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Severe sepsis , sepsis , se

Aline Kirjner Poziomyck, Ana Valeria Gonçalves Fruchtenicht, Georgia Brum Kabke, Bernardo Silveira Volkweis, Jorge Luiz Antoniazzi, Luis Fernando Moreira
Patients with gastrointestinal cancer and malnutrition are less likely to tolerate major surgical procedures, radiotherapy or chemotherapy. In general, they display a higher incidence of complications such as infection, dehiscence and sepsis, which increases the length of stay and risk of death, and reduces quality of life. The aim of this review is to discuss the pros and cons of different points of view to assess nutritional risk in patients with gastrointestinal tract (GIT) tumors and their viability, considering the current understanding and screening approaches in the field...
May 2016: Revista do Colégio Brasileiro de Cirurgiões
Maynara Fernanda Carvalho Barreto, Mara Solange Gomes Dellaroza, Gilselena Kerbauy, Cintia Magalhães Carvalho Grion
OBJECTIVE: To estimate the cost of hospitalization of patients with severe sepsis or septic shock admitted or diagnosed in the Urgent and Emergency sector at a university hospital and followed until the clinical outcome. METHOD: An epidemiological, prospective, observational study conducted in a public hospital in southern Brazil for the period of one year (August 2013 to August 2014). Sepsis notification forms, medical records and data of the cost sector were used for the collection of clinical and epidemiological data...
April 2016: Revista da Escola de Enfermagem da U S P
Marcia C Riyuzo, Liciana V de A Silveira, Célia S Macedo, José R Fioretto
OBJECTIVE: To evaluate the prognosis factors of children with sepsis and acute kidney injury. METHODS: This was a retrospective study of children with sepsis and acute kidney injury that were admitted to the pediatric intensive care unit (PICU) of a tertiary hospital. A multivariate analysis was performed to compare risk factors for mortality. RESULTS: Seventy-seven children (47 males) were retrospectively studied, median age of 4 months. Mean length of hospital stay was 7...
July 2, 2016: Jornal de Pediatria
Dalia Y Saad, Ahmed A Baiomy, Ahmed A Mansour
Sepsis is a systemic inflammatory response to infection and severe sepsis patients can develop acute lung and liver injury. The aim of the present study was to evaluate the efficacy of Holothuria atra methanolic body wall extract (HaE), as an antioxidant and anti-inflammatory agent against induced sepsis in a cecal ligation and puncture (CLP) rat model. In total, 30 males albino rats were divided into three groups (n=10 each) as follows: Sham (Sh), which was used as negative control; sepsis (Se), which was used as a positive control and was subjected to CLP surgery; and Ho, which was subjected to CLP and fed with 200 mg/kg (body weight) of HaE, once daily for 7 days...
July 2016: Experimental and Therapeutic Medicine
Karoline Myglegård Mortensen, Theis Skovsgaard Itenov, Nicolai Haase, Rasmus Beier Müller, Sisse Rye Ostrowski, Pär Ingemar Johansson, Niels Vidiendal Olsen, Anders Perner, Peter Søe-Jensen, Morten Heiberg Bestle
INTRODUCTION: Nitric oxide (NO) likely plays a pivotal role in the pathogenesis of sepsis. Arginine is a substrate for NO, whereas the methylated arginines-asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA)-are endogenous by-products of proteolysis that inhibit NO production.We investigated if high-plasma levels of ADMA, SDMA, and arginine/ADMA ratio were associated with 90-day mortality in patients with severe sepsis or septic shock. METHODS: We included 267 adult patients admitted to intensive care unit with severe sepsis or septic shock...
October 2016: Shock
Martin Matejovic, Zdenek Tuma, Jiri Moravec, Lenka Valesova, Roman Sykora, Jiri Chvojka, Jan Benes, Jan Mares
Although the burden of septic acute kidney injury continues to increase, the molecular pathogenesis remains largely obscure. The aim of this exploratory study was a discovery-driven analysis of dynamic kidney tissue protein expression changes applied for the first time in a classic large mammal model of sepsis. To achieve this goal, analyses of protein expression alterations were performed in serial samples of kidney cortical biopsies (before, 12 and 22 h of sepsis) in mechanically ventilated pigs challenged with continuous infusion of pseudomonas aeruginosa and compared with sham-operated control data...
October 2016: Shock
Cheng-Xiang Lu, Ting Qiu, Hua-Sheng Tong, Zhi-Feng Liu, Lei Su, Biao Cheng
Septic encephalopathy (SE) is a diffuse cerebral dysfunction resulting from a systemic inflammatory response, and is associated with an increased risk of mortality. The pathogenesis of SE is complex and multifactorial, but unregulated immune imbalance may be an important factor. The current retrospective study examined the clinical data of 86 patients with severe sepsis who were admitted to the Intensive Care Unit at Zhongshan Hospital, Xiamen University (Xiamen, China) from January, 2014 to January, 2015. The patients were assigned to SE and non-SE patient groups according to the presence or absence of SE...
March 2016: Experimental and Therapeutic Medicine
Philipp Baumbach, Theresa Götz, Albrecht Günther, Thomas Weiss, Winfried Meissner
OBJECTIVE: There is only limited knowledge about chronic pain conditions resulting from critical care. Experimental and clinical data suggest a close relationship between inflammation and pain perception. Since sepsis is the most severe form of systemic inflammation, the primary objective was to evaluate chronic pain states and functional impairment of septic and nonseptic patients 6 months after discharge from ICU. Second, we aimed to obtain the total prevalence and characteristics of chronic ICU-related pain...
June 2016: Critical Care Medicine
Michaëla A M Huson, Brendon P Scicluna, Lonneke A van Vught, Maryse A Wiewel, Arie J Hoogendijk, Olaf L Cremer, Marc J M Bonten, Marcus J Schultz, Marek Franitza, Mohammad R Toliat, Peter Nürnberg, Martin P Grobusch, Tom van der Poll
HIV patients have an increased risk to develop sepsis and HIV infection affects several components of the immune system involved in sepsis pathogenesis. We hypothesized that HIV infection might aggrevate the aberrant immune response during sepsis, so we aimed to determine the impact of HIV infection on the genomic host response to sepsis. We compared whole blood leukocyte gene expression profiles among sepsis patients with or without HIV co-infection in the intensive care unit (ICU) and validated our findings in a cohort of patients admitted to the same ICUs in a different time frame...
2016: PloS One
J Martitz, N-P Becker, K Renko, M Stoedter, S Hybsier, L Schomburg
Sepsis is a severe inflammatory disease resulting in excessive production of pro-inflammatory cytokines including interleukin-6 (IL-6), causing oxidative stress, tissue damage and organ dysfunction. Health benefits have been observed upon selenium (Se) supplementation in severe sepsis. Selenium is incorporated into selenoproteins implicated in anti-oxidative defence, thyroid hormone metabolism and immunoregulation. Selenium metabolism is controlled by hepatocytes synthesizing and secreting the Se transporter selenoprotein P (SePP)...
November 2015: Metallomics: Integrated Biometal Science
Scott L Weiss, Julie C Fitzgerald, Frank A Maffei, Jason M Kane, Antonio Rodriguez-Nunez, Deyin D Hsing, Deborah Franzon, Sze Ying Kee, Jenny L Bush, Jason A Roy, Neal J Thomas, Vinay M Nadkarni
INTRODUCTION: Consensus criteria for pediatric severe sepsis have standardized enrollment for research studies. However, the extent to which critically ill children identified by consensus criteria reflect physician diagnosis of severe sepsis, which underlies external validity for pediatric sepsis research, is not known. We sought to determine the agreement between physician diagnosis and consensus criteria to identify pediatric patients with severe sepsis across a network of international pediatric intensive care units (PICUs)...
September 16, 2015: Critical Care: the Official Journal of the Critical Care Forum
Sang Hoon Lee, Moo Suk Park, Byung Hoon Park, Won Jai Jung, In Seon Lee, Song Yee Kim, Eun Young Kim, Ji Ye Jung, Young Ae Kang, Young Sam Kim, Se Kyu Kim, Joon Chang, Kyung Soo Chung
BACKGROUND: Despite extensive research and an improved standard of care, sepsis remains a disorder with a high mortality rate. Sepsis is accompanied by severe metabolic alterations. METHODS: We evaluated 117 patients with sepsis (severe sepsis [n = 19] and septic shock [n = 98]) who were admitted to the intensive care unit. Serum cholesterol, triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), free fatty acid (FFA), and apolipoprotein (Apo) A-I levels were measured on days 0, 1, 3, and 7...
2015: BioMed Research International
Whanbong Lee
BACKGROUNDS/AIMS: Aging of population is leading to more operative treatments on elderly patients in various aspects. Growing numbers of patients are going through operations about cholecystitis in the same sense. We tried to survey them anew about remarkably increasing octogenarian patients and the outcome after operative management for cholecystitis seeking to improve treatment result. METHODS: For 5 years, from March 2007 to Febraury 2012, 57 octogenarian patients had cholecystectomy among total 380 cases...
November 2013: Korean Journal of Hepato-biliary-pancreatic Surgery
Paolo Angeli, Marta Tonon, Chiara Pilutti, Filippo Morando, Salvatore Piano
Acute kidney injury (AKI) is a common and life-threatening complication in patients with cirrhosis. Recently, new criteria for the diagnosis of AKI have been proposed in patients with cirrhosis by the International Club of Ascites. Almost all types of bacterial infections can induce AKI in patients with cirrhosis representing its most common precipitating event. The bacterial infection-induced AKI usually meets the diagnostic criteria of hepatorenal syndrome (HRS). Well in keeping with the "splanchnic arterial vasodilation hypothesis", it has been stated that HRS develops as a consequence of a severe reduction of effective circulating volume related to splanchnic arterial vasodilation and to an inadequate cardiac output...
January 2016: Hepatology International
Kenneth R Chapman, Jonathan G W Burdon, Eeva Piitulainen, Robert A Sandhaus, Niels Seersholm, James M Stocks, Berend C Stoel, Liping Huang, Zhenling Yao, Jonathan M Edelman, Noel G McElvaney
BACKGROUND: The efficacy of α1 proteinase inhibitor (A1PI) augmentation treatment for α1 antitrypsin deficiency has not been substantiated by a randomised, placebo-controlled trial. CT-measured lung density is a more sensitive measure of disease progression in α1 antitrypsin deficiency emphysema than spirometry is, so we aimed to assess the efficacy of augmentation treatment with this measure. METHODS: The RAPID study was a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial of A1PI treatment in patients with α1 antitrypsin deficiency...
July 25, 2015: Lancet
Won Jai Jung, Byung Hoon Park, Kyung Soo Chung, Song Yee Kim, Eun Young Kim, Ji Ye Jung, Young Ae Kang, Young Sam Kim, Se Kyu Kim, Joon Chang, Moo Suk Park
PURPOSE: Few studies on plasma glucagon levels in patients with sepsis have been performed. We aimed to assess clinical value of glucagon levels in comparison with clinical parameters and severity scores in patients with severe sepsis or septic shock. METHODS: A total of 112 patients who were admitted to intensive care unit with severe sepsis or septic shock were included. Plasma levels of glucagon on days 0, 1, 3, and 7 were serially measured in 112 patients with severe sepsis or septic shock...
June 2015: Shock
Oded Shamriz, Dan Engelhard, Violeta Temper, Shoshana Revel-Vilk, Shmuel Benenson, Rebecca Brooks, Ariel Tenenbaum, Polina Stepensky, Benjamin Koplewitz, Michal Kaufmann, Diana Averbuch
PURPOSE: This study aimed at reviewing our experience with infections caused by Fusobacterium in children. METHODS: A retrospective analysis of medical records of children admitted to Hadassah-Hebrew University Medical Center from 2000 to 2013, in whom Fusobacterium spp. was identified in any specimen. RESULTS: A total of 22 patients (males = 12) at a mean ± SE age of 5 ± 1 (range 1-17) years, were identified. The most common complication was abscess formation (n = 11, 50 %)...
December 2015: Infection
Sisse Rye Ostrowski, Nicolai Haase, Rasmus Beier Müller, Morten Hylander Møller, Frank Christian Pott, Anders Perner, Pär Ingemar Johansson
INTRODUCTION: Patients with severe sepsis often present with concurrent coagulopathy, microcirculatory failure and evidence of vascular endothelial activation and damage. Given the critical role of the endothelium in balancing hemostasis, we investigated single-point associations between whole blood coagulopathy by thrombelastography (TEG) and plasma/serum markers of endothelial activation and damage in patients with severe sepsis. METHODS: A post-hoc multicenter prospective observational study in a subgroup of 184 patients from the Scandinavian Starch for Severe Sepsis/Septic Shock (6S) Trial...
2015: Critical Care: the Official Journal of the Critical Care Forum
Eu Chang Hwang, Seung Il Jung, Young Ho Seo, Se Heon Jeong, Dong Deuk Kwon, Kwangsung Park, Jin Woong Kim
PURPOSE: To evaluate the risk factors and efficacy of a povidone-iodine enema on infectious complications after transrectal ultrasound-guided prostate biopsy. METHODS: A total of 814 males who underwent transrectal ultrasound-guided prostate biopsy from January 2011 to December 2013 were evaluated retrospectively. Clinical variables, including demographics, prior antibiotic, or quinolone exposure, rectal swab culture results, povidone-iodine rectal cleansing, antibiotic prophylaxis, and infectious complications, were evaluated...
April 2015: International Urology and Nephrology
Gaël Piton, Benoit Cypriani, Jacques Regnard, Cyrille Patry, Marc Puyraveau, Gilles Capellier
Small bowel damage is frequent but underdiagnosed among critically ill patients with shock. High catecholamine doses may have a deleterious effect on mesenteric blood flow. Plasma intestinal fatty acid-binding protein (I-FABP) concentration is a marker of enterocyte damage, whereas plasma citrulline concentration is a marker of functional enterocyte mass. We hypothesized that high doses of catecholamines in critically ill patients may be associated with enterocyte damage. This study aimed to determine the link between catecholamine use and dose with enterocyte damage...
May 2015: Shock
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