The use of pulmonary artery catheter in sepsis patients: A literature review

This article was to review the literature regarding the use of the pulmonary artery catheter (PAC) in the management of patients with sepsis and septic shock. A PubMed search was conducted in order to identify publications evaluating the use of PAC as a tool for management and therapeutic guidance in patients with sepsis. The bibliographies of all identified publications were reviewed for additional relevant references. Much information is identified in the literature regarding the indications for pulmonary artery catheterization in the assessment and treatment of patients with sepsis. Although the PAC has been widely used for many years, there is no clear benefit with regard to outcome, and there is controversy regarding its use. It is not clear that use of the PAC contributes to reduced morbidity and mortality in patients with sepsis. The role of the PAC is becoming less clear, as newer, non-invasive techniques are developed for hemodynamic assessment of sepsis patients. Large, well-designed clinical trials are needed to better assess the role and potential benefit from use of the PAC in sepsis

Pharmacokinetic changes and dosing modification of aminoglycosides in critically ill obese patients: A literature review

The objective of the paper is to review the literature and provide recommendations for use of aminoglycoside antibiotics in critically ill obese patients. Literature search in PubMed for all articles on the use of aminoglycosides in critically ill obese patients was conducted, and all articles related to pharmacokinetics in obesity were reviewed. Bibliographies of all searched manuscripts were also reviewed in an attempt to find additional references. Although aminoglycoside pharmacokinetics have been described in detail, data on aminoglycoside use and appropriate dose modification in critically ill obese patients are very limited. Knowledge on aminoglycoside pharmacokinetics and use in critically ill obese patients is incomplete. Pathophysiologic changes in obesity can result in sub- or supra-therapeutic aminoglycoside plasma concentrations, especially in the presence of sepsis. Rigorous clinical studies are needed to establish aminoglycoside dosing guidelines in critically ill obese patients with sepsis

Hypomagnesemia in critically ill sepsis patients

Magnesium (Mg), also known as “the forgotten electrolyte”, is the fourth most abundant cation overall and the second most abundant intracellular cation in the body. Mg deficiency has been implicated in the pathophysiology of many diseases. This article is a review of the literature regarding Mg abnormalities with emphasis on the implications of hypomagnesemia in critical illness and on treatment options for hypomagnesemia in critically ill patients with sepsis. Hypomagnesemia is common in critically ill patients, and there is strong, consistent clinical evidence, largely from observational studies, showing that hypomagnesemia is significantly associated with increased need for mechanical ventilation, prolonged ICU stay and increased mortality. Although the mechanism linking hypomagnesemia with poor clinical outcomes is not known, experimental data suggest mechanisms contributing to such outcomes. However, at the present time, there is no clear evidence that magnesium supplementation improves outcomes in critically ill patients with hypomagnesemia. Large, well-designed clinical trials are needed to evaluate the role of magnesium therapy for improving outcomes in critically ill patients with sepsis

Levosimendan in critical illness: A literature review

Levosimendan, the active enantiomer of simendan, is a calcium sensitizer developed for treatment of decompensated heart failure, exerts its effects independently of the beta adrenergic receptor and seems beneficial in cases of severe, intractable heart failure. Levosimendan is usually administered as 24-h infusion, with or without a loading dose, but dosing needs adjustment in patients with severe liver or renal dysfunction. Despite several promising reports, the role of levosimendan in critical illness has not been thoroughly evaluated. Available evidence suggests that levosimendan is a safe treatment option in critically ill patients and may reduce mortality from cardiac failure. However, data from well-designed randomized controlled trials in critically ill patients are needed to validate or refute these preliminary conclusions. This literature review is an attempt to synthesize available evidence on the role and possible benefits of levosimendan in critically ill patients with severe heart failure

Use of sodium bicarbonate in cardiac arrest: Current guidelines and literature review

The aim of the review was to summarize the literature over the last 25 years regarding bicarbonate administration in out-of-hospital cardiac arrest. A PubMed search was conducted using the terms “bicarbonates” and “cardiac arrest”, limited to human studies and reviews published in English (or at least with a meaningful abstract in English) in the last 25 years. Clinical and experimental data raised questions regarding the safety and effectiveness of sodium bicarbonate (SB) administration during cardiac arrest. Earlier advanced cardiac life support (ACLS) guidelines recommended routine bicarbonate administration as part of the ACLS algorithm, but recent guidelines no longer recommend its use. The debate in the literature is ongoing, but at the present time, SB administration is only recommended for cardiac arrest related to hypokalemia or overdose of tricyclic antidepressants. Several studies challenge the assumption that bicarbonate administration is beneficial for treatment of acidosis in cardiac arrest. At the present time, there is a trend against using bicarbonates in cardiac arrest, and this trend is supported by guidelines published by professional societies and organizations

Pulsed extraction of ionization from helium buffer gas

The migration of intense ionization created in helium buffer gas under the influence of applied electric fields is considered. First the chemical evolution of the ionization created by fast heavy-ion beams is described. Straight forward estimates of the lifetimes for charge exchange indicate a clear suppression of charge exchange during ion migration in low pressure helium. Then self-consistent calculations of the migration of the ions in the electric field of a gas-filled cell at the National Superconducting Cyclotron Laboratory (NSCL) using a Particle-In-Cell computer code are presented. The results of the calculations are compared to measurements of the extracted ion current caused by beam pulses injected into the NSCL gas cell.Comment: Accepted for pubilication in Nucl. Instrum. Meth. B, 14 pages, 8 figure

The effect of exposure to parodies of thin-ideal images on women’s body image, body shame and mood

This item is only available electronically.Social networking sites are abundant with thin-ideal beauty standards for women. As a result, some users are challenging these unrealistic ideals in creative, humorous ways. The aim of the present study was to experimentally investigate the effect of exposure to humorous, parody images on women’s body dissatisfaction, body shame and mood. Participants were 173 women aged between 18 and 61 years, who were randomly assigned to view either one of three sets of Instagram images: thin-ideal celebrity posts; humorous parody images of the celebrity post paired with the thin-ideal; or the humorous parody post alone. Results indicated that exposure to the parody images alone decreased body dissatisfaction, body shame and negative mood, relative to exposure of thin-ideal images alone. Moreover, exposure to the parody images alone resulted in less body dissatisfaction than exposure to parody images paired with the thin-ideal image. The findings were moderated by trait thin-ideal internalisation, whereby individuals with high thin-ideal internalisation experienced less body dissatisfaction after viewing parody images alone, compared to the paired parody and thinideal images. Overall, the findings contribute to existing literature by providing support for the use of humorous parody images for decreasing body dissatisfaction, body shame and negative mood in women.Thesis (M.Psych(Clinical)) -- University of Adelaide, School of Psychology, 202

Beam Tests of Ionization Chambers for the NuMI Neutrino Beam

We have conducted tests at the Fermilab Booster of ionization chambers to be used as monitors of the NuMI neutrino beamline. The chambers were exposed to proton fluxes of up to 10$^{12}$ particles/cm$^2$/1.56$\mu$s. We studied space charge effects which can reduce signal collection from the chambers at large charged particle beam intensities.Comment: submitted to IEEE Trans Nucl. Sc