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https://www.readbyqxmd.com/read/28220740/the-spectrum-and-outcome-of-surgical-sepsis-in-pietermaritzburg-south-africa
#1
S Green, V Y Kong, D L Clarke, B Sartorius, J Odendaal, J L Bruce, G L Laing, P Brysiewicz, W Bekker, E Harknett
BACKGROUND: Sepsis is a leading cause of morbidity and mortality worldwide, and the incidence appears to be increasing. In the resource-limited environment in low- and middle-income countries, the management of surgical sepsis (SS) continues to represent a significant portion of the workload for most general surgeons. OBJECTIVE: To describe the spectrum of SS seen at a busy emergency department, and categorise the outcomes. METHODS: The Pietermaritzburg Metropolitan Trauma Service (PMTS) and Pietermaritzburg Metropolitan Surgical Service (PMSS) in KwaZulu-Natal Province, South Africa (SA), maintain a prospective electronic registry...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28219665/comparison-of-hospital-outcome-of-transcatheter-versus-surgical-aortic-valve-replacement-in-patients-with-diabetes-mellitus-from-the-nationwide-inpatient-sample
#2
Tomo Ando, Emmanuel Akintoye, Tesfaye Telila, Alexandros Briasoulis, Hisato Takagi, David P Slovut, Theodore Schreiber, Cindy L Grines, Luis Afonso
The comparative outcomes of transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in diabetes mellitus (DM) patients are scarce. We aimed to assess and compare the outcomes of TAVR versus SAVR in DM patients using the Nationwide Inpatient Sample database from 2011 to 2013. A complete case analysis was performed for the multivariate analysis and cases with missing data were excluded. The primary end point was in-patient all-cause mortality and secondary outcomes were perioperative complications...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28217778/a-critical-insight-into-the-development-pipeline-of-microfluidic-immunoassay-devices-for-the-sensitive-quantitation-of-protein-biomarkers-at-the-point-of-care
#3
REVIEW
Ana I Barbosa, Nuno M Reis
The latest clinical procedures for the timely and cost-effective diagnosis of chronic and acute clinical conditions, such as cardiovascular diseases, cancer, chronic respiratory diseases, diabetes or sepsis (i.e. the biggest causes of death worldwide), involve the quantitation of specific protein biomarkers released into the blood stream or other physiological fluids (e.g. urine or saliva). The clinical thresholds are usually in the femtomolar to picolomar range, and consequently the measurement of these protein biomarkers heavily relies on highly sophisticated, bulky and automated equipment in centralised pathology laboratories...
February 20, 2017: Analyst
https://www.readbyqxmd.com/read/28216665/interleukin-10-inhibits-pro-inflammatory-cytokine-responses-and-killing-of-burkholderia-pseudomallei
#4
Bianca Kessler, Darawan Rinchai, Chidchamai Kewcharoenwong, Arnone Nithichanon, Rachael Biggart, Catherine M Hawrylowicz, Gregory J Bancroft, Ganjana Lertmemongkolchai
Melioidosis, caused by Burkholderia pseudomallei, is endemic in northeastern Thailand and Northern Australia. Severe septicemic melioidosis is associated with high levels of pro-inflammatory cytokines and is correlated with poor clinical outcomes. IL-10 is an immunoregulatory cytokine, which in other infections can control the expression of pro-inflammatory cytokines, but its role in melioidosis has not been addressed. Here, whole blood of healthy seropositive individuals (n = 75), living in N. E. Thailand was co-cultured with B...
February 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28211788/hemolytic-uremic-syndrome-complicated-by-clostridium-septicum-bacteremia-and-new-onset-type-1-diabetes-mellitus-report-of-a-case%C3%A2
#5
Anna C Iddings, Asha N Shenoi, Alba Morales Pozzo, Stefan G Kiessling
We report the unusual case of a 5-year-old male hospitalized for management of diabetic ketoacidosis (DKA) and new-onset type 1 diabetes mellitus (T1DM) who developed acute renal injury secondary to hemolytic uremic syndrome (HUS). He was diagnosed with Shiga toxin-producing entero-hemorrhagic Escherichia coli (EHEC) 0157:H7-positive HUS 48 hours after being diagnosed with new-onset T1DM/DKA. His hospital course was complicated by Clostridium septicum sepsis with colonic perforation. This patient's diagnosis of new-onset T1DM just prior to HUS is novel...
February 17, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28193286/tropical-diabetic-hand-syndrome-a-case-report
#6
Eugene Vernyuy Yeika, Jacques Cabral Tchoumi Tantchou, Joyce Bei Foryoung, Paul Nkemtendong Tolefac, Derrick Tembi Efie, Siméon Pierre Choukem
BACKGROUND: Tropical diabetic hand syndrome describes a complex hand sepsis affecting patients with diabetes across the tropics and often results from a trivial hand trauma. The clinical presentation of this syndrome is variable and ranges from localised swelling and cellulitis, with or without ulceration of the hand to progressive fulminant hand sepsis, and gangrene affecting the entire limb which may be fatal. Tropical diabetic hand syndrome could lead to permanent disability and death as a result of delay in presentation, late diagnosis and late medical and surgical intervention...
February 13, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28191374/klebsiella-pneumoniae-liver-abscess-a-case-report-and-review-of-literature
#7
Faisal Kamal, George Williams, Hina Akbar, Muhammad Ali Khan, Dipen Kadaria
Klebsiella pneumoniae (K.pneumoniae) is a known cause of pyogenic liver abscess (PLA) in the absence of hepatobiliary disease. In settings of hepatic infection, it has also been known to cause disseminated infections including meningitis and endopthalmitis. Several groups of patients are particularly susceptible to infection, including patients with diabetes mellitus, those from Southeast Asia and those with the preexisting hepatobiliary disease. We present a case of K.pneumoniae PLA with bacteremia. A 39-year-old Vietnamese male with no previous medical history who presented with complaints of abdominal pain, nausea, vomiting, diarrhea and fever...
January 10, 2017: Curēus
https://www.readbyqxmd.com/read/28179384/a-complicated-multisystem-flare-of-systemic-lupus-erythematosus-during-pregnancy
#8
Philip Webster, Catherine Nelson-Piercy, Liz Lightstone
We report a case of systemic lupus erythematosus (SLE) in a young woman who became pregnant amid a severe flare. She continued to have active disease in the face of aggressive treatments complicated by several side effects of immunosuppressive drugs including recurrent sepsis and gestational diabetes. Her fetus was at risk for congenital heart block during the second and third trimesters. Despite an extremely guarded prognosis, she delivered a healthy baby girl. This case highlights the complexities of SLE management during pregnancy...
February 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28177854/risk-factors-for-30-day-hospital-re-admission-with-an-infectious-complication-after-lower-extremity-vascular-procedures
#9
Joseph C Melvin, Jamie B Smith, Robin L Kruse, Todd R Vogel
BACKGROUND: Lowering the 30-d re-admission rate after vascular surgery offers the potential to improve healthcare quality. This study evaluated re-admission associated with infections after open and endovascular lower extremity (LE) procedures for peripheral artery disease (PAD). METHODS: Patients admitted for elective LE procedures for PAD were selected from the Cerner Health Facts(®) database. Chi-square analysis evaluated the characteristics of the index admission associated with infection at 30-d re-admission...
February 8, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28174631/medication-related-osteonecrosis-of-the-jaws-caused-lethal-sepsis-in-an-edentulous-patient-with-multiple-systemic-factors
#10
Keisuke Yamashiro, Aki Sato, Fumihiko Okazaki, Makoto Nakano, Koichi Sawaki, Yasuhisa Hirata, Eiki Yamachika, Seiji Iida, Shogo Takashiba
Medication-related osteonecrosis of the jaw (MRONJ) is developed even in the patients who are edentulous and treated with short-term bisphosphonate therapy and oral administration. It sometimes causes lethal sepsis in patients who have multiple health problems such as diabetes, cirrhosis, steroid use for interstitial pneumonia, sepsis, and spinal disk herniation.
February 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28168134/ocular-inflammatory-disease-as-a-predictor-for-in-hospital-mortality-in-patients-hospitalized-with-disseminated-tuberculosis
#11
Salil Mehta
AIM: To ascertain whether the presence of ocular inflammatory disease is a predictor for death in patients hospitalized with disseminated tuberculosis. METHODS: This is an IRB-approved retrospective study of patients admitted with a diagnosis of disseminated tuberculosis within a seven-year period (2002-2009). The following data was collected from each record: age, sex, details of previous surgeries or therapy, the findings of anterior segment examination, the findings of dilated indirect ophthalmoscopy, systemic findings, investigations done, treatment rendered, and final status (died or discharged)...
January 5, 2017: Curēus
https://www.readbyqxmd.com/read/28167592/patient-characteristics-management-and-predictors-of-outcome-from-severe-community-onset-staphylococcal-sepsis-in-northeast-thailand-a-prospective-multicenter-study
#12
T Eoin West, Chanthiwa Wikraiphat, Sarunporn Tandhavanant, Pitchayanant Ariyaprasert, Pornpan Suntornsut, Shawna Okamoto, Weera Mahavanakul, Pramot Srisamang, Sunchai Phiphitaporn, Jirasak Anukunananchai, Ploenchan Chetchotisakd, Sharon J Peacock, Narisara Chantratita
Staphylococcus aureus infection is a persistent threat in resource-restricted settings in southeast Asia but informative data about this disease remain limited. We analyzed characteristics, management, and predictors of outcome in severely septic patients with community-onset S. aureus infection in northeast Thailand. We performed a prospective, multicenter observational cohort study of community-onset S. aureus sepsis in four referral hospitals recruiting patients at least 14 years of age admitted between March 2010 and December 2013...
February 6, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28153622/case-report-of-a-primary-pituitary-abscess-and-systematic-literature-review-of-pituitary-abscess-with-a-focus-on-patient-outcomes
#13
REVIEW
Justice O Agyei, Lindsay J Lipinski, Jody Leonardo
BACKGROUND: Pituitary abscess is a rare but potentially life-threatening condition with an incidence of 0.2-1.1% of operative pituitary lesions. Diagnosis can be challenging, as this disorder shares many similarities with other pituitary lesions in terms of symptomatology and radiographic findings. Most pituitary abscesses are categorized as secondary, arising from pre-existing pituitary lesions or in conjunction with transsphenoidal surgery, sepsis, meningitis, or sinusitis. To date, there have been only a handful of reports of primary pituitary abscess, which occurs without any of the aforementioned risk factors...
January 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28149647/hepatitis-c-and-kidney-disease-a-narrative-review
#14
REVIEW
Rashad S Barsoum, Emad A William, Soha S Khalil
Hepatitis-C (HCV) infection can induce kidney injury, mostly due to formation of immune-complexes and cryoglobulins, and possibly to a direct cytopathic effect. It may cause acute kidney injury (AKI) as a part of systemic vasculitis, and augments the risk of AKI due to other etiologies. It is responsible for mesangiocapillary or membranous glomerulonephritis, and accelerates the progression of chronic kidney disease due to other causes. HCV infection increases cardiovascular and liver-related mortality in patients on regular dialysis...
March 2017: Journal of Advanced Research
https://www.readbyqxmd.com/read/28149243/statistical-and-clinical-analysis-of-alterations-in-glucose-values-after-burns
#15
M K Belba, E Petrela, A Belba, V Mano, G Belba
The purpose of this study was to evaluate independent factors (mainly critical hyperglycaemic values on admission) with an impact on outcome in burn patients (sepsis and mortality) and analyse prevalence of critical hyperglycaemia on admission and during burn disease in adult and elderly patients with severe burns. This was an observational retrospective cohort study involving burn patients (≥ 20 years old) hospitalized in the ICU of the Burn Facility in Albania during 2010-2014. Patients were categorized as having euglycaemia, moderate or critical hyperglycaemia...
September 30, 2016: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28137904/bilateral-thigh-methicillin-resistant-staphylococcus-aureus-necrotising-fasciitis-in-a-man-with-newly-diagnosed-human-immunodeficiency-virus-hiv
#16
Dhruv Chaudhary, Amith Subhash, Juan Galvis, Juan Guardiola
Methicillin-resistant Staphylococcus aureus (MRSA) necrotising fasciitis (NF) is rare and constitutes a medical and surgical emergency. We report a case of a 53-year-old man with type-2 diabetes mellitus and newly diagnosed HIV infection who presented with 1 week of progressively worsening bilateral sharp thigh pain. On presentation, he was febrile, tachycardic and had bilateral thigh erythema and mild tenderness without open wounds. He had leucocytosis, lactic acidosis and acute kidney injury. Urgent incision and drainage (I&D) was performed for suspected NF...
January 30, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28137330/impact-of-hiv-on-inpatient-mortality-and-complications-in-stroke-in-thailand-a-national-database-study
#17
K Cumming, S Tiamkao, K Kongbunkiat, A B Clark, J H Bettencourt-Silva, K Sawanyawisuth, N Kasemsap, M A Mamas, J A Seeley, P K Myint
The co-existence of stroke and HIV has increased in recent years, but the impact of HIV on post-stroke outcomes is poorly understood. We examined the impact of HIV on inpatient mortality, length of acute hospital stay and complications (pneumonia, respiratory failure, sepsis and convulsions), in hospitalized strokes in Thailand. All hospitalized strokes between 1 October 2004 and 31 January 2013 were included. Data were obtained from a National Insurance Database. Characteristics and outcomes for non-HIV and HIV patients were compared and multivariate logistic and linear regression models were constructed to assess the above outcomes...
January 31, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28124457/effects-of-silymarin-on-diabetes-mellitus-complications-a-review
#18
REVIEW
Aline Maria Stolf, Cibele Campos Cardoso, Alexandra Acco
Diabetes mellitus is a common metabolic disorder that is caused by a deficit in the production of (type 1) or response to (type 2) insulin. Diabetes mellitus is characterized by a state of chronic hyperglycemia and such symptoms as weight loss, thirst, polyuria, and blurred vision. These disturbances represent one of the major causes of morbidity and mortality nowadays, despite available treatments, such as insulin, insulin secretagogues, insulin sensitizers, and oral hypoglycemic agents. However, many efforts have been made to discover new drugs for diabetes treatment, including medicinal plant extracts...
January 25, 2017: Phytotherapy Research: PTR
https://www.readbyqxmd.com/read/28122835/risk-of-disseminated-intravascular-coagulation-in-patients-with-type-2-diabetes-mellitus-retrospective-cohort-study
#19
Kenichiro Nogami, Isao Muraki, Hironori Imano, Hiroyasu Iso
OBJECTIVES: To determine quantitatively the association between type 2 diabetes mellitus (T2DM) and disseminated intravascular coagulation (DIC). DESIGN: Retrospective cohort study using a claims database. SETTING: Medical care institutions representing 9% of all secondary hospitals (acute care hospitals) in Japan. PARTICIPANTS: In total, 797 324 admissions, comprising 435 354 patients aged 18-79 years at the time of admission, were enrolled between January 2010 and September 2014...
January 25, 2017: BMJ Open
https://www.readbyqxmd.com/read/28112704/evaluation-and-treatment-of-hyperglycemia-in-critically-ill-patients
#20
Andrea Balloni, Federico Lari, Fabrizio Giostra
The hyperglycemic reaction to stress is part of adaptive metabolic response to critical illness, especially hypoxia, hemorrhage and sepsis. It involves neuro-endocrine and immune pathways leading to the development of insulin resistance and hepatic glucose production by gluconeogenesis and glycogenolysis. Over the last years the concept of stress related hyperglycemia has been replaced by the concept of dysglycemia and its three domains: hyperglycemia, hypoglycemia and glycemic variability. Each of the three domains is independently associated with increased risk of mortality in patients admitted in intensive care unit and non critically ill patients, both medical and surgical...
January 16, 2017: Acta Bio-medica: Atenei Parmensis
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