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27. Pain management during the withholding and withdrawal of life support in critically ill patients at the end-of-life: a systematic review and meta-analysis

Author

Laserna, Andres, Durán-Crane, Alejandro, López-Olivo, María A., Cuenca, John A., Fowler, Cosmo, Díaz, Diana Paola, and Cardenas, Yenny R.

Subjects
Palliative treatment -- Analysis, Pain -- Care and treatment, Analgesics -- Analysis, Company business management, Health care industry, University of Texas. M.D. Anderson Cancer Center -- Management
Abstract

Purpose To review and summarize the most frequent medications and dosages used during withholding and withdrawal of life-prolonging measures in critically ill patients in the intensive care unit. Methods We searched PubMed, EMBASE, the Cochrane Database of Systematic Reviews, and the Virtual Health Library from inception through March 2019. We considered any study evaluating pharmaceutical interventions for pain management during the withholding or withdrawing of life support in adult critically ill patients at the end-of-life. Two independent investigators performed the screening and data extraction. We pooled data on utilization rate of analgesic and sedative drugs and summarized the dosing between the moment prior to withholding or withdrawal of life support and the moment before death. Results Thirteen studies met inclusion criteria. Studies were conducted in the United States (38%), Canada (31%), and the Netherlands (31%). Eleven studies were single-cohort and twelve had a Newcastle-Ottawa Scale score of less than 7. The mean age of the patients ranged from 59 to 71 years, 59-100% were mechanically ventilated, and 47-100% of the patients underwent life support withdrawal. The most commonly used opioid and sedative were morphine [utilization rate 60% (95% CI 48-71%)] and midazolam [utilization rate 28% (95% CI 23-32%)], respectively. Doses increased during the end-of-life process (pooled mean increase in the dose of morphine: 2.6 mg/h, 95% CI 1.2-4). Conclusions Pain control is centered on opioids and adjunctive benzodiazepines, with dosages exceeding those recommended by guidelines. Despite consistency among guidelines, there is significant heterogeneity among practices in end-of-life care., Author(s): Andres Laserna [sup.1], Alejandro Durán-Crane [sup.2], María A. López-Olivo [sup.3], John A. Cuenca [sup.4], Cosmo Fowler [sup.5], Diana Paola Díaz [sup.6], Yenny R. Cardenas [sup.6], Catherine Urso [sup.4], Keara [...]

Published
2020
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30. Poor timing and failure of source control are risk factors for mortality in critically ill patients with secondary peritonitis

Author

De Pascale, Gennaro, Antonelli, Massimo, Deschepper, Mieke, Arvaniti, Kostoula, Blot, Koen, Brown, Ben Creagh, de Lange, Dylan, De Waele, Jan, Dikmen, Yalim, Dimopoulos, George, Eckmann, Christian, Francois, Guy, Girardis, Massimo, Koulenti, Despoina, Labeau, Sonia, Lipman, Jeffrey, Lipovetsky, Fernando, Maseda, Emilio, Montravers, Philippe, Mikstacki, Adam, Paiva, José-Artur, Pereyra, Cecilia, Rello, Jordi, Timsit, Jean-Francois, Vogelaers, Dirk, Blot, Stijn, Lamrous, Amin, Lipovestky, Fernando, Rezende-Neto, Joao, Vymazal, Tomas, Fjeldsoee-Nielsen, Hans, Kott, Matthias, Kostoula, Arvaniti, Javeri, Yash, Einav, Sharon, Makikado, Luis Daniel Umezawa, Tomescu, Dana, Gritsan, Alexey, Jovanovic, Bojan, Venkatesan, Kumaresh, Mirkovic, Tomislav, Creagh-Brown, Benedict, Emmerich, Monica, Canale, Mariana, Dietz, Lorena Silvina, Ilutovich, Santiago, Miñope, John Thomas Sanchez, Silva, Ramona Baldomera, Montenegro, Martin Alexis, Martin, Patricio, Saul, Pablo, Chediack, Viviana, Sutton, Giselle, Couce, Rocio, Balasini, Carina, Gonzalez, Susana, Lascar, Florencia Maria, Descotte, Emiliano Jorge, Gumiela, Natalia Soledad, Pino, Carina Alejandra, Cesio, Cristian, Valgolio, Emanuel, Cunto, Eleonora, Dominguez, Cecilia, Nelson, Nydia Funes, Abegao, Esteban Martin, Pozo, Norberto Christian, Bianchi, Luciana, Correger, Enrique, Pastorino, Maria Laura, Miyazaki, Erica Aurora, Grubissich, Nicolas, Garcia, Mariel, Bonetto, Natalia, Quevedo, Noelia Elizabeth, Gomez, Cristina Delia, Queti, Felipe, Estevarena, Luis Gonzalez, Fernandez, Ruben, Santolaya, Ignacio, Grangeat, Sergio Hugo, Doglia, Juan, Zakalik, Graciela, Pellegrini, Carlos, Lloria, Maria Monserrat, Chacon, Mercedes Esteban, Fumale, Mariela, Leguizamon, Mariela, Hidalgo, Irene Beatriz, Tiranti, Roberto Juli an, Capponi, Paola, Tita, Agustin, Cardonnet, Luis, Bettini, Lisandro, Ramos, Agñel, Lovesio, Luciano, Miranda, Edith Miriam, Farfan, Angelica Beatriz, Tolosa, Carina, Segura, Lise, Bellocchio, Adelina, Alvarez, Brian, Manzur, Adriana, Lujan, Rodolfo, Fernandez, Natalia, Scarone, Nahuel, Zazu, Alan, Groh, Carina, Fletcher, Jason, Smith, Julie, Azad, Raman, Chavan, Nitin, Kol, Mark, Campbell, Lewis, Starr, Therese, Roberts, Brigit, Wibrow, Bradley, Warhurst, Timothy, Chinthamuneedi, Meher, Ferney, Bernal Buitrago, Simon, Marc, De Backer, Daniel, Wittebole, Xavier, De Bels, David, Collin, Vincent, Dams, Karolien, Jorens, Philippe, Dubois, Jasperina, Gunst, Jan, Haentjens, Lionel, De Schryver, Nicolas, Dugernier, Thierry, Rizoli, Sandro, Santillan, Paul, Han, Yi, Biskup, Ewelina, Qu, Changjing, Li, Xinyu, Yu, Tao, Weihua, Lu, Molano-Franco, Daniel, Rojas, José, Oviedo, Juan Mauricio Pardo, Pinilla, Dario, Cardenas, Yenny, Celis, Edgar, Arias, Mario, Vukovic, Anita, Vudrag, Maja, Belavic, Matija, Zunic, Josip, Kuharic, Janja, Kricka, Irena Bozanic, Filipovic-Grcic, Ina, Tomasevic, Boris, Obraz, Melanija, Bodulica, Bruna, Dohnal, Martin, Malaska, Jan, Kratochvil, Milan, Satinsky, Igor, Schwarz, Peter, Kos, Zdenek, Blahut, Ladislav, Maca, Jan, Protus, Marek, Kieslichová, Eva, Nielsen, Louise Gramstrup, Krogh, Birgitte Marianne, Rivadeneira, Francisco, Morales, Freddy, Mora, José, Orozco, Alexandra Saraguro, MorochoTutillo, Diego Rolando, Vargas, Nelson Remache, Yepez, Estuardo Salgado, Villamagua, Boris, Alsisi, Adel, Fahmy, Abdelraouf, Dupont, Hervé, Lasocki, Sigismond, Paugam-Burtz, Catherine, Foucrier, Arnaud, Nica, Alexandru, Barjon, Geneviève, Mallat, Jihad, Marcotte, Guillaume, Leone, Marc, Duclos, Gary, Burtin, Philippe, Atchade, Enora, Mahjoub, Yazine, Misset, Benoît, Timsit, Jean-François, Dupuis, Claire, Veber, Benoît, Debarre, Matthieu, Collange, Oliver, Pottecher, Julien, Hecketsweiler, Stephane, Fromentin, Mélanie, Tesnière, Antoine, Koch, Christian, Sander, Michael, Elke, Gunnar, Wrigge, Hermann, Simon, Philipp, Chalkiadaki, Anthoula, Tzanidakis, Charalampos, Pneumatikos, Ioannis, Sertaridou, Eleni, Mastora, Zafiria, Pantazopoulos, Ioannis, Papanikolaou, Metaxia, Papavasilopoulou, Theonymfi, Floros, John, Diakaki, Chryssa, Rallis, Michael, Paridou, Alexandra, Kalogeromitros, Alexandros, Romanou, Vasiliki, Nikolaou, Charikleia, Kounougeri, Katerina, Tsigou, Evdoxia, Psallida, Vasiliki, Karampela, Niki, Mandragos, Konstantinos, Kontoudaki, Eftychia, Pentheroudaki, Alexandra, Farazi-Chongouki, Christos, Karakosta, Agathi, Chouris, Isaac, Radu, Vasiliki, Malliotakis, Polychronis, Kokkini, Sofia, Charalambous, Eliana, Kyritsi, Aikaterini, Koulouras, Vasilios, Papathanakos, Georgios, Nagky, Eva, Lampiri, Clairi, Tsimpoukas, Fotios, Sarakatsanos, Ioannis, Georgakopoulos, Panagiotis, Ravani, Ifigeneia, Prekates, Athanasios, Sakellaridis, Konstantinos, Christopoulos, Christos, Vrettou, Efstratia, Stokkos, Konstantinos, Pentari, Anastasia, Marmanidou, Kyriaki, Kydona, Christina, Tsoumaropoulos, Georgios, Bitzani, Militisa, Kontou, Paschalina, Voudouris, Antonios, Flioni, Elli-Nikki, Antypa, Elli, Chasou, Eleftheria, Anisoglou, Souzana, Papageorgiou, Eirini, Paraforou, Theoniki, Tsioka, Agoritsa, Karathanou, Antigoni, Vakalos, Aristeidis, Shah, Bhagyesh, Thakkar, Chirag, Jain, Nikhilesh, Gurjar, Mohan, Baronia, Arvind, Sathe, Prachee, Kulkarni, Shilpa, Paul, Cherish, Paul, John, Masjedi, Mansoor, Nikandish, Reza, Zand, Farid, Sabetian, Golnar, Mahmoodpoor, Ata, Hashemian, Seyed Mohammadreza, Bala, Miklosh, Flocco, Romeo, Torrente, Sergio, Pota, Vincenzo, Spadaro, Savino, Volta, Carlo, Serafini, Giulia, Boraso, Sabrina, Tiberio, Ivo, Cortegiani, Andrea, Misseri, Giovanni, Barbagallo, Maria, Nicolotti, Davide, Forfori, Francesco, Corradi, Francesco, Pelagalli, Lorella, Brazzi, Luca, Vittone, Ferdinando Giorgio, Russo, Alessandro, Simion, Davide, Cotoia, Antonella, Toppin, Gilda Cinnella Patrick, Johnson-Jackson, Roxanne, Hayashi, Yoshiro, Yamamoto, Ryohei, Yasuda, Hideto, Kishihara, Yuki, Shiotsuka, Junji, Sanchez-Hurtado, Luis Alejandro, Tejeda-Huezo, Brigitte, Gorordo, Luis, Ñamendys-Silva, Silvio A, Garcia-Guillen, Francisco J, Martinez, Manuel, Romero-Meja, Erick, Colorado-Dominguez, Ever, van den Oever, Huub, Kalff, Karel Martijn, Vermeijden, Wytze, Cornet, Alexander Daniel, Beck, Oliver, Cimic, Nedim, Dormans, Tom, Bormans, Laura, Bakker, Jan, Van Duijn, Ditty, Bosman, Gerrit, Vos, Piet, Kesecioglu, Jozef, Haas, Lenneke, Henein, Akram, Miranda, Ariel M, Malca, Gonzalo Ernesto Gianella, Arroyo-Sanchez, Abel, Misiewska-Kaczur, Agnieszka, Akinyi, Frisch, Czuczwar, Miroslaw, Luczak, Karolina, Sulkowski, Wiktor, Tamowicz, Barbara, Swit, Beata, Baranowski, Bronisław, Smuszkiewicz, Piotr, Trojanowska, Iwona, Rzymski, Stanislaw, Sawinski, Mariusz, Trosiak, Marta, Mikaszewska-Sokolewicz, Malgorzata, Alves, Ricardo, Leal, Dina, Krystopchuk, Andriy, Mendonca, Pedro Muguel Hilario, Pereira, Rui Antunes, de Carvalho, Maria Raquel Lopes Marques, Candeias, Carlos, Molinos, Elena, Ferreira, Amélia, Castro, Guiomar, Pereira, José-Manuel, Santos, Lurdes, Ferreira, Alcina, Pascoalinho, Dulce, Ribeiro, Rosa, Domingos, Guilherme, Gomes, Pedro, Nora, David, Costa, Rui Pedro, Santos, Anabela, Alsheikhly, Ahmed Subhy, Popescu, Mihai, Grigoras, Ioana, Patrascanu, Emilia, Zabolotskikh, Igor, Musaeva, Tatiana, Gaigolnik, Denis, Kulabukhov, Vladimir, Belskiy, Vladislav, Zubareva, Nadezhda, Tribulev, Maxim, Abdelsalam, Ahmed, Aldarsani, Ayman, Al-Khalid, Muhammad, Almekhlafi, Ghaleb, Mandourah, Yasser, Doklestic, Krstina, Velickovic, Jelena, Velickovic, Dejan, Jankovic, Radmilo, Skoric-Jokic, Svetlana, Radovanovic, Dragana, Richards, Guy, Alli, Ahmad, Cordoba Nielfa, del Carmen, Iniesta, Rafael Sánchez, Martínez, Adela Benítez-Cano, Bernedo, Carlos Garcia, Gil, Santiago Alberto Picos, Nuvials, Xavier, Garcia, Joseba Gonzalez, Peña, Jose Manuel Garcia, Jimenez, Roberto, Herrera, Luis, Barrachina, Laura Galarza, Monzon, Ignacio Catalan, Redondo, Francisco Javier, Villazala, Ruben, Zapata, Diego Fernando Matallana, Lopez, Isabel Maria Villa, Moreno-Gonzalez, Gabriel, Lopez-Delgado, Juan Carlos, Marin, Jorge Solera, Sanchez-Zamora, Purificacion, Vidal, Montserrat Vallverdú, González, Jesús Flores, Salinas, Irene, Hermosa, Cecilia, Martinez-Sagasti, Fernando, Domingo-Marín, Sara, Victorino, Johanna Abril, Garcia-Alvarez, Raquel, Calleja, Pablo López-Arcas, de la Torre-Prados, Maria Victoria, Vidal-Cortes, Pablo, del Río-Carbajo, Lorena, Izura, Javier, Minguez, Victoria, Alvarez, Josep Trenado, Prous, Anna Parera, Paz, Daniel, Roche-Campo, Ferran, Aguilar, Gerardo, Belda, Javier, Rico-Feijoo, Jesus, Aldecoa, Cesat, Zalba-Etayo, Begoña, Dullenkopf, Alexander, Trongtrakul, Konlawij, Chtsomkasem, Anusang, Akbaş, Türkay, Unal, Mustafa Necmettin, Gumus, Ayca, Ramazanoglu, Atilla, Memis, Dilek, Mehmet, Inal, Urkmez, Seval, Ozgultekin, Asu, Demirkiran, Oktay, Aslan, Nesrin Ahu, Kizilaslan, Deniz, Kahveci, Ferda, Ünlü, Nurdan, Ozkan, Zeynep, Kaye, Callum, Jansen, Jan, O’Neill, Orla, Nutt, Christopher, Jha, Rajeev, Hooker, Nicolas, Grecu, Irina, Petridou, Christina, Shyamsundar, Murali, McNamee, Lia, Trinder, John, Hagan, Samantha, Kelly, Catriona, Silversides, Jonathon, Groba, Casiano Barrera, Boyd, Owen, Bhowmick, Kaushik, Humphreys, Sally, Summers, Charlotte, Polgarova, Petra, Margarson, Michael, Dickens, Justin, Pearson, Suzanne, Chinery, Elaine, Hemmings, Noel, O’Kane, Sinead, Austin, Pauline, Cole, Stephen, Plowright, Catherine, Box, Roberta, Wright, Christopher, Young, Lorna, Creagh-Brown, Ben, Montague, Laura, Parker, Robert, Morton, Ben, Ostermann, Marlies, Bilinska, Julia, Rose, Bernd Oliver, Reece-Anthony, Rosie, Ryan, Christine, Hamilton, Mark, Hopkins, Philip, Wendon, Julia, Brescia, Giovanni, Ijaz, Nazia, Wood, James, George, Michelle, Toth-Tarsoly, Piroska, Yates, Bryan, Armstrong, Maureen, Scott, Carmen, Boyd, Christine, Szakmany, Tamas, Rees, David, Pulak, Paul, Coggon, Mandy, Saha, Bhaskar, Kent, Linda, Gibson, Bethan, Camsooksai, Julie, Reschreiter, Henrik, Morgan, Pat, Sangaralingham, Sivatharshini, Lowe, Alastair, Vondras, Petr, Jamadarkhana, Sunil, Cruz, Carina, Bhandary, Rakesh, Hersey, Peter, Furneval, Julie, Innes, Richard, Doble, Patricia, Attwood, Ben, Parsons, Penny, Page, Valerie, Zhao, Xiaobei, Dalton, Julian, Hegazy, Mohammed, Awad, Yasser, Naylor, Douglas, Naylor, Amanda, Lee, Sarah, Brevard, Sidney, Davis, Noelle, De Pascale, Gennaro, Antonelli, Massimo, Deschepper, Mieke, Arvaniti, Kostoula, Blot, Koen, Brown, Ben Creagh, de Lange, Dylan, De Waele, Jan, Dikmen, Yalim, Dimopoulos, George, Eckmann, Christian, Francois, Guy, Girardis, Massimo, Koulenti, Despoina, Labeau, Sonia, Lipman, Jeffrey, Lipovetsky, Fernando, Maseda, Emilio, Montravers, Philippe, Mikstacki, Adam, Paiva, José-Artur, Pereyra, Cecilia, Rello, Jordi, Timsit, Jean-Francoi, Vogelaers, Dirk, Blot, Stijn, Lamrous, Amin, Lipovestky, Fernando, Rezende-Neto, Joao, Vymazal, Toma, Fjeldsoee-Nielsen, Han, Kott, Matthia, Kostoula, Arvaniti, Javeri, Yash, Einav, Sharon, Makikado, Luis Daniel Umezawa, Tomescu, Dana, Gritsan, Alexey, Jovanovic, Bojan, Venkatesan, Kumaresh, Mirkovic, Tomislav, Creagh-Brown, Benedict, Emmerich, Monica, Canale, Mariana, Dietz, Lorena Silvina, Ilutovich, Santiago, Miñope, John Thomas Sanchez, Silva, Ramona Baldomera, Montenegro, Martin Alexi, Martin, Patricio, Saul, Pablo, Chediack, Viviana, Sutton, Giselle, Couce, Rocio, Balasini, Carina, Gonzalez, Susana, Lascar, Florencia Maria, Descotte, Emiliano Jorge, Gumiela, Natalia Soledad, Pino, Carina Alejandra, Cesio, Cristian, Valgolio, Emanuel, Cunto, Eleonora, Dominguez, Cecilia, Nelson, Nydia Fune, Abegao, Esteban Martin, Pozo, Norberto Christian, Bianchi, Luciana, Correger, Enrique, Pastorino, Maria Laura, Miyazaki, Erica Aurora, Grubissich, Nicola, Garcia, Mariel, Bonetto, Natalia, Quevedo, Noelia Elizabeth, Gomez, Cristina Delia, Queti, Felipe, Estevarena, Luis Gonzalez, Fernandez, Ruben, Santolaya, Ignacio, Grangeat, Sergio Hugo, Doglia, Juan, Zakalik, Graciela, Pellegrini, Carlo, Lloria, Maria Monserrat, Chacon, Mercedes Esteban, Fumale, Mariela, Leguizamon, Mariela, Hidalgo, Irene Beatriz, Tiranti, Roberto Juli an, Capponi, Paola, Tita, Agustin, Cardonnet, Lui, Bettini, Lisandro, Ramos, Agñel, Lovesio, Luciano, Miranda, Edith Miriam, Farfan, Angelica Beatriz, Tolosa, Carina, Segura, Lise, Bellocchio, Adelina, Alvarez, Brian, Manzur, Adriana, Lujan, Rodolfo, Fernandez, Natalia, Scarone, Nahuel, Zazu, Alan, Groh, Carina, Fletcher, Jason, Smith, Julie, Azad, Raman, Chavan, Nitin, Kol, Mark, Campbell, Lewi, Starr, Therese, Roberts, Brigit, Wibrow, Bradley, Warhurst, Timothy, Chinthamuneedi, Meher, Ferney, Bernal Buitrago, Simon, Marc, De Backer, Daniel, Wittebole, Xavier, De Bels, David, Collin, Vincent, Dams, Karolien, Jorens, Philippe, Dubois, Jasperina, Gunst, Jan, Haentjens, Lionel, De Schryver, Nicola, Dugernier, Thierry, Rizoli, Sandro, Santillan, Paul, Han, Yi, Biskup, Ewelina, Qu, Changjing, Li, Xinyu, Yu, Tao, Weihua, Lu, Molano-Franco, Daniel, Rojas, José, Oviedo, Juan Mauricio Pardo, Pinilla, Dario, Cardenas, Yenny, Celis, Edgar, Arias, Mario, Vukovic, Anita, Vudrag, Maja, Belavic, Matija, Zunic, Josip, Kuharic, Janja, Kricka, Irena Bozanic, Filipovic-Grcic, Ina, Tomasevic, Bori, Obraz, Melanija, Bodulica, Bruna, Dohnal, Martin, Malaska, Jan, Kratochvil, Milan, Satinsky, Igor, Schwarz, Peter, Kos, Zdenek, Blahut, Ladislav, Maca, Jan, Protus, Marek, Kieslichová, Eva, Nielsen, Louise Gramstrup, Krogh, Birgitte Marianne, Rivadeneira, Francisco, Morales, Freddy, Mora, José, Orozco, Alexandra Saraguro, MorochoTutillo, Diego Rolando, Vargas, Nelson Remache, Yepez, Estuardo Salgado, Villamagua, Bori, Alsisi, Adel, Fahmy, Abdelraouf, Dupont, Hervé, Lasocki, Sigismond, Paugam-Burtz, Catherine, Foucrier, Arnaud, Nica, Alexandru, Barjon, Geneviève, Mallat, Jihad, Marcotte, Guillaume, Leone, Marc, Duclos, Gary, Burtin, Philippe, Atchade, Enora, Mahjoub, Yazine, Misset, Benoît, Timsit, Jean-Françoi, Dupuis, Claire, Veber, Benoît, Debarre, Matthieu, Collange, Oliver, Pottecher, Julien, Hecketsweiler, Stephane, Fromentin, Mélanie, Tesnière, Antoine, Koch, Christian, Sander, Michael, Elke, Gunnar, Wrigge, Hermann, Simon, Philipp, Chalkiadaki, Anthoula, Tzanidakis, Charalampo, Pneumatikos, Ioanni, Sertaridou, Eleni, Mastora, Zafiria, Pantazopoulos, Ioanni, Papanikolaou, Metaxia, Papavasilopoulou, Theonymfi, Floros, John, Diakaki, Chryssa, Rallis, Michael, Paridou, Alexandra, Kalogeromitros, Alexandro, Romanou, Vasiliki, Nikolaou, Charikleia, Kounougeri, Katerina, Tsigou, Evdoxia, Psallida, Vasiliki, Karampela, Niki, Mandragos, Konstantino, Kontoudaki, Eftychia, Pentheroudaki, Alexandra, Farazi-Chongouki, Christo, Karakosta, Agathi, Chouris, Isaac, Radu, Vasiliki, Malliotakis, Polychroni, Kokkini, Sofia, Charalambous, Eliana, Kyritsi, Aikaterini, Koulouras, Vasilio, Papathanakos, Georgio, Nagky, Eva, Lampiri, Clairi, Tsimpoukas, Fotio, Sarakatsanos, Ioanni, Georgakopoulos, Panagioti, Ravani, Ifigeneia, Prekates, Athanasio, Sakellaridis, Konstantino, Christopoulos, Christo, Vrettou, Efstratia, Stokkos, Konstantino, Pentari, Anastasia, Marmanidou, Kyriaki, Kydona, Christina, Tsoumaropoulos, Georgio, Bitzani, Militisa, Kontou, Paschalina, Voudouris, Antonio, Flioni, Elli-Nikki, Antypa, Elli, Chasou, Eleftheria, Anisoglou, Souzana, Papageorgiou, Eirini, Paraforou, Theoniki, Tsioka, Agoritsa, Karathanou, Antigoni, Vakalos, Aristeidi, Shah, Bhagyesh, Thakkar, Chirag, Jain, Nikhilesh, Gurjar, Mohan, Baronia, Arvind, Sathe, Prachee, Kulkarni, Shilpa, Paul, Cherish, Paul, John, Masjedi, Mansoor, Nikandish, Reza, Zand, Farid, Sabetian, Golnar, Mahmoodpoor, Ata, Hashemian, Seyed Mohammadreza, Bala, Miklosh, Flocco, Romeo, Torrente, Sergio, Pota, Vincenzo, Spadaro, Savino, Volta, Carlo, Serafini, Giulia, Boraso, Sabrina, Tiberio, Ivo, Cortegiani, Andrea, Misseri, Giovanni, Barbagallo, Maria, Nicolotti, Davide, Forfori, Francesco, Corradi, Francesco, Pelagalli, Lorella, Brazzi, Luca, Vittone, Ferdinando Giorgio, Russo, Alessandro, Simion, Davide, Cotoia, Antonella, Toppin, Gilda Cinnella Patrick, Johnson-Jackson, Roxanne, Hayashi, Yoshiro, Yamamoto, Ryohei, Yasuda, Hideto, Kishihara, Yuki, Shiotsuka, Junji, Sanchez-Hurtado, Luis Alejandro, Tejeda-Huezo, Brigitte, Gorordo, Lui, Ñamendys-Silva, Silvio A, Garcia-Guillen, Francisco J, Martinez, Manuel, Romero-Meja, Erick, Colorado-Dominguez, Ever, van den Oever, Huub, Kalff, Karel Martijn, Vermeijden, Wytze, Cornet, Alexander Daniel, Beck, Oliver, Cimic, Nedim, Dormans, Tom, Bormans, Laura, Bakker, Jan, Van Duijn, Ditty, Bosman, Gerrit, Vos, Piet, Kesecioglu, Jozef, Haas, Lenneke, Henein, Akram, Miranda, Ariel M, Malca, Gonzalo Ernesto Gianella, Arroyo-Sanchez, Abel, Misiewska-Kaczur, Agnieszka, Akinyi, Frisch, Czuczwar, Miroslaw, Luczak, Karolina, Sulkowski, Wiktor, Tamowicz, Barbara, Swit, Beata, Baranowski, Bronisław, Smuszkiewicz, Piotr, Trojanowska, Iwona, Rzymski, Stanislaw, Sawinski, Mariusz, Trosiak, Marta, Mikaszewska-Sokolewicz, Malgorzata, Alves, Ricardo, Leal, Dina, Krystopchuk, Andriy, Mendonca, Pedro Muguel Hilario, Pereira, Rui Antune, de Carvalho, Maria Raquel Lopes Marque, Candeias, Carlo, Molinos, Elena, Ferreira, Amélia, Castro, Guiomar, Pereira, José-Manuel, Santos, Lurde, Ferreira, Alcina, Pascoalinho, Dulce, Ribeiro, Rosa, Domingos, Guilherme, Gomes, Pedro, Nora, David, Costa, Rui Pedro, Santos, Anabela, Alsheikhly, Ahmed Subhy, Popescu, Mihai, Grigoras, Ioana, Patrascanu, Emilia, Zabolotskikh, Igor, Musaeva, Tatiana, Gaigolnik, Deni, Kulabukhov, Vladimir, Belskiy, Vladislav, Zubareva, Nadezhda, Tribulev, Maxim, Abdelsalam, Ahmed, Aldarsani, Ayman, Al-Khalid, Muhammad, Almekhlafi, Ghaleb, Mandourah, Yasser, Doklestic, Krstina, Velickovic, Jelena, Velickovic, Dejan, Jankovic, Radmilo, Skoric-Jokic, Svetlana, Radovanovic, Dragana, Richards, Guy, Alli, Ahmad, Cordoba Nielfa, del Carmen, Iniesta, Rafael Sánchez, Martínez, Adela Benítez-Cano, Bernedo, Carlos Garcia, Gil, Santiago Alberto Pico, Nuvials, Xavier, Garcia, Joseba Gonzalez, Peña, Jose Manuel Garcia, Jimenez, Roberto, Herrera, Lui, Barrachina, Laura Galarza, Monzon, Ignacio Catalan, Redondo, Francisco Javier, Villazala, Ruben, Zapata, Diego Fernando Matallana, Lopez, Isabel Maria Villa, Moreno-Gonzalez, Gabriel, Lopez-Delgado, Juan Carlo, Marin, Jorge Solera, Sanchez-Zamora, Purificacion, Vidal, Montserrat Vallverdú, González, Jesús Flore, Salinas, Irene, Hermosa, Cecilia, Martinez-Sagasti, Fernando, Domingo-Marín, Sara, Victorino, Johanna Abril, Garcia-Alvarez, Raquel, Calleja, Pablo López-Arca, de la Torre-Prados, Maria Victoria, Vidal-Cortes, Pablo, del Río-Carbajo, Lorena, Izura, Javier, Minguez, Victoria, Alvarez, Josep Trenado, Prous, Anna Parera, Paz, Daniel, Roche-Campo, Ferran, Aguilar, Gerardo, Belda, Javier, Rico-Feijoo, Jesu, Aldecoa, Cesat, Zalba-Etayo, Begoña, Dullenkopf, Alexander, Trongtrakul, Konlawij, Chtsomkasem, Anusang, Akbaş, Türkay, Unal, Mustafa Necmettin, Gumus, Ayca, Ramazanoglu, Atilla, Memis, Dilek, Mehmet, Inal, Urkmez, Seval, Ozgultekin, Asu, Demirkiran, Oktay, Aslan, Nesrin Ahu, Kizilaslan, Deniz, Kahveci, Ferda, Ünlü, Nurdan, Ozkan, Zeynep, Kaye, Callum, Jansen, Jan, O’Neill, Orla, Nutt, Christopher, Jha, Rajeev, Hooker, Nicola, Grecu, Irina, Petridou, Christina, Shyamsundar, Murali, McNamee, Lia, Trinder, John, Hagan, Samantha, Kelly, Catriona, Silversides, Jonathon, Groba, Casiano Barrera, Boyd, Owen, Bhowmick, Kaushik, Humphreys, Sally, Summers, Charlotte, Polgarova, Petra, Margarson, Michael, Dickens, Justin, Pearson, Suzanne, Chinery, Elaine, Hemmings, Noel, O’Kane, Sinead, Austin, Pauline, Cole, Stephen, Plowright, Catherine, Box, Roberta, Wright, Christopher, Young, Lorna, Creagh-Brown, Ben, Montague, Laura, Parker, Robert, Morton, Ben, Ostermann, Marlie, Bilinska, Julia, Rose, Bernd Oliver, Reece-Anthony, Rosie, Ryan, Christine, Hamilton, Mark, Hopkins, Philip, Wendon, Julia, Brescia, Giovanni, Ijaz, Nazia, Wood, Jame, George, Michelle, Toth-Tarsoly, Piroska, Yates, Bryan, Armstrong, Maureen, Scott, Carmen, Boyd, Christine, Szakmany, Tama, Rees, David, Pulak, Paul, Coggon, Mandy, Saha, Bhaskar, Kent, Linda, Gibson, Bethan, Camsooksai, Julie, Reschreiter, Henrik, Morgan, Pat, Sangaralingham, Sivatharshini, Lowe, Alastair, Vondras, Petr, Jamadarkhana, Sunil, Cruz, Carina, Bhandary, Rakesh, Hersey, Peter, Furneval, Julie, Innes, Richard, Doble, Patricia, Attwood, Ben, Parsons, Penny, Page, Valerie, Zhao, Xiaobei, Dalton, Julian, Hegazy, Mohammed, Awad, Yasser, Naylor, Dougla, Naylor, Amanda, Lee, Sarah, Brevard, Sidney, Davis, Noelle, Morochotutillo, Diego Rolando, Baranowski, Bronislaw, Akbas, Türkay, Mcnamee, Lia, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, and UCL - (SLuc) Service de soins intensifs

Subjects
Adult, Secondary peritoniti, Critical Illness, Peritonitis, Critical Care and Intensive Care Medicine, Anti-Bacterial Agents, Antimicrobial therapy, Intensive Care Units, Secondary peritonitis, Intra-abdominal infection, Anti-Infective Agents, Risk Factors, Source control, Sepsis, Medicine and Health Sciences, Humans, Intraabdominal Infections, Mortality, Retrospective Studies
Abstract

PURPOSE: To describe data on epidemiology, microbiology, clinical characteristics and outcome of adult patients admitted in the intensive care unit (ICU) with secondary peritonitis, with special emphasis on antimicrobial therapy and source control. METHODS: Post hoc analysis of a multicenter observational study (Abdominal Sepsis Study, AbSeS) including 2621 adult ICU patients with intra-abdominal infection in 306 ICUs from 42 countries. Time-till-source control intervention was calculated as from time of diagnosis and classified into 'emergency' (< 2 h), 'urgent' (2-6 h), and 'delayed' (> 6 h). Relationships were assessed by logistic regression analysis and reported as odds ratios (OR) and 95% confidence interval (CI). RESULTS: The cohort included 1077 cases of microbiologically confirmed secondary peritonitis. Mortality was 29.7%. The rate of appropriate empiric therapy showed no difference between survivors and non-survivors (66.4% vs. 61.3%, p = 0.1). A stepwise increase in mortality was observed with increasing Sequential Organ Failure Assessment (SOFA) scores (19.6% for a value ≤ 4-55.4% for a value > 12, p < 0.001). The highest odds of death were associated with septic shock (OR 3.08 [1.42-7.00]), late-onset hospital-acquired peritonitis (OR 1.71 [1.16-2.52]) and failed source control evidenced by persistent inflammation at day 7 (OR 5.71 [3.99-8.18]). Compared with 'emergency' source control intervention (< 2 h of diagnosis), 'urgent' source control was the only modifiable covariate associated with lower odds of mortality (OR 0.50 [0.34-0.73]). CONCLUSION: 'Urgent' and successful source control was associated with improved odds of survival. Appropriateness of empirical antimicrobial treatment did not significantly affect survival suggesting that source control is more determinative for outcome. TRIAL REGISTRATION: ClinicalTrials.gov NCT03270345.

Published
2022
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36. La gobernanza de los Grandes Lagos entre Canadá y Estados Unidos,: ¿siempre de común acuerdo?

Author

Lasserre, Frédéric, Vega Cardenas, Yenny, Lasserre, Frédéric, and Vega Cardenas, Yenny

Abstract

Our objective is to analyze, from a geopolitical and legal point of view, the main challenges of water governance in the Great Lakes of North America. The analysis is based on an extended bibliographic search and a triangulation analysis of the corpus thus produced. The first part of the text identifies the concerns of riparian populations in recent years. The second presents the challenges of protecting the basin from climate change and political uncertainty. Overall, the text provides a better understanding of the construction of a transnational water governance model based on the community of interests, which seems to leave behind the old Harmon theory of absolute sovereignty. We will finally ask ourselves, if it will be necessary to attribute a new juridical status to this basin to protect these ecosystems from the challenges raised by climate change., Nuestro objetivo es analizar desde un punto de vista geopolítico y jurídico los principales desafíos de la gobernanza de los Grandes Lagos de Norteamérica. El análisis se basa en una búsqueda bibliográfica extensa y una triangulación del análisis del corpus producido. La primera parte del artículo identifica preocupaciones de las poblaciones ribereñas de los últimos años. La segunda, presenta los desafíos que impone la protección de la cuenca frente a los cambios climáticos y la incertidumbre política. El artículo contribuye a mejorar el entendimiento para la construcción de un modelo de gobernanza transnacional del agua basado en una comunidad de intereses, lo que parece dejar atrás la antigua teoría Harmon acerca de la soberanía absoluta. Finalmente, nos preguntamos si se requerirá atribuir un nuevo estatus jurídico a esta cuenca, a fin de proteger los ecosistemas de los desafíos que imponen los cambios climáticos

Published
2022

37. El reconocimiento de los derechos de la Naturaleza en Canadá: el caso del río Magpie /Mutehekau Shipu

Author

Mestokosho, Uapukun and Vega Cardenas, Yenny

Subjects
Personalidad jurídica de los ríos, Ecology, Management, Monitoring, Policy and Law, Environmental Science (miscellaneous), Law
Abstract

En febrero de 2021, el río Magpie, también conocido como Mutehekau Shipu en lengua Innu, fue reconocido legalmente como una entidad viva con derechos, por el Consejo Innu de Ekuanitshit y el Condado Regional de Minganie en Côte-Nord, Quebec, Canadá. Este río desempeña un papel integral en la comunidad Indígena Innu, y su reconocimiento como persona jurídica afirma los derechos bioculturales que existen desde hace mucho tiempo entre el río y el pueblo originario. Por primera vez en Canadá, la introducción de los derechos de la Naturaleza permite afirmar la importancia de la cosmología Innu en el contexto jurídico de este país. Este documento explora en primer lugar, el camino emprendido que permitió reconocer la personalidad jurídica y los derechos del río Magpie, incluyendo los efectos potenciales de esta designación. En segundo lugar, se evalúan las dinámicas de los ordenamientos jurídicos en juego y se demuestra cómo el reconocimiento desafía los paradigmas coloniales antropocéntricos. En tercer lugar, analizamos cómo la estructura jurídica de Canadá propicia un enfoque dinámico entre diferentes órdenes jurídicos que puede dar vida a nuevos modelos de preservación de la naturaleza para las generaciones venideras.

Published
2022

38. L'eau douce, son exportation et le droit constitutionnel Canadien.

Author

Cardenas, Yenny Vega and Vega, Nayive Biofanny

Subjects
Fresh water -- Laws, regulations and rules, Water -- Management, Government regulation, Free Trade Agreement, 1992, United States-Canada-Mexico
Abstract

1 La compétence des provinces sur l'eau douce 1.1 Le pouvoir des provinces eu égard à leur domanialité (dominium) 1.2 Le pouvoir des provinces en tant que puissances législatives (imperium) [...], Ressource intrinsèquement fragile, l&apos;eau douce s&apos;avère un enjeu d&apos;importance sur la scène mondiale. Dans cette dynamique, le Canada devient un acteur incontournable. Disposant de 9 p. 100 des ressources mondiales d&apos;eau douce, il est, de facto, projeté au rang privilégié de grande puissance hydrique. Le Canada étant une fédération, tant les provinces que le gouvernement fédéral détiennent d&apos;importants pouvoirs sur l&apos;eau douce à la lumière du droit constitutionnel canadien. De plus, dans le contexte de l&apos;Accord de libre-échange nord-américain (ALENA), la collaboration de ces deux ordres de gouvernement est essentielle pour protéger l&apos;eau douce quant aux projets de dérivation ou d&apos;exportation massive. L&apos;avenir de cette ressource vitale devient donc une question partagée entre les gouvernements fédéral et provinciaux, qui sont en quelque sorte responsables conjointement de la pérennité de cette richesse à l&apos;égard des générations futures. Freshwater, an intrinsically fragile resource, is an issue of key importance on the international scene. As such, hydrological supply and demand dynamics put Canada in a position that cannot be ignored. With 9 percent of the planet&apos;s freshwater resources, the country is de facto projected to the privileged rank of a hydrological super power. Since Canada is a federation and hence in light of its constitutional distribution of authority, the provinces as well as the Federal government are stakeholders in wielding considerable power over freshwater resources. Furthermore, under the North American Free Trade Agreement (NAFTA), collaboration between these two orders of government is essential for protecting freshwater from diversion and bulk exportation projects. The future of this vital resource hence becomes a shared accountability between the federal and provincial governments, who indeed are in various ways jointly responsible for insuring the permanence of this rich legacy for future generations.

Published
2010

39. Antimicrobial Lessons From a Large Observational Cohort on Intra-abdominal Infections in Intensive Care Units

Author

Vogelaers, Dirk, Blot, Stijn, Van den Berge, Andries, Montravers, Philippe, Francois, Guy, Labeau, Sonia, Blot, Koen, Deschepper, Mieke, Antonelli, Massimo, Lipman, Jeffrey, Lamrous, Amin, Pereyra, Cecilia, Lipovestky, Fernando, Koulenti, Despoina, De Waele, Jan, Rezende-Neto, Joao, Cardenas, Yenny, Vymazal, Tomas, Fjeldsoee-Nielsen, Hans, Kott, Matthias, Kostoula, Arvaniti, Javeri, Yash, Girardis, Massimo, Einav, Sharon, de Lange, Dylan, Makikado, Luis Daniel Umezawa, Mikstacki, Adam, Paiva, José-Artur, Tomescu, Dana, Gritsan, Alexey, Jovanovic, Bojan, Venkatesan, Kumaresh, Mirkovic, Tomislav, Maseda, Emilio, Dikmen, Yalim, Creagh-Brown, Benedict, Emmerich, Monica, Canale, Mariana, Dietz, Lorena Silvina, Ilutovich, Santiago, Miñope, John Thomas Sanchez, Silva, Ramona Baldomera, Montenegro, Martin Alexis, Martin, Patricio, Saul, Pablo, Chediack, Viviana, Sutton, Giselle, Couce, Rocio, Balasini, Carina, Gonzalez, Susana, Lascar, Florencia Maria, Descotte, Emiliano Jorge, Gumiela, Natalia Soledad, Pino, Carina Alejandra, Cesio, Cristian, Valgolio, Emanuel, Cunto, Eleonora, Dominguez, Cecilia, Nelson, Nydia Funes, Abegao, Esteban Martin, Pozo, Norberto Christian, Bianchi, Luciana, Correger, Enrique, Pastorino, Maria Laura, Miyazaki, Erica Aurora, Grubissich, Nicolas, Garcia, Mariel, Bonetto, Natalia, Quevedo, Noelia Elizabeth, Gomez, Cristina Delia, Queti, Felipe, Estevarena, Luis Gonzalez, Fernandez, Ruben, Santolaya, Ignacio, Grangeat, Sergio Hugo, Doglia, Juan, Zakalik, Graciela, Pellegrini, Carlos, Lloria, Maria Monserrat, Chacon, Mercedes Esteban, Fumale, Mariela, Leguizamon, Mariela, Hidalgo, Irene Beatriz, Tiranti, Roberto Julian, Capponi, Paola, Tita, Agustin, Cardonnet, Luis, Bettini, Lisandro, Ramos, Agñel, Lovesio, Luciano, Miranda, Edith Miriam, Farfan, Angelica Beatriz, Tolosa, Carina, Segura, Lise, Bellocchio, Adelina, Alvarez, Brian, Manzur, Adriana, Lujan, Rodolfo, Fernandez, Natalia, Scarone, Nahuel, Zazu, Alan, Groh, Carina, Fletcher, Jason, Smith, Julie, Azad, Raman, Chavan, Nitin, Wong, Helen, Kol, Mark, Campbell, Lewis, Starr, Therese, Roberts, Brigit, Wibrow, Bradley, Warhurst, Timothy, Chinthamuneedi, Meher, Ferney, Bernal Buitrago, Simon, Marc, De Backer, Daniel, Wittebole, Xavier, De Bels, David, Collin, Vincent, Dams, Karolien, Jorens, Philippe, Dubois, Jasperina, Gunst, Jan, Haentjens, Lionel, De Schryver, Nicolas, Dugernier, Thierry, Rizoli, Sandro, Santillan, Paul, Han, Yi, Biskup, Ewelina, Qu, Changjing, Li, Xinyu, Yu, Tao, Weihua, Lu, Molano-Franco, Daniel, Rojas, José, Oviedo, Juan Mauricio Pardo, Pinilla, Dario, Celis, Edgar, Arias, Mario, Vukovic, Anita, Vudrag, Maja, Belavic, Matija, Zunic, Josip, Kuharic, Janja, Kricka, Irena Bozanic, Filipovic-Grcic, Ina, Tomasevic, Boris, Obraz, Melanija, Bodulica, Bruna, Dohnal, Martin, Malaska, Jan, Kratochvil, Milan, Satinsky, Igor, Schwarz, Peter, Kos, Zdenek, Blahut, Ladislav, Maca, Jan, Protus, Marek, Kieslichová, Eva, Nielsen, Louise Gramstrup, Krogh, Birgitte Marianne, Rivadeneira, Francisco, Morales, Freddy, Mora, José, Orozco, Alexandra Saraguro, MorochoTutillo, Diego Rolando, Vargas, Nelson Remache, Yepez, Estuardo Salgado, Villamagua, Boris, Alsisi, Adel, Fahmy, Abdelraouf, Dupont, Hervé, Lasocki, Sigismond, Paugam-Burtz, Catherine, Foucrier, Arnaud, Nica, Alexandru, Barjon, Geneviève, Mallat, Jihad, Marcotte, Guillaume, Leone, Marc, Duclos, Gary, Burtin, Philippe, Atchade, Enora, Mahjoub, Yazine, Misset, Benoît, Timsit, Jean-François, Dupuis, Claire, Veber, Benoît, Debarre, Matthieu, Collange, Oliver, Pottecher, Julien, Hecketsweiler, Stephane, Fromentin, Mélanie, Tesnière, Antoine, Koch, Christian, Sander, Michael, Eckmann, Christian, Elke, Gunnar, Wrigge, Hermann, Simon, Philipp, Chalkiadaki, Anthoula, Tzanidakis, Charalampos, Pneumatikos, Ioannis, Sertaridou, Eleni, Mastora, Zafiria, Pantazopoulos, Ioannis, Papanikolaou, Metaxia, Papavasilopoulou, Theonymfi, Floros, John, Kolonia, Virginia, Dimopoulos, George, Diakaki, Chryssa, Rallis, Michael, Paridou, Alexandra, Kalogeromitros, Alexandros, Romanou, Vasiliki, Nikolaou, Charikleia, Kounougeri, Katerina, Tsigou, Evdoxia, Psallida, Vasiliki, Karampela, Niki, Mandragos, Konstantinos, Kontoudaki, Eftychia, Pentheroudaki, Alexandra, Farazi-Chongouki, Christos, Karakosta, Agathi, Chouris, Isaac, Radu, Vasiliki, Malliotakis, Polychronis, Kokkini, Sofia, Charalambous, Eliana, Kyritsi, Aikaterini, Koulouras, Vasilios, Papathanakos, Georgios, Nagky, Eva, Lampiri, Clairi, Tsimpoukas, Fotios, Sarakatsanos, Ioannis, Georgakopoulos, Panagiotis, Ravani, Ifigeneia, Prekates, Athanasios, Sakellaridis, Konstantinos, Christopoulos, Christos, Vrettou, Efstratia, Stokkos, Konstantinos, Pentari, Anastasia, Arvaniti, Kostoula, Marmanidou, Kyriaki, Kydona, Christina, Tsoumaropoulos, Georgios, Bitzani, Militisa, Kontou, Paschalina, Voudouris, Antonios, Elli-Nikki, [missing], Flioni, [missing], Antypa, Elli, Chasou, Eleftheria, Anisoglou, Souzana, Papageorgiou, Eirini, Paraforou, Theoniki, Tsioka, Agoritsa, Karathanou, Antigoni, Vakalos, Aristeidis, Shah, Bhagyesh, Thakkar, Chirag, Jain, Nikhilesh, Gurjar, Mohan, Baronia, Arvind, Sathe, Prachee, Kulkarni, Shilpa, Paul, Cherish, Paul, John, Masjedi, Mansoor, Nikandish, Reza, Zand, Farid, Sabetian, Golnar, Mahmoodpoor, Ata, Hashemian, Seyed Mohammadreza, Bala, Miklosh, Flocco, Romeo, Torrente, Sergio, Pota, Vincenzo, Spadaro, Savino, Volta, Carlo, Serafini, Giulia, Boraso, Sabrina, Tiberio, Ivo, Cortegiani, Andrea, Misseri, Giovanni, Barbagallo, Maria, Nicolotti, Davide, Forfori, Francesco, Corradi, Francesco, De Pascale, Gennaro, Pelagalli, Lorella, Brazzi, Luca, Vittone, Ferdinando Giorgio, Russo, Alessandro, Simion, Davide, Cotoia, Antonella, Cinnella, Gilda, Toppin, Patrick, Johnson-Jackson, Roxanne, Hayashi, Yoshiro, Yamamoto, Ryohei, Yasuda, Hideto, Kishihara, Yuki, Shiotsuka, Junji, Sanchez-Hurtado, Luis Alejandro, Tejeda-Huezo, Brigitte, Gorordo, Luis, Ñamendys-Silva, Silvio A., Garcia-Guillen, Francisco J., Martinez, Manuel, Romero-Meja, Erick, Colorado-Dominguez, Ever, van den Oever, Huub, Kalff, Karel Martijn, Vermeijden, Wytze, Cornet, Alexander Daniel, Beck, Oliver, Cimic, Nedim, Dormans, Tom, Bormans, Laura, Bakker, Jan, Van Duijn, Ditty, Bosman, Gerrit, Vos, Piet, Haas, Lenneke, Henein, Akram, Miranda, Ariel M., Malca, Gonzalo Ernesto Gianella, Arroyo-Sanchez, Abel, Misiewska-Kaczur, Agnieszka, Akinyi, Frisch, Czuczwar, Miroslaw, Luczak, Karolina, Sulkowski, Wiktor, Tamowicz, Barbara, Swit, Beata, Baranowski, Bronisław, Smuszkiewicz, Piotr, Trojanowska, Iwona, Rzymski, Stanislaw, Sawinski, Mariusz, Trosiak, Marta, Mikaszewska-Sokolewicz, Malgorzata, Alves, Ricardo, Leal, Dina, Krystopchuk, Andriy, Mendonca, Pedro Muguel Hilario, Pereira, Rui Antunes, de Carvalho, Maria Raquel Lopes Marques, Candeias, Carlos, Molinos, Elena, Ferreira, Amélia, Castro, Guiomar, Pereira, José-Manuel, Santos, Lurdes, Ferreira, Alcina, Pascoalinho, Dulce, Ribeiro, Rosa, Domingos, Guilherme, Gomes, Pedro, Nora, David, Costa, Rui Pedro, Santos, Anabela, Alsheikhly, Ahmed Subhy, Popescu, Mihai, Grigoras, Ioana, Patrascanu, Emilia, Zabolotskikh, Igor, Musaeva, Tatiana, Gaigolnik, Denis, Kulabukhov, Vladimir, Belskiy, Vladislav, Zubareva, Nadezhda, Tribulev, Maxim, Abdelsalam, Ahmed, Aldarsani, Ayman, Al-Khalid, Muhammad, Almekhlafi, Ghaleb, Mandourah, Yasser, Doklestic, Krstina, Velickovic, Jelena, Velickovic, Dejan, Jankovic, Radmilo, Skoric-Jokic, Svetlana, Radovanovic, Dragana, Richards, Guy, Alli, Ahmad, Del Carmen Cordoba Nielfa, Maria, Iniesta, Rafael Sánchez, Martínez, Adela Benítez-Cano, Bernedo, Carlos Garcia, Gil, Santiago Alberto Picos, Nuvials, Xavier, Rello, Jordi, Garcia, Joseba Gonzalez, Peña, Jose Manuel Garcia, Jimenez, Roberto, Herrera, Luis, Barrachina, Laura Galarza, Monzon, Ignacio Catalan, Redondo, Francisco Javier, Villazala, Ruben, Zapata, Diego Fernando Matallana, Lopez, Isabel Maria Villa, Moreno-Gonzalez, Gabriel, Lopez-Delgado, Juan Carlos, Marin, Jorge Solera, Sanchez-Zamora, Purificacion, Vidal, Montserrat Vallverdú, González, Jesús Flores, Salinas, Irene, Hermosa, Cecilia, Martinez-Sagasti, Fernando, Domingo-Marín, Sara, Victorino, Johanna Abril, Garcia-Alvarez, Raquel, Calleja, Pablo López-Arcas, de la Torre-Prados, Maria-Victoria, Vidal-Cortes, Pablo, Del Río-Carbajo, Lorena, Izura, Javier, Minguez, Victoria, Alvarez, Josep Trenado, Prous, Anna Parera, Paz, Daniel, Roche-Campo, Ferran, Aguilar, Gerardo, Belda, Javier, Rico-Feijoo, Jesus, Aldecoa, Cesat, Zalba-Etayo, Begoña, Lang, Martin, Dullenkopf, Alexander, Trongtrakul, Konlawij, Chtsomkasem, Anusang, Akbaş, Türkay, Unal, Mustafa Necmettin, Ozcelik, Menekse, Gumus, Ayca, Ramazanoglu, Atilla, Memis, Dilek, Mehmet, Inal, Urkmez, Seval, Ozgultekin, Asu, Demirkiran, Oktay, Aslan, Nesrin Ahu, Kizilaslan, Deniz, Kahveci, Ferda, Ünlü, Nurdan, Ozkan, Zeynep, Kaye, Callum, Jansen, Jan, O’Neill, Orla, Nutt, Christopher, Jha, Rajeev, Hooker, Nicolas, Grecu, Irina, Petridou, Christina, Shyamsundar, Murali, McNamee, Lia, Trinder, John, Hagan, Samantha, Kelly, Catriona, Silversides, Jonathon, Groba, Casiano Barrera, Boyd, Owen, Bhowmick, Kaushik, Humphreys, Sally, Summers, Charlotte, Polgarova, Petra, Margarson, Michael, Dickens, Justin, Pearson, Suzanne, Chinery, Elaine, Hemmings, Noel, O’Kane, Sinead, Austin, Pauline, Cole, Stephen, Plowright, Catherine, Box, Roberta, Wright, Christopher, Young, Lorna, Creagh-Brown, Ben, Montague, Laura, Parker, Robert, Morton, Ben, Ostermann, Marlies, Bilinska, Julia, Rose, Bernd Oliver, Reece-Anthony, Rosie, Ryan, Christine, Hamilton, Mark, Hopkins, Philip, Wendon, Julia, Brescia, Giovanni, Ijaz, Nazia, Wood, James, George, Michelle, Toth-Tarsoly, Piroska, Yates, Bryan, Armstrong, Maureen, Scott, Carmen, Boyd, Christine, Szakmany, Tamas, Rees, David, Pulak, Paul, Coggon, Mandy, Saha, Bhaskar, Kent, Linda, Gibson, Bethan, Camsooksai, Julie, Reschreiter, Henrik, Morgan, Pat, Sangaralingham, Sivatharshini, Lowe, Alastair, Vondras, Petr, Jamadarkhana, Sunil, Cruz, Carina, Bhandary, Rakesh, Hersey, Peter, Furneval, Julie, Innes, Richard, Doble, Patricia, Attwood, Ben, Parsons, Penny, Page, Valerie, Zhao, Xiaobei, Dalton, Julian, Hegazy, Mohammed, Awad, Yasser, Naylor, Douglas, Naylor, Amanda, Lee, Sarah, Brevard, Sidney, Davis, Noelle, for the Abdominal Sepsis Study (‘AbSeS’) Group on behalf of the Trials Group of the European Society of Intensive Care Medicine, [missing], Vogelaers D., Blot S., Van den Berge A., Montravers P., Francois G., Labeau S., Blot K., Deschepper M., Antonelli M., Lipman J., Lamrous A., Pereyra C., Lipovestky F., Koulenti D., De Waele J., Rezende-Neto J., Cardenas Y., Vymazal T., Fjeldsoee-Nielsen H., Kott M., Kostoula A., Javeri Y., Girardis M., Einav S., de Lange D., Makikado L.D.U., Mikstacki A., Paiva J.-A., Tomescu D., Gritsan A., Jovanovic B., Venkatesan K., Mirkovic T., Maseda E., Dikmen Y., Creagh-Brown B., Emmerich M., Canale M., Dietz L.S., Ilutovich S., Minope J.T.S., Silva R.B., Montenegro M.A., Martin P., Saul P., Chediack V., Sutton G., Couce R., Balasini C., Gonzalez S., Lascar F.M., Descotte E.J., Gumiela N.S., Pino C.A., Cesio C., Valgolio E., Cunto E., Dominguez C., Nelson N.F., Abegao E.M., Pozo N.C., Bianchi L., Correger E., Pastorino M.L., Miyazaki E.A., Grubissich N., Garcia M., Bonetto N., Quevedo N.E., Gomez C.D., Queti F., Estevarena L.G., Fernandez R., Santolaya I., Grangeat S.H., Doglia J., Zakalik G., Pellegrini C., Lloria M.M., Chacon M.E., Fumale M., Leguizamon M., Hidalgo I.B., Tiranti R.J., Capponi P., Tita A., Cardonnet L., Bettini L., Ramos A., Lovesio L., Miranda E.M., Farfan A.B., Tolosa C., Segura L., Bellocchio A., Alvarez B., Manzur A., Lujan R., Fernandez N., Scarone N., Zazu A., Groh C., Fletcher J., Smith J., Azad R., Chavan N., Wong H., Kol M., Campbell L., Starr T., Roberts B., Wibrow B., Warhurst T., Chinthamuneedi M., Ferney B.B., Simon M., De Backer D., Wittebole X., De Bels D., Collin V., Dams K., Jorens P., Dubois J., 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B., Armstrong M., Scott C., Boyd C., Szakmany T., Rees D., Pulak P., Coggon M., Saha B., Kent L., Gibson B., Camsooksai J., Reschreiter H., Morgan P., Sangaralingham S., Lowe A., Vondras P., Jamadarkhana S., Cruz C., Bhandary R., Hersey P., Furneval J., Innes R., Doble P., Attwood B., Parsons P., Page V., Zhao X., Dalton J., Hegazy M., Awad Y., Naylor D., Naylor A., Lee S., Brevard S., Davis N., UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service de soins intensifs, Vogelaers, D., Blot, S., Van den Berge, A., Montravers, P., Francois, G., Labeau, S., Blot, K., Deschepper, M., Antonelli, M., Lipman, J., Lamrous, A., Pereyra, C., Lipovestky, F., Koulenti, D., De Waele, J., Rezende-Neto, J., Cardenas, Y., Vymazal, T., Fjeldsoee-Nielsen, H., Kott, M., Kostoula, A., Javeri, Y., Girardis, M., Einav, S., de Lange, D., Makikado, L. D. U., Mikstacki, A., Paiva, J. -A., Tomescu, D., Gritsan, A., Jovanovic, B., Venkatesan, K., Mirkovic, T., Maseda, E., Dikmen, Y., Creagh-Brown, B., Emmerich, M., Canale, M., Dietz, L. S., Ilutovich, S., Minope, J. T. S., Silva, R. B., Montenegro, M. A., Martin, P., Saul, P., Chediack, V., Sutton, G., Couce, R., Balasini, C., Gonzalez, S., Lascar, F. M., Descotte, E. J., Gumiela, N. S., Pino, C. A., Cesio, C., Valgolio, E., Cunto, E., Dominguez, C., Nelson, N. F., Abegao, E. M., Pozo, N. C., Bianchi, L., Correger, E., Pastorino, M. L., Miyazaki, E. A., Grubissich, N., Garcia, M., Bonetto, N., Quevedo, N. E., Gomez, C. D., Queti, F., Estevarena, L. G., Fernandez, R., Santolaya, I., Grangeat, S. H., Doglia, J., Zakalik, G., Pellegrini, C., Lloria, M. M., Chacon, M. E., Fumale, M., Leguizamon, M., Hidalgo, I. B., Tiranti, R. J., Capponi, P., Tita, A., Cardonnet, L., Bettini, L., Ramos, A., Lovesio, L., Miranda, E. M., Farfan, A. B., Tolosa, C., Segura, L., Bellocchio, A., Alvarez, B., Manzur, A., Lujan, R., Fernandez, N., Scarone, N., Zazu, A., Groh, C., Fletcher, J., Smith, J., Azad, R., Chavan, N., Wong, H., Kol, M., Campbell, L., Starr, T., Roberts, B., Wibrow, B., Warhurst, T., Chinthamuneedi, M., Ferney, B. B., Simon, M., De Backer, D., Wittebole, X., De Bels, D., Collin, V., Dams, K., Jorens, P., Dubois, J., Gunst, J., Haentjens, L., De Schryver, N., Dugernier, T., Rizoli, S., Santillan, P., Han, Y., Biskup, E., Qu, C., Li, X., Yu, T., Weihua, L., Molano-Franco, D., Rojas, J., Oviedo, J. M. P., Pinilla, D., Celis, E., Arias, M., Vukovic, A., Vudrag, M., Belavic, M., Zunic, J., Kuharic, J., Kricka, I. B., Filipovic-Grcic, I., Tomasevic, B., Obraz, M., Bodulica, B., Dohnal, M., Malaska, J., Kratochvil, M., Satinsky, I., Schwarz, P., Kos, Z., Blahut, L., Maca, J., Protus, M., Kieslichova, E., Nielsen, L. G., Krogh, B. M., Rivadeneira, F., Morales, F., Mora, J., Orozco, A. S., Morochotutillo, D. R., Vargas, N. R., Yepez, E. S., Villamagua, B., Alsisi, A., Fahmy, A., Dupont, H., Lasocki, S., Paugam-Burtz, C., Foucrier, A., Nica, A., Barjon, G., Mallat, J., Marcotte, G., Leone, M., Duclos, G., Burtin, P., Atchade, E., Mahjoub, Y., Misset, B., Timsit, J. -F., Dupuis, C., Veber, B., Debarre, M., Collange, O., Pottecher, J., Hecketsweiler, S., Fromentin, M., Tesniere, A., Koch, C., Sander, M., Eckmann, C., Elke, G., Wrigge, H., Simon, P., Chalkiadaki, A., Tzanidakis, C., Pneumatikos, I., Sertaridou, E., Mastora, Z., Pantazopoulos, I., Papanikolaou, M., Papavasilopoulou, T., Floros, J., Kolonia, V., Dimopoulos, G., Diakaki, C., Rallis, M., Paridou, A., Kalogeromitros, A., Romanou, V., Nikolaou, C., Kounougeri, K., Tsigou, E., Psallida, V., Karampela, N., Mandragos, K., Kontoudaki, E., Pentheroudaki, A., Farazi-Chongouki, C., Karakosta, A., Chouris, I., Radu, V., Malliotakis, P., Kokkini, S., Charalambous, E., Kyritsi, A., Koulouras, V., Papathanakos, G., Nagky, E., Lampiri, C., Tsimpoukas, F., Sarakatsanos, I., Georgakopoulos, P., Ravani, I., Prekates, A., Sakellaridis, K., Christopoulos, C., Vrettou, E., Stokkos, K., Pentari, A., Arvaniti, K., Marmanidou, K., Kydona, C., Tsoumaropoulos, G., Bitzani, M., Kontou, P., Voudouris, A., Elli-Nikki, Flioni, Antypa, E., Chasou, E., Anisoglou, S., Papageorgiou, E., Paraforou, T., Tsioka, A., Karathanou, A., Vakalos, A., Shah, B., Thakkar, C., Jain, N., Gurjar, M., Baronia, A., Sathe, P., Kulkarni, S., Paul, C., Paul, J., Masjedi, M., Nikandish, R., Zand, F., Sabetian, G., Mahmoodpoor, A., Hashemian, S. M., Bala, M., Flocco, R., Torrente, S., Pota, V., Spadaro, S., Volta, C., Serafini, G., Boraso, S., Tiberio, I., Cortegiani, A., Misseri, G., Barbagallo, M., Nicolotti, D., Forfori, F., Corradi, F., De Pascale, G., Pelagalli, L., Brazzi, L., Vittone, F. G., Russo, A., Simion, D., Cotoia, A., Cinnella, G., Toppin, P., Johnson-Jackson, R., Hayashi, Y., Yamamoto, R., Yasuda, H., Kishihara, Y., Shiotsuka, J., Sanchez-Hurtado, L. A., Tejeda-Huezo, B., Gorordo, L., Namendys-Silva, S. A., Garcia-Guillen, F. J., Martinez, M., Romero-Meja, E., Colorado-Dominguez, E., van den Oever, H., Kalff, K. M., Vermeijden, W., Cornet, A. D., Beck, O., Cimic, N., Dormans, T., Bormans, L., Bakker, J., Van Duijn, D., Bosman, G., Vos, P., Haas, L., Henein, A., Miranda, A. M., Malca, G. E. 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O., Reece-Anthony, R., Ryan, C., Hamilton, M., Hopkins, P., Wendon, J., Brescia, G., Ijaz, N., Wood, J., George, M., Toth-Tarsoly, P., Yates, B., Armstrong, M., Scott, C., Boyd, C., Szakmany, T., Rees, D., Pulak, P., Coggon, M., Saha, B., Kent, L., Gibson, B., Camsooksai, J., Reschreiter, H., Morgan, P., Sangaralingham, S., Lowe, A., Vondras, P., Jamadarkhana, S., Cruz, C., Bhandary, R., Hersey, P., Furneval, J., Innes, R., Doble, P., Attwood, B., Parsons, P., Page, V., Zhao, X., Dalton, J., Hegazy, M., Awad, Y., Naylor, D., Naylor, A., Lee, S., Brevard, S., and Davis, N.

Subjects
Drug Resistance, medicine.disease_cause, Severity of Illness Index, law.invention, 0302 clinical medicine, ENTEROBACTERIACEAE, law, Drug Resistance, Multiple, Bacterial, Medicine and Health Sciences, Pharmacology (medical), Cross Infection, biology, Bacterial, Antimicrobial, Intensive care unit, Anti-Bacterial Agents, Community-Acquired Infections, Europe, Intensive Care Units, Critical Illness, Humans, Intraabdominal Infections, Microbial Sensitivity Tests, Peritonitis, Sepsis, ESCHERICHIA-COLI, 030220 oncology & carcinogenesis, KLEBSIELLA-PNEUMONIAE, BLOOD-STREAM INFECTIONS, PYELONEPHRITIS, Multiple, medicine.medical_specialty, Enterococcus faecalis, NO, 03 medical and health sciences, Intra‑abdominal Infections, Antibiotic resistance, FOOD, Intensive care, Internal medicine, medicine, FLUOROQUINOLONE RESISTANCE, Pseudomonas aeruginosa, business.industry, Septic shock, MORTALITY, biology.organism_classification, medicine.disease, RISK-FACTORS, business, 030217 neurology & neurosurgery, Enterococcus faecium
Abstract

Severe intra-abdominal infection commonly requires intensive care. Mortality is high and is mainly determined by disease-specific characteristics, i.e. setting of infection onset, anatomical barrier disruption, and severity of disease expression. Recent observations revealed that antimicrobial resistance appears equally common in community-acquired and late-onset hospital-acquired infection. This challenges basic principles in anti-infective therapy guidelines, including the paradigm that pathogens involved in community-acquired infection are covered by standard empiric antimicrobial regimens, and second, the concept of nosocomial acquisition as the main driver for resistance involvement. In this study, we report on resistance profiles of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecalis and Enterococcus faecium in distinct European geographic regions based on an observational cohort study on intra-abdominal infections in intensive care unit (ICU) patients. Resistance against aminopenicillins, fluoroquinolones, and third-generation cephalosporins in E. coli, K. pneumoniae and P. aeruginosa is problematic, as is carbapenem-resistance in the latter pathogen. For E. coli and K. pneumoniae, resistance is mainly an issue in Central Europe, Eastern and South-East Europe, and Southern Europe, while resistance in P. aeruginosa is additionally problematic in Western Europe. Vancomycin-resistance in E. faecalis is of lesser concern but requires vigilance in E. faecium in Central and Eastern and South-East Europe. In the subcohort of patients with secondary peritonitis presenting with either sepsis or septic shock, the appropriateness of empiric antimicrobial therapy was not associated with mortality. In contrast, failure of source control was strongly associated with mortality. The relevance of these new insights for future recommendations regarding empiric antimicrobial therapy in intra-abdominal infections is discussed.

Published
2021
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40. Qualitative Analysis of a Teacher's Reflections on Medical Students Using Public Narratives to Promote Health.

Author

Jaimes-Peñuela, Claudia Liliana, Duran-Cardenas, Yenny Catalina, Hernandez-Rincon, Erwin Hernando, and Correal-Muñoz, Camilo Alejandro

Subjects
TEAMS in the workplace, SOCIAL mobility, FRUSTRATION, MEDICAL students, MOTIVATION (Psychology), MEDICAL school faculty, COLLEGE teacher attitudes, QUALITATIVE research, HEALTH literacy, PSYCHOSOCIAL factors, CONTENT analysis, COMMITMENT (Psychology), HEALTH promotion, PUBLIC opinion
Abstract

A qualitative, inductive content analysis was done to explore a teacher's reflections on the experiences of a team of medical students using public narratives to promote health within a Colombian university. Data were collected from the teacher's written reflective journal and an academic report, the latter, submitted by the medical students. 'Being mobilized' emerged as an overarching category. The experiences were described in three interrelated categories: team involvement, barriers and countering these barriers. In terms of team involvement, students were motivated, committed, connected with people and frustrated. On the other hand, barriers such as doubts and discomfort remarked, and finally these barriers were countered through training, practice and teamwork. As conclusion, the public narrative framework has changed the way medical students think about how to mobilize people for health promotion in a university. Narrative approaches are gaining strength as sources of motivation to support the adoption of healthy behaviors. [ABSTRACT FROM AUTHOR]

Published
2022
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43. Relación de la comunicación externa como herramienta de relaciones públicas con la imagen corporativa de la empresa Liderman, Lima, año 2018

Author

Vargas Cardenas, Yenny Victoria and Elías Villanueva, Luis Enrique

Subjects
Comunicación externa
Abstract

Esta investigación tiene como objetivo conocer de qué manera la comunicación externa se relaciona con la imagen corporativa en la empresa Liderman, Lima, año 2018. Se utilizó el diseño de investigación no experimental, de tipo aplicativa, de nivel descriptivo correlacional. La población está formada por 35 organizaciones y la muestra establecida aleatoriamente por 32 organizaciones que atiende Liderman. El instrumento utilizado fue una encuesta de tipo Likert sometida a juicio de expertos, con un promedio de validez de 95% en el Coeficiente de Validez de Aiken, y un puntaje de 0.8464 con el Coeficiente de Alfa de Cronbach. Los resultados permitieron conocer que existe una relación directa entre la comunicación externa y la imagen corporativa en la empresa Liderman. Demostrando que las organizaciones a las que les presta servicio reconocen en un 81,17% la relación entre la comunicación comercial y la imagen institucional; que el 71,16% expresa la relación directa entre la comunicación pública y la imagen pública; que el 78,8% reconoce la influencia de las relaciones con los medios y la persuasión; y que el 80,8% manifiesta que existe relación entre la comunicación bidireccional y la fidelización. Por lo que se concluye que la comunicación externa está directamente relacionada con la imagen corporativa, y que la imagen positiva de Liderman se viene construyendo por el uso de distintos medios de comunicación y cumple con una comunicación pública abierta y directa.

Published
2019

46. 1583: OUTCOMES OF SURGICAL ONCOLOGY PATIENTS WITH SEPTIC SHOCK

Author

Cuenca, John, primary, Christensen, Eric, additional, Martin, Peyton, additional, Laserna, Andres, additional, Manjappachar, Nirmala, additional, O’Connell, Keara, additional, Heatter, Juliana, additional, Rathi, Nisha, additional, Cardenas, Yenny, additional, Price, Kristen, additional, and Nates, Joseph, additional

Published
2020
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