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https://www.readbyqxmd.com/read/28812000/diagnostic-imaging-features-of-necrotizing-enterocolitis-a-narrative-review
#1
REVIEW
Francesco Esposito, Rosanna Mamone, Marco Di Serafino, Carmela Mercogliano, Valerio Vitale, Gianfranco Vallone, Patrizia Oresta
Necrotizing enterocolitis (NEC) is an inflammatory process, characterized by intestinal necrosis of variable extension, leading to perforation, generalized peritonitis and death. The classical pathogenetic theory focuses on mucosal damage related to a stress induced intestinal ischemia leading to mucosal injury and bacterial colonization of the wall. A more recent hypothesis emphasizes the role of immaturity of gastrointestinal and immune system, particularly of the premature, responsible of bowel wall vulnerability and suffering...
June 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28811951/granulomatosis-with-polyangiitis-presenting-as-pyrexia-of-unknown-origin-leukocytosis-and-microangiopathic-haemolytic-anemia
#2
Sima Terebelo, Iona Chen
A 66-year-old woman presented to the Emergency Department with a florid sepsis-like picture, a two-week history of fever, relative hypotension with end organ ischemia (unexplained liver enzyme and troponin elevations), and nonspecific constitutional symptoms. She was initially found to have a urinary tract infection but, despite appropriate treatment, her fever persisted and her white blood cell count continued to rise. During her hospitalization the patient manifested leukocytosis to 47,000 WBC/μL, ESR 67 mm/hr (normal range 0-42 mm/hr), CRP 17...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28809619/the-effect-of-hiv-status-on-clinical-outcomes-of-surgical-sepsis-in-kwazulu-natal-province-south-africa
#3
Samantha Green, Victor Y Kong, Jocinta Odendaal, Benn Sartorius, Damian L Clarke, Petra Brysiewicz, Jereme L Bruce, Grant L Laing, Wanda Bekker
BACKGROUND: KwaZulu-Natal Province, South Africa (SA), has long been the epicentre of the HIV epidemic, but the impact of HIV co-infection on the clinical outcomes of emergency surgical patients with sepsis remains largely unknown. OBJECTIVE: To review our experience with the management of patients with HIV co-infection and to compare the disease spectrum and outcome with those without HIV infection. METHODS: A retrospective study was undertaken at the Pietermaritzburg Metropolitan Surgical Service (PMSS), SA over a 5-year period from January 2010 to December 2014...
July 28, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28806451/epidemiology-of-sepsis-among-adolescents-at-community-hospital-emergency-departments-implications-for-rory-s-regulations
#4
Idris V R Evans, R Scott Watson, Joseph Carcillo, Derek C Angus, Christopher W Seymour
No abstract text is available yet for this article.
August 14, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28802807/acute-phase-response-in-babesia-canis-and-dirofilaria-immitis-co-infections-in-dogs
#5
Zorana Milanović, Anja Ilić, Jelena Francuski Andrić, Vladimir Radonjić, Anđelo Beletić, Milica Kovačević Filipović
Babesia canis and Dirofilaria immitis are emerging and geographically overlapping vector-borne pathogens in dogs. Infection with B. canis leads to acute-phase response (APR) that can be mild to severe and results in either non-complicated or complicated forms of the disease. The aim of this study was to determine whether acute B. canis infection is more severe in dogs with underlying asymptomatic D. immitis infection. Dogs of both sexes, different ages and breeds, with naturally occurring mono-infections with B...
August 2, 2017: Ticks and Tick-borne Diseases
https://www.readbyqxmd.com/read/28800866/five-year-trends-of-critical-care-practice-and-outcomes
#6
Craig M Lilly, Sunil Swami, Xinggang Liu, Richard R Riker, Omar Badawi
BACKGROUND: Longitudinal analyses of large detailed adult critical care datasets provide insights into practice trends and generate useful outcome and process benchmarks. METHODS: Data representing 991,571 consecutive critical care visits to160 United States adult ICUs during 2009 to 2013 from the eICU Research Institute clinical practice database were used to quantitate patient characteristics, APACHE IV based acuity predictions, treatments, and outcomes. Analyses for changes over time were performed for patient characteristics, entry and discharge locations, primary admission diagnosis, treatments, adherence to consensus ICU best practices, length of stay (LOS), and inpatient mortality...
August 8, 2017: Chest
https://www.readbyqxmd.com/read/28799580/risk-prediction-of-acute-kidney-injury-by-timp-2-%C3%A2-igfbp7
#7
M Kimmel, M Schanz, M D Alscher
Acute kidney injury (AKI) is a common syndrome with increased mortality, a heavy burden of illness and high cost. The Kidney Disease Improving Global Outcomes (KDIGO) criteria for staging of AKI have been validated in large patient cohorts and classify AKI into three stages. In order to achieve prevention or early therapy, the focus of scientific interest is early detection and risk prediction of AKI. The combination of the two cell cycle arrest markers [TIMP-2]·[IGFBP7] in the urine shows good results in the risk prediction of AKI in different clinical settings (intensive care medicine, sepsis, cardiac surgery, emergency department)...
June 2017: Drugs of Today
https://www.readbyqxmd.com/read/28798922/practical-approach-to-the-patient-with-acute-neuromuscular-weakness
#8
REVIEW
Rajeev Nayak
Acute neuromuscular paralysis (ANMP) is a clinical syndrome characterized by rapid onset muscle weakness progressing to maximum severity within several days to weeks (less than 4 wk). Bulbar and respiratory muscle weakness may or may not be present. It is a common neurological emergency which requires immediate and careful investigations to determine the etiology because accurate diagnosis has significant impact on therapy and prognosis. Respiratory failure caused by neuromuscular weakness is considered as more critical than lung disease because its development may be insidious or subtle until sudden decompensation leads to life threatening hypoxia...
July 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28796735/is-the-failure-of-laparoscopic-peritoneal-lavage-predictable-in-hinchey-iii-diverticulitis-management
#9
Tristan Greilsamer, Emeric Abet, Guillaume Meurette, Michel Comy, Antoine Hamy, Paul-Antoine Lehur, Aurélien Venara, Emilie Duchalais
BACKGROUND: Laparoscopic peritoneal lavage is an alternative to sigmoid resection in Hinchey III diverticulitis (generalized purulent peritonitis). The main limitation of laparoscopic peritoneal lavage is the higher rate of reoperation for persistent sepsis in comparison with sigmoid resection. OBJECTIVE: The purpose of the current study was to identify risk factors for laparoscopic peritoneal lavage failure in patients who have Hinchey III diverticulitis. DESIGN: This was a retrospective multicenter study...
September 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28795679/-research-progress-of-presepsin-in-sepsis-diagnosis
#10
Hui Yu, Yuanlin Zeng, Congyang Zhou
Sepsis is a frequently met syndrome with complex clinical symptoms and high mortality in emergency department. Early diagnosis of sepsis and timely treatment can improve survival. In recent years, the application of biomarkers [such as procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6)] are commonly used in the early diagnosis of sepsis, but their specificity and sensitivity are limited because of the long lag of report time. Soluble leukocyte differentiation antigen 14 sub type (sCD14-ST, namely presepsin) is a kind of novel biomarkers...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28795662/-evaluation-value-of-the-levels-of-peripheral-blood-cd20-cd24-hi-cd38-hi-regulatory-b-cells-on-the-prognosis-of-elderly-patients-with-sepsis
#11
Chunmei Wang, Lunxian Tang, Huihui Xu, Xiaoming Zhang, Jianwen Bai
OBJECTIVE: To explore the predicting value of peripheral blood CD20(+) CD24(hi) CD38(hi) regulatory B cells (Bregs) on the prognosis of elderly patients with sepsis. METHODS: A prospective study was conducted. Septic patients aged > 65 years old, compliance with diagnostic criteria for Sepsis-3, admitted to emergency and emergency intensive care unit (ICU) of Shanghai East Hospital of Tongji University from April 2016 to February 2017 were enrolled. Procalcitonin (PCT), C-reaction protein (CRP) and lactate (Lac) were routinely measured...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28795214/derivation-validation-and-application-of-a-pragmatic-risk-prediction-index-for-benchmarking-of-surgical-outcomes
#12
Richard T Spence, David C Chang, Haytham M A Kaafarani, Eugenio Panieri, Geoffrey A Anderson, Matthew M Hutter
BACKGROUND: Despite the existence of multiple validated risk assessment and quality benchmarking tools in surgery, their utility outside of high-income countries is limited. We sought to derive, validate and apply a scoring system that is both (1) feasible, and (2) reliably predicts mortality in a middle-income country (MIC) context. METHODS: A 5-step methodology was used: (1) development of a de novo surgical outcomes database modeled around the American College of Surgeons' National Surgical Quality Improvement Program (ACS-NSQIP) in South Africa (SA dataset), (2) use of the resultant data to identify all predictors of in-hospital death with more than 90% capture indicating feasibility of collection, (3) use these predictors to derive and validate an integer-based score that reliably predicts in-hospital death in the 2012 ACS-NSQIP, (4) apply the score in the original SA dataset and demonstrate its performance, (5) identify threshold cutoffs of the score to prompt action and drive quality improvement...
August 9, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28794881/procalcitonin-a-promising-diagnostic-marker-for-sepsis-and-antibiotic-therapy
#13
REVIEW
Ashitha L Vijayan, Vanimaya, Shilpa Ravindran, R Saikant, S Lakshmi, R Kartik, Manoj G
BACKGROUND: Sepsis is a global healthcare problem, characterized by whole body inflammation in response to microbial infection, which leads to organ dysfunction. It is becoming a frequent complication in hospitalized patients. Early and differential diagnosis of sepsis is needed critically to avoid unnecessary usage of antimicrobial agents and for proper antibiotic treatments through the screening of biomarkers that sustains with diagnostic significance. MAIN BODY OF ABSTRACT: Current targeting conventional markers (C-reactive protein, white blood cell, tumour necrosis factor-α, interleukins, etc...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28792331/-remember-that-change-is-okay
#14
(no author information available yet)
Drew McDonald qualified as a children's nurse in 2005 from Robert Gordon University in Aberdeen. After working in neonatal care and on a medical ward at Royal Aberdeen Children's Hospital he moved to the emergency department, where he has worked for the past ten years. In May, he won the child health award at the 2017 RCNi Nurse Awards for developing a tool for identifying sepsis in children.
August 9, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28792256/triage-of-septic-patients-using-qsofa-criteria-at-the-samu-regulation-a-retrospective-analysis
#15
R Jouffroy, A Saade, A Carpentier, S Ellouze, P Philippe, R Idialisoa, P Carli, B Vivien
PURPOSE: One of the major prognostic factors in the management of sepsis is the early initiation of appropriate treatment. To serve this purpose, early identification and triage of patients are crucial steps, which are still not optimal. The objective of this study was to determine whether the quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) score is an accurate method for prehospital triaging of septic patients. We evaluated whether the use of qSOFA criteria collected by the Service Mobile d'Urgence et de Réanimation 15 (SAMU 15) regulation call center during prehospital care would facilitate appropriate intensive care unit (ICU) admission of patients with septic syndromes...
August 9, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28791329/clinical-impact-of-eus-treatment-of-walled-off-pancreatic-necrosis-with-dedicated-devices
#16
Ilaria Tarantino, Dario Ligresti, Fabio Tuzzolino, Luca Barresi, Gabriele Curcio, Antonino Granata, Mario Traina
BACKGROUND AND STUDY AIMS:  Walled-off pancreatic necrosis (WOPN) represents the major risk factor for sepsis-related multiple organ failure. Surgical debridement is an invasive approach associated with high rates of adverse events (AEs) and death. As an alternative, endoscopic ultrasound-guided cysto-gastro-anastomosis has emerged as an effective treatment for WOPNs. Recently a new dedicated-lumen apposing metal stent (LAMS) has been used with satisfactory results in treating peri-pancreatic fluid collections, including WOPNs...
August 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28789803/preliminary-performance-on-the-new-cms-sepsis-1-national-quality-measure-early-insights-from-the-emergency-quality-network-e-qual
#17
Arjun K Venkatesh, Todd Slesinger, Jessica Whittle, Tiffany Osborn, Emily Aaronson, Craig Rothenberg, Nalani Tarrant, Pawan Goyal, Donald M Yealy, Jeremiah D Schuur
STUDY OBJECTIVE: We describe current hospital-level performance for the Centers for Medicare & Medicaid Services' Severe Sepsis/Septic Shock Early Management Bundle (SEP-1) quality measure and qualitatively assess emergency department (ED) sepsis quality improvement best practice implementation. METHODS: Using a standardized Web-based submission portal, we surveyed quality improvement data from volunteer hospital-based EDs participating in the Emergency Quality Network Sepsis Initiative...
August 5, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28781769/unraveling-neisseria-meningitidis-pathogenesis-from-functional-genomics-to-experimental-models
#18
REVIEW
Marco Soriani
Neisseria meningitidis is a harmless commensal bacterium finely adapted to humans. Unfortunately, under "privileged" conditions, it adopts a "devious" lifestyle leading to uncontrolled behavior characterized by the unleashing of molecular weapons causing potentially lethal disease such as sepsis and acute meningitis. Indeed, despite the lack of a classic repertoire of virulence genes in N. meningitidis separating commensal from invasive strains, molecular epidemiology and functional genomics studies suggest that carriage and invasive strains belong to genetically distinct populations characterized by an exclusive pathogenic potential...
2017: F1000Research
https://www.readbyqxmd.com/read/28772171/factors-associated-with-an-increased-risk-of-perioperative-cardiac-arrest-in-emergent-and-elective-craniotomy-and-spine-surgery
#19
Timothy D Quinn, Ethan Y Brovman, Linda S Aglio, Richard D Urman
OBJECTIVE: Cardiac arrest following neurosurgery is a devastating complication associated with significant postoperative morbidity and mortality. There are no published studies that have used a large and robust multicenter database to specifically examine demographic and surgical risk factors associated with cardiac arrests following craniotomy and spine surgeries, respectively. PATIENTS AND METHODS: We retrospectively analyzed data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for the period between January 1, 2007 and December 31, 2013, focusing on cardiac arrest associated with craniotomy and spine surgery from the intraoperative period to 30days after surgery...
July 25, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28771567/muscle-oxygenation-as-an-indicator-of-shock-severity-in-patients-with-suspected-severe-sepsis-or-septic-shock
#20
Kenneth A Schenkman, David J Carlbom, Eileen M Bulger, Wayne A Ciesielski, Dana M Fisk, Kellie L Sheehan, Karin M Asplund, Jeremy M Shaver, Lorilee S L Arakaki
PURPOSE: The aim of this pilot study was to evaluate the potential of a new noninvasive optical measurement of muscle oxygenation (MOx) to identify shock severity in patients with suspected sepsis. METHODS: We enrolled 51 adult patients in the emergency department (ED) who presented with possible sepsis using traditional Systematic Inflammatory Response Syndrome criteria or who triggered a "Code Sepsis." Noninvasive MOx measurements were made from the first dorsal interosseous muscles of the hand once potential sepsis/septic shock was identified, as soon as possible after admission to the ED...
2017: PloS One
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