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https://www.readbyqxmd.com/read/28523894/primary-cutaneous-mucormycosis-in-an-extremely-preterm-infant-successfully-treated-with-liposomal-amphotericin-b
#1
Christopher D Lowe, Rebecca J Sainato, David R Stagliano, Maribel M Morgan, Brian P Green
Cutaneous mucormycosis is a rare but often fatal invasive fungal infection that occurs most commonly in patients with diabetes, malignancy, and other immunocompromising conditions. We report an extremely preterm (<28 weeks) baby boy who developed polymicrobial sepsis and primary cutaneous mucormycosis within his first 10 days of life. He was successfully treated with medical management alone since he was not a candidate for surgery. Successful treatment of cutaneous mucormycosis without surgical debridement has been reported on only two other occasions...
May 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28523294/autophagy-in-aging-and-disease
#2
Mădălina Fîlfan, Raluca Elena Sandu, Alexandra Daniela Zăvăleanu, Andrei GreşiŢă, Daniela Gabriela Glăvan, Denissa Greta Olaru, Aurel Popa-Wagner
Autophagy is a catabolic degradation system used to destroy and recycle the unnecessary or damaged components of a cell. Autophagy is present at a basal level in all mammals and is regulated by some conditions, such as oxidative stress, starvation or hypoxia. In aged tissues, increased but also decreased expression of autophagy-specific proteins, Beclin 1, LC3, Atg5 and Atg7 has been reported. Likewise, it could be shown that the lifespan of yeast, nematodes and flies is prolonged by pharmacologically stimulated autophagy using exogenous administered spermidine...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28513118/metformin-does-not-induce-hyperlactatemia-in-patients-admitted-to-internal-medicine-ward
#3
Shlomit Koren, Shani Zilberman-Itskovich, Ronit Koren, Keren Doenyas-Barak, Ahuva Golik
BACKGROUND: Concerns about metformin-associated lactic acidosis (MALA) prohibit the use of metformin in a large subset of diabetic patients, mostly in patients with chronic kidney disease. Increasing evidence suggests that the current safety regulations may be overly restrictive. OBJECTIVES: To examine the association between chronic metformin treatment and lactate level in acute illness on the first day of admission to an internal medicine ward. METHODS: We compared diabetic and non-diabetic hospitalized patients treated or not treated with metformin in different sets of kidney function...
May 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28490270/change-point-detection-for-infinite-horizon-dynamic-treatment-regimes
#4
Yair Goldberg, Moshe Pollak, Alexis Mitelpunkt, Mila Orlovsky, Ahuva Weiss-Meilik, Malka Gorfine
A dynamic treatment regime is a set of decision rules for how to treat a patient at multiple time points. At each time point, a treatment decision is made depending on the patient's medical history up to that point. We consider the infinite-horizon setting in which the number of decision points is very large. Specifically, we consider long trajectories of patients' measurements recorded over time. At each time point, the decision whether to intervene or not is conditional on whether or not there was a change in the patient's trajectory...
January 1, 2017: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/28488657/central-pontine-myelinolysis-associated-with-hypokalemia-in-a-diabetic-patient-with-sepsis
#5
Sweety V Shinde
No abstract text is available yet for this article.
May 2017: Neurology India
https://www.readbyqxmd.com/read/28484782/necrotizing-fasciitis-treatment-concepts-and-clinical-results
#6
M Leiblein, I Marzi, A L Sander, J H Barker, F Ebert, J Frank
BACKGROUND: Necrotizing fasciitis is a life-threatening soft tissue infection characterized by a rapid spreading infection of the subcutaneous tissue and in particular the fascia. The management of infected tissues requires a rapid diagnosis, immediate aggressive surgical management and an extended debridement. In some cases early amputations of the affected tissues and maximum intensive care treatment, in case of sepsis, are required. Due to a rising number of cases we aimed to evaluate our patients in a retrospective review...
May 8, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28470562/outcomes-are-local-patient-disease-and-procedure-specific-risk-factors-for-colorectal-surgical-site-infections-from-a-single-institution
#7
Robert R Cima, John R Bergquist, Kristine T Hanson, Cornelius A Thiels, Elizabeth B Habermann
BACKGROUND: Colorectal surgical site infections (SSIs) contribute to postoperative morbidity, mortality, and resource utilization. Risk factors associated with colorectal SSI are well-documented. However, quality improvement efforts are informed by national data, which may not identify institution-specific risk factors. METHOD: Retrospective cohort study of colorectal surgery patients uses institutional ACS-NSQIP data from 2006 through 2014. ACS-NSQIP data were enhanced with additional variables from medical records...
May 3, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28465288/thirty-day-readmissions-after-endovascular-or-surgical-therapy-for-critical-limb-ischemia-analysis-of-the-2013-2014-nationwide-readmissions-databases
#8
Dhaval Kolte, Kevin F Kennedy, Mehdi H Shishehbor, J Dawn Abbott, Sahil Khera, Peter A Soukas, Shafiq T Mamdani, Omar N Hyder, Douglas E Drachman, Herbert D Aronow
Background -Thirty-day readmission rates have gained increasing importance as a key quality metric. A significant number of patients are hospitalized for the management of critical limb ischemia (CLI), but limited data are available on the incidence, predictors, and causes of 30-day readmission after hospitalization for CLI. Methods -Hospitalizations for a primary diagnosis of CLI during which patients underwent endovascular or surgical therapy (revascularization and/or amputation) and were discharged alive were identified in the 2013-2014 Nationwide Readmissions Databases...
May 2, 2017: Circulation
https://www.readbyqxmd.com/read/28447577/prognostic-value-of-adamts13-in-patients-with-severe-sepsis-and-septic-shock
#9
M Feroz Azfar, M Faisal Khan, S Shahid Habib, Z Al Aseri, A Mohammad Zubaidi, D Ocampo Aguila, M Owais Suriya, Hameed Ullah
PURPOSE: ADAMTS13 level was evaluated as a predictor of mortality in patients with severe sepsis and septic shock, and compared with Acute Physiology and Chronic Health Evaluation II (APACHE II) scores. METHODS: This prospective observational study was conducted in the Medical and Surgical Intensive Care Units of King Khalid University Hospital. Detailed clinical evaluations were performed on 84 patients (56.08±18.18 years of age) with severe sepsis and septic shock...
April 26, 2017: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/28444845/preoperative-sepsis-is-an-independent-risk-factor-for-major-complications-after-lower-extremity-amputation-in-patients-with-diabetic-end-stage-renal-disease
#10
Young Hwan Park, Jong Hyub Song, Gi Won Choi, Hak Jun Kim
AIM: Patients with diabetic end-stage renal disease (ESRD) are at increased risk of lower extremity amputation (LEA) and postoperative complications compared to those without diabetic ESRD. This study sought to determine the factors that influence complications following LEA in patients with diabetic ESRD. METHODS: A total of 41 patients with diabetic ESRD (total of 46 amputations) who underwent LEA were enrolled in this study. The electronic medical records were retrospectively reviewed to identify the predictors of postoperative complications...
April 26, 2017: Nephrology
https://www.readbyqxmd.com/read/28442828/a-case-of-disseminated-sepsis-caused-by-an-unusual-microorganism-in-a-patient-with-diabetes
#11
Carolina Gherman-Ciolac, Amish Patel, Salim Budha, Joanna Macve, Harit Buch
No abstract text is available yet for this article.
April 2017: Clinical Diabetes: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/28433337/increased-resource-utilization-and-overall-morbidity-are-associated-with-general-versus-regional-anesthesia-for-carotid-endarterectomy-in-data-collected-by-the-michigan-surgical-quality-collaborative
#12
Ahmad S Hussain, Andrew Mullard, William F Oppat, Kevin D Nolan
OBJECTIVE: Advocates for performing carotid endarterectomy (CEA) under regional anesthesia (RA) cite reduction in hemodynamic instability and the ability for neurologic monitoring, but many still prefer general anesthesia (GA) as benefits of RA have not been clearly demonstrated, reliable RA may not be available in all centers, and a certain amount of movement by the patient during the procedure may not be uniformly tolerated. We evaluated the association of anesthesia type and perioperative morbidity and mortality as well as resource utilization in patients undergoing CEA using the Michigan Surgical Quality Collaborative (MSQC) database...
April 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28427496/mortality-risk-factors-in-intensive-care-unit-patients-with-acute-kidney-injury-requiring-renal-replacement-therapy-a-retrospective-cohort-study%C3%A2
#13
Michael Schmitz, Frank P Tillmann, Ausra Paluckaite, Erich A Laufer, Brian Rayner, Lars C Rump, Peter J Heering
BACKGROUND: Mortality of critically-ill patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) in an intensive-care setting continues to remain high. There is still uncertainty as to which factors should guide clinical judgement. METHODS: A cohort of 155 patients admitted to an intensive-care unit and necessitating RRT due to AKI were retrospectively analyzed. Demographic and clinical parameters at the time of RRT initiation were retrieved...
April 21, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28426835/outcomes-from-a-cohort-of-patients-with-acute-kidney-injury-subjected-to-continuous-venovenous-hemodiafiltration-the-role-of-negative-fluid-balance
#14
Thais Oliveira Claizoni Dos Santos, Marisa Aparecida de Souza Oliveira, Julio Cesar Martins Monte, Marcelo Costa Batista, Virgilio Gonçalves Pereira Junior, Bento Fortunato Cardoso Dos Santos, Oscar Fernando Pavão Santos, Marcelino de Souza Durão Junior
BACKGROUND: Several factors influence the outcomes in acute kidney injury (AKI), especially in intensive care unit (ICU) patients. In this scenario, continuous renal replacement therapies (CRRT) are used to control metabolic derangements and blood volume. Knowing this fact, it may be possible to change the course of the disease and decrease the high mortality rate observed. Thus, we aimed to evaluate the main risk factors for death in AKI patients needing CRRT. RESULTS: This was a prospective, observational cohort study of ICU patients (N = 183) with AKI who underwent continuous venovenous hemodiafiltration (CVVHDF) as their initial dialysis modality choice...
2017: PloS One
https://www.readbyqxmd.com/read/28423197/diabetic-kidney-transplant-recipients-impaired-infection-control-and-increased-alloreactivity
#15
Thomas Schachtner, Maik Stein, Petra Reinke
BACKGROUND: Posttransplantation diabetes mellitus (PTDM) has been associated with inferior patient and allograft outcomes. However, previous studies didn't identify differences in infection control and alloreactivity. METHODS: We studied 449 kidney transplant recipients (KTRs) between 2005 and 2013. 50 (11.1%) KTRs were diagnosed with PTDM and 60 (13.4%) KTRs with pre-existing diabetes. Samples were collected pretransplantation, at +1, +2, +3 months posttransplantation...
April 19, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28405168/the-black-evil-affecting-patients-with-diabetes-a-case-of-rhino-orbito-cerebral-mucormycosis-causing-garcin-syndrome
#16
Santhosh Narayanan, Geetha Panarkandy, Gomathy Subramaniam, Chandni Radhakrishnan, N K Thulaseedharan, Neeraj Manikath, Sreejith Ramaswamy, Suma Radhakrishnan, Danish Ekkalayil
Mucormycosis is a life-threatening infection affecting patients with diabetes. It is an angioinvasive disease often resistant to treatment with a debilitating course and high mortality. Here, we report a case of a 45 year old woman with type 2 diabetes mellitus who presented to us with history of right-sided ptosis and facial palsy, and subsequently developed loss of vision and palatal palsy. She was in diabetic ketoacidosis. Nervous system examination revealed involvement of right second, third, fourth, sixth, seventh, ninth, and tenth cranial nerves, suggestive of Garcin syndrome...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/28403094/less-invasive-management-of-deep-neck-infection-and-descending-necrotizing-mediastinitis-a-single-center-retrospective-study
#17
Dong Wei, Ling Bi, Huiyong Zhu, Jianfeng He, Huiming Wang
By a 7-year retrospective review, we reported our experience in management of descending necrotizing mediastinitis (DNM) and deep neck infection (DNI). A retrospective design was used to reveal the clinical characteristics of DNI and DNM. The clinical outcome was analyzed to validate less invasive management. We reviewed 82 patients between 2009 and 2016, 12 of which were diagnosed as DNM by clinical and computed tomography findings. A total of 35 patients had relevant systemic conditions, mainly diabetes mellitus (19 patients)...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28398928/anesthetic-management-of-mitochondrial-encephalopathy-with-lactic-acidosis-and-stroke-like-episodes-melas-syndrome-in-a-high-risk-pregnancy-a-case-report
#18
Josh D Bell, Kushlin Higgie, Mital Joshi, Joshua Rucker, Sahar Farzi, Naveed Siddiqui
MELAS syndrome (mitochondrial encephalopathy, lactic acidosis, and stroke-like symptoms) is a rare and complex mitochondrial disorder. We present the in-hospital course of a 36-year-old gravida 2, para 0 with MELAS syndrome and severe preeclampsia, complicated by hyponatremia, hyperkalemia, and diabetes. A retained placenta with postpartum hemorrhage required urgent instrumental delivery under spinal anesthesia, transfusion, and intensive care unit admission for pulmonary edema, effusions, and atelectasis. Postpartum endometritis and sepsis also were encountered...
April 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28396715/immunomodulatory-oligonucleotide-imt504-effects-on-mesenchymal-stem-cells-as-a-first-in-class-immunoprotective-immunoregenerative-therapy
#19
REVIEW
Jorge Zorzopulos, Steven M Opal, Andrés Hernando-Insúa, Juan M Rodriguez, Fernanda Elías, Juan Fló, Ricardo A López, Norma A Chasseing, Victoria A Lux-Lantos, Maria F Coronel, Raul Franco, Alejandro D Montaner, David L Horn
The immune responses of humans and animals to insults (i.e., infections, traumas, tumoral transformation and radiation) are based on an intricate network of cells and chemical messengers. Abnormally high inflammation immediately after insult or abnormally prolonged pro-inflammatory stimuli bringing about chronic inflammation can lead to life-threatening or severely debilitating diseases. Mesenchymal stem cell (MSC) transplant has proved to be an effective therapy in preclinical studies which evaluated a vast diversity of inflammatory conditions...
March 26, 2017: World Journal of Stem Cells
https://www.readbyqxmd.com/read/28391314/continued-monitoring-of-acute-kidney-injury-survivors-might-not-be-necessary-in-those-regaining-an-estimated-glomerular-filtration-rate-60%C3%A2-ml-min-at-1-year
#20
Sokratis Stoumpos, Patrick B Mark, Emily P McQuarrie, Jamie P Traynor, Colin C Geddes
Background.: Severe acute kidney injury (AKI) among hospitalized patients often necessitates initiation of short-term dialysis. Little is known about the long-term outcome of those who recover to normal renal function. The aim of this study was to determine the long-term renal outcome of patients experiencing AKI requiring dialysis secondary to hypoperfusion injury and/or sepsis who recovered to apparently normal renal function. Methods.: All adult patients with AKI requiring dialysis in our centre between 1 January 1980 and 31 December 2010 were identified...
January 1, 2017: Nephrology, Dialysis, Transplantation
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