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Sepsis obesity

Richard H Savel, Ronald J Simon, Yizhak Kupfer
No abstract text is available yet for this article.
November 2016: Critical Care Medicine
Tracey Ying, Samantha Chan, Stephen Lane, Christine Somerville
AIM: To identify risk factors for acute kidney injury following major orthopaedic surgery. METHODS: We included all patients undergoing major orthopaedic surgery at University Hospital Geelong between 2008 and 2014 in the study. Out of 2188 surgeries audited, we identified cases of acute kidney injury using the RIFLE criteria and matched those to controls 2:1 for age, sex, procedure and chronic kidney disease stage. We reviewed their records for risk factors of postoperative acute kidney injury, including medications such as gentamicin, diuretics, non-steroidal anti-inflammatory drugs and angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use...
October 5, 2016: Nephrology
Hayato Yamashita, Michiko Ishikawa, Taketo Inoue, Makoto Usami, Yu Usami, Joji Kotani
BACKGROUND: Dysregulation of glucose metabolism, including hyperglycemia with insulin resistance, is commonly observed in critically ill patients. Interleukin-18 (IL-18) improves the insulin resistance associated with obesity, but the relationship between IL-18 and glucose metabolism in sepsis was unclear. The purpose of this study was to investigate the influence of IL-18 on hyperglycemia during sepsis. METHODS: Sepsis was induced using cecal ligation and puncture (CLP) in wild type (WT) mice, IL-18 knockout (KO) mice, and IL-18 KO mice pretreated with recombinant IL-18...
September 19, 2016: Shock
Fabricia Petronilho, Amanda Della Giustina, Diego Zapelini Nascimento, Graciela Freitas Zarbato, Andriele Aparecida Vieira, Drielly Florentino, Lucinéia Gainski Danielski, Mariana Pereira Goldim, Gislaine Tezza Rezin, Tatiana Barichello
Sepsis progression is linked to the imbalance between reactive oxygen species and antioxidant enzymes. Sepsis affects multiple organs, but when associated with a chronic inflammatory disease, such as obesity, it may be exacerbated. We hypothesized that obesity could aggravate the oxidative damage to peripheral organs of rats submitted to an animal model of sepsis. Male Wistar rats aged 8 weeks received hypercaloric nutrition for 2 months to induce obesity. Sepsis was induced by cecal ligation and puncture (CLP) procedure, and sham-operated rats were considered as control group...
September 19, 2016: Inflammation
Alexander Koch, Ralf Weiskirchen, Sebastian Ludwig, Lukas Buendgens, Jan Bruensing, Eray Yagmur, Christer Baeck, Ulf Herbers, Christian Trautwein, Frank Tacke
PURPOSE: Sclerostin is a negative regulator of bone metabolism and associated with chronic morbidities. We investigated circulating sclerostin in critically ill patients. METHODS: A total of 264 patients (170 with sepsis) were studied prospectively upon admission to the medical intensive care unit (ICU) and on day 7. Patients' survival was followed for up to 3 years. RESULTS: Sclerostin serum levels were significantly elevated in critically ill patients at ICU admission compared with 99 healthy controls...
August 22, 2016: Journal of Critical Care
Xianfeng Wang, Nancy L Buechler, Ayana Martin, Jonathan Wells, Barbara Yoza, Charles E McCall, Vidula Vachharajani
OBJECTIVE: Obesity increases morbidity and resource utilization in sepsis patients. Sepsis transitions from early/hyper-inflammatory to late/hypo-inflammatory phase. Majority of sepsis-mortality occurs during the late sepsis; no therapies exist to treat late sepsis. In lean mice, we have shown that sirtuins (SIRTs) modulate this transition. Here, we investigated the role of sirtuins, especially the adipose-tissue abundant SIRT-2 on transition from early to late sepsis in obese with sepsis...
2016: PloS One
Rachel M Saroka, Michael P Kane, Lawrence Robinson, Robert S Busch
BACKGROUND: Glucocorticoid replacement is commonly required to treat secondary adrenal insufficiency after surgical resection of unilateral cortisol-secreting adrenocortical adenomas. Here, we describe a patient with unilateral cortisol-secreting adenomas in which the preoperative use of mifepristone therapy was associated with recovery of the hypothalamic-pituitary-adrenal (HPA) axis, eliminating the need for postoperative glucocorticoid replacement. CASE PRESENTATION: A 66-year-old Caucasian man with type 2 diabetes mellitus, hyperlipidemia, hypertension, and obesity was hospitalized for Fournier's gangrene and methicillin-resistant Staphylococcus aureus sepsis...
2016: Clinical Medicine Insights. Endocrinology and Diabetes
Marcela C Smid, Catherine J Vladutiu, Sarah K Dotters-Katz, Tracy A Manuck, Kim A Boggess, David M Stamilio
Objective To estimate the association between maternal super obesity (body mass index [BMI] ≥ 50 kg/m(2)) and neonatal morbidity among neonates born via cesarean delivery (CD). Methods Retrospective cohort of singleton neonates delivered via CD ≥ 37 weeks in the Maternal-Fetal Medicine Unit Cesarean Registry. Maternal BMI at delivery was stratified as 18.5 to 29.9 kg/m(2), 30 to 39.9 kg/m(2), 40 to 49.9 kg/m(2), and ≥ 50 kg/m(2). Primary outcomes included acute (5-minute Apgar score < 5, cardiopulmonary resuscitation and ventilator support < 24 hours, neonatal injury, and/or transient tachypnea of the newborn) and severe (grade 3 or 4 intraventricular hemorrhage, necrotizing enterocolitis, seizure, respiratory distress syndrome, hypoxic ischemic encephalopathy, meconium aspiration, ventilator support ≥ 2 days, sepsis and/or neonatal death) neonatal morbidity...
October 2016: American Journal of Perinatology
Eun Jung Park, Young Min Kim, Hye Jung Kim, Se-Yun Jang, Moo Hyun Oh, Duck-Hyung Lee, Ki Churl Chang
Obesity-associated non-alcoholic fatty liver disease (NAFLD) increases coagulation and inflammation. We hypothesized that (S)YS-51, an agent found to be beneficial in animal models of sepsis, may reduce NAFLD in high-fat diet (HFD) mice by reducing coagulation and inflammation. C57BL/6 mice were fed either a chow diet or HFD and each was supplemented with or without (S)YS-51 (10mg/kg, daily, i.p.) for 16 weeks. The results showed that HFD caused significant increases in lipogenesis [CD36, fatty acid synthase (FAS) and sterol response element binding protein (SREBP)-1c mRNA and protein], inflammation [monocyte chemotactic protein (MCP)-1, tumor necrosis factor (TNF)-α, intercellular cell adhesion molecule-1 (ICAM-1), TGF-β, and procollagen type 1 mRNA, macrophage infiltration] and coagulation [tissue factor (TF) and plasminogen activator inhibitor-1 (PAI-1) mRNA and thrombin antithrombin complex (TAT)] in the liver, adipose tissue and serum, which were significantly reduced by (S)YS-51...
October 5, 2016: European Journal of Pharmacology
Dominique J Pepper, Junfeng Sun, Judith Welsh, Xizhong Cui, Anthony F Suffredini, Peter Q Eichacker
BACKGROUND: At least 25 % of adults admitted to intensive care units (ICU) in the United States have an overweight, obese or morbidly obese body mass index (BMI). The effect of BMI on adjusted mortality in adults requiring ICU treatment for sepsis is unclear. We performed a systematic review of adjusted all-cause mortality for underweight, overweight, obese and morbidly obese BMIs relative to normal BMI for adults admitted to the ICU with sepsis, severe sepsis, and septic shock. METHOD: PubMed, the Cochrane Library, and EMBASE electronic databases were searched through November 18, 2015, without language restrictions...
2016: Critical Care: the Official Journal of the Critical Care Forum
M J Gripp, J A Gagliardi
Calciphylaxis is a rare but feared condition thought to related to derangements in calcium and phosphorus metabolism. The syndrome has a predilection for obese women receiving dialysis for chronic renal failure (1, 2). Patients develop painful violaceous lesions in the subcutis, which can lead to ulceration and wound-related sepsis. In severe cases, amputation is required for the gangrenous involved extremity (3). We present two cases of calciphylaxis with similar clinical presentations and physical findings...
2007: Radiology case reports
P Christian Schulze, Konstantinos Drosatos, Ira J Goldberg
The heart utilizes large amounts of fatty acids as energy providing substrates. The physiological balance of lipid uptake and oxidation prevents accumulation of excess lipids. Several processes that affect cardiac function, including ischemia, obesity, diabetes mellitus, sepsis, and most forms of heart failure lead to altered fatty acid oxidation and often also to the accumulation of lipids. There is now mounting evidence associating certain species of these lipids with cardiac lipotoxicity and subsequent myocardial dysfunction...
May 27, 2016: Circulation Research
Bradley S Gordon, Jennifer L Steiner, David L Williamson, Charles H Lang, Scot R Kimball
Since its discovery, the protein regulated in development and DNA damage 1 (REDD1) has been implicated in the cellular response to various stressors. Most notably, its role as a repressor of signaling through the central metabolic regulator, the mechanistic target of rapamycin in complex 1 (mTORC1) has gained considerable attention. Not surprisingly, changes in REDD1 mRNA and protein have been observed in skeletal muscle under various physiological conditions (e.g., nutrient consumption and resistance exercise) and pathological conditions (e...
July 1, 2016: American Journal of Physiology. Endocrinology and Metabolism
Rosario Pivonello, Andrea M Isidori, Maria Cristina De Martino, John Newell-Price, Beverly M K Biller, Annamaria Colao
Cushing's syndrome is a serious endocrine disease caused by chronic, autonomous, and excessive secretion of cortisol. The syndrome is associated with increased mortality and impaired quality of life because of the occurrence of comorbidities. These clinical complications include metabolic syndrome, consisting of systemic arterial hypertension, visceral obesity, impairment of glucose metabolism, and dyslipidaemia; musculoskeletal disorders, such as myopathy, osteoporosis, and skeletal fractures; neuropsychiatric disorders, such as impairment of cognitive function, depression, or mania; impairment of reproductive and sexual function; and dermatological manifestations, mainly represented by acne, hirsutism, and alopecia...
July 2016: Lancet Diabetes & Endocrinology
Jennifer M Kaplan, Marchele Nowell, Patrick Lahni, Hui Shen, Shiva K Shanmukhappa, Basilia Zingarelli
OBJECTIVE: How obesity affects the response to sepsis was not completely understood. It was hypothesized that obesity alters adipose and hepatic tissue inflammation through signal transducer and activator of transcription (STAT3) activation. METHODS: Male C57BL/6 mice at 6 weeks of age were randomized to a high-fat diet (60% kcal fat) or normal diet (16% kcal fat) for 6 to 7 weeks. Sepsis was then induced by cecal ligation and puncture, and animals were monitored for survival or sacrificed and tissue collected...
July 2016: Obesity
Mathilde Guerville, Gaëlle Boudry
The human microbiota consists of 100 trillion microorganisms that provide important metabolic and biological functions benefiting the host. However, the presence in host plasma of a gut-derived bacteria component, the lipopolysaccharide (LPS), has been identified as a causal or complicating factor in multiple serious diseases such as sepsis and septic shock and, more recently, obesity-associated metabolic disorders. Understanding the precise mechanisms by which gut-derived LPS is transported from the gut lumen to the systemic circulation is crucial to advance our knowledge of LPS-associated diseases and elaborate targeted strategies for their prevention...
July 1, 2016: American Journal of Physiology. Gastrointestinal and Liver Physiology
Anh Tuan Nguyen, Chu-Lin Tsai, Lu-Yu Hwang, Dejian Lai, Christine Markham, Bela Patel
OBJECTIVES: The objective of this study was to examine the association between obesity and all-cause mortality, length of stay and hospital cost among patients with sepsis 20 years of age or older. MATERIALS AND METHODS: It was a retrospective cohort study. The dataset was the Nationwide Inpatient Sample 2011, the largest publicly available all-payer inpatient care database in the United States. Hospitalizations of sepsis patients 20 years of age or older were included...
2016: PloS One
Ashraf Khater
Creating TRAM flap in obese patient is a challenging issue with a hazard of flap ischemia and breast envelope loss or sepsis. In this case we show our experience in doing an interval TRAM flap in markedly obese patient (BMI index 39) in the presence of Desmoid tumor of the anterior abdominal wall on top of previous mesh hernioplasty in the contralateral side of the tumor. Interval TRAM was decided with achieving of a complete vascular delay in the same sitting with skin sparing mastectomy. On doing abdominal ultrasonography for perforator mapping a desmoid tumor was encountered in the contralateral side...
December 2015: Indian Journal of Surgical Oncology
Henry E Wang, John P Donnelly, Russell Griffin, Emily B Levitan, Nathan I Shapiro, George Howard, Monika M Safford
OBJECTIVE: We sought to derive and internally validate a Sepsis Risk Score and a Severe Sepsis Risk Score predicting future sepsis and severe sepsis events among community-dwelling adults. DESIGN: National population-based cohort. SETTING: United States. SUBJECTS: A total of 30,239 community-dwelling adults 45 years old or older in the national REasons for Geographic And Racial Differences in Stroke cohort. INTERVENTIONS: None...
July 2016: Critical Care Medicine
Ragesh B Thandassery, Aldo J Montano-Loza
Most widely recognized complications in cirrhotic patients include ascites, hepatic encephalopathy, variceal bleeding, kidney dysfunction, and hepatocellular carcinoma; however, malnutrition and muscle wasting (sarcopenia) constitute common complications which negatively impact survival, quality of life, and response to stressors, such as infection and surgery in patients with cirrhosis. Despite the important role that malnutrition and sarcopenia play in the prognosis of patients with cirrhosis, they are frequently overlooked, in part because nutritional assessment can be a difficult task in patients with cirrhosis due to fluid retention and/or overweight...
June 2016: Current Treatment Options in Gastroenterology
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