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https://www.readbyqxmd.com/read/28918620/conservative-management-of-colonoscopic-perforation-a-case-report
#1
Hossein Parsa, Arash Miroliaee, Zafar Doagoo, Saeed Sina
Colonoscopy is widely used for the diagnosis, treatment and a follow up of colorectal diseases. Perforation of the large bowel during elective colonoscopy is rare but serious life threatening complication. We report a 51-year-old woman who experienced recto sigmoid perforation during diagnostic colonoscopy. During 8 days of total hospitalization, she spent 3 days in ICU with gastrointestinal rest. The patient was hydrated and took intravenous antibiotics. In take-output and temperature were closely monitored...
July 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28918324/simultaneous-determination-and-pharmacokinetic-study-of-twelve-bioactive-compounds-in-rat-plasma-after-intravenous-administration-of-xuebijing-injection-by-uhplc-q-orbitrap-hrms
#2
Lihua Zuo, Qiuyue Zhong, Zhenhui Wang, Zhi Sun, Lin Zhou, Zhuolun Li, Tanye Xu, Yingying Shi, Jinfa Tang, Shuzhang Du, Xiaojian Zhang
Xuebijing injection (XBJ) is a traditional Chinese herbal prescription widely used in the treatment of sepsis. Extensive studies revealed that the major bioactive constituents of XBJ injection, including phenolic acids, flavonoids, monoterpene glycosides, lactones and organic acids, play an important role in the treatment. In this study, a rapid, sensitive and accurate ultra high performance liquid chromatography - Q Exactive hybrid quadrupole - orbitrap high-resolution accurate mass spectrometry (UHPLC-Q-Orbitrap HRMS) method was developed for simultaneous determination of twelve bioactive compounds in rat plasma after intravenous administration of XBJ injection...
September 8, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28916371/ramucirumab-plus-docetaxel-versus-placebo-plus-docetaxel-in-patients-with-locally-advanced-or-metastatic-urothelial-carcinoma-after-platinum-based-therapy-range-a-randomised-double-blind-phase-3-trial
#3
Daniel P Petrylak, Ronald de Wit, Kim N Chi, Alexandra Drakaki, Cora N Sternberg, Hiroyuki Nishiyama, Daniel Castellano, Syed Hussain, Aude Fléchon, Aristotelis Bamias, Evan Y Yu, Michiel S van der Heijden, Nobuaki Matsubara, Boris Alekseev, Andrea Necchi, Lajos Géczi, Yen-Chuan Ou, Hasan Senol Coskun, Wen-Pin Su, Miriam Hegemann, Ivor J Percent, Jae-Lyun Lee, Marcello Tucci, Andrey Semenov, Fredrik Laestadius, Avivit Peer, Giampaolo Tortora, Sufia Safina, Xavier Garcia Del Muro, Alejo Rodriguez-Vida, Irfan Cicin, Hakan Harputluoglu, Ryan C Widau, Astra M Liepa, Richard A Walgren, Oday Hamid, Annamaria H Zimmermann, Katherine M Bell-McGuinn, Thomas Powles
BACKGROUND: Few treatments with a distinct mechanism of action are available for patients with platinum-refractory advanced or metastatic urothelial carcinoma. We assessed the efficacy and safety of treatment with docetaxel plus either ramucirumab-a human IgG1 VEGFR-2 antagonist-or placebo in this patient population. METHODS: We did a randomised, double-blind, phase 3 trial in patients with advanced or metastatic urothelial carcinoma who progressed during or after platinum-based chemotherapy...
September 12, 2017: Lancet
https://www.readbyqxmd.com/read/28916175/early-sepsis-detection-in-critical-care-patients-using-multiscale-blood-pressure-and-heart-rate-dynamics
#4
Supreeth P Shashikumar, Matthew D Stanley, Ismail Sadiq, Qiao Li, Andre Holder, Gari D Clifford, Shamim Nemati
Sepsis remains a leading cause of morbidity and mortality among intensive care unit (ICU) patients. For each hour treatment initiation is delayed after diagnosis, sepsis-related mortality increases by approximately 8%. Therefore, maximizing effective care requires early recognition and initiation of treatment protocols. Antecedent signs and symptoms of sepsis can be subtle and unrecognizable (e.g., loss of autonomic regulation of vital signs), causing treatment delays and harm to the patient. In this work we investigated the utility of high-resolution blood pressure (BP) and heart rate (HR) times series dynamics for the early prediction of sepsis in patients from an urban, academic hospital, meeting the third international consensus definition of sepsis (sepsis-III) during their ICU admission...
August 16, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28915308/mutilating-purpura-fulminans-in-an-adult-with-meningococcal-sepsis
#5
María Elena Arnáiz-García, Ana María Arnáiz-García, Francisco Gutierrez-Diez, Juan Francisco Nistal, Jose María González-Santos, Ivana Pulitani, Carlos Amado-Diago, Javier Arnáiz
We report a dramatic case of meningococcal sepsis manifesting as purpura fulminans in an elderly diabetic woman. Hemodynamic instability and severe bilateral cutaneous lesions involving her hands and feet developed rapidly. Specific antibiotic therapy and the administration of inotropic and vasopressor drugs were initiated. The severity and extension of the cutaneous lesions (attributed to purpura fulminans) worsened because of the need for vasoconstrictors for the treatment of septic shock. Bilateral transmetatarsal and metacarpal amputations were required to stabilize the patient...
September 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28914215/-treatment-of-sepsis-in-perspective-what-have-25-years-of-sepsis-definition-brought-us
#6
M J M M van der Steen, P Dieperink, P Pickkers
The first official definition of sepsis was published in 1992. Last year, in 2016, the third version was published. In this article we discuss the various definitions, the evolving insights into pathophysiology and several of the treatments that have been implemented over the last 25 years.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28914210/-sepsis-new-insights-new-definition
#7
W J Wiersinga, A R H van Zanten, K A Kaasjager, T van der Poll
- Incidence of sepsis is increasing, partly due to an ageing population, increased use of immunosuppressants, and antibiotic resistance. Sepsis survival has improved substantially, in part because of continuously improving intensive care and implementation of evidence-based guidelines.- Sepsis is defined as 'life-threatening organ dysfunction due to a dysregulated host response to infection'. The Sequential Organ Failure Assessment (SOFA) score can be used to estimate organ dysfunction severity.- In this article, we discuss the new sepsis definitions - including reactions to these definitions, an overview of current insights in sepsis pathogenesis, and the new treatment guidelines...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28912862/astragalus-polysaccharides-combined-with-ibuprofen-exhibit-a-therapeutic-effect-on-septic-rats-via-an-anti-inflammatory-cholinergic-pathway
#8
Li Liu, Shibiao Chen, Xiaoyun Xu, Benchao Hou, Fei Mo
The aim of the present study was to investigate the effects of Astragalus polysaccharides (APS) in combination with ibuprofen (IBU) in the treatment of sepsis and the underlying mechanism. The combined drug treatment was evaluated in a rat model of cecal ligation and puncture (CLP). The serum concentrations of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and acetylcholine (ACh) were determined. Nicotinic acetylcholine (nAChR) α7 receptor expression and histopathological changes in the lung tissue were also observed...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28912856/blood-purification-treatment-initiated-at-the-time-of-sepsis-diagnosis-effectively-attenuates-serum-hmgb1-upregulation-and-improves-patient-prognosis
#9
Shixiang Zheng, Qinyong Weng, Wenwei Wu, Guohua Ding
The aim of the present study was to investigate the increase in serum and urine levels of high mobility group box protein 1 (HMGB1) during sepsis and the effect of blood purification treatments on HMGB1 levels and patient prognosis. A total of 40 intensive care patients with sepsis were randomly assigned to different groups (n=10 per group): A control group (sepsis group), a continuous renal replacement treatment (CRRT) group, a hemoperfusion (HP) group and an HP+CRRT group. The blood purification treatments using HP and/or CRRT were performed immediately after the diagnosis of sepsis...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28912009/an-inflammation-based-prognostic-score-the-c-reactive-protein-albumin-ratio-predicts-the-morbidity-and-mortality-of-patients-on-parenteral-nutrition
#10
J Llop-Talaveron, M B Badia-Tahull, E Leiva-Badosa
BACKGROUND: There is no "gold standard" score for predicting poor-nutrition-related outcomes. The objective of this study was to identify the optimal predictive score, based on inflammatory parameters, for the clinical outcomes of parenteral nutrition (PN). MATERIAL AND METHODS: This was a 4-year retrospective observational study of 460 patients treated with PN. C-reactive protein (CRP), prealbumin, albumin, CRP/prealbumin and CRP/albumin were studied as potential prognostic scores at the beginning of PN for clinical outcomes during PN...
August 21, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28906305/risk-of-knee-sepsis-following-treatment-of-open-tibia-fractures-a-multicenter-comparison-of-suprapatellar-and-infrapatellar-approaches
#11
Geoffrey S Marecek, Luke T Nicholson, Frances H Broghammer, Michael Talerico, Caroline Tougas, Derek J Donegan, John A Scolaro
OBJECTIVES: The suprapatellar approach for medullary nailing of the tibia is increasing. This requires intra-articular passage of instruments, which theoretically places the knee at risk for postoperative sepsis in the setting of open fracture. We hypothesized that the risk of knee sepsis is similar after suprapatellar or infrapatellar nailing of open tibia fractures. DESIGN: Retrospective, multicenter. SETTING: Three urban Level-1 trauma centers PATIENTS:: All patients treated with medullary nailing for open diaphyseal tibia fractures (OTA 42) from 2009 to 2015...
September 11, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28906284/effect-of-transfusion-on-mortality-and-other-adverse-events-among-critically-ill-septic-patients-an-observational-study-using-a-marginal-structural-cox-model
#12
Claire Dupuis, Maité Garrouste-Orgeas, Sébastien Bailly, Christophe Adrie, Dany Goldgran-Toledano, Elie Azoulay, Stéphane Ruckly, Guillaume Marcotte, Bertrand Souweine, Michael Darmon, Yves Cohen, Carole Schwebel, Guillaume Lacave, Lila Bouadma, Jean-Francois Timsit
OBJECTIVES: RBC transfusion is often required in patients with sepsis. However, adverse events have been associated with RBC transfusion, raising safety concerns. A randomized controlled trial validated the 7 g/dL threshold, but previously transfused patients were excluded. Cohort studies led to conflicting results and did not handle time-dependent covariates and history of treatment. Additional data are thus warranted to guide patient's management. DESIGN: To estimate the effect of one or more RBC within 1 day on three major outcomes (mortality, ICU-acquired infections, and severe hypoxemia) at day 30, we used marginal structural models...
September 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28906115/use-of-the-antimicrobial-peptide-sublancin-with-combined-antibacterial-and-immunomodulatory-activities-to-protect-against-methicillin-resistant-staphylococcus-aureus-infection-in-mice
#13
Shuai Wang, Qingwei Wang, Xiangfang Zeng, Qianhong Ye, Shuo Huang, Haitao Yu, Tianren Yang, Shiyan Qiao
Methicillin-resistant Staphylococcus aureus (MRSA) is the major pathogen causing serious hospital infections worldwide. With the emergence and rapid spread of drug-resistant bacteria, there is extraordinary interest in antimicrobial peptides (AMPs) as promising candidates for the treatment of antibiotic-resistant bacterial infections. Sublancin, a glycosylated AMP produced by Bacillus subtilis 168, has been reported to possess protective activity against bacterial infection. The present study was performed to evaluate the efficacy of sublancin in prevention of MRSA ATCC43300 intraperitoneal infection in mice...
September 14, 2017: Journal of Agricultural and Food Chemistry
https://www.readbyqxmd.com/read/28904174/in-hospital-outcomes-of-tumor-lysis-syndrome-a-population-based-study-using-the-national-inpatient-sample
#14
Urshila Durani, Nilay D Shah, Ronald S Go
The epidemiology and outcomes of tumor lysis syndrome (TLS) are understudied. We used the National Inpatient Sample (NIS), a nationally representative weighted sample of all U.S. hospital discharges, to study outcomes and predictors of mortality in hospitalized patients with TLS. The NIS was queried for patients with a discharge diagnosis of TLS (ICD-9 code 277.88) from 2010-2013. Baseline characteristics and outcomes were analyzed. A multivariable logistic regression analysis was performed to identify predictors of mortality...
September 13, 2017: Oncologist
https://www.readbyqxmd.com/read/28904017/eliciting-improved-antibacterial-efficacy-of-host-proteins-in-the-presence-of-antibiotics
#15
Joanna Jammal, Fadia Zaknoon, Amram Mor
We recently reported the aptitude of a membrane-active lipopeptide (C10OOc12O) to sensitize gram-negative bacilli (GNB) to host antibacterial proteins. Here we explored the potential of harnessing such capacity in the presence of antibiotics. For this purpose, we compared Escherichia coli sensitization to antibiotics in broth and plasma; assessed inner and outer membrane damages using scanning electron microscopy, dyes, and mutant strains; and assessed the ability to affect disease course using the mouse peritonitis-sepsis model for mono- and combination therapies...
September 13, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28904006/the-crash-report-emergency-management-dilemmas-facing-acute-physicians-in-patients-with-pulmonary-arterial-hypertension
#16
Laura C Price, Konstantinos Dimopoulos, Philip Marino, Rafael Alonso-Gonzalez, Colm McCabe, Aleksander Kemnpy, Lorna Swan, Maria Boutsikou, Ahmed Al Zahrani, Gerry J Coghlan, Benjamin E Schreiber, Luke S Howard, Rachel Davies, Mark Toshner, Joanna Pepke-Zaba, Alistair C Church, Andrew Peacock, Paul A Corris, James L Lordan, Sean Gaine, Robin Condliffe, David G Kiely, Stephen John Wort
Treatment of acute emergencies in patients with pulmonary arterial hypertension (PAH) can be challenging. In the UK and Ireland, management of adult patients with PAH is centred in eight nationally designated pulmonary hypertension (PH) centres. However, many patients live far from these centres and physicians in local hospitals are often required to manage PAH emergencies. A committee of physicians from nationally designated PH centres identified the 'most common' emergency clinical scenarios encountered in patients with PAH...
September 12, 2017: Thorax
https://www.readbyqxmd.com/read/28903171/-intraabdominal-infections
#17
Václava Adámková
Intraabdominal infections are the second most common cause of sepsis in intensive care units. Intraabdominal infections represent a wide variety of pathological conditions that involve lesions of all the intraabdominal organs. They also include intraperitoneal, retroperitoneal and parenchymal abscesses. The etiology of these infections usually includes organisms derived from the gut microbiota. The increasing rate of bacterial resistance is alarming. The treatment of intraabdominal infections is complex and involves source control and antibiotics...
June 2017: Klinická Mikrobiologie a Infekc̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28901725/alamandine-reverses-hyperhomocysteinemia-induced-vascular-dysfunction-via-pka-dependent-mechanisms
#18
Tawar Qaradakhi, Minos Timotheos Matsoukas, Alan Hayes, Emma Rybalka, Martin Caprnda, Kvetoslava Rimarova, Milan Sepsi, Dietrich Büsselberg, Peter Kruzliak, John Matsoukas, Vasso Apostolopoulos, Anthony Zulli
INTRODUCTION: Hyperhomocysteinemia (HHcy) impairs nitric oxide endothelium-dependent vasodilation, consequently leading to atherosclerosis, a risk factor for cardiovascular disease. Novel treatments for HHcy are necessary. AIM: We tested the hypothesis that alamandine, a vasoactive peptide of the renin-angiotensin system (RAS), could reverse HHcy-induced vascular dysfunction through the MrgD receptor, and that this is mediated by the protein kinase A (PKA) pathway...
September 13, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28898742/neutrophil-cd64-c-reactive-protein-and-procalcitonin-in-the-identification-of-sepsis-in-the-icu-post-test-probabilities
#19
Joel Jämsä, Tero Ala-Kokko, Virva Huotari, Pasi Ohtonen, Eeva-Riitta Savolainen, Hannu Syrjälä
PURPOSE: We were interested in whether C-reactive protein (CRP) and procalcitonin (PCT) distinguish sepsis from non-septic controls and whether a combination of CRP, PCT, and neutrophil CD64 improves identification of sepsis in the intensive care unit (ICU). MATERIALS AND METHODS: We analyzed the CRP and PCT concentrations from 27 patients with sepsis and 15 ICU controls. In addition, CD64 on neutrophils was measured using quantitative flow cytometry. We present a multiple marker analysis for sepsis diagnostics combining neutrophil CD64, CRP, and PCT using post-test analysis...
August 31, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28895710/-trichosporon-asahii-sepsis-associated-with-urinary-catheter-in-a-pediatric-burn-unit-2-case-reports
#20
Florencia Escarrá, Jimena Lema, Beatriz Caracciolo, Susana Carnovale, Verónica Alvarez, Nidia Tramonti, Fabián Guarracino, M Teresa Rosanova
Trichosporon asahii is a ubiquitous fungus that has been isolated as part of human microbiota. There has been an emergence of this pathogen in recent years, causing superficial and deep seated infections. There are scarce reports of urinary tract infections in pediatric intensive care burn units caused by this agent. We describe the cases of 2 pediatric patients with prolonged hospitalization due to severe burns that had received several antibiotic courses for previous infections. Both presented sepsis secondary to catheter related urinary tract infection by Trichosporon asahii...
October 1, 2017: Archivos Argentinos de Pediatría
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