Publish in OALib Journal

ISSN: 2333-9721

APC: Only $99


Any time

2020 ( 2 )

2019 ( 281 )

2018 ( 408 )

2017 ( 390 )

Custom range...

Search Results: 1 - 10 of 339957 matches for " David J Dries "
All listed articles are free for downloading (OA Articles)
Page 1 /339957
Display every page Item
Re: Infection control in burn patients: are fungal infections underestimated?
David J Dries
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2009, DOI: 10.1186/1757-7241-17-56
Abstract: Dr. Struck [1] appropriately points out the importance of infecting agents apart from bacteria in the burn-injured patient. Burn patients are frequently cited as having the highest risk for invasive fungal infection as the burn wound provides an ideal portal for invasive infection while inducing immune dysfunction. Management of large burns exposes patients to risks identified in other patient groups including central venous lines, urinary catheters, prolonged mechanical ventilation and broad-spectrum antibiotics.Unfortunately, it is difficult to determine the true incidence and significance of fungal infections in the burn population. Contamination of urine, respiratory tract and skin by organisms such as Candida albicans is extremely common. Criteria for identifying true infection in the setting of burns remain unclear. Clinical findings, such as fever, may not be discriminatory to help identify invasive infection in burn patients. Specific definitions for burn/wound infection rely heavily on wound appearance; fungal infection, in contrast, is notoriously difficult to diagnose on clinical findings alone. At present, a wide variety of practices exist among major North American burn centers to address this problem.The American Burn Association recently published a review of burn patients with positive fungal cultures [2]. In all, positive cultures were seen in approximately 6% of 7,000 total admissions reviewed by reporting facilities. The incidence of positive fungal cultures varied widely, ranging from between 0.7% and 24% of patients treated at individual burn centers. There was no consistent pattern of treatment even if organisms were identified in the bloodstream. The majority of positive cultures came from the wound and respiratory tract (Figure 1).When logistic regression was employed to examine factors relating to mortality, age, burn size and inhalation injury showed positive correlation. A positive culture of mold or Aspergillus was also predictive of deat
Management of burn injuries – recent developments in resuscitation, infection control and outcomes research
David J Dries
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2009, DOI: 10.1186/1757-7241-17-14
Abstract: A selected review of recent reports published by the American Burn Association is provided.The burn-injured patient is easily and frequently over resuscitated with complications including delayed wound healing and respiratory compromise. A feedback protocol is designed to limit the occurrence of excessive resuscitation has been proposed but no new "gold standard" for resuscitation has replaced the Parkland formula. Significant additional work has been included in recent guidelines identifying specific infectious complications and criteria for these diagnoses in the burn-injured patient. While new medical therapies have been proposed for patients sustaining inhalation injury, a new standard of medical therapy has not emerged. Renal failure as a contributor to adverse outcome in burns has been reinforced by recent data generated in Scandinavia. Of special problems addressed in burn centers, soft tissue infections and Toxic Epidermal Necrolysis have been reviewed but new treatment strategies have not been identified. The value of burn centers in management of burns and other soft tissue problems is supported in several recent reports.Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury exists but new standards for description of burn-related infections have been presented. The value of the burn center in care of soft tissue problems including Toxic Epidermal Necrolysis and soft tissue infections is supported in recent papers.The burn-injured patient is unique in resuscitation requirements, metabolic stress, pattern of complications and determinants of outcome.[1] This review highlights a selected group of papers focused on those aspects of care which are unique to burn centers and the burn-injured patient and contribute in important ways to outcome.Contemporary discussion of burn resuscitation features the Parkland formula proposed by Baxter and coworkers in the 1960s.[2] Reviews of recen
The contemporary role of blood products and components used in trauma resuscitation
David J Dries
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2010, DOI: 10.1186/1757-7241-18-63
Abstract: An editorial review of recent reports published by investigators from the United States and Europe is presented. There is little prospective data in this area.Despite increasing sophistication of trauma care systems, hemorrhage remains the major cause of early death after injury. In patients receiving massive transfusion, defined as 10 or more units of packed red blood cells in the first 24 hours after injury, administration of plasma and platelets in a ratio equivalent to packed red blood cells is becoming more common. There is a clear possibility of time dependent enrollment bias. The early use of multiple types of blood products is stimulated by the recognition of coagulopathy after reinjury which may occur as many as 25% of patients. These patients typically have large-volume tissue injury and are acidotic. Despite early enthusiasm, the value of administration of recombinant factor VIIa is now in question. Another dilemma is monitoring of appropriate component administration to control coagulopathy.In patients requiring large volumes of blood products or displaying coagulopathy after injury, it appears that early and aggressive administration of blood component therapy may actually reduce the aggregate amount of blood required. If recombinant factor VIIa is given, it should be utilized in the fully resuscitated patient. Thrombelastography is seeing increased application for real-time assessment of coagulation changes after injury and directed replacement of components of the clotting mechanism.Hemorrhagic shock accounts for a significant number of deaths in patients arriving at hospital with acute injury[1,2]. Patients with uncontrolled hemorrhage continue to succumb despite adoption of damage control techniques and improved transport and emergency care. Coagulopathy, occurring even before resuscitation, contributes significantly to the morbidity associated with bleeding[3,4]. Recognition of the morbidity associated with bleeding and coagulation abnormality goes
Burn Resuscitation
Frederick W Endorf, David J Dries
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2011, DOI: 10.1186/1757-7241-19-69
Abstract: One of the most challenging aspects of caring for burned patients is the acute resuscitation. The profound inflammatory response generated by a burn far surpasses that seen in trauma or sepsis, and the resultant fluid needs can be extreme. There is a large and ever-increasing body of research devoted to refining strategies for acute burn resuscitation, and this article attempts to summarize some the most important recent findings in the field.After treating victims of the infamous Coconut Grove fire in 1942, Cope and Moore first postulated that burn resuscitation needs may have contributions from both the patient's body weight and the size of their burn [1]. Baxter and Shires later built on this knowledge, using canine and human data, to specifically measure fluid requirements by weight and total body surface area (%TBSA). Their formula of 3.5 to 4.5 ml of lactated Ringers per %TBSA per kilogram became known as the Parkland formula after the Dallas medical complex in which their experiments took place [2]. Although the Parkland formula is still the most commonly employed resuscitation formula worldwide, it is far from a perfect solution.Ongoing research focuses on refining existing formulas to prevent complications of over-resuscitation. This includes devising novel means for titrating resuscitation, such as nurse-driven or computer-driven protocols. The composition of the fluids used in resuscitation has generated significant interest, with a particular focus on colloids and hypertonic saline. Pharmaceutical therapies that attempt to down regulate the inflammatory response such as vitamin C may have a role in acute resuscitation. Likewise, investigators are proposing the use of adjuncts such as plasmapheresis to remove inflammatory mediators from the bloodstream during resuscitation. The final topic inviting significant scrutiny is outcomes of resuscitation, both choosing the most appropriate outcomes to use and how to best measure these outcomes in clinical practi
The effect of constraints on information loss and risk for clustering and modification based graph anonymization methods
David F. Nettleton,Vicenc Torra,Anton Dries
Computer Science , 2014,
Abstract: In this paper we present a novel approach for anonymizing Online Social Network graphs which can be used in conjunction with existing perturbation approaches such as clustering and modification. The main insight of this paper is that by imposing additional constraints on which nodes can be selected we can reduce the information loss with respect to key structural metrics, while maintaining an acceptable risk. We present and evaluate two constraints, 'local1' and 'local2' which select the most similar subgraphs within the same community while excluding some key structural nodes. To this end, we introduce a novel distance metric based on local subgraph characteristics and which is calibrated using an isomorphism matcher. Empirical testing is conducted with three real OSN datasets, six information loss measures, five adversary queries as risk measures, and different levels of k-anonymity. The results show that overall, the methods with constraints give the best results for information loss and risk of disclosure.
Collecting core data in severely injured patients using a consensus trauma template: an international multicentre study
Kjetil Ringdal, Hans Lossius, J Mary Jones, Jens M Lauritsen, Timothy J Coats, Cameron S Palmer, Rolf Lefering, Stefano Di Bartolomeo, David J Dries, Kjetil S?reide, The Utstein Trauma Data Collaborators
Critical Care , 2011, DOI: 10.1186/cc10485
Abstract: Trauma centres from three different continents were invited to submit Utstein Trauma Template core data during a defined period, for up to 50 consecutive trauma patients. Directly admitted patients with a New Injury Severity Score (NISS) equal to or above 16 were included. Main outcome variables were data completeness, data differences and data collection difficulty.Centres from Europe (n = 20), North America (n = 3) and Australia (n = 1) submitted data on 965 patients, of whom 783 were included. Median age was 41 years (interquartile range (IQR) 24 to 60), and 73.1% were male. Median NISS was 27 (IQR 20 to 38), and blunt trauma predominated (91.1%). Of the 36 Utstein variables, 13 (36%) were collected by all participating centres. Eleven (46%) centres applied definitions of the survival outcome variable that were different from those of the template. Seventeen (71%) centres used the recommended version of the Abbreviated Injury Scale (AIS). Three variables (age, gender and AIS) were documented in all patients. Completeness > 80% was achieved for 28 variables, and 20 variables were > 90% complete.The Utstein Template was feasible across international trauma centres for the majority of its data variables, with the exception of certain physiological and time variables. Major differences were found in the definition of survival and in AIS coding. The current results give a clear indication of the attainability of information and may serve as a stepping-stone towards creation of a European trauma registry.Major trauma is a leading cause of death and disability around the world [1], and it accounts for approximately 10% of the world's deaths. Globally, unintentional injuries are ranked as the sixth leading cause of death and the fifth leading cause of moderate and severe disability [2]. The introduction of regionalised trauma systems has the potential to reduce preventable deaths [3], but an improved understanding of the benefits and limitations of different trauma care
Singular values of products of random matrices and polynomial ensembles
Arno B. J. Kuijlaars,Dries Stivigny
Mathematics , 2014,
Abstract: Akemann, Ipsen, and Kieburg showed recently that the squared singular values of a product of M complex Ginibre matrices are distributed according to a determinantal point process. We introduce the notion of a polynomial ensemble and show how their result can be interpreted as a transformation of polynomial ensembles. We also show that the squared singular values of the product of M-1 complex Ginibre matrices with one truncated unitary matrix is a polynomial ensemble, and we derive a double integral representation for the correlation kernel associated with this ensemble. We use this to calculate the scaling limit at the hard edge, which turns out to be the same scaling limit as the one found by Kuijlaars and Zhang for the squared singular values of a product of M complex Ginibre matrices. Our final result is that these limiting kernels also appear as scaling limits for the biorthogonal ensembles of Borodin with parameter theta > 0, in case theta or 1/theta is an integer. This further supports the conjecture that these kernels have a universal character.
A vector equilibrium problem for the two-matrix model in the quartic/quadratic case
Maurice Duits,Dries Geudens,Arno B. J. Kuijlaars
Mathematics , 2010, DOI: 10.1088/0951-7715/24/3/012
Abstract: We consider the two sequences of biorthogonal polynomials (p_{k,n})_k and (q_{k,n})_k related to the Hermitian two-matrix model with potentials V(x) = x^2/2 and W(y) = y^4/4 + ty^2. From an asymptotic analysis of the coefficients in the recurrence relation satisfied by these polynomials, we obtain the limiting distribution of the zeros of the polynomials p_{n,n} as n tends to infinity. The limiting zero distribution is characterized as the first measure of the minimizer in a vector equilibrium problem involving three measures which for the case t=0 reduces to the vector equilibrium problem that was given recently by two of us. A novel feature is that for t < 0 an external field is active on the third measure which introduces a new type of critical behavior for a certain negative value of t. We also prove a general result about the interlacing of zeros of biorthogonal polynomials.
Singular value statistics of matrix products with truncated unitary matrices
Mario Kieburg,Arno B. J. Kuijlaars,Dries Stivigny
Mathematics , 2015,
Abstract: We prove that the squared singular values of a fixed matrix multiplied with a truncation of a Haar distributed unitary matrix are distributed by a polynomial ensemble. This result is applied to a multiplication of a truncated unitary matrix with a random matrix. We show that the structure of polynomial ensembles and of certain Pfaffian ensembles is preserved. Furthermore we derive the joint singular value density of a product of truncated unitary matrices and its corresponding correlation kernel which can be written as a double contour integral. This leads to hard edge scaling limits that also include new finite rank perturbations of the Meijer G-kernels found for products of complex Ginibre random matrices.
De partnerkeuze in modern Afrika
H. Dries
Afrika Focus , 1985,
Abstract: Partner choice in Africa was investigated in a modernization study. The research sample consisted of 275 adult males from the Zairean province of Shaba (university students, clerks, workmen and illiterate rurals). The sample was split up into two subgroups : the "moderns" and the "traditionals". Our main research instrument was a series of 14 pictures, inspired on the Thematic Apperception Technique. Traditionally, it was the father, or the family, who arranged marriage for the son. Modern young Africans more and more want to choose their partner on their own. This modern attitude leads to a number of conflict situations, because, on the one hand, Africans want to realise their partner choice by themselves, but on the other hand, they do not like to endanger their relationships with the family.
Page 1 /339957
Display every page Item

Copyright © 2008-2017 Open Access Library. All rights reserved.