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https://www.readbyqxmd.com/read/29923969/clinical-symptoms-laboratory-and-microbial-patterns-of-suspected-neonatal-sepsis-cases-in-a-children-s-referral-hospital-in-northwestern-iran
#1
Majid Mahallei, Mohammad Ahangarzadeh Rezaee, Bahareh Mehramuz, Shayan Beheshtirooy, Babak Abdinia
Sepsis is the systemic response to infection manifested as hyperthermia or hypothermia, tachycardia, tachypnea, and shock. This condition represents a major life-threatening factor in all age groups, particularly in neonatal period. The present study aimed to examine the results of blood, cerebrospinal fluid (CSF), and urine culture tests in suspected neonatal sepsis cases in northwestern Iran.This descriptive-analytical study was conducted on suspected neonatal sepsis cases hospitalized in Tabriz Children's Hospital...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29923896/part-iii-minimum-quality-threshold-in-pre-clinical-sepsis-studies-mqtipss-for-fluid-resuscitation-and-antimicrobial-therapy-endpoints
#2
Judith Hellman, Soheyl Bahrami, Mihaly Boros, Irshad Chaudry, Gerhard Fritsch, Waldemar Gozdzik, Shigeaki Inoue, Peter Radermacher, Mervyn Singer, Marcin F Osuchowski, Markus Huber-Lang
As outlined in the "International Guidelines for Management of Sepsis and Septic Shock: 2016", initial fluid resuscitation and administration of antibiotics are key steps in the early management of sepsis and septic shock. However, such clear guidelines do not exist for pre-clinical sepsis models. To address these shortcomings, the Wiggers-Bernard conference on pre-clinical sepsis models was held in Vienna in May, 2017. The participants reviewed 260 of the most highly cited papers between 2003 and 2012 that used sepsis models...
June 19, 2018: Shock
https://www.readbyqxmd.com/read/29921225/effects-of-acute-ethanol-intoxication-in-an-ovine-peritonitis-model
#3
Koji Hosokawa, Fuhong Su, Fabio Silvio Taccone, Emiel Hendrik Post, Jacques Creteur, Jean-Louis Vincent
BACKGROUND: Acute ethanol intoxication has been shown to have contrasting effects on outcomes in sepsis. The aim of this study was to explore the effects of acute ethanol intoxication on hemodynamics, renal function, brain perfusion and lactate/pyruvate in an ovine sepsis model. METHODS: Anesthetized, mechanically ventilated female sheep were randomized to an ethanol group (n = 7), which received 1 g/kg ethanol diluted in intravenous (i.v.) saline infusion or a control group (n = 7), which received the same volume of i...
June 19, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29915446/refractory-hypotension-due-to-nivolumab-induced-adrenal-insufficiency
#4
Yoshiaki Tsukizawa, Keisuke Kondo, Toshihisa Ichiba, Hiroshi Naito, Kazuhito Mizuki, Ken Masuda
Nivolumab, a new immune checkpoint inhibitor that has been found to improve outcomes for patients with some advanced cancers, is being increasingly used. Immune checkpoint inhibitors can cause immune-related adverse events, including dermatitis, enterocolitis, hepatitis and hypophysitis, but adrenal insufficiency rarely occurs. We present a case of Nivolumab-induced adrenal insufficiency in a man who complained of refractory hypotension. A 52-year-old man with non-small cell lung cancer visited our emergency department complaining of fatigue and diarrhea...
May 2018: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/29912769/factors-related-to-surgical-treatment-and-outcomes-of-thai-patients-with-septic-arthritis
#5
Chonlada Ruangpin, Muchima Rodchuae, Wanruchada Katchamart
OBJECTIVE: The aim of this study was to identify factors associated with the surgical treatment of Thai patients with septic arthritis. METHODS: This retrospective cohort study used a university hospital database in Thailand to identify 450 adult patients with confirmed septic arthritis. Data related to baseline characteristics, clinical and laboratory findings, treatment, and outcomes were collected. A multivariate analysis identified the factors related to surgical treatment...
June 15, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/29904402/identification-of-csf-biomarkers-by-proteomics-in-guillain-barr%C3%A3-syndrome
#6
Pei Li, Sujie Wang, Ruili Zhang, Jian Pei, Lili Chen, Yibin Cao, Haoliang Zhang, Guofeng Yang
The purpose of the present study was to screen for differentially expressed proteins in the cerebrospinal fluid (CSF) of patients with Guillain-Barré syndrome (GBS). The identification of differentially expressed protein can provide new targets for understanding the pathogenic mechanism, early clinical diagnosis, prognosis and for measuring the effectiveness of interventions. We enrolled 50 GBS patients and 50 meningitis patients (control group) to compare protein expression in CSF. The GBS cases included 28 cases of acute inflammatory demyelinating polyneuropathy (AIDP) and 22 cases of acute motor axonal neuropathy (AMAN)...
June 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29899987/-streptococcus-pyogenes-and-invasive-central-nervous-system-infection
#7
Ekamjeet Randhawa, John Woytanowski, Kedesha Sibliss, Ian Sheffer
Streptococcus pyogenes is a Gram-positive beta-hemolytic bacteria, also known as group A streptococci, that causes a range of infections. The most common presentation is acute pharyngitis; however, it is also implicated in skin and soft tissue infections, and less commonly bacteremia, osteomyelitis, pneumonia, otitis media and sinusitis. Group A streptococci infections of the central nervous system are exceedingly rare in the antibiotic era. The mechanism of infection is typically contiguous spread from existing infection or via direct inoculation...
2018: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29898478/-canine-hypoadrenocorticism-an-update-on-pathogenesis-diagnosis-and-treatment
#8
Katja Kalenyak, Romy M Heilmann
Canine hypoadrenocorticism (HoAC) results from a loss of functional adrenal cortex, the most common etiology of which is an immune-mediated destruction leading to an inadequate production of glucocorticoids and mineralocorticoids. The term "atypical" HoAC is used for a subgroup of dogs with either an isolated glucocorticoid deficiency or a combined glucocorticoid and mineralocorticoid deficiency but normal electrolytes. Dogs with HoAC can present with a large variety of clinical signs, ranging from shaking, weakness, and mild gastrointestinal signs to seizures, hypovolemic shock, and collapse...
June 2018: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
https://www.readbyqxmd.com/read/29897100/controlled-hypotension-versus-normotensive-resuscitation-strategy-for-people-with-ruptured-abdominal-aortic-aneurysm
#9
REVIEW
Daniel H Moreno, Daniel G Cacione, Jose Cc Baptista-Silva
BACKGROUND: An abdominal aortic aneurysm (AAA) is the pathological enlargement of the aorta and can develop in both men and women. Progressive aneurysm enlargement can lead to rupture. The rupture of an AAA is frequently fatal and accounts for the death from haemorrhagic shock of at least 45 people per 100,000 population. The outcome of people with ruptured AAA varies among countries and healthcare systems, with mortality ranging from 53% to 90%. Definitive treatment for ruptured AAA includes open surgery or endovascular repair...
June 13, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29896237/effect-of-interleukin-31-on-septic-shock-through-regulating-inflammasomes-and-interleukin-1%C3%AE
#10
Xuyun Gu, Chen Wei, Xishan Zhu, Feiping Lu, Bo Sheng, Xuefeng Zang
Sepsis with severe systemic inflammation remains a great challenge for the intensive care unit in clinics. Although biomarkers have been identified to diagnose, monitor and predict these syndromes, novel therapeutic approaches are required for the amelioration of symptoms of sepsis and septic shock. The present study demonstrated that interleukin (IL)-31 was able reduce the mortality rate of lipopolysaccharide (LPS)-induced sepsis with the reduction of inflammatory cytokines in the sera. IL-31 also inhibited IL-1β production in the peritoneal lavage fluid in LPS-induced or cecal ligation and puncture-induced sepsis...
July 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29889952/management-of-suspected-tension-pneumothorax-in-tactical-combat-casualty-care-tccc-guidelines-change-17-02
#11
Frank K Butler, John B Holcomb, Stacy Shackelford, Harold R Montgomery, Shawn Anderson, Jeffrey S Cain, Howard R Champion, Cord W Cunningham, Warren C Dorlac, Brendon Drew, Kurt Edwards, John V Gandy, Elon Glassberg, Jennifer Gurney, Theodore Harcke, Donald A Jenkins, Jay Johannigman, Bijan S Kheirabadi, Russ S Kotwal, Lanny F Littlejohn, Matthew Martin, Edward L Mazuchowski, Edward J Otten, Travis Polk, Peter Rhee, Jason M Seery, Zsolt Stockinger, Jeremy Torrisi, Avi Yitzak, Ken Zafren, Scott P Zietlow
This change to the Tactical Combat Casualty Care (TCCC) Guidelines that updates the recommendations for management of suspected tension pneumothorax for combat casualties in the prehospital setting does the following things: (1) Continues the aggressive approach to suspecting and treating tension pneumothorax based on mechanism of injury and respiratory distress that TCCC has advocated for in the past, as opposed to waiting until shock develops as a result of the tension pneumothorax before treating. The new wording does, however, emphasize that shock and cardiac arrest may ensue if the tension pneumothorax is not treated promptly...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29889830/renal-resistive-index-as-an-early-predictor-and-discriminator-of-acute-kidney-injury-in-critically-ill-patients-a-prospective-observational-cohort-study
#12
Jelle L G Haitsma Mulier, Sander Rozemeijer, Jantine G Röttgering, Angelique M E Spoelstra-de Man, Paul W G Elbers, Pieter Roel Tuinman, Monique C de Waard, Heleen M Oudemans-van Straaten
BACKGROUND: Acute kidney injury (AKI) complicates shock. Diagnosis is based on rising creatinine, a late phenomenon. Intrarenal vasoconstriction occurs earlier. Measuring flow resistance in the renal circulation, Renal Resistive Index (RRI), could become part of vital organ function assessment using Doppler ultrasound. Our aim was to determine whether RRI on ICU admission is an early predictor and discriminator of AKI developed within the first week. METHODS: In this prospective cohort of mixed ICU patients with and without shock, RRI was measured <24-h of admission...
2018: PloS One
https://www.readbyqxmd.com/read/29885068/a-first-in-man-safety-and-pharmacokinetics-study-of-nangibotide-a-new-modulator-of-innate-immune-response-through-trem-1-receptor-inhibition
#13
V Cuvier, U Lorch, S Witte, A Olivier, S Gibot, I Delor, J J Garaud, M Derive, M Magguilli-Salcedo
BACKGROUND: The peptide nangibotide is the first clinical-stage agent targeting the immunoreceptor TREM-1 (Triggering Receptor Expressed on Myeloid cells-1) and is being investigated as a novel therapy for acute inflammatory disorders such as septic shock. AIMS: This first-in-man, randomised, double-blind, ascending dose, placebo-controlled Phase I study evaluated the safety, tolerability, and pharmacokinetics of nangibotide. METHODS: 27 healthy subjects (aged 18-45 years) were randomised into eight groups...
June 8, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29883040/management-of-postpartum-hemorrhage-how-to-improve-maternal-outcomes
#14
REVIEW
Dacia D C A Henriquez, Kitty W M Bloemenkamp, Johanna G van der Bom
Postpartum hemorrhage is the leading cause of maternal mortality and severe morbidity. Despite efforts to improve maternal outcomes, management of postpartum hemorrhage still faces at least four challenges, discussed in this review. First, current definitions for severe postpartum hemorrhage hamper early identification of women with high risk of adverse outcome. Adaptations to the definitions and the use of clinical tools such as shock index and early warning systems may facilitate this early identification...
June 8, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29882682/unintended-consequences-fluid-resuscitation-worsens-shock-in-an-ovine-model-of-endotoxemia
#15
Liam Byrne, Nchafatso G Obonyo, Sara D Diab, Kimble R Dunster, Margaret R Passmore, Ai-Ching Boon, Louise See Hoe, Sanne Pedersen, Mohd Hashairi Fauzi, Leticia Pretti Pimenta, Frank Van Haren, Christopher M Anstey, Louise Cullen, John-Paul Tung, Kiran Shekar, Kathryn Maitland, John F Fraser
BACKGROUND: Fluid resuscitation is widely considered a life saving intervention in septic shock however recent evidence has questioned both its safety and efficacy in sepsis. This study sought to compare fluid resuscitation with vasopressors with vasopressors alone in a hyperdynamic model of ovine endotoxemia. METHODS: Endotoxemic shock was induced in sixteen sheep after which they received fluid resuscitation with 40mls/kg of 0.9% saline or commenced haemodynamic support with protocolized noradrenaline and vasopressin...
June 8, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29877961/endovascular-perfusion-augmentation-for-critical-care-partial-aortic-occlusion-for-treatment-of-severe-ischemia-reperfusion-shock
#16
M Austin Johnson, Emily M Tibbits, Guillaume L Hoareau, Meryl A Simon, Anders J Davidson, Erik S DeSoucy, E Robert Faulconer, J Kevin Grayson, Lucas P Neff, Timothy K Williams
BACKGROUND: The resuscitation of patients in shock is materially intensive and many patients are refractory to maximal therapy. We hypothesized that partial inflation of an intra-aortic balloon, termed Endovascular Perfusion Augmentation for Critical Care (EPACC), would minimize material requirements while improving physiologic metrics. METHODS: Swine underwent a 25% controlled bleed and 45 minutes of complete aortic occlusion to create a severe ischemia-reperfusion shock state...
June 5, 2018: Shock
https://www.readbyqxmd.com/read/29876860/a-new-avian-cryptosporidium-genotype-in-a-1-month-old-caged-brown-wood-owl-strix-leptogrammica-with-severe-dehydration-and-diarrhea
#17
Ikuko Makino, Mizue Inumaru, Niichiro Abe, Yukita Sato
A 1-month-old brown wood owlet (Strix leptogrammica) purchased from a wholesaler and housed as a companion bird by an individual owner in Japan showed severe dehydration and anorexia following a week of vomiting and severe diarrhea. A great number of approximately 5 × 4-μm-sized Cryptosporidium oocysts were found in the feces by microscopy. The owlet was administered subcutaneous fluid and intragastric tube feeding for 2 weeks, resulting in improvement of the condition with a decreased number of oocysts in the feces...
June 6, 2018: Parasitology Research
https://www.readbyqxmd.com/read/29871901/increased-detection-of-human-parechovirus-infection-in-infants-in-england-during-2016-epidemiology-and-clinical-characteristics
#18
Laura Ferreras Antolín, Seilesh Kadambari, Serena Braccio, Julian Wei-Tze Tang, Jacqueline Xerry, David James Allen, Shamez N Ladhani
BACKGROUND: Human parechovirus (HPeV), like enteroviruses, usually causes mild self-limiting respiratory and gastrointestinal symptoms. In infants, HPeV can occasionally cause serious illnesses, including sepsis-like syndrome and encephalitis. In summer 2016, Public Health England (PHE) received increasing reports of severe HPeV infections nationally. We, therefore, reviewed all infants with confirmed HPeV across England during 2016. METHODS: HPeV cases in infants aged <12 months reported to PHE during 2016 were followed up using a clinical questionnaire...
June 5, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29867441/cerebrospinal-fluid-concentration-of-key-autophagy-protein-lamp2-changes-little-during-normal-aging
#19
David A Loeffler, Andrea C Klaver, Mary P Coffey, Jan O Aasly
Autophagy removes both functional and damaged intracellular macromolecules from cells via lysosomal degradation. Three autophagic mechanisms, namely macroautophagy, chaperone-mediated autophagy (CMA), and microautophagy, have been described in mammals. Studies in experimental systems have found macroautophagy and CMA to decrease with normal aging, despite the fact that oxidative stress, which can activate both processes, increases with normal aging. Whether autophagic mechanisms decrease in the human brain during normal aging is unclear...
2018: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/29866583/does-point-of-care-ultrasonography-improve-clinical-outcomes-in-emergency-department-patients-with-undifferentiated-hypotension-an-international-randomized-controlled-trial-from-the-shoc-ed-investigators
#20
Paul R Atkinson, James Milne, Laura Diegelmann, Hein Lamprecht, Melanie Stander, David Lussier, Chau Pham, Ryan Henneberry, Jacqueline M Fraser, Michael K Howlett, Jayanand Mekwan, Brian Ramrattan, Joanna Middleton, Daniel J van Hoving, Mandy Peach, Luke Taylor, Tara Dahn, Sean Hurley, Kayla MacSween, Luke R Richardson, George Stoica, Samuel Hunter, Paul A Olszynski, David A Lewis
STUDY OBJECTIVE: Point-of-care ultrasonography protocols are commonly used in the initial management of patients with undifferentiated hypotension in the emergency department (ED). There is little published evidence for any mortality benefit. We compare the effect of a point-of-care ultrasonography protocol versus standard care without point-of-care ultrasonography for survival and clinical outcomes. METHODS: This international, multicenter, randomized controlled trial recruited from 6 centers in North America and South Africa and included selected hypotensive patients (systolic blood pressure <100 mm Hg or shock index >1) randomized to early point-of-care ultrasonography plus standard care versus standard care without point-of-care ultrasonography...
June 2, 2018: Annals of Emergency Medicine
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