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https://www.readbyqxmd.com/read/28662085/metabolomic-profiling-to-characterize-acute-intestinal-ischemia-reperfusion-injury
#1
Rachel G Khadaroo, Thomas A Churchill, Victor Tso, Karen L Madsen, Chris Lukowski, Saad Y Salim
Sepsis and septic shock are the leading causes of death in critically ill patients. Acute intestinal ischemia/reperfusion (AII/R) is an adaptive response to shock. The high mortality rate from AII/R is due to the severity of the disease and, more importantly, the failure of timely diagnosis. The objective of this investigation is to use nuclear magnetic resonance (NMR) analysis to characterize urine metabolomic profile of AII/R injury in a mouse model. Animals were exposed to sham, early (30 min) or late (60 min) acute intestinal ischemia by complete occlusion of the superior mesenteric artery, followed by 2 hrs of reperfusion...
2017: PloS One
https://www.readbyqxmd.com/read/28660809/the-effect-of-stage-of-hiv-disease-as-determined-by-cd4-count-on-clinical-outcomes-of-surgical-sepsis-in-south-africa
#2
S Green, V Y Kong, G L Laing, J L Bruce, J Odendaal, B Sartorius, D L Clarke
INTRODUCTION This paper reviews the impact of the stage of human immunodeficiency virus (HIV) disease on the outcome of surgical sepsis. METHODS All adult emergency general surgical patients (aged >15 years) who fulfilled the criteria for sepsis or septic shock, with a documented surgical source of infection, and who were HIV positive were reviewed. RESULTS During the 5-year study period, a total of 675 patients with a documented surgical source of sepsis were managed by our service; 142 (21%) of these were HIV positive...
July 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28657528/il-6-mmp-3-and-prognosis-in-previously-healthy-sepsis-patients
#3
Juan Pablo Ricarte-Bratti, Nilda Y Brizuela, Nicolas Jaime-Albarran, Hilda L Montrull
Sepsis and septic shock are clinical conditions with high mortality despite advances in technology and are the leading cause of death in intensive care. Clinical manifestations and morbidity may be attributable to a disproportionate increase in proinflammatory cytokines. The aim of this study was to evaluate the ability to predict mortality from interleukin 6 [IL-6] and matrix metalloproteinase 3 [MMP-3]. This single-center, observational, prospective study included 48 adult patients admitted to the Hospital Nacional de Clinicas in Cordoba, Argentina, with sepsis or septic shock...
2017: Revista de la Facultad de Ciencias Médicas
https://www.readbyqxmd.com/read/28622312/clinical-features-and-prognostic-factors-of-klebsiella-endophthalmitis-10-year-experience-in-an-endemic-region
#4
C Y Chung, E S Wong, C C H Liu, M O M Wong, K K W Li
AimsTo identify the clinical features and prognostic factors of endogenous endophthalmitis caused by Klebsiella pneumoniae.MethodsThis is a retrospective case series of all patients with Klebsiella endophthalmitis managed from January 2006 to December 2015 by Kowloon East Ophthalmic Service. Statistical analysis involved hypothesis testing on the SPSS 18.0 software (SPSS). A significance level of P<0.05 was taken.ResultsIn the 10-year period, K. pneumoniae accounted for 19 out of 39 cases of endogenous endophthalmitis (48...
June 16, 2017: Eye
https://www.readbyqxmd.com/read/28602703/clinical-predictors-and-outcomes-of-klebsiella-pneumoniae-bacteraemia-in-a-regional-hospital-in-hong-kong
#5
M Y Man, H P Shum, Y H Chan, K C Chan, W W Yan, R A Lee, S K P Lau
BACKGROUND: Klebsiella pneumoniae (KP) infection is associated with high morbidity and mortality. Multidrug resistance, especially extended-spectrum β-lactamase (ESBL) production, in KP is endemic worldwide. AIM: To evaluate the clinical characteristics and outcomes of patients with KP bacteraemia in critical care and general ward settings. METHODS: Adult patients admitted to a regional hospital in Hong Kong from January 1(st), 2009 to June 30(th), 2016 (7...
June 9, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28579457/metformin-ameliorates-gender-and-age-dependent-hemodynamic-instability-and-myocardial-injury-in-murine-hemorrhagic-shock
#6
Dzmitry Matsiukevich, Giovanna Piraino, Patrick Lahni, Paul W Hake, Vivian Wolfe, Michael O'Connor, Jeanne James, Basilia Zingarelli
Severity of multiple organ failure is significantly impacted by age and gender in patients with hemorrhagic shock. However, the molecular mechanisms underlying the enhanced organ injury are not fully understood. AMP-activated protein kinase (AMPK) is a pivotal orchestrator of metabolic responses during stress. We investigated whether hemorrhage-induced myocardial injury is age and gender dependent and whether treatment with metformin, an AMPK activator, affords cardioprotective effects. C57/BL6 young (3-5months) and mature (9-12months) male and female mice were subjected to hemorrhagic shock by blood withdrawing followed by resuscitation with blood and Lactated Ringer's solution...
June 1, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28558024/maternal-age-and-severe-maternal-morbidity-a-population-based-retrospective-cohort-study
#7
Sarka Lisonkova, Jayson Potts, Giulia M Muraca, Neda Razaz, Yasser Sabr, Wee-Shian Chan, Michael S Kramer
BACKGROUND: One of the United Nations' Millennium Development Goals of 2000 was to reduce maternal mortality by 75% in 15 y; however, this challenge was not met by many industrialized countries. As average maternal age continues to rise in these countries, associated potentially life-threatening severe maternal morbidity has been understudied. Our primary objective was to examine the associations between maternal age and severe maternal morbidities. The secondary objective was to compare these associations with those for adverse fetal/infant outcomes...
May 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28329088/short-course-adjunctive-gentamicin-as-empirical-therapy-in-patients-with-severe-sepsis-and-septic-shock-a-prospective-observational-cohort-study
#8
David S Y Ong, Jos F Frencken, Peter M C Klein Klouwenberg, Nicole Juffermans, Tom van der Poll, Marc J M Bonten, Olaf L Cremer
Background.: Metaanalyses failed to demonstrate clinical benefits of beta lactam plus aminoglycoside combination therapy compared to beta lactam monotherapy in patients with sepsis. However, few data exist on the effects of short-course adjunctive aminoglycoside therapy in sepsis patients with organ failure or shock. Methods.: We prospectively enrolled consecutive patients with severe sepsis or septic shock in 2 intensive care units in the Netherlands from 2011 to 2015...
June 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28257334/an-unbalanced-inflammatory-cytokine-response-is-not-associated-with-mortality-following-sepsis-a-prospective-cohort-study
#9
MULTICENTER STUDY
Jos F Frencken, Lonneke A van Vught, Linda M Peelen, David S Y Ong, Peter M C Klein Klouwenberg, Janneke Horn, Marc J M Bonten, Tom van der Poll, Olaf L Cremer
OBJECTIVE: The prevailing theory of host response during sepsis states that an excessive production of pro-inflammatory mediators causes early deaths, whereas a predominantly anti-inflammatory response may lead to immunosuppression, secondary infection, and late deaths. We assessed inflammatory (im)balance by measuring pro-inflammatory interleukin-6 and anti-inflammatory interleukin-10 during three distinct time periods after sepsis, and assessed its association with mortality. DESIGN: Prospective observational cohort...
May 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28231640/mind-the-gap-mechanisms-regulating-the-endothelial-barrier
#10
REVIEW
M Y Radeva, J Waschke
The endothelial barrier consists of intercellular contacts localized in the cleft between endothelial cells, which is covered by the glycocalyx in a sievelike manner. Both types of barrier-forming junctions, i.e. the adherens junction (AJ) serving mechanical anchorage and mechanotransduction and the tight junction (TJ) sealing the intercellular space to limit paracellular permeability, are tethered to the actin cytoskeleton. Under resting conditions, the endothelium thereby builds a selective layer controlling the exchange of fluid and solutes with the surrounding tissue...
February 23, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28121217/qsofa-has-poor-sensitivity-for-prehospital-identification-of-severe-sepsis-and-septic-shock
#11
Maia Dorsett, Melissa Kroll, Clark S Smith, Phillip Asaro, Stephen Y Liang, Hawnwan P Moy
OBJECTIVES: Sepsis is a common and deadly disease process for which early recognition and intervention can significantly improve clinical outcomes. Despite this, sepsis remains underrecognized and therefore undertreated in the prehospital setting. Recent recommendations by the Society of Critical Care and European Society of Intensive Care Medicine advocate use of the qSOFA (quick Sequential [Sepsis-related] Organ Failure Assessment) score in non-ICU settings to screen for septic patients at greater risk for poor outcomes...
July 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28116595/early-risk-factors-and-the-role-of-fluid-administration-in-developing-acute-respiratory-distress-syndrome-in-septic-patients
#12
Raghu R Seethala, Peter C Hou, Imoigele P Aisiku, Gyorgy Frendl, Pauline K Park, Mark E Mikkelsen, Steven Y Chang, Ognjen Gajic, Jonathan Sevransky
BACKGROUND: Sepsis is a major risk factor for acute respiratory distress syndrome (ARDS). However, there remains a paucity of literature examining risk factors for ARDS in septic patients early in their course. This study examined the role of early fluid administration and identified other risk factors within the first 6 h of hospital presentation associated with developing ARDS in septic patients. METHODS: This was a secondary analysis of septic adult patients presenting to the Emergency Department or being admitted for high-risk elective surgery from the multicenter observational cohort study, US Critical Injury and Illness trial Group-Lung Injury Prevention Study 1 (USCIITG-LIPS 1, NCT00889772)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/27916077/-intestinal-barrier-dysfunction-and-its-related-factors-in-patients-with-sepsis
#13
W Liu, X H Wang, X J Yang, X Y Zhang, W J Qi
Objective: To investigate the relationship between related factors of intestinal barrier dysfunction in patients with sepsis or septic shock and severity of the condition. Methods: A prospective observational study was conducted in 31 sepsis patients, 28 septic shock patients, and 21 postoperative patients without sepsis (control group) who were admitted to intensive care unit (ICU) of General Hospital of Ningxia Medical University between November 2015 and June 2016. Blood samples were collected from the patients within 24 hours following admission to ICU...
November 29, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27873263/effects-of-volume-resuscitation-on-the-microcirculation-in-animal-models-of-lipopolysaccharide-sepsis-a-systematic-review
#14
REVIEW
Nchafatso G Obonyo, Jonathon P Fanning, Angela S Y Ng, Leticia P Pimenta, Kiran Shekar, David G Platts, Kathryn Maitland, John F Fraser
BACKGROUND: Recent research has identified an increased rate of mortality associated with fluid bolus therapy for severe sepsis and septic shock, but the mechanisms are still not well understood. Fluid resuscitation therapy administered for sepsis and septic shock targets restoration of the macro-circulation, but the pathogenesis of sepsis is complex and includes microcirculatory dysfunction. OBJECTIVE: The objective of the study is to systematically review data comparing the effects of different types of fluid resuscitation on the microcirculation in clinically relevant animal models of lipopolysaccharide-induced sepsis...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27703980/advanced-hemodynamic-management-in-patients-with-septic-shock
#15
REVIEW
Bernd Saugel, Wolfgang Huber, Axel Nierhaus, Stefan Kluge, Daniel A Reuter, Julia Y Wagner
In patients with sepsis and septic shock, the hemodynamic management in both early and later phases of these "organ dysfunction syndromes" is a key therapeutic component. It needs, however, to be differentiated between "early goal-directed therapy" (EGDT) as proposed for the first 6 hours of emergency department treatment by Rivers et al. in 2001 and "hemodynamic management" using advanced hemodynamic monitoring in the intensive care unit (ICU). Recent large trials demonstrated that nowadays protocolized EGDT does not seem to be superior to "usual care" in terms of a reduction in mortality in emergency department patients with early identified septic shock who promptly receive antibiotic therapy and fluid resuscitation...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27604184/high-reliability-pediatric-septic-shock-quality-improvement-initiative-and-decreasing-mortality
#16
Roni D Lane, Tomohiko Funai, Ron Reeder, Gitte Y Larsen
BACKGROUND AND OBJECTIVE: Septic shock impacts mortality, morbidity, and health care costs. A quality improvement (QI) initiative was launched to improve early recognition and timely treatment of patients with septic shock in a pediatric emergency department (PED). Our primary aim was to describe the longitudinal effectiveness of the program, iterative changes in clinical practice, and associated outcomes. METHODS: We implemented multiple interventions during our QI initiative (February 2007 to December 2014)...
October 2016: Pediatrics
https://www.readbyqxmd.com/read/27586973/-venous-to-arterial-carbon-dioxide-difference-to-arteriovenous-oxygen-content-difference-ratio-combined-with-lactate-to-predict-prognosis-of-patients-with-septic-shock
#17
S J Gong, J Song, J D Zhou, Y H Yu, H W Dai, M J Wang, L Li, Q H Xu, J Yan
OBJECTIVE: To investigate the prognostic significance of venous-to-arterial carbon dioxide difference to arteriovenous oxygen content difference ratio (Pv-aCO2/Ca-vO2 ratio) combined with lactate in patients with septic shock during the early phases of resuscitation. METHODS: A retrospective study was conducted for 104 septic shock patients. All patients received an initial fluid resuscitation according to the Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock, 2012(SSC2012)...
September 1, 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/27500722/treatment-of-pediatric-septic-shock-with-the-surviving-sepsis-campaign-guidelines-and-picu-patient-outcomes
#18
Jennifer K Workman, Stefanie G Ames, Ron W Reeder, E Kent Korgenski, Susan M Masotti, Susan L Bratton, Gitte Y Larsen
OBJECTIVES: The Surviving Sepsis Campaign recommends rapid recognition and treatment of severe sepsis and septic shock. Few reports have evaluated the impact of these recommendations in pediatrics. We sought to determine if outcomes in patients who received initial care compliant with the Surviving Sepsis Campaign time goals differed from those treated more slowly. DESIGN: Single center retrospective cohort study. SETTING: Emergency department and PICU at an academic children's hospital...
October 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27467907/incidence-predictors-and-outcomes-of-new-onset-atrial-fibrillation-in-critically-ill-patients-with-sepsis-a-cohort-study
#19
Peter M C Klein Klouwenberg, Jos F Frencken, Sanne Kuipers, David S Y Ong, Linda M Peelen, Lonneke A van Vught, Marcus J Schultz, Tom van der Poll, Marc J Bonten, Olaf L Cremer
RATIONALE: Patients admitted to intensive care units with sepsis are prone to developing cardiac dysrhythmias, most commonly atrial fibrillation. OBJECTIVES: To determine the incidence, risk factors, and outcomes of atrial fibrillation in a cohort of critically ill patients with sepsis. METHODS: We assessed the association between atrial fibrillation and mortality using time-dependent competing risks survival analysis. Subsequently, for development of a risk score estimating the probability of a first occurrence of atrial fibrillation within the following 24 hours, we performed logistic regression analysis...
January 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27464633/-advances-in-the-research-of-effects-of-cholinergic-anti-inflammatory-pathway-on-vital-organ-function-and-its-mechanism
#20
REVIEW
X H Li, Y M Yao
Serious major burns, trauma and surgical stress can easily develop into sepsis, and further result in septic shock or even multiple organ dysfunction syndrome (MODS). The mechanism of MODS is complicated, including excessive inflammation, immune dysfunction, coagulation disorder, and ischemia-reperfusion injury. Recent studies have demonstrated that the nervous system could significantly and quickly suppress systemic inflammatory response via the vagus nerve, which might improve multiple organ damage following acute injury...
July 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
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