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Septic encephalopathy

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https://www.readbyqxmd.com/read/29232196/mechanisms-of-action-of-intravenous-immunoglobulin-in-septic-encephalopathy
#1
Figen Esen, Perihan Ergin Ozcan, Erdem Tuzun, M Dustin Boone
Acute brain dysfunction associated with sepsis is a serious complication that results in morbidity and mortality. Intravenous immunoglobulin (IVIg) treatment is known to alleviate behavioral deficits in the experimentally induced model of sepsis. To delineate the mechanisms by which IVIg treatment prevents neuronal dysfunction, an array of immunological and apoptosis markers was investigated. Our results suggest that IVIgG and IgGAM administration ameliorates neuronal dysfunction and behavioral deficits by reducing apoptotic cell death and glial cell proliferation...
December 12, 2017: Reviews in the Neurosciences
https://www.readbyqxmd.com/read/29127768/diabetic-ketoacidosis-hyperuricemia-and-encephalopathy-intractable-to-regular-dose-insulin
#2
Jillian Gregory, Sonali Basu
BACKGROUND: Diabetic ketoacidosis (DKA) in children less than 1 year of age is a rare occurrence. Typical presentation includes a prodrome of weight loss and polyuria with subsequent presentation to medical care when acidosis becomes symptomatic. CASE PRESENTATION: We describe an unusual case of a previously healthy infant with a 3 days' history of constipation, presenting acutely with abdominal pain, lethargy, and dehydration. On initial evaluation, our patient had profound encephalopathy, with marked tachypnea and work of breathing...
November 11, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/29107155/the-bbi-at-the-bbi-a-culture-change
#3
Ian Galea, V Hugh Perry
The blood-brain interface (BBI) is the subject of a new named series at Brain, Behavior, and Immunity. It is timely to reflect on a number of advances in the field within the last ten years, which may lead to an increased understanding of human behavior and a wide range of psychiatric and neurological conditions. We cover discoveries made in solute and cell trafficking, endothelial cell and pericyte biology, extracellular matrix and emerging tools, especially those which will enable study of the human BBI. We now recognize the central role of the BBI in a number of immunopsychiatric syndromes, including sickness behaviour, delirium, septic encephalopathy, cognitive side effects of cytokine-based therapies and the frank psychosis observed in neuronal surface antibody syndromes...
October 26, 2017: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/29058589/translational-evidence-for-two-distinct-patterns-of-neuroaxonal-injury-in-sepsis-a-longitudinal-prospective-translational-study
#4
Johannes Ehler, Lucinda K Barrett, Valerie Taylor, Michael Groves, Francesco Scaravilli, Matthias Wittstock, Stephan Kolbaske, Annette Grossmann, Jörg Henschel, Martin Gloger, Tarek Sharshar, Fabrice Chretien, Francoise Gray, Gabriele Nöldge-Schomburg, Mervyn Singer, Martin Sauer, Axel Petzold
BACKGROUND: Brain homeostasis deteriorates in sepsis, giving rise to a mostly reversible sepsis-associated encephalopathy (SAE). Some survivors experience chronic cognitive dysfunction thought to be caused by permanent brain injury. In this study, we investigated neuroaxonal pathology in sepsis. METHODS: We conducted a longitudinal, prospective translational study involving (1) experimental sepsis in an animal model; (2) postmortem studies of brain from patients with sepsis; and (3) a prospective, longitudinal human sepsis cohort study at university laboratory and intensive care units (ICUs)...
October 23, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29023711/alteration-of-sphingolipid-metabolism-as-a-putative-mechanism-underlying-lps-induced-bbb-disruption
#5
Rajkumar Vutukuri, Robert Brunkhorst, Roxane-Isabelle Kestner, Lena Hansen, Nerea Ferreiros Bouzas, Josef Pfeilschifter, Kavi Devraj, Waltraud Pfeilschifter
Septic encephalopathy with confusion and agitation occurs early during sepsis and contributes to the severity of the disease. A decrease of the sphingosine-1-phosphate (S1P) blood levels has been shown in patients and in animal models of sepsis. The lipid mediator S1P is known to be involved in endothelial barrier function in a context-dependent manner. We utilized LPS injected mice as a model for septic encephalopathy and first performed tracer permeability assays to assess the BBB breakdown in vivo. At time points corresponding to the BBB breakdown post LPS injection, we aimed to characterize the regulation of the sphingolipid signaling pathway at the blood-brain barrier (BBB) during sepsis...
October 11, 2017: Journal of Neurochemistry
https://www.readbyqxmd.com/read/28965313/significant-liver-related-morbidity-after-bariatric-surgery-and-its-reversal-a-case-series
#6
Magdalena Eilenberg, Felix B Langer, Andrea Beer, Michael Trauner, Gerhard Prager, Katharina Staufer
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) occurs in up to 80% of patients with obesity. Current data suggest an improvement of NAFLD after established bariatric procedures. OBJECTIVES: This study investigated liver function impairment after Roux-en-Y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB). SETTING: University Hospital, Bariatric Surgery Unit METHODS: In this single-center case series, consecutive in- and outpatients after bariatric surgery who presented with severe liver dysfunction from March 2014 to February 2017 were included and followed until March 2017...
September 30, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28887627/-sepsis-masquerading-as-delirium
#7
REVIEW
A Seifert, C S Hartog, J Zweigner, W Schummer, K Reinhart
A previously healthy 60-year-old patient presented to the emergency department with severe headache, altered personality and fever. He was treated for bacterial meningitis with delirium of unknown cause but presumed to be due to alcohol withdrawal. Despite receiving the antibiotic therapy regimen recommended for bacterial meningitis the patient's condition rapidly deteriorated with profound delirium and tachypnea. The intensivist who was consulted immediately suspected sepsis-associated organ failure and admitted the patient to the intensive care unit (ICU)...
November 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28759530/sevoflurane-attenuates-systemic-inflammation-compared-with-propofol-but-does-not-modulate-neuro-inflammation-a-laboratory-rat-study
#8
Beatrice Beck-Schimmer, Lukas Baumann, Tanja Restin, Philipp Eugster, Melanie Hasler, Christa Booy, Martin Schläpfer
BACKGROUND: Septic encephalopathy is believed to be a result of neuro-inflammation possibly triggered by endotoxins, such as lipopolysaccharides (LPS). Modulation of the immune system is a property of volatile anaesthetics. OBJECTIVE: We aimed to investigate the systemic and cerebral inflammatory response in a LPS-induced sepsis model in rats. We compared two different sedation strategies, intravenous propofol and the volatile anaesthetic sevoflurane, with the hypothesis that the latter may attenuate neuro-inflammatory processes...
July 28, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28738837/assessment-of-cerebral-circulation-in-a-porcine-model-of-intravenously-given-e-coli-induced-fulminant-sepsis
#9
Levente Molnár, Norbert Németh, Mariann Berhés, Endre Hajdú, Lóránd Papp, Ábel Molnár, Judit Szabó, Ádám Deák, Béla Fülesdi
BACKGROUND: The aim of the present work was to assess cerebral hemodynamic changes in a porcine model of E.coli induced fulminant sepsis. METHODS: Nineteen healthy female Hungahib pigs, 10-12 weeks old, randomly assigned into two groups: Control (n = 9) or Septic Group (n = 10). In the Sepsis group Escherichia coli culture suspended in physiological saline was intravenously administrated in a continuously increasing manner according to the following protocol: 2 ml of bacterial culture suspended in physiological saline was injected in the first 30 min, then 4 ml of bacterial culture was administered within 30 min, followed by infusion of 32 ml bacterial culture for 2 h...
July 24, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28671640/chrysin-attenuates-vcam-1-expression-and-monocyte-adhesion-in-lipopolysaccharide-stimulated-brain-endothelial-cells-by-preventing-nf-%C3%AE%C2%BAb-signaling
#10
Bo Kyung Lee, Won Jae Lee, Yi-Sook Jung
Adhesion of leukocytes to endothelial cells plays an important role in neuroinflammation. Therefore, suppression of the expression of adhesion molecules in brain endothelial cells may inhibit neuroinflammation. Chrysin (5,7-dihydroxyflavone) is a flavonoid component of propolis, blue passion flowers, and fruits. In the present study, we examined the effects of chrysin on lipopolysaccharide (LPS)-induced expression of vascular cell adhesion molecule-1 (VCAM-1) in mouse cerebral vascular endothelial (bEnd.3) cells...
July 3, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28601903/can-complications-in-febrile-neutropenia-be-predicted-report-from-a-developing-country
#11
Sapna Oberoi, Anirban Das, Amita Trehan, Pallab Ray, Deepak Bansal
PURPOSE: Febrile neutropenia (FN) is an important cause of morbidity and mortality in children with acute lymphoblastic leukemia (ALL). We aimed to look at complications in febrile neutropenia and to derive a risk model for developing complications from the variables predicting complications. METHODS: Children on treatment for ALL, presenting with FN, were prospectively enrolled over a period of 1 year. Their clinical presentation, course during hospital stay, and outcomes were recorded...
November 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28540694/wernicke-s-encephalopathy-in-exclusive-breastfed-infants
#12
Javeed Iqbal Bhat, Qazi Iqbal Ahmed, Ambreen Ali Ahangar, Bashir Ahmed Charoo, Mushtaq Ahmad Sheikh, Wajid Ali Syed
BACKGROUND: Kashmir has a population that largely consumes polished rice which is deficient in thiamine. Furthermore, lactating women in this region are prone to severe thiamine deficiency because of their traditional food avoidance practices. Infantile beriberi is common in exclusively breastfed infants of thiamine deficient mothers in Kashmir. METHODS: This was a one year prospective hospital-based study. We included 50 exclusively breastfed infants in our study...
October 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/28511674/predictors-of-fifty-days-in-hospital-mortality-in-patients-with-culture-negative-neutrocytic-ascites
#13
Chinmaya Kumar Bal, Vikram Bhatia, Ripu Daman
BACKGROUND: Culture negative neutrocytic ascites is a variant of spontaneous bacterial peritonitis. But there are conflicting reports regarding the mortality associated with culture negativeneutrocytic ascites. Therefore we aim to determine the predictors of mortality associated with culture negativeneutrocytic ascites in a larger sample population. METHODS: We analysed 170 patients consecutively admitted to intensive care unit with diagnosis of culture negative neutrocytic ascites...
May 16, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28407303/rifampicin-reverses-nicardipine-effect-inducing-uncontrolled-essential-hypertension
#14
Elena-Mihaela Cordeanu, Sébastien Gaertner, Alix Faller, Corina Mirea, Jean-Marc Lessinger, Veronique Kemmel, Dominique Stephan
Dihydropyridine calcium-channel blockers are a known substrate for the cytochrome P450 isoform 3A4. Rifampicin, an antitubercular agent, is one of the most potent inducers of hepatic and intestinal CYP3A4 thus increasing dihydropyridine metabolism. We report a case of a 67-year-old hypertensive female treated with a four-drug antihypertensive regimen including a dihydropyridine (nicardipine 50 mg bid), who was admitted for septic arthritis of the knee requiring antibiotic treatment with teicoplanin 400 mg od and rifampicin 600 mg bid...
April 13, 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28306558/monitoring-of-the-physical-exam-in-sepsis
#15
Radu Postelnicu, Laura Evans
PURPOSE OF REVIEW: Monitoring of mental status and peripheral circulatory changes can be accomplished noninvasively in patients in the ICU. Emphasis on physical examination in conditions such as sepsis have gained increased attention as these evaluations can often serve as a surrogate marker for short-term treatment efficacy of therapeutic interventions. Sepsis associated encephalopathy and mental status changes correlate with worse prognosis in patients. Evaluation of peripheral circulation has been shown to be a convenient, easily accessible, and accurate marker for prognosis in patients with septic shock...
June 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28237247/subcutaneous-fat-necrosis-of-the-newborn-report-of-five-cases
#16
Leire González Lara, Asunción Vicente Villa, María Mercedes Otero Rivas, Mariona Sunol Capella, Fredy Prada, María Antonia González Enseñat
Subcutaneous fat necrosis of the newborn (SCFN) is a rare, self-limited disorder of the panniculus which appears in the first few weeks of life. SCFN generally follows an uncomplicated course. However, there are important complications for which the patient must be regularly monitored, including thrombocytopenia, hypoglycemia, hypertriglyceridemia, and most importantly, hypercalcemia. We report five infants with SCFN. All children were born at term. The onset of lesions was between 1 day and 20 days after birth...
February 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28190441/neurologic-complications-of-sepsis
#17
REVIEW
E Schmutzhard, B Pfausler
Over the past decades, the incidence of sepsis and resultant neurologic sequelae has increased, both in industrialized and low- or middle-income countries, by approximately 5% per year. Up to 300 patients per 100 000 population per year are reported to suffer from sepsis, severe sepsis, and septic shock. Mortality is up to 30%, depending on the precision of diagnostic criteria. The increasing incidence of sepsis is partially explained by demographic changes in society, with aging, increasing numbers of immunocompromised patients, dissemination of multiresistant pathogens, and greater availability of supportive medical care in both industrialized and middle-income countries...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187038/minocycline-prevents-the-impairment-of-hippocampal-long-term-potentiation-in-the-septic-mouse
#18
Koji Hoshino, Mineji Hayakawa, Yuji Morimoto
Sepsis-associated encephalopathy is a major complication during sepsis, and an effective treatment remains unknown. Although minocycline (MINO) has neuroprotective effects and is an attractive candidate for treating sepsis-associated encephalopathy, the effect of MINO on synaptic plasticity during sepsis is still unclear. In the present study, we investigated the effects of MINO on long-term potentiation (LTP) in the hippocampus in a cecal ligation and puncture (CLP) mouse model. We divided mice into four groups; sham + vehicle, sham + MINO (60 mg/kg, i...
August 2017: Shock
https://www.readbyqxmd.com/read/28173746/neurodegenerative-changes-and-neuroapoptosis-induced-by-systemic-lipopolysaccharide-administration-are-reversed-by-dexmedetomidine-treatment-in-mice
#19
Qiaoqing Ning, Zhaoguo Liu, Xiuhua Wang, Ruyi Zhang, Jing Zhang, Meizi Yang, Hongliu Sun, Fang Han, Wenxiang Zhao, Xiuli Zhang
BACKGROUND: Sepsis-associated encephalopathy (SAE) is a frequent and nasty complication of sepsis, associated with patients increased risk of death and long-term brain dysfunctions. OBJECTIVE: This study aimed to explore the effect of dexmedetomidine (Dex), an anesthetic adjuvant, on the development of SAE. METHODS: Lipopolysaccharide (LPS, 10 mg/kg) was intraperitoneally injected to male BALB/c mice to induce sepsis. Dex (25 μg/kg) was given intraperitoneally immediately after LPS injection...
April 2017: Neurological Research
https://www.readbyqxmd.com/read/27988455/delayed-diagnosis-of-wernicke-encephalopathy-with-irreversible-neural-damage-after-subtotal-gastrectomy-for-gastric-cancer-a-case-of-medical-liability
#20
Pamela Tozzo, Luciana Caenazzo, Daniele Rodriguez, Matteo Bolcato
INTRODUCTION: Wernicke's encephalopathy (WE) is a neurological syndrome caused by thiamine deficiency, and clinically characterized by ophthalmoplegia, ataxia and acute confusion. In developed countries, most cases of WE have been seen in alcohol misusers. Other reported causes are gastrointestinal tract surgery, hyperemesis gravidarum, chronic malnutrition, prolonged total parenteral nutrition without thiamine supplementation, and increased nutrient requirements as in trauma or septic shock...
2017: International Journal of Surgery Case Reports
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