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Sepsis and ultrasound

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https://www.readbyqxmd.com/read/28637056/-urosepsis-in-children
#1
Josef Oswald
Urinary tract infections (UTI) are the most common infectious diseases in children. Urosepsis in childhood, though rare, is the most complicated possible variant. In newborns and infants, unspecific symptoms are a significant barrier to a fast and reliable diagnosis, which is crucial to successful treatment. In addition to urine and laboratory tests as well as non-invasive examinations (ultrasound), there may be an indication for invasive examinations of the kidneys (DMSA scans) in cases of a severe infection...
June 21, 2017: Aktuelle Urologie
https://www.readbyqxmd.com/read/28634578/neonatal-venous-thromboembolism
#2
REVIEW
Kristina M Haley
Neonates are the pediatric population at highest risk for development of venous thromboembolism (VTE), and the incidence of VTE in the neonatal population is increasing. This is especially true in the critically ill population. Several large studies indicate that the incidence of neonatal VTE is up almost threefold in the last two decades. Central lines, fluid fluctuations, sepsis, liver dysfunction, and inflammation contribute to the risk profile for VTE development in ill neonates. In addition, the neonatal hemostatic system is different from that of older children and adults...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28616405/endoscopic-treatment-for-distal-malignant-biliary-obstruction
#3
REVIEW
Kazuya Matsumoto, Yohei Takeda, Takumi Onoyama, Soichiro Kawata, Hiroki Kurumi, Hiroki Koda, Taro Yamashita, Hajime Isomoto
Distal malignant biliary obstruction (MBO) leads to obstructive jaundice as a result of when the bile excretion from the liver is disturbed and induces hepatic failure and sepsis, which when complicated with cholangitis, it becomes necessary to perform drainage for the MBO. For biliary drainage, we can perform a surgical bypass operation, percutaneous transhepatic biliary drainage (PTBD), endoscopic biliary drainage (EBD) via duodenal papilla, or endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD), which is a transgastrointestinal biliary drainage...
April 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28614270/computer-tomography-urography-assisted-real-time-ultrasound-guided-percutaneous-nephrolithotomy-on-renal-calculus
#4
You-Qiang Fang, Jie-Ying Wu, Teng-Cheng Li, Hao-Feng Zheng, Guan-Can Liang, Yan-Xiong Chen, Xiao-Bin Hong, Wei-Zhong Cai, Zhi-Jun Zang, Jin-Ming Di
This study aimed to assess the role of pre-designed route on computer tomography urography (CTU) in the ultrasound-guided percutaneous nephrolithotomy (PCNL) for renal calculus.From August 2013 to May 2016, a total of 100 patients diagnosed with complex renal calculus in our hospital were randomly divided into CTU group and control group (without CTU assistance). CTU was used to design a rational route for puncturing in CTU group. Ultrasound was used in both groups to establish a working trace in the operation areas...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28593006/ultrasound-detection-of-aortoenteric-fistula-in-a-patient-with-sepsis
#5
Tiziano Perrone, Chiara Pagani, Elisa Eleonora Mossolani
We report a case of an 81-year-old man, hospitalized for sepsis unresponsive to targeted antibiotic therapy, who underwent abdominal aortic aneurysmectomy with stent placement before 12 years. Point-of-care ultrasound examination showed the presence of a voluminous and inhomogeneous lesion adjacent to the anterior wall of aortic bifurcation with pulsatile flow from the aorta into the lesion, highlighted by Color-Doppler, and peripheral (closely with intestinal loops) floating hyperechoic spots marked by posterior comet tail artifact, suggestive for the presence of air bubbles...
June 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28592230/evaluation-of-targeted-antimicrobial-prophylaxis-for-transrectal-ultrasound-guided-prostate-biopsy-a-prospective-cohort-trial
#6
Teresa R Zembower, Kelly M Maxwell, Robert B Nadler, John Cashy, Marc H Scheetz, Chao Qi, Anthony J Schaeffer
BACKGROUND: We evaluated the effectiveness of targeted antimicrobial prophylaxis in transrectal ultrasound guided prostate biopsy (TRUSP). METHODS: A prospective, non-randomized cohort study was conducted. Rectal swab cultures plated on non-selective blood agar and on selective MacConkey agar supplemented with ciprofloxacin identified ciprofloxacin-susceptible and -resistant gram-negative bacteria (CS-GNB and CR-GNB). Patients with CS-GNB received ciprofloxacin while those with CR-GNB received directed prophylaxis...
June 7, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28591966/-the-value-of-early-diastolic-transmitral-velocity-to-early-mitral-anulus-diastolic-velocity-ratio-for-pulmonary-edema-in-severe-sepsis-patients
#7
Wan-Hong Yin, Yi Li, Yao Qin, Yan Kang, Ji-Yuan Zhao, Tong-Juan Zou, Zhi-Yun Tang
OBJECTIVES: To determine the association between the value of early diastolic transmitral velocity to early mitral anulus diastolic velocity ratio (E/E')measured by bedside ultrasound and pulmonary edema in severe sepsis (including septic shock) patients. METHODS: Data were obtained from the critical ultrasound database between November 2014 and August 2015. The severe sepsis (including septic shock) patients were eligible, but those with chronic heart disease or acute heart failure were excluded...
July 2016: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/28551689/perinatal-mortality-and-morbidity-of-growth-restricted-fetuses-and-newborns-own-experience-first-report
#8
Katarzyna Pankiewicz, Tomasz Maciejewski
AIM: to evaluate the outcome of pregnancies complicated by fetal growth restriction with particular emphasis on the factors (fetal and maternal) related to perinatal mortality and morbidity of the fetus and newborn. MATERIAL AND METHODS: Retrospective analysis of the documentation of 53 women admitted with the diagnosis of fetal growth restriction based on ultrasound examination (fetal biometry and fetal vessel Doppler abnormalities). 38 (71.7%) patients were referred to our department with the diagnosis of fetal growth restriction, whereas 15 (28...
2017: Developmental Period Medicine
https://www.readbyqxmd.com/read/28539374/bet-3-in-septic-patients-requiring-fluid-resuscitation-can-the-bedside-lung-ultrasound-be-used-to-assess-the-pulmonary-fluid-status
#9
Alain Judith, Maude St-Onge
A short cut review was carried out to see if the presence of 'B lines' detected on lung ultrasound could be used to guide the volume of fluid replacement necessary in the resuscitation of the patient with sepsis. Four papers with some degree of relevance were found in the literature search. The author, date and country of publication, patient group studied, study type, relevant outcomes, results study weaknesses of these papers are tabulated. Although a promising concept, the remains a paucity of good quality evidence sufficient to recommend this approach...
June 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28499592/risk-factors-for-poor-outcomes-of-children-with-acute-acalculous-cholecystitis
#10
Yi-An Lu, Cheng-Hsun Chiu, Man-Shan Kong, Han-I Wang, Hsun-Chin Chao, Chien-Chang Chen
BACKGROUND: Acute acalculous cholecystitis (AAC) is generally considered to be a mild disease in children; however, if left untreated or treated without caution, AAC can lead to severe outcomes, such as death. The objectives of this study were to present the clinical features and identify the predictors of mortality in pediatric AAC. METHODS: Patients diagnosed with AAC between 2005 and 2012 were enrolled. AAC was defined by the presence of fever and an echo-proven thickened gallbladder wall exceeding 4 mm...
March 25, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28476929/the-case-of-the-mysterious-vanishing-spleen-autosplenectomy-complicating-pneumococcal-sepsis
#11
Georgina Moritz, Megan Jenkins, Dushyant Shetty, Julie Blundell
A 57-year-old previously healthy fisherman was admitted in fulminant pneumococcal septic shock, with disseminated intravascular coagulation, requiring aggressive management including bilateral below-knee amputations for ischaemic necrosis. He began to recover and was discharged for rehabilitation, however during his convalescence was found to be hypercalcaemic. No malignancy was found on CT scan, but it was noted that his spleen was absent, replaced by a 4 cm smooth-walled, fluid-filled lesion. This was unexpected as an ultrasound in intensive care 10 weeks previously had demonstrated a normal spleen...
May 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28425658/endoscopic-management-of-acute-cholangitis-as-a-result-of-common-bile-duct-stones
#12
Mohan Ramchandani, Partha Pal, D Nageshwar Reddy
Acute cholangitis is infectious disease of the biliary system and potentially can cause significant morbidity and mortality. With advances in intensive care, antibiotic therapy advances and endoscopic and other modalities of biliary drainage, mortality rates have significantly come down of late. Although most cases respond to antibiotics alone, definitive therapy is required later in most of the patients. Increased biliary pressure leads to biliovenous reflux of bacteria and purulent bile into the circulation leading to systemic inflammation and sepsis with subsequent organ dysfunction...
April 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28405071/systemic-infection-and-splenic-abscess
#13
Aaron R Belknap, Joseph Guileyardo
Splenic abscess is a rare complication of systemic infection, sometimes associated with infective endocarditis. Due to its rarity and nonspecific symptoms, diagnosis is difficult. Antibiotic therapy alone is usually unsuccessful, and definitive treatment requires splenectomy, although percutaneous ultrasound-guided drainage has been successful in some patients. Abdominal computed tomography scans and ultrasound evaluation are usually diagnostic. We present two patients with treatment-resistant sepsis who were found at autopsy to have splenic abscess...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28383859/-ultrasonographic-measurement-of-the-optical-nerve-sheath-for-the-diagnosis-of-intracranial-hypertension-in-the-emergency-room-a-case-report
#14
R Levy, B Kerzmann, V Franssen, A S Schwab, J F Adam, Th Sottiaux
Early diagnosis and treatment of intracranial hypertension (ICHT) are major components of the management of neurological emergencies. The optic nerve sheath diameter is closely dependent on intracranial pressure and can be measured by bedside ultrasound (US). We report the story of a 70-year-old COPD patient initially admitted to the emergency room for a sepsis of pulmonary origin. An unusual confusion prompted us to perform an US of the optic nerve sheath. This exam clearly suggested the presence of an ICHT...
June 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28341509/dialysis-access-hemorrhage-access-rescue-from-a-surgical-emergency
#15
Tazo Inui, Valy Boulom, Dennis Bandyk, John S Lane, Erik Owens, Andrew Barleben
OBJECTIVE: Hemorrhage from a dialysis access can be a life-threatening condition. This study details our experience using access rescue strategies, including in situ graft replacement, primary repair, or conversion to an autogenous fistula; coupled with treatment of central vein occlusion to maintain access usage in patients presenting with conduit hemorrhage. METHODS: During a 3-yr period (2012-2014), 26 patients (14 women, 12 men) on chronic hemodialysis were treated for access conduit bleeding (n=18) or life-threatening hemorrhage (n=8); located in the upper extremity (n=23) or thigh (n=3)...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28337353/gastric-duplication-a-rare-cause-of-recurrent-vomiting
#16
Brahmananda Koduri, Katie McHale, Christina Yost, Michael H Goodman, Dennis Hoelzer
Vomiting is a physical finding that can occur at any age but presents the greatest challenge when it is recurrent in a child. The etiology is varied (Sieunarine and Manmohansingh, 1989; Suzuki, 1982), and recurrent vomiting can be a symptom of life threatening medical or surgical emergencies. Early recognition is mandatory for preventing delay in management and potential complications. Gastric duplication is rare and mostly diagnosed in infancy with only a few cases documented in the medical literature presenting in childhood...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28331537/combined-totally-mini-invasive-approach-in-necrotizing-pancreatitis-a-case-report-and-systematic-literature-review
#17
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/28301503/cerebral-ultrasound-abnormalities-in-preterm-infants-caused-by-late-onset-sepsis
#18
L C Claessens, I A Zonnenberg, F A M van den Dungen, R J Vermeulen, M M van Weissenbruch
INTRODUCTION: This study describes cerebral ultrasound abnormalities caused by late-onset sepsis (LOS) in very preterm infants with a gestational age of < 32 weeks and/or birthweight < 1500 grams. METHODS: The prospective study ("INFANT study") included 117 preterm infants with suspected LOS. Proven LOS was defined as a positive blood culture after 72 hours of life. In case of coagulase-negative staphylococci an elevated C-reactive protein was additionally required to establish proven LOS...
2017: PloS One
https://www.readbyqxmd.com/read/28298945/doppler-ultrasound-assessment-of-the-splanchnic-circulation-in-preterms-with-neonatal-sepsis-at-risk-for-necrotizing-enterocolitis
#19
Rania H Hashem, Yasmeen A Mansi, Nehal S Almasah, Shereen Abdelghaffar
OBJECTIVE: To evaluate the role of Doppler ultrasonography in the assessment of splanchnic circulation's hemodynamic changes in septic preterms at risk of necrotizing enterocolitis. METHODS: A total of 51 septic preterms were divided into two groups: 25 preterms with clinical signs of necrotizing enterocolitis (NEC) and 26 preterms with no clinical signs of NEC. Both groups were assessed with Doppler ultrasonography of the celiac and superior mesenteric arteries, and each septic preterm's peak systolic velocity (PSV), end-diastolic velocity (EDV), resistivity index (RI), and pulsatility index (PI) was calculated and recorded...
March 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28288838/routine-ertapenem-prophylaxis-for-transrectal-ultrasound-guided-prostate-biopsy-does-not-select-for-carbapenem-resistant-organisms-a-prospective-cohort-study
#20
Maxim G Bloomfield, Matthew J Page, Alice G McLachlan, Rodney C Studd, Timothy K Blackmore
PURPOSE: Sepsis after transrectal ultrasound guided prostate biopsy is an increasing problem in this era of rising antibiotic resistance. Although ertapenem prophylaxis has proved effective at our institution to reduce this, it has raised local and regional antimicrobial stewardship concerns. We investigated the possible selective effect of single dose ertapenem prophylaxis on fecal colonization with carbapenem resistant Enterobacteriaceae. MATERIALS AND METHODS: Patients underwent a rectal swab prior to receiving prebiopsy ertapenem prophylaxis...
March 10, 2017: Journal of Urology
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