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Sepsis review

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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
https://www.readbyqxmd.com/read/28636757/babesiosis-an-unusual-cause-of-sepsis-after-kidney-transplantation-and-review-of-the-literature
#2
Imtiaz Ather, Negiin Pourafshar, Denise Schain, Asmita Gupte, Michael J Casey
We report a unique case of babesiosis presenting as sepsis after kidney transplantation. A 70-year-old female kidney transplant recipient presented with fever, hemolytic anemia, and acute kidney injury, and met three of four systemic inflammatory response syndrome (SIRS) criteria. Serology was positive for Babesia microti, confirmed by polymerase chain reaction. The patient was treated with atovaquone and azithromycin and made a full recovery. Reports of babesiosis after solid organ transplantation are rare, with only four prior cases reported in the literature...
June 21, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28635463/an-overview-of-the-evidence-based-practice-process-for-novice-researchers
#3
Emma Rowles, Amanda McNaughton
This article explores how nurses can use evidence-based practice to critique and evaluate the rationale and evidence for specific nursing procedures or practices. Through the development of a focused research question and search strategy, nurses can select and critique relevant research articles to answer the research question, which can support the provision of optimal practice and high-quality care. This article demonstrates the process of evidence-based practice, with the aim of increasing novice researchers' confidence in applying this process in practice...
June 21, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28634578/neonatal-venous-thromboembolism
#4
REVIEW
Kristina M Haley
Neonates are the pediatric population at highest risk for development of venous thromboembolism (VTE), and the incidence of VTE in the neonatal population is increasing. This is especially true in the critically ill population. Several large studies indicate that the incidence of neonatal VTE is up almost threefold in the last two decades. Central lines, fluid fluctuations, sepsis, liver dysfunction, and inflammation contribute to the risk profile for VTE development in ill neonates. In addition, the neonatal hemostatic system is different from that of older children and adults...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28634421/the-role-of-von-willebrand-factor-in-vascular-inflammation-from-pathogenesis-to-targeted-therapy
#5
REVIEW
Felice Gragnano, Simona Sperlongano, Enrica Golia, Francesco Natale, Renatomaria Bianchi, Mario Crisci, Fabio Fimiani, Ivana Pariggiano, Vincenzo Diana, Andreina Carbone, Arturo Cesaro, Claudia Concilio, Giuseppe Limongelli, Mariagiovanna Russo, Paolo Calabrò
Beyond its role in hemostasis, von Willebrand factor (VWF) is an emerging mediator of vascular inflammation. Recent studies highlight the involvement of VWF and its regulator, ADAMTS13, in mechanisms that underlie vascular inflammation and immunothrombosis, like leukocyte rolling, adhesion, and extravasation; vascular permeability; ischemia/reperfusion injury; complements activation; and NETosis. The VWF/ADAMTS13 axis is implicated in the pathogenesis of atherosclerosis, promoting plaque formation and inflammation through macrophage and neutrophil recruitment in inflamed lesions...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28633544/medical-versus-surgical-management-of-penetrating-crohn-s-disease-the-current-situation-and-future-perspectives
#6
Seema A Patil, Raymond K Cross
The development of penetrating Crohn's disease (CD) occurs in up to 50% of patients over the course of their lifetime. While the presentation of these complications, including free perforation, intra-abdominal abscess, and enteric fistula, are usually obvious, the management can require a nuanced approach, with distinct short and long-term approaches. Areas covered: This review discusses medical and surgical methods of treating these complications, including the role of percutaneous drainage of abscesses, the implications of a stricture associated with a fistula, and the efficacy of postoperative anti-TNF therapy in preventing recurrence after surgical treatment...
June 21, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28633281/the-sweet-side-of-the-pathogenic-neisseria-the-role-of-glycan-interactions-in-colonisation-and-disease
#7
Tsitsi D Mubaiwa, Evgeny A Semchenko, Lauren E Hartley-Tassell, Christopher J Day, Michael P Jennings, Kate L Seib
Glycomics is a rapidly growing field that focuses on the structure and function of carbohydrates (glycans) in biological systems. Glycan interactions play a major role in infectious disease, at all stages of colonisation and disease progression. Neisseria meningitidis, the cause of meningococcal sepsis and meningitis, and Neisseria gonorrhoeae, which causes the sexually transmitted infection gonorrhoea, are responsible for significant morbidity and mortality worldwide. N. meningitidis displays a range of surface glycosylations including capsule polysaccharide, lipooligosaccharide and O-linked glycoproteins...
June 13, 2017: Pathogens and Disease
https://www.readbyqxmd.com/read/28632924/metabolomics-as-a-driver-in-advancing-precision-medicine-in-sepsis
#8
Michelle Eckerle, Lilliam Ambroggio, Michael Puskarich, Brent Winston, Alan E Jones, Theodore J Standiford, Kathleen A Stringer
OBJECTIVE: The objective of this review is to explain the science of metabolomics-a science of systems biology that measures and studies endogenous small molecules (metabolites) that are present in a single biological sample-and its application to the diagnosis and treatment of sepsis. In addition, we discuss how discovery through metabolomics can contribute to the development of precision medicine targets for this complex disease state and the potential avenues for those new discoveries to be applied in the clinical environment...
June 20, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28629136/zinc-in-infection-and-inflammation
#9
REVIEW
Nour Zahi Gammoh, Lothar Rink
Micronutrient homeostasis is a key factor in maintaining a healthy immune system. Zinc is an essential micronutrient that is involved in the regulation of the innate and adaptive immune responses. The main cause of zinc deficiency is malnutrition. Zinc deficiency leads to cell-mediated immune dysfunctions among other manifestations. Consequently, such dysfunctions lead to a worse outcome in the response towards bacterial infection and sepsis. For instance, zinc is an essential component of the pathogen-eliminating signal transduction pathways leading to neutrophil extracellular traps (NET) formation, as well as inducing cell-mediated immunity over humoral immunity by regulating specific factors of differentiation...
June 17, 2017: Nutrients
https://www.readbyqxmd.com/read/28629122/age-related-changes-in-immunological-and-physiological-responses-following-pulmonary-challenge
#10
REVIEW
Edmund J Miller, Helena M Linge
This review examines the current status of knowledge of sepsis and pneumonia in the elderly population and how the dynamics of the pulmonary challenge affects outcome and consequences. Led by an unprecedented shift in demographics, where a larger proportion of the population will reach an older age, clinical and experimental research shows that aging is associated with certain pulmonary changes, but it is during infectious insult of the lungs, as in the case of pneumonia, that the age-related differences in responsiveness and endurance become obvious and lead to a worse outcome than in the younger population...
June 17, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28625450/vasoplegic-syndrome-an-update-on-perioperative-considerations
#11
REVIEW
Henry Liu, Ling Yu, Longqiu Yang, Michael S Green
Vasoplegic syndrome (VS) is increasingly recognized as an important clinical entity in perioperative medicine. VS is characterized by significant arterial hypotension, normal or high cardiac output, low systemic vascular resistance, and increased requirements for intravenous volume and vasopressors. Tremendous variations exist regarding incidence reported in the literature and management at different institutions; and the incidence of VS is likely significantly higher than many anesthesiologists believe. Thus the aims of this article are to review the pertinent aspects related to VS and alert clinical anesthesiologists to this under-recognized yet very challenging clinical condition...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28625309/maternal-mortality-and-the-role-of-the-obstetric-anesthesiologist
#12
REVIEW
Gillian Abir, Jill Mhyre
Maternal mortality is increasing in the United States and remains unacceptably high in many parts of the world. Pre-existing conditions and social determinants of health frequently contribute to maternal death. General solutions to enhance maternal safety focus on systems to identify women at high risk and to tailor the management before, during, and after pregnancy. This review highlights condition-specific solutions for the leading etiologies of maternal death, including cardiac disease, sepsis, hemorrhage, venous thromboembolism, hypertensive disorders of pregnancy, and amniotic fluid embolism...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28625271/-advances-in-immunotherapeutic-research-of-sepsis
#13
Lihua Dong, Juan Lyu, Lili Ding, Zhongmin Liu
Sepsis is a life-threatening organ dysfunction caused by dysregulated host responses to infection. Despite decades of research, it remains the leading cause of death in intensive care units (ICUs). None of the current treatment, including antibiotics, organ protection and liquid resuscitation, is specifically effective for sepsis. Immunosuppression is one of the currently accepted pathogenesis and immunotherapy is one of the hot spot of current sepsis research. Immune related treatments include restricting the release of pathogen toxin and its removal, controlling the excessive inflammatory reaction and apoptosis inhibition, etc...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625270/-progress-in-relationship-of-the-long-non-coding-rna-and-sepsis
#14
Lingling Sun, Li Li, Jing Yan
The mechanism of long chain non-coding RNA (lncRNA) is diverse. LncRNA can regulate the expression of genes at multiple levels and is closely related to some pathological process, such as tumor formation, viral replication, inflammatory damage, etc. The abnormal expression of lncRNA is involved in the patho-physiological changes of the disease, and plays a key role in many links, such as the stability of mRNA, the regulation of translation level, protein transport, RNA processing and modification, and so on...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28624903/early-diagnosis-of-sepsis-is-an-integrated-omics-approach-the-way-forward
#15
REVIEW
Raymond J Langley, Hector R Wong
Sepsis remains one of the leading causes of death in the USA and it is expected to get worse as the population ages. Moreover, the standard of care, which recommends aggressive treatment with appropriate antibiotics, has led to an increase in multiple drug-resistant organisms. There is a dire need for the development of new antibiotics, improved antibiotic stewardship, and therapies that treat the host response. Development of new sepsis therapeutics has been a disappointment as no drugs are currently approved to treat the various complications from sepsis...
June 17, 2017: Molecular Diagnosis & Therapy
https://www.readbyqxmd.com/read/28624098/utility-of-neurovascular-imaging-in-acute-neonatal-arterial-ischemic-stroke
#16
Ishita Siddiq, Derek Armstrong, Ann-Marie Surmava, Nomazulu Dlamini, Daune MacGregor, Mahendranath Moharir, Rand Askalan
OBJECTIVE: To evaluate the prevalence of magnetic resonance angiography (MRA) findings and clinically characterize neonates with arterial ischemic stroke (AIS) who have abnormal or variable vasculature. STUDY DESIGN: This was a single-center, retrospective study of patients with neonatal stroke from 1991 to 2012. We reviewed charts and neuroimaging, including MRA, in neonates with AIS. Clinical data of patients with MRA findings were compared with the control group of neonates with AIS and a normal MRA...
June 14, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28621828/progress-in-the-synthesis-and-biological-evaluation-of-lipid-a-and-its-derivatives
#17
REVIEW
Jian Gao, Zhongwu Guo
Lipid A is one of the core structures of bacterial lipopolysaccharides (LPSs), and it is mainly responsible for the strong immunostimulatory activities of LPS through interactions with the Toll-like receptors and other molecules in the human immune system. To obtain structurally homogeneous and well-defined lipid As and its derivatives in quantities meaningful for various biological studies and applications, their chemical synthesis has become a focal point. This review has provided a survey of significant progresses made in the synthesis of lipid A, and its derivatives that carry diverse saturated and unsaturated lipids, have the phosphate group at its reducing end replaced with a more stable phosphate or carboxyl group, or lack the reducing end phosphate or both phosphate groups, as well as progresses in the synthesis of LPS analogs and other lipid A conjugates...
June 16, 2017: Medicinal Research Reviews
https://www.readbyqxmd.com/read/28620366/vibrio-vulnificus-an-environmental-and-clinical-burden
#18
REVIEW
Sing-Peng Heng, Vengadesh Letchumanan, Chuan-Yan Deng, Nurul-Syakima Ab Mutalib, Tahir M Khan, Lay-Hong Chuah, Kok-Gan Chan, Bey-Hing Goh, Priyia Pusparajah, Learn-Han Lee
Vibrio vulnificus is a Gram negative, rod shaped bacterium that belongs to the family Vibrionaceae. It is a deadly, opportunistic human pathogen which is responsible for the majority of seafood-associated deaths worldwide. V. vulnificus infection can be fatal as it may cause severe wound infections potentially requiring amputation or lead to sepsis in susceptible individuals. Treatment is increasingly challenging as V. vulnificus has begun to develop resistance against certain antibiotics due to their indiscriminate use...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28616283/the-use-of-thrombolytics-in-the-management-of-complex-pleural-fluid-collections
#19
Jessica Heimes, Hannah Copeland, Aditya Lulla, Marjulin Duldulao, Khaled Bahjri, Salman Zaheer, Jason M Wallen
BACKGROUND: To determine the efficacy of thrombolytics for the management of complex pleural fluid collections. METHODS: We reviewed patients that received alteplase for persistent loculated pleural fluid collections after simple tube drainage between July 01, 2007 and November 01, 2012. Our alteplase protocol is 6 mg of alteplase in 50 mL of normal saline injected into the pleural chest tube. The chest tube is clamped for four hours and then opened. Normally this is repeated daily for 2 to 3 days (d)...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616060/early-recognition-of-methicillin-resistant-staphylococcus-aureus-surgical-site-infections-using-risk-and-protective-factors-identified-by-a-group-of-italian-surgeons-through-delphi-method
#20
G Sganga, C Tascini, E Sozio, S Colizza
BACKGROUND: Surgical site infections (SSIs) constitute a major clinical problem in terms of morbidity, mortality, duration of hospital stay, and overall costs. The bacterial pathogens implicated most frequently are Streptococcus pyogenes (S. pyogenes) and Staphylococcus aureus (S. aureus). The incidence of methicillin-resistant S. aureus (MRSA) SSIs is increasing significantly. Since these infections have a significant impact on hospital budgets and patients' health, their diagnosis must be anticipated and therapy improved...
2017: World Journal of Emergency Surgery: WJES
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