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Sepsis treatment

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https://www.readbyqxmd.com/read/29334583/effects-of-carnosine-beta-alanyl-l-histidine-in-an-experimental-rat-model-of-acute-kidney-injury-due-to-septic-shock
#1
Sabiha Sahin, Dilek Burukoglu Donmez
BACKGROUND Acute kidney injury (AKI) secondary to sepsis is a major cause of morbidity and mortality in the human intensive care unit (ICU). Kidney function and the histological findings of AKI were investigated in an experimental rat model with sepsis induced by cecal ligation and puncture (CLP) and compared with and without treatment with carnosine (beta-alanyl-L-histidine). MATERIAL AND METHODS Twenty-four Sprague-Dawley rats were randomly divided into three groups consisting eight rats in each: Group 1 - control; Group 2 - septic shock; and Group 3 - septic shock treated with carnosine...
January 15, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29334018/pyoderma-gangrenosum-demographics-treatments-and-outcomes-an-analysis-of-2-273-cases
#2
Sarah E Sasor, Tahereh Soleimani, Michael W Chu, Julia A Cook, Peter J Nicksic, Sunil S Tholpady
OBJECTIVE: Pyoderma gangrenosum is a rare, neutrophil-mediated, auto-inflammatory dermatosis. This condition has clinical features analogous to infectious processes and must be quickly diagnosed to be properly treated. The purpose of this study was to characterise relevant clinical features associated with pyoderma gangrenosum based on a large inpatient cohort. METHOD: The National Inpatient Sample (US) was used to identify patients with the diagnosis of pyoderma gangrenosum using ICD-9 diagnosis code 686...
January 1, 2018: Journal of Wound Care
https://www.readbyqxmd.com/read/29332614/serelaxin-for-infant-heart-failure-in-congenital-dilated-cardiomyopathy
#3
Patrick O Myers, Alice Bordessoule, Cécile Tissot
Serelaxin has been studied in trials in adults with acute heart failure, but not in children. We report the first compassionate use of serelaxin in an infant. A 6-month-old girl with dilated cardiomyopathy was placed on extracorporeal membrane oxygenation following cardiac arrest unresponsive to medical treatment. Extracorporeal membrane oxygenation weaning failed despite maximal ino-dilator therapy. During the 48-hour infusion of serelaxin, we observed marked improvement in brain natriuretic peptide, left ventricular systolic function, and dilatation...
January 15, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29332515/vasoplegia-in-patients-with-sepsis-and-septic-shock-pathways-and-mechanisms
#4
A-M Burgdorff, M Bucher, J Schumann
Sepsis is one of the most frequent causes of death among patients in intensive care units. Many therapeutic strategies have been assessed without the desired success rates. A key risk factor for death is hypotension due to vasodilatation with vascular hyposensitivity. However, the pathways underlying this process remain unclear. Endotoxemia induces inflammatory mediators, and this is followed by vasoplegia and decreased cardiac contractility. Although inhibition of these mediators diminishes mortality rates in animal models, this phenomenon has not been confirmed in humans...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29331425/low-picomolar-label-free-procalcitonin-analytical-detection-with-an-electrolyte-gated-organic-field-effect-transistor-based-electronic-immunosensor
#5
Preethi Seshadri, Kyriaki Manoli, Nicole Schneiderhan-Marra, Uwe Anthes, Piotr Wierzchowiec, Klaus Bonrad, Cinzia Di Franco, Luisa Torsi
Herein a label-free immunosensor based on electrolyte-gated organic field-effect transistor (EGOFET) was developed for the detection of procalcitonin (PCT), a sepsis marker. Antibodies specific to PCT were immobilized on the poly-3-hexylthiophene (P3HT) organic semiconductor surface through direct physical adsorption followed by a post-treatment with bovine serum albumin (BSA) which served as the blocking agent to prevent non-specific adsorption. Antibodies together with BSA (forming the whole biorecognition layer) served to selectively capture the procalcitonin target analyte...
December 26, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/29331260/multifaceted-behavior-of-meckel-s-diverticulum-in-children
#6
Qingjiang Chen, Zhigang Gao, Lifeng Zhang, Yuebin Zhang, Tao Pan, Duote Cai, Qixing Xiong, Qiang Shu, Yunzhong Qian
PURPOSE/BACKGROUND: Meckel's diverticulum (MD) is one of the most common congenital malformations of gastrointestinal tract in children. However, the nonspecific clinical manifestations of MD often cause a diagnostic as well as therapeutic challenge to pediatric surgeon. This study aimed to review our experience in managing this disease while evaluating the management strategies. METHODS: We retrospectively analyzed the clinical data of all patients diagnosed with MD admitted to our center between January 2010 and December 2015...
December 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29330152/risk-of-infection-in-type-1-and-type-2-diabetes-compared-with-the-general-population-a-matched-cohort-study
#7
Iain M Carey, Julia A Critchley, Stephen DeWilde, Tess Harris, Fay J Hosking, Derek G Cook
OBJECTIVE: We describe in detail the burden of infections in adults with diabetes within a large national population cohort. We also compare infection rates between patients with type 1 and type 2 diabetes mellitus (T1DM and T2DM). RESEARCH DESIGN AND METHODS: A retrospective cohort study compared 102,493 English primary care patients aged 40-89 years with a diabetes diagnosis by 2008 (n = 5,863 T1DM and n = 96,630 T2DM) with 203,518 age-sex-practice-matched control subjects without diabetes...
January 12, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29329118/ce-managing-sepsis-and-septic-shock-current-guidelines-and-definitions
#8
Mary Beth Flynn Makic, Elizabeth Bridges
Recent updates emphasize early recognition and prompt intervention. ABSTRACT: Sepsis is a leading cause of critical illness and hospital mortality. Early recognition and intervention are essential for the survival of patients with this syndrome. In 2002, the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) launched the Surviving Sepsis Campaign (SSC) to reduce overall patient morbidity and mortality from sepsis and septic shock by driving practice initiatives based on current best evidence...
January 11, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29329022/impact-of-non-anticoagulant-therapy-on-patients-with-sepsis-induced-disseminated-intravascular-coagulation-a-multicenter-case-control-study
#9
Daisuke Kudo, Mineji Hayakawa, Kota Ono, Kazuma Yamakawa
INTRODUCTION: Anticoagulant therapy for patients with sepsis is not recommended in the latest Surviving Sepsis Campaign guidelines, and non-anticoagulant therapy is the global standard treatment approach at present. We aimed at elucidating the effect of non-anticoagulant therapy on patients with sepsis-induced disseminated intravascular coagulation (DIC), as evidence on this topic has remained inconclusive. MATERIALS AND METHODS: Data from 3195 consecutive adult patients admitted to 42 intensive care units for the treatment of severe sepsis were retrospectively analyzed via propensity score analyses with and without multiple imputation...
January 3, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29327977/status-and-challenges-of-predicting-and-diagnosing-sepsis-in-burn-patients
#10
Mile Stanojcic, Roohi Vinaik, Marc G Jeschke
Burns are a common form of trauma that account for more than 300,000 deaths each year worldwide. Survival rates have improved over the past decades because of improvements in nutritional and fluid support, burn wound care, and infection control practices. Death, however, remains unacceptably high. The primary cause of death has changed over the last decades from anoxic causes to now predominantly infections and sepsis. Sepsis and septic complications are not only major contributors to poor outcomes, but they further result in longer hospital stay and higher healthcare costs...
January 12, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29325957/effect-and-feasibility-of-therapeutic-hypothermia-in-patients-with-hemorrhagic-stroke-a-systematic-review-and-meta-analysis
#11
REVIEW
Zhong Yao, Chao You, Min He
INTRODUCTION: Therapeutic hypothermia (TH) has shown a good performance in the experimental hemorrhagic stroke. But the clinical application of TH remains controversial since reports regarding its therapeutic effect are inconsistent. METHODS: We conducted a systematic review based on Preferred Reporting Items for Systematic Reviews and Meta-analyses. Compare TH with control group in terms of mortality, the poor outcome, delayed cerebral ischemia (DCI) and specific complications...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29325753/induced-hypothermia-in-patients-with-septic-shock-and-respiratory-failure-cass-a-randomised-controlled-open-label-trial
#12
Theis Skovsgaard Itenov, Maria Egede Johansen, Morten Bestle, Katrin Thormar, Lars Hein, Louise Gyldensted, Anne Lindhardt, Henrik Christensen, Stine Estrup, Henrik Planck Pedersen, Matthew Harmon, Uday Kant Soni, Silvia Perez-Protto, Nicolai Wesche, Ulrik Skram, John Asger Petersen, Thomas Mohr, Tina Waldau, Lone Musaeus Poulsen, Ditte Strange, Nicole P Juffermans, Daniel I Sessler, Else Tønnesen, Kirsten Møller, Dennis Karsten Kristensen, Alessandro Cozzi-Lepri, Jens D Lundgren, Jens-Ulrik Jensen
BACKGROUND: Animal models of serious infection suggest that 24 h of induced hypothermia improves circulatory and respiratory function and reduces mortality. We tested the hypothesis that a reduction of core temperature to 32-34°C attenuates organ dysfunction and reduces mortality in ventilator-dependent patients with septic shock. METHODS: In this randomised, controlled, open-label trial, we recruited patients from ten intensive care units (ICUs) in three countries in Europe and North America...
January 8, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29325521/adjuvant-treatment-of-resectable-biliary-tract-cancer-with-cisplatin-plus-gemcitabine-a-prospective-single-center-phase-ii-study
#13
Alexander R Siebenhüner, Heike Seifert, Helga Bachmann, Burkhardt Seifert, Thomas Winder, Jonas Feilchenfeldt, Stefan Breitenstein, Pierre-Alain Clavien, Roger Stupp, Alexander Knuth, Bernhard Pestalozzi, Panagiotis Samaras
BACKGROUND: Biliary tract cancer (BTC) is a dismal disease, even after curative intent surgery. We conducted this prospective, non-randomized phase II study to evaluate the feasibility and efficacy of cisplatin and gemcitabine as adjuvant treatment in patients with resected BTC. METHODS: Patients initially received gemcitabine 1000 mg/m2 alone on days 1, 8 and 15 every 28-days for a total of six cycles (single agent cohort), and after protocol amendment a combination therapy with gemcitabine 1000 mg/m2 and cisplatin 25 mg/m2 on days 1 and 8 was administered every 21 days for a total of eight cycles (combined regimen cohort)...
January 11, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29324628/ulinastatin-protects-against-lps-induced-acute-lung-injury-by-attenuating-tlr4-nf-%C3%AE%C2%BAb-pathway-activation-and-reducing-inflammatory-mediators
#14
Chao Cao, Chengfen Yin, Songtao Shou, Jun Wang, Lechang Yu, Xuening Li, Yanfen Chai
Acute lung injury (ALI) and its severe form, acute respiratory distress syndrome (ARDS), remain the leading causes of morbidity and mortality in intensive care units. Ulinastatin (UTI), a serine protease inhibitor, possesses anti-inflammatory properties and has been suggested to modulate lipopolysaccharide (LPS)-induced sepsis; thus, it is now widely used in the treatment of pancreatitis, sepsis, and septic shock. Toll-like receptor 4 (TLR4), an essential LPS signaling receptor, plays a critical role in the activation of innate immunity...
January 10, 2018: Shock
https://www.readbyqxmd.com/read/29324626/vascular-effects-of-adrenomedullin-and-the-anti-adrenomedullin-antibody-adrecizumab-in-sepsis
#15
Christopher Geven, Andreas Bergmann, Matthijs Kox, Peter Pickkers
Sepsis remains a major scientific and medical challenge, for which, apart from significant refinements in supportive therapy, treatment has barely changed over the last few decades. During sepsis, both vascular tone and vascular integrity are compromised, and contribute to the development of shock. The free circulating peptide adrenomedullin (ADM) is involved in regulation of the endothelial barrier function and tone of blood vessels. Several animal studies have shown that ADM administration improves outcome of sepsis...
January 10, 2018: Shock
https://www.readbyqxmd.com/read/29324500/hydroxyethyl-starch-130-0-4-and-its-impact-on-perioperative-outcome-a-propensity-score-matched-controlled-observation-study
#16
Judith-Irina Pagel, Markus Rehm, Tobias Kammerer, Nikolai Hulde, Eike Speck, Josef Briegel, Falk Reinholz, Alexander Crispin, Klaus F Hofmann-Kiefer
BACKGROUND: Adverse effects of hydroxyethyl starches (HESs) have been verified in patients suffering from sepsis or kidney disease, but not in surgical patients at large. The investigation aimed to determine whether the use of HES 130/0.4 was associated with the incidence of acute postinterventional adverse events compared to Ringer's acetate alone in a perioperative setting. METHODS: This propensity score matched, controlled observational study was performed in a single-centre university hospital...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29323338/ulinastatin-attenuates-lps-induced-inflammation-in-mouse-macrophage-raw264-7-cells-by-inhibiting-the-jnk-nf-%C3%AE%C2%BAb-signaling-pathway-and-activating-the-pi3k-akt-nrf2-pathway
#17
Si-Tong Li, Qi Dai, Shu-Xian Zhang, Ya-Jun Liu, Qiu-Qiong Yu, Fei Tan, Shu-Hong Lu, Quan Wang, Jian-Wen Chen, He-Qing Huang, Pei-Qing Liu, Min Li
Ulinastatin (UTI) is a broad-spectrum serine protease inhibitor isolated and purified from human urine with strong anti-inflammatory and cytoprotective actions, which is widely used for the treatment of various diseases, such as pancreatitis and sepsis. Although the therapeutic effects of UTI are reported to be associated with a variety of mechanisms, the signaling pathways mediating the anti-inflammatory action of UTI remain to be elucidated. In the present study we carried out a systematic study on the anti-inflammatory and anti-oxidative mechanisms of UTI and their relationships in LPS-treated RAW264...
January 11, 2018: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/29322353/quercetin-exerts-cardiovascular-protective-effects-in-lps-induced-dysfunction-in-vivo-by-regulating-inflammatory-cytokine-expression-nf-%C3%AE%C2%BAb-phosphorylation-and-caspase-activity
#18
Xiqing Wei, Xiangli Meng, Yuxiang Yuan, Fengjuan Shen, Chengqiu Li, Jun Yang
Impaired myocardial contractile function, one of the well-documented features of sepsis, contributes greatly to the high rate of mortality. Quercetin is widely accepted as a potential antioxidant and free radical scavenger. Epidemiologic studies have suggested that an increase in the intake of dietary Quercetin can reduce the risk of cardiac disease. However, presently there is no report yet on the influence of Quercetin on LPS-induced myocardial dysfunction in vivo. Cardiovascular protective effects of Quercetin on LPS-induced sepsis in mice were measured after intragastric administration, using normal saline as a positive control...
January 10, 2018: Molecular and Cellular Biochemistry
https://www.readbyqxmd.com/read/29321098/spondylodiscitis-diagnosis-and-treatment-options
#19
Christian Herren, Norma Jung, Miguel Pishnamaz, Marianne Breuninger, Jan Siewe, Rolf Sobottke
BACKGROUND: A recent population-based study from Denmark showed that the incidence of spondylodiscitis rose from 2.2 to 5.8 per 100 000 persons per year over the period 1995-2008; the age-standardized incidence in Germany has been estimated at 30 per 250 000 per year on the basis of data from the Federal Statistical Office (2015). The early diagnosis and treatment of this condition are essential to give the patient the best chance of a good outcome, but these are often delayed because it tends to present with nonspecific manifestations, and fever is often absent...
December 25, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29319247/infection-associated-secondary-hemophagocytic-lymphohistiocytosis-in-sepsis-syndromes-a-tip-of-an-iceberg
#20
Arun Agarwal, Aakanksha Agarwal
Background: Hemophagocytic lymphohistiocytosis (HLH) is a rare, underdiagnosed, fatal and devastating hyperinflammatory syndrome that has gained increasing recognition over the past decade. Patients with HLH present with clinical and laboratory evidence of uncontrolled inflammation. Delay in diagnosis and management inevitably leads to a rapidly progressive and fatal course. In this case series, we present 7 cases of secondary HLH (sHLH) in adults with their presentation, course, and outcomes...
October 2017: Journal of the Association of Physicians of India
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