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Background : Electroconvulsive therapy (ECT) is a well-established treatment for various psychiatric disorders. This retrospective study evaluates anesthesia practices, patient characteristics, and outcomes in ECT over a two-year period at the "Dr. Gheorghe Preda" Clinical Psychiatry Hospital in Sibiu, Romania. Methods : From March 2022 to July 2024, the Neuroscience Scientific Research Collective at our institution carried out a retrospective observational study on patients who underwent ECT. The evaluation and treatment protocol involved patients from all over the country. Results: The study involved 30 patients aged between 22 and 67 years and a mean age of 39.4 years; among them, 57% were male. The majority of the patients (68%) lived in urban areas, and 80% came from a different county. Schizophrenia was the most prevalent diagnosis (56.6%), followed by depression (40%) and bipolar disorder (3.4%). Common comorbidities included obesity/overweight, high blood pressure, and sinus tachycardia. A total of 330 ECT sessions were conducted, with an average of 11 sessions per patient, and 10 patients underwent multiple treatment courses. The reported adverse events included arterial hypertension, agitation, tachycardia, and shivering. Conclusions : This study underlines the safety and effectiveness of ECT when patients are closely monitored. Our results are consistent with the global data, suggesting that ECT is a good treatment option for severe psychiatric conditions with a manageable incidence of adverse events.

Healthcare-associated infections, such as ventilator-associated pneumonia and biofilm formation on intubation cannulas, impose significant burdens on hospitals, affecting staffing, finances, and patient wellbeing, while also increasing the risk of patient mortality. We propose a research study aimed at exploring various methodologies for detecting these infections, discovered in the biofilm on medical devices, particularly tracheal cannulas, and understanding the role of each method in comprehending these infections from an etiological perspective. Our investigation also involves an analysis of the types of endotracheal tubes utilized in each case, the bacteria species identified, and strategies for combating biofilm-associated infections. The potential impact of our research is the substantial improvement of patient care through enhanced diagnosis and management of these infections.

Around the world, lung cancer is the leading cause of cancer-related death and the most commonly diagnosed cancer. In the early stages, surgery is the preferable therapeutic strategy. We present the case of a male patient aged 49 years diagnosed with non-small cell lung cancer of the left lower lobe who was referred for a radical left pneumonectomy. After careful preoperative preparation, the surgery was proceeded with. During the surgery, the patient needed bronchoscopy for the aspiration of the trachea and bronchial tree; after the aspiration procedure, an intraoperative massive hemorrhage started, with shock and ventricular tachycardia. Nine days after surgery, the patient developed a pulmonary embolism and returned to the ICU. The patient benefited from transfusion, intrathoracic cardiac compressions, pulse index continuous cardiac output (PiCCO), renal replacement therapy (RRT), anticoagulation, and intensive care. After a complicated clinical course, the patient is discharged, and after more than 18 months, the patient comes regularly for follow-up consultation in good health., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Vintila et al.)

The ESKAPE group ( Enterococcus faecium , Staphylococcus aureus , Klebsiella Pneumoniae , Acinetobacter baumannii , Pseudomonas aeruginosa , Enterobacter spp.) is a group of bacteria very difficult to treat due to their high ability to acquire resistance to antibiotics and are the main cause of nosocomial infections worldwide, posing a threat to global public health. Nosocomial infections with MDR bacteria are found mainly in Intensive Care Units, due to the multitude of maneuvers and invasive medical devices used, the prolonged antibiotic treatments, the serious general condition of these critical patients, and the prolonged duration of hospitalization., Materials and Methods: During a period of one year, from January 2023 to December 2023, this cross-sectional study was conducted on patients diagnosed with sepsis admitted to the Intensive Care Unit of the Sibiu County Emergency Clinical Hospital. Samples taken were tracheal aspirate, catheter tip, pharyngeal exudate, wound secretion, urine culture, blood culture, and peritoneal fluid., Results: The most common bacteria isolated from patients admitted to our Intensive Care Unit was Klebsiella pneumoniae , followed by Acinetobacter baumanii and Pseudomonas aeruginosa . Gram-positive cocci ( Enterococcus faecium and Staphilococcus aureus ) were rarely isolated. Most of the bacteria isolated were MDR bacteria., Conclusions: The rise of antibiotic and antimicrobial resistance among strains in the nosocomial environment and especially in Intensive Care Units raises serious concerns about limited treatment options.

The worldwide increase of multidrug-resistant Gram-negative bacteria is a global threat. The emergence and global spread of Klebsiella pneumoniae carbapenemase- (KPC-) producing Klebsiella pneumoniae represent a particular concern. This pathogen has increased resistance and abilities to persist in human reservoirs, in hospital environments, on medical devices, and to generate biofilms. Mortality related to this microorganism is high among immunosuppressed oncological patients and those with multiple hospitalizations and an extended stay in intensive care. There is a severe threat posed by the ability of biofilms to grow and resist antibiotics. Various nanotechnology-based strategies have been studied and developed to prevent and combat serious health problems caused by biofilm infections. The aim of this review was to evaluate the implications of nanotechnology in eradicating biofilms with KPC-producing Klebsiella pneumoniae , one of the bacteria most frequently associated with nosocomial infections in intensive care units, including in our department, and to highlight studies presenting the potential applicability of TiO 2 nanocomposite materials in hospital practice. We also described the frequency of the presence of bacterial biofilms on medical surfaces, devices, and equipment. TiO 2 nanocomposite coatings are one of the best long-term options for antimicrobial efficacy due to their biocompatibility, stability, corrosion resistance, and low cost; they find their applicability in hospital practice due to their critical antimicrobial role for surfaces and orthopedic and dental implants. The International Agency for Research on Cancer has recently classified titanium dioxide nanoparticles (TiO 2 NPs) as possibly carcinogenic. Currently, there is an interest in the ecological, non-toxic synthesis of TiO 2 nanoparticles via biological methods. Biogenic, non-toxic nanoparticles have remarkable properties due to their biocompatibility, stability, and size. Few studies have mentioned the use of nanoparticle-coated surfaces as antibiofilm agents. A literature review was performed to identify publications related to KPC-producing Klebsiella pneumoniae biofilms and antimicrobial TiO 2 photocatalytic nanocomposite coatings. There are few reviews on the antibacterial and antibiofilm applications of TiO 2 photocatalytic nanocomposite coatings. TiO 2 nanoparticles demonstrated marked antibiofilm activity, but being nano in size, these nanoparticles can penetrate cell membranes and may initiate cellular toxicity and genotoxicity. Biogenic TiO 2 nanoparticles obtained via green, ecological technology have less applicability but are actively investigated.

Sudden respiratory and circulatory collapse during or immediately after delivery, vaginal or surgical, can have many causes that can lead to poor maternal outcomes. A pregnancy-induced amniotic fluid embolism and anaphylaxis are two distinct medical conditions that appear similar clinically but have very different underlying mechanisms and treatment approaches. Amniotic fluid embolism is a rare but life-threatening obstetric emergency that leads to a systemic inflammatory response that can be easily confounded with an anaphylactic reaction. We report the case of a patient with no comorbidities or allergies before the current pregnancy that was proposed for delivery by C-Section under spinal anesthesia. After delivery of the placenta and administering the test dose of antibiotic, the patient developed sudden circulatory collapse, altered neurological status, and critical respiratory distress. At that point, the two presumed diagnoses were amniotic fluid embolism and anaphylaxis. Concurrently with the diagnostic pathway, supportive measures (intubation, mechanical ventilation, hemodynamic support) were taken. The clinical evolution was favorable, and after day three, the patient was discharged from the hospital. Our case highlights the significance of promptly distinguishing between anaphylaxis and amniotic fluid embolism to facilitate the timely management of the critical situation., Competing Interests: Conflict of interest The authors declare no conflict of interest., (© 2024 Ioana Roxana Codru et al., published by Sciendo.)

Ventilator-associated pneumonia is one of the most severe complications of critically ill patients that need mechanical respiratory support, as it poses a significant risk of prolonging hospitalization, disability, and even death. This is why physicians worldwide target newer methods for prevention, early diagnosis, and early target treatment for this condition. There are few methods for a quick etiological diagnosis of pneumonia, especially point of care, and most are only readily available in some intensive care units. This is why a new, simple, and cheap method is needed for determining the bacteria that might be infectious in a particular patient. The manner in question is sonication. Method: In this prospective, observational, single-center study, endotracheal cannula specimens will be collected from at least 100 patients in our intensive care unit. This specimen will be submitted to a specific sonication protocol for bacteria to dislodge the biofilm inside the cannula. The resulting liquid will be seeded on growth media, and then a comparison will be made between the germs in the biofilm and the ones in the tracheal secretion of the patient. The primary purpose is to determine the bacteria before the appearance of a manifest infection.