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https://www.readbyqxmd.com/read/28079172/25-oh-d-and-1-25-oh-d-vitamin-d-fails-to-predict-sepsis-and-mortality-in-a-prospective-cohort-study
#1
Franz Ratzinger, Helmuth Haslacher, Markus Stadlberger, Ralf L J Schmidt, Markus Obermüller, Klaus G Schmetterer, Thomas Perkmann, Athanasios Makristathis, Rodrig Marculescu, Heinz Burgmann
The clinical role of vitamin D in sepsis and mortality prediction is controversially discussed. Therefore, we conducted a prospective cohort study on standard care wards, including 461 patients with suspected sepsis fulfilling two or more SIRS criteria. On the first and third day after onset of SIRS symptoms levels of 25(OH)D, 1,25(OH)D and sepsis biomarkers were analysed for their predictive capacity for identifying infection, bacteraemia and an elevated mortality risk. Additionally, several SNPs associated with vitamin D metabolism were evaluated...
January 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28078568/rediagnosing-one-of-smith-s-patients-john-mccann-with-neuromas-tumours-1849
#2
Martino Ruggieri, Andrea D Praticò, Rosario Caltabiano, Agata Polizzi
In 1849, the Irish Professor of Surgery, Sir Robert William Smith, by publishing his "Treatise on the Pathology, Diagnosis and Treatment of Neuroma", collected six previous examples of "general development of neuromatous tumours" and reported three further cases (two personal and one referred) of what is nowadays known as neurofibromatosis. Among these latter cases, there was a 35-year-old cattle-driver, John McCann, who was first admitted at hospital in 1840 because of a large tumour on the right side of his neck thought to be malignant (and a second tumour sublingually) but not operated...
January 11, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28062972/predictive-performance-of-the-quick-sequential-organ-failure-assessment-score-as-a-screening-tool-for-sepsis-mortality-and-intensive-care-unit-admission-in-patients-with-febrile-neutropenia
#3
Minsoo Kim, Shin Ahn, Won Young Kim, Chang Hwan Sohn, Dong Woo Seo, Yoon-Seon Lee, Kyung Soo Lim
PURPOSE: In Sepsis-3, the quick Sequential Organ Failure Assessment (qSOFA) score was developed as criteria to use for recognizing patients who may have poor outcomes. This study was performed to evaluate the predictive performance of the qSOFA score as a screening tool for sepsis, mortality, and intensive care unit (ICU) admission in patients with febrile neutropenia (FN). We also tried to compare its performance with that of the systemic inflammatory response syndrome (SIRS) criteria and Multinational Association of Supportive Care in Cancer (MASCC) score for FN...
January 6, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28050668/antibiotics-may-be-safely-discontinued-within-one-week-of-percutaneous-cholecystostomy
#4
Tyler J Loftus, Scott C Brakenridge, Camille G Dessaigne, George A Sarosi, William J Zingarelli, Frederick A Moore, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Phillip A Efron, Alicia M Mohr
BACKGROUND: For patients with acute cholecystitis managed with percutaneous cholecystostomy (PC), the optimal duration of post-procedural antibiotic therapy is unknown. Our objective was to compare short versus long courses of antibiotics with the hypothesis that patients with persistent signs of systemic inflammation 72 h following PC would receive prolonged antibiotic therapy and that antibiotic duration would not affect outcomes. METHODS: We performed a retrospective cohort analysis of 81 patients who underwent PC for acute cholecystitis at two hospitals during a 41-month period ending November 2014...
January 3, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/27993506/effects-of-aspirin-therapy-on-ultrasound-guided-renal-allograft-biopsy-bleeding-complications
#5
Francis I Baffour, LaTonya J Hickson, Mark D Stegall, Patrick G Dean, Tina M Gunderson, Thomas D Atwell, A Nicholas Kurup, John J Schmitz, Walter D Park, Grant D Schmit
PURPOSE: To determine if patient aspirin exposure and timing affect bleeding risk after renal allograft biopsy. MATERIALS AND METHODS: Review of 6,700 renal allograft biopsies (in 2,362 unique patients) was performed. Median patient age was 53.0 years [interquartile range 43.0, 62.0]; 56.2% of patients were male. Of biopsies, 4,706 (70.2%) were performed in patients with no aspirin exposure within 10 days of biopsy; 664 (9.9%), were performed within 8-10 days of aspirin exposure; 855 (12...
December 16, 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/27979049/medical-management-of-severe-alcoholic-hepatitis-expert%C3%A2-review-from-the-clinical-practice-updates-committee-of%C3%A2-the-aga-institute
#6
Mack C Mitchell, Lawrence S Friedman, Craig J McClain
The purpose of this clinical practice update is to review diagnostic criteria for severe acute alcoholic hepatitis and to determine the current best practices for this life-threatening condition. The best practices in this review are based on clinical trials, systematic reviews including meta-analysis and expert opinion to develop an approach to diagnosis and management. Best Practice Advice 1: Abstinence from drinking alcohol is the cornerstone of treatment for alcohol hepatitis (AH). Best Practice Advice 2: Patients with jaundice and suspected AH should have cultures of blood, urine, and ascites, if present, to determine the presence of bacterial infections regardless of whether they have fever...
January 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27941738/pattern-of-changes-in-the-findings-among-the-patients-undergoing-diagnostic-esophagogastroduodenoscopy-in-bangladesh
#7
C K Ghosh, M R Khan, F Alam, B C Shil, M S Kabir, M Mahmuduzzaman, S C Das, P K Roy
This cross-sectional observational study was conducted in the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Sir Salimullah Medical College and Mitford Hospital, Holy family Red Crescent Medical College and Hospital and Popular Diagnostic Centre, Shantinagar branch, Dhaka, Bangladesh from January 2012 to July 2013. Study subjects were included in the study irrespective of age and sex having different upper GI tract. Complaints like dysphagia, heart burn, abdominal pain/dyspepsia, nausea, vomiting, haematemesis and/or malena, anorexia, unexplained anemia, weight loss etc...
October 2016: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/27907062/sepsis-prevalence-and-outcome-on-the-general-wards-and-emergency-departments-in-wales-results-of-a-multi-centre-observational-point-prevalence-study
#8
Tamas Szakmany, Robert M Lundin, Ben Sharif, Gemma Ellis, Paul Morgan, Maja Kopczynska, Amrit Dhadda, Charlotte Mann, Danielle Donoghue, Sarah Rollason, Emma Brownlow, Francesca Hill, Grace Carr, Hannah Turley, James Hassall, James Lloyd, Llywela Davies, Michael Atkinson, Molly Jones, Nerys Jones, Rhodri Martin, Yousef Ibrahim, Judith E Hall
Data on sepsis prevalence on the general wards is lacking on the UK and in the developed world. We conducted a multicentre, prospective, observational study of the prevalence of patients with sepsis or severe sepsis on the general wards and Emergency Departments (ED) in Wales. During the 24-hour study period all patients with NEWS≥3 were screened for presence of 2 or more SIRS criteria. To be eligible for inclusion, patients had to have a high clinical suspicion of an infection, together with a systemic inflammatory response (sepsis) and evidence of acute organ dysfunction and/or shock (severe sepsis)...
2016: PloS One
https://www.readbyqxmd.com/read/27893641/routine-surveillance-cholangiography-following-percutaneous-cholecystostomy-delays-drain-removal-and-cholecystectomy
#9
Tyler J Loftus, Scott C Brakenridge, Frederick A Moore, Camille G Dessaigne, George A Sarosi, William J Zingarelli, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Philip A Efron, Alicia M Mohr
INTRODUCTION: Percutaneous cholecystostomy (PC) is often performed for patients with acute cholecystitis who are at high risk for operative morbidity and mortality. However, the necessity for routine cholangiography following PC remains unclear. We hypothesized that routine surveillance cholangiography (RSC) following PC would provide no benefit compared to on-demand cholangiography (ODC) triggered by signs or symptoms of biliary pathology. METHODS: We performed a three-year retrospective cohort analysis of patients managed with PC for acute cholecystitis at two tertiary care hospitals...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27876592/sirs-qsofa-and-organ-dysfunction-insights-from-a-prospective-database-of-emergency-department-patients-with-infection
#10
Julian M Williams, Jaimi H Greenslade, Juliet V McKenzie, Kevin Chu, Anthony Ft Brown, Jeffrey Lipman
OBJECTIVE: A proposed revision of sepsis definitions has abandoned SIRS, defined organ dysfunction as an increase in total SOFA score of ≥2, and conceived "qSOFA" as a bedside indicator of organ dysfunction. We aimed to (1) determine the prognostic impact of SIRS, (2) compare diagnostic accuracy of SIRS and qSOFA for organ dysfunction, and (3) compare standard (Sepsis-2) and revised (Sepsis-3) definitions for organ dysfunction in emergency department patients with infection. METHODS: Consecutive ED patients admitted with presumed infection were prospectively enrolled over three years...
November 19, 2016: Chest
https://www.readbyqxmd.com/read/27866368/does-serum-procalcitonin-aid-in-the-diagnosis-of-bloodstream-infection-regardless-of-whether-patients-exhibit-the-systemic-inflammatory-response-syndrome
#11
Rashi Arora, James P Campbell, Gyorgy Simon, Nishant Sahni
BACKGROUND: Physicians frequently rely on the systemic inflammatory response syndrome (SIRS) criteria to detect bloodstream infections (BSIs). We evaluated the diagnostic performance of procalcitonin (PCT) in detecting BSI in patients with and without SIRS. METHODS: We tested the association between BSI, serum PCT levels, contemporaneous SIRS scores and serum lactate using logistic regression in a dataset of 4279 patients. The diagnostic performance of these variables was assessed...
November 19, 2016: Infection
https://www.readbyqxmd.com/read/27856268/validation-of-the-new-sepsis-3-definitions-proposal-for-improvement-in-early-risk-identification
#12
E J Giamarellos-Bourboulis, T Tsaganos, I Tsangaris, M Lada, C Routsi, D Sinapidis, M Koupetori, M Bristianou, G Adamis, K Mandragos, G N Dalekos, I Kritselis, G Giannikopoulos, I Koutelidakis, M Pavlaki, E Antoniadou, G Vlachogiannis, V Koulouras, A Prekates, G Dimopoulos, A Koutsoukou, I Pnevmatikos, A Ioakeimidou, A Kotanidou, S E Orfanos, A Armaganidis, C Gogos
OBJECTIVES: Sepsis-3 definitions generated controversies regarding their general applicability. The Sepsis-3 Task Force outlined the need for validation with emphasis on the quick Sequential Organ Failure Assessment (qSOFA) score. This was done in a prospective cohort from a different healthcare setting. METHODS: Patients with infections and at least two signs of systemic inflammatory response syndrome (SIRS) were analysed. Sepsis was defined as total SOFA ≥2 outside the intensive care unit (ICU) or as an increase of ICU admission SOFA ≥2...
November 14, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27851000/1364-comparison-of-the-qsofa-score-and-sirs-criteria-in-patients-with-known-or-suspected-sepsis
#13
James Gasperino, Evangeline Gabriel-Jocson, Erik Perez, Ronni Levy, Luciano Lemos-Filho
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27847915/is-extended-preoperative-antibiotic-prophylaxis-for-high-risk-patients-necessary-before-percutaneous-nephrolithotomy
#14
Aaron M Potretzke, Alyssa M Park, Tyler M Bauman, Jeffrey A Larson, Joel M Vetter, Brian M Benway, Alana C Desai
PURPOSE: The goal of this study was to compare the rate of systemic inflammatory response syndrome (SIRS) in high-risk patients undergoing percutaneous nephrolithotomy (PCNL) between patients who received 7, 2, or 0 days of preoperative antibiotics. MATERIALS AND METHODS: We retrospectively reviewed a series of consecutive PCNLs performed at our institution. Patients with infected preoperative urine cultures were excluded. High-risk patients were defined as those with a history of previous urinary tract infection (UTI), hydronephrosis, or stone size ≥2 cm...
November 2016: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/27831540/time-trend-and-risk-factors-of-avascular-bone-necrosis-in-patients-with-systemic-lupus-erythematosus
#15
Sau Mei Tse, Chi Chiu Mok
OBJECTIVES: The objective of this paper is to study the time trend and risk factors of avascular bone necrosis (AVN) in patients with systemic lupus erythematosus (SLE). METHODS: Between 1999 and 2014, patients who fulfilled the ACR criteria for SLE and developed symptomatic AVN were identified from our cohort database and compared with those without AVN, matched for age, sex and SLE duration. The standardized incidence ratios (SIRs) of AVN in different SLE age groups were calculated from data derived from our hospital registry and population census...
November 9, 2016: Lupus
https://www.readbyqxmd.com/read/27823893/sepsis-clinical-criteria-in-emergency-department-patients-admitted-to-an-intensive-care-unit-an-external-validation-study-of-quick-sequential-organ-failure-assessment
#16
Michael D April, Jose Aguirre, Lloyd I Tannenbaum, Tyler Moore, Alexander Pingree, Robert E Thaxton, Daniel J Sessions, James H Lantry
BACKGROUND: Quick Sequential Organ Failure Assessment (qSOFA) is a prognostic score for patients with sepsis. OBJECTIVE: Our aim was to compare the area under the receiver operating curve (AUROC), sensitivity, specificity, and likelihood ratios of qSOFA vs. systemic inflammation response syndrome (SIRS) in predicting in-hospital mortality among emergency department (ED) patients with suspected infection admitted to intensive care units (ICUs). METHODS: We conducted a retrospective cohort chart review study of ED patients admitted to an ICU with suspected infection from August 1, 2012 to February 28, 2015...
November 4, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27821083/single-administration-of-selective-internal-radiation-therapy-versus-continuous-treatment-with-sorafenib-in-locally-advanced-hepatocellular-carcinoma-sirvenib-study-protocol-for-a-phase-iii-randomized-controlled-trial
#17
Mihir Gandhi, Su Pin Choo, Choon Hua Thng, Say Beng Tan, Albert Su Chong Low, Peng Chung Cheow, Anthony Soon Whatt Goh, Kiang Hiong Tay, Richard Hoau Gong Lo, Brian Kim Poh Goh, Jen San Wong, David Chee Eng Ng, Khee Chee Soo, Wei Ming Liew, Pierce K H Chow
BACKGROUND: Approximately 20 % of hepatocellular carcinoma (HCC) patients diagnosed in the early stages may benefit from potentially curative ablative therapies such as surgical resection, transplantation or radiofrequency ablation. For patients not eligible for such options, prognosis is poor. Sorafenib and Selective Internal Radiation Therapy (SIRT) are clinically proven treatment options in patients with unresectable HCC, and this study aims to assess overall survival following either SIRT or Sorafenib therapy for locally advanced HCC patients...
November 7, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27777118/the-occurrence-of-infective-endocarditis-with-staphylococcus-lugdunensis-bacteremia-a-retrospective-cohort-study-and-systematic-review
#18
Lemuel R Non, Carlos A Q Santos
BACKGROUND: Staphylococcus lugdunensis is a coagulase-negative staphylococcus with similar virulence characteristics as S. aureus. Whether S. lugdunensis causes infective endocarditis (IE) in a similar proportion of cases as S. aureus (reported to be 12.6% in a definitive multicenter prospective study) is unclear. METHODS: We conducted a retrospective cohort study of adult patients with at least one blood culture positive for S. lugdunensis at our institution from January 2006 to December 2014...
October 21, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27753793/clinical-significance-of-tissue-factor-and-cd13-double-positive-microparticles-in-sirs-patients-with-trauma-and-severe-sepsis
#19
Hisatake Matsumoto, Kazuma Yamakawa, Hiroshi Ogura, Taichin Koh, Naoya Matsumoto, Takeshi Shimazu
Activated immune cells such as monocytes are key factors in systemic inflammatory response syndrome (SIRS) following trauma and sepsis. Activated monocytes induce almost all tissue factor (TF) expression contributing to inflammation and coagulation. TF and CD13 double-positive microparticles (TF/CD13MPs) are predominantly released from these activated monocytes. This study aimed to evaluate TF/CD13MPs and assess their usefulness as a biomarker of pathogenesis in early SIRS following trauma and sepsis. This prospective study comprising 24 trauma patients, 25 severe sepsis patients and 23 healthy controls was conducted from November 2012 to February 2015...
October 6, 2016: Shock
https://www.readbyqxmd.com/read/27734109/conservative-fluid-management-or-deresuscitation-for-patients-with-sepsis-or-acute-respiratory-distress-syndrome-following-the-resuscitation-phase-of-critical-illness-a-systematic-review-and-meta-analysis
#20
Jonathan A Silversides, Emmet Major, Andrew J Ferguson, Emma E Mann, Daniel F McAuley, John C Marshall, Bronagh Blackwood, Eddy Fan
BACKGROUND: It is unknown whether a conservative approach to fluid administration or deresuscitation (active removal of fluid using diuretics or renal replacement therapy) is beneficial following haemodynamic stabilisation of critically ill patients. PURPOSE: To evaluate the efficacy and safety of conservative or deresuscitative fluid strategies in adults and children with acute respiratory distress syndrome (ARDS), sepsis or systemic inflammatory response syndrome (SIRS) in the post-resuscitation phase of critical illness...
October 12, 2016: Intensive Care Medicine
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