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https://www.readbyqxmd.com/read/29331260/multifaceted-behavior-of-meckel-s-diverticulum-in-children
#1
Qingjiang Chen, Zhigang Gao, Lifeng Zhang, Yuebin Zhang, Tao Pan, Duote Cai, Qixing Xiong, Qiang Shu, Yunzhong Qian
PURPOSE/BACKGROUND: Meckel's diverticulum (MD) is one of the most common congenital malformations of gastrointestinal tract in children. However, the nonspecific clinical manifestations of MD often cause a diagnostic as well as therapeutic challenge to pediatric surgeon. This study aimed to review our experience in managing this disease while evaluating the management strategies. METHODS: We retrospectively analyzed the clinical data of all patients diagnosed with MD admitted to our center between January 2010 and December 2015...
December 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29327977/status-and-challenges-of-predicting-and-diagnosing-sepsis-in-burn-patients
#2
Mile Stanojcic, Roohi Vinaik, Marc G Jeschke
Burns are a common form of trauma that account for more than 300,000 deaths each year worldwide. Survival rates have improved over the past decades because of improvements in nutritional and fluid support, burn wound care, and infection control practices. Death, however, remains unacceptably high. The primary cause of death has changed over the last decades from anoxic causes to now predominantly infections and sepsis. Sepsis and septic complications are not only major contributors to poor outcomes, but they further result in longer hospital stay and higher healthcare costs...
January 12, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29325753/induced-hypothermia-in-patients-with-septic-shock-and-respiratory-failure-cass-a-randomised-controlled-open-label-trial
#3
Theis Skovsgaard Itenov, Maria Egede Johansen, Morten Bestle, Katrin Thormar, Lars Hein, Louise Gyldensted, Anne Lindhardt, Henrik Christensen, Stine Estrup, Henrik Planck Pedersen, Matthew Harmon, Uday Kant Soni, Silvia Perez-Protto, Nicolai Wesche, Ulrik Skram, John Asger Petersen, Thomas Mohr, Tina Waldau, Lone Musaeus Poulsen, Ditte Strange, Nicole P Juffermans, Daniel I Sessler, Else Tønnesen, Kirsten Møller, Dennis Karsten Kristensen, Alessandro Cozzi-Lepri, Jens D Lundgren, Jens-Ulrik Jensen
BACKGROUND: Animal models of serious infection suggest that 24 h of induced hypothermia improves circulatory and respiratory function and reduces mortality. We tested the hypothesis that a reduction of core temperature to 32-34°C attenuates organ dysfunction and reduces mortality in ventilator-dependent patients with septic shock. METHODS: In this randomised, controlled, open-label trial, we recruited patients from ten intensive care units (ICUs) in three countries in Europe and North America...
January 8, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29325521/adjuvant-treatment-of-resectable-biliary-tract-cancer-with-cisplatin-plus-gemcitabine-a-prospective-single-center-phase-ii-study
#4
Alexander R Siebenhüner, Heike Seifert, Helga Bachmann, Burkhardt Seifert, Thomas Winder, Jonas Feilchenfeldt, Stefan Breitenstein, Pierre-Alain Clavien, Roger Stupp, Alexander Knuth, Bernhard Pestalozzi, Panagiotis Samaras
BACKGROUND: Biliary tract cancer (BTC) is a dismal disease, even after curative intent surgery. We conducted this prospective, non-randomized phase II study to evaluate the feasibility and efficacy of cisplatin and gemcitabine as adjuvant treatment in patients with resected BTC. METHODS: Patients initially received gemcitabine 1000 mg/m2 alone on days 1, 8 and 15 every 28-days for a total of six cycles (single agent cohort), and after protocol amendment a combination therapy with gemcitabine 1000 mg/m2 and cisplatin 25 mg/m2 on days 1 and 8 was administered every 21 days for a total of eight cycles (combined regimen cohort)...
January 11, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29319760/acute-kidney-injury-in-critically-ill-obstetric-patients-a-cross-sectional-study-in-an-intensive-care-unit-in-northeast-brazil
#5
Geraldo Bezerra da Silva Junior, Suzanne Vieira Saintrain, Gabriel de Castro Castelo, Vanessa Ribeiro de Vasconcelos, Juliana Gomes Ramalho de Oliveira, Amanda Maria Timbó Rocha, Adolfo Gomes Vasconcelos Júnior, Maria Vieira de Lima Saintrain, Elizabeth De Francesco Daher
INTRODUCTION: Acute kidney injury (AKI) is a complication still poorly studied in the setting of obstetric patients, which is associated with increased mortality. Objective: The aim of this study was to investigate the frequency and risk factors of AKI among critically ill obstetric patients. METHODS: A cross-sectional study was conducted with all patients admitted to an intensive care unit (ICU) due to obstetric complications, in Fortaleza, Brazil, in the period between January 2012 and December 2014...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29319247/infection-associated-secondary-hemophagocytic-lymphohistiocytosis-in-sepsis-syndromes-a-tip-of-an-iceberg
#6
Arun Agarwal, Aakanksha Agarwal
Background: Hemophagocytic lymphohistiocytosis (HLH) is a rare, underdiagnosed, fatal and devastating hyperinflammatory syndrome that has gained increasing recognition over the past decade. Patients with HLH present with clinical and laboratory evidence of uncontrolled inflammation. Delay in diagnosis and management inevitably leads to a rapidly progressive and fatal course. In this case series, we present 7 cases of secondary HLH (sHLH) in adults with their presentation, course, and outcomes...
October 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29317968/b-type-natriuretic-peptide-a-predictor-for-mortality-intensive-care-unit-length-of-stay-and-hospital-length-of-stay-in-patients-with-resolving-sepsis
#7
Harsimar Singh, Daryl Ramai, Harshil Patel, Marina Iskandir, Sarina Sachdev, Rabjot Rai, Jay Patolia, Getaw Worku Hassen
Background: B-type natriuretic peptide (BNP) is a hormone secreted by cardiomyocytes in response to myocardial ischemia, increased ventricular wall tension, and overload. BNP is utilized as a diagnostic and prognostic marker in congested heart failure (CHF). Its prognostic value in sepsis is unknown. The aim of this study is to determine if BNP correlates with increased in-hospital mortality for septic patients. Methods: This was a retrospective study of 505 patients admitted for sepsis or severe sepsis or septic shock during the period of January 2013 and August 2014...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29315332/clinical-profile-and-outcomes-of-acute-cardiorenal-syndrome-type-5-in-sepsis-an-eight-year-cohort-study
#8
Saraschandra Vallabhajosyula, Ankit Sakhuja, Jeffrey B Geske, Mukesh Kumar, Rahul Kashyap, Kianoush Kashani, Jacob C Jentzer
BACKGROUND: To evaluate the clinical features and outcomes of acute cardiorenal syndrome type-5 in patients with severe sepsis and septic shock. METHODS: Historical cohort study of all adult patients with severe sepsis and septic shock admitted to the intensive care units (ICU) at Mayo Clinic Rochester from January 1, 2007 through December 31, 2014. Patients with prior renal or cardiac dysfunction were excluded. Patients were divided into groups with and without cardiorenal syndrome type-5...
2018: PloS One
https://www.readbyqxmd.com/read/29310701/severe-thoracic-trauma-still-an-independent-predictor-for-death-in-multiple-injured-patients
#9
Michael Grubmüller, Maximilian Kerschbaum, Eva Diepold, Katharina Angerpointner, Michael Nerlich, Antonio Ernstberger
BACKGROUND: Over the past, the severe thoracic trauma has had decisive influence on the outcome of multiple injured patients. Today, new therapies (e.g. extracorporeal membrane oxygenation (ECMO), protective ventilation methods and new forms of patient positioning) are available and applied regularly. What impact on the patient's outcome does the thoracic trauma have today? METHODS: Prospective data collection of multiple injured patients in a level-I trauma center was performed between 2008 and 2014...
January 8, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29310566/analysis-of-oxidative-stress-related-markers-in-critically-ill-polytrauma-patients-an-observational-prospective-single-center-study
#10
Mihai Sandesc, Alexandru Florin Rogobete, Ovidiu Horea Bedreag, Anca Dinu, Marius Papurica, Carmen Alina Cradigati, Mirela Sarandan, Sonia Elena Popovici, Lavinia Melania Bratu, Tiberiu Bratu, Adrian Tudor Stan, Dorel Sandesc
Critically ill polytrauma patients have increased production of free radicals (FRs) and consequent alterations in biochemical pathways, as well as disruption of cellular integrity, due to increased lipid peroxidation. The aim of this study was to investigate several biomarkers associated with increased oxidative stress in critically ill polytrauma patients, and to evaluate the effect of antioxidant treatment on the clinical outcome in these patients. A total of 67 polytrauma patients from an intensive care unit met the selection criteria...
January 9, 2018: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/29306875/serum-lactate-cut-offs-as-a-risk-stratification-tool-for-in-hospital-adverse-outcomes-in-emergency-department-patients-screened-for-suspected-sepsis
#11
Amith L Shetty, Kelly Thompson, Karen Byth, Petra Macaskill, Malcolm Green, Mary Fullick, Harvey Lander, Jonathan Iredell
OBJECTIVES: We investigated specific lactate thresholds for adverse outcomes in patients presenting to emergency departments (EDs) with suspected sepsis identified based on the performance of a sepsis screening algorithm. DESIGN AND SETTING: A standardised sepsis bundle was implemented across public hospitals in New South Wales, Australia, as a quality improvement initiative. A register of all adult ED presentations (≥18 years) meeting predefined criteria for sepsis was created, using a combination of data linkage and direct reporting from 97 participating sites...
January 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29304308/acute-kidney-injury-and-sepsis
#12
Steven J Skube, Stephen A Katz, Jeffrey G Chipman, Christopher J Tignanelli
BACKGROUND: Worldwide, both acute kidney injury (AKI) and sepsis are significant clinical complications, particularly in critical care patients. Sepsis is an important cause of AKI, and AKI is a common complication of sepsis. METHODS: We reviewed the literature, including current practice guidelines, on sepsis-associated AKI. RESULTS: We assessed causes of renal failure, potential mechanisms of sepsis-associated acute kidney injury, current practice guidelines, diagnostic criteria and methods, prevention strategies, treatment options, and outcomes...
January 5, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29303796/a-comparative-analysis-of-sepsis-identification-methods-in-an-electronic-database
#13
Alistair E W Johnson, Jerome Aboab, Jesse D Raffa, Tom J Pollard, Rodrigo O Deliberato, Leo A Celi, David J Stone
OBJECTIVES: To evaluate the relative validity of criteria for the identification of sepsis in an ICU database. DESIGN: Retrospective cohort study of adult ICU admissions from 2008 to 2012. SETTING: Tertiary teaching hospital in Boston, MA. PATIENTS: Initial admission of all adult patients to noncardiac surgical ICUs. INTERVENTIONS: Comparison of five different algorithms for retrospectively identifying sepsis, including the Sepsis-3 criteria...
January 4, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29296271/epidemiologic-analysis-of-central-vein-catheter-infection-in-burn-patients
#14
Maryam Roham, Mahnoush Momeni, Mohsen Saberi, Rahil Kheirkhah, Ali Jafarian, Hossein Rahbar
Background and Objectives: Currently, there are no well-defined guidelines or criteria for catheter-site care in burn patients, and there is little information about the epidemiology of central vein catheter (CVC) infection in such patients. This study aimed at addressing the epidemiological aspect of CVC infection in a sample of Iranian burn patients admitted to the largest referral burn center in Iran, Motahari Burn Center. Materials and Methods: A total of 191 burn patients were eligible for the study...
October 2017: Iranian Journal of Microbiology
https://www.readbyqxmd.com/read/29289687/a-comparison-of-the-quick-sofa-qsofa-and-sirs-criteria-for-the-diagnosis-of-sepsis-and-prediction-of-mortality-a-systematic-review-and-meta-analysis
#15
Rodrigo Serafim, Jose Andrade Gomes, Jorge Salluh, Pedro Póvoa
BACKGROUND: Several studies were published to validate quick-SOFA (qSOFA), namely in comparison with Systemic Inflammatory Response Syndrome (SIRS) criteria. We performed a systematic review and a meta-analysis with the aim of comparing qSOFA and SIRS in patients outside the ICU. METHOD: We searched the MEDLINE, CINAHL, and Web of Science database, from February 23rd, 2016 until June 30th, 2017, to identify full-text English language studies published after the Sepsis-3 publication that compared qSOFA and SIRS as well as sensitivity or specificity to diagnose sepsis, the hospital and ICU length of stay (LOS) and hospital mortality...
December 28, 2017: Chest
https://www.readbyqxmd.com/read/29289445/incidence-risk-factors-and-clinical-implications-of-pneumonia-after-surgery-for-geriatric-hip-fracture
#16
Daniel D Bohl, Robert A Sershon, Bryan M Saltzman, Brian Darrith, Craig J Della Valle
BACKGROUND: Little is known regarding the occurrence of pneumonia after hip fracture surgery. The purpose of this study is to determine the incidence, risk factors, and clinical implications of pneumonia after surgery for geriatric hip fracture. METHODS: The American College of Surgeons National Surgical Quality Improvement Program was used to retrospectively study geriatric patients undergoing surgery for hip fracture during 2006-2014. Independent risk factors for developing pneumonia within 30 days of surgery were identified using multivariate regression...
December 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29289378/prognostic-power-of-biomarkers-for-short-term-mortality-in-the-elderly-patients-seen-in-emergency-departments-due-to-infections
#17
Agustín Julián-Jiménez, María Cecilia Yañez, Juan González-Del Castillo, Manuel Salido-Mota, Begoña Mora-Ordoñez, María Jesús Arranz-Nieto, Manuel R Chanovas-Borras, Ferrán Llopis-Roca, Josep María Mòdol-Deltell, Gema Muñoz
OBJECTIVES: To analyse and compare 30-day mortality prognostic power of several biomarkers (C-reactive protein, procalcitonin, lactate, suPAR and pro-adremomedullin) in elderly patients seen in Emergency Departments (ED) due to infections. Secondly, if these could improve the prognostic accuracy of sepsis criteria (systemic inflammatory response syndrome and quick Sepsis-related Organ Failure Assessment [qSOFA]). METHODS: A prospective, observational, multicentre and analytical study...
December 27, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/29288645/the-effect-of-alcohol-consumption-on-the-risk-of-ards-a-systematic-review-and-meta-analysis
#18
Evangelia Simou, Jo Leonardi-Bee, John Britton
BACKGROUND: To conduct a systematic review and meta-analysis evaluating the association between alcohol consumption and the risk of Acute Respiratory Distress Syndrome (ARDS) in adults. METHODS: Medline, EMBASE and Web of Science were searched to identify observational studies evaluating the association between prior alcohol intake and the occurrence of ARDS among adults, published between 1985 and 2015 and with no language restriction. Reference lists were also screened...
December 27, 2017: Chest
https://www.readbyqxmd.com/read/29286559/high-incidence-of-acute-kidney-injury-during-chemotherapy-for-childhood-acute-myeloid-leukemia
#19
Liezl Du Plessis, Shahrad Rod Rassekh, Cherry Mammen
BACKGROUND/OBJECTIVES: Childhood acute myeloid leukemia (AML) is a rare and heterogeneous disease. Pediatric data on the epidemiology of acute kidney injury (AKI) in AML are limited. We report on the incidence of AKI in childhood AML and the risk factors associated with AKI episodes. METHODS: A retrospective cohort of 53 patients (≤18 years), with de novo AML, receiving chemotherapy over a 10-year period. All serum creatinine (SCr) levels during therapy-related hospitalizations were assessed to stage AKI episodes as per Kidney Disease: Improving Global Outcomes criteria...
December 29, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29285953/incidence-characteristics-and-prognosis-of-acute-kidney-injury-in-cameroon-a-prospective-study-at-the-douala-general-hospital
#20
Marie Patrice E Halle, Ndjifoum Moselle Chipekam, Gérard Beyiha, Hermine Fouda, Aminata Coulibaly, Romuald Hentchoya, Folefack Francois Kaze, Namme Henry Luma, Gloria Ashuntantang
OBJECTIVE: There are limited data on AKI in sub-Saharan Africa. We aim to determine the incidence, characteristics and prognosis of AKI in Cameroon. PATIENTS AND METHODS: A prospective study including all consenting acute admissions in the internal medicine and the ICU of a tertiary referral hospital in Cameroon from January 2015 to June 2016. Serum creatinine assay was done on admission, days 2 and 7 to diagnose AKI. For patients with AKI, serum creatinine was done on discharge, days 30, 60 and 90...
November 2018: Renal Failure
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