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https://www.readbyqxmd.com/read/29142375/the-effects-of-atorvastatin-on-inflammatory-responses-and-mortality-in-septic-shock-a-single-center-randomized-controlled-trial
#1
Ratender Kumar Singh, Vikas Agarwal, Arvind Kumar Baronia, Sudeep Kumar, Banani Poddar, Afzal Azim
Aim of the Study: Pleiotropic effect of statins can modulate inflammation in septic shock. We tested the hypothesis whether statins can reduce mortality in septic shock. Patients and Methods: We conducted a randomized double-blinded trial with treatment (40 mg dose of atorvastatin for 7 days) and control (placebo) arm in adult septic shock patients admitted to the Intensive Care Unit. Primary (28-day mortality) and secondary (vasopressor-, ventilation-, and renal replacement therapy-free days) outcomes, with lipid profile and adverse effects, were documented...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29142235/proteomic-study-revealed-cellular-assembly-and-lipid-metabolism-dysregulation-in-sepsis-secondary-to-community-acquired-pneumonia
#2
Narendra Kumar Sharma, Alexandre Keiji Tashima, Milena Karina Colo Brunialti, Eden Ramalho Ferreira, Ricardo Jose Soares Torquato, Renato Arruda Mortara, Flavia Ribeiro Machado, Murillo Assuncao, Otelo Rigato, Reinaldo Salomao
Sepsis is a life-threatening disorder characterized by organ dysfunction and a major cause of mortality worldwide. The major challenge in studying sepsis is its diversity in such factors as age, source of infection and etiology. Recently, genomic and proteomic approaches have improved our understanding of its complex pathogenesis. In the present study, we use quantitative proteomics to evaluate the host proteome response in septic patients secondary to community-acquired pneumonia (CAP). Samples obtained at admission and after 7 days of follow-up were analyzed according to the outcomes of septic patients...
November 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29141929/septic-arthritis-of-knee-joint-due-to-parvimonas-micra
#3
Moni Roy, Ashish Kumar Roy, Sharjeel Ahmad
Parvimonas species are anaerobic, Gram-positive cocci that are a constituent of normal oral and gastrointestinal flora. We present a case of right knee joint septic arthritis due to Parvimonas micra in an immunocompromised patient. A 61-year-old male renal and pancreatic transplant recipient on immunosuppressive therapy was admitted to our hospital due to intense pain, joint swelling and inability to move his right knee over the past 9 months. After synovial fluid was drawn, cultures were positive for P. micra, an anaerobic pathogen that is part of the flora of the oral cavity...
November 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29141867/host-resistance-to-endotoxic-shock-requires-the-neuroendocrine-regulation-of-group-1-innate-lymphoid-cells
#4
Linda Quatrini, Elisabeth Wieduwild, Sophie Guia, Claire Bernat, Nicolas Glaichenhaus, Eric Vivier, Sophie Ugolini
Upon infection, the immune system produces inflammatory mediators important for pathogen clearance. However, inflammation can also have deleterious effect on the host and is tightly regulated. Immune system-derived cytokines stimulate the hypothalamic-pituitary-adrenal (HPA) axis, triggering endogenous glucocorticoid production. Through interaction with ubiquitously expressed glucocorticoid receptors (GRs), this steroid hormone has pleiotropic effects on many cell types. Using a genetic mouse model in which the gene encoding the GR is selectively deleted in NKp46(+) innate lymphoid cells (ILCs), we demonstrated a major role for the HPA pathway in host resistance to endotoxin-induced septic shock...
November 15, 2017: Journal of Experimental Medicine
https://www.readbyqxmd.com/read/29141400/antifungal-treatment-with-echinocandins-a-10-year-clinical-experience
#5
R Poves-Alvarez, B Cano-Hernández, S Balbás-Alvarez, P Román-García, M Heredia-Rodríguez, E Gómez-Sánchez, E Gómez-Pesquera, M Lorenzo-López, B Martínez-Rafael, M F Muñoz-Moreno, J M Eiros, E Tamayo
OBJECTIVE: The number of studies evaluating the use of echinocandins, whether or not its indication meets international guidelines, in clinical practice is limited. The objective of the present study was to determine the use of echinocandins in a tertiary Spanish hospital in 10 years of clinical practice, and to evaluate its impact on prognosis. METHODS: This retrospective study involved adult nonneutropenic ill patients with suspicion of fungal invasion who started treatment with echinocandins between 2006 and 2015...
November 10, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29140803/use-of-postmortem-computed-tomography-to-detect-bowel-obstruction-and-its-relationship-to-the-cause-of-death
#6
Dominic Gascho, Sarah Schaerli, Lucile Tuchtan-Torrents, Michael J Thali, Guillaume Gorincour
Bowel distension frequently indicates bowel obstruction, which is a common diagnosis in clinical radiology. Typically, symptoms and complaints lead to radiological examinations and the detection of the etiology. Untreated intestinal obstructions can lead to a fatal outcome through cardiac failure due to septic shock. Certain of these cases undergo medicolegal investigations depending on the case history, the condition of the decedent, the location of the finding, or recent visits to medical professionals. Computed tomography (CT) is a recommended method in clinical radiology for the detection of bowel obstruction, which is indicated by bowel distension and further radiological signs (eg, the whirl sign, which indicates a volvulus)...
November 15, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29138849/elevated-serum-levels-of-lipoprotein%C3%A2-associated-phospholipase%C3%A2-a2-predict-mortality-rates-in-patients-with-sepsis
#7
Zhongwei Huang, Haiyan Jiang, Xiaohui Cui, Guiwen Liang, Yu Chen, Ting Wang, Zhichao Sun, Lei Qi
Sepsis remains one of the leading contributors to mortality rates in the intensive care unit (ICU) and emergency intensive care unit (EICU). Therefore, any treatments against the agents which produce sepsis in a medical emergency, are welcome. Elevated serum levels of lipoprotein‑associated phospholipase A2 (Lp‑PLA2) have been reported in a small cohort of patients with inflammation. The present study evaluated serum levels of Lp‑PLA2 in patients with sepsis and investigated the role of Lp‑PLA2 in sepsis...
November 13, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29138696/use-of-common-inflammatory-markers-in-the-long-term-screening-of-total-hip-arthroprosthesis-infections-our-experience
#8
Gabriele Falzarano, Antonio Piscopo, Predrag Grubor, Giuseppe Rollo, Antonio Medici, Valerio Pipola, Michele Bisaccia, Auro Caraffa, Elizabeth Mary Barron, Francesco Nobile, Raffaele Cioffi, Luigi Meccariello
Orthopedic implants have become essential components of modern medicine. The risk of infection of total hip arthroplasty (THA) is 1.5%-2%. Are the C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) good markers for THA infection screenings? From February 2009 to December 2012 at our Department of Orthopedics and Traumatology, 1248 patients were treated with THA. No prosthesis was cemented. All patients received antibiotic prophylaxis. All patients were discharged approximately 7...
2017: Advances in Orthopedics
https://www.readbyqxmd.com/read/29138652/trauma-a-major-cause-of-death-among-surgical-inpatients-of-a-nigerian-tertiary-hospital
#9
Onyeanunam Ngozi Ekeke, Kelechi Emmanuel Okonta
Introduction: Trauma presents a significant global health burden. Death resulting from trauma remains high in low income countries despite a steady decrease in developed countries. Analysis of the pattern of death will enable intervention to reduce these deaths from trauma in developing countries. This study aims to present the pattern of trauma-related deaths in the surgical wards of University of Port Harcourt Teaching Hospital (UPTH). Methods: This was a retrospective study of all patients who died from trauma during admission into the surgical wards of UPTH from 2007 to 2012...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29138043/non-traumatic-limping-in-paediatric-emergencies-epidemiology-evaluation-and-results
#10
M I Lázaro Carreño, R Fraile Currius, A García Clemente
INTRODUCTION: Non-traumatic limping is a common reason for consultation in paediatric emergencies. Although transient synovitis of the hip (TS) is the most frequent diagnosis, there are cases of limping secondary to serious pathologies. The aim of this review is to describe the variables related to non-traumatic limp that come to the paediatric emergency department to establish the best management protocol, making the most of resources and speeding up emergency care. MATERIAL AND METHOD: A prospective study was conducted, selecting all children less than 15 years old who consulted aspaediatric emergencies for non-traumatic limping during the 2014...
November 11, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29137833/the-role-of-corticosteroid-in-septic-shock-patients
#11
Xianshi Zhou, Ye Ye, Jun Li, Guanghua Tang
No abstract text is available yet for this article.
November 10, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29137585/association-of-positive-fluid-balance-and-mortality-in-sepsis-and-septic-shock-in-an-australian-cohort
#12
M G Pittard, S J Huang, A S McLean, S R Orde
In patients with septic shock, a correlation between positive fluid balance and worsened outcomes has been reported in multiple observational studies worldwide. No published data exists in an Australasian cohort. We set out to explore this association in our institution. We conducted a retrospective audit of patient records from August 2012 to May 2015 in a single-centre, 24-bed surgical and medical intensive care unit (ICU) in Sydney, Australia. All patients with septic shock were included. Exclusion criteria included length of stay less than 24 hours or vasopressors needed for less than six hours...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137405/necroptosis-regulated-proteins-expression-is-an-early-prognostic-biomarker-in-patient-with-sepsis-a-prospective-observational-study
#13
Bing Wang, Jian Li, Hong-Mei Gao, Ying-Hong Xing, Zhu Lin, Hong-Jie Li, Yong-Qiang Wang
Background and aim: Increasing researchers indicate that necroptosis is playing an important role in the regulation of systemic inflammatory response syndrome. The current study was to investigate the prognostic biomarker of the regulated proteins of necroptosis in sepsis patients. Results: One hundred and twenty-four patients were divided into three groups: 43 patients (34.68%) with sepsis, 39 patients (31.45%) with severe sepsis, and 42 patients (33.87%) with septic shock...
October 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/29137105/urgent-laparoscopic-ureterolithotomy-for-proximal-ureter-stones-accompanied-with-obstructive-pyelonephritis-is-it-safe-and-effective-without-preoperative-drainage
#14
Huan Yang, Xiao Yu, Ejun Peng, Cong Li, Lei Cui, Xing Zeng, Shen Wang, Chao Wei, Zhihua Wang, Xiaolin Guo, Zhiqiang Chen, Zhangqun Ye, Shaogang Wang, Chenming Zhao
To evaluate the safety and efficacy of retroperitoneal laparoscopic ureterolithotomy (RLU) in the treatment of proximal ureteral stones accompanied with obstructive pyelonephritis without preoperative drainage.We retrospectively reviewed 21 cases of proximal ureteral stones with infected kidney undergoing RLU between July 2013 and September 2016. Stone-induced obstructive infected hydronephrosis was diagnosed using blood and urine tests and imaging modalities. Empirical effective broad spectrum antibiotic therapy was initiated immediately, and then urgent RLU was performed without preoperative drainage...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136126/risk-of-subsequent-sepsis-within-90-days-of-a-previous-hospital-stay-by-type-of-antibiotic-exposure
#15
James Baggs, Johm A Jernigan, Alison Laufer Halpin, Lauren H Epstein, Kelly M Hatfield, L Clifford McDonald
Background: We examined the risk of sepsis within 90 days after discharge from a previous hospital stay by type of antibiotic received during the previous stay. Methods: We retrospectively identified a cohort of hospitalized patients from the Truven Health MarketScan Hospital Drug Database. We examined the association between the use of certain antibiotics, determined a priori, during the initial hospital stay and risk of post-discharge sepsis controlling for potential confounding factors in a multivariable logistic regression model...
November 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29136027/expression-of-toll-like-receptors-tlrs-in-the-lungs-of-an-experimental-sepsis-mouse-model
#16
Anargyros Bakopoulos, Alkistis Kapelouzou, Diamantis I Tsilimigras, Michalis Katsimpoulas, Dimitrios Schizas, Chrysostomos Aravanis, Evaggelos Balafas, Manolis Mavroidis, Kitty Pavlakis, Anastasios Machairas, Theodore Liakakos
BACKGROUND: Sepsis is a condition characterized by high mortality rates and often accompanied by multiple-organ dysfunction. During sepsis, respiratory system may be affected and possibly result in acute respiratory distress syndrome (ARDS). Toll-like receptors (TLRs), as a first line defense against invading pathogens, seem to be highly expressed in septic states. Therefore, expression of TLRs in the lungs of a sepsis animal model could indicate the involvement of the respiratory system and appear as a severity index of the clinical course...
2017: PloS One
https://www.readbyqxmd.com/read/29133561/outcomes-of-vancomycin-plus-a-%C3%AE-lactam-versus-vancomycin-only-for-the-treatment-of-methicillin-resistant-staphylococcus-aureus-bacteremia
#17
James Truong, John J Veillette, Steve C Forland
The objective of this retrospective study was to compare the rates of treatment failure, which was a composite of clinical and microbiologic failure, of patients receiving vancomycin and a β-lactam to those receiving vancomycin only for MRSA bacteremia. Patients 16 to 89 years of age with MRSA bacteremia admitted to a university-affiliated hospital from January 1(st), 2014 to December 31(st), 2016 were screened for study inclusion. Patients were eligible if they received >48 hours of vancomycin and a β-lactam (combination group) or vancomycin only (standard group) within 48 hours following bacteremia onset...
November 13, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29133417/human-resistin-protects-against-endotoxic-shock-by-blocking-lps-tlr4-interaction
#18
Jessica C Jang, Jiang Li, Luca Gambini, Hashini M Batugedara, Sandeep Sati, Mitchell A Lazar, Li Fan, Maurizio Pellecchia, Meera G Nair
Helminths trigger multiple immunomodulatory pathways that can protect from sepsis. Human resistin (hRetn) is an immune cell-derived protein that is highly elevated in helminth infection and sepsis. However, the function of hRetn in sepsis, or whether hRetn influences helminth protection against sepsis, is unknown. Employing hRetn-expressing transgenic mice (hRETNTg(+)) and recombinant hRetn, we identify a therapeutic function for hRetn in lipopolysaccharide (LPS)-induced septic shock. hRetn promoted helminth-induced immunomodulation, with increased survival of Nippostrongylus brasiliensis (Nb)-infected hRETNTg(+) mice after a fatal LPS dose compared with naive mice or Nb-infected hRETNTg(-) mice...
November 13, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29133071/red-blood-cell-distribution-width-is-associated-with-mortality-in-elderly-patients-with-sepsis
#19
An-Yi Wang, Hon-Ping Ma, Wei-Fong Kao, Shin-Han Tsai, Cheng-Kuei Chang
INTRODUCTION: RDW is a prognostic biomarker and associated with mortality in cardiovascular disease, stroke and metabolic syndrome. For elderly patients, malnutrition and multiple comorbidities exist, which could affect the discrimination ability of RDW in sepsis. The main purpose of our study was to evaluate the prognostic value of RDW in sepsis among elderly patients. METHODS: This was a retrospective cohort study conducted in emergency department intensive care units (ED-ICU) between April 2015 and November 2015...
November 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29133025/perivalvular-mitral-abscess-fistulised-to-the-pericardial-cavity-revealing-staphylococcal-endocarditis
#20
Paul Desaint, Anthony Chauvat, Thomas Garaud, Olivier Andremont, Gaëtan Plantefève, Hervé Mentec, Damien Contou
BACKGROUND: Fistula to the pericardial cavity is a very rare complication of perivalvular abscess during infective endocarditis, with Staphylococcus aureus being the most commonly associated microorganism. METHODS: We report a fatal septic shock due to a mitral endocarditis revealed by a myocardial abscess fistulised toward the pericardial cavity. RESULTS: A 66-year-old female without previous valvular disease was admitted to intensive care for severe sepsis...
October 31, 2017: Heart, Lung & Circulation
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