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  • 1
    Electronic Resource
    Electronic Resource
    Fat embolism (2002)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 57 (2002), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2044.2002.02752_17.x
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  • 2
    Electronic Resource
    Electronic Resource
    The impact of Acinetobacter baumannii in the intensive care unit (2003)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 58 (2003), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary Acinetobacter baumannii is a significant problem in critically ill patients. It is widespread, can colonise patients quickly and causes virulent infections. However, its overall impact on morbidity and mortality in the critically ill remains unmeasured. This study was designed to investigate A. baumannii colonisation and infection rates in a critically ill population over an 18-month period. Twenty-seven patients from a population of 347 were identified as having A. baumannii. Sixteen were colonised, whereas 11 were infected. Eleven of the 27 patients with A. baumannii died (41%). Of these, eight were colonised and three were infected. In the same period, 320 patients did not have A. baumannii and their mortality rate was 20% (n = 64). The mortality rate of patients with A. baumannii was significantly higher than that of patients without infection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2044.2003.30403.x
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  • 3
    Electronic Resource
    Electronic Resource
    White cell count and intensive care unit outcome (2003)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 58 (2003), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary A high white cell count on admission to the intensive care unit (ICU) is generally perceived to be associated with severe illness and poor outcome, but the implications of a low white cell count are less well recognised. We retrospectively analysed data on 4165 patients. The white cell count on admission was split into four categories, leucopenic (〈 4.0 × 109.l−1), normal (4.001–10.0 × 109. l−1), leucemoid (10.001–25.0 × 109.l−1) and an exaggerated leucemoid response (〉 25.001 × 109.l−1). The mortality of patients with leucopenia on admission to the intensive care unit was higher than those with normal or moderately raised white cell count (37.5% vs. 18.9% and 23.9%, respectively). A leucopenic response, as well as an exaggerated leucemoid response, is associated with an increased mortality.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2044.2003.02964_5.x
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  • 4
    Electronic Resource
    Electronic Resource
    Fat embolism (2001)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 56 (2001), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Fat embolism syndrome is a collection of respiratory, haematological, neurological and cutaneous symptoms and signs associated with trauma and other disparate surgical and medical conditions. The incidence of the clinical syndrome is low (〈 1% in retrospective reviews) whilst the embolisation of marrow fat appears to be an almost inevitable consequence of long bone fractures. There is debate over the pathogenesis of fat embolism syndrome and it seems a variety of factors interact to produce a spectrum of end organ damage. Many therapeutic interventions and prophylactic strategies have been tried with varying success. Current treatments are supportive and the condition is usually associated with a good outcome. The literature on fat embolism syndrome is extensive and this review aims to discuss the incidence, aetiology, pathophysiology, diagnosis and treatment of fat embolism.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2044.2001.01724.x
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  • 5
    Electronic Resource
    Electronic Resource
    Risk factors for pressure sores in the critically ill (2000)
    Oxford : Blackwell Science Ltd
    Anaesthesia 55 (2000), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Pressure sore development in the critically ill is a well-recognised problem and several risk factors have been put forward as being relevant; however, none has been proved valid in this population. This study examines the effects of specific risk factors for the development of pressure sores in the critically ill. Data on 22 specific risk factors were recorded every 8 h. Of 286 patients who were identified as having a minimum set of three predetermined risk factors, 77 developed pressure sores. Using univariate regression analysis, 18 of the 22 specific factors were identified as being significant (p 〈 0.05) in the development of pressure sores. Multivariate analysis identified five of these 18 specific risk factors as being independently significant (p 〈 0.05) in pressure sore development. These five factors were norepinephrine infusion, APACHE II score, faecal incontinence, anaemia and length of stay.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2044.2000.01216.x
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  • 6
    Electronic Resource
    Electronic Resource
    Recominant Expression and Immunological Characterization of House Dust Mite Allergen Der P 1 (2004)
    Oxford, UK; Malden, USA : Blackwell Science Ltd/Inc.
    Scandinavian journal of immunology 59 (2004), S. 0 
    Details
    ISSN: 1365-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The cysteine protease Der p1 from dust mite of the genus Dermatophagoides pteronyssinus is a major type I allergen. About 80% of house dust mite (HDM) allergic individuals are reactive to this protease in standard assays for detection of IgE. A curative treatment for atopic allergy is immunotherapy (IT) with HDM extracts which are complex mixtures occasionally resulting in anaphylactic reactions. Novozymes focuses on developing a recombinant variant of Der p1 which exhibit lowered risk of IgE-mediated allergic reactions, while maintaining its ability to trigger proper Th-cell responses. This may provide a safer alternative for specific IT of HDM allergy. A secreted recombinant form of pro-Der p 1 expressed by Saccharamyces cerevisiae was obtained by fusion of the pro-enzyme to a fungal signal peptide. The N-glycosylation site of Der p1 was mutated resulting in a deglycosylated pro-enzyme with a molecular mass of 35 kDa. Protein purification procedure was developed to obtain nearly pure Der p1 protein followed by determination of concentration by active-site-titration with the cysteine protease inhibitor E64. The deglycosylated recombinant pro-Der p 1 revealed immunologic similarity to the native Der p 1 molecule when compared in basophile histamine release, IgE-binding assays and T-cell proliferation assays. By in silico epitope mapping of a modelled 3-dimensional structure of Der p1, five putative IgG and IgE epitopes were predicted. By protein engineering, the predicted epitopes were removed one by one in Der p1 and screening for hypoallergenic variants was performed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0300-9475.2004.01423ag.x
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  • 7
    Electronic Resource
    Electronic Resource
    A survey of physicians' attitudes to transfusion practice in critically ill patients in the UK (2002)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 57 (2002), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary This study aimed to examine the attitudes of intensivists and haematologists to the use of blood and blood products using a scenario-based postal questionnaire. One hundred and sixty-two intensivists and 77 haematologists responded to the survey. In four scenarios, the baseline haemoglobin thresholds for red cell transfusion ranged from 6 to 12 g.dl−1. There was significant variation between scenarios (p 〈 0.005). Increasing age, high Acute Physiology and Chronic Health Status II score, surgery, acute respiratory distress syndrome, septic shock and lactic acidosis significantly (p 〈 0.005) modified the transfusion threshold. There were greater variations in the baseline threshold for platelet transfusion. The majority of respondents (72.3%) selected a baseline haemoglobin threshold between 9 and 10 g.dl−1. The thresholds for platelet transfusion were far less consistent.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2044.2002.02509_1.x
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  • 8
    Electronic Resource
    Electronic Resource
    Blood component use in critically ill patients (2002)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 57 (2002), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary This prospective observational study was conducted to assess the current transfusion practice in critically ill patients. One thousand two hundred and forty-seven consecutive critically ill patients admitted between February 1999 and October 1999 were included in the study. Overall 666 (53%) patients were administered red cells. Transfused patients had significantly higher intensive care unit␣mortality but also had higher Acute Physiology and Chronic Health Evaluation II scores and longer durations of stay. The average pretransfusion haemoglobin concentration was 〈 9 g.dl−1 in 75% of transfusion episodes. The common indications for transfusion were low haemoglobin (72%) and haemorrhage (25%). Overall, 202 (16%) and 281 (22%) of the patients were transfused platelets and fresh frozen plasma, respectively. The indications for transfusion were haemorrhage, low platelet counts, prolonged prothrombin time or to provide cover for invasive interventions. Most platelet transfusions were given at values in the order of 50–100 × 109.l−1. The pretransfusion platelet count varied according to the indications for transfusion. This study showed that transfusion practice is consistent and that in general there does not seem to be an excessive use of blood components in critically ill patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2044.2002.02514.x
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  • 9
    Electronic Resource
    Electronic Resource
    Central venous blood culture: a useful test for catheter colonisation? (2000)
    Springer
    Intensive care medicine 26 (2000), S. 1373-1375 
    Details
    ISSN: 1432-1238
    Keywords: Blood culture Central venous catheter Bacterial colonisation Bacteraemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Objective: To evaluate the widespread practice of using qualitative culture of venous blood taken through central venous catheters (CVCs) as a means of diagnosing catheter colonisation in situ. Design: A prospective clinical study. Patients: Three hundred fifty-one CVCs were inserted into 228 critically ill patients. Interventions: Prior to CVC removal, blood was taken for qualitative culture from the CVC and a peripheral site. All catheter tips underwent semi-quantitative analysis of bacterial colony count [1]. Measurements and results: One hundred eighteen (33.6%) CVCs were found to be colonised on removal. A positive central blood culture had a sensitivity and specificity of 50.8% and 78.9% when compared with the 'gold standard' of catheter tip culture. This gives a positive predictive value of 47.7% and a negative predictive value of 76.5%. The sensitivity and specificity of a positive peripheral blood culture were 41.5% and 77.7% with positive and negative predictive values of 48.8% and 72.9%, respectively. When only those catheters removed because of systemic sepsis (n=139) were considered, a positive central blood culture had a sensitivity of 58.8% and a specificity of 69.3%. Conclusion: Our results indicate that the use of central blood culture confers a small advantage in sensitivity compared with peripheral blood culture. This advantage was further improved by only considering the catheters removed because of systemic sepsis but at the cost of a loss of specificity. Qualitative blood culture is a poor tool for the diagnosis of in-situ CVC colonisation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340000582
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