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Obesity and sepsis

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https://www.readbyqxmd.com/read/27909996/modelling-the-cost-effectiveness-of-human-milk-and-breastfeeding-in-preterm-infants-in-the-united-kingdom
#1
James Mahon, Lindsay Claxton, Hannah Wood
OBJECTIVES: To estimate the cost savings and health benefits in the UK NHS that could be achieved if human milk usage in the NICU was increased. METHODS: A systematic review established the disease areas with the strong sources of evidence of the short, medium and long-term benefits of human milk for preterm infants as opposed to the use of formula milk. The analysis assessed the economic impact of reducing rates of necrotising enterocolitis, sepsis, sudden infant death syndrome, leukaemia, otitis media, obesity and neurodevelopmental impairment...
December 2016: Health Economics Review
https://www.readbyqxmd.com/read/27908330/sepsis-in-special-populations
#2
REVIEW
Matthew P Borloz, Khalief E Hamden
Sepsis is recognized by the presence of physiologic and laboratory changes that reflect the inflammatory response to infection on cellular and systemic levels. Comorbid conditions, such as cirrhosis, end-stage renal disease, and obesity, alter patients' susceptibility to infection and their response to it once present. Baseline changes in vital signs and chronic medications often mask clues to the severity of illness. The physiologic, hematologic, and biochemical adjustments that accompany pregnancy and the puerperium introduce similar challenges...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27897405/premorbid-obesity-but-not-nutrition-prevents-critical-illness-induced-muscle-wasting-and-weakness
#3
Chloë Goossens, Mirna Bastos Marques, Sarah Derde, Sarah Vander Perre, Thomas Dufour, Steven E Thiessen, Fabian Güiza, Thomas Janssens, Greet Hermans, Ilse Vanhorebeek, Katrien De Bock, Greet Van den Berghe, Lies Langouche
BACKGROUND: The 'obesity paradox' of critical illness refers to better survival with a higher body mass index. We hypothesized that fat mobilized from excess adipose tissue during critical illness provides energy more efficiently than exogenous macronutrients and could prevent lean tissue wasting. METHODS: In lean and premorbidly obese mice, the effect of 5 days of sepsis-induced critical illness on body weight and composition, muscle wasting, and weakness was assessed, each with fasting and parenteral feeding...
July 20, 2016: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/27878212/obesity-paradox-obesity-orthodox-and-the-metabolic-syndrome-an-approach-to-unity
#4
Jesse Roth, Navneet Sahota, Priya Patel, Syed Faizan Mehdi, Mohammad Masum Wiese, Hafiz B Mahboob, Michelle Bravo, Daniel J Eden, Muhammad A Bashir, Amrat Kumar, Farah Alsaati, Irwin J Kurland, Wunnie Brima, Ann Danoff, Alessandra L Szulc, Valentin A Pavlov, Kevin J Tracey, Huan Yang
Obesity and the accompanying metabolic syndrome are strongly associated with heightened morbidity and mortality in older adults. In our review of more than 20 epidemiologic studies of major infectious diseases, including leaders such as tuberculosis, community-acquired pneumonia, and sepsis, obesity was associated with better outcomes. A cause-and-effect relationship between over-nutrition and survival with infection is suggested by results of two preliminary studies of infections in mice, where high fat feeding for 8-10 weeks provided much better outcomes...
November 16, 2016: Molecular Medicine
https://www.readbyqxmd.com/read/27851006/1370-volume-administration-and-outcomes-in-obese-patients-with-sepsis-in-the-era-of-protocolized-care
#5
Brice Taylor, Edwin Gunn, Megan Templin, Colleen Karvestski, Stephanie Taylor
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850993/1357-the-effect-of-obesity-on-mortality-in-trauma-patients-with-sepsis
#6
Michael Walsh, Brandon Hobbs, Amanda Giancarelli, Indermeet Bhullar
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27822672/obesity-acute-kidney-injury-and-outcome-of-critical-illness
#7
REVIEW
Helmut Schiffl, Susanne M Lang
Acute kidney injury is a heterogeneous clinical syndrome encompassing a spectrum of risk factors and acute insults, occurring in multiple settings and affecting both short-term and long-term outcomes. Obesity has become an epidemic. The available literature suggests that AKI is common in critically ill surgical or medical obese patients and that obesity is a novel risk factor for this acute renal syndrome. The pathophysiology of obesity-associated AKI is not completely understood. Obesity-related factors combined with the burden of other comorbidities in elderly obese patients may interact with known precipitating factors such as hypotension, nephrotoxins or sepsis and increase the susceptibility of this population to AKI...
November 7, 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/27812378/the-clinical-characteristics-and-hospital-and-post-hospital-survival-of-patients-with-the-obesity-hypoventilation-syndrome-analysis-of-a-large-cohort
#8
P E Marik, C Chen
OBJECTIVE: The worldwide prevalence of obesity has reached epidemic proportions. Obesity hypoventilation syndrome (OHS) is a common yet largely undiagnosed and mistreated condition that likely carries a high mortality. The aim of this study was to determine the clinical characteristics, hospital outcome, outcome following hospital discharge and predictors of death in a large cohort of patients hospitalized with OHS. OHS is an important condition as many patients with this syndrome are misdiagnosed and receive inappropriate treatment...
March 2016: Obesity Science & Practice
https://www.readbyqxmd.com/read/27789087/adipose-tissue-at-the-nexus-of-systemic-and-cellular-immunometabolism
#9
REVIEW
Ayano C Kohlgruber, Nelson M LaMarche, Lydia Lynch
At the simplest interpretation of the word, Immunometabolism describes the intersection of the fields of immunology and metabolism. With rapidly growing interest in this field, the term has expanded, and now encompasses a variety of concepts and definitions shaped by an individual's scientific area of expertise, cell-type and tissue of interest, and biological approach. One scientist may be interested in investigating the intrinsic metabolic checkpoints that drive a M1 versus M2 macrophage response, while another may be interested in how macrophages affect systemic metabolism during obesity...
October 24, 2016: Seminars in Immunology
https://www.readbyqxmd.com/read/27785087/adiponectin-treatment-attenuates-inflammatory-response-during-early-sepsis-in-obese-mice
#10
XianFeng Wang, Nancy L Buechler, Barbara K Yoza, Charles E McCall, Vidula Vachharajani
BACKGROUND: Morbid obesity increases the cost of care in critically ill patients. Sepsis is the leading cause of death in noncoronary intensive care units. Circulating cell-endothelial cell interactions in microcirculation are the rate-determining factors in any inflammation; obesity increases these interactions further. Adiponectin deficiency is implicated in increased cardiovascular risk in obese patients. We have shown that adiponectin deficiency increases microvascular dysfunction in early sepsis...
2016: Journal of Inflammation Research
https://www.readbyqxmd.com/read/27777948/the-role-of-obesity-in-sepsis-outcome-among-critically-ill-patients-a-retrospective-cohort-analysis
#11
Matthaios Papadimitriou-Olivgeris, Diamanto Aretha, Anastasia Zotou, Kyriaki Koutsileou, Aikaterini Zbouki, Aikaterini Lefkaditi, Christina Sklavou, Markos Marangos, Fotini Fligou
Background. The objective of this study was to assess the correlation between sepsis, obesity, and mortality of patients admitted to an Intensive Care Unit (ICU). Subjects and Methods. Data of all patients admitted to the ICU of a tertiary hospital during a 28-month period were retrospectively analyzed and included in the study. Results. Of 834 patients included, 163 (19.5%) were obese, while 25 (3.0%) were morbidly obese. Number of comorbidities (P < 0.001), bloodstream infection (P  0.033), and carbapenemase-producing Klebsiella pneumoniae colonization during ICU stay (P  0...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27755069/unraveling-the-mysterious-relationship-between-obesity-and-outcomes-in-patients-with-sepsis
#12
Richard H Savel, Ronald J Simon, Yizhak Kupfer
No abstract text is available yet for this article.
November 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27706879/acute-kidney-injury-post-major-orthopaedic-surgery-a-single-centre-case-control-study
#13
Tracey Ying, Samantha Chan, Stephen Lane, Christine Somerville
AIM: To identify risk factors for acute kidney injury following major orthopaedic surgery. METHODS: We included all patients undergoing major orthopaedic surgery at University Hospital Geelong between 2008 and 2014 in the study. Out of 2188 surgeries audited, we identified cases of acute kidney injury using the RIFLE criteria and matched those to controls 2:1 for age, sex, procedure and chronic kidney disease stage. We reviewed their records for risk factors of postoperative acute kidney injury, including medications such as gentamicin, diuretics, non-steroidal anti-inflammatory drugs and angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use...
October 5, 2016: Nephrology
https://www.readbyqxmd.com/read/27648697/interleukin-18-reduces-blood-glucose-and-modulates-plasma-corticosterone-in-a-septic-mouse-model
#14
Hayato Yamashita, Michiko Ishikawa, Taketo Inoue, Makoto Usami, Yu Usami, Joji Kotani
BACKGROUND: Dysregulation of glucose metabolism, including hyperglycemia with insulin resistance, is commonly observed in critically ill patients. Interleukin-18 (IL-18) improves the insulin resistance associated with obesity, but the relationship between IL-18 and glucose metabolism in sepsis was unclear. The purpose of this study was to investigate the influence of IL-18 on hyperglycemia during sepsis. METHODS: Sepsis was induced using cecal ligation and puncture (CLP) in wild type (WT) mice, IL-18 knockout (KO) mice, and IL-18 KO mice pretreated with recombinant IL-18...
September 19, 2016: Shock
https://www.readbyqxmd.com/read/27645696/obesity-exacerbates-sepsis-induced-oxidative-damage-in-organs
#15
Fabricia Petronilho, Amanda Della Giustina, Diego Zapelini Nascimento, Graciela Freitas Zarbato, Andriele Aparecida Vieira, Drielly Florentino, Lucinéia Gainski Danielski, Mariana Pereira Goldim, Gislaine Tezza Rezin, Tatiana Barichello
Sepsis progression is linked to the imbalance between reactive oxygen species and antioxidant enzymes. Sepsis affects multiple organs, but when associated with a chronic inflammatory disease, such as obesity, it may be exacerbated. We hypothesized that obesity could aggravate the oxidative damage to peripheral organs of rats submitted to an animal model of sepsis. Male Wistar rats aged 8 weeks received hypercaloric nutrition for 2 months to induce obesity. Sepsis was induced by cecal ligation and puncture (CLP) procedure, and sham-operated rats were considered as control group...
December 2016: Inflammation
https://www.readbyqxmd.com/read/27621111/relevance-of-serum-sclerostin-concentrations-in-critically-ill-patients
#16
Alexander Koch, Ralf Weiskirchen, Sebastian Ludwig, Lukas Buendgens, Jan Bruensing, Eray Yagmur, Christer Baeck, Ulf Herbers, Christian Trautwein, Frank Tacke
PURPOSE: Sclerostin is a negative regulator of bone metabolism and associated with chronic morbidities. We investigated circulating sclerostin in critically ill patients. METHODS: A total of 264 patients (170 with sepsis) were studied prospectively upon admission to the medical intensive care unit (ICU) and on day 7. Patients' survival was followed for up to 3 years. RESULTS: Sclerostin serum levels were significantly elevated in critically ill patients at ICU admission compared with 99 healthy controls...
August 22, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27601939/circulating-adipokine-levels-and-prognostic-value-in-septic-patients
#17
Andreas Hillenbrand, Pengfei Xu, Shaoxia Zhou, Annette Blatz, Manfred Weiss, Sebastian Hafner, Doris Henne-Bruns, Uwe Knippschild
BACKGROUND: Adipokines have a wide range of effects and are linked to sepsis and septic shock. The aim of the present study was to describe the changes in adipokine levels in septic patients in relation to patients' preseptic adipokine levels. Furthermore, we examined adipokines as prognostic markers. METHODS: Fourteen consecutive critically ill patients meeting the clinical criteria for severe sepsis or septic shock 3 days up to 1 month after major visceral surgery were enrolled prospectively...
2016: Journal of Inflammation
https://www.readbyqxmd.com/read/27540247/application-of-pharmaceutical-knowledge-to-the-unconventional-use-of-a-rarely-used-anaesthetic-agent
#18
Caroline Cole
CASE SUMMARY: A 6 yr old 45 kg child with severe Cushinoid features was admitted to PICU with probable hypertensive encephalopathy. She presented with increasing headaches, vomiting and seizures becoming unresponsive with a GCS of 3. She was profoundly hypertensive and her cortisol levels were significantly elevated (>2000 nmol/L). Rapid reduction in cortisol levels was required to stabilise her condition prior to surgery. Etomidate is the only readily available intravenous preparation which reliably suppresses adrenocortical function...
September 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27513541/increased-ratio-of-visceral-to-subcutaneous-adipose-tissue-in-septic-patients-is-associated-with-adverse-outcome
#19
Chawika Pisitsak, Joseph G H Lee, John H Boyd, Harvey O Coxson, James A Russell, Keith R Walley
OBJECTIVES: Visceral and subcutaneous adipose tissue may contribute differentially to the septic inflammatory response. Accordingly, we tested the hypothesis that the ratio of visceral to subcutaneous adipose tissue is associated with altered sepsis outcome. DESIGN: A retrospective analysis from a cohort of sepsis patients admitted between 2004 and 2009. SETTING: A mixed medical-surgical ICU at St. Paul's Hospital in Vancouver, Canada. PATIENTS: Patients older than 16 years old who had sepsis and underwent abdominal CT scan (n = 257) for clinical reasons...
November 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27505113/a-national-database-analysis-comparing-the-nationwide-inpatient-sample-and-american-college-of-surgeons-national-surgical-quality-improvement-program-in-laparoscopic-vs-open-colectomies-inherent-variance-may-impact-outcomes
#20
Andrew T Schlussel, Conor P Delaney, Justin A Maykel, Michael B Lustik, Madhuri Nishtala, Scott R Steele
BACKGROUND: Clinical and administrative databases each have fundamental distinctions and inherent limitations that may impact results. OBJECTIVE: This study aimed to compare the American College of Surgeons National Surgical Quality Improvement Program and the Nationwide Inpatient Sample, focusing on the similarities, differences, and limitations of both data sets. DESIGN: All elective open and laparoscopic segmental colectomies from American College of Surgeons National Surgical Quality Improvement Program (2006-2013) and Nationwide Inpatient Sample (2006-2012) were reviewed...
September 2016: Diseases of the Colon and Rectum
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