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https://www.readbyqxmd.com/read/28727802/diagnostic-accuracy-of-procalcitonin-neutrophil-lymphocyte-count-ratio-c-reactive-protein-and-lactate-in-patients-with-suspected-bacterial-sepsis
#1
Lars Ljungström, Anna-Karin Pernestig, Gunnar Jacobsson, Rune Andersson, Barbara Usener, Diana Tilevik
BACKGROUND: Early recognition is a key factor to achieve improved outcomes for septic patients. Combinations of biomarkers, as opposed to single ones, may improve timely diagnosis and survival. We investigated the performance characteristics of sepsis biomarkers, alone and in combination, for diagnosis of verified bacterial sepsis using Sepsis-2 and Sepsis-3 criteria, respectively. METHODS: Procalcitonin (PCT), neutrophil-lymphocyte count ratio (NLCR), C-reactive protein (CRP), and lactate were determined in a total of 1,572 episodes of adult patients admitted to the emergency department on suspicion of sepsis...
2017: PloS One
https://www.readbyqxmd.com/read/28727676/association-between-diabetes-mellitus-and-outcomes-of-patients-with-sepsis-a-meta-analysis
#2
Zhiwei Wang, Jianan Ren, Gefei Wang, Qinjie Liu, Kun Guo, Jieshou Li
BACKGROUND Diabetes mellitus (DM) is a critical medical problem that can make people more likely to develop infectious complications, even sepsis. However, the influence of DM on the outcomes of septic patients is still controversial. Thus, we conducted the present meta-analysis to investigate whether DM worsens outcomes of septic patients. MATERIAL AND METHODS We searched studies from PubMed, Embase, and Cochrane Library databases from 1966 to July 1, 2016. The primary outcome we chose was 28-day or 30-day mortality or in-hospital mortality...
July 20, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28727607/new-onset-heart-failure-and-mortality-in-hospital-survivors-of-sepsis-related-left-ventricular-dysfunction
#3
Saraschandra Vallabhajosyula, Jacob C Jentzer, Jeffrey B Geske, Mukesh Kumar, Ankit Sakhuja, Akhil Singhal, Joseph T Poterucha, Kianoush Kashani, Joseph G Murphy, Ognjen Gajic, Rahul Kashyap
BACKGROUND: The association between new-onset left ventricular (LV) dysfunction during sepsis with long-term heart failure outcomes is lesser understood. METHODS: Retrospective cohort study of all adult patients with severe sepsis and septic shock between 2007 and 2014 that underwent echocardiography within 72 hours admitted to the intensive care unit. Patients with prior heart failure, LV dysfunction, and structural heart disease were excluded. LV systolic dysfunction was defined as LV ejection fraction <50% and LV diastolic dysfunction as ≥grade II...
July 19, 2017: Shock
https://www.readbyqxmd.com/read/28726607/acute-febrile-illness-and-complications-due-to-murine-typhus-texas-usa1-2
#4
Zeeshan Afzal, Sunand Kallumadanda, Feng Wang, Vagish Hemmige, Daniel Musher
Murine typhus occurs relatively commonly in southern Texas, as well as in California. We reviewed records of 90 adults and children in whom murine typhus was diagnosed during a 3-year period in 2 hospitals in southern Texas, USA. Most patients lacked notable comorbidities; all were immunocompetent. Initial signs and symptoms included fever (99%), malaise (82%), headache (77%), fatigue (70%), myalgias (68%), and rash (39%). Complications, often severe, in 28% of patients included bronchiolitis, pneumonia, meningitis, septic shock, cholecystitis, pancreatitis, myositis, and rhabdomyolysis; the last 3 are previously unreported in murine typhus...
August 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28724977/therapeutic-targeting-of-hmgb1-during-experimental-sepsis-modulates-the-inflammatory-cytokine-profile-to-one-associated-with-improved-clinical-outcomes
#5
Natalie E Stevens, Marianne J Chapman, Cara K Fraser, Tim R Kuchel, John D Hayball, Kerrilyn R Diener
Sepsis remains a significant health burden and a major clinical need exists for therapeutics to dampen the excessive and uncontrolled immune activation. Nuclear protein high mobility group box protein 1 (HMGB1) is released following cell death and is a late mediator in sepsis pathogenesis. While approaches targeting HMGB1 have demonstrated reduced mortality in pre-clinical models of sepsis, the impact of HMGB1 blockade on the complex septic inflammatory milieu and the development of subsequent immunosuppression remain enigmatic...
July 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28724597/multifocal-septic-arthritis-gluteal-abscess-and-spondylodiscitis-by-streptococcus-dysgalactiae-subspecies-equisimilis-after-an-intramuscular-injection
#6
Rita Marques Pocinho, Liliana Antunes, Pedro Pires, Isabel Baptista
We present the case of a 63-year-old man, admitted for hand cellulitis and acute kidney injury. A Streptococcus dysgalactiae subsp equisimilis (SDSE) was isolated in blood cultures and despite directed intravenous antibiotherapy, the patient evolved unfavourably, with dorsolumbar spondylodiscitis, multifocal septic arthritis and abscesses. CT also showed densification of the gluteal muscles, multiple air bubbles in the psoas, paraspinal muscles and spinal canal that were associated with an intramuscular injection administered 1 week earlier for a backache...
July 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28724580/il-7-restores-t-lymphocyte-immunometabolic-failure-in-septic-shock-patients-through-mtor-activation
#7
Fabienne Venet, Julie Demaret, Benjamin J Blaise, Christelle Rouget, Thibaut Girardot, Estellie Idealisoa, Thomas Rimmelé, François Mallet, Alain Lepape, Julien Textoris, Guillaume Monneret
T lymphocyte alterations are central to sepsis pathophysiology, whereas related mechanisms remain poorly understood. We hypothesized that metabolic alterations could play a role in sepsis-induced T lymphocyte dysfunction. Samples from septic shock patients were obtained at day 3 and compared with those from healthy donors. T cell metabolic status was evaluated in the basal condition and after T cell stimulation. We observed that basal metabolic content measured in lymphocytes by nuclear magnetic resonance spectroscopy was altered in septic patients...
July 19, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28720602/a-reminder-of-escherichia-coli-sepsis-induced-reversible-cardiomyopathy
#8
Aung Naing Lin, Atif Shaikh, Sithu Lin, Deepika Misra
Cardiomyopathy is a progressive disease of myocardium causing either mechanical or electrical disturbances. Sepsis-induced cardiomyopathy (SICM) is an entity of cardiomyopathy which is reversible in 1â€"2 weeks after recovery from sepsis or septic shock. SICM is thought to have unpredictable cumulative mortality towards sepsis but its exact mechanism remains elusive. We report a case of Escherichia coli SICM in a 63-year-old woman presented with sudden onset of dyspnoea on exertion and orthopnoea following nausea, vomiting and diarrhoea after consuming Chinese foods...
July 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28720298/steroids-steroid-precursors-and-neuroactive-steroids-in-critically-ill-equine-neonates
#9
K A Dembek, K J Timko, L M Johnson, K A Hart, B S Barr, B David, T A Burns, R E Toribio
Hypothalamic-pituitary-adrenal axis (HPAA) dysfunction has been associated with sepsis and mortality in foals. Most studies have focused on cortisol, while other steroids have not been investigated. The objectives of this study were to characterise the adrenal steroid and steroid precursor response to disease and to determine their association with the HPAA response to illness, disease severity, and mortality in hospitalised foals. All foals (n=326) were classified by two scoring systems into three categories: based on the sepsis score (septic, sick non-septic [SNS] and healthy) and the foal survival score (Group 1: 3-18%; Group 2: 38-62%; Group 3: 82-97% likelihood of survival)...
July 2017: Veterinary Journal
https://www.readbyqxmd.com/read/28719983/neonatal-lemierre-syndrome-youngest-reported-case-and-literature-review
#10
Blake S Raggio, Maria C Grant, Kimsey Rodriguez, Patrick J Cripe
A previously healthy 5-week-old female was admitted for sepsis secondary to methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. After several days of hospitalization, she experienced acute decompensation in mental status despite having received targeted antibiotic therapy. Imaging revealed left peritonsillar/parapharyngeal space abscess, left venous thrombophlebitis of the internal jugular vein, and septic emboli of the lungs and brain consistent with Lemierre syndrome. Bedside needle aspiration of the parapharyngeal abscess confirmed MRSA involvement...
July 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28719839/the-prognostic-value-of-brain-natriuretic-peptide-bnp-in-non-cardiac-patients-with-sepsis-ultra-long-follow-up
#11
Johad Khoury, Majd Arow, Adi Elias, Badira F Makhoul, Gidon Berger, Marielle Kaplan, Tanya Mashiach, Reem Ismael-Badarneh, Doron Aronson, Zaher S Azzam
OBJECTIVES: Sepsis is a multifactorial syndrome with increasing incidence of morbidity and mortality. Identification of outcome predictors is therefore essential. Recently, elevated brain natriuretic peptide (BNP) levels have been observed in patients with septic shock. Little information is available concerning BNP levels in patients with critical illness, especially with sepsis. Therefore, this study aims to evaluate the role of BNP as a biomarker for long-term mortality in patients with sepsis...
July 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28719657/isolation-and-in-vitro-evaluation-of-bacteriophages-against-mdr-bacterial-isolates-from-septic-wound-infections
#12
Roja Rani Pallavali, Vijaya Lakshmi Degati, Dakshayani Lomada, Madhava C Reddy, Vijaya Raghava Prasad Durbaka
Multi-drug resistance has become a major problem for the treatment of pathogenic bacterial infections. The use of bacteriophages is an attractive approach to overcome the problem of drug resistance in several pathogens that cause fatal diseases. Our study aimed to isolate multi drug resistant bacteria from patients with septic wounds and then isolate and apply bacteriophages in vitro as alternative therapeutic agents. Pus samples were aseptically collected from Rajiv Gandhi Institute of Medical Science (RIMS), Kadapa, A...
2017: PloS One
https://www.readbyqxmd.com/read/28719479/a-simulation-based-quality-improvement-initiative-improves-pediatric-readiness-in-community-hospitals
#13
Travis Whitfill, Marcie Gawel, Marc Auerbach
BACKGROUND: The National Pediatric Readiness Project Pediatric Readiness Survey (PRS) measured pediatric readiness in 4149 US emergency departments (EDs) and noted an average score of 69 on a 100-point scale. This readiness score consists of 6 domains: coordination of pediatric patient care (19/100), physician/nurse staffing and training (10/100), quality improvement activities (7/100), patient safety initiatives (14/100), policies and procedures (17/100), and availability of pediatric equipment (33/100)...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28717843/septic-arthritis-associated-with-systemic-sepsis
#14
Sung-Weon Jung, Dong-Hee Kim, Sung-Jin Shin, Byoung-Youl Kang, Yil-Ju Eho, Seong-Wook Yang
PURPOSE: Septic arthritis presents with good joint function, but sometimes leads to poor outcomes. Concurrent systemic sepsis has been regarded as the poor outcome, and the exact cause remains unclear. This paper was performed to identify factors associated with concurrent systemic sepsis and to research results to predict poor outcomes in patients with septic arthritis. METHODS: Laboratory and medical data were reviewed for 137 adults with acute septic arthritis who underwent open or arthroscopic surgical debridement at our institution between January 2005 and December 2014...
July 17, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28717513/unexpected-intensive-care-transfer-of-admitted-patients-with-severe-sepsis
#15
Gabriel Wardi, Arvin R Wali, Julian Villar, Vaishal Tolia, Christian Tomaszewski, Christian Sloane, Peter Fedullo, Jeremy R Beitler, Matthew Nolan, Daniel Lasoff, Rebecca E Sell
BACKGROUND: Patients with severe sepsis generally respond well to initial therapy administered in the emergency department (ED), but a subset later decompensate and require unexpected transfer to the intensive care unit (ICU). This study aimed to identify clinical factors that can predict patients at increased risk for delayed transfer to the ICU and the association of delayed ICU transfer with mortality. METHODS: This is a nested case-control study in a prospectively collected registry of patients with severe sepsis and septic shock at two EDs...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28717346/inflammatory-wnt5a-signalling-pathways-affecting-barrier-function-of-human-vascular-endothelial-cells
#16
Tom Skaria, Gabriele Schoedon
Wnt5A is a chemokine secreted by inflammatory-activated human macrophages that sustains their inflammatory response in an autocrine manner. High levels of Wnt5A are found in sera of patients with sepsis and septic shock. Here, we comment on recently reported Wnt5A signalling pathways in human vascular endothelial cells (VEC). In human VEC, Wnt5A regulates cytoskeleton remodelling and barrier function through Ryk receptor and Rho-associated protein serine/threonine kinase, targeting LIMK2 and CFL1 involved in actin polymerisation...
2017: Journal of Inflammation
https://www.readbyqxmd.com/read/28716595/the-risk-stratification-and-prognostic-evaluation-of-soluble-programmed-death-1-on-patients-with-sepsis-in-emergency-department
#17
Yongzhen Zhao, Yumei Jia, Chunsheng Li, Yingying Fang, Rui Shao
OBJECTIVE: To evaluate the efficacy of soluble programmed death-1 (sPD-1) for risk stratification and prediction of 28-day mortality in patients with sepsis, we compared serum sPD-1 with procalcitonin (PCT), C-reactive protein (CRP), and the Mortality in Emergency Department Sepsis (MEDS) score. METHODS: A total of 60 healthy volunteers and 595 emergency department (ED) patients were recruited for this prospective cohort study. According to the severity of their condition on ED arrival, the patients were allocated to the systemic inflammatory response syndrome group (130 cases), sepsis group (276 cases), severe sepsis group (121 cases), and septic shock group (68 cases)...
July 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28716593/the-critical-care-literature-2016
#18
REVIEW
Michael E Winters, Joseph P Martinez, Haney Mallemat, William J Brady
An emergency physician (EP) is often the first health care provider to evaluate, resuscitate, and manage a critically ill patient. Between 2001 and 2009, the annual hours of critical care delivered in emergency departments (EDs) across the United States increased >200%! (Herring et al., 2013). This trend has persisted since then. In addition to seeing more critically ill patients, EPs are often tasked with providing critical care long beyond the initial resuscitation period. In fact, >33% of critically ill patients who are brought to an ED remain there for >6h (Herring et al...
July 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28714876/sustained-low-serum-substance-p-levels-in-non-surviving-septic-patients
#19
Leonardo Lorente, María M Martín, Antonia Pérez-Cejas, José Ferreres, Jordi Solé-Violán, Lorenzo Labarta, César Díaz, Alejandro Jiménez
Previously, researchers found higher serum substance P (SP) concentrations in survivors of severe sepsis than in non-survivors at the time of severe sepsis diagnosis. The objectives of our current study were to determine whether there is an association between serum SP levels during the first week and sepsis mortality, sepsis severity, serum levels of tumor necrosis factor (TNF)-α and interleukin (IL)-10, and whether serum SP levels during the first week could be used as a biomarker of sepsis mortality. We determined serum concentration of SP, TNF-α, and IL-10 at days 1, 4, and 8...
July 15, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28714582/altered-levels-of-soluble-cd18-may-associate-immune-mechanisms-with-outcome-in-sepsis
#20
Tue Wenzel Kragstrup, Kristian Juul-Madsen, Stig Hill Christiansen, Xianwei Zhang, Jan Krog, Thomas Vorup-Jensen, Anders Gade Kjaergaard
The pathogenesis of sepsis involves a dual inflammatory response, with a hyper-inflammatory phase followed by, or in combination with, a hypo-inflammatory phase. The adhesion molecules LFA-1 (CD11a/CD18) and Mac-1 (CD11b/CD18) support leukocyte adhesion to intercellular adhesion molecules and phagocytosis through complement opsonisation, both processes relevant to the immune response during sepsis. Here, we investigate the role of soluble (s)CD18 in sepsis with emphasis on sCD18 as a mechanistic biomarker of immune reactions and outcome of sepsis...
July 17, 2017: Clinical and Experimental Immunology
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