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https://www.readbyqxmd.com/read/29220755/coronary-artery-calcification-predicts-cardiovascular-complications-after-sepsis
#1
Vedant A Gupta, Matthew Sousa, Nathan Kraitman, Rahul Annabathula, Olga Vsevolozhskaya, Steve W Leung, Vincent L Sorrell
PURPOSE: Sepsis is a highly prevalent and fatal condition, with reported cardiovascular event rates as high as 25-30% at 1year. Risk stratification in septic patients has been extremely limited. MATERIAL AND METHODS: 267 septic patients with detectable troponin levels, APACHE II scores, and CT scans of the chest or abdomen were assessed. Patients with a recent cardiac intervention were excluded. Coronary artery calcification (CAC) was identified as present or absent on body CT scans...
December 2, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29217190/the-down-regulation-of-cardiac-contractile-proteins-underlies-myocardial-depression-during-sepsis-and-is-mitigated-by-carbon-monoxide
#2
Kana Unuma, Toshihiko Aki, Suguru Nagano, Ryo Watanabe, Koichi Uemura
The aim of this study is to investigate the mechanism underling cardiac dysfunction during sepsis, as well as the possible amelioration of this dysfunction by exogenous carbon monoxide (CO) administration. For this purpose, rats (six-weeks-old, male, Sprague-Dawley) were administered LPS (15 mg/kg body weight, i.p. 6 h) and/or CORM (30 mg/kg, i.p.). The decreased left ventricular ejection fraction (EF) observed in LPS group rats was recovered in the LSP + CORM group, confirming the protective role of CO against sepsis-induced myocardial depression...
December 4, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/29216952/-sepsis-induced-cardiomyopathy-complicated-with-cardiogenic-shock-patients-supported-with-extracorporeal-membrane-oxygenation
#3
Changzhi Liu, Ruiqiu Zhu, Zhujiang Zhou, Haifeng Liu, Jingcheng Lin, Shuchao Wen, Liuer Zuo
Sepsis-induced cardiomyopathy is a reversible myocardial dysfunction due to sepsis, which may be severe enough to complicate cardiogenic shock, and without effective drug and with high mortality during the acute phase. A case of sepsis-induced cardiomyopathy complicated with cardiogenic shock was treated in the intensive care unit (ICU) of Shunde Hospital Southern Medical University. A 37 years old female patient was admitted because she had suffered repeated fever for 5 days, chest tightness and abdominal pain for 3 days...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29214686/myricetin-attenuated-lps-induced-cardiac-injury-in-vivo-and-in-vitro
#4
Nan Zhang, Hong Feng, Hai-Han Liao, Si Chen, Zheng Yang, Wei Deng, Qi-Zhu Tang
Sepsis induced myocardial dysfunction (SIMD) is a common complication and leads to an increased mortality. SIMD is closely related to inflammation and oxidative stress. Myricetin exhibits strong capacities of anti-inflammation and anti-oxidative stress, but its pharmacological effects for lipopolysaccharide (LPS) induced cardiac injury remains undefined. This study aimed to explore whether myricetin was efficient to alleviate SIMD in mice and neonatal rat cardiomyocytes injury. Mice administrated with myricetin (100 mg/kg, po, bid) or vehicle groups were challenged with LPS (10 mg/kg, ip), and cardiac functions examined by echocardiography after 12 hr LPS exposure...
December 7, 2017: Phytotherapy Research: PTR
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#5
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29201378/time-to-re-think-the-use-of-dobutamine-in-sepsis
#6
Ryota Sato, Michitaka Nasu
Dobutamine is commonly used worldwide and included in the protocol for early goal-directed therapy (EGDT). Since the use of dobutamine in EGDT was reported, it has been considered to be an important component, especially in the treatment of septic patients with myocardial dysfunction. However, it is questionable whether dobutamine improves the mortality of sepsis and septic shock. In three recent randomized controlled trials (ProCESS, ProMISe, and ARISE trials), the frequency of dobutamine use was significantly higher in the EGDT group than in the standard care group, but there were no significant differences in the mortality between the groups...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29196046/prehospital-antibiotics-in-the-ambulance-for-sepsis-a-multicentre-open-label-randomised-trial
#7
Nadia Alam, Erick Oskam, Patricia M Stassen, Pieternel van Exter, Peter M van de Ven, Harm R Haak, Frits Holleman, Arthur van Zanten, Hien van Leeuwen-Nguyen, Victor Bon, Bart A M Duineveld, Rishi S Nannan Panday, Mark H H Kramer, Prabath W B Nanayakkara
BACKGROUND: Emergency medical services (EMS) personnel have already made substantial contributions to improving care for patients with time-dependent illnesses, such as trauma and myocardial infarction. Patients with sepsis could also benefit from timely prehospital care. METHODS: After training EMS personnel in recognising sepsis, we did a randomised controlled open-label trial in ten large regional ambulance services serving 34 secondary and tertiary care hospitals in the Netherlands...
November 28, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29191740/influence-of-prior-nicotine-and-alcohol-use-on-functional-outcome-in-patients-after-intracerebral-hemorrhage
#8
Jochen A Sembill, Maximilian I Sprügel, Stefan T Gerner, Vanessa D Beuscher, Antje Giede-Jeppe, Margarete Stocker, Philip Hoelter, Hannes Lücking, Joji B Kuramatsu, Hagen B Huttner
BACKGROUND: The influence of prior nicotine or alcohol use (legal drug use [LDU]) on outcome measures after intracerebral hemorrhage (ICH) is insufficiently established. We investigated drug-specific associations with (1) neuroradiologic and clinical parameters and (2) functional long-term outcome after ICH. METHODS: This observational cohort study analyzed consecutive spontaneous patients with ICH (n = 554) from our prospective institutional registry over a 5-year study period (January 2010 to December 2014)...
November 27, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29180214/thioredoxin-1-attenuates-sepsis-induced-cardiomyopathy-after-cecal-ligation-and-puncture-in-mice
#9
Rickesha L Wilson, Vaithinathan Selvaraju, Rajesh Lakshmanan, Mahesh Thirunavukkarasu, Jacob Campbell, David W McFadden, Nilanjana Maulik
BACKGROUND: Sepsis is a leading cause of mortality among patients in intensive care units across the USA. Thioredoxin-1 (Trx-1) is an essential 12 kDa cytosolic protein that, apart from maintaining the cellular redox state, possesses multifunctional properties. In this study, we explored the possibility of controlling adverse myocardial depression by overexpression of Trx-1 in a mouse model of severe sepsis. METHODS: Adult C57BL/6J and Trx-1Tg/+ mice were divided into wild-type sham (WTS), wild-type cecal ligation and puncture (WTCLP), Trx-1Tg/+sham (Trx-1Tg/+S), and Trx-1Tg/+CLP groups...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29180187/glutamine-reduces-myocardial-cell-apoptosis-in-a-rat-model-of-sepsis-by-promoting-expression-of-heat-shock-protein-90
#10
Wanxia Li, Shaoyu Tao, Qinghua Wu, Tao Wu, Ran Tao, Jun Fan
BACKGROUND: Myocardial cell injury and cardiac myocyte apoptosis are associated with sepsis. Glutamine (Gln) has been reported to repair myocardial cell injury. The aim of this study was to explore the role of Gln on cardiac myocytes in a cecal ligation and puncture (CLP) model of sepsis in Wistar rats. MATERIALS AND METHODS: Following induction of sepsis in a CLP rat model, viral encoding heat shock protein 90 (Hsp90) gene and Hsp90dsDNA were designed to express and knockdown Hsp90, respectively...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29176403/tlr4-and-nlrp3-caspase-1-il-1%C3%AE-axis-are-not-involved-in-colon-ascendens-stent-peritonitis-casp-associated-heart-disease
#11
Maria Micaela Lopez Alarcón, Julieta Fernández Ruocco, Fabiano Ferreira, Heitor A Paula-Neto, Marisa Sepúlveda, Martín Vila Petroff, Adriana Bastos Carvalho, Isalira Peroba Ramos, Hugo Justino Branda, Claudia Neto Paiva, Emiliano Medei
Hemodynamic collapse and myocardial dysfunction are among the major causes of death in severe sepsis. The purpose of this study was to assess the role played by TLR4 and by the NLRP3 inflammasome in the cardiac dysfunction that occurs after high-grade polymicrobial sepsis. We performed the colon ascendens stent peritonitis (CASP) surgery in Tlr4, Nlrp3 and caspase-1 mice. We also assessed for the first time the electrical heart function in the CASP model. The QJ interval was increased in wild-type C57BL/6J mice after CASP when compared to sham controls, a result paralleled by an increase in the cardiac action potential duration (APD)...
November 15, 2017: Shock
https://www.readbyqxmd.com/read/29133025/perivalvular-mitral-abscess-fistulised-to-the-pericardial-cavity-revealing-staphylococcal-endocarditis
#12
Paul Desaint, Anthony Chauvat, Thomas Garaud, Olivier Andremont, Gaëtan Plantefève, Hervé Mentec, Damien Contou
BACKGROUND: Fistula to the pericardial cavity is a very rare complication of perivalvular abscess during infective endocarditis, with Staphylococcus aureus being the most commonly associated microorganism. METHODS: We report a fatal septic shock due to a mitral endocarditis revealed by a myocardial abscess fistulised toward the pericardial cavity. RESULTS: A 66-year-old female without previous valvular disease was admitted to intensive care for severe sepsis...
October 31, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29127060/granulocyte-colony-stimulating-factor-and-autologous-cd133-positive-stem-cell-therapy-in-liver-cirrhosis-realistic-an-open-label-randomised-controlled-phase-2-trial
#13
Philip Noel Newsome, Richard Fox, Andrew L King, Darren Barton, Nwe-Ni Than, Joanna Moore, Christopher Corbett, Sarah Townsend, James Thomas, Kathy Guo, Diana Hull, Heather A Beard, Jacqui Thompson, Anne Atkinson, Carol Bienek, Neil McGowan, Neil Guha, John Campbell, Dan Hollyman, Deborah Stocken, Christina Yap, Stuart John Forbes
BACKGROUND: Results of small-scale studies have suggested that stem-cell therapy is safe and effective in patients with liver cirrhosis, but no adequately powered randomised controlled trials have been done. We assessed the safety and efficacy of granulocyte colony-stimulating factor (G-CSF) and haemopoietic stem-cell infusions in patients with liver cirrhosis. METHODS: This multicentre, open-label, randomised, controlled phase 2 trial was done in three UK hospitals and recruited patients with compensated liver cirrhosis and MELD scores of 11·0-15·5...
November 7, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29121301/tissue-doppler-assessment-of-diastolic-function-and-relationship-with-mortality-in-critically-ill-septic-patients-a-systematic-review-and-meta-analysis
#14
F Sanfilippo, C Corredor, A Arcadipane, G Landesberg, A Vieillard-Baron, M Cecconi, N Fletcher
Background: Myocardial dysfunction may contribute to circulatory failure in sepsis. There is growing evidence of an association between left ventricular diastolic dysfunction (LVDD) and mortality in septic patients. Utilizing echocardiography, we know that tissue Doppler imaging (TDI) variables e' and E/e' are reliable predictors of LVDD and are useful measurements to estimate left ventricular (LV) filling pressures. Methods: We conducted a systematic review and meta-analysis to investigate the association of e' and E/e' with mortality of patients with severe sepsis or septic shock...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29118766/the-role-of-endotoxin-in-the-setting-of-cardiorenal-syndrome-type-5
#15
REVIEW
Anna Clementi, Grazia Maria Virzì, Alessandra Brocca, Claudio Ronco
Lipopolysaccharide or endotoxin, the major cell wall component of gram-negative bacteria, plays a pivotal role in the pathogenesis of sepsis. It is able to activate the host defense system through the interaction with Toll-like receptor 4, thus triggering pro-inflammatory mechanisms. When the production of inflammatory mediators becomes uncontrolled and excessive, septic shock develops with multiple organ dysfunction, such as myocardial and renal impairment, which are hallmarks of cardiorenal syndrome type 5...
October 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/29117918/lack-of-soluble-circulating-cardiodepressant-factors-in-takotsubo-cardiomyopathy
#16
Chiara Sonnino, Benjamin W Van Tassell, Stefano Toldo, Marco Giuseppe Del Buono, F Gerard Moeller, Antonio Abbate
Circulating cardiodepressant factors were found to mediate cardiac dysfunction in patients with sepsis and acute systolic heart failure. To investigate the presence of circulating cardiodepressant factors in patients with Takotsubo Cardiomyopathy (TC), plasma samples were collected from 4 patients with TC, 3 with septic shock, 5 with acute systolic heart failure and 4 healthy controls and injected intraperitoneally in mice. The cardiodepressant effects are measured with transthoracic echocardiography. Plasma injection from control and TC subjects had no effects on left ventricle ejection fraction (LVEF) whereas plasma from the other two groups induced a significant reduction in LVEF...
November 2, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29115392/the-inhibition-of-myd88-and-trif-signaling-serve-equivalent-roles-in-attenuating-myocardial-deterioration-due-to-acute-severe-inflammation
#17
Min-Zhi Ouyang, Dan Zhou, Yun Zhu, Ming Zhang, Ling Li
Myeloid differentiation factor 88 (MyD88) and Toll or interleukin-1 receptor-domain-containing adaptor-inducing interferon-β (IFN-β) (TRIF) are two pivotal downstream adaptors of Toll-like receptors. Activation of MyD88 or TRIF signaling in cardiac immune pathology of severe inflammation negatively influences heart function. In the present study, severe septic cardiac injury was induced in C57BL/6 mice by cecum ligation and puncture (CLP). A total of 64 mice were divided randomly into the following four groups (n=16/group; 8 for observation of survival rate, 8 for heart sample analysis): Sham, CLP, anti-MyD88-CLP and anti-TRIF-CLP...
November 7, 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/29103584/selective-aortic-arch-and-root-replacement-in-repair-of-acute-type-a-aortic-dissection
#18
Fernando Fleischman, Ramsey S Elsayed, Robbin G Cohen, James M Tatum, S Ram Kumar, Kayvan Kazerouni, Wendy J Mack, Mark L Barr, Mark J Cunningham, Amy E Hackmann, Craig J Baker, Vaughn A Starnes, Michael E Bowdish
BACKGROUND: Controversy exists regarding the optimal extent of repair for type A aortic dissection. Our approach is to replace the ascending aorta, and only replace the aortic root or arch when intimal tears are present in those areas. We examined intermediate outcomes with this approach to acute type A aortic dissection repair. METHODS: Between March 2005 and October 2016, 195 patients underwent repair of acute type A aortic dissection. Repair was categorized by site of proximal and distal anastomosis and extent of repair...
November 3, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29100618/incidence-and-evolution-of-sepsis-induced-cardiomyopathy-in-a-cohort-of-patients-with-sepsis-and-septic-shock
#19
I Narváez, A Canabal, C Martín, M Sánchez, A Moron, J Alcalá, S Giacoman, M Magro
OBJETIVE: The aim of this study was to establish the incidence of septic cardiomyopathy (SM) in patients with sepsis and septic shock, to describe its characteristics and testing its evolution. DESIGN: Prospective cohort study. PARTICIPANTS: We included 57 consecutive patients admitted to Intensive Care Unit, who met criteria of sepsis and septic shock. PRINCIPAL VARIABLES OF INTEREST: Clinical and biochemical variables were analyzed...
October 31, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29095750/the-use-of-regional-or-neuraxial-anesthesia-for-below-knee-amputations-may-reduce-the-need-for-perioperative-blood-transfusions
#20
Obaid Malik, Ethan Y Brovman, Richard D Urman
BACKGROUND AND OBJECTIVES: Amputations of the lower extremity remain a common procedure in a high-risk population. Perioperative morbidity and mortality reach as high as 14.1% in below-knee amputations. We aimed to determine whether regional, or neuraxial, anesthesia, when compared with general anesthesia (GA), would be associated with reduced perioperative morbidity and mortality. METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program data set...
November 1, 2017: Regional Anesthesia and Pain Medicine
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