Oral Presentations, Monday, 22 September 2009
Cristián RamírezI Bellido Este ́vezM De La Torre-PradosZengbin WangJ H PoulsenKirsten MøllerHenrik KehletAnders PernerLaurent PapazianJean-Marie ForelArnaud GacouinGilles PerrinSamir JaberJudith ArnalD PerezJean-Marie SeghboyanJM ConstantinPierre CourantA. RochAndreas LarentzakisHaridimos MarkogiannakisPanagiotis DrimousisAnna XanthakiMarina ToutouzaEvangelia SamaraNikoleta PachylakiEleni‐Maria TheodorakiD TheodorouKostas ToutouzasStylianos KatsaragakisTomasz MikułaW Stan ́czakJ CianciaraA Wiercin ́ska-Drapało
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INTRODUCTION.To determine the effectiveness of an educational program based on Surviving Sepsis Campaign guidelines to reduce sepsis mortality in several hospitals in Spain.METHODS.Eleven Spanish ICUs, in the South of Spain (Andalucia) were included in a prospective study.A multicentric study realised during 2005 and 2006.We determined the rate of compliance of the resuscitation bundle (first 6 h) and the management bundle (first 24 h) during 2 months before the educational program and 4 months after the educational program.RESULTS.Three hundred and thirty patients were enrolled in this analysis: severe sepsis (29.4%) or septic shock (70.6%) admitted in intensive care units.There were no significant differences between the groups with respect to base-line characteristics and severity of illness measured by the Acute Physiology and Chronic Health Evaluation II were similar for both groups.Patients characteristics were as follows: age, 62 (60, 63) years; APACHE II score, 21 (20, 22).The main sources of infection were: lung (36.1%), abdomen (28.1%) and UTI (11%).CVP and Svc02 monitoring, antibiotics, fluid resuscitation, mechanical ventilation, vasopressors, inotropes, corticosteroides, and rhAPC were included in the educational program.The patients in the after EP period had measured more Svc02 (36.2 vs. 15.5%),CVP (45.7 vs. 39.9%) and lactate (27.7 vs. 23.2%)All patients received broad-spectrum antibiotics, patient in the after group received more corticosteroids (35 vs. 25%), a lower lactate (3.8 vs. 5.19 mmol/l), blood culture (47.4 vs. 37.5%), were more likely to receive intravenous fluids of [20 ml/kg body weight before vasopressor administration (38 vs. 36%), patient in the after group were less likely to require vasopressor (43 vs. 47%).In the after EP period these patients had a shorter length of stay in intensive care (238 vs. 280 h, we reduced the length in 15.1%) and shorter hospital length of stay (688 vs. 719 h).Mortality in ICU pre-EP was 43.8% and after-EP was 31.6%.The percentage of compliance with 6-h and 24-h bundle in the after-EP increased, respectively (9.85%, P \ 0.01 and 8.86%), total compliance was also 46.62%. CONCLUSIONS.Our study found the implementation of a standardized order set for the management of septic shock was associated with an important decreased of the mortality (12.2%), improving early and accurate diagnosis and increasing the use of appropriate treatment and interventions.Keywords:
Pain medicine
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Genentech is partnering with the German cancer company Affimed to develop immunotherapies for multiple kinds of solid and blood cancers. Affimed is developing therapies that engage natural killer cells of the innate immune system to help direct them to attack cancer cells. Genentech will pay Affimed $96 million up front and up to $5 billion more in potential payments.
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Бұл зерттеужұмысындaКaно моделітурaлы жәнеоғaн қaтыстытолықмәліметберілгенжәнеуниверситетстуденттерінебaғыттaлғaн қолдaнбaлы (кейстік)зерттеужүргізілген.АхметЯссaуи университетініңстуденттеріүшін Кaно моделіқолдaнылғaн, олaрдың жоғaры білімберусaпaсынa қоятынмaңыздытaлaптaры, яғнисaпaлық қaжеттіліктері,олaрдың мaңыздылығытурaлы жәнесaпaлық қaжеттіліктерінеқaтыстыөз университетінқaлaй бaғaлaйтындығытурaлы сұрaқтaр қойылғaн. Осы зерттеудіңмaқсaты АхметЯсaуи университетіндетуризмменеджментіжәнеқaржы бaкaлaвриaт бaғдaрлaмaлaрыныңсaпaсынa қaтыстыстуденттердіңқaжеттіліктерінaнықтaу, студенттердіңқaнaғaттaну, қaнaғaттaнбaу дәрежелерінбелгілеу,білімберусaпaсын aнықтaу мен жетілдіружолдaрын тaлдaу болыптaбылaды. Осы мaқсaтқaжетуүшін, ең aлдыменКaно сaуaлнaмaсы түзіліп,116 студенткеқолдaнылдыжәнебілімберугежәнеоның сaпaсынa қaтыстыстуденттердіңтaлaптaры мен қaжеттіліктерітоптықжұмыстaрaрқылыaнықтaлды. Екіншіден,бұл aнықтaлғaн тaлaптaр мен қaжеттіліктерКaно бaғaлaу кестесіменжіктелді.Осылaйшa, сaпa тaлaптaры төрт сaнaтқa бөлінді:болуытиіс, бір өлшемді,тaртымдыжәнебейтaрaп.Соңындa,қaнaғaттaну мен қaнaғaттaнбaудың мәндеріесептелдіжәнестуденттердіңқaнaғaттaну мен қaнaғaттaнбaу деңгейлерінжоғaрылaту мен төмендетудеосытaлaптaр мен қaжеттіліктердіңрөліaйқын aнықтaлды.Түйінсөздер:сaпa, сaпaлық қaжеттіліктер,білімберусaпaсы, Кaно моделі.
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The nationally-recognized Susquehanna
Chorale will delight audiences of all
ages with a diverse mix of classic and
contemporary pieces. The ChoraleAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂA¢AÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂs
performances have been described
as AÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂA¢AÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂemotionally unfiltered, honest
music making, successful in their
aim to make the audience feel,
to be moved, to be part of the
performance - and all this while
working at an extremely high
musical level.AÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂA¢AÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂA Experience choral
singing that will take you to new
heights!
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