groups and certain major diagnostic categories. Results: The study included a total of 52,987 admissions; of these, at least one DRP occurred in 14.9%. After validation of the score (period range, 2010–2013: 0.746–0.764), the area under the curve (AUC) was 0.751 (95% CI: 0.745–0.756). Conclusions: This value is higher than those reported in other studies describing validation of risk scores. The score showed good capacity to identify those patients at higher risk of DRP in a much larger sample of inpatients than previously described in the literature. This tool allows optimization of drug therapy monitoring in admitted patients. Keywords: Drug-related problems, Computerized medical record system, Computerized physician order entry, Risk score, Patient safety
Published: 2018

36. The pitfall of hemolyzed samples: How to manage in vitro hemolysis?

Author: C. Montilla Lopez, M. Muñoz-Calero, and E. Salas Herrero
Subjects: business.industry, Biochemistry (medical), Clinical Biochemistry, medicine, General Medicine, medicine.disease, business, Biochemistry, In vitro, Hemolysis, Microbiology
Published: 2019

37. 0939 Subjective and Objective Sleep in Traumatic Brain Injury (TBI)

Author: Rachel E. Salas, Una D. McCann, Eryka Boyd, Chung J Mun, Charlene E. Gamaldo, Brook A Fulton, Luu V Pham, Vani Rao, Claudia M. Campbell, Matthew F. Peters, Luis F. Buenaver, Michael T. Smith, and Durga Roy
Subjects: medicine.medical_specialty, medicine.diagnostic_test, Traumatic brain injury, business.industry, Actigraphy, Electroencephalography, medicine.disease, Dyssomnias, Obstructive sleep apnea, Physical medicine and rehabilitation, Physiology (medical), medicine, Insomnia, Anxiety, Sleep diary, Neurology (clinical), medicine.symptom, business
Published: 2019

38. Incorporating students into clinic may be associated with both improved clinical productivity and educational value

Author: Karthik Rao, Angeline M. Nguyen, Roy E. Strowd, Jeremy A. Tanner, Evan Mead-Brewer, Rachel E. Salas, Charlene E. Gamaldo, and Alexandra Kornbluh
Subjects: medicine.medical_specialty, business.industry, Research, MEDLINE, Preceptor, Odds ratio, Learning experience, 03 medical and health sciences, 0302 clinical medicine, Family medicine, Ambulatory, medicine, Observational study, 030212 general & internal medicine, Neurology (clinical), business, Value (mathematics), Productivity, 030217 neurology & neurosurgery
Abstract: Background:In this study, we aimed to evaluate ambulatory clinic responsibilities that neurology clerkship students perceive as having the highest educational value and to evaluate the association between a student's presence and level of responsibility and a preceptor's clinical and financial productivity during a clinic session.Methods:Physician preceptors (n = 43) and medical students (n = 67) in the Johns Hopkins Neurology clerkship from 2014 to 2015 were included. Students rated their experience and responsibilities in 291 neurology clinic sessions. Productivity metrics (e.g., relative value units [RVU]/clinic) were collected for each preceptor in the presence and absence of students.Results:A student's rating of a clinic as an effective learning experience increased with each additional patient the student interviewed (odds ratio [OR] 1.89, p < 0.001), presented (OR 1.86, p < 0.001), or documented (OR 2.00, p < 0.001). The mean RVU/session for preceptors also increased based on the number of patients interviewed (β = 2.64, p = 0.026), presented (β = 2.42, p = 0.047), and documented (β = 2.70, p = 0.036) by students. On average, preceptor RVU/session increased by 42% (mean 5.6 ± 1.2, p < 0.0001) when a student was present in clinic compared to sessions without students. In addition, preceptor invoices increased by 35% (mean 2.7 ± 0.6, p < 0.0001) and charges by 39% (mean $929 ± $210, p < 0.0001) when a student was present in clinic.Conclusions:This observational study suggests a mutual benefit to preceptor clinical productivity and student-perceived educational value when students have active responsibilities in neurology clinics. Despite concerns that students slow down preceptors in clinic, these results suggest that preceptors may have an overall boost in productivity, potentially by performing billable work while students independently see patients.
Published: 2017

39. Economic Analysis of Thrombo inCode, a Clinical–Genetic Function for Assessing the Risk of Venous Thromboembolism

Author: J. M. Soria, J. Sala, C. Rubio-Terrés, D. Rubio-Rodríguez, P. Suchon, J. Mateo, Sara Pich, Pierre Morange, E. Salas, Noémie Saut, Alfredo Gracia, and Joan Carles Souto
Subjects: Male, very elderly, Cost-Benefit Analysis, cost benefit analysis, middle aged, Economic analysis, genetics, Original Research Article, Aged, 80 and over, predictive value, medicine.diagnostic_test, Health Policy, Venous Thromboembolism, genetic screening, General Medicine, Middle Aged, Pulmonary embolism, female, Models, Economic, Predictive value of tests, Female, Risk assessment, medicine.drug, Adult, Economics and Econometrics, medicine.medical_specialty, venous thromboembolism, Thrombophilia, Risk Assessment, Sensitivity and Specificity, Predictive Value of Tests, decision tree, Genetic predisposition, medicine, Clinical genetic, Humans, Genetic Predisposition to Disease, human, procedures, Genetic Testing, cardiovascular diseases, Intensive care medicine, Aged, Genetic testing, business.industry, statistical model, Decision Trees, Warfarin, Public Health, Environmental and Occupational Health, Genetic variants, economics, medicine.disease, equipment and supplies, Spain, Physical therapy, business, genetic predisposition, Venous thromboembolism
Abstract: Background: Patients with venous thromboembolism (VTE) commonly have an underlying genetic predisposition. However, genetic tests nowadays in use have very low sensitivity for identifying subjects at risk of VTE. Thrombo inCode® is a new genetic tool that has demonstrated very good sensitivity, thanks to very good coverage of the genetic variants that modify the function of the coagulation pathway. Objective: To conduct an economic analysis of risk assessment of VTE from the perspective of the Spanish National Health System with Thrombo inCode® (a clinical–genetic function for assessing the risk of VTE) versus the conventional/standard method used to date (factor V Leiden and prothrombin G20210A). Methods: An economic model was created from the National Health System perspective, using a decision tree in patients aged 45 years with a life expectancy of 81 years. The predictive capacity of VTE, based on identification of thrombophilia using Thrombo inCode® and using the standard method, was obtained from two case–control studies conducted in two different populations (S. PAU and MARTHA; 1,451 patients in all). Although this is not always the case, patients who were identified as suffering from thrombophilia were subject to preventive treatment of VTE with warfarin, leading to a reduction in the number of VTE events and an increased risk of severe bleeding. The health state utilities (quality-adjusted life-years [QALYs]) and costs (in 2013 EUR values) were obtained from the literature and Spanish sources. Results: On the basis of a price of EUR 180 for Thrombo inCode®, this would be the dominant option (more effective and with lower costs than the standard method) in both populations. The Monte Carlo probabilistic analyses indicate that the dominance would occur in 100 % of the simulations in both populations. The threshold price of Thrombo inCode® needed to reach the incremental cost-effectiveness ratio (ICER) generally accepted in Spain (EUR 30,000 per QALY gained) would be between EUR 3,950 (in the MARTHA population) and EUR 11,993 (in the S. PAU population). Conclusion: According to the economic model, Thrombo inCode® is the dominant option in assessing the risk of VTE, compared with the standard method currently used. © 2015, The Author(s).
Published: 2015

40. Urinary Concentrations of Colistimethate and Formed Colistin after Intravenous Administration in Patients with Multidrug-Resistant Gram-Negative Bacterial Infections

Author: Nuria E. Campillo, Carol Escaño, E. Salas, Luisa Sorlí, Juan Pablo Horcajada, Jian Li, Santiago Grau, and Sonia Luque
Subjects: Acinetobacter baumannii, Adult, Male, 0301 basic medicine, medicine.medical_specialty, Urinary system, 030106 microbiology, Cmax, Urine, Gastroenterology, 03 medical and health sciences, Cmin, 0302 clinical medicine, Pharmacokinetics, health services administration, Drug Resistance, Multiple, Bacterial, Internal medicine, medicine, Humans, Pseudomonas Infections, Pharmacology (medical), Prospective Studies, 030212 general & internal medicine, Infusions, Intravenous, health care economics and organizations, Chromatography, High Pressure Liquid, Aged, Aged, 80 and over, Pharmacology, Colistin, business.industry, Liter, Middle Aged, Anti-Bacterial Agents, Infectious Diseases, Pseudomonas aeruginosa, Urinary Tract Infections, Female, business, Acinetobacter Infections, medicine.drug, Colistimethate
Abstract: Limited information is available on the urinary excretion of colistin in infected patients. This study aimed to investigate the pharmacokinetics of colistimethate sodium (CMS) and formed colistin in urine in patients with multidrug-resistant (MDR) Gram-negative bacterial infections. A pharmacokinetic study was conducted on 12 patients diagnosed with an infection caused by an extremely drug-resistant (XDR) P. aeruginosa strain and treated with intravenous CMS. Fresh urine samples were collected at 2-h intervals, and blood samples were collected predose ( C min ss ) and at the end of the CMS infusion ( C max ss ) for measurement of concentrations of CMS and formed colistin using high-performance liquid chromatography (HPLC). CMS urinary recovery was determined as the summed amount of CMS and formed colistin recovered in urine for each 2-h interval divided by the CMS dose. There were 12 enrolled patients, 9 of whom were male (75%). Data [median (range)] were as follows: age, 65.5 (37 to 86) years; colistimethate urinary recovery 0 to 6 h, 42.6% (2.9% to 72.8%); range of concentrations of colistin in urine, C min ss and C max ss of colistin in plasma, 0.9 (P. aeruginosa in our hospital. Future studies are warranted for optimizing CMS dosage regimens in urinary tract infection (UTI) patients.
Published: 2017

41. AB0840 Local fracture liaison service (FLS): characteristics and first 6 months of evolution in patients after hip fracture: preliminary results

Author: AM Molinos, M.V. Hernández, T Llinares, G. Santos-Soler, B. Statti, JI Hernández, M Marco-Mingot, José Rosas, Xavier Barber, Jorge Jimenez, Aire-Mb Groups, E. Salas, Alicia García, JD Alvarado, José Miguel Senabre-Gallego, C. Cano, Lόpez, C Lόpez, M.A. Lorente, H. Arcos, M Sanchís-Selfa, and A. Pons
Subjects: musculoskeletal diseases, medicine.medical_specialty, Hip fracture, business.industry, Osteoporosis, medicine.disease, Rheumatology, Surgery, Osteopenia, Lumbar, medicine.anatomical_structure, Denosumab, Internal medicine, Hip bone, medicine, business, Femoral neck, medicine.drug
Abstract: Background Hip fracture has great impact on morbi-mortality, but a large percentage of patients do not receive treatment. Objectives To know the characteristics of patients whith hip fracture and its evolution in the first 6 months. Methods A prospective, 6-month follow-up study of patients over 60 years old admitted for hip fracture, evaluated in a local FLS. At 3 months after discharge, patients are evaluated for: epidemiological data, fracture income (days of admission, prior and discharge of osteoporosis (OP) drugs, general biochemistry and vitamin D), OP records and possible diseases or osteopenizing drugs, lumbar spine and hip Bone densitometry (BMD) lateral dorsal and lumbar spine radiology and the treatment was decided. The electronic history before and after 6 months of the fracture were reviewed. Results Of 152 patients >60 years old, admitted in 2016 due hip fracture, 77 (51%) were during the first 6 months. However, radiology or BMD data were not available for 30 (39%) patients, 16 (21%) for death and 14 (18%) for loss of follow-up. Mean BMI was 26.02±6.2. The mean age of menopause was 49±5 years. 1% of the patients received corticosteroids and 2% of patients an osteopenizing disease (COPD) was found. Mean time of admission was 7.57±2.51 days. In 3% of the patients, before the fracture were receiving OP treatment, which continued to discharge. The mean level of calcium, phosphorus and alkaline phosphatase was normal. However, the mean level of 25OH vitamin D was 13.55±8.63 ng/ml (median: 12 ng/ml, range: In 11 of the 27 (41%) patients, in whom radiology was available, the presence of vertebral fracture was demonstrated. The mean T-score for lumbar BMD was 1.8±1.65 DE (32%: the result was normal, 36% osteopenia, 32% OP), femoral neck 2.59±0.77 DE (27%: osteopenia, 77% OP) and in total hip: 2.56±0.86 DE (56%:osteopenia and 44% OPand In Ward of 3.2 DE. 100% of patients evaluated in Rheumatology, initiated treatment for OP: zoledronate: 40%, alendronate: 20%, denosumab: 25%, PTH: 15%. Conclusions In patients with hip fracture: 1) Mortality is high (21%), in the first 6 months after fracture. 2) The prevalence of vertebral fracture is 40%. 3) It is accompanied by very low blood levels of vitamin D. 4) In a high percentage the result of BMD is normal or osteopenia. 5) A minimum number of patients receive specific treatment for osteoporosis after fracture. 6) Evaluation in a FLS, ensures the evaluation and treatment of patients. Acknowledgements The study was supported by a research grant from the Asociaciόn para la Investigaciόn en Reumatologia de la Marina Baixa (AIREMB). Disclosure of Interest None declared
Published: 2017

42. AB0693 Patients with chronic inflammatory arthropathies treated with golimumab achieve a higher serum level of drug if used as the first or second biological drug

Author: G. Santos-Soler, F. Llinares-Tello, M Marco-Mingot, Xavier Barber, Mario García-Carrasco, José Rosas, José Miguel Senabre-Gallego, A. Pons, E. Salas, J. Molina, M.A. Lorente, M Sanchís-Selfa, and C. Cano
Subjects: medicine.medical_specialty, Ankylosing spondylitis, business.industry, medicine.disease, Golimumab, Surgery, Psoriatic arthritis, Concomitant, Rheumatoid arthritis, Internal medicine, medicine, Trough level, business, BASFI, human activities, BASDAI, medicine.drug
Abstract: Objectives To know the influence of the order of introduction of Golimumab (GLM), on clinical efficacy in ankylosing spondylitis (AS), psoriatic arthritis (PSA) and rheumatoid arthritis (RA). Methods A prospective, observational study, in 46 consecutive patients with AS, APS and RA, treated with GLM. Data: epidemiological, concomitant DMARD, time of disease evolution, HLA-B27, RF and ACPA; from GLM: order of introduction, time in treatment, serum level and anti-GLM Ab. The clinical response was assessed in AS patients using BASDAI, BASFI, ASDAS-VSG. In patients with RA or peripheral APS, DAS28-VSG, DAS28-PCR and SDAI. Serum levels of GLM and anti-GLM Ab were determined by ELISA (Progenika, Grifols SA, Spain). Serum cutoff levels for serum GLM levels: 36 ng/mL and for anti-GLM Ab: UA>20 AU/mL. Samples were extracted just prior GLM administration (trough level) and stored frozen at -80°C until analysis. Results Of 33 (72%) AS patients: 52% were males, mean age 53±12 years, mean BMI 28±4, disease mean evolution 16±12 years and in GLM: 1.3±1.1 years, 30% received DMARD, being GLM the first anti-TNF in 25%, second 37%, third 25% and fourth in 13%. The mean GLM level was 0.77±0.62 mg/mL and the prevalence of anti-GLM antibodies was 6%. In the 5 patients with RA and 8 with APS: 23% were men, mean age of 55±11 years, mean BMI 28±6, mean disease evolution of 10.5±8 years and in GLM of 2±1.5 years, the 85% of patients received DMARD, being GLM the first anti-TNF in 31%, second 15%, third 31% and fourth 23%. The mean GLM level was 0.703±0.53 mg/L. No anti-GLM Ab were detected. Conclusions 1. The overall prevalence of anti-GLM Ab was 6% and 17% in AS patients. Not detecting in patients with RA or PSA. 2. Serum GLM level was higher among the patients receiving it as the 1st or 2nd anti-TNF. 3. In AS GLM as 3rd or 4th anti-TNF were able to achieve clinical remission, similar to that achieved as 1st or 2nd drug. Acknowledgements The study was supported by a grant from the Fundaciόn Espanola de Reumatologia (FVR/2012) and the Asociaciόn para la Investigaciόn en Reumatologia de la Marina Baixa (AIRE-MB). Disclosure of Interest None declared
Published: 2017

43. Pain catastrophizing may moderate the association between pain and secondary hyperalgesia

Author: Luis F. Buenaver, Rachel E. Salas, Claudia M. Campbell, B. Lee Peterlin, David A. Tompkins, Jennifer A. Haythornthwaite, and Alexander J. Pressman
Subjects: Cultural Studies, Central sensitization, business.industry, Experimental and Cognitive Psychology, Learned helplessness, Current analysis, Article, 03 medical and health sciences, Clinical Psychology, chemistry.chemical_compound, 0302 clinical medicine, chemistry, 030202 anesthesiology, Capsaicin, Anesthesia, Rumination, Hyperalgesia, medicine, Pain catastrophizing, medicine.symptom, Association (psychology), business, 030217 neurology & neurosurgery, Social Sciences (miscellaneous)
Abstract: Catastrophizing, a persistent negative mental set characterized by helplessness, rumination, and magnification of pain sensations, has a potent effect on pain report and clinical outcomes. Previous studies have documented an association between cognitive factors and central sensitization. The current analysis sought to test the potential modulating effect of pain catastrophizing on the association between capsaicin pain and the region of secondary hyperalgesia. Thirty-eight healthy individuals (50% women, mean age = 25.7, SD = 5.3) completed the Pain Catastrophizing Scale (PCS), then underwent topical application of 10% capsaicin, which was covered by a thermode maintained at 40°C for 90-min. Following removal of the capsaicin, the region of secondary hyperalgesia was determined. Hayes' PROCESS macro was employed to examine catastrophizing's potential moderating effect, which did not reveal a significant association between capsaicin pain ratings and the region of secondary hyperalgesia (β = 15.1, p = .06). Though PCS was not associated with area of secondary hyperalgesia (β = 23.9, p = .29), a significant interaction was present between PCS and capsaicin pain ratings (β = 3.7, p = .0004). Specifically, those endorsing higher catastrophizing levels and higher pain ratings experienced the greatest areas of secondary hyperalgesia. The Johnson-Neyman technique was used to determine the regional effect of the moderation, which indicated that when PCS scores were ≥10.6, capsaicin pain significantly moderated the association between pain and area of secondary hyperalgesia. These results suggest that catastrophizing plays an important role in the area of secondary hyperalgesia, and potentially central sensitization, warranting further testing in future research.
Published: 2017

44. CP-180 Reasons for switching from integrase inhibitors in a real cohort of hiv patients during a 3 year study

Author: E González-Colominas, M De Antonio-Cuscó, Inés Monge-Escartín, Olivia Ferrández, Hernando Knobel, Sonia Luque, and E. Salas
Subjects: medicine.medical_specialty, business.industry, Elvitegravir, Cobicistat, Integrase inhibitor, Retrospective cohort study, Raltegravir, medicine.disease, Surgery, chemistry.chemical_compound, chemistry, Internal medicine, Dolutegravir, medicine, Coinfection, business, Adverse effect, medicine.drug
Abstract: Background Integrase inhibitors (INSTIs) are recommended as firstline antiretroviral treatment (ART) in HIV patients. However, several factors such as toxicity, virological failure or a low adherence can lead to a switch of ART. Purpose To assess the frequency and compare the reasons for switching among the INSTIs in a HIV unit in a tertiary hospital. Material and methods A retrospective study including all patients who switched from INSTIs to other ART (January 2014–September 2016) in our cohort of 1750 HIV infected patients was conducted. Switches involving ART other than INSTIs were not included. Data collected: demographics, hepatitis C virus coinfection, previous and new ART. Reasons for switching were classified as: adverse events (neuropsychiatric toxicity, dermatologic, gastrointestinal and others), schedule optimisation (convenience, simplification or food restrictions), drug–drug interactions, pregnancy and low level viraemia (LV). Results 733 patients were treated with INSTIs during this period: 223 (30.4%) raltegravir, 159 (21.7%) elvitegravir and 351 (47.9%) dolutegravir. The INSTI was switched in 133 patients (7.2% of total patients): 101 (75.9%) men, age 47.0±13.2 years, HCV 39 (29.3%). New ART treatment included INSTIs in 97 (72.9%) (6% raltegravir; 24.8%elvitegravir; 42.1% dolutegravir); non-nucleoside reverse transcriptase inhibitors in 11 (8.3%); protease inhibitors in 20 (15.0%); and others ART in 5 (3.8%) patients. Conclusion In more than 50% of patients, the INSTIs were switched in order to optimise the ART schedule. Raltegravir was the INSTI more frequently switched, because of schedule optimisation and presence of LV (due to poor adherence in almost all patients). Drug interactions leading to an INSTI switch were exceptional and were only seen with elvitegravir, probably related to its coformulation with cobicistat. The most common reason for stopping dolutegravir was adverse events, mostly gastrointestinal, while none of the patients experienced LV. No conflict of interest
Published: 2017

45. Sleep-Related Movement Disorders and Their Unique Motor Manifestations

Author: Rachel E. Salas, Seema Gulyani, Anthony B. Kwan, and Charlene E. Gamaldo
Subjects: 03 medical and health sciences, Sleep related movement disorders, medicine.medical_specialty, 0302 clinical medicine, Physical medicine and rehabilitation, business.industry, Medicine, 030206 dentistry, Motor Manifestations, business, 030217 neurology & neurosurgery
Published: 2017

46. Sleep Complaints in Older Blacks: Do Demographic and Health Indices Explain Poor Sleep Quality and Duration?

Author: Adrienne T. Aiken-Morgan, Rachel E. Salas, Keith E. Whitfield, Jason C. Allaire, Alyssa A. Gamaldo, Charlene E. Gamaldo, and Sarah L. Szanton
Subjects: Employment, Male, Pulmonary and Respiratory Medicine, Gerontology, Health Status, media_common.quotation_subject, Comorbidity, Interpersonal relationship, Risk Factors, Sleep Initiation and Maintenance Disorders, Surveys and Questionnaires, Humans, Medicine, Interpersonal Relations, Quality (business), Duration (project management), Aged, media_common, Aged, 80 and over, Sleep quality, business.industry, Age Factors, Middle Aged, New Research, medicine.disease, Sleep in non-human animals, Poor sleep, Socioeconomic Factors, Neurology, Baltimore, Female, Neurology (clinical), business, Stress, Psychological, Sleep duration
Abstract: To examine the relationship between measures of sleep quality and the presence of commonly encountered comorbid and sociodemographic conditions in elderly Black subjects.Analyses included participants from the Baltimore Study of Black Aging (BSBA; n = 450; mean age 71.43 years; SD 9.21). Pittsburgh Sleep Quality Index (PSQI) measured overall sleep pattern and quality. Self-reported and objective measures of physical and mental health data and demographic information were collected for all participants.Sociodemographic and comorbid health factors were significantly associated with sleep quality. Results from regression analyses revealed that older age, current financial strain, interpersonal problems, and stress were unique predictors of worse sleep quality. Sleep duration was significantly correlated with age, depressive affect, interpersonal problems, and stress; only age was a unique significant predictor. While participants 62 years or younger had worse sleep quality with increasing levels of stress, there was no significant relationship between sleep quality and stress for participants 81 years and older.Several potential mechanisms may explain poor sleep in urban, community dwelling Blacks. Perceived stressors, including current financial hardship or hardship experienced for an extended time period throughout the lifespan, may influence sleep later in life.
Published: 2014

47. Design of a score to identify hospitalized patients at risk of drug-related problems

Author: Elena González, Olivia Ferrández, Mónica Marín-Casino, Sergi Mojal, Alexia Carmona, E. Salas, Sonia Luque, Javier Mateu-de-Antonio, Olatz Urbina, Santiago Grau, David Conde-Estévez, Mercè Espona, and Marta Riu
Subjects: medicine.medical_specialty, Framingham Risk Score, Receiver operating characteristic, Epidemiology, business.industry, Pharmacoepidemiology, Logistic regression, medicine.disease, Comorbidity, Emergency medicine, medicine, Pharmacology (medical), Medical history, Major Diagnostic Category, Medical emergency, Medical prescription, business
Abstract: Purpose The potential impact of drug-related problems (DRP) on morbidity and mortality is a serious concern in hospitalized patients. This study aimed to design a risk score to identify patients most at risk of a DRP. Methods Data from patients admitted to a tertiary university hospital between January and August 2009 were used to design the risk score (training set). DRP were detected through a pharmacy warning system integrated in the computerized medical history. The variables associated with developing a DRP were identified through a binary multivariate logistic regression analysis and were used to compute the DRP risk score, which was subsequently validated in patients admitted between September and December 2009 (validation set). Results Of the 8713 patients included in the training set, at least one DRP was detected in 2425 (27.8%). Prescription of a higher number of drugs, higher comorbidity, advanced age, certain groups of the Anatomical Therapeutic Chemical classification system, and some major diagnostic categories were associated with risk of DRP. These variables were used to compute the DRP risk score. The area under the receiver operator characteristic curve was 0.778 (95%CI [0.768, 0.789]). Of the 4058 admissions included in the validation set, at least one DRP was detected in 876 (21.6%). The area under the receiver operator characteristic curve was 0.776 (95%CI [0.759, 0.792]). Conclusions Knowledge of the variables associated with DRP could aid their early detection in at-risk patients. The use of an application that can be continually updated in daily clinical practice helps to optimize resources. Copyright © 2014 John Wiley & Sons, Ltd.
Published: 2014

48. Management of sleep apnea in the neurology patient: Five new things

Author: Rachel E. Salas, Charlene E. Gamaldo, Rohini Chakravarthy, and Alex Sher
Subjects: medicine.medical_specialty, Neurology, Five New Things, business.industry, medicine.medical_treatment, Gold standard, Sleep apnea, medicine.disease, Sleep medicine, respiratory tract diseases, Obstructive sleep apnea, Health care, Physical therapy, medicine, Neurology (clinical), Continuous positive airway pressure, business, Intensive care medicine, Stroke
Abstract: Recognizing and treating sleep-disordered breathing (SDB) is essential in delivering neurologic care due to its association with a growing list of neurologic conditions (e.g., stroke, neurodegenerative disorders). Thus, increased proficiency in the recognition and management of SDB is likely to result in better outcomes, care, and utilization of health care resources. To date, continuous positive airway pressure remains the gold standard for patients with moderate to severe obstructive sleep apnea and has been shown to be effective in treating variations of SDB. Appropriate application of new methods and technology such as home sleep testing can help bridge the gap between the need and supply for sleep health care and delivery. Increased focus on efficacious strategies to further awareness and education for patients, caretakers, and providers is paramount to long-term adherence to treatment.
Published: 2014

49. Development and Cost-Effectiveness of a Malnutrition Screening Program in a Skilled Nursing Setting

Author: M. Fontenot, E. Salas-Groves, D. Erickson, and Janet Pope
Subjects: Nutrition and Dietetics, Nursing, business.industry, Cost effectiveness, Malnutrition screening, Medicine, General Medicine, Skilled Nursing, business, Food Science
Published: 2019

50. The impact of student absences on grade outcomes in a neurology clerkship setting

Author: Rachel E. Salas, Roy E. Strowd, Christopher B. Oakley, Tiana E. Cruz, Rebecca Riddell, and Charlene E. Gamaldo
Subjects: medicine.medical_specialty, Neurology, business.industry, Family medicine, education, medicine, business
Abstract: This article was migrated. The article was not marked as recommended. Purpose: To evaluate the potential association between student absenteeism and performance on the National Board of Medical Examiners Clinical Neurology Subject Exam (NBME), a Standardized Patient Exam (SPEX) and the overall clinical performance (CPA) in the Neurology Core Clerkship (NCC). Methods: All medical students rotating through the required 4-week NCC at Johns Hopkins University School of Medicine (JHUSOM) were enrolled in this IRB-approved, retrospective cohort study. Student absences, NBME, SPEX, CPA, and overall final clerkship grades were recorded. Results: Between 2014-2017, 252 students were enrolled. Of the total sample, 68 students (27.0%) were absent from the clerkship. The median absence length was one day, and the range was 0.25 to 7.00 days. The total "other" absences dependent variable (defined in the text) was negative and statistically significant for the NBME (p = 0.01). This model suggests that for an average student, a one day's absence for reasons we categorized as "other", will lead to a slightly more than two-point decrease (2.36) in the NBME percent correct score. Conclusion: Data presented here supports that the NBME graded component decreases with increased "other" absenteeism supporting that increased absences may have a negative effect on student performance in the NCC.
Published: 2019

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