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https://www.readbyqxmd.com/read/29474669/treatment-and-outcome-of-congenital-nephrotic-syndrome
#1
Sandra Bérody, Laurence Heidet, Olivier Gribouval, Jérome Harambat, Patrick Niaudet, Veronique Baudouin, Justine Bacchetta, Bernard Boudaillez, Maud Dehennault, Loïc de Parscau, Olivier Dunand, Hugues Flodrops, Marc Fila, Arnaud Garnier, Ferielle Louillet, Marie-Alice Macher, Adrien May, Elodie Merieau, Françoise Monceaux, Christine Pietrement, Caroline Rousset-Rouvière, Gwenaëlle Roussey, Sophie Taque, Julie Tenenbaum, Tim Ulinski, Rachel Vieux, Ariane Zaloszyc, Vincent Morinière, Rémi Salomon, Olivia Boyer
Background: Recommendations for management of Finnish-type congenital nephrotic syndrome (CNS) followed by many teams include daily albumin infusions, early bilateral nephrectomy, dialysis and transplantation. We aimed to assess the treatment and outcome of patients with CNS in France. Methods: We conducted a nationwide retrospective study on 55 consecutive children born between 2000 and 2014 treated for non-infectious CNS. Results: The estimated cumulative incidence of CNS was 0...
February 20, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29472276/using-lean-methodology-to-optimize-time-to-antibiotic-administration-in-patients-with-sepsis
#2
Allison C Brunsman
PURPOSE: Results of a study to apply lean methodology to an inpatient pharmacy workflow to optimize timely administration of Centers for Medicare and Medicaid Services (CMS)-approved antibiotics for patients with severe sepsis or septic shock are presented. METHODS: This quasi-experimental study was conducted at an 802-bed institution using lean methodology to assess the inpatient pharmacy workflow for dispensing antibiotics to adult patients. The preintervention and postintervention phases occurred from February to September, 2015, and from October 2015 to May 2016, respectively...
March 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29470918/early-immune-function-and-duration-of-organ-dysfunction-in-critically-ill-septic-children
#3
Jennifer A Muszynski, Ryan Nofziger, Melissa Moore-Clingenpeel, Kristin Greathouse, Larissa Anglim, Lisa Steele, Josey Hensley, Lisa Hanson-Huber, Jyotsna Nateri, Octavio Ramilo, Mark W Hall
RATIONALE: Late immune suppression is associated with nosocomial infection and mortality in septic adults and children. Relationships between early immune suppression and outcomes in septic children remain unclear. OBJECTIVE: Prospective observational study to test the hypothesis that early innate and adaptive immune suppression are associated with longer duration of organ dysfunction in children with severe sepsis/septic shock. Methods, Measurements and Main Results: Children aged < 18 years meeting consensus criteria for severe sepsis or septic shock were sampled within 48 hours of sepsis onset...
February 22, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29470531/epidemiology-and-risk-factors-of-extensively-drug-resistant-pseudomonas-aeruginosa-infections
#4
Nattawan Palavutitotai, Anupop Jitmuang, Sasima Tongsai, Pattarachai Kiratisin, Nasikarn Angkasekwinai
BACKGROUND: The incidence of nosocomial infections from extensively drug-resistant Pseudomonas aeruginosa (XDR-PA) has been increasing worldwide. We investigated the prevalence and factors associated with XDR-PA infections, including the factors that predict mortality. METHODS: We retrospectively studied a cohort of adult, hospitalized patients with P. aeruginosa (PA) infections between April and December 2014. RESULTS: Of the 255 patients with PA infections, 56 (22%) were due to XDR-PA, 32 (12...
2018: PloS One
https://www.readbyqxmd.com/read/29470360/oral-supplementation-with-bovine-colostrum-prevents-septic-shock-and-brain-barrier-disruption-during-bloodstream-infection-in-preterm-newborn-pigs
#5
Anders Brunse, Päivi Worsøe, Susanne Elisabeth Pors, Kerstin Skovgaard, Per Torp Sangild
Preterm infants have increased risk of neonatal sepsis, potentially inducing brain injury, and they may benefit from early initiation of enteral milk feeding. Using preterm pigs as models, we hypothesized that early provision of bovine colostrum to parentally nourished newborns protects against sepsis and neuroinflammation during bloodstream infection. Preterm newborn pigs were administered 10 CFU/kg of intra-arterial Staphylococcus epidermidis (SE, an opportunistic pathogen often causing sepsis in preterm infants), followed by administration of total parenteral nutrition (TPN, SE + TPN, n = 15) or oral provision of bovine colostrum with supplementary parenteral nutrition (SE + COL, n = 14), and compared with uninfected, TPN-nourished controls (CON + TPN, n = 11)...
February 21, 2018: Shock
https://www.readbyqxmd.com/read/29469783/delayed-presentation-of-toxic-epidermal-necrolysis-like-cutaneous-acute-graft-versus-host-disease-in-the-setting-of-recent-immunosuppressant-discontinuation
#6
Parul K Kathuria Goyal, Shuai Xu, Jennifer Choi
Acute graft-versus-host disease (GvHD) is a process that classically has been defined as occurring less than 100 days after stem cell transplant. When Stage IV cutaneous acute GvHD occurs outside this window, it can be difficult to distinguish clinically from toxic epidermal necrolysis (TEN). A 50-year-old man with diffuse large B-cell lymphoma who had undergone an allogeneic stem cell transplant 20 months previously was admitted for neutropenic septic shock. He developed a slowly progressing macular/papular eruption with multiple tender bullae found to be consistent with TEN-like Stage IV cutaneous acute GvHD on biopsy...
October 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29469010/effect-of-blood-thiamine-concentrations-on-mortality-influence-of-nutritional-status
#7
Heitor Pons Leite, Lúcio Flávio Peixoto de Lima, José Augusto de A C Taddei, Ângela Tavares Paes
OBJECTIVE: To test the hypothesis that low blood thiamine concentrations in malnourished critically ill children are associated with higher risk of 30-d mortality. METHODS: Prospective cohort study in 202 consecutively admitted children who had whole blood thiamine concentrations assessed on admission and on days 5 and 10 of intensive care unit (ICU) stay. The primary outcome variable was 30-d mortality. Mean blood thiamine concentrations within the first 10 d of ICU stay, age, sex, malnutrition, C-reactive protein concentration, Pediatric Index of Mortality 2 score, and severe sepsis/septic shock were the main potential exposure variables for outcome...
December 7, 2017: Nutrition
https://www.readbyqxmd.com/read/29468816/the-cholinergic-anti-inflammatory-pathway-revisited
#8
REVIEW
K Murray, C Reardon
Inflammatory bowel disease negatively affects the quality of life of millions of patients around the world. Although the precise etiology of the disease remains elusive, aberrant immune system activation is an underlying cause. As such, therapies that selectively inhibit immune cell activation without broad immunosuppression are desired. Inhibition of immune cell activation preventing pro-inflammatory cytokine production through neural stimulation has emerged as one such treatment. These therapeutics are based on the discovery of the cholinergic anti-inflammatory pathway, a reflex arc that induces efferent vagal nerve signaling to reduce immune cell activation and consequently mortality during septic shock...
March 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29467854/cholecystokinin-octapeptide-inhibits-the-inflammatory-response-and-improves-neurological-outcome-in-a-porcine-model-of-cardiopulmonary-resuscitation
#9
Sen Ye, Kejia Shi, Jiefeng Xu, Moli Wang, Chun-Jian Li
Previous studies have demonstrated that cholecystokinin octapeptide (CCK8) induces hypothermia and inhibits the systemic inflammatory response in septic shock in rat and murine models. The present study aimed to ascertain whether CCK8 induced hypothermia and improved the neurological outcomes in a porcine model of cardiopulmonary resuscitation (CPR). Ventricular fibrillation was induced and left untreated for 10 min in 12 male Bama miniature pigs. Defibrillation was attempted after 5 min of CPR. At 5 min following resuscitation, the pigs were randomized and equally assigned into the CCK8 or the control group...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29467023/protracted-immune-disorders-at-one-year-after-icu-discharge-in-patients-with-septic-shock
#10
Florence Riché, Benjamin G Chousterman, Patrice Valleur, Alexandre Mebazaa, Jean-Marie Launay, Etienne Gayat
BACKGROUND: Sepsis is a leading cause of mortality and critical illness worldwide and is associated with an increased mortality rate in the months following hospital discharge. The occurrence of persistent or new organ dysfunction(s) after septic shock raises questions about the mechanisms involved in the post-sepsis status. The present study aimed to explore the immune profiles of patients one year after being discharged from the intensive care unit (ICU) following treatment for abdominal septic shock...
February 21, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29467017/adjunctive-ulinastatin-in-sepsis-treatment-in-china-adjust-study-study-protocol-for-a-randomized-controlled-trial
#11
Wei Jiang, Xiangyou Yu, Tongwen Sun, Yanfen Chai, Ping Chang, Zhongqing Chen, Jingye Pan, Zhiyong Peng, Ruilan Wang, Xiaozhi Wang, Yuan Xu, Li Yu, Qingshan Zheng, Bin Du
BACKGROUND: Sepsis is a major challenge in critical care and is associated with high mortality. Current management of sepsis and septic shock remains mainly supportive. Both basic and clinical research has shown that ulinastatin can improve the prognosis of sepsis. The aim of this trial is to evaluate the efficacy and safety profiles of ulinastatin compared with placebo. METHODS/DESIGN: In this multi-center, double-blind, randomized placebo-controlled trial we are recruiting a total of 348 subjects meeting "The Third International Consensus Definitions for Sepsis and Septic Shock" (Sepsis-3)...
February 21, 2018: Trials
https://www.readbyqxmd.com/read/29465571/caspase-1-dependent-pyroptosis-of-peripheral-blood-mononuclear-cells-predicts-the-development-of-sepsis-in-severe-trauma-patients-a-prospective-observational-study
#12
Yu-Chang Wang, Qin-Xin Liu, Tao Liu, Xi-E Xu, Wei Gao, Xiang-Jun Bai, Zhan-Fei Li
Pyroptosis plays a pivotal role in sepsis and septic shock in animal studies. However, its clinical significance in pathological conditions has not been well elucidated. This study aimed to evaluate the correlation between the percentage of pyroptotic peripheral blood mononuclear cells (PBMCs) and the clinical index and to investigate the relationship between PBMCs pyroptosis and the development of sepsis in trauma patients.This prospective study was conducted from October 2016 to May 2017 in a comprehensive trauma center...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29463310/the-practice-of-intensive-care-in-latin-america-a-survey-of-academic-intensivists
#13
Ricardo Castro, Nicolas Nin, Fernando Ríos, Leyla Alegría, Elisa Estenssoro, Gastón Murias, Gilberto Friedman, Manuel Jibaja, Gustavo Ospina-Tascon, Javier Hurtado, María Del Carmen Marín, Flavia R Machado, Alexandre Biasi Cavalcanti, Arnaldo Dubin, Luciano Azevedo, Maurizio Cecconi, Jan Bakker, Glenn Hernandez
BACKGROUND: Intensive care medicine is a relatively young discipline that has rapidly grown into a full-fledged medical subspecialty. Intensivists are responsible for managing an ever-increasing number of patients with complex, life-threatening diseases. Several factors may influence their performance, including age, training, experience, workload, and socioeconomic context. The aim of this study was to examine individual- and work-related aspects of the Latin American intensivist workforce, mainly with academic appointments, which might influence the quality of care provided...
February 21, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29463168/associated-mortality-of-liberal-fluid-administration-in-sepsis
#14
Mathew R Johnson, T Patrick Reed, Denise K Lowe, William D Cahoon
Fluid resuscitation, to restore intravascular volume and improve oxygen delivery, is a crucial step in early resuscitation efforts of patients with sepsis or septic shock. The 2016 Surviving Sepsis Campaign guidelines suggest the use of dynamic versus static measures of fluid responsiveness and fluid resuscitation with at least 30 mL/kg of intravenous crystalloid within the first 3 hours followed by fluid administration if hemodynamic factors continue to improve. Despite these recommendations, risks to this practice may exist as multiple studies have demonstrated an association between a positive fluid balance and/or administration of large fluid volume and increase in mortality...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29462308/comment-on-influence-of-empirical-double-active-combination-antimicrobial-therapy-compared-with-active-monotherapy-on-mortality-in-patients-with-septic-shock-a-propensity-score-adjusted-and-matched-analysis
#15
Ludwig Serge Aho Glélé, Adrien Guilloteau, Mathieu Blot, Lionel Piroth, Karine Astruc, Pascal Chavanet
No abstract text is available yet for this article.
February 16, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29462085/non-occlusive-mesenteric-ischemia-in-patients-with-methamphetamine-use
#16
Jamie E Anderson, Ian E Brown, Kristin A Olson, Katherine Iverson, Christine S Cocanour, Joseph M Galante
BACKGROUND: Data suggest that methamphetamine may increase the risk of non-occlusive mesenteric ischemia (NOMI). We describe patterns of presentation and outcomes of patients with methamphetamine use who present with NOMI to a single institution. METHODS: This is an observational study of patients from January 2015 to September 2017 with methamphetamine use who presented with NOMI at an academic medical center in Northern California. We summarize patient co-morbidities, clinical presentation, operative findings, pathologic findings, hospital course, and survival...
February 17, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29462003/toll-like-receptor-4-signaling-licenses-the-cytosolic-transport-of-lipopolysaccharide-from-bacterial-outer-membrane-vesicles
#17
Lan Gu, Ran Meng, Yiting Tang, Kai Zhao, Fang Liang, Rui Zhang, Qianqian Xue, Fangping Chen, Xianzhong Xiao, Huadong Wang, Haichao Wang, Timothy R Billiar, Ben Lu
Outer membrane vesicles (OMVs), released by variety of bacteria, are membrane-enclosed entities enriched in microbial components, toxins and virulent factors. OMVs could deliver lipopolysaccharide (LPS) into the cytosol of host cells and subsequently activate caspase-11, which critically orchestrates immune responses and mediates septic shock. Though it is known that caspase-11 is activated by intracellular LPS, how OMVs deliver LPS into the cytosol remains largely unknown. Here we show that the activation of toll like receptor 4 (TLR4), a LPS receptor on the cytoplasmic membrane, licenses macrophages to transport LPS from OMVs into the cytosol through TIR domain-containing adaptor-inducing interferon-β (TRIF)...
February 16, 2018: Shock
https://www.readbyqxmd.com/read/29461465/septic-shock-alters-mitochondrial-respiration-of-lymphoid-cell-lines-and-human-peripheral-blood-mononuclear-cells-the-role-of-plasma
#18
Raphael Clere-Jehl, Julie Helms, Mohamad Kassem, Pierrick Le Borgne, Xavier Delabranche, Anne-Laure Charles, Bernard Geny, Ferhat Meziani, Pascal Bilbault
INTRODUCTION: In septic shock patients, post-septic immunosuppression state following the systemic inflammatory response syndrome is responsible for nosocomial infections, with subsequent increased mortality. The aim of the present study was to assess the underlying cellular mechanisms of the post-septic immunosuppression state, by investigating mitochondrial functions of peripheral blood mononuclear cells (PBMCs) from septic shock patients over 7 days. MATERIALS AND METHODS: Eighteen patients admitted to a French intensive care unit for septic shock were included...
February 14, 2018: Shock
https://www.readbyqxmd.com/read/29459977/evidence-underpinning-the-u-s-government-mandated-hemodynamic-interventions-for-sepsis-a-systematic-review
#19
Dominique J Pepper, Dharmvir Jaswal, Junfeng Sun, Judith Welsh, Charles Natanson, Peter Q Eichacker
Background: The Severe Sepsis and Septic Shock Early Management Bundle (SEP-1), the sepsis performance measure introduced by the Centers for Medicare & Medicaid Services (CMS), requires up to 5 hemodynamic interventions, as many as 141 tasks, and 3 hours to document for a single patient. Purpose: To evaluate whether moderate- or high-level evidence shows that use of SEP-1 or its hemodynamic interventions improves survival in adults with sepsis. Data Sources: PubMed, Embase, Scopus, Web of Science, and ClinicalTrials...
February 20, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29459404/septic-shock-shapes-b-cell-response-toward-an-exhausted-like-immunoregulatory-profile-in-patients
#20
Claude-Alexandre Gustave, Morgane Gossez, Julie Demaret, Thomas Rimmelé, Alain Lepape, Christophe Malcus, Françoise Poitevin-Later, Laurent Jallades, Julien Textoris, Guillaume Monneret, Fabienne Venet
Septic shock is accompanied by the development of immune dysfunctions whose intensity and duration are associated with increased risk of secondary infections and mortality. Although B lymphocytes play a pivotal role in the immune response to infections, no comprehensive exploration of circulating B cell status has been performed during the immunosuppressive phase of septic shock. Thus, our aim was to extensively characterize the phenotype and function of B cells in septic shock, including IL-10 production. Circulating B lymphocyte phenotype and function were evaluated by flow cytometry on fresh whole blood and after ex vivo stimulation in adult septic shock patients sampled at day 1, 3, and 6 after the onset of shock...
February 19, 2018: Journal of Immunology: Official Journal of the American Association of Immunologists
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