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Topic Review
Zinc Functions
Zinc is a structural component of proteins, functions as a catalytic co-factor in DNA synthesis and transcription of hundreds of enzymes, and has a regulatory role in protein–DNA interactions of zinc-finger proteins.
  • 106
  • 15 Nov 2023
Topic Review
Ventilation-Perfusion Mismatch in the Acute Respiratory Distress Syndrome
Acute respiratory distress syndrome (ARDS) is a heterogenous condition that is characterized by the development of inflammatory pulmonary edema and life-threatening hypoxemia, and it accounts for nearly 25% of patients who require mechanical ventilation. Acute respiratory distress syndrome (ARDS) remains an important clinical challenge with a mortality rate of 35–45%. It is being increasingly demonstrated that the improvement of outcomes requires a tailored, individualized approach to therapy, guided by a detailed understanding of each patient’s pathophysiology. In patients with ARDS, disturbances in the physiological matching of alveolar ventilation (V) and pulmonary perfusion (Q) (V/Q mismatch) are a hallmark derangement. The perfusion of collapsed or consolidated lung units gives rise to intrapulmonary shunting and arterial hypoxemia, whereas the ventilation of non-perfused lung zones increases physiological dead-space, which potentially necessitates increased ventilation to avoid hypercapnia.
  • 694
  • 12 Jan 2023
Topic Review
Vasopressin in Sepsis and Other Shock States
Septic shock is defined by the need for vasopressors to correct hypotension and lactic acidosis secondary to infection, with a high mortality rate. The Surviving Sepsis Campaign guidelines recommend vasopressin as a second-line vasopressor, added to norepinephrine. 
  • 230
  • 07 Nov 2023
Topic Review
Treatment Advances in Sepsis and Septic Shock
Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection, and it affects over 25 million people every year. Even more severe, septic shock is a subset of sepsis defined by persistent hypotension, and hospital mortality rates are higher than 40%. As new pathophysiological mechanisms have been uncovered, immunostimulatory therapy has emerged as a promising path forward. Highly investigated treatment strategies include cytokines and growth factors, immune checkpoint inhibitors, and even cellular therapies.
  • 264
  • 04 May 2023
Topic Review
Toxic Epidermal Necrolysis
Toxic Epidermal Necrolysis is a rare dermatological condition with high mortality and serious consequences on its survivors. Despite having been first described in 1956, its pathophysiology remains uncertain, mainly regarding its mechanisms, although it seems that certain apoptosis pathways are pivotal in starting keratinocytes’ apoptosis and in activating T cells, especially those mediated by tumour necrosis factor, Fas-FasL and granulysin. In general, its aetiology and presentation are consensual, being defined as a generalized necrolysis of the epidermis that occurs as an uncontrolled immune response to a specific drug or one of its metabolites, highlighting cotrimoxazole and allopurinol as the most important. This necrolysis leads to a massive shedding of the epidermal layer of the skin, with stronger incidences in the torso, upper limbs and face. Its complications tend to be severe, noting that septic ones are responsible for over half of the disease’s mortality. Nearly all survivors develop long-term sequelae, namely hypertrophic scarring and skin pigmentation anomalies.
  • 355
  • 18 Aug 2022
Topic Review
Toll-like Receptors and Eicosanoids in Sepsis
Sepsis is the leading cause of death from infection. Its incidence is on the rise. Sepsis is characterized by life-threatening organ dysfunction caused by a dysregulated host response to infection, and it can occur after major surgery and injury. TLRs (toll-like receptors) regulate free radical generation, macrophage and leukocyte function, and modulate eicosanoid synthesis, and thus have a critical role in inflammation, immune response, and development and/or recovery from sepsis.
  • 105
  • 12 Sep 2023
Topic Review
Thyroid Storm Complicated with Myocardial Involvement and Shock
Thyroid storm (TS) is a rare and fatal endocrine emergency that occurs due to undiagnosed and inadequately treated hyperthyroidism after stressful conditions in patients with thyroid disorders. The myocardial involvement in terms of injury, dysrhythmia, cardiomyopathy, failure, and cardiogenic shock (CS) during TS and the modalities of treatment and their efficiency, including pharmacological, mechanical, and surgical options are explored.
  • 122
  • 27 Sep 2023
Topic Review
Therapeutic Plasma Exchange in the ICU
Therapeutic plasma exchange (TPE) is a treatment paradigm used to remove harmful molecules from the body. In short, it is a technique that employs a process that functions partially outside the body and involves the replacement of the patient’s plasma. It has been used in the ICU for a number of different disease states, for some as a first-line treatment modality and for others as a type of salvage therapy. 
  • 113
  • 09 Jan 2024
Topic Review
Therapeutic Drug Monitoring of Beta-Lactam Antibiotics
Here describes various aspects of beta-lactams use in the critical care, focusing on clinical antibiotic stewardship in the ICU. Pharmacokinetics / pharmacodynamics (PK/PD) characteristics of beta-lactams are described and main factors of PK/PD variability in critically ill patients. Toxicity of beta-lactams, a frequently overlooked issue, is outlined. Analytical methods used in therapeutic drug monitoring (TDM) of beta-lactams are discussed. The evidence supporting antibiotic guidance based on therapeutic drug monitoring (TDM) in critically ill patients is analysed.
  • 232
  • 19 Jun 2023
Topic Review
Telemedicine in Providing Palliative Care to Cancer Patients
Telemedicine, or the use of telecommunications to provide health services, is a technology that has been long studied to help increase access to health care.
  • 322
  • 16 May 2022
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