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https://www.readbyqxmd.com/read/27922551/sphingosine-1-phosphate-s1p-a-potential-biomarker-and-therapeutic-target-for-endothelial-dysfunction-and-sepsis
#1
Martin S Winkler, Axel Nierhaus, Annika Poppe, Gillis Greiwe, Markus Gräler, Guenter Daum
Sepsis is an acute life-threatening multiple organ failure caused by a dysregulated host response to infection. Endothelial dysfunction, particularly barrier disruption leading to increased vascular permeability, edema and insufficient tissue oxygenation is critical to sepsis pathogenesis. Sphingosine-1-phosphate (S1P) is a signaling lipid that regulates important pathophysiological processes including vascular endothelial cell permeability, inflammation and coagulation. It is present at high concentrations in blood and lymph and at very low concentrations in tissues due to the activity of the S1P-degrading enzyme S1P-lyase in tissue cells...
December 2, 2016: Shock
https://www.readbyqxmd.com/read/27922256/statins-in-critical-care-to-give-or-not-to-give
#2
Amr S Omar, Samy Hanoura, Haifa M Aljanubi, Ahmed Mahfouz
Owing to statin's immune modulatory, anti-inflammatory, antioxidant, antithrombotic and endothelial function actions, they are widely used in the critical care settings in diverse disease scenarios. We aim to explore the evidence to globalize the utilization of statins in the intensive care practice for different indications. We carried out a search of the PubMed, Cochrane and EMBASE databases up to January 2016. We included review articles, meta-analyses, and original trials on the effects of statin therapy in the intensive care unit (ICU) combining the following MESH terms: 'satins', 'intensive care, 'cardiac surgery', 'sepsis', 'acute respiratory distress syndrome' 'pneumonia', subarachnoid hemorrhage', traumatic brain injury and 'critical illness'...
December 6, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27920569/does-calcium-channel-blockade-have-a-role-in-prevention-of-expression-of-sepsis-in-renal-transplant-recipients
#3
REVIEW
John A D'Elia, Ray E Gleason, Anthony P Monaco, Larry A Weinrauch
Many antihypertensive agents have been demonstrated to assist in preservation of kidney function, among them those that modulate calcium channels. Calcium channel blockers may also be of value in protecting hemodialysis patients from complications of sepsis. In diabetic recipients of kidney transplant allografts treated with cyclosporine, calcium channel blockade has been retrospectively linked to improved graft preservation and to fewer episodes of sepsis. This brief review outlines clinical and experimental publications on potential protection from sepsis by addition of calcium channel blockers to standard antibiotic therapy in individuals who may or may not have normal kidney function, or in the presence or absence of immunosuppression...
2016: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/27919118/preeclampsia-and-the-risk-of-bronchopulmonary-dysplasia-in-preterm-infants-less-than-32-weeks-gestation
#4
Nancy Soliman, Kathleen Chaput, Belal Alshaikh, Kamran Yusuf
Objective Angiogenesis is essential for normal lung development. The objective of our study was to test the hypothesis that preeclampsia, an antiangiogenic state, is a risk factor for bronchopulmonary dysplasia (BPD). Design Prospective cohort study of infants less than 32 weeks' gestation born to mothers with preeclampsia between January 2007 and June 2010 at a single tertiary care center. Their BPD outcome was compared with infants born to the next two normotensive mothers with a ± 1 week gestational age difference...
December 5, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27918382/conventional-versus-prolonged-infusion-of-meropenem-in-neonates-with-gram-negative-late-onset-sepsis-a-randomized-controlled-trial
#5
Abd Elazeez Shabaan, Islam Nour, Heba Elsayed Eldegla, Nehad Nasef, Basma Shouman, Hesham Abdel-Hady
BACKGROUND: Gram-negative bacteria are associated with significant morbidity and mortality in preterm and term newborns. Meropenem has widespread efficacy and often allows for monotherapy in this group. Prolonged infusion instead of infusion over 30 minutes has been suggested to result in higher microbiologic efficacy. OBJECTIVE: To compare the clinical and microbiologic efficacy and safety of prolonged infusions versus conventional dosing of meropenem in neonates with Gram negative late onset sepsis (GN-LOS)...
November 30, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27918369/preadministration-of-hydrogen-rich-water-protects-against-lipopolysaccharide-induced-sepsis-and-attenuates-liver-injury
#6
Masumi Iketani, Jumi Ohshiro, Takuya Urushibara, Mayumi Takahashi, Tomio Arai, Hideo Kawaguchi, Ikuroh Ohsawa
Despite significant advances in antibiotic therapy and intensive care, sepsis remains the most common cause of death in intensive care units. We previously reported that molecular hydrogen (H2) acts as a therapeutic and preventive antioxidant. Here, we show that preadministration of H2-dissolved water (HW) suppresses lipopolysaccharide (LPS)-induced endotoxin shock in mice. Drinking HW for 3 days before LPS injection prolonged survival in a mouse model of sepsis. The H2 concentration immediately increased in the liver but not in the kidney after drinking HW...
December 1, 2016: Shock
https://www.readbyqxmd.com/read/27917667/prophylactic-antibiotics-in-acute-pancreatitis-endless-debate
#7
M M Mourad, Rpt Evans, V Kalidindi, R Navaratnam, L Dvorkin, S R Bramhall
INTRODUCTION The development of pancreatic infection is associated with the development of a deteriorating disease with subsequent high morbidity and mortality. There is agreement that in mild pancreatitis there is no need to use antibiotics; in severe pancreatitis it would appear to be a logical choice to use antibiotics to prevent secondary pancreatic infection and decrease associated mortality. MATERIALS AND METHODS A non-systematic review of current evidence, meta-analyses and randomized controlled trials was conducted to assess the role of prophylactic antibiotics in acute pancreatitis and whether it might improve morbidity and mortality in pancreatitis...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27916077/-intestinal-barrier-dysfunction-and-its-related-factors-in-patients-with-sepsis
#8
W Liu, X H Wang, X J Yang, X Y Zhang, W J Qi
Objective: To investigate the relationship between related factors of intestinal barrier dysfunction in patients with sepsis or septic shock and severity of the condition. Methods: A prospective observational study was conducted in 31 sepsis patients, 28 septic shock patients, and 21 postoperative patients without sepsis (control group) who were admitted to intensive care unit (ICU) of General Hospital of Ningxia Medical University between November 2015 and June 2016. Blood samples were collected from the patients within 24 hours following admission to ICU...
November 29, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27913489/platelets-in-infectious-disease
#9
Elizabeth Middleton, Matthew T Rondina
Sepsis is a dynamic, acute, infectious disease syndrome characterized by dysregulated thrombo-inflammatory responses. The high mortality associated with sepsis has been recognized since the earliest clinicians' writings. Despite this, advances in the treatment of sepsis have been more modest. This is limited, in part, by the heterogeneity in the definition, population, presentation, and causal factors of infectious syndromes. Given the persistently high morbidity and mortality associated with sepsis, a better understanding of the dysregulated cellular biology underpinning sepsis is needed...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27910086/higher-vs-lower-haemoglobin-threshold-for-transfusion-in-septic-shock-subgroup-analyses-of-the-triss-trial
#10
S L Rygård, L B Holst, J Wetterslev, P I Johansson, A Perner
BACKGROUND: Using a restrictive transfusion strategy appears to be safe in sepsis, but there may be subgroups of patients who benefit from transfusion at a higher haemoglobin level. We explored if subgroups of patients with septic shock and anaemia had better outcome when transfused at a higher vs. a lower haemoglobin threshold. METHODS: In post-hoc analyses of the full trial population of 998 patients from the Transfusion Requirements in Septic Shock (TRISS) trial, we investigated the intervention effect on 90-day mortality in patients with severe comorbidity (chronic lung disease, haematological malignancy or metastatic cancer), in patients who had undergone surgery (elective or acute) and in patients with septic shock as defined by the new consensus definition: lactate above 2 mmol/l and the need for vasopressors to maintain a mean arterial pressure above 65 mmHg...
December 2, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27908336/appropriate-antibiotic-therapy
#11
REVIEW
Michael G Allison, Emily L Heil, Bryan D Hayes
Prescribing antibiotics is an essential component of initial therapy in sepsis. Early antibiotics are an important component of therapy, but speed of administration should not overshadow the patient-specific characteristics that determine the optimal breadth of antimicrobial therapy. Cultures should be drawn before antibiotic therapy if it does not significantly delay administration. Combination antibiotic therapy against gram-negative infections is not routinely required, and combination therapy involving vancomycin and piperacillin/tazobactam is associated with an increase in acute kidney injury...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27907062/sepsis-prevalence-and-outcome-on-the-general-wards-and-emergency-departments-in-wales-results-of-a-multi-centre-observational-point-prevalence-study
#12
Tamas Szakmany, Robert M Lundin, Ben Sharif, Gemma Ellis, Paul Morgan, Maja Kopczynska, Amrit Dhadda, Charlotte Mann, Danielle Donoghue, Sarah Rollason, Emma Brownlow, Francesca Hill, Grace Carr, Hannah Turley, James Hassall, James Lloyd, Llywela Davies, Michael Atkinson, Molly Jones, Nerys Jones, Rhodri Martin, Yousef Ibrahim, Judith E Hall
Data on sepsis prevalence on the general wards is lacking on the UK and in the developed world. We conducted a multicentre, prospective, observational study of the prevalence of patients with sepsis or severe sepsis on the general wards and Emergency Departments (ED) in Wales. During the 24-hour study period all patients with NEWS≥3 were screened for presence of 2 or more SIRS criteria. To be eligible for inclusion, patients had to have a high clinical suspicion of an infection, together with a systemic inflammatory response (sepsis) and evidence of acute organ dysfunction and/or shock (severe sepsis)...
2016: PloS One
https://www.readbyqxmd.com/read/27902475/osthole-protects-sepsis-induced-acute-kidney-injury-via-down-regulating-nf-%C3%AE%C2%BAb-signal-pathway
#13
Chen Yu, Peng Li, Dong Qi, Lei Wang, Hong-Lin Qu, Yue-Juan Zhang, Xue-Kai Wang, Hua-Ying Fan
BACKGROUND AND PURPOSE: As a natural coumarin derivative from the Cnidium monnieri(L)Cusson fruit, osthole consists of 7-methoxy-8-isopentenoxy-coumarin. The purpose of this research is to study the mechanism and effect of osthole on sepsis-induced acute kidney injury. EXPERIMENTAL APPROACH: The protective effect of osthole on mouse macrophage RAW 264.7 and HK-2 cells induced by LPS in vitro and on acute kidney injury model induced by sepsis and established by puncture and cecal ligation (CLP) in vivo were tested...
November 25, 2016: Oncotarget
https://www.readbyqxmd.com/read/27900737/three-year-mortality-in-30-day-survivors-of-critical-care-with-acute-kidney-injury-data-from-the-prospective-observational-finnaki-study
#14
Henriikka Mildh, Ville Pettilä, Anna-Maija Korhonen, Sari Karlsson, Tero Ala-Kokko, Matti Reinikainen, Suvi T Vaara
BACKGROUND: The role of an episode of acute kidney injury (AKI) in long-term mortality among initial survivors of critical illness is controversial. We aimed to determine whether AKI is independently associated with decreased survival at 3 years among 30-day survivors of intensive care. RESULTS: We included 2336 30-day survivors of intensive care enrolled in the FINNAKI study conducted in seventeen medical-surgical ICUs in Finland during a 5-month period in 2011-2012...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27900326/case-of-severe-alcoholic-hepatitis-treated-with-granulocytapheresis
#15
Yukari Watanabe, Kenya Kamimura, Tomohiro Iwasaki, Hiroyuki Abe, Shunsaku Takahashi, Ken-Ichi Mizuno, Manabu Takeuchi, Atsushi Eino, Ichiei Narita, Shuji Terai
Severe alcoholic hepatitis (AH) has a high mortality, and it is associated with encephalopathy, acute renal failure, sepsis, gastrointestinal bleeding, and endotoxemia. The 28-d mortality remains poor (34%-40%), because no effective treatment has been established. Recently, corticosteroids (CS) have been considered effective for significantly improving the prognosis of those with AH, as it prevents the production of pro-inflammatory cytokines. However, CS are not always appropriate as an initial therapeutic option, such as in cases with an infection or resistance to CS...
November 16, 2016: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/27899391/atypical-presentation-of-anti-gbm-nephritis-in-a-90-year-old-patient
#16
Julie Omolola Okiro, Chaudhry Adeel Ebad, Amjad Zaman Khan
A 90-year-old woman who had bloody diarrhoea, nausea, weakness and reduced urine output was found to have acute kidney injury. Her inflammatory markers were raised and her chest X-ray suggested an inflammatory process. She was initially suspected to have acute kidney injury secondary to dehydration and sepsis but when her autoimmune screen returned positive for antiglomerular basement membrane antibodies our diagnosis and management strategy was reconsidered. This is a case report of Goodpasture disease presenting in an elderly patient...
November 29, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27899386/thyroid-abscess-in-case-of-pre-b-acute-lymphoblastic-leukaemia-a-rare-presentation
#17
Siddhesh Arun Kalantri, Saikat Datta, Dhritiman Maitra, Maitreyee Bhattacharyya
Thyroid abscess is a very rare clinical condition. It usually occurs in immunocompromised individuals or those with underlying malignancy. We report a case of multiple thyroid abscesses in the patient with Pre B acute lymphoblastic leukaemia which developed secondary to hematogenous spread from pyomyositis of right calf muscle. The patient developed sepsis-associated disseminated intravascular coagulation, which got resolved after thyroidectomy. He became afebrile after surgical intervention. Unfortunately, all the cultures were negative...
November 29, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27898352/management-of-the-open-abdomen-using-negative-pressure-wound-therapy-with-instillation-in-severe-abdominal-sepsis-a-review-of-48-cases-in-hospital-mexico-costa-rica
#18
Pablo Sibaja, Alfredo Sanchez, Guillermo Villegas, Alvaro Apestegui, Esteban Mora
INTRODUCTION: Despite the numerous advances in recent years, severe abdominal sepsis (with associated organ failure associated with infection) remains a serious, life-threatening condition with a high mortality rate. OA is a viable alternative to the previously used scheduled repeat laparotomy or continuous peritoneal lavage. The use of Negative Pressure Wound Therapy (NPWT) has been described as a successful method of management of the open abdomen. Adding instillation of saline solution to NPWT in a programmed and controlled manner, could offer the clinician an additional tool for the management of complex septic abdomen...
November 17, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27896468/evaluation-of-major-trauma-in-elderly-patients-a%C3%A2-single-trauma-center-analysis
#19
Samo Kocuvan, Drago Brilej, Domen Stropnik, Rolf Lefering, Radko Komadina
BACKGROUND: The objective of the study was to gather information about elderly major trauma patients admitted to one particular Slovenian trauma centre in Celje and examine this group of polytrauma patients, specifically with respect to mechanisms of injury, injury severity and distribution of injuries. Further on, to identify morbidity and mortality rates and compare these to the younger population and, finally, to determine the factors that have the most impact on treatment results...
November 28, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27896146/determination-of-functional-prognosis-in-hospitalized-patients-following-an-intensive-care-admission
#20
Natália A Ferreira, Agnaldo José Lopes, Arthur S Ferreira, George Ntoumenopoulos, Jerffesson Dias, Fernando S Guimaraes
AIM: To investigate the factors associated with the functional progress of hospitalized patients following an intensive care admission. METHODS: Retrospective study including data from a cohort of 198 hospitalized patients following an intensive care admission and not requiring mechanical ventilation in a single tertiary referral hospital. A generalized linear model was used to identify the main effects of clinical and demographic variables on the outcomes of functionality (KATZ Index of Independence in Activities of Daily Living) and muscle strength (MRC Scale)...
November 4, 2016: World Journal of Critical Care Medicine
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