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    Pylephlebitis and Crohn's disease: A rare case of septic shock.
    Int J Surg Case Rep 2017 Aug 10;39:106-109. Epub 2017 Aug 10.
    Digestive Surgery Unit, Department of Surgery and Translational Medicine, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy. Electronic address:
    Introduction: Troncular pylephlebitis, defined as septic thrombophlebitis of the portal vein, is usually secondary to suppurative infection from the regions drained by the portal system. Therefore, pylephlebitis can occur from the portal vein main tributaries. The occurrence of mesenteric pylephlebitis in Crohn's disease is extremely rare. Read More

    [Nomogram to predict a poor outcome in emergency patients with sepsis and at low risk of organ damage according to Sepsis-related Organ Failure Assessment (SOFA)].
    Emergencias 2017 Abr;29(2):81-86
    Universidad Católica San Antonio de Murcia, Murcia, España.
    Objectives: To develop a nomograph to predict a poor outcome (death during hospitalization or a hospital stay longer than 15 days) in emergency patients with sepsis and at low risk of organ damage according to Sepsis-related Organ Failure Assessment (SOFA).

    Material And Methods: Prospective, observational study carried out in a single universitary hospital. All patients admitted from the emergency department with sepsis and SOFA scores of 6 or lower were enrolled. Read More

    Peritonitis in a neonate due to Cyberlindnera fabianii, an ascomycetic yeast.
    Infection 2017 Aug 20. Epub 2017 Aug 20.
    Paediatric Cardiac Intensive Care Unit, German Paediatric Heart Center, Asklepios Klinik St. Augustin GmbH, Arnold-Janssen Str. 29, 53757, Sankt Augustin, Germany.
    The ascomycetous yeast Cyberlindera fabianii is not only present in the environment, but is also occasionally pathogenic. Especially, neonates seem to be prone to infection. Here, we describe a case of peritoneal infection of a neonate after congenital heart surgery. Read More

    HP1330 Contributes to Streptococcus suis Virulence by Inducing Toll-Like Receptor 2- and ERK1/2-Dependent Pro-inflammatory Responses and Influencing In Vivo S. suis Loads.
    Front Immunol 2017 31;8:869. Epub 2017 Jul 31.
    National Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan, China.
    Streptococcus suis 2 (SS2) has evolved into a highly invasive pathogen responsible for two large-scale outbreaks of streptococcal toxic shock-like syndrome (STSLS) in China. Excessive inflammation stimulated by SS2 is considered a hallmark of STSLS, even it also plays important roles in other clinical symptoms of SS2-related disease, including meningitis, septicemia, and sudden death. However, the mechanism of SS2-caused excessive inflammation remains poorly understood. Read More

    Identification of Variable Traits among the Methicillin Resistant and Sensitive Coagulase Negative Staphylococci in Milk Samples from Mastitic Cows in India.
    Front Microbiol 2017 31;8:1446. Epub 2017 Jul 31.
    School of Life Sciences, University of HyderabadHyderabad, India.
    Methicillin resistant Staphylococcus aureus causing bovine mastitis has been very well investigated worldwide. However, there are only limited reports on the characterization of methicillin resistant and sensitive coagulase negative staphylococci (CoNS) across the globe. Hence, in the present study, we aim to determine the phenotypic traits based on antimicrobial susceptibility profile and genotypic characterization by verifying the presence of resistance determinants, virulence and toxin genes present in the CoNS causing clinical mastitis. Read More

    Traceability and distribution of Neisseria meningitidis DNA in archived post mortem tissue samples from patients with systemic meningococcal disease.
    BMC Clin Pathol 2017 16;17:10. Epub 2017 Aug 16.
    Blood Cell Research Group, Section for Research, Department of Medical Biochemistry, Oslo University Hospital HF, Ullevål Hospital, PO Box 4956 Nydalen, 0424 Oslo, Norway.
    Background: The pathophysiology and outcome of meningococcal septic shock is closely associated with the plasma level of N. meningitidis lipopolysaccharides (LPS, endotoxin) and the circulating level of meningococcal DNA. The aim of the present study was to quantify the number of N. Read More

    Group A Streptococcal Peritonitis and Toxic Shock Syndrome in a Postmenopausal Woman.
    Intern Med 2017 Aug 21. Epub 2017 Aug 21.
    Department of Gastroenterology, Fujisawa City Hospital, Japan.
    We herein report the case of a 66-year-old woman presenting with symptoms of gastroenteritis. Computed tomography showed small-bowel dilation without ischemic signs. After admission, she went into shock and was treated for sepsis of unknown origin. Read More

    Initial fluid resuscitation following adjusted body weight dosing is associated with improved mortality in obese patients with suspected septic shock.
    J Crit Care 2017 Aug 15;43:7-12. Epub 2017 Aug 15.
    Department of Internal Medicine, Division of Critical Care, Carolinas Medical Center, Charlotte, NC, USA.
    Objective: The optimal initial fluid resuscitation strategy for obese patients with septic shock is unknown. We evaluated fluid resuscitation strategies across BMI groups.

    Materials And Methods: Retrospective analysis of 4157 patients in a multicenter activation pathway for treatment of septic shock between 2014 and 2016. Read More

    Evaluation of fever in the emergency department.
    Am J Emerg Med 2017 Aug 14. Epub 2017 Aug 14.
    The University of Texas Southwestern Medical Center, Department of Emergency Medicine, 5323 Harry Hines Boulevard, Dallas, 75390, TX, United States.
    Background: Fever is one of the most common complaints in the emergency department (ED) and is more complex than generally appreciated. The broad differential diagnosis of fever includes numerous infectious and non-infectious etiologies. An essential skill in emergency medicine is recognizing the pitfalls in fever evaluation. Read More

    Patients on Long-Term Warfarin Undergo Gynecological Surgeries: A 10-Year Review of Peri-Operative Anticoagulation.
    J Obstet Gynaecol Can 2017 Aug 15. Epub 2017 Aug 15.
    Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong.
    Objective: The aim of this study was to review our experience with patients having gynaecological surgeries while on long-term anticoagulation and to postulate a better guide for their perioperative management.

    Material And Methods: A retrospective review of all women on long-term warfarin who underwent gynaecological surgeries from January 2003 to December 2012. Data from medical records including operation reports and inpatient and outpatient charts were reviewed and analyzed. Read More

    Pathogens and outcomes in pediatric septic shock patients supported by extracorporeal membrane oxygenation.
    J Microbiol Immunol Infect 2017 Aug 4. Epub 2017 Aug 4.
    Division of Pediatric Infectious Diseases, Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan. Electronic address:
    Background: Refractory septic shock is the leading cause of mortality in children. There is limited evidence to support extracorporeal membrane oxygenation (ECMO) use in pediatric septic shock. We described the etiology and outcomes of septic patients in our institution and attempted to find predictive factors. Read More

    Immune-Response Patterns and Next Generation Sequencing Diagnostics for the Detection of Mycoses in Patients with Septic Shock-Results of a Combined Clinical and Experimental Investigation.
    Int J Mol Sci 2017 Aug 18;18(8). Epub 2017 Aug 18.
    Department of Anesthesiology, Heidelberg University Hospital, 110, Im Neuenheimer Feld, D-69120 Heidelberg, Germany.
    Fungi are of increasing importance in sepsis. However, culture-based diagnostic procedures are associated with relevant weaknesses. Therefore, culture- and next-generation sequencing (NGS)-based fungal findings as well as corresponding plasma levels of β-d-glucan, interferon gamma (INF-γ), tumor necrosis factor alpha (TNF-α), interleukin (IL)-2, -4, -6, -10, -17A, and mid-regional proadrenomedullin (MR-proADM) were evaluated in 50 septic patients at six consecutive time points within 28 days after sepsis onset. Read More

    Efficacy and Safety of the Early Addition of Vasopressin to Norepinephrine in Septic Shock.
    J Intensive Care Med 2017 Jan 1:885066617725255. Epub 2017 Jan 1.
    2 University of Arkansas for Medical Sciences Medical Center, Little Rock, AR, USA.
    Background: Delays in achievement of target mean arterial pressure (MAP) have been associated with increased mortality in patients with septic shock. Vasopressin may be added to norepinephrine to raise MAP or decrease norepinephrine dosage. The purpose of this study was to determine whether early initiation of vasopressin to norepinephrine resulted in a reduced time to target MAP compared to norepinephrine monotherapy. Read More

    Prognostic value of left ventricular-arterial coupling in elderly patients with septic shock.
    J Crit Care 2017 Aug 10;42:289-293. Epub 2017 Aug 10.
    Intensive Care Unit, Zhejiang Hospital, Hangzhou 310013, China. Electronic address:
    Purpose: To investigate the predictive value of left ventricular-arterial coupling (VAC) for clinical prognosis of elderly patients with septic shock.

    Materials And Methods: This was a single-center prospective cohort study of 63 elderly patients with septic shock treated between August 2014 and January 2016 at the 30-bed intensive care unit (ICU) of Zhejiang Hospital (China). Left VAC was evaluated by transthoracic echocardiography (TTE). Read More

    Comparison of Consent Models in a Randomized Trial of Corticosteroids in Pediatric Septic Shock.
    Pediatr Crit Care Med 2017 Aug 16. Epub 2017 Aug 16.
    1Research Institute, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada. 2Department of Pediatrics, Faculty of Medicine, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada. 3Department of Economics, Faculty of Public Affairs, Carleton University, Ottawa, ON, Canada. 4Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH. 5Department of Epidemiology, University of Ottawa and Ottawa Hospital Research Institute (OHRI), University of Ottawa, Ottawa, ON, Canada. 6Clinical Epidemiology Program, School of Epidemiology and Public Health, The Ottawa Hospital Research Institute (OHRI), Ottawa, ON, Canada. 7Division of Critical Care, Department of Medicine, Ottawa Hospital Research Institute (OHRI), University of Ottawa, Ottawa, ON, Canada. 8Section of Critical Care Medicine, Department of Pediatrics, Alberta Children's Hospital, Calgary, AB, Canada. 9Department of Pediatrics, CHU Sainte-Justine Hospital, Montreal, QC, Canada. 10Department of Pediatrics, Faculty of Medicine, The University of British Columbia, British Columbia Woman and Children's Hospital, Vancouver, BC, Canada. 11Department of Pediatrics, Faculty of Medicine, McGill University, Montreal Children's Hospital, Montreal, QC, Canada. 12Department of Critical Care Medicine, IWK Health Centre, Halifax, NS, Canada. 13Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, ON, Canada.
    Objectives: To describe the use of deferred and prior informed consent models in the context of a low additional risk to standard of care, placebo-controlled randomized controlled trial of corticosteroids in pediatric septic shock.

    Design: An observational substudy of consent processes in a randomized controlled trial of hydrocortisone versus placebo.

    Setting: Seven tertiary level PICUs in Canada. Read More

    Similar Metabolic, Innate Immunity, and Adipokine Profiles in Adult and Pediatric Sepsis Versus Systemic Inflammatory Response Syndrome-A Pilot Study.
    Pediatr Crit Care Med 2017 Aug 12. Epub 2017 Aug 12.
    1University of Crete, Medical School, University Hospital, PICU, Heraklion, Greece. 2University of Crete, Medical School, Paediatric Haematology Oncology, Heraklion, Greece. 3University of Crete, Medical School, University Hospital, ICU, Heraklion, Greece. 4Institute of Molecular Biology and Biotechnology (IMBB), Postgenomic Research Laboratory, Foundation for Research and Technology - Hellas (FORTH), Heraklion, Greece.
    Objectives: To examine whether the septic profiles of heat shock protein 72, heat shock protein 90α, resistin, adiponectin, oxygen consumption, CO2 production, energy expenditure, and metabolic pattern, along with illness severity, nutritional, and inflammatory indices, differ between adult and pediatric patients compared with systemic inflammatory response syndrome and healthy controls. To evaluate whether these biomolecules may discriminate sepsis from systemic inflammatory response syndrome in adult and pediatric patients.

    Design: Prospective cohort study. Read More

    Antimicrobials and Progression to Septic Shock in Severe Sepsis Patients: Is Delay the Only Thing That Matters?
    Crit Care Med 2017 Sep;45(9):e988-e989
    Scuola di Specializzazione in Anestesia, Rianimazione e Terapia Intensiva, Università degli Studi di Milano, Milan, Italy, and Division of Critical Care, University College Hospital, London, United Kingdom; Department of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy, and Division of Critical Care, University College Hospital, London, United Kingdom.

    [Multiple endoscopy for the treatment of upper urinary tract calculi following ileal conduit: a case report and literature review].
    Beijing Da Xue Xue Bao 2017 Aug;49(4):733-735
    Department of Urology, Peking University Third Hospital, Beijing 100191, China.
    Upper urinary tract calculi with infection is a quite difficult acute urologic emergency. And what is more, upper urinary tract obstruction after radical cystectomy following urinary diversion may be fatal in the vulnerable patients with this kind of situation. Postoperative anatomy and other factors affect the upper urinary tract calculi, and urinary tract infection greatly increased the risk. Read More

    [Analysis of development, safety and efficacy of percutaneous nephrolithotomy for management of upper urinary tract calculi in pediatric patients].
    Beijing Da Xue Xue Bao 2017 Aug;49(4):626-631
    Department of Urology, Peking University People's Hospital, Beijing 100044, China.
    Objective: To evaluate the development, safety and efficacy of percutaneous nephrolithotomy(PNL) for management of upper urinary tract calculi in pediatric patients.

    Methods: In the study, 77 pediatric patients undergoing 87 PNLs through mini or standard tract for upper urinary tract calculi between January 2005 and December 2016 in Peking University People's hospital were reviewed, including 69 renal calculi, 6 upper ureteral calculi, 12 renal and upper ureteral calculi, 35 single calculi, 43 multiple calculi and 9 staghorn calculi. The development and efficacy of PNL in pediatric patients were studied by analyzing the characteristics and clinical indexes, and by reviewing the associated literature. Read More

    Dehydroepiandrosterone sulfate and dehydroepiandrosterone sulfate/cortisol ratio in cirrhotic patients with septic shock: another sign of hepatoadrenal syndrome?
    Crit Care 2017 Aug 15;21(1):214. Epub 2017 Aug 15.
    Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Veteran General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei, 11217, Taiwan.
    Background: Cirrhotic patients are susceptible to sepsis and critical illness-related corticosteroid insufficiency (CIRCI). Dehydroepiandrosterone sulfate (DHEAS) is a corticotropin-dependent adrenal androgen, which has immunostimulating and antiglucocorticoid effects. Considering the synchronized synthesis of cortisol and DHEAS and their opposing effects to each other, investigators have proposed measuring these two hormones as a ratio. Read More

    A retrospective study evaluating the efficacy of identification and management of sepsis at a district-level hospital internal medicine department in the Western Cape Province, South Africa, in comparison with the guidelines stipulated in the 2012 Survivi.
    S Afr Med J 2017 Jul 28;107(8):674-678. Epub 2017 Jul 28.
    Department of Internal Medicine, Karl Bremer Hospital, Cape Town, South Africa.
    Background: Currently there is little information on the identification, management and outcomes of patients with sepsis in developing countries. Simple cost-effective measures such as accurate identification of patients with sepsis and early antibiotic administration are achievable targets, within reach without having to make use of unsustainable protocols constructed in developed countries.

    Objectives: To assess the ability of clinicians at a district-level hospital to identify and manage sepsis, and to assess patient outcome in terms of in-hospital mortality and length of hospital stay given the above management. Read More

    Lymphopaenia in cardiac arrest patients.
    Ann Intensive Care 2017 Aug 14;7(1):85. Epub 2017 Aug 14.
    Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), Route de Lennik, 808, 1070, Brussels, Belgium.
    Background: A decrease in circulating lymphocytes has been described as a marker of poor prognosis after septic shock; however, scarce data are available after cardiac arrest (CA). The aim of this study was to evaluate the impact of lymphopaenia after successful cardiopulmonary resuscitation.

    Methods: This is a retrospective analysis of an institutional database including all adult CA patients admitted to the intensive care unit (ICU) between January 2007 and December 2014 who survived for at least 24 h. Read More

    Next step in the ongoing arms race between myxoma virus and wild rabbits in Australia is a novel disease phenotype.
    Proc Natl Acad Sci U S A 2017 Aug 14. Epub 2017 Aug 14.
    Center for Infectious Disease Dynamics, The Pennsylvania State University, University Park, PA 16802;
    In host-pathogen arms races, increases in host resistance prompt counteradaptation by pathogens, but the nature of that counteradaptation is seldom directly observed outside of laboratory models. The best-documented field example is the coevolution of myxoma virus (MYXV) in European rabbits. To understand how MYXV in Australia has continued to evolve in wild rabbits under intense selection for genetic resistance to myxomatosis, we compared the phenotypes of the progenitor MYXV and viral isolates from the 1950s and the 1990s in laboratory rabbits with no resistance. Read More

    Selepressin, a novel selective vasopressin V1A agonist, is an effective substitute for norepinephrine in a phase IIa randomized, placebo-controlled trial in septic shock patients.
    Crit Care 2017 Aug 15;21(1):213. Epub 2017 Aug 15.
    Ferring Pharmaceuticals A/S, Kay Fiskers Plads 11, DK-2300, Copenhagen, Denmark.
    Background: Vasopressin is widely used for vasopressor support in septic shock patients, but experimental evidence suggests that selective V1A agonists are superior. The initial pharmacodynamic effects, pharmacokinetics, and safety of selepressin, a novel V1A-selective vasopressin analogue, was examined in a phase IIa trial in septic shock patients.

    Methods: This was a randomized, double-blind, placebo-controlled multicenter trial in 53 patients in early septic shock (aged ≥18 years, fluid resuscitation, requiring vasopressor support) who received selepressin 1. Read More

    Impact of Norepinephrine Shortage on Outcomes in Patients with Septic Shock.
    Res Rev J Hosp Clin Pharm 2016 May 12;2(2):87-91. Epub 2016 May 12.
    Department of Public Health, Medical University of South Carolina, Charleston, South Carolina, USA.
    Purpose: With the previous norepinephrine shortage, alternative agents were required to treat patients with septic shock. This retrospective study evaluated whether the shortage of norepinephrine had an adverse effect on patients admitted to the intensive care unit with a diagnosis of severe sepsis or septic shock.

    Methods: This was a retrospective chart review, which compared patients who received norepinephrine versus those who did not. Read More

    Zika virus-induced neurological critical illness in Latin America: Severe Guillain-Barre Syndrome and encephalitis.
    J Crit Care 2017 Aug 9;42:275-281. Epub 2017 Aug 9.
    Latin American Critical Care Trial Investigative Network (LACCTIN), Sta María 1810, Providencia, Santiago, Región Metropolitana, Chile.
    Zika virus (ZIKAV) is classically described as causing minor symptoms in adult patients, however neurologic complications have been recognized. The recent outbreak in Central and South America has resulted in serious illness in some adult patients. We report adult patients in Latin America diagnosed with ZIKAV infection admitted to Intensive Care Units (ICUs). Read More

    Risk Stratification for Major Postoperative Complications in Patients Undergoing Intra-abdominal General Surgery Using Latent Class Analysis.
    Anesth Analg 2017 Aug 10. Epub 2017 Aug 10.
    From the *Department of Anesthesiology, Columbia University Medical Center, New York, New York; and Departments of †Epidemiology and ‡Biostatistics, Mailman School of Public Health, Columbia University, New York, New York.
    Background: Preoperative risk stratification is a critical element in assessing the risks and benefits of surgery. Prior work has demonstrated that intra-abdominal general surgery patients can be classified based on their comorbidities and risk factors using latent class analysis (LCA), a model-based clustering technique designed to find groups of patients that are similar with respect to characteristics entered into the model. Moreover, the latent risk classes were predictive of 30-day mortality. Read More

    Methionine sulfoxide reductase A protects against lipopolysaccharide-induced septic shock via negative regulation of the proinflammatory responses.
    Arch Biochem Biophys 2017 Aug 10;631:42-48. Epub 2017 Aug 10.
    Department of Biochemistry and Molecular Biology, Yeungnam University College of Medicine, Daegu, Republic of Korea. Electronic address:
    Methionine sulfoxide reductase A (MsrA) is a major antioxidant enzyme that specifically catalyzes the reduction of methionine S-sulfoxide. In this study, we used MsrA gene-knockout (MsrA(-/-)) mice and bone marrow-derived macrophages (BMDMs) to investigate the role of MsrA in the regulation of inflammatory responses induced by lipopolysaccharide (LPS). MsrA(-/-) mice were more susceptible to LPS-induced lethal shock than wild-type (MsrA(+/+)) mice. Read More

    An aggressive and fatal craniofacial group A Streptococcus infection resulting from a minimally displaced orbital floor fracture.
    Int J Oral Maxillofac Surg 2017 Aug 10. Epub 2017 Aug 10.
    Attending Surgeon, Department of Surgery, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD, USA.
    While sharp, penetrating trauma is often associated with group A Streptococcus (GAS) infections and subsequent necrotizing fasciitis (NF) and streptococcal toxic shock syndrome (STSS), there are scant reports in the oral and maxillofacial surgery literature regarding blunt, non-penetrating trauma in association with these conditions. With a clinical course that initially appears relatively benign following blunt trauma, NF can progress swiftly through the fascial planes and may quickly become life-threatening if the oral and maxillofacial surgeon fails to recognize some of the critical pathognomonic signs. The case of a 64-year-old female who suffered a ground-level mechanical fall with a minimally displaced lateral orbital wall fracture is reported here. Read More

    Neutrophils, NETs, NETosis - old or new factors in sepsis and septic shock?
    Anaesthesiol Intensive Ther 2017 ;49(3):235-240
    Department of Anaesthesiology and Intensive Care, 4th Military Hospital of Wroclaw Faculty of Health Science, Wroclaw Medical University, Poland.
    Neutrophils are an key part of the innate immune system in the host's defences against pathogens. Circulating neutrophils are recruited at the sites of infection or sterile inflammation in response to pathogen and host-derived inflammatory mediators. In addition to phagocytosis and degranulation, neutrophils display the release of NETs in order to restrain infection. Read More

    Community-acquired Pneumonia Visualized on Computed Tomography but Not Chest X-Ray: Pathogens, Severity, and Clinical Outcomes.
    Chest 2017 Aug 9. Epub 2017 Aug 9.
    Vanderbilt University Medical Center, Nashville, TN. Electronic address:
    Background: The clinical significance of pneumonia visualized on computed tomography (CT) in the setting of a normal chest x-ray (CXR) is uncertain.

    Methods: In a multicenter prospective surveillance study of adults hospitalized with community-acquired pneumonia (CAP), we compared the presenting clinical features, pathogens, and outcomes of patients with pneumonia visualized on CT but not on concurrent CXR (CT-only pneumonia) and those with pneumonia visualized on CXR. All patients underwent CXR; the decision to obtain CT imaging was determined by the treating clinicians. Read More

    Energy expenditure in severe sepsis or septic shock in a Thai Medical Intensive Care Unit.
    Asia Pac J Clin Nutr 2017 ;26(5):794-797
    Clinical Epidemiology Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
    Background And Objectives: Energy expenditure in severe sepsis/septic shock patients was measured by indirect calorimetry and the correlation of energy expenditure between indirect calorimetry and predictive equations was determined.

    Methods And Study Design: This was a prospective, observational analytical study. Severe sepsis or septic shock patients were measured for energy expenditure over 72 hours by indirect calorimetry that was measured by a mechanical ventilator (EngströmCarestation, GE Healthcare). Read More

    Evaluating the Effects of Chronic Antihypertensives on Vasopressor Dosing in Septic Shock.
    Ann Pharmacother 2017 Aug 1:1060028017726552. Epub 2017 Aug 1.
    1 Rush University Medical Center, Chicago, IL, USA.
    Background: In septic shock, chronic antihypertensive medications are held acutely. Vasopressors are often required to maintain blood pressure. The effect of chronic exposure to antihypertensive therapies on vasopressor dosing in septic shock is not known. Read More

    Patterns of C-reactive protein ratio predicts outcomes in healthcare-associated pneumonia in critically ill patients with cancer.
    J Crit Care 2017 Jul 11;42:231-237. Epub 2017 Jul 11.
    Postgraduate Program of Internal Medicine - Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; D'Or Institute for Research and Education, Rio de Janeiro, Brazil. Electronic address:
    Purpose: Describe the patterns of C-reactive protein relative changes in response to antibiotic therapy in critically ill cancer patients with healthcare-associated pneumonia (HCAP) and its ability to predict outcome.

    Methods: Secondary analysis of a prospective cohort of critically ill cancer patients with HCAP. CRP was sampled every other day from D0 to D6 of antibiotic therapy. Read More

    Fms-Like Tyrosine Kinase-3 Ligand Attenuates Local and Systemic Infection in a Model of Post-Burn Pneumonia.
    Shock 2017 Aug 7. Epub 2017 Aug 7.
    *Department of Surgery, University of Texas Medical Branch, and Shriners Hospitals for Children, Galveston, 301 University Blvd, Galveston, TX 77555 †Department of Hand, Plastic and Reconstructive Surgery, Burn Trauma Center, BG Trauma Center Ludwigshafen; University of Heidelberg Ludwigshafen, Germany ‡Department of Anesthesiology, University of Texas Medical Branch, and Shriners Hospitals for Children, Galveston, 301 University Blvd, Galveston, TX 77555 §School of Medicine, University of Texas Medical Branch, Galveston, 301 University Blvd, Galveston, TX 77555 ¶Department of Pathology, University of Texas Medical Branch, and Shriners Hospitals for Children, Galveston, 301 University Blvd, Galveston, TX 77555.
    Background: Burn injury induces immunosuppression and promotes infection with opportunistic pathogens. Pneumonia and sepsis are leading causes of post-burn morbidity and mortality. Fms-like tyrosine kinase-3 ligand (Flt3L) improves local and systemic resistance to P. Read More

    A scoring system to predict mortality in infants with esophageal atresia: A case-control study.
    Medicine (Baltimore) 2017 Aug;96(32):e7755
    Neonatal Diagnosis and Treatment Center, Children's Hospital of Chongqing Medical University; Ministry of Education Key Laboratory of Child Development and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Key Laboratory of Pediatrics in Chongqing, Chongqing, P.R. China.
    Esophageal atresia (EA) is a rare anomaly that mandates surgical intervention. Patients with EA often have complicated medical courses due to both esophageal anomalies and related comorbidities. Although several prognostic classification systems have been developed to decrease the mortality rate in EA, most systems focus only on the influence of the major anomaly, and external risk factors that could be influenced by the neonatal caregivers to a certain extent are not included. Read More

    [Two-dimensional speckle tracking imaging in assessing the left ventricular systolic function and its dynamic changes of patients with septic shock].
    Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2017 Aug;29(8):721-725
    Department of Echocardiography, Subei People's Hospital, Yangzhou 225001, Jiangsu, China (Yang F, Chen Y, Ma Y, Yu HD, Zhang Y); Department of Critical Care Medicine, Subei People's Hospital, Yangzhou 225001, Jiangsu, China (Zheng RQ, Zhang WJ). Corresponding author: Chen Yong, Email:
    Objective: To evaluate early and dynamic changes of the left ventricular systolic function of patients with septic shock by two-dimensional speckle tracking imaging (2D-STI), and to provide guidance for treatment and prognosis.

    Methods: Fifty-eight septic shock patients admitted to intensive care unit (ICU) of Subei People's Hospital from January 2016 to April 2017 were enrolled. The septic shock patients were given early fluid resuscitation. Read More

    [Value of serum CRISPLD2 levels for the diagnosis and prognosis evaluation of sepsis patients].
    Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2017 Aug;29(8):694-699
    Department of Critical Care Medicine, the First Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei, China (Wang L, Yang XF, Zhang SL); Department of Critical Care Medicine, Hebei Children's Hospital, Shijiazhuang 050031, Hebei, China (Zhu MS). Corresponding author: Yang Xiufen, Email:
    Objective: To investigate the value of cysteine-rich secretory protein LCCL domain-containing 2 (CRISPLD2) in diagnosis and prognosis in patients with sepsis.

    Methods: Clinical data of patients admitted to intensive care unit (ICU) of the First Hospital of Hebei Medical University from December 2014 to December 2016 were retrospectively analyzed. According to the severity of sepsis, the patients were divided into three groups: sepsis patients, severe sepsis patients and septic shock patients, and 100 healthy persons were enrolled as control group. Read More

    [Evaluation value of the levels of peripheral blood CD20(+) CD24(hi) CD38(hi) regulatory B cells on the prognosis of elderly patients with sepsis].
    Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2017 Aug;29(8):673-678
    Department of Emergency, Shanghai East Hospital of Tongji University, Shanghai 200120, China (Wang CM, Tang LX, Bai JW); Institute Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China (Xu HH, Zhang XM). Corresponding author: Bai Jianwen, Email:
    Objective: To explore the predicting value of peripheral blood CD20(+) CD24(hi) CD38(hi) regulatory B cells (Bregs) on the prognosis of elderly patients with sepsis.

    Methods: A prospective study was conducted. Septic patients aged > 65 years old, compliance with diagnostic criteria for Sepsis-3, admitted to emergency and emergency intensive care unit (ICU) of Shanghai East Hospital of Tongji University from April 2016 to February 2017 were enrolled. Read More

    Derivation, Validation and Application of a Pragmatic Risk Prediction Index for Benchmarking of Surgical Outcomes.
    World J Surg 2017 Aug 9. Epub 2017 Aug 9.
    Department of General Surgery, Codman Center for Clinical Effectiveness in Surgery, Massachusetts General Hospital, Boston, MA, USA.
    Background: Despite the existence of multiple validated risk assessment and quality benchmarking tools in surgery, their utility outside of high-income countries is limited. We sought to derive, validate and apply a scoring system that is both (1) feasible, and (2) reliably predicts mortality in a middle-income country (MIC) context.

    Methods: A 5-step methodology was used: (1) development of a de novo surgical outcomes database modeled around the American College of Surgeons' National Surgical Quality Improvement Program (ACS-NSQIP) in South Africa (SA dataset), (2) use of the resultant data to identify all predictors of in-hospital death with more than 90% capture indicating feasibility of collection, (3) use these predictors to derive and validate an integer-based score that reliably predicts in-hospital death in the 2012 ACS-NSQIP, (4) apply the score in the original SA dataset and demonstrate its performance, (5) identify threshold cutoffs of the score to prompt action and drive quality improvement. Read More

    Sepsis in the burn patient: a different problem than sepsis in the general population.
    Burns Trauma 2017 8;5:23. Epub 2017 Aug 8.
    Shriners Hospitals for Children Northern California, 2425 Stockton Blvd., Sacramento, CA 95817 USA.
    Sepsis has recently been defined as "life-threatening organ dysfunction caused by a dysregulated host response to infection". A great amount of effort has been made to develop early treatments for sepsis through the Surviving Sepsis Campaign. There are similar but slightly different recommendations for the treatment of sepsis in the pediatric population. Read More

    A Rare Case of Gastric Ulcer Penetrating the Pancreas that was Successfully Managed by Conservative Therapy.
    Intern Med 2017 Aug 10. Epub 2017 Aug 10.
    Department of Gastroenterology, NTT West Osaka Hospital, Japan.
    A 62-year-old woman was admitted to our hospital with septic shock due to left submandibular osteomyelitis and cellulitis. Her condition improved following tooth extraction, drainage, and the administration of antibiotics. However, on the 4th day of hospitalization, she went into hemorrhagic shock after defecating a massive tarry stool. Read More

    Nasopharyngeal infection by Streptococcus pyogenes requires superantigen-responsive Vβ-specific T cells.
    Proc Natl Acad Sci U S A 2017 Aug 9. Epub 2017 Aug 9.
    Department of Microbiology and Immunology, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada;
    The globally prominent pathogen Streptococcus pyogenes secretes potent immunomodulatory proteins known as superantigens (SAgs), which engage lateral surfaces of major histocompatibility class II molecules and T-cell receptor (TCR) β-chain variable domains (Vβs). These interactions result in the activation of numerous Vβ-specific T cells, which is the defining activity of a SAg. Although streptococcal SAgs are known virulence factors in scarlet fever and toxic shock syndrome, mechanisms by how SAgs contribute to the life cycle of S. Read More

    Diagnostic value of Pentraxin-3 in patients with sepsis and septic shock in accordance with latest sepsis-3 definitions.
    BMC Infect Dis 2017 Aug 9;17(1):554. Epub 2017 Aug 9.
    First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, Mannheim, 68167, Germany.
    Background: Pentraxin-3 (PTX-3) is an acute-phase protein involved in inflammatory and infectious processes. This study assesses its diagnostic and prognostic value in patients with sepsis or septic shock in a medical intensive care unit (ICU).

    Methods: The study includes 213 ICU patients with clinical criteria of sepsis and septic shock. Read More

    The Effects of Selective Hematopoietic Expression of Human IL-37 on Systemic Inflammation and Atherosclerosis in LDLr-Deficient Mice.
    Int J Mol Sci 2017 Aug 9;18(8). Epub 2017 Aug 9.
    Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Post Zone C7Q, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
    The human cytokine interleukin (IL)-37 has potent anti-inflammatory capacities, and hematopoietic cell-specific transgenic overexpression of IL-37 in mice protects against septic shock and colitis. In the present study we investigated the effect of hematopoietic expression of IL-37 on atherosclerosis development under low-grade inflammatory conditions. Low-density lipoprotein receptor (LDLr)-deficient mice were lethally irradiated and transplanted with bone marrow from IL-37-transgenic or control wild-type mice and fed a Western-type diet (WTD; 1% cholesterol) for eight weeks. Read More

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