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Delirium is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or multiple causes, which usually develops over the course of hours to days. As a syndrome, delirium presents with disturbances in attention, awareness, and higher-order cognition. People with delirium may experience other neuropsychiatric disturbances, including changes in psychomotor activity, disrupted sleep-wake cycle, emotional disturbances, disturbances of consciousness, or, altered state of consciousness, as well as perceptual disturbances, although these features are not required for diagnosis.
Sepsis, also known as septicemia, septicaemia, or blood poisoning, is a potentially life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs.
Intensive care medicine, also called critical care medicine, is a medical specialty that deals with seriously or critically ill patients who have, are at risk of, or are recovering from conditions that may be life-threatening. It includes providing life support, invasive monitoring techniques, resuscitation, and end-of-life care. Doctors in this specialty are often called intensive care physicians, critical care physicians, or intensivists.
Septic shock is a potentially fatal medical condition that occurs when sepsis, which is organ injury or damage in response to infection, leads to dangerously low blood pressure and abnormalities in cellular metabolism. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defines septic shock as a subset of sepsis in which particularly profound circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone. Patients with septic shock can be clinically identified by requiring a vasopressor to maintain a mean arterial pressure of 65 mm Hg or greater and having serum lactate level greater than 2 mmol/L (>18 mg/dL) in the absence of hypovolemia. This combination is associated with hospital mortality rates greater than 40%.
Acute respiratory distress syndrome (ARDS) is a type of respiratory failure characterized by rapid onset of widespread inflammation in the lungs. Symptoms include shortness of breath (dyspnea), rapid breathing (tachypnea), and bluish skin coloration (cyanosis). For those who survive, a decreased quality of life is common.
Stress hyperglycemia is a medical term referring to transient elevation of the blood glucose due to the stress of illness. It usually resolves spontaneously, but must be distinguished from various forms of diabetes mellitus.
Ventilator-associated pneumonia (VAP) is a type of lung infection that occurs in people who are on mechanical ventilation breathing machines in hospitals. As such, VAP typically affects critically ill persons that are in an intensive care unit (ICU) and have been on a mechanical ventilator for at least 48 hours. VAP is a major source of increased illness and death. Persons with VAP have increased lengths of ICU hospitalization and have up to a 20–30% death rate. The diagnosis of VAP varies among hospitals and providers but usually requires a new infiltrate on chest x-ray plus two or more other factors. These factors include temperatures of >38 °C or <36 °C, a white blood cell count of >12 × 109/ml, purulent secretions from the airways in the lung, and/or reduction in gas exchange.
The sequential organ failure assessment score, previously known as the sepsis-related organ failure assessment score, is used to track a person's status during the stay in an intensive care unit (ICU) to determine the extent of a person's organ function or rate of failure. The score is based on six different scores, one each for the respiratory, cardiovascular, hepatic, coagulation, renal and neurological systems.
An intensive care unit (ICU), also known as an intensive therapy unit or intensive treatment unit (ITU) or critical care unit (CCU), is a special department of a hospital or health care facility that provides intensive care medicine.
The Surviving Sepsis Campaign (SSC) is a global initiative to bring together professional organizations in reducing mortality from sepsis. The purpose of the SSC is to create an international collaborative effort to improve the treatment of sepsis and reduce the high mortality rate associated with the condition. The Surviving Sepsis Campaign and the Institute for Healthcare Improvement have teamed up to achieve a 25 percent reduction in sepsis mortality by 2009. The guidelines were updated in 2016 and again in 2021.
Early goal-directed therapy was introduced by Emanuel P. Rivers in The New England Journal of Medicine in 2001 and is a technique used in critical care medicine involving intensive monitoring and aggressive management of perioperative hemodynamics in patients with a high risk of morbidity and mortality. In cardiac surgery, goal-directed therapy has proved effective when commenced after surgery. The combination of GDT and Point-of-Care Testing has demonstrated a marked decrease in mortality for patients undergoing congenital heart surgery. Furthermore, a reduction in morbidity and mortality has been associated with GDT techniques when used in conjunction with an electronic medical record.
The Society of Intensive Care Medicine (SICM) is the representative body for Intensive Care Medicine (ICM) professionals in Singapore.
Derek Calder Angus is an American-based, British medical scientist, whose work focuses on clinical, epidemiologic and translational studies of sepsis, pneumonia, multisystem organ failure and the organization and delivery of critical care services.
Paul Ellis Marik is a medical doctor and former professor of medicine who until his resignation in January 2022 served as chair of the Division of Pulmonary and Critical Care Medicine at Eastern Virginia Medical School in Norfolk, Virginia, and was also a critical care doctor at Sentara Norfolk General Hospital. His research interests include sepsis and tissue oxygenation. In August 2023 the American Board of Internal Medicine informed Marik his certification was to be revoked for spreading misinformation.
The COVID-19 pandemic in Italy is part of the ongoing pandemic of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2.
Allison Joan McGeer is a Canadian infectious disease specialist in the Sinai Health System, and a professor in the Department of Laboratory Medicine and Pathobiology at the University of Toronto. She also appointed at the Dalla Lana School of Public Health and a Senior Clinician Scientist at the Lunenfeld-Tanenbaum Research Institute, and is a partner of the National Collaborating Centre for Infectious Diseases. McGeer has led investigations into the severe acute respiratory syndrome outbreak in Toronto and worked alongside Donald Low. During the COVID-19 pandemic, McGeer has studied how SARS-CoV-2 survives in the air and has served on several provincial committees advising aspects of the Government of Ontario's pandemic response.
Proning or prone positioning is the placement of patients into a prone position so that they are lying on their front. This is used in the treatment of patients in intensive care with acute respiratory distress syndrome (ARDS). It has been especially tried and studied for patients on ventilators but, during the COVID-19 pandemic, it is being used for patients with oxygen masks and CPAP as an alternative to ventilation.
Although several medications have been approved in different countries as of April 2022, not all countries have these medications. Patients with mild to moderate symptoms who are in the risk groups can take nirmatrelvir/ritonavir or remdesivir, either of which reduces the risk of serious illness or hospitalization. In the US, the Biden Administration COVID-19 action plan includes the Test to Treat initiative, where people can go to a pharmacy, take a COVID test, and immediately receive free Paxlovid if they test positive.
The International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) is an international research initiative based in Oxford, England. It is hosted at the Nuffield Department of Medicine within the University of Oxford and led by the Epidemic diseases Research Group Oxford (ERGO). ISARIC is funded by the Bill & Melinda Gates Foundation, Foreign, Commonwealth and Development Office, and Wellcome Trust.
References
- 1 2 "Mattarella ha insignito dell'onorificenza di Cavaliere al Merito della Repubblica Italiana cittadini distintisi nel servizio alla comunità durante l'emergenza del coronavirus" [Mattarella has awarded the honor of Knight of the Order of Merit of the Italian Republic to citizens who distinguished themselves in the service to the community during the coronavirus emergency] (in Italian). Rome, Italy: Italian Presidency. June 3, 2020. Archived from the original on June 20, 2020.
- 1 2 3 4 5 6 "Dr Maurizio Cecconi".
- 1 2 3 4 5 6 7 8 "Il cervello friulano che lascia Londra e fa ritorno in Italia". Messaggero Veneto. September 1, 2018.
- ↑ "Maurizio Cecconi – Directed Systems".
- ↑ "Maurizio Cecconi, Humanitas: la tecnologia rafforzerà il rapporto medico-paziente". Wired Italia.
- 1 2 3 "Cittadinanza onoraria di Gonars a Maurizio Cecconi, medico in prima linea per il Covid: "Solo coi vaccini batteremo il virus"". Messaggero Veneto. June 11, 2021.
- ↑ "Thirty minutes with Maurizio Cecconi" – via www.youtube.com.
- ↑ "Global Clinical Scholars Research Training - Faculty". postgraduateeducation.hms.harvard.edu.
- 1 2 Rankin, Jennifer (June 5, 2020). "Lockdown may return if there is second wave, says Italy medical chief" – via The Guardian.
- 1 2 "Humanitas di Rozzano, il nuovo volto dell'anestesia". Il Giorno. August 19, 2018.
- ↑ "Lombardy ICU capacity stressed to breaking point by COVID-19 outbreak". www.mdedge.com.
- ↑ "Coronavirus: Maurizio Cecconi, il medico simbolo italiano - Video Tgcom24". April 25, 2020 – via www.tgcom24.mediaset.it.
- ↑ TG24, Sky (November 18, 2020). "Covid, Cecconi: "Ci sono anche molti giovani in terapia intensiva"". tg24.sky.it.
- ↑ "Coronavirus, un italiano tra i tre eroi della pandemia: ecco chi è Maurizio Cecconi". www.leggo.it. April 26, 2020.
- ↑ Paterlini, Marta (2021-03-02). "Covid-19: Maurizio Cecconi—one year since Italy's darkest moment". The BMJ . doi: 10.1136/bmj.n525 .
- ↑ "President elect, Professor Maurizio Cecconi, in conversation with JAMA Q&A". The European Society of Intensive Care Medicine.
- ↑ "Oggi è un altro giorno 2020/21 - Maurizio Cecconi: un eroe al tempo della pandemia - 20/10/2020 - Video". RaiPlay.
- ↑ "Il primario di Rozzano, "eroe della pandemia"". la Repubblica. April 24, 2020.
- ↑ M, Gabriele (October 20, 2020). "Maurizio Cecconi, chi è il medico eroe dell'emergenza Coronavirus". ViaggiNews.com.
- ↑ "Covid-19 Jama premia l'Italia: riconoscimento al Prof. Cecconi". May 5, 2020.
- ↑ Cecconi *, Maurizio (August 12, 2022). "L'Europa dopo la pandemia". Corriere della Sera.
- ↑ "Seuraava pandemia on jo täällä". Lapin Kansa.
- ↑ Jarmala, Veikko (June 30, 2023). "Sirpa Pietikäinen: Lääkevastustuskyky luo pandemiauhan".
