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https://www.readbyqxmd.com/read/29908046/sepsis-induced-acute-kidney-injury-a-disease-of-the-microcirculation
#1
Shuai Ma, Roger G Evans, Naoya Iguchi, Marianne Tare, Helena C Parkington, Rinaldo Bellomo, Clive N May, Yugeesh R Lankadeva
Acute kidney injury (AKI) is a common complication of sepsis and is significantly associated with mortality. Sepsis accounts for more than 50% of the cases of AKI, with a mortality rate of up to 40%. The pathogenesis of septic AKI is complex, but there is emerging evidence that, at least in the first 48 hours, the defects may be functional rather than structural in nature. For example, septic AKI is associated with an absence of histopathological changes, but with microvascular abnormalities and tubular stress...
June 16, 2018: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/29907130/acute-kidney-injury-is-associated-with-a-decrease-in-cortical-renal-perfusion-during-septic-shock
#2
Anatole Harrois, Nicolas Grillot, Samy Figueiredo, Jacques Duranteau
BACKGROUND: Renal perfusion status remains poorly studied at the bedside during septic shock. We sought to measure cortical renal perfusion in patients with septic shock during their first 3 days of care using renal contrast enhanced ultrasound (CEUS). METHODS: We prospectively included 20 ICU patients with septic shock and 10 control patients (CL) without septic shock admitted to a surgical ICU. Cortical renal perfusion was evaluated with CEUS during continuous infusion of Sonovue (Milan, Italy) within the first 24 h (day 0), between 24 and 48 h (day 1) and after 72 h (day 3) of care...
June 15, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29907107/complete-abdominal-wound-and-anastomotic-leak-with-diffuse-peritonitis-closure-achieved-by-an-abdominal-vacuum-sealing-drainage-in-a-critical-ill-patient-a-case-report
#3
Yusuke Fujii, Yoshitsugu Tajima, Shunsuke Kaji, Takashi Kishi, Yoshiko Miyazaki, Takahito Taniura, Noriyuki Hirahara
BACKGROUND: Negative pressure wound therapy (NPWT) is a widely accepted technique to treat local infectious wounds of the skin, subcutaneous tissue, fascia, or muscle. Recently, several reports describing the efficacy of NPWT for various types of fistulas and anastomotic leaks have been published. We herein describe a patient with an open abdominal wound due to colonic anastomotic leakage and diffuse peritonitis, in whom abdominal vacuum sealing (AVS) as a modified NPWT was useful for the management of this complex wound...
June 15, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29906560/erythrocyte-sod1-activity-but-not-sod1-polymorphisms-is-associated-with-icu-mortality-in-patients-with-septic-shock
#4
Nara Aline Costa, Natália Baraldi Cunha, Ana Lucia Gut, Paula Schmidt Azevedo, Bertha Furlan Polegato, Leonardo Antonio Mamede Zornoff, Sergio Alberto Rupp de Paiva, Bruna Zavarize Reis, Ana Angelica Henrique Fernandes, Marcelo Macedo Rogero, Marina Maintinguer Norde, Marcos Ferreira Minicucci
The objective of our study was to evaluate the influence of the superoxide dismutase 1 (SOD1) polymorphisms on erythrocyte SOD1 activity and the mortality of patients with septic shock.We prospectively evaluated 175 patients aged over 18 years with septic shock upon ICU admission. However, 38 patients were excluded. Thus, 137 patients were enrolled in the study. Blood samples were taken within the first 24hours of the patient's admission to determine erythrocyte SOD1 activity and nine SOD1 gene polymorphisms...
June 12, 2018: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/29905672/alterations-in-mitochondrial-function-in-blood-cells-obtained-from-patients-with-sepsis-presenting-to-an-emergency-department
#5
David H Jang, Clinton J Orloski, Shawn Owiredu, Frances S Shofer, John C Greenwood, David M Eckmann
OBJECTIVE: Mitochondrial dysfunction has been implicated as a key cellular event leading to organ dysfunction in sepsis. Our objective is to measure changes in mitochondrial bioenergetics in subjects with early presentation of sepsis to provide insight into the incompletely understood pathophysiology of the dysregulated host response in sepsis. DESIGN: Prospective observational study SETTING:: Single site tertiary academic emergency department SUBJECTS:: We enrolled a total of 48 subjects were enrolled in the study, 10 with sepsis or septic shock, 10 with infection without sepsis, 14 older and 14 younger healthy controls...
June 13, 2018: Shock
https://www.readbyqxmd.com/read/29905549/recent-principles-of-antimicrobial-treatment-in-polytrauma-induced-sepsis-and-septic-shock-review
#6
B Kanashvili, Kh Saganelidze, L Ratiani
20% of trauma deaths occur late after the injury. It is usually the result of sepsis, multi-system organ failure, or other complications. In Polytrauma induced sepsis and septic shock patients, antibacterial management is crucial. The knowledge of recent aspects of treatment is decreasing the costs and the resistance of pathogens, morbidity and mortality. Different models of treatment are suggested by authors, basically they are depended on: the patients age, there health condition, the factors of immunodeficiency, at the location of infection and others...
May 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29905091/refractory-hyperlactatemia-after-a-septic-shock-in-a-patient-with-carnitine-deficiency-a-case-report
#7
Philippe Hogan, Roxane Plourde, Maude Fortier, Dave Brindamour, Colin Lagrenade-Verdant, Simon Demers-Marcil, Sébastien Dupuis
A 56-year-old woman with septic shock presented with persistent hyperlactatemia, despite an adequate clinical response to treatment. Carnitine deficiency was suspected, as the patient was malnourished and chronically taking valproic acid. No other plausible cause of hyperlactatemia was found. Carnitine supplementation resulted in rapid normalization of lactatemia.
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29904286/utility-of-venous-blood-gases-in-severe-sepsis-and-septic-shock
#8
Heath D White, Alfredo Vazquez-Sandoval, Pedro F Quiroga, Juhee Song, Shirley F Jones, Alejandro C Arroliga
Acid-base status is frequently assessed in severe sepsis and septic shock. Venous blood gas sampling is proposed as a less-invasive modality but lacks evidence within this population. The objective of this study was to evaluate the correlation and agreement between arterial blood gas (ABG), peripheral venous blood gas (pVBG), and central venous blood gas (cVBG) in severe sepsis and septic shock. We conducted a prospective, observational cohort study in subjects admitted to the medical intensive care unit. Simultaneous blood gas samples, including ABG, pVBG, and cVBG, were analyzed for correlation and agreement...
July 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29903528/evaluation-of-gastric-motility-through-surface-electrogastrography-in-critically-ill-septic-patients-comparison-of-metoclopramide-and-domperidone-effects-a-pilot-randomized-clinical-trial
#9
C Mancilla Asencio, L R Gálvez-Arévalo, E Tobar Almonacid, G Landskron-Ramos, A M Madrid-Silva
INTRODUCTION AND OBJECTIVES: Critically ill patients present with a broad spectrum of gastrointestinal motility disorders that affect the digestive tract. Our aim was to compare the effect of two prokinetic drugs on gastric electrical rhythm in critically ill septic patients, measured through surface electrogastrography (EGG). MATERIAL AND METHODS: A prospective triple-blinded randomized study was conducted on 36 patients admitted to the intensive care unit (ICU) with the diagnosis of septic shock...
June 11, 2018: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/29899987/-streptococcus-pyogenes-and-invasive-central-nervous-system-infection
#10
Ekamjeet Randhawa, John Woytanowski, Kedesha Sibliss, Ian Sheffer
Streptococcus pyogenes is a Gram-positive beta-hemolytic bacteria, also known as group A streptococci, that causes a range of infections. The most common presentation is acute pharyngitis; however, it is also implicated in skin and soft tissue infections, and less commonly bacteremia, osteomyelitis, pneumonia, otitis media and sinusitis. Group A streptococci infections of the central nervous system are exceedingly rare in the antibiotic era. The mechanism of infection is typically contiguous spread from existing infection or via direct inoculation...
2018: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29898794/attitudes-of-emergency-department-physicians-and-nurses-toward-implementation-of-an-early-warning-score-to-identify-critically-ill-patients-qualitative-explanations-for-failed-implementation
#11
Blair L Bigham, Teresa Chan, Steven Skitch, Alison Fox-Robichaud
CLINICIAN'S CAPSULE What is known about the topic? Early warning scores reduce morbidity and mortality by identifying patients at risk for deterioration on the medical wards. What did this study ask? This study sought opinions from emergency department (ED) staff on the use of early warning scores in the ED. What did this study find? Emergency doctors and nurses did not value early warning scores despite quantitative data showing efficacy in the ED. Why does this study matter to clinicians? We gleaned insight into how to implement a computer-based early warning score into the ED to reduce morbidity and mortality from septic shock...
June 14, 2018: CJEM
https://www.readbyqxmd.com/read/29896237/effect-of-interleukin-31-on-septic-shock-through-regulating-inflammasomes-and-interleukin-1%C3%AE
#12
Xuyun Gu, Chen Wei, Xishan Zhu, Feiping Lu, Bo Sheng, Xuefeng Zang
Sepsis with severe systemic inflammation remains a great challenge for the intensive care unit in clinics. Although biomarkers have been identified to diagnose, monitor and predict these syndromes, novel therapeutic approaches are required for the amelioration of symptoms of sepsis and septic shock. The present study demonstrated that interleukin (IL)-31 was able reduce the mortality rate of lipopolysaccharide (LPS)-induced sepsis with the reduction of inflammatory cytokines in the sera. IL-31 also inhibited IL-1β production in the peritoneal lavage fluid in LPS-induced or cecal ligation and puncture-induced sepsis...
July 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29895518/disseminated-cryptococcosis-associated-with-administration-of-eculizumab
#13
Megan Clancy, Ryan McGhan, Jeremy Gitomer, Ana Marie Inocencio, Christina Aldrich, Roberto Iaderosa, Ryan Stevens
PURPOSE: A case report of fatal disseminated cryptococcosis in a patient treated with eculizumab is presented along with a review of literature suggesting a possible etiologic mechanism. SUMMARY: A 23-year-old man with a history of minimal change nephrotic syndrome was hospitalized for acute kidney injury and abdominal pain and swelling. He was found to have disseminated pneumococcal disease, including peritonitis, bacteremia, and pulmonic endocarditis. The patient developed evidence of microangiopathic hemolytic anemia, leading to a diagnosis of atypical hemolytic uremic syndrome, and was started on eculizumab...
June 12, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29895453/mediastinitis-superinfected-by-achromobacter-xylosoxidans-a-case-report
#14
Karine Marion-Sanchez, François Lion, Claude Olive, Géraldine Cailleaux, François Roques
We describe an extremely rare case of mediastinitis superinfected by emerging Achromobacter xylosoxidans. After mitral and aortic valves replacement, the patient first developed a Staphylococcus aureus mediastinitis, and five days after starting adapted antibiotic therapy, superficial pus analysis revealed the presence of Achromobacter xylosoxidans. This superinfection was considered superficial and focus was made on Staphylococcus aureus mediastinitis. Three weeks later, no more Staphylococcus aureus was found in pus samples and the sepsis seemed under control...
June 9, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29894845/protein-tyrosine-phosphatase-1b-regulates-endothelial-endoplasmic-reticulum-stress-role-in-endothelial-dysfunction
#15
Pierre-Alain Thiebaut, Eugénie Delile, David Coquerel, Jean-Michel Brunel, Sylvanie Renet, Fabienne Tamion, Vincent Richard
Protein tyrosine phosphatase 1B (PTP1B) impairs nitric oxide (NO) production and induces endothelial dysfunction in various diseases, including diabetes, septic shock and heart failure. In non-cardiovascular tissues, PTP1B modulates endoplasmic reticulum stress (ERS) however this role has never been assessed in endothelial cells. We evaluated the link between PTP1B, ERS and endothelial dysfunction in mice. Induction of ERS (Tunicamycin) in vivo in mice or ex vivo in mouse arteries led to severe arterial endothelial dysfunction (i...
June 9, 2018: Vascular Pharmacology
https://www.readbyqxmd.com/read/29893802/efficacy-of-ceftazidime-avibactam-salvage-therapy-in-patients-with-infections-caused-by-kpc-producing-klebsiella-pneumoniae
#16
Mario Tumbarello, Enrico Maria Trecarichi, Alberto Corona, Francesco Giuseppe De Rosa, Matteo Bassetti, Cristina Mussini, Francesco Menichetti, Claudio Viscoli, Caterina Campoli, Mario Venditti, Andrea De Gasperi, Alessandra Mularoni, Carlo Tascini, Giustino Parruti, Carlo Pallotto, Simona Sica, Ercole Concia, Rosario Cultrera, Gennaro De Pascale, Alessandro Capone, Spinello Antinori, Silvia Corcione, Elda Righi, Angela Raffaella Losito, Margherita Digaetano, Francesco Amadori, Daniele Roberto Giacobbe, Giancarlo Ceccarelli, Ernestina Mazza, Francesca Raffaelli, Teresa Spanu, Roberto Cauda, Pierluigi Viale
Background: Ceftazidime-avibactam (CAZ-AVI) has been approved in Europe for the treatment of complicated intra-abdominal and urinary-tract infections, as well as hospital-acquired pneumonia, and for Gram-negative infections with limited treatment options. CAZ-AVI displays in vitro activity against KPC-enzyme producers, but clinical-trial data on its efficacy in this setting are lacking. Methods: We retrospectively reviewed 138 cases of infections caused by Klebsiella pneumoniae carbapenemase-producing (KPC-Kp) in adults who received CAZ-AVI in compassionate-use programs in Italy...
June 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29892207/infectious-adverse-events-following-acupuncture-clinical-progress-and-microbiological-etiology
#17
Youn-Jung Kim, Sung-Han Kim, Hak Jin Lee, Won Young Kim
Background: We investigated the clinical progress and bacteriological characteristics of infectious adverse events (AEs) following acupuncture and compared patient characteristics between serious and non-serious outcome groups. Methods: A retrospective observational study was conducted in 1,174 patients with infectious complications associated with acupuncture at the emergency department (ED) in a tertiary hospital in Korea between 2010 and 2014. Serious outcome was defined as development of septic shock, admission to intensive care unit (ICU) or attaining permanent morbidity...
June 11, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29891911/nf-%C3%B0%C2%BAb-increases-lps-mediated-procalcitonin-production-in-human-hepatocytes
#18
Yongfeng Bai, Jun Lu, Ying Cheng, Feng Zhang, Xueyu Fan, Yuanyuan Weng, Jin Zhu
For years, procalcitonin (PCT) has been employed as a diagnostic biomarker for the severity of sepsis and septic shock, as well as for guiding the application of antibiotics. However, the molecular/cellular basis for the regulation of PCT production is not fully understood. In this study, we identified the signalling pathway by which the expression of PCT was induced by lipopolysaccharide in human hepatocytes at the mRNA and protein levels. This expression was dependent on nuclear transcription factor κB (NF-κB), as indicated by a NF-κB binding site (nt -53 to -44) found in the PCT promoter region...
June 11, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29891404/influenza-associated-neurological-complications-during-2014-2017-in-taiwan
#19
Li-Wen Chen, Chao-Ku Teng, Yi-Shan Tsai, Jieh-Neng Wang, Yi-Fang Tu, Ching-Fen Shen, Ching-Chuan Liu
INTRODUCTION: Seasonal influenza-associated neurological complications had high mortality and morbidity rates in recent studies. We reported influenza-associated encephalitis/encephalopathy in children during 2014-2017 in Taiwan, focusing on neurological presentations, neuroimaging correlations, and critical care managements. MATERIALS/SUBJECTS: During January 1st 2014 to June 30th 2017, pediatric patients reported to the Taiwan Centers for Disease Control surveillance system for severe complicated influenza infections in the hospital were retrospectively reviewed...
June 8, 2018: Brain & Development
https://www.readbyqxmd.com/read/29891035/antibiotic-timing-and-outcomes-in-sepsis
#20
Richard Y Kim, Alex M Ng, Annuradha K Persaud, Stephen P Furmanek, Yash N Kothari, John D Price, Timothy L Wiemken, Mohamed A Saad, Juan J Guardiola, Rodrigo S Cavallazzi
BACKGROUND: We evaluated the effect of time spent in the emergency department (ED) and process of care on mortality and length of hospital stay in patients with sepsis or septic shock. METHODS: An observational cohort study was conducted on 117 patients who came through the University of Louisville Hospital ED and subsequently were directly admitted to the intensive care unit (ICU). Variables of interest were time in the ED from triage to physical transport to the ICU, from triage to antibiotic(s) ordered, and from triage to antibiotic(s) administered...
June 2018: American Journal of the Medical Sciences
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