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https://www.readbyqxmd.com/read/28331537/combined-totally-mini-invasive-approach-in-necrotizing-pancreatitis-a-case-report-and-systematic-literature-review
#1
REVIEW
Luca Sorrentino, Osvaldo Chiara, Massimiliano Mutignani, Fabrizio Sammartano, Paolo Brioschi, Stefania Cimbanassi
BACKGROUND: Currently, both the step-up approach, combining percutaneous drainage (PD) and video-assisted retroperitoneal debridement (VARD), and endoscopic transgastric necrosectomy (ETN) are mini-invasive techniques for infected necrosis in severe acute pancreatitis. A combination of these approaches could maximize the management of necrotizing pancreatitis, conjugating the benefits from both the experiences. However, reporting of this combined strategy is anecdotal. This is the first reported case of severe necrotizing pancreatitis complicated by biliary fistula treated by a combination of ETN, PD, VARD, and endoscopic biliary stenting...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28329088/short-course-adjunctive-gentamicin-as-empirical-therapy-in-patients-with-severe-sepsis-and-septic-shock-a-prospective-observational-cohort-study
#2
David S Y Ong, Jos F Frencken, Peter M C Klein Klouwenberg, Nicole Juffermans, Tom van der Poll, Marc Bonten, Olaf Cremer
Background.: Meta-analyses failed to demonstrate clinical benefits of beta lactam plus aminoglycoside combination therapy, compared to beta lactam monotherapy, in patients with sepsis. However, few data exist on the effects of short-course adjunctive aminoglycoside therapy in sepsis patients with organ failure or shock. Methods.: We prospectively enrolled consecutive patients with severe sepsis or septic shock in two intensive care units in the Netherlands from 2011 to 2015...
February 28, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28328652/delayed-second-dose-antibiotics-for-patients-admitted-from-the-emergency-department-with-sepsis-prevalence-risk-factors-and-outcomes
#3
Daniel Leisman, Victor Huang, Qiuping Zhou, Jeanie Gribben, Andrea Bianculli, Michelle Bernshteyn, Mary Frances Ward, Sandra M Schneider
OBJECTIVE: 1) Determine frequency and magnitude of delays in second antibiotic administration among patients admitted with sepsis; 2) Identify risk factors for these delays; and 3) Exploratory: determine association between delays and patient-centered outcomes (mortality and mechanical ventilation after second dose). DESIGN: Retrospective, consecutive sample sepsis cohort over 10 months. SETTING: Single, tertiary, academic medical center. PATIENTS: All patients admitted from the emergency department with sepsis or septic shock (defined: infection, ≥ 2 systemic inflammatory response syndrome criteria, hypoperfusion/organ dysfunction) identified by a prospective quality initiative...
March 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28324661/improved-risk-stratification-in-pediatric-septic-shock-using-both-protein-and-mrna-biomarkers-persevere-xp
#4
Hector R Wong, Natalie Z Cvijanovich, Nick Anas, Geoffrey L Allen, Neal J Thomas, Michael T Bigham, Scott L Weiss, Julie C Fitzgerald, Paul A Checchia, Keith Meyer, Michael Quasney, Mark Hall, Rainer Gedeit, Robert J Freishtat, Jeffrey Nowak, Shekhar S Raj, Shira Gertz, Jocelyn R Grunwell, Christopher J Lindsell
RATIONALE: We previously derived and validated the Pediatric Sepsis Biomarker Risk Model (PERSEVERE) to estimate baseline mortality risk in children with septic shock. The PERSEVERE biomarkers are serum proteins, selected from among the proteins directly related to 80 mortality risk assessment genes. The initial approach to selecting the PERSEVERE biomarkers left 68 genes unconsidered. OBJECTIVE: Determine if the 68 previously unconsidered genes can improve upon the performance of PERSEVERE and provide biological information regarding the pathophysiology of septic shock...
March 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28322887/staphylococcus-aureus-bacteremia-in-patients-with-rheumatoid-arthritis-data-from-the-prospective-instinct-cohort
#5
Insa Joost, Achim Kaasch, Christine Pausch, Gabriele Peyerl-Hoffmann, Christian Schneider, Reinhard E Voll, Harald Seifert, Winfried V Kern, Siegbert Rieg
OBJECTIVES: Patients with rheumatoid arthritis (RA) are considered to be at increased risk of severe infections. We here describe the clinical characteristics, course and outcome of RA patients with Staphylococcus aureus bacteremia (SAB). METHODS: We conducted a post hoc analysis of data from a German bi-centre prospective SAB cohort study (period 2006-2014). Patients were followed-up for one year. Primary and secondary outcomes were survival time and osteoarticular infection (OAI)...
March 17, 2017: Journal of Infection
https://www.readbyqxmd.com/read/28322834/anti-human-cd14-monoclonal-antibody-improves-survival-following-sepsis-induced-by-endotoxin-but-not-following-polymicrobial-infection
#6
Masaki Nakamura, Takashi Takeuchi, Kamon Shirakawa, Shoji Furusako
Cluster of differentiation 14 (CD14), a pattern recognition receptor expressed on myeloid cells and a critical component of the innate immune system, mediates local and systemic host responses to gram-negative bacterial products, including lipopolysaccharide (LPS). Therefore, CD14 is an attractive target for development of sepsis therapies, and several monoclonal anti-CD14 antibodies have been reported. In this study, we prepared an anti-human CD14 monoclonal antibody, F1024-1-3, which suppressed LPS-induced upregulation of pro-inflammatory cytokines and an adhesion molecule in human peripheral mononuclear cells and human vascular endothelial cells...
March 16, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28321823/cardiovascular-disease-and-resuscitated-septic-shock-lead-to-the-downregulation-of-the-h2s-producing-enzyme-cystathionine-%C3%AE-lyase-in-the-porcine-coronary-artery
#7
Tamara Merz, Tatjana Stenzel, Benedikt Nußbaum, Martin Wepler, Csaba Szabo, Rui Wang, Peter Radermacher, Oscar McCook
BACKGROUND: Downregulation of the hydrogen sulfide (H2S)-producing enzymes cystathionine-γ-lyase (CSE), cystathionine-β-synthase (CBS), and/or 3-mercaptopyruvate sulfurtransferase (3-MST) is associated with chronic cardiovascular pathologies. Nevertheless, equivocal data are available on both the expression and function of these enzymes in coronary arteries (CA). We recently reported that atherosclerotic pigs subjected to sepsis developed impaired cardiac function, which coincided with decreased myocardial CSE expression and increased nitrotyrosine formation...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28319494/heparin-binding-protein-hbp-a-causative-marker-and-potential-target-for-heparin-treatment-of-human-sepsis-induced-acute-kidney-injury
#8
Jane Fisher, James A Russell, Peter Bentzer, Devyn Parsons, Stefano Secchia, Matthias Mörgelin, Keith R Walley, John H Boyd, Adam Linder
RATIONALE: Sepsis-induced acute kidney injury (AKI) is a common condition with high morbidity and mortality. Neutrophil-derived heparin-binding protein (HBP) induces vascular leakage and is a promising biomarker of sepsis-induced organ dysfunction. It remains unknown if HBP is prognostic of AKI in septic shock and if HBP could play a role in the pathophysiology of sepsis-induced AKI. OBJECTIVES: To determine the association of plasma HBP levels with development of AKI, investigate the role of HBP in the pathophysiology of sepsis-induced AKI, and test the effect of blocking HBP using heparin derivatives...
March 17, 2017: Shock
https://www.readbyqxmd.com/read/28318952/glycaemic-variability-in-patients-with-severe-sepsis-or-septic-shock-admitted-to-an-intensive-care-unit
#9
L M Silveira, A Basile-Filho, E A Nicolini, C A M Dessotte, G C S Aguiar, A M Stabile
BACKGROUND: Sepsis is associated with morbidity and mortality, which implies high costs to the global health system. Metabolic alterations that increase glycaemia and glycaemic variability occur during sepsis. OBJECTIVE: To verify mean body glucose levels and glycaemic variability in Intensive Care Unit (ICU) patients with severe sepsis or septic shock. METHOD: Retrospective and exploratory study that involved collection of patients' sociodemographic and clinical data and calculation of severity scores...
March 15, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28318176/fluid-overload-and-kidney-failure-in-children-with-severe-sepsis-and-septic-shock-a-cohort-study
#10
Omar E Naveda Romero, Andrea F Naveda Meléndez
INTRODUCTION: In children with sepsis, fluid overload as a result of an aggressive fluid replacement or excessive fluid administration may result in kidney impairment and increased mortality. Objective. To determine the association between fluid overload and the rate of kidney failure in a group of children with severe sepsis and septic shock. POPULATION AND METHODS: This was a prospective cohort study conducted in the intensive care unit of Hospital Universitario de Pediatría “Dr...
April 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28317295/two-year-follow-up-of-patients-with-septic-shock-presenting-with-low-hdl-the-effect-upon-acute-kidney-injury-death-and-estimated-glomerular-filtration-rate
#11
K Roveran Genga, C Lo, M Cirstea, G Zhou, K R Walley, J A Russell, A Levin, J H Boyd
BACKGROUND: Sepsis is associated with decreased levels of high-density lipoprotein (HDL) cholesterol. HDL has anti-inflammatory properties, and the use of Apo A-I mimetic peptides is associated with renal function improvement in animal models of sepsis. However, it is not known whether decreased HDL level results in impaired renal function in human sepsis. We investigated whether low levels of HDL conferred an increased risk of sepsis-associated acute kidney injury (AKI) or long-term decreased estimated glomerular filtration rate (eGFR) after sepsis...
March 19, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28315452/comparing-the-therapeutic-efficacies-of-third-generation-cephalosporins-and-broader-spectrum-%C3%AE-lactams-as-appropriate-empirical-therapy-in-adults-with-community-onset-monomicrobial-enterobacteriaceae-bacteraemia-a-propensity-score-matched-analysis
#12
Chung-Hsun Lee, Chih-Chia Hsieh, Ming-Yuan Hong, Yuan-Pin Hung, Wen-Chien Ko, Ching-Chi Lee
In this study, the therapeutic efficacy of third-generation cephalosporins (3GCs) was compared with that of broader-spectrum β-lactams (BSBLs) [fourth-generation cephalosporins (4GCs) and carbapenems] as empirical therapy in adults with community-onset monomicrobial Enterobacteriaceae bacteraemia. Compared with those in the 3GC group (n = 477), a significantly higher proportion of patients in the BSBL group (n = 141) had initial presentation with severe sepsis or septic shock, critical illness (Pitt bacteraemia score ≥4) at bacteraemia onset and fatal co-morbidities (McCabe classification)...
March 14, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28314653/assessment-of-risk-factors-for-candidemia-in-non-neutropenic-patients-hospitalized-in-internal-medicine-wards-a-multicenter-study
#13
M Falcone, G Tiseo, C Tascini, A Russo, E Sozio, G Raponi, C Rosin, P Pignatelli, P Carfagna, A Farcomeni, R Luzzati, F Violi, F Menichetti, M Venditti
BACKGROUND: An increasing prevalence of candidemia has been reported in Internal Medicine wards (IMWs). The aim of our study was to identify risk factors for candidemia among non-neutropenic patients hospitalized in IMWs. METHODS: A multicenter case-control study was performed in three hospitals in Italy. Patients developing candidemia (cases) were compared to patients without candidemia (controls) matched by age, time of admission and duration of hospitalization...
March 14, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28306558/monitoring-of-the-physical-exam-in-sepsis
#14
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...
March 16, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28304355/the-glyoxalase-system-and-methylglyoxal-derived-carbonyl-stress-in-sepsis-glycotoxic-aspects-of-sepsis-pathophysiology
#15
REVIEW
Thomas Schmoch, Florian Uhle, Benedikt H Siegler, Thomas Fleming, Jakob Morgenstern, Peter P Nawroth, Markus A Weigand, Thorsten Brenner
Sepsis remains one of the leading causes of death in intensive care units. Although sepsis is caused by a viral, fungal or bacterial infection, it is the dysregulated generalized host response that ultimately leads to severe dysfunction of multiple organs and death. The concomitant profound metabolic changes are characterized by hyperglycemia, insulin resistance, and profound transformations of the intracellular energy supply in both peripheral and immune cells. A further hallmark of the early phases of sepsis is a massive formation of reactive oxygen (ROS; e...
March 17, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28301336/sepsis-in-obstetrics-clinical-features-and-early-warning-tools
#16
Sheryl E Parfitt, Mary L Bogat, Sandra L Hering, Charlotte Ottley, Cheryl Roth
Morbidity and mortality associated with sepsis has gained widespread attention on a local, state, and national level, yet, it remains a complicated disorder that can be difficult to identify in a timely manner. Sepsis in obstetric patients further complicates the diagnosis as alterations in physiology related to pregnancy can mask sepsis indicators normally seen in the general population. If early signs of sepsis go unrecognized, septic shock can develop, leading to organ dysfunction and potential death. Maternal early warning tools have been designed to assist clinicians in recognizing early indications of illness...
March 15, 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/28299952/n-acetylcysteine-s-role-in-sepsis-and-potential-benefit-in-patients-with-microcirculatory-derangements
#17
Jason Chertoff
OBJECTIVE: To review the data surrounding the utility of N-acetylcysteine (NAC) in sepsis and identify areas needed for additional research. DATA SOURCES: A review of articles describing the mechanisms of action and clinical use of NAC in sepsis. SUMMARY OF REVIEW: Despite many advances in critical care medicine, still as many as 50% of patients with septic shock die. Treatments thus far have focused on resuscitation and restoration of macrocirculatory targets in the early phases of sepsis, with less focus on microcirculatory dysfunction...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28296035/sepsis-after-renal-transplantation-clinical-immunological-and-microbiological-risk-factors
#18
Thomas Schachtner, Maik Stein, Petra Reinke
BACKGROUND: As immunosuppressive therapy and allograft survival have improved, the increased incidence of sepsis has become a major hurdle of disease-free survival after renal transplantation. METHODS: We identified 112 of 957 kidney transplant recipients (KTRs) with sepsis. 31 KTRs developed severe sepsis or septic shock, and 30 KTRs died from sepsis. KTRs without sepsis were used for comparison. CMV-specific and alloreactive T-cells were measured using an interferon-γ Elispot-assay...
March 11, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28291766/sepsis-3-on-the-block-what-does-it-mean-for-pre-clinical-sepsis-modeling
#19
Marcin F Osuchowski, Christoph Thiemermann, Daniel G Remick
To effectively improve outcomes of septic patients, we first need to elucidate the multifaceted pathogenesis of sepsis syndromes and related inflammatory conditions. In fulfillment of such needs, in February 2016, new definitions for sepsis and septic shock were published under the acronym Sepsis-3. Although aimed at the clinical area, Sepsis-3 will have an inevitable influence upon the field of translational research as well. Sepsis-3 brings a considerable shift regarding the experimental focal point: from inflammatory states (SIRS/CARS) to organ failure (single and multiple) as the decisive factor...
October 25, 2016: Shock
https://www.readbyqxmd.com/read/28289047/are-patients-with-cancer-with-sepsis-and-bacteraemia-at-a-higher-risk-of-mortality-a-retrospective-chart-review-of-patients-presenting-to-a-tertiary-care-centre-in-lebanon
#20
Gilbert Abou Dagher, Christopher El Khuri, Ahel Al-Hajj Chehadeh, Ali Chami, Rana Bachir, Dina Zebian, Ralphe Bou Chebl
OBJECTIVE: Most sepsis studies have looked at the general population. The aim of this study is to report on the characteristics, treatment and hospital mortality of patients with cancer diagnosed with sepsis or septic shock. SETTING: A single-centre retrospective study at a tertiary care centre looking at patients with cancer who presented to our tertiary hospital with sepsis, septic shock or bacteraemia between 2010 and 2015. PARTICIPANTS: 176 patients with cancer were compared with 176 cancer-free controls...
March 13, 2017: BMJ Open
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