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Sepsis and septic shock

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https://www.readbyqxmd.com/read/28648651/the-impact-of-functional-status-on-the-outcomes-of-endovascular-lower-extremity-revascularization-for-critical-limb-ischemia-in-the-elderly
#1
Isidore Dinga Madou, Martin D Slade, Kristine C Orion, Timur Sarac, Cassius Iyad Ochoa Chaar
INTRODUCTION: Functional status is an important predictor of outcomes after infrainguinal bypass surgery. There is little data on the effect of functional status on the outcomes of endovascular LE interventions, especially in the elderly frail population. METHODS: This is a retrospective analysis of the American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) files for the years 2011-2013 to assess the impact of functional status on outcome after endovascular intervention for critical limb ischemia...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28645776/selective-inhibition-of-flt3-by-gilteritinib-in-relapsed-or-refractory-acute-myeloid-leukaemia-a-multicentre-first-in-human-open-label-phase-1-2-study
#2
Alexander E Perl, Jessica K Altman, Jorge Cortes, Catherine Smith, Mark Litzow, Maria R Baer, David Claxton, Harry P Erba, Stan Gill, Stuart Goldberg, Joseph G Jurcic, Richard A Larson, Chaofeng Liu, Ellen Ritchie, Gary Schiller, Alexander I Spira, Stephen A Strickland, Raoul Tibes, Celalettin Ustun, Eunice S Wang, Robert Stuart, Christoph Röllig, Andreas Neubauer, Giovanni Martinelli, Erkut Bahceci, Mark Levis
BACKGROUND: Internal tandem duplication mutations in FLT3 are common in acute myeloid leukaemia and are associated with rapid relapse and short overall survival. The clinical benefit of FLT3 inhibitors in patients with acute myeloid leukaemia has been limited by rapid generation of resistance mutations, particularly in codon Asp835 (D835). We aimed to assess the highly selective oral FLT3 inhibitor gilteritinib in patients with relapsed or refractory acute myeloid leukaemia. METHODS: In this phase 1-2 trial, we enrolled patients aged 18 years or older with acute myeloid leukaemia who either were refractory to induction therapy or had relapsed after achieving remission with previous treatment...
June 20, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28643487/proenkephalin-neutrophil-gelatinase-associated-lipocalin-and-estimated-glomerular-filtration-rates-in-patients-with-sepsis
#3
Hanah Kim, Mina Hur, Seungho Lee, Rossella Marino, Laura Magrini, Patrizia Cardelli, Joachim Struck, Andreas Bergmann, Oliver Hartmann, Salvatore Di Somma
BACKGROUND: Proenkephalin (PENK) has been suggested as a novel biomarker for kidney function. We investigated the diagnostic and prognostic utility of plasma PENK in comparison with neutrophil gelatinase-associated lipocalin (NGAL) and estimated glomerular filtration rates (eGFR) in septic patients. METHODS: A total of 167 septic patients were enrolled: 99 with sepsis, 37 with septic shock, and 31 with suspected sepsis. PENK and NGAL concentrations were measured and GFR was estimated by using the isotope dilution mass spectrometry traceable-Modification of Diet in Renal Disease (MDRD) Study and three Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations: CKD-EPI(Cr), CDK-EPI(CysC), and CKD-EPI(Cr-CysC)...
September 2017: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/28642140/emergence-of-carbapenem-resistant-enterobacteriaceae-isolated-from-patients-in-a-university-hospital-in-saudi-arabia-epidemiology-clinical-profiles-and-outcomes
#4
Fawzia E Alotaibi, Elham E Bukhari, Maha M Al-Mohizea, Taghreed Hafiz, Eman Bin Essa, Yasmeen I AlTokhais
Carbapenemase-producing Enterobacteriaceae have been steadily spreading worldwide during the last decade. Nine patients were identified prospectively and were followed during their hospitalization course to identify the epidemiology, clinical profiles and outcomes. These patients had one or more cultures positive for a CRE isolate, contributing to a total of eleven positive cultures from various sites without including duplicates of isolates obtained from the same site. Isolates from these patients included five Klebseilla pneumoniae, three Escherichia coli, and one Enterobacter aerogenes...
June 19, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28641580/marked-regional-endothelial-dysfunction-in-mottled-skin-area-in-patients-with-severe-infections
#5
Simon Bourcier, Jérémie Joffre, Vincent Dubée, Gabriel Preda, Jean-Luc Baudel, Naïke Bigé, Guillaume Leblanc, Bernard I Levy, Bertrand Guidet, Eric Maury, Hafid Ait-Oufella
BACKGROUND: Mottling around the knee, reflecting a reduced skin blood flow, is predictive of mortality in patients with septic shock. However, the causative pathophysiology of mottling remains unknown. We hypothesized that the cutaneous hypoperfusion observed in the mottled area is related to regional endothelial dysfunction. METHODS: This was a prospective, observational study in a medical ICU in a tertiary teaching hospital. Consecutive adult patients with sepsis admitted to ICU were included...
June 23, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28640137/china-s-growing-contribution-to-sepsis-research-from-1984-to-2014-a-bibliometric-study
#6
Kai Zhang, Jialian Zhao, Lihua Chu, Yue Jin, Baoli Cheng, Guohao Xie, Yan Wang, Xiangming Fang
BACKGROUND: The aim of this study was to analyze the global trends of sepsis research and investigate China's contribution by comparing the quantity and quality of sepsis-related publications. METHODS: Sepsis-related publications were main retrieved from the Web of Science online database by using the keywords "sepsis" or "septic shock." Bibliometric indicators, including the number of publications, total citation frequency, citation frequency per paper, h-index, research type, orientation, organization, author, journal, and funding support were analyzed...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639164/lipid-peroxidation-in-gram-negative-bacteremia-modulates-the-risk-for-septic-shock-and-infections-by-resistant-klebsiella-pneumoniae
#7
S Christodoulou, E Kyriazopoulou, M Chrysanthakopoulou, G Karlis, I Karampela, K Gkizeli, N Veliki, A Safarika, E J Giamarellos-Bourboulis, G Adamis
Controversies in outcomes with the parenteral administration of antioxidants as adjuvant therapies led to the measurement of malondialdehyde (MDA), a product of lipid peroxidation, in serum collected from 120 patients with primary Gram-negative bacteremia during the first 24 h from sepsis onset. MDA was measured by the thiobarbiturate assay, followed by high-performance liquid chromatography (HPLC) analysis. After receiver operator characteristic (ROC) curve analysis, patients were divided into those with high levels of MDA and low levels of MDA...
June 21, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28637738/the-reanimation-low-immune-status-markers-realism-project-a-protocol-for-broad-characterisation-and-follow-up-of-injury-induced-immunosuppression-in-intensive-care-unit-icu-critically-ill-patients
#8
Mary-Luz Rol, Fabienne Venet, Thomas Rimmele, Virginie Moucadel, Pierre Cortez, Laurence Quemeneur, David Gardiner, Andrew Griffiths, Alexandre Pachot, Julien Textoris, Guillaume Monneret
INTRODUCTION: The host response to septic shock is dynamic and complex. A sepsis-induced immunosuppression phase has recently been acknowledged and linked to bad outcomes and increased healthcare costs. Moreover, a marked suppression of the immune response has also been partially described in patients hospitalized in intensive care unit (ICU) for severe trauma or burns. It has been hypothesized that immune monitoring could enable identification of patients who might most benefit from novel, adjunctive immune-stimulating therapies...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28635463/an-overview-of-the-evidence-based-practice-process-for-novice-researchers
#9
Emma Rowles, Amanda McNaughton
This article explores how nurses can use evidence-based practice to critique and evaluate the rationale and evidence for specific nursing procedures or practices. Through the development of a focused research question and search strategy, nurses can select and critique relevant research articles to answer the research question, which can support the provision of optimal practice and high-quality care. This article demonstrates the process of evidence-based practice, with the aim of increasing novice researchers' confidence in applying this process in practice...
June 21, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28625257/-albumin-corrected-anion-gap-is-an-independent-risk-factor-for-long-term-mortality-of-patients-with-sepsis
#10
Xiaoli He, Xuelian Liao, Zhichao Xie, Chao Jiang, Yan Kang
OBJECTIVE: To explore whether albumin corrected anion gap (ACAG) is associated with long-term mortality of sepsis patients. METHODS: Adult patients with a diagnosis of sepsis within the first 24 hours (from December 2013 to December 2014) admitted to the intensive care unit (ICU) were included via the Sepsis database of West China Hospital Sichuan University. To record their long-term survival, patients were followed up by telephone interview one year after enrollment...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625255/-effect-of-vitamin-d3-on-the-severity-and-prognosis-of-patients-with-sepsis-a-prospective-randomized-double-blind-placebo-study
#11
Fulai Ding, Bin Zang, Jiahong Fu, Kaiqiang Ji
OBJECTIVE: To observe the relationship between vitamin D3 and the severity as well as prognosis in patients with sepsis, and to explore whether exogenous vitamin D3 can improve the prognosis in patients with sepsis. METHODS: A prospective randomized double-blind placebo study was conducted. Fifty-seven patients with sepsis admitted to intensive care unit (ICU) of Shengjing Hospital Affiliated to China Medical University from March to November in 2015 were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28623891/systolic-blood-pressure-variability-in-patients-with-early-severe-sepsis-or-septic-shock-a-prospective-cohort-study
#12
Yi Tang, Jeff Sorenson, Michael Lanspa, Colin K Grissom, V J Mathews, Samuel M Brown
BACKGROUND: Severe sepsis and septic shock are often lethal syndromes, in which the autonomic nervous system may fail to maintain adequate blood pressure. Heart rate variability has been associated with outcomes in sepsis. Whether systolic blood pressure (SBP) variability is associated with clinical outcomes in septic patients is unknown. The propose of this study is to determine whether variability in SBP correlates with vasopressor independence and mortality among septic patients. METHODS: We prospectively studied patients with severe sepsis or septic shock, admitted to an intensive care unit (ICU) with an arterial catheter...
June 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28622312/clinical-features-and-prognostic-factors-of-klebsiella-endophthalmitis-10-year-experience-in-an-endemic-region
#13
C Y Chung, E S Wong, C C H Liu, M O M Wong, K K W Li
AimsTo identify the clinical features and prognostic factors of endogenous endophthalmitis caused by Klebsiella pneumoniae.MethodsThis is a retrospective case series of all patients with Klebsiella endophthalmitis managed from January 2006 to December 2015 by Kowloon East Ophthalmic Service. Statistical analysis involved hypothesis testing on the SPSS 18.0 software (SPSS). A significance level of P<0.05 was taken.ResultsIn the 10-year period, K. pneumoniae accounted for 19 out of 39 cases of endogenous endophthalmitis (48...
June 16, 2017: Eye
https://www.readbyqxmd.com/read/28620804/core-elements-of-general-supportive-care-for-patients-with-sepsis-and-septic-shock-in-resource-limited-settings
#14
Mervyn Mer, Marcus J Schultz, Neill K Adhikari
No abstract text is available yet for this article.
June 15, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28618763/comparison-of-endothelin-and-nitric-oxide-synthase-blockers-on-hemorheological-parameters-in-endotoxemic-rats
#15
Neslihan H Dikmenoğlu Falkmarken, Okan Arihan, Alper B Iskit
BACKGROUND/AIM: Septic shock is an important health problem that vastly alters cardiovascular and hemodynamic status. Increased production of nitric oxide (NO) and endothelin is a counterpart of this endotoxemic state. This study was conducted to test the hypothesis that nonselective NO synthesis blocker (L-NAME), inducible NO synthesis blocker (L-canavanine), or endothelin receptor antagonist (bosentan) will reverse the effects of sepsis on hemorheological parameters. MATERIALS AND METHODS: Forty-eight male Sprague-Dawley rats were used in 8 groups: saline (control), endotoxin, bosentan, L-NAME, L-canavanine, endotoxin + bosentan, endotoxin + L-NAME, and endotoxin + L-canavanine...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28617696/should-hyperoxia-be-avoided-during-sepsis-an-experimental-study-in-ovine-peritonitis
#16
Xinrong He, Fuhong Su, Keliang Xie, Fabio Silvio Taccone, Katia Donadello, Jean-Louis Vincent
OBJECTIVES: Optimizing oxygen delivery is an important part of the hemodynamic resuscitation of septic shock, but concerns have been raised over the potentially deleterious effects of hyperoxia. We evaluated the impact of hyperoxia on hemodynamics, the microcirculation, and cerebral and renal metabolism in an ovine model of septic shock. DESIGN: Randomized animal study. SETTING: University hospital animal research laboratory. SUBJECTS: Fourteen adult female sheep...
June 14, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28616838/assessment-of-renal-hemodynamic-toxicity-of-fluid-challenge-with-0-9-nacl-compared-to-balanced-crystalloid-plasmalyte-%C3%A2-in-a-rat-model-with-severe-sepsis
#17
Pierre-Yves Olivier, François Beloncle, Valérie Seegers, Maher Tabka, Mathilde Renou de La Bourdonnaye, Alain Mercat, Paul Cales, Daniel Henrion, Peter Radermacher, Lise Piquilloud, Nicolas Lerolle, Pierre Asfar
BACKGROUND: According to international guidelines, volume expansion with crystalloids is the first-line treatment for hemodynamic management in patients with severe sepsis or septic shock. Compared to balanced crystalloids, 0.9% sodium chloride (0.9% NaCl) induces hyperchloremia and metabolic acidosis and may alter renal hemodynamics and function. We compared the effects of 0.9% NaCl to a less chloride-concentrated fluid, PlasmaLyte(®) (PL) in targeted fluid resuscitation in a randomized, double-blind controlled study in an experimental model of severe sepsis in rats...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28616781/impact-of-hyperglycemia-on-cystathionine-%C3%AE-lyase-expression-during-resuscitated-murine-septic-shock
#18
Tamara Merz, Josef A Vogt, Ulrich Wachter, Enrico Calzia, Csaba Szabo, Rui Wang, Peter Radermacher, Oscar McCook
BACKGROUND: Cystathionine-γ-lyase (CSE) was shown to have a regulatory role in glucose metabolism. Circulatory shock can induce metabolic stress, thereby leading to hyperglycemia and mitochondrial dysfunction. In vitro data suggest an effect of high glucose on CSE expression. Therefore, the aim of this study was to investigate the effects of hyperglycemia on CSE expression in resuscitated murine septic shock. METHODS: Normo- (80-150 mg/dl) and hyperglycemic (>200 mg/dl) male C57/BL6J mice (n = 5-6 per group) underwent cecal ligation and puncture (CLP)-induced polymicrobial sepsis or sham procedure (n = 6 per group) and, 15 h afterwards, were anesthetized again, surgically instrumented and received intensive care treatment, including antibiotics, lung protective mechanical ventilation, circulatory support, and intravenous (i...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28616211/acute-kidney-injury-in-patients-with-severe-sepsis-or-septic-shock-a-comparison-between-the-risk-injury-failure-loss-of-kidney-function-end-stage-kidney-disease-rifle-acute-kidney-injury-network-akin-and-kidney-disease-improving-global-outcomes-kdigo-classifications
#19
Marta Pereira, Natacha Rodrigues, Iolanda Godinho, Joana Gameiro, Marta Neves, João Gouveia, Zélia Costa E Silva, José António Lopes
PURPOSE: Using the Risk, Injury, Failure, Loss of kidney function, End-stage kidney disease (RIFLE), Acute Kidney Injury Network (AKIN) and Kidney Disease: Improving Global Outcomes (KDIGO) systems, the incidence of acute kidney injury (AKI) and their ability to predict in-hospital mortality in severe sepsis or septic shock was compared. MATERIALS AND METHODS: We performed a retrospective analysis of 457 critically ill patients with severe sepsis or septic shock hospitalized between January 2008 and December 2014...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28614081/spontaneous-fungal-peritonitis-a-rare-but-severe-complication-of-liver-cirrhosis
#20
Marta Gravito-Soares, Elisa Gravito-Soares, Sandra Lopes, Graça Ribeiro, Pedro Figueiredo
INTRODUCTION AND AIM: Spontaneous bacterial peritonitis is the most common infectious complication in cirrhosis. Spontaneous fungal peritonitis is rare and remains unknown. In this work, spontaneous fungal peritonitis as well as risk factors and prognosis are characterized. PATIENTS AND METHODS: A retrospective case-control study of 253 consecutive admissions by peritonitis in cirrhotic patients was carried out between 2006 and 2015. Comparison of patients with spontaneous fungal peritonitis (cases) and spontaneous bacterial peritonitis with positive microbiologic ascitic fluid culture (controls) was performed...
June 13, 2017: European Journal of Gastroenterology & Hepatology
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