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  1. Article ; Online: Challenges in providing critical care for patients with anti-N-methyl-D-aspartate receptor encephalitis.

    Howard, Christopher M / Kass, Joseph S / Bandi, Venkata D P / Guntupalli, Kalpalatha K

    Chest

    2014  Volume 145, Issue 5, Page(s) 1143–1147

    Abstract: Anti-N-methyl-d-aspartate receptor encephalitis (NMDARE) is characterized by a constellation of psychiatric, neurologic, autonomic, and cardiopulmonary manifestations. Although patients typically recover with appropriate treatment, they commonly require ... ...

    Abstract Anti-N-methyl-d-aspartate receptor encephalitis (NMDARE) is characterized by a constellation of psychiatric, neurologic, autonomic, and cardiopulmonary manifestations. Although patients typically recover with appropriate treatment, they commonly require weeks to months of inpatient care, including prolonged stays in critical care units. This case series not only advocates for consideration of the disease in the appropriate context but also specifically highlights the distinct challenges intensivists encounter caring for patients with NMDARE. With a greater knowledge of the nuances and sequelae of NMDARE, critical care specialists will be better equipped to anticipate and manage the potentially life-threatening complications of the disease.
    MeSH term(s) Anti-N-Methyl-D-Aspartate Receptor Encephalitis/diagnosis ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis/therapy ; Cerebrospinal Fluid/chemistry ; Cognitive Therapy/methods ; Critical Care/standards ; Critical Care/trends ; Dose-Response Relationship, Drug ; Female ; Glucocorticoids/administration & dosage ; Humans ; Immunoglobulins, Intravenous/administration & dosage ; Immunologic Factors/administration & dosage ; Injections, Intravenous ; Plasma Exchange/methods ; Receptors, N-Methyl-D-Aspartate/immunology ; Receptors, N-Methyl-D-Aspartate/metabolism ; Respiration, Artificial/methods ; Young Adult
    Chemical Substances Glucocorticoids ; Immunoglobulins, Intravenous ; Immunologic Factors ; Receptors, N-Methyl-D-Aspartate
    Language English
    Publishing date 2014-05
    Publishing country United States
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1378/chest.13-1490
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Critically ill obstetric patients in an American and an Indian public hospital: comparison of case-mix, organ dysfunction, intensive care requirements, and outcomes.

    Munnur, Uma / Karnad, Dilip R / Bandi, Venkata D P / Lapsia, Vijay / Suresh, Maya S / Ramshesh, Priya / Gardner, Michael A / Longmire, Stephen / Guntupalli, Kalpalatha K

    Intensive care medicine

    2005  Volume 31, Issue 8, Page(s) 1087–1094

    Abstract: Objective: To compare case-mix, health care practices, and outcome in obstetric ICU admissions in inner-city teaching hospitals in economically developed and developing countries.: Design: Retrospective study.: Setting: Ben Taub General Hospital ( ... ...

    Abstract Objective: To compare case-mix, health care practices, and outcome in obstetric ICU admissions in inner-city teaching hospitals in economically developed and developing countries.
    Design: Retrospective study.
    Setting: Ben Taub General Hospital (BTGH), Houston, Texas, and King Edward Memorial Hospital (KEMH), Mumbai, India.
    Patients: Women admitted during pregnancy or 6 weeks postpartum between 1992 and 2001.
    Measurements and results: Patients from BTGH (n=174) and KEMH (n=754) had comparable age, number of organs affected, incidence of medical disorders (30%), liver dysfunction, and thrombocytopenia. Fewer KEMH patients received prenatal care (27 vs 86%) and came to hospital within 24 h of onset of symptoms (60 vs 90%). They had higher APACHE II scores (median 16 vs 10), greater incidence of neurological (63 vs 36%), renal (50 vs 37%), and cardiovascular dysfunction (39 vs 29%). Severe malaria, viral hepatitis, cerebral venous thrombosis, and poisoning were common medical disorders. The BTGH group had higher incidence of respiratory dysfunction (59 vs 46%) and disseminated intravascular coagulation (40 vs 23%), placental anomalies, HELLP syndrome, chorioamnionitis, peripartum cardiomyopathy, puerperal sepsis, urinary infection, bacteremia, substance abuse, and asthma. More BTGH patients required mechanical ventilation and blood component therapy, whereas more KEMH patients needed dialysis. Of BTGH patients, 78.2% were delivered by cesarean section (vs 15.4%). Maternal (2.3 vs 25%) and fetal (13 vs 51%) mortality were lower in BTGH patients.
    Conclusions: There were marked differences in medical diseases, organ failure, and intensive care needs. Higher mortality in the Indian ICU may be due to difference in case mix, inadequate prenatal care, delay in reaching hospital, and greater severity of illness.
    MeSH term(s) Adult ; Critical Care/economics ; Critical Illness ; Female ; Gestational Age ; Hospitals, Public ; Humans ; India ; Intensive Care Units ; Multiple Organ Failure/etiology ; Multiple Organ Failure/therapy ; Pregnancy ; Pregnancy Complications/classification ; Pregnancy Complications/diagnosis ; Pregnancy Complications/therapy ; Retrospective Studies ; Thrombocytopenia/etiology ; Thrombocytopenia/therapy ; Treatment Outcome ; United States
    Keywords covid19
    Language English
    Publishing date 2005-07-13
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0342-4642 ; 0340-0964 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0342-4642 ; 0340-0964 ; 0935-1701
    DOI 10.1007/s00134-005-2710-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    ab Jg. 2022: Lesesaal (EG)

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