Severe cytomegalovirus infections in immunocompetent patients at admission as dengue mimic: Successful treatment with intravenous ganciclovir

Cytomegalovirus (CMV) infection is associated with adverse clinical outcomes in immunosuppressed persons. The incidence and association of CMV reactivation with adverse clinical outcomes in critically ill persons lacking evidence of immunosuppression at ICU admission has received great attention in the practice of critical care medicine. Critically ill patients in ICU who had associated risk factors such as mechanical ventilation, severe sepsis, or blood transfusion are more prone to CMV activation, which in turn led to increased mortality and morbidity in terms of increased ICU stay, longer duration of mechanical ventilation, and higher rates of nosocomial infections. However, severe CMV as initial presentation mimicking dengue infection is rare. We recently came across seven cases with positive CMV serology at ICU admission, which we discuss in the light of current literature.     

Psychometric properties of two physical activity questionnaires, the AQuAA and the PASE, in cancer patients

Background  

This study aimed to evaluate the reliability and validity of two self-report physical activity (PA) questionnaires - the AQuAA (Activity Questionnaire for Adults and Adolescents) and PASE (Physical Activity Scale for the Elderly) - in cancer patients.     

慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停患者的随访结果

背景和目的:COPD合并阻塞性睡眠呼吸暂停(OSA)的患者,较单独患有其中1种疾病的患者更容易罹患肺动脉高压.本研究旨在评价COPD合并OSA患者的病死率及因COPD急性加重而首次住院的关系,以及持续气道正压通气(CPAP)对患者主要临床结局的影响.     

Spontaneous hypothermia on intensive care unit admission is a predictor of unfavorable neurological outcome in patients after resuscitation: an observational cohort study

Introduction  

A large number of patients resuscitated for primary cardiac arrest arrive in the intensive care unit (ICU) with a body temperature < 35.0°C. The aim of this observational cohort study was to determine the association between ICU admission temperature and neurological outcome in this patient group.     

An international survey of EEG use in the neonatal intensive care unit

Objective: To examine the extent of EEG monitoring in neonatal intensive care units (NICUs), and to survey the level of experience and training of those using it. Study design: A web‐based survey, the link to which was circulated via e‐mail, personal contact, specialist societies and professional groups. Survey data were exported to SPSS for analysis. Results: In total 210 surveys were analysed; 124 from Europe, 54 from the US. Ninety percent of respondents had access to either EEG or aEEG monitoring; 51% had both. EEG was mainly interpreted by neurophysiologists (72%) whereas aEEG was usually interpreted by neonatologists (80%). Only 9% of respondents reported that they felt ‘very confident’ in their ability to interpret aEEG/EEG with 31% reporting that they were ‘not confident’. Half had received no formal training in EEG. Conclusion: Both aEEG and conventional EEG were used extensively in the NICUs surveyed for this study. Most of the survey respondents were not confident in their ability to interpret EEGs despite the fact that they used monitoring routinely. There is an urgent need for a structured and appropriately targeted training programme in EEG methodologies and EEG interpretation for neonatal intensive care unit staff.     

An abnormal screening ultrasound: concordance with a tertiary obstetrical ultrasound unit

Objective: To determine concordance of ultrasound diagnosis in referrals to a tertiary obstetrical ultrasound unit (TOU) for suspected abnormalities.

Study design: Consecutive referrals for ‘abnormal outside ultrasound’ during a 6-month period were compared with the TOU ultrasound diagnosis. Concordance of diagnosis was compared on the basis of organ system involved and referral for single or multiple suspected abnormalities. χ² analysis was used; p?<?0.05 was considered significant.

Results: Of 104 consecutive referrals reviewed, 42 (40.4%) had no abnormality documented at the TOU. Of the 62 abnormal ultrasound scans at the TOU, 78.3% were concordant. Concordance based on organ system involvement was central nervous system, 30.3%; cardiothoracic, 66.7%; gastrointestinal, 63.6%; genitourinary, 50%. Referrals for a single suspected anomaly were statistically no more likely to have a normal TOU ultrasound scan (40.4%) than those referred for multiple suspected anomalies (36.4%, p?>?0.05).

Conclusions: Most referrals to a tertiary center for ‘abnormal outside ultrasound’ will be diagnosed with an abnormality.