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https://www.readbyqxmd.com/read/29346650/persistence-of-zika-virus-after-birth-clinical-virological-neuroimaging-and-neuropathological-documentation-in-a-5-month-infant-with-congenital-zika-syndrome
#1
Leila Chimelli, Sheila Moura Pone, Elyzabeth Avvad-Portari, Zilton Farias Meira Vasconcelos, Andrea Araújo Zin, Daniela Prado Cunha, Nathalia Raposo Thompson, Maria Elisabeth Lopes Moreira, Clayton A Wiley, Marcos Vinicius da Silva Pone
During the Zika epidemic in Brazil, a baby was born at term with microcephaly and arthrogryposis. The mother had Zika symptoms at 10 weeks of gestation. At 17 weeks, ultrasound showed cerebral malformation and ventriculomegaly. At 24 weeks, the amniotic fluid contained ZIKV RNA and at birth, placenta and maternal blood were also positive using RT-qPCR. At birth the baby urine contained ZIKV RNA, whereas CSF at birth and urine at 17 days did not. Seizures started at 6 days. EEG was abnormal and CT scan showed cerebral atrophy, calcifications, lissencephaly, ventriculomegaly, and cerebellar hypoplasia...
January 13, 2018: Journal of Neuropathology and Experimental Neurology
https://www.readbyqxmd.com/read/29346232/use-of-point-of-care-ultrasound-to-guide-pediatric-gastrostomy-tube-replacement-in-the-emergency-department
#2
Toby C Myatt, Anthony J Medak, Samuel H F Lam
The presentation of a pediatric patient to the emergency department for a malfunctioning or dislodged gastrostomy tube (G-tube) is not uncommon. As such, these tubes are often replaced at the bedside. Improper placement can result in a number of complications, including perforation, fistula tract formation, peritonitis, and sepsis. The current criterion standard method to confirm proper G-tube placement is contrast-enhanced radiography. However, point-of-care ultrasound may be an alternative method to guide and confirm pediatric G-tube replacement in the emergency department...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29346221/a-validation-argument-for-a-simulation-based-training-course-centered-on-assessment-recognition-and-early-management-of-pediatric-sepsis
#3
Gary L Geis, Derek S Wheeler, Amy Bunger, Laura G Militello, Regina G Taylor, Jerome P Bauer, Terri L Byczkowski, Benjamin T Kerrey, Mary D Patterson
INTRODUCTION: Early recognition of sepsis remains one of the greatest challenges in medicine. Novice clinicians are often responsible for the recognition of sepsis and the initiation of urgent management. The aim of this study was to create a validity argument for the use of a simulation-based training course centered on assessment, recognition, and early management of sepsis in a laboratory-based setting. METHODS: Five unique simulation scenarios were developed integrating critical sepsis cues identified through qualitative interviewing...
January 17, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29346183/near-infrared-spectroscopy-to-predict-organ-failure-and-outcome-in-sepsis-the-assessing-risk-in-sepsis-using-a-tissue-oxygen-saturation-aristos-study
#4
Stephen P J Macdonald, Frances B Kinnear, Glenn Arendts, Kwok M Ho, Daniel M Fatovich
OBJECTIVES: Sepsis is acute organ dysfunction in the setting of infection. An accurate diagnosis is important to guide treatment and disposition. Tissue oxygen saturation (StO2) can be estimated noninvasively by near-infrared spectroscopy (NIRS), and may be an indicator of microcirculatory dysfunction in early sepsis. We aimed to determine the utility of StO2 for sepsis recognition and outcome prediction among patients presenting to the emergency department (ED) with infection. PATIENTS AND METHODS: A multicentre, prospective, observational cohort study recruited patients who were being admitted to hospital with infection...
January 17, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29346034/coagulopathy-in-severe-sepsis-interconnectivity-of-coagulation-and-the-immune-system
#5
Jason M Samuels, Hunter B Moore, Ernest E Moore
BACKGROUND: Disseminated intravascular coagulation (DIC) remains a challenging complication of infection with inadequate treatment and significant morbidity and mortality rates. METHODS: Review of the English-language literature. RESULTS: Disseminated intravascular coagulation arises from the immune system's response to microbial invasion, as well as the byproducts of cell death that result from severe sepsis. This response triggers the coagulation system through an interconnected network of cellular and molecular signals, which developed originally as an evolutionary mechanism intended to isolate micro-organisms via fibrin mesh formation...
January 18, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29346030/the-challenge-of-surgical-sepsis
#6
Donald E Fry
No abstract text is available yet for this article.
January 18, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29345380/cirp-increases-icam-1-phenotype-of-neutrophils-exhibiting-elevated-inos-and-nets-in-sepsis
#7
Yasumasa Ode, Monowar Aziz, Ping Wang
Sepsis represents uncontrolled inflammation due to an infection. Cold-inducible RNA-binding protein (CIRP) is a stress-induced damage-associated molecular pattern (DAMP). A subset of neutrophils expressing ICAM-1+ neutrophils was previously shown to produce high levels of reactive oxygen species. The role of CIRP for the development and function of ICAM-1+ neutrophils during sepsis is unknown. We hypothesize that CIRP induces ICAM-1 expression in neutrophils causing injury to the lungs during sepsis. Using a mouse model of cecal ligation and puncture (CLP)-induced sepsis, we found increased expression of CIRP and higher frequencies and numbers of ICAM-1+ neutrophils in the lungs...
January 17, 2018: Journal of Leukocyte Biology
https://www.readbyqxmd.com/read/29345117/candida-auris-a-systematic-review-and-meta-analysis-of-current-updates-on-an-emerging-multidrug-resistant-pathogen
#8
John Osei Sekyere
From 2009, Candida auris has emerged as a multidrug-resistant ascomycete yeast pathogen with the capacity for easy transmission between patients and hospitals, as well as persistence on environmental surfaces. Its association with high mortalities, breakthrough and persistent candidaemia, inconsistencies in susceptibility testing results, misidentification by available commercial identification systems and treatment failure, complicates its management and detection. Within the last nine years, C. auris has been increasingly reported from far-Eastern Asia, the Middle East, Africa, Europe, South and North America with substantial fatalities and misidentification...
January 18, 2018: MicrobiologyOpen
https://www.readbyqxmd.com/read/29345058/frontline-science-anti-pd-l1-protects-against-infection-with-common-bacterial-pathogens-after-burn-injury
#9
Naeem K Patil, Liming Luan, Julia K Bohannon, Antonio Hernandez, Yin Guo, Edward R Sherwood
Burn patients are susceptible to infections due, in part, to immune dysfunction. Upregulation of programmed death-1 (PD-1) receptor on T cells and programmed cell death ligand-1 (PD-L1) on myeloid cells contribute to immune dysfunction in nonburn-related sepsis. We hypothesized that PD-1/PDL1 interactions contribute to immune dysfunction after burn injury. To determine the impact of burn injury and infection on PD-L1, PD-1 and costimulatory receptor expression by leukocytes and its relationship to T cell functions...
January 2018: Journal of Leukocyte Biology
https://www.readbyqxmd.com/read/29344981/severe-and-recurrent-levamisole-induced-cutaneous-vasculopathy
#10
J M Fernandez Armenteros, A Veà Jódar, C Matas Nadal, C Cortés Pinto, X Soria Gili, R M Martí Laborda, F Vilardell Villellas, J M Casanova Seuma
Levamisole-induced vasculopathy is a thrombotic and necrotic vasculitis usually seen in cocaine users due to adulteration of the drug with this veterinary medication. Some cases can be severe or very extensive, which could lead to sepsis and death.
January 18, 2018: Journal of Cutaneous Pathology
https://www.readbyqxmd.com/read/29344568/non-surgical-management-of-boerhaave-s-syndrome-a-case-series-study-and-review-of-the-literature
#11
Khalil Aloreidi, Bhavesh Patel, Tim Ridgway, Terry Yeager, Muslim Atiq
Background and study aims:  Boerhaave's syndrome (BS) is a life-threatening condition with morbidity and mortality rates as high as 50 % in some reports. Until recently, surgical intervention has been the mainstay of management plans. With advances in therapeutic endoscopy, however, there has been increasing interest in non-surgical options including endoscopic esophageal stenting. Patients and methods:  We reviewed the medical records of all patients diagnosed with BS and managed with endoscopic interventions between November 2011 and November 2016...
January 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29344053/an-overview-of-exposure-to-ethanol-containing-substances-and-ethanol-intoxication-in-children-based-on-three-illustrated-cases
#12
REVIEW
Kam Lun Hon, Alexander Kc Leung, Eddie Cheung, Bryan Lee, Michelle Mc Tsang, Alcy R Torres
Alcohol addiction and intoxication are major health problems worldwide. Acute alcohol intoxication is well reported in adults and adolescents but less frequently reported in children of younger ages. We report three anonymized cases of pediatric ethanol exposure and illustrate the different mechanisms of intoxication. In all cases, a focused history is the key to prompt diagnosis and timely management. Physicians should be aware of this potential poison in children presented with acute confusional or encephalopathic state...
2018: Drugs in Context
https://www.readbyqxmd.com/read/29344006/histone-deacetylase-2-hdac2-attenuates-lipopolysaccharide-lps-induced-inflammation-by-regulating-pai-1-expression
#13
Wen-Feng Fang, Yu-Mu Chen, Chiung-Yu Lin, Hui-Lin Huang, Hua Yeh, Ya-Ting Chang, Kuo-Tung Huang, Meng-Chih Lin
Background: Sepsis is a life-threatening organ dysfunction caused by dysregulated host response to infection, and is primarily characterized by an uncontrolled systemic inflammatory response. In the present study, we developed an effective adjunct therapy mediated by a novel mechanism, to attenuate overt inflammation. LPS-treated macrophages were adopted as an in vitro model of endotoxin-induced inflammation during sepsis. Experiments were carried out using primary mouse peritoneal macrophages and the murine macrophage cell line RAW264...
2018: Journal of Inflammation
https://www.readbyqxmd.com/read/29343993/management-of-disseminated-intravascular-coagulation-current-insights-on-antithrombin-and-thrombomodulin-treatments
#14
REVIEW
Mineji Hayakawa
Sepsis and septic shock are frequently complicated by disseminated intravascular coagulation (DIC), which decreases the survival rate of patients with sepsis. In the past, large international randomized controlled trials (RCTs) using physiological anticoagulants for sepsis-induced DIC were not performed; however, RCTs have been conducted for sepsis and/or septic shock. In these trials, physiological anticoagulants did not show any beneficial effects compared with placebo for the treatment of sepsis and/or septic shock...
2018: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29343648/par1-agonists-stimulate-apc-like-endothelial-cytoprotection-and-confer-resistance-to-thromboinflammatory-injury
#15
Karen De Ceunynck, Christian G Peters, Abhishek Jain, Sarah J Higgins, Omozuanvbo Aisiku, Jennifer L Fitch-Tewfik, Sharjeel A Chaudhry, Chris Dockendorff, Samir M Parikh, Donald E Ingber, Robert Flaumenhaft
Stimulation of protease-activated receptor 1 (PAR1) on endothelium by activated protein C (APC) is protective in several animal models of disease, and APC has been used clinically in severe sepsis and wound healing. Clinical use of APC, however, is limited by its immunogenicity and its anticoagulant activity. We show that a class of small molecules termed "parmodulins" that act at the cytosolic face of PAR1 stimulates APC-like cytoprotective signaling in endothelium. Parmodulins block thrombin generation in response to inflammatory mediators and inhibit platelet accumulation on endothelium cultured under flow...
January 17, 2018: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29343555/antagonism-of-integrin-cd11b-affords-protection-against-endotoxin-shock-and-polymicrobial-sepsis-via-attenuation-of-hmgb1-nucleocytoplasmic-translocation-and-extracellular-release
#16
Huiting Zhou, Yanhong Li, Huan Gui, He Zhao, Ming Wu, Gang Li, Yiping Li, Zhenjiang Bai, Zhimin Yin, H Paul Redmond, Jian Wang, Jiang Huai Wang, Zhihui Zhao
High mobility group box 1 (HMGB1), a chromatin-binding nuclear protein, plays a critical role in sepsis by acting as a key "late-phase" inflammatory mediator. Integrin CD11b is essential for inflammatory cell activation and migration, thus mediating inflammatory responses. However, it is unclear whether CD11b participates in the development of sepsis. In this study, we report that CD11b contributes to LPS-induced endotoxin shock and microbial sepsis, as antagonism of CD11b with the CD11b blocking Ab or CD11b inhibitor Gu-4 protects mice against LPS- and microbial sepsis-related lethality, which is associated with significantly diminished serum HMGB1 levels...
January 17, 2018: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/29343506/how-to-use%C3%A2-procalcitonin
#17
Philip Robinson, Surjo Kiran De
Diagnosing bacterial infection in the unwell or febrile child is a common challenge faced by all paediatricians. Despite the advent of novel molecular techniques, there is ongoing need for diagnostic assays with adequate performance and turnaround time to facilitate safe clinical decision-making when bacterial sepsis is suspected, such as whether to commence empirical treatment with antibiotics. Procalcitonin is an established marker of infection that has a potential role in the diagnosis and exclusion of serious or invasive bacterial infection in neonates and children...
January 17, 2018: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/29343482/par1-biased-signaling-is-required-for-activated-protein-c-in-vivo-benefits-in-sepsis-and-stroke
#18
Ranjeet K Sinha, Yaoming Wang, Zhen Zhao, Xiao Xu, Laurent Burnier, Naveen Gupta, José A Fernandez, Greg Martin, Sergey Kupriyanov, Laurent O Mosnier, Berislav V Zlokovic, John H Griffin
Activated Protein C (APC) cleaves protease activated receptor (PAR)1 in vitro at R46 to initiate beneficial cell signaling; however, thrombin and APC can cleave at R41. To elucidate PAR1-dependent aspects of pharmacologic APC's in vivo mechanisms, we generated C57BL/6 mouse strains carrying QQ41 or QQ46 point mutations in PAR1 (F2r gene). Using these strains, we determined whether or not recombinant murine signaling-selective APC mutants would reduce septic death or provide neuroprotection against ischemic stroke when mice carried PAR1 homozygous mutations that prevent cleavage at either R41 or R46...
January 17, 2018: Blood
https://www.readbyqxmd.com/read/29343440/chanzyme-trpm7-mediates-the-ca2-influx-essential-for-lipopolysaccharide-induced-toll-like-receptor-4-endocytosis-and-macrophage-activation
#19
Michael S Schappe, Kalina Szteyn, Marta E Stremska, Suresh K Mendu, Taylor K Downs, Philip V Seegren, Michelle A Mahoney, Sumeet Dixit, Julia K Krupa, Eric J Stipes, Jason S Rogers, Samantha E Adamson, Norbert Leitinger, Bimal N Desai
Toll-like receptors (TLRs) sense pathogen-associated molecular patterns to activate the production of inflammatory mediators. TLR4 recognizes lipopolysaccharide (LPS) and drives the secretion of inflammatory cytokines, often contributing to sepsis. We report that transient receptor potential melastatin-like 7 (TRPM7), a non-selective but Ca2+-conducting ion channel, mediates the cytosolic Ca2+ elevations essential for LPS-induced macrophage activation. LPS triggered TRPM7-dependent Ca2+ elevations essential for TLR4 endocytosis and the subsequent activation of the transcription factor IRF3...
January 16, 2018: Immunity
https://www.readbyqxmd.com/read/29343314/cell-free-dna-the-role-in-pathophysiology-and-as-a-biomarker-in-kidney-diseases
#20
Peter Celec, Barbora Vlková, Lucia Lauková, Janka Bábíčková, Peter Boor
Cell-free DNA (cfDNA) is present in various body fluids and originates mostly from blood cells. In specific conditions, circulating cfDNA might be derived from tumours, donor organs after transplantation or from the foetus during pregnancy. The analysis of cfDNA is mainly used for genetic analyses of the source tissue -tumour, foetus or for the early detection of graft rejection. It might serve also as a nonspecific biomarker of tissue damage in critical care medicine. In kidney diseases, cfDNA increases during haemodialysis and indicates cell damage...
January 18, 2018: Expert Reviews in Molecular Medicine
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