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Devaun M Reid, Monica Khadka, Sunny Kahlon, Nishanth Chalasani, Kathryn Kass
Shewanella algae is an opportunistic Gram-negative bacillus primarily found in marine environments. It can cause a range of infections in humans, from superficial soft tissue infections to more severe conditions like bacteremia, otitis, and hepatobiliary infections. While infections are rare, they can be significant, leading to complications such as sepsis and tissue necrosis. We present the case of severe cellulitis caused by Shewanella in an 88-year-old patient with multiple comorbidities. Following a blue crab pinch and consequent saltwater exposure, the patient developed severe cellulitis, sepsis, delirium, and atrial fibrillation...
March 2024: Curēus
#2
JOURNAL ARTICLE
Xiaoyin Li, Hao Xie, Shuxia Liu, Jian Wang, Zhanjun Shi, Qiaobing Yao, Qinfeng Yang, Qiuhong Li, Liangxiao Bao
OBJECTIVE: This study sought to determine the incidence and risk factors of blood transfusion among patients undergoing total knee revision (TKR) using a nationwide database. METHODS: A retrospective data analysis was conducted based on the Nationwide Inpatient Sample (NIS), enrolling patients who underwent TKR from 2010 to 2019 with complete information. The patients were divided into two groups based on whether they received blood transfusion or not. The demographic characteristics (race, sex, and age), length of stay (LOS), total charge of hospitalization, hospital characteristics (admission type, insurance type, bed size, teaching status, location, and region of hospital), hospital mortality, comorbidities, and perioperative complications were analyzed...
March 20, 2024: BMC Musculoskeletal Disorders
#3
Wei Wang, Wei Yao, Wanyun Tang, Yuhao Li, Hongbo Sun, Wenbo Ding
BACKGROUND: Urinary tract infection (UTI) is a prevalent and consequential complication in hip fracture patients, leading to significant disability and heightened healthcare expenditures. Consequently, there is a critical need for a comprehensive systematic review to identify risk factors and establish early and effective preventive measures. METHODS: A comprehensive search was performed across the PubMed, Cochrane, Embase, Web of Science, and Scopus databases (up to August 31, 2023)...
2024: Frontiers in Medicine
#4
JOURNAL ARTICLE
Kylie T Callan, Megan Donnelly, Brandon Lung, Maddison McLellan, Ryan DiGiovanni, William McMaster, Steven Yang, Russell Stitzlein
BACKGROUND: Postoperative delirium is a common problem affecting admitted patients that decreases patient satisfaction and increases the cost and complexity of care. The purpose of this study was to use the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to compare rates and risk factors of postoperative delirium for total hip arthroplasty (THA) and hemiarthroplasty patients indicated for osteoarthritis or proximal femur fracture. METHODS: The 2021 NSQIP database was queried for patients using Current Procedural Terminology (CPT) codes for THA and hemiarthroplasty and ICD-10 codes for osteoarthritis or proximal femur fracture...
January 17, 2024: BMC Musculoskeletal Disorders
#5
JOURNAL ARTICLE
Maria Aparecida Camargos Bicalho, Márlon Juliano Romero Aliberti, Polianna Delfino-Pereira, Victor Schulthais Chagas, Patryk Marques da Silva Rosa, Magda Carvalho Pires, Lucas Emanuel Ferreira Ramos, Adriana Falangola Benjamin Bezerra, Ana Beatriz de Castro Feres, Angélica Gomides Dos Reis Gomes, Angelinda Rezende Bhering, Bruno Porto Pessoa, Carla Thais Cândida Alves da Silva, Christiane Corrêa Rodrigues Cimini, Claudia Kimie Suemoto, Cristiana Andrade Coelho Dias, Daniela Dos Reis Carazai, Daniela Ponce, Danyelle Romana Alves Rios, Euler Manenti, Fernando Anschau, Joanna d'Arc Lyra Batista, Joice Coutinho de Alvarenga, Julia Avancini Viguini, Julia Mariot Zanellato, Juliana Machado Rugolo, Karen Brasil Ruschel, Leticia do Nascimento, Luanna Silva Monteiro Menezes, Lucas Moyses Carvalho de Oliveira, Luís César de Castro, Luiz Antônio Nasi, Marcelo Carneiro, Maria Angélica Pires Ferreira, Mariana Frizzo de Godoy, Milton Henriques Guimarães-Júnior, Neimy Ramos de Oliveira, Patricia Klarmann Ziegelmann, Paula Fonseca Porto, Paulo Mascarenhas Mendes, Pedro Gibson Paraíso, Priscilla Pereira Dos Reis, Saionara Cristina Francisco, Silvia Ferreira Araújo, Thiago Junqueira Avelino-Silva, Milena Soriano Marcolino
BACKGROUND: Although dementia has emerged as an important risk factor for severe SARS-CoV-2 infection, results on COVID-19-related complications and mortality are not consistent. We examined the clinical presentations and outcomes of COVID-19 in a multicentre cohort of in-hospital patients, comparing those with and without dementia. METHODS: This retrospective observational study comprises COVID-19 laboratory-confirmed patients aged ≥ 60 years admitted to 38 hospitals from 19 cities in Brazil...
January 5, 2024: BMC Geriatrics
#6
REVIEW
Yinuo Liu, Shengnan Hu, Bowen Shi, Bodong Yu, Wei Luo, Shengliang Peng, Xiaohong Du
Sepsis-associated encephalopathy (SAE) is an acute cerebral dysfunction secondary to infection, and the severity can range from mild delirium to deep coma. Disorders of iron metabolism have been proven to play an important role in a variety of neurodegenerative diseases by inducing cell damage through iron accumulation in glial cells and neurons. Recent studies have found that iron accumulation is also a potential mechanism of SAE. Systemic inflammation can induce changes in the expression of transporters and receptors on cells, especially high expression of divalent metal transporter1 (DMT1) and low expression of ferroportin (Fpn) 1, which leads to iron accumulation in cells...
December 19, 2023: Molecular Neurobiology
#7
JOURNAL ARTICLE
Tracey H Fan, Lavienraj Premraj, Jacob Roberts, Melissa Lydston, Chiara Robba, David Hager, Jose I Suarez, Denise Battaglini, Sung-Min Cho
OBJECTIVES: Although delirium is well described in patients with sepsis, there are limited data on other neurologic complications. We aimed to systematically review the prevalence, neuromonitoring tools, and neurocognitive outcomes in sepsis patients with neurologic complications. DATA SOURCES: MEDLINE and six other databases (Embase, Web of Science, Cochrane CENTRAL, and ClinicalTrials.gov ) were searched through January 2023. STUDY SELECTION: Studies of adult patients with sepsis reported neurologic complications, use of neuromonitoring tools, neuropathology, and cognitive outcomes...
March 1, 2024: Critical Care Medicine
#8
JOURNAL ARTICLE
Wen Han, Hongbo Luo, Jiahui Zhang, Wei Cheng, Dongkai Li, Mingxi Zhao, Na Cui, Huadong Zhu
OBJECTIVE: To investigate the effect of improved nursing strategy on prognosis of older immunosuppressed patients with pneumonia and sepsis. METHODS: A prospective study was conducted. The older immunosuppressed patients with pneumonia and sepsis admitted to the department of intensive care medicine and emergency intensive care unit (ICU) of Peking Union Medical College Hospital from January 2017 to July 2022 were enrolled. In the first stage (from January 2017 to December 2019), patients received the original nursing strategy (original nursing strategy group), including: (1) nurses were randomly assigned; (2) routine terminal cleaning; (3) ICU environmental cleaning twice a day; (4) oral care was performed with chlorhexidine twice a day; (5) original lung physiotherapy [head of bed elevated at 30 degree angle-45 degree angle, maintaining a Richmond agitation-sedation scale (RASS) -2 to 1, sputum aspiration as needed]...
October 2023: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
#9
REVIEW
Romain Sonneville, Sarah Benghanem, Lina Jeantin, Etienne de Montmollin, Marc Doman, Augustin Gaudemer, Michael Thy, Jean-François Timsit
Sepsis-associated encephalopathy is a severe neurologic syndrome characterized by a diffuse dysfunction of the brain caused by sepsis. This review provides a concise overview of diagnostic tools and management strategies for SAE at the acute phase and in the long term. Early recognition and diagnosis of SAE are crucial for effective management. Because neurologic evaluation can be confounded by several factors in the intensive care unit setting, a multimodal approach is warranted for diagnosis and management...
October 5, 2023: Critical Care: the Official Journal of the Critical Care Forum
#10
JOURNAL ARTICLE
Alvaro Ibaseta, Ahmed Emara, Pedro J Rullán, Daniel C Santana, Mitchell K Ng, Daniel Grits, Viktor E Krebs, Robert M Molloy, Nicolas S Piuzzi
BACKGROUND: Prolonged operative time is a risk factor for increased morbidity and mortality after open reduction and internal fixation (ORIF) of hip fractures. However, the quantitative nature of such association, including graduated risk levels, has yet to be described. This study outlines the graduated associations between operative time and (1) healthcare utilisation, and (2) 30-day complications after ORIF of hip fractures. METHODS: The National Surgical Quality Improvement Program (NSQIP) database was queried (January 2016-December 2019) for all patients who underwent ORIF of hip fractures ( n = 35,710)...
October 5, 2023: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
#11
REVIEW
Sandra Schütze, Douglas A Drevets, Simone C Tauber, Roland Nau
Next to acute sickness behavior, septic encephalopathy is the most frequent involvement of the brain during infection. It is characterized by a cross-talk of pro-inflammatory cells across the blood-brain barrier, by microglial activation and leukocyte migration, but not by the entry of infecting organisms into the brain tissue. Septic encephalopathy is very frequent in older persons because of their limited cognitive reserve. The predominant clinical manifestation is delirium, whereas focal neurological signs and symptoms are absent...
2023: Frontiers in Cellular Neuroscience
#12
Ann Hudson, Daniel Bobo, Libardo Rueda Prada, Igor Dumic, Emilia Petcu, Milena Cardozo, Fnu Shweta
Streptococcus agalactiae , also known as Group B Streptococcus (GBS), is a common pathogen in the neonatal period, causing meningitis and sepsis. In non-pregnant adults it is an unusual cause of meningitis. We report about an elderly female with several risk factors for invasive GBS infection who developed GBS meningoencephalitis one month after treatment for COVID-19 upper respiratory tract infection. The patient presented with mania, and the classic triad of headache, neck stiffness, and fever was absent which contributed to the delay in diagnosis...
2023: IDCases
#13
REVIEW
Yixiao Hong, Peiling Chen, Jingqi Gao, Yingying Lin, Linfang Chen, Xiuling Shang
Sepsis-associated encephalopathy, which presents as delirium and coma, is a significant complication of sepsis characterized by acute brain dysfunction. The presence of inflammatory pathological changes in the brain of sepsis patients and animal models has been recognized since the 1920 s, initially attributed to the entry of microbial toxins into the brain. In the early 2000 s, attention shifted towards the impact of oxidative stress, the cholinergic system, and cytokines on brain function following sepsis onset...
August 22, 2023: International Immunopharmacology
#14
REVIEW
Mu-Huo Ji, Yu-Zhu Gao, Cui-Na Shi, Xin-Miao Wu, Jian-Jun Yang
INTRODUCTION: Sepsis is a severe host response to infection, which induces both acute and long-term cognitive impairment. Despite its high incidence following sepsis, the underlying mechanisms remain elusive and effective treatments are not available clinically. AREA COVERED: This review focuses on elucidating the pathological mechanisms underlying cognitive impairment following sepsis. Specifically, the authors discuss the role of systemic inflammation response, blood-brain barrier disruption, neuroinflammation, mitochondrial dysfunction, neuronal dysfunction, and Aβ accumulation and tau phosphorylation in cognitive impairment after sepsis...
August 24, 2023: Expert Review of Neurotherapeutics
#15
JOURNAL ARTICLE
The Association of Infection with Delirium in the Post-Operative Period after Elective CABG Surgery.
Agnieszka Zukowska, Mariusz Kaczmarczyk, Mariusz Listewnik, Maciej Zukowski
Delirium is one of the most common complications of coronary artery by-pass graft (CABG) surgery. The identification of patients at increased risk of delirium and the implementation of preventive measures to reduce the risk of postoperative delirium is necessary to improve treatment outcomes after CABG. The aim of this study was to assess the association between postoperative delirium and postoperative infection and 10-year mortality in patients undergoing CABG surgery. This is a retrospective, observational cohort study of patients undergoing planned on-pump CABG between April 2010 and December 2012...
July 17, 2023: Journal of Clinical Medicine
#16
JOURNAL ARTICLE
Emily S Mills, Kevin Mertz, Ethan Faye, Jennifer A Bell, Andy T Ton, Jeffrey C Wang, Ram K Alluri, Raymond J Hah
OBJECTIVE: The objective of this study is to assess differences in complication profiles between 3-level posterior column osteotomy (PCO) and single-level pedicle subtraction osteotomy (PSO) as both are reported to provide similar degrees of sagittal correction. METHODS: The PearlDiver database was queried retrospectively using International Classification of Disease, 9th and 10th edition and Current Procedural Terminology codes to identify patients who underwent PCO or PSO for degenerative spine disease...
June 2023: Neurospine
#17
JOURNAL ARTICLE
Edward T Qian, Li Wang, Joanna L Stollings, Jonathan D Casey, Todd W Rice, Matthew W Semler
Background: Prior studies suggest associations between receipt of piperacillin-tazobactam and development of acute kidney injury and receipt of anti-pseudomonal cephalosporins and neurotoxicity. We compared clinically-relevant renal and neurologic outcomes in critically ill patients who received piperacillin-tazobactam versus anti-pseudomonal cephalosporins. Methods: We conducted a secondary analysis of data from the Isotonic Solutions and Major Adverse Renal Events Trial examining patients who received piperacillin-tazobactam or an anti-pseudomonal cephalosporin within 24 h of intensive care unit admission...
December 2023: Journal of Intensive Care Medicine
#18
REVIEW
Application background and mechanism of short-chain fatty acids in sepsis-associated encephalopathy.
Qiulei Zhang, Chang Lu, Weixuan Fan, Jingxiao Zhang, Yongjie Yin
Sepsis-associated encephalopathy (SAE) is a frequent brain dysfunction found in sepsis patients, manifesting as delirium, cognitive impairment, and abnormal behaviors. The gut microbiome and short-chain fatty acids (SCFAs) are particularly associated with neuroinflammation in patients with SAE, thus noticeably attracting scholars' attention. The association of brain function with the gut-microbiota-brain axis was frequently reported. Although the occurrence, development, and therapeutic strategies of SAE have been extensively studied, SAE remains a critical factor in determining the long-term prognosis of sepsis and is typically associated with high mortality...
2023: Frontiers in Cellular and Infection Microbiology
#19
JOURNAL ARTICLE
Edward Tang Qian, Jonathan D Casey, Adam Wright, Li Wang, Justin Siemann, Mary Lynn Dear, Joanna Stollings, Bradley Daniel Lloyd, Kevin Seitz, George Nelson, Patty Wright, Edward D Siew, Bradley Dennis, Jesse Wrenn, Jonathan Andereck, Wesley H Self, Matthew W Semler, Todd W Rice
INTRODUCTION: Antibiotics are time-critical in the management of sepsis. When infectious organisms are unknown, patients are treated with empiric antibiotics to include coverage for gram-negative organisms, such as antipseudomonal cephalosporins and penicillins. However, in observational studies, some antipseudomonal cephalosporins (eg, cefepime) are associated with neurologic dysfunction while the most common antipseudomonal penicillin (piperacillin-tazobactam) is associated with acute kidney injury (AKI)...
March 10, 2023: BMJ Open
#20
REVIEW
Simone Piva, Michele Bertoni, Nicola Gitti, Francesco A Rasulo, Nicola Latronico
PURPOSE OF REVIEW: Sepsis, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, is a leading cause of hospital and ICU admission. The central and peripheral nervous system may be the first organ system to show signs of dysfunction, leading to clinical manifestations such as sepsis-associated encephalopathy (SAE) with delirium or coma and ICU-acquired weakness (ICUAW). In the current review, we want to highlight developing insights into the epidemiology, diagnosis, prognosis, and treatment of patients with SAE and ICUAW...
April 1, 2023: Current Opinion in Critical Care
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