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https://www.readbyqxmd.com/read/28731485/th17-regulatory-t-cell-imbalance-in-sepsis-patients-with-multiple-organ-dysfunction-syndrome-attenuated-by-high-volume-hemofiltration
#1
Jiguang Guo, Wu Tao, Dan Tang, Jianbin Zhang
BACKGROUND: We assessed the Th17 (T-helper cell)/Treg (Regulatory T cell) imbalance in sepsis patients with multiple organ dysfunction syndrome (MODS) and the clinical benefits of continuous high-volume hemofiltration (HVHF). METHODS: 48 sepsis patients, including 22 patients with MODS (MODS group, n = 22) and 26 without (non-MODS group, n = 26), and 20 healthy volunteer controls were enrolled. The patients in MODS group were randomly divided into the continuous blood purification (CBP) group (n = 11) receiving conventional comprehensive treatment plus high-volume hemofiltration and the non-CBP group (n = 11) receiving conventional comprehensive treatment only...
July 14, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28719839/the-prognostic-value-of-brain-natriuretic-peptide-bnp-in-non-cardiac-patients-with-sepsis-ultra-long-follow-up
#2
Johad Khoury, Majd Arow, Adi Elias, Badira F Makhoul, Gidon Berger, Marielle Kaplan, Tanya Mashiach, Reem Ismael-Badarneh, Doron Aronson, Zaher S Azzam
OBJECTIVES: Sepsis is a multifactorial syndrome with increasing incidence of morbidity and mortality. Identification of outcome predictors is therefore essential. Recently, elevated brain natriuretic peptide (BNP) levels have been observed in patients with septic shock. Little information is available concerning BNP levels in patients with critical illness, especially with sepsis. Therefore, this study aims to evaluate the role of BNP as a biomarker for long-term mortality in patients with sepsis...
July 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28718340/characterization-of-sepsis-and-sepsis-associated-encephalopathy
#3
Qing Feng, Yu-Hang Ai, Hua Gong, Long Wu, Mei-Lin Ai, Song-Yun Deng, Li Huang, Qian-Yi Peng, Li-Na Zhang
BACKGROUND: Sepsis and sepsis-associated encephalopathy (SAE) are common intensive care unit (ICU) diseases; the morbidity and mortality are high. The present study analyzed the sensitivity of different diagnostic criteria of sepsis 1.0 and 3.0, epidemiological characteristics of sepsis and SAE, and explored its risk factors for death, short-term, and long-term prognosis. METHODS: The retrospective study included patients in ICU from January 2015 to June 2016. After excluding 58 patients, 175 were assigned to either an SAE or a non-SAE group (patients with sepsis but no encephalopathy)...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28717075/clinical-characteristics-of-bacteremia-caused-by-extended-spectrum-beta-lactamase-producing-escherichia-coli-at-a-tertiary-hospital
#4
Hiroki Namikawa, Koichi Yamada, Hiroki Fujimoto, Ken-Ichi Oinuma, Yoshihiro Tochino, Yasuhiko Takemoto, Yukihiro Kaneko, Taichi Shuto, Hiroshi Kakeya
Objective In recent years, infection caused by extended-spectrum beta-lactamase (ESBL)-producing organisms has become an important issue. However, comparative studies of the bacteremia caused by ESBL Enterobacteriaceae and non-ESBL Enterobacteriaceae are extremely rare in Japan. This study aimed to assess the risk factors and prognosis of patients with bacteremia due to ESBL Escherichia coli (E. coli). Methods The medical records of 31 patients with ESBL E. coli bacteremia and 98 patients with non-ESBL E. coli bacteremia who had been admitted to Osaka City University Hospital between January 2011 and June 2015 were retrospectively reviewed...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28714876/sustained-low-serum-substance-p-levels-in-non-surviving-septic-patients
#5
Leonardo Lorente, María M Martín, Antonia Pérez-Cejas, José Ferreres, Jordi Solé-Violán, Lorenzo Labarta, César Díaz, Alejandro Jiménez
Previously, researchers found higher serum substance P (SP) concentrations in survivors of severe sepsis than in non-survivors at the time of severe sepsis diagnosis. The objectives of our current study were to determine whether there is an association between serum SP levels during the first week and sepsis mortality, sepsis severity, serum levels of tumor necrosis factor (TNF)-α and interleukin (IL)-10, and whether serum SP levels during the first week could be used as a biomarker of sepsis mortality. We determined serum concentration of SP, TNF-α, and IL-10 at days 1, 4, and 8...
July 15, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28711593/clinical-evaluation-of-sepsis-1-and-sepsis-3-in-the-intensive-care-unit
#6
Xueling Fang, Zhenzhen Wang, Jun Yang, Hongliu Cai, Zhengjie Yao, Kun Li, Qiang Fang
BACKGROUND: There has been considerable controversy between sepsis-1 and sepsis-3 criteria. METHODS: Patients with infection meeting SIRS ≥ 2 criteria (sepsis-1) or a SOFA score ≥ 2 (sepsis-3) on the first day after ICU admission were selected from the MIMIC-III database, and their outcomes were compared using all-cause death as the endpoint. Subgroup analysis was also performed based on prior chronic organ dysfunction. RESULTS: 21,491 infected patients were included...
July 12, 2017: Chest
https://www.readbyqxmd.com/read/28709458/markers-of-nitric-oxide-are-associated-with-sepsis-severity-an-observational-study
#7
Martin Sebastian Winkler, Stefan Kluge, Maximilian Holzmann, Eileen Moritz, Linda Robbe, Antonia Bauer, Corinne Zahrte, Marion Priefler, Edzard Schwedhelm, Rainer H Böger, Alwin E Goetz, Axel Nierhaus, Christian Zoellner
BACKGROUND: Nitric oxide (NO) regulates processes involved in sepsis progression, including vascular function and pathogen defense. Direct NO measurement in patients is unfeasible because of its short half-life. Surrogate markers for NO bioavailability are substrates of NO generating synthase (NOS): L-arginine (lArg) and homoarginine (hArg) together with the inhibitory competitive substrate asymmetric dimethylarginine (ADMA). In immune cells ADMA is cleaved by dimethylarginine-dimethylaminohydrolase-2 (DDAH2)...
July 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28706425/procalcitionin-as-a-diagnostic-marker-to-distinguish-upper-and-lower-gastrointestinal-perforation
#8
Yang Gao, Kai-Jiang Yu, Kai Kang, Hai-Tao Liu, Xing Zhang, Rui Huang, Jing-Dong Qu, Si-Cong Wang, Rui-Jin Liu, Yan-Song Liu, Hong-Liang Wang
AIM: To assess the accuracy of serum procalcitionin (PCT) as a diagnostic marker in verifying upper and lower gastrointestinal perforation (GIP). METHODS: This retrospective study included 46 patients from the surgical intensive care unit (ICU) of the Second Affiliated Hospital of Harbin Medical University who were confirmed to have GIP between June 2013 and December 2016. Demographic and clinical patient data were recorded on admission to ICU. Patients were divided into upper (n = 19) and lower (n = 27) GIP groups according to the perforation site (above or below Treitz ligament)...
June 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28705667/clinical-characteristics-of-bacteraemia-caused-by-burkholderia-cepacia-complex-species-and-antimicrobial-susceptibility-of-the-isolates-in-a-medical-centre-in-taiwan
#9
Ying-Chun Chien, Chun-Hsing Liao, Wang-Huei Sheng, Jung-Yien Chien, Yu-Tsung Huang, Chong-Jen Yu, Po-Ren Hsueh
This study investigated the clinical characteristics and outcomes of bacteraemia due to Burkholderia cepacia complex (BCC) species among 54 patients without cystic fibrosis from January 2013 to February 2015. BCC isolates were identified to the species level by the Bruker Biotyper MALDI-TOF MS system and by sequencing analysis of the 16S rRNA and recA genes. Antimicrobial susceptibilities of the isolates were determined by the agar dilution method. Sequencing of the recA gene in the 54 blood isolates revealed 37 (68...
July 10, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28699088/sepsis-prediction-in-critically-ill-patients-by-platelet-activation-markers-on-icu-admission-a-prospective-pilot-study
#10
Nathalie Layios, Céline Delierneux, Alexandre Hego, Justine Huart, Christian Gosset, Christelle Lecut, Nathalie Maes, Pierre Geurts, Arnaud Joly, Patrizio Lancellotti, Adelin Albert, Pierre Damas, André Gothot, Cécile Oury
BACKGROUND: Platelets have been involved in both immune surveillance and host defense against severe infection. To date, whether platelet phenotype or other hemostasis components could be associated with predisposition to sepsis in critical illness remains unknown. The aim of this work was to identify platelet markers that could predict sepsis occurrence in critically ill injured patients. METHODS: This single-center, prospective, observational, 7-month study was based on a cohort of 99 non-infected adult patients admitted to ICUs for elective cardiac surgery, trauma, acute brain injury, and post-operative prolonged ventilation and followed up during ICU stay...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28698265/risk-factors-for-noninvasive-ventilation-failure-in-critically-ill-subjects-with-confirmed-influenza-infection
#11
Alejandro Rodríguez, Cristina Ferri, Ignacio Martin-Loeches, Emili Díaz, Joan R Masclans, Federico Gordo, Jordi Sole-Violán, María Bodí, Francesc X Avilés-Jurado, Sandra Trefler, Monica Magret, Gerard Moreno, Luis F Reyes, Judith Marin-Corral, Juan C Yebenes, Andres Esteban, Antonio Anzueto, Stefano Aliberti, Marcos I Restrepo
BACKGROUND: Despite wide use of noninvasive ventilation (NIV) in several clinical settings, the beneficial effects of NIV in patients with hypoxemic acute respiratory failure (ARF) due to influenza infection remain controversial. The aim of this study was to identify the profile of patients with risk factors for NIV failure using chi-square automatic interaction detection (CHAID) analysis and to determine whether NIV failure is associated with ICU mortality. METHODS: This work was a secondary analysis from prospective and observational multi-center analysis in critically ill subjects admitted to the ICU with ARF due to influenza infection requiring mechanical ventilation...
July 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28687209/new-sepsis-and-septic-shock-definitions-clinical-implications-and-controversies
#12
REVIEW
Chanu Rhee, Michael Klompas
New sepsis definitions shift emphasis from the systemic inflammatory response syndrome to organ dysfunction, quantified using the Sequential Organ Failure Assessment (SOFA) score. The new definitions also propose Quick SOFA criteria to rapidly identify potentially infected patients at risk for poor outcomes. Diagnosing septic shock requires vasopressor dependence and increased lactate levels. Strengths of these definitions include their simplicity and clear association with adverse outcomes. However, their utility in identifying patients with serious infections before frank sepsis ensues remains to be seen...
July 5, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28682944/a-simplified-mortality-score-using-delta-neutrophil-index-and-the-thrombotic-microangiopathy-score-for-prognostication-in-critically-ill-patients
#13
Eun Kyong Goag, Jong Wook Lee, Yun Ho Roh, Ah Young Leem, Song Yee Kim, Joo Han Song, Eun Young Kim, Ji Ye Jung, Moo Suk Park, Young Sam Kim, Se Kyu Kim, Joon Chang, Kyung Soo Chung
BACKGROUND: This study was conducted to assess the prognostic value of a simplified mortality score (SMS) using the delta neutrophil index (DNI) and thrombotic microangiopathy (TMA) score, both easily obtained from the complete blood count, to identify critically ill patients at high risk of death. METHODS: This was a retrospective study performed in the medical ICU at Yonsei University College of Medicine from June 2015 to February 2016. The primary end-point was 28-day all-cause mortality...
July 4, 2017: Shock
https://www.readbyqxmd.com/read/28678876/survival-predictor-in-patients-with-acute-respiratory-distress-syndrome-and-diffuse-alveolar-damage-undergoing-open-lung-biopsy
#14
Kuo-Chin Kao, Chih-Hao Chang, Chen-Yiu Hung, Li-Chung Chiu, Chung-Chi Huang, Han-Chung Hu
BACKGROUND: Diffuse alveolar damage (DAD) is a typical pathological finding of open lung biopsies in patients with acute respiratory distress syndrome (ARDS). Patients with ARDS and DAD have been reported to have a poorer prognosis than those without DAD. The aim of this study was to investigate the survival predictors in patients with ARDS and DAD. METHODS: We retrospectively reviewed all ARDS patients who underwent an open lung biopsy which showed evidence of DAD from January 2006 to June 2015 at Chang Gung Memorial Hospital...
2017: PloS One
https://www.readbyqxmd.com/read/28678546/mortality-prediction-using-serum-biomarkers-and-various-clinical-risk-scales-in-community-acquired-pneumonia
#15
Min Woo Kim, Jee Yong Lim, Sang Hoon Oh
We evaluated the predictive value of serum biomarkers and various clinical risk scales for the 28-day mortality of community-acquired pneumonia (CAP). Serum biomarkers including procalcitonin (PCT) and C-reactive protein (CRP) were evaluated in the emergency department. Scores for the pneumonia severity index (PSI); CURB65 (confusion, urea, respiration, blood pressure; age >65 years); Infectious Disease Society of America (IDSA) and American Thoracic Society (ATS) guidelines for severe CAP; Acute Physiology, Chronic Health Evaluation (APACHE) II; Sequential Organ Failure Assessment (SOFA); and quick SOFA (qSOFA) were calculated...
July 5, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28674715/urinary-neutrophil-gelatinase-associated-lipocalin-is-an-excellent-predictor-of-mortality-in-intensive-care-unit-patients
#16
Haifa M Algethamy, Fatma I Albeladi
OBJECTIVES: To assess urine neutrophil gelatinase-associated lipocalin (uNGAL) level as a potential predictor of acute kidney injury (AKI), and both intensive care unit (ICU) and in-hospital mortality. METHODS: Patients presenting to our ICU with a systolic blood pressure (SBP) less than 90 mmHg or mean arterial pressure (MAP) less than 65 mmHg, and no prior kidney disease were followed prospectively. Baseline data were collected on patient demographics, admission diagnosis, APACHE II and SOFA scores, SBP, MAP, serum creatinine and cystatin C, and uNGAL...
July 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28673381/biomarkers-of-necrotising-soft-tissue-infections-aspects-of-the-innate-immune-response
#17
Marco Bo Hansen
Necrotising soft tissue infection (NSTI) is a life-threatening and rapidly progressing bacterial infection involving one or more layers of the soft tissue compartments causing necrosis. The amputation and mortality rates remain high despite increased focus on the patients. Timely treatment, including surgical intervention, reduces the risk of severe disability and death. However, the lack of pathognomonic signs impedes early diagnosis and treatment. Moreover, the rarity of the disease makes it difficult to conduct large prospective studies, thus prospective research is almost non-existent in this group of patients...
July 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28673010/rhubarb-vs-glycerin-enema-for-treatment-of-critically-ill-patients-with-intra-abdominal-hypertension
#18
Bing Wan, Hao Zhang, Jiangtao Yin, Haiyan Fu, Yikun Chen, Liping Yang, Dadong Liu, Tangfeng Lv, Yong Song
Rhubarb has been used as an evacuant for thousands of years. However, recent research has indicated that rhubarb inhibits inflammation and protects organ function. In the current study, the use of rhubarb was investigated in patients with intra-abdominal hypertension (IAH). Specifically, its dual role in attenuating lung and bowel injury by catharsis and inhibiting inflammation was evaluated. Patients in the glycerin group (n=56) received 110 ml of glycerin enema by coloclysis once daily for 7 to 9 days. Patients in the rhubarb group (n=56) were treated with a mixture of 0...
July 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28670195/cortisol-response-to-low-dose-1-%C3%A2%C2%B5g-acth-stimulation-for-the-prediction-of-outcome-in-patients-with-systemic-inflammatory-response-syndrome
#19
Jelica Bjekić-Macut, Vojislav Radosavljević, Zoran Andrić, Dušan Ilić, Olivera Stanojlović, Danijela Vojnović Milutinović, Ivana Božić Antić, Marija Zdravković, Saša Hinić, Djuro Macut, Miloš Žarković
BACKGROUND: Systemic inflammatory response syndrome (SIRS) changes cortisol dynamics and indicates dissociation between the adrenal cortex and the hypothalamo-pituitary unit. The aim of this study was to assess the cortisol response after stimulation with ACTH1-24 in patients with SIRS at admission to the Respiratory Intensive Care Unit (RICU) and seven days later. METHODS: Fifty-four subjects were included in the study, and SIRS was defined according to the Consensus Conference criteria from 1992...
October 2016: Journal of Medical Biochemistry
https://www.readbyqxmd.com/read/28669830/drivers-and-impact-of-antifungal-therapy-in-critically-ill-patients-with-aspergillus-positive-respiratory-tract-cultures
#20
J A Paiva, P Mergulhão, A Gomes, F S Taccone, A-M Van den Abeele, P Bulpa, B Misset, W Meersseman, G Dimopoulos, J Rello, D Vogelaers, S Blot
BACKGROUND: Invasive pulmonary aspergillosis (IPA) is an increasingly recognized problem in critically ill patients. Little is known about how intensivists react to a Aspergillus-positive respiratory sample and about the efficacy of antifungals. Our goal was to identify drivers of antifungal therapy (AFT) prescription and diagnostic workup in patients with Aspergillus isolation in respiratory specimens as well as the impact of AFT in these patients. METHODS: ICU patients with a Aspergillus-positive respiratory sample from the database of a previous observational multicenter study were analysed...
June 29, 2017: International Journal of Antimicrobial Agents
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