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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/28728102/uterine-necrosis-following-a-combination-of-uterine-compression-sutures-and-vascular-ligation-during-a-postpartum-hemorrhage-a-case-report
#2
Saad Benkirane, Hanane Saadi, Badr Serji, Ahmed Mimouni
INTRODUCTION: The Postpartum bleeding is the first cause of maternal mortality in Morocco. It is an obstetrical emergency that requires a fast multimodal management including medical care, interventional procedure and in few cases a salvatory surgery. CLINICAL CASE: We report a rare case of uterine necrosis following postpartum hemorrhage, refractory to medical therapy, and which was controlled by a combination of uterine hemostatic techniques and vascular ligation three days after surgery, the patient developed a fever (39°C)...
July 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28728072/postmortem-diagnosis-of-sepsis-a-preliminary-immunohistochemical-study-with-an-anti-procalcitonin-antibody
#3
Aniello Maiese, Franca Del Nonno, Marco Dell'Aquila, Mario Moauro, Andrea Baiocchini, Antonio Mastracchio, Giorgio Bolino
No abstract text is available yet for this article.
July 13, 2017: Legal Medicine
https://www.readbyqxmd.com/read/28727802/diagnostic-accuracy-of-procalcitonin-neutrophil-lymphocyte-count-ratio-c-reactive-protein-and-lactate-in-patients-with-suspected-bacterial-sepsis
#4
Lars Ljungström, Anna-Karin Pernestig, Gunnar Jacobsson, Rune Andersson, Barbara Usener, Diana Tilevik
BACKGROUND: Early recognition is a key factor to achieve improved outcomes for septic patients. Combinations of biomarkers, as opposed to single ones, may improve timely diagnosis and survival. We investigated the performance characteristics of sepsis biomarkers, alone and in combination, for diagnosis of verified bacterial sepsis using Sepsis-2 and Sepsis-3 criteria, respectively. METHODS: Procalcitonin (PCT), neutrophil-lymphocyte count ratio (NLCR), C-reactive protein (CRP), and lactate were determined in a total of 1,572 episodes of adult patients admitted to the emergency department on suspicion of sepsis...
2017: PloS One
https://www.readbyqxmd.com/read/28727676/association-between-diabetes-mellitus-and-outcomes-of-patients-with-sepsis-a-meta-analysis
#5
Zhiwei Wang, Jianan Ren, Gefei Wang, Qinjie Liu, Kun Guo, Jieshou Li
BACKGROUND Diabetes mellitus (DM) is a critical medical problem that can make people more likely to develop infectious complications, even sepsis. However, the influence of DM on the outcomes of septic patients is still controversial. Thus, we conducted the present meta-analysis to investigate whether DM worsens outcomes of septic patients. MATERIAL AND METHODS We searched studies from PubMed, Embase, and Cochrane Library databases from 1966 to July 1, 2016. The primary outcome we chose was 28-day or 30-day mortality or in-hospital mortality...
July 20, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28727607/new-onset-heart-failure-and-mortality-in-hospital-survivors-of-sepsis-related-left-ventricular-dysfunction
#6
Saraschandra Vallabhajosyula, Jacob C Jentzer, Jeffrey B Geske, Mukesh Kumar, Ankit Sakhuja, Akhil Singhal, Joseph T Poterucha, Kianoush Kashani, Joseph G Murphy, Ognjen Gajic, Rahul Kashyap
BACKGROUND: The association between new-onset left ventricular (LV) dysfunction during sepsis with long-term heart failure outcomes is lesser understood. METHODS: Retrospective cohort study of all adult patients with severe sepsis and septic shock between 2007 and 2014 that underwent echocardiography within 72 hours admitted to the intensive care unit. Patients with prior heart failure, LV dysfunction, and structural heart disease were excluded. LV systolic dysfunction was defined as LV ejection fraction <50% and LV diastolic dysfunction as ≥grade II...
July 19, 2017: Shock
https://www.readbyqxmd.com/read/28727130/the-utility-of-maternal-mean-platelet-volume-levels-for-early-onset-neonatal-sepsis-prediction-of-term-infants
#7
Yasemin Cekmez, Merve Dizdar Güleçoğlu, Cemile Özcan, Leyla Karadeniz, Gürkan Kıran
OBJECTIVES: This study is aimed to evaluate the role of maternal mean platelet volume (MPV) levels for antenatal prediction marker of early onset neonatal sepsis in term infants born to mothers who have low infection risk. MATERIAL AND METHODS: A total of 62 pregnant women who gave birth in our hospital and whose neonates were admitted to a third level Neonatal Intensive Care Unit due to confirmed neonatal sepsis between January 2010 and May 2016 were selected as a study group...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28726607/acute-febrile-illness-and-complications-due-to-murine-typhus-texas-usa1-2
#8
Zeeshan Afzal, Sunand Kallumadanda, Feng Wang, Vagish Hemmige, Daniel Musher
Murine typhus occurs relatively commonly in southern Texas, as well as in California. We reviewed records of 90 adults and children in whom murine typhus was diagnosed during a 3-year period in 2 hospitals in southern Texas, USA. Most patients lacked notable comorbidities; all were immunocompetent. Initial signs and symptoms included fever (99%), malaise (82%), headache (77%), fatigue (70%), myalgias (68%), and rash (39%). Complications, often severe, in 28% of patients included bronchiolitis, pneumonia, meningitis, septic shock, cholecystitis, pancreatitis, myositis, and rhabdomyolysis; the last 3 are previously unreported in murine typhus...
August 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28726327/changing-metrics-of-organ-procurement-organization-performance-in-order-to-increase-organ-donation-rates-in-the-united-states
#9
D Goldberg, M J Kallan, L Fu, M Ciccarone, J Ramirez, P Rosenberg, J Arnold, G Segal, K P Moritsugu, H Nathan, R Hasz, P L Abt
The shortage of deceased-donor organs is compounded by donation metrics that fail to account for the total pool of possible donors, leading to ambiguous donor statistics. We sought to assess potential metrics of organ procurement organizations (OPOs) utilizing data from the Nationwide Inpatient Sample (NIS) from 2009-2012 and State Inpatient Databases (SIDs) from 2008-2014. A possible donor was defined as a ventilated inpatient death ≤75 years of age, without multi-organ system failure, sepsis, or cancer, whose cause of death was consistent with organ donation...
July 20, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28726146/an-odyssey-of-complications-from-band-to-sleeve-to-bypass-definitive-laparoscopic-completion-gastrectomy-with-distal-esophagectomy-and-esophagojejunostomy-for-persistent-leak
#10
Hideo Takahashi, Andrew T Strong, Alfredo D Guerron, John H Rodriguez, Matthew Kroh
INTRODUCTION: Anastomotic leaks are uncommon yet potentially devastating complications after bariatric surgery. While the initial management includes resuscitation and sepsis control, the definitive management often requires endoscopic or surgical interventions. Surgical revision of the initial surgery may be necessary for chronic non-healing fistula. PATIENTS AND METHODS: The patient is a 45-year-old female with history of laparoscopic adjustable gastric banding who underwent band removal and conversion to a sleeve gastrectomy (SG) due to her failed weight loss, which resulted in a leak at gastroesophageal junction...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28726118/epidural-steroid-injection-related-events-requiring-hospitalisation-or-emergency-room-visits-among-52-935-procedures-performed-at-a-single-centre
#11
Joon Woo Lee, Eugene Lee, Guen Young Lee, Yusuhn Kang, Joong Mo Ahn, Heung Sik Kang
OBJECTIVES: To analyse the incidence and type of epidural steroid injection (ESI)-related adverse events, including procedure-related complications and drug-related systemic effects requiring hospitalisation or emergency room (ER) visits. METHODS: This study included 52,935 ESI procedures performed in 22,059 patients in our department from March 2004 to February 2016. Of these, we retrospectively reviewed the cases of 1570 patients (1713 procedures) who were hospitalised or visited the ER within 1 month after ESI...
July 19, 2017: European Radiology
https://www.readbyqxmd.com/read/28724977/therapeutic-targeting-of-hmgb1-during-experimental-sepsis-modulates-the-inflammatory-cytokine-profile-to-one-associated-with-improved-clinical-outcomes
#12
Natalie E Stevens, Marianne J Chapman, Cara K Fraser, Tim R Kuchel, John D Hayball, Kerrilyn R Diener
Sepsis remains a significant health burden and a major clinical need exists for therapeutics to dampen the excessive and uncontrolled immune activation. Nuclear protein high mobility group box protein 1 (HMGB1) is released following cell death and is a late mediator in sepsis pathogenesis. While approaches targeting HMGB1 have demonstrated reduced mortality in pre-clinical models of sepsis, the impact of HMGB1 blockade on the complex septic inflammatory milieu and the development of subsequent immunosuppression remain enigmatic...
July 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28724597/multifocal-septic-arthritis-gluteal-abscess-and-spondylodiscitis-by-streptococcus-dysgalactiae-subspecies-equisimilis-after-an-intramuscular-injection
#13
Rita Marques Pocinho, Liliana Antunes, Pedro Pires, Isabel Baptista
We present the case of a 63-year-old man, admitted for hand cellulitis and acute kidney injury. A Streptococcus dysgalactiae subsp equisimilis (SDSE) was isolated in blood cultures and despite directed intravenous antibiotherapy, the patient evolved unfavourably, with dorsolumbar spondylodiscitis, multifocal septic arthritis and abscesses. CT also showed densification of the gluteal muscles, multiple air bubbles in the psoas, paraspinal muscles and spinal canal that were associated with an intramuscular injection administered 1 week earlier for a backache...
July 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28724580/il-7-restores-t-lymphocyte-immunometabolic-failure-in-septic-shock-patients-through-mtor-activation
#14
Fabienne Venet, Julie Demaret, Benjamin J Blaise, Christelle Rouget, Thibaut Girardot, Estellie Idealisoa, Thomas Rimmelé, François Mallet, Alain Lepape, Julien Textoris, Guillaume Monneret
T lymphocyte alterations are central to sepsis pathophysiology, whereas related mechanisms remain poorly understood. We hypothesized that metabolic alterations could play a role in sepsis-induced T lymphocyte dysfunction. Samples from septic shock patients were obtained at day 3 and compared with those from healthy donors. T cell metabolic status was evaluated in the basal condition and after T cell stimulation. We observed that basal metabolic content measured in lymphocytes by nuclear magnetic resonance spectroscopy was altered in septic patients...
July 19, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28724325/use-and-timing-of-surfactant-administration-impact-on-neonatal-outcomes-in-extremely-low-gestational-age-infants-born-in-canadian-neonatal-intensive-care-units
#15
Amelie Stritzke, Khorshid Mohammad, Prakesh S Shah, Xiang Y Ye, Vineet Bhandari, Albert Akierman, Adele Harrison, Valerie Bertelle, Abhay Lodha
BACKGROUND: Use, timing and doses of surfactant in preterm infants are variable in practice in modern NICUs. OBJECTIVE: To explore the association between use and timing of surfactant administration and common neonatal adverse outcomes in preterm infants with gestational age (GA) < 28 weeks. MATERIAL AND METHODS: Neonates admitted to a participating Canadian Neonatal Network NICU between 2013 and 2015 were studied. Infants were divided into three groups based on surfactant administration: None, early (within 30 minutes of life), and late surfactant (> 30 minutes)...
July 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28724127/in-treating-sepsis-questions-about-timing-and-mandates
#16
Jennifer Abbasi
No abstract text is available yet for this article.
July 19, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28724042/hyperglycemia-in-critical-patients-determinants-of-insulin-dose-choice
#17
Aline Klitzke Paliosa, Cassiano Teixeira, Regis Goulart Rosa, Carine Raquel Blatt
Objective: To identify factors that can determine the choice of intermittent subcutaneous regular insulin dose in critically ill patients with hyperglycemia. Method: Cross-sectional study in a general adult ICU with 26 beds, data collected between September and October 2014. The variables analyzed were: sex, age, previous diagnosis of diabetes mellitus, use of corticosteroids, use of lactulose, sepsis, fasting, enteral nutrition, use of dextrose 5% in water, NPH insulin prescription and blood glucose level...
May 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28723551/understanding-immunosuppression-after-sepsis
#18
Fatemeh Fattahi, Peter A Ward
Following a severe primary infection or trauma, the risk of developing pneumonia increases due to acquired immune defects collectively known as sepsis-induced immunosuppression. In this issue of Immunity, Roquilly et al. (2017) show that dendritic cells and macrophages developing in the lung after the resolution of a severe infection acquire tolerogenic properties that contribute to persistent immunosuppression and susceptibility to secondary infections.
July 18, 2017: Immunity
https://www.readbyqxmd.com/read/28723546/local-modulation-of-antigen-presenting-cell-development-after-resolution-of-pneumonia-induces-long-term-susceptibility-to-secondary-infections
#19
Antoine Roquilly, Hamish E G McWilliam, Cedric Jacqueline, Zehua Tian, Raphael Cinotti, Marie Rimbert, Linda Wakim, Irina Caminschi, Mireille H Lahoud, Gabrielle T Belz, Axel Kallies, Justine D Mintern, Karim Asehnoune, Jose A Villadangos
Lung infections cause prolonged immune alterations and elevated susceptibility to secondary pneumonia. We found that, after resolution of primary viral or bacterial pneumonia, dendritic cells (DC), and macrophages exhibited poor antigen-presentation capacity and secretion of immunogenic cytokines. Development of these "paralyzed" DCs and macrophages depended on the immunosuppressive microenvironment established upon resolution of primary infection, which involved regulatory T (Treg) cells and the cytokine TGF-β...
July 18, 2017: Immunity
https://www.readbyqxmd.com/read/28723479/infectious-complications-of-circumcision-and-their-prevention
#20
REVIEW
Itzhak Brook
CONTEXT: A growing body of evidence supports the health benefits of circumcision, but the occurrence of infectious complications is of concern. OBJECTIVE: To review literature presenting past data and studies of infectious complications of circumcision and their prevention. EVIDENCE ACQUISITION: A literature search was conducted of the Cochrane Library, Embase, Turning Research into Practice, PubMed, and Medline databases from their inception through June 25, 2015...
October 2016: European Urology Focus
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