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Sepsis and ultrasound

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https://www.readbyqxmd.com/read/29771701/dynamic-contrast-enhanced-ultrasound-identifies-microcirculatory-alterations-in-sepsis-induced-acute-kidney-injury
#1
Alexandre Lima, Tom van Rooij, Bulent Ergin, Michele Sorelli, Yasin Ince, Patricia A C Specht, Egbert G Mik, Leonardo Bocchi, Klazina Kooiman, Nico de Jong, Can Ince
OBJECTIVES: We developed quantitative methods to analyze microbubble kinetics based on renal contrast-enhanced ultrasound imaging combined with measurements of sublingual microcirculation on a fixed area to quantify early microvascular alterations in sepsis-induced acute kidney injury. DESIGN: Prospective controlled animal experiment study. SETTING: Hospital-affiliated animal research institution. SUBJECTS: Fifteen female pigs...
May 15, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29763777/incorporation-of-point-of-care-ultrasound-into-morning-round-is-associated-with-improvement-in-clinical-outcomes-in-critically-ill-patients-with-sepsis
#2
Zhonghua Chen, Yucai Hong, Junru Dai, Lifeng Xing
OBJECTIVES: Point-of-care ultrasound (POCUS) has been widely used in the intensive care unit (ICU). However, it is largely unknown whether the use of POCUS is associated with improved patient-important outcomes. The study aimed to investigate whether incorporation of POCUS during morning round on a routine basis was able to improve clinical outcomes in critically ill patients with sepsis. DESIGN: It was a prospective observational study. SETTING: A tertiary care emergency intensive care unit...
May 11, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29757913/association-between-muscle-wasting-and-muscle-strength-in-patients-who-developed-severe-sepsis-and-septic-shock
#3
Rodrigo Cerqueira Borges, Francisco Garcia Soriano
PURPOSE: To evaluate the association between the rectus femoris cross-sectional area (RFCSA) and the muscular strength obtained at the bedside in patients forwarded to the intensive care unit (ICU) for severe sepsis and septic shock. METHODS: A prospective cohort study. RFCSA was assessed by ultrasound on the following day of the ICU admission and monitored during hospitalization. The patients performed clinical tests of muscle strength (Medical Research Council (MRC) scale and handgrip dynamometry), when they could understand the verbal commands of the examiners...
May 11, 2018: Shock
https://www.readbyqxmd.com/read/29753570/xanthogranulomatous-pyelonephritis-a-complicated-febrile-urinary-tract-infection-detected-by-point-of-care-ultrasound-in-the-emergency-department
#4
Ryan Gibbons, Nicole Leonard, Mark Magee, Allison Zanaboni, Jessica Patterson, Thomas Costantino
BACKGROUND: Febrile urinary tract infections (UTIs) include a spectrum of pathologies from uncomplicated pyelonephritis to urosepsis, including xanthogranulomatous pyelonephritis (XGP). Most febrile UTIs are treated with antibiotics alone, but studies indicate nearly 12% of cases of presumed simple pyelonephritis require emergent urologic intervention. How to identify these individuals, while limiting unnecessary advanced imaging and delays in diagnosis, challenges all emergency providers...
May 9, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29747214/intestinal-perforation-due-to-deep-infiltrating-endometriosis-during-pregnancy-case-report
#5
Márcia Mendonça Carneiro, Luciana Maria Pyramo Costa, Maria Das Graças Torres, Patrícia Salomé Gouvea, Ivete de Ávila
We report the case of a 33 year-old woman who complained of severe dysmenorrhea since menarche. From 2003 to 2009, she underwent 4 laparoscopies for the treatment of pain associated with endometriosis. After all four interventions, the pain recurred despite the use of gonadotropin-releasing hormone (GnRH) analogues and the insertion of a levonorgestrel intrauterine system (LNG-IUS). Finally, a colonoscopy performed in 2010 revealed rectosigmoid stenosis probably due to extrinsic compression. The patient was advised to get pregnant before treating the intestinal lesion...
April 2018: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/29723457/-one-puncture-one-needle-trus-guided-prostate-biopsy-for-prevention-of-postoperative-infections
#6
Xiao-Fu Qiu, Guo-Sheng Yang, Bo-Te Chen, Li Ma
Objective: To explore the feasibility and effectiveness of "one-puncture one-needle" transrectal ultrasound (TRUS)-guided prostate biopsy in the prevention of postoperative infections. METHODS: We retrospectively analyzed the clinical data about "one-puncture one-needle" (the observation group) and "one-person one-needle" (the control group) TRUS-guided prostate biopsy performed in the Second People's Hospital of Guangdong Province from January 2005 to December 2015, and compared the incidence rates of puncture-related infection between the two strategies...
July 2017: Zhonghua Nan Ke Xue, National Journal of Andrology
https://www.readbyqxmd.com/read/29719745/acute-acalculous-cholecystitis-in-the-setting-of-negative-ultrasound-and-computed-tomography-scan-of-the-abdomen
#7
Muhammad Shafiq, Yousaf Zafar
Acute acalculous cholecystitis (AAC) is most commonly seen after surgery in critically ill patients. Early diagnosis and treatment is the key in the management of AAC. Ultrasound is the commonly used first modality for right upper quadrant (RUQ) pain with sensitivity equal to or greater than 80% for AAC. Computed tomography (CT) scan is reported to have a sensitivity close to 90% and if both the ultrasound and CT scan are combined, it further increases the sensitivity for the diagnosis of AAC. It is unlikely for AAC to be present in the setting of both negative ultrasound and CT scan of the abdomen...
February 28, 2018: Curēus
https://www.readbyqxmd.com/read/29677008/evolution-of-acute-kidney-injury-and-its-association-with-systemic-hemodynamics-in-children-with-fluid-refractory-septic-shock
#8
Akash Deep, Hiremath Sagar, Chulananda Goonasekera, Palaniswamy Karthikeyan, Joe Brierley, Abdel Douiri
OBJECTIVES: There are no studies in pediatrics evaluating the progression of acute kidney injury in septic shock. We investigated the evolution of sepsis-associated acute kidney injury and its association with systemic hemodynamics in children with fluid-refractory septic shock. DESIGN: Prospective cohort study. SETTING: PICU of a tertiary care hospital. PATIENTS: All patients with fluid-refractory septic shock (n = 61) between September 2010 and February 2014...
April 19, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29651944/role-of-point-of-care-ultrasonography-for-management-of-sepsis-and-septic-shock
#9
Gentle Sunder Shrestha, Shrikanth Srinivasan
BACKGROUND: Sepsis and septic shock remain a major cause of morbidity and mortality globally. In recent years, outcome of patients with sepsis and septic shock has gradually improved, in part due to early recognition and timely appropriate management. Bedside physical examination can be of limited value to identify the source of infection and to decide appropriate management. Moreover, the clinical status of these patients can change rapidly, as a part of disease progression or in response to treatment or intervention...
April 12, 2018: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/29626305/prevalence-and-predictors-of-preoperative-venous-thromboembolism-in-asymptomatic-patients-undergoing-major-oncologic-surgery
#10
Melanie L Gainsbury, Jennifer Erdrich, Dani Taubman, James Mirocha, Nicholas Manguso, Farin Amersi, Allan W Silberman
BACKGROUND: Postoperative venous thromboembolism (VTE) is a leading cause of in-hospital mortality for cancer patients; however, the prevalence of preoperative VTE remains unclear. OBJECTIVE: The aim of this study was to evaluate the prevalence and risk factors associated with preoperative VTE in asymptomatic patients undergoing major oncologic surgery. METHODS: Retrospective analysis of 346 patients identified from our prospectively maintained database of patients undergoing abdominopelvic oncologic surgery from 2009 to 2016...
April 6, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29582149/obtaining-central-access-in-challenging-pediatric-patients
#11
Cory N Criss, Jake Claflin, Matthew W Ralls, Samir K Gadepalli, Marcus D Jarboe
PURPOSE: Central catheter placement is one of the most commonly performed procedures by pediatric surgeons. Here, we present a case series of patients where central access was obtained at our institution with the utilization of a novel ultrasound-guided technique. This series represents the first of its kind where the native, parent vessels were inaccessible, resulting in a challenging situation for providers. METHODS: A retrospective chart review was performed in pediatric patients (0-17 years) at a tertiary care institution between July 2012 and November 2017 on all central line procedures where ultrasound was utilized to cannulate the brachiocephalic or superior vena cava in face of proximal occlusion...
March 26, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29577030/eus-guided-gall-bladder-drainage-in-severe-liver-disease-a-single-center-experience-in-critically-ill-cirrhotics
#12
Kapil Dev Jamwal, Manoj Kumar Sharma, Rakhi Maiwall, Barjesh Kumar Sharma, Shiv Kumar Sarin
Background and Aims : Acute calculous cholecystitis with impending gall bladder perforation in severe liver diseases including decompensated cirrhosis and acute-on-chronic liver failure (ACLF) is difficult to manage, due to the procedures such as cholecystectomy and per cutaneous cholecystostomy being associated with high risk and complications in these patients. Methods : Four cases of severe liver disease with acute calculous cholecystitis who presented to the Institute of Liver and Biliary Sciences (New Delhi, India) for further management were included in the study if they underwent endoscopic ultrasound-guided gall bladder drainage (EUS-GBD)...
March 28, 2018: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/29574427/septic-presentation-of-a-giant-fibroepithelial-polyp-of-the-vulva
#13
Arzoo Amin, Zohra Amin, Abdul Rahman Al Farsi
Fibroepithelial stromal polyps are mesenchymal lesions occurring typically in reproductive age women with a predilection for the vulvo-vaginal region. Malignancy may mimic this polyp in morphology, rendering further investigations including detailed histopathology mandatory. Histologically its characteristic features are stellate and multinucleate stromal cells identified near the epithelial-stromal interface. This case report discusses incidental finding of largest fibroepithelial polyp presented in a 31-year-old nulliparous woman...
March 23, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29573596/lemierre-s-syndrome-following-perianal-abscess-a-case-report
#14
Qusai Aljarrah, Yara Khazaleh, Mooath Al-Jarrah, Jordan W Oldbury, Ahmad K Abou-Foul
INTRODUCTION: Lemierre's syndrome (LS) is a rare and life-threatening condition characterized by suppurative thrombophlebitis of the internal jugular vein (IJV), and a history of head and neck (H&N) sepsis. LS is usually caused by Fusobacterium necrophorum, which is part of the normal flora in the oro-pharynx, and the digestive and urogenital tracts. We here report the first case of LS following perianal sepsis. PRESENTATION OF CASE: A 60-year-old man with a painful left neck swelling, dysphagia and worsening sepsis was referred from a peripheral unit where he had an incision and drainage of a perianal abscess a week earlier...
March 16, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29543049/postoperative-monitoring-of-the-free-jejunal-flap-use-of-colour-duplex-and-systematic-review-of-available-techniques
#15
R Cuthbert, C Deutsch, A Roy, P Stimpson, H Patel
Introduction The free jejunal flap represents the gold standard for circumferential defects in upper digestive tract reconstruction. It is a technically demanding procedure with significant failure rates. Unrecognised failure leads to flap necrosis and potentially fatal sequelae, including sepsis and carotid artery bleed. Despite these catastrophic consequences, however, there remains no consensus on an optimum method for postoperative flap monitoring. Our unit has pioneered the use of external colour duplex ultrasound to monitor flap vascularity...
March 15, 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29532359/feasibility-and-safety-of-endoscopic-ultrasound-guided-biliary-drainage-eus-bd-for-malignant-biliary-obstruction-associated-with-ascites-results-of-a-pilot-study
#16
María Victoria Alvarez-Sánchez, O B Luna, I Oria, K Marchut, F Fumex, G Singier, A Salgado, B Napoléon
BACKGROUND: It has been suggested that EUS-BD may be a feasible and safer alternative to percutaneous transhepatic biliary drainage (PTBD) after failed ERCP in patients with ascites. To date, no study has specifically evaluated the performance of EUS-BD in this context. METHODS: Retrospective analysis was done for patients with and without ascites who underwent EUS-BD for malignant biliary obstruction after failed ERCP between July 2010 and September 2014. Complications and technical and clinical successes between the two groups were compared...
March 12, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29520998/does-respiratory-variation-of-inferior-vena-cava-diameter-predict-fluid-responsiveness-in-spontaneously-ventilating-children-with-sepsis
#17
Elliot Long, Trevor Duke, Ed Oakley, Adam O'Brien, Bennett Sheridan, Franz E Babl
OBJECTIVE: The intent of fluid bolus therapy (FBT) is to increase cardiac output and tissue perfusion, yet only 50% of septic children are fluid responsive. We evaluated respiratory variation of inferior vena cava (IVC) diameter as a predictor of fluid responsiveness. METHODS: A prospective observational study in the ED of The Royal Children's Hospital, Melbourne, Australia. Patients were spontaneously ventilating children treated with FBT for sepsis-induced acute circulatory failure...
March 8, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29519280/-variability-of-peripheral-arterial-peak-velocity-predicts-fluid-responsiveness-in-patients-with-septic-shock
#18
Nianfang Lu, Li Jiang, Bo Zhu, Wenyong Han, Yingqi Zhao, Yuntao Shi, Fashuang Guo, Xiuming Xi
OBJECTIVE: To explore the accuracy of fluid responsiveness assessment by variability of peripheral arterial peak velocity and variability of inferior vena cava diameter (ΔIVC) in patients with septic shock. METHODS: A prospective study was conducted. The patients with septic shock undergoing mechanical ventilation (MV) admitted to intensive care unit (ICU) of Beijing Electric Power Hospital from January 2016 to December 2017 were enrolled. According to sepsis bundles of septic shock, volume expansion (VE) was conducted...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29514546/efficacy-and-safety-of-peripherally-inserted-central-venous-catheters-in-acute-cardiac-care-management
#19
Fabrizio Poletti, Claudio Coccino, Davide Monolo, Paolo Crespi, Giorgio Ciccioli, Giuseppe Cordio, Giovanni Seveso, Stefano De Servi
PURPOSE: Patients admitted to cardiac intensive care unit need administration of drugs intravenously often in concomitance of therapeutic techniques such as non-invasive ventilation, continuous renal replacement therapy and intra-aortic balloon counterpulsation. Therefore, the insertion of central venous catheters provides a reliable access for delivering medications, laboratory testing and hemodynamic monitoring, but it is associated with the risk of important complications. In our study, we tested the efficacy and safety of peripherally inserted central catheters to manage cardiac intensive care...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29506842/evaluation-of-the-fluid-responsiveness-in-patients-with-septic-shock-by-ultrasound-plus-the-passive-leg-raising-test
#20
Jingyi Wu, Zhen Wang, Tao Wang, Tao Yu, Jing Yuan, Qingling Zhang, Weihua Lu, Xia Zhang
BACKGROUND: Prompt, accurate, and noninvasive prediction of fluid responsiveness is still lacking in intensive care unit. This study is to investigate the value of the Doppler ultrasound evaluation of variation in brachial artery peak velocity (VVpeakbrach ) and passive leg raising (PLR)-induced changes in the brachial artery peak velocity (ΔVpeakPLR ) in predicting the fluid responsiveness in mechanically ventilated patients with severe sepsis or septic shock. METHODS: A prospective study was conducted involving 62 patients...
April 2018: Journal of Surgical Research
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