Integral Health

12/02/2025

Estamos en el mes del amor 💟 celebra San Valentín de forma segura y responsable

12/02/2025

Hablemos del Dengue

10/01/2025

Cytomegalovirus infection in immunocompromised patients: be aware!
🩺 pathophysiology of CMV infection
🧫 CMV infection and disease definitions
🔥 CMV reactivation in non-immunocompromised critically ill
🕯️ CMV in previously immunocompromised critically ill
⚠️ incidence & risk factors
🔬 (broad/variable) clinical presentations & diagnosis of CMV infection/disease: challenging to distinguish signs/symptoms!
🩺 treatment & prevention
CMV common among patients with overt immunosuppression and may lead to or develop during ICU admission. Asymptomatic reactivation does not always warrant treatment; viral load kinetics over time, clinical symptoms, potential for improving underlying immunosuppression must be considered.
Free to read on Intensive Care Medicine
🔓 https://rdcu.be/d5Sqt

29/12/2024

The provision of in critical care:
🔍 multi-centre survey of critical care units in UK & Crown Dependencies 🇬🇧, March - April 2024 led by TRIC Network and endorsed by Intensive Care Society Faculty of Intensive Care Medicine & British Society of Echocardiography
178 critical care units completed the survey;
🖥️ 96% had a clinician accredited in echocardiography
🖥️ 89% an approved trainer, teaching provided in 55%
🖥️ 62% an echocardiography lead, but only 44% of them had dedicated time for this role
🖥️ 16% of medical staff accredited in FOCUS & 4% in advanced
🖥️ only 15% units reported all-hours access to emergency , 42% described unreliable/no access
🖥️ regional echocardiographer-to-bed ratio: 0.48 to 0.14
Significant heterogeneity in echocardiography provision was observed, potentially due to varying access to training and reliable infrastructure
Free to read on Intensive Care Medicine
🔓 https://rdcu.be/d47LM

29/12/2024

Managing adults with in resource-limited settings:
🔍 international panel of experts reached stable consensus using Delphi process for 94% of the statements after 4 survey rounds
🩺 these statements complement existing guidelines where evidence is lacking and add relevant aspects that are not addressed, providing additional guidance for management of critically ill patient with sepsis while awaiting bed or safe transfer, and providing specific considerations related to infection seen in some resource-limited settings.
Free to read on Intensive Care Medicine
🔓 https://rdcu.be/d4XWB

07/10/2024

🫀 Refractory cardiac arrest?? Still a challenge for community, particularly refractory for the chain of survival. In past couple years, evidence has been generated about ... still, evidence remains controversial, though many centres adopted to be a state-of-the-art treatment & American Heart Association guidelines recognized ECPR as a valuable intervention in refractory CA.
Come to ECPR Prague School to discuss these issues: an amazing faculty will guide you through in cardiac arrest from A to Z.
🗺️ Prague
🗓️ Oct 24-26, 2024
🔗 ecprprague.com

24/09/2024

La Sociedad Peruana de Inmunología y el Centro de Referencia Nacional en Alergias, Asma e Inmunología del Instituto de Salud del Niño tienen el agrado de presentarles su primer Congreso de Bioterapias Inmunológicas.
EJES TEMÁTICOS
▸ Fundamentos del Sistema Inmune
▸ El Sistema Inmune en Autoinmunidad, Inmunología tumoral
▸ Biológicos en Alergología, en Dermatología, en Reumatología, en Oncología, en Gastroenterología
DIRIGIDO A:
Inmunólogos, Médicos Internistas,Pediatras, Médicos Generales, Reumatólogos, Alergólogos, Dermatólogos, Gastroenterólogos, Oncólogos.
Residentes y Estudiantes
INVERSIÓN (Hasta 16 Octubre)
Miembros SPI: S/. 290
Profesionales: S/. 390
Residentes: S/. 250
Estudiantes pre-grado: S/. 150

Infórmate aquí: http://congreso-bioterapias.gr8.com/

24/09/2024

https://www.kidney-international.org/action/showPdf?pii=S0085-2538%2816%2900289-1

23/09/2024

When should I start broad‑spectrum antibiotics?
⚖️ potential benefits of broad-spectrum ABTs
⚖️ negative impact of broad-spectrum ABTs
⏱️ role of rapid diagnostic tests
Early targeted therapy based on final culture & /or molecular results likely optimal approach to appropriately start. Critical elements in ABT choice: knowledge of guidelines, identification of common pathogens based on infection source, previous MDROs or prior ABT exposure, epidemiology of MDROs in country, hospital, . Individualize decision according to clinical severity & estimated cost-benefit ratio of each strategy. Advisable: using microbiological labs & rapid tests to reduce empirical use/promptly de-escalate + having multidisciplinary antibiotic stewardship team.
on Intensive Care Medicine
🖇️ https://bit.ly/4gxRzYd

22/09/2024

Acute brain injury in VA & :
🔍 ELSO - Extracorporeal Life Support Organization Registry analysis, 2009-2021: largest study/first sufficiently powered international predicting neurological complications through
🧠 36K adults receiving non ECPR VA : 7.7% experienced
🧠 11K patients receiving , 16.5% experienced
⏱️ longer run duration & higher 24-hour pump flow most important factors associated with acute brain injury
Overall performance of suboptimal, likely because of lack of data granularity:
👁️ 🖥️ standardized neurological monitoring & imaging protocols urgently needed, as more granular data collection across ELSO centers!
Open access
🔓 https://bit.ly/3BdVfyf

21/09/2024

Your weekly selection of from the ICM Journal:

🔹Central venous catheter-related infection: does insertion site still matter? A French multicentric cohort study 👉 https://rdcu.be/dUi1c
🔹Fludrocortisone dose–response relationship in septic shock: a randomised phase II trial 👉 https://rdcu.be/dUiYy
🔹Fluid responsiveness in acute respiratory distress syndrome patients: a post hoc analysis of the HEMOPRED study 👉 https://rdcu.be/dUiZW
🔹OPEN ACCESS ~ Long-term mortality and health-related quality of life with lower versus higher oxygenation targets in intensive care unit patients with COVID-19 and severe hypoxemia 👉 https://rdcu.be/dUiYA
🔹OPEN ACCESS ~ Pressure control plus spontaneous ventilation versus volume assist-control ventilation in acute respiratory distress syndrome. A randomised clinical trial 👉 https://rdcu.be/dUiOq
🔹Plasma exchange in septic shock: are we ready for prime time? CON 👉 https://rdcu.be/dUi0k
🔹Plasma exchange in septic shock: are we ready for prime time? PRO
👉 https://rdcu.be/dUi0j
🔹Less is best for oxygen therapy in adults in the intensive care unit with severe hypoxaemia due to COVID-19 👉 https://rdcu.be/dUi0Y
🔹OPEN ACCESS ~ Management of cardiogenic shock: state-of-the-art 👉 https://rdcu.be/dUiZV
🔹Complement system activation: bridging physiology, pathophysiology, and therapy 👉 https://rdcu.be/dUiZT
🔹Clinical vs. autopsy diagnostic discrepancies in the intensive care unit: a systematic review and meta-analysis of autopsy series 👉 https://rdcu.be/dUi1b
🔹Implementing palliative care in the intensive care unit: a systematic review and mapping of knowledge to the implementation research logic model 👉 https://rdcu.be/dUi0t
🔹OPEN ACCESS ~ From bytes to bedside: a systematic review on the use and readiness of artificial intelligence in the neonatal and pediatric intensive care unit 👉 https://rdcu.be/dUi0u
🔹Early endothelial injury in cardiogenic shock patients on venoarterial ECMO 👉 https://rdcu.be/dUi1k

21/09/2024