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    An overview of the evidence-based practice process for novice researchers.
    Nurs Stand 2017 Jun;31(43):50-60
    King's College London, London, England.
    This article explores how nurses can use evidence-based practice to critique and evaluate the rationale and evidence for specific nursing procedures or practices. Through the development of a focused research question and search strategy, nurses can select and critique relevant research articles to answer the research question, which can support the provision of optimal practice and high-quality care. This article demonstrates the process of evidence-based practice, with the aim of increasing novice researchers' confidence in applying this process in practice. Read More

    Emerging Biomarkers of Illness Severity: Urinary Metabolites Associated with Sepsis and Necrotizing Methicillin-Resistant Staphylococcus aureus Pneumonia.
    Pharmacotherapy 2017 Jun 20. Epub 2017 Jun 20.
    Nuclear Magnetic Resonance Metabolomics Laboratory.
    Study Objective: To illustrate the potential of metabolomics to identify novel biomarkers of illness severity in a child with fatal necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA).

    Design: Case report with two control groups and a metabolomics analysis.

    Patients: An infant with fatal MRSA pneumonia, four children with influenza pneumonia (pneumonia control group), and seven healthy children with no known infections (healthy control group). Read More

    MAIT cells launch a rapid, robust and distinct hyperinflammatory response to bacterial superantigens and quickly acquire an anergic phenotype that impedes their cognate antimicrobial function: Defining a novel mechanism of superantigen-induced immunopathology and immunosuppression.
    PLoS Biol 2017 Jun 20;15(6):e2001930. Epub 2017 Jun 20.
    Department of Microbiology and Immunology, Western University, London, Ontario, Canada.
    Superantigens (SAgs) are potent exotoxins secreted by Staphylococcus aureus and Streptococcus pyogenes. They target a large fraction of T cell pools to set in motion a "cytokine storm" with severe and sometimes life-threatening consequences typically encountered in toxic shock syndrome (TSS). Given the rapidity with which TSS develops, designing timely and truly targeted therapies for this syndrome requires identification of key mediators of the cytokine storm's initial wave. Read More

    Itraq-Based Quantitative Proteomic Analysis of Lungs in Murine Polymicrobial Sepsis with Hydrogen Gas Treatment.
    Shock 2017 Jun 19. Epub 2017 Jun 19.
    *Department of Anesthesiology, Tianjin Institute of Anesthesiology, General Hospital of Tianjin Medical University, Tianjin 300052, PR China †Department of Anesthesiology, Nankai University Affiliated Tianjin Fourth Hospital, Tianjin 300222, PR China ‡Department of Anesthesiology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, P. R. China.
    Sepsis-associated acute lung injury (ALI), which carries a high morbidity and mortality in patients, has no effective therapeutic strategies to date. Our group have already reported that hydrogen gas (H2) exerts a protective effect against sepsis in mice. However, the molecular mechanisms underlying H2 treatment are not fully understood. Read More

    Increased resistance to intradermal Francisella tularensis LVS infection by inactivation of the Sts phosphatases.
    Infect Immun 2017 Jun 19. Epub 2017 Jun 19.
    Department of Molecular Genetics and Microbiology, Stony Brook University, Stony Brook, New York, USA.
    The Suppressor of TCR signaling proteins (Sts-1 and Sts-2) are two homologous phosphatases that negatively regulate signaling pathways in a number of hematopoietic lineages, including T lymphocytes. Mice lacking Sts expression are characterized by enhanced T cell responses. Additionally, a recent study demonstrated that Sts-/- mice are profoundly resistant to systemic infection of Candida albicans, with resistance characterized by enhanced survival, more rapid fungal clearance in key peripheral organs, and an altered inflammatory response. Read More

    Systemic antimicrobial prophylaxis in burn patients: a systematic review.
    J Hosp Infect 2017 Jun 16. Epub 2017 Jun 16.
    Hospital Cosme Argerich, Department of Intensive Care Medicine, Sanatorio Dupuytren, Cesar Diaz 3026, 1416 Buenos Aires, Argentina.
    Objective: To review studies of systemic antibiotic prophylaxis in burn patients.

    Methods: Human clinical trials during the period 1966-2016 where prophylactic systemic antibiotics were compared with placebo or no intervention were identified in electronic databases.

    Results: Nineteen trials met the selection criteria. Read More

    Cardiac overexpression of Epac1 in transgenic mice rescues lipopolysaccharide-induced cardiac dysfunction and inhibits Jak-STAT pathway.
    J Mol Cell Cardiol 2017 Jun 16. Epub 2017 Jun 16.
    Cardiovascular Research Institute, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan. Electronic address:
    Pro-inflammatory cytokines are released in septic shock and impair cardiac function via the Jak-STAT pathway. It is well known that sympathetic stimulation leads to coupling of the β-adrenergic receptor/Gs/adenylyl cyclase, a membrane-bound enzyme that catalyzes the conversion of ATP to cAMP, thereby stimulating protein kinase A (PKA) and ultimately compensating for cardiac dysfunction. The mechanism of such compensation by catecholamine has been traditionally understood as PKA-mediated enforcement of cardiac contractility. Read More

    [Ultrasonographic evaluation of diaphragm structure and function].
    Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2017 Mar;29(3):276-280
    Ningxia Medical University, Yinchuan 750004, Ningxia, China (Wang FF); Department of Respiratory Disease, Shanghai East Hospital, Tongji University of School Medicine, Shanghai 200120, China (Zhu XP); Department of Critical Care Medicine, Shanghai East Hospital, Tongji University of School Medicine, Shanghai 200120, China (Ma SL). Corresponding author: Ma Shaolin, Email:
    Objective: Diaphragm is the principal respiratory muscle. Diaphragm dysfunction resulting from mechanical ventilation, chronic cardiopulmonary disease, medicine, cardio-thoracic surgery, septic shock and chronic malnutrition predisposes to weaning failure from mechanical ventilation and prolongs intensive care unit (ICU) stay. Traditionally, the method of assessment of diaphragm structure and function was invasive, lacking specific, and was difficult to be used bedside. Read More

    [Albumin corrected anion gap is an independent risk factor for long-term mortality of patients with sepsis].
    Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2017 Feb;29(2):117-121
    Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China (He XL, Liao XL, Xie ZC, Kang Y); Department of Pharmaceutical and Biological Examination, Patent Examination Cooperation Center of the Patent Office, State Intellectual Property Office, Chengdu 610213, Sichuan, China (Jiang C). Corresponding author: Kang Yan, Email:
    Objective: To explore whether albumin corrected anion gap (ACAG) is associated with long-term mortality of sepsis patients.

    Methods: Adult patients with a diagnosis of sepsis within the first 24 hours (from December 2013 to December 2014) admitted to the intensive care unit (ICU) were included via the Sepsis database of West China Hospital Sichuan University. To record their long-term survival, patients were followed up by telephone interview one year after enrollment. Read More

    [Comparison of effect of norepinephrine and terlipressin on patients with ARDS combined with septic shock: a prospective single-blind randomized controlled trial].
    Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2017 Feb;29(2):111-116
    Department of Critical Care Medicine, People's Hospital of Jiangxi Province, Nanchang 330006, Jiangxi, China (Chen Z, Lu YH, Yang CL); Department of Nephrology, People's Hospital of Jiangxi Province, Nanchang 330006, Jiangxi, China (Zhou P). Corresponding author: Yang Chunli, Email:
    Objective: To approach the effect of different vasopressor on hemodynamics, volume responsiveness, fluid volume balance, renal function and prognosis in patients with acute respiratory distress syndrome (ARDS) complicated with septic shock.

    Methods: A prospective single-blind randomized controlled trial was conducted. ARDS patients with septic shock admitted to the Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2015 to May 1st, 2016 were enrolled. Read More

    [Effect of vitamin D3 on the severity and prognosis of patients with sepsis: a prospective randomized double-blind placebo study].
    Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2017 Feb;29(2):106-110
    Department of Intensive Care Unit, Shengjing Hospital Affiliated to China Medical University, Shenyang 110004, Liaoning, China. Corresponding author: Zang Bin, Email:
    Objective: To observe the relationship between vitamin D3 and the severity as well as prognosis in patients with sepsis, and to explore whether exogenous vitamin D3 can improve the prognosis in patients with sepsis.

    Methods: A prospective randomized double-blind placebo study was conducted. Fifty-seven patients with sepsis admitted to intensive care unit (ICU) of Shengjing Hospital Affiliated to China Medical University from March to November in 2015 were enrolled. Read More

    [Fulminant Clostridium difficile colitis: new challenges in critical care medicine].
    Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2017 Jun;29(6):564-567
    Department of Critical Care Medicine, General Hospital of Tianjin Medical University, Tianjin 300052, China. Corresponding author: Liu Bin, Email:
    Objective: Fulminant Clostridium difficile colitis (FCDC) means severe Clostridium difficile colitis (CDC), which often manifested with severe diarrhea, fever, abdominal distention, electrolyte disorder, hypoalbuminemia, and it can lead to pseudo membrane colonitis, toxic megacolon, bowel perforation, septic shock, and multiple organ dysfunction. Now Clostridium difficile (CD) becomes one of the most important medical institutions related infectious pathogens. In particular, the recently discovered mutant CD strain NAP1/BI/ribotype 027 has high pathogenicity in the global epidemic and its outbreak. Read More

    [Effect of global end diastolic volume index guidance fluid resuscitation in elderly patients with septic shock].
    Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2017 Jun;29(6):486-490
    Department of Critical Care Medicine, Zibo Central Hospital, Zibo 255036, Shandong, China. Corresponding author: Zhang Rumin, Email:
    Objective: To evaluate the effect of global end diastolic volume index (GEDVI) on fluid resuscitation in elderly patients with septic shock.

    Methods: A prospective randomized controlled trial (RCT) was conducted. Septic shock patients over 65 years admitted to intensive care unit (ICU) of Shandong Province, Zibo Central Hospital from January 2013 to December 2015 were enrolled. Read More

    Systolic blood pressure variability in patients with early severe sepsis or septic shock: a prospective cohort study.
    BMC Anesthesiol 2017 Jun 17;17(1):82. Epub 2017 Jun 17.
    Pulmonary and Critical Care, Intermountain Medical Center, 5121 Cottonwood St, Murray, UT, 84107, USA.
    Background: Severe sepsis and septic shock are often lethal syndromes, in which the autonomic nervous system may fail to maintain adequate blood pressure. Heart rate variability has been associated with outcomes in sepsis. Whether systolic blood pressure (SBP) variability is associated with clinical outcomes in septic patients is unknown. Read More

    Clinical features and prognostic factors of Klebsiella endophthalmitis-10-year experience in an endemic region.
    Eye (Lond) 2017 Jun 16. Epub 2017 Jun 16.
    Department of Ophthalmology, United Christian Hospital, Kowloon, Hong Kong.
    AimsTo identify the clinical features and prognostic factors of endogenous endophthalmitis caused by Klebsiella pneumoniae.MethodsThis is a retrospective case series of all patients with Klebsiella endophthalmitis managed from January 2006 to December 2015 by Kowloon East Ophthalmic Service. Statistical analysis involved hypothesis testing on the SPSS 18. Read More

    Discontinuation of Vasopressin Before Norepinephrine in the Recovery Phase of Septic Shock.
    J Intensive Care Med 2017 Jan 1:885066617714209. Epub 2017 Jan 1.
    2 University of Arkansas for Medical Sciences Medical Center, Little Rock, AR, USA.
    Background: Guidance for the discontinuation of vasopressors in the recovery phase of septic shock is limited. Norepinephrine is more easily titrated; however, septic shock is a vasopressin deficient state, which exogenous vasopressin endeavors to resolve. Discontinuation of vasopressin before norepinephrine may result in clinically significant hypotension. Read More

    Comparison of endothelin and nitric oxide synthase blockers on hemorheological parameters in endotoxemic rats.
    Turk J Med Sci 2017 Jun 12;47(3):1045-1052. Epub 2017 Jun 12.
    Department of Pharmacology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
    Background/aim: Septic shock is an important health problem that vastly alters cardiovascular and hemodynamic status. Increased production of nitric oxide (NO) and endothelin is a counterpart of this endotoxemic state. This study was conducted to test the hypothesis that nonselective NO synthesis blocker (L-NAME), inducible NO synthesis blocker (L-canavanine), or endothelin receptor antagonist (bosentan) will reverse the effects of sepsis on hemorheological parameters. Read More

    Serious Bacterial Infections Acquired During Treatment of Patients Given a Diagnosis of Chronic Lyme Disease - United States.
    MMWR Morb Mortal Wkly Rep 2017 Jun 16;66(23):607-609. Epub 2017 Jun 16.
    The term "chronic Lyme disease" is used by some health care providers as a diagnosis for various constitutional, musculoskeletal, and neuropsychiatric symptoms (1,2). Patients with a diagnosis of chronic Lyme disease have been provided a wide range of medications as treatment, including long courses of intravenous (IV) antibiotics (3,4). Studies have not shown that such treatments lead to substantial long-term improvement for patients, and they can be harmful (1,5). Read More

    Short-Term Peripheral Vasoactive Infusions in Pediatrics: Where Is the Harm?
    Pediatr Crit Care Med 2017 Jun 14. Epub 2017 Jun 14.
    1Department of Cardiac Critical Care Medicine, Children's National Health System, The George Washington School of Medicine, Washington, DC. 2Department of Critical Care Medicine, Johns Hopkins All Children's Hospital, The Johns Hopkins University, St. Petersburg, FL.
    Objective: Pediatric shock represents a major cause of morbidity and mortality in the United States. Standardization of treatment such as volume resuscitation and vasoactive administration has resulted in improved patient outcomes. Vasoactives have been anecdotally associated with peripheral IV infiltration and extravasation. Read More

    Should Hyperoxia Be Avoided During Sepsis? An Experimental Study in Ovine Peritonitis.
    Crit Care Med 2017 Jun 14. Epub 2017 Jun 14.
    1Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium. 2Department of Intensive Care, Sun Yat-sen University Cancer Center, Guangzhou, China. 3Anesthesia and Intensive Care B, Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, AOUI-University Hospital Integrated Trust of Verona, Verona, Italy.
    Objectives: Optimizing oxygen delivery is an important part of the hemodynamic resuscitation of septic shock, but concerns have been raised over the potentially deleterious effects of hyperoxia. We evaluated the impact of hyperoxia on hemodynamics, the microcirculation, and cerebral and renal metabolism in an ovine model of septic shock.

    Design: Randomized animal study. Read More

    Identification of Pathogenic Factors in Klebsiella pneumoniae Using Impedimetric Sensor Equipped with Biomimetic Surfaces.
    Sensors (Basel) 2017 Jun 15;17(6). Epub 2017 Jun 15.
    Department of Food Science and Biotechnology & Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Yongin 17104, Korea.
    K.pneumoniae is an opportunistic pathogen that causes nosocomial infections, such as, pneumonia, urinary tract infections, septic shock, and gastro intestinal disease. Lipopolysaccharide (LPS), capsular polysaccharide, and fimbriae are recognized major virulence factors of K. Read More

    Assessment of renal hemodynamic toxicity of fluid challenge with 0.9% NaCl compared to balanced crystalloid (PlasmaLyte(®)) in a rat model with severe sepsis.
    Ann Intensive Care 2017 Dec 14;7(1):66. Epub 2017 Jun 14.
    CHU d'Angers, 4 rue Larrey, 49000, Angers, France.
    Background: According to international guidelines, volume expansion with crystalloids is the first-line treatment for hemodynamic management in patients with severe sepsis or septic shock. Compared to balanced crystalloids, 0.9% sodium chloride (0. Read More

    Impact of hyperglycemia on cystathionine-γ-lyase expression during resuscitated murine septic shock.
    Intensive Care Med Exp 2017 Dec 14;5(1):30. Epub 2017 Jun 14.
    Institute of Anesthesiological Pathophysiology and Process Engineering, University Medical School, Helmholtzstrasse 8-1, 89081, Ulm, Germany.
    Background: Cystathionine-γ-lyase (CSE) was shown to have a regulatory role in glucose metabolism. Circulatory shock can induce metabolic stress, thereby leading to hyperglycemia and mitochondrial dysfunction. In vitro data suggest an effect of high glucose on CSE expression. Read More

    Passive leg raising test with minimally invasive monitoring: the way forward for guiding septic shock resuscitation?
    J Intensive Care 2017 8;5:36. Epub 2017 Jun 8.
    Intensive Care Medicine, ICU Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101, Laarbeeklaan, 1090 Jette, Brussels Belgium.
    Background: Swift and adequate fluid loading is a cornerstone of septic shock therapy. Yet, careful assessment of volume responsiveness and volume amount during the resuscitation process is a prerequisite. Both overzealous initial fluid administration and late fluid overload are harmful and may be associated with increased mortality. Read More

    Acute kidney injury in patients with severe sepsis or septic shock: a comparison between the 'Risk, Injury, Failure, Loss of kidney function, End-stage kidney disease' (RIFLE), Acute Kidney Injury Network (AKIN) and Kidney Disease: Improving Global Outcomes (KDIGO) classifications.
    Clin Kidney J 2017 Jun 13;10(3):332-340. Epub 2016 Dec 13.
    Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, EPE, Av. Prof. Egas Moniz, Lisboa, Portugal.
    Purpose: Using the Risk, Injury, Failure, Loss of kidney function, End-stage kidney disease (RIFLE), Acute Kidney Injury Network (AKIN) and Kidney Disease: Improving Global Outcomes (KDIGO) systems, the incidence of acute kidney injury (AKI) and their ability to predict in-hospital mortality in severe sepsis or septic shock was compared.

    Materials And Methods: We performed a retrospective analysis of 457 critically ill patients with severe sepsis or septic shock hospitalized between January 2008 and December 2014. Multivariate logistic regression was employed to evaluate the association between the RIFLE, AKIN and KDIGO systems with in-hospital mortality. Read More

    Early initiation of low-dose hydrocortisone treatment for septic shock in adults: A randomized clinical trial.
    Am J Emerg Med 2017 Jun 5. Epub 2017 Jun 5.
    Department of Critical Care Medicine, Subei People's Hospital, Clinical Medical School of Yangzhou University, Yangzhou, China. Electronic address:
    Background: Physiologic dose hydrocortisone is part of the suggested adjuvant therapies for patients with septic shock. However, the association between the corticosteroid therapy and mortality in patients with septic shock is still not clear. Some authors considered that the mortality is related to the time frame between development of septic shock and start of low dose hydrocortisone. Read More

    Skin and soft tissue infections in the intensive care unit: a retrospective study in a tertiary care center.
    Rev Bras Ter Intensiva 2017 Jun 12. Epub 2017 Jun 12.
    Serviço de Moléstias Infecciosas, Centro Hospitalar de São João - Porto, Portugal.
    Objective:: To identify factors that may influence outcomes in patients with severe skin and soft tissue infections in the intensive care unit.

    Methods:: A retrospective observational study was conducted in a cohort of 1,123 critically ill patients admitted to an intensive care unit with a primary or secondary diagnosis of severe skin and soft tissues infection between January 2006 and December 2014.

    Results:: Thirty patients were included, 20 (66. Read More

    Spontaneous fungal peritonitis: a rare but severe complication of liver cirrhosis.
    Eur J Gastroenterol Hepatol 2017 Jun 13. Epub 2017 Jun 13.
    Departments of aGastroenterology bMicrobiology, Centro Hospitalar e Universitário de Coimbra cDigestive System Pathology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
    Introduction And Aim: Spontaneous bacterial peritonitis is the most common infectious complication in cirrhosis. Spontaneous fungal peritonitis is rare and remains unknown. In this work, spontaneous fungal peritonitis as well as risk factors and prognosis are characterized. Read More

    Ecthyma Gangrenosum: Escherichia coli or Pseudomonas aeruginosa?
    Front Microbiol 2017 30;8:953. Epub 2017 May 30.
    Division of Infectious Diseases, Department of Medical Specialties, Geneva University HospitalsGeneva, Switzerland.
    Background: Ecthyma gangrenosum (EG) are necrotic lesions that develop in the context of Pseudomonas aeruginosa bacteremia. Isolated reports describe EG in the setting of non-Pseudomonal infections. In a patient with EG, initial blood cultures showed Escherichia coli, and almost occulted P. Read More

    Synergistic antibiotic effect of looped antimicrobial peptide CLP-19 with bactericidal and bacteriostatic agents.
    Oncotarget 2017 May 23. Epub 2017 May 23.
    Department of Pharmacy, Southwest Hospital, Third Military Medical University, Chongqing, China.
    The treatment of drug-resistant infections is complicated and the alarming rise in infectious diseases poses a unique challenge for development of effective therapeutic strategies. Antibiotic-induced liberation of the bacterial endotoxin lipopolysaccharide (LPS) may have immediate adverse effects promoting septic shock in patients. In the present study, we first confirmed our previous finding that looped antimicrobial peptide CLP-19 exerts non-specific direct antibacterial activity with no toxic to mammalian cells and second revealed that CLP-19 has synergistic effect to enhance the antibacterial activities of other conventional bactericidal (ampicillin and ceftazidime) and bacteriostatic (erythromycin and levofloxacin) agents. Read More

    Red blood cell transfusion in the resuscitation of septic patients with hematological malignancies.
    Ann Intensive Care 2017 Dec 12;7(1):62. Epub 2017 Jun 12.
    Réanimation médicale, hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP) and Université Paris Descartes, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.
    Background: Indications for red blood cell (RBC) transfusion in septic acute circulatory failure remain unclear. We addressed the practices and the prognostic impact of RBC transfusion in the early resuscitation of severe sepsis and septic shock in patients with hematological malignancies.

    Methods: We performed a retrospective analysis of a prospectively collected database of patients with hematological malignancies who required intensive care unit (ICU) admission in 2010-2011. Read More

    Frequency, associated factors and outcome of multi-drug-resistant intensive care unit-acquired pneumonia among patients colonized with extended-spectrum β-lactamase-producing Enterobacteriaceae.
    Ann Intensive Care 2017 Dec 12;7(1):61. Epub 2017 Jun 12.
    Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor, DHU A-TVB, Service de Réanimation Médicale, 94010, Créteil, France.
    Background: We assessed prevalence, associated factors and prognosis of extended-spectrum beta-lactamase-producing Enterobacteriaceae pneumonia acquired in intensive care unit (ESBL-PE pneumonia) among carriers. Variables associated with nosocomial pneumonia caused by carbapenem-resistant bacteria (CRB) were also assessed.

    Methods: A 6-year prospective study (May 2009-March 2015) in the medical ICU of an 850-bed university-affiliated hospital was conducted. Read More

    Blood purification with continuous venovenous hemofiltration in patients with sepsis or acute respiratory distress syndrome. A systematic review and meta-analysis of randomized evidence.
    Minerva Anestesiol 2017 Jun 12. Epub 2017 Jun 12.
    Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
    Introduction: Severe inflammatory conditions, as severe sepsis/septic shock and acute respiratory distress syndrome (ARDS), are related to high morbidity and mortality. We performed a meta-analysis of randomized trials to assess if blood purification with continuous venovenous hemofiltration (CVVH) reduces mortality in these settings.

    Evidence Acquisition: Online databases were searched for pertinent studies up to March 2017. Read More

    Infectious diseases team for the early management of severe sepsis and septic shock in the emergency department.
    Clin Infect Dis 2017 Jun 12. Epub 2017 Jun 12.
    Infectious Diseases Unit, Department of Medical and Surgical Sciences, Hospital S. Orsola-Malpighi, University of Bologna, Bologna, Italy.
    Background.: To assess the impact on all-cause 14-day survival of the implementation of an infectious disease (ID) team for the early management of severe sepsis/septic shock (SS/SS) in the Emergency Department (ED).

    Methods. Read More

    Infections in patients affected by liver cirrhosis: an update.
    Infez Med 2017 Jun;25(2):91-97
    Institute of Hygiene, University of Salerno, Salerno, Italy.
    Patients with liver cirrhosis present an increased incidence of infections. The main cause has been founded in alterations of the enteric flora and of the intestinal barrier probably due to portal hypertension, in addition to a reticulo-endothelial system dysfunction. Furthermore, those living with cirrhosis can report a high predisposition to sepsis and septic shock, due to the excessive response of pro-inflammatory cytokines and a complessive hemodynamic derangement. Read More

    Clinical Predictors and Outcomes of Klebsiella pneumoniae Bacteraemia in a Regional Hospital in Hong Kong.
    J Hosp Infect 2017 Jun 8. Epub 2017 Jun 8.
    Department of Microbiology, The University of Hong Kong, Hong Kong.
    Background: Klebsiella pneumoniae (KP) infection is associated with high morbidity and mortality. Multidrug resistance, especially extended spectrum beta-lactamase (ESBL) production, in KP is endemic worldwide. Our study aimed to evaluate the clinical characteristics and outcomes of patients with KP bacteraemia in critical care and general ward settings. Read More

    Can complications in febrile neutropenia be predicted? Report from a developing country.
    Support Care Cancer 2017 Jun 11. Epub 2017 Jun 11.
    Division of Pediatric Hematology Oncology, Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012, India.
    Purpose: Febrile neutropenia (FN) is an important cause of morbidity and mortality in children with acute lymphoblastic leukemia (ALL). We aimed to look at complications in febrile neutropenia and to derive a risk model for developing complications from the variables predicting complications.

    Methods: Children on treatment for ALL, presenting with FN, were prospectively enrolled over a period of 1 year. Read More

    Predictors of readmission in nonagenarians: analysis of the American College of Surgeons National Surgical Quality Improvement Project dataset.
    J Surg Res 2017 Jun 24;213:32-38. Epub 2017 Feb 24.
    Department of Surgery, Beaumont Health, Royal Oak, Michigan.
    Background: Increased longevity has led to more nonagenarians undergoing elective surgery. Development of predictive models for hospital readmission may identify patients who benefit from preoperative optimization and postoperative transition of care intervention. Our goal was to identify significant predictors of 30-d readmission in nonagenarians undergoing elective surgery. Read More

    Potential Impact of the 2016 Consensus Definitions of Sepsis and Septic Shock on Future Sepsis Research.
    Ann Emerg Med 2017 Jun 7. Epub 2017 Jun 7.
    Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Austin Hospital, Melbourne, Victoria, Australia.
    Study Objective: The influence of the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) on the conduct of future sepsis research is unknown. We seek to examine the potential effect of the new definitions on the identification and outcomes of patients enrolled in a sepsis trial.

    Methods: This was a post hoc analysis of the Australasian Resuscitation in Sepsis Evaluation (ARISE) trial of early goal-directed therapy that recruited 1,591 adult patients presenting to the emergency department (ED) with early septic shock diagnosed by greater than or equal to 2 systemic inflammatory response syndrome criteria and either refractory hypotension or hyperlactatemia. Read More

    Group A streptococci infection. A systematic clinical review exemplified by cases from an obstetric department.
    Eur J Obstet Gynecol Reprod Biol 2017 Jun 1;215:33-40. Epub 2017 Jun 1.
    Aarhus University Hospital, Department of Obstetrics and Gynecology(,) Aarhus, Denmark.
    Group A streptococci infection has re-emerged since the 1980s and onward, despite the awareness of the etiology and the use of penicillin. It now accounts for more than 75,000 deaths worldwide every year. Postpartum women have a 20-fold increased incidence of group A streptococci disease compared to non-pregnant women. Read More

    [Sepsis and septic shock : Overview after sepsis-3 and the requirements of the clinician regarding the autopsy of critically ill patients].
    Pathologe 2017 Jun 9. Epub 2017 Jun 9.
    Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
    Sepsis and septic shock are frequent conditions of patients in the intensive care unit. Recent guidelines adjusted the diagnostic criteria for sepsis and septic shock as well as the recommendations for sepsis treatment, which together is important for the intensivist as well as for the pathologist. Patients who die from septic shock despite invasive and intense therapies display various pathological findings that have to be placed in a reasonable clinical context, which is challenging for the pathologist without close cooperation with the former caring clinician. Read More

    Arterial versus venous lactate: a measure of sepsis in children.
    Eur J Pediatr 2017 Jun 10. Epub 2017 Jun 10.
    Institute for Medical and Biomedical Education, St. George's University of London, London, SW17 0QT, UK.
    This study assessed the agreement between arterial and venous blood lactate and pH levels in children with sepsis. This retrospective, three-year study involved 60 PICU patients, with data collected from electronic or paper patient records. The inclusion criteria comprised of children (≤17 years old) with sepsis and those who had a venous blood gas taken first with an arterial blood gas taken after within one hour. Read More

    Dexmedetomidine for Sedation During Noninvasive Ventilation in Pediatric Patients.
    Pediatr Crit Care Med 2017 Jun 8. Epub 2017 Jun 8.
    1Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH. 2Emory Sleep Center, Emory University, Atlanta, GA. 3Critical Care Medicine, Children's Healthcare of Atlanta, Children's at Egleston, Atlanta, GA. 4Biostatistics Core, The Research Institute at Nationwide Children's Hospital, Columbus, OH. 5Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH. 6Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, OH.
    Objectives: To describe the use of dexmedetomidine for sedation in a large cohort of nonintubated children with acute respiratory insufficiency receiving noninvasive ventilatory support.

    Design: Single-center, retrospective, observational cohort study.

    Setting: A large quaternary-care PICU. Read More

    Tetrahydrobiopterin improves microcirculation in experimental sepsis.
    Clin Hemorheol Microcirc 2017 Jun 8. Epub 2017 Jun 8.
    Background: Tetrahydrobiopterin (BH4), an endogenous nucleic acid derivative, acts as an important cofactor for several enzymes found within the vascular endothelium, which is deranged in sepsis.

    Objective: We hypothesized that BH4 would improve capillary density and decrease inflammation within the intestinal microcirculation of septic rats.

    Methods: We conducted a randomized, controlled trial using two previously validated models of sepsis in rats: 1) A fecal peritonitis model using a stent perforating the ascending colon, and 2) An endotoxemia model using lipopolysaccharide (LPS) toxin from E. Read More

    Emphysematous Gastritis with Air in Portal Venous System.
    J Assoc Physicians India 2017 May;65(5):105-106
    Former Consultant, Department of Medicine, Dayanand Medical College & Hospital, Ludhiana, Punjab.
    Emphysematous gastritis is a rare but severe form of phlegmonous gastritis caused by gastric mucosal disruption and infection of stomach wall by gas-forming bacteria. Ingestion of corrosive substances is the most common predisposing factor, followed by alcohol abuse, abdominal surgery, diabetes and immunosuppression. Patients usually present with abdominal pain, vomiting, diarrhea, constipation and/or gastro-intestinal hemorrhage. Read More

    Role of Plasma Fibrinogen in Diagnosis and Prediction of Short Term Outcome in Neonatal Sepsis.
    Indian J Hematol Blood Transfus 2017 Jun 14;33(2):195-199. Epub 2016 May 14.
    Department of Biochemistry, Nilratan Sircar Medical College and Hospital, Kolkata, West Bengal India.
    The study was carried out to determine the role of plasma fibrinogen in diagnosis of neonatal sepsis and to evaluate its role in predicting short term outcome. Sixty five neonates with clinical features suggestive of neonatal sepsis were included in this study. Seventy five neonates served as the control group. Read More

    Microdialysis-Assessed Adipose Tissue Metabolism in Critically Ill Patients.
    Recent Pat Endocr Metab Immune Drug Discov 2017 Jun 8. Epub 2017 Jun 8.
    Department of Experimental Physiology, National & Kapodistrian University of Athens, Athens. Greece.
    Background: Microdialysis is a minimally invasive technique that allows direct in situ and in vivo sampling, studies and manipulations of the interstitial/extracellular fluid/space. It has been shown to be of use mainly in acute brain injury/neurocritical care.

    Methods: Microdialysis has been used to study obesity, diabetes mellitus, inflammation and pharmacokinetics at the adipose tissue level. Read More

    The ubiquitin ligase ZNRF1 promotes caveolin-1 ubiquitination and degradation to modulate inflammation.
    Nat Commun 2017 Jun 8;8:15502. Epub 2017 Jun 8.
    Institute of Molecular Medicine, National Taiwan University, No. 7 Chung San South Road, Taipei 10002, Taiwan.
    Caveolin-1 (CAV1), the major constituent of caveolae, plays a pivotal role in various cellular biological functions, including cancer and inflammation. The ubiquitin/proteasomal pathway is known to contribute to the regulation of CAV1 expression, but the ubiquitin ligase responsible for CAV1 protein stability remains unidentified. Here we reveal that E3 ubiquitin ligase ZNRF1 modulates CAV1 protein stability to regulate Toll-like receptor (TLR) 4-triggered immune responses. Read More

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