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https://www.readbyqxmd.com/read/28749265/emergency-anesthesia-and-exploratory-laparotomy-in-a-compromised-pacific-white-sided-dolphin-lagenorhynchus-obliquidens
#1
Justin F Rosenberg, Martin Haulena, James E Bailey, Dean A Hendrickson, Marina Ivančić, Stephen A Raverty
Anesthesia and surgery in cetaceans have inherent risks and have rarely been utilized as viable treatment options. This report represents the first known multidisciplinary team approach to emergency laparotomy in a compromised, 22-yr-old, female Pacific white-sided dolphin ( Lagenorhynchus obliquidens ). The inciting clinical signs and ancillary diagnostics were consistent with a mechanical ileus. Although no torsion or obstruction was apparent during surgery, severe enteritis and peritonitis were noted. Postoperatively, the animal was maintained on aggressive medical management with continuous supportive care until succumbing 3 days later with clinical pathology indicative of terminal sepsis and profound inflammation...
June 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28747072/regulation-of-staphylococcus-aureus-infection-of-macrophages-by-cd44-reactive-oxygen-species-and-acid-sphingomyelinase
#2
Cao Li, Yuqing Wu, Veronique Orian-Rousseau, Yang Zhang, Erich Gulbins, Heike Grassme
AIMS: Staphylococcus aureus plays an important role in sepsis, pneumonia, and wound infections. Acid sphingomyelinase (Asm)-deficient mice are highly susceptible to pulmonary S. aureus infections. Here, we investigated the role of CD44 as a molecule that mediates important aspects of the infection of macrophages with S. aureus. RESULTS: We showed that CD44 activation by S. aureus stimulated Asm via the formation of reactive oxygen species (ROS), resulting in ceramide release, clustering of CD44 in ceramide-enriched membrane platforms, CD44/Asm-dependent activation of Rho family GTPases, translocation of phospho-ezrin/radixin/moesin to the plasma-membrane, and a rapid rearrangement of the actin cytoskeleton with cortical actin polymerization...
July 26, 2017: Antioxidants & Redox Signaling
https://www.readbyqxmd.com/read/28746898/circulating-levels-of-the-angiogenesis-mediators-endoglin-hb-egf-bmp-9-and-fgf-2-in-patients-with-severe-sepsis-and-septic-shock
#3
Vanessa Boury Faiotto, Daniel Franci, Rodolfo Monteiro Enz Hubert, Gleice Regina de Souza, Maiara Marx Luz Fiusa, Bidossessi Wilfried Hounkpe, Thiago Martins Santos, Marco Antonio Carvalho-Filho, Erich Vinicius De Paula
PURPOSE: Endothelial barrier dysfunction is a hallmark of sepsis, and is at least partially mediated by pathways that regulate endothelial barrier assembly during angiogenesis. Not surprisingly, increased levels of key angiogenic proteins such as VEGF-A and Angiopoietin-2 have been described in sepsis. The purpose of this study was to investigate if additional pathways that regulate endothelial barrier integrity during angiogenesis could also be involved in the host response of sepsis...
July 17, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28743646/sepsis-and-septic-shock-new-definitions-new-diagnostic-and-therapeutic-approaches
#4
REVIEW
Silvano Esposito, Giuseppe De Simone, Giovanni Boccia, Francesco De Caro, Pasquale Pagliano
Sepsis and septic shock are common life-threatening pathologies associated with high mortality and substantial costs for healthcare system. Clinical guidelines and bundles for the management of patients with sepsis have recently been updated. Herein, we review the history of sepsis and related conditions definitions from the first consensus conference in 1991 to nowadays, the epidemiologic data resulting from worldwide studies on incidence and mortality, the diagnostic approaches including the microbiological assessment of infection and the use of several prognostic and diagnostic biomarkers and finally we review the main therapeutic measures as the intravenous immunoglobulin therapy and the administration of appropriate antibiotic treatment to provide patients with sepsis a favourable outcome in the antibiotic-resistance era...
July 22, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28742984/single-versus-combined-immunoregulatory-approach-using-pd-1-and-ctla-4-modulators-in-controlling-sepsis
#5
Courtney P Rudick, David L Cornell, Devendra K Agrawal
Sepsis is a disease process characterized by an extreme inflammatory response followed by a period of severe immunosuppression. In recent years, there has been improved survival in the initial immune response during systemic inflammatory response syndrome, and compensatory anti-inflammatory response, yet is mostly unchanged with 18-30% mortality during the later stage of sepsis despite numerous Phase 3 clinical trials. Areas covered: This review article presents a critical evaluation of the most promising newer studies aimed at improving the immunosuppressive stage of sepsis...
July 25, 2017: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/28742812/broad-range-lytic-bacteriophages-that-kill-staphylococcus-aureus-local-field-strains
#6
Virginia Abatángelo, Natalia Peressutti Bacci, Carina A Boncompain, Ariel A Amadio, Soledad Carrasco, Cristian A Suárez, Héctor R Morbidoni
Staphylococcus aureus is a very successful opportunistic pathogen capable of causing a variety of diseases ranging from mild skin infections to life-threatening sepsis, meningitis and pneumonia. Its ability to display numerous virulence mechanisms matches its skill to display resistance to several antibiotics, including β-lactams, underscoring the fact that new anti-S. aureus drugs are urgently required. In this scenario, the utilization of lytic bacteriophages that kill bacteria in a genus -or even species- specific way, has become an attractive field of study...
2017: PloS One
https://www.readbyqxmd.com/read/28742549/readmissions-for-recurrent-sepsis-new-or-relapsed-infection
#7
Kimberley Marie DeMerle, Stephanie C Royer, Mark E Mikkelsen, Hallie C Prescott
OBJECTIVES: Sepsis hospitalizations are frequently followed by hospital readmissions, often for recurrent sepsis. However, it is unclear how often sepsis readmissions are for relapsed/recrudescent versus new infections. The aim of this study was to assess the extent to which 90-day readmissions for recurrent sepsis are due to infection of the same site and same pathogen as the initial episode. DESIGN: Retrospective cohort study. SETTING: University of Michigan Health System...
July 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28741035/biomarkers-of-hepatic-injury-and-function-in-neonatal-hypoxic-ischemic-encephalopathy-and-with-therapeutic-hypothermia
#8
Hemananda Muniraman, Danielle Gardner, Jane Skinner, Anna Paweletz, Anitha Vayalakkad, Ying Hui Chee, Clare Clifford, Sunil Sanka, Vidheya Venkatesh, Anna Curley, Suresh Victor, Mark A Turner, Paul Clarke
Therapeutic hypothermia (TH) is now provided as standard care to infants with moderate-severe hypoxic ischemic encephalopathy (HIE). The role of TH in limiting neuronal injury is well recognized, but its effect on hepatic injury which occurs frequently in neonatal HIE is not known. Our objective was to characterize biomarkers of liver injury and function in the setting of neonatal HIE and to describe whether HIE severity and provision of TH influence these hepatic biomarkers. We performed a multicenter retrospective study and compared hepatic biomarkers obtained during the first postnatal week, according to the severity of HIE and whether treated with TH...
July 24, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28739652/in-hospital-quality-of-care-measures-for-pediatric-sepsis-syndrome
#9
Folafoluwa O Odetola, Gary Freed, Caroline Shevrin, Brian Madden, Julie McCormick, Kevin Dombkowski
BACKGROUND AND OBJECTIVES: Sepsis syndrome, comprising sepsis, severe sepsis, and septic shock, is a leading cause of child mortality and morbidity, for which the delivery of time-sensitive care leads to improved survival. We aimed to describe the development and testing of quality measures for in-hospital care of pediatric sepsis syndrome. METHODS: Seven measures of quality of care for children hospitalized with sepsis syndrome were developed by using an iterative process including literature review, development of concepts and candidate measures, and selection of measures for feasibility and importance by 2 panels of experts...
July 24, 2017: Pediatrics
https://www.readbyqxmd.com/read/28737878/-unusual-case-of-food-protein-induced-enterocolitis-syndrome
#10
M Teresa Sobrevia Elfau, Yolanda Aliaga Mazas, Gonzalo Herraiz Gastesi, Paula M Barberá Pérez, Ángela M Ascaso Matamala
Food protein-induced enterocolitis syndrome is a nonimmunoglobulin E mediated gastrointestinal food hypersensitivity that manifests as profuse, repetitive vomiting, pallor and hypotonia, often with diarrhea leading to severe dehydration and lethargy (sepsis-like symptoms) in the acute setting. An oral food challenge is sometimes performed to confirm the diagnosis and treatment consists of elimination of the food trigger(s) from the diet. We report a case of a 3-monthsold infant with several episodes of food protein-induced enterocolitis syndrome after taking infant formula milk with tolerance of another trademark...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28737626/perinatal-chikungunya-virus-associated-encephalitis-leading-to-postnatal-onset-microcephaly-and-optic-atrophy
#11
Regina Ramos, Rafaela Viana, Alessandra Brainer-Lima, Telma Florêncio, Maria Durce Carvalho, Vanessa van Der Linden, Antonio Amorim, Maria Ângela Rocha, Fabíola Medeiros
Chikungunya virus is capable of affecting the nervous system of children and adults. We describe a case of sepsis and encephalitis triggered by this agent in a newborn whose mother developed symptoms of acute infection two days before delivery. Consequently, the infant had severe encephalitis that evolved with postnatal-onset microcephaly, bilateral optic atrophy, epilepsy and cerebral palsy.
July 21, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28737575/diabetes-is-not-associated-with-increased-90-day-mortality-risk-in-critically-ill-patients-with-sepsis
#12
Lonneke A van Vught, Rebecca Holman, Evert de Jonge, Nicolette F de Keizer, Tom van der Poll
OBJECTIVES: To determine the association of pre-existing diabetes, hyperglycemia, and hypoglycemia during the first 24 hours of ICU admissions with 90-day mortality in patients with sepsis admitted to the ICU. DESIGN: We used mixed effects logistic regression to analyze the association of diabetes, hyperglycemia, and hypoglycemia with 90-day mortality (n = 128,222). SETTING: All ICUs in the Netherlands between January 2009 and 2014 that participated in the Dutch National Intensive Care Evaluation registry...
July 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28735135/endoscope-assisted-abscess-drainage-secondary-to-endoscope-assisted-tlif-1-year-follow-up
#13
Karthik Madhavan, Steven Shelby Burks, Lee Onn Chieng, Anand Veeravagu, Michael Y Wang
INTRODUCTION: Endoscopic discectomy and fusions have been gaining popularity in the recent past and are noted to be safe for its application in elderly population. It involves ultra-small incision for discectomy followed by placement of percutaneous screws in awake patients. Treatment of advanced spinal pathology using endoscope-assisted techniques are challenging. Although not common with endoscopic approach, post-operative infection can be problematic as there are no established guidelines on its management...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28731899/current-perspectives-on-invasive-nontyphoidal-salmonella-disease
#14
Andrea H Haselbeck, Ursula Panzner, Justin Im, Stephen Baker, Christian G Meyer, Florian Marks
PURPOSE OF REVIEW: We searched PubMed for scientific literature published in the past 2 years for relevant information regarding the burden of invasive nontyphoidal Salmonella disease and host factors associated with nontyphoidal Salmonella infection and discuss current knowledge on vaccine development. The following search terms were used: Salmonella, non typhoidal/nontyphoidal, NTS, disease, bloodstream infection, invasive, sepsis/septicaemia/septicemia, bacteraemia/bacteremia, gastroenteritis, incidence, prevalence, morbidity, mortality, case fatality, host/risk factor, vaccination, and prevention/control...
July 20, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28731836/mortality-rate-and-antibiotic-resistance-in-complicated-diverticulitis-report-of-272-consecutive-patients-worldwide-a-prospective-cohort-study
#15
Federico Coccolini, Mattia Trevisan, Giulia Montori, Massimo Sartelli, Fausto Catena, Marco Ceresoli, Antonio Costanzo, Arianna Heyer, Luca Ansaloni
BACKGROUND: Complicated diverticulitis (CD) is a common problem for surgeons. In treating it, as a general principle, every verified source of infection should be controlled. Supplementary antimicrobial management involves a delicate balance of optimizing empirical therapy while reducing unnecessary antibiotic use. The necessity to know the most frequent infecting pathogens and their spectra of resistance is becoming pivotal. The aim of this study was to determine the microbiologic profile of complicated intra-abdominal infections (IAIs) secondary to CD, to analyze the role of empirical antimicrobial therapy, and to describe the clinical aspects of CD worldwide...
July 21, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28730906/mortality-intensive-care-treatment-and-cost-evaluation-role-of-a-polymerase-chain-reaction-assay-in-patients-with-sepsis
#16
Markota Andrej, Sinkovič Andreja
Objective We examined whether patients with a positive SeptiFast (SF) assay (LightCycler SeptiFast; Roche Diagnostics, Basel, Switzerland) developed higher long-term mortality, a more difficult course of treatment, and a higher antimicrobial treatment cost than patients with a negative SF assay. Methods We performed a post-hoc analysis of data collected in a 1-year prospective interventional study of adults with severe sepsis and septic shock. In addition to the standard treatment, an additional 5 ml of blood was obtained for an SF assay, and the antimicrobial treatment was changed according to the SF results...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28729906/update-on-pediatric-sepsis-a-review
#17
REVIEW
Tatsuya Kawasaki
BACKGROUND: Sepsis is one of the leading causes of mortality among children worldwide. Unfortunately, however, reliable evidence was insufficient in pediatric sepsis and many aspects in clinical practice actually depend on expert consensus and some evidence in adult sepsis. More recent findings have given us deep insights into pediatric sepsis since the publication of the Surviving Sepsis Campaign guidelines 2012. MAIN TEXT: New knowledge was added regarding the hemodynamic management and the timely use of antimicrobials...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28727802/diagnostic-accuracy-of-procalcitonin-neutrophil-lymphocyte-count-ratio-c-reactive-protein-and-lactate-in-patients-with-suspected-bacterial-sepsis
#18
Lars Ljungström, Anna-Karin Pernestig, Gunnar Jacobsson, Rune Andersson, Barbara Usener, Diana Tilevik
BACKGROUND: Early recognition is a key factor to achieve improved outcomes for septic patients. Combinations of biomarkers, as opposed to single ones, may improve timely diagnosis and survival. We investigated the performance characteristics of sepsis biomarkers, alone and in combination, for diagnosis of verified bacterial sepsis using Sepsis-2 and Sepsis-3 criteria, respectively. METHODS: Procalcitonin (PCT), neutrophil-lymphocyte count ratio (NLCR), C-reactive protein (CRP), and lactate were determined in a total of 1,572 episodes of adult patients admitted to the emergency department on suspicion of sepsis...
2017: PloS One
https://www.readbyqxmd.com/read/28727607/new-onset-heart-failure-and-mortality-in-hospital-survivors-of-sepsis-related-left-ventricular-dysfunction
#19
Saraschandra Vallabhajosyula, Jacob C Jentzer, Jeffrey B Geske, Mukesh Kumar, Ankit Sakhuja, Akhil Singhal, Joseph T Poterucha, Kianoush Kashani, Joseph G Murphy, Ognjen Gajic, Rahul Kashyap
BACKGROUND: The association between new-onset left ventricular (LV) dysfunction during sepsis with long-term heart failure outcomes is lesser understood. METHODS: Retrospective cohort study of all adult patients with severe sepsis and septic shock between 2007 and 2014 that underwent echocardiography within 72 hours admitted to the intensive care unit. Patients with prior heart failure, LV dysfunction, and structural heart disease were excluded. LV systolic dysfunction was defined as LV ejection fraction <50% and LV diastolic dysfunction as ≥grade II...
July 19, 2017: Shock
https://www.readbyqxmd.com/read/28726607/acute-febrile-illness-and-complications-due-to-murine-typhus-texas-usa1-2
#20
Zeeshan Afzal, Sunand Kallumadanda, Feng Wang, Vagish Hemmige, Daniel Musher
Murine typhus occurs relatively commonly in southern Texas, as well as in California. We reviewed records of 90 adults and children in whom murine typhus was diagnosed during a 3-year period in 2 hospitals in southern Texas, USA. Most patients lacked notable comorbidities; all were immunocompetent. Initial signs and symptoms included fever (99%), malaise (82%), headache (77%), fatigue (70%), myalgias (68%), and rash (39%). Complications, often severe, in 28% of patients included bronchiolitis, pneumonia, meningitis, septic shock, cholecystitis, pancreatitis, myositis, and rhabdomyolysis; the last 3 are previously unreported in murine typhus...
August 2017: Emerging Infectious Diseases
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