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Jean-Louis Vincent, Marc Leone
Distributive shock is associated with decreased systemic vascular resistance and altered oxygen extraction. Septic shock is the most frequent form of distributive shock. In shock states, duration of hypotension is associated with poor outcomes. The speed at which treatment to restore adequate perfusion pressure is initiated is, therefore, important to improve survival. Areas covered: This review presents an overview of the literature related to the management of vasopressor-dependent distributive shock, and in particular the relationship between arterial pressure and organ perfusion and function...
October 24, 2016: Expert Review of Anti-infective Therapy
Bshara Mansour, Adib Habib, Nazih Asli, Yuval Geffen, Dan Miron, Nael Elias
Infective endocarditis is a rare condition in children with normal hearts. We present here a case of previously healthy eleven-year-old girl with infective endocarditis and pulmonary septic emboli caused by a very rare bacterial etiology (Lactococcus lactis). Identification of this pathogen was only made by polymerase chain reaction.
2016: Case Reports in Pediatrics
Jiangquan Yu, Ruiqiang Zheng, Hua Lin, Qihong Chen, Jun Shao, Daxin Wang
PURPOSE: This study aimed to investigate the clinical effects of early goal-directed therapy according to the global end-diastolic volume index (GEDI) on chronic obstructive pulmonary disease (COPD) patients with septic shock. METHODS: A total of 71 COPD patients with septic shock were randomly assigned to 2 groups. In the control group (n = 37), fluid resuscitation was performed based on the central venous pressure. In the study group (n = 34), fluid resuscitation was performed until GEDI reached 800 mL/m(2)...
October 8, 2016: American Journal of Emergency Medicine
Wan Faiziah Wan Abdul Rahman, Nur Asyilla Che Jalil, Hadif Samsudin, Siti Rahmah H I Merican, Alfred K-Y Lam
No abstract text is available yet for this article.
February 2016: Pathology
T Gosiewski, A H Ludwig-Galezowska, K Huminska, A Sroka-Oleksiak, P Radkowski, D Salamon, J Wojciechowicz, M Kus-Slowinska, M Bulanda, P P Wolkow
Blood is considered to be a sterile microenvironment, in which bacteria appear only periodically. Previously used methods allowed only for the detection of either viable bacteria with low sensitivity or selected species of bacteria. The Next-Generation Sequencing method (NGS) enables the identification of all bacteria in the sample with their taxonomic classification. We used NGS for the analysis of blood samples from healthy volunteers (n = 23) and patients with sepsis (n = 62) to check whether any bacterial DNA exists in the blood of healthy people and to identify bacterial taxonomic profile in the blood of septic patients...
October 22, 2016: European Journal of Clinical Microbiology & Infectious Diseases
Sharukh Lokhandwala, Lars W Andersen, Sunil Nair, Parth Patel, Michael N Cocchi, Michael W Donnino
PURPOSE: Lactate reduction, a common method of risk stratification, has been variably defined. Among patients with an initial lactate >4mmol/L, we compared mortality prediction between a subsequent lactate ≥4mmol/L to a <10% and <20% decrease between initial and subsequent lactate values. MATERIALS AND METHODS: We performed a single-center retrospective study of patients presenting to the emergency department with an initial lactate ≥4mmol/L and suspected infection...
October 6, 2016: Journal of Critical Care
Ye Chen, Yu Lei, Li-Qun Mo, Jun Li, Mao-Hua Wang, Ji-Cheng Wei, Jun Zhou
Sepsis is associated with high morbidity and mortality. This study was to investigate the protective effects of electroacupuncture (EA) pretreatment with different waveforms on septic brain injury in rats and its mechanism. Male Sprague-Dawley rats were pretreated by EA with different waveforms (continuous wave, dilatational wave, or intermittent wave) at Baihui (GV20) and Tsusanli (ST36) acupoints for 30min, and underwent cecal ligation and puncture (CLP) or sham operation. The results showed that EA pretreatment with different waveforms improved survival rate, attenuated encephaledema, brain injury, neuronal apoptosis and cognitive dysfunction, and preserved blood-brain barrier(BBB)...
October 19, 2016: Brain Research Bulletin
L García-López, S Grau-Cerrato, A de Frutos-Soto, F Bobillo-Delamo, R Cítores-Gónzalez, F Diez-Gutierrez, M F Muñoz-Moreno, T Sánchez-Sánchez, F Gandía-Martínez, D Andaluz-Ojeda
INTRODUCTION: A study is made of the impact of a Sepsis Code Hospital Protocol upon antibiotic use, hospital stay and mortality. DESIGN: A quasi-experimental, retrospective observational study was carried out. SETTING: A polyvalent ICU with 11 beds belonging to a tertiary hospital. PATIENTS: Patients admitted to the ICU with severe sepsis or septic shock. INTERVENTIONS: A post-intervention group (POST-SC) (September 2012-August 2013) was compared with a historical control group (PRE-SC) (January-December 2010)...
October 19, 2016: Medicina Intensiva
N Didbaridze, N Lomidze, T Abuladze, G Qiliptari, T Didbaridze, I Gvasalia, Z Mkervalishvili, N Gogokhia
Anaerobic clostridial infection is the most severe form of paraproctitis. The incubation period is very short, from 3 to 6 hours, sometimes lasting for 1-2 days. Clostridial infection spreads rapidly and induces gas gangrene, causes destruction of cells and other intermediate substances, and impedes blood circulation. This paper presents a case study of an extremely severe form of anaerobic infection with spontaneous gas gangrene, cellulitis, fasciomyositic necrosis, severe intoxication and septic shock on the abdominal front and lateral surfaces...
September 2016: Georgian Medical News
Shara I Feld, Sarah E Tevis, Alexander G Cobian, Mark W Craven, Gregory D Kennedy
BACKGROUND: Many studies have evaluated predictors of postoperative complications, yet little is known about the development of multiple complications. The goal of this study was to assess complication timing in cascades of multiple complications and the risk of future complications given a patient's first complication. METHODS: This study includes 30-day, postoperative complications from the American College of Surgeons National Surgical Quality Improvement Program for all patients who underwent major inpatient and outpatient operative procedures from 2005-2013...
October 18, 2016: Surgery
Zsolt Sziklavari, Michael Ried, Florian Zeman, Christian Grosser, Tamas Szöke, Reiner Neu, Rudolf Schemm, Hans-Stefan Hofmann
BACKGROUND: This retrospective study analyzed the effectiveness of intrathoracic negative pressure therapy for debilitated patients with empyema and compared the short-term and long-term outcomes of three different intrapleural vacuum-assisted closure (VAC) techniques. METHODS: We investigated 43 consecutive (pre)septic patients with poor general condition (Karnofsky index ≤ 50 %) and multimorbidity (≥ 3 organ diseases) or immunosuppression, who had been treated for primary, postoperative, or recurrent pleural empyema with VAC in combination with open window thoracostomy (OWT-VAC) with minimally invasive technique (Mini-VAC), and instillation (Mini-VAC-Instill)...
October 21, 2016: Journal of Cardiothoracic Surgery
S Pscherer, A Nüssler, C Bahrs, M Reumann, C Ihle, U Stöckle, S Ehnert, T Freude, B G Ochs, I Flesch, P Ziegler
Background: The increasing incidence of diabetes mellitus is also reflected in the patient population of a trauma and orthopaedic centre. Diabetics also exhibit more comorbidities than non-diabetics. In addition to surgical problems in these patients, hospitalisation is often accompanied by complications, which can prolong treatment and increase costs. The aim of this retrospective study is to analyse hospitalisation of diabetics compared to non-diabetics, as well as differences in treatment costs, depending on associated age and comorbidities...
October 21, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Yi-Kun Chen, Ying-Kun Xu, Hao Zhang, Jiang-Tao Yin, Xin Fan, Da-Dong Liu, Hai-Yan Fu, Bing Wan
Emodin is an anthraquinone derived from Chinese herb that exerts anti-inflammation effects. This study aimed to investigate whether emodin provides the protection for jejunum injury by inhibiting inflammation. We established a model of sepsis caused by cecal ligation and puncture. Forty-eight male Wistar rats were divided into four groups (n=12). Jejunum injury was assessed by pathological examination. The activity of pJAK1/pSTAT3 and protein levels of Bcl-2 and Bax were detected by Western blot analysis. Inflammatory factors IL-6, TNF-α and procalcitonin were detected by ELISA...
October 18, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Sumeja Zahirovic, Faizah Siddique
A 55 year-old African American man presented to the Emergency Room with acute-onset fevers, chills, and bilateral thumb pain, swelling, and redness. MRI revealed extensive cellulitis involving bilateral hands and wrists, along with fluid collection and carpal bone erosion on the left. Given concerns for septic arthritis and osteomyelitis, patient underwent surgical debridement revealing an abscess in the wrist without osteomyelitis. Blood cultures grew Pasteurella multocida. Subsequently, patient noted two pet dogs at home, but no history of bites...
October 21, 2016: Arthritis Care & Research
Patrícia Napoleão, Ekaterina Potapova, Sara Moleirinho, Carlota Saldanha, António Messias
AIM: Soluble CD40 ligand (sCD40L) has been considered as a marker of thrombosis and inflammation in several diseases, including sepsis. Recent studies challenge this view and point to a role of sCD40L in vascular and endothelial function. An indication of that association in sepsis has not been obtained so far. Therefore, herein we evaluated association between sCD40L and markers of hemorheology and inflammation on context of septic shock. METHODS: Time-changes of sCD40L levels over 72 hours of Intensive Care Unit (ICU) internment were assessed in 22 patients with septic shock and compared with 36 healthy volunteers...
October 20, 2016: Clinical Hemorheology and Microcirculation
Martin Rozanovic, Csaba Csontos, Lajos Bogár, Lívia Szélig, Tímea Bocskai, Patrícia Kovács, Marianna Matancic, Attila Miseta, Csaba Loibl
BACKGROUND: In polytrauma and burn injury Systemic Inflammatory Response Syndrome (SIRS) develops. SIRS is presented in many hospitalized patients, including those who never develop infection or sepsis. Both in SIRS and sepsis the leukocyte activation occurs. In acute phase reaction leukocytes' upward flotation i.e. leukocyte antisedimentation rate (LAR) can indicate infectious origin. OBJECTIVE: To evaluate the predictive power of LAR, serum C-reactive protein (CRP) and procalcitonin (PCT) levels regarding mortality risk and development of septic complications...
October 20, 2016: Clinical Hemorheology and Microcirculation
Hitesh Soni, Adebowale Adebiyi
Apoptosis of renal tubular and glomerular cells during kidney disease involves activation of Fas ligand (FasL)-dependent death pathway. The significance of FasL in neonates with septic acute kidney injury (AKI) is unresolved, but an increase in renal FasL production, and/or infiltration of circulating FasL into the kidneys may occur following initial septic insult. Here, we examined whether soluble Fas ligand (sFasL) levels are altered during early phase of septic AKI in neonates. Six hours of polymicrobial sepsis elicited by cecal ligation and puncture (CLP) elevated serum C-reactive protein (CRP) (a bacteremia and sepsis marker) concentration in anesthetized and mechanically ventilated neonatal pigs...
October 21, 2016: Renal Failure
Jessica L Partlow, Meghann Lustgarten, W Rich Redding
To the authors' knowledge, the ultrasonographic appearance of hair shafts within a synovial structure of the horse has not been described previously. The purpose of this descriptive study was to illustrate the clinical, ultrasonographic, and arthroscopic characteristics of confirmed hair shafts within synovial structures of seven horses. A review of medical records of the Farm and Equine Veterinary Medical Center at North Carolina State University College of Veterinary Medicine identified seven horses with clinical signs suspicious for inflammatory or septic synovitis/tenosynovitis that had hair shafts identified within those structures ultrasonographically...
October 20, 2016: Veterinary Radiology & Ultrasound
Xavier Flecher, Benjamin Appy, Sébastien Parratte, Matthieu Ollivier, Jean-Noel Argenson
INTRODUCTION: Recent studies have reported short-term favourable results of tantalum-made components in acetabular revisions with bone loss. However, there is a lack of information regarding the mid to long-term results of such components. OBJECTIVES: The objective of this study was to analyse the outcome and survivorship of acetabular revision hip arthroplasty using tantalum components for loosening associated with bone loss at a minimum of five-year follow-up...
October 21, 2016: International Orthopaedics
Tur-Fu Huang, Chun-Chieh Hsu, Yu-Ju Kuo
Snake venoms affect blood coagulation and platelet function in a complex manner. However, two classes of venom proteins, snaclecs and disintegrins have been shown to specifically target receptors including GPIb, α2β1, GPVI, CLEC-2 and integrins αIIbβ3, αvβ3, α5β1 expressed on platelets, endothelial cells, phagocytes, tumor cells, thus affecting cell-matrices and cell-cell interactions. Here, we focus on disintegrins, a class of low molecular mass Arg-Gly-Asp(RGD)/Lys-Gly-Asp(KGD)-containing, cysteine-rich polypeptide derived from various viper snake venoms...
2016: Thrombosis Journal
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