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https://www.readbyqxmd.com/read/29765783/multiorgan-failure-and-refractory-lactic-acidosis-due-to-pasteurella-multocida-septicemia-in-a-patient-with-no-animal-exposure
#1
Damaris Pena, Yaneidy Santana, Jose Perez Lara, Efrain Gonzalez, Misbahuddin Khaja
Introduction: Pasteurella multocida is a gram-negative coccobacillus pathogenic to animals. It can cause infection in humans by a bite, scratch, or lick from a cat or dog. P. multocida can cause a variety of infections in humans, including cellulitis, osteomyelitis, endocarditis, peritonitis, and septic shock. Case Presentation: A 56-year-old male presented to our hospital with a 2-day history of fever, abdominal pain, nausea, and vomiting. He denied exposure to cats, dogs or other pets...
2018: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29764273/the-association-between-sequential-organ-failure-assessment-scores-and-mortality-in-patients-with-sepsis-during-the-first-week-the-jseptic-dic-study
#2
Tsuyoshi Nakashima, Kyohei Miyamoto, Toshio Shimokawa, Seiya Kato, Mineji Hayakawa
OBJECTIVE: Predicting prognosis is a complex process, particularly in patients with severe sepsis or septic shock. This study aimed to determine the relationship between the Sequential Organ Failure Assessment (SOFA) scores for individual organs during the first week of admission and the in-hospital mortality in patients with sepsis. METHODS: This study was a post hoc evaluation of the Japan Septic Disseminated Intravascular Coagulation study and included patients admitted to 42 intensive care units in Japan for severe sepsis or septic shock, between January 2011 and December 2013...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29763385/pyruvate-enriched-resuscitation-for-shock
#3
Robert T Mallet, Albert H Olivencia-Yurvati, Rolf Bünger
This commentary addresses the recent retraction of an article which reported favorable outcomes in septic patients treated with intravenous pyruvate. The retracted report was cited in the authors' recent minireview on the cellular mechanisms and clinical application of pyruvate to improve cardiac performance. Because the retracted article reports pyruvate-enhanced resuscitation of critically ill patients, the authors wish to inform the readership, especially critical care providers, that this particular clinical application of pyruvate is not now supported by robust evidence...
May 2018: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29761216/low-dose-corticosteroids-for-adult-patients-with-septic-shock-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#4
Sofie Louise Rygård, Ethan Butler, Anders Granholm, Morten Hylander Møller, Jeremy Cohen, Simon Finfer, Anders Perner, John Myburgh, Balasubramanian Venkatesh, Anthony Delaney
PURPOSE: To assess the effect of low dose corticosteroids on outcomes in adults with septic shock. METHODS: We systematically reviewed randomised clinical trials (RCTs) comparing low-dose corticosteroids to placebo in adults with septic shock. Trial selection, data abstraction and risk of bias assessment were performed in duplicate. The primary outcome was short-term mortality. Secondary and tertiary outcomes included longer-term mortality, adverse events, quality of life, and duration of shock, mechanical ventilation and ICU stay...
May 14, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29756704/cerebrospinal-fluid-shunt-associated-infections-in-pediatrics-analysis-of-the-epidemiology-and-mortality-risk-factors
#5
Soledad González, Mirta Carbonaro, Ana G Fedullo, María I Sormani, María Del C Ceinos, Roberto González, María T Rosanova
INTRODUCTION: Infections are the most common complications of ventricular cerebrospinal fluid shunts. The objective of this study was to describe the clinical, microbiological, and evolutionary characteristics of children with ventricular cerebrospinal fluid shunt-associated infections and analyze the risk factors for mortality. POPULATION AND METHODS: Descriptive, retrospective study carried out at Hospital "Prof. Dr. Juan P. Garrahan" in the Autonomous City of Buenos Aires...
June 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29753454/response-of-a-local-hospital-to-a-burn-disaster-contributory-factors-leading-to-zero-mortality-outcomes
#6
Eng-Kean Yeong, Ciaran P O'Boyle, Hui-Fu Huang, Hao-Chih Tai, Yen-Chun Hsu, Shu-Yang Chuang, Yu-Feng Wu, Che-Wei Chang, Tom J Liu, Hong-Shiee Lai
OBJECTIVE: To investigate the outcomes of a local healthcare system in managing a burn mass casualty incident (BMCI). METHODS: Thirty-three victims admitted to the National Taiwan University Hospital within 96h of the explosion were included in the study. Data were recorded on: patient demographics, Baux score, laboratory data, management response, treatment strategies, and outcomes. Case notes from June 27, 2015 to November 2015 were reviewed with a focus on fluid resuscitation, ventilation support, nutrition, infection control, sepsis treatment, and wound closure plan...
May 9, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29742584/predictive-validity-of-sepsis-3-definitions-and-sepsis-outcomes-in-critically-ill-patients-a-cohort-study-in-49-icus-in-argentina
#7
Elisa Estenssoro, Vanina S Kanoore Edul, Cecilia I Loudet, Javier Osatnik, Fernando G Ríos, Daniela N Vázquez, Mario O Pozo, Bernardo Lattanzio, Fernando Pálizas, Francisco Klein, Damián Piezny, Paolo N Rubatto Birri, Graciela Tuhay, Anatilde Díaz, Analía Santamaría, Graciela Zakalik, Arnaldo Dubin
OBJECTIVES: The new Sepsis-3 definitions have been scarcely assessed in low- and middle-income countries; besides, regional information of sepsis outcomes is sparse. Our objective was to evaluate Sepsis-3 definition performance in Argentina. DESIGN: Cohort study of 3-month duration beginning on July 1, 2016. SETTINGS: Forty-nine ICUs. PATIENTS: Consecutive patients admitted to the ICU with suspected infection that triggered blood cultures and antibiotic administration...
May 8, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29742211/antibiotic-therapy-in-ventilator-associated-tracheobronchitis-a-literature-review
#8
Abel Eduardo Alves, José Manuel Pereira
The concept of ventilator-associated tracheobronchitis is controversial; its definition is not unanimously accepted and often overlaps with ventilator-associated pneumonia. Ventilator-associated tracheobronchitis has an incidence similar to that of ventilator-associated pneumonia, with a high prevalence of isolated multiresistant agents, resulting in an increase in the time of mechanical ventilation and hospitalization but without an impact on mortality. The performance of quantitative cultures may allow better diagnostic definition of tracheobronchitis associated with mechanical ventilation, possibly avoiding the overdiagnosis of this condition...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29740793/immune-checkpoint-receptors-homeostatic-regulators-of-immunity
#9
REVIEW
Antonio Riva, Shilpa Chokshi
Alcoholic liver disease (ALD) is an escalating global problem accounting for more than 3 million deaths annually. Bacterial infections are diagnosed in 25-47% of hospitalized patients with cirrhosis and represent the most important trigger for acute decompensation, multi-organ failure, septic shock and death. Current guidelines recommend intensive antibiotic therapy, but this has led to the emergence of multi-drug resistant bacteria, which are associated with increased morbidity and mortality rates. As such, there is a pressing need to explore new paradigms for anti-infective therapy and host-directed immunomodulatory therapies are a promising approach...
May 8, 2018: Hepatology International
https://www.readbyqxmd.com/read/29734352/role-of-matrix-metalloproteinases-2-and-9-toll-like-receptor-4-and-platelet-leukocyte-aggregate-formation-in-sepsis-associated-thrombocytopenia
#10
Caroline M Larkin, Nadhim Kamil Hante, Eamon P Breen, Krzysztof A Tomaszewski, Simon Eisele, Marek W Radomski, Thomas A Ryan, Maria-Jose Santos-Martinez
BACKGROUND: The development of thrombocytopenia in sepsis is a poor prognostic indicator associated with a significantly increased mortality risk. Mechanisms underlying this phenomenon remain to be clearly elucidated. Matrix metalloproteinases (MMPs) are enzymes that regulate the turnover of the extra-cellular matrix. MMP-2 is recognised as a platelet agonist with MMP-9 proposed as an inhibitor of platelet activation. The existence of MMP-9 in platelets is a subject of debate. There is limited evidence thus far to suggest that toll-like receptor 4 (TLR-4) and platelet-leukocyte aggregate (PLA) formation may be implicated in the development of sepsis-associated thrombocytopenia...
2018: PloS One
https://www.readbyqxmd.com/read/29733491/recognition-and-treatment-of-sepsis-in-pregnancy
#11
Anthony M Kendle, Judette Louis
Sepsis that occurs in the context of pregnancy is associated with significant maternal morbidity and mortality. International and multidisciplinary organizations have advocated for expedient diagnosis and initiation of treatment in patients with sepsis. However, the physiologic changes of pregnancy complicate both identification and treatment of maternal sepsis. This article describes a case of a woman presenting with symptoms of sepsis progressing to septic shock. Strategies for identifying and treating women with presumed sepsis are reviewed, and recent data regarding maternal and fetal outcomes are discussed...
May 7, 2018: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29732457/a-computable-definition-of-sepsis-facilitates-screening-and-performance-improvement-tracking
#12
Lauren J Alessi, Holly R Warmus, Erin K Schaffner, Sajel Kantawala, Joseph Carcillo, Johanna Rosen, Christopher M Horvat
Background: Sepsis kills almost 5,000 children annually, accounting for 16% of pediatric health care spending in the United States. Objectives: We sought to identify sepsis within the Electronic Health Record (EHR) of a quaternary children's hospital to characterize disease incidence, improve recognition and response, and track performance metrics. Methods: Methods are organized in a plan-do-study-act cycle. During the "plan" phase, electronic definitions of sepsis (blood culture and antibiotic within 24 hours) and septic shock (sepsis plus vasoactive medication) were created to establish benchmark data and track progress with statistical process control...
March 2018: Pediatric Quality & Safety
https://www.readbyqxmd.com/read/29730473/the-intensive-care-unit-icu-course-and-outcome-in-acute-on-chronic-liver-failure-are-comparable-to-other-populations
#13
Philippe Meersseman, Lies Langouche, Johannie du Plessis, Hannelie Korf, Michaël Mekeirele, Wim Laleman, Frederik Nevens, Alexander Wilmer, Greet Van den Berghe, Schalk W van der Merwe
BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) is characterized by acute decompensation of cirrhosis, development of organ failure and high short term mortality. Whether the outcome in ACLF patients admitted to the ICU with organ failure differs from other ICU populations is unknown. We compared the clinical course and host response in ICU patients with or without ACLF, matched for baseline severity of illness scores and characteristics. METHODS: From the large prospective EPaNIC randomized control trial database (n=4640), 133 patients were identified with cirrhosis of whom 71 fulfilled the CLIF criteria for ACLF...
May 3, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29728790/in-vitro-comparison-of-the-adsorption-of-inflammatory-mediators-by-blood-purification-devices
#14
Benjamin Malard, Corine Lambert, John A Kellum
BACKGROUND: Septic shock, a leading cause of acute kidney injury, induces release of pro-/anti-inflammatory mediators, leading to increased mortality and poor renal recovery. This is the first in vitro study directly comparing three single-use blood purification devices in terms of removing sepsis-associated mediators and endotoxins. METHODS: In vitro hemoperfusion was performed using oXiris® , CytoSorb® , and Toraymyxin® . Heparinized human plasma from healthy volunteers was pre-incubated with pathologic quantities of inflammatory mediators and filtered in a closed-loop circulation model for 2 h...
May 4, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29727371/mortality-measures-to-profile-hospital-performance-for-patients-with-septic-shock
#15
Allan J Walkey, Meng-Shiou Shieh, Vincent X Liu, Peter K Lindenauer
OBJECTIVES: Sepsis care is becoming a more common target for hospital performance measurement, but few studies have evaluated the acceptability of sepsis or septic shock mortality as a potential performance measure. In the absence of a gold standard to identify septic shock in claims data, we assessed agreement and stability of hospital mortality performance under different case definitions. DESIGN: Retrospective cohort study. SETTING: U.S...
April 30, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29726824/advances-in-the-management-of-pediatric-septic-shock-old-questions-new-answers
#16
Javed Ismail, M Jayashree
Septic shock in children is associated with high mortality, especially in developing countries. Management includes early recognition, timely antibiotics, aggressive fluid resuscitation, and appropriate vasoactive therapy, to achieve the therapeutic end points. The evidence at each step in management has evolved over the past decade with a paradigm shift in emphasis from a 'protocolized care' to an 'individualized physiology-based care'. This shift mirrors the general trend one observes in critical care with respect to various treatment modalities i...
April 15, 2018: Indian Pediatrics
https://www.readbyqxmd.com/read/29724988/total-gastric-necrosis-due-to-mucormycosis-a-rare-case-of-gastric-perforation
#17
Salah Termos, Feras Othman, Mohammad Alali, Bader M S Al Bader, Talal Alkhadher, Wael Fathi Hassanaiah, Ali Taqi, Abhijit Sapkal
BACKGROUND Spontaneous gastric perforation is usually a complication of peptic ulcer disease, or a postoperative complication resulting from gastric torsion. Mucormycosis (or zygomycosis) is an uncommon opportunistic fungal infection that is usually seen in immunocompromised patients and is associated with significant morbidity and mortality. This report is of a rare case of spontaneous gastric perforation due to mucormycosis infection. CASE REPORT A 52-year-old woman, with a past medical history of heroin abuse, diabetes mellitus, hypertension, and chronic kidney disease treated by dialysis, presented to the emergency department with cellulitis of the arms...
May 4, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29722636/recent-advances-in-nanomedicine-for-sepsis-treatment
#18
Simseok A Yuk, Diego A Sanchez-Rodriguez, Michael D Tsifansky, Yoon Yeo
Sepsis and septic shock are life-threating conditions, which form a continuum of the body's response to overwhelming infection. The current treatment consists of fluid and metabolic resuscitation, hemodynamic and end-organ support, and timely initiation of antibiotics. However, these measures may be ineffective and the sepsis-related mortality toll remains substantial; therefore, an urgent need exists for new therapies. Recently, several nanoparticle (NP) systems have shown excellent protective effects against sepsis in preclinical models, suggesting a potential utility in the management of sepsis and septic shock...
May 1, 2018: Therapeutic Delivery
https://www.readbyqxmd.com/read/29722335/role-of-combining-peripheral-with-sublingual-perfusion-on-evaluating-microcirculation-and-predicting-prognosis-in-patients-with-septic-shock
#19
Pan Pan, Da-Wei Liu, Long-Xiang Su, Huai-Wu He, Xiao-Ting Wang, Chao Yu
Background: Measurement of general microcirculation remains difficult in septic shock patients. The peripheral perfusion index (PI) and sublingual microcirculation monitoring are thought to be possible methods. This study was performed to determine whether assessing microcirculation by PI and a new parameter, proportion of perfusion vessel change rate (△PPV) from sublingual microcirculation monitoring, can be associated with patients' outcome. Methods: A prospective observational study was carried out, including 74 patients with septic shock in a mixed intensive care unit...
May 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29720052/high-density-lipoprotein-mean-platelet-volume-and-uric-acid-as-biomarkers-for-outcomes-in-patients-with-sepsis-an-observational-study
#20
Luis Bolívar Montero-Chacón, Juan Ignacio Padilla-Cuadra, Sy Han Chiou, Gabriel Torrealba-Acosta
BACKGROUND: We conducted an observational study evaluating the association between uric acid, mean platelet volume (MPV), and high-density lipoprotein (HDL) with complications and outcomes of patients with sepsis in a critical care setting. METHODS: We followed patients with a diagnosis of severe sepsis and septic shock for a maximum of 28 days. Main outcomes assessed included length of stay (LOS), the need for renal replacement therapy (RRT), assisted mechanical ventilation (AMV), and vasopressor support as well as in-unit mortality...
January 1, 2018: Journal of Intensive Care Medicine
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