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https://www.readbyqxmd.com/read/27933652/nonobstructive-diffuse-dilated-bowel-loops-prenatal-diagnosis-fetal-characteristics-and-neonatal-outcomes
#1
Guy Katz, Ben Pode-Shakked, Michal Berkenstadt, Ron Bilik, Sylvie Polak Charcon, Iris Barshack, Reuven Achiron, Yinon Gilboa
OBJECTIVES: The purpose of this study was to describe the characteristics and outcomes of fetuses with a diagnosis of nonobstructive diffuse dilated bowel loops. METHODS: We conducted a retrospective study of all pregnancies with fetal diagnosis of nonobstructive diffuse dilated bowel loops over 14 years in a large tertiary referral center. Fetomaternal and neonatal characteristics and outcomes were assessed. RESULTS: Seven fetuses had sonograms showing diffuse dilated bowel loops; none of them had intestinal obstruction after labor...
December 8, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27932520/myeloid-derived-nf-%C3%AE%C2%BAb-negative-regulation-of-pu-1-and-c-ebp-%C3%AE-driven-pro-inflammatory-cytokine-production-restrains-lps-induced-shock
#2
Simone Vanoni, Yi-Ting Tsai, Amanda Waddell, Lisa Waggoner, Jared Klarquist, Senad Divanovic, Kasper Hoebe, Kris A Steinbrecher, Simon P Hogan
Sepsis is a life-threatening event predominantly caused by Gram-negative bacteria. Bacterial infection causes a pronounced macrophage (MΦ) and dendritic cell activation that leads to excessive pro-inflammatory cytokine IL-1β, IL-6 and TNF-α production (cytokine storm), resulting in endotoxic shock. Previous experimental studies have revealed that inhibiting NF-κB signaling ameliorates disease symptoms; however, the contribution of myeloid p65 in endotoxic shock remains elusive. In this study, we demonstrate increased mortality in mice lacking p65 in the myeloid lineage (p65(Δmye)) compared with wild type mice upon ultra-pure LPS challenge...
December 8, 2016: Innate Immunity
https://www.readbyqxmd.com/read/27932182/recovery-after-critical-illness-polyneuropathy-in-a-patient-with-orthotopic-liver-transplantation-a-case-report
#3
J Watanabe, E Ito, M Hatano, T Tohyama, Y Okada, Y Takada
After liver transplantation, some patients show neuromuscular abnormalities. A 43-year-old man with liver cirrhosis due to hepatitis C virus underwent living-donor liver transplantation. He developed severe neuromuscular dysfunction after sepsis, and acute respiratory distress syndrome. After the inflammatory reaction gradually improved, we observed bilateral weakness of the extremities and foot drop. Electrophysiological studies indicated primary axonal degeneration of peripheral motor and sensory fibers without inflammation...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932161/sofosbuvir-monotherapy-for-asymptomatic-and-noncirrhotic-hepatitis-c-infection-in-a-renal-retransplantation-recipient-a-case-report
#4
G Deng, J Ma, S Shen, Q Li, L Peng, S Meng, J Zhou, J Wu, D Liu
Renal transplant recipients infected with hepatitis C virus (HCV) have a high risk of progressing to cirrhosis, end-stage liver diseases, and hepatocellular carcinoma. It is also considered as an independent risk for graft loss and is correlated with proteinuria, transplant glomerulopathy, HCV-associated glomerulonephritis, and chronic rejection. Previous therapy involving interferon alfa and ribavirin led to treatment complications, including toxicity, anemia, sepsis, and drug-drug interactions with calcineurin inhibitors, as well as reduced tolerability and efficacy...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932159/fulminant-clostridium-perfringens-sepsis-in-kidney-transplant-a-case-report
#5
P Mihaylov, J A Powelson, W C Goggins
BACKGROUND: Infections, particularly urinary tract infections, and cardiovascular accidents are the main causes of morbidity and mortality during the 1st year after kidney transplantation (KT). Bacteria and viruses, such as Escherichia coli, Enteroccoci, and Polyoma BK virus are common in the 1st 6 months, so they are controlled routinely. On the other hand, Clostridium perfringens infection is a rare life-threatening condition, associated with a high mortality rate especially in the transplant population, that is not controlled routinely...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931779/complement-and-sepsis-induced-heart-dysfunction
#6
Fatemeh Fattahi, Peter A Ward
It is well known that cardiac dysfunction develops during sepsis in both humans and in rodents (rats, mice). These defects appear to be reversible, since after "recovery" from sepsis, cardiac dysfunction disappears and the heart returns to its function that was present before the onset of sepsis. Our studies, using in vivo and in vitro models, have demonstrated that C5a and its receptors (C5aR1 and C5aR2) play key roles in cardiac dysfunction developing during sepsis. Use of a neutralizing antibody to C5a largely attenuates cardiac dysfunction and other adverse events developing during sepsis...
December 5, 2016: Molecular Immunology
https://www.readbyqxmd.com/read/27931654/the-response-of-the-microcirculation-to-mechanical-support-of-the-heart-in-critical-illness
#7
REVIEW
Sakir Akin, Atila Kara, Corstiaan A den Uil, Can Ince
Critical illness associated with cardiac pump failure results in reduced tissue perfusion in all organs and occurs in various conditions such as sepsis, cardiogenic shock, and heart failure. Mechanical circulatory support (MCS) devices can be used to maintain organ perfusion in patients with cardiogenic shock and decompensated chronic heart failure. However, correction of global hemodynamic parameters by MCS does not always cause a parallel improvement in microcirculatory perfusion and oxygenation of the organ systems, a condition referred to as a loss of hemodynamic coherence between macro- and microcirculation (MC)...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27931649/hemodynamic-coherence-in-sepsis
#8
REVIEW
Andrea Morelli, Maurizio Passariello
Microvascular alterations are a hallmark of sepsis and play a crucial role in its pathophysiology. Such alterations are the result of overwhelming inflammation, which negatively affects all the components of the microcirculation. As the severity of microvascular alterations is associated with organ dysfunction and mortality, several strategies have been tested for improving microcirculation. Nevertheless, they are mainly based on the conventional manipulation of systemic hemodynamics to increase the total flow to the organs and tissues...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27931645/haemodynamic-coherence%C3%A2-%C3%A2-the-relevance-of-fluid-therapy
#9
REVIEW
Philip Arnemann, Laura Seidel, Christian Ertmer
The ultimate goal of fluid therapy is to improve the oxygenation of cells by improving the cardiac output, thus improving microcirculation by optimizing macrocirculation. This haemodynamic coherence is often altered in patients with haemorrhagic shock and sepsis. The loss of haemodynamic coherence is associated with adverse outcomes. It may be influenced by the mechanisms of the underlying disease and properties of different fluids used for resuscitation in these critically ill patients. Monitoring microcirculation and haemodynamic coherence may be an additional tool to predict the response to fluid administration...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27931643/microvascular-monitoring-do-global-markers-help
#10
REVIEW
Jean-Louis Vincent, Fabio Silvio Taccone
The microcirculation is altered in sepsis, and the degree and persistence of these alterations are associated with outcome. When there are significant alterations of the systemic circulation, as in shock, the microcirculation is always altered. However, sometimes global variables can be restored to normal while the microcirculation remains altered. Monitoring the microcirculation has, therefore, been proposed as a more precise means of assessing the effects of therapy. In this review, we will discuss the limitations of global haemodynamic variables such as mean arterial pressure, cardiac output and mixed venous oxygen saturation as markers of microcirculatory abnormalities...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27931259/abdominal-septic-shock-endotoxin-adsorption-treatment-asset-endotoxin-removal-in-abdominal-and-urogenital-septic-shock-with-the-alteco%C3%A2-lps-adsorber-study-protocol-for-a-double-blinded-randomized-placebo-controlled-trial
#11
Miklos Lipcsey, Jyrki Tenhunen, Jan Sjölin, Robert Frithiof, Stepani Bendel, Hans Flaatten, Rafael Kawati, Anne Kuitunen, Tor Inge Tønnessen, Sten Rubertsson
BACKGROUND: Severe sepsis and septic shock are common in intensive care and carry high mortality rates. In patients with Gram-negative infections, early and extensive removal of endotoxin may limit the inflammatory response that characterizes septic shock. The Alteco® LPS Adsorber (hereafter referred to cited as the lipopolysaccharide (LPS) Adsorber) can be used for endotoxin removal and attenuate the deleterious inflammatory and clinical responses seen in septic shock. METHODS/DESIGN: The Abdominal Septic Shock - Endotoxin Adsorption Treatment (ASSET) trial is a pilot study investigating the feasibility and safety of LPS Adsorber therapy...
December 8, 2016: Trials
https://www.readbyqxmd.com/read/27931193/coagulase-negative-staphylococcal-sepsis-in-neonates-do-we-need-to-adapt-vancomycin-dose-or-target
#12
Helgi Padari, Kersti Oselin, Tõnis Tasa, Tuuli Metsvaht, Krista Lõivukene, Irja Lutsar
BACKGROUND: Despite differences in types of infection and causative organisms, pharmacokinetic-pharmacodynamic (PKPD) targets of vancomycin therapy derived from adult studies are suggested for neonates. We aimed to identify doses needed for the attainment of AUC/MIC > 400 and AUC/MIC > 300 in neonates with sepsis and correlate these targets with recommended doses and treatment outcome. METHODS: Neonates who had Vancomycin therapeutic drug monitoring (TDM) performed between January 1, 2010 and December 31, 2012 were studied...
December 8, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27930814/septic-ketoacidosis-a-potentially-lethal-entity-with-renal-tubular-epithelial-vacuolization
#13
Chong Zhou, Roger W Byard
Fatal ketoacidosis due to diabetes mellitus, alcoholism, and starvation may produce characteristic basal vacuolization of renal tubular epithelial cells (RTEC). Septic ketoacidosis has recently been recognized clinically as a distinct condition in which septicemia can lead to elevation of ketones and various anions unrelated to diabetes mellitus, alcoholism, or caloric deprivation. We report four lethal cases with significantly elevated vitreous ketones secondary to sepsis and/or severe localized infection in individuals with no history of diabetes mellitus, alcoholism, or starvation...
December 8, 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27930596/systemic-inflammatory-response-syndrome-is-more-associated-with-bacteremia-in-elderly-patients-with-suspected-sepsis-in-emergency-departments
#14
Hsien-Ling Chou, Shih-Tsung Han, Chun-Fu Yeh, I-Shaing Tzeng, Tsung-Han Hsieh, Chin-Chieh Wu, Jen-Tse Kuan, Kuan-Fu Chen
Early diagnosis of bacteremia for patients with suspected sepsis is 1 way to improve prognosis of sepsis. Systemic inflammatory response syndrome (SIRS) has long been utilized as a screening tool to detect bacteremia by front-line healthcare providers. The value of SIRS to predict bacteremia in elderly patients (≥65 years) with suspected sepsis has not yet been examined in emergency departments (EDs).We aimed to evaluate the performance of SIRS components in predicting bacteremia among elderly patients in EDs...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27930461/odontogenic-orofacial-infections
#15
Dario Bertossi, Antonio Barone, Antonio Iurlaro, Simone Marconcini, Daniele De Santis, Marco Finotti, Pasquale Procacci
Acute dental abscess is a frequent and sometimes underestimated disease of the oral cavity. The acute dental abscess usually occurs secondary to caries, trauma, or failed endodontic treatment. After the intact pulp chamber is opened, colonization of the root canals takes place with a variable set of anaerobic bacteria, which colonize the walls of the necrotic root canals forming a specialized mixed anaerobic biofilm. Asymptomatic necrosis is common. However, abscess formation occurs when these bacteria and their toxic products breach into the periapical tissues through the apical foramen and induce acute inflammation and pus formation...
December 7, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27929426/serum-soluble-fms-like-tyrosine-kinase-1-sflt-1-predicts-the-severity-of-acute-pancreatitis
#16
Paulina Dumnicka, Mateusz Sporek, Małgorzata Mazur-Laskowska, Piotr Ceranowicz, Marek Kuźniewski, Ryszard Drożdż, Tadeusz Ambroży, Rafał Olszanecki, Beata Kuśnierz-Cabala
Organ failure is the most important determinant of the severity of acute pancreatitis (AP). Soluble fms-like tyrosine kinase 1 (sFlt-1) is positively associated with organ failure in sepsis. Our aim was to evaluate the diagnostic utility of automated sFlt-1 measurements for early prediction of AP severity. Adult patients (66) with AP were recruited, including 46 with mild (MAP), 15 with moderately-severe (MSAP) and 5 with severe AP (SAP). Serum and urine samples were collected twice. Serum sFlt-1 was measured with automated electrochemiluminescence immunoassay...
December 6, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27929277/acute-monoarthritis-diagnosis-in-adults
#17
Jonathan A Becker, Jennifer P Daily, Katherine M Pohlgeers
Acute monoarthritis can be the initial manifestation of many joint disorders. The most common diagnoses in the primary care setting are osteoarthritis, gout, and trauma. It is important to understand the prevalence of specific etiologies and to use the appropriate diagnostic modalities. A delay in diagnosis and treatment, particularly in septic arthritis, can have catastrophic results including sepsis, bacteremia, joint destruction, or death. The history and physical examination can help guide the use of laboratory and imaging studies...
November 15, 2016: American Family Physician
https://www.readbyqxmd.com/read/27927811/improving-multidisciplinary-severe-sepsis-management-using-the-sepsis-six%C3%A2
#18
Amar Bhat, Maryam Asghar, Gagandeep Raulia, Amit Keiran John Mandal
Each year in the UK, it is estimated that more than 100,000 people are admitted to hospital with sepsis and around 37,000 people will die as a result of the condition. We present an audit, re-audit and the implications these have had on the management of severe sepsis using the Sepsis Six, ultimately through actively promoting teamwork to initiate the protocol. This led to a significant improvement in management, decreasing admissions to the intensive care unit (ITU), length of stay in hospital and the number of patient deaths...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927771/propagation-of-thrombosis-by-neutrophils-and-extracellular-nucleosome-networks
#19
Susanne Pfeiler, Konstantin Stark, Steffen Massberg, Bernd Engelmann
Neutrophils, early mediators of innate immune defense, are recruited to developing thrombi in different types of thrombosis. They amplify intravascular coagulation by stimulating the tissue factor-dependent extrinsic pathway via inactivation of endogenous anticoagulants, enhancing factor XII activation or decreasing plasmin generation. Neutrophil-dependent prothrombotic mechanisms are supported by the externalization of decondensed nucleosomes and granule proteins that together form neutrophil extracellular traps...
December 7, 2016: Haematologica
https://www.readbyqxmd.com/read/27927604/factors-predicting-failure-of-noninvasive-ventilation-assist-for-preventing-reintubation-among-medical-critically-ill-patients
#20
Preecha Thomrongpairoj, Surat Tongyoo, Withaya Tragulmongkol, Chairat Permpikul
PURPOSE: Reintubation after failed extubation is associated with high mortality. Noninvasive ventilation (NIV) has been used to prevent reintubation, but the results have been inconclusive. We investigated the factors predicting failure of NIV-assisted extubation among medical critically ill patients. MATERIALS AND METHODS: This retrospective cohort study enrolled patients who were admitted to medical intensive care units at Siriraj Hospital between March 2012 and August 2015 who required more than 48 hours of mechanical ventilation and who received NIV after endotracheal extubation...
November 30, 2016: Journal of Critical Care
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