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Fluid sepsis

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https://www.readbyqxmd.com/read/29679726/late-presenting-dural-tear-incidence-risk-factors-and-associated-complications
#1
Wesley M Durand, J Mason DePasse, Eren O Kuris, JaeWon Yang, Alan H Daniels
BACKGROUND CONTEXT: Unrecognized and inadequately repaired intraoperative durotomies may lead to cerebrospinal fluid leak, pseudomeningocele, and other complications. Few studies have investigated durotomy that is unrecognized intraoperatively and requires additional postoperative management (hereafter, late-presenting dural tear [LPDT]), though estimates of LPDT range from 0.6 - 8.3 per 1,000 spinal surgeries. These single-center studies are based on relatively small sample sizes for an event of this rarity, all with <10 patients experiencing LPDT...
April 18, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29677008/evolution-of-acute-kidney-injury-and-its-association-with-systemic-hemodynamics-in-children-with-fluid-refractory-septic-shock
#2
Akash Deep, Hiremath Sagar, Chulananda Goonasekera, Palaniswamy Karthikeyan, Joe Brierley, Abdel Douiri
OBJECTIVES: There are no studies in pediatrics evaluating the progression of acute kidney injury in septic shock. We investigated the evolution of sepsis-associated acute kidney injury and its association with systemic hemodynamics in children with fluid-refractory septic shock. DESIGN: Prospective cohort study. SETTING: PICU of a tertiary care hospital. PATIENTS: All patients with fluid-refractory septic shock (n = 61) between September 2010 and February 2014...
April 19, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29675402/poor-compliance-with-sepsis-guidelines-in-a-tertiary-care-children-s-hospital-emergency-room
#3
Benjamin Louis Moresco, Clinton Woosley, Morris Sauter, Utpal Bhalala
Objectives: This study aimed to assess factors related to adherence to the Pediatric Advanced Life Support guidelines for severe sepsis and septic shock in an emergency room (ER) of a tertiary care children's hospital. Methods: This was a retrospective, observational study of children (0-18 years old) in The Children's Hospital of San Antonio ER over 1 year with the International Consensus Definition Codes, version-9 (ICD-9) diagnostic codes for "severe sepsis" and "shocks...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29673855/activation-of-a-code-sepsis-in-the-emergency-department-is-associated-with-a-decrease-in-mortality
#4
Neus Robert Boter, Josep Maria Mòdol Deltell, Irma Casas Garcia, Gemma Rocamora Blanch, Gemma Lladós Beltran, Anna Carreres Molas
OBJECTIVES: To evaluate the impact of a code sepsis (CS) activation, complying with recommendations, the evolution of patients with severe sepsis in the emergency room and determine independent factors associated to mortality. METHOD: All patients attending the emergency room with severe sepsis during a 6-month period were included. Complying with Surviving Sepsis Campaign recommendations, patients' average stay, intensive care admissions and 30-day mortality were assessed...
April 16, 2018: Medicina Clínica
https://www.readbyqxmd.com/read/29670801/nonoperative-management-of-multiple-penetrating-cardiac-and-colon-wounds-from-a-shotgun-a-case-report-and-literature-review
#5
Paula M Jaramillo, Jaime A Montoya, David A Mejia, Salin Pereira Warr
Introduction: Surgery for cardiac trauma is considered fatal and for wounds of the colon by associated sepsis is normally considered; however, conservative management of many traumatic lesions of different injured organs has progressed over the years. Presentation of the Case: A 65-year-old male patient presented with multiple shotgun wounds on the left upper limb, thorax, and abdomen. On evaluation, he was hemodynamically stable with normal sinus rhythm and normal blood pressure, no dyspnea, or abdominal pain...
2018: Case Reports in Surgery
https://www.readbyqxmd.com/read/29666092/a-rare-cause-of-oligoarthritis-with-septic-presentation
#6
Patrick Hoversten, Joel Beachey, Michael Pham, Anjali Bhagra
A 33-year-old man presented with new-onset, asymmetric, migratory oligoarthritis in the setting of several weeks of nausea and vomiting, diarrhoea, fevers and dysuria. He was initially treated in the inpatient setting with broad-spectrum antibiotics due to concern for an evolving sepsis presentation. Arthrocentesis of a large right knee effusion revealed inflammatory synovial fluid without findings suggestive of septic arthritis. Human leucocyte antigen B27 was positive and, taken together with the antecedent history of gastroenteritis, dysuria and inflammatory oligoarthritis, the clinical diagnosis was most consistent with reactive arthritis...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29657863/fluid-resuscitation-associated-increased-mortality-and-inflammatory-cytokine-expression-in-murine-polymicrobial-sepsis
#7
Young Im Lee, Robert L Smith, Erin J Caraher, George Crowley, Syed Hissam Haider, Sophia Kwon, Anna Nolan
No abstract text is available yet for this article.
August 2017: Journal of Clinical and Translational Science
https://www.readbyqxmd.com/read/29655568/luteolin-attenuates-acute-lung-injury-in-experimental-mouse-model-of-sepsis
#8
Soya Rungsung, Thakur Uttam Singh, Dipankar Jyoti Rabha, Tarun Kumar, Madhu Cholenahalli Lingaraju, Subhashree Parida, Avishek Paul, Monalisa Sahoo, Dinesh Kumar
The present investigation was undertaken to assess the result of pretreatment of luteolin in sepsis-induced acute lung injury in mice and its mechanism of action. Luteolin was administered intraperitoneally one hour before caecal ligation and puncture (CLP) surgery in mice. Acute lung injury was assessed by estimation of different parameters like lung edema, protein content, cytokines level, oxidative stress, inducible nitric oxide synthase (iNOS), intercellular adhesion molecule (ICAM)-1 expression and histopathology...
April 11, 2018: Cytokine
https://www.readbyqxmd.com/read/29651944/role-of-point-of-care-ultrasonography-for-management-of-sepsis-and-septic-shock
#9
Gentle Sunder Shrestha, Shrikanth Srinivasan
BACKGROUND: Sepsis and septic shock remain a major cause of morbidity and mortality globally. In recent years, outcome of patients with sepsis and septic shock has gradually improved, in part due to early recognition and timely appropriate management. Bedside physical examination can be of limited value to identify the source of infection and to decide appropriate management. Moreover, the clinical status of these patients can change rapidly, as a part of disease progression or in response to treatment or intervention...
April 12, 2018: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/29627349/recurrent-ethylene-glycol-poisoning-with-elevated-lactate-levels-to-obtain-opioid-medications
#10
Matthew Zuckerman, Tim Vo
BACKGROUND: Malingering is when a patient feigns illness for secondary gain. While most patients with malingering manufacture or exaggerate symptoms, some patients may induce illness. Previous reports of malingering patients inducing illness include sepsis, kidney pain, migraine, and chest pain. However, acute poisoning as a manifestation of malingering appears to be rare. CASE REPORT: We describe the case of a 39-year-old man who presented to the emergency department complaining of diffuse body pain...
April 4, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29626314/necrotising-fasciitis-a-fatal-case-of-sepsis-and-a-diagnostic-challenge-case-report-and-review-of-literature
#11
Lekha Agarwal, Athar Yasin
BACKGROUND: Necrotising fasciitis (NF) is a severe, devastating soft tissue infection characterised by rapidly progressing tissue necrosis. This rare condition has a high mortality rate and poses diagnostic and management challenges to the clinician. There is usually a history of trauma, which maybe trivial. Some of the premorbid conditions associated with NF are diabetes and or immunocompromised state. It requires prompt recognition and early treatment with intravenous antibiotics and extensive surgical debridement...
April 6, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29626019/diagnosis-and-management-of-sepsis
#12
Tom Evans
Sepsis is a common condition with high morbidity and mortality. Although many patients may require critical care, this article considers the features of sepsis that are of most relevance to acute general physicians. Recently updated definitions of sepsis and septic shock have been proposed which better identify patients who are likely to have a poor outcome, and therefore give an opportunity to escalate care. Despite these advances, there is still no molecular signature able to diagnose sepsis. Pathogenesis is complex, with many immune and non-immune mediators involved...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29621117/cerebral-multimodal-monitoring-in-sepsis-an-experimental-study
#13
Pedro Kurtz, Joana C d'Avila, Darwin Prado, Caroline Madeira, Charles Vargas-Lopes, Rogerio Panizzutti, Luciano Cesar Pontes Azevedo, Fernando A Bozza
Acute brain dysfunction is a complication of sepsis and its pathophysiology remains poorly understood. We studied the brain metabolism in a resuscitated animal model of sepsis. Twelve anesthetized, mechanically ventilated and invasively monitored pigs were allocated to a sham procedure (N = 5) or sepsis (N = 7). Sepsis was induced through fecal inoculation in the peritoneum. Fluid resuscitation was maintained during the entire study period. Animals were observed until spontaneous death or for a maximum of 24 hours...
April 4, 2018: Shock
https://www.readbyqxmd.com/read/29617940/intraosseous-versus-intravenous-access-in-pediatric-septic-shock-patients-admitted-to-alexandria-university-pediatric-intensive-care-unit
#14
Ahmed A El-Nawawy, Omneya M Omar, Mona Khalil
The cornerstone of emergency management of sepsis is early, goal-directed therapy. The purpose of this study was to evaluate the effect of intraosseous (IO) vs. intravenous (IV) access for resuscitation of patients with septic shock admitted to pediatric intensive care unit. This prospective interventional randomized clinical trial study was conducted on 60 patients with septic shock who need rapid administration of fluids and drugs; 30 cases were randomly chosen for IO vascular access, while the other 30 were selected for IV access...
April 1, 2018: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/29617417/role-of-protein-kinase-c-delta-in-regulating-platelet-activation-and-platelet-leukocyte-interaction-during-sepsis
#15
Elisabetta Liverani, Mark J Mondrinos, Shuang Sun, Satya P Kunapuli, Laurie E Kilpatrick
Sepsis is characterized by an intense systemic inflammatory response activating a cascade of proinflammatory events resulting in leukocyte dysregulation and host tissue damage. The lung is particularly susceptible to systemic inflammation, leading to acute lung injury. Key to inflammation-induced lung damage is the excessive migration of neutrophils across the vascular endothelium. The mechanisms which regulate neutrophil activation and migration in sepsis are not well defined but there is growing evidence that platelets are actively involved and play a key role in microvascular permeability and neutrophil-mediated organ damage...
2018: PloS One
https://www.readbyqxmd.com/read/29610253/deconstructing-progression-from-pneumococcal-colonization-to-disease
#16
Stephen I Pelton
Despite advances in treatment and prevention, the pneumococcus continues as a dominant cause of severe pneumonia and sepsis, of otitis media, sinusitis and nonbacteremic pneumonia. Lewnard and colleagues use a unique data set of nasopharyngeal and middle ear fluid samples to provide further insight into the progression of nasopharyngeal pneumococcal colonization to disease. They report the comparative rate of progression from colonization to otitis media by serotype, providing insight as to how conjugate vaccines that do not reduce the overall presence of pneumococci in the nasopharynx dramatically impact the incidence of acute and complex otitis media...
April 2, 2018: Infection and Immunity
https://www.readbyqxmd.com/read/29602841/effect-of-levosimendan-on-mortality-in-severe-sepsis-and-septic-shock-a-meta-analysis-of-randomised-trials
#17
Wei Chang, Jian-Feng Xie, Jing-Yuan Xu, Yi Yang
OBJECTIVE: We aim to synthesise up-to-date randomised trials to investigate the effects of levosimendan on mortality and clinical outcomes in severe sepsis and septic shock. METHODS: A collection of databases including PubMed, EMBASE, Cochrane Central Register and Web of Science were searched updated to August 2017. Randomised trials were included when they pertain to the use of levosimendan in severe sepsis or septic shock compared with any category of inotropes, or as an adjunct to standard therapy with mortality reported...
March 30, 2018: BMJ Open
https://www.readbyqxmd.com/read/29602260/c-reactive-protein-and-immature-to-total-neutrophil-ratio-have-no-utility-in-guiding-lumbar-puncture-in-suspected-neonatal-sepsis
#18
Christopher D Goldfinch, Tony Korman, Despina Kotsanas, David P Burgner, Kenneth Tan
AIM: Meningitis may complicate neonatal sepsis, but there is scant evidence to inform the decision to perform a lumbar puncture (LP) and considerable variation in practice. We investigated whether inflammatory markers - C-reactive protein (CRP) and immature-to-total neutrophil ratio (ITR) - were predictive of meningitis or significant cerebrospinal fluid (CSF) pleocytosis and useful in guiding the decision to perform a LP. METHODS: We studied all inpatients in a single tertiary neonatal unit who were <6 months of age who had a LP performed between March 2011 and October 2014...
March 30, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29597227/from-continuous-renal-replacement-therapies-to-multiple-organ-support-therapy
#19
Zaccaria Ricci, Stefano Romagnoli, Claudio Ronco, Gaetano La Manna
The incidence of the multiple organ dysfunction syndrome (MODS) is rapidly increasing in intensive care units (ICU). It usually combines with sepsis and is the most frequent cause of death in the ICU patients. The nature of the ICU patients has changed in the last years. It includes a variety of patients with severe cases due to major surgical interventions, trauma, hemodynamic instability, sepsis, and so on but also older people than previous times. All these situations can easily lead to MODS. In the prior years, the only available and efficient therapy was renal replacement therapy (RRT) for treating acute renal failure, but the development of technology also gives us devices to support the other systems...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29597218/membranes-and-sorbents
#20
William R Clark, Dayong Gao, Anna Lorenzin, Claudio Ronco
For continuous renal replacement therapy (CRRT), the extracorporeal filter provides solute depuration, fluid removal, and control of electrolyte and acid-base balance in critically ill patients with acute kidney injury (AKI). The membranes comprising CRRT filters are almost exclusively based on hollow fiber designs and, while adapted from the chronic hemodialysis field, have features that are specific to the requirements of CRRT nevertheless. In addition, these devices have evolved through the 40 years of CRRT in response to changes in clinical practice and the desire to extend the solute removal spectrum...
2018: Contributions to Nephrology
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