No abstract available.

PURPOSE: This study was conducted to identify endotracheal colonization and the incidence of ventilator-associated pneumonia related to the type of endotracheal suction system. METHODS: The participants in this study were ICU patients hospitalized between October 2009 to March 2010 who used ventilators for over 48 hr with closed (CSS, n=30) or open (OSS, n=32) suction systems. To standardize the pre-intervention suction system, a suctioning protocol was taught to the ICU nurses. Collected data were analyzed using chi2-test, Fisher's exact test, Wilcoxon rank sums test, Wilcoxon test, Log-rank test and Poisson regression. RESULTS: Endotracheal colonization was higher in OSS than CSS from day 1 to day 8 while using a ventilator and there was a significant difference between the two groups. The CSS reached 50% of endotracheal colonization by the 4th day, whereas for the OSS, it was the 2nd day (p=.04). The incidence of ventilator-associated pneumonia showed no significant difference. CONCLUSION: For patients with a high risk of pneumonia, CSS must be used to lower endotracheal colonization.
Adult ; Aged ; Aged, 80 and over ; Female ; Gram-Negative Bacteria/isolation & purification ; Gram-Positive Bacteria/isolation & purification ; Humans ; Incidence ; Intensive Care Units ; Intubation, Intratracheal/instrumentation/*methods ; Male ; Middle Aged ; Pneumonia, Ventilator-Associated/*epidemiology ; Risk ; Severity of Illness Index ; Time Factors ; Ventilators, Mechanical/*microbiology

Carotid ultrasound is an imaging modality that allows non-invasive assessment of vascular anatomy and function. Carotid intima-media thickness (IMT) has been shown to predict cardiovascular (CV) risk in multiple large studies. However, in 2013, American College of Cardiology/American Heart Association guidelines designated that the carotid IMT as class III evidence level was not recommended for use in clinical practice as a routine measurement of risk assessment for a first atherosclerotic CV event. Following the announcement of this guideline, combined common carotid IMT and plaque, including plaque tissue characterization and plaque burden, using 3D ultrasound was reported to be better than either measurement alone in a variety of studies. Moreover, changes in the intima thickness were related to aging and early atherosclerosis, and remodeling of the media thickness was associated with hypertension. Separate measurement is useful for evaluating the effects of different atherosclerotic risk factors on the arterial wall; however, a more detailed and elaborate technique needs to be developed. If so, separate measurement will play an important role in the assessment of atherosclerosis and arterial wall change according to a variety of risk factors, such as metabolic syndrome. In addition, although carotid blood flow velocity is a useful tool for risk classification and prediction in clinical practice, further clinical research is needed. The value of carotid IMT by ultrasound examination for risk stratification remains controversial, and groups developing future guidelines should consider the roles of plaque presence and burden and hemodynamic parameters in additional risk stratification beyond carotid IMT in clinical practice.
Aging ; Atherosclerosis* ; Blood Flow Velocity ; Carotid Arteries* ; Carotid Artery Diseases ; Carotid Intima-Media Thickness ; Carotid Stenosis ; Classification ; Heart ; Hemodynamics ; Hypertension ; Methods* ; Risk Assessment ; Risk Factors ; Ultrasonography*

To obtain achievements in addressing the clinical challenges of brain metastasis, we need a clear understanding of its biological mechanisms. Brain metastasis research is challenged by many practical scientific barriers. Depending on the purpose of the study, experimental brain metastasis models in vivo can be used. It is now possible to re-create the architecture and physiology of human organs. Human organoids provide unique opportunities for the study of human disease and complement animal models. The translation of experimental findings to clinical application has several barriers in the development of treatment for brain metastasis. A variety of models have provided significant contributions to the knowledge of brain metastasis pathology and remain pivotal tools for examining novel therapeutic strategies.

Background/Aims: Motility disorders are prevalent, often leading to disrupted regional or whole gut transit times. In this study, we conducted a comparative analysis between the wireless motility capsule and an innovative gas-sensing capsule to evaluate regional and whole gut transit times in individuals with diagnosed motility disorders. Methods: We prospectively enrolled 48 patients (34 women) diagnosed with functional dyspepsia and/or functional constipation according to Rome IV criteria. Patients ingested the capsules in tandem. We assessed the agreement between transit times recorded by both devices using Spearman correlation and Bland-Altman analysis. Additionally, diagnostic concordance between the capsules were evaluated using confusion matrices. Results: We observed a significant correlation between the wireless motility capsule and the gas-sensing capsule for gastric emptying time (r = 0.79, P < 0.001) and colonic transit time (r = 0.66, P < 0.001). The gas-sensing capsule exhibited a sensitivity of 0.83, specificity of 0.96, and accuracy of 0.94 when using the standard cutoff for delayed gastric emptying (5 hours). Similarly, when applying the cutoff value for delayed colonic transit (> 59 hours), the gas-sensing capsule demonstrated a sensitivity of 0.79, specificity of 0.84, and accuracy of 0.82. Importantly, the gas-sensing capsule was well-tolerated, and no serious adverse events were reported during the study. Conclusions Our findings underscore the gas-sensing capsule’s suitability as a dependable tool for assessing regional and whole gut transit times.It represents a promising alternative to the wireless motility capsule for evaluating patients with suspected motility disorders.

Purpose: We evaluated a novel surgical technique for managing the intraocular lens (IOL) through in situ scleral fixation and its outcomes.Case summary: This retrospective case series included three eyes of three patients treated with the in situ scleral fixation technique for IOL. Our method involves suturing the haptics of an already intraocularly injected IOL in situ using a Siepser sliding knot suture, while the other haptic is tied externally. Notably, no intraoperative or postoperative complications, such as cystoid macula edema, were observed. Conclusions This novel technique is a user-friendly and effective approach to improve IOL-capsular bag stability, requiring minimal intraocular intervention or preoperative preparation compared to conventional IOL scleral fixation methods. Furthermore, it is particularly effective for addressing concerns related to IOL-capsular bag stability following IOL insertion, as it eliminates the possibility of performing the typical IOL scleral fixation due to the absence of preoperative preparation and evaluation.