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Treatment of ventilator-associated pneumonia with high-dose colistin under continuous veno-venous hemofiltration

favorable clinical and microbiological response, died after 67 and 101 days in the ICU. All surviving patients had normal or recovered baseline renal function at hospital discharge. Discussion The highest achievable steady-state plasma COL concentration should be pursued in MDR-GNB VAP. As the MIC usually is unknown at the initiation of treatment, a steady-state plasma COL concentration of 2 mg/L seems to be a reasonable target. [ 12 ] For years, 9 MIU COL daily was prescribed for the treatment of systemic MDR-GNB infections in adult patients. However, the first

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Sympathectomized tumor-bearing mice survive longer but develop bigger melanomas


Objectives. Previously we have shown that 20 days after the tumor cells injection smaller melanomas have been developed in chemically sympathectomized mice in comparison with animals having intact sympathetic nervous system. However, it is known that chemical sympathectomy reduces the sympathetic neurotransmission only temporarily. In the present study, we monitored the survival of the sympathectomized mice with melanoma with an attempt to find out how long the suppressing effect of sympathectomy on the melanoma growth may endure.

Methods. The chemical sympathectomy was performed by intraperitoneal injection of neurotoxin 6-hydroxydopamine in male C57BL/6J mice. Seven days later, the animals were injected subcutaneously with B16-F10 melanoma cells. Then, melanoma development, survival of the tumor-bearing mice and weight of the developed tumor mass were analyzed.

Results. Sympathectomy delayed the development of the palpable tumors (18th day vs.14th day) and significantly prolonged the survival of the tumor-bearing mice (median 34 days vs. 29 days). However, the weight of the developed melanoma was significantly increased in the sympathectomized mice in comparison with the animals having intact sympathetic nervous system.

Conclusions. The data of the present study showed that effect of the chemical sympathectomy, performed before the tumor growth induction, persisted even at the time when sympathetic nerves started to regenerate that resulted in a prolonged survival of the mice with melanoma. However, comparing to our previous study, in which we have shown a reduced tumor mass in earlier stages of the tumor growth, specifically 20 days after melanoma cells injection, now we indicate that in later stages of the melanoma progression, the tumor mass was significantly increased in sympathectomized animals. These contra-intuitive findings may indicate that interventions affecting the sympathetic nervous system may exert complex effect on the tumor progression. Based on these data we may suggest that the potential therapeutic interventions affecting the sympathetic signaling in the tumor tissue and its microenvironment should attenuate the sympathetic neurotransmission not only temporarily but till the complete regression of the tumor tissue.

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Clinical outcomes in patients with cancer of unknown primary site treated by gastrointestinal oncologists

of lesion sites, the administered chemotherapy regimens, survival times, and outcomes in the 16 patients with adenocarcinoma who belonged to the unfavorable prognostic subset and received chemotherapy. Gastrointestinal oncologists selected the chemotherapy regimens on the basis of their clinical experience. Seven (44%) of the 16 patients survived for 21 months or longer, and 3 patients who received 3 or more regimens survived for 46 months or longer. Table 2 Clinical courses in 16 patients with adenocarcinoma who belonged to the unfavorable prognostic

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Clinical conundrums in management of sepsis in the elderly

bundle. Am J Respir Crit Care Med 2013;188:77-82. 40. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med 2013;41:580-637. 41. Chronopoulos A, Cruz DN, Ronco C. Hospital-acquired acute kidney injury in the elderly. Nat Rev Nephrol 2010;6:141-9. 42. Shah PR, Gireesh MS, Kute VB, Vanikar AV, Gumber MR, Patel HV, et al. Renal involvement in sepsis: a prospective single-center study of

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Steroids in critically ill-patients with septic shock and acute respiratory distress syndrome: A limited review of current knowledge

depend on dose and severity of illness: An updated meta-analysis. Clin Microbiol Infect 2009;15:308-18. 10. Sligl WI, Milner DA Jr, Sundar S, Mphatswe W, Majumdar SR. Safety and efficacy of corticosteroids for the treatment of septic shock: A systematic review and meta-analysis. Clin Infect Dis 2009;49:93-101. 11. Casserly B, Gerlach H, Phillips GS, Lemeshow S, Marshall JC, Osborn TM, et al. Low-dose steroids in adult septic shock: Results of the Surviving Sepsis Campaign. Intensive Care Med 2012;38:1946-54. 12. Dellinger

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Prediction of survival following percutaneous biliary drainage for malignant biliary obstruction

bilirubin level, presence of ascites, presence of plural effusion, and liver metastasis. We compared the median total serum bilirubin level before and after PTBD. We classified the patients according to their survival into two groups: patients who survived less than 30 days (group 1) and patients who survived more than 30 days (group 2). We compared the difference in total serum bilirubin level before and after PTBD in both groups. This study was carried in compliance with the Declaration of Helsinki and was approved by the Institutional Review Board at King Hussein

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Quinoa Beverages: Formulation, Processing and Potential Health Benefits

-012-0021-4 14. Koksoy A, Kilic M . Use of hydrocolloids in textural stabilization of a yoghurt drink, ayran. Food Hydroc 18: 593–600, 2004. Accessed at: 15. Walsh H, Cheng J, Guo M . Effects of carbonation on probiotic survivability, physicochemical, and sensory properties of milk-based symbiotic beverages. J Food Sci 79: M604-613, 2014. 16. Ranilla LG, Kwon YI, Genovese MI, Lajolo FM, Shetty K. Antidiabetes and antihypertension potential of commonly consumed carbohydrate sweeteners using in

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Post-intensive care syndrome: An overview

Introduction The advancement in the critical care medicine and consequently, the improvement in survival after a critical illness have led the clinicians to discover the significant functional disabilities that many of these surviving patients suffer. This has led to further research which is focused on improving the long-term outcomes for the critical illness survivors and their functional recovery. Post-intensive care syndrome (PICS) describes the disability that remains in the surviving the critical illness. This comprises of impairment in cognition

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Inhibition of cyst growth in PCK and Wpk rat models of polycystic kidney disease with low doses of peroxisome proliferator-activated receptor γ agonists

to the NIH Guide for the Care and Use of Laboratory Animals. The animal protocols were designed to minimize pain or discomfort to the animals. Methods Both rosiglitazone (Avandia®) and pioglitazone (Actos®) were purchased in tablet form. PCK rats were fed rosiglitazone as part of their chow starting at weaning (4 weeks of age). Treatment groups were fed Purina no. 5002 LabDiet (control diet) supplemented with rosiglitazone calculated to provide the stated doses. Wpk -/- rats with cystic disease do not survive past weaning and, therefore, the pioglitazone

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H1N1 influenza induced acute respiratory distress syndrome rescued by extracorporeal membrane oxygenation: A case report

is not a treatment modality; it actually prevents the lung from further injury by decreasing the incidence of ventilator-induced lung injury due to mechanical ventilation with high PEEP and prevents multi-organ failure due to hypoxemia and high vasopressor requirement.[ 5 , 6 ] Thus, ECMO support provides time for the lungs to recover from the potentially reversible cause such as pneumonia. In the presented case, the patient may not have survived with the persistent hypoxia, hypercarbia, and increasing vasopressor requirement despite high optimum ventilatory

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