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https://www.readbyqxmd.com/read/27918869/paramedic-initiated-cms-sepsis-core-measure-bundle-prior-to-hospital-arrival-a-stepwise-approach
#1
Jason G Walchok, Ronald G Pirrallo, Douglas Furmanek, Martin Lutz, Colt Shope, Brandi Giles, Greta Gue, Aaron Dix
BACKGROUND: To improve patient outcomes, the Center for Medicare and Medicaid Services (CMS) implemented core measures that outline the initial treatment of the septic patient. These measures include initial blood culture collection prior to antibiotics, adequate intravenous fluid resuscitation, and early administration of broad spectrum antibiotics. We sought to determine if Paramedics can initiate the CMS sepsis core measure bundle in the prehospital field reliably. METHODS: This is a retrospective, case series from a 3rd service EMS system model in Greenville, South Carolina between November 17, 2014 and February 20, 2016...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918369/preadministration-of-hydrogen-rich-water-protects-against-lipopolysaccharide-induced-sepsis-and-attenuates-liver-injury
#2
Masumi Iketani, Jumi Ohshiro, Takuya Urushibara, Mayumi Takahashi, Tomio Arai, Hideo Kawaguchi, Ikuroh Ohsawa
Despite significant advances in antibiotic therapy and intensive care, sepsis remains the most common cause of death in intensive care units. We previously reported that molecular hydrogen (H2) acts as a therapeutic and preventive antioxidant. Here, we show that preadministration of H2-dissolved water (HW) suppresses lipopolysaccharide (LPS)-induced endotoxin shock in mice. Drinking HW for 3 days before LPS injection prolonged survival in a mouse model of sepsis. The H2 concentration immediately increased in the liver but not in the kidney after drinking HW...
December 1, 2016: Shock
https://www.readbyqxmd.com/read/27916077/-intestinal-barrier-dysfunction-and-its-related-factors-in-patients-with-sepsis
#3
W Liu, X H Wang, X J Yang, X Y Zhang, W J Qi
Objective: To investigate the relationship between related factors of intestinal barrier dysfunction in patients with sepsis or septic shock and severity of the condition. Methods: A prospective observational study was conducted in 31 sepsis patients, 28 septic shock patients, and 21 postoperative patients without sepsis (control group) who were admitted to intensive care unit (ICU) of General Hospital of Ningxia Medical University between November 2015 and June 2016. Blood samples were collected from the patients within 24 hours following admission to ICU...
November 29, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27916032/-lung-transplantation-for-phase-%C3%A2-silicosis-a-series-of-32-cases
#4
W J Mao, J Y Chen, M F Zheng, R Chen, Y J He, F Liu, S G Ye, R G Lu
Objective: To evaluate the effect of lung transplantation for phase Ⅲ silicosis. Methods: From September 2002 to September 2015, 32 patients with end-stage silicosis underwent lung transplantation at Department of Thoracic Surgery, Affiliated Wuxi People's Hospital, Nanjing Medical University. There were 29 male and 3 female patients aged from 24 to 63 years. Thirty-two patients were diagnosed as phase Ⅲ silicosis by the local occupational disease prevention and control center. Fifteen patients were type Ⅰ respiratory failure and 17 patients were type Ⅱ...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27910218/octreotide-use-and-safety-in-infants-with-hyperinsulinism
#5
Ann W McMahon, Gerold T Wharton, Paul Thornton, Diva D De Leon
BACKGROUND: Octreotide is a synthetic peptide analog of naturally occurring somatostatin. Octreotide is used off-label in children <6 years of age for hyperinsulinism, chylothorax, and gastrointestinal bleeding. There is a lack of controlled data on efficacy or potential adverse events from this off-label use. METHODS: Three pediatric hospitals participated in this study. Patients were hospitalized January 2007-December 2010 and administered octreotide for congenital hyperinsulinism (CHI) at least 1 day...
December 2, 2016: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/27910086/higher-vs-lower-haemoglobin-threshold-for-transfusion-in-septic-shock-subgroup-analyses-of-the-triss-trial
#6
S L Rygård, L B Holst, J Wetterslev, P I Johansson, A Perner
BACKGROUND: Using a restrictive transfusion strategy appears to be safe in sepsis, but there may be subgroups of patients who benefit from transfusion at a higher haemoglobin level. We explored if subgroups of patients with septic shock and anaemia had better outcome when transfused at a higher vs. a lower haemoglobin threshold. METHODS: In post-hoc analyses of the full trial population of 998 patients from the Transfusion Requirements in Septic Shock (TRISS) trial, we investigated the intervention effect on 90-day mortality in patients with severe comorbidity (chronic lung disease, haematological malignancy or metastatic cancer), in patients who had undergone surgery (elective or acute) and in patients with septic shock as defined by the new consensus definition: lactate above 2 mmol/l and the need for vasopressors to maintain a mean arterial pressure above 65 mmHg...
December 2, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27908594/rucaparib-in-relapsed-platinum-sensitive-high-grade-ovarian-carcinoma-ariel2-part-1-an-international-multicentre-open-label-phase-2-trial
#7
Elizabeth M Swisher, Kevin K Lin, Amit M Oza, Clare L Scott, Heidi Giordano, James Sun, Gottfried E Konecny, Robert L Coleman, Anna V Tinker, David M O'Malley, Rebecca S Kristeleit, Ling Ma, Katherine M Bell-McGuinn, James D Brenton, Janiel M Cragun, Ana Oaknin, Isabelle Ray-Coquard, Maria I Harrell, Elaina Mann, Scott H Kaufmann, Anne Floquet, Alexandra Leary, Thomas C Harding, Sandra Goble, Lara Maloney, Jeff Isaacson, Andrew R Allen, Lindsey Rolfe, Roman Yelensky, Mitch Raponi, Iain A McNeish
BACKGROUND: Poly(ADP-ribose) polymerase (PARP) inhibitors have activity in ovarian carcinomas with homologous recombination deficiency. Along with BRCA1 and BRCA2 (BRCA) mutations genomic loss of heterozygosity (LOH) might also represent homologous recombination deficiency. In ARIEL2, we assessed the ability of tumour genomic LOH, quantified with a next-generation sequencing assay, to predict response to rucaparib, an oral PARP inhibitor. METHODS: ARIEL2 is an international, multicentre, two-part, phase 2, open-label study done at 49 hospitals and cancer centres in Australia, Canada, France, Spain, the UK, and the USA...
November 28, 2016: Lancet Oncology
https://www.readbyqxmd.com/read/27908337/source-identification-and-source-control
#8
REVIEW
Zeke P Oliver, Jack Perkins
Identifying sources of infection and establishing source control is an essential component of the workup and treatment of sepsis. Investigation with history, physical examination, laboratory tests, and imaging can in identifying sources of infection. All organ systems have the potential to develop sources of infection. However, there are inherent difficulties presented by some that require additional diligence, namely, urinalysis, chest radiographs, and intraabdominal infections. Interventions include administration of antibiotics and may require surgical or other specialist intervention...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27906828/presence-of-cytotoxic-extracellular-histones-in-machine-perfusate-of-donation-after-circulatory-death-kidneys
#9
Tim C van Smaalen, Daniëlle M H Beurskens, E R Pieter Hoogland, Bjorn Winkens, Maarten H L Christiaans, Chris P Reutelingsperger, L W Ernest van Heurn, Gerry A F Nicolaes
BACKGROUND: Extracellular histones are cytotoxic molecules that are related to cell stress and death. They have been shown to play a crucial role in multiple pathophysiologic processes like sepsis, inflammation, vascular dysfunction and thrombosis. Their role in organ donation and graft function and survival is still unknown. The aim of this study was to assess whether an association exists between the presence of extracellular histones in machine perfusates and deceased donor kidney viability...
December 1, 2016: Transplantation
https://www.readbyqxmd.com/read/27905971/trends-causes-and-risk-factors-of-mortality-among-children-under-5-in-ethiopia-1990-2013-findings-from-the-global-burden-of-disease-study-2013
#10
Amare Deribew, Gizachew Assefa Tessema, Kebede Deribe, Yohannes Adama Melaku, Yihunie Lakew, Azmeraw T Amare, Semaw F Abera, Mesoud Mohammed, Abiy Hiruye, Efrem Teklay, Awoke Misganaw, Nicholas Kassebaum
BACKGROUND: Ethiopia has made remarkable progress in reducing child mortality over the last two decades. However, the under-5 mortality rate in Ethiopia is still higher than the under-5 mortality rates of several low- and middle-income countries (LMIC). On the other hand, the patterns and causes of child mortality have not been well investigated in Ethiopia. The objective of this study was to investigate the mortality trend, causes of death, and risk factors among children under 5 in Ethiopia during 1990-2013...
November 14, 2016: Population Health Metrics
https://www.readbyqxmd.com/read/27902585/long-term-complications-of-splenectomy-in-adult-immune-thrombocytopenia
#11
Lan-Huong Thai, Matthieu Mahévas, Françoise Roudot-Thoraval, Nicolas Limal, Laetitia Languille, Guillaume Dumas, Mehdi Khellaf, Philippe Bierling, Marc Michel, Bertrand Godeau
The recent large decrease in splenectomy use for chronic immune thrombocytopenia (ITP) is partly due to still-unsolved questions about long-term safety. We performed the first single-center exposed/unexposed cohort study evaluating the long-term incidence of splenectomy complications in patients with primary ITP. Overall, 83 patients who underwent splenectomy more than 10 years ago (exposed) were matched with 83 nonsplenectomized patients (unexposed) on the date of ITP diagnosis ±5 years, age and gender. After a median follow-up of 192 months (range 0...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27902475/osthole-protects-sepsis-induced-acute-kidney-injury-via-down-regulating-nf-%C3%AE%C2%BAb-signal-pathway
#12
Chen Yu, Peng Li, Dong Qi, Lei Wang, Hong-Lin Qu, Yue-Juan Zhang, Xue-Kai Wang, Hua-Ying Fan
BACKGROUND AND PURPOSE: As a natural coumarin derivative from the Cnidium monnieri(L)Cusson fruit, osthole consists of 7-methoxy-8-isopentenoxy-coumarin. The purpose of this research is to study the mechanism and effect of osthole on sepsis-induced acute kidney injury. EXPERIMENTAL APPROACH: The protective effect of osthole on mouse macrophage RAW 264.7 and HK-2 cells induced by LPS in vitro and on acute kidney injury model induced by sepsis and established by puncture and cecal ligation (CLP) in vivo were tested...
November 25, 2016: Oncotarget
https://www.readbyqxmd.com/read/27900737/three-year-mortality-in-30-day-survivors-of-critical-care-with-acute-kidney-injury-data-from-the-prospective-observational-finnaki-study
#13
Henriikka Mildh, Ville Pettilä, Anna-Maija Korhonen, Sari Karlsson, Tero Ala-Kokko, Matti Reinikainen, Suvi T Vaara
BACKGROUND: The role of an episode of acute kidney injury (AKI) in long-term mortality among initial survivors of critical illness is controversial. We aimed to determine whether AKI is independently associated with decreased survival at 3 years among 30-day survivors of intensive care. RESULTS: We included 2336 30-day survivors of intensive care enrolled in the FINNAKI study conducted in seventeen medical-surgical ICUs in Finland during a 5-month period in 2011-2012...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27899784/-effectiveness-of-carboplatin-plus-taxane-chemotherapy-for-advanced-or-recurrent-uterine-serous-carcinoma
#14
Takuto Matsuura, Isao Otsuka
OBJECTIVE: Uterine serous carcinoma(USC)is more aggressive compared to endometrioid adenocarcinoma, and often exhibits intraperitoneal spread, resulting in a poor prognosis. It is a rare subtype of uterine cancers, accounting for 5%of cases in Japan; therefore, optimal chemotherapy regimens for patients with advanced or recurrent disease have not been established. In the present study, we evaluated the safety and efficacy of carboplatin plus taxane chemotherapy for the treatment of patients withadvanced and recurrent USC...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/27899278/benznidazole-the-trypanocidal-drug-used-for-chagas-disease-induces-hepatic-nrf2-activation-and-attenuates-the-inflammatory-response-in-a-murine-model-of-sepsis
#15
Flavia Lambertucci, Omar Motiño, Silvina Villar, Juan Pablo Rigalli, María de Luján Alvarez, Viviana Catania, Paloma Martín-Sanz, Cristina Ester Carnovale, Ariel Darío Quiroga, Daniel Eleazar Francés, María Teresa Ronco
Molecular mechanisms on sepsis progression are linked to the imbalance between reactive oxygen species (ROS) production and cellular antioxidant capacity. Previous studies demonstrated that benznidazole (BZL), known for its antiparasitic action on Trypanosoma cruzi, has immunomodulatory effects, increasing survival in C57BL/6 mice in a model of polymicrobial sepsis induced by cecal ligation puncture (CLP). The mechanism by which BZL inhibits inflammatory response in sepsis is poorly understood. Also, our group recently reported that BZL is able to activate the nuclear erythroid 2-related factor 2 (NRF2) in vitro...
November 26, 2016: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/27898352/management-of-the-open-abdomen-using-negative-pressure-wound-therapy-with-instillation-in-severe-abdominal-sepsis-a-review-of-48-cases-in-hospital-mexico-costa-rica
#16
Pablo Sibaja, Alfredo Sanchez, Guillermo Villegas, Alvaro Apestegui, Esteban Mora
INTRODUCTION: Despite the numerous advances in recent years, severe abdominal sepsis (with associated organ failure associated with infection) remains a serious, life-threatening condition with a high mortality rate. OA is a viable alternative to the previously used scheduled repeat laparotomy or continuous peritoneal lavage. The use of Negative Pressure Wound Therapy (NPWT) has been described as a successful method of management of the open abdomen. Adding instillation of saline solution to NPWT in a programmed and controlled manner, could offer the clinician an additional tool for the management of complex septic abdomen...
November 17, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27897405/premorbid-obesity-but-not-nutrition-prevents-critical-illness-induced-muscle-wasting-and-weakness
#17
Chloë Goossens, Mirna Bastos Marques, Sarah Derde, Sarah Vander Perre, Thomas Dufour, Steven E Thiessen, Fabian Güiza, Thomas Janssens, Greet Hermans, Ilse Vanhorebeek, Katrien De Bock, Greet Van den Berghe, Lies Langouche
BACKGROUND: The 'obesity paradox' of critical illness refers to better survival with a higher body mass index. We hypothesized that fat mobilized from excess adipose tissue during critical illness provides energy more efficiently than exogenous macronutrients and could prevent lean tissue wasting. METHODS: In lean and premorbidly obese mice, the effect of 5 days of sepsis-induced critical illness on body weight and composition, muscle wasting, and weakness was assessed, each with fasting and parenteral feeding...
July 20, 2016: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/27896468/evaluation-of-major-trauma-in-elderly-patients-a%C3%A2-single-trauma-center-analysis
#18
Samo Kocuvan, Drago Brilej, Domen Stropnik, Rolf Lefering, Radko Komadina
BACKGROUND: The objective of the study was to gather information about elderly major trauma patients admitted to one particular Slovenian trauma centre in Celje and examine this group of polytrauma patients, specifically with respect to mechanisms of injury, injury severity and distribution of injuries. Further on, to identify morbidity and mortality rates and compare these to the younger population and, finally, to determine the factors that have the most impact on treatment results...
November 28, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27895847/efficacy-of-a-low-cost-bubble-cpap-system-in-treatment-of-respiratory-distress-in-a-neonatal-ward-in-malawi
#19
Kondwani Kawaza, Heather E Machen, Jocelyn Brown, Zondiwe Mwanza, Suzanne Iniguez, Al Gest, E O'Brian Smith, Maria Oden, Rebecca R Richards-Kortum, Elizabeth Molyneux
BACKGROUND: Respiratory failure is a leading cause of neonatal mortality in the developing world. Bubble continuous positive airway pressure (bCPAP) is a safe, effective intervention for infants with respiratory distress and is widely used in developed countries. Because of its high cost, bCPAP is not widely utilized in low-resource settings. We evaluated the performance of a new bCPAP system to treat severe respiratory distress in a low resource setting, comparing it to nasal oxygen therapy, the current standard of care...
September 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/27895446/a-case-of-fatal-sepsis-due-to-multidrug-resistant-corynebacterium-striatum
#20
M Chatzopoulou, T Koufakis, I Voulgaridi, I Gabranis, M Tsiakalou
BACKGROUND: Although non-diphtheria corynebacteria have traditionally been regarded as avirulent members of human bacterial flora, their pathogenic potential is increasingly recognized in our time. Reasons for this include the prolonged survival of severely ill and immunocompromised patients, the development of more invasive diagnostic and therapeutic procedures and the sub-optimal use of antibiotics that disrupts normal microbial balance and favors superinfections. CASE REPORT: We present a rare case of sepsis due to multidrug-resistant Corynebacterium striatum in a 76-year-old host...
January 2016: Hippokratia
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