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Sepsis

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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/28934717/expression-of-c-ebp%C3%AE-in-myeloid-progenitors-during-sepsis-promotes-immunosuppression
#2
Jun Dai, Ajinkya Kumbhare, Dima Youssef, Zhi Q Yao, Charles E McCall, Mohamed El Gazzar
Sepsis-induced myeloid-derived suppressor cells (MDSCs) contribute to immunosuppression associated with sepsis. We reported that the CCAAT enhancer-binding protein C/EBPβ activates microRNA (miR)-21 and miR-181b expressions, which induce transcription factor NFI-A to support the generation and expansion of MDSCs in the bone marrow and spleens of septic mice. Here, using a conditional knockout mouse model lacking C/EBPβ in the myeloid lineage, we find that without C/EBPβ, myeloid progenitor cells could not express miR-21 or miR-181b, and ectopic expression of C/EBPβ in the C/EBPβ-deficient myeloid progenitors activated the expression of the two miRNAs...
September 18, 2017: Molecular Immunology
https://www.readbyqxmd.com/read/28934705/vitamin-c-the-next-step-in-sepsis-management
#3
REVIEW
J Teng, A Pourmand, M Mazer-Amirshahi
Sepsis is a life-threatening medical condition, affecting approximately 26 million people worldwide every year. The disease is a continuum, marked by dysregulated inflammation and hemodynamic instability leading to shock, multi-system organ dysfunction, and death. Over the past decades, there has been a focus on the early identification and treatment of sepsis primarily with bundled and goal directed therapy. Despite these advances, morbidity and mortality has remained high, prompting investigation into novel therapies...
September 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28933634/development-of-a-multiplexed-opsonophagocytic-killing-assay-mopa-for-group-b-streptococcus
#4
Min Joo Choi, Ji Yun Noh, Hee Jin Cheong, Woo Joo Kim, Shun-Mei Lin, Yong Zhi, Jae Hyang Lim, Sangyong Lim, Ho Seong Seo, Joon Young Song
Group B Streptococcus (GBS) is a leading cause of sepsis in infants as well as chorioamnionitis in pregnant women. Opsonophagocytic killing assays (OPAs) are an essential technique in vaccine studies of encapsulated bacteria for estimating serotype-specific functional antibody levels in vitro. Here, we developed a three-fold multiplexed OPA (MOPA) to enable practical, large-scale assessment of GBS vaccine immunogenicity, including against serotypes Ia, III, and V. First, three target bacteria strains resistant to streptomycin, spectinomycin, or kanamycin were generated by natural selection through exposure to increasing antibiotic concentrations...
September 21, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28933370/a-case-of-systemic-infection-caused-by-streptococcus-pyogenes-oral-infection-in-an-edentulous-patient
#5
Yumi Inagaki, Masanobu Abe, Ryoko Inaki, Liang Zong, Hideyuki Suenaga, Takahiro Abe, Kazuto Hoshi
BACKGROUND: Infections in the oral and maxillofacial region can sometimes extend beyond the oral cavity, with serious consequences. Most oral infections are odontogenic, occurring through the root apex of the tooth or the periodontal pocket. It thus makes sense that edentulous patients have a much lower risk of oral bacterial infection. For this reason, while there are many reports on systemic infections caused by oral infections, few of these describe such infections in edentulous patients...
August 18, 2017: Diseases (Basel)
https://www.readbyqxmd.com/read/28933172/-development-of-views-on-pathophysiology-of-sepsis
#6
Jiří Beneš
Sepsis was understood as a disease caused by an invasive bacterial infection associated with deluging of organism with bacterial toxins (blood poisoning). Schottmüllers definition emphasized the existence of a focus as the source of invading bacteria. Further research led to the discovery of the cytokine cascade and to the recognition that sepsis is induced by our own endogenous mediators. The dysfunction or failure of various organs in sepsis can be explained both by hemodynamic disorders which originate in the altered microcapillars but also by a complex transformation of metabolism...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28932731/extracorporeal-membrane-oxygenation-support-for-refractory-septic-shock-in-liver-transplantation-recipients
#7
Kyo Won Lee, Chan Woo Cho, Nuri Lee, Gyu-Seong Choi, Yang Hyun Cho, Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh
PURPOSE: This study was designed to assess the outcome of the extracorporeal membrane oxygenation (ECMO) in liver transplantation (LT) recipients with refractory septic shock and predict the prognosis of those cases. METHODS: From February 2005 to October 2012, ECMO was used in 8 cases of refractory septic shock. Laboratory values including lactate and total bilirubin level just before starting ECMO were obtained and sepsis-related organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACH) II score and simplified acute physiology score (SAPS) 3 were calculated...
September 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28932401/practical-approach-to-detection-and-management-of-acute-kidney-injury-in-critically-ill-patient
#8
REVIEW
Vahid Mohsenin
BACKGROUND: Acute kidney injury (AKI) is a common complication in critically ill patients and is associated with high morbidity and mortality. This paper provides a critical review of the etiologies of AKI and a systematic approach toward its diagnosis and management with emphasis on fluid volume assessment and the use of urine biochemical profile and microscopy in identifying the nature and the site of kidney injury. MATERIALS AND METHODS: The search of PubMed and selection of papers had employed observational designs or randomized control trials relevant to AKI...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28932195/hydroxysafflor-yellow-a-attenuates-the-apoptosis-of-peripheral-blood-cd4-t-lymphocytes-in-a-murine-model-of-sepsis
#9
Jinping Wang, Ping Wang, Shuiqing Gui, Yun Li, Runhua Chen, Renqing Zeng, Peiyan Zhao, Hanwei Wu, Zheyu Huang, Jianlong Wu
Sepsis is generally considered as a severe condition of inflammation that leads to lymphocyte apoptosis and multiple organ dysfunction. Hydroxysafflor yellow A (HSYA) exerts anti-inflammatory and anti-apoptotic effects in infectious diseases. However, the therapeutic effect of HSYA on polymicrobial sepsis remains unknown. This study was undertaken to investigate the therapeutic effects and the mechanisms of action of HSYA on immunosuppression in a murine model of sepsis induced by cecal ligation and puncture (CLP)...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28931916/salidroside-ameliorates-sepsis-induced-acute-lung-injury-and-mortality-via-downregulating-nf-%C3%AE%C2%BAb-and-hmgb1-pathways-through-the-upregulation-of-sirt1
#10
Kuo-Cheng Lan, Sung-Chuan Chao, Hsiao-Yi Wu, Chia-Lien Chiang, Ching-Chia Wang, Shing-Hwa Liu, Te-I Weng
Sepsis is a life-threatening medical condition. Salidroside, a substance isolated from Rhodiola rosea, possesses antioxidant and anti-inflammatory properties. The effect and mechanism of salidroside on sepsis-induced acute lung injury still remains to be well clarified. Here, we investigated the effect and mechanism of salidroside on septic mouse models and explored the role of salidroside-upregulated SIRT1. Salidroside inhibited the inflammatory responses and HMGB1 productions in bacterial lipopolysaccharide (LPS)-treated macrophages and mice...
September 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28931365/predictive-value-of-matrix-metalloproteinases-and-their-inhibitors-for-mortality-in-septic-patients-a-cohort-study
#11
Sergio Serrano-Gomez, Gabriel Burgos-Angulo, Daniela Camila Niño-Vargas, María Eugenia Niño, María Eugenia Cárdenas, Estephania Chacón-Valenzuela, Diana Margarita McCosham, Juan Sebastián Peinado-Acevedo, M Marcos Lopez, Fernando Cunha, Antonio Pazin-Filho, Ramses Ilarraza, Richard Schulz, Diego Torres-Dueñas
PURPOSE: Over 170 biomarkers are being investigated regarding their prognostic and diagnostic accuracy in sepsis in order to find new tools to reduce morbidity and mortality. Matrix metalloproteinases (MMPs) and their inhibitors have been recently studied as promising new prognostic biomarkers in patients with sepsis. This study is aimed at determining the utility of several cutoff points of these biomarkers to predict mortality in patients with sepsis. MATERIALS AND METHODS: A multicenter, prospective, analytic cohort study was performed in the metropolitan area of Bucaramanga, Colombia...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28931287/enhanced-capture-of-bacteria-and-endotoxin-by-antimicrobial-wlbu2-peptide-tethered-on-polyethylene-oxide-spacers
#12
Ramya Raman, Miranda A Raper, Erik Hahn, Kate F Schilke
Severe sepsis is a life threatening immune response that may be caused by endotoxins (lipopolysaccharides) in circulating bacterial cell wall fragments. Hemoperfusion through a sorbent column coated with the antimicrobial peptide polymyxin B (PMB) is a promising treatment for sepsis. However, PMB is cytotoxic and neurotoxic, and is a membrane disruptor that may fragment endotoxin vesicles. In addition, the blood is not protected from nonspecific interactions with the synthetic surface of the solid support. These effects may be responsible for the variety of undesirable clinical outcomes, including nonspecific adsorption of proteins, blood cell damage, platelet activation, and a lack of clear evidence of efficacy of the current hemoperfusion products...
September 20, 2017: Biointerphases
https://www.readbyqxmd.com/read/28931235/monoclonal-antibody-protects-against-acinetobacter-baumannii-infection-by-enhancing-bacterial-clearance-and-evading-sepsis
#13
Travis B Nielsen, Paul Pantapalangkoor, Brian M Luna, Kevin W Bruhn, Jun Yan, Ken Dekitani, Sarah Hsieh, Brandon Yeshoua, Bryan Pascual, Evgeny Vinogradov, Kristine M Hujer, T Nicholas Domitrovic, Robert A Bonomo, Thomas A Russo, Magda Lesczcyniecka, Thomas Schneider, Brad Spellberg
Background: Extremely drug-resistant (XDR) Acinetobacter baumannii is one of the most commonly encountered, highly resistant pathogens requiring novel therapeutic interventions. Methods: We developed C8, a monoclonal antibody (mAb), by immunizing mice with sublethal inocula of a hypervirulent XDR clinical isolate. Results: C8 targets capsular carbohydrate on the bacterial surface, enhancing opsonophagocytosis. Treating with a single dose of C8 as low as 0...
August 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28931118/unpacking-the-enabling-factors-for-hand-cord-and-birth-surface-hygiene-in-zanzibar-maternity-units
#14
Giorgia Gon, Said M Ali, Catriona Towriss, Catherine Kahabuka, Ali O Ali, Sue Cavill, Mohammed Dahoma, Sally Faulkner, Haji S Haji, Ibrahim Kabole, Emma Morrison, Rukaiya M Said, Amour Tajo, Yael Velleman, Susannah L Woodd, And Wendy J Graham
Recent national surveys in The United Republic of Tanzania have revealed poor standards of hygiene at birth in facilities. As more women opt for institutional delivery, improving basic hygiene becomes an essential part of preventative strategies for reducing puerperal and newborn sepsis. Our collaborative research in Zanzibar provides an in-depth picture of the state of hygiene on maternity wards to inform action. Hygiene was assessed in 2014 across all 37 facilities with a maternity unit in Zanzibar. We used a mixed methods approach, including structured and semi-structured interviews, and environmental microbiology...
October 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28930916/peripheral-muscle-near-infrared-spectroscopy-nirs-variables-are-altered-early-in-septic-shock
#15
Diego Orbegozo, Fuhong Su, Keliang Xie, Lokmane Rahmania, Fabio Silvio Taccone, Daniel De Backer, Jean-Louis Vincent, Jacques Creteur
BACKGROUND: Non-invasive evaluation of muscle perfusion using near infrared spectroscopy (NIRS) coupled with a vascular occlusion test (VOT) may provide an early and simple marker of altered perfusion and microcirculatory function in sepsis. OBJECTIVE: To compare the time-course of NIRS-derived variables with systemic measures of perfusion in an experimental model of peritonitis. METHODS: Peritonitis was induced in eight anesthetized, mechanically ventilated, adult sheep (24-34 Kg), by injecting autologous feces into the peritoneal cavity...
September 19, 2017: Shock
https://www.readbyqxmd.com/read/28930915/microvesicle-subsets-in-sepsis-due-to-community-acquired-pneumonia-compared-to-faecal-peritonitis
#16
Hazem M S Lashin, Suchita Nadkarni, Silvia Oggero, Hefin R Jones, Julian C Knight, Charles J Hinds, Mauro Perretti
RATIONALE: Microvesicles (MV) act as a non-soluble means of inter-cellular communication, with effector roles in disease pathogenesis and potentially as biomarkers. Previously, we reported that neutrophil MV expressing alpha-2-macroglobulin (A2MG) are protective in experimental sepsis and associate with survival in a small cohort of patients with sepsis due to community acquired pneumonia (CAP). OBJECTIVES: To characterise MV profiles in sepsis due to CAP or faecal peritonitis (FP) and determine their relation to outcome...
September 19, 2017: Shock
https://www.readbyqxmd.com/read/28930826/infective-endocarditis-in-patients-with-cancer-a-consequence-of-invasive-procedures-or-a-harbinger-of-neoplasm-a-prospective-multicenter-cohort
#17
Ana Fernández-Cruz, Patricia Muñoz, Carmen Sandoval, Carmen Fariñas, Manuel Gutiérrez-Cuadra, Juan M Pericás Pulido, José M Miró, Miguel Á Goenaga-Sánchez, Arístides de Alarcón, Francisco Bonache-Bernal, MªÁngeles Rodríguez, Mariam Noureddine, Emilio Bouza Santiago
The aim of the study was to draw a comparison between the characteristics of infective endocarditis (IE) in patients with cancer and those of IE in noncancer patients.Patients with IE, according to the modified Duke criteria, were prospectively included in the GAMES registry between January 2008 and February 2014 in 30 hospitals. Patients with active cancer were compared with noncancer patients.During the study period, 161 episodes of IE fulfilled the inclusion criteria. We studied 2 populations: patients whose cancer was diagnosed before IE (73...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28930569/the-biology-of-the-platelet-with-special-reference-to-inflammation-wound-healing-and-immunity
#18
Alan T Nurden
While platelets have long been known to be essential for maintaining hemostasis in the vasculature, their role in tissue repair, inflammation and innate and adaptive immunity is a more recent science. The ability of platelets to attach to the vessel wall, form aggregates and promote fibrin formation, key elements of blood clotting, has been said to both favor and dampen inflammation, to fight infection and to assure an adequate immune response. To fulfill their different roles platelets often synchronize with leukocytes and cells of the immune system...
January 1, 2018: Frontiers in Bioscience (Landmark Edition)
https://www.readbyqxmd.com/read/28930478/mechanical-ventilation-induced-diaphragm-atrophy-strongly-impacts-clinical-outcomes
#19
Ewan C Goligher, Martin Dres, Eddy Fan, Gordon D Rubenfeld, Damon C Scales, Margaret S Herridge, Stefannie Vorona, Michael C Sklar, Nuttapol Rittayamai, Ashley Lanys, Alistair Murray, Deborah Brace, Cristian Urrea, W Darlene Reid, George Tomlinson, Arthur S Slutsky, Brian P Kavanagh, Laurent J Brochard, Niall D Ferguson
Rationale Diaphragm dysfunction worsens outcomes in mechanically ventilated patients but the clinical impact of potentially preventable changes in diaphragm structure and function due to mechanical ventilation is unknown. Objectives To determine whether diaphragm atrophy developing during mechanical ventilation leads to prolonged ventilation. Methods Diaphragm thickness was measured daily by ultrasound in adults requiring invasive mechanical ventilation; inspiratory effort was assessed by thickening fraction...
September 20, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28930036/role-for-laparoscopy-in-the-management-of-bile-duct-injuries
#20
Vaibhav Gupta, Shiva Jayaraman
Common bile duct (CBD) injury is the most serious complication of laparoscopic cholecystectomy. Recently, laparoscopic techniques have been used in the management of postoperative bile leak and CBD injury; this literature has not been reviewed. We reviewed the literature on CBD injury, the approach to its diagnosis and management, and reports of laparoscopic management techniques. We combined this review with our experience in laparoscopic methods to highlight diagnostic and therapeutic options. Laparoscopic techniques can be used to prevent, diagnose and treat CBD injuries...
September 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
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