Global Distribution of Infectious Diseases Requiring Intensive Care

Istúriz, Raúl; Torres, Jaime R.; Besso, Jose

doi:10.1016/j.ccc.2006.03.004

Cited by 13 publications

(4 citation statements)

References 70 publications

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“…The global importance of this disease is highlighted by estimates that leptospirosis causes severe complications for 1 million people annually. [5][6][7] Immunity to Leptospira in humans is mediated primarily by antibodies directed towards lipopolysaccharide. 8 This immunity is serovar specific and has led to a search for conserved cell surface proteins that might elicit cross-serovar immunity.…”

Section: Introductionmentioning

confidence: 99%

Crystal Structure of LipL32, the Most Abundant Surface Protein of Pathogenic Leptospira spp.

Vivian

Beddoe

McAlister

et al. 2009

Journal of Molecular Biology

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Section: Introductionmentioning

confidence: 99%

Crystal Structure of LipL32, the Most Abundant Surface Protein of Pathogenic Leptospira spp.

Vivian

Beddoe

McAlister

et al. 2009

Journal of Molecular Biology

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“…In the last decade, endemic and epidemic severe pulmonary hemorrhage has increasingly become recognized as an important manifestation of leptospirosis. The disease has a worldwide distribution but is more common in the tropics where conditions for its transmission are particularly favorable [2, 4]. In Brazil, the disease is endemic, with outbreaks during the rainy seasons, when flooding occurs [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Predictors of Oliguric Acute Kidney Injury in Leptospirosis

Daher

Silva²,

Karbage³

et al. 2009

Nephron Clin Pract

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Background: Acute kidney injury (AKI) occurs in 10 to 60% of patients with leptospirosis. The aim of this study is to investigate markers for oliguric AKI in leptospirosis. Methods: A retrospective study was performed with 196 consecutive patients with leptospirosis-associated AKI. These patients were categorized into either oliguric or non-oliguric according to their urine output. Clinical and laboratory characteristics were compared between the two groups. Results: Among these patients, 64 (32.6%) were oliguric and 132 (67.4%) nonoliguric. Markers for oliguria were age higher than 40 years (OR = 1.02, p = 0.04), hyponatremia (OR = 0.94, p = 0.03), elevated serum creatinine (OR = 1.11, p = 0.04), low arterial pH (OR = 1.0002, p = 0.01), high levels of AST (OR = 1.005, p = 0.01), crackles (OR = 3.83, p < 0.001) and direct bilirubin (OR = 1.03, p = 0.03). Elevated activated prothrombin time (OR = 0.97, p = 0.03) was a factor associated with nonoliguric AKI. Independent markers for oliguria were crackles (OR = 5.17, p = 0.0016) and direct bilirubin levels (OR = 1.051, p = 0.04). Mortality was significantly higher in oliguric than nonoliguric (27 vs. 8%, p < 0.001). Renal function at discharge was similar in oliguric and nonoliguric patients. Conclusion: Age higher than 40 years, hyponatremia, elevated serum creatinine, low arterial pH, high levels of AST, crackles and direct bilirubin levels would be useful to early identify patients with oliguric AKI in leptospirosis.

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“…Malaria leads to another 1.5 to 3.5 million deaths annually [ 21 ]. The global incidence of tetanus is approximately 1 million cases per year, with a case fatality rate that can approach 50% [ 22 ]. Tetanus is a particularly frustrating critical illness given that it can be prevented by a simple and safe series of childhood immunizations.…”

Section: Health and Critical Care In The Developing Worldmentioning

confidence: 99%

Clinical review: Critical care in the global context – disparities in burden of illness, access, and economics

2008

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World health care expenditures exceed US $4 trillion. However, there is marked variation in global health care spending, from upwards of US $7,000 per capita in the US to under US $25 per capita in most of sub-Saharan Africa. In developed countries, care of the critically ill comprises a large proportion of health care spending; however, in developing countries, with a greater burden of both illness and critical illness, there is little infrastructure to provide care for these patients. There is sparse research to inform the needs of critically ill patients, but often basic requirements such as trained personnel, medications, oxygen, diagnostic and therapeutic equipment, reliable power supply, and safe transportation are unavailable. Why should this be a focus of intensivists of the developed world? Nearly all of those dying in developing countries would be our patients without the accident of latitude. Tailored to the needs of the region, the provision of critical care has a role, even in the context of limited preventive and primary care. Internationally and locally driven solutions are needed. We can help by recognizing the '10/90 gap' that is pervasive within global health care and our profession by educating ourselves of needs, contacting and collaborating with colleagues in the developing world, and advocating that our professional societies and funding agencies consider an increasingly global perspective in education and research.

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Global Distribution of Infectious Diseases Requiring Intensive Care

Cited by 13 publications

References 70 publications

Crystal Structure of LipL32, the Most Abundant Surface Protein of Pathogenic Leptospira spp.

Crystal Structure of LipL32, the Most Abundant Surface Protein of Pathogenic Leptospira spp.

Predictors of Oliguric Acute Kidney Injury in Leptospirosis

Clinical review: Critical care in the global context – disparities in burden of illness, access, and economics

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