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https://www.readbyqxmd.com/read/28102514/carbapenemase-producing-klebsiella-pneumoniae-bloodstream-infection-in-critically-ill-patients-risk-factors-and-predictors-of-mortality
#1
M Papadimitriou-Olivgeris, F Fligou, C Bartzavali, A Zotou, A Spyropoulou, K Koutsileou, S Vamvakopoulou, N Sioulas, V Karamouzos, E D Anastassiou, I Spiliopoulou, M Christofidou, M Marangos
A significant increase in carbapenemase-producing Klebsiella pneumoniae (CP-Kp) bacteraemias has been observed worldwide. The objective of the present work was to study the risk factors and predictors of mortality of CP-Kp bacteraemias among critically ill patients. During a 4-year period (2012-3015), a matched 1:2 case-control study was conducted. Klebsiella pneumoniae was identified by Vitek 2 technology. Antibiotic susceptibility was performed by the agar disc diffusion method and Etest. The presence of the bla KPC, bla VIM and bla NDM genes was confirmed by polymerase chain reaction (PCR)...
January 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28102164/results-of-total-cementless-hip-joint-arthroplasty-with-taperloc-stem
#2
Marek Drobniewski, Andrzej Borowski, Magdalena Krasińska, Marcin Sibiński, Marek Synder
BACKGROUND: The aim of this paper is to present the results of hip joint arthroplasty with the use of the Taperloc stem. MATERIAL AND METHODS: The study group consisted of 117 patients (75 women and 42 men) who underwent 121 hip joint arthroplasties with Taperloc stems. Mean age of the patients at surgery was 53.8 years (range: 2475 years). Mean follow-up period was 159.5 months. RESULTS: Pre-operative Merle d'Aubigne-Postel scores (modified by Charnley) of the study group were poor in all patients...
August 30, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28101752/the-impact-of-hydrocortisone-treatment-on-neutrophil-gelatinase-associated-lipocalin-release-in-porcine-endotoxemic-shock
#3
E Söderberg, M Eriksson, A Larsson, M Lipcsey
BACKGROUND: A key feature of sepsis is systemic inflammatory activation that could be counteracted by steroids. In this experimental model of systemic inflammation, we sought to investigate whether septic neutrophil activation, evaluated by the plasma levels of neutrophil gelatinase-associated protein (NGAL), is modulated by the timing of hydrocortisone treatment. METHODS: Sixteen anesthetized pigs were allocated to one of four equally sized groups. Three of these groups received endotoxin at 2 μg × kg(-1) × h(-1) for 6 h so as to induce endotoxemic shock...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28101605/surviving-sepsis-campaign-international-guidelines-for-management-of-sepsis-and-septic-shock-2016
#4
Andrew Rhodes, Laura E Evans, Waleed Alhazzani, Mitchell M Levy, Massimo Antonelli, Ricard Ferrer, Anand Kumar, Jonathan E Sevransky, Charles L Sprung, Mark E Nunnally, Bram Rochwerg, Gordon D Rubenfeld, Derek C Angus, Djillali Annane, Richard J Beale, Geoffrey J Bellinghan, Gordon R Bernard, Jean-Daniel Chiche, Craig Coopersmith, Daniel P De Backer, Craig J French, Seitaro Fujishima, Herwig Gerlach, Jorge Luis Hidalgo, Steven M Hollenberg, Alan E Jones, Dilip R Karnad, Ruth M Kleinpell, Younsuk Koh, Thiago Costa Lisboa, Flavia R Machado, John J Marini, John C Marshall, John E Mazuski, Lauralyn A McIntyre, Anthony S McLean, Sangeeta Mehta, Rui P Moreno, John Myburgh, Paolo Navalesi, Osamu Nishida, Tiffany M Osborn, Anders Perner, Colleen M Plunkett, Marco Ranieri, Christa A Schorr, Maureen A Seckel, Christopher W Seymour, Lisa Shieh, Khalid A Shukri, Steven Q Simpson, Mervyn Singer, B Taylor Thompson, Sean R Townsend, Thomas Van der Poll, Jean-Louis Vincent, W Joost Wiersinga, Janice L Zimmerman, R Phillip Dellinger
OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012". DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015...
January 18, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28101570/inhibition-of-tlr4-protects-rat-islets-against-lipopolysaccharide-induced-dysfunction
#5
Xiao Wang, Qin Min Ge, Fan Bian, Yan Dong, Chun Mei Huang
Oxidative stress leads to dysfunction in pancreatic cells, causing a reduction in insulin secretion following exposure to glucose. Toll-like receptor 4 (TLR4) may be activated by exposure to lipopolysaccharide (LPS) stress. TLR4 may mediate the initiation of inflammatory and immune defense responses; however, the importance of the LPS/TLR4 interaction in apoptosis induced by oxidative stress in pancreatic β cells remains to be elucidated. The present study aimed to investigate the importance of TLR4 during LPS‑induced oxidative stress, apoptosis and dysfunction of insulin secretion in isolated islets of rats...
February 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28101334/implementation-of-short-incubation-maldi-tof-ms-identification-from-positive-blood-cultures-in-routine-diagnostics-and-effects-on-empiric-antimicrobial-therapy
#6
Robin Köck, Jörg Wüllenweber, Dagmar Horn, Christian Lanckohr, Karsten Becker, Evgeny A Idelevich
BACKGROUND: Results of blood culture (BC) diagnostics should be swiftly available to guide treatment of critically ill patients. Conventional BC diagnostics usually performs species identification of microorganisms from mature solid medium colonies. Species identification might be speed up by using matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry (MS) of biomass from shortly incubated solid media. METHODS: This single-center analysis compared the applicability of MALDI-TOF-based species identification from shortly incubated cultures in laboratory routine vs...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28100477/inability-to-replete-white-adipose-tissue-during-the-recovery-phase-of-sepsis-is-associated-with-increased-autophagy-apoptosis-and-proteasome-activity
#7
Kristen T Crowell, David I Soybel, Charles H Lang
Adipose tissue is an important energy depot and endocrine organ, and the degree of adiposity impacts the host response to infection. However, little is known regarding the mechanisms by which white adipose tissue (WAT) is lost acutely and then restored after resolution of sepsis. Therefore, signaling pathways governing protein synthesis, autophagy, apoptosis and the ubiquitin-proteasome were investigated to identify potential mechanisms mediating the acute (24 h) loss of WAT after cecal ligation and puncture (CLP) as well as the failure to replenish WAT during recovery (day 10)...
January 18, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28100407/pressure-ulcer-reconstruction-in-patients-with-heterotopic-ossification-after-spinal-cord-injury-a-case-series-and-review-of-literature
#8
REVIEW
Kai Yang, Alexander Graf, James Sanger
Heterotopic ossification (HO) is widely recognized as a common occurrence among patients suffering from traumatic spinal cord injuries (SCI). The exact etiology of HO formation remains unknown. Published medical and surgical management strategies are often plagued with questionable effectiveness and frequent complications. There are minimal publications regarding the management strategies of HO in SCI patients as it pertains to plastic surgery. We present a case series of patients treated at our institution who underwent treatment for pressure ulcers with underlying HO to highlight the vast spectrum of clinical phenotypes present in this population...
December 21, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28100194/interspecies-transfer-of-vancomycin-erythromycin-and-tetracycline-resistance-among-enterococcus-species-recovered-from-agrarian-sources
#9
M Conwell, V Daniels, P J Naughton, J S G Dooley
BACKGROUND: Enterococci are now well recognised for their ability to transfer antibiotic resistance and for their association with nosocomial infections, but less is known regarding their relevance in the wider environment. Enterococcus faecalis and Enterococcus faecium were isolated from a range of agrarian associated sources (low-flow water, septic tank, poultry litter, high flow water, slurry/soil) and were assessed for latent ability to transfer antimicrobial resistance. RESULTS: The isolates were tested for phenotypic clumping in the presence of cell-free supernatant from other isolates...
January 18, 2017: BMC Microbiology
https://www.readbyqxmd.com/read/28100110/mortality-in-patients-with-septic-shock-by-multidrug-resistant-bacteria
#10
Stefano Busani, Giulia Serafini, Elena Mantovani, Claudia Venturelli, Maddalena Giannella, Pierluigi Viale, Cristina Mussini, Andrea Cossarizza, Massimo Girardis
BACKGROUND: Patients with septic shock by multidrug resistant (MDR) microorganism maybe considered a specific population of critical patients at very high risk of death in whom the effects of standard sepsis treatment has never been assessed. The objective of this retrospective analysis was to evaluate the risk factors for 30-day mortality and the impact of sepsis management in patients with septic shock caused by MDR bacteria. METHODS: Patients with septic shock by MDR bacteria admitted to the mixed intensive care unit (ICU) of Modena University Hospital during a 6-year period were studied...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28099689/effectiveness-and-safety-of-procalcitonin-evaluation-for-reducing-mortality-in-adults-with-sepsis-severe-sepsis-or-septic-shock
#11
REVIEW
Brenda Ng Andriolo, Regis B Andriolo, Reinaldo Salomão, Álvaro N Atallah
BACKGROUND: Serum procalcitonin (PCT) evaluation has been proposed for early diagnosis and accurate staging and to guide decisions regarding patients with sepsis, severe sepsis and septic shock, with possible reduction in mortality. OBJECTIVES: To assess the effectiveness and safety of serum PCT evaluation for reducing mortality and duration of antimicrobial therapy in adults with sepsis, severe sepsis or septic shock. SEARCH METHODS: We searched the Central Register of Controlled Trials (CENTRAL; 2015, Issue 7); MEDLINE (1950 to July 2015); Embase (Ovid SP, 1980 to July 2015); Latin American Caribbean Health Sciences Literature (LILACS via BIREME, 1982 to July 2015); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO host, 1982 to July 2015), and trial registers (ISRCTN registry, ClinicalTrials...
January 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28099645/mechanical-ventilation-in-coffin-lowry-syndrome-a-case-report
#12
Edmilson Bastos de Moura, Érica Leal Teixeira de Moura, Fábio Ferreira Amorim, Vânia Maria Oliveira
We describe a 27-year-old patient with Coffin-Lowry syndrome with severe community pneumonia, septic shock and respiratory failure. We summarize both the mechanical ventilatory assistance and the hospitalization period in the intensive care unit.
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099643/balanced-crystalloids-for-septic-shock-resuscitation
#13
Thiago Domingos Corrêa, Alexandre Biasi Cavalcanti, Murillo Santucci Cesar de Assunção
Timely fluid administration is crucial to maintain tissue perfusion in septic shock patients. However, the question concerning which fluid should be used for septic shock resuscitation remains a matter of debate. A growing body of evidence suggests that the type, amount and timing of fluid administration during the course of sepsis may affect patient outcomes. Crystalloids have been recommended as the first-line fluids for septic shock resuscitation. Nevertheless, given the inconclusive nature of the available literature, no definitive recommendations about the most appropriate crystalloid solution can be made...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099636/use-of-reactive-hyperemia-peripheral-arterial-tonometry-and-circulating-biological-markers-to-predict-outcomes-in-sepsis
#14
Vandack Nobre, Thiago Bragança Ataíde, Luisa Caldeira Brant, Clara Rodrigues Oliveira, Lucas Vieira Rodrigues, Antonio Luiz Pinho Ribeiro, Fernanda Barbosa Lopes, Ivan Euclides Saraiva, Marcus Vinícius Andrade
Objective: To evaluate the usefulness and prognostic value of reactive hyperemia - peripheral arterial tonometry in patients with sepsis. Moreover, we investigated the association of reactive hyperemia - peripheral arterial tonometry results with serum levels of certain inflammatory molecules. Methods: Prospective study, conducted in an 18-bed mixed intensive care unit for adults. The exclusion criteria included severe immunosuppression or antibiotic therapy initiated more than 48 hours before assessment...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099233/primary-outcome-measures-in-pediatric-septic-shock-trials-a-systematic-review
#15
Kusum Menon, James Dayre McNally, Jerry J Zimmerman, Michael S D Agus, Katie O'Hearn, R Scott Watson, Hector R Wong, Mark Duffett, David Wypij, Karen Choong
OBJECTIVE: To evaluate all published pediatric randomized controlled trials of patients with septic shock from any cause to examine the outcome measures used, the strengths and limitations of these measurements and whether the trial outcomes met feasibility criteria. DATA SOURCES: We used a previously published database of pediatric critical care randomized controlled trials (PICUtrials.net) derived from searches of MEDLINE, EMBASE, LILACS, and CENTRAL. STUDY SELECTION: We included randomized controlled trials of interventions to children admitted to a PICU with septic or dengue hemorrhagic shock which were published in English...
January 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28098900/endothelial-microparticles-activate-endothelial-cells-to-facilitate-the-inflammatory-response
#16
Yiyun Liu, Ruyuan Zhang, Hongping Qu, Jun Wu, Lei Li, Yaoqing Tang
Endothelial microparticles (EMPs) and endothelial cells (ECs) are involved in the pathophysiological mechanisms of sepsis and septic shock. EMPs are small vesicles released by ECs and are considered biomarkers for endothelial cell function and mediators for intercellular information exchange. However, the effect of EMPs on their parental ECs remains unknown. The present study collected tumor necrosis factor‑α‑derived EMPs and detected the proinflammatory cytokines released from unstimulated and EMP‑stimulated ECs by proteome profiler array...
January 12, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28098629/right-dose-right-now-customized-drug-dosing-in-the-critically-ill
#17
Jason A Roberts, Anand Kumar, Jeffrey Lipman
Drugs are key weapons that clinicians have to battle against the profound pathologies encountered in critically ill patients. Antibiotics in particular are commonly used and can improve patient outcomes dramatically. Despite this, there are strong opportunities for further reducing the persisting poor outcomes for infected critically ill patients. However, taking these next steps for improving patient care requires a new approach to antibiotic therapy. Giving the right dose is highly likely to increase the probability of clinical cure from infection and suppress the emergence of resistant pathogens...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28098591/surviving-sepsis-campaign-international-guidelines-for-management-of-sepsis-and-septic-shock-2016
#18
Andrew Rhodes, Laura E Evans, Waleed Alhazzani, Mitchell M Levy, Massimo Antonelli, Ricard Ferrer, Anand Kumar, Jonathan E Sevransky, Charles L Sprung, Mark E Nunnally, Bram Rochwerg, Gordon D Rubenfeld, Derek C Angus, Djillali Annane, Richard J Beale, Geoffrey J Bellinghan, Gordon R Bernard, Jean-Daniel Chiche, Craig Coopersmith, Daniel P De Backer, Craig J French, Seitaro Fujishima, Herwig Gerlach, Jorge Luis Hidalgo, Steven M Hollenberg, Alan E Jones, Dilip R Karnad, Ruth M Kleinpell, Younsuk Koh, Thiago Costa Lisboa, Flavia R Machado, John J Marini, John C Marshall, John E Mazuski, Lauralyn A McIntyre, Anthony S McLean, Sangeeta Mehta, Rui P Moreno, John Myburgh, Paolo Navalesi, Osamu Nishida, Tiffany M Osborn, Anders Perner, Colleen M Plunkett, Marco Ranieri, Christa A Schorr, Maureen A Seckel, Christopher W Seymour, Lisa Shieh, Khalid A Shukri, Steven Q Simpson, Mervyn Singer, B Taylor Thompson, Sean R Townsend, Thomas Van der Poll, Jean-Louis Vincent, W Joost Wiersinga, Janice L Zimmerman, R Phillip Dellinger
OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012." DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015...
January 17, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28098573/managing-maternal-sepsis-early-warning-criteria-to-ecmo
#19
Cesar Padilla, Arvind Palanisamy
Maternal sepsis is now a leading cause of direct maternal death during pregnancy. This review addresses the latest advances in the identification and management of critically ill parturients. Specifically, this review will focus on the vulnerability of pregnant women to sepsis, the utility of early warning criteria in the identification of the septic parturient, emphasize the immediate antibiotic management of suspected sepsis, and elaborate upon the latest understanding in the ventilatory management of parturients with sepsis...
January 16, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28097649/hospital-variation-in-utilization-of-life-sustaining-treatments-among-patients-with-do-not-resuscitate-orders
#20
Allan J Walkey, Janice Weinberg, Renda Soylemez Wiener, Colin R Cooke, Peter K Lindenauer
OBJECTIVE: To determine between-hospital variation in interventions provided to patients with do not resuscitate (DNR) orders. DATA SOURCES/SETTING: United States Agency of Healthcare Research and Quality, Healthcare Cost and Utilization Project, California State Inpatient Database. STUDY DESIGN: Retrospective cohort study including hospitalized patients aged 40 and older with potential indications for invasive treatments: in-hospital cardiac arrest (indication for CPR), acute respiratory failure (mechanical ventilation), acute renal failure (hemodialysis), septic shock (central venous catheterization), and palliative care...
January 18, 2017: Health Services Research
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