Sepsis

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...

OBJECTIVES: To evaluate the comparative clinical effectiveness and safety of dexamethasone versus betamethasone for preterm birth. DATA SOURCES: The sources searched were MEDLINE, EMBASE, Cochrane Library, LILACS, Clinical Trials.gov, International Clinical Trials Registry Platform without language restrictions until October 2019, along with reference lists of included studies. Field experts were also contacted. STUDY ELIGIBILITY CRITERIA: Randomized or quasi-randomized controlled trials comparing any corticosteroids against each other or against placebo at any dose for preterm birth were included in the study...

Efforts have been made to determine new predictors of morbidity and mortality in patients with severe burn injuries. This prospective cohort study aimed to determine the association of serum albumin concentration on admission and renal failure, pulmonary infection, sepsis, and death in patients with burn injuries. We included 141 patients, aged >18 years, who were admitted to our institution between April and August 2018. Among them, 59.1% were male and 83.8% had burns covering <20% of the body surface area...

BACKGROUND: Procalcitonin (PCT) has been widely investigated as an infection biomarker. The study aimed to prove that serum PCT, combining with other relevant variables, has an even better sepsis-detecting ability in critically ill patients. METHODS: We conducted a retrospective cohort study in a regional teaching hospital enrolling eligible patients admitted to intensive care units (ICU) between July 1, 2016, and December 31, 2016, and followed them until March 31, 2017...

Burn injuries are a common form of traumatic injury that leads to significant morbidity and mortality worldwide. Burn injuries are characterized by inflammatory processes and alterations in numerous organ systems and functions. Recently, it has become apparent that the gastrointestinal bacterial microbiome is a key component of regulating the immune response and recovery from burn and can also contribute to significant detrimental sequelae after injury, such as sepsis and multiple organ failure. Microbial dysbiosis has been linked to multiple disease states, however, its role in exacerbating acute traumatic injuries, such as burn, are poorly understood...

OBJECTIVES: Catecholaminergic vasopressors are the cornerstone of circulatory shock management. Nevertheless, catecholamines have problematic side effects, arousing a growing interest in noncatecholaminergic agents such as vasopressin or angiotensin-II. However, their respective effects on sepsis-associated microvascular endothelial dysfunction such as permeability or inflammation remain elusive. We investigated the role of catecholamines and other vasopressors on Toll-like receptor agonists-induced microvascular endothelial permeability and inflammation...

INTRODUCTION: The ongoing COVID-19 pandemic has led to devastating repercussions on healthcare systems worldwide. This viral infection has a broad clinical spectrum broad (ranging from influenza-like disease, viral pneumonia, hypoxemia to ARDS requiring prolonged ICU stays). The prognostic impact of measuring viral load on nasopharyngeal swab specimens (by RT-PCR) is yet to be elucidated. METHODS: Between March 3rd and April 5th , 2020, we conducted a retrospective study on a cohort of COVID-19 patients (mild or severe disease) who were hospitalized after presenting to the emergency department (ED) and had at least one positive nasopharyngeal swab during their hospital stay...

OBJECTIVE: To evaluate the impact of pre-intensive care unit admission (pre-ICU) statin use on all-cause in-hospital mortality and ICU length of stay (LOS). DESIGN: Retrospective cohort study. SETTING: Adult ICUs at tertiary hospitals. PATIENTS: Adult critically ill patients diagnosed with sepsis admitted to the ICUs. INTERVENTION: The exposure was pre-ICU statin prescription (statin users); unexposed represented absence of pre-ICU prescription (non-users)...

Sepsis is a life-threatening disease, which can cause the dysfunction of multiple organs, including kidney. Recently, a number of studies found that the long non-coding RNA (lncRNA) is closely associated with the development and progression of sepsis; however, the role of long intergenic non-protein coding RNA 261 (LINC00261) in sepsis-induced acute kidney injury is poorly understood. In this study, we found the expression of LINC00261 was significantly decreased in the serum of patients with sepsis than healthy controls...

Objective Sex-specific differences in hypothalamic-pituitary-adrenal axis activity might explain why male preterm infants are at higher risk of neonatal mortality and morbidity than their female counterparts. We examined whether male and female preterm infants differed in cortisol production and metabolism at 10 days post-partum. Design and methods This prospective study included 36 preterm born infants (18 boys) with a very low birth weight (VLBW) (<1.500 gram). At 10 days postnatal age, urine was collected over a 4- to 6-hr period...

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BACKGROUND: Anastomotic leak (AL) is a devastating complication. Several new treatment options are available, endoluminal negative pressure therapy is one. The aims of this systematic review are; to report success rates and stoma closure rates following endoluminal negative pressure therapy in colorectal AL patients. METHODS: A systematic review of MEDLINE, PubMed, Cochrane and Embase databases from inception to June 2018. Search limits were; English language, humans, sample >5 and >18 years...

Sepsis is an acute systemic infectious disease engendered by infectious factors, which can cause the dysfunction of multiple organs, including acute kidney injury (AKI). Recently, more and more researchers are focusing on long non-coding RNA (lncRNA) that is closely associated with the development and progression of various diseases; however, the role and mechanism of lncRNA in sepsis-induced acute kidney injury is not fully understood. Here, we found a significant increase in the expression of lncRNA small nuclear RNA host gene 5 (SNHG5) in the serum of patients with sepsis than healthy controls...

OBJECTIVE: Determine risk of death or neurodevelopmental impairment (NDI) in infants with late-onset sepsis (LOS) versus late-onset, antibiotic-treated, blood culture-negative conditions (LOCNC). DESIGN: Retrospective cohort study. SETTING: 24 neonatal centres. PATIENTS: Infants born 1/1/2006-31/12/2014, at 22-26 weeks gestation, with birth weight 401-1000 g and surviving >7 days were included. Infants with early-onset sepsis, necrotising enterocolitis, intestinal perforation or both LOS and LOCNC were excluded...

BACKGROUND: Diabetes mellitus is a known risk factor for infection. Pay for Performance (P4P) program is designed to enhance the comprehensive patient care. The aim of this study is to evaluate the effect of the P4P program on infection incidence in type 2 diabetic patients. METHODS: This is a retrospective longitudinal cohort study using data from the National Health Insurance Research Database in Taiwan. Diabetic patients between 1 January 2002 and 31 December 2013 were included...

BACKGROUND: Transrectal ultrasonography (TRUS)-guided prostate biopsy is the conventional method of diagnosing prostate cancer. TRUS-guided prostate biopsy can occasionally be associated with severe complications. Here, we report the first case of a prostate abscess with aneurysms and spondylodiscitis as a complication of TRUS-guided prostate biopsy, and we review the relevant literature. CASE PRESENTATION: A 78-year-old man presented with back pain, sepsis, and prostate abscesses...

Group B Streptococcus (hereinafter GBS) is the main pathogen in neonatal sepsis and meningitis, accounting for approximately one quarter of the cases. 1) Prevention of infection is therefore crucial. The GBS carriage testing of pregnant women is necessary to prevent infections. In this study, we examined the clinical utility of Pourmedia ViGBS agar medium (Eiken Chemical Co., Ltd.) in GBS screening, using a total of 197 vaginal and urine samples. Of these samples, 32 (16.2%) tested GBS positive with Pourmedia ViGBS agar medium, and 29 (14...

Hemodynamic optimization during sepsis and septic shock is based on a prompt and large fluid resuscitation strategy associated with early administration of norepinephrine. In our hospital, norepinephrine is administered in the emergency department (ED), within a protocol-guided management context, to reduce norepinephrine infusion timing due to central line insertion. This choice, however, can be associated with side effects. OBJECTIVES: We conducted a retrospective analysis regarding the safety of norepinephrine in the ED...

Pseudomonas mendocina is an environmental bacterium, rarely isolated in clinical specimens, although it has been described as producing endocarditis and sepsis. Little is known about its genome. Whole genome sequencing can be used to learn about the phylogeny, evolution, or pathogenicity of these isolates. Thus, the aim of this study was to analyze the resistome, virulome, and phylogenetic relationship of two P. mendocina strains, Ps542 and Ps799, isolated from a healthy Anas platyrhynchos fecal sample and a lettuce, respectively...

Eleven years ago, a 64-year-old Caucasian man had LNH Follicular 3a, IV A stage, FLIPI 2 as a prognostic index of follicular lymphoma. He received 8 cycles of RCHOP followed by rituximab maintenance, with complete remission. Due to a systemic recurrence, a new treatment schedule (RCOMP, 6 cycles) was introduced with partial remission persisting during a long-term maintenance treatment with rituximab. Three years ago, LNH Follicular 3a progressed into GC type diffuse large B-cell lymphomas (DLBCL); 6 cycles of rituximab and bendamustine were followed by R-ICE and R OXALI DHAP treatments without beneficial effect...