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Sepsis 3

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https://www.readbyqxmd.com/read/29792103/prolonged-use-of-antibiotics-after-birth-is-associated-with-increased-morbidity-in-preterm-infants-with-negative-cultures
#1
C Fajardo, B Alshaikh, A Harabor
BACKGROUND: Most preterm infants are exposed to a variable duration of antibiotic therapy after birth despite negative cultures. Data is emerging about the risks of prolonged antibiotics. We sought to assess the association between length of initial antibiotic course and neonatal outcomes in a cohort from a single large perinatal centre. METHODS: Retrospective cohort study of prospectively collected data on all infants with a birth weight of less than 1250 g hospitalized in our NICU in a 4-year window and who had negative blood and CSF cultures in the first 2 days of life...
May 23, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29792096/neonatal-outcome-in-preterm-deliveries-before-34-week-gestation-the-influence-of-the-mechanism-of-labor-onset
#2
Sara Pinto, Maria Filipa Malheiro, Ana Vaz, Teresa Rodrigues, Nuno Montenegro, Hercília Guimarães
PURPOSE: To evaluate neonatal outcomes in preterm infants with less than 34 weeks after spontaneous labor, preterm premature rupture of membranes (PPROM) or iatrogenic delivery and to clarify whether the mechanism of labor onset is a risk factor for adverse short-term neonatal outcome. METHODS: We performed a retrospective case-control study, which included 266 preterm newborns with less than 34-week gestation, between 2011 and 2015. Neonatal outcomes were compared according to the mechanism of labor onset...
May 23, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29791315/incidence-of-early-onset-sepsis-in-infants-born-to-women-with-clinical-chorioamnionitis
#3
Tara M Randis, Madeline Murguia Rice, Leslie Myatt, Alan T N Tita, Kenneth J Leveno, Uma M Reddy, Michael W Varner, John M Thorp, Brian M Mercer, Mara J Dinsmoor, Susan M Ramin, Marshall W Carpenter, Philip Samuels, Anthony Sciscione, Jorge E Tolosa, George Saade, Yoram Sorokin
OBJECTIVE: To determine the frequency of sepsis and other adverse neonatal outcomes in women with a clinical diagnosis of chorioamnionitis. METHODS: We performed a secondary analysis of a multi-center placebo-controlled trial of vitamins C/E to prevent preeclampsia in low risk nulliparous women. Clinical chorioamnionitis was defined as either the "clinical diagnosis" of chorioamnionitis or antibiotic administration during labor because of an elevated temperature or uterine tenderness in the absence of another cause...
May 23, 2018: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29789918/recent-experience-and-follow-up-after-surgical-closure-of-secundum-atrial-septal-defect-in-120-children
#4
Geoffroy de Beco, Natasha Mambour, Christophe Vô, Laetitia Vanhoutte, Stéphane Moniotte, Alain Poncelet, Thierry Sluysmans
While percutaneous catheter closure proves an effective treatment for secundum atrial septal defect (ASD2), some child patients require surgical closure. We assessed the risks associated with isolated surgical ASD2 closure by reviewing the outcomes of 120 children operated on between 1999 and 2011 (mean age 4.6 ± 3.9 years, mean weight 17 ± 12 kg). Direct sutures were performed in 4% and patch closures in 96%. The mean cardiopulmonary bypass duration was 38 ± 14 min, aortic cross-clamp time 19 ± 9 min, intensive care unit length of stay 1...
May 22, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29789571/a-novel-extracellular-vesicle-associated-endodeoxyribonuclease-helps-streptococcus-pneumoniae-evade-neutrophil-extracellular-traps-and-is-required-for-full-virulence
#5
Hina Jhelum, Hema Sori, Devinder Sehgal
Streptococcus pneumoniae (pneumococcus) is a major bacterial pathogen that causes pneumonia and septicemia in humans. Pneumococci are cleared from the host primarily by antibody dependent opsonophagocytosis by phagocytes like neutrophils. Neutrophils release neutrophil extracellular traps (NETs) on contacting pneumococci. NETs immobilize pneumococci and restrict its dissemination in the host. One of the strategies utilized by pneumococci to evade the host immune response involves use of DNase(s) to degrade NETs...
May 22, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29789006/outcomes-of-lung-transplantation-in-adults-with-bronchiectasis
#6
Jodie Birch, Syba S Sunny, Katy L M Hester, Gareth Parry, F Kate Gould, John H Dark, Stephen C Clark, Gerard Meachery, James Lordan, Andrew J Fisher, Paul A Corris, Anthony De Soyza
BACKGROUND: Lung transplantation is a well-established treatment for end-stage non-cystic fibrosis bronchiectasis (BR), though information regarding outcomes of transplantation remains limited. Our results of lung transplantation for Br are reported here. METHODS: A retrospective review of case notes and transplantation databases was conducted for patients that had underwent lung transplantation for bronchiectasis at the Freeman Hospital between 1990 and 2013. RESULTS: Fourty two BR patients underwent lung transplantation, the majority (39) having bilateral sequential lung transplantation...
May 22, 2018: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29788810/clinical-and-immunological-pattern-and-outcome-of-egyptian-systemic-lupus-erythematosus-patients-a-single-center-experience
#7
G A Mahmoud, A A Shahin, H S Zayed, A Moghazy, B M Eissa
Objective The objective of this study was to describe the clinical and immunological pattern and disease outcome in Egyptian systemic lupus erythematosus patients. Patients and methods The medical records of 770 systemic lupus erythematosus patients who were followed from 2002-2015 at Kasr Alainy Hospital, Cairo University, were retrospectively reviewed. Results There were 707 (91.8%) females. The mean age at disease onset was 22.1 ± 8.6 and the disease duration was 6.1 ± 4.5 years. The main clinical manifestations were mucocutaneous (90...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29788474/umbilical-cord-blood-transplantation-corrects-very-early-onset-inflammatory-bowel-disease-in-chinese-patients-with-il10ra-associated-immune-deficiency
#8
Kaiyue Peng, Xiaowen Qian, Zhiheng Huang, Junping Lu, Yuhuan Wang, Ying Zhou, Huijun Wang, Bingbing Wu, Ying Wang, Lingli Chen, Xiaowen Zhai, Ying Huang
Background: Hematopoietic stem cell transplantation is considered the only curative therapy for very early-onset inflammatory bowel disease with specific immune defects, such as interleukin-10 receptor deficiency. We performed reduced-intensity conditioning before umbilical cord blood transplantation in patients with interleukin-10 receptor-A deficiency. Methods: We enrolled 9 very early-onset inflammatory bowel disease patients with typical manifestations. We diagnosed the patients with interleukin-10 receptor-A deficiency by whole-exome sequencing...
May 18, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29788135/the-hepatic-glucocorticoid-receptor-is-crucial-for-cortisol-homeostasis-and-sepsis-survival-in-humans-and-male-mice
#9
Marc Jenniskens, Ruben Weckx, Thomas Dufour, Sarah Vander Perre, Lies Pauwels, Sarah Derde, Arno Téblick, Fabian Güiza, Greet Van den Berghe, Lies Langouche
Sepsis is hallmarked by hypercortisolemia, a stress response that is essential for survival. This elevation in plasma cortisol is partially brought about by suppressed hepatic cortisol breakdown. We now demonstrated that a controlled downregulation of the hepatic glucocorticoid receptor (hepatic GR) is crucial herein. In a mouse model of fluid-resuscitated, antibiotic-treated abdominal sepsis and in human ICU patients, sepsis reduced hepatic GR expression and signaling, but increased (free) plasma cortisol/corticosterone, explained by suppressed cortisol/corticosterone binding proteins and A-ring-reductases...
May 17, 2018: Endocrinology
https://www.readbyqxmd.com/read/29787546/selective-non-operative-management-of-pharyngo-esophageal-injuries-secondary-to-penetrating-neck-trauma-a-single-center-review-of-86-cases
#10
Andre S Madsen, George V Oosthuizen, John L Bruce, Wanda Bekker, Grant L Laing, Damian L Clarke
BACKGROUND: This paper describes our experience with penetrating pharyngo-esophageal injuries (PEI) in the light of a selective conservative approach, and has the objective to define criteria for non-operative management (NOM). METHODS: This retrospective single-center review of patients with penetrating neck injury (PNI) treated for confirmed PEI over a 6-year period aimed to test our proposed hypothesis that NOM is safe for hemodynamically stable patients with PEI, who have no competing indications for exploration, have no established sepsis and who have a water-soluble contrast swallow (WS-swallow) either showing no- or a contained extravasation...
May 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29787415/cooccurrence-of-post-intensive-care-syndrome-problems-among-406-survivors-of-critical-illness
#11
Annachiara Marra, Pratik P Pandharipande, Timothy D Girard, Mayur B Patel, Christopher G Hughes, James C Jackson, Jennifer L Thompson, Rameela Chandrasekhar, Eugene Wesley Ely, Nathan E Brummel
OBJECTIVES: To describe the frequency of cooccurring newly acquired cognitive impairment, disability in activities of daily livings, and depression among survivors of a critical illness and to evaluate predictors of being free of post-intensive care syndrome problems. DESIGN: Prospective cohort study. SETTING: Medical and surgical ICUs from five U.S. centers. PATIENTS: Patients with respiratory failure or shock, excluding those with preexisting cognitive impairment or disability in activities of daily livings...
May 21, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29786928/evaluation-of-medication-dose-omissions-amongst-inpatients-in-a-hospital-using-an-electronic-medication-management-system
#12
Katherine V Hunt, Andrew M Harding, Simone E Taylor, Colin Curtain
RATIONALE, AIMS, AND OBJECTIVES: Whilst many dose omissions cause no patient harm, inappropriate dose omissions have been associated with increased length of hospital stay, risk of sepsis, and mortality. This study aimed to comprehensively describe the prevalence and nature of omitted doses overall and of high risk medication dose omissions in an organization using an electronic Medication Management System. METHODS: A retrospective cross-sectional study was undertaken in an Australian tertiary referral health service...
May 22, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29786457/xanthine-oxidase-inhibitors-and-sepsis
#13
Maria Fátima de Paula Ramos, Alceni do Carmo Morais Monteiro de Barros, Clara Versolato Razvickas, Fernanda T Borges, Nestor Schor
Xanthine oxidase activation occurs in sepsis and results in the generation of uric acid (UrAc) and reactive oxygen species (ROS). We aimed to evaluate the effect of xanthine oxidase inhibitors (XOis) in rats stimulated with lipopolysaccharide (LPS). LPS (10 mg/kg) was administered intraperitoneally (i.p.) immediately after allopurinol (Alo, 2 mg/kg) or febuxostat (Feb, 1 mg/kg) every 24 h for 3 days. To increase UrAc levels, oxonic acid (Oxo) was administered by gavage (750 mg/kg per day) for 5 days...
January 2018: International Journal of Immunopathology and Pharmacology
https://www.readbyqxmd.com/read/29783819/-value-of-urine-soluble-triggering-receptor-expressed-on-myeloid-cells-1-in-the-early-diagnosis-of-sepsis-associated-acute-kidney-injury
#14
Z K Yuan, F Fang, C J Liu, J Li, Y F Chen, F Xu
Objective: To assess the value of urine soluble triggering receptor expressed on myeloid cells-1(sTREM-1) in early diagnosis and prognosis of sepsis associated acute kidney injury (AKI). Methods: This was a case-control study. A total of 62 patients with sepsis during November 2016 to June 2017 were collected, who were divided into non-AKI sepsis ( n= 49) and AKI sepsis ( n= 13) groups according to the serum creatinine (SCr) or urine output, sepsis with shock ( n= 22) and sepsis without shock ( n= 40) groups according to the presence of shock, survival ( n= 47) and death ( n= 15) groups according to the mortality...
May 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
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
#15
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/29780817/clinical-profile-and-outcome-of-patients-with-acute-kidney-injury-requiring-hemodialysis-two-years-experience-at-a-tertiary-hospital-in-rwanda
#16
Grace Igiraneza, Benedicte Ndayishimiye, Menelas Nkeshimana, Vincent Dusabejambo, Onyema Ogbuagu
Introduction: Acute kidney injury (AKI) requiring renal replacement therapy is associated with high mortality. The study assessed the impact of the introduction of hemodialysis (HD) on outcomes of patients with AKI in Rwanda. Methods: A single center retrospective study that evaluated the clinical profile and survival outcomes of patients with AKI requiring HD [AKI-D] at a tertiary hospital in Rwanda. Data was collected on patients who received HD for AKI from September 2014 to December 2016...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29780599/perioperative-blood-transfusion-is-associated-with-post-operative-infectious-complications-in-patients-with-crohn-s-disease
#17
Nan Lan, Luca Stocchi, Yi Li, Bo Shen
Background: We have previously demonstrated that blood transfusion (BT) was associated with post-operative complications in patients undergoing surgery for Crohn's disease (CD), based on our institutional data registry. The aim of this study was to verify the association between perioperative BT and infectious complications in CD patients enrolled in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. Methods: All CD patients undergoing surgery between 2005 and 2013 were identified from NSQIP...
May 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29779820/cost-analysis-of-omega-3-supplementation-in-critically-ill-patients-with-sepsis
#18
Kwadwo Kyeremanteng, Jennifer Shen, Kednapa Thavorn, Shannon M Fernando, Brent Herritt, Dipayan Chaudhuri, Peter Tanuseputro
INTRODUCTION: Nutritional supplement of omega-3 fatty acids have been proposed to improve clinical outcomes in critically ill patients. While previous work have demonstrated that omega-3 supplementation in patients with sepsis is associated with reduced ICU and hospital length of stay, the financial impact of this intervention is unknown. OBJECTIVE: Perform a cost analysis to evaluate the impact of omega-3 supplementation on ICU and hospital costs. METHODS: We extracted data related to ICU and hospital length of stay from the individual studies reported in a recent systematic review...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29778659/sepsis-3-septic-shock-criteria-and-associated-mortality-among-infected-hospitalized-patients-assessed-by-a-rapid-response-team
#19
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/29778648/impact-of-insulin-on-the-intestinal-microcirculation-in-a-model-of-sepsis-related-hyperglycemia
#20
Alexa Caldwell, Jan Niklas Morick, Anne-Marie Jentsch, Annette Wegener, Dragan Pavlovic, Nadia Al-Banna, Christian Lehmann
BACKGROUND: Sepsis involves dysfunctional glucose metabolism. Among patients with sepsis, hyperglycemia is frequent and insulin administration has been evaluated for glycemic control to improve patient outcomes. Only few studies have examined the hyperglycemic microcirculation and the impact of insulin on the microvasculature in sepsis. OBJECTIVE: To study the functional capillary density (FCD) and leukocyte activation within the intestinal microcirculation in endotoxin-induced experimental sepsis...
May 17, 2018: Microvascular Research
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