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Sepsis and ultrasound

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https://www.readbyqxmd.com/read/28499592/risk-factors-for-poor-outcomes-of-children-with-acute-acalculous-cholecystitis
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
Maxim G Bloomfield, Matthew J Page, Alice G McLachlan, Rodney C Studd, Timothy K Blackmore
PURPOSE: Post-transrectal ultrasound-guided prostate biopsy sepsis is an increasing problem in this era of rising antibiotic resistance. Ertapenem prophylaxis has proven very effective at our institution for reducing this, however has raised local and regional antimicrobial stewardship concerns. This study investigated the possible selective effect of single dose ertapenem prophylaxis on fecal colonization with carbapenem-resistant Enterobacteriaceae. MATERIALS AND METHODS: Patients had a rectal swab taken prior to receiving pre-biopsy ertapenem prophylaxis...
March 10, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28280717/impact-of-preoperative-screening-for-rectal-colonization-with-fluoroquinolone-resistant-enteric-bacteria-on-the-incidence-of-sepsis-following-transrectal-ultrasound-guided-prostate-biopsy
#12
John J Farrell, Jennifer L Hicks, Stephanie E Wallace, Allen D Seftel
With the universal adoption of antibiotic prophylaxis prior to prostate biopsy, the current risk of post-biopsy infection (including sepsis) is <2%. Preoperative prophylactic antibiotic regimens can vary, and although fluoroquinolones have emerged as the standard of care, there is no universally agreed upon preoperative antibiotic regimen. Recently, an increase in the proportion of postoperative infections caused by fluoroquinolone-resistant Escherichia coli (as well as other Enterobacteriaceae) has led to the exploration of simple, practical, and cost-effective methods to minimize this postoperative infection risk...
2017: Research and Reports in Urology
https://www.readbyqxmd.com/read/28275563/neonatal-cranial-sonography-ultrasound-findings-in-neonatal-meningitis-a-pictorial-review
#13
REVIEW
Nishant Gupta, Hemal Grover, Itisha Bansal, Kusum Hooda, Joshua M Sapire, Rama Anand, Yogesh Kumar
Neonatal bacterial meningitis is a common manifestation of late onset neonatal sepsis. Cranial sonography (CRS) has a crucial role in assessment of infants with clinical suspicion of bacterial meningitis as well as follows up of its complications. CRS is performed with high frequency transducer through anterior fontanelle in both coronal and sagittal planes. Various sonographic findings range from echogenic and widened sulci, ventriculomegaly, ventriculitis, hydrocephalus, extra-axial fluid collections, cerebritis and brain abscess...
February 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28266289/non-complicated-acute-appendicitis-in-adults-treated-successfully-by-conservative-treatment-without-recurrences
#14
Anestis Charalampopoulos, Ioannis Dimopoulos, Nikolaos Koliakos, Konstantinos Kopanakis, Theodoros Liakakos And
Backround: Surgical treatment of appendicitis remains the standard treatment, but many cases respond conservatively. Our purpose was the clarification of the clinical, laboratory and imaging characteristics of uncomplicated cases undergoing successful conservative treatment without recurrence. Methods: 105 adult patients (66 female, 39 male) with non-complicated acute appendicitis. Symptom duration, clinical abdominal examination, body temperature, inflammatory markers, imaging studies results and in-hospital treatment were recorded...
January 2017: Chirurgia
https://www.readbyqxmd.com/read/28225634/journal-club-ultrasound-guided-breast-interventions-low-incidence-of-infectious-complications-with-use-of-an-uncovered-probe
#15
Chris Reisenauer, Robert T Fazzio, Gina Hesley
OBJECTIVE: The purpose of this study was to determine the incidence of infectious complications after ultrasound-guided breast interventions performed with an intermediate-level disinfection protocol without an ultrasound probe cover. MATERIALS AND METHODS: Two independent institutional databases were searched to identify breast infections in patients who underwent ultrasound-guided interventions between January 2005 and July 2013. The departments of radiology and infectious diseases independently maintained these databases...
May 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28221154/prospective-outcomes-of-11-13ch-ultra-mini-percutaneous-nephrolithotomy-ump-a-consecutive-cohort-study
#16
Janak D Desai
Ultra mini PCNL (UMP) has been described as a less invasive technique of PCNL for the treatment of small to medium sized stones in attempt to reduce the surgical morbidity. OBJECTIVE: Evaluate prospectively the outcomes of UMP. METHODS: Single surgeon prospective concurrent cohort study of UMP in India. Effectiveness was assessed by stone-free rates, operative time, complications including transfusion, sepsis rates, length of stay and analgesic requirements. RESULTS: In 2013, data on 98 consecutive patients who underwent UMP was collected prospectively...
January 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28179200/laparoscopic-management-of-abdomininal-pregnancy
#17
Francesco Cosentino, Cristiano Rossitto, Luigi Carlo Turco, Salvatore Gueli Alletti, Carmine Vascone, Lavinia Di Meglio, Giovanni Scambia, Mario Malzoni
CASE REPORT OBJECTIVE: To show the surgical management in laparoscopy of a particular localization of an extra-uterine pregnancy misunderstood until 12 week of EG complicated by hemoperitoneum and abortion. BACKGROUND: The prevalence of ectopic pregnancy among women who go to an emergency department with first trimester bleeding, pain, or both ranges from 1 to 16 percent [1]. The most common localization of ectopic pregnancy are the Fallopian tubes while abdominal pregnancy represent at least 1 percent of extra-uterine pregnancies...
February 4, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28158932/the-association-of-neonatal-morbidity-with-long-term-neurological-outcome-in-infants-who-were-growth-restricted-and-preterm-at-birth-secondary-analyses-from-truffle-trial-of-randomized-umbilical-and-fetal-flow-in-europe
#18
A G Van Wassenaer-Leemhuis, N Marlow, C Lees, H Wolf
OBJECTIVE: To study the relationship between neonatal morbidity (NNM) and two-year neurodevelopmental impairment (NDI) in surviving children after early fetal growth restriction (FGR). DESIGN: Secondary analysis of a European randomised trial (TRUFFLE) of delivery for very preterm fetuses dependent on venous Doppler or cardiotocographic criteria. SETTING: Tertiary perinatal centres, participants in TRUFFLE. POPULATION: 402 surviving children after early FGR...
February 3, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28144779/focused-cardiac-ultrasound-in-the-early-resuscitation-of-severe-sepsis-and-septic-shock-a-prospective-pilot-study
#19
Hiroshi Sekiguchi, Yohei Harada, Hector R Villarraga, Sunil V Mankad, Ognjen Gajic
PURPOSE: Point-of-care ultrasonography has been increasingly used in the care of critically ill patients; however, reports on its use during active resuscitation are limited. The aim of this study was to investigate the true impact of focused cardiac ultrasound (FCU) during the management of sepsis with early (6-h) resuscitation. METHODS: A prospective pilot observational study was conducted at an academic medical center from March 2011 through July 2012. Patients undergoing resuscitation for severe sepsis or septic shock were prospectively enrolled at medical and combined medical-surgical intensive care units...
January 31, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28132006/ultrasound-and-nicom-in-the-assessment-of-fluid-responsiveness-in-patients-with-mild-sepsis-in-the-emergency-department-a-pilot-study
#20
Martha Oord, Tycho J Olgers, Mirjam Doff-Holman, Mark P M Harms, Jack J M Ligtenberg, Jan C Ter Maaten
OBJECTIVE: We investigated whether combining the caval index, assessment of the global contractility of the heart and measurement of stroke volume with Noninvasive Cardiac Output Monitoring (NICOM) can aid in fluid management in the emergency department (ED) in patients with sepsis. SETTING: A prospective observational single-centre pilot study in a tertiary care centre. PRIMARY AND SECONDARY OUTCOMES: Ultrasound was used to assess the caval index, heart contractility and presence of B-lines in the lungs...
January 27, 2017: BMJ Open
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