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  • Letter to the Editor

    Death by community-based methicillin-resistant Staphylococcus aureus: case report

    Crit Care Sci. 2023;35(4):416-420

    Abstract

    Letter to the Editor

    Death by community-based methicillin-resistant Staphylococcus aureus: case report

    Crit Care Sci. 2023;35(4):416-420

    DOI 10.5935/2965-2774.20230078-pt

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    INTRODUCTIONCommunity methicillin-resistant Staphylococcus aureus (CA-MRSA) has by definition a minimum inhibitory concentration for oxacillin ≥ 4mcg/mL, giving it intrinsic resistance to all beta-lactams, including cephalosporins, which is associated with the presence of the mecA gene. It also has bacteriological and epidemiological characteristics distinct from hospital-acquired MRSA, including its resistance profile to other antimicrobials, its genotypic […]
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    Death by community-based methicillin-resistant Staphylococcus
						aureus: case report
  • Case Reports

    Accidental strangulation in children by the automatic closing of a car window

    Rev Bras Ter Intensiva. 2018;30(1):112-115

    Abstract

    Case Reports

    Accidental strangulation in children by the automatic closing of a car window

    Rev Bras Ter Intensiva. 2018;30(1):112-115

    DOI 10.5935/0103-507X.20180017

    Views1

    ABSTRACT

    Among the main causes of death in our country are car accidents, drowning and accidental burns. Strangulation is a potentially fatal injury and an important cause of homicide and suicide among adults and adolescents. In children, its occurrence is usually accidental. However, in recent years, several cases of accidental strangulation in children around the world have been reported. A 2-year-old male patient was strangled in a car window. The patient was admitted to the pediatric intensive care unit with a Glasgow Coma Scale score of 8 and presented with progressive worsening of respiratory dysfunction and torpor. The patient also presented acute respiratory distress syndrome, acute pulmonary edema and shock. He was managed with protective mechanical ventilation, vasoactive drugs and antibiotic therapy. He was discharged from the intensive care unit without neurological or pulmonary sequelae. After 12 days of hospitalization, he was discharged from the hospital, and his state was very good. The incidence of automobile window strangulation is rare but of high morbidity and mortality due to the resulting choking mechanism. Fortunately, newer cars have devices that stop the automatic closing of the windows if resistance is encountered. However, considering the severity of complications strangulated patients experience, the intensive neuro-ventilatory and hemodynamic management of the pathologies involved is important to reduce morbidity and mortality, as is the need to implement new campaigns for the education of parents and caregivers of children, aiming to avoid easily preventable accidents and to optimize safety mechanisms in cars with electric windows.

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    Accidental strangulation in children by the automatic closing of a car window
  • Original Articles

    Evaluation of intensivists’ knowledge on brain death

    Rev Bras Ter Intensiva. 2008;20(2):144-148

    Abstract

    Original Articles

    Evaluation of intensivists’ knowledge on brain death

    Rev Bras Ter Intensiva. 2008;20(2):144-148

    DOI 10.1590/S0103-507X2008000200005

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    BACKGROUND AND OBJECTIVES: Failure or delay to diagnose brain death leads to needless occupation of a hospital bed, emotional and financial losses, and unavailability of organs for transplants. The intensive care physician plays an essential role in this diagnosis. This study intended to evaluate intensivists’ knowledge concerning brain death. METHODS: Cross-sectional study in 15 intensive care units (ICU) in eight hospitals in the city of Porto Alegre, Brazil. RESULTS: Two hundred forty-six intensivists were interviewed in a consecutive sample between April and December 2005. The prevalence of lack of knowledge regarding the concept was of 17%. Twenty per cent of the interviewees ignored the legal need for complementary confirmatory tests for their diagnosis. Forty-seven per cent considered themselves as having the highest level of assurance to explain the concept to a patient’s family members. Twenty-nine per cent erroneously determined the legal time of death for brain dead patients. Pediatric intensivists had less knowledge about the concept, when compared to intensivists for adults (p < 0.001). CONCLUSIONS: Current knowledge of brain death is insufficient in Brazil, among the health care professionals who most often find patients in this situation. Education on the subject is needed to avoid unnecessary expenses, reduce family suffering and increase the offer of organs for transplant.

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