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Sepsis obesity

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https://www.readbyqxmd.com/read/28423197/diabetic-kidney-transplant-recipients-impaired-infection-control-and-increased-alloreactivity
#1
Thomas Schachtner, Maik Stein, Petra Reinke
BACKGROUND: Posttransplantation diabetes mellitus (PTDM) has been associated with inferior patient and allograft outcomes. However, previous studies didn't identify differences in infection control and alloreactivity. METHODS: We studied 449 kidney transplant recipients (KTRs) between 2005 and 2013. 50 (11.1%) KTRs were diagnosed with PTDM and 60 (13.4%) KTRs with pre-existing diabetes. Samples were collected pretransplantation, at +1, +2, +3 months posttransplantation...
April 19, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28333140/metabolic-and-molecular-insights-into-an-essential-role-of-nicotinamide-phosphoribosyltransferase
#2
Li Q Zhang, Leon Van Haandel, Min Xiong, Peixin Huang, Daniel P Heruth, Charlie Bi, Roger Gaedigk, Xun Jiang, Ding-You Li, Gerald Wyckoff, Dmitry N Grigoryev, Li Gao, Linheng Li, Min Wu, J Steven Leeder, Shui Qing Ye
Nicotinamide phosphoribosyltransferase (NAMPT) is a pleiotropic protein implicated in the pathogenesis of acute respiratory distress syndrome, aging, cancer, coronary heart diseases, diabetes, nonalcoholic fatty liver disease, obesity, rheumatoid arthritis, and sepsis. However, the underlying molecular mechanisms of NAMPT in these physiological and pathological processes are not fully understood. Here, we provide experimental evidence that a Nampt gene homozygous knockout (Nampt(-/-)) resulted in lethality at an early stage of mouse embryonic development and death within 5-10 days in adult mice accompanied by a 25...
March 23, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/28324798/conservative-management-of-an-unusual-bilioduodenal-fistula-post-laparoscopic-duodeno-ileal-switch-sadi-s-case-report
#3
E Chelala, E Adam, A Rizk, E Makhoul
INTRODUCTION: Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is an advanced operation for morbid obesity. To our knowledge, no internal Biliodigestive Fistula has yet been reported as specific complication in the field of metabolic and bariatric Biliopancreatic diversion. CASE PRESENTATION: In this case report, we detail the case of a 57-year-old man who underwent a Single Anastomosis Duodeno-Ileal Switch (SADI-S) bariatric procedure for morbid obesity...
March 6, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28323791/obesity-is-associated-with-high-peri-operative-complications-among-surgically-treated-intertrochanteric-fracture-of-the-femur
#4
Harish Kempegowda, Raveesh Richard, Amrut Borade, Akhil Tawari, Graham Jove, Michael Suk, Abby Howenstein, Erik N Kubiak, Vanessa Rojas Sotomayor, Kenneth Koval, Frank A Liporace, Nirmal Tejwani, Daniel S Horwitz
OBJECTIVES: The purpose of this study was to document the complications among obese patients who underwent surgical fixation for intertrochanteric femur fractures and to compare with non-obese patients. DESIGN: Retrospective cohort study SETTING:: Four level I trauma centers. PATIENTS: 1078 intertrochanteric femur fracture patients INTERVENTIONS:: None MAIN OUTCOME MEASURES:: Patient and fracture characteristics, surgical duration, surgical delay intra-operative and post-operative complications, inpatient mortality and length of stay...
March 8, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28296035/sepsis-after-renal-transplantation-clinical-immunological-and-microbiological-risk-factors
#5
Thomas Schachtner, Maik Stein, Petra Reinke
BACKGROUND: As immunosuppressive therapy and allograft survival have improved, the increased incidence of sepsis has become a major hurdle of disease-free survival after renal transplantation. METHODS: We identified 112 of 957 kidney transplant recipients (KTRs) with sepsis. 31 KTRs developed severe sepsis or septic shock, and 30 KTRs died from sepsis. KTRs without sepsis were used for comparison. CMV-specific and alloreactive T-cells were measured using an interferon-γ Elispot-assay...
March 11, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28240688/repeated-piperacillin-tazobactam-plasma-concentration-measurements-in-severely-obese-versus-nonobese-critically-ill-septic-patients-and-the-risk-of-under-and-overdosing
#6
Boris Jung, Martin Mahul, Dominique Breilh, Rachel Legeron, Jeremy Signe, Helene Jean-Pierre, Anne-Catrin Uhlemann, Nicolas Molinari, Samir Jaber
OBJECTIVE: Obesity and critical illness modify pharmacokinetics of antibiotics, but piperacillin-tazobactam continuous IV infusion pharmacokinetics has been poorly studied in obese critically ill patients. We aimed to compare pharmacokinetics of piperacillin in severely obese and nonobese patients with severe sepsis or septic shock. We hypothesized that plasma concentration variability would expose the critically ill to both piperacillin under and overdosing. METHODS: Prospective comparative study...
May 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28099093/patients-with-infectious-endocarditis-and-drug-dependence-have-worse-clinical-outcomes-after-valvular-surgery
#7
Anthony Lemaire, Viktor Dombrovskiy, Siavash Saadat, George Batsides, Aziz Ghaly, Alan Spotnitz, Leonard Y Lee
BACKGROUND: Patients with infective endocarditis (IE) are at high risk for post-operative morbidity and death, which might be associated with drug abuse. The purpose of this study is to evaluate the impact of drug dependence on outcomes in patients who have IE and undergo valvular surgery (VS). PATIENTS AND METHODS: The Nationwide/National Inpatient Sample 2001-2012 was queried to select patients with IE who had elective VS using International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis and procedure codes...
April 2017: Surgical Infections
https://www.readbyqxmd.com/read/28079244/preoperative-multidisciplinary-program-for-bariatric-surgery-a-proposal-for-the-brazilian-public-health-system
#8
Elinton Adami Chaim, José Carlos Pareja, Martinho Antonio Gestic, Murillo Pimentel Utrini, Everton Cazzo
BACKGROUND: - Bariatric surgery has become the gold standard treatment for morbid obesity, but access to surgery remains difficult and low compliance to postoperative follow-up is common. To improve outcomes, enable access and optimize follow-up, we developed a multidisciplinary preoperative approach for bariatric surgery. OBJECTIVE: - To determine the impact of this program in the outcomes of bariatric surgery in the Brazilian public health system. METHODS: - A prospective evaluation of the individuals who underwent a preoperative multidisciplinary program for bariatric surgery and comparison of their surgical outcomes with those observed in the prospectively collected historical database of the individuals who underwent surgery before the beginning of the program...
January 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28012327/incarcerated-and-eventrated-abdominal-wall-hernia-reconstruction-with-autologous-double-layer-dermal-graft-in-the-field-of-purulent-peritonitis-a-case-report
#9
Gábor Martis, Máté Rózsahegyi, János Deák, László Damjanovich
INTRODUCTION: Double-layer dermal grafts are used for the management of complicated abdominal wall hernias in obese, high risk patients. The method has not yet been used in case of emergency in septic/dirty environment. CASE REPORT: A 76-year old female patient (BMI 36.7kg/m(2)) was admitted with mechanical bowel obstruction and sepsis caused by a third time recurred, incarcerated and eventrated abdominal wall hernia. During the emergency surgery perforation of the terminal ileum and the ascending colon was detected, along with a feculent peritonitis and extended abdominal wall necrosis...
December 6, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27925869/endovascular-management-of-infected-iliofemoral-pseudoaneurysms-a-systematic-review
#10
Konstantinos G Moulakakis, Vangelis G Alexiou, George S Sfyroeras, John Kakisis, Andreas Lazaris, Spyridon N Vasdekis, Elias N Brountzos, George Geroulakos
We conducted a systematic review regarding the efficacy and outcome of endovascular treatment of infected iliofemoral arterial pseudoaneurysms with covered stents. 35 cases were identified, including 5 own. 22 pseudoaneurysms were located in the femoral area and 13 in the iliac vessels. The most commonly reported complaints were pulsatile groin mass (40 %), sepsis (37.1 %), active bleeding (31.4 %), and groin infection with purulent discharge (17.1 %). S. aureus (65.7 %) and Streptococcus species (22.9 %) were the most common microbes isolated...
December 7, 2016: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27909996/modelling-the-cost-effectiveness-of-human-milk-and-breastfeeding-in-preterm-infants-in-the-united-kingdom
#11
James Mahon, Lindsay Claxton, Hannah Wood
OBJECTIVES: To estimate the cost savings and health benefits in the UK NHS that could be achieved if human milk usage in the NICU was increased. METHODS: A systematic review established the disease areas with the strong sources of evidence of the short, medium and long-term benefits of human milk for preterm infants as opposed to the use of formula milk. The analysis assessed the economic impact of reducing rates of necrotising enterocolitis, sepsis, sudden infant death syndrome, leukaemia, otitis media, obesity and neurodevelopmental impairment...
December 2016: Health Economics Review
https://www.readbyqxmd.com/read/27908330/sepsis-in-special-populations
#12
REVIEW
Matthew P Borloz, Khalief E Hamden
Sepsis is recognized by the presence of physiologic and laboratory changes that reflect the inflammatory response to infection on cellular and systemic levels. Comorbid conditions, such as cirrhosis, end-stage renal disease, and obesity, alter patients' susceptibility to infection and their response to it once present. Baseline changes in vital signs and chronic medications often mask clues to the severity of illness. The physiologic, hematologic, and biochemical adjustments that accompany pregnancy and the puerperium introduce similar challenges...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27897405/premorbid-obesity-but-not-nutrition-prevents-critical-illness-induced-muscle-wasting-and-weakness
#13
Chloë Goossens, Mirna Bastos Marques, Sarah Derde, Sarah Vander Perre, Thomas Dufour, Steven E Thiessen, Fabian Güiza, Thomas Janssens, Greet Hermans, Ilse Vanhorebeek, Katrien De Bock, Greet Van den Berghe, Lies Langouche
BACKGROUND: The 'obesity paradox' of critical illness refers to better survival with a higher body mass index. We hypothesized that fat mobilized from excess adipose tissue during critical illness provides energy more efficiently than exogenous macronutrients and could prevent lean tissue wasting. METHODS: In lean and premorbidly obese mice, the effect of 5 days of sepsis-induced critical illness on body weight and composition, muscle wasting, and weakness was assessed, each with fasting and parenteral feeding...
February 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/27878212/obesity-paradox-obesity-orthodox-and-the-metabolic-syndrome-an-approach-to-unity
#14
Jesse Roth, Navneet Sahota, Priya Patel, Syed Faizan Mehdi, Mohammad Masum Wiese, Hafiz B Mahboob, Michelle Bravo, Daniel J Eden, Muhammad A Bashir, Amrat Kumar, Farah Alsaati, Irwin J Kurland, Wunnie Brima, Ann Danoff, Alessandra L Szulc, Valentin A Pavlov, Kevin J Tracey, Huan Yang
Obesity and the accompanying metabolic syndrome are strongly associated with heightened morbidity and mortality in older adults. In our review of more than 20 epidemiologic studies of major infectious diseases, including leaders such as tuberculosis, community-acquired pneumonia, and sepsis, obesity was associated with better outcomes. A cause-and-effect relationship between over-nutrition and survival with infection is suggested by results of two preliminary studies of infections in mice, where high fat feeding for 8-10 weeks provided much better outcomes...
November 16, 2016: Molecular Medicine
https://www.readbyqxmd.com/read/27851006/1370-volume-administration-and-outcomes-in-obese-patients-with-sepsis-in-the-era-of-protocolized-care
#15
Brice Taylor, Edwin Gunn, Megan Templin, Colleen Karvestski, Stephanie Taylor
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850993/1357-the-effect-of-obesity-on-mortality-in-trauma-patients-with-sepsis
#16
Michael Walsh, Brandon Hobbs, Amanda Giancarelli, Indermeet Bhullar
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27822672/obesity-acute-kidney-injury-and-outcome-of-critical-illness
#17
REVIEW
Helmut Schiffl, Susanne M Lang
Acute kidney injury is a heterogeneous clinical syndrome encompassing a spectrum of risk factors and acute insults, occurring in multiple settings and affecting both short-term and long-term outcomes. Obesity has become an epidemic. The available literature suggests that AKI is common in critically ill surgical or medical obese patients and that obesity is a novel risk factor for this acute renal syndrome. The pathophysiology of obesity-associated AKI is not completely understood. Obesity-related factors combined with the burden of other comorbidities in elderly obese patients may interact with known precipitating factors such as hypotension, nephrotoxins or sepsis and increase the susceptibility of this population to AKI...
November 7, 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/27812378/the-clinical-characteristics-and-hospital-and-post-hospital-survival-of-patients-with-the-obesity-hypoventilation-syndrome-analysis-of-a-large-cohort
#18
P E Marik, C Chen
OBJECTIVE: The worldwide prevalence of obesity has reached epidemic proportions. Obesity hypoventilation syndrome (OHS) is a common yet largely undiagnosed and mistreated condition that likely carries a high mortality. The aim of this study was to determine the clinical characteristics, hospital outcome, outcome following hospital discharge and predictors of death in a large cohort of patients hospitalized with OHS. OHS is an important condition as many patients with this syndrome are misdiagnosed and receive inappropriate treatment...
March 2016: Obesity Science & Practice
https://www.readbyqxmd.com/read/27789087/adipose-tissue-at-the-nexus-of-systemic-and-cellular-immunometabolism
#19
REVIEW
Ayano C Kohlgruber, Nelson M LaMarche, Lydia Lynch
At the simplest interpretation of the word, Immunometabolism describes the intersection of the fields of immunology and metabolism. With rapidly growing interest in this field, the term has expanded, and now encompasses a variety of concepts and definitions shaped by an individual's scientific area of expertise, cell-type and tissue of interest, and biological approach. One scientist may be interested in investigating the intrinsic metabolic checkpoints that drive a M1 versus M2 macrophage response, while another may be interested in how macrophages affect systemic metabolism during obesity...
October 2016: Seminars in Immunology
https://www.readbyqxmd.com/read/27785087/adiponectin-treatment-attenuates-inflammatory-response-during-early-sepsis-in-obese-mice
#20
XianFeng Wang, Nancy L Buechler, Barbara K Yoza, Charles E McCall, Vidula Vachharajani
BACKGROUND: Morbid obesity increases the cost of care in critically ill patients. Sepsis is the leading cause of death in noncoronary intensive care units. Circulating cell-endothelial cell interactions in microcirculation are the rate-determining factors in any inflammation; obesity increases these interactions further. Adiponectin deficiency is implicated in increased cardiovascular risk in obese patients. We have shown that adiponectin deficiency increases microvascular dysfunction in early sepsis...
2016: Journal of Inflammation Research
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