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sepsis physiology

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https://www.readbyqxmd.com/read/29147897/vacuum-assisted-wound-closure-with-mesh-mediated-fascial-traction-achieves-better-outcomes-than-vacuum-assisted-wound-closure-alone-a-comparative-study
#1
Giuseppe Salamone, Leo Licari, Giovanni Guercio, Albert Comelli, Mirko Mangiapane, Nicolò Falco, Roberta Tutino, Noemi Bagarella, Sofia Campanella, Calogero Porrello, Roberto Gullo, Gianfranco Cocorullo, Gaspare Gulotta
BACKGROUND: Open abdomen (OA) permits the application of damage control surgery principles when abdominal trauma, sepsis, severe acute peritonitis and abdominal compartmental syndrome (ACS) occur. METHODS: Non-traumatic patients treated with OA between January 2010 and December 2015 were identified in a prospective database, and the data collected were retrospectively reviewed. Patients' records were collected from charts and the surgical and intensive care unit (ICU) registries...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29146383/not-just-antibiotics-is-cancer-chemotherapy-driving-antimicrobial-resistance
#2
REVIEW
Lito E Papanicolas, David L Gordon, Steve L Wesselingh, Geraint B Rogers
The global spread of antibiotic-resistant pathogens threatens to increase the mortality of cancer patients significantly. We propose that chemotherapy contributes to the emergence of antibiotic-resistant bacteria within the gut and, in combination with antibiotics, drives pathogen overgrowth and translocation into the bloodstream. In our model, these processes are mediated by the effects of chemotherapy on bacterial mutagenesis and horizontal gene transfer, the disruption of commensal gut microbiology, and alterations to host physiology...
November 13, 2017: Trends in Microbiology
https://www.readbyqxmd.com/read/29138849/elevated-serum-levels-of-lipoprotein%C3%A2-associated-phospholipase%C3%A2-a2-predict-mortality-rates-in-patients-with-sepsis
#3
Zhongwei Huang, Haiyan Jiang, Xiaohui Cui, Guiwen Liang, Yu Chen, Ting Wang, Zhichao Sun, Lei Qi
Sepsis remains one of the leading contributors to mortality rates in the intensive care unit (ICU) and emergency intensive care unit (EICU). Therefore, any treatments against the agents which produce sepsis in a medical emergency, are welcome. Elevated serum levels of lipoprotein‑associated phospholipase A2 (Lp‑PLA2) have been reported in a small cohort of patients with inflammation. The present study evaluated serum levels of Lp‑PLA2 in patients with sepsis and investigated the role of Lp‑PLA2 in sepsis...
November 13, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29137585/association-of-positive-fluid-balance-and-mortality-in-sepsis-and-septic-shock-in-an-australian-cohort
#4
M G Pittard, S J Huang, A S McLean, S R Orde
In patients with septic shock, a correlation between positive fluid balance and worsened outcomes has been reported in multiple observational studies worldwide. No published data exists in an Australasian cohort. We set out to explore this association in our institution. We conducted a retrospective audit of patient records from August 2012 to May 2015 in a single-centre, 24-bed surgical and medical intensive care unit (ICU) in Sydney, Australia. All patients with septic shock were included. Exclusion criteria included length of stay less than 24 hours or vasopressors needed for less than six hours...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29129241/zinc-and-selenium-status-in-critically-ill-patients-according-to-severity-stratification
#5
Marina Augusta Cirino Ruocco, Evelin Drociunas Pacheco Cechinatti, Fernando Barbosa, Anderson Marliere Navarro
OBJECTIVE: The aim of this study was to evaluate the concentrations of zinc and selenium in different biological materials and to associate them with the clinical severity score according to the Simplified Acute Physiology Score (SAPS) III. METHODS: The study was conducted in a 10-bed general intensive care unit of the Américo Brasiliense State Hospital/SP, with 95 patients stratified by the SAPS III score cutoff points (63.5 points) as less or more severe and by the diagnosis of sepsis...
January 2018: Nutrition
https://www.readbyqxmd.com/read/29124742/lactate-improves-saps-3-prognostication
#6
P Andersson, A Frigyesi
INTRODUCTION: Lactate concentration is known to be a strong predictor of mortality, but is not included in any of the major intensive care scorings systems such as the Simplified Acute Physiology Score (SAPS 3). The objective of this study was to investigate the prognostic value of lactate concentration when combined with SAPS 3. MATERIALS AND METHODS: In the period of 2008 to June 2017 the general intensive care unit at Skåne University Hospital in Lund, Sweden had 5141 first-time admissions...
November 10, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29121281/epidemiology-of-sepsis-and-septic-shock-in-critical-care-units-comparison-between-sepsis-2-and-sepsis-3-populations-using-a-national-critical-care-database
#7
M Shankar-Hari, D A Harrison, G D Rubenfeld, K Rowan
Background: New sepsis and septic shock definitions could change the epidemiology of sepsis because of differences in criteria. We therefore compared the sepsis populations identified by the old and new definitions. Methods: We used a high-quality, national, intensive care unit (ICU) database of 654 918 consecutive admissions to 189 adult ICUs in England, from January 2011 to December 2015. Primary outcome was acute hospital mortality. We compared old (Sepsis-2) and new (Sepsis-3) incidence, outcomes, trends in outcomes, and predictive validity of sepsis and septic shock populations...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29118838/a-complex-obstetric-case
#8
Michael Hoy, Kate Flavin, Venkat Prasad
A 33-year-old primigravida presented with severe sepsis, severe pre-eclampsia, peripartum cardiomyopathy and the haemolysis, elevated liver enzymes and low platelets syndrome manifesting over the course of 24 h causing a diagnostic conundrum and a difficult sequence of physiological problems to overcome. We describe a previously unreported sequence of events involving a pre-eclamptic, septic parturient to improve anaesthetic and intensive care physician awareness of confounding factors that complicate assessment and management of these patients...
August 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29118026/carbon-monoxide-in-lung-cell-physiology-and-disease
#9
Stefan W Ryter, Kevin C Ma, Augustine M K Choi
Carbon monoxide (CO) is an endogenously produced gas that has gained recognition as a biological signal transduction effector with properties similar, but not identical, to that of nitric oxide (NO). CO, which binds primarily to heme iron, may activate the hemoprotein guanylate cyclase (sGC), although with lower potency than NO. Furthermore, CO can modulate the activities of several cellular signaling molecules such as p38 MAPK, ERK1/2, JNK, AKT, NF-κB, and others. Emerging studies suggest that mitochondria, the energy-generating organelle of cells, represent a key target of CO action in eukaryotes...
November 8, 2017: American Journal of Physiology. Cell Physiology
https://www.readbyqxmd.com/read/29116996/leptospirosis-in-icu-a-retrospective-study-of-134-consecutive-admissions
#10
Benjamin Delmas, Julien Jabot, Paul Chanareille, Cyril Ferdynus, Jérôme Allyn, Nicolas Allou, Loïc Raffray, Bernard-Alex Gaüzere, Olivier Martinet, David Vandroux
OBJECTIVES: Leptospirosis causes reversible multiple organ failure, and its mortality remains high. The aim of this study was to determine the mortality rate of leptospirosis in an ICU offering all types of organ support available nowadays and to compare it with mortality in bacterial sepsis. DESIGN: Retrospective, descriptive, and single-center cohort study. SETTINGS: The largest ICU of Reunion Island (Indian Ocean) in a teaching hospital...
November 7, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29111542/a-call-to-action-to-develop-integrated-curricula-in-cardiorenal-medicine
#11
Claudio Ronco, Federico Ronco, Peter A McCullough
With the adoption of the new definition and classification of cardiorenal syndrome (CRS) and its relevant subtypes, much attention has been placed on elucidating the mechanisms of heart and kidney interactions. The pathophysiologic pathways are of great interest by which acute heart failure may result in acute kidney injury (AKI; type 1), chronic heart failure accelerates the progression of chronic kidney disease (CKD; type 2), AKI provokes cardiac events (type 3), and CKD increases the risk and severity of cardiovascular disease (type 4)...
2017: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29102324/prolonged-versus-short-term-intravenous-infusion-of-antipseudomonal-%C3%AE-lactams-for-patients-with-sepsis-a-systematic-review-and-meta-analysis-of-randomised-trials
#12
Konstantinos Z Vardakas, Georgios L Voulgaris, Athanasios Maliaros, George Samonis, Matthew E Falagas
BACKGROUND: The findings of randomised controlled trials (RCT), observational studies, and meta-analyses vary regarding the effectiveness of prolonged β-lactam infusion. We aimed to identify the effectiveness of prolonged versus short-term infusion of antipseudomonal β-lactams in patients with sepsis. METHODS: We did a systematic review and meta-analysis to compare prolonged versus short-term intravenous infusion of antipseudomonal β-lactams in patients with sepsis...
October 25, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29091954/comparison-of-the-mortality-in-emergency-department-sepsis-score-modified-early-warning-score-rapid-emergency-medicine-score-and-rapid-acute-physiology-score-for-predicting-the-outcomes-of-adult-splenic-abscess-patients-in-the-emergency-department
#13
Shang-Kai Hung, Chip-Jin Ng, Chang-Fu Kuo, Zhong Ning Leonard Goh, Lu-Hsiang Huang, Chih-Huang Li, Yi-Ling Chan, Yi-Ming Weng, Joanna Chen-Yeen Seak, Chen-Ken Seak, Chen-June Seak
BACKGROUND: Splenic abscess is rare but has mortality rates as high as 14% even with recent improvements in management. Early and appropriate intervention may improve patient outcomes, yet at present there is no identified method that can predict mortality risk rapidly and accurately for emergency physicians, surgeons, and intensivists to decide on the ideal course of action. OBJECTIVE: This study aims to evaluate the performance of Mortality in Emergency Department Sepsis Score (MEDS), Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS) and Rapid Acute Physiology Score (RAPS) for predicting the mortality risk of adult splenic abscess patients...
2017: PloS One
https://www.readbyqxmd.com/read/29091053/multiscale-network-representation-of-physiological-time-series-for-early-prediction-of-sepsis
#14
Supreeth Prajwal Shashikumar, Qiao Li, Gari D Clifford, Shamim Nemati
Sepsis, a dysregulated immune-mediated host response to infection, is the leading cause of morbidity and mortality in critically ill patients. Indices of heart rate variability and complexity (such as entropy) have been proposed as surrogate markers of Neuro-immune system dysregulation with diseases such as sepsis. However, these indices only provide an average, one dimensional description of complex neuro-physiological interactions. We propose a novel multiscale network construction and analysis method for multivariate physiological time series, and demonstrate its utility for early prediction of sepsis...
November 1, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/29090212/metabolism-of-citrate-and-other-carboxylic-acids-in-erythrocytes-as-a-function-of-oxygen-saturation-and-refrigerated-storage
#15
Travis Nemkov, Kaiqi Sun, Julie A Reisz, Tatsuro Yoshida, Andrew Dunham, Edward Y Wen, Alexander Q Wen, Rob C Roach, Kirk C Hansen, Yang Xia, Angelo D'Alessandro
State-of-the-art proteomics technologies have recently helped to elucidate the unanticipated complexity of red blood cell metabolism. One recent example is citrate metabolism, which is catalyzed by cytosolic isoforms of Krebs cycle enzymes that are present and active in mature erythrocytes and was determined using quantitative metabolic flux analysis. In previous studies, we reported significant increases in glycolytic fluxes in red blood cells exposed to hypoxia in vitro or in vivo, an observation relevant to transfusion medicine owing to the potential benefits associated with hypoxic storage of packed red blood cells...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29074644/extracellular-signal-regulated-kinase-1-2-regulates-kidney-injury-molecule-1-expression-physiologically-and-following-ischemic-and-septic-renal-injury
#16
Justin B Collier, Rick G Schnellmann
The upregulation of kidney injury molecule-1 (KIM-1) has been extensively studied in various renal diseases and following acute injury; however, the initial mechanisms controlling KIM-1 expression remain limited. In this study, KIM-1 expression was examined in mouse renal cell cultures and in two different models of acute kidney injury (AKI), ischemia-reperfusion (IR) and lipopolysaccharide (LPS)-induced sepsis. KIM-1 mRNA increased in both AKI models and pharmacological inhibition of extracellular signal-regulated kinase 1/2 (ERK1/2) signaling attenuated injury induced KIM-1 expression in the renal cortex...
October 26, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/29068553/serum-alpha1-proteinase-inhibitor-concentrations-in-dogs-with-systemic-inflammatory-response-syndrome-or-sepsis
#17
Romy M Heilmann, Niels Grützner, Brittany E Thames, Jörg M Steiner, James W Barr
OBJECTIVE: To determine whether the concentration of serum canine alpha1 -proteinase inhibitor (cα1 -PI) has diagnostic or prognostic utility in dogs with sepsis or noninfectious systemic inflammatory response syndrome (SIRS). DESIGN: Prospective, observational study from May to December 2010. SETTING: University teaching hospital ICU. ANIMALS: Sixty-nine client-owned dogs: 19 dogs with SIRS or sepsis and 50 healthy control dogs...
October 25, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/29065398/a-call-to-action-to-develop-integrated-curricula-in-cardiorenal-medicine
#18
Claudio Ronco, Federico Ronco, Peter A McCullough
With the adoption of the new definition and classification of cardiorenal syndrome (CRS) and its relevant subtypes, much attention has been placed on elucidating the mechanisms of heart and kidney interactions. Of great interest are the pathophysiological pathways by which acute heart failure may result in acute kidney injury (AKI; type 1), chronic heart failure accelerating the progression of chronic kidney disease (CKD; type 2), AKI provoking cardiac events (type 3), and CKD increasing the risk and severity of cardiovascular disease (type 4)...
October 25, 2017: Blood Purification
https://www.readbyqxmd.com/read/29064085/the-biology-of-natural-killer-cells-during-sepsis
#19
REVIEW
Yin Guo, Naeem K Patil, Liming Luan, Julia K Bohannon, Edward R Sherwood
Natural killer (NK) cells are large granular lymphocytes largely recognized for their importance in tumor surveillance and the host response to viral infections. However, as the major innate lymphocyte population, NK cells also coordinate early responses to bacterial infections by amplifying the antimicrobial functions of myeloid cells, especially macrophages, by production of IFNγ. Alternatively, excessive NK cell activation and IFNγ production can amplify the systemic inflammatory response during sepsis resulting in increased physiologic dysfunction and organ injury...
October 24, 2017: Immunology
https://www.readbyqxmd.com/read/29062271/aminoglycoside-induced-cochleotoxicity-a-review
#20
REVIEW
Meiyan Jiang, Takatoshi Karasawa, Peter S Steyger
Aminoglycoside antibiotics are used as prophylaxis, or urgent treatment, for many life-threatening bacterial infections, including tuberculosis, sepsis, respiratory infections in cystic fibrosis, complex urinary tract infections and endocarditis. Although aminoglycosides are clinically-essential antibiotics, the mechanisms underlying their selective toxicity to the kidney and inner ear continue to be unraveled despite more than 70 years of investigation. The following mechanisms each contribute to aminoglycoside-induced toxicity after systemic administration: (1) drug trafficking across endothelial and epithelial barrier layers; (2) sensory cell uptake of these drugs; and (3) disruption of intracellular physiological pathways...
2017: Frontiers in Cellular Neuroscience
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