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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/28549307/thymoquinone-protects-against-the-sepsis-induced-mortality-mesenteric-hypoperfusion-aortic-dysfunction-and-multiple-organ-damage-in-rats
#2
Erdem Kamil Ozer, Mustafa Tugrul Goktas, Aysun Toker, Sultan Pehlivan, Hulagu Bariskaner, Ceyhan Ugurluoglu, Alper Bektas Iskit
BACKGROUND: Thymoquinone (TQ) is a potent cytoprotective, antioxidant and anti-inflammatory agent. We aimed to investigate the possible protective effects of TQ on survival, mesenteric artery blood flow (MABF), vascular reactivity, oxidative and inflammatory injuries in a murine sepsis model induced by cecal ligation and puncture (CLP). METHODS: Wistar rats were divided into the following four groups: Sham, CLP, Sham+TQ and CLP+TQ. TQ (1mg/kg/day) or vehicle (dimethyl sulfoxide, 1mL/kg/day) was intraperitoneally injected for 3 days...
March 24, 2017: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/28549029/a-contemporary-approach-to-reoperative-aortic-valve-surgery-when-is-less-more
#3
Deane E Smith, Michael S Koeckert, Patrick F Vining, Elias A Zias, Eugene A Grossi, Aubrey C Galloway
OBJECTIVE: Although the benefits of minimally invasive valvular surgery are well established, the applicability of extending these techniques to reoperative aortic valve surgery is unknown. We evaluated our experience with a minimally invasive approach to this patient population. METHODS: From January 2010 to September 2015, 21 patients underwent reoperative isolated aortic valve replacement via a minimally invasive approach by a single surgeon. All patients had preoperative evaluation with computerized tomography and coronary catheterization...
May 25, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28549024/the-epidemiology-of-hospital-death-following-pediatric-severe-sepsis-when-why-and-how-children-with-sepsis-die
#4
Scott L Weiss, Fran Balamuth, Josey Hensley, Julie C Fitzgerald, Jenny Bush, Vinay M Nadkarni, Neal J Thomas, Mark Hall, Jennifer Muszynski
OBJECTIVE: The epidemiology of in-hospital death after pediatric sepsis has not been well characterized. We investigated the timing, cause, mode, and attribution of death in children with severe sepsis, hypothesizing that refractory shock leading to early death is rare in the current era. DESIGN: Retrospective observational study. SETTING: Emergency departments and ICUs at two academic children's hospitals. PATIENTS: Seventy-nine patients less than 18 years old treated for severe sepsis/septic shock in 2012-2013 who died prior to hospital discharge...
May 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28548951/development-of-a-novel-score-for-the-prediction-of-hospital-mortality-in-patients-with-severe-sepsis-the-use-of-electronic-healthcare-records-with-lasso-regression
#5
Zhongheng Zhang, Yucai Hong
BACKGROUND AND OBJECTIVE: There are several disease severity scores being used for the prediction of mortality in critically ill patients. However, none of them was developed and validated specifically for patients with severe sepsis. The present study aimed to develop a novel prediction score for severe sepsis. RESULTS: A total of 3206 patients with severe sepsis were enrolled, including 1054 non-survivors and 2152 survivors. The LASSO score showed the best discrimination (area under curve: 0...
May 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28548696/the-roles-of-continuous-renal-replacement-therapy-in-septic-acute-kidney-injury
#6
Takuya Ueno
Despite hundreds of clinical and basic studies that have led to a better mechanistic understanding of sepsis, the number of cases with sepsis in the United States is still rising. Sepsis is a common cause of acute kidney injury (AKI) and may explain long-term complications and mortality. In the current article, a new therapeutic concept using continuous renal replacement therapy to prevent and manage long-term sequelae in septic AKI is described.
May 26, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28548476/is-cold-blood-cardioplegia-absolutely-superior-to-cold-crystalloid-cardioplegia-in-aortic-valve-surgery
#7
Daniel A Lerman, Matilde Otero-Losada, Kiddy Ume, Pablo A Salgado, Sai Prasad, Kelvin Lim, Bruno Péault, Nasri Alotti
BACKGROUND: Experimental evidence suggests that blood cardioplegia (BCP) may be superior to cold crystalloid cardioplegia (CCP) for myocardial protection. However, robust clinical data are lacking. We compared post-operative outcome of patients undergoing aortic valve replacement (AVR) using cold anterograde-retrograde intermittent BCP versus anterograde (CCP). METHODS: Adult consecutive isolated AVR performed between April 2006 and February 2011 at the Royal Infirmary Hospital of Edinburgh were retrospectively analyzed...
May 26, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28547815/balancing-the-autonomic-nervous-system-to-reduce-inflammation-in-rheumatoid-arthritis
#8
F A Koopman, M A van Maanen, M J Vervoordeldonk, P P Tak
Imbalance in the autonomic nervous system (ANS) has been observed in many established chronic autoimmune diseases, including rheumatoid arthritis (RA), which is a prototypic immune-mediated inflammatory disease (IMID). We recently discovered that autonomic dysfunction precedes and predicts arthritis development in subjects at risk of developing seropositive RA. In addition, RA patients with relatively high vagus nerve tone (higher parasympathetic parameters, measured by heart rate variability) respond better to antirheumatic therapies...
May 26, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28547631/management-of-diverticulitis-in-2017
#9
Sarah E Deery, Richard A Hodin
Diverticulitis has become increasingly more common in the 20(th) century and is now one of the most frequent indications for gastrointestinal tract-related hospitalizations. The spectrum of clinical presentation can vary widely from mild, uncomplicated disease that can be managed as an outpatient, to complicated diverticulitis with peritonitis and sepsis. Historically, all patients with diverticulitis were managed with, at a minimum, a course of antibiotics, with many patients undergoing urgent or emergent surgery with a sigmoid colectomy, end colostomy, and oversewn rectosigmoid "Hartmann's" stump...
May 25, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28546861/association-between-recurrence-of-acute-kidney-injury-and-mortality-in-intensive-care-unit-patients-with-severe-sepsis
#10
Emilio Rodrigo, Borja Suberviola, Miguel Santibáñez, Lara Belmar, Álvaro Castellanos, Milagros Heras, Juan Carlos Rodríguez-Borregán, Angel Luis Martín de Francisco, Claudio Ronco
BACKGROUND: Acute kidney injury (AKI) occurs in more than half critically ill patients admitted in intensive care units (ICU) and increases the mortality risk. The main cause of AKI in ICU is sepsis. AKI severity and other related variables such as recurrence of AKI episodes may influence mortality risk. While AKI recurrence after hospital discharge has been recently related to an increased risk of mortality, little is known about the rate and consequences of AKI recurrence during the ICU stay...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28546860/predictors-of-intracranial-hemorrhage-in-adult-patients-on-extracorporeal-membrane-oxygenation-an-observational-cohort-study
#11
Alexander Fletcher Sandersjöö, Jiri Bartek, Eric Peter Thelin, Anders Eriksson, Adrian Elmi-Terander, Mikael Broman, Bo-Michael Bellander
BACKGROUND: Intracranial hemorrhage (ICH) is a recognized complication of adults treated with extracorporeal membrane oxygenation (ECMO) and is associated with increased morbidity and mortality. However, the predictors of ICH in this patient category are poorly understood. The purpose of this study was to identify predictors of ICH in ECMO-treated adult patients. METHODS: We conducted a retrospective review of adult patients (≥18 years) treated with ECMO at the Karolinska University Hospital (Stockholm, Sweden) between September 2005 and June 2016, excluding patients with ICH upon admission or those who were treated with ECMO for less than 12 h...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28546077/systemic-administration-of-l-kynurenine-sulfate-induces-cerebral-hypoperfusion-transients-in-adult-c57bl-6-mice
#12
Dániel Péter Varga, Ákos Menyhárt, Tamás Puskás, Ferenc Bari, Eszter Farkas, Zsolt Kis, László Vécsei, József Toldi, Levente Gellért
The kynurenine pathway is a cascade of enzymatic steps generating biologically active compounds. l-kynurenine (l-KYN) is a central metabolite of tryptophan degradation. In the mammalian brain, l-KYN is partly converted to kynurenic acid (KYNA), which exerts multiple effects on neurotransmission. Recently, l-KYN or one of its derivatives were attributed a direct role in the regulation of the systemic circulation. l-KYN dilates arterial blood vessels during sepsis in rats, while it increases cerebral blood flow (CBF) in awake rabbits...
May 22, 2017: Microvascular Research
https://www.readbyqxmd.com/read/28545952/early-detection-of-sepsis-to-adapt-or-to-die
#13
Juan Carlos Yébenes
No abstract text is available yet for this article.
May 22, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28545914/epidemiology-and-outcome-analysis-of-sepsis-and-organ-dysfunction-failure-after-burns
#14
Monika Kristaq Belba, Elizana Ylber Petrela, Amy Gjergji Belba
BACKGROUND: The aim of this prospective study in adult population is to give frequency data (prevalence, incidence) of burn wound sepsis and its consequences (organ dysfunction/failure); to analyze the evolution of the SOFA cumulative score during the disease and relationship between the SOFA score in the 3rd, 7th, 14th and 21th day after burn with mortality. METHOD: A prospective cohort study was performed among adult patients (age ≥20 years) admitted in the ICU, with major and moderate burns...
May 22, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28545723/emergence-of-a-urogenital-pathotype-of-neisseria-meningitidis
#15
Charlene M Kahler
Neisseria meningitidis is the causative agent of transmissible sepsis and meningitis in humans. A urogenital pathotype of N. meningitidis as the causative agent of transmissible urethritis in the USA has been recently characterised. This pathotype belongs to clonal complex 11 and has lost capsule production but gained anaerobic growth.
May 22, 2017: Trends in Microbiology
https://www.readbyqxmd.com/read/28545548/circulating-microparticle-levels-are-reduced-in-patients-with-ards
#16
Ciara M Shaver, Justin Woods, Jennifer K Clune, Brandon S Grove, Nancy E Wickersham, J Brennan McNeil, Gregory Shemancik, Lorraine B Ware, Julie A Bastarache
BACKGROUND: It is unclear how to identify which patients at risk for acute respiratory distress syndrome (ARDS) will develop this condition during critical illness. Elevated microparticle (MP) concentrations in the airspace during ARDS are associated with activation of coagulation and in vitro studies have demonstrated that MPs contribute to acute lung injury, but the significance of MPs in the circulation during ARDS has not been well studied. The goal of the present study was to test the hypothesis that elevated levels of circulating MPs could prospectively identify critically ill patients who will develop ARDS and that elevated circulating MPs are associated with poor clinical outcomes...
May 25, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28545475/urinary-neprilysin-in-the-critically-ill-patient
#17
Sahra Pajenda, Karl Mechtler, Ludwig Wagner
BACKGROUND: Critically ill patients in intensive care face hazardous conditions. Among these, acute kidney injury (AKI) is frequently seen as a result of sepsis. Early diagnosis of kidney injury is of the utmost importance in the guidance of interventions or avoidance of treatment-induced kidney injury. On these grounds, we searched for markers that could indicate proximal tubular cell injury. METHODS: Urine samples of 90 patients admitted to the intensive or intermediate care unit were collected over 2 to 5 days...
May 25, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28543910/wheatgrass-derived-polysaccharide-has-antiinflammatory-anti-oxidative-and-anti-apoptotic-effects-on-lps-induced-hepatic-injury-in-mice
#18
Sarmila Nepali, Hyeon-Hui Ki, Ji-Hyun Lee, Hoon-Yeon Lee, Dae-Ki Kim, Young-Mi Lee
Hepatic injury occurs frequently during sepsis, and polysaccharides isolated from plants have been reported to have antiinflammatory and antioxidant effects in various models. However, the effect of wheatgrass-derived polysaccharide (WGP) has not been previously studied. In the present study, we investigated the effect of WGP on lipopolysaccharide (LPS)-induced hepatic injury in mice. Mice were pre-treated with WGP (100 or 200 mg/kg daily for 2 days) and then challenged with LPS (1 mg/kg, intraperitoneal), and sacrificed after 12 h...
May 24, 2017: Phytotherapy Research: PTR
https://www.readbyqxmd.com/read/28543844/death-and-liver-transplantation-within-two-years-of-onset-of-drug-induced-liver-injury
#19
Paul H Hayashi, Don Rockey, Robert J Fontana, Hans L Tillmann, Neil Kaplowitz, Huiman Barnhart, Jiezhan Gu, Naga P Chalasani, K Rajender Reddy, Averell H Sherker, Jay H Hoofnagle
Drug-induced liver injury (DILI) is an important cause of death and indication for liver transplantation (fatality). The role of DILI in these fatalities ispoorly characterized particularly when fatalities occur > 26 weeks after DILI onset. We analyzed patients in the U.S. Drug-Induced Liver Injury Network prospective study having a fatal outcome within 2 years of onset. Each case was reviewed by 8 Network investigators and categorized as DILI having a primary, contributory or no role in the fatality...
May 23, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28543519/a-new-treatment-of-sepsis-caused-by-veillonella-parvula-a-case-report-and-literature-review
#20
J Li, P Chen, J Li, X Gao, X Chen, J Chen
WHAT IS KNOWN AND OBJECTIVES: Veillonella parvula is usually regarded as a contaminant bacteria associated with polymicrobial infection. Here we report a rare case of sepsis caused by V. parvula, which was successfully treated by chloramphenicol. In addition, the therapeutic strategy for V. parvula infection was reviewed. CASE SUMMARY: A 55-year-old woman underwent surgery for lumbar spinal stenosis and developed high fever (39.5°C) after surgery, accompanied by chills and fatigue...
May 23, 2017: Journal of Clinical Pharmacy and Therapeutics
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