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Sepsis care

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https://www.readbyqxmd.com/read/29045957/-clinical-characteristics-of-neonatal-fungal-sepsis-in-neonatal-intensive-care-unit
#1
X Zhang, X F Ru, Y Wang, X Li, T Sang, Q Feng
OBJECTIVE: To study the characteristics of neonatal fungal sepsis and the difference between bacterial sepsis and fungal sepsis. To improve the understanding of neonatal fungal sepsis. METHODS: Clinical data of neonatal fungal sepsis in neonatal intensive care unit (NICU) were collected from 2011 to 2016 in Peking University first Hospital. The clinical characteristics were analyzed retrospectively. The difference between neonatal fungal sepsis and bacterial sepsis was also analyzed...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29038667/predicting-mortality-of-patients-with-sepsis-a-comparison-of-apache-ii-and-apache-iii-scoring-systems
#2
Farid Sadaka, Cheikh EthmaneAbouElMaali, Margaret A Cytron, Kimberly Fowler, Victoria M Javaux, Jacklyn O'Brien
BACKGROUND: Acute Physiology, Age and Chronic Health Evaluation (APACHE) II and III scores were developed in 1985 and 1991, respectively, and are used mainly for critically ill patients of all disease categories admitted to the intensive care unit (ICU). They differ in how chronic health status is assessed, in the number of physiologic variables included (12 vs. 17), and in the total score. These two scoring systems have not been compared in predicting hospital mortality in patients with sepsis...
November 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29038261/coadministration-of-minocycline-with-colistin-in-critically-ill-patients-is-associated-with-reduced-frequency-of-acute-renal-failure-a-retrospective-cohort-analysis
#3
Thomas P Lodise, Weihong Fan, David C Griffith, Michael N Dudley, Katherine A Sulham
Nonclinical studies have suggested oxidative damage, caspase-mediated apoptosis, and inducible nitric oxide synthase levels may be involved in the pathogenesis of colistin (CST)-associated acute renal failure. Synergistic antibacterial activity of minocycline (MIN) with polymyxins has been demonstrated in vitro, and MIN inhibits caspase 1, caspase 3, and inducible nitric oxide synthase, leading to the hypothesis that coadministration of CST with MIN (CST-MIN) may reduce incidence of acute renal failure. A multicenter retrospective cohort study was conducted using the Premier Research database to examine the impact of CST-MIN on acute renal failure...
October 16, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29036464/the-mimic-code-repository-enabling-reproducibility-in-critical-care-research
#4
Alistair E W Johnson, David J Stone, Leo A Celi, Tom J Pollard
Objective: Lack of reproducibility in medical studies is a barrier to the generation of a robust knowledge base to support clinical decision-making. In this paper we outline the Medical Information Mart for Intensive Care (MIMIC) Code Repository, a centralized code base for generating reproducible studies on an openly available critical care dataset. Materials and Methods: Code is provided to load the data into a relational structure, create extractions of the data, and reproduce entire analysis plans including research studies...
September 27, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29027207/resource-availability-for-the-management-of-maternal-sepsis-in-malawi-other-low-income-countries-and-lower-middle-income-countries
#5
Mohammed Abdu, Amie Wilson, Chisale Mhango, Fatima Taki, Arri Coomarasamy, David Lissauer
OBJECTIVE: To assess the availability of key resources for the management of maternal sepsis and evaluate the feasibility of implementing the Surviving Sepsis Campaign (SSC) recommendations in Malawi and other low-resource settings. METHODS: A cross-sectional study was conducted at health facilities in Malawi, other low-income countries, and lower-middle-income countries during January-March 2016. English-speaking healthcare professionals (e.g. doctors, nurses, midwives, and administrators) completed a questionnaire/online survey to assess the availability of resources for the management of maternal sepsis...
October 13, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29025165/impact-of-an-emergency-department-electronic-sepsis-surveillance-system-on-patient-mortality-and-length-of-stay
#6
Jonathan S Austrian, Catherine T Jamin, Glenn R Doty, Saul Blecker
Objective: The purpose of this study was to determine whether an electronic health record-based sepsis alert system could improve quality of care and clinical outcomes for patients with sepsis. Materials and Methods: We performed a patient-level interrupted time series study of emergency department patients with severe sepsis or septic shock between January 2013 and April 2015. The intervention, introduced in February 2014, was a system of interruptive sepsis alerts triggered by abnormal vital signs or laboratory results...
August 28, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29022532/hiv-positive-patients-in-the-intensive-care-unit-a-retrospective-audit
#7
P Mkoko, R I Raine
BACKGROUND: The indications for and outcomes of intensive care unit (ICU) admission of HIV-positive patients in resource-poor settings such as sub-Saharan Africa are unknown. OBJECTIVE: To identify indications for ICU admission and determine factors associated with high ICU and hospital mortality in HIV-positive patients. METHODS: We reviewed case records of HIV-positive patients admitted to the medical and surgical ICUs at Groote Schuur Hospital, Cape Town, South Africa, from 1 January 2012 to 31 December 2012...
September 22, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29020720/pyelonephritis-can-lead-to-life-threatening-complications
#8
Declan B Keenan, Declan M O'Rourke, Aisling E Courtney
Acute pyelonephritis is suggested by the constellation of fever (temperature ≥ 38.5° C), flank pain (typically unilateral), nausea and vomiting, and costovertebral angle tenderness. Complaints typical of lower UTI are variably present. The severity of symptoms ranges from a mild pyrexial illness to life-threatening sepsis. The diagnosis of acute pyelonephritis should be suspected on the basis of the history and clinical examination. If the urine dipstick is negative for nitrites and leukocyte esterase this does not exclude the diagnosis, but it should prompt a re-evaluation of the clinical features and consideration of other potential diagnoses...
February 2017: Practitioner
https://www.readbyqxmd.com/read/29016584/morbidities-and-outcome-of-a-neonatal-intensive-care-in-western-nepal
#9
Sudhir Adhikari, Kalipatanam Seshagiri Rao, Ganesh B K, Namraj Bahadur
BACKGROUND: Neonatal mortality rate of developing countries is declining over decades. In the recent years increasing number of preterm and high risk neonates have facilities for tertiary care treatment. The aim of the study was to assess the morbidities and outcome of neonatal intensive care admissions. METHODS: It was a retrospective observational study carried out in neonatal intensive care unit of the Manipal Teaching Hospital, Pokhara, Nepal from January 2014 to December 2015...
September 8, 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/29016490/neonatal-morbidity-and-maternal-complication-rates-in-women-with-a-delivery-body-mass-index-of-60-or-higher
#10
Tana Kim, Sabrina C Burn, Ananta Bangdiwala, Samantha Pace, Phillip Rauk
OBJECTIVE: To investigate neonatal morbidity and maternal complication rates with delivery body mass index (BMI) 60 or greater. METHODS: This retrospective, multicenter cohort study included singleton pregnancies between 23 and 42 weeks of gestation from January 2005 to April 2016. Women with BMI 60 or greater were compared with a random sample of women with BMI 30-59. The primary outcome, composite neonatal morbidity, was defined as 5-minute Apgar score less than 7, hypoglycemia, respiratory distress syndrome, sepsis, hospital stay greater than 5 days, neonatal intensive care unit admission, or neonatal death...
October 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29016484/a-novel-combination-of-biomarkers-to-herald-the-onset-of-sepsis-prior-to-the-manifestation-of-symptoms
#11
Hallie H Dolin, Thomas J Papadimos, Stanislaw Stepkowski, Xiaohuan Chen, Zhixing K Pan
Sepsis, which kills over 200,000 patients and costs over $20 billion in the U.S. alone, presents a constant but preventable challenge in the healthcare system. Among the more challenging problems that it presents is misdiagnosis due to conflation with other inflammatory processes, as its mechanisms are identical to those of other inflammatory states. Unfortunately, current biomarker tests can only assess the severity and mortality risk of each case, While no single test exists that can predict sepsis prior to the onset of symptoms for the purpose of pre-emptive care and monitoring...
October 6, 2017: Shock
https://www.readbyqxmd.com/read/28993230/the-importance-of-blood-platelet-lipid-signaling-in-thrombosis-and-in-sepsis
#12
REVIEW
Fanny Vardon Bounes, Abdulrahman Mujalli, Claire Cenac, Sonia Severin, Pauline Le Faouder, Gaëtan Chicanne, Frédérique Gaits-Iacovoni, Vincent Minville, Marie-Pierre Gratacap, Bernard Payrastre
Blood platelets are the first line of defense against hemorrhages and are also strongly involved in the processes of arterial thrombosis, a leading cause of death worldwide. Besides their well-established roles in hemostasis, vascular wall repair and thrombosis, platelets are now recognized as important players in other processes such as inflammation, healing, lymphangiogenesis, neoangiogenesis or cancer. Evidence is accumulating they are key effector cells in immune and inflammatory responses to host infection...
September 29, 2017: Advances in Biological Regulation
https://www.readbyqxmd.com/read/28993134/sepsis-caused-by-bloodstream-infection-in-patients-in-the-intensive-care-unit-the-impact-of-inactive-empiric-antimicrobial-therapy-on-outcome
#13
Daniel Brooks, Padmaja Polubothu, D Young, M G Booth, A Smith
BACKGROUND: Sepsis is one of the leading causes of death in the UK. AIMS: The aims of this study were to identify the rate of inactive antimicrobial therapy (AMT) in the ICU and whether inactive AMT had an effect on in hospital mortality, ICU mortality, 90-day mortality and length of hospital stay. Additionally, we wanted to identify risk factors for receiving inactive AMT. METHODS: This was a retrospective observational study conducted at Glasgow Royal Infirmary ICU between January 2010 and December 2013, with 12,000 blood cultures taken over this time period, of which n=127 were deemed clinically significant...
October 6, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28993098/acute-oncology-care-a-narrative-review-of-the-acute-management-of-neutropenic-sepsis-and-immune-related-toxicities-of-checkpoint-inhibitors
#14
Thomas Knight, Shin Ahn, Terry W Rice, Tim Cooksley
Cancer care has become increasingly specialized and advances in therapy have resulted in a larger number of patients receiving care. There has been a significant increase in the number of patients presenting with cancer related emergencies including treatment toxicities and those directly related to the malignancy. Suspected neutropenic sepsis is an acute medical emergency and empirical antibiotic therapy should be administered immediately. The goal of empirical therapy is to cover the most likely pathogens that will cause life-threatening infections in neutropenic patients...
October 6, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28993097/prognostic-value-of-early-warning-scores-in-the-emergency-department-ed-and-acute-medical-unit-amu-a-narrative-review
#15
REVIEW
R S Nannan Panday, T C Minderhoud, N Alam, P W B Nanayakkara
BACKGROUND: A wide array of early warning scores (EWS) have been developed and are used in different settings to detect which patients are at risk of deterioration. The aim of this review is to provide an overview of studies conducted on the value of EWS on predicting intensive care (ICU) admission and mortality in the emergency department (ED) and acute medical unit (AMU). METHODS: A literature search was conducted in the bibliographic databases PubMed and EMBASE, from inception to April 2017...
October 6, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28991827/sepsis-survivors-admitted-to-skilled-nursing-facilities-cognitive-impairment-activities-of-daily-living-dependence-and-survival
#16
William J Ehlenbach, Andrea Gilmore-Bykovskyi, Michael D Repplinger, Ryan P Westergaard, Elizabeth A Jacobs, Amy J H Kind, Maureen Smith
OBJECTIVE: Severe sepsis survivors frequently experience cognitive and physical functional impairment. The degree of impairment and its association with mortality is understudied, particularly among those discharged to a skilled nursing facility. Our objective was to quantify the cognitive and physical impairment among severe sepsis survivors discharged to a skilled nursing facility and to investigate the relationship between impairment and long-term mortality. DESIGN: Retrospective cohort study...
October 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28991317/-incidence-and-risk-factors-for-bacteremia-on-pediatric-patients-with-burns-in-a-specialized-care-center-in-mexico
#17
Teresa de J Chávez-Velarde, Juan C Lona-Reyes, Alejandra Riebeling-Dueñas, Luis G Orozco-Alatorre
BACKGROUND: Bacteremia events are frequent cause of mortality in burn patients and may originate from infected wounds, by bacterial translocation of endogenous microorganisms, from invasive devices or contaminated intravenous solutions. OBJECTIVE: To quantify the incidence of bacteremia in pediatric patients with burns and to identify risk factors. MATERIAL AND METHODS: A prospective cohort study was performed in pediatric patients with burns of Hospital Civil de Guadalajara "Dr...
June 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28991050/selective-lps-adsorption-using-polymyxin-b-immobilized-fiber-cartridges-in-sepsis-patients-following-cardiac-surgery
#18
Michael Yaroustovsky, Marina Abramyan, Ekaterina Komardina, Helen Nazarova, Dmitrii Popov, Marina Plyushch, Alina Soldatkina, Ekaterina Rogalskaya
Sepsis remains the leading cause of morbidity and mortality in intensive care units. The extracorporeal therapy in the complex treatment of sepsis seems to be the most promising direction.The aim of this study was to assess the safety and effectiveness of selective endotoxin adsorption on the basis of the analysis of our own experience with the intensive therapy for sepsis in adult cardiac surgical patients. MATERIALS AND METHODS: Our single-center study included 143 patients with sepsis...
October 4, 2017: Shock
https://www.readbyqxmd.com/read/28991047/vasopressors-do-not-influence-cerebral-critical-closing-pressure-during-systemic-inflammation-evoked-by-experimental-endotoxemia-and-sepsis-in-humans
#19
Judith Maria Dimphena van den Brule, Roeland Stolk, Elisabeth Janine Vinke, Lex Maxim van Loon, Peter Pickkers, Johannes Gerardus van der Hoeven, Matthijs Kox, Cornelia Wilhelmina Elisabeth Hoedemaekers
AIM: The aim of this study was to investigate the effects of different vasopressors on the cerebral vasculature during experimental human endotoxemia and sepsis. We used the critical closing pressure (CrCP) as a measure of cerebral vascular tone. METHODS: We performed a prospective pilot study, at the intensive care department (ICU) of a tertiary care university hospital in the Netherlands, in 40 healthy male subjects during experimental human endotoxemia (administration of bacterial lipopolysaccharide [LPS]) and in 10 patients with severe sepsis or septic shock...
October 4, 2017: Shock
https://www.readbyqxmd.com/read/28988002/the-effect-of-sepsis-and-septic-shock-on-the-viscoelastic-properties-of-clot-quality-and-mass-using-rotational-thromboelastometry-a-prospective-observational-study
#20
Gareth R Davies, Matthew Lawrence, Suresh Pillai, Gavin M Mills, Robert Aubrey, Dafydd Thomas, Rhodri Williams, Keith Morris, Phillip Adrian Evans
PURPOSE: The study purpose was to define changes in coagulation across the sepsis spectrum using rotational thromboelastometry (ROTEM). METHODS: Sepsis patients were recruited on admission to the Emergency Department and Intensive Care Units of a large teaching hospital in Wales. ROTEM markers of clot development and fibrinolysis were determined, as well as standard coagulation markers. A healthy control group matched for age and gender was also recruited (n=44)...
October 2, 2017: Journal of Critical Care
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