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https://www.readbyqxmd.com/read/29164555/an-insight-into-the-role-of-cyclooxygenase-and-lipooxygenase-pathway-in-renal-ischemia
#1
M Kinra, J Mudgal, D Arora, M Nampoothiri
OBJECTIVE: Renal ischemia (RI) is a clinical condition that occurs due to marked decrease in renal blood flow. The pathophysiology of RI is interlinked with atherosclerotic renal artery stenosis, infarction, organ transplantation and sepsis. The mechanism of RI injury depends on various factors such as inflammatory response, oxidative stress and apoptosis. In this review, we evaluate the role of cyclooxygenase and lipoxygenase in modulating the process of ischemic renal injury. MATERIALS AND METHODS: This is a literature review of articles published on PubMed and Web of Science in English...
November 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29161706/endotoxin-effects-on-cardiac-and-renal-functions-and-cardiorenal-syndromes
#2
Grazia Maria Virzì, Anna Clementi, Alessandra Brocca, Claudio Ronco
Gram-negative sepsis is a major cause of morbidity and mortality in critical ill patients. Recent findings in molecular biology and in signaling pathways have enhanced our understanding of its pathogenesis and opened up opportunities of innovative therapeutic approaches. Endotoxin plays a pivotal role in the pathogenesis of multi-organ dysfunction in the setting of gram-negative sepsis. Indeed, heart and kidney impairments seem to be induced by the release of circulating pro-inflammatory and pro-apoptotic mediators triggered by endotoxin interaction with immune cells...
November 22, 2017: Blood Purification
https://www.readbyqxmd.com/read/29148292/cholestatic-liver-injury-as-a-side-effect-of-dabigatran-and-the-use-of-coagulation-tests-in-dabigatran-intoxication-and-after-reversal-by-idarucizumab-in-bleeding-and-sepsis
#3
Willemijn J Comuth, Anne-Mette Haase, Linda Ø Henriksen, Jerzy Malczynski, Daan van de Kerkhof, Anna-Marie B Münster
Idarucizumab, an antidote specific for dabigatran, became available recently. Dabigatran is not associated with increased risk of hepatotoxicity in comparison with warfarin, but it is seen as a rare side-effect. Cases of cholestatic liver injury due to dabigatran have not been reported previously. We present a case of severe gastro-intestinal bleeding with underlying dabigatran intoxication in a patient with renal failure and the effect of reversal of dabigatran using idaruzicumab on coagulation assays. International normalized ratio (INR) and activated partial thromboplastin time (APTT) results were elevated in a setting of sepsis, possibly due to liver failure...
November 17, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/29133918/fast-simultaneous-assessment-of-renal-and-liver-function-using-polymethine-dyes-in-animal-models-of-chronic-and-acute-organ-injury
#4
A T Press, M J Butans, T P Haider, C Weber, S Neugebauer, M Kiehntopf, U S Schubert, M G Clemens, M Bauer, A Kortgen
Simultaneous assessment of excretory liver and kidney function is still an unmet need in experimental stress models as well as in critical care. The aim of the study was to characterize two polymethine-dyes potentially suitable for this purpose in vivo. Plasma disappearance rate and elimination measurements of simultaneously injected fluorescent dyes DY-780 (hepato-biliary elimination) and DY-654(renal elimination) were conducted using catheter techniques and intravital microscopy in animals subjected to different organ injuries, i...
November 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29132515/acute-kidney-injury-in-the-critically-ill
#5
REVIEW
Robert A Maxwell, Christopher Michael Bell
Acute kidney injury (AKI) occurs frequently in the surgical intensive care unit and results in significant morbidity and mortality. AKI needs to be identified early and underlying causes treated or eliminated. Sepsis, major surgery such as coronary artery bypass, and hypovolemia are the most common causes and patients with underlying comorbidities have increased susceptibility. Treatment should begin by ensuring that patients are adequately resuscitated and all contributing causes are replaced or eliminated...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29123901/respiratory-extracorporeal-membrane-oxygenation-for-severe-sepsis-and-septic-shock-in-adults-a-propensity-score-analysis-in-a-multicenter-retrospective-observational-study
#6
Shuhei Takauji, Mineji Hayakawa, Kota Ono, Hiroshi Makise
Aim: This multicenter retrospective observational study aimed to evaluate the efficacy of extracorporeal membrane oxygenation (ECMO) support for septic patients with severe respiratory failure using propensity score analyses. Methods: The data of severe sepsis patients from 42 intensive care units between January 2011 and December 2013 were retrospectively collected. Propensity score matching analyses were undertaken for severe respiratory failure patients with/without veno-venous ECMO support...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123842/severe-sepsis-caused-by-capnocytophaga-canimorsus-complicated-by-thrombotic-microangiopathy-in-an-immunocompetent-patient
#7
Shota Maezawa, Daisuke Kudo, Keiichiro Asanuma, Daisuke Takekoshi, Ryuichiro Egashira, Shigeki Kushimoto
Case: A 61-year-old man with an unremarkable medical history was admitted with fever 7 days after being bitten by his dog. On day 3, he showed altered mental status, and laboratory data showed progressive hemolytic anemia, thrombocytopenia, hyperbilirubinemia, renal dysfunction, coagulopathy, and schistocytosis. Severe sepsis complicated with thrombotic microangiopathy caused by Capnocytophaga canimorsus was suspected. Outcome: Plasma exchange was applied to treat the thrombotic microangiopathy and resulted in platelet count increase and improved renal function, hyperbilirubinemia, and schistocytosis...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29118926/gts-21-attenuates-lps-induced-renal-injury-via-the-cholinergic-anti-inflammatory-pathway-in-mice
#8
Yang Gao, Kai Kang, Haitao Liu, Weilan Kong, Qiuyuan Han, Xing Zhang, Rui Huang, Jingdong Qu, Hongliang Wang, Sicong Wang, Ruijin Liu, Yansong Liu, Kaijiang Yu
This study aimed to investigate the role of GTS-21 in cholinergic anti-inflammatory pathway-mediated protection of LPS-induced septic renal injury in mice. C57BL/6 mice were used to construct septic injury models. The optimal duration of lipopolysaccharide (LPS) treatment was determined using HE staining and TUNEL assay. Mice injected with saline were used as blank control and with LPS (10 mg/kg) as model, which were further treated with α-bungarotoxin (BT-LPS), GTS-21 (GTS-21-LPS) and BT and GTS-21 (BT-GTS-21-LPS)...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/29118766/the-role-of-endotoxin-in-the-setting-of-cardiorenal-syndrome-type-5
#9
REVIEW
Anna Clementi, Grazia Maria Virzì, Alessandra Brocca, Claudio Ronco
Lipopolysaccharide or endotoxin, the major cell wall component of gram-negative bacteria, plays a pivotal role in the pathogenesis of sepsis. It is able to activate the host defense system through the interaction with Toll-like receptor 4, thus triggering pro-inflammatory mechanisms. When the production of inflammatory mediators becomes uncontrolled and excessive, septic shock develops with multiple organ dysfunction, such as myocardial and renal impairment, which are hallmarks of cardiorenal syndrome type 5...
October 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/29117994/role-of-adenosine-1a-receptor-signaling-on-gfr-early-after-the-induction-of-sepsis
#10
Jonathan M Street, Erik H Koritzinsky, Tiffany R Bellomo, Xuzhen Hu, Peter S T Yuen, Robert A Star
Sepsis and acute kidney injury (AKI) synergistically increase morbidity and mortality in the ICU. How sepsis reduces GFR and causes AKI is poorly understood; one proposed mechanism includes tubuloglomerular feedback (TGF). When sodium reabsorption by the proximal tubules is reduced in normal animals, the macula densa senses increased luminal sodium chloride, then adenosine 1a receptor (A1aR) signaling triggers tubuloglomerular feedback, reducing GFR through afferent arteriole vasoconstriction. We measured GFR and systemic hemodynamics early during cecal ligation and puncture-induced sepsis in wild-type and A1aR knockout mice...
November 8, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29116996/leptospirosis-in-icu-a-retrospective-study-of-134-consecutive-admissions
#11
Benjamin Delmas, Julien Jabot, Paul Chanareille, Cyril Ferdynus, Jérôme Allyn, Nicolas Allou, Loïc Raffray, Bernard-Alex Gaüzere, Olivier Martinet, David Vandroux
OBJECTIVES: Leptospirosis causes reversible multiple organ failure, and its mortality remains high. The aim of this study was to determine the mortality rate of leptospirosis in an ICU offering all types of organ support available nowadays and to compare it with mortality in bacterial sepsis. DESIGN: Retrospective, descriptive, and single-center cohort study. SETTINGS: The largest ICU of Reunion Island (Indian Ocean) in a teaching hospital...
November 7, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29113335/maternal-and-fetal-outcomes-of-pregnant-women-with-type-1-diabetes-a-national-population-study
#12
Shu-Fu Lin, Chang-Fu Kuo, Meng-Jiun Chiou, Shang-Hung Chang
Pregnancy in women with type 1 diabetes is associated with poor maternal and neonatal outcomes. However, the risk of these outcomes has never been evaluated in an Asian national population. In this work, we report the maternal and fetal outcomes of pregnant women with type 1 diabetes in Taiwan. A total of 2,350,339 pregnancy records created between 2001 and 2012 were obtained from the National Health Insurance database and analyzed. Here, 630 pregnancy records were identified in women having type 1 diabetes...
October 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/29112081/predictors-prevalence-and-outcomes-of-early-crystalloid-responsiveness-among-initially-hypotensive-patients-with-sepsis-and-septic-shock
#13
Daniel E Leisman, Martin E Doerfler, Sandra M Schneider, Kevin D Masick, Jason A D'Amore, John K D'Angelo
OBJECTIVES: The prevalence of responsiveness to initial fluid challenge among hypotensive sepsis patients is unclear. To avoid fluid overload, and unnecessary treatment, it is important to differentiate these phenotypes. We aimed to 1) determine the proportion of hypotensive sepsis patients sustaining favorable hemodynamic response after initial fluid challenge, 2) determine demographic and clinical risk factors that predicted refractory hypotension, and 3) assess the association between timeliness of fluid resuscitation and refractoriness...
November 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29112080/%C3%AE-lactam-therapeutic-drug-management-in-the-picu
#14
Jeffrey J Cies, Wayne S Moore, Adela Enache, Arun Chopra
OBJECTIVES: To determine whether contemporary β-lactam anti-infective dosing recommendations in critically ill children achieve concentrations associated with maximal anti-infective activity. The secondary objective was to describe the microbiological and clinical outcomes associated with β-lactam therapeutic drug management. DESIGN: Electronic Medical Record Review. SETTING: A 189-bed, freestanding children's tertiary care teaching hospital in Philadelphia, PA...
November 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29104728/oxidative-stress-and-acute-kidney-injury-in-critical-illness-pathophysiologic-mechanisms-biomarkers-interventions-and-future-perspectives
#15
REVIEW
Paraskevi Pavlakou, Vassilios Liakopoulos, Theodoros Eleftheriadis, Michael Mitsis, Evangelia Dounousi
Acute kidney injury (AKI) is a multifactorial entity that occurs in a variety of clinical settings. Although AKI is not a usual reason for intensive care unit (ICU) admission, it often complicates critically ill patients' clinical course requiring renal replacement therapy progressing sometimes to end-stage renal disease and increasing mortality. The causes of AKI in the group of ICU patients are further complicated from damaged metabolic state, systemic inflammation, sepsis, and hemodynamic dysregulations, leading to an imbalance that generates oxidative stress response...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29104127/incidence-risk-factors-and-prognostic-impact-of-re-exploration-for-bleeding-after-cardiac-surgery-a-retrospective-cohort-study
#16
Lucas B Ohmes, Antonino Di Franco, T Sloane Guy, Christopher Lau, Monica Munjal, William Debois, Zhongyi Li, Karl H Krieger, Alexandra N Schwann, Jeremy R Leonard, Leonard N Girardi, Mario Gaudino
BACKGROUND: Postoperative re-exploration for bleeding (RB) is a frequent complication following cardiac surgery. We aim to assess incidence, risk factors, and prognostic significance of RB in a large cohort of cardiac patients. MATERIALS AND METHODS: We reviewed prospectively collected data for all patients who underwent cardiac surgery at our institution from 2007 to 2015. Logistic regression analysis was used to identify independent predictors of RB and specific outcomes...
November 7, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29103584/selective-aortic-arch-and-root-replacement-in-repair-of-acute-type-a-aortic-dissection
#17
Fernando Fleischman, Ramsey S Elsayed, Robbin G Cohen, James M Tatum, S Ram Kumar, Kayvan Kazerouni, Wendy J Mack, Mark L Barr, Mark J Cunningham, Amy E Hackmann, Craig J Baker, Vaughn A Starnes, Michael E Bowdish
BACKGROUND: Controversy exists regarding the optimal extent of repair for type A aortic dissection. Our approach is to replace the ascending aorta, and only replace the aortic root or arch when intimal tears are present in those areas. We examined intermediate outcomes with this approach to acute type A aortic dissection repair. METHODS: Between March 2005 and October 2016, 195 patients underwent repair of acute type A aortic dissection. Repair was categorized by site of proximal and distal anastomosis and extent of repair...
November 3, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29103257/-fever-hepatic-dysfunction-and-interstitial-pneumonia-caused-by-intravesical-bacillus-calmette-guerin-bcg-instillation-after-urethral-bougie-a-case-report
#18
Satoshi Nitta, Shotaro Sakka, Tsuyoshi Endo, Manabu Komine, Masakazu Tsutsumi, Hiroyuki Nishiyama
A 60-year-old man had a past history of urothelial carcinoma of the left renal pelvis treated with laparoscopic left total nephroureterectomy in October 2004. He underwent transurethral resection of the bladder tumor (TUR-Bt) twice for recurrence of urothelial carcinoma in the bladder in April 2014 and February 2015, and subsequently received intravesical Bacillus Calmette-Guerin (BCG) instillation at weekly intervalsfor prevention of recurrence. In November 2016, a year and a half after BCG induction, he received BCG therapy after urethral bougie to dilate the urethral stricture...
October 2017: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/29102324/prolonged-versus-short-term-intravenous-infusion-of-antipseudomonal-%C3%AE-lactams-for-patients-with-sepsis-a-systematic-review-and-meta-analysis-of-randomised-trials
#19
Konstantinos Z Vardakas, Georgios L Voulgaris, Athanasios Maliaros, George Samonis, Matthew E Falagas
BACKGROUND: The findings of randomised controlled trials (RCT), observational studies, and meta-analyses vary regarding the effectiveness of prolonged β-lactam infusion. We aimed to identify the effectiveness of prolonged versus short-term infusion of antipseudomonal β-lactams in patients with sepsis. METHODS: We did a systematic review and meta-analysis to compare prolonged versus short-term intravenous infusion of antipseudomonal β-lactams in patients with sepsis...
October 25, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29098196/perirenal-abscess-after-partial-nephrectomy-because-of-migration-of-upper-calix-stone-and-urine-leakage-a-case-report
#20
Sheng-Chun Hung, Li-Wen Chang, Cheng-Kuang Yang
Background: Nephron-sparing surgery has been shown to achieve oncological results equivalent to those of radical nephrectomy in patients with compromised renal function who have renal tumors <4 cm. However, technical difficulties and potential surgical complications remain challenges to the surgeon. Various factors, such as tumor size and location, collecting system invasion, and patient's expectations, are major concerns that may affect the feasibility of performing an effective partial nephrectomy. We report a patient with renal cell carcinoma who underwent open partial nephrectomy and suffered from complications of perirenal abscess because of stone migration, obstruction, and subsequence urine leakage...
2017: Journal of Endourology Case Reports
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