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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
https://www.readbyqxmd.com/read/30006923/multicentre-international-trial-of-laparoscopic-lavage-for-hinchey-iii-acute-diverticulitis-llo-study
#2
G A Binda, M A Bonino, G Siri, S Di Saverio, G Rossi, R Nascimbeni, M Sorrentino, A Arezzo, N Vettoretto, R Cirocchi
BACKGROUND: Laparoscopic lavage was proposed in the 1990s to treat purulent peritonitis in patients with perforated acute diverticulitis. Prospective randomized trials had mixed results. The aim of this study was to determine the success rate of laparoscopic lavage in sepsis control and to identify a group of patients that could potentially benefit from this treatment. METHODS: This retrospective multicentre international study included consecutive patients from 24 centres who underwent laparoscopic lavage from 2005 to 2015...
July 14, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/30006348/interaction-of-the-%C3%AE-7-nicotinic-subunit-with-its-human-specific-duplicated-dup%C3%AE-7-isoform-in-mammalian-cells-relevance-in-human-inflammatory-responses
#3
María C Maldifassi, Carolina Martín-Sánchez, Gema Atienza, José L Cedillo, Francisco Arnalich, Anna Bordas, Francisco Zafra, Cecilio Giménez, María Extremera, Jaime Renart, Carmen Montiel
The α7 nicotinic receptor subunit and its partially duplicated human-specific dupα7 isoform are co-expressed in neuronal and non-neuronal cells. In these cells, α7 subunits form homopentameric α7 nicotinic acetylcholine receptors (α7-nAChRs) implicated in numerous pathologies. In immune cells, α7-nAChRs are essential for vagal control of inflammatory response in sepsis. Recent studies show that the dupα7 subunit is a dominant-negative regulator of α7-nAChR activity in Xenopus oocytes. However, its biological significance in mammalian cells, particularly immune cells, remains unexplored, as the duplicated form is indistinguishable from the original subunit in standard tests...
July 13, 2018: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/30006152/extracellular-histones-activate-autophagy-and-apoptosis-via-mtor-signaling-in-human-endothelial-cells
#4
José Santiago Ibañez-Cabellos, Carmen Aguado, Daniel Pérez-Cremades, José Luis García-Giménez, Carlos Bueno-Betí, Eva M García-López, Carlos Romá-Mateo, Susana Novella, Carlos Hermenegildo, Federico V Pallardó
Circulating histones have been proposed as targets for therapy in sepsis and hyperinflammatory symptoms. However, the proposed strategies have failed in clinical trials. Although different mechanisms for histone-related cytotoxicity are being explored, those mediated by circulating histones are not fully understood. Extracellular histones induce endothelial cell death, thereby contributing to the pathogenesis of complex diseases such as sepsis and septic shock. Therefore, the comprehension of cellular responses triggered by histones is capital to design effective therapeutic strategies...
July 10, 2018: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/30006071/the-role-of-glucocorticoids-as-adjunctive-treatment-for-sepsis-in-the-modern-era
#5
Paul E Marik
Glucocorticoids have been used as adjunctive therapy in patients with sepsis and septic shock for more than four decades. The rationale for the use of glucocorticoids is that this class of drugs downregulates the proinflammatory response and limits the anti-inflammatory response while preserving innate immunity. Between 1976 and 2017, 22 randomised placebo-controlled trials have been published evaluating the benefit of glucocorticoids in patients with community-acquired pneumonia, sepsis, and septic shock. These studies produced conflicting results...
July 10, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/30005731/obstructive-uropathy-and-sepsis-caused-by-an-inguinoscrotal-bladder-hernia-a-case-report
#6
Seena Safavy, Emmanuel Mitsinikos, Bradford Tropea, Allen Chang, Hetal Patel
INTRODUCTION: Inguinoscrotal bladder hernia is a very rare pathology, occurring in up to 4% of all inguinal hernias in the general population. We present a case of an inguinoscrotal bladder hernia causing obstructive uropathy and sepsis. CASE PRESENTATION: A 59-year-old obese man presented with left-sided flank and abdominal pain that radiated to his left groin. On initial clinical examination, there was no evidence of an inguinal hernia. A computed tomography scan revealed a left inguinoscrotal bladder hernia with associated left-sided upper tract urinary obstruction...
June 18, 2018: Permanente Journal
https://www.readbyqxmd.com/read/30005671/repeated-vital-sign-measurements-in-the-emergency-department-predict-patient-deterioration-within-72-hours-a-prospective-observational-study
#7
Vincent M Quinten, Matijs van Meurs, Tycho J Olgers, Judith M Vonk, Jack J M Ligtenberg, Jan C Ter Maaten
BACKGROUND: More than one in five patients presenting to the emergency department (ED) with (suspected) infection or sepsis deteriorate within 72 h from admission. Surprisingly little is known about vital signs in relation to deterioration, especially in the ED. The aim of our study was to determine whether repeated vital sign measurements in the ED can differentiate between patients who will deteriorate within 72 h and patients who will not deteriorate. METHODS: We performed a prospective observational study in patients presenting with (suspected) infection or sepsis to the ED of our tertiary care teaching hospital...
July 13, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30005596/plasma-myeloperoxidase-conjugated-dna-level-predicts-outcomes-and-organ-dysfunction-in-patients-with-septic-shock
#8
Yuki Maruchi, Masanobu Tsuda, Hisatake Mori, Nobuyoshi Takenaka, Takayoshi Gocho, Muhammad A Huq, Naoshi Takeyama
BACKGROUND: Recent studies have suggested that excessive formation of neutrophil extracellular traps (NETs) plays a critical role in the pathogenesis of sepsis. Although elevation of the plasma level of cell-free DNA (cf-DNA) has been reported in sepsis patients, there has been little direct measurement of circulating free NETs such as myeloperoxidase-conjugated DNA (MPO-DNA). The objectives of this study were to detect NETs in the bloodstream of patients with septic shock, and to assess the correlations of circulating NET levels with organ dysfunction, disease severity, and mortality...
July 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/30005438/-fluid-resuscitation-and-management-in-patients-with-sepsis-and-septic-shock
#9
Matthias Kochanek, Boris Böll
Sepsis and septic shock are common diseases with high mortality rates. Although volume therapy has been a central component of sepsis therapy for decades, the choice of optimal fluid and fluid intake is unclear. This paper summarizes findings on pathophysiology, clinical trial results, and current recommendations for optimal volume and fluid management in sepsis.
July 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/30005305/prognostic-ability-of-quick-sofa-across-different-age-groups-of-patients-with-suspected-infection-outside-the-intensive-care-unit-a-cohort-study
#10
João Gabriel Rosa Ramos, Rogério da Hora Passos, Mauricio Brito Teixeira, Andre Luiz Nunes Gobatto, Rafael Viana Dos Santos Coutinho, Juliana Ribeiro Caldas, Suzete Farias da Guarda, Michel Pordeus Ribeiro, Paulo Benigno Pena Batista
OBJECTIVES: Sepsis identification in older patients is challenging. We evaluated the performance of qSOFA across different age groups of patients with suspected infection outside the intensive care unit (ICU). METHODS: Retrospective cohort in a tertiary hospital in Brazil, from January 2016 to December 2016. Outcomes were hospital mortality, ICU admission and bacteremia. Performance of qSOFA was compared over three age groups: (1) reference: ≤65 years, (2) old: 65 to 79 years and (3) very old: ≥80 years...
July 7, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30004979/is-the-tail-wagging-the-dog-in-sepsis
#11
Rashan Haniffa, Abi Beane, Arjen M Dondorp
No abstract text is available yet for this article.
August 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/30004973/blue-light-illuminates-a-novel-sepsis-treatment
#12
Sonal Pannu, Elliott D Crouser
No abstract text is available yet for this article.
August 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/30004971/sepsis-the-gift-that-keeps-on-giving-regardless-of-age
#13
Steven Q Simpson
No abstract text is available yet for this article.
August 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/30004970/sepsis-redefined%C3%A2-again
#14
John Gaughan
No abstract text is available yet for this article.
August 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/30004905/ce-a-review-of-the-revised-sepsis-care-bundles
#15
Donna Lester, Tonja Hartjes, Amanda Bennett
The rationale behind the new definitions, screening tools, and treatment guidelines. ABSTRACT: Sepsis is an extreme response to infection that can cause tissue damage, organ failure, and death if not treated promptly and appropriately. Each year in the United States, sepsis affects more than 1.5 million people and kills roughly 250,000. Prompt recognition and treatment of sepsis are essential to saving lives, and nurses play a critical role in the early detection of sepsis, as they are often first to recognize the signs and symptoms of infection...
July 12, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/30004393/clinical-significance-of-interleukin-6-in-the-diagnosis-of-sepsis-and-discriminating-sepsis-induced-by-gram-negative-bacteria
#16
Wen-Xia Shao, Dao-Jun Yu, Wei-Ying Zhang, Xian-Jun Wang
BACKGROUND: To discuss the clinical significance of interleukin (IL)-6 in the differential diagnosis of sepsis and its capability of differentiating the sepsis induced by Gram-negative bacteria from that induced by Gram-positive bacteria. METHODS: A total of 379 children with sepsis were involved in this study to form the case group, and their C-reactive protein (CRP), procalcitonin (PCT) and IL-6 levels before antibiotics and after recovery were checked. Receiver operating characteristic curve was applied to evaluate the significance of CRP, PCT and IL-6 in the differential diagnosis of sepsis and their capability of differentiating the sepsis induced by Gram-negative bacteria from that induced by Gram-positive bacteria...
August 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/30004358/maternal-near-miss-audit-in-the-metro-west-maternity-service-cape-town-south-africa-a-retrospective-observational-study
#17
I A Iwuh, S Fawcus, L Schoeman
BACKGROUND: A maternal near-miss is defined as a life-threatening pregnancy-related complication where the woman survives. The World Health Organization (WHO) has produced a tool for identifying near-misses according to criteria that include the occurrence of a severe maternal complication together with organ dysfunction and/or specified critical interventions. Maternal deaths have been audited in the public sector Metro West maternity service in Cape Town, South Africa, for many years, but there has been no monitoring of near-misses...
February 27, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/30003852/association-of-vitamin-d-deficiency-with-an-increased-risk-of-late-onset-neonatal-xepsis
#18
Rajeshwari Dhandai, Mamta Jajoo, Amitabh Singh, Anirban Mandal, Rahul Jain
Background Vitamin D deficiency in mothers and neonates is being recognised increasingly as a leading cause of many adverse health effects in the newborn infant, including sepsis. Methods A prospective observational study was conducted at a tertiary care Paediatric teaching hospital in northern India to assess vitamin D deficiency as a possible risk factor for late-onset sepsis (LOS) in term and late preterm neonates and also to examine the correlation between maternal and infant vitamin D levels during the neonatal period...
July 13, 2018: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/30003825/dihydromyricetin-improves-vascular-hyporesponsiveness-in-experimental-sepsis-via-attenuating-the-over-excited-maxik-and-k-atp-channels
#19
Jin Peng, Jian Zhang, Li Zhang, Yonggang Tian, Yahong Li, Lujun Qiao
CONTEXT: Dihydromyricetin (DMY) has oxidation resistance, anti-inflammatory and free radical scavenging capabilities. The preventive effects of DMY for vascular hyporeactivity remain unclear. OBJECTIVE: This study investigates the preventive effects of DMY in vascular hyporeactivity. MATERIALS AND METHODS: The experimental sepsis was induced by transvenous administration of lipopolysaccharide (LPS) to Sprague-Dawley (SD) rats. DMY-treated rats received daily administration of DMY, 5 μg/kg dissolved in DMSO through the tail vein for 7 days...
December 2018: Pharmaceutical Biology
https://www.readbyqxmd.com/read/30003641/hot-off-the-press-a-novel-algorithm-to-decrease-unnecessary-hospitalizations-in-patients-with-atrial-fibrillation
#20
Justin Morgenstern, Corey Heitz, Chris Bond, William K Milne
This is a retrospective cohort study with a before and after design, comparing the admission rate for patients with AFib during a one-year period before the initiation of a new management algorithm to a one-year period after the algorithm was introduced. Physicians were first instructed to determine whether the AFib was secondary to another important diagnosis, such as sepsis or pulmonary embolism. (These patients were admitted to hospital). Among the patients with primary AFib, physicians assessed for four high-risk criteria: hemodynamic instability, acute heart failure, syncope, and acute coronary syndrome...
July 12, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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