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"Septic Shock"

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https://www.readbyqxmd.com/read/28647651/concomitant-vasopressin-and-hydrocortisone-therapy-on-short-term-hemodynamic-effects-and-vasopressor-requirements-in-refractory-septic-shock
#1
Mitchell S Buckley, Robert MacLaren
PURPOSE: The objective of this study was to evaluate the short-term hemodynamic effects as well as vasopressor requirements with concomitant vasopressin (AVP) and hydrocortisone (HCT) compared to either agent alone in refractory septic shock. MATERIALS AND METHODS: This was a retrospective, cohort study conducted in adult septic shock patients. Patients received continuous infusion AVP at 0.04units/min and/or HCT 200-300mg intravenous daily in divided doses for refractory septic shock...
June 17, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28645776/selective-inhibition-of-flt3-by-gilteritinib-in-relapsed-or-refractory-acute-myeloid-leukaemia-a-multicentre-first-in-human-open-label-phase-1-2-study
#2
Alexander E Perl, Jessica K Altman, Jorge Cortes, Catherine Smith, Mark Litzow, Maria R Baer, David Claxton, Harry P Erba, Stan Gill, Stuart Goldberg, Joseph G Jurcic, Richard A Larson, Chaofeng Liu, Ellen Ritchie, Gary Schiller, Alexander I Spira, Stephen A Strickland, Raoul Tibes, Celalettin Ustun, Eunice S Wang, Robert Stuart, Christoph Röllig, Andreas Neubauer, Giovanni Martinelli, Erkut Bahceci, Mark Levis
BACKGROUND: Internal tandem duplication mutations in FLT3 are common in acute myeloid leukaemia and are associated with rapid relapse and short overall survival. The clinical benefit of FLT3 inhibitors in patients with acute myeloid leukaemia has been limited by rapid generation of resistance mutations, particularly in codon Asp835 (D835). We aimed to assess the highly selective oral FLT3 inhibitor gilteritinib in patients with relapsed or refractory acute myeloid leukaemia. METHODS: In this phase 1-2 trial, we enrolled patients aged 18 years or older with acute myeloid leukaemia who either were refractory to induction therapy or had relapsed after achieving remission with previous treatment...
June 20, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28644271/norepinephrine-shortage-led-to-increased-deaths-from-septic-shock
#3
Serena Stockwell
Though drug shortages are common, their impact is rarely studied.
July 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28643487/proenkephalin-neutrophil-gelatinase-associated-lipocalin-and-estimated-glomerular-filtration-rates-in-patients-with-sepsis
#4
Hanah Kim, Mina Hur, Seungho Lee, Rossella Marino, Laura Magrini, Patrizia Cardelli, Joachim Struck, Andreas Bergmann, Oliver Hartmann, Salvatore Di Somma
BACKGROUND: Proenkephalin (PENK) has been suggested as a novel biomarker for kidney function. We investigated the diagnostic and prognostic utility of plasma PENK in comparison with neutrophil gelatinase-associated lipocalin (NGAL) and estimated glomerular filtration rates (eGFR) in septic patients. METHODS: A total of 167 septic patients were enrolled: 99 with sepsis, 37 with septic shock, and 31 with suspected sepsis. PENK and NGAL concentrations were measured and GFR was estimated by using the isotope dilution mass spectrometry traceable-Modification of Diet in Renal Disease (MDRD) Study and three Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations: CKD-EPI(Cr), CDK-EPI(CysC), and CKD-EPI(Cr-CysC)...
September 2017: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/28642140/emergence-of-carbapenem-resistant-enterobacteriaceae-isolated-from-patients-in-a-university-hospital-in-saudi-arabia-epidemiology-clinical-profiles-and-outcomes
#5
Fawzia E Alotaibi, Elham E Bukhari, Maha M Al-Mohizea, Taghreed Hafiz, Eman Bin Essa, Yasmeen I AlTokhais
Carbapenemase-producing Enterobacteriaceae have been steadily spreading worldwide during the last decade. Nine patients were identified prospectively and were followed during their hospitalization course to identify the epidemiology, clinical profiles and outcomes. These patients had one or more cultures positive for a CRE isolate, contributing to a total of eleven positive cultures from various sites without including duplicates of isolates obtained from the same site. Isolates from these patients included five Klebseilla pneumoniae, three Escherichia coli, and one Enterobacter aerogenes...
June 19, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28641580/marked-regional-endothelial-dysfunction-in-mottled-skin-area-in-patients-with-severe-infections
#6
Simon Bourcier, Jérémie Joffre, Vincent Dubée, Gabriel Preda, Jean-Luc Baudel, Naïke Bigé, Guillaume Leblanc, Bernard I Levy, Bertrand Guidet, Eric Maury, Hafid Ait-Oufella
BACKGROUND: Mottling around the knee, reflecting a reduced skin blood flow, is predictive of mortality in patients with septic shock. However, the causative pathophysiology of mottling remains unknown. We hypothesized that the cutaneous hypoperfusion observed in the mottled area is related to regional endothelial dysfunction. METHODS: This was a prospective, observational study in a medical ICU in a tertiary teaching hospital. Consecutive adult patients with sepsis admitted to ICU were included...
June 23, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28641577/a-case-report-of-septic-shock-syndrome-caused-by-s-pneumoniae-in-an-immunocompromised-patient-despite-of-vaccination
#7
Josef Singer, Christoph Testori, Peter Schellongowski, Ammon Handisurya, Catharina Müller, Eva-Maria Reitter, Wolfgang Graninger, Paul Knöbl, Thomas Staudinger, Stefan Winkler, Florian Thalhammer
BACKGROUND AND CASE PRESENTATION: We report a case of septic shock syndrome caused by Streptococcus pneumoniae in a patient who had undergone splenectomy due to an autoimmune lymphoproliferative syndrome (ALPS), which is characterized as a dysfunction of immunoregulation. Although the patient was vaccinated with a conjugated polysaccharide vaccine after the splenectomy, he was still susceptible to S. pneumoniae infection, because the isolated serovar (24F), a serovar long thought to be apathogenic, is not covered by any vaccine currently approved, neither a conjugated nor an unconjugated polysaccharide one...
June 22, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28640137/china-s-growing-contribution-to-sepsis-research-from-1984-to-2014-a-bibliometric-study
#8
Kai Zhang, Jialian Zhao, Lihua Chu, Yue Jin, Baoli Cheng, Guohao Xie, Yan Wang, Xiangming Fang
BACKGROUND: The aim of this study was to analyze the global trends of sepsis research and investigate China's contribution by comparing the quantity and quality of sepsis-related publications. METHODS: Sepsis-related publications were main retrieved from the Web of Science online database by using the keywords "sepsis" or "septic shock." Bibliometric indicators, including the number of publications, total citation frequency, citation frequency per paper, h-index, research type, orientation, organization, author, journal, and funding support were analyzed...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639164/lipid-peroxidation-in-gram-negative-bacteremia-modulates-the-risk-for-septic-shock-and-infections-by-resistant-klebsiella-pneumoniae
#9
S Christodoulou, E Kyriazopoulou, M Chrysanthakopoulou, G Karlis, I Karampela, K Gkizeli, N Veliki, A Safarika, E J Giamarellos-Bourboulis, G Adamis
Controversies in outcomes with the parenteral administration of antioxidants as adjuvant therapies led to the measurement of malondialdehyde (MDA), a product of lipid peroxidation, in serum collected from 120 patients with primary Gram-negative bacteremia during the first 24 h from sepsis onset. MDA was measured by the thiobarbiturate assay, followed by high-performance liquid chromatography (HPLC) analysis. After receiver operator characteristic (ROC) curve analysis, patients were divided into those with high levels of MDA and low levels of MDA...
June 21, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28639163/agr-functionality-affects-clinical-outcomes-in-patients-with-persistent-methicillin-resistant-staphylococcus-aureus-bacteraemia
#10
C K Kang, Y K Kim, S-I Jung, W B Park, K-H Song, K-H Park, P G Choe, H-C Jang, S Lee, Y-S Kim, Y G Kwak, K T Kwon, S Kiem, C-J Kim, E S Kim, H B Kim
Methicillin-resistant Staphylococcus aureus bacteremia (MRSAB) often persists despite appropriate antibiotic therapy. It is unclear what microbiological factors contribute to poor clinical outcomes in persistent MRSAB (pMRSAB). We aimed to identify clinical and microbiological risk factors for in-hospital mortality in pMRSAB. We analysed MRSAB cases prospectively collected between 2009 and 2016 at 11 hospitals in Korea, defining cases of pMRSAB as MRSAB lasting ≥5 days despite administration of effective antibiotics...
June 21, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28638939/-consequences-of-autopsies-for-the-living-causes-of-death-in-the-clinical-diagnosis-septic-and-toxic-shock
#11
REVIEW
L Ozretić, A Schwindowski, H-P Dienes, R Büttner, U Drebber, J W U Fries
BACKGROUND: There is reason to believe that the diagnosis of septic and toxic shock, as indicated on the death certificate, cannot be confirmed as the cause of death without autopsy and subsequent histological analysis. The external examination of the corpse can therefore not represent the sole basis for a reliable statement about the infection status of a corpse, e. g. as a prerequisite for embalming. MATERIAL AND METHODS: The validity of autopsy in determining septic and toxic shock as the cause of death is demonstrated in 7 exemplary cases...
June 21, 2017: Der Pathologe
https://www.readbyqxmd.com/read/28638723/low-dose-methotrexate-in-sickle-cell-disease-a-pilot-study-with-rationale-borrowed-from-rheumatoid-arthritis
#12
Silvia R Brandalise, Rosemary Assis, Angelo B A Laranjeira, José Andrés Yunes, Pedro O de Campos-Lima
BACKGROUND: Inflammation is a major feature of sickle cell disease (SCD). Low-dose methotrexate (MTX) has long been used in chronic inflammatory diseases. This pilot study examined the MTX effect on acute vaso-occlusive pain crises (VOC) in SCD patients. METHODS: Fourteen adults on hydroxyurea with severe and refractory VOC received one intramuscular injection of 10 mg of MTX per week for 12 weeks. A single weekly dose of 5 mg of leucovorin was administered orally 48 h after each MTX injection...
2017: Experimental Hematology & Oncology
https://www.readbyqxmd.com/read/28638665/a-rare-case-of-septic-shock-secondary-to-emphysematous-hepatitis
#13
Khaled M Nada, Ibrahim El Husseini, Mohammad E Abu Hishmeh, Neerav S Shah, Nadezhda Ibragimova, Riyad Basir
OBJECTIVE: To describe a case of emphysematous hepatitis which is a rare clinical entity, characterized by a fatal, rapidly progressive infection of the liver with a radiological appearance simulating emphysematous pyelonephritis and to help provide more data about the causative organisms and precipitating factors of this pathology. DATA SOURCES AND SYNTHESIS: Relevant literature was reviewed and, to the best of our knowledge, there is limited data regarding the pathogenesis, causative organisms, and management of this condition...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28638458/anti-metastatic-effect-of-semi-purified-nuphar-lutea-leaf-extracts
#14
Janet Ozer, Daniel Fishman, Brit Eilam, Avi Golan-Goldhirsh, Jacob Gopas
Nuphar lutea L. SM., leaf and rhizome extracts (NUP), contain nupharidines as active components. Nupharidines belong to the sesquiterpene lactones class of a naturally occurring plant terpenoids. This family of compounds has gained considerable interest for treating infection, inflammation and cancer. NF-κB is a central, downstream regulator of inflammation, cell proliferation and apoptosis. In our previous work we demonstrated strong inhibition of NF-κB activity and induction of apoptosis by NUP. In addition, NUP exhibited anti-inflammatory properties and partial protection from LPS-induced septic shock by modulating ERK pathway and cytokine secretion in macrophages...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28638247/is-sutureless-pancreaticogastrostomy-more-effective-than-single-layer-duct-to-mucosa-pancreaticojejunostomy-in-pancreaticoduodenectomy
#15
Daniel Kostov, Georgi Kobakov
OBJECTIVE: The present study aimed to assess the safety of pancreatic anastomosis after pancreaticoduodenectomy (PD) and to compare the results of sutureless pancreatogastrostomy (PG) with those of single-layer duct-to-mucosa pancreatojejunostomy (PJ) after PD in patients with malignant disease of the pancreatic head and of the periampullary region. MATERIALS AND METHODS: The study included 173 consecutive patients undergoing PD from May 2009 to December 2015 at a single surgical center...
June 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28637738/the-reanimation-low-immune-status-markers-realism-project-a-protocol-for-broad-characterisation-and-follow-up-of-injury-induced-immunosuppression-in-intensive-care-unit-icu-critically-ill-patients
#16
Mary-Luz Rol, Fabienne Venet, Thomas Rimmele, Virginie Moucadel, Pierre Cortez, Laurence Quemeneur, David Gardiner, Andrew Griffiths, Alexandre Pachot, Julien Textoris, Guillaume Monneret
INTRODUCTION: The host response to septic shock is dynamic and complex. A sepsis-induced immunosuppression phase has recently been acknowledged and linked to bad outcomes and increased healthcare costs. Moreover, a marked suppression of the immune response has also been partially described in patients hospitalized in intensive care unit (ICU) for severe trauma or burns. It has been hypothesized that immune monitoring could enable identification of patients who might most benefit from novel, adjunctive immune-stimulating therapies...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28635463/an-overview-of-the-evidence-based-practice-process-for-novice-researchers
#17
Emma Rowles, Amanda McNaughton
This article explores how nurses can use evidence-based practice to critique and evaluate the rationale and evidence for specific nursing procedures or practices. Through the development of a focused research question and search strategy, nurses can select and critique relevant research articles to answer the research question, which can support the provision of optimal practice and high-quality care. This article demonstrates the process of evidence-based practice, with the aim of increasing novice researchers' confidence in applying this process in practice...
June 21, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28630061/increased-resistance-to-intradermal-francisella-tularensis-lvs-infection-by-inactivation-of-the-sts-phosphatases
#18
Kaustubh Parashar, Erik Kopping, David Frank, Vinaya Sampath, David G Thanassi, Nick Carpino
The Suppressor of TCR signaling proteins (Sts-1 and Sts-2) are two homologous phosphatases that negatively regulate signaling pathways in a number of hematopoietic lineages, including T lymphocytes. Mice lacking Sts expression are characterized by enhanced T cell responses. Additionally, a recent study demonstrated that Sts-/- mice are profoundly resistant to systemic infection of Candida albicans, with resistance characterized by enhanced survival, more rapid fungal clearance in key peripheral organs, and an altered inflammatory response...
June 19, 2017: Infection and Immunity
https://www.readbyqxmd.com/read/28629760/cardiac-overexpression-of-epac1-in-transgenic-mice-rescues-lipopolysaccharide-induced-cardiac-dysfunction-and-inhibits-jak-stat-pathway
#19
Huiling Jin, Takayuki Fujita, Meihua Jin, Reiko Kurotani, Iyuki Namekata, Shogo Hamaguchi, Yuko Hidaka, Wenqian Cai, Kenji Suita, Yoshiki Ohnuki, Yasumasa Mototani, Kouichi Shiozawa, Rajesh Prajapati, Chen Liang, Masanari Umemura, Utako Yokoyama, Motohiko Sato, Hikaru Tanaka, Satoshi Okumura, Yoshihiro Ishikawa
Pro-inflammatory cytokines are released in septic shock and impair cardiac function via the Jak-STAT pathway. It is well known that sympathetic stimulation leads to coupling of the β-adrenergic receptor/Gs/adenylyl cyclase, a membrane-bound enzyme that catalyzes the conversion of ATP to cAMP, thereby stimulating protein kinase A (PKA) and ultimately compensating for cardiac dysfunction. The mechanism of such compensation by catecholamine has been traditionally understood as PKA-mediated enforcement of cardiac contractility...
June 16, 2017: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/28627353/-ultrasonographic-evaluation-of-diaphragm-structure-and-function
#20
Feifei Wang, Xiaoping Zhu, Shaolin Ma
Diaphragm is the principal respiratory muscle. Diaphragm dysfunction resulting from mechanical ventilation, chronic cardiopulmonary disease, medicine, cardio-thoracic surgery, septic shock and chronic malnutrition predisposes to weaning failure from mechanical ventilation and prolongs intensive care unit (ICU) stay. Traditionally, the method of assessment of diaphragm structure and function was invasive, lacking specific, and was difficult to be used bedside. A number of recent studies have been suggested that ultrasonographic evaluation has been proposed as an accurate, safe and noninvasive method of quantification of diaphragm structure and function...
March 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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