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    Healthcare-Associated Pneumonia and Hospital-Acquired Pneumonia: Bacterial Aetiology, Antibiotic Resistance and Treatment Outcomes: A Study From North India.
    Lung 2018 Apr 25. Epub 2018 Apr 25.
    Department of Internal Medicine (Pulmonary Medicine), Sher I Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu and Kashmir, 190001, India.
    Background: Data regarding the comparative profiling of HCAP and HAP from developing countries like India are scant. We set out to address the microbial aetiology, antibiotic resistance and treatment outcomes in patients with HCAP and HAP.

    Methods: 318 consenting patients with HCAP (n = 165, aged 16-90 years; median 60 years; 97 males) or HAP (n = 153; aged 16-85 years; median 45 years; 92 males) presenting to a tertiary care hospital in North India from 2013 to 2015 were prospectively recruited for the study. Read More

    [Current status of diagnosis and treatment of community-acquired pneumonia in Shanghai revealed by a questionnaire analysis].
    Zhonghua Jie He He Hu Xi Za Zhi 2018 Apr;41(4):288-295
    Department of Respiratory and Critical Care Medicine, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai 200433, China.
    To understand the current status of diagnosis and treatment of community-acquired pneumonia (CAP) among doctors in various hospitals across Shanghai, for the purpose of promoting the 2016 clinical practice guidelines for adult CAP of China. A questionnaire was designed to address the common questions in CAP management. The responses were collected via WeChat and the data were analyzed. Read More

    Adipose Tissue Lactate Clearance but Not Blood Lactate Clearance Is Associated with Clinical Outcome in Sepsis or Septic Shock during the Post-Resuscitation Period.
    Metabolites 2018 Apr 21;8(2). Epub 2018 Apr 21.
    First Department of Critical Care Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, Medical School, Athens 10676, Greece.
    No study has directly measured tissue lactate clearance in patients with sepsis during the post-resuscitation period. In this study we aimed to assess in ICU patients with sepsis ( = 32) or septic shock ( = 79)—during the post-resuscitation phase—the relative kinetics of blood/tissue lactate clearances and to examine whether these are associated with outcome. We measured serially—over a 48-h period—blood and adipose tissue interstitial fluid lactate levels (with microdialysis) and we calculated lactate clearance. Read More

    When All Else Fails: Novel Use of Angiotensin II for Vasodilatory Shock: A Case Report.
    A A Pract 2018 Apr 23. Epub 2018 Apr 23.
    Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
    Angiotensin (AT) II is an endogenous hormone that acts on venous and arterial smooth muscle to cause vasoconstriction. Recent trials have sparked great interest in its ability to be used as a vasopressor for catecholamine-refractory hypotension. Herein, we describe the successful use of AT II in a patient with a colonic perforation with septic shock refractory to conventional treatment. Read More

    Early goal-directed therapy using a physiological holistic view: the ANDROMEDA-SHOCK-a randomized controlled trial.
    Ann Intensive Care 2018 Apr 23;8(1):52. Epub 2018 Apr 23.
    Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile.
    Background: Septic shock is a highly lethal condition. Early recognition of tissue hypoperfusion and its reversion are key factors for limiting progression to multiple organ dysfunction and death. Lactate-targeted resuscitation is the gold-standard under current guidelines, although it has several pitfalls including that non-hypoxic sources of lactate might predominate in an unknown proportion of patients. Read More

    Chromobacterium violaceum: The Deadly Sepsis.
    Acta Med Indones 2018 Jan;50(1):80-81
    Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran-Hasan Sadikin Hospita, Bandung, Indonesia.
    Chromobacterium violaceum is a Gram-negative facultatively anaerobic, oxidase-positive bacterium producing a dark violet antioxidant pigment called violacein. It is an opportunistic pathogen and has an ubiquitous distribution, mainly resides in water and soil of tropical and subtropical regions.An-18-year-old man referred to the emergency room with a 5-day history of progressively worsening swelling of the right cheek. Read More

    Assessment of antimicrobiral prophylaxis in transperineal prostate biopsy: A single-center retrospective study of 485 cases.
    J Infect Chemother 2018 Apr 20. Epub 2018 Apr 20.
    Department of Urology, Gunma University Hospital, Japan.
    To verify the validity of our antimicrobial prophylaxis regimen for transperineal prostate biopsies, we investigated the rate of infectious complications in this procedure. We retrospectively investigated the infectious complications in 485 patients who underwent a transperineal prostate biopsy between 2014 and 2016 at our hospital. In the clinic, we use cefazolin (CEZ) for antimicrobial prophylaxis. Read More

    Phenotypic and genotypic characteristics of Staphylococcus aureus isolates from zoo and wild animals.
    Vet Microbiol 2018 May 20;218:98-103. Epub 2018 Mar 20.
    Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut (FLI), Neustadt-Mariensee, Germany; Institute of Microbiology and Epizootics, Centre for Infection Medicine, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
    Antimicrobial resistance of Staphylococcus aureus is a major problem in human and veterinary medicine. The aim of this study was to characterise S. aureus isolates from wild and zoo animals mainly associated with bacterial infections. Read More

    Genotypic identification of staphylococcal enterotoxins and toxic shock syndrome toxin 1 by the enzymatic detection of polymerase chain reaction-amplified DNA.
    J Infect Chemother 1996 5;2(2):90-93. Epub 2014 Apr 5.
    Department of Clinical Pathology, School of Medicine, Teikyo University, Tokyo, Japan.
    The enzymatic detection of a polymerase chain reaction product (ED-PCR), a new detection method of PCR-amplified DNA, was evaluated for the identification of staphylococcal enterotoxin (SE) and toxic shock syndrome toxin 1 (TSST-1) genes. A total of 61 Staphylococcus aureus strains, including reference strains and strains isolated from clinical specimens and food poisoning outbreaks, were examined by ED-PCR and by reverse passive latex agglutination (RPLA) phenotypic identification. There was 100% agreement between the genotypic and phenotypic identification of SEA, SEB, SEC, SEE strains and TSST-1. Read More

    Vitamin C for the treatment of sepsis: The scientific rationale.
    Pharmacol Ther 2018 Apr 21. Epub 2018 Apr 21.
    Division of Pulmonary and Critical Care Medicine, Eastern Virginia Medical School, 825 Fairfax Ave, Suite 410, Norfolk, VA 23517, USA. Electronic address:
    Most vertebrates can synthesize vitamin C with synthesis increasing during stress. Humans, however, have lost the ability to synthesize vitamin C. Vitamin C is an important anti-oxidant and an enzyme cofactor for many important biological reactions. Read More

    Fluid therapy and shock: an integrative literature review.
    Br J Nurs 2018 Apr;27(8):449-454
    Assistant Teacher, Portuguese Catholic University, Lisbon, Portugal.
    Background: shock refers to a physiological situation that puts life at risk. Its early identification and the timely institution of therapeutic measures can avoid death. Despite the frequent administration of fluid therapy as a treatment for shock, the type and dose of fluids to be delivered remain undetermined. Read More

    High-Frequency Percussive Ventilation Rescue Therapy in Morbidly Obese Patients Failing Conventional Mechanical Ventilation.
    J Intensive Care Med 2018 Jan 1:885066618769596. Epub 2018 Jan 1.
    4 Department of Cardiothoracic Surgery, Staten Island University Hospital, Staten Island, NY, USA.
    Background: Morbidly obese patients with respiratory failure who do not improve on conventional mechanical ventilation (CMV) often undergo rescue therapy with extracorporeal membrane oxygenation (ECMO). We describe our experience with high-frequency percussive ventilation (HFPV) as a rescue modality.

    Methods: In a retrospective analysis from 2009 to 2016, 12 morbidly obese patients underwent HFPV after failing to wean from CMV. Read More

    Fatal Pneumococcus Sepsis after Treatment of Late Antibody-Mediated Kidney Graft Rejection.
    Case Rep Nephrol 2018 28;2018:1415450. Epub 2018 Feb 28.
    Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.
    Antibody-mediated rejection (ABMR) is a major cause of late renal allograft dysfunction and graft loss. Risks and benefits of treatment of late ABMR have not been evaluated in randomized clinical trials. We report on a 35-year-old patient with deterioration in renal function and progressive proteinuria 15 years after transplantation. Read More

    Bedside Endoscopic Retrograde Cholangiopancreatography Using Portable X-Ray in Acute Severe Cholangitis.
    Case Rep Gastrointest Med 2018 28;2018:8763671. Epub 2018 Feb 28.
    Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA, USA.
    Patients with acute cholangitis require emergent biliary decompression. Those who are hemodynamically unstable on vasopressor support and mechanical ventilation are too critically ill to move outside of the intensive care unit. This prohibits performing Endoscopic Retrograde Cholangiopancreatography (ERCP) in the endoscopy unit. Read More

    Transduced PEP-1-Heme Oxygenase-1 Fusion Protein Attenuates Lung Injury in Septic Shock Rats.
    Oxid Med Cell Longev 2018 27;2018:6403861. Epub 2018 Feb 27.
    Department of Anesthesiology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, China.
    Oxidative stress and inflammation have been identified to play a vital role in the pathogenesis of lung injury induced by septic shock. Heme oxygenase-1 (HO-1), an effective antioxidant and anti-inflammatory and antiapoptotic substance, has been used for the treatment of heart, lung, and liver diseases. Thus, we postulated that administration of exogenous HO-1 protein transduced by cell-penetrating peptide PEP-1 has a protective role against septic shock-induced lung injury. Read More

    Application of the new Sepsis-3 definition in a cohort of patients with severe sepsis and septic shock admitted to Intensive Care Unit from the Emergency Department.
    Med Clin (Barc) 2018 Apr 18. Epub 2018 Apr 18.
    Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España.
    Background And Objectives: After the publication of the new definition for sepsis and septic shock, our objective is to analyse the evolution of patients admitted to ICU with an infection process using the previous and new recommendations.

    Materials And Methods: This is a sub-analysis of a previous observational prospective study. We included 98 patients admitted to ICU from the emergency department due to infection during an 18-month period. Read More

    Impact of currently marketed tampons and menstrual cups on growth and TSST-1 production in vitro.
    Appl Environ Microbiol 2018 Apr 20. Epub 2018 Apr 20.
    CIRI, Centre International de Recherche en Infectiologie, Inserm U1111, Université Lyon 1, Ecole Normale Supérieure de Lyon, CNRS UMR 5308, Lyon, France
    Fifteen currently marketed intravaginal protection products (11 types of tampon and four menstrual cups) were tested by the modified tampon sac method to determine their effect on growth and toxic shock toxin 1 (TSST-1) production. Most tampons reduced growth and TSST-1 production, with differences based on brand and composition, and growth was higher in de-structured than in unaltered tampons. We observed higher growth and toxin production in menstrual cups than in tampons, potentially due to the additional air introduced to the bag by cups, with differences based on cup composition and size. Read More

    Simplification of first-line antibacterial regimen for complicated appendicitis in children was associated with better adherence to guidelines, and reduced use of antibiotics.
    Int J Antimicrob Agents 2018 Apr 17. Epub 2018 Apr 17.
    Infectious Diseases and Intensive Care Unit, Rennes University Hospital, France. Electronic address:
    Acute appendicitis in children requires early surgery, and a short course of antibiotics active on Enterobacteriaceae and anaerobes. Although aminoglycoside-containing 3-drug regimen have been used successfully for decades, simpler regimens with similar efficacy are increasingly used. We aimed to evaluate the impact of a switch from the combination of cefotaxime, metronidazole, and gentamicin (regimen 1), to piperacillin-tazobactam (regimen 2), as first-line regimen for complicated acute appendicitis in children. Read More

    Evolution of Acute Kidney Injury and Its Association With Systemic Hemodynamics in Children With Fluid-Refractory Septic Shock.
    Crit Care Med 2018 Apr 19. Epub 2018 Apr 19.
    Department of Primary Care and Public Health Sciences & NIHR Biomedical Research Centre, Guy's and St Thomas' NHS Foundation Trust, King's College London, London, United Kingdom.
    Objectives: There are no studies in pediatrics evaluating the progression of acute kidney injury in septic shock. We investigated the evolution of sepsis-associated acute kidney injury and its association with systemic hemodynamics in children with fluid-refractory septic shock.

    Design: Prospective cohort study. Read More

    Poor Compliance with Sepsis Guidelines in a Tertiary Care Children's Hospital Emergency Room.
    Front Pediatr 2018 5;6:53. Epub 2018 Apr 5.
    Baylor College of Medicine, Houston, TX, United States.
    Objectives: This study aimed to assess factors related to adherence to the Pediatric Advanced Life Support guidelines for severe sepsis and septic shock in an emergency room (ER) of a tertiary care children's hospital.

    Methods: This was a retrospective, observational study of children (0-18 years old) in The Children's Hospital of San Antonio ER over 1 year with the International Consensus Definition Codes, version-9 (ICD-9) diagnostic codes for "severe sepsis" and "shocks." Patients in the adherent group were those who met all three elements of adherence: (1) rapid vascular access with at most one IV attempt before seeking alternate access (unless already in place), (2) fluids administered within 15 min from sepsis recognition, and (3) antibiotic administration started within 1 h of sepsis recognition. Read More

    Livedo reticularis: a cutaneous clue to an underlying endocrine crisis.
    Endocrinol Diabetes Metab Case Rep 2018 12;2018. Epub 2018 Apr 12.
    Department of Diabetes and Endocrinology, Royal Glamorgan Hospital, Llantrisant, UK.
    A 54-year-old woman was admitted to hospital with a presumed allergic reaction to a single dose of amoxicillin given for a suspected upper respiratory tract infection. She complained of chest tightness although there was no wheeze or stridor. On examination, she was pyrexial, tachycardic, hypertensive and had a diffuse mottled rash on her lower limbs. Read More

    Extended Sessions of Polymyxin-B Immobilized Fiber Column Hemoperfusion Ameliorate Renal Outcome and Mortality in Septic Shock with Acute Kidney Injury.
    Blood Purif 2018 Apr 19;46(2):81-89. Epub 2018 Apr 19.
    Department of Nephrology, Toshiba General Hospital, Tokyo, Japan.
    Background/aims: Polymyxin-B (PMX) treatment has been reported to decrease mortality in patients with septic shock and acute kidney injury (AKI). In this study, we aimed to evaluate whether extended sessions of PMX (Ext-PMX) immobilized fiber column hemoperfusion ameliorate clinical outcomes in patients complicated with septic shock and AKI without surgical control.

    Methods: Twenty-two patients with nonsurgical septic shock and AKI who received PMX were included. Read More

    Empyema Thoracis: A Community-Acquired Infection Requiring a High Index of Suspicion.
    Case Rep Infect Dis 2018 18;2018:8039803. Epub 2018 Feb 18.
    Department of Pulmonary Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA.
    Empyema thoracis is a serious condition characterized by the accumulation of purulent fluid in the pleural cavity, typically following a pneumonia, subdiaphragmatic abscess, or esophageal rupture. Fungal empyema thoracis is a rare form of this condition with especially high mortality, in which the most frequently isolated fungus is spp. This article presents a 74-year-old female with pneumonia and a complicated hospital course, initially presenting with nausea, vomiting, and dysphagia. Read More

    Clostridium sordellii outer spore proteins maintain spore structural integrity and promote bacterial clearance from the gastrointestinal tract.
    PLoS Pathog 2018 Apr 18;14(4):e1007004. Epub 2018 Apr 18.
    Infection and Immunity Program, Monash Biomedicine Discovery Institute and Department of Microbiology, Monash University, Clayton, Victoria, Australia.
    Bacterial spores play an important role in disease initiation, transmission and persistence. In some species, the exosporium forms the outermost structure of the spore and provides the first point of contact between the spore and the environment. The exosporium may also be involved in spore adherence, protection and germination. Read More

    Immunophenotyping of Monocytes During Human Sepsis Shows Impairment in Antigen Presentation: A Shift Toward Nonclassical Differentiation and Upregulation of FcγRi-Receptor.
    Shock 2017 Dec 5. Epub 2017 Dec 5.
    Disciplina de Infectologia e de, Sao Paulo, SP, Brazil.
    Monocytes and macrophages are pivotal in the host response to sepsis, recognizing the infecting microorganism and triggering an inflammatory response. These functions are, at least in part, modulated by the expression of cell surface receptors. We aimed to characterize the monocyte phenotype from septic patients during an ongoing sepsis process and its association with clinical outcomes. Read More

    Aortic Dissection Presenting as Septic Shock: A Case Report and Literature Review.
    Case Rep Emerg Med 2018 14;2018:9706290. Epub 2018 Feb 14.
    Department of Emergency Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China.
    Acute aortic dissection is a life-threatening clinical emergency, which mostly occurs in aged patients and presents with sharp chest pain. In this paper, we reported a case of acute aortic dissection, which induced septic shock in a young woman, without typical chest pain. The septic shock was possibly due to the bacterial translocation caused by aortic dissection-induced intestinal ischemia and intestinal epithelial barrier dysfunction. Read More

    Eustachian Valve Endocarditis: Echocardiographic Diagnosis in a Critical Care Patient.
    Case Rep Crit Care 2018 31;2018:5193976. Epub 2018 Jan 31.
    Hospital Beatriz Ângelo, Unidade de Cuidados Intensivos, Loures, Portugal.
    Eustachian valve endocarditis is rare. A literature review revealed that only 29 cases have been reported and, among them, there is only one mention of an intensive care unit (ICU) admission. We present an 82-year-old man without previous medical records who presented with septic shock with multiple organ dysfunction. Read More

    Predictors of Mortality with Staphylococcus aureus Bacteremia in Elderly Adults.
    J Am Geriatr Soc 2018 Apr 17. Epub 2018 Apr 17.
    Santa Maria Misericordia Hospital and University of Udine, Udine, Italy.
    Objectives: To analyze risk factors for early and late mortality in individuals aged 75 and older with Staphylococcus aureus bacteremia (SAB) in Italy.

    Design: Four-year retrospective observational study (January 2011-December 2014).

    Setting: Two tertiary care university hospitals in Italy (Santa Maria Misericordia Hospital in Udine, Policlinico Universitario Agostino Gemelli in Rome). Read More

    Transfer Status: A Significant Risk Factor for Mortality in Emergency General Surgery Patients Requiring Colon Resection.
    J Trauma Acute Care Surg 2018 Apr 16. Epub 2018 Apr 16.
    Section of General Surgery, Trauma, and Surgical Critical Care, Department of Surgery, Yale School of Medicine, New Haven, Connecticut.
    Background: Patients requiring emergency surgery have increased rates of morbidity and mortality. Transfer from outside institution delays effective control of ongoing infection and has been linked with worse outcomes. Previous research suggests transfer status negatively impacts survival but hasn't examined the effect of location and type of institution prior to transfer. Read More

    Chronic Alcohol Ingestion Worsens Survival and Alters Gut Epithelial Apoptosis and Cd8+ T Cell Function after Pseudomonas Aeruginosa Pneumonia-Induced Sepsis.
    Shock 2018 Apr 16. Epub 2018 Apr 16.
    Department of Surgery and Emory Critical Care Center.
    Mortality is higher in septic patients with a history of alcohol use disorder than in septic patients without a history of chronic alcohol usage. We have previously described a model of chronic alcohol ingestion followed by sepsis from cecal ligation and puncture in which alcohol-fed septic mice have higher mortality than water-fed septic mice, associated with altered gut integrity and increased production of TNF and IFNγ by splenic CD4 T cells without alterations in CD8 T cell function. The purpose of this study was to determine whether this represents a common host response to the combination of alcohol and sepsis by creating a new model in which mice with chronic alcohol ingestion were subjected to a different model of sepsis. Read More

    Phagocytosis by Fibrocytes as a Mechanism to Decrease Bacterial Burden and Increase Survival in Sepsis.
    Shock 2018 Apr 16. Epub 2018 Apr 16.
    Unit for Laboratory Animal Medicine, University of Michigan, Ann Arbor, 48109.
    Fibrocytes are unique cells with innate and adaptive immune functions, but these mechanisms have not been fully explored. The aim of this study was to explain the mechanism by which adoptive transfer of exogenous fibrocytes improved bacterial clearance and increased sepsis survival. Initial flow cytometry-based, in vitro assays demonstrated phagocytosis by fibrocytes and intracellular bacterial killing was confirmed by direct plating of cell lysates after exposure to live bacteria. Read More

    [Risk factors of atrial fibrillation in critical ill patients].
    Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2018 Apr;30(4):337-341
    Guizhou Medical University, Guiyang 550004, Guizhou, China (Fu JY, Xia YS, Fang H); Department of Intensive Care Unit, the Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou, China (Bi HY, Liu X, Tang Y, Wang DF). Corresponding author: Tang Yan, Email:
    Objective: To observe the clinical features of atrial fibrillation (AF) patients, and to explore the correlation between the routine detection index and the new-onset AF and to find out risk factors for new AF in critically ill patients.

    Methods: A prospective observational study was conducted. The patients with AF admitted to intensive care unit (ICU) of the Affiliated Hospital of Guizhou Medical University from March 2016 to June 2017 were enrolled. Read More

    Basis of Virulence in Enterotoxin-Mediated Staphylococcal Food Poisoning.
    Front Microbiol 2018 13;9:436. Epub 2018 Mar 13.
    Pathogen Molecular Genetics Section, Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States.
    The enterotoxins are a superfamily of secreted virulence factors that share structural and functional similarities and possess potent superantigenic activity causing disruptions in adaptive immunity. The enterotoxins can be separated into two groups; the classical (SEA-SEE) and the newer (SEG-SEY and counting) enterotoxin groups. Many members from both these groups contribute to the pathogenesis of several serious human diseases, including toxic shock syndrome, pneumonia, and sepsis-related infections. Read More

    Multilocus Sequence Typing and Virulence-Associated Gene Profile Analysis of Isolates From Retail Ready-to-Eat Food in China.
    Front Microbiol 2018 13;9:197. Epub 2018 Mar 13.
    State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Guangdong Institute of Microbiology, Guangzhou, China.
    The aim of this study was to characterize the subtypes and virulence profiles of 69 isolates obtained from retail ready-to-eat food in China. The isolates were analyzed using multilocus sequence typing (MLST) and polymerase chain reaction (PCR) analysis of important virulence factor genes, including the staphylococcal enterotoxin (SE) genes (, , , , , , , , ), the exfoliative toxin genes ( and ), the toxic shock syndrome toxin-1 gene (), and the Panton-Valentine leucocidin-encoding gene (). The isolates encompassed 26 different sequence types (STs), including four new STs (ST3482, ST3484, ST3485, ST3504), clustered in three clonal complexes and 17 singletons. Read More

    Myeloid cell deficiency of p38γ/p38δ protects against candidiasis and regulates antifungal immunity.
    EMBO Mol Med 2018 Apr 16. Epub 2018 Apr 16.
    Department of Immunology and Oncology, Centro Nacional de Biotecnología/CSIC, Madrid, Spain
    is a frequent aetiologic agent of sepsis associated with high mortality in immunocompromised patients. Developing new antifungal therapies is a medical need due to the low efficiency and resistance to current antifungal drugs. Here, we show that p38γ and p38δ regulate the innate immune response to We describe a new TAK1-TPL2-MKK1-ERK1/2 pathway in macrophages, which is activated by Dectin-1 engagement and positively regulated by p38γ/p38δ. Read More

    Epidemiologic Profile of Patients Transplanted With Hematopoietic Stem Cells in a Reference Service in the State of Rio Grande do Norte, Brazil.
    Transplant Proc 2018 Apr;50(3):819-823
    Nursing Department, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
    Background: Hematopoietic stem cell transplantation (HSCT) consists of the intravenous infusion of healthy hematopoietic stem cells to restore the medullary and immunologic function of patients affected by a series of hematologic, oncologic, immunologic, malignant and nonmalignant inherited or acquired diseases, with the possibility of cure or increase of disease-free survival.

    Objective: To characterize the epidemiologic profile and the cases of death of patients who underwent HSCT.

    Methods: This is a cohort quantitative study, nested with a retrospective, descriptive, and analytical study of a hospital-based cohort that included the patients who underwent HSCT at a referral service in the state of Rio Grande do Norte, a region of northeastern Brazil. Read More

    Lymphocyte subset expression and serum concentrations of PD-1/PD-L1 in sepsis - pilot study.
    Crit Care 2018 Apr 17;22(1):95. Epub 2018 Apr 17.
    Department of Intensive Care Medicine, Guy's and St Thomas' Hospitals NHS Foundation Trust, London, SE1 7EH, UK.
    Background: Sepsis remains a major cause of mortality in critical care, for which specific treatments are lacking. The dysregulated response to infection seen in sepsis includes features of lymphocyte dysfunction and exhaustion, suggesting that immune-stimulatory therapy may improve outcomes in certain patient groups. Monoclonal antibodies targeting checkpoint molecules, such as programmed-death 1 protein (PD-1) and its ligand PD-L1, have shown success in stimulating the immune response in patients with cancer, and are being considered for future sepsis trials. Read More

    How to Deal with the Empty Space after Organ Removal for Transplantation: A Single Medical Center Experience.
    World Neurosurg 2018 Apr 13. Epub 2018 Apr 13.
    Division of General Surgery, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan; Center for General Education, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
    Purpose: Dealing with the empty space after organ removal for transplantation has not been investigated.

    Materials And Methods: From January 28, 2005, to November 21, 2017, 111 organ donors were enrolled in this study. They were divided into three groups: no replacement, replaced with paper printed with organ graphics, or replaced with 3D-printed simulated organs after the organs were removed at different periods. Read More

    The Relationship Between Prevalence of Antibiotics Resistance and Virulence Factors Genes of MRSA and MSSA Strains Isolated from Clinical Samples, West Iran.
    Oman Med J 2018 Mar;33(2):134-140
    Department of Microbiology, Pasteur Institute of Iran, Tehran, Iran.
    Objectives: We sought to evaluate the relationship between the prevalence of antibiotics resistance and virulence factors genes in methicillin-resistant (MRSA) and methicillin-sensitive (MSSA) strains from clinical samples taken in west Iran.

    Methods: We performed a cross-sectional study using 100 MRSA and 100 MSSA samples isolated from clinical specimens. We used biochemical methods to identify the isolates, which were confirmed by the polymerase chain reaction (PCR) assay. Read More

    Epidemiology of sepsis in intensive care units in Turkey: a multicenter, point-prevalence study.
    Crit Care 2018 Apr 16;22(1):93. Epub 2018 Apr 16.
    Department of Anesthesiology, Division of Critical Care, School of Medicine, Ankara University, Ankara, Turkey.
    Background: The prevalence and mortality of sepsis are largely unknown in Turkey, a country with high antibiotic resistance. A national, multicenter, point-prevalence study was conducted to determine the prevalence, causative microorganisms, and outcome of sepsis in intensive care units (ICUs) in Turkey.

    Methods: A total of 132 ICUs from 94 hospitals participated. Read More

    Predictive value of liver damage for severe early complications and survival after heart transplantation: A retrospective analysis.
    Clin Res Hepatol Gastroenterol 2018 Apr 11. Epub 2018 Apr 11.
    Cardiothoracic Surgical Unit, Paris, France.
    Background: Hepatic dysfunction is often associated with advanced heart failure. Its impact on complications following heart transplantation is not well known. We studied the influence of preoperative hepatic dysfunction on the results of heart transplantation with a specific priority access for critical patients. Read More

    Cost of hospitalised patients due to complicated urinary tract infections: a retrospective observational study in countries with high prevalence of multidrug-resistant Gram-negative bacteria: the COMBACTE-MAGNET, RESCUING study.
    BMJ Open 2018 Apr 12;8(4):e020251. Epub 2018 Apr 12.
    UCL Department of Applied Health Research, University College London, London, UK.
    Objective: Complicated urinary tract infections (cUTIs) impose a high burden on healthcare systems and are a frequent cause of hospitalisation. The aims of this paper are to estimate the cost per episode of patients hospitalised due to cUTI and to explore the factors associated with cUTI-related healthcare costs in eight countries with high prevalence of multidrug resistance (MDR).

    Design: This is a multinational observational, retrospective study. Read More

    The early chain of care in bacteraemia patients: Early suspicion, treatment and survival in prehospital emergency care.
    Am J Emerg Med 2018 Apr 5. Epub 2018 Apr 5.
    Skaraborg Hospital, Infection Disease Department, Skövde, Sweden.
    Introduction: Bacteraemia is a first stage for patients risking conditions such as septic shock. The primary aim of this study is to describe factors in the early chain of care in bacteraemia, factors associated with increased chance of survival during the subsequent 28days after admission to hospital. Furthermore, the long-term outcome was assessed. Read More

    RS3PE syndrome developing during the course of probable toxic shock syndrome: a case report.
    BMC Infect Dis 2018 Apr 13;18(1):174. Epub 2018 Apr 13.
    Department of Internal Medicine, Hyogo Prefectural Kaibara Hospital, 5208-1, Kaibara, Kaibara-cho, Tanba, Hyogo, 669-3395, Japan.
    Background: Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare syndrome characterized by "remitting," "seronegative" (namely rheumatoid factor-negative), and "symmetrical" synovitis with pitting edema on the dorsum of the hands and feet. Recently, there have been reports that serum vascular endothelial growth factor (VEGF) is elevated in this condition.

    Case Presentation: An 85-year-old man visited our department with a rash that had appeared 2 days earlier and a fever that had developed on the day of his visit. Read More

    Role of point-of-care ultrasonography for management of sepsis and septic shock.
    Rev Recent Clin Trials 2018 Apr 12. Epub 2018 Apr 12.
    Department of Critical Care Medicine, Medanta the Medicity, Gurgaon, Haryana. India.
    Background: Sepsis and septic shock remain a major cause of morbidity and mortality globally. In recent years, outcome of patients with sepsis and septic shock has gradually improved, in part due to early recognition and timely appropriate management. Bedside physical examination can be of limited value to identify the source of infection and to decide appropriate management. Read More

    Evaluating the effect of growing patient numbers and changing data elements in the national surgical quality improvement program (NSQIP) database over the years: a study of posterior lumbar fusion outcomes.
    Spine J 2018 Apr 9. Epub 2018 Apr 9.
    Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 Howard Avenue, New Haven, CT 06510, USA. Electronic address:
    Background Context: The use of national databases in spinal surgery outcomes research is increasing. A number of variables collected by the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) changed between 2010 and 2011, coinciding with a rapid increase in the number of patients included per year. However, there has been limited study evaluating the effect that these changes may have on the results of outcomes studies. Read More

    Nephrotoxicity of piperacillin-tazobactam combined with vancomycin: Should it be a concern?
    Int J Antimicrob Agents 2018 Apr 9. Epub 2018 Apr 9.
    Hacettepe University Faculty of Medicine, Department of Infectious Disease and Clinical Microbiology, Ankara, Turkey.
    The combination of piperacillin-tazobactam (pip-tazo) and vancomycin provides a wide spectrum of activity against many pathogens acquired in the health-care setting. However, there have been reports of increased potential for nephrotoxicity with this combination. The aim of this study was to evaluate the nephrotoxic effect of pip-tazo plus vancomycin and compare it with that of pip-tazo and vancomycin alone, and meropenem plus vancomycin, another broad-spectrum combination. Read More

    Prevalence of the systemic inflammatory response syndrome in patients who underwent orthognathic surgery.
    Oral Maxillofac Surg 2018 Apr 11. Epub 2018 Apr 11.
    Chief of Oral and Maxillofacial Surgery Department, Brazilian Red Cross Hospital, São Paulo, Brazil.
    Purpose: The systemic inflammatory response syndrome (SIRS) is the body's response to an insult, such as infection, trauma, burn, and surgical stress linked to several factors deemed potential for multiple organ failure if left untreated. Thus, the aim of this paper was a prospective study to examine the incidence of SIRS in postoperative patients who underwent orthognathic surgery from June/2013 to July/2016.

    Methods: The sample consisted of 80 patients who underwent bimaxillary orthognathic surgery, with data on vital signs and white blood cell count collected preoperatively, and the same data collected in the immediate postoperative period, in addition to CO pressure in arterial blood by blood gas analysis. Read More

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