BackgroundMiddle East respiratory syndrome coronavirus infection is associated with high mortality rates but limited clinical data have been reported. We describe the clinical features and outcomes of patients admitted to an intensive care unit (ICU) with Middle East respiratory syndrome coronavirus (MERS-CoV) infection.MethodsRetrospective analysis of data from all adult (>18 years old) patients admitted to our 20-bed mixed ICU with Middle East respiratory syndrome coronavirus infection between October 1, 2012 and May 31, 2014. Diagnosis was confirmed in all patients using real-time reverse transcription polymerase chain reaction on respiratory samples.ResultsDuring the observation period, 31 patients were admitted with MERS-CoV infection (mean age 59 ± 20 years, 22 [71 %] males). Cough and tachypnea were reported in all patients; 22 (77.4 %) patients had bilateral pulmonary infiltrates. Invasive mechanical ventilation was applied in 27 (87.1 %) and vasopressor therapy in 25 (80.6 %) patients during the intensive care unit stay. Twenty-three (74.2 %) patients died in the ICU. Nonsurvivors were older, had greater APACHE II and SOFA scores on admission, and were more likely to have received invasive mechanical ventilation and vasopressor therapy. After adjustment for the severity of illness and the degree of organ dysfunction, the need for vasopressors was an independent risk factor for death in the ICU (odds ratio = 18.33, 95 % confidence interval: 1.11–302.1, P = 0.04).ConclusionsMERS-CoV infection requiring admission to the ICU is associated with high morbidity and mortality. The need for vasopressor therapy is the main risk factor for death in these patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-016-1303-8) contains supplementary material, which is available to authorized users.

Background Chronic mesenteric ischaemia (CMI) and median arcuate ligament syndrome (MALS) have similar clinical presentations with surgical intervention as the mainstay of treatment. However, surgical response varies and is unpredictable. Therefore, we aim to evaluate the technical and clinical success rates of selective revascularisation in older patients with CMI and younger patients with MALS undergoing arcuate ligament decompression with celiac sympathectomy. Methods We conducted a retrospective single-centre longitudinal comparative study of all the patients who underwent surgery for symptoms of CMI and MALS from December 2002 to 2020 at our tertiary referral vascular centre. Our primary outcome was symptom-free survival post-intervention. The secondary outcomes were perioperative mortality, technical success, and all-cause mortality at 17 years. Results We operated on 28 patients; 17 patients with CMI (revascularisations with bypass) and 11 with MALS (decompression and celiac sympathectomy). All (100%) patients had technical success. There was no perioperative mortality. All the MALS patients had symptom-free survival following the procedure throughout follow-up. In contrast, three patients with CMI complained of recurring abdominal pain even after one year of the surgery. However, there was no further weight loss and none of them required any intervention. Conclusion Stratified management of CMI with revascularisation and open surgical decompression with celiac sympathectomy in MALS are effective treatments with favourable long-term outcomes.

The effect of an organic super gel commercially called Jalma (containing 24% humic acids, and 3.8% polysaccharides) at rates of 0.0, 0.4, 0.8, and 1.6% on aggregation index (AI) and relative swelling index (RSI) of loamy sand, sandy loam, and clay loam soils was studied. Furthermore, the influence of these rates and two irrigation intervals, 7 and 14 d, on intermittent evaporation from surface‐treated soil columns were also investigated. Twenty‐two or 44‐mm of water were applied every 7 or 14 d, respectively. The soil columns were placed in a walk‐in controlled growth chamber with potential evaporation of 8.2 mm/d. Addition of 0.4% Jalma significantly increased AI of the three soils by 33 to 38%. Increase of the Jalma rate to 0.8% significantly improved the AI of the fine‐textured sample but not the coarse‐textured samples. Further increase to 1.6% had no significant effect on the AI of the three samples. The lowest rate of Jalma significantly increased RSI of the three samples. The results also indicated a sharp, significant increase in RSI with increase in Jalma rate to 1.6%. In general, Jalma treatment significantly reduced cumulative evaporation and hence increased the amount of water conserved (AWC) after the first wetting/drying cycle. After four evaporation cycles, on 0.4% treated loamy sand, sandy loam, and clay loam soils, the AWC values were, respectively, 4.3, 3.2, and 1.5 times that of the untreated soils. The AWC values for untreated loamy sand, sandy loam, and clay loam soils irrigated every 14 d were, respectively, 2.6, 1.7, and 1.6 times those irrigated weekly.

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