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https://www.readbyqxmd.com/read/28810889/dehydroepiandrosterone-sulfate-and-dehydroepiandrosterone-sulfate-cortisol-ratio-in-cirrhotic-patients-with-septic-shock-another-sign-of-hepatoadrenal-syndrome
#1
Ming-Hung Tsai, Hui-Chun Huang, Yun-Shing Peng, Yung-Chang Chen, Ya-Chung Tian, Chih-Wei Yang, Jau-Min Lien, Ji-Tseng Fang, Cheng-Shyong Wu, Sen-Yung Hsieh, Fa-Yauh Lee
BACKGROUND: Cirrhotic patients are susceptible to sepsis and critical illness-related corticosteroid insufficiency (CIRCI). Dehydroepiandrosterone sulfate (DHEAS) is a corticotropin-dependent adrenal androgen, which has immunostimulating and antiglucocorticoid effects. Considering the synchronized synthesis of cortisol and DHEAS and their opposing effects to each other, investigators have proposed measuring these two hormones as a ratio. Severe sepsis has been associated with low DHEAS, especially relative to high cortisol...
August 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28809612/a-retrospective-study-evaluating-the-efficacy-of-identification-and-management-of-sepsis-at-a-district-level-hospital-internal-medicine-department-in-the-western-cape-province-south-africa-in-comparison-with-the-guidelines-stipulated-in-the-2012-survivi
#2
Raisa Bhikoo, Sarah Versfeld, M M De V Basson, Almero H Oosthuizen
BACKGROUND: Currently there is little information on the identification, management and outcomes of patients with sepsis in developing countries. Simple cost-effective measures such as accurate identification of patients with sepsis and early antibiotic administration are achievable targets, within reach without having to make use of unsustainable protocols constructed in developed countries. OBJECTIVES: To assess the ability of clinicians at a district-level hospital to identify and manage sepsis, and to assess patient outcome in terms of in-hospital mortality and length of hospital stay given the above management...
July 28, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28809515/a-biosignature-predicting-complicated-course-in-children-presenting-with-septic-shock-why-persevere
#3
Adrienne G Randolph
No abstract text is available yet for this article.
August 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28808927/lymphopaenia-in-cardiac-arrest-patients
#4
Paola Villois, David Grimaldi, Savino Spadaro, Claudia Righy Shinotsuka, Vito Fontana, Sabino Scolletta, Federico Franchi, Jean-Louis Vincent, Jacques Creteur, Fabio Silvio Taccone
BACKGROUND: A decrease in circulating lymphocytes has been described as a marker of poor prognosis after septic shock; however, scarce data are available after cardiac arrest (CA). The aim of this study was to evaluate the impact of lymphopaenia after successful cardiopulmonary resuscitation. METHODS: This is a retrospective analysis of an institutional database including all adult CA patients admitted to the intensive care unit (ICU) between January 2007 and December 2014 who survived for at least 24 h...
August 14, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28808019/next-step-in-the-ongoing-arms-race-between-myxoma-virus-and-wild-rabbits-in-australia-is-a-novel-disease-phenotype
#5
Peter J Kerr, Isabella M Cattadori, June Liu, Derek G Sim, Jeff W Dodds, Jason W Brooks, Mary J Kennett, Edward C Holmes, Andrew F Read
In host-pathogen arms races, increases in host resistance prompt counteradaptation by pathogens, but the nature of that counteradaptation is seldom directly observed outside of laboratory models. The best-documented field example is the coevolution of myxoma virus (MYXV) in European rabbits. To understand how MYXV in Australia has continued to evolve in wild rabbits under intense selection for genetic resistance to myxomatosis, we compared the phenotypes of the progenitor MYXV and viral isolates from the 1950s and the 1990s in laboratory rabbits with no resistance...
August 14, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28807037/selepressin-a-novel-selective-vasopressin-v1a-agonist-is-an-effective-substitute-for-norepinephrine-in-a-phase-iia-randomized-placebo-controlled-trial-in-septic-shock-patients
#6
James A Russell, Jean-Louis Vincent, Anne Louise Kjølbye, Håkan Olsson, Allan Blemings, Herbert Spapen, Peder Carl, Pierre-Francois Laterre, Lars Grundemar
BACKGROUND: Vasopressin is widely used for vasopressor support in septic shock patients, but experimental evidence suggests that selective V1A agonists are superior. The initial pharmacodynamic effects, pharmacokinetics, and safety of selepressin, a novel V1A-selective vasopressin analogue, was examined in a phase IIa trial in septic shock patients. METHODS: This was a randomized, double-blind, placebo-controlled multicenter trial in 53 patients in early septic shock (aged ≥18 years, fluid resuscitation, requiring vasopressor support) who received selepressin 1...
August 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28806562/zika-virus-induced-neurological-critical-illness-in-latin-america-severe-guillain-barre-syndrome-and-encephalitis
#7
Sebastián U Ugarte, Angel Ricardo V Arenas, Bruno C Alvarez, Angela Cubides, Angélica F Luna, Max Arroyo-Parejo, Cayri E Acuña, Agamenón V Quintero, Orlando Ch Villareal, Oscar S Pinillos, Elías Vieda, Manuel Bello, Susana Peña, Carmelo Dueñas-Castell, Gloria M V Rodriguez, Jorge L M Ranero, Rosa L M López, Sandra G Olaya, José C Vergara, Ana Tandazo, Juan P S Ospina, Igor M Leyton Soto, R A Fowler, John C Marshall
Zika virus (ZIKAV) is classically described as causing minor symptoms in adult patients, however neurologic complications have been recognized. The recent outbreak in Central and South America has resulted in serious illness in some adult patients. We report adult patients in Latin America diagnosed with ZIKAV infection admitted to Intensive Care Units (ICUs). METHODS: Multicenter, prospective case series of adult patients with laboratory diagnosis of ZIKAV in 16 ICUs in 8 countries. RESULTS: Between December 1st 2015 and April 2nd 2016, 16 ICUs in 8 countries enrolled 49 critically ill patients with diagnosis of ZIKAV infection...
August 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28806210/risk-stratification-for-major-postoperative-complications-in-patients-undergoing-intra-abdominal-general-surgery-using-latent-class-analysis
#8
Minjae Kim, Melanie M Wall, Guohua Li
BACKGROUND: Preoperative risk stratification is a critical element in assessing the risks and benefits of surgery. Prior work has demonstrated that intra-abdominal general surgery patients can be classified based on their comorbidities and risk factors using latent class analysis (LCA), a model-based clustering technique designed to find groups of patients that are similar with respect to characteristics entered into the model. Moreover, the latent risk classes were predictive of 30-day mortality...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28803836/methionine-sulfoxide-reductase-a-protects-against-lipopolysaccharide-induced-septic-shock-via-negative-regulation-of-the-proinflammatory-responses
#9
Mahendra Pratap Singh, Ki Young Kim, Geun-Hee Kwak, Suk-Hwan Baek, Hwa-Young Kim
Methionine sulfoxide reductase A (MsrA) is a major antioxidant enzyme that specifically catalyzes the reduction of methionine S-sulfoxide. In this study, we used MsrA gene-knockout (MsrA(-/-)) mice and bone marrow-derived macrophages (BMDMs) to investigate the role of MsrA in the regulation of inflammatory responses induced by lipopolysaccharide (LPS). MsrA(-/-) mice were more susceptible to LPS-induced lethal shock than wild-type (MsrA(+/+)) mice. Serum levels of the proinflammatory cytokines IL-6 and TNF-α induced by LPS were higher in MsrA(-/-) than in MsrA(+/+) mice...
August 10, 2017: Archives of Biochemistry and Biophysics
https://www.readbyqxmd.com/read/28803442/neutrophils-nets-netosis-old-or-new-factors-in-sepsis-and-septic-shock
#10
Małgorzata Lipinska-Gediga
Neutrophils are an key part of the innate immune system in the host's defences against pathogens. Circulating neutrophils are recruited at the sites of infection or sterile inflammation in response to pathogen and host-derived inflammatory mediators. In addition to phagocytosis and degranulation, neutrophils display the release of NETs in order to restrain infection. NETs are able to entrap and kill microbes, and display proinflammatory and prothrombotic properties.
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28802696/community-acquired-pneumonia-visualized-on-computed-tomography-but-not-chest-x-ray-pathogens-severity-and-clinical-outcomes
#11
Cameron P Upchurch, Carlos G Grijalva, Richard G Wunderink, Derek J Williams, Grant W Waterer, Evan J Anderson, Yuwei Zhu, Eric M Hart, Frank Carroll, Anna M Bramley, Seema Jain, Kathryn M Edwards, Wesley H Self
BACKGROUND: The clinical significance of pneumonia visualized on computed tomography (CT) in the setting of a normal chest x-ray (CXR) is uncertain. METHODS: In a multicenter prospective surveillance study of adults hospitalized with community-acquired pneumonia (CAP), we compared the presenting clinical features, pathogens, and outcomes of patients with pneumonia visualized on CT but not on concurrent CXR (CT-only pneumonia) and those with pneumonia visualized on CXR...
August 9, 2017: Chest
https://www.readbyqxmd.com/read/28802287/energy-expenditure-in-severe-sepsis-or-septic-shock-in-a-thai-medical-intensive-care-unit
#12
Anupol Panitchote, Nontapak Thiangpak, Pranithi Hongsprabhas, Cameron Hurst
BACKGROUND AND OBJECTIVES: Energy expenditure in severe sepsis/septic shock patients was measured by indirect calorimetry and the correlation of energy expenditure between indirect calorimetry and predictive equations was determined. METHODS AND STUDY DESIGN: This was a prospective, observational analytical study. Severe sepsis or septic shock patients were measured for energy expenditure over 72 hours by indirect calorimetry that was measured by a mechanical ventilator (EngströmCarestation, GE Healthcare)...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28799416/evaluating-the-effects-of-chronic-antihypertensives-on-vasopressor-dosing-in-septic-shock
#13
Joshua M DeMott, Gourang Patel, Ishaq Lat
BACKGROUND: In septic shock, chronic antihypertensive medications are held acutely. Vasopressors are often required to maintain blood pressure. The effect of chronic exposure to antihypertensive therapies on vasopressor dosing in septic shock is not known. OBJECTIVE: To determine the effects of chronic exposure to antihypertensive therapies, specifically β-blockers and angiotensin-converting enzyme (ACE) inhibitors, on cumulative vasopressor dosing in septic shock...
August 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28797895/patterns-of-c-reactive-protein-ratio-predicts-outcomes-in-healthcare-associated-pneumonia-in-critically-ill-patients-with-cancer
#14
Ligia S C F Rabello, Pedro Póvoa, Jose R Lapa E Silva, Luciano C P Azevedo, Fernando Jose da Silva Ramos, Thiago Lisboa, Marcio Soares, Jorge I F Salluh
PURPOSE: Describe the patterns of C-reactive protein relative changes in response to antibiotic therapy in critically ill cancer patients with healthcare-associated pneumonia (HCAP) and its ability to predict outcome. METHODS: Secondary analysis of a prospective cohort of critically ill cancer patients with HCAP. CRP was sampled every other day from D0 to D6 of antibiotic therapy. Patients were classified according to an individual pattern of CRP-ratio response: fast - CRP at D4 of therapy was <0...
July 11, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28796065/a-scoring-system-to-predict-mortality-in-infants-with-esophageal-atresia-a-case-control-study
#15
Xiao-Wen Li, Ya-Jun Jiang, Xue-Qiu Wang, Jia-Lin Yu, Lu-Quan Li
Esophageal atresia (EA) is a rare anomaly that mandates surgical intervention. Patients with EA often have complicated medical courses due to both esophageal anomalies and related comorbidities. Although several prognostic classification systems have been developed to decrease the mortality rate in EA, most systems focus only on the influence of the major anomaly, and external risk factors that could be influenced by the neonatal caregivers to a certain extent are not included. The aim of this study was to investigate the risk factors for in-hospital mortality in neonates with EA and develop a scoring model to predict mortality...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28795671/-two-dimensional-speckle-tracking-imaging-in-assessing-the-left-ventricular-systolic-function-and-its-dynamic-changes-of-patients-with-septic-shock
#16
Fei Yang, Yong Chen, Ruiqiang Zheng, Yong Ma, Haidi Yu, Wenjuan Zhang, Yang Zhang
OBJECTIVE: To evaluate early and dynamic changes of the left ventricular systolic function of patients with septic shock by two-dimensional speckle tracking imaging (2D-STI), and to provide guidance for treatment and prognosis. METHODS: Fifty-eight septic shock patients admitted to intensive care unit (ICU) of Subei People's Hospital from January 2016 to April 2017 were enrolled. The septic shock patients were given early fluid resuscitation. The left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), early diastolic mitral flow velocity/early diastolic mitral annular peak velocity (E/Em) were obtained by conventional echocardiography, and the left ventricular global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS) were obtained by 2D-STI before fluid resuscitation and 1, 3, 7, 14 days after fluid resuscitation...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28795666/-value-of-serum-crispld2-levels-for-the-diagnosis-and-prognosis-evaluation-of-sepsis-patients
#17
Lai Wang, Xiufen Yang, Shuli Zhang, Mengsha Zhu
OBJECTIVE: To investigate the value of cysteine-rich secretory protein LCCL domain-containing 2 (CRISPLD2) in diagnosis and prognosis in patients with sepsis. METHODS: Clinical data of patients admitted to intensive care unit (ICU) of the First Hospital of Hebei Medical University from December 2014 to December 2016 were retrospectively analyzed. According to the severity of sepsis, the patients were divided into three groups: sepsis patients, severe sepsis patients and septic shock patients, and 100 healthy persons were enrolled as control group...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28795662/-evaluation-value-of-the-levels-of-peripheral-blood-cd20-cd24-hi-cd38-hi-regulatory-b-cells-on-the-prognosis-of-elderly-patients-with-sepsis
#18
Chunmei Wang, Lunxian Tang, Huihui Xu, Xiaoming Zhang, Jianwen Bai
OBJECTIVE: To explore the predicting value of peripheral blood CD20(+) CD24(hi) CD38(hi) regulatory B cells (Bregs) on the prognosis of elderly patients with sepsis. METHODS: A prospective study was conducted. Septic patients aged > 65 years old, compliance with diagnostic criteria for Sepsis-3, admitted to emergency and emergency intensive care unit (ICU) of Shanghai East Hospital of Tongji University from April 2016 to February 2017 were enrolled. Procalcitonin (PCT), C-reaction protein (CRP) and lactate (Lac) were routinely measured...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28795214/derivation-validation-and-application-of-a-pragmatic-risk-prediction-index-for-benchmarking-of-surgical-outcomes
#19
Richard T Spence, David C Chang, Haytham M A Kaafarani, Eugenio Panieri, Geoffrey A Anderson, Matthew M Hutter
BACKGROUND: Despite the existence of multiple validated risk assessment and quality benchmarking tools in surgery, their utility outside of high-income countries is limited. We sought to derive, validate and apply a scoring system that is both (1) feasible, and (2) reliably predicts mortality in a middle-income country (MIC) context. METHODS: A 5-step methodology was used: (1) development of a de novo surgical outcomes database modeled around the American College of Surgeons' National Surgical Quality Improvement Program (ACS-NSQIP) in South Africa (SA dataset), (2) use of the resultant data to identify all predictors of in-hospital death with more than 90% capture indicating feasibility of collection, (3) use these predictors to derive and validate an integer-based score that reliably predicts in-hospital death in the 2012 ACS-NSQIP, (4) apply the score in the original SA dataset and demonstrate its performance, (5) identify threshold cutoffs of the score to prompt action and drive quality improvement...
August 9, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28795054/sepsis-in-the-burn-patient-a-different-problem-than-sepsis-in-the-general-population
#20
REVIEW
David G Greenhalgh
Sepsis has recently been defined as "life-threatening organ dysfunction caused by a dysregulated host response to infection". A great amount of effort has been made to develop early treatments for sepsis through the Surviving Sepsis Campaign. There are similar but slightly different recommendations for the treatment of sepsis in the pediatric population. These international efforts have led to earlier diagnosis and treatments for sepsis that have led to improvements in survival. Sepsis is also the leading cause of death in the burn patient but most clinical sepsis studies have excluded burns...
2017: Burns and trauma
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