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https://www.readbyqxmd.com/read/28934705/vitamin-c-the-next-step-in-sepsis-management
#1
REVIEW
J Teng, A Pourmand, M Mazer-Amirshahi
Sepsis is a life-threatening medical condition, affecting approximately 26 million people worldwide every year. The disease is a continuum, marked by dysregulated inflammation and hemodynamic instability leading to shock, multi-system organ dysfunction, and death. Over the past decades, there has been a focus on the early identification and treatment of sepsis primarily with bundled and goal directed therapy. Despite these advances, morbidity and mortality has remained high, prompting investigation into novel therapies...
September 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28931235/monoclonal-antibody-protects-against-acinetobacter-baumannii-infection-by-enhancing-bacterial-clearance-and-evading-sepsis
#2
Travis B Nielsen, Paul Pantapalangkoor, Brian M Luna, Kevin W Bruhn, Jun Yan, Ken Dekitani, Sarah Hsieh, Brandon Yeshoua, Bryan Pascual, Evgeny Vinogradov, Kristine M Hujer, T Nicholas Domitrovic, Robert A Bonomo, Thomas A Russo, Magda Lesczcyniecka, Thomas Schneider, Brad Spellberg
Background: Extremely drug-resistant (XDR) Acinetobacter baumannii is one of the most commonly encountered, highly resistant pathogens requiring novel therapeutic interventions. Methods: We developed C8, a monoclonal antibody (mAb), by immunizing mice with sublethal inocula of a hypervirulent XDR clinical isolate. Results: C8 targets capsular carbohydrate on the bacterial surface, enhancing opsonophagocytosis. Treating with a single dose of C8 as low as 0...
August 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28930036/role-for-laparoscopy-in-the-management-of-bile-duct-injuries
#3
Vaibhav Gupta, Shiva Jayaraman
Common bile duct (CBD) injury is the most serious complication of laparoscopic cholecystectomy. Recently, laparoscopic techniques have been used in the management of postoperative bile leak and CBD injury; this literature has not been reviewed. We reviewed the literature on CBD injury, the approach to its diagnosis and management, and reports of laparoscopic management techniques. We combined this review with our experience in laparoscopic methods to highlight diagnostic and therapeutic options. Laparoscopic techniques can be used to prevent, diagnose and treat CBD injuries...
September 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28929043/supraventricular-tachycardia-and-tricuspid-regurgitation-in-the-setting-of-misplaced-implantable-port-catheter-tip
#4
Ahmad Awan, Bisma Ahsan, Hasan Iftikhar, Akbar Khan, Fasil Tiruneh, Yididia Bekele, Ankit Mahajan, Ahmed A Awan
We present the case of a 31-year-old female with a past medical history of B-cell leukemia, on maintenance chemotherapy administered via centrally placed implantable catheter port, who presented to the emergency room with fever, chills, and generalized body pain of one day's duration. After initial workup, the patient was admitted to the intensive care unit and managed for severe sepsis. The patient was found to have a new-onset 3/6 holosystolic murmur at the left lower sternal border. Furthermore, she developed an episode of supraventricular tachycardia that responded to adenosine...
July 11, 2017: Curēus
https://www.readbyqxmd.com/read/28927439/barriers-and-facilitators-towards-implementing-the-sepsis-six-care-bundle-bliss-1-a-mixed-methods-investigation-using-the-theoretical-domains-framework
#5
Neil Roberts, Guy Hooper, Fabiana Lorencatto, Wendell Storr, Michael Spivey
BACKGROUND: The 'Sepsis 6', a care bundle of basic, but vital, measures (e.g. intravenous fluid, antibiotics) has been implemented to improve sepsis treatment. However, uptake has been variable. Tools from behavioral sciences, such as the Theoretical Domains Framework (TDF) may be used to understand and address such implementation issues. This study used a behavioral science approach to identify barriers and facilitators towards Sepsis Six implementation at a case study hospital. METHODS: Semi-structured interviews based on the TDF were conducted with a sample group of consultants, junior doctors and nurses from Emergency Department, Medical and Surgical Admissions, to explore barriers/facilitators to Sepsis Six performance...
September 19, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28924483/thyroidectomy-for-the-treatment-of-graves-thyrotoxicosis-in-thioamide-induced-agranulocytosis-and-sepsis
#6
Colin L Knight, Shamil D Cooray, Jaideep Kulkarni, Michael Borschmann, Mark Kotowicz
A 51 year old man presented with sepsis in the setting of thioamide-induced agranulocytosis. Empiric broad-spectrum antibiotics was followed by directed narrow-spectrum antibiotics, and his neutrophil count recovered with support from granulocyte-colony stimulating factor (G-CSF) analogue transfusions. After a brief period of multi-modal therapy for nine days including potassium iodide (Lugol's iodine), cholestyramine, propanolol and lithium to temper his persisting hyperthyroidism, a total thyroidectomy was performed while thyroid hormone levels remained at thyrotoxic levels...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28923883/microtubules-associated-rac-regulation-of-endothelial-barrier-a-role-of-asef-in-acute-lung-injury
#7
Pratap Karki, Anna A Birukova
The endothelial barrier function regulated by the cytoskeletal reorganizations has been implicated in the pathogenesis of multiple lung diseases including asthma, sepsis, edema, and acute respiratory distress syndrome. The extensive studies have established that activation of small GTPase Rac is a key mechanism in endothelial barrier protection but the role of microtubules-associated Rac in the endothelial functions remains poorly understood. With the emerging evidences that microtubules disassembly also plays a critical role in actin cytoskeleton remodeling leading to endothelial permeability, the knowledge on microtubules-mediated regulation of endothelial barrier is imperative to better understand the etiology of lung injuries as well as to develop novel therapeutics against these disorders...
September 18, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28923774/endotoxin-adsorption-direct-hemoperfusion-with-the-polymyxin-b-immobilized-fiber-column-pmx
#8
REVIEW
Tomoharu Shimizu, Toru Miyake, Naomi Kitamura, Masaji Tani, Yoshihiro Endo
Toraymyxin(®) is a medical device developed to adsorb circulating endotoxins in the blood using direct hemoperfusion therapy for patients with septic shock. In 1994, the Japanese National Health Insurance system approved the use of Toraymyxin for the treatment of endotoxemia and septic shock. Since then, Toraymyxin has been safely used in more than 100,000 cases in emergency and intensive care units in Japan. Toraymyxin is currently available for use in the clinical setting in 14 countries worldwide. In this study, we reviewed and introduced the development, clinical use, and efficacy of Toraymyxin and commented on its anticoagulant use and cartridge clotting issue in the treatment of severe sepsis and septic shock...
August 31, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28920027/rupture-of-umbilical-hernia-with-evisceration-in-a-newborn-a-case-report
#9
Dinesh H Kittur, Kailas P Bhandarkar, Santosh V Patil, Sudhakar S Jadhav
Most umbilical hernias in infants do not need surgery and the ring will eventually close. Occasionally few complications can arise and incarceration is most common. Spontaneous rupture of the hernia and eventual evisceration is a rarely seen complication. A 3-week-old neonate having umbilical hernia presented with rupture of the sac with evisceration of bowel within a few days of first visit. No underlying cause like umbilical sepsis was found. The baby had emergency repair of the hernia with an uneventful recovery...
July 2017: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/28916371/ramucirumab-plus-docetaxel-versus-placebo-plus-docetaxel-in-patients-with-locally-advanced-or-metastatic-urothelial-carcinoma-after-platinum-based-therapy-range-a-randomised-double-blind-phase-3-trial
#10
Daniel P Petrylak, Ronald de Wit, Kim N Chi, Alexandra Drakaki, Cora N Sternberg, Hiroyuki Nishiyama, Daniel Castellano, Syed Hussain, Aude Fléchon, Aristotelis Bamias, Evan Y Yu, Michiel S van der Heijden, Nobuaki Matsubara, Boris Alekseev, Andrea Necchi, Lajos Géczi, Yen-Chuan Ou, Hasan Senol Coskun, Wen-Pin Su, Miriam Hegemann, Ivor J Percent, Jae-Lyun Lee, Marcello Tucci, Andrey Semenov, Fredrik Laestadius, Avivit Peer, Giampaolo Tortora, Sufia Safina, Xavier Garcia Del Muro, Alejo Rodriguez-Vida, Irfan Cicin, Hakan Harputluoglu, Ryan C Widau, Astra M Liepa, Richard A Walgren, Oday Hamid, Annamaria H Zimmermann, Katherine M Bell-McGuinn, Thomas Powles
BACKGROUND: Few treatments with a distinct mechanism of action are available for patients with platinum-refractory advanced or metastatic urothelial carcinoma. We assessed the efficacy and safety of treatment with docetaxel plus either ramucirumab-a human IgG1 VEGFR-2 antagonist-or placebo in this patient population. METHODS: We did a randomised, double-blind, phase 3 trial in patients with advanced or metastatic urothelial carcinoma who progressed during or after platinum-based chemotherapy...
September 12, 2017: Lancet
https://www.readbyqxmd.com/read/28916127/open-thoracic-and-thoraco-abdominal-aortic-repair-in-patients-with-connective-tissue-disease
#11
Paula R Keschenau, Drosos Kotelis, Jeroen Bisschop, Mohammad E Barbati, Jochen Grommes, Barend Mees, Alexander Gombert, Arnoud G Peppelenbosch, Geert Willem H Schurink, Johannes Kalder, Michael J Jacobs
OBJECTIVE/BACKGROUND: The aim is to present current results of open complex aortic repair in patients with connective tissue disease (CTD). METHODS: This was a retrospective cross-border, single centre study. From February 2000 to April 2016 72 aortic operations were performed on 65 patients with CTD (41 male, median age 41 years [range 19-70 years]). Fifty-six patients (86%) underwent at least one previous aortic repair (71 open, four endovascular), including 33 patients (51%) operated before at the site of the procedure reported here...
September 12, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28916121/controversies-in-corticosteroid-use-for-sepsis
#12
Brit Long, Alex Koyfman
BACKGROUND: Severe sepsis and septic shock are potentially deadly conditions managed in the emergency department (ED). Management centers on source control, fluid resuscitation, broad-spectrum antimicrobials, and vasopressors as needed. The use of corticosteroids is controversial. OBJECTIVE: To evaluate the evidence behind corticosteroid therapy in patients with septic shock. DISCUSSION: Septic shock is associated with severe mortality and morbidity...
September 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28916120/does-early-and-appropriate-antibiotic-administration-improve-mortality-in-emergency-department-patients-with-severe-sepsis-or-septic-shock
#13
Robert Sherwin, Michael E Winters, Gary M Vilke, Gabriel Wardi
BACKGROUND: Severe sepsis and septic shock remain significant public health concerns. Appropriate emergency department management includes early recognition, hemodynamic resuscitation, source control, and prompt antibiotic administration. Current international guidelines strongly recommend administration of early and appropriate antibiotics for patients with severe sepsis and septic shock. Interestingly, a recent Cochrane Review found insufficient evidence to provide a similar recommendation on antibiotic administration...
September 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28914721/sepsis-in-children-global-implications-of-the-world-health-assembly-resolution-on-sepsis
#14
Niranjan Kissoon, Konrad Reinhart, Ron Daniels, Machado Flavia R Machado, Raymond D Schachter, Simon Finfer
BACKGROUND: Sepsis, worldwide the leading cause of death in children, has now been recognized as the global health emergency it is. On May 26, 2017, the World Health Assembly, the decision-making body of the World Health Organization, adopted a resolution proposed by the Global Sepsis Alliance to improve the prevention, diagnosis, and management of sepsis. OBJECTIVE: To discuss the implications of this resolution for children worldwide. CONCLUSIONS: The resolution highlights sepsis as a global threat and urges the 194 United Nations member states to take specific actions and implement appropriate measures to reduce its human and health economic burden...
September 13, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28911341/rapid-detection-of-staphylococcus-aureus-and-related-species-isolated-from-food-environment-cosmetics-a-medical-device-and-clinical-samples-using-the-vitek-ms-microbial-identification-system
#15
Irshad M Sulaiman, Pratik Banerjee, Ying-Hsin Hsieh, Nancy Miranda, Steven Simpson, Khalil Kerdahi
Staphylococcus spp. is considered as one of the most common human-pathogenic bacteria, causing illnesses ranging from nonthreatening skin infections to lethal diseases, including sepsis, pneumonia, bloodstream infections, and food poisoning. The emergence of methicillin-resistant Staphylococcus aureus strains has increased morbidity and mortality and resulted in a major healthcare burden worldwide. Single and multilocus sequence typing have been extensively used in the identification of Staphylococcus species...
September 15, 2017: Journal of AOAC International
https://www.readbyqxmd.com/read/28906388/retrospective-cause-analysis-of-troponin-i-elevation-in-non-cad-patients-special-emphasis-on-sepsis
#16
Chien-Wen Yang, Huijun Li, Lisa Thomas, Manuel Ramos, Po-Hong Liu, Thomas Roe, Ravinder Valadri, Michael C Kiel, Vincent Yi-Fong Su, Qi Shi
BACKGROUND: Troponin I is one of the most commonly tested biochemical markers in the emergency room (ER) and in the hospital setting. Besides coronary artery disease (CAD), demand ischemia with underlying tachycardia, anemia, hypertensive emergency, congestive heart failure, kidney disease, sepsis, and pulmonary embolism have also been reported to cause troponin I elevations. Few reports have excluded patients with CAD, and no study has summarized the proportion of these factors relative to an increased troponin I level...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28906286/serial-daily-organ-failure-assessment-beyond-icu-day-5-does-not-independently-add-precision-to-icu-risk-of-death-prediction
#17
Andre L Holder, Elizabeth Overton, Peter Lyu, Jordan A Kempker, Shamim Nemati, Fereshteh Razmi, Greg S Martin, Timothy G Buchman, David J Murphy
OBJECTIVES: To identify circumstances in which repeated measures of organ failure would improve mortality prediction in ICU patients. DESIGN: Retrospective cohort study, with external validation in a deidentified ICU database. SETTING: Eleven ICUs in three university hospitals within an academic healthcare system in 2014. PATIENTS: Adults (18 yr old or older) who satisfied the following criteria: 1) two of four systemic inflammatory response syndrome criteria plus an ordered blood culture, all within 24 hours of hospital admission; and 2) ICU admission for at least 2 calendar days, within 72 hours of emergency department presentation...
September 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28906115/use-of-the-antimicrobial-peptide-sublancin-with-combined-antibacterial-and-immunomodulatory-activities-to-protect-against-methicillin-resistant-staphylococcus-aureus-infection-in-mice
#18
Shuai Wang, Qingwei Wang, Xiangfang Zeng, Qianhong Ye, Shuo Huang, Haitao Yu, Tianren Yang, Shiyan Qiao
Methicillin-resistant Staphylococcus aureus (MRSA) is the major pathogen causing serious hospital infections worldwide. With the emergence and rapid spread of drug-resistant bacteria, there is extraordinary interest in antimicrobial peptides (AMPs) as promising candidates for the treatment of antibiotic-resistant bacterial infections. Sublancin, a glycosylated AMP produced by Bacillus subtilis 168, has been reported to possess protective activity against bacterial infection. The present study was performed to evaluate the efficacy of sublancin in prevention of MRSA ATCC43300 intraperitoneal infection in mice...
September 14, 2017: Journal of Agricultural and Food Chemistry
https://www.readbyqxmd.com/read/28904006/the-crash-report-emergency-management-dilemmas-facing-acute-physicians-in-patients-with-pulmonary-arterial-hypertension
#19
Laura C Price, Konstantinos Dimopoulos, Philip Marino, Rafael Alonso-Gonzalez, Colm McCabe, Aleksander Kemnpy, Lorna Swan, Maria Boutsikou, Ahmed Al Zahrani, Gerry J Coghlan, Benjamin E Schreiber, Luke S Howard, Rachel Davies, Mark Toshner, Joanna Pepke-Zaba, Alistair C Church, Andrew Peacock, Paul A Corris, James L Lordan, Sean Gaine, Robin Condliffe, David G Kiely, Stephen John Wort
Treatment of acute emergencies in patients with pulmonary arterial hypertension (PAH) can be challenging. In the UK and Ireland, management of adult patients with PAH is centred in eight nationally designated pulmonary hypertension (PH) centres. However, many patients live far from these centres and physicians in local hospitals are often required to manage PAH emergencies. A committee of physicians from nationally designated PH centres identified the 'most common' emergency clinical scenarios encountered in patients with PAH...
September 12, 2017: Thorax
https://www.readbyqxmd.com/read/28895710/-trichosporon-asahii-sepsis-associated-with-urinary-catheter-in-a-pediatric-burn-unit-2-case-reports
#20
Florencia Escarrá, Jimena Lema, Beatriz Caracciolo, Susana Carnovale, Verónica Alvarez, Nidia Tramonti, Fabián Guarracino, M Teresa Rosanova
Trichosporon asahii is a ubiquitous fungus that has been isolated as part of human microbiota. There has been an emergence of this pathogen in recent years, causing superficial and deep seated infections. There are scarce reports of urinary tract infections in pediatric intensive care burn units caused by this agent. We describe the cases of 2 pediatric patients with prolonged hospitalization due to severe burns that had received several antibiotic courses for previous infections. Both presented sepsis secondary to catheter related urinary tract infection by Trichosporon asahii...
October 1, 2017: Archivos Argentinos de Pediatría
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