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https://www.readbyqxmd.com/read/29792059/pitfalls-in-the-diagnosis-of-meningitis-in-neonates-and-young-infants-the-role-of-lumbar-puncture
#1
Luca Bedetti, Lucia Marrozzini, Alessandro Baraldi, Elisabetta Spezia, Lorenzo Iughetti, Laura Lucaccioni, Alberto Berardi
Meningitis occurs frequently in neonates and can lead to a number of acute, severe complications and long-term disabilities. An early diagnosis of neonatal meningitis is essential to reduce mortality and to improve outcomes. Initial clinical signs of meningitis are often subtle and frequently overlap with those of sepsis, and current haematologic tests do not distinguish sepsis from meningitis. Thus, lumbar puncture remains the gold standard for the diagnosis of meningitis in infants, and this procedure is recommended in clinical guidelines...
May 23, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29790843/empirical-antibiotic-treatment-for-children-suffering-from-dysentery-cholera-pneumonia-sepsis-or-severe-acute-malnutrition
#2
Per Ashorn
No abstract text is available yet for this article.
November 2018: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/29788457/the-reliability-of-the-clinical-examination-in-predicting-hemodynamic-status-in-acute-febrile-illness-in-a-tropical-resource-limited-setting
#3
Felix Moek, Poe Poe, Prakaykaew Charunwatthana, Wirichada Pan-Ngum, Yupaporn Wattanagoon, Wirongrong Chierakul
Introduction: The clinical examination alone is widely considered unreliable when assessing fluid responsiveness in critically ill patients. Little evidence exists on the performance of the clinical examination to predict other hemodynamic derangements or more complex hemodynamic states. Materials and methods: Patients with acute febrile illness were assessed on admission, both clinically and per non-invasive hemodynamic measurement. Correlations between clinical signs and hemodynamics patterns were analyzed, and the predictive capacity of the clinical signs was examined...
May 19, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29788135/the-hepatic-glucocorticoid-receptor-is-crucial-for-cortisol-homeostasis-and-sepsis-survival-in-humans-and-male-mice
#4
Marc Jenniskens, Ruben Weckx, Thomas Dufour, Sarah Vander Perre, Lies Pauwels, Sarah Derde, Arno Téblick, Fabian Güiza, Greet Van den Berghe, Lies Langouche
Sepsis is hallmarked by hypercortisolemia, a stress response that is essential for survival. This elevation in plasma cortisol is partially brought about by suppressed hepatic cortisol breakdown. We now demonstrated that a controlled downregulation of the hepatic glucocorticoid receptor (hepatic GR) is crucial herein. In a mouse model of fluid-resuscitated, antibiotic-treated abdominal sepsis and in human ICU patients, sepsis reduced hepatic GR expression and signaling, but increased (free) plasma cortisol/corticosterone, explained by suppressed cortisol/corticosterone binding proteins and A-ring-reductases...
May 17, 2018: Endocrinology
https://www.readbyqxmd.com/read/29787415/cooccurrence-of-post-intensive-care-syndrome-problems-among-406-survivors-of-critical-illness
#5
Annachiara Marra, Pratik P Pandharipande, Timothy D Girard, Mayur B Patel, Christopher G Hughes, James C Jackson, Jennifer L Thompson, Rameela Chandrasekhar, Eugene Wesley Ely, Nathan E Brummel
OBJECTIVES: To describe the frequency of cooccurring newly acquired cognitive impairment, disability in activities of daily livings, and depression among survivors of a critical illness and to evaluate predictors of being free of post-intensive care syndrome problems. DESIGN: Prospective cohort study. SETTING: Medical and surgical ICUs from five U.S. centers. PATIENTS: Patients with respiratory failure or shock, excluding those with preexisting cognitive impairment or disability in activities of daily livings...
May 21, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29783922/lethal-phlegmonous-colitis
#6
John D Gilbert, Roger W Byard
A 52-year-old man died soon after admission to hospital with a severe metabolic acidosis and likely sepsis. He had a past history of alcohol abuse with withdrawal seizures. An abdominal computed tomography scan showed thickened bowel loops but no obvious ischaemic changes, and a blood culture yielded a pure growth of Escherichia coli. At autopsy, the liver showed well-established micro-nodular cirrhosis with steatosis. The peritoneal cavity contained 200 mL of turbid yellow-brown fluid, and the caecum and ascending colon were unusually thickened...
January 1, 2018: Medicine, Science, and the Law
https://www.readbyqxmd.com/read/29783819/-value-of-urine-soluble-triggering-receptor-expressed-on-myeloid-cells-1-in-the-early-diagnosis-of-sepsis-associated-acute-kidney-injury
#7
Z K Yuan, F Fang, C J Liu, J Li, Y F Chen, F Xu
Objective: To assess the value of urine soluble triggering receptor expressed on myeloid cells-1(sTREM-1) in early diagnosis and prognosis of sepsis associated acute kidney injury (AKI). Methods: This was a case-control study. A total of 62 patients with sepsis during November 2016 to June 2017 were collected, who were divided into non-AKI sepsis ( n= 49) and AKI sepsis ( n= 13) groups according to the serum creatinine (SCr) or urine output, sepsis with shock ( n= 22) and sepsis without shock ( n= 40) groups according to the presence of shock, survival ( n= 47) and death ( n= 15) groups according to the mortality...
May 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29782519/increased-circulating-microrna-122-is-a-biomarker-for-discrimination-and-risk-stratification-in-patients-defined-by-sepsis-3-criteria
#8
Tim Rahmel, Simon T Schäfer, Ulrich H Frey, Michael Adamzik, Jürgen Peters
BACKGROUND: Sepsis is now operationally defined as life-threatening organ dysfunction caused by an infection, identified by an acute change in SOFA-Score of at least two points, including clinical chemistry such as creatinine or bilirubin concentrations. However, little knowledge exists about organ-specific microRNAs as potentially new biomarkers. Accordingly, we tested the hypotheses that micro-RNA-122, the foremost liver-related micro-RNA (miR), 1) discriminates between sepsis and infection, 2) is an early predictor for mortality, and 3) improves the prognostic value of the SOFA-score...
2018: PloS One
https://www.readbyqxmd.com/read/29780817/clinical-profile-and-outcome-of-patients-with-acute-kidney-injury-requiring-hemodialysis-two-years-experience-at-a-tertiary-hospital-in-rwanda
#9
Grace Igiraneza, Benedicte Ndayishimiye, Menelas Nkeshimana, Vincent Dusabejambo, Onyema Ogbuagu
Introduction: Acute kidney injury (AKI) requiring renal replacement therapy is associated with high mortality. The study assessed the impact of the introduction of hemodialysis (HD) on outcomes of patients with AKI in Rwanda. Methods: A single center retrospective study that evaluated the clinical profile and survival outcomes of patients with AKI requiring HD [AKI-D] at a tertiary hospital in Rwanda. Data was collected on patients who received HD for AKI from September 2014 to December 2016...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29780651/fatal-outcome-of-imatinib-in-a-patient-with-idiopathic-hypereosinophilic-syndrome
#10
Ashraf Abugroun, Ahmed Chaudhary, Gabriel Rodriguez
Cytokine storm is a poorly explained clinical entity caused by an undesired and aggrandized immune system response leading to unregulated activation of the proinflammatory cascade, often contributing to multisystem organ failure and even death. Its potentially diverse etiologies and sepsis-like presentation have made it even more challenging to diagnose, and so far, no well-established treatment protocol has been proposed. Its association with certain medications, especially with monoclonal antibodies, has well been reported in literature...
2018: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/29779449/continuous-cytokine-haemoadsorption-incorporated-into-a-venoarterial-ecmo-circuit-for-the-management-of-postcardiotomy-cardiogenic-and-septic-shock-a-case-report
#11
Endre Nemeth, Szabolcs Szigeti, Tamas Varga, Laszlo Daroczi, Zoltan Barati, Bela Merkely, Janos Gal
INTRODUCTION: The acute surgical treatment of infective endocarditis (IE) carries a high risk of postoperative mortality. Most complications are linked to uncontrolled sepsis and inflammatory processes. Cytokine haemoadsorption is an extracorporeal technique which has benefits reported in haemodynamic stability and inflammatory response. CASE REPORT: A 46-year-old male patient underwent emergency cardiac surgery due to progressive IE. Postcardiotomy cardiogenic shock associated with cardiac surgery required the implantation of venoarterial (VA)-ECMO...
May 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29778842/curcumin-attenuates-sepsis-induced-acute-organ-dysfunction-by-preventing-inflammation-and-enhancing-the-suppressive-function-of-tregs
#12
Longwang Chen, Yang Lu, Linjun Zhao, Lili Hu, Qiaomeng Qiu, Zhuoling Zhang, Mengfang Li, Guangliang Hong, Bing Wu, Guangju Zhao, Zhongqiu Lu
Sepsis is characterized by the extensive release of cytokines and other mediators. It results in a dysregulated immune response and can lead to organ damage and death. Curcumin has anti-inflammatory properties and immunoregulation functions in various disorders such as sepsis, cancer, rheumatoid arthritis, cardiovascular diseases, lung fibrosis, gallstone formation, and diabetes. This paper investigates the effects of curcumin on immune status and inflammatory response in mice subjected to cecal ligation and puncture (CLP)...
May 17, 2018: International Immunopharmacology
https://www.readbyqxmd.com/read/29778659/sepsis-3-septic-shock-criteria-and-associated-mortality-among-infected-hospitalized-patients-assessed-by-a-rapid-response-team
#13
Shannon M Fernando, Peter M Reardon, Bram Rochwerg, Nathan I Shapiro, Donald M Yealy, Andrew J E Seely, Jeffrey J Perry, Douglas P Barnaby, Kyle Murphy, Peter Tanuseputro, Kwadwo Kyeremanteng
BACKGROUND: Rapid Response Teams (RRTs) respond to deteriorating hospitalized patients, and help determine subsequent management, including Intensive Care Unit (ICU) admission. In such patients with sepsis and septic shock, the Sepsis-3 clinical criteria have a potential role in detection, risk-stratification, and prognostication, though their accuracy in comparison to the Systemic Inflammatory Response Syndrome (SIRS)-based septic shock criteria are unknown. We sought to evaluate prognostic accuracy of the Sepsis-3 criteria for in-hospital mortality among infected hospitalized patients with acute deterioration...
May 17, 2018: Chest
https://www.readbyqxmd.com/read/29777456/distal-bowel-re-feeding-in-patients-with-proximal-jejunostomy
#14
Anand Nagar, Siddharth Mehrotra, Amitabh Yadav, Vivek Mangla, Shailendra Lalwani, Naimish Mehta, Samiran Nundy
BACKGROUND: Patients who have a proximal jejunostomy are difficult to manage because of their high stoma output which results in fluid and electrolyte imbalance with repeated hospital admissions and the necessity for expensive parenteral nutrition (PN). There are few reports on the use of re-feeding of the proximal effluents in this situation. METHODS: We here relate our experience with this manoeuvre in 35 patients between Jan 2010 and Feb 2016 who had stomas less than 120 cm away from the duodenojejunal flexure...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29777009/feasibility-of-cxcr4-directed-radioligand-therapy-in-advanced-diffuse-large-b-cell-lymphoma
#15
Constantin Lapa, Heribert Hänscheid, Malte Kircher, Andreas Schirbel, Gerd Wunderlich, Rudolf Werner, Samuel Samnick, Jörg Kotzerke, Hermann Einsele, Andreas Buck, Hans-Jürgen Wester, Götz Ulrich Grigoleit
We have recently reported on our experience with C-X-C-motif chemokine receptor 4- (CXCR4-) directed radioligand therapy (RLT) in multiple myeloma and acute leukemia. Methods: Six patients with heavily pre-treated relapsed diffuse large B cell lymphoma (DLBCL) (3 males, 3 females; aged, 54±8 years) underwent CXCR4-directed RLT in combination with conditioning chemotherapy and allogeneic stem cell transplantation (SCT). In 2 patients, radioimmunotherapy (RIT) targeting CD20 or CD66 was added to enhance anti-lymphoma activity...
May 18, 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/29776828/septic-acute-kidney-injury-patients-in-emergency-department-the-risk-factors-and-its-correlation-to-serum-lactate
#16
Yin-Chou Hsu, Chih-Wei Hsu
BACKGROUND: Acute kidney injury (AKI) is a common complication in septic patients, imposing a heavy burden of illness in terms of morbidity and mortality. Serum lactate is a widely used marker predicting the severity of sepsis. A paucity of research has investigated septic AKI in emergency departments (EDs) and its correlation with initial serum lactate level. This study aimed at identifying risk factors for septic AKI and clarifying the link between initial serum lactate level and septic AKI in ED patients...
May 15, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29776670/-predictors-of-in-hospital-mortality-in-patients-undergoing-elective-surgery-in-a-university-hospital-a-prospective-cohort
#17
Adriene Stahlschmidt, Betânia Novelo, Luiza Alexi Freitas, Sávio Cavalcante Passos, Jairo Alberto Dussián-Sarria, Elaine Aparecida Félix, Patrícia Wajnberg Gamermann, Wolnei Caumo, Luciana Paula Cadore Stefani
INTRODUCTION: Morbidity and mortality associated with urgent or emergency surgeries are high compared to elective procedures. Perioperative risk scores identify the non-elective character as an independent factor of complications and death. The present study aims to characterize the population undergoing non-elective surgeries at the Hospital de Clínicas de Porto Alegre and identify the clinical and surgical factors associated with death within 30 days postoperatively. METHODOLOGY: A prospective cohort study of 187 patients undergoing elective surgeries between April and May 2014 at the Hospital de Clínicas, Porto Alegre...
May 15, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29774564/mortality-in-sepsis-comparison-of-outcomes-between-patients-with-demand-ischemia-acute-myocardial-infarction-and-neither-demand-ischemia-nor-acute-myocardial-infarction
#18
Mahek Shah, Soumya Patnaik, Obiora Maludum, Brijesh Patel, Byomesh Tripathi, Manyoo Agarwal, Lohit Garg, Sahil Agrawal, Ulrich P Jorde, Matthew W Martinez
INTRODUCTION: Elevation in cardiac troponins is common among septic patients. We sought to explore outcomes among those admitted with demand ischemia(DI), acute myocardial infarction(AMI) and neither DI nor AMI in sepsis. METHODS: We analyzed data from the 2011-2014 National Inpatient Sample among patients admitted for sepsis. We compared outcomes among sepsis patients with i)DI versus AMI and ii)DI versus neither DI nor AMI using separate propensity matched cohorts...
May 18, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29774558/clinical-outcome-and-comparison-of-three-different-left-ventricular-assist-devices-in-a-high-risk-cohort
#19
Konstantin Zhigalov, Ahmed Mashhour, Marcin Szczechowicz, Sabreen Mkalaluh, Sergei Karagezian, Irakli Gogia, Maxim Isaev, Bakitbek K Kadyraliev, Jerry Easo, Juergen Ennker, Harald C Eichstaedt, Alexander Weymann
We present a comparison between three left ventricular assist devices (LVADs): HeartWare (HVAD) (HeartWare International Inc., Framingham, MA, USA), HeartMate II (HMII) and HeartMate III (HMIII) (Thoratec Corp., Pleasanton, CA, USA). To our knowledge, no study to date has aimed at placing these three devices in juxtaposition. Between June 2007 and June 2017, 108 consecutive patients received HMII, n = 77 (71.3%), HVAD, n = 14 (13%), or HM III, n = 17 (15.7%), for end-stage heart failure. Mean age was 63...
May 17, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29773712/acute-kidney-injury-and-risk-of-heart-failure-and-atherosclerotic-events
#20
Alan S Go, Chi-Yuan Hsu, Jingrong Yang, Thida C Tan, Sijie Zheng, Juan D Ordonez, Kathleen D Liu
BACKGROUND AND OBJECTIVES: AKI in the hospital is common and is associated with excess mortality. We examined whether AKI is also independently associated with a higher risk of different cardiovascular events in the first year after discharge. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective analysis of a cohort between 2006 and 2013 with follow-up through 2014, within Kaiser Permanente Northern California. We identified all adults admitted to 21 hospitals who had one or more in-hospital serum creatinine test result and survived to discharge...
May 17, 2018: Clinical Journal of the American Society of Nephrology: CJASN
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