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treating septic shock

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https://www.readbyqxmd.com/read/27924179/ischemic-stroke-and-septic-shock-after-subacute-endocarditis-caused-by-haemophilus-parainfluenzae-case-report
#1
Mayra Goncalves Menegueti, Jaciara Machado-Viana, Gilberto Gambero Gaspar, Edson Antonio Nicolini, Anibal Basile-Filho, Maria Auxiliadora-Martins
Haemophilus parainfluenzae, which belongs to the HACEK (Haemophilus ssp, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae) group, is a rare cause of subacute endocarditis and may lead to ischemic stroke. A 65-year-old female patient previously diagnosed with rheumatic valve disease was submitted to surgical mitral valve repair in 1996. Physical examination did not reveal any murmurs; physical examination of the lungs and abdomen was normal. The patient was admitted to hospital with progressive dyspnea, dry cough, and fever...
January 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/27908335/the-past-present-and-future-of-the-centers-for-medicare-and-medicaid-services-quality-measure-sep-1-the-early-management-bundle-for-severe-sepsis-septic-shock
#2
REVIEW
Jeremy S Faust, Scott D Weingart
SEP-1, the new national quality measure on sepsis, resulted from an undertaking to standardize care for severe sepsis and septic shock regardless of the size of the emergency department where the patient is being treated. SEP-1 does not necessarily follow the best current evidence available. Nevertheless, a thorough understanding of SEP-1 is crucial because all hospitals and emergency providers will be accountable for meeting the requirements of this measure. SEP-1 is the first national quality measure on early management of sepsis care...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27876693/a-case-of-septic-shock-due-to-serratia-marcescens-pyelonephritis-and-bacteremia-in-a-patient-receiving-empagliflozin
#3
Wesley D Kufel, Ali Scrimenti, Jeffrey M Steele
Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been associated with serious urinary tract infections (UTIs) including pyelonephritis and urosepsis. The Food and Drug Administration (FDA) issued a label change to include this warning in December 2015 due to a small number of cases (n = 19) reported to the FDA Adverse Event Reporting System. Details of these cases are limited and none involved empagliflozin. To date, there has been no published literature comprehensively describing serious UTIs attributed to empagliflozin...
November 21, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27854183/prognostic-factors-in-the-survival-of-patients-with-blood-disorders-recovering-from-septic-shock
#4
Anna Waszczuk-Gajda, Wieslaw Wiktor Jedrzejczak
BACKGROUND: Septic shock is one of the major direct causes of death in patients in hematology departments. OBJECTIVES: The knowledge about clinical outcomes and factors associated with negative outcome in these patients can be important and useful for physicians to identify the patients who are most likely to benefit from ICU therapy. METHODS: We retrospectively analyzed records of 214 episodes of septic shock in patients with different blood diseases hospitalized between 1998 and 2011 in the Department of Hematology, Oncology and Internal Medicine, the Medical University of Warsaw, Poland...
November 17, 2016: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/27848903/-necrotising-soft-tissue-infection-of-orbital-area-and-hand-an-unusual-combination
#5
M P M Paridaans, J A Govaert, E H Scholten, D H de Lange
BACKGROUND: Necrotising soft tissue infection (NSTI) is an infection of the subcutaneous tissues and often follows a fulminant course if not recognised in time. CASE DESCRIPTION: A 78-year-old man was brought to our emergency department in septic shock. Physical examination revealed an erythematous and painful swelling of the right eyelids and to a lesser extent of the right hand. The infection progressed at both sites, and suspicion of NSTI arose. An emergency surgical debridement was performed...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27848054/incidence-and-predictive-risk-factors-of-postoperative-sepsis-in-orthopedic-trauma-patients
#6
Nikita Lakomkin, Vasanth Sathiyakumar, Brandon Wick, Michelle S Shen, A Alex Jahangir, Hassan Mir, William T Obremskey, Ashley C Dodd, Manish K Sethi
BACKGROUND: Postoperative sepsis is associated with high mortality and the national costs of septicemia exceed those of any other diagnosis. While numerous studies in the basic orthopedic science literature suggest that traumatic injuries facilitate the development of sepsis, it is currently unclear whether orthopedic trauma patients are at increased risk. The purpose of this study was thus to assess the incidence of sepsis and determine the risk factors that significantly predicted septicemia following orthopedic trauma surgery...
November 15, 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/27846837/prevalence-aetiology-treatment-and-outcomes-of-shock-in-children-admitted-to-kenyan-hospitals
#7
George Mbevi, Philip Ayieko, Grace Irimu, Samuel Akech, Mike English
BACKGROUND: Shock may complicate several acute childhood illnesses in hospitals within low-income countries and has a high case fatality. Hypovolemic shock secondary to diarrhoea/dehydration and septic shock are thought to be common, but there are few reliable data on prevalence or treatment that differ for the two major forms of shock. Examining prevalence and treatment practices has become important since reports suggest high risks from liberal use of fluid boluses in African children...
November 16, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27836382/propensity-score-matched-analysis-comparing-the-therapeutic-efficacies-of-cefazolin-and-extended-spectrum-cephalosporins-as-appropriate-empirical-therapy-in-adults-with-community-onset-escherichia-coli-klebsiella-spp-and-proteus-mirabilis-bacteraemia
#8
Chih-Chia Hsieh, Chung-Hsun Lee, Ming-Yuan Hong, Yuan-Pin Hung, Nan-Yao Lee, Wen-Chien Ko, Ching-Chi Lee
In this study, the therapeutic efficacy of cefazolin was compared with that of extended-spectrum cephalosporins (ESCs) (cefotaxime, ceftriaxone and ceftazidime) as appropriate empirical therapy in adults with community-onset monomicrobial bacteraemia caused by Escherichia coli, Klebsiella spp. or Proteus mirabilis (EKP). Compared with cefazolin-treated patients (n = 135), significantly higher proportions of patients in the ESC treatment group (n = 456) had critical illness at bacteraemia onset (Pitt bacteraemia score ≥4) and fatal co-morbidities (McCabe classification)...
October 26, 2016: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/27821152/a-20-year-multicentre-outcome-analysis-of-salvage-mechanical-circulatory-support-for-refractory-cardiogenic-shock-after-cardiac-surgery
#9
Maziar Khorsandi, Scott Dougherty, Andrew Sinclair, Keith Buchan, Fiona MacLennan, Omar Bouamra, Philip Curry, Vipin Zamvar, Geoffrey Berg, Nawwar Al-Attar
BACKGROUND: Refractory post-cardiotomy cardiogenic shock (PCCS) is a relatively rare phenomenon that can lead to rapid multi-organ dysfunction syndrome and is almost invariably fatal without advanced mechanical circulatory support (AMCS), namely extra-corporeal membrane oxygenation (ECMO) or ventricular assist devices (VAD). In this multicentre observational study we retrospectively analyzed the outcomes of salvage venoarterial ECMO (VA ECMO) and VAD for refractory PCCS in the 3 adult cardiothoracic surgery centres in Scotland over a 20-year period...
November 8, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27821087/comparing-culture-and-molecular-methods-for-the-identification-of-microorganisms-involved-in-necrotizing-soft-tissue-infections
#10
Vibeke Børsholt Rudkjøbing, Trine Rolighed Thomsen, Yijuan Xu, Rachael Melton-Kreft, Azad Ahmed, Steffen Eickhardt, Thomas Bjarnsholt, Steen Seier Poulsen, Per Halkjær Nielsen, Joshua P Earl, Garth D Ehrlich, Claus Moser
BACKGROUND: Necrotizing soft tissue infections (NSTIs) are a group of infections affecting all soft tissues. NSTI involves necrosis of the afflicted tissue and is potentially life threatening due to major and rapid destruction of tissue, which often leads to septic shock and organ failure. The gold standard for identification of pathogens is culture; however molecular methods for identification of microorganisms may provide a more rapid result and may be able to identify additional microorganisms that are not detected by culture...
November 8, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27802854/syphilis-an-atypical-case-of-sepsis-and-multiple-anogenital-lesions-in-secondary-syphilis
#11
Nichole Smith, Sonu Dhillon, John G Cotter, Zohair Ahmed
The incidence of syphilis has historically been cyclical in nature, often in relation to the rise and fall of public health initiatives directed toward eradication along with social attitudes toward sexual practices. The incidence of syphilis has increased by 15% in the last 6 years in the United States, with similar increases worldwide. Herein, we present an atypical case of syphilis presenting with severe septic shock and multiple anogenital lesions in an immunocompetent host. A 22-year-old male with no significant past medical history presented with fevers, chills, sore throat, diaphoresis, and diarrhea...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27796503/spontaneous-pulmonary-hematoma-in-a%C3%A2-patient-with-sepsis-treated-with-dual-antiplatelet-therapy
#12
Janko Vlaović, Gorazd Voga
A 72-year-old patient was admitted to the medical intensive care unit due to a right-sided, hospital-acquired pneumonia and septic shock with respiratory failure and deterioration of chronic renal failure. During hospitalization the patient required hemodynamic support with norepinephrine and dobutamine, mechanical ventilation and hemodialysis. The patient suffered a non-ST segment elevation myocardial infarction (NSTEMI) and received dual antiplatelet therapy. After 14 days an acute intrapulmonary infiltrate of unknown origin developed, accompanied by fever and a significant increase of the C‑reactive protein (CRP) level...
October 28, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27788216/selepressin-and-arginine-vasopressin-do-not-display-cardiovascular-risk-in-atherosclerotic-rabbit
#13
Olivier Boucheix, Robert Blakytny, Gerard Haroutunian, Marie Henriksson, Regent Laporte, Stephane Milano, Torsten M Reinheimer
BACKGROUND: Septic shock remains associated with significant mortality rates. Arginine vasopressin (AVP) and analogs with V1A receptor agonist activity are increasingly used to treat fluid-resistant vasodilatory hypotension, including catecholamine-refractory septic shock. Clinical studies have been restricted to healthy volunteers and catecholamine-refractory septic shock patients excluding subjects with cardiac co-morbidities because of presumed safety issues. The novel selective V1A receptor agonist selepressin, with short half-life, has been designed to avoid V2 receptor-related complications and long-term V1A receptor activation...
2016: PloS One
https://www.readbyqxmd.com/read/27779186/pkm2-dependent-glycolysis-promotes-nlrp3-and-aim2-inflammasome-activation
#14
Min Xie, Yan Yu, Rui Kang, Shan Zhu, Liangchun Yang, Ling Zeng, Xiaofang Sun, Minghua Yang, Timothy R Billiar, Haichao Wang, Lizhi Cao, Jianxin Jiang, Daolin Tang
Sepsis, severe sepsis and septic shock are the main cause of mortality in non-cardiac intensive care units. Immunometabolism has been linked to sepsis; however, the precise mechanism by which metabolic reprogramming regulates the inflammatory response is unclear. Here we show that aerobic glycolysis contributes to sepsis by modulating inflammasome activation in macrophages. PKM2-mediated glycolysis promotes inflammasome activation by modulating EIF2AK2 phosphorylation in macrophages. Pharmacological and genetic inhibition of PKM2 or EIF2AK2 attenuates NLRP3 and AIM2 inflammasomes activation, and consequently suppresses the release of IL-1β, IL-18 and HMGB1 by macrophages...
October 25, 2016: Nature Communications
https://www.readbyqxmd.com/read/27777780/initial-central-venous-pressure-could-be-a-prognostic-marker-for-hemodynamic-improvement-of-polymyxin-b-direct-hemoperfusion-a-retrospective-cohort-study
#15
Hiroyuki Yamada, Tatsuo Tsukamoto, Hiromichi Narumiya, Kazumasa Oda, Satoshi Higaki, Ryoji Iizuka, Motoko Yanagita, Masako Deguchi
BACKGROUND: Direct hemoperfusion with polymyxin B-immobilized fiber column (PMX-DHP) could improve the hemodynamic status of septic shock patients. As PMX-DHP is an invasive and costly procedure, it is desirable to estimate the therapeutic effect before performing the therapy. However, it is still unclear when this therapy should be started and what type of sepsis it should be employed for. In this study, we retrospectively examined the clinical effect of patients treated with PMX-DHP by using central venous pressure (CVP)...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27762469/medical-emergency-team-may-reduce-obstetric-intensive-care-unit-admissions
#16
Moon Seong Baek, Jeongsuk Son, Jin Won Huh, Chae-Man Lim, Younsuck Koh, Hye-Sung Won, Jae-Yoon Shim, Sang-Bum Hong
AIM: Some recent studies have reported that early intervention by a medical emergency team (MET) for clinical deterioration before intensive care unit (ICU) admission was associated with a survival benefit in critically ill cancer patients. We hypothesized that early MET intervention for an obstetric crisis in the general wards would be related to favorable outcomes in critically ill obstetric patients. METHODS: Data of obstetric patients who were managed by a MET were collected retrospectively from 1 March 2008 to 30 April 2015...
October 20, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27761292/pediatric-fulminant-leptospirosis-complicated-by-pericardial-tamponade-macrophage-activation-syndrome-and-sclerosing-cholangitis
#17
Osman Yeşilbaş, Hasan Serdar Kıhtır, Hamdi Murat Yıldırım, Nevin Hatipoğlu, Esra Şevketoğlu
BACKGROUND: Leptospirosis is a zoonotic infectious disease caused by pathogenic spirochetes of the genus Leptospira. Although it is usually asymptomatic and self-limited, severe potentially fatal illness accompanied by multi-organ failure may occur. CASE REPORT: Here we report an unusual case of severe leptospirosis successfully treated with continuous venovenous hemofiltration (CVVHF) and therapeutic plasma exchange (TPE). The patient presented with pericardial tamponade, renal failure and macrophage activation syndrome, and later suffered prolonged jaundice and sclerosing cholangitis during hospitalization in the pediatric intensive care unit (PICU)...
September 2016: Balkan Medical Journal
https://www.readbyqxmd.com/read/27757433/pan-spinal-infection-a-case-series-and-review-of-the-literature
#18
Chien Yew Kow, Patrick Chan, Greg Etherington, Lu Ton, Susan Liew, Allen C Cheng, Jeffrey V Rosenfeld
BACKGROUND: Panspinal infection usually presents with fever, back pain, neurological deficit, and in advanced cases multi-organ failure and septic shock. The choice of treatment for panspinal infection is challenging because these patients are usually medically unstable with severe neurological compromise. The objective of this study is to review management and long term outcomes for patients with panspinal infection. METHODS: A retrospective review of patients with panspinal infection treated in our center over a 5-year period [Jan 2010-Dec 2014] and a review of the current published literatures was undertaken...
September 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/27752314/making-the-journey-safe-recognising-and-responding-to-severe-sepsis-in-accident-and-emergency
#19
Sarah Pinnington, Brigid Atterton, Sarah Ingleby
Severe sepsis is a clinical emergency. Despite the nationwide recognition of the sepsis six treatment bundle as the first line emergency treatment for this presentation, compliance in sepsis six provision remains inadequately low. The project goals were to improve compliance with the implementation of the Sepsis Six in patients with severe sepsis and/or septic shock. In improving timely care delivery it was anticipated improvements would be made in relation to patient safety and experience, and reductions in length of stay (LoS) and mortality...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27751177/successful-treatment-with-fecal-microbiota-transplantation-in-patients-with-multiple-organ-dysfunction-syndrome-and-diarrhea-following-severe-sepsis
#20
Yanling Wei, Jun Yang, Jun Wang, Yang Yang, Juan Huang, Hao Gong, Hongli Cui, Dongfeng Chen
BACKGROUND: The dysbiosis of intestinal microbiota plays an important role in the development of gut-derived infections, making it a potential therapeutic target against multiple organ dysfunction syndrome (MODS) after sepsis. However, the effectiveness of fecal microbiota transplantation (FMT) in treating this disease has been rarely investigated. METHODS: Two male patients, a 65-year-old and an 84-year-old, were initially diagnosed with cerebellar hemorrhage and cerebral infarction, respectively, after admission...
October 18, 2016: Critical Care: the Official Journal of the Critical Care Forum
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