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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/29346034/coagulopathy-in-severe-sepsis-interconnectivity-of-coagulation-and-the-immune-system
#2
Jason M Samuels, Hunter B Moore, Ernest E Moore
BACKGROUND: Disseminated intravascular coagulation (DIC) remains a challenging complication of infection with inadequate treatment and significant morbidity and mortality rates. METHODS: Review of the English-language literature. RESULTS: Disseminated intravascular coagulation arises from the immune system's response to microbial invasion, as well as the byproducts of cell death that result from severe sepsis. This response triggers the coagulation system through an interconnected network of cellular and molecular signals, which developed originally as an evolutionary mechanism intended to isolate micro-organisms via fibrin mesh formation...
January 18, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29345117/candida-auris-a-systematic-review-and-meta-analysis-of-current-updates-on-an-emerging-multidrug-resistant-pathogen
#3
John Osei Sekyere
From 2009, Candida auris has emerged as a multidrug-resistant ascomycete yeast pathogen with the capacity for easy transmission between patients and hospitals, as well as persistence on environmental surfaces. Its association with high mortalities, breakthrough and persistent candidaemia, inconsistencies in susceptibility testing results, misidentification by available commercial identification systems and treatment failure, complicates its management and detection. Within the last nine years, C. auris has been increasingly reported from far-Eastern Asia, the Middle East, Africa, Europe, South and North America with substantial fatalities and misidentification...
January 18, 2018: MicrobiologyOpen
https://www.readbyqxmd.com/read/29344568/non-surgical-management-of-boerhaave-s-syndrome-a-case-series-study-and-review-of-the-literature
#4
Khalil Aloreidi, Bhavesh Patel, Tim Ridgway, Terry Yeager, Muslim Atiq
Background and study aims:  Boerhaave's syndrome (BS) is a life-threatening condition with morbidity and mortality rates as high as 50 % in some reports. Until recently, surgical intervention has been the mainstay of management plans. With advances in therapeutic endoscopy, however, there has been increasing interest in non-surgical options including endoscopic esophageal stenting. Patients and methods:  We reviewed the medical records of all patients diagnosed with BS and managed with endoscopic interventions between November 2011 and November 2016...
January 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29344053/an-overview-of-exposure-to-ethanol-containing-substances-and-ethanol-intoxication-in-children-based-on-three-illustrated-cases
#5
REVIEW
Kam Lun Hon, Alexander Kc Leung, Eddie Cheung, Bryan Lee, Michelle Mc Tsang, Alcy R Torres
Alcohol addiction and intoxication are major health problems worldwide. Acute alcohol intoxication is well reported in adults and adolescents but less frequently reported in children of younger ages. We report three anonymized cases of pediatric ethanol exposure and illustrate the different mechanisms of intoxication. In all cases, a focused history is the key to prompt diagnosis and timely management. Physicians should be aware of this potential poison in children presented with acute confusional or encephalopathic state...
2018: Drugs in Context
https://www.readbyqxmd.com/read/29343506/how-to-use%C3%A2-procalcitonin
#6
Philip Robinson, Surjo Kiran De
Diagnosing bacterial infection in the unwell or febrile child is a common challenge faced by all paediatricians. Despite the advent of novel molecular techniques, there is ongoing need for diagnostic assays with adequate performance and turnaround time to facilitate safe clinical decision-making when bacterial sepsis is suspected, such as whether to commence empirical treatment with antibiotics. Procalcitonin is an established marker of infection that has a potential role in the diagnosis and exclusion of serious or invasive bacterial infection in neonates and children...
January 17, 2018: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/29343314/cell-free-dna-the-role-in-pathophysiology-and-as-a-biomarker-in-kidney-diseases
#7
Peter Celec, Barbora Vlková, Lucia Lauková, Janka Bábíčková, Peter Boor
Cell-free DNA (cfDNA) is present in various body fluids and originates mostly from blood cells. In specific conditions, circulating cfDNA might be derived from tumours, donor organs after transplantation or from the foetus during pregnancy. The analysis of cfDNA is mainly used for genetic analyses of the source tissue -tumour, foetus or for the early detection of graft rejection. It might serve also as a nonspecific biomarker of tissue damage in critical care medicine. In kidney diseases, cfDNA increases during haemodialysis and indicates cell damage...
January 18, 2018: Expert Reviews in Molecular Medicine
https://www.readbyqxmd.com/read/29342997/-x-linked-inhibitor-of-apoptosis-deficiency-manifested-as-crohn-s-disease-a-case-report-and-literature-review
#8
L J Xu, Y Y Luo, J D Yu, J G Lou, Y H Fang, J Chen
Objective: To analyze the clinical characteristics of X-linked inhibitor of apoptosis (XIAP) deficient patients with clinical manifestation of Crohn's disease. Methods: Clinical manifestations, laboratory investigations, genetic testing and therapeutic interventions of one case of XIAP deficiency who was admitted to Department of Gastroenterology in Children's Hospital, Zhejiang University School of Medicine in May 2016 were summarized. PubMed and Chinese database for articles published from January 2016 to June 2017 were searched using the key words of'Crohn's disease'and'XIAP', and the relevant literature was reviewed...
January 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29342010/the-ever-expanding-saga-of-the-proprotein-convertases-and-their-roles-in-body-homeostasis-emphasis-on-novel-proprotein-convertase-subtilisin-kexin-number-9-functions-and-regulation
#9
Nabil G Seidah, Michel Chrétien, Majambu Mbikay
PURPOSE OF REVIEW: The nine members of the proprotein convertase family play major physiological roles during development and in the adult, and their dysregulation leads to various diseases. The primary objective of this article is to review recent findings on the clinical importance of some of these convertases concentrating mostly on PCSK9, the ninth member of the convertase family. This includes the transcriptional and translational regulation of PCSK9, its ability to enhance the degradation of LDL receptor (LDLR), and the implication of PCSK9 in inflammation and sepsis...
January 15, 2018: Current Opinion in Lipidology
https://www.readbyqxmd.com/read/29341864/comparison-of-acute-kidney-injury-of-different-aetiology-reveals-in-common-mechanisms-of-tissue-damage
#10
Michael Hultström, Mediha Becirovic-Agic, Sofia Jönsson
Acute kidney injury (AKI) is a syndrome of reduced glomerular filtration rate (GFR) and urine production caused by a number of different diseases. It is associated with renal tissue damage. This tissue damage can cause tubular atrophy and interstitial fibrosis that leads to nephron loss and progression of chronic kidney disease (CKD). This review describes the in-common mechanisms behind tissue damage in AKI caused by different underlying diseases. Comparing six high-quality microarray studies of renal gene expression after AKI in disease models (gram-negative sepsis, gram-positive sepsis, ischemia-reperfusion, malignant hypertension, rhabdomyolysis and cisplatin toxicity) identified 5254 differentially expressed genes in at least one of the AKI models...
December 20, 2017: Physiological Genomics
https://www.readbyqxmd.com/read/29341844/empiric-antibiotics-for-sepsis
#11
Sara A Buckman, Isaiah R Turnbull, John E Mazuski
BACKGROUND: Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. Early recognition and treatment are the cornerstones of management. METHODS: Review of the English-language literature. RESULTS: For both sepsis and septic shock "antimicrobials [should be] be initiated as soon as possible and within one hour" (Surviving Sepsis Campaign). The risk of progression from severe sepsis to septic shock increases 8% for each hour before antibiotics are started...
January 17, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29341498/review-article-sepsis-in-the-emergency-department-part-2-investigations-and-monitoring
#12
REVIEW
Amith Shetty, Stephen Pj Macdonald, Gerben Keijzers, Julian M Williams, Benjamin Tang, Bas de Groot, Kelly Thompson, John F Fraser, Simon Finfer, Rinaldo Bellomo, Jonathan Iredell
Sepsis is characterised by organ dysfunction resulting from infection, with no reliable single objective test and current diagnosis based on clinical features and results of investigations. In the ED, investigations may be conducted to diagnose infection as the cause of the presenting illness, identify the source, distinguish sepsis from uncomplicated infection (i.e. without organ dysfunction) and/ or risk stratification. Appropriate sample collection for microbiological testing remains key for subsequent confirmation of diagnosis and rationalisation of antimicrobials...
January 16, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29341032/-epidemiology-diagnosis-and-treatment-of-adult-patients-with-nosocomial-pneumonia-update-2017-s3-guideline-of-the-german-society-for-anaesthesiology-and-intensive-care-medicine-the-german-society-for-infectious-diseases-the-german-society-for-hygiene-and-microbiology
#13
K Dalhoff, M Abele-Horn, S Andreas, M Deja, S Ewig, P Gastmeier, S Gatermann, H Gerlach, B Grabein, C P Heußel, G Höffken, M Kolditz, E Kramme, H Kühl, C Lange, K Mayer, I Nachtigall, M Panning, M Pletz, P-M Rath, G Rohde, S Rosseau, B Schaaf, D Schreiter, H Schütte, H Seifert, C Spies, T Welte
Nosocomial pneumonia (HAP) is a frequent complication of hospital care. Most data are available on ventilator-associated pneumonia. However, infections on general wards are increasing. A central issue are infections with multidrug resistant (MDR) pathogens which are difficult to treat in the empirical setting potentially leading to inappropriate use of antimicrobial therapy.This guideline update was compiled by an interdisciplinary group on the basis of a systematic literature review. Recommendations are made according to GRADE giving guidance for the diagnosis and treatment of HAP on the basis of quality of evidence and benefit/risk ratio...
January 2018: Pneumologie
https://www.readbyqxmd.com/read/29340720/correction-to-polymyxin-b-immobilized-hemoperfusion-and-mortality-in-critically-ill-adult-patients-with-sepsis-septic-shock-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#14
Tomoko Fujii, Riki Ganeko, Yuki Kataoka, Toshi A Furukawa, Robin Featherstone, Kent Doi, Jean-Louis Vincent, Daniela Pasero, René Robert, Claudio Ronco, Sean M Bagshaw
Owing to an oversight by the authors, Figure 2 in this article was not the version intended for publication. The correct Figure 2, reproduced here, features footnote symbols and Figure 2b includes three studies as described in the main text.
January 16, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29340294/a-comparison-of-endoscopic-and-non-endoscopic-biliary-intervention-outcomes-in-patients-with-prior-bariatric-surgery
#15
Amrit K Kamboj, Victorio Pidlaoan, Mohammad H Shakhatreh, Alice Hinton, Darwin L Conwell, Somashekar G Krishna
Background and study aims : Endoscopic biliary intervention (BI) is often difficult to perform in patients with prior bariatric surgery (BRS). We sought to analyze outcomes of patients with prior BRS undergoing endoscopic and non-endoscopic BI. Patients and methods:  The Nationwide Inpatient Sample (2007 - 2011) was reviewed to identify all adult inpatients (≥ 18 years) with a history of BRS undergoing BI. The clinical outcomes of interest were in-patient mortality, length of stay (LOS), and total hospital charges...
January 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29338914/prophylactic-antibiotics-following-radical-cystectomy-reduces-urinary-tract-infections-and-readmission-for-sepsis-from-a-urinary-source
#16
Ryan P Werntz, Ann Martinez-Acevedo, Hamed Amadi, Ryan Kopp, Jeffrey La Rochelle, Theresa Koppie, Christopher Amling, Kamran P Sajadi
INTRODUCTION: Urinary tract infections (UTI) and sepsis contribute significantly to the morbidity associated with cystectomy and urinary diversion in the first 30 days. We hypothesized that continuous antibiotic prophylaxis decreased UTIs in the first 30 days following radical cystectomy. METHODS: Patients with urothelial carcinoma of the bladder who underwent a radical cystectomy with urinary diversion for bladder cancer at Oregon Health and Science University from January 2014 to May 2015 were included in the study...
January 12, 2018: Urologic Oncology
https://www.readbyqxmd.com/read/29337416/the-role-of-adamts-13-in-the-coagulopathy-of-sepsis
#17
REVIEW
Marcel Levi, Marie Scully, Mervyn Singer
The interaction between platelets and the vessel wall is mediated by various receptors and adhesive proteins, of which von Willebrand factor is most prominent. The multimeric size of von Willebrand factor is an important determinant of a more intense platelet-vessel wall interaction. and is regulated by the von Willebrand factor cleaving protease, ADAMTS-13. A deficiency in ADAMTS-13 leads to higher concentrations of ultra-large von Willebrand factor multimers and pathological platelet-vessel wall interactions, in its most typical and extreme form leading to thrombocytopenic thrombotic purpura (TTP), a thrombotic microangiopathy characterized by thrombocytopenia, non-immune haemolysis, and organ dysfunction...
January 16, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29337035/early-warning-scores-do-not-accurately-predict-mortality-in-sepsis-a-meta-analysis-and-systematic-review-of-the-literature
#18
F Hamilton, D Arnold, A Baird, M Albur, P Whiting
OBJECTIVES: Early Warning scores are used to evaluate patients in many hospital settings. It is not clear if these are accurate in predicting mortality in sepsis. We performed a systematic review and meta-analysis of multiple studies in sepsis. Our aim was to estimate the accuracy of EWS for mortality in this setting. METHODS: PubMED, CINAHL, Cochrane, Web of Science and EMBASE were searched to October 2016. Studies of adults with sepsis who had EWS calculated using any appropriate tool (e...
January 11, 2018: Journal of Infection
https://www.readbyqxmd.com/read/29336676/vasopressors-in-sepsis
#19
Kristin P Colling, Kaysie L Banton, Greg J Beilman
BACKGROUND: Sepsis accounts for 10% of intensive care unit admissions and significant healthcare costs. Although the mortality rate from sepsis has been decreasing with better critical care, early identification of septic patients, and prompt interventions, the mortality rate remains 20%-30%. METHOD: Review of the English-language literature. RESULTS: Norepinephrine is the first-line vasopressor in shock and is associated with a lower mortality rate as well as fewer adverse effects...
January 16, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29332972/clinical-utility-and-measurement-of-procalcitonin
#20
REVIEW
Intan Samsudin, Samuel D Vasikaran
Procalcitonin (PCT), regarded as a biomarker specific for bacterial infections, is used in a variety of clinical settings including primary care, emergency department and intensive care. PCT measurement aids in the diagnosis of sepsis and to guide and monitor antibiotic therapy. This article gives a brief overview of PCT and its use in guiding antibiotic therapy in various clinical settings, as well as its limitations. PCT performance in comparison with other biomarkers of infection in particular CRP is also reviewed...
April 2017: Clinical Biochemist. Reviews
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