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
Hanan F Nazir, Abdulhakim Al Rawas, Salem Al Tamemi, Shoaib Al Zadjali, Saif Al Hosni, Melanie Tauro, Jamal Al Qassabi, Ibtisam Elnour, Rupert Handgretinger, David Dennison
Autosomal recessive complete interferon- gamma receptor-2 (IFN-γR2) deficiency is a rare potentially fatal primary immune deficiency that predisposes to disseminated mycobacterial disease.Hematopoietic stem cell transplantation (HSCT) is currently the only curative treatment. Few patients had been reported so far. OBJECTIVE: To report on the outcome of hematopoietic stem cell transplantation (HSCT) in patients with IFNγR2 deficiency transplanted in Sultan Qaboos University Hospital (SQUH), Oman...
July 19, 2021: Transplantation and cellular therapy
Meredith Holt, Matthew Zerden
BACKGROUND: Adolescents and young adults are responsible for the majority of new genital herpes virus infections. Historically, primary genital herpes infections were thought to be caused by herpes simplex virus-2, however, recent studies suggest that up to 50% of incident episodes of genital herpes are caused by herpes simplex virus-1. CASE: This case discusses an 18-year-old G1P0010 female who presented with a primary genital HSV-1 outbreak that resulted in sepsis secondary to Streptococcus pyogenes bacteremia...
July 19, 2021: Journal of Pediatric and Adolescent Gynecology
Alan S Go, Kristi Reynolds, Grace H Tabada, Priya A Prasad, Sue Hee Sung, Elisha Garcia, Cecilia Portugal, Dongjie Fan, Ashok P Pai, Margaret C Fang
BACKGROUND: Limited existing data suggest the novel coronavirus disease 2019 (Covid-19) may increase risk for venous thromboembolism (VTE) but information from large, ethnically diverse populations with appropriate controls are lacking. RESEARCH QUESTION: Does the rate of VTE among adults hospitalized with Covid-19 differ from matched hospitalized controls without Covid-19? STUDY DESIGN AND METHODS: We conducted a retrospective study among hospitalized adults with laboratory-confirmed Covid-19 and hospitalized adults without evidence of Covid-19 matched on age, gender, race/ethnicity, acute illness severity, and month of hospitalization between February-August 2020 from two integrated healthcare delivery systems with 36 hospitals...
July 19, 2021: Chest
Preston Atteberry, Benjamin Biederman, Arun Jesudian, Catherine Lucero, Robert S Brown, Elizabeth Verna, Vinay Sundaram, Brett Fortune, Russell Rosenblatt
BACKGROUND & AIMS: Infection is associated with substantial morbidity and mortality in cirrhosis, but presumably not all infections carry the same risk of mortality. We compared outcomes of different sites of infection in a nationally representative sample of inpatients with cirrhosis. METHODS: We queried the Nationwide Readmissions Database (NRD) for patients with cirrhosis from 2011-2014. Cirrhosis and infection diagnoses were identified by previously used algorithms of ICD-9 codes...
July 22, 2021: Journal of Gastroenterology and Hepatology
Stanley Mwita, Eveline Konje, Benjamin Kamala, Angelina Izina, Semvua Kilonzo, Andrew Kigombola, Karol J Marwa, Mary Jande, Deborah Dewey
OBJECTIVES: The primary aims of this study were to investigate if exposure to antenatal corticosteroids (ACS) was associated with lower rates of perinatal mortality (primary outcome) and other adverse perinatal outcomes (i.e., stillbirth, early neonatal mortality, APGAR score of < 7 at 5 mins, neonatal sepsis and respiratory distress syndrome) in preterm infants in hospitals in Tanzania. We also examine factors associated with administration of ACS among women at risk of preterm delivery...
2021: PloS One
Christina Scharf, Ines Schroeder, Michael Paal, Martin Winkels, Michael Irlbeck, Michael Zoller, Uwe Liebchen
BACKGROUND: A cytokine storm is life threatening for critically ill patients and is mainly caused by sepsis or severe trauma. In combination with supportive therapy, the cytokine adsorber Cytosorb® (CS) is increasingly used for the treatment of cytokine storm. However, it is questionable whether its use is actually beneficial in these patients. METHODS: Patients with an interleukin-6 (IL-6) > 10,000 pg/ml were retrospectively included between October 2014 and May 2020 and were divided into two groups (group 1: CS therapy; group 2: no CS therapy)...
July 22, 2021: Annals of Intensive Care
Domitille Callon, Auré Lien Guedra, Anne-Laure Lebreil, Caroline Rambaud, Paul Fornés, Laurent Andreoletti
Group-B Enteroviruses, such as Echoviruses, are a common cause of infections in neonates but fatal myocarditis during Echovirus-induced sepsis have been rarely reported. We report on 2 cases of neonatal Echovirus-related sepsis with myocarditis. Fatal cardiorespiratory failure occurred in both cases. Autopsies and thorough histologic and microbiologic investigations evidenced Echoviruses 5- and 11-induced myocarditis as the cause of death.
July 20, 2021: Pediatric Infectious Disease Journal
Abhay Bang, Mahesh Deshmukh, Sanjay Baitule, Jessica Duby
BACKGROUND: Sepsis is a leading cause of neonatal mortality globally. The home-based neonatal care (HBNC) field trial (1995-1998) in rural Gadchiroli demonstrated a reduction in the incidence of neonatal sepsis. The current study examines the trend of neonatal sepsis during the twenty-one years (1998-2019) following the trial's completion. METHODS: We conducted a retrospective cohort study based on the HBNC program data in rural Gadchiroli, India, from April 1998 to March 2019...
July 20, 2021: Pediatric Infectious Disease Journal
Alieke van der Hoeven, Martha T van der Beek, Enrico Lopriore, Sylke J Steggerda, Vincent Bekker
BACKGROUND: In many infants, treatment is started for suspicion of early onset sepsis (EOS), of whom the majority do not have an infection. Early prediction of the absence of a culture-proven sepsis (CPS) would significantly reduce the time of antibiotic treatment and hospitalization. Our objective was to analyze 3 criteria in infants with CPS: positive blood culture (BC) at 24 hours after the onset of suspicion of EOS (OSEOS), C-reactive protein (CRP) ≥10 mg/L and clinical signs of infection, so we can consequently consider to stop antibiotic treatment in infants without these criteria...
July 20, 2021: Pediatric Infectious Disease Journal
Fernando Jose da Silva Ramos, Flávio Geraldo Rezende de Freitas, Flavia Ribeiro Machado
PURPOSE OF REVIEW: To discuss why severe COVID-19 should be considered sepsis and how co-infection and secondary infection can aggravate this condition and perpetuate organ dysfunction leading to high mortality rates. RECENT FINDINGS: In severe COVID-19, there is both direct viral toxicity and dysregulated host response to infection. Although both coinfection and/or secondary infection are present, the latest is of greater concern mainly in resource-poor settings...
July 20, 2021: Current Opinion in Critical Care
Eric K Patterson, Carolina Gillio-Meina, Claudio M Martin, Douglas D Fraser, Logan R Van Nynatten, Marat Slessarev, Gediminas Cepinskas
In sepsis-induced inflammation, polymorphonuclear neutrophils (PMNs) contribute to vascular dysfunction. The serine proteases proteinase 3 (PR3) and human leukocyte elastase (HLE) are abundant in PMNs and are released upon degranulation. While HLE's role in inflammation-induced endothelial dysfunction is well studied, PR3's role is largely uninvestigated. We hypothesized that PR3, similarly to HLE, contributes to vascular barrier dysfunction in sepsis. Plasma PR3 and HLE concentrations and their leukocyte mRNA levels were measured by ELISA and qPCR, respectively, in sepsis patients and controls...
July 22, 2021: Experimental Biology and Medicine
Hamed Nikoupour, Peyman Arasteh, Alireza Shamsaeefar, Fardin Ghanbari, Arash Boorboor, Ali Mosa Jafar Almayali, Mojtaba Shafiekhani, Pirouz Samidoust, Reza Shahriarirad, Alireza Shojazadeh, Keivan Ranjbar, Mohammad Hasan Darabi, Sina Tangestanipour, Seyed Morteza Hosseini, Leila Zahiri, Saman Nikeghbalian
OBJECTIVE: For the first time, we aimed to report experiences with an intestinal rehabilitation unit (IRU) from a country without home parenteral nutrition (HPN). METHODS: We included all patients with a diagnosis of intestinal failure (IF) since the establishment of our IRU from February 2018 to February 2020. We further report on our protocols for management of enterocutaneous fistulas (ECF), short bowel syndrome (SBS), chronic intestinal pseudo-obstruction and motility disorders...
July 22, 2021: JPEN. Journal of Parenteral and Enteral Nutrition
Qingzeng Gao, Marina Sorrentino Hernandes
Sepsis is a life-threatening clinical condition caused by a dysregulated host response to infection. Sepsis-associated encephalopathy (SAE) is a common but poorly understood neurological complication of sepsis, which is associated with increased morbidity and mortality. SAE clinical presentation may range from mild confusion and delirium to severe cognitive impairment and deep coma. Important mechanisms associated with SAE include excessive microglial activation, impaired endothelial barrier function, and blood-brain barrier (BBB) dysfunction...
July 21, 2021: Inflammation
Erik K Amundsen, Christina Binde, Erik E Christensen, Olav Klingenberg, Dag Kvale, Aleksander R Holten
OBJECTIVES: Increase of nucleated RBCs in peripheral blood has been shown to be predictive of mortality in ICU patients. The aim of this study was to explore the prognostic value of nucleated RBCs in the first blood sample taken at admission to the emergency department from patients with suspected sepsis. DESIGN: Single-center prospective cohort study. SETTING: Emergency department. PATIENTS: One-thousand two-hundred thirty-one consecutive adult patients with suspected sepsis were included in a prospective quality register-based cohort study...
July 2021: Critical care explorations
Stuart S Kaufman, Elsadig Hussan, Alexander Kroemer, Olga Timofeeva, Helena B Pasieka, Juan Francisco Guerra, Nada A Yazigi, Khalid M Khan, Udeme D Ekong, Sukanya Subramanian, Jason S Hawksworth, Raffaelle Girlanda, Shahira S Ghobrial, Thomas M Fishbein, Cal S Matsumoto
Background: Graft versus host disease (GVHD) is an uncommon but highly morbid complication of intestinal transplantation (ITx). In this study, we reviewed our 17-y experience with GVHD focusing on factors predicting GVHD occurrence and survival. Methods: Retrospective review of 271 patients who received 1 or more ITx since program inception in 2003 with survival analysis using Cox proportional hazard modeling. Results: Of 271 patients, 28 developed GHVD 34 (18-66) d after ITx presenting with rash or rash with fever in 26, rectosigmoid disease in 1, and hemolysis in 1; other sites, mainly rectosigmoid colon, were involved in 13...
August 2021: Transplantation Direct
Longxiang Su, Zheng Xu, Fengxiang Chang, Yingying Ma, Shengjun Liu, Huizhen Jiang, Hao Wang, Dongkai Li, Huan Chen, Xiang Zhou, Na Hong, Weiguo Zhu, Yun Long
Background: Early prediction of the clinical outcome of patients with sepsis is of great significance and can guide treatment and reduce the mortality of patients. However, it is clinically difficult for clinicians. Methods: A total of 2,224 patients with sepsis were involved over a 3-year period (2016-2018) in the intensive care unit (ICU) of Peking Union Medical College Hospital. With all the key medical data from the first 6 h in the ICU, three machine learning models, logistic regression, random forest, and XGBoost, were used to predict mortality, severity (sepsis/septic shock), and length of ICU stay (LOS) (>6 days, ≤ 6 days)...
2021: Frontiers in Medicine
Neema W Minja, Huda Akrabi, Karen Yeates, Kajiru Gad Kilonzo
Background: Acute kidney injury (AKI) is a recognized complication in critically ill patients. The epidemiology of AKI varies worldwide, depending on the diagnostic criteria used and the setting. The International Society of Nephrology has called for a reduction in preventable deaths from AKI to zero by the year 2025. It is suspected that the majority of AKI cases are in limited-resource countries, but the true burden of AKI in these settings remains unknown. Objective: We aimed to determine, using standardized KDIGO (Kidney Disease Improving Global Outcomes) criteria, the prevalence of AKI, associated factors, and clinical characteristics of adult (≥18 years) patients admitted to intensive care units (ICUs) at a tertiary hospital in Tanzania...
2021: Canadian Journal of Kidney Health and Disease
Xu Yang, Anwarul Haque, Shigenobu Matsuzaki, Tetsuya Matsumoto, Shigeki Nakamura
The emergence of multi-drug resistant Pseudomonas aeruginosa necessitates the search for treatment options other than antibiotic use. The use of bacteriophages is currently being considered as an alternative to antibiotics for the treatment of bacterial infections. A number of bacteriophages were introduced to treat pneumonia in past reports. However, there are still lack of knowledge regarding the dosages, application time, mechanism and safety of phage therapy against P. aeruginosa pneumonia. We used the bacteriophage KPP10 against P...
2021: Frontiers in Microbiology
Dermot Cox
It is clear that COVID-19 is more than a pneumonia and is associated with a coagulopathy and multi-organ failure. While the use of anti-coagulants does reduce the incidence of pulmonary emboli, it does not help with survival. This suggests that the coagulopathy is more likely to be platelet-driven rather than thrombin-driven. There is significant evidence to suggest that SARS-CoV-2 virions directly interact with platelets to trigger activation leading to thrombocytopenia and thrombosis. I propose a model of multiple interactions between SARS-CoV-2 and platelets that has many similarities to that with Staphylococcus aureus and Dengue virus...
2021: Frontiers in Pharmacology
Fetch more papers »
Fetching more papers... Fetching...
Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"