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Fluid sepsis

L Gui, S Loukas, F Lazeyras, P S Hüppi, D E Meskaldji, C Borradori Tolsa
Premature birth has been associated with poor neurodevelopmental outcomes. However, the relation between such outcomes and brain growth in the neonatal period has not yet been fully elucidated. This study investigates longitudinal brain development between birth and term-equivalent age (TEA) by quantitative imaging in a cohort of premature infants born between 26 and 36 weeks gestational age (GA), to provide insight into the relation of brain growth with later neurodevelopmental outcomes. Longitudinal T2-weighted magnetic resonance images (MRI) of 84 prematurely born infants acquired shortly after birth and TEA were automatically segmented into cortical gray matter (CGM), unmyelinated white matter (UWM), subcortical gray matter (SGM), cerebellum (CB) and cerebrospinal fluid (CSF)...
June 13, 2018: NeuroImage
Pelle Ohlsson, Klara Petersson, Per Augustsson, Thomas Laurell
Sepsis is a common and often deadly systemic response to an infection, usually caused by bacteria. The gold standard for finding the causing pathogen in a blood sample is blood culture, which may take hours to days. Shortening the time to diagnosis would significantly reduce mortality. To replace the time-consuming blood culture we are developing a method to directly separate bacteria from red and white blood cells to enable faster bacteria identification. The blood cells are moved from the sample flow into a parallel stream using acoustophoresis...
June 14, 2018: Scientific Reports
Kevin M Rice, Venkata Vinay Kumar Bandarupalli, Nandini D P K Manne, Eric R Blough
Sepsis is a serious life threatening medical emergency which, if not treated properly, oftentimes results in organ failure and death. Current sepsis treatment protocols are largely centered on the use of antibiotics and supportive care. Recent studies have suggested that antibiotics fail to be effective for sepsis treatment when administered during hypo-dynamic phase of sepsis that is usually characterized by the presence of a cytokine storm. As such, there is an urgent need to develop novel therapeutic drugs that target the inflammatory cytokines that are secreted as a result of increased reactive oxygen species...
June 2018: Data in Brief
Xuyun Gu, Chen Wei, Xishan Zhu, Feiping Lu, Bo Sheng, Xuefeng Zang
Sepsis with severe systemic inflammation remains a great challenge for the intensive care unit in clinics. Although biomarkers have been identified to diagnose, monitor and predict these syndromes, novel therapeutic approaches are required for the amelioration of symptoms of sepsis and septic shock. The present study demonstrated that interleukin (IL)-31 was able reduce the mortality rate of lipopolysaccharide (LPS)-induced sepsis with the reduction of inflammatory cytokines in the sera. IL-31 also inhibited IL-1β production in the peritoneal lavage fluid in LPS-induced or cecal ligation and puncture-induced sepsis...
July 2018: Experimental and Therapeutic Medicine
Fatima Naumeri, Ali Ijaz Ahmad, Hafiz Mahmood Ahmad, Uzma Ahmad, Muhammad Zeeshan Sarwar
The aim of study was to evaluate whether adequate initial management and safe transfer of paediatric burn patients was carried out in our setup. Patients transferred from other hospitals/ cities to Paediatric Surgery Department, Mayo Hospital were evaluated in this prospective study. Data was entered in a proforma. Around 90.4% patients on presentation had discrepancy in their burn percentage calculation. No intravenous fluids were administered to 75.4% patients and 71.1% patients did not have any intravenous access...
May 2018: JPMA. the Journal of the Pakistan Medical Association
Liam Byrne, Nchafatso G Obonyo, Sara D Diab, Kimble R Dunster, Margaret R Passmore, Ai-Ching Boon, Louise See Hoe, Sanne Pedersen, Mohd Hashairi Fauzi, Leticia Pretti Pimenta, Frank Van Haren, Christopher M Anstey, Louise Cullen, John-Paul Tung, Kiran Shekar, Kathryn Maitland, John F Fraser
BACKGROUND: Fluid resuscitation is widely considered a life saving intervention in septic shock however recent evidence has questioned both its safety and efficacy in sepsis. This study sought to compare fluid resuscitation with vasopressors with vasopressors alone in a hyperdynamic model of ovine endotoxemia. METHODS: Endotoxemic shock was induced in sixteen sheep after which they received fluid resuscitation with 40mls/kg of 0.9% saline or commenced haemodynamic support with protocolized noradrenaline and vasopressin...
June 8, 2018: American Journal of Respiratory and Critical Care Medicine
Andreas Taenzer, Allison Kinslow, Christine Gorman, Shelley Schoepflin Sanders, Shilpa J Patel, Sally Kraft, Lucy Savitz
The dissemination of evidence-based best practice through the entire health care system remains an elusive goal, despite public pressure and regulatory guidance. Many patients do not receive the same quality of care at different hospitals across the same health care system. We describe the role of a data driven learning collaborative, the High Value Healthcare Collaborative (HVHC), in the dissemination of best practice using adherence to the 3-hour-bundle for sepsis care. Compliance with and adoption of sepsis bundle care elements comparing sites with mature vs non-mature care delivery processes were measured during the improvement effort for a cohort of 20,758 patients...
December 15, 2017: EGEMS
Laura Ferreras Antolín, Seilesh Kadambari, Serena Braccio, Julian Wei-Tze Tang, Jacqueline Xerry, David James Allen, Shamez N Ladhani
BACKGROUND: Human parechovirus (HPeV), like enteroviruses, usually causes mild self-limiting respiratory and gastrointestinal symptoms. In infants, HPeV can occasionally cause serious illnesses, including sepsis-like syndrome and encephalitis. In summer 2016, Public Health England (PHE) received increasing reports of severe HPeV infections nationally. We, therefore, reviewed all infants with confirmed HPeV across England during 2016. METHODS: HPeV cases in infants aged <12 months reported to PHE during 2016 were followed up using a clinical questionnaire...
June 5, 2018: Archives of Disease in Childhood
Paul R Atkinson, James Milne, Laura Diegelmann, Hein Lamprecht, Melanie Stander, David Lussier, Chau Pham, Ryan Henneberry, Jacqueline M Fraser, Michael K Howlett, Jayanand Mekwan, Brian Ramrattan, Joanna Middleton, Daniel J van Hoving, Mandy Peach, Luke Taylor, Tara Dahn, Sean Hurley, Kayla MacSween, Luke R Richardson, George Stoica, Samuel Hunter, Paul A Olszynski, David A Lewis
STUDY OBJECTIVE: Point-of-care ultrasonography protocols are commonly used in the initial management of patients with undifferentiated hypotension in the emergency department (ED). There is little published evidence for any mortality benefit. We compare the effect of a point-of-care ultrasonography protocol versus standard care without point-of-care ultrasonography for survival and clinical outcomes. METHODS: This international, multicenter, randomized controlled trial recruited from 6 centers in North America and South Africa and included selected hypotensive patients (systolic blood pressure <100 mm Hg or shock index >1) randomized to early point-of-care ultrasonography plus standard care versus standard care without point-of-care ultrasonography...
June 2, 2018: Annals of Emergency Medicine
Sophia Lionaki, Eystratios Tsakonas, Athina Androulaki, George Liapis, Panagiotis Panayiotidis, George Zavos, John N Boletis
This is a case of a renal transplant recipient who developed a primary hepatic Burkitt lymphoma a few years after kidney transplantation. The past medical history of the patient was significant for anti-HCV positivity with liver histopathology showing minimal changes of grades 0 and 1, stage 0. She received a graft from a deceased donor, with rabbit antithymocyte globulin and methyl-prednisolone, as induction therapy, and was maintained on azathioprine, cyclosporine, and low dose methyl-prednisolone with normal renal function...
2018: Case Reports in Nephrology
Sun Ju Kim, Sumg Oh Hwang, Yong Won Kim, Jun Hyeok Lee, Kyoung-Chul Cha
INTRODUCTION: The recent definition of sepsis was modified based on a scoring system focused on organ failure (Sepsis-3). It would be a time-consuming process to detect the sepsis patient using Sepsis-3. Procalcitonin (PCT) is a well-known biomarker for diagnosing sepsis/septic shock and monitoring the efficacy of treatment. We conducted a study to verify the predictability of PCT for diagnosing sepsis based on Sepsis-3 definition. MATERIALS & METHODS: This is a retrospective cohort study...
May 26, 2018: American Journal of Emergency Medicine
Sam Roberts
No abstract text is available yet for this article.
June 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
Sindhura Bandaru, Sukesh Manthri, Vidya Sundareshan, Vidhya Prakash
Empyema necessitans (EN) is a rare phenomenon that refers to an insidious extension of the empyema through parietal pleura and subsequent dissection into subcutaneous tissue of the chest wall. A 29-year-old man presented to the hospital with fever and chills a few days after an inadvertent needle stick while injecting heroin. His left forearm was warm with an area of fluctuance. He underwent incision and drainage of the left forearm abscess with fluid submitted for Gram stain and culture. His condition rapidly deteriorated due to sepsis, and he required transfer to the intensive care unit...
2018: Case Reports in Infectious Diseases
Maria Corazon Astorga, Kyle J Piscitello, Nina Menda, Ann M Ebert, Steven C Ebert, Michael A Porte, Pamela J Kling
Background: Meeting antibiotic stewardship goals in the neonatal intensive care unit (NICU) is challenging because of the unique nature of newborns and the lack of specificity of clinical signs of sepsis. Antibiotics are commonly continued for 48 hours pending culture results and clinical status. The goal of this study was to examine if the implementation of a 48-hour automatic stop (autostop) order during NICU admissions would decrease antibiotic use at UnityPoint Health-Meriter. Methods: An observational double-cohort study was performed in a level 3 NICU...
May 28, 2018: Journal of the Pediatric Infectious Diseases Society
Yue Zhao, Cong Ding
BACKGROUND Severe sepsis is among the most common causes of death in Emergency Departments, with more than 30% mortality. Hydrocortisone is used in severe sepsis patients who were not responsive to fluid resuscitation and vasopressor therapy. However, the effect of hydrocortisone on regulating inflammation, hemodynamic stability, and preventing shock is still unclear in Chinese patients. MATERIAL AND METHODS In this prospective observational study, we included 105 severe sepsis patients. We measured the level of serum inflammatory cytokines, hemodynamic variables, and phagocytic ability of innate immune cells during the treatment...
May 30, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Yu Wang, Xiaofeng Wang, Lichun Zhang, Rong Zhang
BACKGROUND Resveratrol (Res) is a type of polyphenol found in many plants, which can protect important organs from the damage induced by sepsis. However, the exact mechanism of its protective effect has not been established. This study investigated the effect of Res on the PI3K/Nrf2/HO-1 signaling pathway in rats with sepsis-induced acute lung injury (ALI). MATERIAL AND METHODS Male Wistar rats were treated with 30 mg/kg Res by intraperitoneal administration for 1 hour immediately after cecal ligation and puncture...
May 30, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Tim Harris, Timothy J Coats, Mohammed H Elwan
Intravenous fluid therapy is one of the most common therapeutic interventions performed in the ED and is a long-established treatment. The potential benefits of fluid therapy were initially described by Dr W B O'Shaughnessy in 1831 and first administered to an elderly woman with cholera by Dr Thomas Latta in 1832, with a marked initial clinical response. However, it was not until the end of the 19th century that medicine had gained understanding of infection risk that practice became safer and that the practice gained acceptance...
May 28, 2018: Emergency Medicine Journal: EMJ
Mengling Feng, Jakob I McSparron, Dang Trung Kien, David J Stone, David H Roberts, Richard M Schwartzstein, Antoine Vieillard-Baron, Leo Anthony Celi
PURPOSE: While the use of transthoracic echocardiography (TTE) in the ICU is rapidly expanding, the contribution of TTE to altering patient outcomes among ICU patients with sepsis has not been examined. This study was designed to examine the association of TTE with 28-day mortality specifically in that population. METHODS AND RESULTS: The MIMIC-III database was employed to identify patients with sepsis who had and had not received TTE. The statistical approaches utilized included multivariate regression, propensity score analysis, doubly robust estimation, the gradient boosted model, and an inverse probability-weighting model to ensure the robustness of our findings...
May 28, 2018: Intensive Care Medicine
Xuan Han, Dana P Edelson, Ashley Snyder, Natasha Pettit, Sarah Sokol, Carmen Barc, Michael D Howell, Matthew M Churpek
BACKGROUND: Sepsis remains a significant cause of morbidity and mortality in the United States, leading to the implementation of the Severe Sepsis and Septic Shock Early Management Bundle (SEP-1). SEP-1 identifies patients with "severe sepsis" via clinical and laboratory criteria and mandates interventions, including lactate draws and antibiotics, within a specific time window. We sought to characterize the patients affected and to study the implications of SEP-1 on patient care and outcomes...
May 19, 2018: Chest
Yang Lv, Kyungho Kim, Yue Sheng, Jaehyung Cho, Zhijian Qain, You-Yang Zhao, Gang Hu, Duojia Pan, Asrar B Malik, Guochang Hu
<u>Rationale:</u> Microvascular inflammation and endothelial dysfunction secondary to unchecked activation of endothelium plays a critical role in the pathophysiology of sepsis and organ failure. The intrinsic signaling mechanisms responsible for dampening excessive activation of endothelial cells are not completely understood. <u>Objective:</u> To determine the central role of Yes-associated protein (YAP), the major transcriptional co-activator of the Hippo pathway, in modulating the strength and magnitude of endothelial activation and vascular inflammation...
May 23, 2018: Circulation Research
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