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Sepsis and infections

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https://www.readbyqxmd.com/read/29334496/oxygen-in-the-critically-ill-friend-or-foe
#1
Elisa Damiani, Abele Donati, Massimo Girardis
PURPOSE OF REVIEW: To examine the potential harmful effects of hyperoxia and summarize the results of most recent clinical studies evaluating oxygen therapy in critically ill patients. RECENT FINDINGS: Excessive oxygen supplementation may have detrimental pulmonary and systemic effects because of enhanced oxidative stress and inflammation. Hyperoxia-induced lung injury includes altered surfactant protein composition, reduced mucociliary clearance and histological damage, resulting in atelectasis, reduced lung compliance and increased risk of infections...
January 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29334018/pyoderma-gangrenosum-demographics-treatments-and-outcomes-an-analysis-of-2-273-cases
#2
Sarah E Sasor, Tahereh Soleimani, Michael W Chu, Julia A Cook, Peter J Nicksic, Sunil S Tholpady
OBJECTIVE: Pyoderma gangrenosum is a rare, neutrophil-mediated, auto-inflammatory dermatosis. This condition has clinical features analogous to infectious processes and must be quickly diagnosed to be properly treated. The purpose of this study was to characterise relevant clinical features associated with pyoderma gangrenosum based on a large inpatient cohort. METHOD: The National Inpatient Sample (US) was used to identify patients with the diagnosis of pyoderma gangrenosum using ICD-9 diagnosis code 686...
January 1, 2018: Journal of Wound Care
https://www.readbyqxmd.com/read/29333818/community-acquired-methicillin-resistant-staphylococcus-aureus-infections-hospitalization-and-case-fatality-risk-in-10-pediatric-facilities-in-argentina
#3
Ángela Gentile, Julia Bakir, Gabriela Ensinck, Aldo Cancellara, Enrique V Casanueva, Verónica Firpo, Martín Caruso, María F Lución, Alejandro Santillán Iturres, Fabiana Molina, Héctor J Abate, Andrea Gajo Gane, Santiago López Papucci
INTRODUCTION: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are prevalent both in Argentina and worldwide, and they may have a severe clinical course. OBJECTIVES: To estimate the hospitalization rate and case fatality risk factors of CA-MRSA infection. METHODS: Cross-sectional, analytical study. All patients < 15 years old with community-acquired Staphylococcus aureus (CA-SA) infections admitted to 10 pediatric facilities between January 2012 and December 2014 were included...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29333081/innate-immunity-recovers-earlier-than-acquired-immunity-during-severe-postoperative-immunosuppression
#4
Gunnar Lachmann, Clarissa von Haefen, Johannes Kurth, Fatima Yuerek, Claudia Spies
Background: Postoperative immune suppression, particularly a loss of cell-mediated immunity, is commonly seen after surgery and is associated with worse outcome, i.e. delayed wound healing, infections, sepsis, multiple-organ failure and cancer recurrence. However, the recovery of immune cells focusing on differences between innate and acquired immunity during severe postoperative immunosuppression is not investigated. Methods: In this retrospective randomized controlled trial (RCT) subgroup analysis, 10 postoperatively immune suppressed patients after esophageal or pancreatic resection were analyzed...
2018: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/29332972/clinical-utility-and-measurement-of-procalcitonin
#5
REVIEW
Intan Samsudin, Samuel D Vasikaran
Procalcitonin (PCT), regarded as a biomarker specific for bacterial infections, is used in a variety of clinical settings including primary care, emergency department and intensive care. PCT measurement aids in the diagnosis of sepsis and to guide and monitor antibiotic therapy. This article gives a brief overview of PCT and its use in guiding antibiotic therapy in various clinical settings, as well as its limitations. PCT performance in comparison with other biomarkers of infection in particular CRP is also reviewed...
April 2017: Clinical Biochemist. Reviews
https://www.readbyqxmd.com/read/29330406/adjuvant-role-of-septifast-to-improve-the-diagnosis-of-sepsis-in-a-large-cohort-of-hematological-patients
#6
Raffaella Greco, Maria Chiara Barbanti, Nicasio Mancini, Lara Crucitti, Chiara Oltolini, Alessandra Forcina, Francesca Lorentino, Luca Vago, Carlo Messina, Daniela Clerici, Mara Morelli, Fabio Giglio, Maria Teresa Lupo Stanghellini, Laura Infurnari, Matteo G Carrabba, Sarah Marktel, Andrea Assanelli, Paolo Scarpellini, Massimo Bernardi, Jacopo Peccatori, Consuelo Corti, Massimo Clementi, Fabio Ciceri
Febrile neutropenia and sepsis are common and life-threatening complications in hematological diseases. This study was performed retrospectively in 514 patients treated for febrile neutropenia at our institute, to investigate the clinical usefulness of a molecular tool, LightCycler® SeptiFast test (SF), to promptly recognize pathogens causing sepsis in hematological patients. We collected 1837 blood samples of 514 consecutive hematological patients. The time of processing is short. Overall, 757 microorganisms in 663 episodes were detected by molecular test and standard blood cultures (BC): 73...
January 12, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29330152/risk-of-infection-in-type-1-and-type-2-diabetes-compared-with-the-general-population-a-matched-cohort-study
#7
Iain M Carey, Julia A Critchley, Stephen DeWilde, Tess Harris, Fay J Hosking, Derek G Cook
OBJECTIVE: We describe in detail the burden of infections in adults with diabetes within a large national population cohort. We also compare infection rates between patients with type 1 and type 2 diabetes mellitus (T1DM and T2DM). RESEARCH DESIGN AND METHODS: A retrospective cohort study compared 102,493 English primary care patients aged 40-89 years with a diabetes diagnosis by 2008 (n = 5,863 T1DM and n = 96,630 T2DM) with 203,518 age-sex-practice-matched control subjects without diabetes...
January 12, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29330015/mother-to-child-transmission-of-extended-spectrum-beta-lactamase-producing-enterobacteriaceae
#8
Dana Danino, Rimma Melamed, Batya Sterer, Nurith Porat, Guy Hazan, Alex Gushanski, Eilon Shany, David Greenberg, Avraham Borer
BACKGROUND: Preterm infants are at high risk for extended spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E) sepsis and neonatal intensive care unit (NICU) outbreaks. Maternal colonization with ESBL-E may be precursory to maternal-neonatal transmission. However, there is no consensus regarding surveillance of pregnant women for ESBL-E colonization. AIM: To identify pairs of mothers and offspring harbouring same-strain ESBL-E colonization and to determine whether maternal transmission may play a role in increasing ESBL-E carriage in preterm infants...
January 9, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29329118/ce-managing-sepsis-and-septic-shock-current-guidelines-and-definitions
#9
Mary Beth Flynn Makic, Elizabeth Bridges
Recent updates emphasize early recognition and prompt intervention. ABSTRACT: Sepsis is a leading cause of critical illness and hospital mortality. Early recognition and intervention are essential for the survival of patients with this syndrome. In 2002, the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) launched the Surviving Sepsis Campaign (SSC) to reduce overall patient morbidity and mortality from sepsis and septic shock by driving practice initiatives based on current best evidence...
January 11, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29327977/status-and-challenges-of-predicting-and-diagnosing-sepsis-in-burn-patients
#10
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/29327522/clinical-profile-and-outcome-of-pregnant-patients-with-acute-hev-hepatitis-during-water-borne-epidemic-in-himachal-pradesh-a-hospital-based-study
#11
Asha Ranjan, Surinder Thakur, Jatinder Mokta, Rajesh Bhawani, Varsha Ranjan
Background: Recent outbreak of HEV hepatitis epidemic in Himachal Pradesh in Shimla caused significant morbidity and mortality especially among pregnant patients. Overall mortality is 0.5- 4% in patients developing acute hepatic failure (ALF) and is significantly higher in pregnant patients (20%). Present study conducted to observe clinical profile and outcome in pregnant patients. Methodology: this is a retrospective observational study done on admitted pregnant and post partum patients with acute HEV hepatitis during 3 months periods...
December 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29327298/the-impact-of-obesity-on-outcomes-for-patients-undergoing-mastectomy-using-the-acs-nsqip-data-set
#12
Mary Garland, Fang-Chi Hsu, Clancy Clark, Akiko Chiba, Marissa Howard-McNatt
PURPOSE: According to the World Health Organization (WHO), 34.7% of females in the United States are obese (BMI ≥ 30) in 2014, compared to 32.5% in 2010. The previous research has demonstrated high BMI as an independent risk factor for surgical complications after breast surgery. As more patients become obese, we sought to examine whether increasing obesity had an effect on outcomes of women who underwent a unilateral mastectomy without breast reconstruction. METHODS: The study reviewed the 2007-2012 ACS-NSQIP database and identified all patients who underwent a unilateral mastectomy without reconstruction...
January 11, 2018: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29327282/ziziphus-spina-christi-leaf-extract-pretreatment-inhibits-liver-and-spleen-injury-in-a-mouse-model-of-sepsis-via-anti-oxidant-and-anti-inflammatory-effects
#13
Mohamed A Dkhil, Saleh Al-Quraishy, Ahmed E Abdel Moneim
Sepsis is a systemic response to infection that can result in acute hepatic and splenic damage. Ziziphus spina-christi (L.) is a wild tree used as a medicinal plant by ancient Egyptians. However, little is known about the mechanism underlying its effects on sepsis. The current study investigated the protective effects of a Z. spina-christi leaf extract (ZSCLE) on liver and spleen damage in a male C57BL/6 mouse model of sepsis, induced by cecal ligation and puncture (CLP). Prior to CLP, ZSCLE was administered daily for five consecutive days via oral gavage at doses of 100, 200, or 300 mg/kg...
January 11, 2018: Inflammopharmacology
https://www.readbyqxmd.com/read/29325753/induced-hypothermia-in-patients-with-septic-shock-and-respiratory-failure-cass-a-randomised-controlled-open-label-trial
#14
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
#15
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/29325063/epidemiology-and-outcomes-of-hematopoietic-stem-cell-transplant-in-hiv-patients-from-1998-to-2012-a-nationwide-analysis
#16
Kathan Mehta, Annie Im, Farah Rahman, Hong Wang, Peter Veldkamp
Background: Prior studies have shown that outcomes of hematopoietic stem cell transplantation (HSCT) in HIV (+) patients are similar to HIV (-) patients since effective implementation of HAART by 1998; but they are limited by small sample size or non-inclusion of recent data. Methods: We queried National Inpatient Sample, a large inpatient dataset in the US, from 1998 to 2012 for HSCT using ICD9 procedure code 41.0. HIV patients were identified by ICD9 diagnostic code of 042, 043, 044, V08 and 079...
January 6, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29324733/antibiotics-dispensed-to-privately-insured-pregnant-women-with-urinary-tract-infections-united-states-2014
#17
Elizabeth C Ailes, April D Summers, Emmy L Tran, Suzanne M Gilboa, Kathryn E Arnold, Dana Meaney-Delman, Jennita Reefhuis
Urinary tract infections (UTIs) occur in about 8% of pregnant women, and untreated UTIs can have serious consequences, including pyelonephritis, preterm labor, low birth weight, and sepsis (1). Pregnant women are typically screened for UTIs during early pregnancy, and those with bacteriuria are treated with antibiotics (1,2). Antibiotic stewardship is critical to improving patient safety and to combating antibiotic resistance. Because of the potential risk for birth defects, including anencephaly, heart defects, and orofacial clefts, associated with use of sulfonamides and nitrofurantoin during pregnancy (3), a 2011 committee opinion from the American College of Obstetricians and Gynecologists (ACOG) recommended that sulfonamides and nitrofurantoin may be prescribed in the first trimester of pregnancy only when other antimicrobial therapies are deemed clinically inappropriate (4)...
January 12, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29324599/risk-factors-incidence-and-morbidity-associated-with-obstetric-clostridium-difficile-infection
#18
Jacob Ruiter-Ligeti, Sophie Vincent, Nicholas Czuzoj-Shulman, Haim Arie Abenhaim
OBJECTIVE: To evaluate the risk factors, incidence, and morbidity associated with the diagnosis of obstetric Clostridium difficile infection. METHODS: We performed a retrospective cohort study on women admitted for delivery using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from the United States. The delivery admission records of pregnant women were reviewed between 1999 and 2013. After adjusting for demographic and clinical characteristics, we assessed risk factors for the diagnosis of C difficile infection using unconditional logistic regression...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29323441/a-low-muscle-mass-increases-mortality-in-compensated-cirrhotic-patients-with-sepsis
#19
Cristina Lucidi, Barbara Lattanzi, Vincenza Di Gregorio, Simone Incicco, Daria D'Ambrosio, Mario Venditti, Oliviero Riggio, Manuela Merli
BACKGROUND & AIMS: Severe infections and muscle wasting are both associated to poor outcome in cirrhosis. A possible synergic effect of these two entities in cirrhotic patients has not been previously investigated. We aimed at analyzing if a low muscle mass may deteriorate the outcome of cirrhotic patients with sepsis. METHODS: Consecutive cirrhotic patients hospitalized for sepsis were enrolled. Patients were classified for the severity of liver impairment (Child-Pugh class) and for the presence of "low muscle mass" (mid-arm muscle circumference<5th percentile)...
January 11, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29322872/a-collaborative-approach-to-improve-consistent-use-of-procalcitonin-in-lower-respiratory-tract-infections
#20
Alexander R Levine, Robyn Riggott, Kristela Vulaj, Tera R Falcetti, Syed Ali, Gagandeep Singh
BACKGROUND: Procalcitonin (PCT) is a biomarker that can help differentiate bacterial from viral infections and has been extensively studied in patients with sepsis and pneumonia to guide antibiotic therapy. However, there is poor adherence to prescribed algorithms when used to discontinue antibiotics in the real world. A quality improvement project was implemented to increase consistent use of PCT. OBJECTIVE: To evaluate use of PCT and impact on antibiotic length of therapy (LOT) preimplementation and postimplementation of a quality improvement initiative...
January 1, 2018: Annals of Pharmacotherapy
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