35,683 results match your criteria Toxic Shock Syndrome


Rates, Predictors and Mortality of Community-Onset Bloodstream Infections due to Pseudomonas aeruginosa: Systematic Review and Meta-Analysis.

Clin Microbiol Infect 2019 Apr 14. Epub 2019 Apr 14.

Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena / Departamento de Medicina, Universidad de Sevilla / Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain.

Background: Pseudomonas aeruginosa is mostly a nosocomial pathogen affecting predisposed patients. However, community-onset bloodstream infections (CO-BSI) caused by this organism are not exceptional.

Objectives: To assess the predisposing factors for CO-BSI due to P. Read More

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http://dx.doi.org/10.1016/j.cmi.2019.04.005DOI Listing

Survival analysis of patients with sepsis in Brazil.

Rev Soc Bras Med Trop 2019 Apr 11;52:e20180121. Epub 2019 Apr 11.

Departamento de Saúde Coletiva, Programa de Pós-graduação em Saúde Coletiva e Programa de Pós-graduação em Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN, Brasil.

Introduction: This study aimed to analyze the survival of septic patients and to assess prognostic factors.

Methods: Patients with sepsis, severe sepsis, and septic shock were followed up and clinical and laboratory data were collected. The sepsis-related organ failure assessment (SOFA) score was calculated. Read More

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http://dx.doi.org/10.1590/0037-8682-0121-2018DOI Listing

Timing of administration of epinephrine predicts the responsiveness to epinephrine in norepinephrine-refractory septic shock: a retrospective study.

J Intensive Care 2019 5;7:20. Epub 2019 Apr 5.

Department of Emergency and Critical Care, Nagoya, University Graduate School of Medicine, Tsurumai-cho 64, Syowa-ku, Nagoya, Aichi 4668560 Japan.

Background: Currently, the appropriate method of management of patients with refractory septic shock remains unclear. This study aimed to evaluate the factors associated with response to epinephrine in norepinephrine-refractory septic shock.

Methods: A retrospective single-center observational study was performed using data from adult patients (≥ 18 years old) admitted to our emergency and medical intensive care unit (ICU) from January 2014 to December 2017 who had received epinephrine to treat norepinephrine-refractory septic shock. Read More

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http://dx.doi.org/10.1186/s40560-019-0377-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451296PMC

Data-driven discovery of a novel sepsis pre-shock state predicts impending septic shock in the ICU.

Sci Rep 2019 Apr 16;9(1):6145. Epub 2019 Apr 16.

Institute for Computational Medicine, The Johns Hopkins University, Maryland, USA.

Septic shock is a life-threatening condition in which timely treatment substantially reduces mortality. Reliable identification of patients with sepsis who are at elevated risk of developing septic shock therefore has the potential to save lives by opening an early window of intervention. We hypothesize the existence of a novel clinical state of sepsis referred to as the "pre-shock" state, and that patients with sepsis who enter this state are highly likely to develop septic shock at some future time. Read More

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http://dx.doi.org/10.1038/s41598-019-42637-5DOI Listing

Broad spectrum vasopressors: a new approach to the initial management of septic shock?

Crit Care 2019 Apr 16;23(1):124. Epub 2019 Apr 16.

La Jolla Pharmaceutical Company, San Diego, CA, USA.

The mainstay of hemodynamic treatment of septic shock is fluid resuscitation followed by vasopressors where fluids alone are insufficient to achieve target blood pressure. Norepinephrine, a catecholamine, is the first-line vasopressor used worldwide but given that all routinely used catecholamines target the same adrenergic receptors, many clinicians may add a non-catecholamine vasopressor where refractory hypotension due to septic shock is present. However, the timing of this additional intervention is variable. Read More

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http://dx.doi.org/10.1186/s13054-019-2420-yDOI Listing

Persistently Elevated Glucagon-Like Peptide 1 Levels Among Critically-Ill Surgical Patients After Sepsis and Development of Chronic Critical Illness and Dismal Long-Term Outcomes.

J Am Coll Surg 2019 Apr 13. Epub 2019 Apr 13.

Department of Surgery, University of Florida, Gainsville, FL.

Background: Glucagon-like peptide-1 (GLP-1) is a gut derived incretin hormone that stimulates insulin secretion, cellular glucose uptake and has immune-regulatory functions. GLP-1 is markedly altered following trauma and sepsis, but the implications remain unclear.

Study Design: We performed an analysis of a prospective, longitudinal cohort study of critically-ill surgical patients with sepsis. Read More

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http://dx.doi.org/10.1016/j.jamcollsurg.2019.04.014DOI Listing

Isolated Bone Marrow Non-Langerhans Cell Histiocytosis Preceding RUNX1-Mutated Acute Myeloid Leukemia.

Am J Clin Pathol 2019 Apr 16. Epub 2019 Apr 16.

Division of Hematology and HSCT, Department of Oncology, King Abdul Aziz Medical City, Riyadh, KSA.

Objectives: The prevalence of concomitant myeloid neoplasms was recently reported to be unexpectedly high among adults without non-Langerhans cell histiocytosis (non-LCH); however, the coexistence of non-LCH with RUNX1 genetic aberration has not been reported previously.

Methods: Herein, we report a 23-year-old woman with severe pancytopenia diagnosed with non-LCH following presentation with pancytopenia and marrow examination showing histiocytosis positive for CD45, CD68, CD136, and lysozyme but negative for CD1a, langerin, and S100.

Results: Whole-exome sequencing showed RUNX1 mutation and NF1 mutation. Read More

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http://dx.doi.org/10.1093/ajcp/aqz018DOI Listing

TEG in the monitoring of coagulation changes in patients with sepsis and the clinical significance.

Exp Ther Med 2019 May 5;17(5):3373-3382. Epub 2019 Mar 5.

Department of Intensive Care Unit, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China.

Application values of thromboelastography (TEG) in dynamic monitoring of coagulation parameters of sepsis patients were investigated. Eighty-one patients with sepsis who were admitted to the ICU department of the General Hospital of Ningxia Medical University from April 1, 2015 to December 31, 2015 were collected. Clinical data of the patients were collected. Read More

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http://dx.doi.org/10.3892/etm.2019.7342DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447775PMC

Cardiovascular determinants of resuscitation from sepsis and septic shock.

Crit Care 2019 Apr 15;23(1):118. Epub 2019 Apr 15.

Department of Critical Care Medicine, University of Pittsburgh, 1215.4 Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA.

Background: We hypothesized that the cardiovascular responses to Surviving Sepsis Guidelines (SSG)-defined resuscitation are predictable based on the cardiovascular state.

Methods: Fifty-five septic patients treated by SSG were studied before and after volume expansion (VE), and if needed norepinephrine (NE) and dobutamine. We measured mean arterial pressure (MAP), cardiac index (CI), and right atrial pressure (Pra) and calculated pulse pressure and stroke volume variation (PPV and SVV), dynamic arterial elastance (Ea), arterial elastance (Ea) and left ventricular (LV) end-systolic elastance (Ees), Ees/Ea (VAC), LV ejection efficiency (LVeff), mean systemic pressure analogue (Pmsa), venous return pressure gradient (Pvr), and cardiac performance (Eh), using standard formulae. Read More

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https://ccforum.biomedcentral.com/articles/10.1186/s13054-01
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http://dx.doi.org/10.1186/s13054-019-2414-9DOI Listing
April 2019
5 Reads

Reduced Mannose-Binding Lectin-Associated Serine Protease (MASP)-1 is Associated with Disturbed Coagulation in Septic Shock.

Thromb Haemost 2019 Apr 15. Epub 2019 Apr 15.

Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.

Background:  Activation of the complement system is part of the dysregulated immune response in sepsis. The mannose-binding lectin-associated serine proteases (MASP)-1 and -2 activate the lectin pathway of the complement system. Besides, these proteins can activate coagulation in vitro. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1685140
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http://dx.doi.org/10.1055/s-0039-1685140DOI Listing
April 2019
2 Reads

Sepsis Presenting in Hospitals versus Emergency Departments: Demographic, Resuscitation, and Outcome Patterns in a Multicenter Retrospective Cohort.

J Hosp Med 2019 Apr 8;14:E1-E9. Epub 2019 Apr 8.

Department of Medicine, Hofstra-Northwell School of Medicine, Hempstead, New York.

Background: Differences between hospital-presenting sepsis (HPS) and emergency department-presenting sepsis (EDPS) are not well described.

Objectives: We aimed to (1) quantify the prevalence of HPS versus EDPS cases and outcomes; (2) compare HPS versus EDPS characteristics at presentation; (3) compare HPS versus EDPS in process and patient outcomes; and (4) estimate risk differences in patient outcomes attributable to initial resuscitation disparities.

Design: Retrospective consecutive-sample cohort. Read More

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http://dx.doi.org/10.12788/jhm.3188DOI Listing

The Restrictive IV Fluid Trial in Severe Sepsis and Septic Shock (RIFTS): A Randomized Pilot Study.

Crit Care Med 2019 Apr 12. Epub 2019 Apr 12.

Department of Medicine, Division of Pulmonary Critical Care and Sleep, Alpert Medical School of Brown University, Providence, RI.

Objectives: It is unclear if a low- or high-volume IV fluid resuscitation strategy is better for patients with severe sepsis and septic shock.

Design: Prospective randomized controlled trial.

Setting: Two adult acute care hospitals within a single academic system. Read More

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http://dx.doi.org/10.1097/CCM.0000000000003779DOI Listing
April 2019
1 Read

Quality of Life and 1-Year Survival in Patients With Early Septic Shock: Long-Term Follow-Up of the Australasian Resuscitation in Sepsis Evaluation Trial.

Crit Care Med 2019 Apr 8. Epub 2019 Apr 8.

Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.

Objectives: To examine long-term survival and quality of life of patients with early septic shock.

Design: Prospective, randomized, parallel-group trial.

Setting: Fifty-one hospitals in Australia, New Zealand, Finland, Hong Kong, and the Republic of Ireland. Read More

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http://dx.doi.org/10.1097/CCM.0000000000003762DOI Listing

Unusual Presentation of Hemophagocytic Lymphohistiocytosis in a Kidney Transplant Patient.

Case Rep Transplant 2019 10;2019:3682378. Epub 2019 Mar 10.

Division of Nephrology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

We are presenting a case of a middle-aged woman with history of remote kidney transplantation who had multiple admissions for septic shock-like picture, recurrent fever, and hypotension. Her shock manifestation would resolve after stress dose steroid administration and less than 24 hours of vasopressor administration. Initially, extensive workup was performed without revealing etiology. Read More

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http://dx.doi.org/10.1155/2019/3682378DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6431471PMC

Methicillin-Resistant Blood Isolates Harboring a Novel Pseudo-staphylococcal Cassette Chromosome Element.

Front Microbiol 2019 29;10:540. Epub 2019 Mar 29.

Department of Laboratory Medicine, Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea.

The aim of this work was to assess a novel pseudo-staphylococcal cassette chromosome (ΨSCC) element in methicillin-resistant (MRSA) blood isolates. Community-associated MRSA E16SA093 and healthcare-associated MRSA F17SA003 isolates were recovered from the blood specimens of patients with bacteremia in 2016 and in 2017, respectively. Antimicrobial susceptibility was determined the disk diffusion method, and SCC typing was conducted by multiplex polymerase chain reaction. Read More

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http://dx.doi.org/10.3389/fmicb.2019.00540DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6450365PMC

[Extracorporeal therapy in sepsis].

G Ital Nefrol 2019 Apr;36(2)

Struttura Complessa Universitaria di Nefrologia e Dialisi - CMID, Ospedale San Giovanni Bosco, ASL Città di Torino, Torino.

Acute renal injury (AKI) occurs in 19% of patients with sepsis, 23% of those with severe sepsis and up to 50% of patients with septic shock. AKI represents an independent prognostic factor of mortality (about 45%); epidemiological studies have pointed out that the onset of AKI in sepsis (S-AKI) correlates with an unfavourable outcome, reaching a mortality of 75%. Over the years, efforts have been made to prevent and treat "low flow" hemodynamic damage resulting from shock by increasing renal blood flow, improving cardiac output and perfusion pressure. Read More

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Living donor liver transplantation for a patient with a history of total gastrectomy.

Biosci Trends 2019 Apr 15. Epub 2019 Apr 15.

Department of Transplantation and Pediatric Surgery, Kumamoto University Graduate School of Medical Sciences.

Adhesions due to previous upper abdominal surgery may complicate later liver transplantation. Here we report successful living donor liver transplantation (LDLT) in a patient with a history of total gastrectomy. A 32-year-old Japanese woman developed end-stage liver failure due to alcoholic cirrhosis. Read More

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http://dx.doi.org/10.5582/bst.2019.01037DOI Listing
April 2019
2 Reads

Sepsis Management with a Blood Purification Membrane: European Experience.

Blood Purif 2019 12;47 Suppl 3:1-9. Epub 2019 Apr 12.

Baxter, Baxter Deutschland GmbH, Unterschleissheim, Germany.

Background: Septic shock is a leading cause of acute kidney injury (AKI). Endotoxins and cytokine levels are associated with the occurrence and severity of AKI, and different blood purification devices are available to remove them from circulation. One such device, oXiris, is a hollow-fibre purification filter that clears both endotoxins and cytokines. Read More

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http://dx.doi.org/10.1159/000499355DOI Listing

oXiris® Use in Septic Shock: Experience of Two French Centres.

Blood Purif 2019 12;47 Suppl 3:1-7. Epub 2019 Apr 12.

Anaesthesia and Critical Care Medicine Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.

Background: Sepsis is a dysregulated host response to an infection and can result in organ dysfunctions and death. Extracorporeal blood purification techniques aim to improve the prognosis of these patients by modulating the unbalanced immune response. This study reports our experience with the use of the oXiris® membrane for septic shock patients requiring continuous renal replacement therapy (CRRT). Read More

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http://dx.doi.org/10.1159/000499510DOI Listing

Analysis of Endotoxin Adsorption in Two Swedish Patients with Septic Shock.

Blood Purif 2019 12;47 Suppl 3:1-3. Epub 2019 Apr 12.

Perioperative and Intensive Care, Skåne University Hospital, Lund, Sweden.

Background: Lipopolysaccharide (endotoxin) from the outer Gram-negative bacterial wall can induce a harmful immunologic response, involving hemodynamic deprivation, and is one important motor driving the septic cascade. The positively charged poly-imine ethylene layer on the oXiris membrane is capable of adsorbing negatively charged endotoxin molecules and removing them from the blood compartment. Endotoxin is detrimental and should be removed from blood. Read More

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http://dx.doi.org/10.1159/000499546DOI Listing

Continuous Renal Replacement Therapy with the Adsorbing Filter oXiris in Septic Patients: A Case Series.

Blood Purif 2019 12;47 Suppl 3:1-5. Epub 2019 Apr 12.

Cardiac Surgery European Hospital Rome, Rome, Italy.

Background: Extracorporeal treatment may be useful during sepsis, but definitive recommendations are lacking. Aim of this study is to review retrospectively the medical records of septic patients submitted to continuous renal replacement therapy (CRRT) with the adsorbing membrane oXiris and evaluate (1) the safety of the device, (2) the cardiorenal response, and (3) the immunological response.

Materials And Methods: The medical records of 60 septic patients submitted to CRRT with the membrane oXiris from April 2011 to December 2018 have been reviewed. Read More

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http://dx.doi.org/10.1159/000499589DOI Listing

Streptococcal Toxic Shock Syndrome After Insertion of a Levonorgestrel Intrauterine Device.

J Obstet Gynaecol Can 2019 Apr 10. Epub 2019 Apr 10.

Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montréal, QC. Electronic address:

Background: The insertion of intrauterine devices (IUDs) is associated with a small increased risk of pelvic inflammatory disease and ascending infection, particularly in patients with risk factors. However, the risk of sepsis and toxic shock syndrome after insertion of an IUD is a rare event, described only through case reports in the literature.

Case: This report describes the case of a 40-year-old woman who presented with high fever, myalgias, and abdominal pain 2 days following the insertion of a levonorgestrel-releasing IUD. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S17012163193009
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http://dx.doi.org/10.1016/j.jogc.2019.02.017DOI Listing
April 2019
1 Read

Efficacy and safety of Shenfu injection for septic shock: A systematic review and meta-analysis of randomized controlled trials.

Am J Emerg Med 2019 Apr 5. Epub 2019 Apr 5.

Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China; Capital Medical University, Beijing 100010, China; Beijing institute of Traditional Chinese Medicine, Beijing 100010, China; Beijing Key Laboratory of Basic Research with Traditional Chinese Medicine on Infectious Diseases, Beijing 100010, China. Electronic address:

Objective: To evaluate the efficacy and safety of Shenfu injection (SFI) combined with standard therapy versus standard therapy for septic shock, three groups of patients with septic shock were analyzed based on the level of mean arterial lactate. They were mean arterial lactate level < 4.5 mmol/L, 4. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.032DOI Listing

ERK1/2 mediates the lipopolysaccharide-induced upregulation of FGF-2, uPA, MMP-2, MMP-9 and cellular migration in cardiac fibroblasts.

Chem Biol Interact 2019 Apr 11;306:62-69. Epub 2019 Apr 11.

Department of Biotechnology, Asia University, Taichung, Taiwan; College of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan; Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan. Electronic address:

Myocardial fibrosis is a critical event during septic shock. Upregulation in the fibrosis signaling cascade proteins such as fibroblast growth factor (FGF), urokinase plasminogen activator (uPA), tissue plasminogen activator (tPA) and activation of matrix metalloproteinases (MMPs) are widely associated with the development of myocardial infarction, dilated cardiomyopathy, cardiac fibrosis and heart failure. However, evidences suggest that the common upstream mediators of fibrosis cascade play little role in cardiac fibrosis induced by LPS; further, it is unknown if LPS directly triggers the expressions and/or activity of FGF-2, uPA, tPA, MMP-2 and MMP-9 in cardiac fibroblasts. Read More

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http://dx.doi.org/10.1016/j.cbi.2019.04.010DOI Listing

Synthetic Anti-lipopolysaccharide Peptides (SALPs) as Effective Inhibitors of Pathogen-Associated Molecular Patterns (PAMPs).

Adv Exp Med Biol 2019 ;1117:111-129

Brandenburg Antiinfektiva GmbH, c/o Forschungszentrum Borstel, Borstel, Germany.

Antimicrobial peptides (AMPs) are in the focus of scientific research since the 1990s. In most cases, the main aim was laid on the design of AMP to kill bacteria effectively, with particular emphasis on broadband action and independency on antibiotic resistance. However, so far no approved drug on the basis of AMP has entered the market. Read More

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http://link.springer.com/10.1007/978-981-13-3588-4_8
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http://dx.doi.org/10.1007/978-981-13-3588-4_8DOI Listing
January 2019
3 Reads

Clinical characteristics of patients with polymicrobial septic arthritis.

Eur J Clin Microbiol Infect Dis 2019 Apr 13. Epub 2019 Apr 13.

Azrieli Faculty of Medicine, Bar-ilan University, Ramat Gan, Israel.

Little is known about the incidence, risk factors, clinical characteristics, and outcomes of patients with polymicrobial SA (PMSA). We aimed to determine the unique characteristics of patients with PMSA by comparing them to patients with monomicrobial SA (MMSA). We conducted a retrospective cohort study of patients 18 years and older admitted to a single tertiary care medical center, between 1998 and 2015, with surgically treated culture-positive SA affecting one or more joints. Read More

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http://dx.doi.org/10.1007/s10096-019-03557-4DOI Listing

Infections Caused by Group C and G Streptococcus ( subsp. and Others): Epidemiological and Clinical Aspects.

Authors:
Gio J Baracco

Microbiol Spectr 2019 03;7(2)

University of Miami Miller School of Medicine and Miami Veterans Affairs Healthcare System, Miami, FL 33125.

Streptococci carrying serogroup C and G antigens, and in particular, subsp. (SDSE), are emerging human pathogens that are increasingly isolated from patients with a myriad of infections that range from mundane to life-threatening. SDSE is microbiologically similar to . Read More

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http://dx.doi.org/10.1128/microbiolspec.GPP3-0016-2018DOI Listing

Mediterranean spotted fever as a cause of septic shock.

IDCases 2019 21;15:e00528. Epub 2019 Mar 21.

Department of Infectious Diseases, Fattouma Bourguiba Hospital, Monastir, Tunisia.

Mediterranean spotted fever is a generally benign disease but with the potential of serious manifestations. We report a case of Mediterranean spotted fever in a 56-year-old woman, with pet dog exposure, who presented with a septic shock pattern. Based on clinical symptoms, history, and laboratory results, the diagnosis of Mediterranean spotted fever was suspected and the outcome was favorable with doxycycline treatment. Read More

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http://dx.doi.org/10.1016/j.idcr.2019.e00528DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441820PMC
March 2019
8 Reads

Influenza-associated septic shock accompanied by septic cardiomyopathy that developed in summer and mimicked fulminant myocarditis.

Acute Med Surg 2019 Apr 10;6(2):192-196. Epub 2019 Feb 10.

The Emergency and Critical Care Center Mie University Hospital Tsu Mie Japan.

Case: Fulminant myocarditis (FM) and septic cardiomyopathy (SC) are two different disease entities, and distinction between them is important. A 34-year-old man had refractory shock, multiple organ failure, and elevation of cardiogenic markers. Echocardiogram showed tachycardia with extended ST elevation, and a rapid test for influenza A virus was positive. Read More

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https://onlinelibrary.wiley.com/doi/abs/10.1002/ams2.394
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http://dx.doi.org/10.1002/ams2.394DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442530PMC
April 2019
4 Reads

Hemodynamic efficiency of hemodialysis treatment with high cut-off membrane during the early period of post-resuscitation shock: The HYPERDIA trial.

Resuscitation 2019 Apr 8. Epub 2019 Apr 8.

Medical Intensive Care Unit, Cochin University Hospital, APHP, Paris, France; Paris Descartes University, Sorbonne Paris Cité-Medical School, Paris, France; Sudden Death Expertise Centre, INSERM U970 (team 4), Paris Cardiovascular Research Centre, Paris, France. Electronic address:

Background: After resuscitation of cardiac arrest (CA), an acute circulatory failure occurs in about 50% of cases, which shares many characteristics with septic shock. Most frequently, supportive treatments are poorly efficient to prevent multiple organ failure and death. We evaluated whether an early plasma removal of inflammatory mediators using high cut-off continuous veno-venous hemodialysis (HCO-CVVHD) could improve hemodynamic status and outcome of these patients. Read More

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http://dx.doi.org/10.1016/j.resuscitation.2019.03.045DOI Listing
April 2019
2 Reads

Septic shock among patients with systemic lupus erythematosus: short and long-term outcome. Analysis of a French nationwide database.

J Infect 2019 Apr 8. Epub 2019 Apr 8.

APHP Medical and infectious diseases ICU Bichat hospital, F75018, Paris.

Objectives: We aimed to assess the characteristics, outcomes and costs of septic shock complicating Systemic Lupus Erythematosus (SLE).

Methods: Characteristics of SLE patients experiencing a septic shock in France from 2010 to 2015 were analyzed through the French medico-administrative database. Factors associated with the 1-year post-admission mortality were analyzed, the crude 1-year survival of SLE patients experiencing septic shock was compared to those admitted for another reason, and we compared the 1-year outcome associated with SLE septic shock survival to a matched SLE ICU control population. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S01634453193011
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http://dx.doi.org/10.1016/j.jinf.2019.04.005DOI Listing
April 2019
5 Reads

Efficacy of continuous renal replacement on acute renal injury developed in severe sepsis.

J Biol Regul Homeost Agents 2019 Mar-Apr;33(2):525-530

Department of Nephrology, The Second Affiliated Hospital of Mudanjiang Medical University, MudanJiang, Heilongjiang, China.

Sepsis is a systemic inflammatory response that can further develop into severe sepsis (septic shock), which eventually leads to multiple organ dysfunction syndrome (MODS). This study aimed to assess the effects of continuous renal replacement therapy (CRRT) on acute renal injury caused by severe sepsis by monitoring biochemical parameters. A total of 60 patients with septic shock and acute kidney injury were included. Read More

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April 2019
1 Read

A Cohort Study of the Impact of Carbapenem-Resistant Infections on Mortality of Patients Presenting with Sepsis.

mSphere 2019 04 10;4(2). Epub 2019 Apr 10.

Infectious Diseases Service, Hospital São Lucas da PUCRS, Porto Alegre, Brazil

The objective of this study is to evaluate the impact of carbapenem-resistant (CRE) infection on sepsis 30-day mortality. A retrospective cohort of patients >18 years old with sepsis and organ dysfunction or septic shock was conducted. Univariate analysis was done for variables potentially related to 30-day mortality, and the ones with values of <0. Read More

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http://msphere.asm.org/lookup/doi/10.1128/mSphere.00052-19
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http://dx.doi.org/10.1128/mSphere.00052-19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458433PMC
April 2019
2 Reads

Vitamin C, Hydrocortisone, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Analysis of Real-World Application.

J Clin Med 2019 Apr 9;8(4). Epub 2019 Apr 9.

Department of Pharmacy Practice, Loma Linda University School of Pharmacy, 24745 Stewart Street, Loma Linda, CA 92350, USA.

A recent study suggested mortality benefits using vitamin C, hydrocortisone, and thiamine combination therapy (triple therapy) in addition to standard care in patients with severe sepsis and septic shock. In order to further evaluate the effects of triple therapy in real-world clinical practice, we conducted a retrospective observational cohort study at an academic tertiary care hospital. A total of 94 patients (47 in triple therapy group and 47 in standard care group) were included in the analysis. Read More

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https://www.mdpi.com/2077-0383/8/4/478
Publisher Site
http://dx.doi.org/10.3390/jcm8040478DOI Listing
April 2019
2 Reads

Refeeding Syndrome as a Possible Cause of Very Early Mortality in Acute Pancreatitis.

Gut Liver 2019 Feb 27. Epub 2019 Feb 27.

Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.

Background/aims: : The incidence and cause of early mortality in acute pancreatitis (AP) arenot fully understood. Refeeding syndrome (RFS) is a fatal clinical complication that can occuras a result of fluid and electrolyte shifts during early nutritional rehabilitation for malnourishedpatients. This study was conducted to determine the clinical implications of RFS in patientswith AP. Read More

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http://dx.doi.org/10.5009/gnl18458DOI Listing
February 2019
3 Reads

Association between site of infection and in-hospital mortality in patients with sepsis admitted to emergency departments of tertiary hospitals in Medellin, Colombia.

Rev Bras Ter Intensiva 2019 Jan-Mar;31(1):47-56

Grupo Académico de Epidemiología Clínica, Universidad de Antioquia - Medellín, Colombia.

Objective: To determine the association between the primary site of infection and in-hospital mortality as the main outcome, or the need for admission to the intensive care unit as a secondary outcome, in patients with sepsis admitted to the emergency department.

Methods: This was a secondary analysis of a multicenter prospective cohort. Patients included in the study were older than 18 years with a diagnosis of severe sepsis or septic shock who were admitted to the emergency departments of three tertiary care hospitals. Read More

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http://dx.doi.org/10.5935/0103-507X.20190011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6443304PMC
August 2018
1 Read

[Update on the use of steroids in infectious diseases].

Rev Med Suisse 2019 Apr;15(646):792-796

Service des maladies infectieuses, HUG, 1211 Genève 14.

It is well established in daily clinical practice, on the basis of randomized studies, to add corticosteroïds to the antibiotherapy in cases of S. pneumoniae H. influenzae meningitis, tuberculous meningitis and Pneumocystis jiroveci pneumonia in HIV patients. Read More

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April 2019
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[Animal and human bites : what to do and what to know ?]

Rev Med Suisse 2019 Apr;15(646):780-785

Service des maladies infectieuses, HUG, 1211 Genève 14.

Animal and human bites are a common cause of admission to the emergency room and the infections are common, although they are often trivialized. Complications can range from simple cellulitis to septic shock especially in asplenic patients with Capnoyctophaga canimorsus infection. Other less common infections are possible such as rat-bite fever, leptospirosis, tularemia, and evaluation of post-exposure prophylaxis (anti-tetanus, anti-rabies, HIV, HBV) is essential. Read More

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April 2019
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Initial clinical outcomes and prognostic variables in the implementation of a Code Sepsis in a high complexity University Hospital.

Rev Esp Quimioter 2019 Apr 9. Epub 2019 Apr 9.

Fernando Ramasco, Anesthesiology and Surgical Critical Care Departament, University Hospital of La Princesa, C/ Diego de León 62, Madrid, 28006, Spain.

Objective: To assess the impact of the first months of application of a Code Sepsis in a high complexity hospital, analyzing patient´s epidemiological and clinical characteristics and prognostic factors.

Methods: A long-term observational study was carried out throughout a consecutive period of seven months (February 2015 - September 2015). The relationship with mortality of risk factors, and analytic values was analyzed using uni- and multivariate analyses. Read More

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April 2019
5 Reads

Target attainment of cefotaxime in critically ill children with meningococcal septic shock as a model for cefotaxime dosing in severe pediatric sepsis.

Eur J Clin Microbiol Infect Dis 2019 Apr 9. Epub 2019 Apr 9.

Department of Pharmacology-Toxicology, Radboudumc, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.

Reduced target attainment of β-lactam antibiotics is reported in critically ill patients. However, as target attainment of cefotaxime in severely ill pediatric sepsis patients may differ from adults due to age-related variation in pharmacokinetics, we aimed to assess target attainment of cefotaxime in this pilot study using meningococcal septic shock patients as a model for severe sepsis. Secondary analysis of prospectively collected data from a randomized controlled trial. Read More

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http://dx.doi.org/10.1007/s10096-019-03535-wDOI Listing
April 2019
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The shape change index (SCI) of inferior vena cava (IVC) measuring by transabdominal ultrasound to predict the presence of septic shock in intensive care unit (ICU) patients.

Eur Rev Med Pharmacol Sci 2019 Mar;23(6):2505-2512

Department of Intensive Care Unit, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, P.R. China.

Objective: This study is designed as prospective and observational research of patients with sepsis. It was carried out in the intensive care unit (ICU). We investigated the shape change index (SCI) of inferior vena cava (IVC) measured with trans-abdominal ultrasound to detect the signs of septic shock. Read More

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http://dx.doi.org/10.26355/eurrev_201903_17398DOI Listing
March 2019
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Sepsis in the emergency department: key points, controversies, and proposals for improvements in Latin America.

Emergencias 2019 Abr;31(2):123-135

Sociedad Mexicana de Medicina de Emergencia A.C., México. Unidad de Cuidados Intensivos Adultos. Hospital Juárez de México. México D.F., México.

En: Although infection rates and the impact of infection on hospital emergency departments (EDs) are known or can be reliably estimated, the incidence and prevalence of sepsis vary in relation to which definitions or registers used. Sepsis is also well known to be under-diagnosed by physicians in general and by ED physicians in particular. Over half of sepsis cases are community-acquired, and 50% to 60% of patients in intensive care units (ICUs) with sepsis or septic shock are admitted directly from the ED. Read More

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April 2019
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Innate immunity to intracellular LPS.

Nat Immunol 2019 Apr 8. Epub 2019 Apr 8.

National Institute of Biological Sciences, Beijing, China.

Monitoring of the cytosolic compartment by the innate immune system for pathogen-encoded products or pathogen activities often enables the activation of a subset of caspases. In most cases, the cytosolic surveillance pathways are coupled to activation of caspase-1 via canonical inflammasome complexes. A related set of caspases, caspase-11 in rodents and caspase-4 and caspase-5 in humans, monitors the cytosol for bacterial lipopolysaccharide (LPS). Read More

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http://dx.doi.org/10.1038/s41590-019-0368-3DOI Listing
April 2019
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Norepinephrine and Vasopressin Compared With Norepinephrine and Epinephrine in Adults With Septic Shock.

Ann Pharmacother 2019 Apr 8:1060028019843664. Epub 2019 Apr 8.

1 Rush University Medical Center, Chicago, IL, USA.

Background: The optimal adjuvant vasopressor to norepinephrine in septic shock remains controversial.

Objective: To compare durations of shock-free survival between adjuvant vasopressin and epinephrine.

Methods: A retrospective, single-center, matched cohort study of adults with septic shock refractory to norepinephrine was conducted. Read More

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http://dx.doi.org/10.1177/1060028019843664DOI Listing
April 2019
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Transient Systolic Anterior Motion of the Anterior Mitral Valve Leaflet in a Critical Care Patient with a Structurally Normal Heart.

Cureus 2019 Jan 25;11(1):e3963. Epub 2019 Jan 25.

Internal Medicine, Abington Memorial Hospital, Abington, USA.

Systolic anterior motion (SAM) is defined as the displacement of the anterior mitral leaflet towards the left ventricular outflow tract, which results in left ventricular outflow tract obstruction (LVOTO). The SAM of the anterior mitral leaflet is a well-established phenomenon in hypertrophic obstructive cardiomyopathy (HOCM), but its occurrence in a structurally healthy heart is uncommon. We present a critical care patient with presumed septic shock whose blood pressure was previously controlled by fluid resuscitation and vasopressors. Read More

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http://dx.doi.org/10.7759/cureus.3963DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6438412PMC
January 2019
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Correlations of Changes in Brain Natriuretic Peptide (BNP) and Cardiac Troponin I (cTnI) with Levels of C-Reactive Protein (CRP) and TNF-α in Pediatric Patients with Sepsis.

Med Sci Monit 2019 Apr 8;25:2561-2566. Epub 2019 Apr 8.

Department of Pediatrics, The Second People's Hospital of Kashgar, Kashgar, Xinjiang, China (mainland).

BACKGROUND This study investigated the changes in plasma brain natriuretic peptide (BNP) and cardiac troponin I (cTnI) levels in pediatric patients with sepsis, and explored their relationships with serum inflammatory factors in pediatric patients. MATERIAL AND METHODS A total of 120 pediatric patients with sepsis admitted to and treated at our hospital from 2013 to 2017 were divided into 4 groups: a systemic inflammatory response syndrome (SIRS) group (n=28), a sepsis group (n=35), a severe sepsis group (n=27), and a septic shock group (n=30). Plasma BNP, cTnI, and creatine kinase-MB (CK-MB) levels in pediatric patients in the 4 groups were measured, and the correlations of BNP and cTnI with plasma inflammatory factors C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-alpha) were investigated. Read More

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http://dx.doi.org/10.12659/MSM.912318DOI Listing
April 2019
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The Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) Protocol: a prospective, multi-center, double-blind, adaptive sample size, randomized, placebo-controlled, clinical trial.

Trials 2019 Apr 5;20(1):197. Epub 2019 Apr 5.

Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University, Atlanta, GA, USA.

Background: Sepsis accounts for 30% to 50% of all in-hospital deaths in the United States. Other than antibiotics and source control, management strategies are largely supportive with fluid resuscitation and respiratory, renal, and circulatory support. Intravenous vitamin C in conjunction with thiamine and hydrocortisone has recently been suggested to improve outcomes in patients with sepsis in a single-center before-and-after study. Read More

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http://dx.doi.org/10.1186/s13063-019-3254-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451231PMC

Role of vimentin in modulating immune cell apoptosis and inflammatory responses in sepsis.

Sci Rep 2019 Apr 5;9(1):5747. Epub 2019 Apr 5.

Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.

New diagnostic biomarkers or therapeutic targets for sepsis have substantial significance for critical care medicine. In this study, 192 differentially expressed proteins were selected through iTRAQ. Based on cluster analysis of protein expression dynamics and protein-protein interactions, hemopexin, vimentin, and heat shock protein 90 were selected for further investigation. Read More

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http://dx.doi.org/10.1038/s41598-019-42287-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451033PMC
April 2019
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Necrotizing fasciitis of the neck and head complicated with chronic osteomyelitis: Case report presentation.

Int J Surg Case Rep 2019 Mar 26. Epub 2019 Mar 26.

Hospital Angeles del Pedregal, Mexico; Hospital Infantil de México Federico Gómez, Mexico.

Introduction: Necrotizing fasciitis (NF) is a severe infectious condition associated with significant morbidity and mortality and characteristically has a higher incidence in adults; pediatric cases are very rare. In this case report we describe, the clinical presentation, management and outcome of a patient with necrotizing fasciitis of the neck and head complicated with chronic osteomyelitis.

Presentation Of The Case: An 18 month-old, latin, male, diagnosed with rickets and Crouzon syndrome, twenty-four hours post- craniofacial remodeling surgery presented tissue edema, indurated skin and violaceous and well delimited lesions in the neck and head. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S22102612193014
Publisher Site
http://dx.doi.org/10.1016/j.ijscr.2019.03.025DOI Listing
March 2019
3 Reads