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treating septic shock

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https://www.readbyqxmd.com/read/28533998/ipilimumab-as-a-cause-of-severe-pan-colitis-and-colonic-perforation
#1
Raj Shah, Danielle Witt, Talal Asif, Fahad F Mir
Ipilimumab is a human monoclonal antibody that functions as a cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor that is used to treat malignant melanoma. Due to ipilimumab's removal of immune regulation, specifically through the inactivation of CTLA-4, it is commonly associated with inflammatory and autoimmune events. Gastrointestinal (GI) related immune-related adverse events such as diarrhea occur in 29% of patients with 7.6% of patients specifically suffering from colitis. We describe a case of colonic perforation with ipilimumab use...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28533774/the-role-of-ifn-%C3%AE-during-the-course-of-sepsis-progression-and-its-therapeutic-potential
#2
REVIEW
Gorjana Rackov, Rahman Shokri, Melchor Álvarez De Mon, Carlos Martínez-A, Dimitrios Balomenos
Sepsis is a complex biphasic syndrome characterized by both pro- and anti-inflammatory immune states. Whereas early sepsis mortality is caused by an acute, deleterious pro-inflammatory response, the second sepsis phase is governed by acute immunosuppression, which predisposes patients to long-term risk for life-threatening secondary infections. Despite extensive basic research and clinical trials, there is to date no specific therapy for sepsis, and mortality rates are on the rise. Although IFN-β is one of the most-studied cytokines, its diverse effects are not fully understood...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28531175/weekly-high-dose-liposomal-amphotericin-b-l-amb-in-critically-ill-septic-patients-with-multiple-candida-colonization-the-ambidex-study
#3
Elie Azoulay, Jean-François Timsit, Alexandre Lautrette, Stephane Legriel, Adeline Max, Stephane Ruckly, Benoit Misset, Yves Cohen, Michel Wolff
BACKGROUND: To demonstrate the feasibility and safety of weekly high-dose liposomal amphotericin B (L-AmB) (as a pre-emptive antifungal treatment) for 2 weeks in patients with septic shock and Candida colonization. METHODS: Pilot, multicentre, open-label, prospective study conducted in seven French ICUs. Non-immunocompromised patients, receiving mechanical ventilation were eligible if they presented ICU-acquired severe sepsis requiring newly administered antibacterial agents and Candida colonization in at least two sites...
2017: PloS One
https://www.readbyqxmd.com/read/28524025/-effect-of-esmolol-on-hemodynamics-and-clinical-outcomes-in-patients-with-septic-shock
#4
Shupeng Wang, Min Li, Jun Duan, Li Yi, Xu Huang, Desheng Chen, Gang Li
OBJECTIVE: To evaluate the effect of heart rate control with esmolol on hemodynamics, inflammatory cytokines and clinical outcomes in patients with septic shock. METHODS: A prospective randomized controlled trial was conducted. The patients with septic shock admitted to Department of Critical Care Medicine of China-Japan Friendship Hospital from August 2014 to October 2016 were enrolled. After 24 hours of resuscitation and other therapy, they were randomly divided into two groups by sealed envelope...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28523249/risk-factors-clinical-presentation-and-outcome-of-acinetobacter-baumannii-bacteremia
#5
Tala Ballouz, Jad Aridi, Claude Afif, Jihad Irani, Chantal Lakis, Rakan Nasreddine, Eid Azar
Infections caused by Acinetobacter baumannii (AB), an increasingly prevalent nosocomial pathogen, have been associated with high morbidity and mortality. We conducted this study to analyze the clinical features, outcomes, and factors influencing the survival of patients with AB bacteremia. We retrospectively examined the medical records of all patients developing AB bacteremia during their hospital stay at a tertiary care hospital in Beirut between 2010 and 2015. Ninety episodes of AB bacteremia were documented in eighty-five patients...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28521809/role-of-mitral-valve-repair-in-active-infective-endocarditis-long-term-results
#6
Carlo Rostagno, Enrico Carone, Pier Luigi Stefàno
BACKGROUND: Although mitral valve repair is at present the technique of choice in mitral regurgitation (MR) due to degenerative valve disease, long term results in patients with active mitral infective endocarditis (IE) are still under evaluation. METHODS: In the study were included 34 consecutive patients (22 males; mean age, 60 years; range 32-84 years) referred to our institution between January 1, 2005 to December 31, 2011 who were treated with valve repair for mitral valve (MV) active infective endocarditis...
May 18, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28514322/relationship-between-a-sepsis-intervention-bundle-and-in-hospital-mortality-among-hospitalized-patients-a-retrospective-analysis-of-real-world-data
#7
Priya A Prasad, Erica R Shea, Stephen Shiboski, Mary C Sullivan, Ralph Gonzales, David Shimabukuro
BACKGROUND: Sepsis is a systemic response to infection that can lead to tissue damage, organ failure, and death. Efforts have been made to develop evidence-based intervention bundles to identify and manage sepsis early in the course of the disease to decrease sepsis-related morbidity and mortality. We evaluated the relationship between a minimally invasive sepsis intervention bundle and in-hospital mortality using robust methods for observational data. METHODS: We performed a retrospective cohort study at the University of California, San Francisco, Medical Center among adult patients discharged between January 1, 2012, and December 31, 2014, and who received a diagnosis of severe sepsis/septic shock (SS/SS)...
May 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28497242/-new-sepsis-3-definition-do-we-have-to-treat-sepsis-before-we-can-diagnose-it-from-now-on
#8
T Schmoch, M Bernhard, F Uhle, M Gründling, T Brenner, M A Weigand
The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) have been available since the beginning of 2016. SEPSIS-3 completely replaces the old SIRS criteria in the definition of sepsis and defines sepsis from now on as "life-threatening organ dysfunction caused by a dysregulated host response to infection". However, it seems questionable whether in clinical practice the new definition is really superior to the old one. The most important question is the following: Is it helpful to have a definition that first recognizes a patient once organ dysfunction has occurred and the patient already needs intensive care?...
May 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28492295/elderly-versus-non-elderly-patients-with-intra-abdominal-candidiasis-in-the-icu
#9
George Dimopoulos, Dimitrios K Matthaiou, Elda Righi, Maria Merelli, Matteo Bassetti
BACKGROUND: Intra-abdominal candidiasis (IAC) has a considerable cost in terms of mortality and morbidity. We sought to study the epidemiology, characteristics and outcome of elderly (>75 years old) versus non-elderly patients with IAC and risk factors for mortality in elderly patients. METHODS: Post-hoc analysis of a retrospective multinational cohort study over a 3- year period (2011-2013). RESULTS: Of 482 patients, 124 (25.7%) were elderly and 358 (74...
May 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28466151/effect-of-a-multifaceted-educational-intervention-for-anti-infectious-measures-on-sepsis-mortality-a-cluster-randomized-trial
#10
Frank Bloos, Hendrik Rüddel, Daniel Thomas-Rüddel, Daniel Schwarzkopf, Christine Pausch, Stephan Harbarth, Torsten Schreiber, Matthias Gründling, John Marshall, Philipp Simon, Mitchell M Levy, Manfred Weiss, Andreas Weyland, Herwig Gerlach, Tobias Schürholz, Christoph Engel, Claudia Matthäus-Krämer, Christian Scheer, Friedhelm Bach, Reimer Riessen, Bernhard Poidinger, Karin Dey, Norbert Weiler, Andreas Meier-Hellmann, Helene H Häberle, Gabriele Wöbker, Udo X Kaisers, Konrad Reinhart
PURPOSE: Guidelines recommend administering antibiotics within 1 h of sepsis recognition but this recommendation remains untested by randomized trials. This trial was set up to investigate whether survival is improved by reducing the time before initiation of antimicrobial therapy by means of a multifaceted intervention in compliance with guideline recommendations. METHODS: The MEDUSA study, a prospective multicenter cluster-randomized trial, was conducted from July 2011 to July 2013 in 40 German hospitals...
May 2, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28460504/-the-predictive-value-of-dynamic-arterial-elastance-in-arterial-pressure-response-after-norepinephrine-dosage-reduction-in-patients-with-septic-shock
#11
F M Liang, T Yang, L Dong, J J Hui, J Yan
Objective: To assess whether dynamic arterial elastance(Ea(dyn))can be used to predict the reduction of arterial pressure after decreasing norepinephrine (NE) dosage in patients with septic shock. Methods: A prospective observational cohort study was conducted. Thirty-two patients with septic shock and mechanical ventilationwere enrolledfrom January 2014 to December 2015 in ICU of Wuxi People's Hospital of Nanjing Medical University. Hemodynamic parameters were recorded by pulse contour cardiac output(PiCCO)monitoring technology before and after decreasing norepinephrine dosage...
May 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28449463/efficacy-of-nebulized-colistin-based-therapy-without-concurrent-intravenous-colistin-for-ventilator-associated-pneumonia-caused-by-carbapenem-resistant-acinetobacter-baumannii
#12
Yong Kyun Kim, Jae Ha Lee, Hyun-Kyung Lee, Byung Cheol Chung, Seung Jung Yu, Ho-Young Lee, Jin-Han Park, Sunyoung Kim, Hyeon-Kuk Kim, Sungmin Kiem, Hang-Jea Jang
BACKGROUND: Although there have been studies regarding the role of nebulized colistin as adjunctive therapy of ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii (CRAB), a paucity of information on the efficacy of nebulized colistin as monotherapy is available. METHODS: We retrospectively reviewed 219 patients with VAP caused by CRAB treated with either intravenous (n=93) or nebulized colistin (n=126), from March 2010 to November 2015...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28448995/cytoprotective-effect-of-heat-shock-protein-27-against-lipopolysaccharide-induced-apoptosis-of-renal-epithelial-hk-2-cells
#13
Chunmei Li, Jiang Wu, Yuan Li, Guangqun Xing
BACKGROUND: In response to various stimuli, heat shock protein 27 (Hsp27) functions as an anti-apoptotic or/and anti-inflammatory factor which confers a survival advantage to cells. This study was aimed to explore whether Hsp27 also has a cytoprotective role in human renal tubular epithelial cells, and to evaluate its potential in treating septic acute kidney injury (septic AKI). METHODS: HK-2 cells were subjected to different concentrations (0-10 µg/mL) of lipopolysaccharide (LPS) for various times (0-24 h) to establish a septic AKI model in vitro...
April 25, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28445239/aldosterone-and-vascular-mineralocorticoid-receptors-in-murine-endotoxic-and-human-septic-shock
#14
Fouad Fadel, Gwennan André-Grégoire, Basile Gravez, Brigitte Bauvois, Sandrine Bouchet, Catalina Sierra-Ramos, Andrea Polito, Arnaud Mansart, Diego Alvarez de la Rosa, Djillali Annane, Frédéric Jaisser
OBJECTIVES: Vascular mineralocorticoid receptors play a role in vascular tone and blood pressure regulation, might participate in the pathophysiology of circulatory failure during sepsis, and represent a potential therapeutic target in this disease. We aimed to study the effects of mineralocorticoids and the involvement of vascular mineralocorticoid receptors in murine endotoxic and human septic shock. DESIGN: Experimental study. SETTING: Translational investigation including animal research and in vitro experiments using human vascular cells and plasma from septic patients...
April 25, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28440981/-leading-causes-of-death-during-the-induction-therapy-in-pediatric-patients-with-acute-lymphoblastic-leukemia
#15
Máximo Aguilar-Hernández, Gabriela Fernández-Castillo, Nora Nancy Núñez-Villegas, Ruy Xavier Pérez-Casillas, Juan Carlos Núñez-Enríquez
BACKGROUND: Leukemias are the leading cause of childhood cancer. In most developed countries 1-2% of patients die during remission induction; however, in developing countries, this figure is higher and the causes of death apparently vary among the populations studied. The aim was to determine the cause of death during remission induction in pediatric patients with acute lymphoblastic leukemia (ALL) in the hospital "Dr. Gaudencio González Garza" of Centro Médico Nacional La Raza from January 1, 2009, to December 31, 2014...
May 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28437459/management-and-outcomes-of-severe-dengue-patients-presenting-with-sepsis-in-a-tropical-country
#16
Prapit Teparrukkul, Viriya Hantrakun, Nicholas P J Day, T Eoin West, Direk Limmathurotsakul
BACKGROUND: Dengue is a common cause of infection in adults in tropical countries. Sepsis is a syndrome of systemic manifestations induced by infection of any organisms; including bacterial, fungal and viral agents. Here, we investigated the diagnosis, management and outcomes of dengue patients presenting with sepsis in a prospective study of community-acquired sepsis in Thailand. METHODS: From June to December 2015, 874 adult patients (age≥18 years) with suspected or documented community-acquired infection, with ≥3 diagnostic criteria for sepsis according to the Surviving Sepsis Campaign 2012, and within 24 hours of admission were evaluated...
2017: PloS One
https://www.readbyqxmd.com/read/28430717/multilateral-functional-alterations-of-human-neutrophils-in-sepsis-from-the-point-of-diagnosis-to-the-seventh-day
#17
Akira Endo, Miko Okamura, Shunsuke Yoshikawa, Yasuhiro Otomo, Tomohiro Morio
Neutrophil functional changes caused by sepsis itself and their time-course variation have not been fully elucidated because previous studies targeted patients who had received therapeutic interventions. We explored the multilateral functions of circulating neutrophils in patients with severe sepsis or septic shock who had not yet undergone interventions, and followed their changes. Patients were treated based on the Surviving Sepsis Campaign Guidelines 2012. Neutrophil functions were evaluated on days 0 (before therapeutic intervention), 3, and 7 in fifty-nine sepsis patients...
April 20, 2017: Shock
https://www.readbyqxmd.com/read/28426466/physician-variation-in-time-to-antimicrobial-treatment-for-septic-patients-presenting-to-the-emergency-department
#18
Ithan D Peltan, Kristina H Mitchell, Kristina E Rudd, Blake A Mann, David J Carlbom, Catherine L Hough, Thomas D Rea, Samuel M Brown
OBJECTIVES: Delayed initiation of appropriate antimicrobials is linked to higher sepsis mortality. We investigated interphysician variation in septic patients' door-to-antimicrobial time. DESIGN: Retrospective cohort study. SETTING: Emergency department of an academic medical center. SUBJECTS: Adult patients treated with antimicrobials in the emergency department between 2009 and 2015 for fluid-refractory severe sepsis or septic shock...
June 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28425407/persistence-of-virologic-response-after-liver-transplant-in-hepatitis-c-patients-treated-with-ledipasvir-sofosbuvir-plus-ribavirin-pretransplant
#19
Eric M Yoshida, Paul Kwo, Kosh Agarwal, Christophe Duvoux, François Durand, Markus Peck-Radosavljevic, Leslie Lilly, Bernard Willems, Hugo Vargas, Princy Kumar, Robert S Brown, Yves Horsmans, Shampa De-Oertel, Sarah Arterburn, Hadas Dvory-Sobol, Diana M Brainard, John G McHutchison, Norah Terrault, Mario Rizzetto, Beat Müllhaupt
INTRODUCTION: Recurrence of HCV infection in patients with chronic hepatitis C virus (HCV) at the time of liver transplantation is nearly universal and reduces the likelihood of graft and patient survival. MATERIALS AND METHODS: We evaluated outcomes of 17 patients (16 with HCV genotype 1 and 1 with genotype 4) who received up to 12 or 24 weeks of ledipasvir/sofosbuvir plus ribavirin prior to or up to the time of liver transplant in the SOLAR-1 and SOLAR-2 trials...
May 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28408302/pharmacokinetics-of-linezolid-during-continuous-hemodiafiltration-a-case-report
#20
Takuya Yamashina, Moeko Tsuruyama, Miki Odawara, Minako Tsuruta, Hirochika Miyata, Aki Kozono, Yasuhiro Tsuji, Takanori Miyoshi, Yosei Kawamata, Yoichi Hiraki
The pharmacokinetics of linezolid clearance (CLLZD) during continuous hemodiafiltration (CHDF) has not been comprehensively analyzed. Here, we examined CLLZD by CHDF in a patient with septic shock and disseminated intravascular coagulation due to methicillin-resistant Staphylococcus aureus. The extraction ratio of LZD by CHDF was 22.6%, and the protein-binding rate was 17.9% ± 7.7%. In addition, it was determined that the calculated total body clearance of LZD was 30.2 mL/min, plasma elimination half-life was 8...
April 10, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
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