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SIRS and sepsis

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https://www.readbyqxmd.com/read/28321803/prognosis-of-cirrhotic-patients-admitted-to-intensive-care-unit-a-meta-analysis
#1
Delphine Weil, Eric Levesque, Marc McPhail, Rodrigo Cavallazzi, Eleni Theocharidou, Evangelos Cholongitas, Arnaud Galbois, Heng Chih Pan, Constantine J Karvellas, Bertrand Sauneuf, René Robert, Jérome Fichet, Gaël Piton, Thierry Thevenot, Gilles Capellier, Vincent Di Martino
BACKGROUND: The best predictors of short- and medium-term mortality of cirrhotic patients receiving intensive care support are unknown. METHODS: We conducted meta-analyses from 13 studies (2523 cirrhotics) after selection of original articles and response to a standardized questionnaire by the corresponding authors. End-points were in-ICU, in-hospital, and 6-month mortality in ICU survivors. A total of 301 pooled analyses, including 95 analyses restricted to 6-month mortality among ICU survivors, were conducted considering 249 variables (including reason for admission, organ replacement therapy, and composite prognostic scores)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28316860/hmgb1-and-histones-play-a-significant-role-in-inducing-systemic-inflammation-and-multiple-organ-dysfunctions-in-severe-acute-pancreatitis
#2
REVIEW
Runkuan Yang, Jyrki Tenhunen, Tor Inge Tonnessen
Severe acute pancreatitis (SAP) starts as a local inflammation of pancreatic tissue that induces the development of multiple extrapancreatic organs dysfunction; however, the underlying mechanisms are still not clear. Ischemia-reperfusion, circulating inflammatory cytokines, and possible bile cytokines significantly contribute to gut mucosal injury and intestinal bacterial translocation (BT) during SAP. Circulating HMGB1 level is significantly increased in SAP patients and HMGB1 is an important factor that mediates (at least partly) gut BT during SAP...
2017: International Journal of Inflammation
https://www.readbyqxmd.com/read/28291766/sepsis-3-on-the-block-what-does-it-mean-for-pre-clinical-sepsis-modeling
#3
Marcin F Osuchowski, Christoph Thiemermann, Daniel G Remick
To effectively improve outcomes of septic patients, we first need to elucidate the multifaceted pathogenesis of sepsis syndromes and related inflammatory conditions. In fulfillment of such needs, in February 2016, new definitions for sepsis and septic shock were published under the acronym Sepsis-3. Although aimed at the clinical area, Sepsis-3 will have an inevitable influence upon the field of translational research as well. Sepsis-3 brings a considerable shift regarding the experimental focal point: from inflammatory states (SIRS/CARS) to organ failure (single and multiple) as the decisive factor...
October 25, 2016: Shock
https://www.readbyqxmd.com/read/28286784/the-influence-of-metabolic-imbalances-and-oxidative-stress-on-the-outcome-of-critically-ill-polytrauma-patients-a-review
#4
REVIEW
Alexandru Florin Rogobete, Dorel Sandesc, Marius Papurica, Emil Robert Stoicescu, Sonia Elena Popovici, Lavinia Melania Bratu, Corina Vernic, Adriana Mariana Sas, Adrian Tudor Stan, Ovidiu Horea Bedreag
The critically ill polytrauma patient presents with a series of associated pathophysiologies secondary to the traumatic injuries. The most important include systemic inflammatory response syndrome (SIRS), sepsis, oxidative stress (OS), metabolic disorders, and finally multiple organ dysfunction syndrome (MODS) and death. The poor outcome of these patients is related to the association of the aforementioned pathologies. The nutrition of the critically ill polytrauma patient is a distinct challenge because of the rapid changes in terms of energetic needs associated with hypermetabolism, sepsis, SIRS, and OS...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28268067/application-of-the-third-international-consensus-definitions-for-sepsis-sepsis-3-classification-a-retrospective-population-based-cohort-study
#5
John P Donnelly, Monika M Safford, Nathan I Shapiro, John W Baddley, Henry E Wang
BACKGROUND: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) present clinical criteria for the classification of patients with sepsis. We investigated incidence and long-term outcomes of patients diagnosed with these classifications, which are currently unknown. METHODS: We did a retrospective analysis using data from 30 239 participants from the USA who were aged at least 45 years and enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort...
March 3, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28266902/soluble-triggering-receptor-expressed-on-myeloid-cells-1-as-a-novel-marker-for-abdominal-sepsis
#6
Xiaofei Song, Yucheng Song, Xuedong Zhang, Huanzhou Xue
BACKGROUND: The aim of the study was to investigate the concentration and diagnostic significance of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in acute abdominal conditions. METHODS: Plasma specimens were obtained from 68 patients with abdominal sepsis, 60 patients with systemic inflammatory response syndrome (SIRS), and 60 healthy individuals. The sepsis group was divided into the survival and death groups according to the 28-d outcome...
March 7, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28224564/increased-glucocorticoid-receptor-expression-in-sepsis-is-related-to-heat-shock-proteins-cytokines-and-cortisol-and-is-associated-with-increased-mortality
#7
Konstantinos Vardas, Stavroula Ilia, Amalia Sertedaki, Evangelia Charmandari, Efrossini Briassouli, Dimitris Goukos, Kleovoulos Apostolou, Katerina Psarra, Efthimia Botoula, Stylianos Tsagarakis, Eleni Magira, Christina Routsi, Constantine A Stratakis, Serafim Nanas, George Briassoulis
BACKGROUND: The purposes of this study are to examine if the human glucocorticoid receptor (hGR) isoform-α mRNA and hGR protein expressions are deficient in the acute phase of sepsis (S) compared to systemic inflammatory response syndrome (SIRS) and healthy subjects (H) and to evaluate if the hGRα and hGR alterations are associated with cortisol changes and if they are related to (1) extracellular and intracellular heat shock proteins (HSP) 72 and 90α; (2) ACTH, prolactin, and interleukins (ILs); and (3) outcome...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28223734/early-thrombomodulin-%C3%AE-administration-outcome-for-acute-disseminated-intravascular-coagulopathy-in-gastrointestinal-surgery
#8
Hirotaka Konishi, Kazuma Okamoto, Katsutoshi Shoda, Tomohiro Arita, Toshiyuki Kosuga, Ryo Morimura, Shuhei Komatsu, Yasutoshi Murayama, Atsushi Shiozaki, Yoshiaki Kuriu, Hisashi Ikoma, Masayoshi Nakanishi, Daisuke Ichikawa, Hitoshi Fujiwara, Eigo Otsuji
AIM: To investigate the efficacy of thrombomodulin (TM)-α for treatment of disseminated intravascular coagulopathy (DIC) in the field of gastrointestinal surgery. METHODS: Thirty-six peri-operative DIC patients in the field of gastrointestinal surgery who were treated with TM-α were retrospectively investigated. The relationships between patient demographics and the efficacy of TM-α were examined. Analysis of survival at 28 d was also performed on some parameters by means of the Kaplan-Meier method...
February 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28215126/new-sepsis-definition-changes-incidence-of-sepsis-in-the-intensive-care-unit
#9
James N Fullerton, Kelly Thompson, Amith Shetty, Jonathan R Iredell, Harvey Lander, John A Myburgh, Simon Finfer
OBJECTIVE: To estimate the impact of adopting the proposed new diagnostic criteria for sepsis, based on Sequential Organ Failure Assessment (SOFA) criteria, on the diagnosis and apparent mortality of sepsis in Australian and New Zealand intensive care units. DESIGN, SETTING AND PARTICIPANTS: A two-stage, post hoc analysis of prospectively collected ICU research data from 3780 adult patients in 77 Australian and New Zealand ICUs on 7 study days, between 2009 and 2014...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28190560/filtering-authentic-sepsis-arising-in-the-icu-using-administrative-codes-coupled-to-a-sirs-screening-protocol
#10
Christopher L Sudduth, Elizabeth C Overton, Peter F Lyu, Ramzy H Rimawi, Timothy G Buchman
PURPOSE: Using administrative codes and minimal physiologic and laboratory data, we sought a high-specificity identification strategy for patients whose sepsis initially appeared during their ICU stay. MATERIALS AND METHODS: We studied all patients discharged from an academic hospital between September 1, 2013 and October 31, 2014. Administrative codes and minimal physiologic and laboratory criteria were used to identify patients at high risk of developing the onset of sepsis in the ICU...
February 3, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28175943/-treatment-of-traumatic-lesions-of-the-bursa-olecrani-and-chronic-bursitis-olecrani
#11
D Saul, K Dresing
OBJECTIVE: Complete olecranon bursectomy with debridement, protection of veins and nerves. Risk-adapted antibiotic therapy and early functional aftercare. INDICATIONS: Acute, traumatic laceration of the bursa olecrani, chronic therapy-resistant bursitis olecrani. CONTRAINDICATIONS: For traumatic bursa injuries: general contraindications for anesthesia and surgery; chronic bursitis: initially not closable skin defect (plastic surgery required), hemodynamically instable patient (e...
February 7, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28149888/scoring-systems-for-the-characterization-of-sepsis-and-associated-outcomes
#12
COMMENT
Natalie McLymont, Guy W Glover
Sepsis is responsible for the utilisation of a significant proportion of healthcare resources and has high mortality rates. Early diagnosis and prompt interventions are associated with better outcomes but is impeded by a lack of diagnostic tools and the heterogeneous and enigmatic nature of sepsis. The recently updated definitions of sepsis have moved away from the centrality of inflammation and the systemic inflammatory response syndrome (SIRS) criteria which have been shown to be non-specific. Sepsis is now defined as a "life-threatening organ dysfunction caused by a dysregulated host response to infection"...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28145460/caffeic-acid-cyclohexylamide-rescues-lethal-inflammation-in-septic-mice-through-inhibition-of-i%C3%AE%C2%BAb-kinase-in-innate-immune-process
#13
Jun Hyeon Choi, Sun Hong Park, Jae-Kyung Jung, Won-Jea Cho, Byeongwoo Ahn, Cheong-Yong Yun, Yong Pyo Choi, Jong Hun Yeo, Heesoon Lee, Jin Tae Hong, Sang-Bae Han, Youngsoo Kim
Targeting myeloid differentiation protein 2 (MD-2) or Toll-like receptor 4 (TLR4) with small molecule inhibitor rescues the systemic inflammatory response syndrome (SIRS) in sepsis due to infection with Gram-negative bacteria but not other microbes. Herein, we provided IκB kinase β (IKKβ) in innate immune process as a molecular target of caffeic acid cyclohexylamide (CGA-JK3) in the treatment of polymicrobial TLR agonists-induced lethal inflammation. CGA-JK3 ameliorated E. coli lipopolysaccharide (LPS, MD-2/TLR4 agonist)-induced endotoxic shock, cecal ligation and puncture (CLP)-challenged septic shock or LPS plus D-galactosamine (GalN)-induced acute liver failure (ALF) in C57BL/6J mice...
February 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28126452/early-sepsis-bundle-compliance-for-non-hypotensive-patients-with-intermediate-versus-severe-hyperlactemia
#14
Daniel E Leisman, Jason A Zemmel D'Amore, Jeanie L Gribben, Mary Frances Ward, Kevin D Masick, Andrea R Bianculli, Kathryn H Bradburn, John K D'Angelo, Martin E Doerfler
OBJECTIVE: To compare the association of 3-h sepsis bundle compliance with hospital mortality in non-hypotensive sepsis patients with intermediate versus severe hyperlactemia. METHODS: This was a cohort study of all non-hypotensive, hyperlactemic sepsis patients captured in a prospective quality-improvement database, treated October 2014 to September 2015 at five tertiary-care centers. We defined sepsis as 1) infection, 2) ≥2 SIRS criteria, and 3) ≥1 organ dysfunction criterion...
January 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28120605/hemophagocytic-lymphohistiocytosis-mimics-many-common-conditions-case-series-and-review-of-literature
#15
A T Akenroye, N Madan, F Mohammadi, J Leider
Introduction. Hemophagocytic lymphohistiocytosis (HLH), a rare but potentially fatal disease, is characterized by excessive immune activation and cytokine release which stimulates bone marrow macrophages to engulf hematopoietic cells. HLH could be secondary to infections: viral, fungal, and bacterial; malignancies and autoimmune diseases. The diagnosis of HLH is usually delayed due to the presence of non-specific symptoms at presentation. This delay contributes to increased mortality. Cases and review. We present the case of 4 patients who presented with subjective fevers and extreme fatigue...
January 2017: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28119177/immunoparalysis-clinical-and-immunological-associations-in-sirs-and-severe-sepsis-patients
#16
Panagiotis Papadopoulos, Aikaterini Pistiki, Maria Theodorakopoulou, Theodora Christodoulopoulou, Georgia Damoraki, Dimitris Goukos, Efrossini Briassouli, Ioanna Dimopoulou, Apostolos Armaganidis, Serafim Nanas, George Briassoulis, Sotirios Tsiodras
INTRODUCTION: This study was designed to identify changes in the monocytic membrane marker HLA-DR and heat shock proteins (HSPs) in relation to T-regulatory cells (T-regs) and other immunological marker changes in patients with systemic inflammatory response syndrome (SIRS) or sepsis/septic shock. METHODS: Healthy volunteers, intensive care unit (ICU) patients with SIRS due to head injury and ICU patients with severe sepsis/septic shock were enrolled in the current study...
April 2017: Cytokine
https://www.readbyqxmd.com/read/28114554/prognostic-accuracy-of-sepsis-3-criteria-for-in-hospital-mortality-among-patients-with-suspected-infection-presenting-to-the-emergency-department
#17
MULTICENTER STUDY
Yonathan Freund, Najla Lemachatti, Evguenia Krastinova, Marie Van Laer, Yann-Erick Claessens, Aurélie Avondo, Céline Occelli, Anne-Laure Feral-Pierssens, Jennifer Truchot, Mar Ortega, Bruno Carneiro, Julie Pernet, Pierre-Géraud Claret, Fabrice Dami, Ben Bloom, Bruno Riou, Sébastien Beaune
Importance: An international task force recently redefined the concept of sepsis. This task force recommended the use of the quick Sequential Organ Failure Assessment (qSOFA) score instead of systemic inflammatory response syndrome (SIRS) criteria to identify patients at high risk of mortality. However, these new criteria have not been prospectively validated in some settings, and their added value in the emergency department remains unknown. Objective: To prospectively validate qSOFA as a mortality predictor and compare the performances of the new sepsis criteria to the previous ones...
January 17, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28114553/prognostic-accuracy-of-the-sofa-score-sirs-criteria-and-qsofa-score-for-in-hospital-mortality-among-adults-with-suspected-infection-admitted-to-the-intensive-care-unit
#18
Eamon P Raith, Andrew A Udy, Michael Bailey, Steven McGloughlin, Christopher MacIsaac, Rinaldo Bellomo, David V Pilcher
Importance: The Sepsis-3 Criteria emphasized the value of a change of 2 or more points in the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score, introduced quick SOFA (qSOFA), and removed the systemic inflammatory response syndrome (SIRS) criteria from the sepsis definition. Objective: Externally validate and assess the discriminatory capacities of an increase in SOFA score by 2 or more points, 2 or more SIRS criteria, or a qSOFA score of 2 or more points for outcomes among patients who are critically ill with suspected infection...
January 17, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28104273/physiologically-based-predictive-analytics-using-the-heart-rate-to-systolic-ratio-significantly-improves-the-timeliness-and-accuracy-of-sepsis-prediction-compared-to-sirs
#19
Omar K Danner, Sandra Hendren, Ethel Santiago, Brittany Nye, Prasad Abraham
BACKGROUND: Enhancing the efficiency of diagnosis and treatment of severe sepsis by using physiologically-based, predictive analytical strategies has not been fully explored. We hypothesize assessment of heart-rate-to-systolic-ratio significantly increases the timeliness and accuracy of sepsis prediction after emergency department (ED) presentation. METHODS: We evaluated the records of 53,313 ED patients from a large, urban teaching hospital between January and June 2015...
January 7, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28104099/coexisting-systemic-infections-in-patients-who-present-with-a-fall
#20
Alex Blair, Farrin A Manian
BACKGROUND: Although the causes of falls are legion, infectious disease-related factors are not commonly reported in the published literature. We investigated the characteristics of patients presenting to the hospital because of a fall and who were subsequently found to have a coexisting systemic infection (CSI). MATERIALS AND METHODS: This was a retrospective study performed at Massachusetts General Hospital, using the electronic database of adult patients receiving care during the period January 1, 2000 through December 31, 2014...
January 2017: American Journal of the Medical Sciences
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