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https://www.readbyqxmd.com/read/28923774/endotoxin-adsorption-direct-hemoperfusion-with-the-polymyxin-b-immobilized-fiber-column-pmx
#1
REVIEW
Tomoharu Shimizu, Toru Miyake, Naomi Kitamura, Masaji Tani, Yoshihiro Endo
Toraymyxin(®) is a medical device developed to adsorb circulating endotoxins in the blood using direct hemoperfusion therapy for patients with septic shock. In 1994, the Japanese National Health Insurance system approved the use of Toraymyxin for the treatment of endotoxemia and septic shock. Since then, Toraymyxin has been safely used in more than 100,000 cases in emergency and intensive care units in Japan. Toraymyxin is currently available for use in the clinical setting in 14 countries worldwide. In this study, we reviewed and introduced the development, clinical use, and efficacy of Toraymyxin and commented on its anticoagulant use and cartridge clotting issue in the treatment of severe sepsis and septic shock...
August 31, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28919596/outcome-of-pregnancy-related-acute-kidney-injury-observed-in-a-tertiary-care-hospital
#2
S U Ahammed, A A Chowdhury, A S Roy, M A Muqueet, M A Rahman, M S Kabir, M G Rabbani, M Asadujjaman, M B Hossain, M Akhtaruzzaman, S K Das, E H Khan, M A Islam, M J Hasan, M A Rahman, R K Talukder, J Ara, G C Barman, P P Roy, M K Saha, D Mondal
This prospective case control study was carried out in Mymensingh Medical College Hospital (MMCH) from April 2011 to March 2012. The main objective of the study was to determine the short term maternal outcome of pregnancy related Acute Kidney Injury and to identify aetiological factors and to observe clinical features of pregnancy related Acute Kidney Injury. Total 60 pregnant women with AKI were included in the study as sample and equal (60) number of pregnant women with normal renal function was taken as control...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28919283/clinical-manifestations-risk-factors-and-prognosis-of-patients-with-morganella-morganii-sepsis
#3
David Erlanger, Marc Victor Assous, Yonit Wiener-Well, Amos Moshe Yinnon, Eli Ben-Chetrit
BACKGROUND: There are few studies of Morganella bacteremia. We evaluated risk factors and outcome of patients with Morganella bacteremia. METHODS: Medical records of patients with Morganella bacteremia were reviewed (1997-2014). Control group patients with Escherichiacoli sepsis were matched by year of diagnosis and infection acquisition site. RESULTS: The study group included 136 adult patients. Mean age and gender of study and control groups were similar...
September 6, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28918911/mortality-of-severe-septic-patients-between-physician-s-high-and-low-care-volumes
#4
Chun-Yao Lin, Jo-Chi Tseng, Chih-Yu Huang, Chien-Ming Chu, Huang-Pin Wu
BACKGROUND: Patients with severe sepsis frequently require intensive care unit (ICU) admission and different ICU care models may influence their outcomes. The mortality of severe septic patients between physician's high and low care volume remains unclear. METHODS: We analyzed the data from a three-year prospective observation study, which was performed in an adult medical ICU of Chung Gung Memorial Hospital, Keelung. The data included initial bundle therapies based on the Surviving Sepsis Campaign (SSC) guidelines for patients with severe sepsis...
August 2017: Biomedical Journal
https://www.readbyqxmd.com/read/28918465/congenital-lumbar-kyphosis-with-skin-ulceration-and-osteomyelitis-in-a-myelomeningocele-child-a-case-report
#5
Benoit Vibert, Marco Turati, Pierre-Yves Rabattu, Marco Bigoni, Ahmad Eid, Aurélien Courvoisier
INTRODUCTION: Kyphosis is a frequent problem in children with spina bifida, and this deformity may cause different complications as respiratory insufficiency, bowel dysfunction, and skin ulcers. CASE REPORT: We report on a 13-year-old myelomeningocele male with a lumbar kyphoscoliosis associated to a septic skin ulceration that resulted in an acute sepsis. An X-ray revealed a kyphosis of 110° and a scoliosis of 25° between T9 and L5. The wound and blood cultures showed Staphylococcus aureus colonization, and an appropriate antibiotic therapy was started...
September 16, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28917998/clinical-characteristics-and-outcomes-in-polyarticular-septic-arthritis
#6
Sarah B Lieber, Mary Louise Fowler, Clara Zhu, Andrew Moore, Robert H Shmerling, Ziv Paz
OBJECTIVES: Septic polyarthritis is rarer than septic monoarthritis, but associated with higher mortality. Septic polyarthritis may be difficult to distinguish clinically from noninfectious inflammatory arthritis. We describe one of the largest samples of septic polyarthritis with the aim of distinguishing septic monoarthritis from polyarthritis. METHODS: We conducted a retrospective study of adults admitted to tertiary care with septic monoarthritis and polyarthritis...
September 13, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28916973/myeloperoxidase-can-differentiate-between-sepsis-and-non-infectious-sirs-and-predicts-mortality-in-intensive-care-patients-with-sirs
#7
Irene T Schrijver, Hans Kemperman, Mark Roest, Jozef Kesecioglu, Dylan W de Lange
BACKGROUND: Systemic inflammatory response syndrome (SIRS) is a clinical syndrome following inflammation. Clinically, it is difficult to distinguish SIRS following an infection, i.e., sepsis, from non-infectious SIRS. Myeloperoxidase is a hemeprotein stored in the neutrophil azurophilic granules and is one of the main pillars of neutrophil attack. Therefore, we hypothesized that myeloperoxidase can differentiate between sepsis and non-infectious SIRS in patients with systemic inflammatory response syndrome in the intensive care unit (ICU)...
September 15, 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28916848/interleukin-17-as-a-predictor-of-sepsis-in-polytrauma-patients-a-prospective-cohort-study
#8
M Ahmed Ali, E S Mikhael, A Abdelkader, L Mansour, R El Essawy, R El Sayed, A Eladawy, A Mukhtar
Sepsis is one of the most serious complications after major trauma, and may be associated with increased mortality. We sought to determine whether there is an association between serum levels of interleukin-17 (IL-17) at the time of admission to the intensive care unit (ICU) and the development of sepsis. We evaluated 100 adult patients with major trauma admitted to the surgical ICU over a 6-month period. Serum levels of IL-17, IL-6, and TNF-α were determined by enzyme-linked immunosorbent assays (ELISA). The IL-17 rs1974226 genotype was determined by real-time PCR...
September 15, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28916121/controversies-in-corticosteroid-use-for-sepsis
#9
Brit Long, Alex Koyfman
BACKGROUND: Severe sepsis and septic shock are potentially deadly conditions managed in the emergency department (ED). Management centers on source control, fluid resuscitation, broad-spectrum antimicrobials, and vasopressors as needed. The use of corticosteroids is controversial. OBJECTIVE: To evaluate the evidence behind corticosteroid therapy in patients with septic shock. DISCUSSION: Septic shock is associated with severe mortality and morbidity...
September 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28916120/does-early-and-appropriate-antibiotic-administration-improve-mortality-in-emergency-department-patients-with-severe-sepsis-or-septic-shock
#10
Robert Sherwin, Michael E Winters, Gary M Vilke, Gabriel Wardi
BACKGROUND: Severe sepsis and septic shock remain significant public health concerns. Appropriate emergency department management includes early recognition, hemodynamic resuscitation, source control, and prompt antibiotic administration. Current international guidelines strongly recommend administration of early and appropriate antibiotics for patients with severe sepsis and septic shock. Interestingly, a recent Cochrane Review found insufficient evidence to provide a similar recommendation on antibiotic administration...
September 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28915394/overcoming-the-warburg-effect-is-it-the-key-to-survival-in-sepsis
#11
REVIEW
David Bar-Or, Matthew Carrick, Allen Tanner, Mark J Lieser, Leonard T Rael, Edward Brody
Sepsis is a leading cause of mortality in the U.S. and Europe. Sepsis and septic shock are the results of severe metabolic abnormalities following infection. Aerobic glycolysis (the Warburg Effect) is as much a hallmark of sepsis as it is of cancer. Warburg observed that cancer cells generated energy through glycolysis (generation of ATP through degradation of glucose, usually associated with anaerobic conditions) rather than through oxidative phosphorylation (generation of ATP through the mitochondrial inner membrane via the tricarboxylic acid cycle, usually associated with aerobic conditions)...
September 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28915308/mutilating-purpura-fulminans-in-an-adult-with-meningococcal-sepsis
#12
María Elena Arnáiz-García, Ana María Arnáiz-García, Francisco Gutierrez-Diez, Juan Francisco Nistal, Jose María González-Santos, Ivana Pulitani, Carlos Amado-Diago, Javier Arnáiz
We report a dramatic case of meningococcal sepsis manifesting as purpura fulminans in an elderly diabetic woman. Hemodynamic instability and severe bilateral cutaneous lesions involving her hands and feet developed rapidly. Specific antibiotic therapy and the administration of inotropic and vasopressor drugs were initiated. The severity and extension of the cutaneous lesions (attributed to purpura fulminans) worsened because of the need for vasoconstrictors for the treatment of septic shock. Bilateral transmetatarsal and metacarpal amputations were required to stabilize the patient...
September 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28914622/ce-assessing-patients-during-septic-shock-resuscitation
#13
Elizabeth Bridges
How to integrate capillary refill time and skin mottling score into the six-hour bundle. ABSTRACT: In 2015, the Surviving Sepsis Campaign six-hour bundle was updated. The revised version now recommends documenting the reassessment of volume status and tissue perfusion after initial fluid resuscitation through a repeated focused examination. This article addresses the practice and interpretation of two components of this examination in adults: capillary refill time and skin mottling score...
September 13, 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28912862/astragalus-polysaccharides-combined-with-ibuprofen-exhibit-a-therapeutic-effect-on-septic-rats-via-an-anti-inflammatory-cholinergic-pathway
#14
Li Liu, Shibiao Chen, Xiaoyun Xu, Benchao Hou, Fei Mo
The aim of the present study was to investigate the effects of Astragalus polysaccharides (APS) in combination with ibuprofen (IBU) in the treatment of sepsis and the underlying mechanism. The combined drug treatment was evaluated in a rat model of cecal ligation and puncture (CLP). The serum concentrations of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and acetylcholine (ACh) were determined. Nicotinic acetylcholine (nAChR) α7 receptor expression and histopathological changes in the lung tissue were also observed...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28912777/class-a-cpg-oligonucleotide-priming-rescues-mice-from-septic-shock-via-activation-of-platelet-activating-factor-acetylhydrolase
#15
Yoshinari Yamamoto, Ryu Sugimura, Takafumi Watanabe, Suguru Shigemori, Takuma Okajima, Shireen Nigar, Fu Namai, Takashi Sato, Tasuku Ogita, Takeshi Shimosato
Sepsis is a life-threatening, overwhelming immune response to infection with high morbidity and mortality. Inflammatory response and blood clotting are caused by sepsis, which induces serious organ damage and death from shock. As a mechanism of pathogenesis, platelet-activating factor (PAF) induces excessive inflammatory responses and blood clotting. In this study, we demonstrate that a Class A CpG oligodeoxynucleotide (CpG-A1585) strongly induced PAF acetylhydrolase, which generates lyso-PAF. CpG-A1585 rescued mice from acute lethal shock and decreased fibrin deposition, a hallmark of PAF-induced disseminated intravascular coagulation...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28910403/polymicrobial-sepsis-impairs-bystander-recruitment-of-effector-cells-to-infected-skin-despite-optimal-sensing-and-alarming-function-of-skin-resident-memory-cd8-t-cells
#16
Derek B Danahy, Scott M Anthony, Isaac J Jensen, Stacey M Hartwig, Qiang Shan, Hai-Hui Xue, John T Harty, Thomas S Griffith, Vladimir P Badovinac
Sepsis is a systemic infection that enhances host vulnerability to secondary infections normally controlled by T cells. Using CLP sepsis model, we observed that sepsis induces apoptosis of circulating memory CD8 T-cells (TCIRCM) and diminishes their effector functions, leading to impaired CD8 T-cell mediated protection to systemic pathogen re-infection. In the context of localized re-infections, tissue resident memory CD8 T-cells (TRM) provide robust protection in a variety of infectious models. TRM rapidly 'sense' infection in non-lymphoid tissues and 'alarm' the host by enhancing immune cell recruitment to the site of the infection to accelerate pathogen clearance...
September 2017: PLoS Pathogens
https://www.readbyqxmd.com/read/28906287/racial-disparities-in-sepsis-related-in-hospital-mortality-using-a-broad-case-capture-method-and-multivariate-controls-for-clinical-and-hospital-variables-2004-2013
#17
Jenna M Jones, Kathryn R Fingar, Melissa A Miller, Rosanna Coffey, Marguerite Barrett, Thomas Flottemesch, Kevin C Heslin, Darryl T Gray, Ernest Moy
OBJECTIVES: As sepsis hospitalizations have increased, in-hospital sepsis deaths have declined. However, reported rates may remain higher among racial/ethnic minorities. Most previous studies have adjusted primarily for age and sex. The effect of other patient and hospital characteristics on disparities in sepsis mortality is not yet well-known. Furthermore, coding practices in claims data may influence findings. The objective of this study was to use a broad method of capturing sepsis cases to estimate 2004-2013 trends in risk-adjusted in-hospital sepsis mortality rates by race/ethnicity to inform efforts to reduce disparities in sepsis deaths...
September 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28906284/effect-of-transfusion-on-mortality-and-other-adverse-events-among-critically-ill-septic-patients-an-observational-study-using-a-marginal-structural-cox-model
#18
Claire Dupuis, Maité Garrouste-Orgeas, Sébastien Bailly, Christophe Adrie, Dany Goldgran-Toledano, Elie Azoulay, Stéphane Ruckly, Guillaume Marcotte, Bertrand Souweine, Michael Darmon, Yves Cohen, Carole Schwebel, Guillaume Lacave, Lila Bouadma, Jean-Francois Timsit
OBJECTIVES: RBC transfusion is often required in patients with sepsis. However, adverse events have been associated with RBC transfusion, raising safety concerns. A randomized controlled trial validated the 7 g/dL threshold, but previously transfused patients were excluded. Cohort studies led to conflicting results and did not handle time-dependent covariates and history of treatment. Additional data are thus warranted to guide patient's management. DESIGN: To estimate the effect of one or more RBC within 1 day on three major outcomes (mortality, ICU-acquired infections, and severe hypoxemia) at day 30, we used marginal structural models...
September 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28903972/lactobacillus-the-not-so-friendly-bacteria
#19
Abirami Pararajasingam, Juliet Uwagwu
We present a 65-year-old diabetic patient with a complex liver abscess and bacteraemia from Lactobacillus paracasei The abscess resulted in a prolonged hospital stay due to ongoing sepsis despite ultrasound-guided drainage and broad-spectrum antibiotics. Furthermore, the patient developed several secondary complications including a right-sided pleural effusion, an inferior vena cava thrombus and septic lung emboli. The abscess was eventually managed successfully with a prolonged course of antibiotics and multiple ultrasound-guided drainage procedures...
September 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28903154/incidence-and-trends-of-sepsis-in-us-hospitals-using-clinical-vs-claims-data-2009-2014
#20
Chanu Rhee, Raymund Dantes, Lauren Epstein, David J Murphy, Christopher W Seymour, Theodore J Iwashyna, Sameer S Kadri, Derek C Angus, Robert L Danner, Anthony E Fiore, John A Jernigan, Greg S Martin, Edward Septimus, David K Warren, Anita Karcz, Christina Chan, John T Menchaca, Rui Wang, Susan Gruber, Michael Klompas
Importance: Estimates from claims-based analyses suggest that the incidence of sepsis is increasing and mortality rates from sepsis are decreasing. However, estimates from claims data may lack clinical fidelity and can be affected by changing diagnosis and coding practices over time. Objective: To estimate the US national incidence of sepsis and trends using detailed clinical data from the electronic health record (EHR) systems of diverse hospitals. Design, Setting, and Population: Retrospective cohort study of adult patients admitted to 409 academic, community, and federal hospitals from 2009-2014...
September 13, 2017: JAMA: the Journal of the American Medical Association
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