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https://www.readbyqxmd.com/read/30286493/-do-vitamins-play-a-role-in-the-pathogenesis-and-therapy-of-sepsis
#1
Ulrich Häussler, Reimer Riessen, Michael Haap
Hospital mortality of severe sepsis and septic shock is still around 40 % according to recent studies. In accordance to the current sepsis definition, sepsis is a life-threatening organ dysfunction caused by a dysregulated response of the organism to infection. Septic shock is defined by vasopressor-dependent circulatory failure and lactic acidosis. Patients with sepsis and septic shock are often old and/or characterized by severe comorbidities, e. g. tumor or liver disease. These factors also predispose to malnutrition and hence to a corresponding deficiency of essential nutritional components e...
October 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/30232287/haptoglobin-improves-shock-lung-injury-and-survival-in-canine-pneumonia
#2
Kenneth E Remy, Irene Cortés-Puch, Steven B Solomon, Junfeng Sun, Benjamin M Pockros, Jing Feng, Juan J Lertora, Roy R Hantgan, Xiaohua Liu, Andreas Perlegas, H Shaw Warren, Mark T Gladwin, Daniel B Kim-Shapiro, Harvey G Klein, Charles Natanson
During the last half-century, numerous antiinflammatory agents were tested in dozens of clinical trials and have proven ineffective for treating septic shock. The observation in multiple studies that cell-free hemoglobin (CFH) levels are elevated during clinical sepsis and that the degree of increase correlates with higher mortality suggests an alternative approach. Human haptoglobin binds CFH with high affinity and, therefore, can potentially reduce iron availability and oxidative activity. CFH levels are elevated over approximately 24-48 hours in our antibiotic-treated canine model of S...
September 20, 2018: JCI Insight
https://www.readbyqxmd.com/read/30180873/-1-3-%C3%AE-d-glucan-based-diagnosis-of-invasive-candida-infection-versus-culture-based-diagnosis-in-patients-with-sepsis-and-with-an-increased-risk-of-invasive-candida-infection-candisep-study-protocol-for-a-randomized-controlled-trial
#3
Frank Bloos, Jürgen Held, Peter Schlattmann, Nicole Brillinger, Oliver Kurzai, Oliver A Cornely, Daniel Thomas-Rüddel
BACKGROUND: The time to diagnosis of invasive Candida infection (ICI) is often too long to initiate timely antifungal therapy in patients with sepsis. Elevated serum (1,3)-β-D-glucan (BDG) concentrations have a high diagnostic sensitivity for detecting ICI. However, the clinical significance of elevated BDG concentrations is unclear in critically ill patients. The goal of this study is to investigate whether measurement of BDG in patients with sepsis and a high risk for ICI can be used to decrease the time to empiric antifungal therapy and thus, increase survival...
September 4, 2018: Trials
https://www.readbyqxmd.com/read/29977465/sepsis-in-a-panorama-what-the-cardiovascular-physician-should-know
#4
REVIEW
Deepa B Gotur
Sepsis accounts for an estimated 30 million cases and 6 million deaths globally each year. According to a multidisciplinary task force convened by the Society of Critical Care Medicine and European Society of Intensive Care Medicine, sepsis is defined as life-threatening organ dysfunction due to a dysregulated host response to infection. Sepsis is a medical emergency, so much so that the World Health Organization made it a global health priority. Since patients with cardiovascular diseases have unique risk factors for sepsis, prompt and accurate diagnosis is critical...
April 2018: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29756955/multicenter-study-of-parenteral-nutrition-in-non-critically-ill-elderly-patients-compared-to-younger-patients-study-iaios-pn-incidence-and-assessment-of-iatrogenesis-in-older-subjects-receiving-parenteral-nutrition
#5
Javier Mateu-de Antonio, David Berlana, Montserrat Pons-Bussom, Maria B Badia-Tahull, María Teresa Miana-Mena, Beatriz Martínez-Castro, Neus Sunyer-Esquerrà, Mónica Sanmartin-Suñer, Juan González-Valdivieso, Elisabet Leiva-Badosa, Eva Martínez-Bernabé, Anna Murgadella-Sancho, Nuria Mirerachs-Aranda, Anna Vila-Bundó, Jordi Fernández-Morató, María Teresa Vitales-Farrero
OBJECTIVE: this study assessed the incidence of hyperglycemia, hypertriglyceridemia, and liver function test (LFT) alterations among patients older and younger than 65 years receiving parenteral nutrition (PN). A secondary objective was to compare the incidence of any of these three events. MATERIAL AND METHODS: inclusion criteria were non-critically ill adult inpatients receiving PN for ≥ 7 days in 15 hospitals in Spain. Exclusion criteria were hyperglycemia, hypertriglyceridemia, LFT alterations, sepsis, shock, pancreatic/hepatobiliary surgery, renal failure, diabetes mellitus (DM) type 1, insulin-treated DM type 2, acute DM complications, or obesity prior to PN...
February 27, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29753454/response-of-a-local-hospital-to-a-burn-disaster-contributory-factors-leading-to-zero-mortality-outcomes
#6
Eng-Kean Yeong, Ciaran P O'Boyle, Hui-Fu Huang, Hao-Chih Tai, Yen-Chun Hsu, Shu-Yang Chuang, Yu-Feng Wu, Che-Wei Chang, Tom J Liu, Hong-Shiee Lai
OBJECTIVE: To investigate the outcomes of a local healthcare system in managing a burn mass casualty incident (BMCI). METHODS: Thirty-three victims admitted to the National Taiwan University Hospital within 96h of the explosion were included in the study. Data were recorded on: patient demographics, Baux score, laboratory data, management response, treatment strategies, and outcomes. Case notes from June 27, 2015 to November 2015 were reviewed with a focus on fluid resuscitation, ventilation support, nutrition, infection control, sepsis treatment, and wound closure plan...
August 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29587920/-treatment-experience-of-continuous-negative-pressure-drainage-in-the-acute-anterior-mediastinal-infection-of-oropharyngeal-origined
#7
Anping Chen, Gang Xu, Jian Li, Yongxiang Song, Qingyong Cai
BACKGROUND: Mediastinal infection is a serious infection of mediastinal connective tissue, with more complications and higher mortality. Application of broad-spectrum antibiotics and nutritional support, early sufficient drainage is the key to successful treatment. In the mode of drainage, this paper discusses the application of continuous negative pressure drainage technique to treat acute anterior mediastinal infection of severe mouth pharynx source, and the good results are summarized and shared...
April 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/29470531/epidemiology-and-risk-factors-of-extensively-drug-resistant-pseudomonas-aeruginosa-infections
#8
Nattawan Palavutitotai, Anupop Jitmuang, Sasima Tongsai, Pattarachai Kiratisin, Nasikarn Angkasekwinai
BACKGROUND: The incidence of nosocomial infections from extensively drug-resistant Pseudomonas aeruginosa (XDR-PA) has been increasing worldwide. We investigated the prevalence and factors associated with XDR-PA infections, including the factors that predict mortality. METHODS: We retrospectively studied a cohort of adult, hospitalized patients with P. aeruginosa (PA) infections between April and December 2014. RESULTS: Of the 255 patients with PA infections, 56 (22%) were due to XDR-PA, 32 (12...
2018: PloS One
https://www.readbyqxmd.com/read/29470360/oral-supplementation-with-bovine-colostrum-prevents-septic-shock-and-brain-barrier-disruption-during-bloodstream-infection-in-preterm-newborn-pigs
#9
Anders Brunse, Päivi Worsøe, Susanne Elisabeth Pors, Kerstin Skovgaard, Per Torp Sangild
Preterm infants have increased risk of neonatal sepsis, potentially inducing brain injury, and they may benefit from early initiation of enteral milk feeding. Using preterm pigs as models, we hypothesized that early provision of bovine colostrum to parentally nourished newborns protects against sepsis and neuroinflammation during bloodstream infection. Preterm newborn pigs were administered 10 CFU/kg of intra-arterial Staphylococcus epidermidis (SE, an opportunistic pathogen often causing sepsis in preterm infants), followed by administration of total parenteral nutrition (TPN, SE + TPN, n = 15) or oral provision of bovine colostrum with supplementary parenteral nutrition (SE + COL, n = 14), and compared with uninfected, TPN-nourished controls (CON + TPN, n = 11)...
February 21, 2018: Shock
https://www.readbyqxmd.com/read/29469010/effect-of-blood-thiamine-concentrations-on-mortality-influence-of-nutritional-status
#10
Heitor Pons Leite, Lúcio Flávio Peixoto de Lima, José Augusto de A C Taddei, Ângela Tavares Paes
OBJECTIVE: To test the hypothesis that low blood thiamine concentrations in malnourished critically ill children are associated with higher risk of 30-d mortality. METHODS: Prospective cohort study in 202 consecutively admitted children who had whole blood thiamine concentrations assessed on admission and on days 5 and 10 of intensive care unit (ICU) stay. The primary outcome variable was 30-d mortality. Mean blood thiamine concentrations within the first 10 d of ICU stay, age, sex, malnutrition, C-reactive protein concentration, Pediatric Index of Mortality 2 score, and severe sepsis/septic shock were the main potential exposure variables for outcome...
April 2018: Nutrition
https://www.readbyqxmd.com/read/29378240/fluconazole-non-susceptible-breakthrough-candidemia-after-prolonged-low-dose-prophylaxis-a-prospective-funginos-study
#11
Christina Orasch, Dominik Mertz, Jorge Garbino, Christian van Delden, Stephane Emonet, Jacques Schrenzel, Stefan Zimmerli, Lauro Damonti, Konrad Mühlethaler, Alexander Imhof, Christian Ruef, Jan Fehr, Reinhard Zbinden, Katia Boggian, Thomas Bruderer, Ursula Flückiger, Anna Conen, Nina Khanna, Reno Frei, Thomas Bregenzer, Frédéric Lamoth, Véronique Erard, Pierre-Yves Bochud, Thierry Calandra, Jacques Bille, Oscar Marchetti
OBJECTIVES: Breakthrough candidemia (BTC) on fluconazole was associated with non-susceptible Candida spp. and increased mortality. This nationwide FUNGINOS study analyzed clinical and mycological BTC characteristics. METHODS: A 3-year prospective study was conducted in 567 consecutive candidemias. Species identification and antifungal susceptibility testing (CLSI) were performed in the FUNGINOS reference laboratory. Data were analyzed according to STROBE criteria...
May 2018: Journal of Infection
https://www.readbyqxmd.com/read/29261735/docosahexaenoic-acid-but-not-eicosapentaenoic-acid-improves-septic-shock-induced-arterial-dysfunction-in-rats
#12
Alexandra Boivin, Mélanie Burban, Raphaël Clere-Jehl, Pierrick Le Borgne, Hamid Merdji, Cyril Auger, Valérie Schini-Kerth, Ferhat Meziani, Julie Helms
INTRODUCTION: Long chain n-3 fatty acid supplementation may modulate septic shock-induced host response to pathogen-induced sepsis. The composition of lipid emulsions for parenteral nutrition however remains a real challenge in intensive care, depending on their fatty acid content. Because they have not been assessed yet, we aimed at determining the respective effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) during septic shock-induced vascular dysfunction. METHODS: In a peritonitis-induced septic shock model, rats were infused with EPA, DHA, an EPA/DHA mixture or 5% dextrose (D5) during 22 hours...
2017: PloS One
https://www.readbyqxmd.com/read/29203713/therapeutic-potential-of-heat-shock-protein-induction-for-muscular-dystrophy-and-other-muscle-wasting-conditions
#13
REVIEW
Savant S Thakur, Kristy Swiderski, James G Ryall, Gordon S Lynch
Duchenne muscular dystrophy is the most common and severe of the muscular dystrophies, a group of inherited myopathies caused by different genetic mutations leading to aberrant expression or complete absence of cytoskeletal proteins. Dystrophic muscles are prone to injury, and regenerate poorly after damage. Remorseless cycles of muscle fibre breakdown and incomplete repair lead to progressive and severe muscle wasting, weakness and premature death. Many other conditions are similarly characterized by muscle wasting, including sarcopenia, cancer cachexia, sepsis, denervation, burns, and chronic obstructive pulmonary disease...
January 19, 2018: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
https://www.readbyqxmd.com/read/29176375/vitamin-c-in-sepsis
#14
REVIEW
Sven-Olaf Kuhn, Konrad Meissner, Lena M Mayes, Karsten Bartels
PURPOSE OF REVIEW: This narrative review summarizes recent insights into the role of vitamin C in sepsis. RECENT FINDINGS: Septic shock remains a major source of morbidity and mortality in critically ill patients. Although many nutritional supplements have previously been tested unsuccessfully, vitamins are still being explored as a therapeutic option in septic patients. In particular, vitamin C-containing regimens as adjunctive therapy in sepsis have received much attention...
February 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29128300/enteral-versus-parenteral-early-nutrition-in-ventilated-adults-with-shock-a-randomised-controlled-multicentre-open-label-parallel-group-study-nutrirea-2
#15
RANDOMIZED CONTROLLED TRIAL
Jean Reignier, Julie Boisramé-Helms, Laurent Brisard, Jean-Baptiste Lascarrou, Ali Ait Hssain, Nadia Anguel, Laurent Argaud, Karim Asehnoune, Pierre Asfar, Frédéric Bellec, Vlad Botoc, Anne Bretagnol, Hoang-Nam Bui, Emmanuel Canet, Daniel Da Silva, Michael Darmon, Vincent Das, Jérôme Devaquet, Michel Djibre, Frédérique Ganster, Maité Garrouste-Orgeas, Stéphane Gaudry, Olivier Gontier, Claude Guérin, Bertrand Guidet, Christophe Guitton, Jean-Etienne Herbrecht, Jean-Claude Lacherade, Philippe Letocart, Frédéric Martino, Virginie Maxime, Emmanuelle Mercier, Jean-Paul Mira, Saad Nseir, Gael Piton, Jean-Pierre Quenot, Jack Richecoeur, Jean-Philippe Rigaud, René Robert, Nathalie Rolin, Carole Schwebel, Michel Sirodot, François Tinturier, Didier Thévenin, Bruno Giraudeau, Amélie Le Gouge
BACKGROUND: Whether the route of early feeding affects outcomes of patients with severe critical illnesses is controversial. We hypothesised that outcomes were better with early first-line enteral nutrition than with early first-line parenteral nutrition. METHODS: In this randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2 trial) done at 44 French intensive-care units (ICUs), adults (18 years or older) receiving invasive mechanical ventilation and vasopressor support for shock were randomly assigned (1:1) to either parenteral nutrition or enteral nutrition, both targeting normocaloric goals (20-25 kcal/kg per day), within 24 h after intubation...
January 13, 2018: Lancet
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