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Sepsis care

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https://www.readbyqxmd.com/read/29684391/a-randomized-control-trial-of-preoperative-prophylactic-antibiotics-prior-to-percutaneous-nephrolithotomy-in-low-infectious-risk-population-a-report-from-the-edge-consortium
#1
Ben H Chew, Nicole L Miller, Joel E Abbott, Dirk Lange, Mitchell R Humphreys, Vernon M Pais, Manoj Monga, Amy E Krambeck, Roger L Sur
INTRODUCTION: Single institution studies suggest a benefit of a week of preoperative antibiotics prior to percutaneous nephrolithotomy (PCNL). These studies are limited by lower quality methodology such as the inclusion of heterogeneous populations or the use of non-standard definitions of sepsis. The American Urological Association (AUA) Best Practice Statement recommends <24 hours of IV antibiotics, but no other data exist about the duration/benefit of preoperative antibiotics. We sought to perform a rigorous (using CONSORT guidelines), multi-institutional trial to assess preoperative antibiotics in PCNL patients at low risk of developing infections...
April 20, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29684341/predictors-of-outcome-in-patients-with-hematologic-malignancies-admitted-to-the-intensive-care-unit
#2
Nassar Al-Zubaidi, Emad Shehada, Khaled Alshabani, Jihane ZazaDitYafawi, Pascal Kingah, Ayman O Soubani
PURPOSE: Several studies showed conflicting results about prognosis and predictors of outcome of critically ill patients with hematological malignancies (HM). The aim of this study is to determine the hospital outcome of critically ill patients with HM and the factors predicting the outcome. METHODS AND MATERIALS: All patients with HM admitted to MICU at a tertiary academic medical center were enrolled. Clinical data upon admission and during ICU stay were collected...
April 17, 2018: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/29680459/application-of-the-new-sepsis-3-definition-in-a-cohort-of-patients-with-severe-sepsis-and-septic-shock-admitted-to-intensive-care-unit-from-the-emergency-department
#3
Renata García-Gigorro, Zaira Molina-Collado, Ignacio Sáez-de la Fuente, José Ángel Sanchez-Izquierdo, Juan Carlos Montejo González
BACKGROUND AND OBJECTIVES: After the publication of the new definition for sepsis and septic shock, our objective is to analyse the evolution of patients admitted to ICU with an infection process using the previous and new recommendations. MATERIALS AND METHODS: This is a sub-analysis of a previous observational prospective study. We included 98 patients admitted to ICU from the emergency department due to infection during an 18-month period. We studied the clinical evolution during ICU admission and hospital mortality...
April 18, 2018: Medicina Clínica
https://www.readbyqxmd.com/read/29680327/clinical-characteristics-of-patients-with-newly-developed-acute-cholecystitis-after-admission-to-the-intensive-care-unit
#4
Soo Jung Kim, Seok Jeong Lee, Su Hwan Lee, Jin Hwa Lee, Jung Hyun Chang, Yon Ju Ryu
INTRODUCTION: Critical care patients have many risk factors for acute cholecystitis (AC). However, less data are available regarding newly developed AC in critically ill patients. OBJECTIVES: To investigate the clinical features of AC occurring in critically ill patients after admission to an intensive care unit (ICU). METHODS: We performed a retrospective cohort study from January 2006 to August 2016 at a tertiary care university hospital...
April 18, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29680262/clinical-implications-of-intravenous-drug-incompatibilities-in-critically-ill-patients
#5
REVIEW
Malik Benlabed, Maxime Perez, Romain Gaudy, Stéphanie Genay, Damien Lannoy, Christine Barthélémy, Pascal Odou, Gilles Lebuffe, Bertrand Décaudin
OBJECTIVE: The aim of this review is to analyse the clinical consequences of intravenous drug incompatibilities in critically ill patients, especially the incidence of organ dysfunctions and mortality. METHODS: A review of literature was conducted according to the PRISMA statement in June 2017, using Medline, ISI Web of Science and Clinicaltrials.gov. DATA EXTRACTION: Eligible studies were case reports and randomised controlled trials (RCTs) that evaluated the effects of drug incompatibilities in critically ill patients on morbidity or mortality as primary or secondary outcomes, or adverse events...
April 19, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29679983/evaluation-of-a-real-time-pcr-assay-for-detection-and-quantification-of-bacterial-dna-directly-in-blood-of-preterm-neonates-with-suspected-late-onset-sepsis
#6
Marre van den Brand, Frank A M van den Dungen, Martine P Bos, Mirjam M van Weissenbruch, A Marceline van Furth, Annemieke de Lange, Anna Rubenjan, Remco P H Peters, Paul H M Savelkoul
BACKGROUND: Rapid and accurate diagnosis of neonatal sepsis is highly warranted because of high associated morbidity and mortality. The aim of this study was to evaluate the performance of a novel multiplex PCR assay for diagnosis of late-onset sepsis and to investigate the value of bacterial DNA load (BDL) determination as a measure of infection severity. METHODS: This cross-sectional study was conducted in a neonatal intensive care unit. Preterm and/or very low birth weight infants suspected for late-onset sepsis were included...
April 22, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29679702/alamandine-attenuates-sepsis-associated-cardiac-dysfunction-via-inhibiting-mapks-signaling-pathways
#7
Peng Li, Xi-Ru Chen, Fei Xu, Chi Liu, Chang Li, Hui Liu, Hui Wang, Wei Sun, Yan-Hui Sheng, Xiang-Qing Kong
Sepsis-induced myocardial dysfunction represents a major cause of death in intensive care units. Alamandine is an important biologically active peptide in the renin-angiotensin system. The present study evaluated whether alamandine improves cardiac dysfunction, inflammation, and apoptosis, and affects the signaling pathways involved in these events. Experiments were carried out in mice treated with lipopolysaccharide (LPS) or alamandine, and in neonatal rat cardiomyocytes. Alamandine increased the ejection fraction and fractional shortening, both of which were decreased upon LPS infusion in mice...
April 18, 2018: Life Sciences
https://www.readbyqxmd.com/read/29679162/circulating-troponin-i-level-in-patients-with-acute-ischemic-stroke
#8
REVIEW
Jacob VanHouten, Gregory Fricker, Bridget Collins, Ritwik Bhatia, Christopher Ellis, Matthew Schrag
PURPOSE OF REVIEW: Cardiac troponin levels in the blood are an important biomarker of acute coronary events, but may also be elevated in the context of acute ischemic stroke without an obvious concurrent myocardial insult. The objective of this study and systematic review is to determine how high the circulating troponin I level can rise due to ischemic stroke. RECENT FINDINGS: Anonymized medical records from Vanderbilt University Medical Center were reviewed identifying 151,972 unique acute ischemic stroke events, of which 1226 met criteria for inclusion in this study...
April 20, 2018: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/29678190/neonatal-and-congenital-malaria-a-case-series-in-malaria-endemic-eastern-uganda
#9
Peter Olupot-Olupot, Emma I E Eregu, Ketty Naizuli, Julie Ikiror, Linda Acom, Kathy Burgoine
BACKGROUND: Congenital malaria is the direct infection of an infant with malaria parasites from their mother prior to or during birth. Neonatal malaria is due to an infective mosquito bite after birth. Neonatal and congenital malaria (NCM) are potentially life-threatening conditions that are believed to occur at relatively low rates in malaria endemic regions. However, recent reports suggest that the number of NCM cases is increasing, and its epidemiology remains poorly described. NCM can mimic other neonatal conditions and because it is thought to be rare, blood film examinations for malaria are not always routinely performed...
April 20, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29677008/evolution-of-acute-kidney-injury-and-its-association-with-systemic-hemodynamics-in-children-with-fluid-refractory-septic-shock
#10
Akash Deep, Hiremath Sagar, Chulananda Goonasekera, Palaniswamy Karthikeyan, Joe Brierley, Abdel Douiri
OBJECTIVES: There are no studies in pediatrics evaluating the progression of acute kidney injury in septic shock. We investigated the evolution of sepsis-associated acute kidney injury and its association with systemic hemodynamics in children with fluid-refractory septic shock. DESIGN: Prospective cohort study. SETTING: PICU of a tertiary care hospital. PATIENTS: All patients with fluid-refractory septic shock (n = 61) between September 2010 and February 2014...
April 19, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29676341/the-prevalence-and-risk-factors-for-trichomonas-vaginalis-infection-amongst-human-immunodeficiency-virus-infected-pregnant-women-attending-the-antenatal-clinics-of-a-university-teaching-hospital-in-lagos-south-western-nigeria
#11
Olaolopin Ijasan, Kehinde Sharafadeen Okunade, Ayodeji Ayotunde Oluwole
Background: Trichomonas vaginalis infection is the most prevalent non-viral sexually transmitted infection worldwide. Interactions between this infection and human immunodeficiency virus (HIV) may cause adverse pregnancy outcomes such as preterm labour, premature rupture of membranes, chorioamnionitis, low birth weight and post-abortal sepsis. Aims: This study was aimed to determine the prevalence and risk factors of T. vaginalis infection amongst HIV-positive pregnant women attending antenatal care at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria...
January 2018: Nigerian Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29675402/poor-compliance-with-sepsis-guidelines-in-a-tertiary-care-children-s-hospital-emergency-room
#12
Benjamin Louis Moresco, Clinton Woosley, Morris Sauter, Utpal Bhalala
Objectives: This study aimed to assess factors related to adherence to the Pediatric Advanced Life Support guidelines for severe sepsis and septic shock in an emergency room (ER) of a tertiary care children's hospital. Methods: This was a retrospective, observational study of children (0-18 years old) in The Children's Hospital of San Antonio ER over 1 year with the International Consensus Definition Codes, version-9 (ICD-9) diagnostic codes for "severe sepsis" and "shocks...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29675258/livedo-reticularis-a-cutaneous-clue-to-an-underlying-endocrine-crisis
#13
Natasha Shrikrishnapalasuriyar, Mirena Noyvirt, Philip Evans, Bethan Gibson, Elin Foden, Atul Kalhan
A 54-year-old woman was admitted to hospital with a presumed allergic reaction to a single dose of amoxicillin given for a suspected upper respiratory tract infection. She complained of chest tightness although there was no wheeze or stridor. On examination, she was pyrexial, tachycardic, hypertensive and had a diffuse mottled rash on her lower limbs. Her initial investigations showed raised inflammatory markers. She was treated in the intensive care for a presumed anaphylactic reaction with an underlying sepsis...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29674368/effectiveness-of-the-facility-based-maternal-near-miss-case-reviews-in-improving-maternal-and-newborn-quality-of-care-in-low-income-and-middle-income-countries-a-systematic-review
#14
Marzia Lazzerini, Sonia Richardson, Valentina Ciardelli, Anna Erenbourg
OBJECTIVES: The maternal near-miss case review (NMCR) has been promoted by WHO as an approach to improve quality of care (QoC) at facility level. This systematic review synthesises evidence on the effectiveness of the NMCR on QoC and maternal and perinatal health outcomes in low-income and middle-income countries (LMICs). METHODS: Studies were searched for in six electronic databases (MEDLINE, Index Medicus, Web of Science, the Cochrane library, Embase, LILACS), with no language restrictions...
April 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29673855/activation-of-a-code-sepsis-in-the-emergency-department-is-associated-with-a-decrease-in-mortality
#15
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/29671037/-geriatric-intensive-care-patients-perspectives-and-limits-of-geriatric-intensive-care-medicine
#16
REVIEW
U Müller-Werdan, H-J Heppner, G Michels
Critically ill geriatric patients are vitally endangered due to the aging processes of organs, the frequently existing multimorbidity with subsequent polypharmacy and the typical geriatric syndrome of functional impairments. Aging processes in organs lower the clinical threshold for organ dysfunction and organ failure. Physiological organ aging processes with practical consequences for intensive care medicine are atypical manifestion of sepsis in immunosenescence, altered pharmacokinetics, reduced tolerance to hypovolemia due to proportionally reduced water compartment of the body in old age, the frequently only apparently normal function of the kidneys and the continuous reduction in pulmonary function in old age...
April 18, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29670801/nonoperative-management-of-multiple-penetrating-cardiac-and-colon-wounds-from-a-shotgun-a-case-report-and-literature-review
#17
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/29670613/innate-immunity-in-the-persistent-inflammation-immunosuppression-and-catabolism-syndrome-and-its-implications-for-therapy
#18
REVIEW
Hiroyuki Horiguchi, Tyler J Loftus, Russell B Hawkins, Steven L Raymond, Julie A Stortz, McKenzie K Hollen, Brett P Weiss, Elizabeth S Miller, Azra Bihorac, Shawn D Larson, Alicia M Mohr, Scott C Brakenridge, Hironori Tsujimoto, Hideki Ueno, Frederick A Moore, Lyle L Moldawer, Philip A Efron
Clinical and technological advances promoting early hemorrhage control and physiologic resuscitation as well as early diagnosis and optimal treatment of sepsis have significantly decreased in-hospital mortality for many critically ill patient populations. However, a substantial proportion of severe trauma and sepsis survivors will develop protracted organ dysfunction termed chronic critical illness (CCI), defined as ≥14 days requiring intensive care unit (ICU) resources with ongoing organ dysfunction...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29670404/evaluation-of-vancomycin-therapy-in-the-adult-icus-of-a-teaching-hospital-in-southern-iran
#19
Afsaneh Vazin, Motahare Mahi Birjand, Masoud Darake
Background: Vancomycin resistance in intensive care units (ICUs) accounts for significant morbidity and excess costs. The objective of the present study was to determine the appropriateness of vancomycin use in the various ICUs of Nemazee Hospital, Shiraz, Iran. Methods: This prospective study was performed on 95 critically ill patients (48 males and 47 females) who were treated with vancomycin for at least 3 subsequent doses in 6 ICUs during 12 months. Required demographic, clinical, and paraclinical data were collected by a pharmacist...
2018: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/29669791/retrospective-evaluation-of-infants-aged-1-60-days-with-residual-csf-tested-using-the-filmarray%C3%A2-meningitis-encephalitis-me-panel
#20
Anne J Blaschke, Kristen M Holmberg, Judy A Daly, Amy L Leber, Jennifer Dien Bard, Ernest K Korgenski, Kevin M Bourzac, Kristen J Kanack
In pediatric practice it is common for infants under 2 months of age to undergo evaluation for sepsis when they are ill, often including lumbar puncture (LP) to assess for central nervous system (CNS) infection. The FilmArray® Meningitis/Encephalitis (ME) Panel is a newly approved test for rapid identification of CNS pathogens. Our objective was to study the epidemiology of CNS infection in young infants and the potential impact of rapid multiplex PCR on their care.A performance evaluation of the FilmArray ME Panel was conducted from 2/2014-9/2014 at 11 sites...
April 18, 2018: Journal of Clinical Microbiology
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