The future of intensive care: the study of the microcirculation will help to guide our therapies.

The goal of hemodynamic resuscitation is to optimize the microcirculation of organs to meet their oxygen and metabolic needs. Clinicians are currently blind to what is happening in the microcirculation of organs, which prevents them from achieving an additional degree of individualization of the hemodynamic resuscitation at tissue level. Indeed, clinicians never know whether optimization of the microcirculation and tissue oxygenation is actually achieved after macrovascular hemodynamic optimization. The challenge for the future is to have noninvasive, easy-to-use equipment that allows reliable assessment and immediate quantitative analysis of the microcirculation at the bedside. There are different methods for assessing the microcirculation at the bedside; all have strengths and challenges. The use of automated analysis and the future possibility of introducing artificial intelligence into analysis software could eliminate observer bias and provide guidance on microvascular-targeted treatment options. In addition, to gain caregiver confidence and support for the need to monitor the microcirculation, it is necessary to demonstrate that incorporating microcirculation analysis into the reasoning guiding hemodynamic resuscitation prevents organ dysfunction and improves the outcome of critically ill patients.

An overview of the dietary supplements in Turkey and the world

In recent years, especially during the COVID-19 pandemic, the idea that individuals should strengthen their immune system and meet the lack of nutrients has increased the orientation to dietary supplements (DS). The production and consumption of these products is increasing all over the world, as the use of DS has become a trend in society and successful marketing strategies through some sales channels. DSs are products with a specific daily intake which supplement nutritional elements that cannot be met with daily nutrition. DSs are mostly used to strengthen the immune system and to stay physically and mentally fit in the challenging working conditions of daily life. The most commonly used types of DSs, which do not cause any health problems when consumed consciously, are single preparations of minerals or vitamins and/or their complex forms. In this study, DSs, whose recognition, consumption and product portfolio increase day by day are examined.

Dietary supplements used to prevent COVID-19 disease and their effects on health

Novel Coronavirus Disease (COVID-19) is a serious infectious disease transmitted from person to person through the respiratory route. This disease, which has become a pandemic all over the world, has become an important public health problem. Adequate and balanced nutrition is known as a preventive method in reducing the spread of the virus. In order to increase the immune system with the formation of this awareness in individuals, in addition to adequate and balanced nutrition during the pandemic period, it is seen that the use of dietary supplements (DS) has increased significantly.

C-reactive protein to albumin ratio is associated with increased risk of mortality in COVID-19 pneumonia patients

Purpose: The aim of this retrospective observational study is to compare C-reactive protein to albumin ratio and CURB-65 score in the emergency department in terms of predicting mortality in patients over the age of 18 who were hospitalized for COVID-19 pneumonia. Materials and Methods: The study includes 613 patients hospitalized between March 15 and April 30, 2020 due to COVID-19 pneumonia detected on thorax computed tomography at the emergency department pandemic area. Hospitalized patients were divided into groups according to positive and negative real-time polymerase chain reaction results. Results: While 73.1% (n: 448) of 613 patients included in the study were hospitalized in the ward, 26.9% (n: 165) were hospitalized in intensive care. 8.6% (n: 53) of the total patients died. In non-survivors patients the mean CURB 65 score was 4 +/- 1 (and C-Reactive Protein to Albumin Ratio was 5.6 +/- 4.2 Multivariate logistic regression analysis showed that CURB 65 and high C-Reactive Protein to Albumin Ratio are independent risk factors for COVID19 pneumonia. Conclusion: The C-reactive protein to albumin ratio is as sensitive as CURB 65 and can guide the clinician in the early detection of patients with poor prognosis COVID19 pneumonia.