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https://www.readbyqxmd.com/read/28239813/ucp2-in-early-diagnosis-and-prognosis-of-sepsis
#1
Z-M Jiang, Q-H Yang, C-Q Zhu
OBJECTIVE: Sepsis, a systemic inflammatory response syndrome caused by infection, is a serious threat to the lives of patients. Sepsis can cause tissue hypoperfusion and septic shock which leads to organ dysfunction and death via a variety of mechanisms. Mitochondrial protein (UCP2) involves in immune response, regulation of oxidative stress, and maintenance of mitochondrial membrane potential as well as energy production. However, the role of UCP2 in sepsis remains to be further explored...
February 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28239476/prolonged-direct-hemoperfusion-using-a-polymyxin-b-immobilized-fiber-cartridge-provides-sustained-circulatory-stabilization-in-patients-with-septic-shock-a-retrospective-observational-before-after-study
#2
Kyohei Miyamoto, Yu Kawazoe, Seiya Kato
BACKGROUND: Direct hemoperfusion therapy with polymyxin B immobilized fiber cartridges (PMX-DHP) is widely used for septic shock in Japan and parts of Europe. Although this treatment is usually administered for 2 h, the optimal duration has not been established. METHODS: This retrospective study compared the effects of prolonged and conventional PMX-DHP durations (2 and 12 h, respectively) for septic shock. Between October 2013 and March 2015, 18 patients underwent conventional PMX-DHP, and between April 2015 and May 2016, 18 patients underwent prolonged PMX-DHP...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28238416/quantitative-multiplexed-tandem-pcr-for-direct-detection-of-bacteraemia-in-critically-ill-patients
#3
Andrew N Ginn, Briony Hazelton, Shereen Shoma, Martin Cullen, Thomas Solano, Jonathan R Iredell
Culture remains the gold standard for diagnosis of blood stream infections (BSI), but its clinical utility is limited by slow turnaround times. Here we describe a method for rapid quantitative detection of bacterial DNA directly extracted from whole blood using a multiplexed tandem real-time PCR (MT-PCR) assay targeting Staphylococcus, Streptococcus, Pseudomonas, Enterococcus and Enterobacteriaceae 16S rDNA genes. Results were available less than 3.5 hours after blood collection with all five bacterial targets having limits of detection between 10(1) and 10(3) CFU/mL...
February 23, 2017: Pathology
https://www.readbyqxmd.com/read/28238385/distributive-shock-in-the-emergency-department-sepsis-anaphylaxis-or-capillary-leak-syndrome
#4
Cansu Alyeşil, Nurettin Özgür Doğan, İbrahim Ulaş Özturan, Seda Güney
BACKGROUND: Distributive shock is a hyperdynamic process resulting from excessive vasodilatation. Impaired blood flow causes inadequate tissue perfusion, which can lead to end-organ damage. Although the most common etiology is septic shock, anaphylactic and other etiologies should be considered. CASE REPORT: We report the case of a 30-year-old female who presented to the emergency department with nonspecific symptoms and hypotension after a viral upper respiratory infection...
February 18, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28237894/early-continuous-renal-replacement-therapy-in-septic-acute-kidney-injury-could-be-defined-by-its-initiation-within-24-hours-of-vasopressor-infusion
#5
Seung Don Baek, Hoon Yu, Seulgi Shin, Hyang-Sook Park, Mi-Soon Kim, So Mi Kim, Eun Kyoung Lee, Jai Won Chang
PURPOSE: The optimal timing for the initiation of early continuous renal replacement therapy (CRRT) is uncertain and requires a practically feasible definition with acceptable evidence. MATERIALS AND METHODS: We investigated the clinical impacts of 3-time interval parameters on the morbidity and mortality of 177 patients with septic shock-induced acute kidney injury: (1) time from vasopressor initiation to CRRT initiation (Tvaso-CRRT), (2) time from intensive care unit (ICU) admission to CRRT initation (TICU-CRRT), and (3) time from endotracheal intubation to CRRT initiation (Tendo-CRRT)...
December 27, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28237623/effect-of-underlying-immune-compromise-on-the-manifestations-and-outcomes-of-group-a-streptococcal-bacteremia
#6
Kathleen A Linder, Leen Alkhouli, Mayur Ramesh, George A Alangaden, Carol A Kauffman, Marisa H Miceli
BACKGROUND: Group A streptococcal bloodstream infection is the most common presentation of invasive group A streptococcal disease. We sought to determine the impact of immunosuppression on severity of disease and clinical outcomes. METHODS: This retrospective review of 148 patients with at least one positive blood culture for Streptococcus pyogenes from 1/2003 to 3/2013 compared immunocompromised patients with those with no immunocompromise in regards to development of severe complications and mortality...
February 22, 2017: Journal of Infection
https://www.readbyqxmd.com/read/28237439/esophagopericardial-fistula-septic-shock-and-intracranial-hemorrhage-with-hydrocephalus-after-lung-transplantation
#7
M M Schuurmans, C Benden, C Moehrlen, C Gubler, M Wilhelm, W Weder, I Inci
A 57-year old woman underwent lung transplantation for non-specific interstitial pneumonia. Primary graft dysfunction was diagnosed requiring continued use of extracorporeal membrane oxygenation (ECMO). Within three days she developed recurring hemothoraces requiring two surgical evacuations. After ECMO removal a series of complications occurred within four months: femoral thrombosis, persisting tachycardic atrial fibrillation, pneumopericardium with an esophagopericardial fistula and purulent pericarditis, septic shock, multiorgan failure and intracerebral hemorrhage with ventricular involvement requiring external ventricular drainage...
February 22, 2017: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/28237247/subcutaneous-fat-necrosis-of-the-newborn-report-of-five-cases
#8
Leire González Lara, Asunción Vicente Villa, María Mercedes Otero Rivas, Mariona Sunol Capella, Fredy Prada, María Antonia González Enseñat
Subcutaneous fat necrosis of the newborn (SCFN) is a rare, self-limited disorder of the panniculus which appears in the first few weeks of life. SCFN generally follows an uncomplicated course. However, there are important complications for which the patient must be regularly monitored, including thrombocytopenia, hypoglycemia, hypertriglyceridemia, and most importantly, hypercalcemia. We report five infants with SCFN. All children were born at term. The onset of lesions was between 1 day and 20 days after birth...
February 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28236500/mortality-among-high-risk-patients-admitted-with-septic-shock-to-u-s-teaching-hospitals-in-july-does-the-july-effect-exist
#9
Amina Saqib, Uroosa Ibrahim, Parshva Patel, Abhyudaya Joshi, Michel Chalhoub
BACKGROUND: The 'July effect' is a phenomenon of inferior delivery of care at teaching hospitals during July because of relative inexperience of new physicians. OBJECTIVE: To study the difference in mortality among septic shock patients during July and another month. METHODS: Using the U.S. Nationwide Inpatient Sample, we estimated the difference in mortality among septic shock patients admitted during May and July from 2003 to 2011. RESULTS: 117,593 and 121,004 patients with septic shock were admitted to non-teaching and teaching hospitals, respectively, in May and July...
February 21, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28236396/challenges-in-sepsis-care-new-sepsis-definitions-and-fluid-resuscitation-beyond-the-central-venous-pressure
#10
REVIEW
Maureen A Seckel, Thomas Ahrens
There are two important recent changes in sepsis care. The first key change is the 2016 Sepsis-3 definitions from the recent consensus workgroup with new sepsis and septic shock definitions. Useful tools for assessing patients that have a greater risk of mortality include Sequential Organ Failure Assessment (SOFA) in intensive care units and quick SOFA outside intensive care units. The second change involves management of fluid resuscitation and measures of volume responsiveness. Measures such as blood pressure and central venous pressure are not reliable...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28234790/effects-of-levosimendan-on-cellular-metabolic-alterations-in-patients-with-septic-shock-a-randomized-controlled-pilot-study
#11
Zied Hajjej, Bilel Meddeb, Walid Sellami, Iheb Labbene, Andrea Morelli, Mustapha Ferjani
INTRODUCTION: Mitochondrial dysfunction and consequent cellular energetic failure play a key role in the development of sepsis-related organs failure. Evidence suggest that the pleiotropic effects of levosimendan may positively affect cellular metabolism during septic shock. OBJECTIVES: To investigate changes in the concentration of glucose, lactate, pyruvate and glycerol in the extracellular fluid of the skeletal muscle following levosimendan administration in patients with septic shock...
February 23, 2017: Shock
https://www.readbyqxmd.com/read/28233644/the-impact-of-emergency-department-crowding-on-early-interventions-and-mortality-in-patients-with-severe-sepsis
#12
David F Gaieski, Anish K Agarwal, Mark E Mikkelsen, Byron Drumheller, S Cham Sante, Frances S Shofer, Munish Goyal, Jesse M Pines
OBJECTIVE: Critically ill patients require significant time and care coordination in the emergency department (ED). We hypothesized that ED crowding would delay time to intravenous fluids and antibiotics, decrease utilization of protocolized care, and increase mortality for patients with severe sepsis or septic shock. METHODS: This was a retrospective cohort study of severe sepsis patients admitted to the hospital from the ED between January 2005 and February 2010...
January 31, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28232501/photo-quiz-an-88-year-old-immunosuppressed-thai-man-with-diarrhea-septic-shock-and-rashes
#13
EDITORIAL
Nattapol Pruetpongpun, Pansachee Damronglerd, Worapop Suthiwartnarueput, Sasinuch Rujanavej, Thana Khawcharoenporn, William Michael Dunne, Anucha Apisarnthanarak
No abstract text is available yet for this article.
March 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28232275/recent-advances-in-the-pathophysiology-and-molecular-basis-of-sepsis-associated-organ-dysfunction-novel-therapeutic-implications-and-challenges
#14
REVIEW
Yuichi Hattori, Kohshi Hattori, Tokiko Suzuki, Naoyuki Matsuda
Sepsis is one of the most common reasons for critically ill patients to be admitted to an intensive care unit and, despite advances in overall medical care, it represents a major clinical problem and remains the leading cause of death in the critically ill patient population. Although sepsis has been defined as a systemic inflammatory syndrome, in which there is an identifiable focus of infection, clinical trials aimed at anti-inflammatory therapeutic approaches have largely failed to identify an effective therapeutic target to improve clinical outcomes in sepsis...
February 20, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28230556/comparison-of-automated-methods-versus-the-american-burn-association-sepsis-definition-to-identify-sepsis-and-sepsis-with-organ-dysfunction-septic-shock-in-burn-injured-adults
#15
Megan A Rech, Michael J Mosier, Susan Zelisko, Giora Netzer, Elizabeth J Kovacs, Majid Afshar
To develop an algorithm to identify sepsis and sepsis with organ dysfunction/septic shock in burn-injured patients incorporating criteria from the American Burn Association sepsis definition that possesses good test characteristics compared with International Classification of Diseases, Ninth Revision-Clinical Modification (ICD-9) codes and an algorithm previously validated in nonburn-injured septic patients (Martin et al method). This was a retrospective cohort study of consecutive patients admitted to the burn intensive care unit between January 2008 and March 2015...
February 22, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28229893/safety-and-efficacy-of-natalizumab-in-patients-with-acute-ischaemic-stroke-action-a-randomised-placebo-controlled-double-blind-phase-2-trial
#16
Jacob Elkins, Roland Veltkamp, Joan Montaner, S Claiborne Johnston, Aneesh B Singhal, Kyra Becker, Maarten G Lansberg, Weihua Tang, Ih Chang, Kumar Muralidharan, Sarah Gheuens, Lahar Mehta, Mitchell S V Elkind
BACKGROUND: In animal models of acute ischaemic stroke, blocking of the leukocyte-endothelium adhesion by antagonism of α4 integrin reduces infarct volumes and improves outcomes. We assessed the effect of one dose of natalizumab, an antibody against the leukocyte adhesion molecule α4 integrin, in patients with acute ischaemic stroke. METHODS: In this double-blind, phase 2 study, patients with acute ischaemic stroke (aged 18-85 years) from 30 US and European clinical sites were randomly assigned (1:1) to 300 mg intravenous natalizumab or placebo with stratification by treatment window and baseline infarct size...
March 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28229066/a-case-of-influenza-a-h3n2-complicated-by-community-acquired-pneumonia-and-death-in-a-young-healthy-adult-during-the-2013-2014-season
#17
Lauren F Collins, Benjamin D Anderson, Gregory C Gray
With multiple available vaccines and antivirals, seasonal influenza A is typically a self-limited acutely debilitating illness in young healthy adults. Here, we illustrate unexpected morbidity and mortality in a relatively young and healthy patient seen at a large tertiary care academic medical center for seasonal influenza A (H3N2) complicated by community-acquired pneumonia, hypoxic respiratory failure, septic shock, and death.
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28227782/predicting-short-term-icu-outcomes-using-a-sequential-contrast-motif-based-classification-framework
#18
Shameek Ghosh, Hung Nguyen, Jinyan Li, Shameek Ghosh, Hung Nguyen, Jinyan Li, Shameek Ghosh, Hung Nguyen, Jinyan Li
Critical ICU events like acute hypotension and septic shock are dangerous complications, leading to multiple organ failures and eventual death. Previously, pattern mining algorithms have been employed for extracting interesting rules in various clinical domains. However, the extracted rules are directly investigated by clinicians for diagnosing a disease. Towards this purpose, there is a need to develop advanced prediction models which integrate dynamic patterns to learn a patient's physiological condition...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28224127/early-diagnosis-and-surgical-treatment-for-necrotizing-fasciitis-a-multicenter-study
#19
Evangelos P Misiakos, George Bagias, Iordanis Papadopoulos, Nickolaos Danias, Paul Patapis, Nickolaos Machairas, Theodore Karatzas, Nickolaos Arkadopoulos, Konstantinos Toutouzas, Nickolaos Alexakis, Manousos N Konstantoulakis, George Zografos, Vasilis Smyrniotis, Gregory Kouraklis, Anastasios Machairas
BACKGROUND: Necrotizing fasciitis (NF) is a group of relatively rare infections, usually caused by two or more pathogens. It affects the skin and subcutaneous tissues of lower and upper limbs, perineal area (Fournier's gangrene), and the abdominal wall. Early diagnosis and aggressive surgical management are of high significance for the management of this potentially lethal disease. METHODS: We conducted a retrospective study in patients who presented, during the last decade, at four University Surgical Departments in the area of Athens, Greece, with an admission diagnosis of NF...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28224109/timing-method-and-discontinuation-of-hydrocortisone-administration-for-septic-shock-patients
#20
Miguel A Ibarra-Estrada, Quetzalcóatl Chávez-Peña, Claudia I Reynoso-Estrella, Jorge Rios-Zermeño, Pável E Aguilera-González, Miguel A García-Soto, Guadalupe Aguirre-Avalos
AIM: To characterize the prescribing patterns for hydrocortisone for patients with septic shock and perform an exploratory analysis in order to identify the variables associated with better outcomes. METHODS: This prospective cohort study included 59 patients with septic shock who received stress-dose hydrocortisone. It was performed at 2 critical care units in academic hospitals from June 1(st), 2015, to July 31(st), 2016. Demographic data, comorbidities, medical management details, adverse effects related to corticosteroids, and outcomes were collected after the critical care physician indicated initiation of hydrocortisone...
February 4, 2017: World Journal of Critical Care Medicine
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