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sepsis management

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https://www.readbyqxmd.com/read/28088183/incidence-aetiology-and-outcome-of-community-acquired-acute-kidney-injury-in-medical-admissions-in-malawi
#1
Rhys D R Evans, Ulla Hemmilä, Alison Craik, Mwayi Mtekateka, Fergus Hamilton, Zuze Kawale, Christopher J Kirwan, Hamish Dobbie, Gavin Dreyer
BACKGROUND: Epidemiological data on Acute Kidney Injury (AKI) from low-income countries is sparse. The aim of this study was to establish the incidence, severity, aetiology, and outcomes of community-acquired AKI in Malawi. METHODS: We conducted a prospective observational study of general medical admissions to a tertiary hospital in Blantyre between 27(th) April and 17(th) July 2015. All patients were screened on admission with a serum creatinine; those with creatinine above laboratory reference range were managed by the nephrology team...
January 14, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28087145/-computerised-sepsis-protocol-management-description-of-an-early-warning-system
#2
Begoña de Dios, Marcio Borges, Timothy D Smith, Alberto Del Castillo, Antonia Socias, Leticia Gutiérrez, Jordi Nicolás, Bartolomé Lladó, Jose A Roche, Maria P Díaz, Yolanda Lladó
INTRODUCTION: New strategies need to be developed for the early recognition and rapid response for the management of sepsis. To achieve this purpose, the Multidisciplinary Sepsis Team (MST) developed the Computerised Sepsis Protocol Management (PIMIS). The aim of this study was to evaluate the convenience of using PIMIS, as well as the activity of the MST. METHODS: An analysis was performed on the data collected from solicited MST consultations (direct activation of PIMIS by attending physician or telephone request) and unsolicited ones (by referral from the microbiology laboratory or an automatic referral via the hospital vital signs recording software [SIDCV]), as well as the hospital department, source of infection, treatment recommendation, and acceptance of this...
January 10, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28078172/gastric-rupture-in-pregnancy-case-series-from-a-tertiary-institution-in-rwanda-and-review-of-the-literature
#3
David Ntirushwa, Stephen Rulisa, Febronie Muhorakeye, Lisa Bazzett-Matabele, Theogene Rurangwa, Maria Small
Background Gastric rupture is a rare, life-threatening condition during pregnancy. Case study We present three cases of gastric perforation during pregnancy and the puerperium. The first patient presented with gastric perforation 4 days following an uncomplicated cesarean delivery for obstetric indications. She initially complained of epigastric pain; however, those symptoms resolved. She later demonstrated worsening abdominal distension, intra-abdominal free fluid, and signs of peritonitis. At laparotomy, an ascariasis-associated gastric rupture was diagnosed...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28075032/-microbiological-findings-and-antibacterial-therapy-in-stevens-johnson-syndrome-toxic-epidermal-necrolysis-patients-from-a-swedish-burn-center
#4
Ilaria Tocco-Tussardi, Fredrik Huss, Benjamin Presman
BACKGROUND: Superimposed infections/sepsis are the major cause of morbidity/mortality in Stevens-Johnson syndrome/Toxic Epidermal Necrolysis (SJS/TEN). It is a delicate balance between avoiding new pharmaceuticals and prophylactically treat an incipient infection. The objective of this study was to investigate the rates and types of infection-microbials and antibiotics involved in SJS/TEN patients. METHODS: Microbiology and clinical data were collected for SJS/TEN patients admitted to our Burn Centre from January 2010 through January 2016...
January 11, 2017: Journal of Cutaneous Pathology
https://www.readbyqxmd.com/read/28071947/presacral-abscess-as-a-rare-complication-of-sacral-nerve-stimulator-implantation
#5
A Gumber, S Ayyar, H Varia, S Pettit
A 50-year-old man with intractable anal pain attributed to proctalgia fugax underwent insertion of a sacral nerve stimulator via the right S3 vertebral foramen for pain control with good symptomatic relief. Thirteen months later, he presented with signs of sepsis. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large presacral abscess. MRI demonstrated increased enhancement along the pathway of the stimulator electrode, indicating that the abscess was caused by infection introduced at the time of sacral nerve stimulator placement...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28071865/the-impact-of-evidence-based-sepsis-guidelines-on-emergency-department-clinical-practice-a-pre-post-medical-record-audit
#6
Bernadine Romero, Margaret Fry, Michael Roche
AIMS AND OBJECTIVES: The aim of this study was to explore the number of patients presenting with sepsis before and after guideline implementation; the impact of sepsis guidelines on triage assessment, Emergency Department management and time to antibiotics. BACKGROUND: Sepsis remains one of the leading causes of mortality and morbidity within hospitals. Globally, strategies have been implemented to reduce morbidity and mortality rates, which rely on the early recognition and management of sepsis...
January 10, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28069912/idiosyncratic-drug-induced-neutropenia-agranulocytosis
#7
Emmanuel Andrès, Rachel Mourot-Cottet, Frédéric Maloisel, François Séverac, Olivier Keller, Thomas Vogel, Martine Tebacher, Jean-Christophe Weber, Georges Kaltenbach, Jacques-Eric Gottenberg, Bernard Goichot, Jean Sibilia, Anne-Sophie Korganow, Raoul Herbrecht
BACKGROUD: Few data is currently available on neutropenia and agranulocytosis related to drug intake. We report here data on 203 patients with established idiosyncratic drug-induced agranulocytosis, followed up in a referral centre within a university hospital. PATIENTS AND METHODS: Data from 203 patients with idiosyncratic drug-induced agranulocytosis were retrospectively reviewed. All cases were extracted from a cohort study on agranulocytosis in the Strasbourg University Hospital (Strasbourg, France) RESULTS: : The mean age was 61...
January 9, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28069781/acute-colonic-pseudo-obstruction-associated-with-abdominal-paracentesis
#8
Michael Patrick Turner, Sophie Arndtz, George MacFaul
A 61-year-old man presented with accumulation of ascites secondary to alcoholic liver disease. He had an ascitic drain sited and 24 hours later he developed acute colonic pseudo-obstruction (ACPO). This is a rare condition previously associated with major surgery and severe sepsis. The patient did well with conservative management, and avoided the need for endoscopic decompression or surgical intervention. We believe that this is the first report of ACPO secondary to abdominal paracentesis.
January 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28063460/managing-two-decades-of-visceral-leishmaniasis-and-hiv-co-infection-a-case-report-that-illustrates-the-urgent-research-needs-in-the-field
#9
Melissa L Kelly, Angie N Pinto, Dan Suan, Debbie Marriott, David A Cooper, Sarah L Pett
Visceral leishmaniasis and HIV co-infection presents diagnostic, monitoring and treatment challenges. This is a report of a co-infected patient who developed multiple complications and treatment side-effects, including renal and liver failure, pancytopenia with recurrent sepsis, along with anal cancer, depression and poor quality-of-life spanning over two decades. Urgent research specific to this cohort is needed.
January 9, 2017: Sexual Health
https://www.readbyqxmd.com/read/28062417/pulmonary-tuberculosis-presenting-as-post-operative-fever-of-unknown-origin
#10
Patrick Bogue, Mhairi Bolland, Peter How, Harrison Benziger
Post-operative fever is common following emergency surgery. Investigation and management of post-operative fever can be challenging when a clear source of sepsis is not evident or the underlying source of infection is not recognised. We herein report a case of secondary pulmonary tuberculosis presenting as post-operative fever following emergency laparotomy for a perforated duodenal ulcer. This case of tuberculosis was diagnosed on day 41 post-operatively and prior inconclusive results meant that we relied mainly on re-visiting history and examination in order to identify 3 targeted investigations: plain chest X-ray, sputum sample and blood test...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28062114/effect-of-immediate-administration-of-antibiotics-in-patients-with-sepsis-in-tertiary-care-a-systematic-review-and-meta-analysis
#11
REVIEW
Amy N B Johnston, Joon Park, Suhail A Doi, Vicki Sharman, Justin Clark, Jemma Robinson, Julia Crilly
PURPOSE: The goal of this review was to synthesize existing evidence regarding outcomes (mortality) for patients who present to the emergency department, are administered antibiotics immediately (within 1 hour) or later (>1 hour), and are diagnosed with sepsis. METHODS: A search of PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL, using the MeSH descriptors "sepsis," "systemic inflammatory response syndrome," "mortality," "emergency," and "antibiotics," was performed to identify studies reporting time to antibiotic administration and mortality outcome in patients with sepsis...
January 3, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28061799/ralstonia-picketti-neonatal-sepsis-a-case-report
#12
Deepak Sharma, Pradeep Sharma, Priyanka Soni, Basudev Gupta
BACKGROUND: Ralstonia genus are gram negative bacillus and includes four bacteria namely Ralstonia picketti, Ralstonia Solanacearum, Ralstonia insidiosa and Ralstonia mannitolilytica. These are opportunistic pathogens and cause infections in immunocompromised host. The sources of infection are usually contaminated solutions and water. The majority of the reported cases are caused by R. picketti. It is very rare cause of neonatal sepsis with less than twenty cases reported in literature till date...
January 7, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28061498/skull-metastasis-of-gastric-gastrointestinal-stromal-tumor-successfully-managed-by-surgery
#13
Inkeun Park, Dong Hae Chung, Chan Jong Yoo, Dong Bok Shin
Gastrointestinal stromal tumors (GISTs) are rare, but are the most common mesenchymal neoplasm of the gastrointestinal tract. The most common sites of metastasis are liver and peritoneum, while bone metastasis is rare. We report on a patient with skull metastasis after seven years of treatment with imatinib for metastatic GIST. She underwent metastasectomy consisting of craniectomy with excision of the mass, and cranioplasty and continued treatment with imatinib and sunitinib, without evidence of cranial recurrence...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28060181/predicting-periarticular-infection-in-children-with-septic-arthritis-of-the-hip-regionally-derived-criteria-may-not-apply-to-all-populations
#14
Christian A Refakis, Alexandre Arkader, Keith D Baldwin, David A Spiegel, Wudbhav N Sankar
BACKGROUND: The management of septic arthritis of the hip in children can be complicated by the presence of additional coexisting periarticular infections (PAIs). Criteria predicting the presence of PAI have recently been proposed by Rosenfeld and colleagues with the goal of using magnetic resonance imaging (MRI) efficiently in the workup of septic arthritis. The purpose of this study was to determine the applicability of recently published predictive criteria for PAI (developed in the Southwestern United States using a variety of joints) to septic arthritis of the hip treated at a large Northeastern tertiary care center...
January 5, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28057990/predictors-of-systemic-inflammatory-response-syndrome-following-percutaneous-nephrolithotomy
#15
Karunamoorthy Ramaraju, Arun Kumar Paranjothi, Dhinakar Babu Namperumalsamy, Ilamparuthi Chennakrishnan
INTRODUCTION AND OBJECTIVES: Sepsis remains one of the dreaded complications of percutaneous nephrolithotomy (PCNL). To analyze prospectively the preoperative and intraoperative factors that predict the occurrence of systemic inflammatory response syndrome (SIRS) in patients undergoing PCNL so that we can aggressively manage those patients from the preoperative period itself and avert the dangerous complications. MATERIALS AND METHODS: A prospective study was carried out between August 2012 and March 2013 including all patients who underwent PCNL...
October 2016: Urology Annals
https://www.readbyqxmd.com/read/28052950/sepsis-and-siderosis-yersinia-enterocolitica-and-hereditary-haemochromatosis
#16
Phoebe A Thwaites, Marion L Woods
A 60-year-old woman was admitted with sepsis, relative bradycardia, CT evidence of numerous small liver abscesses and 'skin bronzing' consistent with hereditary haemochromatosis (HH). Yersinia enterocolitica O:9 infection was confirmed by serology specimens taken 10 days apart. Iron overload was detected, and homozygous C282Y gene mutation confirmed HH. Liver biopsy revealed grade IV siderosis with micronodular cirrhosis. Haemochromatosis is a common, inherited disorder leading to iron overload that can produce end-organ damage from excess iron deposition...
January 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28052283/the-feasibility-of-conservative-management-for-morbidly-adherent-placenta-accidentally-encountered-after-vaginal-delivery
#17
Ran Cui, Junli Lu, Zhenyu Zhang, Huimin Bai
OBJECTIVE: To evaluate the feasibility of conservative management for patients with morbidly adherent placenta (MAP) accidentally encountered after term vaginal delivery. METHODS: Medical records of patients with MAP who were accidentally encountered after term vaginal delivery and treated in our hospital from January 2009 to December 2015 were retrospectively reviewed. RESULTS: A total of 8 eligible patients were included in this analysis...
January 5, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28051046/typhoid-perforation-post-operative-intensive-care-unit-care-and-outcome
#18
Mukaila Oyegbade Akinwale, Arinola A Sanusi, Oluwaseun K Adebayo
BACKGROUND: Typhoid perforation ileitis is a serious complication of typhoid fever, a common and unfortunate health problem in a resource-poor country like Nigeria. Following bowel perforation, treatment is usually by simple closure or bowel resection and anastomosis after adequate aggressive fluid resuscitation and electrolyte correction. Postoperatively, some of these patients do require management in Intensive Care Unit (ICU) on account of sepsis or septic shock and to improve survival...
October 2016: African Journal of Paediatric Surgery: AJPS
https://www.readbyqxmd.com/read/28051043/experience-with-neonatal-hydrometrocolpos-in-the-niger-delta-area-of-nigeria-upsurge-or-increased-recognition
#19
Philemon Ekemenye Okoro, C Obiorah, C E Enyindah
BACKGROUND: Hydrometrocolpos (HMC) is a clinical condition in which there is a cystic distension of the vagina (hydrocolpos), uterus and sometimes, fallopian tubes (hydrosalpinx) with fluid. This study described our experience with cases of HMC seen in our practice, and highlighted the flare in our practice. PATIENTS AND METHODS: A retrospective study of cases of HMC managed at the University of Port Harcourt Teaching Hospital between September 2010 and August 2012...
October 2016: African Journal of Paediatric Surgery: AJPS
https://www.readbyqxmd.com/read/28050900/planned-early-birth-versus-expectant-management-waiting-for-prelabour-rupture-of-membranes-at-term-37-weeks-or-more
#20
REVIEW
Philippa Middleton, Emily Shepherd, Vicki Flenady, Rosemary D McBain, Caroline A Crowther
BACKGROUND: Prelabour rupture of membranes (PROM) at term is managed expectantly or by planned early birth. It is not clear if waiting for birth to occur spontaneously is better than intervening, e.g. by inducing labour. OBJECTIVES: The objective of this review is to assess the effects of planned early birth (immediate intervention or intervention within 24 hours) when compared with expectant management (no planned intervention within 24 hours) for women with term PROM on maternal, fetal and neonatal outcomes...
January 4, 2017: Cochrane Database of Systematic Reviews
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