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Sepsis And Anesthesia

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https://www.readbyqxmd.com/read/28345549/sub-anesthesia-dose-of-isoflurane-in-60-oxygen-reduces-inflammatory-responses-in-experimental-sepsis-models
#1
Yi Huang, Xiao-Xia Wang, Dong-Dong Sun, Ze-Xin Zhang, Wan-Wan Yang, Tian Shao, Han Han, Er-Fei Zhang, Zhong-Shu Pu, Zuo-Xu Hou, Hai-Long Dong, Li-Ze Xiong, Li-Chao Hou
BACKGROUND: Sepsis is a major cause of mortality in Intensive Care Units. Anesthetic dose isoflurane and 100% oxygen were proved to be beneficial in sepsis; however, their application in septic patients is limited because long-term hyperoxia may induce oxygen toxicity and anesthetic dose isoflurane has potential adverse consequences. This study was scheduled to find the optimal combination of isoflurane and oxygen in protecting experimental sepsis and its mechanisms. METHODS: The effects of combined therapy with isoflurane and oxygen on lung injury and sepsis were determined in animal models of sepsis induced by cecal ligation and puncture (CLP) or intraperitoneal injection of lipopolysaccharide (LPS) or zymosan...
April 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28260769/morbidity-and-mortality-after-pancreatoduodenectomy-a-five-year-experience-in-bangabandhu-sheikh-mujib-medical-university
#2
B C Das, A S Khan, N E Elahi, M S Uddin, B C Debnath, Z R Khan
Mortality and morbidity was assessed after adoption of a systematic care for patient with pancreatoduodenectomy starting from patient selection and preparation, operative technique, and postoperative care. In this prospective study seventy patients who underwent pancreatoduodenectomy for periampullary carcinoma with curative intent between January 2010 and December 2014 were carefully analyzed prospectively. Patients were selected those who had ampullary carcinoma, lower bile duct carcinoma and small size carcinoma head of pancreas without local invasion and distant metastasis, and the patient who did not have any major disabling comorbid diseases...
January 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28258299/vasopressors-induce-passive-pulmonary-hypertension-by-blood-redistribution-from-systemic-to-pulmonary-circulation
#3
Chunling Jiang, Hong Qian, Shuhua Luo, Jing Lin, Jerry Yu, Yajiao Li, Qi An, Nanfu Luo, Lei Du
Vasopressors are widely used in resuscitation, ventricular failure, and sepsis, and often induce pulmonary hypertension with undefined mechanisms. We hypothesize that vasopressor-induced pulmonary hypertension is caused by increased pulmonary blood volume and tested this hypothesis in dogs under general anesthesia. In normal hearts (model 1), phenylephrine (2.5 μg/kg/min) transiently increased right but decreased left cardiac output, associated with increased pulmonary blood volume (63% ± 11.8, P = 0...
May 2017: Basic Research in Cardiology
https://www.readbyqxmd.com/read/28228109/fms-like-tyrosine-kinase-3-ligand-increases-resistance-to-burn-wound-infection-through-effects-on-plasmacytoid-dendritic-cells
#4
Leon Bae, Julia K Bohannon, Weihua Cui, Monika Vinish, Tracy Toliver-Kinsky
BACKGROUND: Patients experiencing large thermal injuries are susceptible to opportunistic infections that can delay recovery and lead to sepsis. Dendritic cells (DC) are important for the detection of pathogens and activation of the innate and acquired immune responses. DCs are significantly decreased in burn patients early after injury, and the development of sepsis is associated with persistent DC depletion. In a murine model of burn wound infection, the enhancement of DCs after injury by treatment with the DC growth factor Fms-like tyrosine kinase-3 ligand (FL) enhances neutrophil migration to infection, improves bacterial clearance, and increases survival in a DC-dependent manner...
February 22, 2017: BMC Immunology
https://www.readbyqxmd.com/read/28222674/administration-of-hes-in-elderly-patients-undergoing-hip-arthroplasty-under-spinal-anesthesia-is-not-associated-with-an-increase-in-renal-injury
#5
Yuanyuan Zhang, Yonghao Yu, Junya Jia, Wenli Yu, Rubin Xu, Licheng Geng, Ying Wei
BACKGROUND: Hydroxyethyl starch (HES) is applied to achieve volume expansion during surgery; however, nephrotoxicity may be induced in patients with sepsis. Simultaneously, neutrophil gelatinase-associated lipocalin (NGAL) and IL-18 have been illustrated as pivotal indicators to diagnose the acute kidney injury (AKI) early. This multi-center, randomized, double-blinded, placebo-controlled study aimed to investigate whether 6% HES 130/0.4 administration caused postoperative AKI, which can be revealed by urinary and plasma NGAL and IL-18 estimations in elderly patients with normal renal function undergoing hip arthroplasty under spinal anesthesia...
February 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28216060/incidence-of-fever-in-labor-and-risk-of-neonatal-sepsis
#6
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: We sought 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 newborns delivered from mothers without intrapartum fever...
February 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28198553/treatment-of-septic-arthritis-of-the-coxofemoral-joint-in-12-foals
#7
F Barceló Oliver, T M Russell, K L Uprichard, K M Neil, P J Pollock
OBJECTIVE: To describe the clinical signs, surgical treatment, and outcome of septic arthritis of the coxofemoral joint in foals. STUDY DESIGN: Retrospective clinical study. SAMPLE POPULATION: Foals (n = 12) with confirmed sepsis of the coxofemoral joint. METHODS: Lameness was localized to the coxofemoral joint based on physical examination. Sepsis was confirmed by cytological analysis of synovial fluid obtained under ultrasonographic guidance, during general anesthesia or standing sedation...
February 15, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28194346/safe-and-simplified-salvage-technique-for-exposed-implantable-cardiac-electronic-devices-under-local-anesthesia
#8
Chang Young Jung, Tae Gon Kim, Sung-Eun Kim, Kyu-Jin Chung, Jun Ho Lee, Yong-Ha Kim
BACKGROUND: Skin erosion is a dire complication of implantable cardiac pacemakers and defibrillators. Classical treatments involve removal of the entire generator and lead systems, however, these may result in fatal complications. In this study, we present our experience with a simplified salvage technique for exposed implantable cardiac electronic devices (ICEDs) without removing the implanted device, in an attempt to reduce the risks and complication rates associated with this condition...
January 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28185643/oral-triiodothyronine-for-infants-and-children-undergoing-cardiopulmonary-bypass
#9
Eva M Marwali, Cindy E Boom, Novik Budiwardhana, Dicky Fakhri, Poppy S Roebiono, Anwar Santoso, Sudigdo Sastroasmoro, April Slee, Michael A Portman
BACKGROUND: This study evaluated the efficacy and safety of oral triiodothyronine (T3; Tetronine, Dalim BioTech, Korea) for infants and children undergoing cardiopulmonary bypass in an Indonesian population. METHODS: We performed a single-center, randomized, double-blind, and placebo-controlled trial in children aged 3 years and younger undergoing congenital heart disease operations with cardiopulmonary bypass. We administered oral T3 (1 μg/kg per body weight/dose) or placebo (saccharum lactis) by nasogastric tube every 6 hours for 60 hours after induction of anesthesia...
February 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28175943/-treatment-of-traumatic-lesions-of-the-bursa-olecrani-and-chronic-bursitis-olecrani
#10
D Saul, K Dresing
OBJECTIVE: Complete olecranon bursectomy with debridement, protection of veins and nerves. Risk-adapted antibiotic therapy and early functional aftercare. INDICATIONS: Acute, traumatic laceration of the bursa olecrani, chronic therapy-resistant bursitis olecrani. CONTRAINDICATIONS: For traumatic bursa injuries: general contraindications for anesthesia and surgery; chronic bursitis: initially not closable skin defect (plastic surgery required), hemodynamically instable patient (e...
February 7, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28118659/video-laryngoscopy-vs-direct-laryngoscopy-on-successful-first-pass-orotracheal-intubation-among-icu-patients-a-randomized-clinical-trial
#11
RANDOMIZED CONTROLLED TRIAL
Jean Baptiste Lascarrou, Julie Boisrame-Helms, Arthur Bailly, Aurelie Le Thuaut, Toufik Kamel, Emmanuelle Mercier, Jean-Damien Ricard, Virginie Lemiale, Gwenhael Colin, Jean Paul Mira, Ferhat Meziani, Jonathan Messika, Pierre Francois Dequin, Thierry Boulain, Elie Azoulay, Benoit Champigneulle, Jean Reignier
Importance: In the intensive care unit (ICU), orotracheal intubation can be associated with increased risk of complications because the patient may be acutely unstable, requiring prompt intervention, often by a practitioner with nonexpert skills. Video laryngoscopy may decrease this risk by improving glottis visualization. Objective: To determine whether video laryngoscopy increases the frequency of successful first-pass orotracheal intubation compared with direct laryngoscopy in ICU patients...
February 7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28032565/surgical-site-infection-after-stoma-closure-in-children-outcomes-and-predictors
#12
Dani O Gonzalez, Erica Ambeba, Peter C Minneci, Katherine J Deans, Benedict C Nwomeh
BACKGROUND: Surgical site infection (SSI) is a burdensome complication following intestinal stoma closure, with reported rates ranging from 0% to 40%. We aimed to identify risk factors for SSI in children undergoing stoma closure. MATERIALS AND METHODS: Using 2012-2014 NSQIP Pediatric data, we identified patients aged 0-18 years undergoing stoma closure. Demographic, clinical, and 30-day outcome characteristics between children with and without SSI were compared...
November 4, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/28003439/prolonged-exposure-to-volatile-anesthetic-isoflurane-worsens-the-outcome-of-polymicrobial-abdominal-sepsis
#13
Sophia Koutsogiannaki, Matthew M Schaefers, Toshiaki Okuno, Mai Ohba, Takehiko Yokomizo, Gregory P Priebe, James A DiNardo, Soriano G Sulpicio, Koichi Yuki
Sepsis continues to result in high morbidity and mortality. General anesthesia is often administered to septic patients, but the impacts of general anesthesia on host defense are not well understood. General anesthesia can be given by volatile and intravenous anesthetics. Our previous in vitro study showed that volatile anesthetic isoflurane directly inhibits leukocyte function-associated antigen-1 (LFA-1) and macrophage-1 antigen (Mac-1), critical adhesion molecules on leukocytes. Thus, the role of isoflurane exposure on in vivo LFA-1 and Mac-1 function was examined using polymicrobial abdominal sepsis model in mice...
December 20, 2016: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/27897974/delayed-coloanal-anastomosis-for-rectovaginal-fistula-after-colorectal-resection-for-deep-endometriosis
#14
Gaetano Gallo, Alberto Realis Luc, Roberta Tutino, Giuseppe Clerico, Mario Trompetto
AIM: The deep infiltrating endometriosis, defined as a subperitoneal infiltration of endometrial implants of ≥ 5 mm involving not only the colorectal tract but also rectovaginal septum, vagina and bladder often requires a challenging surgery. Endometriosis nodes of the rectovaginal septum, if symptomatic, need a resection of the involved colorectal tract with colorectal or coloanal anastomosis. Unfortunately in these cases is not uncommon the possibility of a postoperative rectovaginal fistula (RVF), caused by the weakness of the septum that must be skeletonized to completely remove the endometriosis nodes...
November 28, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27889458/transcatheter-device-closure-of-postmyocardial-infarction-ventricular-septal-defect
#15
You-Lin Nie, Ming-Chih Lin, Wei-Wen Lin, Chung-Chi Wang, Ching-Pei Chen, Chia-Hsun Lin, Tsung-Cheng Shyu, Yeak-Wun Quek, Sheng-Ling Jan, Yun-Ching Fu
BACKGROUND: Transcatheter device closure of postmyocardial infarction ventricular septal defect (PMIVSD) is less invasive than surgical repair. However, its feasibility, timing, outcome, and prognostic factors remain unclear. METHODS: This was a multicenter, retrospective cohort study. Between February 2012 and July 2015, a total of 10 (8 male and 2 female) patients with PMIVSD undergoing attempted device closure were enrolled retrospectively. The procedures were performed under general anesthesia with fluoroscopic and transesophageal echocardiographic guidance...
January 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/27884349/endotoxemia-accelerates-diaphragm-dysfunction-in-ventilated-rabbits
#16
Yi Yang, Tao Yu, Chun Pan, Federico Longhini, Ling Liu, Yingzi Huang, Fengmei Guo, Haibo Qiu
BACKGROUND: Ventilators may induce diaphragm dysfunction, and most of the septic population who are admitted to the intensive care unit require mechanical ventilation. However, there is no evidence that sepsis accelerates the onset of ventilator-induced diaphragm dysfunction or affects the microcirculation. Our study investigated whether lipopolysaccharide (LPS)-induced endotoxemia accelerated diaphragm dysfunction in ventilated rabbits by evaluating microcirculation, lipid accumulation, and diaphragm contractility...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27882755/prague-1337-the-first-successful-caesarean-section-in-which-both-mother-and-child-survived-may-have-occurred-in-the-court-of-john-of-luxembourg-king-of-bohemia
#17
A Pařízek, V Drška, M Říhová
OBJECTIVE: An interdisciplinary historical-medical study, analysis of historical sources, and critical interpretation of the indirect evidence surrounding the childbirth of Beatrice of Bourbon, the second wife of the Bohemian King John of Luxembourg. STUDY TYPE: A material-based study founded on a comparative analysis of available private and public sources, particularly surviving letters, and narrative sources. The conclusions are reached based on a textual interpretation according to historical methods...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27878281/etomidate-inhibits-nuclear-factor-%C3%AE%C2%BAb-through-decreased-expression-of-glucocorticoid-receptor-in-septic-rats
#18
Yu Zhang, Ruo-Meng Li, Chun Wang, Na Liu, Shen Lv, Jun-Yu Xiong
The present study aimed to investigate the effect of etomidate administered prior to or following cecal ligation and puncture (CLP) on the expression of glucocorticoid receptor (GR) and lymphocyte apoptosis in septic rats. Right jugular vein catheterization was performed on female Sprague‑Dawley rats under isoflurane anesthesia, and CLP surgery was performed to induce sepsis 3 days following catheterization. The rats were randomly divided into five groups. All groups were infused with 2 ml of either etomidate or 5‰ dimethyl sulfoxide (DMSO) at 1 ml/h for 2 h from 6 h post‑surgery...
December 2016: Molecular Medicine Reports
https://www.readbyqxmd.com/read/27849320/management-of-perforation-after-endoscopic-retrograde-cholangiopancreatography
#19
Cengiz Tavusbay, Emrah Alper, Melek Gökova, Erdinç Kamer, Haldun Kar, Kemal Atahan, Oğuzhan Özşay, Özlem Gür, Necat Cin, Emir Çapkınoğlu, Evren Durak
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP)-related perforation is an infrequent complication. It is associated with significant morbidity and mortality. The present study is an evaluation of experience with management and outcomes of ERCP-related perforations and a review of relevant literature. METHODS: Between January 2008 and January 2015, a total of 9383 ERCPs were performed in endoscopy unit. A total of 29 perforations (0.33%) were identified and retrospectively reviewed...
September 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27829181/effect-of-thoracic-epidural-block-on-infection-induced-inflammatory-response-a-randomized-controlled-trial
#20
Asha Tyagi, Anuradha Bansal, Shukla Das, Ashok Kumar Sethi, Aanchal Kakkar
PURPOSE: Epidural block decreases inflammation and oxidative stress in experimental models of sepsis as well as after surgery. There is, however, no clinical evidence evaluating its effect on infection-induced inflammatory process. The present trial evaluated the effect of thoracic epidural block (TEB) on systemic inflammatory response in patients with small intestinal perforation peritonitis. Outcome measures included systemic levels of interleukin (IL)-6, IL-10, procalcitonin, and C-reactive protein and postoperative Sepsis-Related Organ Failure Assessment scores...
April 2017: Journal of Critical Care
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