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Sepsis, ards, pneumonia, infection,

Devin M Boe, Lisbeth A Boule, Elizabeth J Kovacs
The world is undergoing an unprecedented shift in demographics, with the number of individuals over the age of 60 projected to reach 2 billion or more by 2050, representing 22% of the global population. The elderly are at a higher risk for chronic disease and more susceptible to infection, due in part to age-related dysfunction of the immune system resulting from low-grade chronic inflammation known as "inflamm-aging". The innate immune system of older individuals exhibits a diminished ability to respond to microbial threats and clear infections, resulting in a greater occurrence of many infectious diseases in the elderly...
October 6, 2016: Clinical and Experimental Immunology
M S Reich, A J Dolenc, T A Moore, H A Vallier
BACKGROUND: Previous work established resuscitation parameters that minimize complications with early fracture management. This Early Appropriate Care (EAC) protocol was applied to patients with advanced age to determine if they require unique parameters to mitigate complications. METHODS: Between October 2010 and March 2013, 376 consecutive skeletally mature patients with unstable fractures of the pelvis, acetabulum, thoracolumbar spine, and/or proximal or diaphyseal femur fractures were treated at a level I trauma center and were prospectively studied...
September 26, 2016: Journal of Orthopaedic Surgery and Research
Rakesh Bhadade, Rosemarie de'Souza, Minal Harde, Dileep Asgaonkar, Nilesh Tuplondhe
BACKGROUND: Acute respiratory distress syndrome (ARDS) is a clinical syndrome of severe dyspnoea of rapid onset, hypoxemia, and diffuse pulmonary infiltrates leading to respiratory failure in the absence of cardiac failure. We did the study to asses various aetiologies of ARDS, to determine the correlation between the diagnostic criteria, mortality predictors, need of mechanical ventilation and the outcome of patients. This was an observational, prospective study in medical intensive care unit (MICU) of a tertiary care hospital, over a period of 15 months...
November 2015: Journal of the Association of Physicians of India
Niteen D Karnik, Anish V Gupta
Acute respiratory distress syndrome (ARDS) is a fulminant clinical disorder of varied etiology, characterized by diffuse lung injury and severe hypoxemia. It is a leading cause of ICU admission and the associated high mortality has sparked a lot of research on etiology, outcome, scoring systems, mortality predictors, biomarkers including inflammatory cytokines and even genomics in ARDS. The previously used AECC (American European Consensus Conference) definition (1994) of ARDS was replaced by the recent Berlin definition (2012) so as to improve its validity and reliability...
November 2015: Journal of the Association of Physicians of India
Verónica Giubergia, Florencia Alessandrini, Carolina Barrias, Carlos Giuseppucci, Aixa Reusmann, Marcelo Barrenechea, Claudio Castaños
BACKGROUND AND OBJECTIVE: Pneumonectomy (PNE) is a procedure infrequently performed in children. A high morbidity/mortality rate associated with PNE has been described. Few series have been published in the last 15 years. Risk factors associated with morbidity/mortality after PNE were evaluated. Indications, course, survival and complications of PNE in children were also analized. METHODS: In a case series of 51 children who underwent PNE, death within 30 days of surgery, pneumonia, empyema, sepsis, adult respiratory distress syndrome, bronchopleural fistula, bleeding, pneumothorax and post-PNE syndrome were considered major morbidities...
August 10, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Benjamin R Childs, Nickolas J Nahm, Timothy A Moore, Heather A Vallier
OBJECTIVES: To compare single versus multiple procedures in the same surgical setting. We hypothesized that complication rates would not be different and length of stay would be shorter in patients undergoing multiple procedures. DESIGN: Prospective, cohort. SETTING: Level 1 trauma center. PATIENTS/PARTICIPANTS: A total of 370 patients with high-energy fractures were treated after a standard protocol for resuscitation to lactate <4...
August 2016: Journal of Orthopaedic Trauma
Djillali Annane
Sepsis is a common disorder associated with high morbidity and mortality. It is now defined as an abnormal host response to infection, resulting in life-threatening dysfunction of organs. There is evidence from in vitro and in vivo experiments in various animal models and in patients that endotoxin or sepsis may directly and indirectly alter the hypothalamic-pituitary-adrenal response to severe infection. These alterations may include necrosis or hemorrhage or inflammatory mediator-mediated decreased ACTH synthesis, steroidogenesis, cortisol delivery to tissues, clearance from plasma, and decreased sensitivity of tissues to cortisol...
2016: Frontiers in Endocrinology
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
Srujana Mohanty, Gourahari Pradhan, Manoj Kumar Panigrahi, Prasanta Raghab Mohapatra, Baijayantimala Mishra
Melioidosis, caused by the environmental saprophyte, Burkholderia pseudomallei, is an important public health problem in Southeast Asia and Northern Australia. It is being increasingly reported from other parts, including India, China, and North and South America expanding the endemic zone of the disease. We report a case of systemic melioidosis in a 58-year-old diabetic, occupationally-unexposed male patient, who presented with chronic fever, sepsis, pneumonia, pleural effusion and subcutaneous abscess, was undiagnosed for long, misidentified as Pseudomonas aeruginosa infection elsewhere, but was saved due to correct identification of the etiologic agent and timely institution of appropriate therapy at our institute...
2016: Pneumonologia i Alergologia Polska
Alex Soroceanu, Douglas C Burton, Jonathan H Oren, Justin S Smith, Richard Hostin, Christopher I Shaffrey, Behrooz A Akbarnia, Christopher P Ames, Thomas J Errico, Shay Bess, Munish C Gupta, Vedat Deviren, Frank J Schwab, Virginie Lafage
STUDY DESIGN: Retrospective review of a prospective multi-center database evaluating surgical ASD patients. OBJECTIVE: This study aims to identify risk factors for medical complications in ASD patients undergoing surgery SUMMARY OF BACKGROUND DATA.: Adult Spinal Deformity (ASD) surgery is known for its high complication rate. This study examines baseline patient characteristics for predictors of medical complications in surgical ASD patients. METHODS: Intra and perioperative medical complications were included...
April 19, 2016: Spine
M Piastra, A Tempera, E Luca, E Buffone, C Cafforio, V Briganti, O Genovese, M Marano, D Rigante
Streptococcus pneumoniae sepsis has high morbidity, particularly if complicated by renal injury. Four patients with S. pneumonia invasive infections complicated by renal disorders are presented. The first case was an 18-month-old girl with pneumococcal empyema complicated by haemolytic uraemic (HUS) syndrome. She made a full recovery after mechanical ventilation, inotropic support and haemodiafiltration. The second was a 4-year-old boy who presented with acute post-infectious glomerulonephritis associated with bilateral pneumococcal pneumonia...
January 29, 2016: Paediatrics and International Child Health
Laurent Papazian, Carolyn S Calfee, Davide Chiumello, Charles-Edouard Luyt, Nuala J Meyer, Hiroshi Sekiguchi, Michael A Matthay, Gianfranco Umberto Meduri
Acute respiratory distress syndrome (ARDS) is defined by the association of bilateral infiltrates and hypoxaemia following an initial insult. Although a new definition has been recently proposed (Berlin definition), there are various forms of ARDS with potential differences regarding their management (ventilator settings, prone positioning use, corticosteroids). ARDS can be caused by various aetiologies, and the adequate treatment of the responsible cause is crucial to improve the outcome. It is of paramount importance to characterize the mechanisms causing lung injury to optimize both the aetiological treatment and the symptomatic treatment...
May 2016: Intensive Care Medicine
Yongan Xu, Lin Ge, Osama Abdel-Razek, Sumeet Jain, Zhiyong Liu, Yucai Hong, Gary Nieman, Francis Johnson, Lorne M Golub, Robert N Cooney, Guirong Wang
Staphylococcus aureus is a common cause of nosocomial pneumonia frequently resulting in acute respiratory distress syndrome (ARDS). Surfactant protein B (SP-B) gene expresses two proteins involved in lowering surface tension and host defense. Genotyping studies demonstrate a significant association between human SP-B genetic variants and ARDS. Curcumins have been shown to attenuate host inflammation in many sepsis models. Our hypothesis is that functional differences of SP-B variants and treatment with curcumin (CMC2...
April 2016: Shock
Djillali Annane
Neuromuscular blocking agents and corticosteroids are widely used in medicine and in particular in the intensive care unit (ICU). Neuromuscular blockade is commonly used to ease tracheal intubation, to optimize mechanical ventilation and oxygenation in acute respiratory disorders such as status asthmaticus and acute respiratory distress syndrome (ARDS), to prevent shivering during therapeutic hypothermia, and also in patients with elevated intracranial pressure. In the ICU, patients with sepsis, ARDS, community-acquired pneumonia, exacerbation of chronic obstructive pulmonary disease, severe asthma, or trauma may receive corticosteroids...
February 2016: Seminars in Respiratory and Critical Care Medicine
M Piastra, A Tempera, E Luca, E Buffone, C Cafforio, V Briganti, O Genovese, M Marano, D Rigante, On Behalf Of The Intrepid Group
Streptococcus pneumoniae sepsis has high morbidity, particularly if complicated by renal injury. Four patients with S. pneumonia invasive infections complicated by renal disorders are presented. The first case was an 18-month-old girl with pneumococcal empyema complicated by haemolytic uraemic (HUS) syndrome. She made a full recovery after mechanical ventilation, inotropic support and haemodiafiltration. The second was a 4-year-old boy who presented with acute post-infectious glomerulonephritis associated with bilateral pneumococcal pneumonia...
September 13, 2015: Paediatrics and International Child Health
Adil H Haider, Sonia Gupta, Cheryl K Zogg, Mehreen T Kisat, Alexander Schupper, David T Efron, Elliott R Haut, Augustine C Obirieze, Eric B Schneider, Peter J Pronvost, Ellen J MacKenzie, Edward E Cornwell
INTRODUCTION: Trauma patients have greater rates of complications than general surgery patients; however, existing surgical pay-for-performance (P4P) guidelines have yet to be adapted for trauma care. To better understand whether current P4P measures are applicable to trauma, this study used nationally representative data to determine the mortality and attributable costs associated with the presence or absence of both Centers for Medicare and Medicaid Services-recognized complications (urinary tract infections, surgical site infections [SSIs], and pneumonia) and other major trauma-related complications...
July 2015: Surgery
Kirsten Neudoerffer Kangelaris, Arun Prakash, Kathleen D Liu, Bradley Aouizerat, Prescott G Woodruff, David J Erle, Angela Rogers, Eric J Seeley, Jeffrey Chu, Tom Liu, Thomas Osterberg-Deiss, Hanjing Zhuo, Michael A Matthay, Carolyn S Calfee
The early sequence of events leading to the development of the acute respiratory distress syndrome (ARDS) in patients with sepsis remains inadequately understood. The purpose of this study was to identify changes in gene expression early in the course of illness, when mechanisms of injury may provide the most relevant treatment and prognostic targets. We collected whole blood RNA in critically ill patients admitted from the Emergency Department to the intensive care unit within 24 h of admission at a tertiary care center...
June 1, 2015: American Journal of Physiology. Lung Cellular and Molecular Physiology
Marc G Jeschke, Ruxandra Pinto, Robert Kraft, Avery B Nathens, Celeste C Finnerty, Richard L Gamelli, Nicole S Gibran, Matthew B Klein, Brett D Arnoldo, Ronald G Tompkins, David N Herndon
OBJECTIVE: Characterizing burn sizes that are associated with an increased risk of mortality and morbidity is critical because it would allow identifying patients who might derive the greatest benefit from individualized, experimental, or innovative therapies. Although scores have been established to predict mortality, few data addressing other outcomes exist. The objective of this study was to determine burn sizes that are associated with increased mortality and morbidity after burn...
April 2015: Critical Care Medicine
Freny J Nirappil, Ana Maheshwari, Joel Andrews, Greg S Martin, Annette M Esper, Sushma K Cribbs
PURPOSE: We determined the prevalence of risk factors for the development of acute respiratory distress syndrome (ARDS), outcomes of critical illness, and the impact of highly active antiretroviral therapy in HIV-1-infected patients. We hypothesized that in an urban county hospital, HIV-1-infected patients with ARDS would have a higher mortality than their HIV-1-uninfected counterparts. MATERIALS AND METHODS: Subjects were enrolled between 2006 and 2012. Baseline patient demographics, comorbidities, illness severity, causes of ARDS, and clinical outcomes were obtained...
February 2015: Journal of Critical Care
Flávia Carolina Davini Georgetti, Gisela de Rezende Eugênio
BACKGROUND AND OBJECTIVES: Severe sepsis represents the systemic inflammatory response resulting from an infection, associated with one of the following: cardiovascular organ dysfunction, acute respiratory distress syndrome or two or more organ dysfunctions. Although the mortality rate from sepsis in children has steadily decreased in the last decades, the mortality rate in newborns remains high (20% to 40%) despite the development in intensive care. The authors describe a newborn who suffered from sepsis, shock and multiple organ dysfunction syndromes (MODS) that recovered after the administration of activated C protein...
December 2006: Revista Brasileira de Terapia Intensiva
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