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https://www.readbyqxmd.com/read/29676703/effect-of-intraoperative-single-shot-application-of-vancomycin-in-liver-transplant-recipients-on-postoperative-infections-with-enterococcus-faecium-and-enterococcus-faecalis
#1
Christian Siebers, Johannes Kinzinger, Ludwig C Hinske, Andreas Bauer, Patrick Scheiermann, Michael Zoller, Markus Guba, Martin Angele, Sebastian Pratschke, Thomas Weig
OBJECTIVES: Infections are major causes of morbidity and mortality in the early postoperative period after liver transplant. We observed a high rate of enterococcal infections at our center. Therefore, we added an intraoperative single shot of vancomycin to the standard regimen of meropenem given over 5 days. The aim of this study was to determine the prevalence of both Enterococcus faecium and Enterococcus faecalis infections during the first 28 days after surgery depending on the type of antibiotic prophylaxis and their implications on mortality and morbidity...
April 20, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29675709/acid-base-status-and-its-clinical-implications-in-critically-ill-patients-with-cirrhosis-acute-on-chronic-liver-failure-and-without-liver-disease
#2
Andreas Drolz, Thomas Horvatits, Kevin Roedl, Karoline Rutter, Richard Brunner, Christian Zauner, Peter Schellongowski, Gottfried Heinz, Georg-Christian Funk, Michael Trauner, Bruno Schneeweiss, Valentin Fuhrmann
BACKGROUND: Acid-base disturbances are frequently observed in critically ill patients at the intensive care unit. To our knowledge, the acid-base profile of patients with acute-on-chronic liver failure (ACLF) has not been evaluated and compared to critically ill patients without acute or chronic liver disease. RESULTS: One hundred and seventy-eight critically ill patients with liver cirrhosis were compared to 178 matched controls in this post hoc analysis of prospectively collected data...
April 19, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29673096/impact-of-graft-thickness-reduction-of-left-lateral-segment-on-outcomes-following-pediatric-living-donor-liver-transplantation
#3
Toshihiro Kitajima, Seisuke Sakamoto, Kengo Sasaki, Soichi Narumoto, Kourosh Kazemi, Yoshihiro Hirata, Akinari Fukuda, Rumi Imai, Osamu Miyazaki, Rie Irie, Satoshi Teramukai, Shinji Uemoto, Mureo Kasahara
Reducing graft thickness is essential to prevent large-for-size graft problems in pediatric living donor liver transplantation (LDLT). However, long-term outcomes of LDLT using reduced-thickness left lateral segment (LLS) grafts are unclear. In 89 patients who underwent LDLT using reduced LLS grafts between 2005 and 2017, short-term and long-term outcomes were compared between a non-anatomically reduced LLS (NAR-LLS) graft group and a reduced-thickness LLS graft group. Estimated blood loss was lower and abdominal skin closure was less needed in the recipient operation in the reduced-thickness LLS graft group...
April 19, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29668565/the-effects-of-genetic-3-mercaptopyruvate-sulfurtransferase-deficiency-in-murine-traumatic-hemorrhagic-shock
#4
Michael Gröger, Martin Wepler, Ulrich Wachter, Tamara Merz, Oscar McCook, Sandra Kress, Britta Lukaschewski, Sebastian Hafner, Markus Huber-Lang, Enrico Calzia, Michael Georgieff, Noriyuki Nagahara, Csaba Szabó, Peter Radermacher, Clair Hartmann
INTRODUCTION: Hemorrhagic shock is a major cause of death after trauma. An additional blunt chest trauma independently contributes to mortality upon the development of an acute lung injury (ALI) by aggravating pathophysiological consequences of hemorrhagic shock. The maintenance of hydrogen sulfide availability is known to play an important role during hemorrhage and ALI. We therefore tested the impact of a genetic 3-mercaptopyruvate sulfurtransferase mutation (Δ3-MST) in a resuscitated murine model of traumatic-hemorrhagic shock...
April 17, 2018: Shock
https://www.readbyqxmd.com/read/29664834/alkaline-phosphatase-activity-and-endotoxemia-after-infant-cardiothoracic-surgery
#5
Jesse A Davidson, Tracy T Urban, Suhong Tong, Aline Maddux, Gerald Hill, Benjamin S Frank, John D Watson, James Jaggers, Eric A F Simões, Paul Wischmeyer
OBJECTIVE: Infant cardiopulmonary bypass (CPB) increases intestinal permeability leading to endotoxemia. Alkaline phosphatase (AP) reduces endotoxin toxicity in vitro but its effects on endotoxemia in human disease are poorly understood. We assessed the association between serum AP activity and endotoxemia in infants undergoing CPB and determined the effect of ex vivo addition of AP on endotoxemia. METHODS: Prospective cohort study of 62 infants ≤120 days of age undergoing CPB...
April 16, 2018: Shock
https://www.readbyqxmd.com/read/29662967/maternal-serum-uric-acid-level-and-maternal-and-neonatal-complications-in-preeclamptic-women-a-cross-sectional-study
#6
Maryam Asgharnia, Fariba Mirblouk, Soudabeh Kazemi, Davood Pourmarzi, Mina Mahdipour Keivani, Seyedeh Fatemeh Dalil Heirati
Background: Preeclampsia is associated with maternal and neonatal complications. It has been indicated that increased uric acid might have a predictive role on preeclampsia. Objective: We aimed to investigate the relationship between the level of uric acid with maternal and neonatal complications in women with preeclampsia. Materials and Methods: In this cross-sectional study, 160 singleton preeclamptic women at more than 28 wk gestational age were included...
September 2017: International Journal of Reproductive Biomedicine (Yazd, Iran)
https://www.readbyqxmd.com/read/29661433/better-selection-criteria-with-prognostic-factors-for-liver-transplantation
#7
L S Nacif, R S Pinheiro, V Rocha-Santos, V M Barbosa, A P de Moura Dias, R B Martino, R A Macedo, L Ducatti, L Haddad, F Galvão, W Andraus, L Carneiro D' Albuquerque
BACKGROUND: Liver transplantation has evolved significantly in recent years, with each advancement part of the effort toward increasing patient and graft survival as well as quality of life. The objective of this study was to evaluate the prognostic factors and selection criteria for liver transplantation. METHODS: Our study was a statistical analysis, logistic regression, and survival evaluation of a total of 80 liver transplants that were performed between June 1, 2016 and September 24, 2016...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29658839/comparison-of-emergency-cholecystectomy-with-delayed-cholecystectomy-after-percutaneous-transhepatic-gallbladder-drainage-in-patients-with-moderate-acute-cholecystitis
#8
Chang-Wei Ke, Shuo-Dong Wu
INTRODUCTION: Patients with moderate (grade II) acute cholecystitis patients, as defined by the 2013 Tokyo Guidelines, were retrospectively compared with respect to emergency cholecystectomy (EC) and delayed cholecystectomy (DC) after percutaneous transhepatic gallbladder drainage (PTGBD) to determine the better treatment strategy. METHODS: Forty-nine of 103 patients with PTGBD and 47 of 54 patients with EC were assessed for eligibility from January 2013 to January 2017...
April 16, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29652753/hybrid-extracorporeal-therapies-as-a-bridge-to-pediatric-liver-transplantation
#9
Ayse Akcan Arikan, Poyyapakkam Srivaths, Ryan W Himes, Naile Tufan Pekkucuksen, Fong Lam, Trung Nguyen, Tamir Miloh, Michael Braun, John Goss, Moreshwar S Desai
OBJECTIVES: Standard intensive care treatment is inadequate to keep children with liver failure alive without catastrophic complications to ensure successful transplant, as accumulation of endogenous protein-bound toxins often lead to hepatic encephalopathy, hepatorenal syndrome, cardiovascular instability, and multiple organ failure. Given paucity of proven treatment modalities for liver failure, blood purification using different extracorporeal treatments as a bridge to transplantation is used, but studies evaluating the safety and efficacy of combination of these therapies, especially in pediatric liver failure, are lacking...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29644153/acute-fatty-liver-of-pregnancy-a-thorough-examination-of-a-harmful-obstetrical-syndrome-and-its-counterparts
#10
Joshua Ronen, Shahzeb Shaheen, David Steinberg, Kevin R Justus
Diagnosed in one of every 20,000 deliveries, acute fatty liver of pregnancy (AFLP) was considered to be a deadly disease for many years. However, advancements in the clinical and surgical management of pregnant mothers have lead to a drastic decrease in maternal morbidity and mortality. The corresponding case recounts a 23-year-old gravida 2 para 1 (G2P1) at 38 weeks gestational age (GA) with no relevant past medical or family medical history that presented to the emergency department (ED) with a five-day history of nausea, protracted vomiting, hypertension, and new-onset headache...
February 6, 2018: Curēus
https://www.readbyqxmd.com/read/29628586/postoperative-cardiac-surgery-outcomes-in-a-statin-native-population
#11
Sameh Aboulnaga, Ahmed Mahfouz, Hesham A Ewila, Alejandro Kohn Tuli, Rajvir Singh, Amr S Omar, Abdulaziz Al Khualifi
Background: Statin utilization had been associated with improved survival after cardiac surgery. We aim to study whether perioperative treatment with statin could be associated with increased postoperative complications. Design: This was a retrospective, descriptive, single-center study. Settings: We analyzed morbidity after cardiac surgery as well as the outcome related to statin therapy in a tertiary cardiac center. Patients: A total of 202 consecutive patients were enrolled over 1 year after cardiac surgery...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29625787/tropical-diseases-in-the-icu-a-syndromic-approach-to-diagnosis-and-treatment
#12
Dilip R Karnad, Guy A Richards, Gisele Sampaio Silva, Pravin Amin
Tropical infections form 20-30% of ICU admissions in tropical countries. Diarrheal diseases, malaria, dengue, typhoid, rickettsial diseases and leptospirosis are common causes of critical illness. Overlapping clinical features makes initial diagnosis challenging. A systematic approach involving (1) history of specific continent or country of travel, (2) exposure to specific environments (forests or farms, water sports, consumption of exotic foods), (3) incubation period, and (4) pattern of organ involvement and subtle differences in manifestations help in differential diagnosis and choice of initial empiric therapy...
March 27, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29624025/hepatic-encephalopathy-and-cirrhotic-cardiomyopathy-in-intensive-care-unit
#13
Giuliana Scarpati, Edoardo DE Robertis, Ciro Esposito, Ornella Piazza
Acute and chronic liver diseases may escalate to hepatic encephalopathy (HE) and multiple organ failure, requiring admission and organ support in Intensive Care Unit (ICU). Hepatic dysfunction in ICU is a broad and complex topic; unfortunately, up to now, the understanding of its underlying pathophysiology is far from complete. HE and cirrhotic cardiomyopathy (CCM) need timely diagnostic and therapeutic measures aiming at the identification and elimination of causative factors, to improve patients' prognosis...
April 5, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29623618/cost-of-intensive-care-treatment-for-liver-disorders-at-tertiary-care-level-in-india
#14
Shankar Prinja, Pankaj Bahuguna, Ajay Duseja, Manmeet Kaur, Yogesh Kumar Chawla
BACKGROUND: Liver diseases contribute significantly to the health and economic burden globally. We undertook this study to assess the health system costs, out-of-pocket (OOP) expenditure and extent of financial risk protection associated with treatment of liver disorders in a tertiary care public sector hospital in India. METHODOLOGY: The present study was undertaken in an intensive care unit (ICU) of a tertiary care hospital in North India. It comprised an ICU and an HDU (high dependency unit)...
July 14, 2017: PharmacoEconomics Open
https://www.readbyqxmd.com/read/29621834/application-of-accelerated-time-models-to-compare-performance-of-two-comorbidity-adjusting-methods-with-apache-ii-in-predicting-short-term-mortality-among-the-critically-ill
#15
George Mnatzaganian, Melanie Bish, Jason Fletcher, Cameron Knott, John Stephenson
OBJECTIVE: This study aimed to determine how the abilities of the Charlson Index and Elixhauser comorbidities compared with the chronic health components of the Acute Physiology and Chronic Health Evaluation (APACHE II) to predict in-hospital 30 day mortality among adult critically ill patients treated inside and outside of Intensive Care Unit (ICU). METHODS: A total of 701 critically ill patients, identified in a prevalence study design on four randomly selected days in five acute care hospitals, were followed up from the date of becoming critically ill for 30 days or until death, whichever occurred first...
February 2018: Methods of Information in Medicine
https://www.readbyqxmd.com/read/29617497/opcabg-for-moderate-cimr-in-elderly-patients-a-superior-option
#16
Amber Malhotra, Chandrasekaran Ananthanarayanan, Vivek Wadhawa, Sumbul Siddiqui, Pranav Sharma, Kartik Patel, Komal Shah, Pratik Shah
OBJECTIVE: To compare the early and late outcomes of off-pump coronary artery bypass grafting and coronary artery bypass graft + mitral valve repair in elderly patients with moderate chronic ischemic mitral regurgitation. METHODS: One hundred and fifty elderly (age > 70 years) patients with moderate chronic ischemic mitral regurgitation who underwent off-pump coronary artery bypass grafting (n=95) or coronary artery bypass graft + mitral valve repair (n=55) between January 2007 and December 2014 were studied...
January 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29616404/intensive-care-management-of-patients-with-cirrhosis
#17
REVIEW
Jody C Olson
PURPOSE OF REVIEW: Cirrhosis is a major worldwide health problem which results in a high level of morbidity and mortality. Patients with cirrhosis who require intensive care support have high mortality rates of near 50%. The goal of this review is to address the management of common complications of cirrhosis in the ICU. RECENT FINDINGS: Recent epidemiological studies have shown an increase in hospitalizations due to advanced liver disease with an associated increase in intensive care utilization...
April 4, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29605074/management-of-acute-liver-failure-in-the-intensive-care-unit-setting
#18
REVIEW
Priyanka Rajaram, Ram Subramanian
This article discusses the intensive care unit management of patients with acute liver failure. It focuses on the clinical presentation, identification, and management of the myriad of complications seen in patients with acute liver failure.
May 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29605073/non-intensive-care-unit-management-of-acute-liver-failure
#19
REVIEW
Andres F Carrion, Paul Martin
Acute liver failure (ALF) is an uncommon syndrome with a highly variable and unpredictable clinical course. The initial diagnostic evaluation is typically performed in a non-intensive care unit (ICU) setting, like the emergency department or general hospital ward. Prompt restoration of intravascular volume with intravenous fluids and correction of electrolyte, metabolic, and acid-base disturbances are important initial interventions in the management of ALF and can be safely accomplished in non-ICU settings in many patients...
May 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29605023/a-subgroup-analysis-of-penetrating-injuries-to-the-pancreas-777-patients-from-the-national-trauma-data-bank-2010-2014
#20
Bradley Phillips, Lauren Turco, Dan McDonald, Elizabeth Mause, Ryan W Walters
BACKGROUND: This study is the first to analyze penetrating injuries to the pancreas within subgroups of severe traumatic brain injury (TBI), early deaths, and potential survivors. Our objectives were to identify national patterns of injury, predictors of mortality, and to validate the American Association for Surgery of Trauma Organ Injury Scale (AAST-OIS) pancreas injury grades by mortality. Secondary outcomes included hospital and intensive care unit length of stay and days on mechanical ventilation...
May 2018: Journal of Surgical Research
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