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Abdominal sepsis

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https://www.readbyqxmd.com/read/29678565/simplification-of-first-line-antibacterial-regimen-for-complicated-appendicitis-in-children-was-associated-with-better-adherence-to-guidelines-and-reduced-use-of-antibiotics
#1
Marion Taleb, Nicolas Nardi, Alexis Arnaud, Nathalie Costet, Pierre-Yves Donnio, Charlotte Engrand, Edouard Habonimana, Eric Wodey, Pierre Tattevin
Acute appendicitis in children requires early surgery, and a short course of antibiotics active on Enterobacteriaceae and anaerobes. Although aminoglycoside-containing 3-drug regimen have been used successfully for decades, simpler regimens with similar efficacy are increasingly used. We aimed to evaluate the impact of a switch from the combination of cefotaxime, metronidazole, and gentamicin (regimen 1), to piperacillin-tazobactam (regimen 2), as first-line regimen for complicated acute appendicitis in children...
April 17, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29677586/impact-of-sarcopenic-obesity-on-30-day-mortality-in-critically-ill-patients-with-intra-abdominal-sepsis
#2
Yun Ji, Baoli Cheng, Zhipeng Xu, Hui Ye, Weina Lu, Xiaoqian Luo, Shuiqiao Fu, Xiangming Fang
PURPOSE: This study aimed to investigate the association between sarcopenic obesity and 30-day mortality in critically ill patients with intra-abdominal sepsis. MATERIAL AND METHODS: We analyzed 236 surgical ICU patients with sepsis due to intra-abdominal infection who underwent urgent surgical intervention. Sarcopenia, visceral obesity and sarcopenic obesity were analyzed by computed tomography scans using the third lumbar vertebrae skeletal muscle index and visceral adipose tissue area, using previously reported cutoff values...
March 16, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29673855/activation-of-a-code-sepsis-in-the-emergency-department-is-associated-with-a-decrease-in-mortality
#3
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/29672927/interleukin-33-contributes-to-ilc2-activation-and-early-inflammation-associated-lung-injury-during-abdominal-sepsis
#4
Hui Xu, Jing Xu, Li Xu, Shuqing Jin, Heth R Turnquist, Rosemary Hoffman, Patricia Loughran, Timothy R Billiar, Meihong Deng
Sepsis is defined as infection with organ dysfunction due to a dysregulated immune response. The lung is one of the most vulnerable organs at the onset of sepsis. Interleukin-33 (IL-33) can be released by injured epithelial and endothelial cells in the lung and regulate immune activation and infiltration. Therefore, we postulated that IL-33 would contribute to the immune response in the lung during sepsis. Using the cecal ligation and puncture (CLP) sepsis model, we show here that IL-33 contributes significantly to both sepsis-induced inflammation in the lung and systemic inflammatory response in the early phase of sepsis...
April 19, 2018: Immunology and Cell Biology
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/29669701/crizotinib-in-patients-with-advanced-inoperable-inflammatory-myofibroblastic-tumours-with-and-without-anaplastic-lymphoma-kinase-gene-alterations-european-organisation-for-research-and-treatment-of-cancer-90101-create-a-multicentre-single-drug-prospective-non
#6
Patrick Schöffski, Jozef Sufliarsky, Hans Gelderblom, Jean-Yves Blay, Sandra J Strauss, Silvia Stacchiotti, Piotr Rutkowski, Lars H Lindner, Michael G Leahy, Antoine Italiano, Nicolas Isambert, Maria Debiec-Rychter, Raf Sciot, Thomas Van Cann, Sandrine Marréaud, Axelle Nzokirantevye, Sandra Collette, Agnieszka Wozniak
BACKGROUND: An inflammatory myofibroblastic tumour (IMFT) is a rare mesenchymal neoplasm characterised by anaplastic lymphoma kinase (ALK) gene rearrangements. We assessed the activity and safety of crizotinib, a tyrosine kinase inhibitor, targeting ALK in patients with advanced IMFT either with or without ALK alterations. METHODS: We did a multicentre, biomarker-driven, single-drug, non-randomised, open-label, two-stage phase 2 trial (European Organisation for Research and Treatment of Cancer 90101 CREATE) at 13 study sites (five university hospitals and eight specialty clinics) in eight European countries (Belgium, France, Germany, Italy, Netherlands, Poland, Slovakia, and the UK)...
April 12, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29667417/review-of-duodenal-perforations-after-endoscopic-retrograde-cholangiopancreatography-in-hospital-puerta-de-hierro-from-1999-to-2014
#7
Elena Jiménez Cubedo, Javier López Monclús, José Luis Lucena de la Poza, Natalia González Alcolea, Pablo Calvo Espino, Arturo García Pavia, Victor Sánchez Turrión
INTRODUCTION: endoscopic retrograde cholangiopancreatography (ERCP) remains the gold standard in biliary and pancreatic pathology. Although the procedure has a significant morbidity and mortality rate. Algorithms are needed for the management and treatment of the associated complications. OBJECTIVE: to review the post-ERCP perforations treated in the Department of General Surgery of the Hospital Puerta de Hierro from 1999 to 2014. The results were evaluated according to the types of perforation and treatment...
April 18, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29661440/renopancreatic-transplantation-evaluation-of-15-years-in-131-patients
#8
C G Marmanillo, C Langaro, J E Nicoluzzi, R T Belila, M Macri, R Zamprogna, M Luvizotto, M Takahashi
BACKGROUND: The most common multiple-organ transplant is the simultaneous pancreas-kidney transplantation (SPK). It is usually offered to patients who have insulin-dependent diabetes mellitus and those with diabetic nephropathy and renal failure that has already been established. In this study we present the results of 15 years of SPK in a transplant hospital center in Paraná, Brazil, and evaluated survival, immunosuppression, and transplant-related problems. METHODS: This study was a retrospective analysis of 131 SPK transplants performed at the Angelina Caron Hospital between January 2001 and December 2015...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29661420/use-of-georges-lopez-institute-preservation-solution-igl-1-in-pancreas-transplantation-a-series-of-47-cases
#9
M R Igreja, J C Wiederkehr, B A Wiederkehr, A Maykon Massutti, H de Aguiar Wiederkehr
BACKGROUND: Graft preservation continues to be one of the main pillars of pancreas transplantation (PT). Surgical complications, possibly caused or facilitated by organ damage during preservation, continue to occur more frequently after PT than for any other abdominal organ. During the past few years, the Georges Lopez Institute preservation solution IGL-1 has been introduced with satisfactory results for the perfusion and cold storage of abdominal grafts such as kidney and liver. METHODS: Aspects related to 47 PTs with the use of IGL-1 as the only preservation solution performed from January 2012 to September 2017 at Hospital Santa Isabel, Blumenau, Brazil, were retrospectively analyzed...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29661294/serum-lactate-predicts-resource-utilization-but-not-surgical-need-in-the-emergency-department
#10
Carly Richards, Kelli Ishihara, Cary Grayson, Michael Lustik, Christopher Yheulon
BACKGROUND: Serum lactate is frequently tested in the emergency department (ED) setting to diagnose visceral ischemia and as a marker of end-organ perfusion. It is highly nonspecific, and levels can be affected by both kidney and liver function. In this retrospective chart review, we aim to demonstrate that serum lactate is overused in the ED setting and predicts resource utilization but not the need for surgical intervention. METHODS: ED records with a chief complaint of "abdominal pain" were queried for the preceding 12 mo...
June 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29649951/biliary-ascariasis-presenting-with-gangrenous-perforation-of-the-gall-bladder-report-of-a-case-and-brief-review-of-literature
#11
Ankush Sharma, Priyansh Jariwala, Navneet Kaur
The most common cause of gallbladder perforation is calculous cholecystitis. Rarer causes include trauma, iatrogenic injuries, biliary stasis and gall bladder ischemia. We report a case of gall bladder gangrene with perforation, secondary to extensive ascariasis. A 45-year-old woman presented with acute intestinal obstruction and jaundice. She had abdominal distension and right hypochondrial tenderness. Abdominal radiography showed dilated bowel loops and ultrasonogram showed worms in the small intestine and biliary tree...
January 1, 2018: Tropical Doctor
https://www.readbyqxmd.com/read/29625879/tivantinib-for-second-line-treatment-of-met-high-advanced-hepatocellular-carcinoma-metiv-hcc-a-final-analysis-of-a-phase-3-randomised-placebo-controlled-study
#12
Lorenza Rimassa, Eric Assenat, Markus Peck-Radosavljevic, Marc Pracht, Vittorina Zagonel, Philippe Mathurin, Elena Rota Caremoli, Camillo Porta, Bruno Daniele, Luigi Bolondi, Vincenzo Mazzaferro, William Harris, Nevena Damjanov, Davide Pastorelli, María Reig, Jennifer Knox, Francesca Negri, Jörg Trojan, Carlos López López, Nicola Personeni, Thomas Decaens, Marie Dupuy, Wolfgang Sieghart, Giovanni Abbadessa, Brian Schwartz, Maria Lamar, Terri Goldberg, Dale Shuster, Armando Santoro, Jordi Bruix
BACKGROUND: Tivantinib (ARQ 197), a selective, oral MET inhibitor, improved overall survival and progression-free survival compared with placebo in a randomised phase 2 study in patients with high MET expression (MET-high) hepatocellular carcinoma previously treated with sorafenib. The aim of this phase 3 study was to confirm the results of the phase 2 trial. METHODS: We did a phase 3, randomised, double-blind, placebo-controlled study in 90 centres in Australia, the Americas, Europe, and New Zealand...
April 3, 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29625745/evaluation-of-a-single-pass-with-biphasic-intravenous-contrast-medium-injection-ct-protocol-for-the-assessment-of-complications-post-simultaneous-pancreas-kidney-transplant
#13
D Y-F Chung, E M Anderson
AIM: To evaluate the use of a single-pass with biphasic intravenous contrast medium injection computed tomography (CT) protocol to provide diagnostic quality CT studies for the assessment of complications post-simultaneous pancreas-kidney transplant (SPK). MATERIALS AND METHODS: This was an audit of practice and the need for informed consent was waived. The protocol was used in consecutive patients undergoing CT to exclude intra-abdominal sepsis post-SPK between June and December 2015...
April 3, 2018: Clinical Radiology
https://www.readbyqxmd.com/read/29616752/adrenal-hemorrhage-a-single-center-experience-and-literature-review
#14
Izabela M Karwacka, Łukasz Obołończyk, Krzysztof Sworczak
BACKGROUND: Adrenal hemorrhage (AH) is a rare condition that can lead to acute adrenal insufficiency and may be fatal. The risk factors of AH include focal adrenal lesion, abdominal trauma and anticoagulation therapy. The clinical manifestation of AH varies widely; the symptoms may be related to adrenal insufficiency or may reflect multiple organ failure. However, in many cases, the course of AH is asymptomatic. OBJECTIVES: The study is a retrospective analysis of 23 cases of AH, whose aim is to discuss the etiology and the management of selected patients, as well as a literature review...
March 27, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29613958/the-impact-of-age-on-the-innate-immune-response-and-outcomes-after-severe-sepsis-septic-shock-in-trauma-and-surgical-intensive-care-unit-patients
#15
Scott C Brakenridge, Philip A Efron, Julie A Stortz, Teczan Ozrazgat-Baslanti, Gabriela Ghita, Zhongkai Wang, Azra Bihorac, Alicia M Mohr, Babette A Brumback, Lyle L Moldawer, Frederick A Moore
INTRODUCTION: Advancing age is a strong risk factor for adverse outcomes across multiple disease processes. However, septic surgical and trauma patients are unique in they incur two or more inflammatory insults. The effects of advanced age on sepsis pathophysiology and outcomes remain unclear. METHODS: We performed a single center, prospective observational cohort study of Surgical ICU patients with severe sepsis/septic shock. Peripheral blood was collected for genomic, cytokine and biomarker analysis at 0...
April 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29610732/thoracic-perforations-surgical-techniques
#16
REVIEW
Atilla Eroglu, Yener Aydin, Omer Yilmaz
Esophageal perforation may occur spontaneously, iatrogenically or in connection with traumas. Sepsis may develop in connection with mediastinal and pleural exposure in a very short time as a consequence of disintegration of the esophagus. Esophageal perforation is an emergency accompanied with a high level of mortality and morbidity. Rate of mortality for the perforations in the thoracic region is higher than that in the cervical and abdominal regions. Delay in diagnosis and treatment is the most important factor to affect the mortality...
February 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29610604/correlation-of-procalcitonin-and-c-reactive-protein-with-intra-abdominal-hypertension-in-intra-abdominal-infections-their-predictive-role-in-the-progress-of-the-disease
#17
Bedri Braha, Dafina Mahmutaj, Mehmet Maxhuni, Burim Neziri, Shaip Krasniqi
AIM: To analyse the correlation of procalcitonin (PCT) and C-reactive protein (CRP) values with increased intra-abdominal pressure and to evaluate their predictive role in the progression of Intra-abdominal infections. MATERIALS AND METHODS: A non-randomized prospective study conducted in the group of 80 patients. We have measured the PCT, CRP and intra-abdominal pressure (IAP). RESULTS: According to IAH grades (G), there was a significant difference of PCT values: G I 3...
March 15, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29605724/timing-of-laparotomy-and-closure-in-burn-patients-with-abdominal-compartment-syndrome-effects-on-survival
#18
Jesus I Ramirez, Soman Sen, Tina L Palmieri, David G Greenhalgh
BACKGROUND: Survival of burned patients with abdominal compartment syndrome (ACS) is uniformly reported to be poor, averaging just 16% after laparotomy. We hypothesize that better outcomes may be achieved with a strategy of immediate laparotomy and early fascial closure. STUDY DESIGN: Patients with burn injury who were diagnosed with ACS between 2005 and 2016 were identified through a search of databases. Data was gathered from electronic medical records. Timing of laparotomy and closure were calculated for each patient...
March 29, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29592994/rare-case-of-cystic-artery-pseudoaneurysm
#19
Matta S Kuzman, Alfred Adiamah, Yutaro Higashi, Dhanny Gomez
A patient with a cystic artery pseudoaneurysm (CAP) presented to the emergency department with upper abdominal and back pain. The patient also had clinical signs of sepsis. CT revealed gallstones with acute suppurative cholecystitis with a gallbladder perforation. In addition, a CAP was also suspected and subsequently diagnosed on CT angiography. The pseudoaneurysm was treated with embolisation and a cholecystostomy was performed for the gallbladder perforation. Following her acute admission, the patient underwent an elective cholecystectomy and made a good recovery post surgery...
March 28, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29579262/acute-kidney-injury-in-critically-ill-patients-with-solid-tumours
#20
Delphine Kemlin, Lucie Biard, Lionel Kerhuel, Lara Zafrani, Marion Venot, Luis Teixeira, Benoit Schlemmer, Elie Azoulay, Emmanuel Canet
Background: Patients with solid tumours are at risk for acute kidney injury (AKI), however, epidemiological data are limited. Methods: We conducted a study that included patients with solid tumours admitted to a single-centre intensive care unit (ICU) from January 2011 to December 2015. We analysed factors associated with the occurence of AKI, ICU and Day-90 mortality. Results: Two-hundred and four patients were included. The incidence of AKI was 59%, chiefly related to sepsis (80%), hypovolaemia (40%) and outflow tract obstruction (17%)...
March 22, 2018: Nephrology, Dialysis, Transplantation
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