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https://www.readbyqxmd.com/read/29782519/increased-circulating-microrna-122-is-a-biomarker-for-discrimination-and-risk-stratification-in-patients-defined-by-sepsis-3-criteria
#1
Tim Rahmel, Simon T Schäfer, Ulrich H Frey, Michael Adamzik, Jürgen Peters
BACKGROUND: Sepsis is now operationally defined as life-threatening organ dysfunction caused by an infection, identified by an acute change in SOFA-Score of at least two points, including clinical chemistry such as creatinine or bilirubin concentrations. However, little knowledge exists about organ-specific microRNAs as potentially new biomarkers. Accordingly, we tested the hypotheses that micro-RNA-122, the foremost liver-related micro-RNA (miR), 1) discriminates between sepsis and infection, 2) is an early predictor for mortality, and 3) improves the prognostic value of the SOFA-score...
2018: PloS One
https://www.readbyqxmd.com/read/29782353/implementing-best-practice-into-the-emergency-department-triage-process
#2
Luke Burgess, Kathryn Kynoch, Sonia Hines
BACKGROUND: Triage is the process by which emergency departments (EDs) sort patients presenting for medical treatment. The Australasian Triage Scale, validated to measure urgency, answers the question 'This patient should wait for medical assessment and treatment no longer than…' Multiple patients may present within short time frames, and some will have conditions that have outcomes directly related to timeliness of treatment such as stroke, sepsis and myocardial infarction. The safety of patients within the ED is thus directly related to the triage system...
May 17, 2018: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/29781085/effect-of-hypothermia-treatment-on-gentamicin-pharmacokinetics-in-neonates-with-hypoxic-ischaemic-encephalopathy-a-systematic-review-and-meta-analysis
#3
REVIEW
D W Choi, J H Park, S Y Lee, S H An
WHAT IS KNOWN AND OBJECTIVE: Hypothermia is the current standard therapy for asphyxiated neonates with hypoxic-ischaemic encephalopathy (HIE). Gentamicin is used for the empirical treatment of early-onset neonatal sepsis. We investigated the influence of hypothermia treatment on gentamicin pharmacokinetics and suggested the appropriate dosing recommendations for gentamicin in neonates with HIE receiving hypothermia treatment. METHODS: We searched studies published until February 2017 in MEDLINE using PubMed, EMBASE and the Cochrane Library...
May 20, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29778659/sepsis-3-septic-shock-criteria-and-associated-mortality-among-infected-hospitalized-patients-assessed-by-a-rapid-response-team
#4
Shannon M Fernando, Peter M Reardon, Bram Rochwerg, Nathan I Shapiro, Donald M Yealy, Andrew J E Seely, Jeffrey J Perry, Douglas P Barnaby, Kyle Murphy, Peter Tanuseputro, Kwadwo Kyeremanteng
BACKGROUND: Rapid Response Teams (RRTs) respond to deteriorating hospitalized patients, and help determine subsequent management, including Intensive Care Unit (ICU) admission. In such patients with sepsis and septic shock, the Sepsis-3 clinical criteria have a potential role in detection, risk-stratification, and prognostication, though their accuracy in comparison to the Systemic Inflammatory Response Syndrome (SIRS)-based septic shock criteria are unknown. We sought to evaluate prognostic accuracy of the Sepsis-3 criteria for in-hospital mortality among infected hospitalized patients with acute deterioration...
May 17, 2018: Chest
https://www.readbyqxmd.com/read/29776828/septic-acute-kidney-injury-patients-in-emergency-department-the-risk-factors-and-its-correlation-to-serum-lactate
#5
Yin-Chou Hsu, Chih-Wei Hsu
BACKGROUND: Acute kidney injury (AKI) is a common complication in septic patients, imposing a heavy burden of illness in terms of morbidity and mortality. Serum lactate is a widely used marker predicting the severity of sepsis. A paucity of research has investigated septic AKI in emergency departments (EDs) and its correlation with initial serum lactate level. This study aimed at identifying risk factors for septic AKI and clarifying the link between initial serum lactate level and septic AKI in ED patients...
May 15, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29775620/a-monoclonal-antibody-sandwich-elisa-for-vitamin-d-binding-protein-vdbp-is-unaffected-by-gc-globulin-phenotype-peptides-and-actin-and-demonstrates-reduced-levels-in-sepsis-and-non-sepsis-intensive-care-patients
#6
Katrina Hong, Christopher M Florkowski, Matthew P Doogue, Peter A Elder, John G Lewis
The measurement of vitamin D-binding protein (VDBP) by immunoassay has been confounded by variable antibody recognition of the Gc1s, Gc1F and Gc2 phenotypes. This has led to spurious conclusions regarding vitamin D status in different ethnic groups. In order to overcome these problems there is a requirement for VDBP antibodies that are unaffected by phenotype status. Here we report the generation and testing of three monoclonal antibodies to VDBP which recognise linear epitopes and are unaffected by vast molar excesses of synthetic peptides spanning these phenotypic domains...
May 15, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29773712/acute-kidney-injury-and-risk-of-heart-failure-and-atherosclerotic-events
#7
Alan S Go, Chi-Yuan Hsu, Jingrong Yang, Thida C Tan, Sijie Zheng, Juan D Ordonez, Kathleen D Liu
BACKGROUND AND OBJECTIVES: AKI in the hospital is common and is associated with excess mortality. We examined whether AKI is also independently associated with a higher risk of different cardiovascular events in the first year after discharge. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective analysis of a cohort between 2006 and 2013 with follow-up through 2014, within Kaiser Permanente Northern California. We identified all adults admitted to 21 hospitals who had one or more in-hospital serum creatinine test result and survived to discharge...
May 17, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29771353/predictors-for-identifying-burn-sepsis-and-performance-versus-existing-criteria
#8
David M Hill, Matthew D Percy, Sai R Velamuri, Julio Lanfranco, Ivan Romero Legro, Scott E Sinclair, William L Hickerson
Sepsis is the largest cause of mortality in thermally injured patients. Traditional SIRS criteria do not aid diagnosis of sepsis in burn centers. Studies have attempted identification of the best indicators of sepsis in the thermal injured patient, but predictive variables are inconsistent across the various studies. Currently, consensus guidelines lack evidential support as to which patients will benefit most from prompt antimicrobial therapy. The purpose of our study was to evaluate novel diagnostic parameters for thermal injured patients with known sepsis and compare these parameters with existing diagnostic criteria...
May 16, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29770247/using-statistical-and-machine-learning-methods-to-evaluate-the-prognostic-accuracy-of-sirs-and-qsofa
#9
Akash Gupta, Tieming Liu, Scott Shepherd, William Paiva
Objectives: The objective of this study was to compare the performance of two popularly used early sepsis diagnostic criteria, systemic inflammatory response syndrome (SIRS) and quick Sepsis-related Organ Failure Assessment (qSOFA), using statistical and machine learning approaches. Methods: This retrospective study examined patient visits in Emergency Department (ED) with sepsis related diagnosis. The outcome was 28-day in-hospital mortality. Using odds ratio (OR) and modeling methods (decision tree [DT], multivariate logistic regression [LR], and naïve Bayes [NB]), the relationships between diagnostic criteria and mortality were examined...
April 2018: Healthcare Informatics Research
https://www.readbyqxmd.com/read/29763753/a-prospective-study-of-cancer-survivors-and-risk-of-sepsis-within-the-regards-cohort
#10
Justin Xavier Moore, Tomi Akinyemiju, Alfred Bartolucci, Henry E Wang, John Waterbor, Russell Griffin
BACKGROUND: Hospitalized cancer patients are nearly 10 times more likely to develop sepsis when compared to patients with no cancer history. We compared the risk of sepsis between cancer survivors and no cancer history participants, and examined whether race was an effect modifier. METHODS: We performed a prospective analysis of data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We categorized participants as "cancer survivors" or "no cancer history" derived from self-reported responses of being diagnosed with any cancer, excluding non-melanoma skin cancer...
May 11, 2018: Cancer Epidemiology
https://www.readbyqxmd.com/read/29761674/screening-arab-israeli-pregnant-women-for-group-b-streptococcus-by-the-amplivue-gbs-assay-are-the-rates-higher-than-the-national-average
#11
Marwan Hakim, Adel Jabour, Miriam Anton, Meggie Hakim, Sahar Kheirallah
BACKGROUND: The recommendation of the U.S. Centers for Disease Control and Prevention regarding universal screening for Group B Streptococcus (GBS) at 35-37 weeks gestational age in pregnancy is not accepted in Israel. The National Council for Obstetrics, Neonatology and Genetics recommends intrapartum prophylaxis, mainly based on risk factors, to prevent early neonatal GBS infection. This policy is based on past studies demonstrating low colonization rates of the bacteria in Israeli pregnant women and very low neonatal sepsis rates...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29758393/phase-i-trial-of-brentuximab-vedotin-for-steroid-refractory-chronic-graft-versus-host-disease-after-allogeneic-hematopoietic-cell-transplantation
#12
Zachariah DeFilipp, Shuli Li, Maria E Kempner, Jami Brown, Candice Del Rio, Betsy Valles, Chrisa Hunnewell, Meredith Saylor, Julie Vanderklish, Bimalangshu R Dey, Areej El-Jawahri, Steven L McAfee, Thomas R Spitzer, Yi-Bin Chen
We conducted a phase I study of brentuximab vedotin (BV), an antibody-drug conjugate targeting CD30, for the treatment of steroid-refractory chronic graft-versus-host disease (cGVHD). A modified 3+3 study design was used with the primary endpoint to determine the maximum tolerated dose (MTD) of BV in this population. Escalating doses of BV were planned, starting with 0.6 mg/kg q3weeks (dose level 0) and increasing by 0.3 mg/kg per dose level. BV was administered in 21-day cycles for up to 16 cycles of therapy...
May 11, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29756955/multicenter-study-of-parenteral-nutrition-in-non-critically-ill-elderly-patients-compared-to-younger-patients-study-iaios-pn-incidence-and-assessment-of-iatrogenesis-in-older-subjects-receiving-parenteral-nutrition
#13
Javier Mateu-de Antonio, David Berlana, Montserrat Pons-Bussom, Maria B Badia-Tahull, María Teresa Miana-Mena, Beatriz Martínez-Castro, Neus Sunyer-Esquerrà, Mónica Sanmartin-Suñer, Juan González-Valdivieso, Elisabet Leiva-Badosa, Eva Martínez-Bernabé, Anna Murgadella-Sancho, Nuria Mirerachs-Aranda, Anna Vila-Bundó, Jordi Fernández-Morató, María Teresa Vitales-Farrero
OBJECTIVE: this study assessed the incidence of hyperglycemia, hypertriglyceridemia, and liver function test (LFT) alterations among patients older and younger than 65 years receiving parenteral nutrition (PN). A secondary objective was to compare the incidence of any of these three events. MATERIAL AND METHODS: inclusion criteria were non-critically ill adult inpatients receiving PN for ≥ 7 days in 15 hospitals in Spain. Exclusion criteria were hyperglycemia, hypertriglyceridemia, LFT alterations, sepsis, shock, pancreatic/hepatobiliary surgery, renal failure, diabetes mellitus (DM) type 1, insulin-treated DM type 2, acute DM complications, or obesity prior to PN...
February 27, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29753454/response-of-a-local-hospital-to-a-burn-disaster-contributory-factors-leading-to-zero-mortality-outcomes
#14
Eng-Kean Yeong, Ciaran P O'Boyle, Hui-Fu Huang, Hao-Chih Tai, Yen-Chun Hsu, Shu-Yang Chuang, Yu-Feng Wu, Che-Wei Chang, Tom J Liu, Hong-Shiee Lai
OBJECTIVE: To investigate the outcomes of a local healthcare system in managing a burn mass casualty incident (BMCI). METHODS: Thirty-three victims admitted to the National Taiwan University Hospital within 96h of the explosion were included in the study. Data were recorded on: patient demographics, Baux score, laboratory data, management response, treatment strategies, and outcomes. Case notes from June 27, 2015 to November 2015 were reviewed with a focus on fluid resuscitation, ventilation support, nutrition, infection control, sepsis treatment, and wound closure plan...
May 9, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29750814/one-year-mortality-after-recovery-from-critical-illness-a-retrospective-cohort-study
#15
Sharukh Lokhandwala, Ned McCague, Abdullah Chahin, Braiam Escobar, Mengling Feng, Mohammad M Ghassemi, David J Stone, Leo Anthony Celi
RATIONALE: Factors associated with one-year mortality after recovery from critical illness are not well understood. Clinicians generally lack information regarding post-hospital discharge outcomes of patients from the intensive care unit, which may be important when counseling patients and families. OBJECTIVE: We sought to determine which factors among patients who survived for at least 30 days post-ICU admission are associated with one-year mortality. METHODS: Single-center, longitudinal retrospective cohort study of all ICU patients admitted to a tertiary-care academic medical center from 2001-2012 who survived ≥30 days from ICU admission...
2018: PloS One
https://www.readbyqxmd.com/read/29742943/comparison-between-presepsin-and-procalcitonin-in-early-diagnosis-of-neonatal-sepsis
#16
Agustin Iskandar, Maimun Z Arthamin, Kristin Indriana, Muhammad Anshory, Mina Hur, Salvatore Di Somma
BACKGROUND: Neonatal sepsis remains worldwide one of the leading causes of morbidity and mortality in both term and preterm infants. Lower mortality rates are related to timely diagnostic evaluation and prompt initiation of empiric antibiotic therapy. Blood culture, as gold standard examination for sepsis, has several limitations for early diagnosis, so that sepsis biomarkers could play an important role in this regard. This study was aimed to compare the value of the two biomarkers presepsin and procalcitonin in early diagnosis of neonatal sepsis...
May 9, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29739452/-elective-caesarean-section-at-38-39-weeks-gestation-compared-to-39-weeks-on-neonatal-outcomes-a-prospective-cohort-study
#17
Reihaneh Pirjani, Motahareh Afrakhteh, Mahdi Sepidarkish, Shahin Nariman, Mahboobeh Shirazi, Ashraf Moini, Ladan Hosseini
BACKGROUND: This study was conducted to compare neonatal complications in scheduled cesarean sections (CS) between 38 and 39 gestational weeks with CS performed after 39 gestational weeks in Iranian low -risk pregnant women. METHODS: In this cohort study, 2086 patients were enrolled based on the inclusion and exclusion criteria. The neonates were evaluated in terms of the following items: transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), sepsis, need for NICU hospitalization, birth weight, birth height, head circumference, and the first minute and fifth minute Apgar score...
May 8, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29735870/an-investigation-of-the-effects-of-the-mean-platelet-volume-platelet-distribution-width-platelet-lymphocyte-ratio-and-platelet-counts-on-mortality-in-patents-with-sepsis-who-applied-to-the-emergency-department
#18
M Orak, Y Karakoç, M Ustundag, Y Yildirim, M K Celen, C Güloglu
Aim: The aim of this study is to examine the role of the mean platelet volume (MPV), platelet distribution width (PDW), platelet/lymphocyte ratio (PLR), and platelet values for predicting mortality in patients with sepsis. Materials and Methods: This is a retrospective study, involving patients 18 years and above who were diagnosed with sepsis. Blood samples were analyzed for platelets characteristics (counts, MPV, PDW, and PLR). The patients were separated into two groups namely the survivors and deceased...
May 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29732433/bowel-injury-in-lumbar-spine-surgery-a-review-of-the-literature
#19
REVIEW
Ioannis Siasios, Kunal Vakharia, Asham Khan, Joshua E Meyers, Samantha Yavorek, John Pollina, Vassilios Dimopoulos
Although rarely documented in the medical literature, bowel perforation injury can be a severe complication of spine surgery. Our goal was to review current literature regarding this complication and study possible methods of avoidance. We conducted a literature search in the PubMed database between January 1960 and March 2016 using the terms abrasion, bowels, bowel, complication, injury, intestine, intra-abdominal sepsis/shock, perforation, lumbar, spine, surgery, visceral. Diagnostic criteria, outcomes, risk factors, surgical approach, and treatment strategy were the parameters extracted from the search results and used for review...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29727410/improved-diagnosis-and-treatment-of-bone-and-joint-infections-using-an-evidence-based-treatment-guideline
#20
Rachel D Quick, John Williams, Marisol Fernandez, Hilton Gottschalk, Peter Cosgrove, Kyle Kahlden, Kathryn Merkel, Lynn Thoreson, Patrick Boswell, Sarmistha B Hauger
BACKGROUND: Our institution created a multidisciplinary guideline for treatment of acute hematogenous osteomyelitis (AHO) and septic arthritis (SA) in response to updates in evidence-based literature in the field and existing provider variability in treatment. This guideline aims to improve the care of these patients by standardizing diagnosis and treatment and incorporating up to date evidence-based research into practice. The primary objective of this study is to compare cases before versus after the implementation of the guideline to determine concrete effects the guideline has had in the care of patients with AHO and SA...
May 2, 2018: Journal of Pediatric Orthopedics
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