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Sepsis and renal function

Valentine de A C de Castro Lima, Ana Luisa Figueira Gouvêa, Paulo Menezes, Jacqueline da F Santos, Mayra Carrijo Rochael, Fabiana Rabe Carvalho, Jorge Reis Almeida, Jocemir Ronaldo Lugon
Hemophagocytic lymphohistiocytosis (HLH) is an uncommon and life-threating condition characterized by major immune activation and massive cytokine production by mononuclear inflammatory cells, due to defects in cytotoxic lymphocyte function. It is even more unusual in renal transplant recipients, in which it is often associated with uncontrolled infection. The mortality is high in HLH and differential diagnosis with sepsis is a challenge. The approach and management depend on the underlying trigger and comorbidities...
October 11, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Raphaël Burger, Monia Guidi, Valérie Calpini, Frédéric Lamoth, Laurent Decosterd, Corinne Robatel, Thierry Buclin, Chantal Csajka, Oscar Marchetti
Background: Meropenem plasma concentration above a pathogen's MIC over the whole dosing interval (100% ƒT>MIC) is a determinant of outcome in severe infections. Significant variability of meropenem pharmacokinetics is reported in ICU patients. Objectives: To characterize meropenem pharmacokinetics in variable CLCR or renal replacement therapy and assess the appropriateness of recommended regimens for MIC coverage. Methods: A pharmacokinetic analysis (NONMEM) was conducted with external model validation...
October 9, 2018: Journal of Antimicrobial Chemotherapy
Sooghee Chang, Youn-Hee Kim, Young-Joo Kim, Young-Woo Kim, Sungyoon Moon, Yong Yook Lee, Jin Sun Jung, Youngsoo Kim, Hi-Eun Jung, Tae-Joo Kim, Taek-Chin Cheong, Hye-Jung Moon, Jung-Ah Cho, Hang-Rae Kim, Dohyun Han, Yirang Na, Seung-Hyeok Seok, Nam-Hyuk Cho, Hai-Chon Lee, Eun-Hee Nam, Hyosuk Cho, Murim Choi, Nagahiro Minato, Seung-Yong Seong
Bile acids (BAs) control metabolism and inflammation by interacting with several receptors. Here, we report that intravenous infusion of taurodeoxycholate (TDCA) decreases serum pro-inflammatory cytokines, normalizes hypotension, protects against renal injury, and prolongs mouse survival during sepsis. TDCA increases the number of granulocytic myeloid-derived suppressor cells (MDSCLT ) distinctive from MDSCs obtained without TDCA treatment (MDSCL ) in the spleen of septic mice. FACS-sorted MDSCLT cells suppress T-cell proliferation and confer protection against sepsis when adoptively transferred better than MDSCL ...
2018: Frontiers in Immunology
D J Gross, E H Chang, P L Rosen, V Roudnitsky, M Muthusamy, G Sugiyama, P J Chung
BACKGROUND: Most thoracic surgical procedures in the United States are being performed by general surgeons (GSs) without any advanced training. With the recent approval of computed tomography screening for lung malignancy in high-risk populations, the number of thoracic oncologic resections is expected to rise. Previous literature has demonstrated consistently worsened outcomes for patients undergoing thoracic surgical procedure when done by nonthoracic fellowship-trained surgeons. Using the American College of Surgeons National Surgical Quality Improvement Project database, we examined short-term outcomes in patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy for malignancy...
November 2018: Journal of Surgical Research
Mary J Kwasny, Adam I Edelstein, David W Manning
BACKGROUND: Elevated body mass index (BMI) is considered a risk factor for complications after THA and TKA. Stakeholders have proposed BMI cutoffs for those seeking arthroplasty. The research that might substantiate BMI cutoffs is sensitive to the statistical methods used, but the impact of the statistical methods used to model BMI has not been defined. QUESTIONS/PURPOSES: (1) How does the estimated postarthroplasty risk of minor and major complications vary as a function of the statistical method used to model BMI? (2) What is the prognostic value of BMI for predicting complications with each statistical method? METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program from 2005 to 2012, we investigated the impact of BMI on major and minor complication risk for THA and TKA...
September 25, 2018: Clinical Orthopaedics and related Research
Mustafa Serkan Durdu, Mehmet Cakici, Fatih Gumus, Gunseli Cubukcuoglu Deniz, Sinem Civriz Bozdag, Evren Ozcinar, Nur Dikmen Yaman, Osman Ilhan, Kemalettin Ucanok
OBJECTIVE: Apheresis is performed for treatment of numerous diseases by removing auto-antibodies, antigen-antibody complexes, allo-antibodies, paraproteins, non-Ig proteins, toxins, exogenous poisons. In current study, we present our experience of using therapeutic plasma exchange (TPE) in patients with different types of clinical scenarios. METHODS: Between January 2013 and May 2016, we retrospectively presented the results of 64 patients in whom postoperative TPE was performed in ICU setting after cardiac surgery...
September 18, 2018: Transfusion and Apheresis Science
Chun Zhang, Ting Lin, Jingyao Zhang, Huan Liang, Ying Di, Na Li, Jie Gao, Wenjing Wang, Sinan Liu, Zheng Wang, Hongli Jiang, Chang Liu
OBJECTIVE: To evaluate the clinical effect and safety of regional citrate anticoagulation (RCA) in continuous renal replacement therapy (CRRT) for acute kidney injury (AKI) after hepatectomy. METHODS: A retrospective analysis of the clinical data of all patients with AKI after hepatectomy for CRRT admitted to surgical intensive care unit (ICU) of the First Affiliated Hospital of Xi'an Jiaotong University from January 19th, 2013 to January 19th, 2018 was performed...
August 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Steven Van Laecke
INTRODUCTION: Magnesium is an essential element which also has pleiotropic effects in humans. Recent studies have altered our interpretation of a disturbed magnesium balance both leading to hypomagnesemia and hypermagnesemia. METHODS: a narrative review of their clinical relevance is presented. RESULTS: Although magnesium balance is strictly controlled by the kidneys, hypomagnesemia is fairly common, especially in people with comorbid conditions...
September 17, 2018: Acta Clinica Belgica
Yan Wang, Fenling Feng, Minna Liu, Jiahong Xue, Huimei Huang
Acute kidney injury (AKI) is a hyper-inflammation-induced abrupt loss of kidney function and has become a major public health problem. The cecal ligation and puncture (CLP) model of peritonitis in rat pups mimics the development of sepsis-induced pediatric AKI is pre-renal without morphological changes of the kidneys and high lethality. Resveratrol, a natural polyphenolic compound with low toxicity, has obvious anti-oxidant and anti-inflammatory properties. The present study aimed to determine whether resveratrol alleviates pediatric AKI and investigated the potential mechanism...
October 2018: Experimental and Therapeutic Medicine
Haroon Ahmed, Daniel Farewell, Nick A Francis, Shantini Paranjothy, Christopher C Butler
BACKGROUND: Few studies have investigated the risk of adverse outcomes in older people with renal impairment presenting to primary care with a urinary tract infection (UTI). The aim of this study was to determine the risk of adverse outcomes in patients aged ≥65 years presenting to primary care with a UTI, by estimated glomerular filtration rate (eGFR) and empirical prescription of nitrofurantoin versus trimethoprim. METHODS AND FINDINGS: This was a retrospective cohort study using linked health record data from 795,484 patients from 393 general practices in England, who were aged ≥65 years between 2010 and 2016...
September 2018: PLoS Medicine
Bianca Ballarin Albino, Mariele Gobo-Oliveira, André Luís Balbi, Daniela Ponce
Purpose: This trial aimed to compare mortality and recovery of renal function in acute kidney injury (AKI) patients treated with different durations of prolonged hemodialysis (PHD) sessions (6 h versus 10 h). Methodology: We included patients with sepsis-associated AKI, >18 years, who are in use of a norepinephrine (lower than 0.7 ucg/kg/min). Results: One hundred and ninety-four patients were treated with 531 sessions of PHD (G1=104 and G2=90 patients)...
2018: International Journal of Nephrology
In-Chul Lee, Jong-Sup Bae
Pelargonidin (PEL) is a well-known red pigment found in plants, and it has been reported to have important biological activities that are potentially beneficial for human health. This study was initiated to determine whether PEL could modulate renal functional damage in a mouse model of sepsis, and to elucidate the underlying mechanisms. The potential of PEL treatment to reduce renal damage induced by cecal ligation and puncture (CLP) surgery in mice was measured by assessment of serum creatinine, blood urea nitrogen (BUN), lipid peroxidation, total glutathione, glutathione peroxidase (GSH-Px) activity, catalase activity, and superoxide dismutase (SOD) activity...
August 30, 2018: Journal of Medicinal Food
Bong-Seon Lee, Changhun Lee, Sumin Yang, Sae-Kwang Ku, Jong-Sup Bae
Zingerone (ZGR), a phenolic alkanone isolated from ginger, has been reported to possess pharmacological activities such as anti-inflammatory and anti-apoptotic effects. This study was initiated to determine whether ZGR could modulate renal functional damage in a mouse model of sepsis and to elucidate the underlying mechanisms. The potential of ZGR treatment to reduce renal damage induced by cecal ligation and puncture (CLP) surgery in mice was measured by assessment of serum creatinine, blood urea nitrogen (BUN), lipid peroxidation, total glutathione, glutathione peroxidase activity, catalase activity, and superoxide dismutase activity...
August 30, 2018: BMB Reports
Shraddha Goswami, Naresh Pahwa, Rubina Vohra, Bhavani M Raju
Acute kidney injury (AKI) is a common disorder worldwide that is associated with severe morbidity, mortality and cost. If managed adequately and in a timely manner, the majority of these cases are preventable, treatable and often reversible with simple measures. We conducted a two years prospective study of patients admitted to medical and surgical units of a tertiary care center in Central India to identify the causes of Hospital Acquired AKI (HAAKI) and its impact on patient outcomes. HAAKI occurred in 215 of 9,800 patients (2...
July 2018: Saudi Journal of Kidney Diseases and Transplantation
Muzaffer Tunç, Cengiz Şahutoğlu, Nursen Karaca, Seden Kocabaş, Fatma Zekiye Aşkar
Objective: Prolonged intensive care unit (ICU) stay prevents the use of ICU equipment by other patients and increases hospital cost. This retrospective study aimed to investigate the risk factors for prolonged ICU stay in patients undergoing open heart surgery. Methods: The medical records of 513 patients who underwent coronary artery bypass grafting and valvular heart surgery were retrospectively evaluated. Patients were divided into two groups based on their ICU stay: groups I (<48 h) and II (≥48 h)...
August 2018: Turkish Journal of Anaesthesiology and Reanimation
Muhammad Sardar, Nasreen Shaikh, Saad Ullah Malik, Faiz Anwer, Patrick Lee, David Sharon, Margaret Hh Eng
BACKGROUND: Despite cancer being the second most common cause of death in the United States, more people are living longer after the diagnosis of cancer than before. Healthcare workers will be treating an increasing number of patients with cancer. Various studies have identified predictors of cardiac arrest in the general population, however, none have been done to identify such factors in cancer patients who form a more vulnerable group with lower survival rate following cardiac arrest...
June 18, 2018: Curēus
Jun Shen, Junhao Zhang, Xinan Jiang, Huan Wang, Guanghui Pan
OBJECTIVE: This study investigated the role of long noncoding RNA (lncRNA) HOX transcript antisense RNA (HOTAIR) in kidney injury induced by urine-derived sepsis (US). MATERIALS AND METHODS: An Escherichia coli suspension was injected into the distal ureter of adult male Sprague Dawley rats to establish a US model. Lipopolysaccharides (LPSs) were used to induce an in vitro septic model. The interaction between HOTAIR and microRNA 22 (miR-22) was detected by RNA precipitation and RNA pull-down assays...
October 1, 2018: Life Sciences
Ling-Ling Zhu, Quan Zhou
Background: Sporadic studies in antimicrobial therapy have evaluated the effects of infusion rates on therapeutic and economic outcomes, and new findings may challenge the regular infusion regimen. Methods: Focusing on studies comparing the outcomes of different infusion regimens, the relevant literature was identified by searching PubMed, Web of Science, and Scopus from January 1, 2013 to March 1, 2018. Papers were finally chosen using a PRISMA flowchart. Results: Antimicrobials with the superiority of prolonged infusion to standard infusion in terms of efficacy and safety include meropenem, doripenem, imipenem, cefepime, ceftazidime, piperacillin/tazobactam, linezolid, and vancomycin...
2018: Infection and Drug Resistance
Francisco Adelvane de Paulo Rodrigues, Alan Diego da Conceição Santos, Pedro Henrique Quintela Soares de Medeiros, Mara de Moura Gondim Prata, Tailane Caína de Souza Santos, James Almada da Silva, Gerly Anne de Castro Brito, Armênio Aguiar Dos Santos, Edilberto Rocha Silveira, Aldo Ângelo Moreira Lima, Alexandre Havt
Acute kidney injury (AKI) and metabolic dysfunction are critical complications in sepsis syndrome; however, their pathophysiological mechanisms remain poorly understood. Therefore, we evaluated whether the pharmacological properties of 6-gingerol (6G) and 10-gingerol (10G) could modulate AKI and metabolic disruption in a rat model of sepsis (faecal peritonitis). Animals from the sham and AKI groups were intraperitoneally injected with 6G or 10G (25 mg/kg). Septic AKI decreased creatinine clearance and renal antioxidant activity, but enhanced oxidative stress and the renal mRNA levels of tumour necrosis factor-α, interleukin-1β, and transforming growth factor-β...
August 14, 2018: Scientific Reports
Youn H Kim, Martine Bagot, Lauren Pinter-Brown, Alain H Rook, Pierluigi Porcu, Steven M Horwitz, Sean Whittaker, Yoshiki Tokura, Maarten Vermeer, Pier Luigi Zinzani, Lubomir Sokol, Stephen Morris, Ellen J Kim, Pablo L Ortiz-Romero, Herbert Eradat, Julia Scarisbrick, Athanasios Tsianakas, Craig Elmets, Stephane Dalle, David C Fisher, Ahmad Halwani, Brian Poligone, John Greer, Maria Teresa Fierro, Amit Khot, Alison J Moskowitz, Amy Musiek, Andrei Shustov, Barbara Pro, Larisa J Geskin, Karen Dwyer, Junji Moriya, Mollie Leoni, Jeffrey S Humphrey, Stacie Hudgens, Dmitri O Grebennik, Kensei Tobinai, Madeleine Duvic
BACKGROUND: Cutaneous T-cell lymphomas are rare non-Hodgkin lymphomas with substantial morbidity and mortality in advanced disease stages. We compared the efficacy of mogamulizumab, a novel monoclonal antibody directed against C-C chemokine receptor 4, with vorinostat in patients with previously treated cutaneous T-cell lymphoma. METHODS: In this open-label, international, phase 3, randomised controlled trial, we recruited patients with relapsed or refractory mycosis fungoides or Sézary syndrome at 61 medical centres in the USA, Denmark, France, Italy, Germany, the Netherlands, Spain, Switzerland, the UK, Japan, and Australia...
September 2018: Lancet Oncology
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