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https://www.readbyqxmd.com/read/27924081/liver-guardian-modifier-and-target-of-sepsis
#1
REVIEW
Pavel Strnad, Frank Tacke, Alexander Koch, Christian Trautwein
Sepsis and septic shock are characterized by life-threatening organ dysfunction caused by a dysregulated host response to infection. The liver has a central role during sepsis, and is essential to the regulation of immune defence during systemic infections by mechanisms such as bacterial clearance, acute-phase protein or cytokine production and metabolic adaptation to inflammation. However, the liver is also a target for sepsis-related injury, including hypoxic hepatitis due to ischaemia and shock, cholestasis due to altered bile metabolism, hepatocellular injury due to drug toxicity or overwhelming inflammation, as well as distinct pathologies such as secondary sclerosing cholangitis in critically ill patients...
December 7, 2016: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27832556/can-femoral-venous-pressure-be-used-as-an-estimate-for-standard-vesical-intra-abdominal-pressure-measurement
#2
A E Howard, A Regli, E Litton, M M Malbrain, A-M Palermo, B L De Keulenaer
Intra-abdominal hypertension (IAH) is highly prevalent in critically ill patients admitted to the intensive care unit and is associated with an increased morbidity and mortality. The present study investigated whether femoral venous pressure (FVP) can be used as a surrogate parameter for intra-abdominal pressure (IAP) measured via the bladder in IAH grade II (IAP <20 mmHg) or grade III (IAP ≥20 mmHg). This was a single-centre prospective study carried out in a tertiary adult intensive care unit. IAP was measured via the bladder with a urinary catheter with simultaneous recording of the FVP via a femoral central line...
November 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27803712/abnormalities-of-thyroid-hormone-metabolism-during-systemic-illness-the-low-t3-syndrome-in-different-clinical-settings
#3
REVIEW
Arnaldo Moura Neto, Denise Engelbrecht Zantut-Wittmann
Thyroid hormone abnormalities are common in critically ill patients. For over three decades, a mild form of these abnormalities has been described in patients with several diseases under outpatient care. These alterations in thyroid hormone economy are a part of the nonthyroidal illness and keep an important relationship with prognosis in most cases. The main feature of this syndrome is a fall in free triiodothyronine (T3) levels with normal thyrotropin (TSH). Free thyroxin (T4) and reverse T3 levels vary according to the underlying disease...
2016: International Journal of Endocrinology
https://www.readbyqxmd.com/read/27742148/pressure-ulcers-in-maturing-skin-a-clinical-perspective
#4
Anna-Barbara Schlüer
While the problem of Pressure Ulcers (PU) in adults has received a great deal of attention, far less is known about PUs in neonates and children. The overall health status of children is generally better and multi-morbidity is limited to a small percentage of patients, like very low term neonates (born before 32 weeks of gestation age), newborns with congenital abnormalities, genetic disorders, perinatal distress syndrome or children with a limited immunity. Survival rates of both critically and chronically ill neonates, infants and children have improved dramatically in recent years, introducing new challenges for medical and nursing care...
October 8, 2016: Journal of Tissue Viability
https://www.readbyqxmd.com/read/27732721/clinical-practice-guidelines-from-the-aabb-red-blood-cell-transfusion-thresholds-and-storage
#5
Jeffrey L Carson, Gordon Guyatt, Nancy M Heddle, Brenda J Grossman, Claudia S Cohn, Mark K Fung, Terry Gernsheimer, John B Holcomb, Lewis J Kaplan, Louis M Katz, Nikki Peterson, Glenn Ramsey, Sunil V Rao, John D Roback, Aryeh Shander, Aaron A R Tobian
Importance: More than 100 million units of blood are collected worldwide each year, yet the indication for red blood cell (RBC) transfusion and the optimal length of RBC storage prior to transfusion are uncertain. Objective: To provide recommendations for the target hemoglobin level for RBC transfusion among hospitalized adult patients who are hemodynamically stable and the length of time RBCs should be stored prior to transfusion. Evidence Review: Reference librarians conducted a literature search for randomized clinical trials (RCTs) evaluating hemoglobin thresholds for RBC transfusion (1950-May 2016) and RBC storage duration (1948-May 2016) without language restrictions...
November 15, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27727256/-venous-thromboembolism-in-critically-ill-patients-analysis-of-the-main-age-related-risk-factors-and-definition-of-specific-scores
#6
Manuel Monti, Giovanni Maria Vincentelli, Giuseppe Murdolo, Giuliano Bertazzoni, Francesco Rocco Pugliese, Francesco Borgognoni, Maria Pia Ruggieri, Raffaele Landolfi
INTRODUCTION: Venous thromboembolism (VTE) is the third most common cardiovascular illness after acute coronary syndrome and stroke and and the most common preventable cause of hospital-related death. Several studies have demonstrated a significant reduction of fatal pulmonary embolism attributed to the introduction of thromboprophylactic measures and changes in hospital practices. However, the influence of some demographical variables, especially age, has largely been under appreciated...
September 2016: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/27715455/assessment-of-geriatric-syndromes-and-physical-function-in-people-living-with-hiv
#7
Meredith Greene, Amy C Justice, Kenneth E Covinsky
: As the number of older adults living with HIV continues to increase, understanding how to incorporate geriatric assessments within HIV care will be critical. Assessment of geriatric syndromes and physical function can be useful tools for HIV clinicians and researchers to help identify the most vulnerable older adults and to better understand the aging process in PLWH. This review focuses on the assessment of falls, frailty and physical function, first in the general population of older adults and includes a specific focus on use of these assessments in older adults living with HIV...
October 7, 2016: Virulence
https://www.readbyqxmd.com/read/27692490/-primary-immunodeficiencies-in-seriously-ill-children-report-of-3-clinical-cases
#8
Leticia Yañez, Pamela Lama, Carolina Rivacoba, Juanita Zamorano, Maria Angélica Marinovic
: Primary immunodeficiency diseases (PID) are congenital disorders secondary to an impaired immune response. Infections, autoimmune disorders, atopy, and lymphoproliferative syndromes are commonly associated with this disorder. OBJECTIVE: To present and discuss 3 infants diagnosed with PID. CLINICAL CASES: The cases are presented of three patients with PID diagnosed during their first admission to a Paediatric Intensive Critical Care Unit...
September 27, 2016: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/27670853/recovery-of-sit-to-stand-function-in-patients-with-intensive-care-unit-acquired-muscle-weakness-results-from-the-general-weakness-syndrome-therapy-cohort-study
#9
Simone Thomas, Jane H Burridge, Marcus Pohl, Frank Oehmichen, Jan Mehrholz
OBJECTIVES: To describe the time course of recovery of sit-to-stand function in patients with intensive-care-unit-acquired muscle weakness and the impact of recovery. METHODS: A cohort study in post-acute intensive care unit and rehabilitation units. Patients with chronic critical illness and intensive-care-unit-acquired muscle weakness were included. Sit-to-stand function was measured daily, using a standardized chair height, defined as 120% of the individual's knee height...
October 12, 2016: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/27663800/cardiovascular-diseases-in-patients-with-bipolar-disease-pragmatic-management
#10
Cátia Jesus, Inês Jesus, Mark Agius
BACKGROUND: Bipolar disorder (BD), also known as manic-depressive illness, is a condition characterized by unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Bipolar disorder is known to be a chronic and disabling disease associated with higher incidence of obesity, diabetes, metabolic syndrome, dyslipidemias, hypertension and tobacco use which all together are known risk factors for the development of Cardiovascular diseases. With this research we wish to collect evidence to show how Cardiovascular diseases (CVD) affect Patients with Bipolar disease, the burden it can have in patients lives, to understand how this problem has been assessed so far and present suggestions that may improve the health care of these patients...
September 2016: Psychiatria Danubina
https://www.readbyqxmd.com/read/27632674/sepsis-pathophysiology-chronic-critical-illness-and-persistent-inflammation-immunosuppression-and-catabolism-syndrome
#11
Juan C Mira, Lori F Gentile, Brittany J Mathias, Philip A Efron, Scott C Brakenridge, Alicia M Mohr, Frederick A Moore, Lyle L Moldawer
OBJECTIVES: To provide an appraisal of the evolving paradigms in the pathophysiology of sepsis and propose the evolution of a new phenotype of critically ill patients, its potential underlying mechanism, and its implications for the future of sepsis management and research. DESIGN: Literature search using PubMed, MEDLINE, EMBASE, and Google Scholar. MEASUREMENTS AND MAIN RESULTS: Sepsis remains one of the most debilitating and expensive illnesses, and its prevalence is not declining...
September 14, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27529321/development-and-validation-of-a-risk-stratification-score-for-children-with-congenital-heart-disease-undergoing-noncardiac-surgery
#12
David Faraoni, Daniel Vo, Viviane G Nasr, James A DiNardo
BACKGROUND: Children with major and severe congenital heart disease (CHD) undergoing noncardiac surgery are at increased risk of mortality. The objective of this study was to identify the predictors for in-hospital mortality, and to develop a risk stratification score that could be used to help decision making and the development of perioperative management guidelines. METHODS: We included all children with major (eg, tetralogy of Fallot with wide open pulmonary insufficiency, hypoplastic left heart syndrome including stage 1 repair) or severe CHD (eg, children with uncorrected CHD, children with documented pulmonary hypertension, children with ventricular dysfunction requiring medications, or children listed for heart transplant) recorded in the 2012 and 2013 American College of Surgeons National Surgical Quality Improvement Program Pediatric databases in a derivation cohort, and those recorded in the 2014 database in a validation cohort...
October 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27490213/chronic-pain-disorders-after-critical-illness-and-icu-acquired-opioid-dependence-two-clinical-conundra
#13
Kathleen Ann Puntillo, Ramana Naidu
PURPOSE OF REVIEW: Is to describe the potential for patients to undergo an acute-to-chronic pain transition after ICU discharge as a result of pain they experienced in ICU and to explore the phenomenon of ICU-acquired opioid dependence. Both topics are timely, in that they can negatively influence patient recovery after critical illness and contribute to post-ICU syndrome. RECENT FINDINGS: Recognizing and treating pain in patients while they are in the ICU has always been important...
October 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27452748/-maintenance-of-intestinal-barrier-function-in-patients-with-chronic-critical-illness
#14
Xiuwen Wu, Jianan Ren, Jieshou Li
The syndrome known as chronic critical illness (CCI) is defined as that critically ill patients survive their initial acute illness but go on to experience persistent organ failures necessitating prolonged intensive care. Intestinal barrier is the physical barrier that separates the internal and external environments and prevents the invasion of pathogenic antigens. Due to its pathogenesis, many CCI patients have injured intestinal barrier. Gut is the motor organ of stress responses, and gut-associated infections may initiate multiple organ dysfunction...
July 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27452747/-prevention-and-management-of-refeeding-syndrome-in-patients-with-chronic-critical-illness
#15
Jun Chen, Chaogang Fan
Nutritional support is an important means to treat the patients with chronic critical illness for commonly associated malnutrition. Refeeding syndrome is a serious complication during the process, mainly manifested as severe electrolyte with hypophosphataemia being the most common. Refeeding syndrome is not uncommon but it is often ignored. In our future clinical work, we need to recognize this chinical situation and use preventative and treatment measures. According to NICE clinical nutrition guideline, we discussed the risk factors, treatment methods and preventive measures of refeeding syndrome in patients with chronic critical illness...
July 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27452746/-persistent-inflammation-immunosuppression-catabolism-syndrome-a-special-type-of-chronic-critical-illness
#16
Renyu Ding, Xiaochun Ma
After the concept of "chronic critical illness (CCI)" was proposed, the new concept persistent inflammation immunosuppression catabolism syndrome (PICS) is present recently. Patients with PICS are manifested by fast decreasing body weight, poor nutritional status, long-term immunosuppression and repeated nosocomial infections. These patients are faced with great challenges of persistent inflammation, acquired immunosuppression and high catabolism, which finally results in repeated nosocomial infections, prolonged hospital stay and increased mortality...
July 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27381107/acute-physiology-and-chronic-health-evaluation-ii-score-of-%C3%A2-15-a-risk-factor-for-sepsis-induced-critical-illness-polyneuropathy
#17
Salil Gupta, Mayank Mishra
BACKGROUND: Critical illness polyneuropathy (CIP) is a common complication of severe sepsis and systemic inflammatory response syndrome (SIRS). The risk factors for sepsis-induced CIP have not been well established. AIM: The aim of this study was to find out the risk factors of sepsis-induced CIP, especially its relationship with the severity of illness. PATIENTS AND METHODS: A cohort of 100 patients with sepsis defined as SIRS of proven or presumed microbial etiology were followed up with nerve conduction studies (NCS) performed within the first 14 days of admission...
July 2016: Neurology India
https://www.readbyqxmd.com/read/27349577/mitochondrial-dysfunction-in-cardiorenal-syndrome
#18
Kent Doi, Eisei Noiri
SIGNIFICANCE: Acute kidney injury (AKI) has a significant impact on the outcomes of critically ill patients, although no effective and specific treatment against AKI is currently available in the clinical setting. It is assumed that reactive oxygen species production by the mitochondria plays a crucial role in renal damage especially caused by cellular apoptosis. Mitochondrial injury in the heart is reported as an important determinant of myocardial contractility. Clinical epidemiological data indicate that remote organ effects induced by AKI, especially organ cross talk between the kidney and heart, might contribute to the poor outcome of AKI patients...
August 1, 2016: Antioxidants & Redox Signaling
https://www.readbyqxmd.com/read/27340909/the-effect-of-concomitant-sirolimus-and-propofol-therapy-on-triglyceride-concentrations-in-critically-ill-patients
#19
Kevin M Dube, Paul M Szumita, Megan A Rocchio, Po-Shun Lee, Kevin E Anger
BACKGROUND: Sirolimus and propofol are both independently associated with the development of hypertriglyceridemia (HTG) during therapy. To date, there are no published reports describing synergistic or additive drug interaction resulting in HTG with concomitant use of these medications. STUDY QUESTION: To identify the occurrence of HTG in patients receiving concomitant sirolimus and propofol infusion therapy. METHODS: Adult patients receiving sirolimus and a continuous propofol infusion for at least 12 hours from January 2005 to August 2009 were retrospectively evaluated...
June 23, 2016: American Journal of Therapeutics
https://www.readbyqxmd.com/read/27333845/children-with-down-syndrome-clinical-course-and-mortality-associated-factors-in-a-french-medical-paediatric-intensive-care-unit
#20
Christelle Joffre, Fabrice Lesage, Olivier Bustarret, Philippe Hubert, Mehdi Oualha
AIM: To investigate clinical course and mortality-associated factors in children with Down syndrome (DS) managed in a medical paediatric intensive care unit. METHODS: A single-centre, retrospective study conducted between 2001 and 2010 in DS children aged 1 month to 16 years. RESULTS: Sixty-six patients with a median age of 24 months (1-192) and a male/female ratio of 1.5 were analysed. Patients presented with history of congenital heart disease (n = 52, 78...
June 2016: Journal of Paediatrics and Child Health
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