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Li Liu, Wanjun Chen, Xiaoye Lu, Keji Zhang, Changqing Zhu
BACKGROUND: Pyogenic liver abscesses have become common in emergency departments (EDs) in recent years in Shanghai, China due to a variety of risk factors contributory to the disease. OBJECTIVE: To review our experience in managing pyogenic liver abscesses to aid in the current management of this complex condition. METHODS: This retrospective study was conducted to collect and analyze information from adult patients diagnosed with liver hepatic abscesses who were admitted to Ren Ji Hospital during the period from January 1, 2010 to December 31, 2015...
October 17, 2016: Journal of Emergency Medicine
Iris K Minichmayr, André Schaeftlein, Joseph L Kuti, Markus Zeitlinger, Charlotte Kloft
OBJECTIVES: We aimed to assess linezolid pharmacokinetics in the plasma and interstitial space fluid (ISF) of patients with sepsis, diabetic foot infections or cystic fibrosis and healthy volunteers. The impacts of joint characteristics and disease on plasma and target-site exposure were to be identified together with the benefit of dose intensification in critically ill patients. METHODS: Rich plasma (n = 1598) and ISF concentrations in subcutaneous adipose (n = 1430) and muscle tissue (n = 1089) measured by microdialysis were pooled from three clinical trials with 51 individuals receiving 600 mg of intravenous and oral linezolid...
October 17, 2016: Clinical Pharmacokinetics
Michael A Bohl, James Forseth, Peter Nakaji
BACKGROUND: Arginine vasopressin (AVP) is a common second-line or third-line vasopressor used in critically ill neurosurgical patients. Neurosurgical indications include hyperdynamic therapy for vasospasm, maintenance of cerebral perfusion pressure in patients with intracranial hypertension, and prevention of hypotension in patients with sepsis. CASE DESCRIPTION: A series of six neurosurgical patients receiving AVP infusions developed severe but transient diabetes insipidus (tDI) after cessation of AVP...
October 11, 2016: World Neurosurgery
Talerngsak Kanjanabuch, Nuttha Lumlertgul, Lachlan J Pearson, Tanittha Chatsuwan, Krit Pongpirul, Asada Leelahavanichkul, Nisa Thongbor, Gunticha Nuntawong, Laksamon Praderm, Pantiwa Wechagama, Surapong Narenpitak, Apinya Wechpradit, Worauma Punya, Guttiga Halue, Phetpailin Naka, Somboon Jeenapongsa, Somchai Eiam-Ong
♦ Background: Melioidosis, an infectious disease caused by Burkholderia pseudomallei, is endemic in Southeast Asia and Northern Australia. Although a wide range of clinical manifestations from this organism are known, peritonitis associated with peritoneal dialysis (PD) has rarely been reported. ♦ Patients and Methods: Peritoneal dialysis patients from all regions in Thailand were eligible for the study if they had peritonitis and either peritoneal fluid or effluent culture positive for B.pseudomallei Patient data obtained included baseline characteristics, laboratory investigations, treatments, and clinical outcomes...
October 13, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Andrés M Bur, Jason A Brant, Carolyn L Mulvey, Elizabeth A Nicolli, Robert M Brody, John P Fischer, Steven B Cannady, Jason G Newman
Importance: Unplanned hospital readmission is costly and in recent years has become a focus of health care legislation intended to reduce health care expenditures. Greater understanding of which perioperative complications are associated with hospital readmission after surgery for head and neck cancer is needed to reduce unplanned readmissions. Objective: To determine which clinical risk factors and complications are associated with 30-day unplanned readmission after surgery for malignant neoplasms of the head and neck...
October 13, 2016: JAMA Otolaryngology—Head & Neck Surgery
Yasumasa Kawano, Shinichi Morimoto, Yoshito Izutani, Kentaro Muranishi, Hironari Kaneyama, Kota Hoshino, Takeshi Nishida, Hiroyasu Ishikura
BACKGROUND: Augmented renal clearance (ARC) of circulating solutes and drugs has been recently often reported in intensive care unit (ICU) patients. However, only few studies on ARC have been reported in Japan. The aims of this pilot study were to determine the prevalence and risk factors for ARC in Japanese ICU patients with normal serum creatinine levels and to evaluate the association between ARC and estimated glomerular filtration rate (eGFR) calculated using the Japanese equation...
2016: Journal of Intensive Care
Florian B Mayr, Sachin Yende
No abstract text is available yet for this article.
October 12, 2016: Critical Care: the Official Journal of the Critical Care Forum
Tracey Ying, Samantha Chan, Stephen Lane, Christine Somerville
AIM: To identify risk factors for acute kidney injury following major orthopaedic surgery. METHODS: We included all patients undergoing major orthopaedic surgery at University Hospital Geelong between 2008 and 2014 in the study. Out of 2188 surgeries audited, we identified cases of acute kidney injury using the RIFLE criteria and matched those to controls 2:1 for age, sex, procedure and chronic kidney disease stage. We reviewed their records for risk factors of postoperative acute kidney injury, including medications such as gentamicin, diuretics, non-steroidal anti-inflammatory drugs and angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use...
October 5, 2016: Nephrology
Marcel Doerflinger, Jason Glab, Christina Nedeva, Irvin Jose, Ann Lin, Lorraine O'Reilly, Cody Allison, Marc Pellegrini, Richard S Hotchkiss, Hamsa Puthalakath
Sepsis-induced lymphopenia is a major cause of morbidities in intensive care units and in populations with chronic conditions such as renal failure, diabetes, HIV and alcohol abuse. Currently, other than supportive care and antibiotics, there are no treatments for this condition. We developed an in vitro assay to understand the role of the ER-stress-mediated apoptosis process in lymphocyte death during polymicrobial sepsis, which was reproducible in in vivo mouse models. Modulating ER stress using chemical chaperones significantly reduced the induction of the pro-apoptotic protein Bim both in vitro and in mice...
October 3, 2016: Scientific Reports
Marie Szymanowski, Maria Salomon Estebanez, Raja Padidela, Bing Han, Karolina Mosinska, Adam Stevens, Lena Damaj, Florence Pihan-Le Bars, Emilie Lascouts, Rachel Reynaud, Catherine Ferreira, Claire Bansept, Pascale de Lonlay, Cécile Saint-Martin, Mark J Dunne, Indraneel Banerjee, Jean-Baptiste Arnoux
CONTEXT: Congenital hyperinsulinism (CHI) is the commonest cause of persistent hypoglycemia in neonates and infants. In medically unresponsive CHI, subtotal pancreatectomy is performed to achieve euglycaemia with consequent diabetes in later life. Sirolimus, a mammalian target of rapamycin (mTOR) inhibitor has been reported to obviate the need for pancreatectomy, but experience is limited. OBJECTIVE: We have investigated the efficacy and adverse effect profile of mTOR inhibitors in the treatment of severe CHI...
October 3, 2016: Journal of Clinical Endocrinology and Metabolism
Sebastian Rasch, Veit Phillip, Stephanie Reichel, Bettina Rau, Christian Zapf, Jonas Rosendahl, Ulrich Halm, Markus Zachäus, Martin Müller, Alexander Kleger, Albrecht Neesse, Jochen Hampe, Mark Ellrichmann, Felix Rückert, Peter Strauß, Alexander Arlt, Volker Ellenrieder, Thomas M Gress, Werner Hartwig, Ernst Klar, Joachim Mössner, Stefan Post, Roland M Schmid, Thomas Seufferlein, Marco Siech, Jens Werner, Uwe Will, Hana Algül
BACKGROUND: Necrotising pancreatitis, and particularly infected necrosis, are still associated with high morbidity and mortality. Since 2011, a step-up approach with lower morbidity rates compared to initial open necrosectomy has been established. However, mortality and complication rates of this complex treatment are hardly studied thereafter. METHODS: The German Pancreatitis Study Group performed a multicenter, retrospective study including 220 patients with necrotising pancreatitis requiring intervention, treated at 10 hospitals in Germany between January 2008 and June 2014...
2016: PloS One
Andrew Baird, Chenliang Deng, Matthew H Eliceiri, Fatima Haghi, Xitong Dang, Raul Coimbra, Todd W Costantini, Bruce E Torbett, Brian P Eliceiri
Mice engrafted with human CD34(+) hematopoietic stem and progenitor cells (CD34(+) -HSPCs) have been used to study human infection, diabetes, sepsis, and burn, suggesting that they could be highly amenable to characterizing the human inflammatory response to injury. To this end, human leukocytes infiltrating subcutaneous implants of polyvinyl alcohol (PVA) sponges were analyzed in immunodeficient NSG mice reconstituted with CD34(+) -HSPCs. It was reported that human CD45(+) (hCD45(+) ) leukocytes were present in PVA sponges 3 and 7 days postimplantation and could be localized within the sponges by immunohistochemistry...
September 24, 2016: Wound Repair and Regeneration
Monera Mm Mohammed, Sirageldin Mk Abdel Rahman
Hyperglycaemia has become a significant risk factor for morbidity and mortality of the smaller fragile infants surviving the neonatal period. Its risk is inversely related to gestational age, birth weight and baby's clinical condition. The aim of this study was to determine the frequency, some clinical aspects and immediate outcome of hyperglycaemia in neonates admitted to the neonatal intensive care unit (NICU) at Gaafar Ibnauf Children's Hospital, Khartoum. The study was a prospective, descriptive and hospital-based, conducted during the period of 1st January to 31st December 2014...
2016: Sudan J Paediatr
Yaara Leibovici-Weissman, Alaa Atamna, Agata Schlesinger, Noa Eliakim-Raz, Jihad Bishara, Dafna Yahav
AIM: Most cases of Clostridium difficile infections (CDI) occur in patients aged 65 years and older. Older age is associated with increased mortality. Risk factors for mortality in patients aged 80 years and older are not well recognized. METHODS: We analyzed retrospective data including 184 patients aged 80 years and older hospitalized with CDI during 2009-2014. We aimed to delineate risk factors for short- and long-term mortality. RESULTS: The 30-day mortality was 33...
September 20, 2016: Geriatrics & Gerontology International
Nicholas D Ward, Jennifer W Harris, David A Sloan
Necrotizing fasciitis is a rare, aggressive, soft-tissue infection that results in necrosis of skin, subcutaneous tissue, and fascia. It spreads rapidly and may progress to sepsis, multi-organ failure, and death. Predisposing conditions include diabetes, chronic alcoholism, advanced age, vascular disease, and immunosuppression and many cases are preceded by an injury or invasive procedure. Necrotizing soft-tissue infection of the breast is uncommon, with only a few reported cases in the literature. We present a 53-year-old diabetic woman who presented to the emergency room with several weeks of worsening breast and shoulder pain, swelling, and erythema...
September 16, 2016: Breast Journal
Nunzia Caporarello, Mario Salmeri, Marina Scalia, Carla Motta, Cristina Parrino, Lucia Frittitta, Melania Olivieri, Martina Cristaldi, Roberto Avola, Vincenzo Bramanti, Maria Antonietta Toscano, Carmelina Daniela Anfuso, Gabriella Lupo
It is suspected that microbial infections take part in the pathogenesis of diabetes mellitus type 1 (T1DM). Glucose-induced insulin secretion is accompanied by the release of free arachidonic acid (AA) mainly by cytosolic- and calcium independent phospholipases A2 (cPLA2 and iPLA2). Insulinoma cell line (INS-1E) was infected with E. coli isolated from the blood culture of a patient with sepsis. Invasion assay, Scanning Electron Microscopy and Transmission Electron Microscopy demonstrated the capacity of E. coli to enter cells, which was reduced by PLA2 inhibitors...
2016: PloS One
Meryem Kurek Eken, Abdülhamit Tüten, Enis Özkaya, Güner Karatekin, Ateş Karateke
OBJECTIVE: To assess the predictors of outcome in terms of length of stay in the neonatal intensive care unit (NICU) and survival of neonates from women with preterm premature rupture of membranes (PPROM). METHODS: A population-based retrospective study including three hundred thirty-one singleton pregnant women with PPROM at 24-34 gestational weeks between January 2013 and December 2015 was conducted. Gestational age at delivery, birth weight, route of delivery, newborn gender, maternal age,oligohydramnios, premature retinopathy (ROP), necrotising enterocolitis (NEC), sepsis, fetal growth retardation (FGR), intracranial hemorrhagia (ICH), bronchopulmonary dysplasia (BPD), respiratory distress syndrome (RDS), primary pulmonary hypertension (PPH), congenital cardiac disease (CCD), patent ductus arteriosus (PDA), use of cortisol (betamethasone) and maternal complications including gestational diabetes, preeclampsia, and chorioamnionitis were used to predict neonatal outcomes in terms of length of stay in the NICU and survival...
September 14, 2016: Journal of Maternal-fetal & Neonatal Medicine
Alexander Koch, Ralf Weiskirchen, Sebastian Ludwig, Lukas Buendgens, Jan Bruensing, Eray Yagmur, Christer Baeck, Ulf Herbers, Christian Trautwein, Frank Tacke
PURPOSE: Sclerostin is a negative regulator of bone metabolism and associated with chronic morbidities. We investigated circulating sclerostin in critically ill patients. METHODS: A total of 264 patients (170 with sepsis) were studied prospectively upon admission to the medical intensive care unit (ICU) and on day 7. Patients' survival was followed for up to 3 years. RESULTS: Sclerostin serum levels were significantly elevated in critically ill patients at ICU admission compared with 99 healthy controls...
August 22, 2016: Journal of Critical Care
Bryan Stanistreet, Derek Bell
Mucormycosis is a rare, rapidly progressive and often fatal fungal infection. The rarity of the condition lends itself to unfamiliarity, delayed treatment, and poor outcomes. Diagnosis of fungal infections early enough to enable appropriate treatment occurs in less than half of affected patients. A 56-year-old male with a history of diabetes mellitus II, hepatitis C, and intravenous drug abuse was involved in a rollover motor vehicle accident. He sustained circumferential partial and full-thickness burns to his lower extremities with 20% BSA burns...
September 9, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
Nicholas M Mohr, Karisa K Harland, Dan M Shane, Azeemuddin Ahmed, Brian M Fuller, Marcia M Ward, James C Torner
OBJECTIVE: To identify factors associated with rural sepsis patients' bypassing rural emergency departments to seek emergency care in larger hospitals, and to measure the association between rural hospital bypass and sepsis survival. DESIGN: Observational cohort study. SETTING: Emergency departments of a rural Midwestern state. PATIENTS: All adults treated with severe sepsis or septic shock between 2005 and 2014, using administrative claims data...
September 8, 2016: Critical Care Medicine
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