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Septic peritonitis

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https://www.readbyqxmd.com/read/27898352/management-of-the-open-abdomen-using-negative-pressure-wound-therapy-with-instillation-in-severe-abdominal-sepsis-a-review-of-48-cases-in-hospital-mexico-costa-rica
#1
Pablo Sibaja, Alfredo Sanchez, Guillermo Villegas, Alvaro Apestegui, Esteban Mora
INTRODUCTION: Despite the numerous advances in recent years, severe abdominal sepsis (with associated organ failure associated with infection) remains a serious, life-threatening condition with a high mortality rate. OA is a viable alternative to the previously used scheduled repeat laparotomy or continuous peritoneal lavage. The use of Negative Pressure Wound Therapy (NPWT) has been described as a successful method of management of the open abdomen. Adding instillation of saline solution to NPWT in a programmed and controlled manner, could offer the clinician an additional tool for the management of complex septic abdomen...
November 17, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27870785/abdominal-pain-caused-by-a-potentially-fatal-attraction
#2
Danielle Claire Mercurio, Candace Scace, Bhairav Shah, Evan Weiner, Rajeev Prasad
Abdominal pain is a challenging presentation in children. Examination findings and etiology vary greatly, spanning a vast spectrum from flatulence to frank peritonitis with septic shock. Here, we discuss a 10-year-old boy with 24 hours of progressively worsening lower abdominal pain, nausea, and subjective fevers. History and physical examination findings were consistent with appendicitis. However, physicians were surprised when the single-view abdominal radiograph showed an unanticipated, somewhat perplexing discovery...
November 19, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27867692/osteonecrosis-of-both-knees-in-a-woman-with-crohn-s-disease
#3
Mara Barbosa, José Cotter
Osteonecrosis is a very rare complication of Crohn's disease (CD). It is not clear if it is related to corticosteroid therapy or if it occurs as an extraintestinal manifestation of inflammatory bowel disease. We present the case of a patient with CD who presented with osteonecrosis of both knees. A 22 years old woman was diagnosed with CD in April 2012 (Montreal Classification A2L1 + L4B3p). She was started on prednisolone (40 mg/d), azathioprine (100 mg/d) and messalazine (3 g/d). In July 2012, due to active perianal disease, infliximab therapy was initiated...
November 6, 2016: World Journal of Gastrointestinal Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27847654/the-case-for-improved-interprofessional-care-fatal-analgesic-overdose-secondary-to-acute-dental-pain-during-pregnancy
#4
Sarah K Y Lee, Rocio B Quinonez, Alice Chuang, Stephanie M Munz, Darya Dabiri
Prenatal oral health extends beyond the oral cavity, impacting the general well-being of the pregnant patient and her fetus. This case report follows a 19-year-old pregnant female presenting with acute liver failure secondary to acetaminophen overdose for management of dental pain following extensive dental procedures. Through the course of her illness, the patient suffered adverse outcomes including fetal demise, acute kidney injury, spontaneous bacterial peritonitis, and septic shock before eventual death from multiple organ failure...
2016: Case Reports in Dentistry
https://www.readbyqxmd.com/read/27846855/changes-in-ceftriaxone-pharmacokinetics-pharmacodynamics-during-the-early-phase-of-sepsis-a-prospective-experimental-study-in-the-rat
#5
Valentina Selmi, Beatrice Loriga, Luca Vitali, Martina Carlucci, Alessandro Di Filippo, Giulio Carta, Eleonora Sgambati, Lorenzo Tofani, Angelo Raffaele De Gaudio, Andrea Novelli, Chiara Adembri
BACKGROUND: Sepsis is characterized by the loss of the perm-selectivity properties of the glomerular filtration barrier (GFB) with consequent albuminuria. We examined whether the pharmacokinetics-pharmacodynamics (PK/PD) of ceftriaxone (CTX), an extensively protein-bound 3rd generation cephalosporin, is altered during early sepsis and whether an increase in urinary loss of bound-CTX, due to GFB alteration, can occur in this condition. METHODS: A prospective, experimental, randomized study was carried out in adult male Sprague-Dawley rats...
November 15, 2016: Journal of Translational Medicine
https://www.readbyqxmd.com/read/27833044/statins-prevent-cognitive-impairment-after-sepsis-by-reverting-neuroinflammation-and-microcirculatory-endothelial-dysfunction
#6
Patricia A Reis, Pedro C B Alexandre, Joana C D'Avila, Luciana D Siqueira, Barbara Antunes, Vanessa Estato, Eduardo V Tibiriça, Franck Verdonk, Tarek Sharshar, Fabrice Chrétien, Hugo C Castro-Faria-Neto, Fernando A Bozza
Acute brain dysfunction is a frequent condition in sepsis patients and is associated with increased mortality and long-term neurocognitive consequences. Impaired memory and executive function are common findings in sepsis survivors. Although neuroinflammation and blood-brain barrier dysfunction have been associated with acute brain dysfunction and its consequences, no specific treatments are available that prevent cognitive impairment after sepsis. Experimental sepsis was induced in Swiss Webster mice by intraperitoneal injection of cecal material (5 mg/kg, 500 μL)...
November 7, 2016: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/27799334/distinct-roles-of-integrins-%C3%AE-x%C3%AE-2-and-%C3%AE-m%C3%AE-2-on-leukocyte-subpopulations-during-inflammation-and-antimicrobial-responses
#7
Samir Jawhara, Elzbieta Pluskota, Wei Cao, Edward F Plow, Dmitry A Soloviev
Integrins αMβ2 and αXβ2 are homologous adhesive receptors that are expressed on many of the same leukocyte populations and bind many of the same ligands. Although αMβ2 was extensively characterized and implicated in leukocyte inflammatory and immune functions, the roles of αXβ2 remain largely obscure. Here, we tested the ability of mice deficient in integrins αMβ2 or αXβ2 to deal with opportunistic infections and the capacity of cells derived from these animals to execute inflammatory functions...
October 31, 2016: Infection and Immunity
https://www.readbyqxmd.com/read/27794168/cd46-accelerates-macrophage-mediated-host-susceptibility-to-meningococcal-sepsis-in-a-murine-model
#8
Xiao Wang, Ding Zhang, Mikael Sjölinder, Yi Wan, Hong Sjölinder
CD46, a membrane cofactor expressed on all nucleated human cells, plays an essential role in suppressing autoimmune reactions and protecting host cells from complement-mediated attack. Human transgenic CD46 homozygous mice (CD46(+/+) ) are prone to lethal sepsis upon infection with Neisseria meningitidis (N. meningitidis). However, the underlying mechanisms are poorly understood. Here, we determined that CD46(+/+) mice produce large numbers of M1 type macrophages with enhanced surface expression of MHC II and production of pro-inflammatory mediators such as IL-6, TNF, IL-12, and IL-1β In the presence of M-CSF or GM-CSF, CD46 signaling enhances monocyte-macrophage differentiation...
October 28, 2016: European Journal of Immunology
https://www.readbyqxmd.com/read/27790119/paraneoplastic-dermatomyositis-in-hepatocellular-carcinoma-with-colonic-perforation-a-case-report
#9
Naoteru Miyata, Katsura Emoto, Yoshiaki Dei, Kazuhiro Tomiyasu, Ryoko Ishiyama, Tomofumi Horie, Gen Sakai, Toshiyuki Tahara
BACKGROUND: Dermatomyositis (DM) is an autoimmune disease characterized by cutaneous Gottron papules, heliotrope rash, and proximal myopathy. It may also present as a paraneoplastic syndrome that can complicate a variety of different cancers, such as lung, cervical, and breast cancer. However, the association with hepatocellular carcinoma (HCC) is extremely rare. Moreover, to our knowledge, there are no previous reports of colonic perforation following steroid pulse treatment for a DM patient...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27747129/delayed-diagnosis-of-iatrogenic-bladder-perforation-in-a-neonate
#10
Antoinette S Birs, Jose A Perez, Mark A Rich, Hubert S Swana
Iatrogenic bladder injuries have been reported in the neonate during umbilical artery/vein catheterization, voiding cystourethrogram, urinary catheterizations, and overwhelming hypoxic conditions. Patients with iatrogenic bladder perforations can present with acute abdomen indicating urinary peritonitis, septic-uremic shock, or subtle symptoms like abdominal distension, pain, hematuria, uremia, electrolyte imbalances, and/or difficulty urinating. The following neonatal case report of perforated bladder includes a review of the signs, symptoms, diagnostic tools, and management of bladder injury in neonates...
2016: Case Reports in Urology
https://www.readbyqxmd.com/read/27687315/-type-ii-quadratus-lumborum-block-for-a-sub-total-gastrectomy-in-a-septic-patient
#11
José Miguel Cardoso, Miguel Sá, Hugo Reis, Liliana Almeida, José Carlos Sampaio, Célia Pinheiro, Duarte Machado
INTRODUCTION AND OBJECTIVES: Quadratus Lumborum block was recently described and has already shown good results as an analgesic technique in abdominal surgeries, having the potential to significantly reduce opioids consumption and be a valid alternative to epidural catheter. We performed a type II Quadratus Lumborum block for analgesia in a septic patient having a sub-total gastrectomy. CASE REPORT: An 80 year-old, ASA III, male patient, weighting 50kg, with a history of arterial hypertension and hypercholesterolemia, diagnosed with sepsis due to purulent peritonitis was submitted to an open laparotomy...
September 26, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27676715/bladder-rupture-secondary-to-emphysematous-bladder-a-diabetic-patient-report
#12
Astrid Balança
OBJECTIVE: We report an emphysematous cystitis in a diabetic patient complicated by peritonitis. OBSERVATIONS: A 66-year-old male presented to the emergency with septic shock. Patient's history: poorly controlled diabetes and prostate adenoma. Clinical examination revealed a surgical abdomen and signs of shock. Blood sugar was 6g/L. CRP 274mg/L. The abdomino-pelvic CT scan showed a perforated bladder with emphysema of the bladder wall and endoluminal air bubbles...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27646023/surgical-treatment-of-colorectal-cancer-with-peritoneal-and-liver-metastases-using-combined-liver-and-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-report-from-a-single-centre-experience
#13
Julie Navez, Christophe Remue, Daniel Leonard, Radu Bachmann, Alex Kartheuser, Catherine Hubert, Laurent Coubeau, Mina Komuta, Marc Van den Eynde, Francis Zech, Nicolas Jabbour
BACKGROUND: Chemotherapeutic advances have enabled successful cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) expansion in treating metastatic colorectal cancer. OBJECTIVES: The aims of this study were to evaluate the safety of combining liver surgery (LS) with HIPEC and CRS (which remains controversial) and its impact on overall survival (OS) rates. METHODS: From 2007 to 2015, a total of 77 patients underwent CRS/HIPEC for peritoneal carcinomatosis (PC) of colorectal cancer...
September 19, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27631642/sigmoid-resection-with-primary-anastomosis-and-ileostomy-versus-laparoscopic-lavage-in-purulent-peritonitis-from-perforated-diverticulitis-outcome-analysis-in-a-prospective-cohort-of-40-consecutive-patients
#14
Jonathan Catry, Antoine Brouquet, Frédérique Peschaud, Karina Vychnevskaia, Solafah Abdalla, Robert Malafosse, Benoit Lambert, Bruno Costaglioli, Stéphane Benoist, Christophe Penna
PURPOSE: This prospective study aimed to compare outcomes after laparoscopic peritoneal lavage (LPL) and sigmoid resection with primary colorectal anastomosis (RPA). METHODS: From June 2010 to June 2015, 40 patients presenting with Hinchey III peritonitis from perforated diverticulitis underwent LPL or RPA. Patients with Hinchey II or IV peritonitis and patients who underwent an upfront Hartmann procedure were excluded. Primary endpoint was overall 30-day or in-hospital postoperative morbidity after surgical treatment of peritonitis...
October 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27618701/floating-stoma-an-alternative-strategy-in-the-context-of-damage-control-surgery
#15
C Manterola, P Flores, T Otzen
INTRODUCTION: Floating stoma (FS) is a strategy to be considered in the context of damage control surgery (DCS). The purpose of this study is to describe the technique used and the results of a series of patients where FS was used. METHODS: Case series of relaparotomized patients at two emergency services in Temuco, Chile (2005-2014). In all of them, once drainage of septic focus or damage was controlled, the abdomen was left open with a Bogota bag (BB) and FS. Outcome variables were FS indications, morbidity, time to first replacement of BB, definitive maturation of the stoma (DMS), time to withdraw the BB and mortality...
December 2016: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/27618331/pelvic-inflammatory-disease-multimodality-imaging-approach-with-clinical-pathologic-correlation
#16
Margarita V Revzin, Mahan Mathur, Haatal B Dave, Matthew L Macer, Michael Spektor
Pelvic inflammatory disease (PID) is a common medical problem, with almost 1 million cases diagnosed annually. Historically, PID has been a clinical diagnosis supplemented with the findings from ultrasonography (US) or magnetic resonance (MR) imaging. However, the diagnosis of PID can be challenging because the clinical manifestations may mimic those of other pelvic and abdominal processes. Given the nonspecific clinical manifestations, computed tomography (CT) is commonly the first imaging examination performed...
September 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27586056/keratin-8-limits-tlr-triggered-inflammatory-responses-through-inhibiting-traf6-polyubiquitination
#17
Xiao-Ming Dong, En-Dong Liu, Yun-Xiao Meng, Chao Liu, Ya-Lan Bi, Huan-Wen Wu, Yan-Chao Jin, Jing-Hui Yao, Liu-Jun Tang, Jian Wang, Min Li, Chao Zhang, Miao Yu, Yi-Qun Zhan, Hui Chen, Chang-Hui Ge, Xiao-Ming Yang, Chang-Yan Li
Toll-like receptors (TLRs) have critical roles in innate immunity and inflammation and the detailed mechanisms by which TLR signaling is fine tuned remain unclear. Keratin 8 (CK8) belongs to the type II keratin family and is the major compontent of the intermediate filaments of simple or single-layered epithelia. Here we report that down-regulation of CK8 in mice enhanced TLR-mediated responses, rendering mice more susceptible to lipopolysaccharide (LPS)-induced endotoxin shock and Escherichia coli-caused septic peritonitis with reduced survival, elevated levels of inflammation cytokines and more severe tissue damage...
2016: Scientific Reports
https://www.readbyqxmd.com/read/27567704/stigmurin-and-tsap-2-from-tityus-stigmurus-scorpion-venom-assessment-of-structure-and-therapeutic-potential-in-experimental-sepsis
#18
Alessandra Daniele-Silva, Richele J A Machado, Norberto K V Monteiro, Andréia B Estrela, Elizabeth C G Santos, Eneas Carvalho, Raimundo F Araújo Júnior, Raniere F Melo-Silveira, Hugo Alexandre O Rocha, Arnóbio A Silva-Júnior, Matheus F Fernandes-Pedrosa
Microbial resistance to conventional antibiotics is a public health problem worldwide, motivating the search for new therapeutic alternatives in varied natural sources. Cationic peptides without disulfide bridges from scorpions have been targeted in this context, mainly due to their multifunctional action and the limited ability of microorganisms to develop resistance against them. The present study was focused on Stigmurin and TsAP-2, cationic peptides found in the transcriptome of the venom gland from the scorpion Tityus stigmurus...
October 2016: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/27566923/factors-associated-with-survival-of-horses-following-relaparotomy
#19
J A Findley, S Salem, R Burgess, D C Archer
REASONS FOR PERFORMING STUDY: Relaparotomy may be required to investigate and manage complications that occur following surgical management of colic. OBJECTIVES: To report factors associated with survival following relaparotomy. STUDY DESIGN: Retrospective cohort study. METHODS: Records of horses that had undergone exploratory laparotomy for treatment of colic over a 10-year period (2002-2012) and had undergone relaparotomy <8 weeks following the initial surgery were reviewed...
August 27, 2016: Equine Veterinary Journal
https://www.readbyqxmd.com/read/27563565/hepatic-artery-reinforcement-after-post-pancreatectomy-haemorrhage-caused-by-pancreatitis
#20
Aude Merdrignac, Damien Bergeat, Giovanni Battista Levi Sandri, Marina Agus, Karim Boudjema, Laurent Sulpice, Bernard Meunier
Post-pancreatectomy hemorrhage (PPH) is a major complication occurring in 6-8% of patients after pancreaticoduodenectomy (PD). Arterial bleeding is the most frequent cause. Mortality rate could reach 30% after grade C PPH according to ISGPS classification. Complete interruption of hepatic arterial flow has to be a salvage procedure because of the high risk of intrahepatic abscess following the procedure. We report a technique to perform an artery reinforcement after PPH caused by pancreatitis. A PD according to Whipple's procedure with child's reconstruction was performed in a 68-year-old man...
August 2016: Gland Surgery
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