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Shock Septic

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https://www.readbyqxmd.com/read/28551603/vibrio-vulnificus-septic-shock-due-to-a-contaminated-tattoo
#1
Nicholas Hendren, Senthil Sukumar, Craig S Glazer
We present a case of Vibrio vulnificus septic shock and cellulitis in a patient with chronic liver disease that occurred after obtaining a leg tattoo with subsequent seawater exposure in the Gulf of Mexico. Initial suspicion for V. vulnificus was high and he was started on empiric doxycycline and ceftriaxone at admission. Blood and wound cultures grew oxidase positive and comma-shaped Gram-negative rods ultimately confirmed to be V. vulnificus. Despite aggressive initial treatment, the patient developed septic shock and died...
May 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28550994/prospective-validation-of-a-near-real-time-ehr-integrated-automated-sofa-score-calculator
#2
Christopher Aakre, Pablo Moreno Franco, Micaela Ferreyra, Jaben Kitson, Man Li, Vitaly Herasevich
OBJECTIVES: We created an algorithm for automated Sequential Organ Failure Assessment (SOFA) score calculation within the Electronic Health Record (EHR) to facilitate detection of sepsis based on the Third International Consensus Definitions for Sepsis and Septic Shock (SEPSIS-3) clinical definition. We evaluated the accuracy of near real-time and daily automated SOFA score calculation compared with manual score calculation. METHODS: Automated SOFA scoring computer programs were developed using available EHR data sources and integrated into a critical care focused patient care dashboard at Mayo Clinic in Rochester, Minnesota...
July 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28550906/procalcitonin-and-white-blood-cells-combined-predictors-of-infection-in-cardiac-surgery-patients
#3
María Heredia-Rodríguez, Juan Bustamante-Munguira, Mario Lorenzo, Esther Gómez-Sánchez, F Javier Álvarez, Inmaculada Fierro, Esther Conejo, Eduardo Tamayo
BACKGROUND: Sepsis is strongly associated with an increased risk of postoperative mortality, longer length of hospital stay, and elevated health care costs. Early clinical symptoms overlap with those of systemic inflammatory response syndrome, a response that commonly occurs after cardiac surgery with cardiopulmonary bypass. Since a combination of biomarkers has been demonstrated to improve the prediction of postoperative infection, the objective of the present study was to test whether the combination of C-reactive protein (CRP), white blood cells (WBC), and procalcitonin (PCT) is able to predict postoperative infection in a large cohort of cardiac surgery patients...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28550443/timing-to-antibiotic-therapy-in-septic-oncologic-patients-presenting-without-hypotension
#4
Kathleen Morneau, Gary B Chisholm, Frank Tverdek, Jeffrey Bruno, Katy M Toale
PURPOSE: Sepsis accounts for only 2% of the hospitalizations worldwide but more than 17% of total in-hospital mortality. Inappropriate antimicrobial selection and delays in appropriate therapy have been associated with reduced survival in severe sepsis and septic shock. No studies to date have exclusively targeted septic oncologic patients without hypotension. METHODS: This study was a retrospective chart review of 100 adult cancer patients presenting to the emergency department with sepsis without hypotension...
May 26, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28549777/p32-is-required-for-appropriate-interleukin-6-production-upon-lps-stimulation-and-protects-mice-from-endotoxin-shock
#5
Katsuhiko Sasaki, Kazuhito Gotoh, Sho Miake, Daiki Setoyama, Mikako Yagi, Ko Igami, Takeshi Uchiumi, Donchon Kang
Sepsis is a major cause of morbidity and mortality in seriously ill patients and mitochondrial dysfunction is associated with poor outcomes in septic patients. Although interleukin-6 (IL-6) is a good prognostic marker for sepsis, the relationship between mitochondrial dysfunction and IL-6 remains poorly understood. We identified p32/C1QBP/HABP1 as a regulator of IL-6 production in response to lipopolysaccharide (LPS). LPS induced IL-6 overproduction in p32 deficient mouse embryonic fibroblasts (MEFs) through NF-κB independent but activating transcription factor (ATF) 4 dependent pathways...
May 11, 2017: EBioMedicine
https://www.readbyqxmd.com/read/28549024/the-epidemiology-of-hospital-death-following-pediatric-severe-sepsis-when-why-and-how-children-with-sepsis-die
#6
Scott L Weiss, Fran Balamuth, Josey Hensley, Julie C Fitzgerald, Jenny Bush, Vinay M Nadkarni, Neal J Thomas, Mark Hall, Jennifer Muszynski
OBJECTIVE: The epidemiology of in-hospital death after pediatric sepsis has not been well characterized. We investigated the timing, cause, mode, and attribution of death in children with severe sepsis, hypothesizing that refractory shock leading to early death is rare in the current era. DESIGN: Retrospective observational study. SETTING: Emergency departments and ICUs at two academic children's hospitals. PATIENTS: Seventy-nine patients less than 18 years old treated for severe sepsis/septic shock in 2012-2013 who died prior to hospital discharge...
May 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28548199/-acute-small-bowel-diverticulitis-in-a-patient-with-crohn%C3%A2-s-disease
#7
Macarena Hevia, Rodrigo Quera, Leonardo Soto, Tomás Regueira, Andrés O'Brien, Andrés Larach, Udo Kronberg
Diverticular disease of the small intestine is rare, especially when it is located in the jejunum. It is generally asymptomatic, but in some patients it may have complications such as acute diverticulitis with peritonitis, gastrointestinal bleeding or obstruction. In such cases, the recommended treatment is surgery. We report a 77-year-old patient with ileal Crohn’s disease with a long-standing inflammatory phenotype, who developed acute diverticulitis of the jejunum presenting a severe septic shock and secondary multiple-organ failure...
March 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28546861/association-between-recurrence-of-acute-kidney-injury-and-mortality-in-intensive-care-unit-patients-with-severe-sepsis
#8
Emilio Rodrigo, Borja Suberviola, Miguel Santibáñez, Lara Belmar, Álvaro Castellanos, Milagros Heras, Juan Carlos Rodríguez-Borregán, Angel Luis Martín de Francisco, Claudio Ronco
BACKGROUND: Acute kidney injury (AKI) occurs in more than half critically ill patients admitted in intensive care units (ICU) and increases the mortality risk. The main cause of AKI in ICU is sepsis. AKI severity and other related variables such as recurrence of AKI episodes may influence mortality risk. While AKI recurrence after hospital discharge has been recently related to an increased risk of mortality, little is known about the rate and consequences of AKI recurrence during the ICU stay...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28543387/the-hematocrit-affects-the-volume-of-plasma-treated-with-coupled-plasma-filtration-and-adsorption-with-predilution
#9
Stefano Finazzi, Elena Garbero, Giampietro Trussardi, Guido Bertolini
Coupled plasma filtration and adsorption (CPFA) is an extracorporeal blood purification technique proposed for the treatment of septic-shock. By removing pro- and anti-inflammatory mediators from plasma, CPFA is supposed to have a therapeutic effect on the abnormal inflammatory response seen in this condition. Recently, blood predilution with citrate solution has been adopted to prevent clotting in the CPFA circuit-one of the main problems of the technique. Taking into account the patient's hematocrit, we worked out a formula for the volume of plasma effectively treated by CPFA after predilution...
May 2017: Artificial Organs
https://www.readbyqxmd.com/read/28542440/plasma-kallistatin-in-critically-ill-patients-with-severe-sepsis-and-septic-shock
#10
Wei-Chieh Lin, Chang-Wen Chen, Lee Chao, Julie Chao, Yee-Shin Lin
Kallistatin, an endogenous serine proteinase inhibitor, is protective against sepsis in animal models. The aim of this study was to determine the plasma concentration of kallistatin in intensive care unit (ICU) patients with severe sepsis and septic shock and to determine their potential correlation with disease severity and outcomes. We enrolled 86 ICU patients with severe sepsis and septic shock. Their plasma concentrations of kallistatin, kallikrein, tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and IL-8 were measured by enzyme-linked immunosorbent assay...
2017: PloS One
https://www.readbyqxmd.com/read/28542029/the-impact-of-the-sepsis-3-septic-shock-definition-on-previously-defined-septic-shock-patients
#11
Sarah A Sterling, Michael A Puskarich, Andrew F Glass, Faheem Guirgis, Alan E Jones
OBJECTIVE: The Third International Consensus Definitions Task Force (Sepsis-3) recently recommended changes to the definitions of sepsis. The impact of these changes remains unclear. Our objective was to determine the outcomes of patients meeting Sepsis-3 septic shock criteria versus patients meeting the "old" (1991) criteria of septic shock only. DESIGN: Secondary analysis of two clinical trials of early septic shock resuscitation. SETTING: Large academic emergency departments in the United States...
May 24, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28538389/antimicrobial-resistance-patterns-clinical-features-and-risk-factors-for-septic-shock-and-death-of-nosocomial-e-coli-bacteremia-in-adult-patients-with-hematological-disease-a-monocenter-retrospective-study-in-china
#12
Jie Ma, Ning Li, Yajie Liu, Chong Wang, Xiaoyan Liu, Shengmei Chen, Xinsheng Xie, Silin Gan, Meng Wang, Weijie Cao, Fang Wang, Yanfan Liu, Dingming Wan, Ling Sun, Hui Sun
The aim of this retrospective analysis was to evaluate the antimicrobial resistance, clinical features, and risk factors for septic shock and death of nosocomial E coli bacteremia in adult patients in a single hematological center in China. A retrospective case-control study of 157 adult hematological patients with 168 episodes of E coli bacteremia was initiated from April 2012 to July 2015. Antimicrobial susceptibility as well as antimicrobial co-resistance rates were analyzed. Clinical features and outcomes were also studied...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28535517/coupled-plasma-filtration-adsorption-application-for-liver-and-thyroid-toxins
#13
Gabriele Donati, Irene Capelli, Anna Laura Croci Chiocchini, Nicolò Natali, Anna Scrivo, Gaetano La Manna
Coupled plasma filtration and adsorption (CPFA) is a detoxification system that combines a plasma adsorption circuit and a continuous renal replacement therapy circuit. Its main application is for sepsis and septic shock with or without acute renal failure. Several recent studies have suggested that CPFA can reduce the mortality when the volume of plasma absorbed on the styrenic resin is at least >0.18 L/kg/day. At present, new applications for CPFA are under investigation, also in patients without significant kidney failure...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28533998/ipilimumab-as-a-cause-of-severe-pan-colitis-and-colonic-perforation
#14
Raj Shah, Danielle Witt, Talal Asif, Fahad F Mir
Ipilimumab is a human monoclonal antibody that functions as a cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor that is used to treat malignant melanoma. Due to ipilimumab's removal of immune regulation, specifically through the inactivation of CTLA-4, it is commonly associated with inflammatory and autoimmune events. Gastrointestinal (GI) related immune-related adverse events such as diarrhea occur in 29% of patients with 7.6% of patients specifically suffering from colitis. We describe a case of colonic perforation with ipilimumab use...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28533774/the-role-of-ifn-%C3%AE-during-the-course-of-sepsis-progression-and-its-therapeutic-potential
#15
REVIEW
Gorjana Rackov, Rahman Shokri, Melchor Álvarez De Mon, Carlos Martínez-A, Dimitrios Balomenos
Sepsis is a complex biphasic syndrome characterized by both pro- and anti-inflammatory immune states. Whereas early sepsis mortality is caused by an acute, deleterious pro-inflammatory response, the second sepsis phase is governed by acute immunosuppression, which predisposes patients to long-term risk for life-threatening secondary infections. Despite extensive basic research and clinical trials, there is to date no specific therapy for sepsis, and mortality rates are on the rise. Although IFN-β is one of the most-studied cytokines, its diverse effects are not fully understood...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28531183/a-scoping-review-on-bio-aerosols-in-healthcare-and-the-dental-environment
#16
Charifa Zemouri, Hans de Soet, Wim Crielaard, Alexa Laheij
BACKGROUND: Bio-aerosols originate from different sources and their potentially pathogenic nature may form a hazard to healthcare workers and patients. So far no extensive review on existing evidence regarding bio-aerosols is available. OBJECTIVES: This study aimed to review evidence on bio-aerosols in healthcare and the dental setting. The objectives were 1) What are the sources that generate bio-aerosols?; 2) What is the microbial load and composition of bio-aerosols and how were they measured?; and 3) What is the hazard posed by pathogenic micro-organisms transported via the aerosol route of transmission? METHODS: Systematic scoping review design...
2017: PloS One
https://www.readbyqxmd.com/read/28531175/weekly-high-dose-liposomal-amphotericin-b-l-amb-in-critically-ill-septic-patients-with-multiple-candida-colonization-the-ambidex-study
#17
Elie Azoulay, Jean-François Timsit, Alexandre Lautrette, Stephane Legriel, Adeline Max, Stephane Ruckly, Benoit Misset, Yves Cohen, Michel Wolff
BACKGROUND: To demonstrate the feasibility and safety of weekly high-dose liposomal amphotericin B (L-AmB) (as a pre-emptive antifungal treatment) for 2 weeks in patients with septic shock and Candida colonization. METHODS: Pilot, multicentre, open-label, prospective study conducted in seven French ICUs. Non-immunocompromised patients, receiving mechanical ventilation were eligible if they presented ICU-acquired severe sepsis requiring newly administered antibacterial agents and Candida colonization in at least two sites...
2017: PloS One
https://www.readbyqxmd.com/read/28530771/macrophage-migration-inhibitory-factor-levels-correlate-with-an-infection-in-trauma-patients
#18
Young Duck Cho, Sung Hyuk Choi, Jung Youn Kim, Sung Jun Park, Young Hoon Yoon, Han Jin Cho, Ji Won Yeom
BACKGROUND: The role of migration inhibitory factor (MIF) is best understood in septic shock and septic disease; however, the role of MIF in a secondary infection after trauma has not yet been completely studied. This study aimed to evaluate the role of MIF in trauma patients. METHODS: The patients in the study population were divided into two groups according to the results of their MIF levels. The initial MIF levels, trauma mechanism, revised trauma score, survival rate, length of stay (LOS) in the intensive care unit (ICU), level of leukocytes, and level of C-reactive protein (CRP) were compared between the groups...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28528569/time-to-treatment-and-mortality-during-mandated-emergency-care-for-sepsis
#19
Christopher W Seymour, Foster Gesten, Hallie C Prescott, Marcus E Friedrich, Theodore J Iwashyna, Gary S Phillips, Stanley Lemeshow, Tiffany Osborn, Kathleen M Terry, Mitchell M Levy
Background In 2013, New York began requiring hospitals to follow protocols for the early identification and treatment of sepsis. However, there is controversy about whether more rapid treatment of sepsis improves outcomes in patients. Methods We studied data from patients with sepsis and septic shock that were reported to the New York State Department of Health from April 1, 2014, to June 30, 2016. Patients had a sepsis protocol initiated within 6 hours after arrival in the emergency department and had all items in a 3-hour bundle of care for patients with sepsis (i...
May 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28525777/prevalence-and-clinical-significance-of-early-high-endotoxin-activity-in-septic-shock-an-observational-study
#20
Maurizio Bottiroli, Gianpaola Monti, Riccardo Pinciroli, Irene Vecchi, Valeria Terzi, Giuseppe Ortisi, Giampaolo Casella, Roberto Fumagalli
PURPOSE: To measure the prevalence of elevated Endotoxin Activity (EA) in a large cohort of patients with Septic Shock (SS), and to assess its value as an early indicator of Gram-Negative (GN) infection, disease severity, and patient risk. MATERIALS AND METHODS: Adult patients were enrolled in this observational study if an EA determination was obtained within 24-h from SS onset. Demographic, clinical, and microbiological data were collected. In-hospital follow-up was also conducted...
April 26, 2017: Journal of Critical Care
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