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Int J Lab Hematol 2022 Jun 24. Epub 2022 Jun 24.

Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan, China.

Objective: This study aimed to explore the relationship between red cell distribution width (RDW) and in-hospital mortality in septic shock based on a large-scale public database.

Methods: All patients with septic shock in MIMIC-IV were enrolled. Based on RDW values, the general characteristics of different groups were compared. Read More

Urol Oncol 2022 Jun 21. Epub 2022 Jun 21.

Memorial Sloan Kettering Cancer Center, Department of Surgery, Urology Service, New York, NY. Electronic address:

Purpose: Timely and appropriate discharge placement for patients who have undergone radical cystectomy (RC) remains challenging. Our objective was to improve the discharge planning process by creating a machine learning model that helps to predict the need for non-home hospital discharge to a higher level of care.

Materials And Methods: Patients undergoing elective radical cystectomy for bladder cancer from 2014-2019 were identified in the ACS-NSQIP database. Read More

Air Med J 2022 Jul-Aug;41(4):370-375. Epub 2022 May 23.

Department of General Surgery, Novant Health New Hanover Regional Medical Center, Wilmington, NC.

Objective: Point-of-care laboratory testing (POCT) is associated with a reduced time to testing results and critical decision making within emergency departments. POCT is an essential clinical assessment tool because laboratory data are used to support timely critical decisions regarding acute medical conditions onditions ; however, there is currently limited research to support the use of POCT in the critical care transport environment. Few studies have evaluated the changes in patient care that occur after POCT during critical care transport. Read More

J Antimicrob Chemother 2022 Jun 24. Epub 2022 Jun 24.

Department of Infectious Diseases, University Hospital of Nantes and CIC 1413, Nantes, France.

Background: Early antibiotic discontinuation according to the Fourth European Conference on Infections in Leukaemia (ECIL-4) recommendations is not systematically applied in high-risk neutropenic patients with haematological malignancies.

Methods: A retrospective multicentre observational study was conducted over 2 years to evaluate the safety of early antibiotic discontinuation for fever of unknown origin (FUO) during neutropenia after induction chemotherapy or HSCT, in comparison with a historical cohort. We used Cox proportional hazards models, censored on neutropenia resolution, to analyse factors associated with febrile recurrence. Read More

Cureus 2022 Jun 17;14(6):e26048. Epub 2022 Jun 17.

Medicine, Hamad General Hospital, Doha, QAT.

Since the first isolation of Achromobacter xylosoxidans, it has been increasingly recognized as an opportunistic pathogen. It is an aerobic Gram-negative bacillus mainly found in aquatic environments. It has been reported to cause nosocomial infections, especially in immunocompromised patients. Read More

Cureus 2022 May 20;14(5):e25163. Epub 2022 May 20.

Internal Medicine, Coimbra Hospital and University Center, Coimbra, PRT.

Background Hyperlactatemia is defined by a lactate concentration of >2 mmol/L, and a lactate concentration of above >4 mmol/L is commonly used to define severe hyperlactatemia. It is a common disorder in critically ill patients and is associated with adverse prognosis. Diabetes mellitus(DM) can also be associated with increased lactate levels at baseline. Read More

Medicina (Kaunas) 2022 May 25;58(6). Epub 2022 May 25.

The Second Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan.

The use of veno-arterial extracorporeal membrane oxygenation (ECMO) in patients with sepsis-induced cardiogenic shock has been reported, but the clinical implication of the Impella percutaneous axial-flow left ventricular assist device for such patients remains unknown. We had a 37-year-old man with septic shock and severely reduced cardiac function. Veno-arterial ECMO and concomitant Impella CP support ameliorated his end-organ dysfunction and achieved cardiac recovery, whereas severe mitral valve regurgitation due to chordal rupture developed later. Read More

Biomolecules 2022 Jun 4;12(6). Epub 2022 Jun 4.

Department of Medicine, Division of Infectious Diseases, Escola Paulista de Medicina, Federal University of São Paulo (EPM/UNIFESP), São Paulo 04023, Brazil.

Prior studies demonstrate the activation of poly-(ADP-ribose) polymerase 1 (PARP1) in various pathophysiological conditions, including sepsis. We have assessed the effect of olaparib, a clinically used PARP1 inhibitor, on the responses of human peripheral blood leukocytes (PBMCs) obtained from healthy volunteers in response to challenging with live bacteria, bacterial lipopolysaccharide (LPS), or oxidative stress (hydrogen peroxide, HO). The viability of PBMCs exposed to olaparib or to the earlier generation PARP inhibitor PJ-34 (0. Read More

Antioxidants (Basel) 2022 Jun 16;11(6). Epub 2022 Jun 16.

Department of Cardiology 1-Molecular Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany.

Tetrahydrobiopterin (BH4) is an essential cofactor of all nitric oxide synthase isoforms, thus determination of BH4 levels can provide important mechanistic insight into diseases. We established a protocol for high-performance liquid chromatography/electrochemical detection (HPLC/ECD)-based determination of BH4 in tissue samples. We first determined the optimal storage and work-up conditions for authentic BH4 and its oxidation product dihydrobiopterin (BH2) under various conditions (pH, temperature, presence of antioxidants, metal chelators, and storage time). Read More

Hereditas 2022 Jun 23;159(1):27. Epub 2022 Jun 23.

School of Pharmacy, Second Military Medical University, Shanghai, 200433, China.

Background: Sepsis is a life-threatening multi-organ dysfunction caused by the dysregulated host response to infection. Sepsis remains a major global concern with high mortality and morbidity, while management of sepsis patients relies heavily on early recognition and rapid stratification. This study aims to identify the crucial genes and biomarkers for sepsis which could guide clinicians to make rapid diagnosis and prognostication. Read More

In Vivo 2022 Jul-Aug;36(4):1959-1965

Medical Physics Department, ASST Spedali Civili Hospital, Brescia, Italy.

Aim: To evaluate the feasibility and tolerability of low-dose radiotherapy (LDRT) delivered to both lungs in the treatment of SARS-CoV-2-immune-mediated pneumonia in the COLOR-19 study (NCT0437747).

Patients And Methods: From May 2020 to April 2021 at Brescia University Radiation Oncology Department, three patients with COVID-19-related pneumonia were treated with LDRT according to the COLOR-19 protocol. All patients were treated with a single fraction at the average prescription dose of 0. Read More

J Mycol Med 2022 Jun 15;32(4):101304. Epub 2022 Jun 15.

Uludağ University Faculty of Medicine, Department of Hematology, Bursa, Turkey.

Introduction: The first consensus definitions for invasive fungal diseases (IFD) were published in 2002. Advances in diagnostic tests and a clear need for improvement in certain areas led to a revision of these definitions in 2008. However, growing data on Aspergillus galactomannan (GM) thresholds and the introduction of new polymerase chain reaction-based diagnostic tests resulted in a further update by EORTC and Mycoses Study Group Education and Research Consortium (MSGERC) in 2020. Read More

World J Pediatr 2022 Jun 23. Epub 2022 Jun 23.

Pediatric Intensive Care Unit, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, No. 56 Nan-Li-Shi Road, Beijing, 100045, China.

Background: We explored the differences in baseline characteristics, pathogens, complications, outcomes, and risk factors between children with hospital-acquired septic shock (HASS) and community-acquired septic shock (CASS) in the pediatric intensive care unit (PICU).

Methods: This retrospective study enrolled children with septic shock at the PICU of Beijing Children's Hospital from January 1, 2016, to December 31, 2019. The patients were followed up until 28 days after shock or death and were divided into the HASS and CASS group. Read More

Pathophysiology 2022 Jun 10;29(2):281-297. Epub 2022 Jun 10.

Department of Physiology, Saint-Petersburg State University, Saint-Petersburg 199034, Russia.

In spite of intensive studies of different aspects of a new coronavirus infection, many issues still remain unclear. In a screening analysis of histopathology in l200 lethal cases, authors succeeded in performing a wide spectrum of immune histochemical reactions (CD2, CD 3, CD 4, CD 5, CD 7, CD 8, CD14, CD 20, CD 31, CD 34, CD 56, CD 57, CD 68, CD 163, collagen 1,3, spike protein SARS-CoV-2, caspase-3, MLCM; ACE2 receptor, occludin, and claudin-1 and -3) and electron microscopy. The results of the histological and IHC studies of deceased people with varying degrees of severity of coronavirus infection confirmed the ability of these pathogens to cause cytoproliferative changes, primarily in epithelial and endothelial cells. Read More

Ned Tijdschr Geneeskd 2022 May 18;166. Epub 2022 May 18.

Martini Ziekenhuis, afd. Interne Geneeskunde, Groningen.

Background: Lemierre's syndrome is a rare disease with different clinical and microbiological criteria. Without adequate treatment mortality is high. It often concerns healthy adolescents who present with common and usually harmless complaints such as fever and sore throat. Read More

Curr Oncol 2022 May 29;29(6):3881-3893. Epub 2022 May 29.

Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, 5 Fusing St., Gueishan Dist., Taoyuan City 333, Taiwan.

Background: Patients with hepatocellular carcinoma (HCC) tend to be referred for liver transplantation (LT) at an early stage of cirrhosis, with lower pre-LT Model of End-Stage Liver Disease (MELD) scores. We investigated the impact of high MELD scores on post-LT outcomes in patients with HCC and validated the prognostic significance of the neutrophil-to-lymphocyte ratio (NLR).

Patients And Method: This retrospective single-center cohort study enrolled 230 patients with HCC who underwent LDLT from 2004-2019 in our institute. Read More

Rev Med Chil 2021 Nov;149(11):1664-1667

Departamento de Urología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

We report a 32-year-old woman with chronic kidney disease on hemodialysis undergoing a nephrectomy for left xanthogranulomatous pyelonephritis with a coralliform calculus and septic shock. Her clinical evolution was torpid, subfebrile, with persistent elevation of inflammatory parameters and with the finding of intra-abdominal collections interpreted as post-surgical. Finally faced with microbiological evidence of infection of the collections, the patient was operated and tended to improve. Read More

Expert Rev Clin Pharmacol 2022 Jun 23. Epub 2022 Jun 23.

Department of Clinical Pharmacy, Faculty of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Introduction: Antibiotic prescription is a challenging issue in critical care settings. Different pharmacokinetic and pharmacodynamic properties, polypharmacy, drug interactions, and high incidence of multidrug-resistant microorganisms in this population can influence the selection, safety, and efficacy of prescribed antibiotics.

Areas Covered: In the current article we searched PubMed, Scopus and Google Scholar for neurotoxicities, hematologic toxicity and fluid stewardship in intensive care units. Read More

Ann Med Surg (Lond) 2022 Jun 4;78:103930. Epub 2022 Jun 4.

Urology Department La Rabta Hospital, Tunis, Tunisia.

Introduction: Emphysematous pyelonephritis (EPN) is a severe form of life-threatening renal infection. Conservative treatment represents the gold standard in the management of EPN, but nephrectomy remains appropriate in certain situations.

Objective: The aim of our study was to report our experience in the conservative management of emphysematous pyelonephritis and to identify the predictive factors of failure of conservative treatment. Read More

Crit Care Explor 2022 Jun 15;4(6):e0716. Epub 2022 Jun 15.

Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington, Seattle, WA.

It is unknown which families are at risk for poor outcomes following a child's critical illness.

Objectives: To evaluate if pediatric septic shock severity is associated with caregiver distress and family dysfunction throughout the year postadmission and if caregiver outcomes are associated with child health-related quality of life (HRQL).

Design Setting And Participants: Secondary analysis of the Life After Pediatric Sepsis Evaluation prospective cohort study among children less than 18 years old with community-acquired septic shock requiring vasoactive-inotropic support and invasive or noninvasive ventilation in 12 academic U. Read More

Eur J Pharm Sci 2022 Jun 19:106240. Epub 2022 Jun 19.

Department of Anesthesia, The Special Characteristic Medicine Center of Chinese People Armed Police Force, Chenglin Road NO 222, Hedong District, Tianjin 300162, China. Electronic address:

BMJ Case Rep 2022 Jun 22;15(6). Epub 2022 Jun 22.

Department of Cardiovascular Disease, Michigan State University, East Lansing, Michigan, USA.

A man in his 60s with stage 3 squamous cell carcinoma of the left lung status postchemotherapy and radiation therapy presented with mixed septic and obstructive shock with multiorgan dysfunction. Initial electrocardiogram showed sinus tachycardia and diffuse concaved ST elevation. Transthoracic echocardiogram revealed pericardial effusion with tamponade physiology. Read More

BMJ Case Rep 2022 Jun 22;15(6). Epub 2022 Jun 22.

Oral & Maxillofacial Surgery, AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India.

We report a patient in his early 70s, with an alleged history of trauma to the right temporal region, following which a swelling developed. A week later, erythematous changes, throbbing pain and occasional fever spikes were noted. A month after the initial trauma, he presented to our institution with necrosed skin over the right temporal region and swelling extending up to the vertex of the skull. Read More

Eur Rev Med Pharmacol Sci 2022 Jun;26(11):3886-3892

Hanoi Medical College, Hanoi, Vietnam.

Objective: The objective of the present communication is to report the safety and efficacy of applying miniaturized percutaneous nephrolithotomy (mini-PCNL) in Vietnamese patients with recurrent kidney stones using a miniature nephroscope through a 18F metal access sheath.

Patients And Methods: We performed a retrospective cohort study of patients who were diagnosed with recurrent nephrolithiasis and underwent mini-PCNL after previous treatments between 2017 and 2020. Clinical profile, preoperative characteristics, intraoperative events, and postoperative outcomes were obtained from the hospital database. Read More

Crit Care 2022 06 21;26(1):186. Epub 2022 Jun 21.

Department of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center-IRCCS, Via Alessandro Manzoni, 56, 20089, Rozzano, Milano, Italy.

Introduction: Fluid challenges are widely adopted in critically ill patients to reverse haemodynamic instability. We reviewed the literature to appraise fluid challenge characteristics in intensive care unit (ICU) patients receiving haemodynamic monitoring and considered two decades: 2000-2010 and 2011-2021.

Methods: We assessed research studies and collected data regarding study setting, patient population, fluid challenge characteristics, and monitoring. Read More

BMC Pulm Med 2022 Jun 21;22(1):238. Epub 2022 Jun 21.

Department of Critical Care Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.

Background: Less is known about the risk factors for acute respiratory distress syndrome (ARDS) in sepsis patients diagnosed according to sepsis 3.0 criteria. Moreover, the risk factors for ARDS severity remain unclear. Read More

BMC Infect Dis 2022 Jun 21;22(1):564. Epub 2022 Jun 21.

Department of Emergency Medicine, Tianjin Medical University General Hospital, 154 Anshan Road, Tianjin, 300052, China.

Background: Sepsis, a life-threatening organ dysfunction induced by infection, is a major public health problem. This study aimed to evaluate the frequency and mortality of sepsis, severe sepsis, and septic shock in China.

Methods: We Searched MEDLINE, Embase, PubMed, and Cochrane Library from 1 January 1992 to 1 June 2020 for studies that reported on the frequency and mortality of sepsis, severe sepsis, and septic shock conducted in China. Read More

Surg Case Rep 2022 Jun 22;8(1):120. Epub 2022 Jun 22.

Department of Surgery, The Jikei University Hospital, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan.

Background: Surgery for perforated rectal cancer is technically difficult because of paralytic dilatation due to generalized fecal peritonitis, the presence of a bulky tumor, and fecal retention due to obstruction. Transanal total mesorectal excision (TaTME) is the latest minimally invasive transanal technique pioneered to facilitate difficult pelvic dissections. It can provide a good surgical field linearly from the perineal side and reduce manipulations from the intraabdominal side. Read More

Sci Rep 2022 Jun 21;12(1):10414. Epub 2022 Jun 21.

Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 1# Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China.

The purpose of this study is to determine whether the levels of serum Sirt3 correlate with disease severity and perfusion indicators in septic patients, as well as to assess the clinical value of Sirt3 as a potential novel marker for sepsis diagnosis and mortality prediction. A total of 79 patients in the ICU were included in the study, of which 28 were postoperatively noninfectious and the remaining 51 patients were all diagnosed with sepsis during the study period. The levels of Sirt3 were detected and dynamically monitored by enzyme-linked adsorption method, Pearson or Spearman coefficient for correlation analysis between Sirt3 and clinical indicators, ROC curve for evaluation of diagnosis and mortality prediction, Kaplan-Meier method for the significance of Sirt3 in 28-day survival. Read More

N Z Med J 2022 Feb 25;135(1550):62-73. Epub 2022 Feb 25.

Cardiologist, Green Lane Cardiovascular Service, Auckland City Hospital.

Aims: We reviewed the baseline characteristics and outcomes of patients with infective endocarditis (IE) and compared those with and without rheumatic heart disease (RHD).

Methods: We retrospectively reviewed patients ≥15 years with IE treated at Auckland City Hospital between January 2016 and December 2018 and excluded device-related IE and complex congenital heart disease. RHD status was based on echocardiographic features or previous history of rheumatic fever with valvular disease. Read More