Aim:The present study was carried out to examine this hypothesis that administration of selenium can prevent the development of injuries by brain trauma and thus can modulate patients’ functional recovery and also improve posttraumatic outcome.Materials and Methods:This double-blinded controlled trial was carried out on 113 patients who were hospitalized following traumatic brain injury (TBI) with Glasgow Coma Scale score of 4–12 that were randomly assigned to receive selenium within 8 h after injury plus standard treatment group or routine standard treatment alone as the control. The primary endpoint was to assess patients’ functional recovery at 2 months after the injury based on extended Glasgow Outcome Scale score (GOS-E). Secondary outcomes included the changes in Full Outline of Unresponsiveness score (FOUR) score, Sequential Organ Failure Assessment (SOFA) score, and acute physiology and chronic health evaluation (APACHE) III score, side effects of selenium, length of Intensive Care Unit (ICU) stay, and length of hospital stay.Results:There was no difference in the length of ICU and hospital stay, the trend of the change in FOUR and SOFA scores within 15 days of first interventions, and the mean APACHE III score on the 1st and 15th days between the two groups. Mortality was 15.8% in selenium group and 19.6% in control group with no between-group difference. No difference was revealed between the two groups in appropriate outcome according to GOS-E score at 60 ± 10 days and also 30 ± 5 days according to the severity of TBI.Conclusion:This human trial study could not demonstrate beneficial effects of intravenous infusion of selenium in the improvement of outcomes in patients with acute TBI.

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Background and Aims:The aim of this study was to evaluate the preventive effects of high-fat enteral feeding on glycemic control and clinical outcomes in critically ill patients: a randomized clinical trial.Materials and Methods:This study was done on 42 normoglycemic patients admitted to Intensive Care Unit (ICU). Patients were randomly classified into three groups of 14 each. Control group (A) received carbohydrate-based diet (protein: 20%, fat: 30%, and carbohydrate: 50%), study groups received two types of high-fat diet; Group B (protein: 20%, fat: 45% including half of olive oil and half sunflower oil, and carbohydrate: 35%); and Group C (protein: 20%, fat: 45% including sunflower oil, and carbohydrate: 35%) in the first 48 h of admission.Results:Basal characteristics of participants were the same. After the feeding trial, there was no difference between the groups in mean plasma and capillary glucose levels and insulin requirements. Serum high density lipoprotein (HDL)-cholesterol level was increased significantly in Group B on day 10 compared to admission level (40.75 ± 5.58 vs. 43.56 ± 2.25, P = 0.05). We did not find any difference in organ failure involvement and mortality rate between groups. The number of ICU free days was significantly more in Group B compared to the control group (P = 0.04).Conclusion:High-fat diets have no preventive effect on stress hyperglycemia. High monounsaturated fat diet may increase serum HDL-cholesterol level and decrease the length of stay in ICU.

This study pertains to a six-channel acoustic monitoring system for use in patient monitoring during or after surgery. The base hardware consists of a USB data acquisition system, a custom-built six-channel amplification system, and a series of microphones of various designs. The software is based on the MATLAB platform with data acquisition drivers installed. The displayed information includes: time domain signals, frequency domain signals, and tools to aid in the detection of endobronchial intubation. We hypothesize that the above mentioned arrangement may be helpful to the anesthesiologist in recognizing clinical conditions like wheezing, bronchospasm, endobronchial intubation, and apnea. The study also evaluated various types of microphone designs used to transduce breath sounds. The system also features selectable band-pass filtering using MATLAB algorithms as well as a collection of recordings obtained with the system to establish what respiratory acoustic signals look like under various conditions.

Energy protein malnutrition is a significant cause of immune system deficiency and increased vulnerability to infection.

The need for simple and reliable means of respiratory monitoring has existed since the beginnings of medicine. In the present study, we describe the use of color spectrographic analysis of breathing sounds recorded from the external ear canal as a candidate technology to meet this need. A miniature electret microphone was modified with the addition of an adapter to allow it to be placed comfortably in the external ear canal. The amplified signal was then connected to a real-time color spectrogram program running on a laptop personal computer utilizing the Windows operating system. Based on the results obtained, we hypothesize that the real-time display of color spectrogram breathing patterns locally or at a central monitoring station may turn out to be a useful means of respiratory monitoring in patients at increased risk of respiratory depression or other respiratory problems. Finally, we conducted a statistical analysis that suggests that significant spectrogram differences may exist among some groups investigated in the study.

Background: Increased levels of alanine transaminase (ALT) and alkaline phosphatase in the liver are associated with an increased risk of mortality in hospitalized patients. This study aimed to survey the relationship between changes in liver enzymes and mortality of patients admitted to a surgical intensive care unit (ICU). Methods: This cross sectional study was based on the electronic and clinical records of patients, hospitalized in the ICU of Rasool Akram hospital from 2012 to 2015. The information of 199 alive and 140 deceased patients was studied. The laboratory parameters, clinical information, acute physiology and chronic health evaluation (APACHE-II) scores, and sequential organ failure assessment (SOFA) scores were determined upon admission, and length of ICU stay was measured. Results: There was a significant difference in the aspartate aminotransferase (AST) level upon admission in alive and deceased groups (42.01 ± 46.65 and 58.54 ± 80.95 mg/dL, respectively) (P < 0.05). However, there was no significant difference in the level of AST at discharge between the groups (39.05 ± 36.69 and 67.95 ± 21.7mg/dL, respectively) (P > 0.05). There was a significant difference in the level of ALT upon admission between the groups (34.21 ± 58.13 and 41.32 ± 66.77 mg/dL, respectively) (P > 0.05). However, there was no significant difference in ALT level at discharge between the groups (38.44 ± 48.69 and 42.94 ± 76.47 mg/dL, respectively) (P > 0.05). Based on the multivariate logistic regression model, the predictive factors for mortality included use of inotropes, alkaline phosphatase, and reduced platelet count, potassium level, and heart rate. Conclusions: Measurement of serum liver enzymes has inadequate predictive value for mortality in ICU patients.