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https://www.readbyqxmd.com/read/28930826/infective-endocarditis-in-patients-with-cancer-a-consequence-of-invasive-procedures-or-a-harbinger-of-neoplasm-a-prospective-multicenter-cohort
#1
Ana Fernández-Cruz, Patricia Muñoz, Carmen Sandoval, Carmen Fariñas, Manuel Gutiérrez-Cuadra, Juan M Pericás Pulido, José M Miró, Miguel Á Goenaga-Sánchez, Arístides de Alarcón, Francisco Bonache-Bernal, MªÁngeles Rodríguez, Mariam Noureddine, Emilio Bouza Santiago
The aim of the study was to draw a comparison between the characteristics of infective endocarditis (IE) in patients with cancer and those of IE in noncancer patients.Patients with IE, according to the modified Duke criteria, were prospectively included in the GAMES registry between January 2008 and February 2014 in 30 hospitals. Patients with active cancer were compared with noncancer patients.During the study period, 161 episodes of IE fulfilled the inclusion criteria. We studied 2 populations: patients whose cancer was diagnosed before IE (73...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28930478/mechanical-ventilation-induced-diaphragm-atrophy-strongly-impacts-clinical-outcomes
#2
Ewan C Goligher, Martin Dres, Eddy Fan, Gordon D Rubenfeld, Damon C Scales, Margaret S Herridge, Stefannie Vorona, Michael C Sklar, Nuttapol Rittayamai, Ashley Lanys, Alistair Murray, Deborah Brace, Cristian Urrea, W Darlene Reid, George Tomlinson, Arthur S Slutsky, Brian P Kavanagh, Laurent J Brochard, Niall D Ferguson
Rationale Diaphragm dysfunction worsens outcomes in mechanically ventilated patients but the clinical impact of potentially preventable changes in diaphragm structure and function due to mechanical ventilation is unknown. Objectives To determine whether diaphragm atrophy developing during mechanical ventilation leads to prolonged ventilation. Methods Diaphragm thickness was measured daily by ultrasound in adults requiring invasive mechanical ventilation; inspiratory effort was assessed by thickening fraction...
September 20, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28929056/clinico-pathological-profile-of-deep-neck-space-infection-a-prospective-study
#3
Rumpa Das, Gorakh Nath, Anupam Mishra
Deep neck space infections (DNI) has been a common and serious disease, involving several spaces created by planes of greater and lesser resistance between the fascial layers of the neck. Infection of deep neck space has been dangerous due to its potential ease of spread from one space to other space, associated sepsis and upper airway obstruction. This prospective study was done in 45 patients of DNI over a period of 1 year. Patients with age of 1 month to 80 years of both the sexes were included. Patient's particular, clinical presentation and associated co-morbid conditions, physical examination, routine laboratory investigations and radiological investigations were analyzed...
September 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28929043/supraventricular-tachycardia-and-tricuspid-regurgitation-in-the-setting-of-misplaced-implantable-port-catheter-tip
#4
Ahmad Awan, Bisma Ahsan, Hasan Iftikhar, Akbar Khan, Fasil Tiruneh, Yididia Bekele, Ankit Mahajan, Ahmed A Awan
We present the case of a 31-year-old female with a past medical history of B-cell leukemia, on maintenance chemotherapy administered via centrally placed implantable catheter port, who presented to the emergency room with fever, chills, and generalized body pain of one day's duration. After initial workup, the patient was admitted to the intensive care unit and managed for severe sepsis. The patient was found to have a new-onset 3/6 holosystolic murmur at the left lower sternal border. Furthermore, she developed an episode of supraventricular tachycardia that responded to adenosine...
July 11, 2017: Curēus
https://www.readbyqxmd.com/read/28929005/long-standing-esophageal-perforation-due-to-foreign-body-impaction-in-children-a-therapeutic-challenge-in-a-resource-limited-setting
#5
Ngo Nonga Bernadette, Jean Jacques Ze, Angele O Pondy, Claude M Kalla, Nelly Kamgaing, Daniel Handy Eone
Late presentation of foreign body impaction in the esophagus, complicated by perforation in children, has rarely been reported in the literature. Esophageal surgery is very difficult and challenging in Cameroon (a resource limited setting). We are reporting herein 2 cases of esophageal perforation in children seen very late (12 days and 40 days) after foreign body impaction, complicated with severe sepsis, who were successfully operated upon with very good results.
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28926879/-systematic-evaluation-on-effectiveness-and-safety-of-recombinant-human-growth-hormone-in-treating-adult-patients-with-severe-burn
#6
F Y Tian, B Wu, T Xu, X H Jiang
Objective: To systcmatically evaluate the effectiveness and safety of recombinant human growth hormone (rhGH) in treating adults with severe burn. Methods: Databases including PubMed, Cochrane Library, and Embase were searched using key words " burns, thermal, human growth hormone, growth hormone, hGH, and somatropin (human)" , and China Biology Medicine disc, Chinese Journals Full-text Database, VIP Database, and Wanfang Database were searched using key words in Chinese version "," to obtain the randomized controlled trials about rhGH in the treatment of adults with severe burn from the establishment of each database to December 2016...
September 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28926489/high-levels-of-morbidity-and-mortality-among-pediatric-hematopoietic-cell-transplant-recipients-with-severe-sepsis-insights-from-the-sepsis-prevalence-outcomes-and-therapies-international-point-prevalence-study
#7
Robert B Lindell, Shira J Gertz, Courtney M Rowan, Jennifer McArthur, Florian Beske, Adrian Plunkett, Scott L Weiss, Neal J Thomas, Vinay M Nadkarni, Julie C Fitzgerald
OBJECTIVES: Pediatric severe sepsis is a major cause of morbidity and mortality worldwide, and hematopoietic cell transplant patients represent a high-risk population. We assessed the epidemiology of severe sepsis in hematopoietic cell transplant patients, describing patient outcomes compared with children with no history of hematopoietic cell transplant. DESIGN: Secondary analysis of the Sepsis PRevalence, OUtcomes, and Therapies point prevalence study, comparing demographics, sepsis etiology, illness severity, organ dysfunction, and sepsis-related treatments in patients with and without hematopoietic cell transplant...
September 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28924483/thyroidectomy-for-the-treatment-of-graves-thyrotoxicosis-in-thioamide-induced-agranulocytosis-and-sepsis
#8
Colin L Knight, Shamil D Cooray, Jaideep Kulkarni, Michael Borschmann, Mark Kotowicz
A 51 year old man presented with sepsis in the setting of thioamide-induced agranulocytosis. Empiric broad-spectrum antibiotics was followed by directed narrow-spectrum antibiotics, and his neutrophil count recovered with support from granulocyte-colony stimulating factor (G-CSF) analogue transfusions. After a brief period of multi-modal therapy for nine days including potassium iodide (Lugol's iodine), cholestyramine, propanolol and lithium to temper his persisting hyperthyroidism, a total thyroidectomy was performed while thyroid hormone levels remained at thyrotoxic levels...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28924310/use-of-corticosteroids-in-acute-respiratory-distress-syndrome-perspective-from-an-indian-intensive-care-unit
#9
Naveen G S Chandra, Saraschandra Vallabhajosyula, Barkur A Shastry, Shashaank Vallabhajosyula, Saarwaani Vallabhajosyula, Kavita Saravu
BACKGROUND: Acute respiratory distress syndrome (ARDS) causes overwhelming inflammation, which serves as a potential target for corticosteroids. Despite extensive Western literature, there are no Indian studies evaluating steroids in ARDS. METHODS: This was a retrospective study at an Indian intensive care unit (ICU) on ARDS patients. Demographic, clinical, laboratory, and imaging parameters were collected. Patients were divided into cohorts based on steroid use, and some received high-dose (2 mg/kg/day), whereas others received low-dose (1 mg/kg/day) steroids...
April 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28924140/linoleic-and-palmitoleic-acid-block-streptokinase-mediated-plasminogen-activation-and-reduce-severity-of-invasive-group-a-streptococcal-infection
#10
Katharina Rox, Rolf Jansen, Torsten G Loof, Christine M Gillen, Steffen Bernecker, Mark J Walker, Gursharan Singh Chhatwal, Rolf Müller
In contrast to mild infections of Group A Streptococcus (GAS) invasive infections of GAS still pose a serious health hazard: GAS disseminates from sterile sites into the blood stream or deep tissues and causes sepsis or necrotizing fasciitis. In this case antibiotics do not provide an effective cure as the bacteria are capable to hide from them very quickly. Therefore, new remedies are urgently needed. Starting from a myxobacterial natural products screening campaign, we identified two fatty acids isolated from myxobacteria, linoleic and palmitoleic acid, specifically blocking streptokinase-mediated activation of plasminogen and thereby preventing streptococci from hijacking the host's plasminogen/plasmin system...
September 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28923774/endotoxin-adsorption-direct-hemoperfusion-with-the-polymyxin-b-immobilized-fiber-column-pmx
#11
REVIEW
Tomoharu Shimizu, Toru Miyake, Naomi Kitamura, Masaji Tani, Yoshihiro Endo
Toraymyxin(®) is a medical device developed to adsorb circulating endotoxins in the blood using direct hemoperfusion therapy for patients with septic shock. In 1994, the Japanese National Health Insurance system approved the use of Toraymyxin for the treatment of endotoxemia and septic shock. Since then, Toraymyxin has been safely used in more than 100,000 cases in emergency and intensive care units in Japan. Toraymyxin is currently available for use in the clinical setting in 14 countries worldwide. In this study, we reviewed and introduced the development, clinical use, and efficacy of Toraymyxin and commented on its anticoagulant use and cartridge clotting issue in the treatment of severe sepsis and septic shock...
August 31, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28923474/beyond-the-inhaled-nitric-oxide-in-persistent-pulmonary-hypertension-of-the-newborn
#12
REVIEW
Mei-Yin Lai, Shih-Ming Chu, Satyan Lakshminrusimha, Hung-Chih Lin
Persistent pulmonary hypertension (PPHN) is a consequence of failed pulmonary vascular transition at birth and leads to pulmonary hypertension with shunting of deoxygenated blood across the ductus arteriosus (DA) and foramen ovale (FO) resulting in severe hypoxemia, and it may eventually lead to life-threatening circulatory failure. PPHN is a serious event affecting both term and preterm infants in the neonatal intensive care unit. It is often associated with diseases such as congenital diaphragmatic hernia, meconium aspiration, sepsis, congenital pneumonia, birth asphyxia and respiratory distress syndrome...
August 10, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28923303/an-extremely-high-bioavailability-of-orally-administered-vancomycin-in-a-patient-with-severe-colitis-and-renal-insufficiency
#13
Shingo Yamazaki, Takaaki Suzuki, Tatsuya Suzuki, Hirokazu Takatsuka, Masayuki Ishikawa, Noriyuki Hattori, Takeshi Fujishiro, Hideaki Miyauchi, Takehiko Oami, Noritaka Ariyoshi, Shigeto Oda, Hisahiro Matsubara, Itsuko Ishii
Because there is little absorption of orally administered vancomycin hydrochloride (VCM) through the normal intestinal microvillus membrane, the pharmacokinetics of VCM absorbed from the digestive tract are mostly unknown. Here we report a case of severe colitis and renal insufficiency in which the serum concentration of VCM reached the supratherapeutic range after oral administration. A 54-year-old man receiving outpatient chemotherapy for rectal cancer was admitted to our hospital for severe sepsis and acute renal failure...
September 8, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28919614/use-of-acute-physiology-and-chronic-health-evaluation-apache-ii-and-red-cell-distribution-width-rdw-for-assessment-of-mortality-of-patients-with-sepsis-in-icu
#14
A Q Huda, M R Karim, M A Mahmud, M S Islam, M F Haque, M R Islam, M A Hossain
Critically ill patients of Intensive Care Unit (ICU) need highest level of monitoring, intense nursing care and integrated management which are very expensive and consume significant part of hospital resources. Prediction of outcome from disease has become an essential component of health science. So, various scoring systems have been developed to predict outcome of critically ill patients in ICU. There is no perfect model of severity score to predict ICU mortality. Search for new system is still remaining as continuous efforts to find the best model to get accurate information about the prognosis and outcome of critically ill patients...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28918911/mortality-of-severe-septic-patients-between-physician-s-high-and-low-care-volumes
#15
Chun-Yao Lin, Jo-Chi Tseng, Chih-Yu Huang, Chien-Ming Chu, Huang-Pin Wu
BACKGROUND: Patients with severe sepsis frequently require intensive care unit (ICU) admission and different ICU care models may influence their outcomes. The mortality of severe septic patients between physician's high and low care volume remains unclear. METHODS: We analyzed the data from a three-year prospective observation study, which was performed in an adult medical ICU of Chung Gung Memorial Hospital, Keelung. The data included initial bundle therapies based on the Surviving Sepsis Campaign (SSC) guidelines for patients with severe sepsis...
August 2017: Biomedical Journal
https://www.readbyqxmd.com/read/28918906/radiotherapy-and-the-tumor-microenvironment-the-macro-picture
#16
EDITORIAL
Emma Louise Walton
In this issue of the Biomedical Journal, we explore the inner workings of tumor-associated macrophages and seek to understand how these cells can boost or limit the efficacy of radiotherapy, depending on the context. We also highlight a study revealing that staffing patterns in the intensive care unit may affect the outcome of patients with severe sepsis. Finally, we learn how an advanced imaging technique can improve endodontic treatment planning.
August 2017: Biomedical Journal
https://www.readbyqxmd.com/read/28917004/critical-illness-associated-diaphragm-weakness
#17
REVIEW
Martin Dres, Ewan C Goligher, Leo M A Heunks, Laurent J Brochard
Diaphragm weakness is highly prevalent in critically ill patients. It may exist prior to ICU admission and may precipitate the need for mechanical ventilation but it also frequently develops during the ICU stay. Several risk factors for diaphragm weakness have been identified; among them sepsis and mechanical ventilation play central roles. We employ the term critical illness-associated diaphragm weakness to refer to the collective effects of all mechanisms of diaphragm injury and weakness occurring in critically ill patients...
September 15, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28916371/ramucirumab-plus-docetaxel-versus-placebo-plus-docetaxel-in-patients-with-locally-advanced-or-metastatic-urothelial-carcinoma-after-platinum-based-therapy-range-a-randomised-double-blind-phase-3-trial
#18
Daniel P Petrylak, Ronald de Wit, Kim N Chi, Alexandra Drakaki, Cora N Sternberg, Hiroyuki Nishiyama, Daniel Castellano, Syed Hussain, Aude Fléchon, Aristotelis Bamias, Evan Y Yu, Michiel S van der Heijden, Nobuaki Matsubara, Boris Alekseev, Andrea Necchi, Lajos Géczi, Yen-Chuan Ou, Hasan Senol Coskun, Wen-Pin Su, Miriam Hegemann, Ivor J Percent, Jae-Lyun Lee, Marcello Tucci, Andrey Semenov, Fredrik Laestadius, Avivit Peer, Giampaolo Tortora, Sufia Safina, Xavier Garcia Del Muro, Alejo Rodriguez-Vida, Irfan Cicin, Hakan Harputluoglu, Ryan C Widau, Astra M Liepa, Richard A Walgren, Oday Hamid, Annamaria H Zimmermann, Katherine M Bell-McGuinn, Thomas Powles
BACKGROUND: Few treatments with a distinct mechanism of action are available for patients with platinum-refractory advanced or metastatic urothelial carcinoma. We assessed the efficacy and safety of treatment with docetaxel plus either ramucirumab-a human IgG1 VEGFR-2 antagonist-or placebo in this patient population. METHODS: We did a randomised, double-blind, phase 3 trial in patients with advanced or metastatic urothelial carcinoma who progressed during or after platinum-based chemotherapy...
September 12, 2017: Lancet
https://www.readbyqxmd.com/read/28916127/open-thoracic-and-thoraco-abdominal-aortic-repair-in-patients-with-connective-tissue-disease
#19
Paula R Keschenau, Drosos Kotelis, Jeroen Bisschop, Mohammad E Barbati, Jochen Grommes, Barend Mees, Alexander Gombert, Arnoud G Peppelenbosch, Geert Willem H Schurink, Johannes Kalder, Michael J Jacobs
OBJECTIVE/BACKGROUND: The aim is to present current results of open complex aortic repair in patients with connective tissue disease (CTD). METHODS: This was a retrospective cross-border, single centre study. From February 2000 to April 2016 72 aortic operations were performed on 65 patients with CTD (41 male, median age 41 years [range 19-70 years]). Fifty-six patients (86%) underwent at least one previous aortic repair (71 open, four endovascular), including 33 patients (51%) operated before at the site of the procedure reported here...
September 12, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28916121/controversies-in-corticosteroid-use-for-sepsis
#20
Brit Long, Alex Koyfman
BACKGROUND: Severe sepsis and septic shock are potentially deadly conditions managed in the emergency department (ED). Management centers on source control, fluid resuscitation, broad-spectrum antimicrobials, and vasopressors as needed. The use of corticosteroids is controversial. OBJECTIVE: To evaluate the evidence behind corticosteroid therapy in patients with septic shock. DISCUSSION: Septic shock is associated with severe mortality and morbidity...
September 12, 2017: Journal of Emergency Medicine
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