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  1 / 48846 MEDLINE  
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[PMID]:29505508
[Au] Autor:Li W; Cheng X; Guo L; Li H; Sun C; Cui X; Zhang Q; Song G
[Ad] Endereço:Department of ICU, Affiliated Children's Hospital of Capital Institute of Pediatrics.
[Ti] Título:Association between serum 25-hydroxyvitamin D concentration and pulmonary infection in children.
[So] Source:Medicine (Baltimore);97(1):e9060, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We assessed the relationship between serum 25-hydroxyvitamin D (25(OH)D) level and community-acquired pneumonia (CAP) among Chinese children.This observational study examined children aged 3 days to 14 years (n = 1582) from the Capital Institute of Pediatrics in 2009 to 2011. There were 797 children in the CAP group and 785 controls. The CAP group was divided into 2 groups: a pneumonia group and pneumonia-induced sepsis group. The serum 25(OH)D level was estimated using micro whole blood chemiluminescence.The average serum 25(OH)D level in all samples was 25.32 ±â€Š14.07 ng/mL, with the CAP group showing a lower value than the control group (P < .001). There were also significant differences between the pneumonia group and pneumonia-induced sepsis group (P < .001). In the pneumonia-induced sepsis group, significant differences in serum 25(OH)D levels were observed in children who received mechanical ventilation or presenting with multiple organ dysfunction (P < .01).All serum 25(OH)D levels in the pneumonia group and pneumonia-induced sepsis group were below normal levels, particularly in the sepsis group. A lower serum 25(OH)D level was associated with more serious symptoms in CAP children. Children with low serum 25(OH)D levels may be at higher risk of receiving mechanical ventilation and presenting with multiple organ dysfunction. These findings suggest that vitamin D supplements are beneficial for the treatment and prevention of CAP.
[Mh] Termos MeSH primário: Pneumonia/sangue
Deficiência de Vitamina D/complicações
Vitamina D/análogos & derivados
[Mh] Termos MeSH secundário: Adolescente
Estudos de Casos e Controles
Criança
Pré-Escolar
Infecções Comunitárias Adquiridas/sangue
Infecções Comunitárias Adquiridas/etiologia
Feminino
Seres Humanos
Lactente
Recém-Nascido
Masculino
Estado Nutricional
Pneumonia/etiologia
Curva ROC
Estações do Ano
Sepse/sangue
Sepse/etiologia
Vitamina D/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
1406-16-2 (Vitamin D); 64719-49-9 (25-hydroxyvitamin D)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009060


  2 / 48846 MEDLINE  
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[PMID]:29381746
[Au] Autor:Koyama K; Katayama S; Muronoi T; Tonai K; Goto Y; Koinuma T; Shima J; Nunomiya S
[Ad] Endereço:Division of Intensive Care, Department of Anesthesiology & Intensive Care Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
[Ti] Título:Time course of immature platelet count and its relation to thrombocytopenia and mortality in patients with sepsis.
[So] Source:PLoS One;13(1):e0192064, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The pathogenesis of thrombocytopenia in patients with sepsis is not fully understood. The aims of this study were to investigate changes in thrombopoietic activity over time by using absolute immature platelet counts (AIPC) and to examine the impact of platelet production on thrombocytopenia and mortality in patients with sepsis. METHODS: This retrospective observational study included adult patients with sepsis admitted to the intensive care unit at a university hospital. Two hundred five consecutive sepsis patients were stratified into four groups according to nadir platelet count: severe (nadir ≤40×103/µL), moderate (41-80×103/µL), or mild thrombocytopenia (81-120×103/µL), or normal-increased platelet count (>120×103/µL). The development of thrombocytopenia was assessed during the first week; mortality was assessed at day 28. RESULT: Of the 205 patients included, 61 (29.8%) developed severe thrombocytopenia. On admission, AIPC did not differ among the four groups. In patients with severe thrombocytopenia, AIPC decreased significantly from days 2 to 7, but remained within or above the normal range in the other three groups (overall group comparison, P<0.0001). Multivariate analysis including coagulation biomarkers revealed that AIPC was independently associated with the development of severe thrombocytopenia (day 3 AIPC, odds ratio 0.49 [95% confidence interval (CI) 0.35-0.66], P<0.0001; day 5 AIPC, 0.59 [95% CI 0.45-0.75], P<0.0001). AIPC was a significant predictor of 28-day mortality in Cox hazard models adjusted for Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores (day 3 AIPC, hazard ratio 0.70 [95% CI 0.52-0.89], P = 0.0029; day 5 AIPC, 0.68 [95% CI 0.49-0.87], P = 0.0012). CONCLUSIONS: Thrombopoietic activity was generally maintained in the acute phase of sepsis. However, a decrease in AIPC after admission was independently associated with the development of severe thrombocytopenia and mortality, suggesting the importance of suppressed thrombopoiesis in the pathophysiology of sepsis-induced thrombocytopenia.
[Mh] Termos MeSH primário: Contagem de Plaquetas
Sepse/complicações
Trombocitopenia/patologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Sepse/mortalidade
Trombocitopenia/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180131
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0192064


  3 / 48846 MEDLINE  
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[PMID]:29364941
[Au] Autor:Yang HS; Hur M; Yi A; Kim H; Lee S; Kim SN
[Ad] Endereço:Department of Cardiovascular Medicine, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea.
[Ti] Título:Prognostic value of presepsin in adult patients with sepsis: Systematic review and meta-analysis.
[So] Source:PLoS One;13(1):e0191486, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Presepsin is a novel biomarker to diagnose sepsis but its prognostic value has not been comprehensively reviewed. We conducted this meta-analysis to evaluate the mortality prediction value of presepsin in sepsis. METHODS: We searched comprehensive electronic databases from PubMed, EMBASE, and Cochrane Library through September 2017 using the key words of ('presepsin' or 'sCD14-ST' or 'soluble CD14 subtype') and ('sepsis' or 'septic shock') and ('prognosis' or 'prognostic value' or 'prognostic biomarker' or 'mortality'). We extracted the presepsin levels in survivors and non-survivors from each individual study and evaluated the standardized mean difference (SMD) using a web-based meta-analysis with the R statistical analysis program. RESULTS: A total of 10 studies and 1617 patients were included. Presepsin levels in the first sampling (within 24 hours) were significantly lower among survivors as compared with non-survivors: the pooled SMD between survivors and non-survivors was 0.92 (95% CI: 0.62-1.22) in the random effects model (I2 = 79%, P< 0.01). In subgroups, divided by the sepsis severity or study site, pooled SMD was consistently noting higher presepsin levels in non-survivals (P< 0.05). CONCLUSION: This meta-analysis demonstrates some mortality prediction value in presepsin in patients with sepsis. Further studies are needed to define the optimal cut-off point to predict mortality in sepsis.
[Mh] Termos MeSH primário: Receptores de Lipopolissacarídeos/metabolismo
Fragmentos de Peptídeos/metabolismo
Sepse/metabolismo
[Mh] Termos MeSH secundário: Seres Humanos
Prognóstico
Sepse/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
0 (Lipopolysaccharide Receptors); 0 (Peptide Fragments); 0 (presepsin protein, human)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191486


  4 / 48846 MEDLINE  
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[PMID]:28749085
[Au] Autor:Llewellyn EA; Todd JM; Sharkey LC; Rendahl A
[Ad] Endereço:Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, MN, 55108.
[Ti] Título:A pilot study evaluating the prognostic utility of platelet indices in dogs with septic peritonitis.
[So] Source:J Vet Emerg Crit Care (San Antonio);27(5):569-578, 2017 Sep.
[Is] ISSN:1476-4431
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To characterize platelet indices at time of diagnosis of septic peritonitis in dogs and to assess the relationship between platelet parameter data and survival to discharge in dogs treated surgically. DESIGN: Retrospective, observational, descriptive pilot study from 2009 to 2014. SETTING: University teaching hospital. ANIMALS: Forty-eight dogs diagnosed with septic peritonitis were included in this study. Thirty-six dogs had surgical source control. Blood samples from 46 healthy control dogs were used for reference interval (RI) generation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Dogs with septic peritonitis had significantly increased mean values for mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW) with increased proportions of dogs having values above the RI compared to healthy dogs. A significantly increased proportion of dogs with septic peritonitis had platelet counts above (12.5%) and below (8.3%) the RI, with no significant difference in mean platelet count compared to healthy dogs. No significant differences in the mean platelet count, MPV, PCT, or PDW were found between survivors and nonsurvivors in dogs with surgical source control; however, dogs with MPV values above the RI had significantly increased mortality compared to dogs within the RI (P = 0.025). Values outside the RI for other platelet parameters were not associated with significant differences in mortality. CONCLUSIONS: Dogs with septic peritonitis have increased frequency of thrombocytosis and thrombocytopenia with increased MPV, PCT, and PDW. An increased MPV may be a useful indicator of increased risk of mortality in dogs treated surgically.
[Mh] Termos MeSH primário: Transtornos Plaquetários/veterinária
Doenças do Cão/sangue
Peritonite/veterinária
Contagem de Plaquetas/veterinária
Sepse/veterinária
[Mh] Termos MeSH secundário: Animais
Transtornos Plaquetários/sangue
Cães
Volume Plaquetário Médio
Peritonite/sangue
Projetos Piloto
Prognóstico
Valores de Referência
Estudos Retrospectivos
Sepse/sangue
Trombocitopenia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1111/vec.12628


  5 / 48846 MEDLINE  
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[PMID]:29441967
[Au] Autor:Sheng F; Han M; Huang Z; Zhang L
[Ti] Título:Interleukin 6 receptor inhibitor tocilizumab suppresses cytokine expression, inflammasome activation and phagocytosis in a cell model of sepsis.
[So] Source:Pharmazie;71(11):636-639, 2016 Nov 02.
[Is] ISSN:0031-7144
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Sepsis is a life-threatening condition, usually accompanied by excessive inflammation. Tocilizumab (TCZ) is a humanized monoclonal antibody against the interleukin (IL) 6 receptor and has been studied in various inflammatory diseases, but little is known about its effects in sepsis. This study aims to reveal the role of TCZ in inflammation during sepsis. METHODS: Human monocyte cell line THP-1 was stimulated by lipopolysaccharide (LPS) as a cell model for sepsis. After TCZ treatment, the expression of cytokines tumor necrosis factor (TNF) and IL10, the production of chemokine (C-C motif) ligand 2 (CCL2) and IL1B, and the expression of inflammasome factors NLR family pyrin domain containing 3 (NLRP3) and caspase 1 (CASP1), were detected by qRT-PCR and ELISA. Phagocytosis assay was also performed to assess the phagocytosis activity of TCZ-treated cells. RESULTS: LPS stimulation significantly upregulated TNF and IL10 mRNA levels (P < 0.01) and CCL2 and IL1B production (P < 0.001), promoted NLRP3 and CASP1 levels (P < 0.01) and elevated phagocytosis activity of THP-1 cells (P < 0.001). TCZ treatment had the opposite effects of decreasing TNF and IL10 mRNA levels (P < 0.05), CCL2 and IL1B production (P < 0.001), inhibiting NLRP3 and CASP1 (P < 0.01), and suppressing phagocytosis activity (P < 0.001) compared to the LPS group. CONCLUSION: These results indicate the suppressive role of TCZ in cytokine production, inflammation activation and phagocytosis in sepsis cell model, implying its effects on controlling "cytokine storm" during sepsis. Thus TCZ provides a promising strategy for treating sepsis.
[Mh] Termos MeSH primário: Anticorpos Monoclonais Humanizados/farmacologia
Citocinas/antagonistas & inibidores
Inflamassomos/efeitos dos fármacos
Fagocitose/efeitos dos fármacos
Receptores de Interleucina-6/antagonistas & inibidores
Sepse/patologia
[Mh] Termos MeSH secundário: Linhagem Celular
Citocinas/biossíntese
Seres Humanos
Lipopolissacarídeos/antagonistas & inibidores
Lipopolissacarídeos/farmacologia
Monócitos/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Monoclonal, Humanized); 0 (Cytokines); 0 (Inflammasomes); 0 (Lipopolysaccharides); 0 (Receptors, Interleukin-6); I031V2H011 (tocilizumab)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1691/ph.2016.6713


  6 / 48846 MEDLINE  
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[PMID]:29297082
[Au] Autor:Prescott HC; Angus DC
[Ad] Endereço:Department of Internal Medicine and Institute for Healthcare Policy & Innovation, University of Michigan, Ann Arbor.
[Ti] Título:Enhancing Recovery From Sepsis: A Review.
[So] Source:JAMA;319(1):62-75, 2018 01 02.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Survival from sepsis has improved in recent years, resulting in an increasing number of patients who have survived sepsis treatment. Current sepsis guidelines do not provide guidance on posthospital care or recovery. Observations: Each year, more than 19 million individuals develop sepsis, defined as a life-threatening acute organ dysfunction secondary to infection. Approximately 14 million survive to hospital discharge and their prognosis varies. Half of patients recover, one-third die during the following year, and one-sixth have severe persistent impairments. Impairments include development of an average of 1 to 2 new functional limitations (eg, inability to bathe or dress independently), a 3-fold increase in prevalence of moderate to severe cognitive impairment (from 6.1% before hospitalization to 16.7% after hospitalization), and a high prevalence of mental health problems, including anxiety (32% of patients who survive), depression (29%), or posttraumatic stress disorder (44%). About 40% of patients are rehospitalized within 90 days of discharge, often for conditions that are potentially treatable in the outpatient setting, such as infection (11.9%) and exacerbation of heart failure (5.5%). Compared with patients hospitalized for other diagnoses, those who survive sepsis (11.9%) are at increased risk of recurrent infection than matched patients (8.0%) matched patients (P < .001), acute renal failure (3.3% vs 1.2%, P < .001), and new cardiovascular events (adjusted hazard ratio [HR] range, 1.1-1.4). Reasons for deterioration of health after sepsis are multifactorial and include accelerated progression of preexisting chronic conditions, residual organ damage, and impaired immune function. Characteristics associated with complications after hospital discharge for sepsis treatment are not fully understood but include both poorer presepsis health status, characteristics of the acute septic episode (eg, severity of infection, host response to infection), and quality of hospital treatment (eg, timeliness of initial sepsis care, avoidance of treatment-related harms). Although there is a paucity of clinical trial evidence to support specific postdischarge rehabilitation treatment, experts recommend referral to physical therapy to improve exercise capacity, strength, and independent completion of activities of daily living. This recommendation is supported by an observational study involving 30 000 sepsis survivors that found that referral to rehabilitation within 90 days was associated with lower risk of 10-year mortality compared with propensity-matched controls (adjusted HR, 0.94; 95% CI, 0.92-0.97, P < .001). Conclusions and Relevance: In the months after hospital discharge for sepsis, management should focus on (1) identifying new physical, mental, and cognitive problems and referring for appropriate treatment, (2) reviewing and adjusting long-term medications, and (3) evaluating for treatable conditions that commonly result in hospitalization, such as infection, heart failure, renal failure, and aspiration. For patients with poor or declining health prior to sepsis who experience further deterioration after sepsis, it may be appropriate to focus on palliation of symptoms.
[Mh] Termos MeSH primário: Sepse/complicações
Sepse/reabilitação
[Mh] Termos MeSH secundário: Atividades Cotidianas
Adulto
Transtornos Cognitivos/etiologia
Hospitalização/estatística & dados numéricos
Seres Humanos
Transtornos Mentais/etiologia
Sepse/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.17687


  7 / 48846 MEDLINE  
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[PMID]:28453834
[Au] Autor:Sánchez-Encinales V; Álvarez-Marín R; Pachón-Ibáñez ME; Fernández-Cuenca F; Pascual A; Garnacho-Montero J; Martínez-Martínez L; Vila J; Tomás MM; Cisneros JM; Bou G; Rodríguez-Baño J; Pachón J; Smani Y
[Ad] Endereço:Clinic Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville, IBiS, University Hospital Virgen del Rocío/CSIC/University of Seville, Spain.
[Ti] Título:Overproduction of Outer Membrane Protein A by Acinetobacter baumannii as a Risk Factor for Nosocomial Pneumonia, Bacteremia, and Mortality Rate Increase.
[So] Source:J Infect Dis;215(6):966-974, 2017 03 15.
[Is] ISSN:1537-6613
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: Outer membrane protein A (OmpA) is a porin involved in Acinetobacter baumannii pathogenesis. However, OmpA clinical implication in hospital-acquired infections remains unknown. We aimed to determine whether OmpA overproduction was a risk factor associated with pneumonia, bacteremia, and mortality. Methods: We analyzed demographic, microbiological, and clinical data from 100 patients included in a unicenter cohort and 246 included in a unicenter cohort and a multicenter cohort. Representative isolates were classified into 2 groups: (1) isolates from patients colonized by A. baumannii (16 from the unicenter and 20 from the multicenter cohort) and (2) isolates from bacteremic or nonbacteremic patients with pneumonia (PP) caused by A. baumannii (13 from the unicenter and 23 from the multicenter cohort) Expression of ompA was determined with quantitative reverse-transcription polymerase chain reaction. Results: Isolates from PP overexpressed more ompA than those from colonized patients from the unicenter (ratio, 1.76 vs 0.36; P < .001) and the multicenter (1.36 vs 0.91; P = .03) cohorts. Among isolates from PP, those from bacteremic patients overexpressed nonsignificantly more ompA than those from nonbacteremic patients in the unicenter (ratio, 2.37 vs 1.43; P = .06) and the multicenter (2.03 vs 0.91; P = .14) cohorts. Multivariate analysis in both cohorts together showed ompA overexpression as independent risk factor for pneumonia (P < .001), bacteremia (P = .005), and death (P = .049). Conclusions: These data suggest that ompA overexpression is an associated factor for pneumonia, bacteremia, and death due to A. baumannii.
[Mh] Termos MeSH primário: Acinetobacter baumannii/genética
Bacteriemia/epidemiologia
Proteínas da Membrana Bacteriana Externa/genética
Infecção Hospitalar/epidemiologia
Pneumonia Bacteriana/epidemiologia
Sepse/mortalidade
[Mh] Termos MeSH secundário: Acinetobacter baumannii/isolamento & purificação
Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Animais
Infecção Hospitalar/microbiologia
Modelos Animais de Doenças
Feminino
Seres Humanos
Masculino
Camundongos
Camundongos Endogâmicos C57BL
Testes de Sensibilidade Microbiana
Meia-Idade
Análise Multivariada
Fatores de Risco
Índice de Gravidade de Doença
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Bacterial Outer Membrane Proteins); 149024-69-1 (OMPA outer membrane proteins)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/infdis/jix010


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[PMID]:29374921
[Au] Autor:Xiao R; Huang YS; Lin GA; Yuan SA; Hu DS
[Ad] Endereço:Burn Center, the 159th Hospital of PLA, Zhumadian 463008, China.
[Ti] Título:[Effects of cardiac support on delayed resuscitation in extensively burned patients with shock].
[So] Source:Zhonghua Shao Shang Za Zhi;34(1):8-13, 2018 Jan 20.
[Is] ISSN:1009-2587
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To explore the effects of cardiac support on delayed resuscitation in extensively burned patients with shock. Clinical data of 62 extensively burned patients with shock on admission, admitted to the 159th Hospital of PLA (hereinafter referred to as our hospital) from January 2012 to January 2017, were retrospectively analyzed. They were divided into cardiac support group ( =35) and control group ( =27) according to the use of deslanoside and ulinastatin. All patients were treated with routine fluid resuscitation based on the formula of the Third Military Medical University till post injury hour (PIH) 48. Patients in cardiac support group were given slow intravenous injection of deslanoside which was added in 20 mL 100 g/L glucose injection with first dose of 0.4 to 0.6 mg, 0.2 to 0.4 mg per 6 to 8 h, no more than 1.6 mg daily, and slow intravenous injection of 1×10(5)U ulinastatin which was added in 100 mL 50 g/L glucose injection, once per 12 h. Other treatments of patients in the two groups followed the same conventional procedures of our hospital. The following data of the two groups of patients were collected. (1) The data of urine volume per hour within PIH 48, heart rate, mean arterial pressure (MAP), central venous pressure (CVP), blood lactic acid, base excess, hematocrit, and albumin at PIH 48 were recorded. (2) The input volumes of electrolyte, colloid within the first and second 24 hours post burn and the total fluid input volumes within PIH 48 were recorded. (3) The data of creatine kinase, creatine kinase isoenzyme-MB, lactate dehydrogenase, total bile acid, alanine aminotransferase, aspartate aminotransferase, ß(2)-microglobulin, urea nitrogen, and creatinine at PIH 48 were recorded. (4) The complications including cardiac failure, pulmonary edema, pleural effusion, seroperitoneum, renal failure, sepsis, and death were also recorded. Data were processed with independent sample test, Fisher's exact test, Pearson chi-square test, or continuous correction chi-square test. (1) There were no statistically significant differences in urine volume within PIH 48, heart rate, MAP, CVP, hematocrit, or albumin at PIH 48 between the patients of two groups ( =0.150, 0.488, 0.805, 0.562, 1.742, 0.696, >0.05). While the levels of blood lactic acid and base excess were respectively (4.2±2.2) and (-4.3±2.0) mmol/L in patients of cardiac support group, which were significantly better than (5.9±1.7) and (-6.0±3.1) mmol/L in patients of control group ( =3.249, 2.480, <0.05 or <0.01). (2) There was no statistically significant difference in input volume of colloid within the first 24 hours post burn between the patients of two groups ( =0.642, >0.05). The input volume of electrolyte within the first 24 hours post burn, the input volumes of electrolyte and colloid within the second 24 hours post burn, and the total fluid input volume within PIH 48 of patients in cardiac support group were significantly less than those in control group ( =2.703, 4.223, 3.437, 2.515, <0.05 or <0.01). (3) The levels of creatine kinase, creatine kinase isoenzyme-MB, lactate dehydrogenase, total bile acid, alanine aminotransferase, aspartate aminotransferase, ß(2)-microglobulin, urea nitrogen, and creatinine of patients in cardiac support group at PIH 48 were significantly lower than those in control group ( =3.066, 3.963, 3.225, 2.943, 2.431, 3.084, 4.052, 2.915, 3.353, <0.05 or <0.01). (4) The occurrences of pleural effusion and seroperitoneum and mortality of patients in cardiac support group were significantly lower than those in control group ( (2)=5.514, 6.984, 4.798, <0.05 or <0.01). There were no statistically significant differences in cardiac failure, pulmonary edema, renal failure, and sepsis between the patients of two groups [ (2)=1.314 (sepsis), >0.05]. The cardiotonic and cardiac protection treatments in delayed resuscitation of extensively burned patients with shock contribute to improving the cellular anonic metabolism, reducing the volume of fluid resuscitation, and mitigating the ischemic and hypoxic damage to organs, so as to lay foundation for decreasing further complication incidences and mortality.
[Mh] Termos MeSH primário: Queimaduras
Ressuscitação
Choque
[Mh] Termos MeSH secundário: Coloides
Hidratação
Hematócrito
Seres Humanos
Edema Pulmonar
Estudos Retrospectivos
Sepse
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Colloids)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180129
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1009-2587.2018.01.003


  9 / 48846 MEDLINE  
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[PMID]:29419388
[Au] Autor:Ladher N; Godlee F
[Ad] Endereço:The BMJ, London, UK nladher@bmj.com.
[Ti] Título:Criminalising doctors.
[So] Source:BMJ;360:k479, 2018 02 01.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Assistência à Saúde/legislação & jurisprudência
Política de Saúde/legislação & jurisprudência
Imperícia/legislação & jurisprudência
Sepse/complicações
[Mh] Termos MeSH secundário: Criança
Direito Penal/ética
Assistência à Saúde/normas
Evolução Fatal
Seres Humanos
Masculino
Pediatras
Médicos
Qualidade da Assistência à Saúde/normas
Sepse/mortalidade
[Pt] Tipo de publicação:CASE REPORTS; EDITORIAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k479


  10 / 48846 MEDLINE  
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[PMID]:28460438
[Au] Autor:Chen X; Zhu W; Tan J; Nie H; Liu L; Yan D; Zhou X; Sun X
[Ad] Endereço:Chinese Cochrane Centre, Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, Sichuang, China.
[Ti] Título:Early outcome of early-goal directed therapy for patients with sepsis or septic shock: a systematic review and meta-analysis of randomized controlled trials.
[So] Source:Oncotarget;8(16):27510-27519, 2017 Apr 18.
[Is] ISSN:1949-2553
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Various trials and meta-analyses have reported conflicting results concerning the application of early goal-directed therapy (EGDT) for sepsis and septic shock. The aim of this study was to update the evidence by performing a systematic review and meta-analysis. Multiple databases were searched from initial through August, 2016 for randomized controlled trials (RCTs) which investigated the associations between the use of EGDT and mortality in patients with sepsis or septic shock. Meta-analysis was performed using random-effects model and heterogeneity was examined through subgroup analyses. The primary outcome of interest was patient all-cause mortality including hospital or ICU mortality. Seventeen RCTs including 6207 participants with 3234 in the EGDT group and 2973 in the control group were eligible for this study. Meta-analysis showed that EGDT did not significantly reduce hospital or intensive care unit (ICU) mortality (relative risk [RR] 0.89, 95% CI 0.78 to 1.02) compared with control group for patients with sepsis or septic shock. The findings of subgroup analyses stratified by study region, number of research center, year of enrollment, clinical setting, sample size, timing of EGDT almost remained constant with that of the primary analysis. Our findings provide evidence that EGDT offers neutral survival effects for patients with sepsis or septic shock. Further meta-analyses based on larger well-designed RCTs or individual patient data meta-analysis are required to explore the survival benefits of EDGT in patients with sepsis or septic shock.
[Mh] Termos MeSH primário: Sepse/terapia
Choque Séptico/terapia
Tempo para o Tratamento
[Mh] Termos MeSH secundário: Terapia Combinada
Gerenciamento Clínico
Mortalidade Hospitalar
Seres Humanos
Unidades de Terapia Intensiva
Razão de Chances
Viés de Publicação
Ensaios Clínicos Controlados Aleatórios como Assunto
Sepse/diagnóstico
Sepse/mortalidade
Choque Séptico/diagnóstico
Choque Séptico/mortalidade
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.18632/oncotarget.15550



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