David Sweet , Julian Marsden , Kendall Ho , Christina Krause , James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: British Columbia Medical Journal
Difan Lu, Wenchao Mao
BACKGROUND: This study explored the efficacy of hydrocortisone combined with vitamin C and thiamine (HVT) in the treatment of sepsis/septic shock. METHODS: PubMed, EMBASE and Web of Science were searched (establishment of the database to October 31, 2022). The meta-analysis included randomized controlled trials (RCTs); comparing the efficacy of HVT regimen and placebo in the treatment of sepsis/septic shock. The Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias...
March 26, 2023: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
Chengzi Huang, Yilian Zhong, Chaochi Yue, Bin He, Yaling Li, Jun Li
BACKGROUND: To determine the efficacy of hyperbaric oxygen therapy (HBO) in the treatment of necrotizing soft tissue infections (NSTI), we conducted a meta-analysis of the available evidence. METHODS: Data sources were PubMed, Embase, Web of Science, Cochrane Library, and reference lists. The study included observational trials that compared HBO with non-HBO, or standard care. The primary outcome was the mortality rate. Secondary outcomes were the number of debridement, amputation rate and complication rate...
March 25, 2023: World Journal of Emergency Surgery: WJES
Yiwen Cao, Ying Wang, Bian Li, Dehai Zhu, Tian Sang, Xueyan Du, Wanjun Shi, Liu Yang
OBJECTIVE: To investigate the perinatal and in-hospital risk factors associated with the high incidence of amblyopia in preterm infants and to analyze the correlation between the amblyopia and neurodevelopment. METHODS: Children discharged from the neonatal intensive care unit (NICU) at 12 months of corrected gestational age were retrospectively included in this study. Ocular screening was performed in children. At the risk of amblyopia was determined according to the American Academy of Ophthalmology Guidelines for automated preschool vision screening factors...
March 25, 2023: BMC Pediatrics
Mohammad Anas, Tayyab Hasan, Usman Raja, Wajid A Raza
STUDY DESIGN: Prospective observational cohort study. OBJECTIVE: To understand if serum procalcitonin (PCT) is a reliable indicator of sepsis in spinal cord injury (SCI) patients for better prognosis and earlier diagnosis when compared with other common biomarkers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cells (WBC), blood culture and body temperature. METHODS: From March 2021 to August 2022, data were collected for SCI patients who developed septicaemia...
March 26, 2023: European Spine Journal
Xiao Zhang, Wei Ning, Ge Gao, Yong Zhou, Xiang-Bing Duan, Xin Li, Dai Li, Ren Guo
Acute inflammatory injury is the primary cause of sepsis, leading to various organ failures. Bazedoxifene (BAZ) has been proven to have anti-inflammatory effects. However, its effects on sepsis-induced intestinal injury are unclear. Here, we demonstrated the beneficial effects of BAZ on intestinal injury and explored the underlying mechanisms using cecal ligation and perforation (CLP)-mediated sepsis mouse model and in vitro cultured intestinal epithelial MODE-K cells. We found that BAZ elevated the survival rate of septic mice and attenuated CLP-triggered intestinal damage...
March 23, 2023: European Journal of Pharmacology
Estevão Bassi, Bruno Martins Tomazini, Bárbara Vieira Carneiro, Amanda Rodrigues de Oliveira Siqueira, Sara Rodrigues de Oliveira Siqueira, Thais Guimarães, Fernando da Costa Ferreira Novo, Edivaldo Massazo Utiyama, Paolo Pelosi, Luiz Marcelo Sá Malbouisson
BACKGROUND: Systemic inflammatory responses mimicking infectious complications are often present in surgical patients. METHODS: The objective was to assess the association between withholding early antimicrobial therapy while investigating alternative diagnoses and worse outcomes in nonseptic patients with suspected nosocomial infection in a retrospective cohort of critically ill surgical patients. The initiation of antibiotic therapy within 24h of the suspicion of infection was defined as the Early Empirical Antibiotic strategy (EEA) group and the initiation after 24h of suspicion or not prescribed was defined as the Conservative Antibiotic strategy (CA) group...
March 23, 2023: Brazilian Journal of Anesthesiology
Kerina J Denny, Rodney A Lea, Ross Lindell-Innes, Larisa M Haupt, Aaron J Heffernan, Nicholas R Harvey, Oliver Hughes, Van T Cao, Janine Stuart, David L Paterson, John F McNamara, Jacobus P J Ungerer, Carel J Pretorius, Lyn R Griffiths, Jeffrey Lipman
PURPOSE: We aimed to identify a gene signature that discriminates between sepsis and aseptic inflammation in patients administered antibiotics in the intensive care unit and compare it to commonly utilised sepsis biomarkers. METHODS: 91 patients commenced on antibiotics were retrospectively diagnosed as having: (i) blood culture positive sepsis; (ii) blood culture negative sepsis; or (iii) aseptic inflammation. Bloods were collected after <24 h of antibiotic commencement for both gene expression sequencing analysis and measurement of previously identified biomarkers...
March 23, 2023: Journal of Critical Care
Richard T Spence, Keegan Guidolin, Fayez A Quereshy, Sami A Chadi, David C Chang, Matthew M Hutter
AIM: The simple six-variable Codman score is a tool designed to reduce the complexity of contemporary risk-adjusted postoperative mortality rate predictions. We sought to externally validate the Codman score in colorectal surgery. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) participant user file and colectomy targeted dataset of 2020 were merged. A Codman score (composed of six variables: age, American Society of Anesthesiologists score, emergency status, degree of sepsis, functional status and preoperative blood transfusion) was assigned to every patient...
March 25, 2023: Colorectal Disease
Li Fan, Li Yao, Zhelong Li, Zhuo Wan, Wenqi Sun, Shuo Qiu, Wei Zhang, Dan Xiao, Liqiang Song, Guodong Yang, Yi Zhang, Mengying Wei, Xuekang Yang
Sepsis is one of the most common causes of death, which is closely related to the uncontrolled systemic inflammation. Dysregulation of M1 macrophage polarization is the primary contributor to serious inflammation. In this study, it is revealed that the murine homologue of circRNA SCAR (steatohepatitis-associated circRNA ATP5B regulator), denoted as circRNA mSCAR hereafter, decreases in the macrophages of septic mice, which correlates with the excessive M1 polarization. To restore circRNA mSCAR in mitochondria, exosomes encapsulated with circRNA mSCAR are further electroporated with poly-D-lysine-graft-triphenylphosphine (TPP-PDL), and thus TPP-PDL facilitates the bound circRNA delivered into mitochondria when the exosomes engulf by the recipient cells...
March 25, 2023: Advanced Science (Weinheim, Baden-Wurttemberg, Germany)
Simon A Amacher, Jules Miazza, Martin Siegemund, David Santer
No abstract text is available yet for this article.
March 25, 2023: Interdiscip Cardiovasc Thorac Surg
Xavier Monnet, Christopher Lai, Jean-Louis Teboul
During septic shock, fluid therapy is aimed at increasing cardiac output and improving tissue oxygenation, but it poses two problems: it has inconsistent and transient efficacy, and it has many well-documented deleterious effects. We suggest that there is a place for its personalization according to the patient characteristics and the clinical situation, at all stages of circulatory failure. Regarding the choice of fluid for volume expansion, isotonic saline induces hyperchloremic acidosis, but only for very large volumes administered...
March 24, 2023: Critical Care: the Official Journal of the Critical Care Forum
Qing Ma, Paul E Wischmeyer
INTRODUCTION: Glutamine (GLN) and n-3 polyunsaturated fatty acids (n-3PUFAs) have been shown to potentially possess immune-modulating and disease-modifying properties in experimental and clinical critical illness when given with parenteral nutrition (PN). However, we recently showed in experimental cancer models that combinations of GLN/n-3 PUFA may antagonize benefits of either nutrient alone. Thus, our aim was to explore the effects of PN-containing GLN and n-3PUFA mixed lipid emulsion (MLE) alone and in combination in experimental sepsis...
April 2023: Clinical Nutrition ESPEN
Ramesh Vidavalur, Naveed Hussain
OBJECTIVE: To estimate national time-trends of overall and state-wise antibiotic utilization (AU) rates for suspected neonatal sepsis (SNS) in the United States. STUDY DESIGN: In this cross-sectional study, we used retrospective linked-birth-cohort and vital records data from CDC-WONDER database for the years 2016- 2020 and analyzed data containing antibiotic use for SNS. The primary outcome was proportional national and state-specific AU rates per 1000 live births during the birth hospitalization...
March 24, 2023: American Journal of Perinatology
Maveric K I L Abella, Anson Y Lee, Riley K Kitamura, Hyeong Jun Ahn, Russell K Woo
INTRODUCTION: American Indian and Alaskan Natives (AIAN) and Native Hawaiian and Pacific Islanders (NHPI) research is limited, particularly in postoperative surgical outcomes. This study analyzes disparities in AIAN and NHPI surgical complications across all surgical types and identifies factors that contribute to postoperative complications. METHODS: This retrospective cohort study examined all surgeries from 2011 to 2020 in the National Surgical Quality Improvement Program, queried by race...
March 22, 2023: Journal of Surgical Research
Yang Zhang, Juntai Chen, Haidong Wu, Lixin Li, Xuejia Yang, Keguan Lai, Jingyu Bao, Keliang Xie, Yonghao Yu
BACKGROUND: Sepsis-associated encephalopathy (SAE) is a complication of the central nervous system in patients with sepsis. Currently, no effective treatment for sepsis is available. Hydrogen plays a protective role in different diseases; however, the detailed mechanism of hydrogen-treated disease remains unclear. The purpose of this study was to investigate the effect of hydrogen on SAE in vitro and in vivo and the mechanism of hydrogen in mitochondrial dynamics and its function in astrocytes and microglia stimulated by lipopolysaccharides (LPSs)...
March 22, 2023: International Immunopharmacology
Rachael M Burke, Hussein H Twabi, Cheryl Johnston, Marriott Nliwasa, Ankur Gupta-Wright, Katherine Fielding, Nathan Ford, Peter MacPherson, Elizabeth L Corbett
People living with HIV (PLHIV) admitted to hospital have a high risk of death. We systematically appraised evidence for interventions to reduce mortality among hospitalised PLHIV in low- and middle-income countries (LMICs). Using a broad search strategy with terms for HIV, hospitals, and clinical trials, we searched for reports published between 1 Jan 2003 and 23 August 2021. Studies of interventions among adult HIV positive inpatients in LMICs were included if there was a comparator group and death was an outcome...
2023: PLOS Glob Public Health
Mary Kakuru Muhindo, Joshua Bress, Jean Armas, Elon Danziger, Andrew Wu, Ryan C L Brewster
Hypothermia (axillary temperature less than 36.5°) is a major source of neonatal morbidity and mortality, with a disproportionate burden of disease in low- and middle-income countries. Despite the importance of thermoregulation on newborn outcomes, the global epidemiologic landscape of neonatal hypothermia is poorly characterized. Clinical decision support (CDS) software provides point-of-care recommendations to guide clinical management and may support data capture in settings with limited informatics infrastructure...
2023: PLOS Glob Public Health
Sara Singh, Winsome Scott, Caitlin Yeager, Madan Rambaran, Narendra C Singh, Leif D Nelin
Neonatal mortality is a significant contributor to child mortality, and there is increasing interest in low resource settings to implement neonatal intensive care practices to lower neonatal mortality. In Guyana, South America neonatal mortality remains relatively high. At Georgetown Public Hospital Corporation (GPHC), the only tertiary referral hospital in Guyana, a Level III NICU was developed starting in January, 2012 with full implementation in September, 2015. In this study, we report the association of the implementation of a Level III NICU with in-hospital neonatal survival at GPHC...
2023: PLOS Glob Public Health
Epshita A Islam, Jamie E Fegan, Takele A Tefera, David M Curran, Regula C Waeckerlin, Dixon Ng, Sang Kyun Ahn, Chun Heng Royce Lai, Quynh Huong Nguyen, Megha Shah, Liyuwork Tesfaw, Kassaye Adamu, Wubet W Medhin, Abinet Legesse, Getaw Deresse, Belayneh Getachew, Neil Rawlyk, Brock Evans, Andrew Potter, Anthony B Schryvers, Scott D Gray-Owen, Trevor F Moraes
Pasteurella multocida can infect a multitude of wild and domesticated animals, with infections in cattle resulting in hemorrhagic septicemia (HS) or contributing to bovine respiratory disease (BRD) complex. Current cattle vaccines against P. multocida consist of inactivated bacteria, which only offer limited and serogroup specific protection. Here, we describe a newly identified surface lipoprotein, PmSLP, that is present in nearly all annotated P. multocida strains isolated from cattle. Bovine associated variants span three of the four identified phylogenetic clusters, with PmSLP-1 and PmSLP-2 being restricted to BRD associated isolates and PmSLP-3 being restricted to isolates associated with HS...
March 24, 2023: PLoS Pathogens
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