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Sepsis treatment

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https://www.readbyqxmd.com/read/29165795/therapeutic-potency-of-mtor-signaling-pharmacological-inhibitors-in-the-treatment-of-proinflammatory-diseases-current-status-and-perspectives
#1
REVIEW
Arash Soltani, Amirhossein Bahreyni, Nadia Boroumand, Mostafa Karimi Roshan, Majid Khazaei, Mikhail Ryzhikov, Saman Soleimanpour, Amir Avan, Seyed Mahdi Hassanian
Mammalian target of rapamycin (mTOR) signaling pathway controls cell energy metabolism. There is an interplay between mTOR and proinflammatory signaling pathways, supporting the role of the pathway in the pathogenesis of inflammatory diseases. Inhibition of mTOR signaling using specific pharmacological inhibitors could offer therapeutic promise in several inflammatory-associated diseases. In this review, we summarize recent findings on the regulatory effects of mTOR signaling on inflammation and the therapeutic potency of mTOR pharmacological inhibitors in the treatment of inflammatory diseases including cancer, neurodegenerative diseases, atherosclerosis, sepsis and rheumatoid arthritis for a better understanding and hence a better management of these diseases...
November 22, 2017: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/29164508/eus-guided-transrectal-evacuation-of-organized-pelvic-collection-following-roux-en-y-gastric-bypass-after-failure-of-radiological-and-surgical-approach
#2
Gianfranco Donatelli, Jean-Loup Dumont, Fabrizio Cereatti, Bruto Randone, Bruno Meduri, Panagiotis Lainas, Hadrien Tranchart, Ibrahim Dagher
INTRODUCTION: Postoperative collections are an important cause of morbidity following obesity surgery. Surgical revision is most often required if general sepsis is present. Conservative treatment consists of broad spectrum antibiotics and percutaneous drainage of any collection. EUS drainage is a new technique that is gaining momentum allowing an easy access to collections close to the GI tract. MATERIALS AND METHODS: We present the case report of a 39-year-old woman who underwent to robotic Roux-en-Y gastric bypass for morbid obesity...
November 21, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29164361/bacteraemia-in-emergency-departments-effective-antibiotic-reassessment-is-associated-with-a-better-outcome
#3
Charlotte Aillet, Didier Jammes, Agnès Fribourg, Sophie Léotard, Olivier Pellat, Patricia Etienne, Dominique Néri, Djamel Lameche, Olivier Pantaloni, Serge Tournoud, Pierre-Marie Roger
Patients with bacteraemia constitute an useful population for an audit of antibiotic treatments. Empirical antibiotic therapy (EAT) and its reassessment must take into account clinical data and microbiological results. Our aim was to determine the impact of these sequential steps of the therapy on survival. This was a retrospective multicentre study which included patients admitted to emergency departments (ED) for whom blood cultures were positive over a 4-month period. Microbial results were compiled from the database of the laboratories...
November 21, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29163487/baicalin-inhibits-nod-like-receptor-family-pyrin-containing-domain-3-inflammasome-activation-in-murine-macrophages-by-augmenting-protein-kinase-a-signaling
#4
Chen-Guang Li, Liang Yan, Feng-Yi Mai, Zi-Jian Shi, Li-Hui Xu, Yan-Yun Jing, Qing-Bing Zha, Dong-Yun Ouyang, Xian-Hui He
The flavonoid baicalin has been reported to possess potent anti-inflammatory activities by suppressing inflammatory signaling pathways. However, whether baicalin can suppress the activation of NOD-like receptor (NLR) family, pyrin containing domain 3 (NLRP3) inflammasome in macrophages is largely unknown. Here, we showed that baicalin treatment dose-dependently inhibited adenosine triphosphate (ATP) or nigericin-induced NLRP3 inflammasome activation, as revealed by the decreased release of mature interleukin (IL)-1β, active caspase-1p10, and high-mobility group box-1 protein from lipopolysaccharide (LPS)-primed bone marrow-derived macrophages...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29163354/diabetes-and-sepsis-risk-recurrence-and-ruination
#5
REVIEW
Lynn M Frydrych, Fatemeh Fattahi, Katherine He, Peter A Ward, Matthew J Delano
Sepsis develops when an infection surpasses local tissue containment. A series of dysregulated physiological responses are generated, leading to organ dysfunction and a 10% mortality risk. When patients with sepsis demonstrate elevated serum lactates and require vasopressor therapy to maintain adequate blood pressure in the absence of hypovolemia, they are in septic shock with an in-hospital mortality rate >40%. With improvements in intensive care treatment strategies, overall sepsis mortality has diminished to ~20% at 30 days; however, mortality continues to steadily climb after recovery from the acute event...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29161713/clinical-benefits-of-high-volume-hemofiltration-in-critically-ill-pediatric-patients-with-severe-sepsis-a-retrospective-cohort-study
#6
Huijie Miao, Fei Wang, Xi Xiong, Chunxia Wang, Yucai Zhang
AIMS: The study aimed to assess the clinical benefits of high-volume hemofiltration (HVHF) in pediatric patients with severe sepsis compared with standard-volume continuous veno-venous hemofiltration (CVVH). METHODS: We retrospectively analyzed the medical records of 155 pediatric patients with severe sepsis admitted to the pediatric intensive care unit of Shanghai Children's Hospital from January 2010 to June 2016. A total of 93 patients were treated with HVHF and 62 patients were treated with CVVH...
November 22, 2017: Blood Purification
https://www.readbyqxmd.com/read/29161385/are-we-close-to-the-ideal-intravenous-fluid
#7
N MacDonald, R M Pearse
The approach to i.v. fluid therapy for hypovolaemia may significantly influence outcomes for patients who experience a systemic inflammatory response after sepsis, trauma, or major surgery. Currently, there is no single i.v. fluid agent that meets all the criteria for the ideal treatment for hypovolaemia. The physician must choose the best available agent(s) for each patient, and then decide when and how much to administer. Findings from large randomized trials suggest that some colloid-based fluids, particularly starch-based colloids, may be harmful in some situations, but it is unclear whether they should be withdrawn from use completely...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29160639/predictors-of-mortality-in-neonates-with-giant-omphaloceles
#8
Amulya K Saxena, Maja Raicevic
INTRODUCTION: This analysis was performed a review of giant-omphaloceles to determine the predictors of mortality. EVIDENCE ACQUISITION: Pubmed® and KoBson databases were searched for terms "giant" "omphalocele" and "mortality". Primary end points included mortality correlation with gestational age (GA), birth weight (BW), eviscerated organs, associated anomalies and management. To calculate mean and median values IBM SPSS version 23.0 was used. EVIDENCE SYNTHESIS: After de-duplication and review search revealed 42 articles of which 23 met our inclusion criteria with 396 giant-omphaloceles for this analysis...
November 21, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/29159658/lung-necrosectomy-in-pediatric-patients-with-necrotizing-pneumonia
#9
Francina V Bolaños-Morales, Emmanuel Peña Gómez-Portugal, María E Aguilar-Mena, Patricio J Santillán-Doherty, Avelina Sotres-Vega, J Alfredo Santibáñez-Salgado
INTRODUCTION: Necrotizing pneumonia is the consolidation of lung parenchyma with destruction and necrosis, forming solitary or multiloculated radiolucent foci. When antibiotic treatment fails and clinical course does not improve, patients might need lung tissue resection: segmentectomy, lobectomy or bilobectomy. We have performed a more conservative surgical approach in pediatric patients with necrotizing pneumonia, lung necrosectomy: resection of unviable necrotic tissue, to preserve more healthy and potentially recoverable lung parenchyma...
November 20, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29158243/point-of-care-lactate-testing-for-sepsis-at-presentation-to-health-care-a-systematic-review-of-patient-outcomes
#10
Elizabeth Morris, David McCartney, Daniel Lasserson, Ann Van den Bruel, Rebecca Fisher, Gail Hayward
BACKGROUND: Lactate is measured in hospital settings to identify patients with sepsis and severe infections, and to guide initiation of early treatment. Point-of-care technology could facilitate measurement of lactate by clinicians in the community. However, there has been little research into its utility in these environments. AIM: To investigate the effect of using point-of-care lactate at presentation to health care on mortality and other clinical outcomes, in patients presenting with acute infections...
November 20, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29157085/sequential-occurrence-of-small-cell-and-non-small-lung-cancer-in-a-male-patient-is-it-a-transformation
#11
Ahsan Wahab, Kavitha Kesari, Siddique Chaudhary, Mahin Khan, Hafiz Khan, Susan Smith, Yanis Boumber
Lung cancer is one of the leading causes of cancer-related mortality and is categorized into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). We present a patient with epidermal growth factor receptor (EGFR)-mutant-NSCLC who developed metastatic SCLC after initial therapy with second-generation EGFR-tyrosine kinase inhibitor, afatinib. A 65-year-old male non-smoker was diagnosed with adenocarcinoma of the right lung, stage IVA (M1a). Due to tumor positivity for EGFR-Exon 19 deletion, the patient was started on oral afatinib, which resulted in a partial response...
November 20, 2017: Cancer Biology & Therapy
https://www.readbyqxmd.com/read/29156532/paclitaxel-alleviated-liver-injury-of-septic-mice-by-alleviating-inflammatory-response-via-microrna-27a-tab3-nf-%C3%AE%C2%BAb-signaling-pathway
#12
Qiu Yang, Dongshan Zhang, Ya Li, Yongquan Li, Yinpeng Li
Excessive inflammatory response and apoptosis play an important role in the sepsis-induced liver injury. Paclitaxel, a diterpene alkaloid of Taxus brevifolia, is widely used as an anti-tumor drug and shows protective effects on acute lung and kidney injury. However, whether it has a protective effect against sepsis-induced liver injury has not been reported. The objective of this study was to investigate the protective effects of paclitaxel in septic liver injury in mice and associated molecular mechanisms...
November 15, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29154519/current-treatments-for-anal-condylomata-acuminata
#13
Massimiliano Mistrangelo, Ivano Dal Conte, Silvio Volpatto, Giulio DI Benedetto, Valentina Testa, Francesca Currado, Mario Morino
INTRODUCTION: Condylomata acuminate are the most common sexually transmitted disease worldwide. They are usually a serious problem, but it causes emotional distress to patient and physician alike because of its marked tendency to recurrence. The presence of anogenital warts mandates treatment, also for potential degeneration of the lesions. EVIDENCE ACQUISITION: A review of the Literature has been performed to analyze proposed treatments for anogenital warts. EVIDENCE SYNTHESIS: Many treatments have been employed...
November 20, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/29153062/-diagnostic-accuracy-of-the-lightcycler%C3%A2-septifast-assay-in-the-childhood-febrile-neutropenia
#14
Esra Mimaroğlu, Elvan Çağlar Çıtak, Necdet Kuyucu, Gönül Arslan
Infection is the main problem among the patients receiving cancer therapy. The mortality rate can be reduced by the appropriate treatment in the right time. Although blood culture is the gold standard for the diagnoses of sepsis, many factors influence the results of blood culture in children. For this reason, real time polymerase chain reaction (Rt-PCR) has gained importance for the diagnoses of microbiological agents as it is faster than the conventional methods. In this study, we aimed to compare the efficacy of SeptiFast (SF) test with blood culture among children with neutropenic fever...
October 2017: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/29151426/-effects-of-antibiotics-on-intestinal-microflora-and-intestinal-mucosal-barrier-function-and-its-mechanisms
#15
Yue Han, Yuxin Leng, Gaiqi Yao
Antibiotics are the cornerstone to cure infectious diseases, however, it also destroys the intestinal inherent microflora, and may cause serious gastrointestinal dysfunction, such as abdominal distension, diarrhea, mucosal barrier damage etc. In severe conditions, it may induce intestinal sepsis. With the development of the human microbiology group program and the popularity of microbial sequencing technology, people can comprehend the effects of antibiotics on intestinal flora deeply, meanwhile the traditional biomedical model (the basis of bacterial disease) is questioned...
November 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29150444/toll-like-receptor-4-induced-ryanodine-receptor-2-oxidation-and-sarcoplasmic-reticulum-ca2-leakage-promote-cardiac-contractile-dysfunction-in-sepsis
#16
Jie Yang, Rui Zhang, Xin Jiang, Jingzhang Lv, Ying Li, Hongyu Ye, Wenjuan Liu, Gang Wang, Cuicui Zhang, Na Zheng, Ming Dong, Yan Wang, Peiya Chen, Kumar Santosh, Yong Jiang, Jie Liu
Studies suggest the potential role of sarcoplasmic reticulum (SR) Ca2+ leak in cardiac contractile dysfunction in sepsis. However, direct supporting evidence is lacking, and the mechanisms underlying this SR leak are poorly understood. Here, we investigated the changes in cardiac Ca2+ handling and contraction in LPS-treated rat cardiomyocytes and a mouse model of polymicrobial sepsis produced by cecal ligation and puncture (CLP). LPS decreased the systolic Ca2+ transient and myocyte contraction, as well as SR Ca2+ content...
November 17, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/29149943/endocrine-and-metabolic-alterations-in-sepsis-and-implications-for-treatment
#17
REVIEW
Catherine Ingels, Jan Gunst, Greet Van den Berghe
Sepsis induces profound neuroendocrine and metabolic alterations. During the acute phase, the neuroendocrine changes are directed toward restoration of homeostasis, and also limit unnecessary energy consumption in the setting of restricted nutrient availability. Such changes are probably adaptive. In patients not recovering quickly, a prolonged critically ill phase may ensue, with different neuroendocrine changes, which may represent a maladaptive response. Whether stress hyperglycemia should be aggressively treated or tolerated remains a matter of debate...
January 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29149939/improving-long-term-outcomes-after-sepsis
#18
REVIEW
Hallie C Prescott, Deena Kelly Costa
Although acute survival from sepsis has improved in recent years, a large fraction of sepsis survivors experience poor long-term outcomes. In particular, sepsis survivors have high rates of weakness, cognitive impairment, hospital readmission, and late death. To improve long-term outcomes, in-hospital care should focus on early, effective treatment of sepsis; minimization of delirium, distress, and immobility; and preparing patients for hospital discharge. In the posthospital setting, medical care should focus on addressing new disability and preventing medical deterioration, providing a sustained period out of the hospital to allow for recovery...
January 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29149937/personalizing-sepsis-care
#19
REVIEW
Mervyn Singer
Sepsis describes a broad-based syndrome covering many infectious agents, affecting various sites in patients of differing age, gender, and comorbidity and resulting in varying degrees and combinations of organ dysfunction. Protocolized care with rigid goals may suit populations, assuming the evidence-lite recommendations are beneficial, but not necessarily individual patients. A personalized approach to management is rational and preferable. Other than clinical heterogeneity, a range of biological signatures exist in sepsis, and these fluctuate over the disease course...
January 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29149936/epidemiology-and-outcomes
#20
REVIEW
Bourke Tillmann, Hannah Wunsch
Sepsis is a global public health concern. Internationally it contributes to more than 5 million deaths annually. Although rates are variable between countries, over the past 40 years reported incidence has continued to increase. Aside from potential differences in patient populations, the variation in reported rates also reflects differences in identification strategies, access to health care, and awareness of the diagnosis. Factors such as age, sex, socioeconomic status, comorbid disease, and type and site of infection impact the development of and outcomes from sepsis...
January 2018: Critical Care Clinics
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