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Sepsis treatment

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https://www.readbyqxmd.com/read/28226613/using-demographic-and-time-series-physiological-features-to-classify-sepsis-in-the-intensive-care-unit
#1
Kristin Gunnarsdottir, Vijay Sadashivaiah, Matthew Kerr, Sabato Santaniello, Sridevi V Sarma, Kristin Gunnarsdottir, Vijay Sadashivaiah, Matthew Kerr, Sabato Santaniello, Sridevi V Sarma, Sridevi V Sarma, Sabato Santaniello, Kristin Gunnarsdottir, Matthew Kerr, Vijay Sadashivaiah
Sepsis, a systemic inflammatory response to infection, is a major health care problem that affects millions of patients every year in the intensive care units (ICUs) worldwide. Despite the fact that ICU patients are heavily instrumented with physiological sensors, early sepsis detection remains challenging, perhaps because clinicians identify sepsis by (i) using static scores derived from bed-side measurements individually, and (ii) deriving these scores at a much slower rate than the rate for which patient data is collected...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28224112/intravenous-vitamin-c-as-adjunctive-therapy-for-enterovirus-rhinovirus-induced-acute-respiratory-distress-syndrome
#2
Alpha A Fowler Iii, Christin Kim, Lawrence Lepler, Rajiv Malhotra, Orlando Debesa, Ramesh Natarajan, Bernard J Fisher, Aamer Syed, Christine DeWilde, Anna Priday, Vigneshwar Kasirajan
We report a case of virus-induced acute respiratory distress syndrome (ARDS) treated with parenteral vitamin C in a patient testing positive for enterovirus/rhinovirus on viral screening. This report outlines the first use of high dose intravenous vitamin C as an interventional therapy for ARDS, resulting from enterovirus/rhinovirus respiratory infection. From very significant preclinical research performed at Virginia Commonwealth University with vitamin C and with the very positive results of a previously performed phase I safety trial infusing high dose vitamin C intravenously into patients with severe sepsis, we reasoned that infusing identical dosing to a patient with ARDS from viral infection would be therapeutic...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28223734/early-thrombomodulin-%C3%AE-administration-outcome-for-acute-disseminated-intravascular-coagulopathy-in-gastrointestinal-surgery
#3
Hirotaka Konishi, Kazuma Okamoto, Katsutoshi Shoda, Tomohiro Arita, Toshiyuki Kosuga, Ryo Morimura, Shuhei Komatsu, Yasutoshi Murayama, Atsushi Shiozaki, Yoshiaki Kuriu, Hisashi Ikoma, Masayoshi Nakanishi, Daisuke Ichikawa, Hitoshi Fujiwara, Eigo Otsuji
AIM: To investigate the efficacy of thrombomodulin (TM)-α for treatment of disseminated intravascular coagulopathy (DIC) in the field of gastrointestinal surgery. METHODS: Thirty-six peri-operative DIC patients in the field of gastrointestinal surgery who were treated with TM-α were retrospectively investigated. The relationships between patient demographics and the efficacy of TM-α were examined. Analysis of survival at 28 d was also performed on some parameters by means of the Kaplan-Meier method...
February 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#4
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28222313/cytokine-profiles-as-novel-diagnostic-markers-of-epstein-barr-virus-associated-hemophagocytic-lymphohistiocytosis-in-children
#5
Xiu-Cui Han, Qing Ye, Wei-Ying Zhang, Yong-Min Tang, Xiao-Jun Xu, Ting Zhang
PURPOSE: The aim of this study was to identify specific laboratory indices to distinguish Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) in children. MATERIALS AND METHODS: In this prospective study, Th1/Th2 cytokines, including IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ, were analyzed in patients with EBV-HLH or sepsis at the onset of disease by flow cytometry. RESULTS: IL-10, IFN-γ, IL-10/IL-6, and IFN-γ/IL-6 were higher and IL-6 was lower in EBV-HLH patients compared to sepsis patient levels...
February 10, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28221298/mr-proadm-a-new-biomarker-for-early-diagnosis-of-sepsis-in-burned-patients
#6
Jochen Gille, Hanfried Ostermann, Adrian Dragu, Armin Sablotzki
Mid-regional pro-adrenomedullin (MR-proADM) has been used as a marker of sepsis, but its dynamics and role in a burn injury setting has not been tested. In a prospective observational study, we included 42 consecutive patients with >15% TBSA. Daily blood specimens collected during the initial 20 days of treatment were submitted for laboratory analysis of MR-proADM and procalcitonin (PCT) via immunoluminometric sandwich assay (Kryptor, BRAHMS, Berlin, Germany). In patients with an absence of sepsis, an initial increase in MR-proADM and PCT levels was noted post burn injury, peaking on the second day post admission and thereafter demonstrated a continued decline in MR-proADM and PCT levels...
February 15, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28221185/antipyretic-therapy-in-critically-ill-septic-patients-a-systematic-review-and-meta-analysis
#7
Anne M Drewry, Enyo A Ablordeppey, Ellen T Murray, Carolyn R T Stoll, Sonya R Izadi, Catherine M Dalton, Angela C Hardi, Susan A Fowler, Brian M Fuller, Graham A Colditz
OBJECTIVE: This meta-analysis aimed to examine the impact of antipyretic therapy on mortality in critically ill septic adults. DATA SOURCES: Literature searches were implemented in Ovid Medline, Embase, Scopus, Cumulative Index of Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, NHS Economic Evaluation Database, and ClinicalTrials.gov through February 2016. STUDY SELECTION: Inclusion criteria were observational or randomized studies of septic patients, evaluation of antipyretic treatment, mortality reported, and English-language version available...
February 17, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28221154/prospective-outcomes-of-11-13ch-ultra-mini-percutaneous-nephrolithotomy-ump-a-consecutive-cohort-study
#8
Janak D Desai
: Ultra mini PCNL (UMP) has been described as a less invasive technique of PCNL for the treatment of small to medium sized stones in attempt to reduce the surgical morbidity. OBJECTIVE: Evaluate prospectively the outcomes of UMP. METHODS: Single surgeon prospective concurrent cohort study of UMP in India. Effectiveness was assessed by stone-free rates, operative time, complications including transfusion, sepsis rates, length of stay and analgesic requirements...
January 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28221147/-update-in-the-management-of-ureteral-lithiasis-semirigid-and-flexible-ureterorenoscopy
#9
Carlos Torrecilla Ortiz, Sergi Colom Feixas
OBJECTIVE: The contribution of therapeutic ureteroscopy done by Perez Castro in 1980 varied the management algorithm for ureteral lithiasis worldwide. The techniques of Retrograde Ureteroscopy and transrenal antegrade ureteroscopy led to the abandonment of open surgery for the treatment of ureteral lithiasis. Only Shock wave lithotripsy has maintained similar success rates in selected cases. METHODS: Descriptive analysis of the semirigid and flexible ureteroscopy techniques performed in our department over the last 10 years giving detail on the technique and safety tips to increase the efficacy and efficiency of ureteroscopy...
January 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28220742/calcific-uraemic-arteriolopathy-calciphylaxis-in-patients-on-renal-replacement-therapy
#10
S Sebastian, H F Jordaan, J W Schneider, M R Moosa, M R Davids
BACKGROUND: Calcific uraemic arteriolopathy (calciphylaxis) is an unusual and potentially fatal condition characterised by small-vessel calcification and ischaemic skin necrosis. It mainly affects patients with end-stage renal disease (ESRD) on haemodialysis, but may rarely occur in the absence of ESRD in conditions such as primary hyperparathyroidism, malignancy, alcoholic liver disease and connective tissue disease. METHODS: We reviewed the records of all patients diagnosed with calciphylaxis while on renal replacement therapy at Tygerberg Hospital, Cape Town, South Africa, between 1990 and 2014, to describe its presentation, course and final outcome...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28220264/treatment-of-stage-ii-medication-related-osteonecrosis-of-the-jaw-with-necrosectomy-and-autologous-bone-marrow-mesenchymal-stem-cells
#11
Pit Jacob Voss, Akihiko Matsumoto, Esteban Alvarado, Rainer Schmelzeisen, Fabian Duttenhöfer, Philipp Poxleitner
Treatment strategies for medication-related osteonecrosis of the jaw (MRONJ) remain controversial. Although the AAOMS suggests a conservative approach, a surgical management with necrosectomy is often required when conservative management has failed. Moreover, recent studies have shown promising results using an early stage surgical treatment. Over the past decade, cell-based bone regeneration utilizing bone marrow mesenchymal stem cells (MSCs) received increased attention. MSCs are known to promote wound healing and induce new bone formation in compromised tissue...
February 20, 2017: Odontology
https://www.readbyqxmd.com/read/28219190/-efficacy-and-safety-of-procalcitonin-guidance-in-reducing-the-duration-of-antibiotic-treatment-of-sepsis-patients
#12
X L Xu, F D Yan, J Q Yu, Q H Chen, H Lin, R Q Zheng
Objective: To assesse the efficacy and safety of procalcitonin-guided antibiotic treatment of sepsis patients in intensive care units (ICU). Methods: A prospective, randomised, controlled trial was gone in ICU of Northern Jiangsu People's Hospital.Between January 2013 and December 2015.One hundred and fifty-six patients assessed for eligibility were randomly assigned to the procalcitonin-guided group (PCT group, 79) or to regular antibiotic group (RAT group, 77). Patients who received antibiotics for presumed infection according to principle of antimicrobial usage...
February 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28219189/-effects-of-phentolamine-on-haemodynamics-of-patients-with-severe-sepsis
#13
W Yang, X B Li, Y Zhou, X M Mo
Objective: To explore the effects of phentolamine on hemodynamic of patients with severe sepsis . Methods: From January 2015 to August 2016, using random number table, 59 patients with severe sepsis were divided into research group and the control group by conventional treatment in Department of Emergency, the Second People's Hospital of Nanning City. The patients of the research group were given phentolamine injection. The CI, ITBVI, EVLWI, SVRI of the patients were monitored by PICCO on 6, 12, 24, 48, 72 h before and after treatment...
February 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28218881/mr-imaging-of-perianal-crohn-disease
#14
Shannon P Sheedy, David H Bruining, Eric J Dozois, William A Faubion, Joel G Fletcher
Pelvic magnetic resonance (MR) imaging is currently the standard for imaging perianal Crohn disease. Perianal fistulas are a leading cause of patient morbidity because closure often requires multimodality treatments over a prolonged period of time. This review summarizes clinically relevant anal sphincter anatomy, imaging methods, classification systems, and treatment objectives. In addition, the MR appearance of healing perianal fistulas and fistula complications is described. Difficult imaging tasks including the assessment of rectovaginal fistulas and ileoanal anastomoses are highlighted, along with illustrative cases...
March 2017: Radiology
https://www.readbyqxmd.com/read/28218629/fever-induced-brugada-pattern-misdiagnosed-as-an-acute-myocardial-infarction
#15
David Tadin, Roberto Quintal
The Brugada syndrome is a rare condition associated with increased risk of ventricular tachyarrhythmias and sudden cardiac death (SCD). The Brugada pattern on electrocardiogram (EKG) is known to be revealed by several precipitants including febrile illnesses. The appearance of a Brugada pattern on EKG with fever may indicate an elevated risk of arrhythmia or sudden cardiac death. We report a case in which the electrocardiographic abnormality of Brugada pattern induced by sepsis was initially misinterpreted as a ST-segment elevation myocardial infarction (STEMI)...
January 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28218356/a-new-integrated-technique-for-the-supportive-treatment-of-sepsis
#16
Jens Hartmann, Stephan Harm
Although there has been continuous, intensive research for many years in the field of sepsis treatment, currently available treatment options are limited, and there is still a lack of systems that efficiently remove endotoxins as well as mediators. Here, we discuss a newly developed, integrated technique that combines different aspects for their use in extracorporeal blood purification for the supportive treatment of liver failure and sepsis.
February 8, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28217595/impact-of-pre-hospital-care-on-the-outcome-of-children-arriving-with-agonal-breathing-to-a-pediatric-emergency-service-in-south-india
#17
Debasis Das Adhikari, Krishna Mahathi, Urmi Ghosh, Indira Agarwal, Anila Chacko, Ebor Jacob, Kala Ebenezer
BACKGROUND: Data on the prehospital interventions received by critically ill children at arrival to Paediatric Emergency Services (PES) is limited in developing countries. This study aims to describe the pre-hospital care scenario, transport and their impact on outcome in non-traumatic, acutely ill children presenting in PES with agonal breathing. METHODS: Prospective observational study done on children aged below 15 years arriving in PES with agonal breathing due to non-trauma related causes...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28216060/incidence-of-fever-in-labor-and-risk-of-neonatal-sepsis
#18
Craig V Towers, Angela Yates, Nikki Zite, Casey Smith, Lindsey Chernicky, Bobby Howard
BACKGROUND: The current recommendation regarding the management of a term newborn delivered of a mother with an intrapartum fever or a diagnosis of clinical chorioamnionitis is that the neonate should have baseline laboratory work drawn along with blood cultures and be universally treated with antibiotics until culture results return. These guidelines report that the rate of intrapartum fever is about 3%; however, a few large studies suggest that the rate is higher at about 7%. OBJECTIVE: To prospectively evaluate the rate of fever during labor in a large number of deliveries and determine the rate of early onset neonatal sepsis in newborns delivered from mothers with an intrapartum fever compared with the newborns that delivered from mothers that did not have an intrapartum fever...
February 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28215135/rapid-response-team-diagnoses-frequencies-and-related-hospital-mortality
#19
Roger J Smith, John D Santamaria, Espedito E Faraone, Jennifer A Holmes, David A Reid
OBJECTIVES: To describe the frequency and hospital mortality of problems (diagnoses) encountered by a rapid response team (RRT), and to identify the most common diagnoses for RRT triggers and for treating units. DESIGN: For each RRT event in 2015 at a tertiary hospital for adults, we chose the diagnosis that best explained the RRT event from a pre-defined list after reviewing relevant test results and clinical notes. RESULTS: There were 937 RRT events during 700 admissions and there were 58 different RRT diagnoses in 11 diagnosis groups...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28213800/invasive-aspergillus-laryngotracheobronchitis-in-an-adult-with-primary-cns-lymphoma
#20
Mark E Barry, William Walsh Thomas, Buer Song, Natasha Mirza
Invasive aspergillosis can be difficult to diagnose, and early recognition and initiation of therapy is imperative for improving patient outcomes. A case of invasive Aspergillus laryngotracheobronchitis is presented here with a review of the relevant literature. A 58-year-old male undergoing treatment for CNS lymphoma presented with neutropenic sepsis and acute respiratory distress requiring intubation. Following extubation, he reported persistent hoarseness for 1-month duration and he was found to have pseudomembranous plaques and ulcers of the larynx, trachea, and right mainstem bronchus consistent with Aspergillus laryngotracheobronchitis...
February 17, 2017: Mycopathologia
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