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treating septic shock

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https://www.readbyqxmd.com/read/28701197/a-case-of-bowel-perforation-due-to-traumatic-hernia-at-a-pelvic-fracture-site-a-case-report-and-review-of-the-literature
#1
Ryota Tanaka, Hisashi Nagahara, Kiyoshi Maeda, Hiroshi Ohtani, Masatsune Shibutani, Tatsuro Tamura, Tetsuro Ikeya, Kenji Sugano, Yasuhito Iseki, Katsunobu Sakurai, Sadaaki Yamazoe, Kenjiro Kimura, Takahiro Toyokawa, Ryosuke Amano, Naoshi Kubo, Hiroaki Tanaka, Kazuya Muguruma, Kosei Hirakawa, Masaichi Ohira
BACKGROUND: Common complications of pelvic fractures include visceral injury, large-volume hemorrhage, genitourinary injury, rectal injury, and pulmonary embolism. On the other hand, traumatic hernia is a rare complication, especially in association with pelvic fractures. We report a case of bowel perforation due to traumatic hernia at a pelvic fracture site. CASE PRESENTATION: A 65-year-old female was presented at our hospital for further examination and treatment of ileus...
July 12, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28699713/-potential-role-of-norepinephrine-in-the-immune-dysfunction-associated-with-sepsis
#2
Anna Bauer-Dörries, Sarah De Cupis, Lucas Liaudet
Septic shock may be complicated by a state of immune suppression, with ominous prognosis significance. Although the underlying pathophysiological mechanisms are poorly understood, it is possible that norepinephrine, used to treat circulatory failure during septic shock, plays a significant contributing role. Indeed, besides its hemodynamic effects, norepinephrine exerts multiple immunosuppressive actions, which are primarily mediated by beta-2 adrenergic receptors expressed by immune cells. Furthermore, norepinephrine has the ability to promote the growth of numerous bacteria, and could thereby foster the development of nosocomial infections...
July 12, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28696597/-sepsis-particularities-in-the-elderly-patients
#3
Xavier Roux, Benedikt Huttner, Jérôme Pugin, Virginie Prendki, Jean-Luc Reny
Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to an infection. The clinical presentation of sepsis in the elderly is very variable and sepsis is therefore challenging to diagnose in this population. The new sepsis definitions published in 2016, which are based on objective clinical and biological scores, should lead to earlier recognition and diagnosis. Treatment should start as soon as possible because the specific pathophysiological changes of aging increase the risk of a sudden deterioration to septic shock...
November 9, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28690852/is-polymyxin-b-immobilized-fiber-column-ineffective-for-septic-shock-a-discussion-on-the-press-release-for-euphrates-trial
#4
Toshiaki Iba, Lucy Fowler
The efficacy of polymyxin B-immobilized (PMX) fiber column on septic shock is still under debate. Recently, the result from "Evaluating the Use of Polymyxin B Hemoperfusion in a Randomized controlled trial of Adults Treated for Endotoxemia and Septic shock (EUPHRATES)" trial has been announced as a press release. According to that report, less than a 5% mortality difference was recognized in the "per protocol population" (n = 244, 31.9 vs. 36.9%) and the decrease was not statistically significant. However, among the patients in refractory shock with a multiple organ dysfunction score of more than 9 and an EAA between 0...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28690758/osteolytic-bone-lesions-severe-hypercalcemia-without-circulating-blasts-unusual-presentation-of-childhood-acute-lymphoblastic-leukemia
#5
Achour Bechir, Regaieg Haifa, Ben Abdelkader Atef, Bouslema Emna, Achour Asma, Ben Sayed Nesrine, Ben Youssef Yosra, Khelif Abdrrahim
Hypercalcemia and severe osteolytic lesions are rare complications of acute lymphoblastic leukemia (ALL) in childhood. We report a case of a 3 years old boy who presented with prolonged fever, nausea, vomiting and increasing lower limbs pain. Skeletal X-rays and CT scan showed severe osteolytic lesions of the skull and extremities. Her physical examination showed multiple cervical lymph nodes. In laboratory tests, he had severe hypercalcemia. Parathyroid hormone (PTH) was not elevated. Despite the absence of circulating blasts, bone marrow biopsy revealed B-precursor (ALL)...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28681830/isolation-of-salmonella-typhi-from-high-vaginal-swab-in-a-case-of-septic-abortion
#6
Pragnya Paramita Jena, Shalini Dewan Duggal, Avinash Kumar, Tanisha Bharara, Abha Sharma, Renu Gur
Salmonella Typhi can be a significant cause of morbidity and mortality in pregnant females with adverse outcomes. Risk of infections increases manifold during pregnancy due to hormonal changes and immunological phenomena. S. Typhi has the ability to cross placenta (vertical transmission) resulting in miscarriage, stillbirth or premature labour. We report a case of a pregnant female who was admitted to emergency department with fever, missed abortion and hypovolaemic shock. Subsequently, S. Typhi was isolated from her high vaginal swab and blood cultures...
April 2017: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28680609/hydrocortisone-therapy-in-a-cat-with-vasopressor-refractory-septic-shock-and-suspected-critical-illness-related-corticosteroid-insufficiency
#7
Simone R R Pisano, Judith Howard, Horst Posthaus, Alan Kovacevic, Ivayla D Yozova
A 27-month-old female cat was presented with septic peritonitis secondary to a ruptured pyometra and subsequent pyothorax. Vasopressor-refractory septic shock led to a suspicion of critical illness-related corticosteroid insufficiency, successfully treated with intravenous hydrocortisone. Previous megestrol acetate administration may have played a role in the development of adrenocortical dysfunction.
July 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28679413/double-carbapenem-as-a-rescue-strategy-for-the-treatment-of-severe-carbapenemase-producing-klebsiella-pneumoniae-infections-a-two-center-matched-case-control-study
#8
Gennaro De Pascale, Gennaro Martucci, Luca Montini, Giovanna Panarello, Salvatore Lucio Cutuli, Daniele Di Carlo, Valentina Di Gravio, Roberta Di Stefano, Guido Capitanio, Maria Sole Vallecoccia, Piera Polidori, Teresa Spanu, Antonio Arcadipane, Massimo Antonelli
BACKGROUND: Recent reports have suggested the efficacy of a double carbapenem (DC) combination, including ertapenem, for the treatment of carbapenem-resistant Klebsiella pneumoniae (CR-Kp) infections. We aimed to evaluate the clinical impact of such a regimen in critically ill patients. METHODS: This case-control (1:2), observational, two-center study involved critically ill adults with a microbiologically documented CR-Kp invasive infection treated with the DC regimen matched with those receiving a standard treatment (ST) (i...
July 5, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28678812/augmented-renal-clearance-is-not-a-risk-factor-for-mortality-in-enterobacteriaceae-bloodstream-infections-treated-with-appropriate-empiric-antimicrobials
#9
Jason P Burnham, Scott T Micek, Marin H Kollef
The main objective of the study was to assess whether augmented renal clearance was a risk factor for mortality in a cohort of patients with Enterobacteriaceae sepsis, severe sepsis, or septic shock that all received appropriate antimicrobial therapy within 12 hours. Using a retrospective cohort from Barnes-Jewish Hospital, a 1,250-bed teaching hospital, we collected data on individuals with Enterobacteriaceae sepsis, severe sepsis, and septic shock who received appropriate initial antimicrobial therapy between June 2009 and December 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28676904/differences-in-cvvh-vs-cvvhdf-in-the-management-of-sepsis-induced-acute-kidney-injury-in-critically-ill-patients
#10
Vedran Premuzic, Nikolina Basic-Jukic, Bojan Jelakovic, Petar Kes
We hypothesized that patients with sepsis and AKI, especially patients without preserved renal function, and treated with continuous veno-venous hemodiafiltration (CVVHDF), have lower risk for mortality than patients treated with continuous veno-venous hemofiltration (CVVH). Patients were included if they fulfilled the diagnosis of severe sepsis or septic shock, suffered AKI and received continuous renal replacement therapy (CRRT) in intensive care unit. There were 62 patients treated by CVVH and 75 treated by CVVHDF...
July 4, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28667502/lysophosphatidic-acid-protects-against-endotoxin-induced-acute-kidney-injury
#11
Koryun Mirzoyan, Colette Denis, Audrey Casemayou, Marion Gilet, Dimitri Marsal, Dominique Goudounéche, Stanislas Faguer, Jean-Loup Bascands, Joost P Schanstra, Jean-Sébastien Saulnier-Blache
Septic shock is the most common cause of acute kidney injury (AKI), but the underlying mechanisms remain unclear and no targeted therapies exist. Lysophosphatidic acid (LPA) is a bioactive lipid which in vivo administration was reported to mitigate inflammation and injuries caused by bacterial endotoxemia in the liver and lung. The objective of the present study was to determine whether LPA can protect against sepsis-associated AKI. C57BL/6 mice were treated with LPA 18:1 (5 mg/kg, i.p.) 1 h before being injected with the endotoxin lipopolysaccharide (LPS), and AKI was evaluated after 24 h...
June 30, 2017: Inflammation
https://www.readbyqxmd.com/read/28665804/septic-arthritis-of-the-shoulder-a-comparison-of-treatment-methods
#12
Jimmy J Jiang, Hristo I Piponov, Daniel P Mass, Jovito G Angeles, Lewis L Shi
INTRODUCTION: In-hospital outcomes were compared among patients with shoulder septic arthritis treated with arthrocentesis, open irrigation and débridement, or arthroscopic irrigation and débridement. METHODS: The Nationwide Inpatient Sample database was queried for all cases of native shoulder septic arthritis between 2002 and 2011. Patient demographics, comorbidities, and hospitalization complications were compared for the shoulder arthrocentesis (nonsurgical) and open or arthroscopic irrigation and débridement (surgical) groups...
June 29, 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28659996/the-immunomodulatory-effect-of-trichophyton-rubrum-exoantigens-in-the-treatment-of-experimental-septic-arthritis
#13
Seyed A Ghiasian, Amir H Maghsood, Asadollah Abniki, Abbas Mirshafiey
BACKGROUND: Understanding the nature and function of fungal exoantigens might lead to novel approaches in the treatment and prophylaxis of some infectious diseases. Septic arthritis represents a serious problem for medicine due to the high incidence rate and severe complications. OBJECTIVE: The present study aimed at assessing the immunomodulatory effects of Trichophyton rubrum culture filtrate as a novel compound in experimental septic arthritis. METHOD: The septic arthritis was haematogenously induced in Sprague-Dawley rats by a single intravenous injection of 10(9) colony forming units of the human clinical isolate Staphylococcus aureus producing toxic shock syndrome toxin-1...
2017: Open Microbiology Journal
https://www.readbyqxmd.com/read/28659059/endovascular-treatment-of-visceral-artery-aneurysms-and-pseudoaneurysms-in-100-patients-covered-stenting-vs-transcatheter-embolization
#14
Massimo Venturini, Paolo Marra, Michele Colombo, Marco Alparone, Giulia Agostini, Luca Bertoglio, Claudio Sallemi, Marco Salvioni, Simone Gusmini, Gianpaolo Balzano, Renata Castellano, Luca Aldrighetti, Yamume Tshomba, Massimo Falconi, Germano Melissano, Francesco De Cobelli, Roberto Chiesa, Alessandro Del Maschio
PURPOSE: To retrospectively report a large single-center experience of visceral artery aneurysms (VAAs) and pseudoaneurysms (VAPAs) treated with covered stenting (CS) as the first therapeutic option vs transcatheter embolization (TE). METHODS: One hundred patients (mean age 59±14 years; 58 men) underwent 59 elective and 41 emergent endovascular procedures to treat 51 VAAs and 49 VAPAs. Seventy patients had TE and 30 received CS (27 Viabahn and 3 coronary stent grafts)...
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28658042/coagulation-profile-as-a-risk-factor-for-30-day-morbidity-following-cervical-laminectomy-and-fusion
#15
Rachel S Bronheim, Eric K Oermann, Samuel K Cho, John M Caridi
STUDY DESIGN: Retrospective analysis of prospectively collected data. OBJECTIVE: To determine the ability of abnormal coagulation profile to predict adverse events following Posterior cervical laminectomy and fusion (PCLF). SUMMARY OF BACKGROUND DATA: PCLF is an increasingly common procedure used to treat a variety of traumatic and degenerative spinal conditions. Abnormal coagulation profile is associated with postoperative adverse events, including blood transfusion...
June 27, 2017: Spine
https://www.readbyqxmd.com/read/28655868/double-peripheral-venous-and-arterial-cannulation-for-extracorporeal-membrane-oxygenation-in-combined-septic-and-cardiogenic-shock
#16
Markus Kredel, Steffen Kunzmann, Paul-Gerhardt Schlegel, Matthias Wölfl, Peter Nordbeck, Christoph Bühler, Christopher Lotz, Philipp M Lepper, Johannes Wirbelauer, Norbert Roewer, Ralf M Muellenbach
BACKGROUND The use of venoarterial extracorporeal membrane oxygenation (va-ECMO) via peripheral cannulation for septic shock is limited by blood flow and increased afterload for the left ventricle. CASE REPORT A 15-year-old girl with acute myelogenous leukemia, suffering from severe septic and cardiogenic shock, was treated by venoarterial extracorporeal membrane oxygenation (va-ECMO). Sufficient extracorporeal blood flow matching the required oxygen demand could only be achieved by peripheral cannulation of both femoral arteries...
June 28, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28654446/sepsis-in-obstetrics-pathophysiology-and-diagnostic-definitions
#17
Sheryl E Parfitt, Mary L Bogat, Sandra L Hering, Cheryl Roth
In spite of many medical breakthroughs, sepsis continues to be challenging to identify, treat, and successfully resolve, including among the obstetric population. Sepsis is the result of an overactive, complex inflammatory response that is not completely understood. Currently there are no nationally agreed-upon criteria for systemic inflammatory response syndrome or sepsis in pregnant or peripartum women, as the physiologic changes of pregnancy have not been taken into consideration.This article is the first in a series of three that discuss the importance of sepsis and septic shock in pregnancy...
July 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/28651927/doxorubicin-plus-evofosfamide-versus-doxorubicin-alone-in-locally-advanced-unresectable-or-metastatic-soft-tissue-sarcoma-th-cr-406-sarc021-an-international-multicentre-open-label-randomised-phase-3-trial
#18
William D Tap, Zsuzsanna Papai, Brian A Van Tine, Steven Attia, Kristen N Ganjoo, Robin L Jones, Scott Schuetze, Damon Reed, Sant P Chawla, Richard F Riedel, Anders Krarup-Hansen, Maud Toulmonde, Isabelle Ray-Coquard, Peter Hohenberger, Giovanni Grignani, Lee D Cranmer, Scott Okuno, Mark Agulnik, William Read, Christopher W Ryan, Thierry Alcindor, Xavier F Garcia Del Muro, G Thomas Budd, Hussein Tawbi, Tillman Pearce, Stew Kroll, Denise K Reinke, Patrick Schöffski
BACKGROUND: Evofosfamide is a hypoxia-activated prodrug of bromo-isophosphoramide mustard. We aimed to assess the benefit of adding evofosfamide to doxorubicin as first-line therapy for advanced soft-tissue sarcomas. METHODS: We did this international, open-label, randomised, phase 3, multicentre trial (TH CR-406/SARC021) at 81 academic or community investigational sites in 13 countries. Eligible patients were aged 15 years or older with a diagnosis of an advanced unresectable or metastatic soft-tissue sarcoma, of intermediate or high grade, for which no standard curative therapy was available, an Eastern Cooperative Oncology Group performance status of 0-1, and measurable disease by Response Evaluation Criteria in Solid Tumors version 1...
June 23, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28648516/-mycosis-fungoides-in-a-heart-transplant-recipient
#19
Q Bodard, N Litrowski, D Carre, M Midhat, P Chenal, P Bravard
BACKGROUND: Skin cancer occurs frequently in organ transplant patients as a result of induced immunosuppression. Most cases involve carcinomas or B-cell lymphomas induced by the Epstein Barr virus (EBV). Cutaneous T-cell lymphomas remain rare. We report a case of cutaneous T-cell lymphoma of the mycosis fungoides type in a heart transplant recipient. PATIENTS AND METHODS: A 68-year-old man who had received a heart transplant 21years earlier and was being treated with tacrolimus, mycophenolate mofetil and prednisolone had been presenting a psoriasiform rash on his trunk, limbs and head for 4years...
June 22, 2017: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/28638458/anti-metastatic-effect-of-semi-purified-nuphar-lutea-leaf-extracts
#20
Janet Ozer, Daniel Fishman, Brit Eilam, Avi Golan-Goldhirsh, Jacob Gopas
Nuphar lutea L. SM., leaf and rhizome extracts (NUP), contain nupharidines as active components. Nupharidines belong to the sesquiterpene lactones class of a naturally occurring plant terpenoids. This family of compounds has gained considerable interest for treating infection, inflammation and cancer. NF-κB is a central, downstream regulator of inflammation, cell proliferation and apoptosis. In our previous work we demonstrated strong inhibition of NF-κB activity and induction of apoptosis by NUP. In addition, NUP exhibited anti-inflammatory properties and partial protection from LPS-induced septic shock by modulating ERK pathway and cytokine secretion in macrophages...
2017: Journal of Cancer
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