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https://www.readbyqxmd.com/read/28724042/hyperglycemia-in-critical-patients-determinants-of-insulin-dose-choice
#1
Aline Klitzke Paliosa, Cassiano Teixeira, Regis Goulart Rosa, Carine Raquel Blatt
Objective: To identify factors that can determine the choice of intermittent subcutaneous regular insulin dose in critically ill patients with hyperglycemia. Method: Cross-sectional study in a general adult ICU with 26 beds, data collected between September and October 2014. The variables analyzed were: sex, age, previous diagnosis of diabetes mellitus, use of corticosteroids, use of lactulose, sepsis, fasting, enteral nutrition, use of dextrose 5% in water, NPH insulin prescription and blood glucose level...
May 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28720399/prenatal-and-postnatal-administration-of-prebiotics-and-probiotics
#2
REVIEW
Kristin Sohn, Mark A Underwood
Colonization of the neonatal gut by beneficial bacteria is important for the establishment and maintenance of the mucosal barrier, thus protecting the neonate from enteric pathogens and local and systemic inflammation. The neonatal microbiome is influenced by infant diet, environment, and the maternal microbiome. Dysbiosis in pregnancy increases the risk of pre-eclampsia, diabetes, infection, preterm labor, and later childhood atopy. Dysbiosis of the neonatal gut plays an important role in colic in the term infant, in the disease processes which plague preterm infants, including necrotizing enterocolitis and sepsis, and in the long-term outcomes of neonates...
July 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28714876/sustained-low-serum-substance-p-levels-in-non-surviving-septic-patients
#3
Leonardo Lorente, María M Martín, Antonia Pérez-Cejas, José Ferreres, Jordi Solé-Violán, Lorenzo Labarta, César Díaz, Alejandro Jiménez
Previously, researchers found higher serum substance P (SP) concentrations in survivors of severe sepsis than in non-survivors at the time of severe sepsis diagnosis. The objectives of our current study were to determine whether there is an association between serum SP levels during the first week and sepsis mortality, sepsis severity, serum levels of tumor necrosis factor (TNF)-α and interleukin (IL)-10, and whether serum SP levels during the first week could be used as a biomarker of sepsis mortality. We determined serum concentration of SP, TNF-α, and IL-10 at days 1, 4, and 8...
July 15, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28713749/mucormycosis-of-the-frontal-sinus-a-rare-case-report-and-review
#4
Nanda Kishore Sahoo, Vishal Kulkarni, Amit K Bhandari, Arun Kumar
Mucormycosis of the frontal sinus are rarely seen in day to day clinical practice. Although this fungus is commonly found in the environment, the disease is usually prevented by the immune system and is hence rare. Well-recognized risk factors for the disease include diabetes mellitus, leukemia, aplastic anemia, myelodysplastic syndrome, blood dyscrasias, and immunosuppressive therapy in organ transplantation, renal disease, sepsis, and severe burns. The disease is primarily found in those who are immunocompromised, but it may also manifest in immuno competent persons...
January 2017: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28711129/care-of-infectious-conditions-in-an-observation-unit
#5
REVIEW
Pawan Suri, Taruna K Aurora
Infectious conditions such as skin and soft tissue infections (SSTIs), Urogenital infections and peritonsillar abscesses frequently require care beyond emergency stabilization and are well-suited for short term care in an observation unit. SSTIs are a growing problem, partly due to emergence of strains of methicillin-resistant S. aureus (MRSA). Antibiotic choice is guided by the presence of purulence and site of infection. Purulent cellulitis is much more likely to be associated with MRSA. Radiographic imaging should be considered to aid in management in patients who are immunosuppressed, have persistent symptoms despite antibiotic therapy, recurrent infections, sepsis or diabetes...
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28709443/severity-of-acute-gastrointestinal-injury-grade-is-a-predictor-of-all-cause-mortality-in-critically-ill-patients-a-multicenter-prospective-observational-study
#6
Bangchuan Hu, Renhua Sun, Aiping Wu, Yin Ni, Jingquan Liu, Feng Guo, Lijun Ying, Guoping Ge, Aijun Ding, Yunchao Shi, Changwen Liu, Lei Xu, Ronglin Jiang, Jun Lu, Ronghai Lin, Yannan Zhu, Weidong Wu, Bo Xie
BACKGROUND: In 2012, the European Society of Intensive Care Medicine proposed a definition for acute gastrointestinal injury (AGI) based on current medical evidence and expert opinion. The aim of the present study was to evaluate the feasibility of using the current AGI grading system and to investigate the association between AGI severity grades with clinical outcome in critically ill patients. METHODS: Adult patients at 14 general intensive care units (ICUs) with an expected ICU stay ≥24 h were prospectively studied...
July 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28708971/short-term-alcohol-abstinence-improves-antibacterial-defenses-of-chronic-alcohol-consuming-mice-against-gut-bacteria-associated-sepsis-caused-by-enterococcus-faecalis-oral-infection
#7
Makiko Kobayashi, Akira Asai, Ichiaki Ito, Sumihiro Suzuki, Kazuhide Higuchi, Fujio Suzuki
The effects of short-term alcohol abstinence on host antibacterial resistance against Enterococcus faecalis oral infection was investigated in chronic alcohol-consuming mice [mice with 0.1 g/day of 20% ethanol consumption for 12 or 16 weeks (CAC-mice)]. These mice were highly susceptible to the infection; however, after 7 days of alcohol abstinence (aaCAC-mice), their antibacterial resistances were completely restored to the normal mouse level. Normal mice inoculated with CAC-mouse hepatic macrophages were shown to be susceptible to the infection, whereas the same macrophage preparation from aaCAC-mice did not impair the antibacterial resistance of normal mice...
July 11, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28700186/-the-treatment-of-aki-in-nephrology-hospitalization-the-sle-hdf-15-litres-in-10-hours
#8
REVIEW
Marcello Napoli, Maria Luisa Lefons, Giovanni Sandri, Efisio Sozzo, Carmela Ambrosino
The AKI in intensive care has been widely treated by international and national guidelines. The treatment of AKI in patients not requiring admission in Intensive Care Unit, but often hospitalized in Nephrology Unit, it is showed of less relevance. For over 5 years we have used for the treatment of AKI of patients admitted in Nephrology Unit an intermittent slow technique, implemented in approximately 600 patients with AKI for a total of about 3000 treatments. In this study we report the clinical results obtained in 100 consecutive patients referred to our Nephrology Unit from 1st January 2014...
June 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28692671/immune-profiles-and-clinical-outcomes-between-sepsis-patients-with-or-without-active-cancer-requiring-admission-to-intensive-care-units
#9
Wen-Feng Fang, Yu-Mu Chen, Chiung-Yu Lin, Kuo-Tung Huang, Hsu-Ching Kao, Ying-Tang Fang, Chi-Han Huang, Ya-Ting Chang, Yi-His Wang, Chin-Chou Wang, Meng-Chih Lin
BACKGROUND: Immunoparalysis was observed in both patients with cancer and sepsis. In cancer patients, Cytotoxic T lymphocyte antigen-4 and programmed cell death protein 1/programmed death-ligand 1 axis are two key components of immunoparalysis. Several emerging therapies against these two axes gained significant clinical benefit. In severe sepsis patients, immunoparalysis was known as compensatory anti-inflammatory response syndrome and this has been suggested as an important cause of death in patients with sepsis...
2017: PloS One
https://www.readbyqxmd.com/read/28688914/glucagon-and-glucagon-like-peptide-1-as-novel-anti-inflammatory-and-immunomodulatory-compounds
#10
REVIEW
Daniella B R Insuela, Vinicius F Carvalho
Glucagon and glucagon-like peptide-1 (GLP-1) are polypeptide hormones that are produced by pancreatic α-cells and the intestine, respectively, whose main function is to control glucose homeostasis. The glucagon and GLP-1 levels are imbalanced in diabetes. Furthermore, type 1diabetic patients and animals present with a diminished inflammatory response, which is related to some morbidities of diabetes, such as a higher incidence of infectious diseases, including sepsis. The focus of this review is to briefly summarize the state of the art concerning the effects of glucagon and GLP-1 on the inflammatory response...
July 5, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28682855/management-of-a-complex-peristomal-calciphylaxis-a-case-study
#11
Mary Famorca, Debra Beauchaine, Nancy Angulo
BACKGROUND: Calciphylaxis, also referred to as calcific uremic arteriolopathy, is a rare and serious syndrome of small blood vessels with a high mortality rate. Calciphylaxis lesions require intensive wound management with medical interventions for the patient to survive the sequelae of sepsis and present unique challenges when found in the peristomal skin. CASE: A 33-year-old man presented with multiple malodorous stage 4 pressure injuries of his sacrococcygeal and gluteal area...
July 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28674636/diabetes-during-pregnancy-influence-of-body-mass-index-on-composite-morbidity
#12
Amy E O'Neil Dudley, Zachary B Jenner, Hector Mendez-Figueroa, Viviana S Ellis, Suneet P Chauhan
Objective  This study aims to compare composite maternal and neonatal morbidities (MM, NM) among pregnant women with diabetes mellitus whose body mass index (BMI) at delivery was < 30 (group 1), 30.0 to 39.9 (group 2), and ≥ 40 kg/m (2) (group 3). We hypothesized that increased BMI class at delivery would be associated with worsening maternal and neonatal outcomes. Methods  This is a retrospective cohort study. MM was defined as: chorioamnionitis, wound infection, eclampsia, diabetic ketoacidosis, hypoglycemia admission, third/fourth degree laceration, and/or death...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28664412/early-use-of-ceftaroline-fosamil-in-the-united-states-veterans-health-care-system
#13
Rachel S Britt, Kirk E Evoy, Grace C Lee, Kelly R Reveles, Kimberly M Sorensen, Xavier Jones, Mary Bollinger, Christopher R Frei
BACKGROUND: Ceftaroline fosamil is US Food and Drug Administration-approved for acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia, but it is not known how ceftaroline is being used in real-world settings or how adverse effects (AEs) and mortality compare to clinical trials. OBJECTIVE: This study describes ceftaroline use, AEs, and mortality in US Veterans Health Administration (VHA) hospital patients. METHODS: This phase IV, population-based, epidemiologic study analyzed patients ≥18 years old who received one or more ceftaroline doses within 14 days of admission to 69 VHA hospitals in 41 US states/territories from 1 October 2010 to 30 September 2014...
June 29, 2017: Drugs
https://www.readbyqxmd.com/read/28662955/determining-the-threshold-for-hba1c-as-a-predictor-for-adverse-outcomes-after-total-joint-arthroplasty-a-multicenter-retrospective-study
#14
Majd Tarabichi, Noam Shohat, Michael M Kheir, Muyibat Adelani, David Brigati, Sean M Kearns, Pankajkumar Patel, John C Clohisy, Carlos A Higuera, Brett R Levine, Ran Schwarzkopf, Javad Parvizi, William A Jiranek
BACKGROUND: Although HbA1c is commonly used for assessing glycemic control before surgery, there is no consensus regarding its role and the appropriate threshold in predicting adverse outcomes. This study was designed to evaluate the potential link between HbA1c and subsequent periprosthetic joint infection (PJI), with the intention of determining the optimal threshold for HbA1c. METHODS: This is a multicenter retrospective study, which identified 1645 diabetic patients who underwent primary total joint arthroplasty (1004 knees and 641 hips) between 2001 and 2015...
May 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28658023/preadmission-use-of-calcium-channel-blocking-agents-is-associated-with-improved-outcomes-in-patients-with-sepsis-a-population-based-propensity-score-matched-cohort-study
#15
Chien-Chang Lee, Meng-Tse Gabriel Lee, Wan-Chien Lee, Chih-Cheng Lai, Christin Chih-Ting Chao, Wan-Ting Hsu Hsu, Shy-Shin Chang, Matthew Lee
OBJECTIVES: Use of calcium channel blockers has been found to improve sepsis outcomes in animal studies and one clinical study. This study determines whether the use of calcium channel blockers is associated with a decreased risk of mortality in patients with sepsis. DESIGN: Population-based matched cohort study. SETTING: National Health Insurance Research Database of Taiwan. PATIENTS: Hospitalized severe sepsis patients identified from National Health Insurance Research Database by International Classification of Diseases, Ninth Revision, Clinical Modification codes...
June 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28648651/the-impact-of-functional-status-on-the-outcomes-of-endovascular-lower-extremity-revascularization-for-critical-limb-ischemia-in-the-elderly
#16
Isidore Dinga Madou, Martin D Slade, Kristine C Orion, Timur Sarac, Cassius Iyad Ochoa Chaar
INTRODUCTION: Functional status is an important predictor of outcomes after infrainguinal bypass surgery. There is little data on the effect of functional status on the outcomes of endovascular LE interventions, especially in the elderly frail population. METHODS: This is a retrospective analysis of the American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) files for the years 2011-2013 to assess the impact of functional status on outcome after endovascular intervention for critical limb ischemia...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28648331/il-35-as-a-newly-proposed-homeostasis-associated-molecular-pattern-plays-three-major-functions-including-anti-inflammatory-initiator-effector-and-blocker-in-cardiovascular-diseases
#17
Xinyuan Li, Pu Fang, William Y Yang, Hong Wang, Xiaofeng Yang
IL-35 is a new anti-inflammatory cytokine identified in 2007, which inhibits inflammation and immune responses by inducing regulatory T cells and regulatory B cells and suppressing effector T cells and macrophages. The unique initiator and effector anti-inflammatory properties of IL-35 bring tremendous interest in investigating its role during cardiovascular disease (CVD) development, in which inflammatory processes are firmly established as central to its development and complications. In this review, we update recent understanding of how IL-35 is produced and regulated in the cells...
June 22, 2017: Cytokine
https://www.readbyqxmd.com/read/28640135/hospitalization-with-hypoglycemia-in-patients-without-diabetes-mellitus-a-retrospective-study-using-a-national-inpatient-database-in-japan-2008-2012
#18
Akahito Sako, Hideo Yasunaga, Hiroki Matsui, Kiyohide Fushimi, Hidetaka Hamasaki, Hisayuki Katsuyama, Tetsuro Tsujimoto, Atsushi Goto, Hidekatsu Yanai
We aimed to examine prevalence, patient characteristics, etiology, and clinical outcomes of hospitalized patients who had hypoglycemia without a diagnosis of diabetes mellitus, using a Japanese nationwide database.This was a retrospective observational study using a national database of acute-care inpatients in Japan. Nondiabetic patients aged ≥15 years who were hospitalized for hypoglycemia were eligible. We estimated the annual numbers of hospitalized cases in Japan. We also investigated the patient characteristics, and risk factors of in-hospital mortality...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28638013/-surgical-treatment-of-diabetic-neuroosteoarthropathy-dnoap-and-its-long-term-results
#19
V M Bensman, Yu P Savchenko, S E Gumenyuk, K G Triandafilov, P P Vasil'chenko, S N Pyatakov, V V Khoritonenko
AIM: To develop pathogenetically justified surgical treatment of diabetic neuroosteoarthropathy (DNOAP). MATERIAL AND METHODS: 52 patients were operated and long-term results were studied in 36 of them. 2 groups were assessed depending on completeness of surgical treatment including changed synovial structures removal. Tarso-metatarsal arthrodesis was created after synovectomy in median foot to restore longitudinal arch. Cruro-calcaneal neoarthrosis was performed after elimination of posterior focus of DNOAP...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28634535/effectiveness-and-safety-of-daptomycin-in-patients-with-infective-endocarditis-undergoing-heart-valve-replacement-a-subgroup-analysis-from-real-world-data
#20
Achyut Guleri, Riccardo Utili, Pascal Dohmen, Kamal Hamed
BACKGROUND: European Cubicin(®) Outcomes Registry and Experience (EU-CORE) was a retrospective, non-interventional, multicenter registry that collected real-world clinical outcomes following daptomycin use for the treatment of Gram-positive infections. EU-CORE data from patients with infective endocarditis (IE) who underwent heart valve replacement were analysed. METHODS: Clinical outcomes were assessed as success (cured or improved), failure, or non-evaluable...
March 2017: Therapeutic Advances in Infectious Disease
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