Continuing Education in Anaesthesia Critical Care & Pain最新文献_第5页

Fungal infections and critically ill adults 真菌感染和危重成人

Continuing Education in Anaesthesia Critical Care & Pain Pub Date : 2014-12-01 DOI: 10.1093/BJACEACCP/MKT067

M. Beed, R. Sherman, S. Holden

{"title":"Fungal infections and critically ill adults","authors":"M. Beed, R. Sherman, S. Holden","doi":"10.1093/BJACEACCP/MKT067","DOIUrl":"https://doi.org/10.1093/BJACEACCP/MKT067","url":null,"abstract":"Fungi are eukaryotes (i.e. having membranes that cover the nucleus and other intracellular organelles); this makes them structurally similar to animals and plants, but different from prokaryotes such as bacteria. Fungi have rigid cell walls containing chitin, chitosan, mannan, and glucan. Fungi also have cell membranes structurally different from that of animals as they contain ergosterol rather than cholesterol. The simplest subclassification of fungi responsible for human infections is as either moulds (e.g. Aspergillus species) or yeasts (e.g. Candida species). Under the microscope, yeasts are small rounded cells that can bud, while moulds demonstrate a stranded, filamentous appearance caused by hyphae. Some fungi can exist in both forms (these are said to be dimorphic, e.g. Blastomyces), and some yeasts can develop pseudo-hyphae (e.g. Candida species). When the hyphae of filamentous fungi develop a matted, intermeshed network, this is referred to as a mycelium. Fungi are slow-growing, with cell-doubling times often as long as days, which can affect the ability to identify clinically relevant infections. Reproduction may be sexual, asexual, or both; and may result in the production of ‘daughter cells’ or spores. Many fungi and spores are environmentally ubiquitous, for example, Aspergillus species are commonly found in soil, and their spores are prevalent in the atmosphere. Several fungi are common human flora (for example, Candida occur within the human gut) or are able to colonize structures such as the gut, oropharynx, or upper and lower airways. It can sometimes be difficult to tell whether or not a positive fungal culture is indicative of invasive disease or simply the result of the capture of normal flora.","PeriodicalId":100332,"journal":{"name":"Continuing Education in Anaesthesia Critical Care & Pain","volume":"385 1","pages":"262-267"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84973893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 10

Fungal infections and critically ill adults 真菌感染和危重成人

Continuing Education in Anaesthesia Critical Care & Pain Pub Date : 2014-12-01 DOI: 10.1093/bjaceaccp/mkt067

Martin Beed FRCA FFICM DM, Richard Sherman MRCP FRCA FFICM, Stephen Holden MSc FRCPath

引用次数: 10

Cancer pain management—Part I: General principles 癌症疼痛管理-第一部分:一般原则

Continuing Education in Anaesthesia Critical Care & Pain Pub Date : 2014-12-01 DOI: 10.1093/BJACEACCP/MKT070

J. Scott-Warren, A. Bhaskar

{"title":"Cancer pain management—Part I: General principles","authors":"J. Scott-Warren, A. Bhaskar","doi":"10.1093/BJACEACCP/MKT070","DOIUrl":"https://doi.org/10.1093/BJACEACCP/MKT070","url":null,"abstract":"In 2008, there were more than 2 million people in the UK with a present or past history of cancer, with the lifetime risk of developing the disease estimated at one in three (http://www. cancerresearchuk.org/cancer-info/cancerstats/). Breast cancer is the single most common form of cancer, followed by lung, prostate, and bowel. Over the last 10 yr, there has been an overall increase in incidence of 3%, with cancers strongly linked to lifestyle choices such as melanoma or oral cancers seeing the greatest increase. Fifty-three per cent of patients with cancer will experience pain, including 59% of those undergoing active treatment and increasing to 64% of patients with advanced or metastatic disease. Thirty-three per cent of those considered cured or in remission will have a chronic pain condition related to their cancer or treatment received. The three-step World Health Organization analgesic ladder (Fig. 1) was developed in 1986 to specifically address the worldwide problem of under, poorly treating cancer pain, or both. Designed in a format that can be implemented easily, with clinical and cost-effectiveness in mind, it is reported to be successful in 80–90% of patients (http://www.who.int/cancer/palliative/ painladder/en/), and emphasizes regular ‘by the clock’ administration of appropriate, effective oral analgesia. Methods of pain control in patients with cancer can be divided into pharmacological, oncological, surgical, interventional, physical therapy, psychotherapy, and complementary therapy. A holistic, multidisciplinary and multimodal approach is essential to optimize outcomes for patient benefit and this can be delivered only by established and effective communication between surgeons, oncologists, pain specialists, palliative care teams, primary care teams, and other allied healthcare professionals, thus ensuring that patients receive the best possible seamless and continuing care. Mechanisms of pain in cancer","PeriodicalId":100332,"journal":{"name":"Continuing Education in Anaesthesia Critical Care & Pain","volume":"38 1","pages":"278-284"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83973642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Management of haemorrhage in major trauma 重大创伤出血的处理

Continuing Education in Anaesthesia Critical Care & Pain Pub Date : 2014-12-01 DOI: 10.1093/BJACEACCP/MKT065

C. Gaunt, T. Woolley

引用次数: 10

Painful diabetic neuropathy 疼痛性糖尿病神经病变

Continuing Education in Anaesthesia Critical Care & Pain Pub Date : 2014-10-01 DOI: 10.1093/bjaceaccp/mkt063

Rajinikanth Sundara Rajan MD FRCA EDRA, Lorraine de Gray MD LLM (Medical Law) FRCA FFPMRCA, Emad George MD FRCP (UK) PG Cert Med Ed

引用次数: 6

Anaesthesia for children with liver disease 小儿肝病的麻醉

Continuing Education in Anaesthesia Critical Care & Pain Pub Date : 2014-10-01 DOI: 10.1093/bjaceaccp/mkt057

Peter Bromley MBBS FRCA, James Bennett MBBS FRCA

引用次数: 76

Pulmonary atelectasis in anaesthesia and critical care 肺不张在麻醉和重症监护中的应用

Continuing Education in Anaesthesia Critical Care & Pain Pub Date : 2014-10-01 DOI: 10.1093/bjaceaccp/mkt064

Komal Ray MBBS FRCA, Andrew Bodenham MBBS FRCA FICM, Elankumaran Paramasivam MBBS MRCP FICM

引用次数: 43

Multiple Choice Questions 选择题

Continuing Education in Anaesthesia Critical Care & Pain Pub Date : 2014-10-01 DOI: 10.1093/bjaceaccp/mku036

引用次数: 0

Coma 吃

Continuing Education in Anaesthesia Critical Care & Pain Pub Date : 2014-10-01 DOI: 10.1093/bjaceaccp/mkt061

Shilpa Patel MBBS FRCA, Nicholas Hirsch FRCA FRCP FFICM

引用次数: 0

Common viral illnesses in intensive care: presentation, diagnosis, and management 重症监护常见病毒性疾病:表现、诊断和管理

Continuing Education in Anaesthesia Critical Care & Pain Pub Date : 2014-10-01 DOI: 10.1093/bjaceaccp/mkt060

Craig Johnstone MBChB BSc FRCA, Alison Hall BSc MBChB FRCA FFICM MD, Ian J Hart BSc MBChB PhD FRCPath

{"title":"Common viral illnesses in intensive care: presentation, diagnosis, and management","authors":"Craig Johnstone MBChB BSc FRCA, Alison Hall BSc MBChB FRCA FFICM MD, Ian J Hart BSc MBChB PhD FRCPath","doi":"10.1093/bjaceaccp/mkt060","DOIUrl":"10.1093/bjaceaccp/mkt060","url":null,"abstract":"Early references to viral illnesses are found in ancient Egyptian texts with stone tablet depictions of patients suffering from poliomyelitis. Despite this, early experimentation into viral infections, led by Jenner, did not begin until 1798 with later contributions from Pasteur in the early 1880s. Viruses as a distinct biological entity, however, were not discovered until 1892 when Ivanovsky identified non-bacterial pathogens affecting tobacco plants. Subsequent work by Beijerink, Loeffler, and Frosch in 1898 distinguished the tobacco mosaic disease and footand-mouth disease agents from pathogenic bacteria and recorded their ‘obligate parasite’ nature. The first recorded human illness to be confirmed of viral origin was yellow fever in 1901, a discovery made by Reed et al. Since then, large numbers of viral pathogens have been identified. This review does not attempt to be exhaustive but deals with some of the more common viral illnesses that can necessitate ICU admission. Despite this, there remain notable exclusions including arboviruses (including those which cause viral haemorrhagic fever), zoonotic viruses (including rabies), and the hepatitis viruses, which could in themselves constitute a review article. In cases where rare viruses are the cause for ICU admission and where the patient is immunocompromised, early involvement from a medical virologist or medical microbiologist is required.","PeriodicalId":100332,"journal":{"name":"Continuing Education in Anaesthesia Critical Care & Pain","volume":"14 5","pages":"Pages 213-219"},"PeriodicalIF":0.0,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/bjaceaccp/mkt060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83333960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3