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JOURNAL ARTICLE
Elizabeth A Lilly, Breah E Bender, Mairi C Noverr, Paul L Fidel
Protection against lethal Candida albicans ( Ca )/ Staphylococcus aureus ( Sa ) intra-abdominal infection (IAI)-mediated sepsis can be achieved by a novel form of trained innate immunity (TII) involving Gr-1+ myeloid-derived suppressor cells (MDSCs) that are induced by inoculation (immunization) with low virulence Candida species [i.e., Candida dubliniensis ( Cd )] that infiltrate the bone marrow (BM). In contrast, more virulent Candida species (i.e., C. albicans ), even at sub-lethal inocula, fail to induce similar levels of protection...
September 13, 2023: Infection and Immunity
#62
JOURNAL ARTICLE
Shuiqiao Fu, Wenqiao Yu, Qinghui Fu, Zhipeng Xu, Shaoyang Zhang, Ting-Bo Liang
BACKGROUND: Septic shock is one of the leading causes of mortality in intensive care units. This retrospective study was carried out to evaluate the association of clinical available factors with 28-day mortality. PATIENTS AND METHOD: In this observational study, patients with perioperative septic shocks secondary to intra-abdominal infection caused by enteric perforation were included. A total of 328 sepsis patients were admitted to the surgical intensive care units from January 2012 to December 2016...
September 12, 2023: BMC Surgery
#63
JOURNAL ARTICLE
Shannon Esher Righi, Amanda J Harriett, Elizabeth A Lilly, Paul L Fidel, Mairi C Noverr
Polymicrobial intra-abdominal infections (IAI) can lead to life-threatening sepsis with significant morbidity and mortality, especially when pathogenic fungi are involved. We have employed an established clinically relevant mouse model of fungal/bacterial IAI and shown that immunization with low-virulence Candida species, that is, Candida dubliniensis , can induce responses that protect against sepsis via the suppression of lethal inflammation. This protection is dependent on long-lived Gr-1+ polymorphonuclear leukocytes that display characteristics consistent with myeloid-derived suppressor cells (MDSCs) and trained innate immunity...
September 8, 2023: MBio
#64
JOURNAL ARTICLE
Rifat Latifi, Abbas Smiley
INTRODUCTION: Open abdomen (OA) management post damage control laparotomy (DCL) is common in complex abdominal trauma and intra-abdominal catastrophe (IAC). Use of polyglactin 910 mesh (VICRYL™, Johnson & Johnson, New Brunswick, New Jersey) to cover the intra-abdominal contents and wound vacuum-assisted closure (VAC) is current practice in the management of temporary abdominal closure (TAC). This may have complications and requires two to three weeks for granulations to be ready for skin grafting...
September 6, 2023: Surgical Technology International
#65
Natasha Rooksana Jeenah, Ramesh Damodaran Prabha, Harald Puhalla
INTRODUCTION AND IMPORTANCE: Splenic cysts are classified as true cysts, or pseudocysts, and larger cysts tend to be symptomatic, requiring management which has evolved to include spleen-sparing procedures to minimize the risk of overwhelming post-splenectomy sepsis (OPSS) Pitiakoudis et al. (2011), Hansen and Moller (2004), Knook et al. (2019) [1-3]. Total splenectomy remains the gold standard management, and the importance of this case is the uncommon spontaneous occurrence of a pseudocyst, and the importance to pre-operatively consent and prepare the patient for total splenectomy would intra-operative conditions not allow for spleen-preserving techniques...
August 28, 2023: International Journal of Surgery Case Reports
#66
JOURNAL ARTICLE
Qiujing Li, Na Shang, Tiecheng Yang, Qian Gao, Shubin Guo
BACKGROUND: Studies on prognostic factors for older patients with intra-abdominal sepsis are scarce, and the association between skeletal muscle mass and prognosis among such patients remains unclear. AIMS: To develop a nomogram to predict in-hospital mortality among older patients with intra-abdominal sepsis. METHODS: Older patients with intra-abdominal sepsis were prospectively recruited. Their demographics, clinical features, laboratory results, abdominal computed tomography-derived muscle mass, and in-hospital mortality were recorded...
September 5, 2023: Aging Clinical and Experimental Research
#67
JOURNAL ARTICLE
Sukumaran Vengail, Dharamveer Chandrakar, Ajit K Naik, Amiya K Nayak, Akriti Mahajan, Priyanjali Dutta
INTRODUCTION: In emergency surgeries, open abdomen or laparostomy, especially with perforated viscus, has been used primarily to prevent delayed ventral hernia, burst abdomen, and abdominal compartment syndrome. In the present study, the clinical and resuscitative factors that are linked with open abdomen morbidity are evaluated. MATERIAL AND METHODS: A retrospective analysis was done for all the subjects who were admitted at the tertiary care center between May 2020 and May 2022 for the open abdomen surgeries...
July 2023: Journal of Pharmacy & Bioallied Sciences
#68
JOURNAL ARTICLE
Lauren Thompson, Brianna L Cohen, Tizeta Wolde, D Dante Yeh, Walter A Ramsey, Patricia M Byers, Nicholas Namias, Jonathan P Meizoso
Background: We sought to understand which factors are associated with open appendectomy as final operative approach. We hypothesize that higher American Association for the Surgery of Trauma (AAST) Emergency General Surgery (EGS) grade is associated with open appendectomy. Patients and Methods: Post hoc analysis of the Eastern Association for the Surgery of Trauma (EAST) Multicenter Study of the Treatment of Appendicitis in America: Acute, Perforated and Gangrenous (MUSTANG) prospective appendicitis database was performed...
August 30, 2023: Surgical Infections
#69
JOURNAL ARTICLE
Bryan Boling, Abbye Solis
Point-of-care ultrasonography is becoming standard practice for diagnosis and management of patients in the critical care setting. When using point-of-care ultrasonography for evaluation of the abdomen, most providers will immediately think of the Focused Assessment with Sonography for Trauma examination. However, there are a number of important abdominal applications for the nontrauma patient, including evaluation of the function of abdominal organs, differentiation of shock states, and identification of sources of sepsis...
September 15, 2023: AACN Advanced Critical Care
#70
JOURNAL ARTICLE
Dai Shimizu, Chie Tanaka, Mitsuro Kanda, Koki Nakanishi, Seiji Ito, Yachiyo Kuwatsuka, Masahiko Ando, Kenta Murotani, Michitaka Fujiwara, Yasuhiro Kodera
Pancreatic fistula after gastrectomy with lymph node dissection is associated with prolonged hospital stay and critical complications such as intra-abdominal bleeding and sepsis. Polyglycolic acid (PGA) sheets are absorbable suture reinforcement materials. A randomized Phase II trial has been planned to evaluate the effect of PGA sheets on preventing postoperative pancreatic fistula. A total of 320 patients will be recruited from thirteen institutions. Patients who are scheduled to undergo distal or total gastrectomy will be randomly allocated into the PGA group or control group, and the dissected area around the pancreas will be covered by the PGA sheet in the PGA group...
2023: Clinical and Experimental Gastroenterology
#71
JOURNAL ARTICLE
Beiyuan Zhang, Xiancheng Chen, Chenhang He, Ting Su, Ke Cao, Xiaoyao Li, Jianfeng Duan, Ming Chen, Zhanghua Zhu, Wenkui Yu
BACKGROUND: Sepsis-associated liver dysfunction (SALD) has high incidence and mortality in patients with intra-abdominal infection (IAI). The associations between acute gastrointestinal injury (AGI), gut microbiota, and SALD were evaluated in patients with IAI. METHODS: A retrospective study was conducted to assess the relationship between AGI and SALD in patients with IAI. Patients were divided into non-SALD and sepsis-induced cholestasis ( SIC ) groups, which is a subtype of SALD...
2023: Frontiers in Medicine
#72
REVIEW
Alice Dalrymple, Luzern Tan, Roger W Byard
The spleen is located in the left upper quadrant of the abdominal cavity and has both immunological and haematological functions. A variety of quite different entities may be associated with sudden death due to splenic involvement. These range from simple traumatic disruption of the parenchyma of a normal spleen with marked intra-abdominal haemorrhage, to conditions such as malaria and infectious mononucleosis where splenomegaly predisposes to rupture. Haematological diseases such as malignancies and haemoglobinopathies may causes sudden death due to haemorrhage or red cell sequestration...
October 2023: Medicine, Science, and the Law
#73
JOURNAL ARTICLE
Daithi S Heffernan, Chun-Shiang Chung, Alfred Ayala
BACKGROUND: Sepsis is marked by a dysregulated immune response to an infection. Invariant Natural Killer T-cells (iNKT-cells) are a pluripotent lymphocyte subpopulation capable of affecting and coordinating the immune response to sepsis. The spleen is an important site of immune interactions in response to an infection. Splenic iNKT-cells have emerged as important potential front-line mediators of chronic immune response. There is little data addressing the role splenic of iNKT-cells in response to intra-abdominal polymicrobial sepsis...
July 24, 2023: Shock
#74
JOURNAL ARTICLE
Varish Ahmad, Alam Jamal, Mohammad Imran Khan, Faisal A Alzahrani, Raed Albiheyri, Qazi Mohammad Sajid Jamal
Morganella morganii is a Gram-negative bacterial pathogen that causes bacteremia, urinary tract infections, intra-abdominal infections, chorioamnionitis, neonatal sepsis, and newborn meningitis. To control this bacterial pathogen a total of 3565 putative proteins targets in Morganella morganii were screened using comparative subtractive analysis of biochemical pathways annotated by the KEGG that did not share any similarities with human proteins. One of the targets, D-alanyl-D-alanine carboxypeptidase DacB [ Morganella ] was observed to be implicated in the majority of cell wall synthesis pathways, leading to its selection as a novel pharmacological target...
July 22, 2023: Journal of Biomolecular Structure & Dynamics
#75
REVIEW
Federico Coccolini, Massimo Sartelli, Robert Sawyer, Kemal Rasa, Bruno Viaggi, Fikri Abu-Zidan, Kjetil Soreide, Timothy Hardcastle, Deepak Gupta, Cino Bendinelli, Marco Ceresoli, Vishal G Shelat, Richard Ten Broek, Gian Luca Baiocchi, Ernest E Moore, Ibrahima Sall, Mauro Podda, Luigi Bonavina, Igor A Kryvoruchko, Philip Stahel, Kenji Inaba, Philippe Montravers, Boris Sakakushev, Gabriele Sganga, Paolo Ballestracci, Manu L N G Malbrain, Jean-Louis Vincent, Manos Pikoulis, Solomon Gurmu Beka, Krstina Doklestic, Massimo Chiarugi, Marco Falcone, Elena Bignami, Viktor Reva, Zaza Demetrashvili, Salomone Di Saverio, Matti Tolonen, Pradeep Navsaria, Miklosh Bala, Zsolt Balogh, Andrey Litvin, Andreas Hecker, Imtiaz Wani, Andreas Fette, Belinda De Simone, Rao Ivatury, Edoardo Picetti, Vladimir Khokha, Edward Tan, Chad Ball, Carlo Tascini, Yunfeng Cui, Raul Coimbra, Michael Kelly, Costanza Martino, Vanni Agnoletti, Marja A Boermeester, Nicola De'Angelis, Mircea Chirica, Walt L Biffl, Luca Ansaloni, Yoram Kluger, Fausto Catena, Andrew W Kirkpatrick
Intra-abdominal infections (IAI) are among the most common global healthcare challenges and they are usually precipitated by disruption to the gastrointestinal (GI) tract. Their successful management typically requires intensive resource utilization, and despite the best therapies, morbidity and mortality remain high. One of the main issues required to appropriately treat IAI that differs from the other etiologies of sepsis is the frequent requirement to provide physical source control. Fortunately, dramatic advances have been made in this aspect of treatment...
July 21, 2023: World Journal of Emergency Surgery: WJES
#76
Andrew B Herson, Camila A Villacreses, Gina M Rehm, Sean A Briceno, Kevin D Healey, Matthew R Brown, Brooke T Miller, Michael W Fountain
Ureteral injury is a rare occurrence in medical practice. Most cases encountered stem from blunt trauma or are iatrogenic, occurring during open abdominal or pelvic surgery and laparoscopic procedures. Prompt diagnosis of ureteral injury allows clinicians to avoid complications including ureteral strictures, abscess, renal failure, sepsis, and loss of the ipsilateral kidney. Treatment depends on whether the ureteral injury was discovered intraoperatively or if it was a delayed diagnosis. Several procedures can be used, including ureteroureterostomy, ureteroileal interposition, and nephrectomy...
June 2023: Curēus
#77
Sanketh Edem, Aakansha Giri Goswami, Bibek Karki, Preeti Acharya, Udit Chauhan, Navin Kumar, Somprakas Basu
BACKGROUND: Superior mesenteric artery syndrome is a very rare cause of proximal intestinal obstruction. The objective of this clinical case report is to highlight that this unusual condition can occur in the early postoperative period and medical management may completely cure the condition. CLINICAL CASE: A middle-aged female who was being treated for pulmonary tuberculosis underwent exploratory laparotomy with limited ileal resection and a loop ileostomy for multiple ileal perforations...
2023: Clinical and Experimental Gastroenterology
#78
JOURNAL ARTICLE
Dilip Dubey, Manish Roy, Tajamul H Shah, Noor Bano, Vidushi Kulshrestha, Sandeep Mitra, Pushpender Sangwan, Madhulika Dubey, Ali Imran, Bhawna Jain, Aravind Velmurugan, Yamuna Devi Bakthavatchalam, Balaji Veeraraghavan
Infections in critically-ill patients caused by extensively-drug-resistant (XDR)-Pseudomonas aeruginosa are challenging to manage due to paucity of effective treatment options. Cefepime/zidebactam, which is currently in global Phase 3 clinical development (Clinical Trials Identifier: NCT04979806, registered on July 28, 2021) is a novel mechanism of action based β-lactam/ β-lactam-enhancer combination with a promising activity against a broad-range of Gram-negative pathogens including XDR P. aeruginosa...
July 5, 2023: Annals of Clinical Microbiology and Antimicrobials
#79
Sirin Falconi, Christopher Wilhelm, Jocelin Loewen, Basem Soliman
Acute appendicitis is one of the most common surgical emergencies worldwide. Many complications can occur secondary to complicated appendicitis including abscess formation, gangrene, sepsis, and perforation, rarely, leading to abdominal wall necrotizing fasciitis. The incidence of necrotizing fasciitis as a complication of ruptured appendicitis is extremely uncommon. The formation of an enterocutaneous fistula leading to this complication further emphasizes the rarity of such occurrence with few cases reported in the literature...
May 2023: Curēus
#80
JOURNAL ARTICLE
Se Hun Kim, Ki Hoon Kim
BACKGROUND: The effects of prior antiplatelet and/or nonsteroidal anti-inflammatory drug (NSAID) use on mortality in critically ill patients remain unclear. We investigated the relationship between antiplatelet and/or NSAID use and mortality in patients who had undergone surgery for sepsis caused by intra-abdominal infection. METHODS: We obtained data from adult patients (aged >18 years) admitted to the intensive care unit after abdominal surgery due to intra-abdominal infection...
June 27, 2023: Surgery
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