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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/29783255/management-of-the-patients-with-blunt-renal-trauma-20-years-of-clinical-experience
#2
Leonid P Sarychev, Yaroslav V Sarychev, Hanna L Pustovoyt, Sergiy A Sukhomlin, Sergiy M Suprunenko
OBJECTIVE: Introduction: Blunt renal trauma (BRT) is a dangerous medical condition. The aim: Analysis of effectiveness of conservative and expectant treatment tactics under ultrasound and CT monitoring in patients with blunt renal trauma (BRT). PATIENTS AND METHODS: Materials and methods: The results of treatment of 81 patients with BRT during 20 years (1998-2017) were analyzed. Amount of men was 58 (71.6%), women - 23 (28.4%). Grade I trauma was seen in 37.0% of cases, grade II - in 25...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29782199/bacteriolysis-a-mere-laboratory-curiosity
#3
Isaac Ginsburg, Erez Koren
The role of bacteriolysis in the pathophysiology of microbial infections dates back to 1893 when Buchner and Pfeiffer reported for the first time the lysis of bacteria by immune serum and related this phenomenon to the immune response. Later on, basic anti-microbial peptides and certain beta-lactam antibiotics have been shown not only to kill microorganisms but also to induce bacteriolysis and the release of cell-wall components. In 2009, a novel paradigm was offered suggesting that the main cause of death in sepsis is due to the exclusive release from activated human phagocytic neutrophils (PMNs) traps adhering upon endothelial cells of highly toxic nuclear histone...
May 21, 2018: Critical Reviews in Microbiology
https://www.readbyqxmd.com/read/29781085/effect-of-hypothermia-treatment-on-gentamicin-pharmacokinetics-in-neonates-with-hypoxic-ischaemic-encephalopathy-a-systematic-review-and-meta-analysis
#4
REVIEW
D W Choi, J H Park, S Y Lee, S H An
WHAT IS KNOWN AND OBJECTIVE: Hypothermia is the current standard therapy for asphyxiated neonates with hypoxic-ischaemic encephalopathy (HIE). Gentamicin is used for the empirical treatment of early-onset neonatal sepsis. We investigated the influence of hypothermia treatment on gentamicin pharmacokinetics and suggested the appropriate dosing recommendations for gentamicin in neonates with HIE receiving hypothermia treatment. METHODS: We searched studies published until February 2017 in MEDLINE using PubMed, EMBASE and the Cochrane Library...
May 20, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29780817/clinical-profile-and-outcome-of-patients-with-acute-kidney-injury-requiring-hemodialysis-two-years-experience-at-a-tertiary-hospital-in-rwanda
#5
Grace Igiraneza, Benedicte Ndayishimiye, Menelas Nkeshimana, Vincent Dusabejambo, Onyema Ogbuagu
Introduction: Acute kidney injury (AKI) requiring renal replacement therapy is associated with high mortality. The study assessed the impact of the introduction of hemodialysis (HD) on outcomes of patients with AKI in Rwanda. Methods: A single center retrospective study that evaluated the clinical profile and survival outcomes of patients with AKI requiring HD [AKI-D] at a tertiary hospital in Rwanda. Data was collected on patients who received HD for AKI from September 2014 to December 2016...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29780654/penile-and-scrotal-strangulation-due-to-metal-rings-case-reports-and-a-review-of-the-literature
#6
Neel H Patel, Ariel Schulman, Jonathan Bloom, Nikil Uppaluri, Michael Iorga, Suraj Parikh, John Phillips, Muhammad Choudhury
Penile and scrotal entrapment from a metal ring placed at the base of the penis is a rare, but important clinical dilemma encountered in urology. Emergent presentation to the urologist, after ring placement far longer than safely practiced, risks ischemic and permanent injury to penile, scrotal, and intrascrotal structures. Treating urologists should be aware of the prevalence of metal ring use, their potential complications, and the surgical approach to their safe removal. We present two patients who were identified at our institution with strangulating injuries of retained penile rings...
2018: Case Reports in Surgery
https://www.readbyqxmd.com/read/29779820/cost-analysis-of-omega-3-supplementation-in-critically-ill-patients-with-sepsis
#7
Kwadwo Kyeremanteng, Jennifer Shen, Kednapa Thavorn, Shannon M Fernando, Brent Herritt, Dipayan Chaudhuri, Peter Tanuseputro
INTRODUCTION: Nutritional supplement of omega-3 fatty acids have been proposed to improve clinical outcomes in critically ill patients. While previous work have demonstrated that omega-3 supplementation in patients with sepsis is associated with reduced ICU and hospital length of stay, the financial impact of this intervention is unknown. OBJECTIVE: Perform a cost analysis to evaluate the impact of omega-3 supplementation on ICU and hospital costs. METHODS: We extracted data related to ICU and hospital length of stay from the individual studies reported in a recent systematic review...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29779703/idiopathic-systemic-capillary-leak-syndrome-presenting-as-septic-shock-a-case-report
#8
Eamon P Raith, Joshua F Ihle, Jennifer Jamieson, Anna Kalff, Julian Bosco
BACKGROUND: Idiopathic capillary leak syndrome (Clarkson's Disease) is a rare angiopathy with a heterogenous phenotype that may present as distributive shock refractory to resuscitative management. OBJECTIVE: We report a case of idiopathic systemic capillary leak syndrome presenting as septic shock. METHODS: Structured case report and review of the literature. RESULTS: A 27-year old man admitted to our institution with coryzal symptoms rapidly deteriorated with presumed sepsis, leading to intensive care unit admission...
May 17, 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29776828/septic-acute-kidney-injury-patients-in-emergency-department-the-risk-factors-and-its-correlation-to-serum-lactate
#9
Yin-Chou Hsu, Chih-Wei Hsu
BACKGROUND: Acute kidney injury (AKI) is a common complication in septic patients, imposing a heavy burden of illness in terms of morbidity and mortality. Serum lactate is a widely used marker predicting the severity of sepsis. A paucity of research has investigated septic AKI in emergency departments (EDs) and its correlation with initial serum lactate level. This study aimed at identifying risk factors for septic AKI and clarifying the link between initial serum lactate level and septic AKI in ED patients...
May 15, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29773345/t-cells-and-their-immunometabolism-a-novel-way-to-understanding-sepsis-immunopathogenesis-and-future-therapeutics
#10
REVIEW
V Kumar
Sepsis has always been considered as a big challenge for pharmaceutical companies in terms of discovering and designing new therapeutics. The pathogenesis of sepsis involves aberrant activation of innate immune cells (i.e. macrophages, neutrophils etc.) at early stages. However, a stage of immunosuppression is also observed during sepsis even in the patients who have recovered from it. This stage of immunosuppression is observed due to the loss of conventional (i.e. CD4+ , CD8+ ) T cells, Th17 cells and an upregulation of regulatory T cells (Tregs)...
May 5, 2018: European Journal of Cell Biology
https://www.readbyqxmd.com/read/29771353/predictors-for-identifying-burn-sepsis-and-performance-versus-existing-criteria
#11
David M Hill, Matthew D Percy, Sai R Velamuri, Julio Lanfranco, Ivan Romero Legro, Scott E Sinclair, William L Hickerson
Sepsis is the largest cause of mortality in thermally injured patients. Traditional SIRS criteria do not aid diagnosis of sepsis in burn centers. Studies have attempted identification of the best indicators of sepsis in the thermal injured patient, but predictive variables are inconsistent across the various studies. Currently, consensus guidelines lack evidential support as to which patients will benefit most from prompt antimicrobial therapy. The purpose of our study was to evaluate novel diagnostic parameters for thermal injured patients with known sepsis and compare these parameters with existing diagnostic criteria...
May 16, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29767696/clinical-outcomes-related-to-the-gastrointestinal-trophic-effects-of-erythropoietin-in-preterm-neonates-a-systematic-review-and-meta-analysis
#12
Anitha Ananthan, Haribalakrishna Balasubramanian, Shripada Rao, Sanjay Patole
Erythropoietin (EPO) plays an important role in the development and maturation of the gastrointestinal tract. Recombinant EPO (rEPO) has been used to prevent anemia of prematurity. The gastrointestinal trophic effects of EPO may reduce feeding intolerance and necrotizing enterocolitis (NEC) in preterm neonates. The aim of this systematic review of randomized controlled trials (RCTs) was to evaluate the effects of rEPO on clinical outcomes such as feeding intolerance, stage II or higher NEC, any stage NEC, sepsis, retinopathy of prematurity, and bronchopulmonary dysplasia in preterm neonates...
May 1, 2018: Advances in Nutrition
https://www.readbyqxmd.com/read/29766208/-adequate-anti-infective-treatment-importance-of-individual-dosing-and-application
#13
A Brinkmann, A C Röhr, A Köberer, T Fuchs, W A Krüger, C König, D Richter, M A Weigand, O R Frey
Sepsis-induced changes in pharmacokinetic parameters are a well-known problem in intensive care medicine. Dosing of antibiotics in this setting is therefore challenging. Alterations to the substance-specific kinetics of anti-infective substances have an effect on the distribution and excretion processes in the body. Increased clearance and an increased distribution volume (Vd ) and particularly compromized organ function with reduced antibiotic elimination are often encountered in patients with sepsis. Renal replacement treatment, which is frequently used in intensive care medicine, represents a substantial intervention in this system...
May 15, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29763894/the-understanding-and-management-of-organism-toxicity-in-septic-shock
#14
Kelly Roveran Genga, Tadanaga Shimada, John H Boyd, Keith R Walley, James A Russell
The toxicity caused by different organisms in septic shock is substantially complex and characterized by an intricate pathogenicity that involves several systems and pathways. Immune cells' pattern recognition receptors initiate the host response to pathogens after the recognition of pathogen-associated molecular patterns. In essence, the subsequent activation of downstream pathways may progress to infection resolution or to a dysregulated host response that represents the hallmark of organ injury in septic shock...
May 15, 2018: Journal of Innate Immunity
https://www.readbyqxmd.com/read/29763469/rapid-diagnosis-of-bloodstream-infections-in-the-critically-ill-evaluation-of-the-broad-range-pcr-esi-ms-technology
#15
Martina Tassinari, Silvia Zannoli, Patrizia Farabegoli, Maria Federica Pedna, Anna Pierro, Antonio Mastroianni, Riccardo Fontan, Luciano Luongo, Giuseppe Sarnataro, Elisa Menegatti, Assunta Caruso, Vittorio Sambri
Bloodstream infection (BSI) and associated sepsis represent a major source of mortality in industrialized countries. Prompt treatment with targeted antibiotics affects both the financial impact and the clinical outcome of BSI: every hour gained in initiating the correct antimicrobial therapy significantly increases the probability of patient survival. However, the current standard-of-care, which depends on blood culture-based diagnosis, are often unable to provide such a fast response. Fast and sensitive molecular techniques for the detection of sepsis-related pathogens from primary blood samples are strongly needed...
2018: PloS One
https://www.readbyqxmd.com/read/29761676/planned-re-laparotomy-in-a-non-trauma-setting-a-single-center-experience
#16
Yehuda Hershkovitz, Itamar Ashkenazi, Zahar Shapira, Oded Zmora, Igor Jeroukhimov
BACKGROUND: Damage control laparotomy (DCL) is the widely accepted procedure of choice in management of severely injured trauma patient. It has been implemented in non-trauma-related surgical pathology in the last decade. OBJECTIVES: To evaluate our experience with planned re-laparotomy (PRL) in non-trauma patients and compare it to other reports. METHODS: Charts of all patients admitted to Assaf Harofeh Medical Center who underwent PRL for non-trauma-related abdominal pathology during a 6 year period were reviewed...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29761622/host-heme-oxygenase-1-friend-or-foe-in-tackling-pathogens
#17
REVIEW
Nisha Singh, Zeeshan Ahmad, Navin Baid, Ashwani Kumar
Infectious diseases are a major challenge in management of human health worldwide. Recent literature suggests that host immune system could be modulated to ameliorate the pathogenesis of infectious disease. Heme oxygenase (HMOX1) is a key regulator of cellular signaling and it could be modulated using pharmacological reagents. HMOX1 is a cytoprotective enzyme that degrades heme to generate carbon monoxide (CO), biliverdin, and molecular iron. CO and biliverdin (or bilirubin derived from it) can restrict the growth of a few pathogens...
May 14, 2018: IUBMB Life
https://www.readbyqxmd.com/read/29755322/microglial-activation-after-systemic-stimulation-with-lipopolysaccharide-and-escherichia-coli
#18
Inge C M Hoogland, Dunja Westhoff, Joo-Yeon Engelen-Lee, Jeroen Melief, Mercedes Valls Serón, Judith H M P Houben-Weerts, Inge Huitinga, David J van Westerloo, Tom van der Poll, Willem A van Gool, Diederik van de Beek
Background: Microglial activation after systemic infection has been suggested to mediate sepsis-associated delirium. A systematic review of animal studies suggested distinct differences between microglial activation after systemic challenge with live bacteria and lipopolysaccharide (LPS). Here, we describe a mouse model of microglial activation after systemic challenge with live Escherichia coli ( E. coli ) and compare results with systemic challenge with LPS. Methods: Sixty mice were intraperitoneally injected with E...
2018: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/29755021/a-single-center-experience-of-post-transplant-lymphoproliferative-disorder-ptld-cases-after-pediatric-liver-transplantation-incidence-outcomes-and-association-with-food-allergy
#19
Zeren Barış, Figen Özçay, Özlem Yılmaz Özbek, Nihan Haberal, Faik Sarıalioğlu, Mehmet Haberal
BACKGROUND/AIMS: We evaluated our 16-year single-center experience of pediatric post-transplant lymphoproliferative disorder (PTLD) cases who underwent liver transplantation between 2001 and 2017. MATERIALS AND METHODS: Of the 236 pediatric patients who underwent liver transplantation between 2001 and 2017, the clinical and laboratory data of eight patients diagnosed with PTLD were reviewed. The pre-transplant Epstein-Barr virus (EBV) status of 172 patients was also recorded...
May 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/29754879/congenital-pyloric-atresia-nine-new-cases-single-center-experience-of-the-long-term-follow-up-and-the-lessons-learnt-over-a-decade
#20
Monal Kansra, V Shankar Raman, Kamal Kishore, Sanat Khanna, Bipin Puri, Abhishek Sharma
BACKGROUND: Congenital pyloric atresia (CPA) is a rare anomaly with an incidence of 1 in 100,000 live births. Depending on the type of anomaly patients can either present in the neonatal period or later in life with subtle nonspecific signs and symptoms. We present our institute's experience in handling these cases over the last decade and highlight lessons learnt. MATERIALS AND METHODS: We retrospectively reviewed records of patients diagnosed with CPA and managed at our centre between Jan 2006 to June 2016...
April 14, 2018: Journal of Pediatric Surgery
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