In this study, 60 patients with septic shock were selected over the course of 1 year, and the effects of dopamine and norepinephrine combined with dobutamine on hepatic and intestinal circulation and intestinal barrier in patients with septic shock were studied by comparison between the control group and the experimental group. All patients received mechanical ventilation to maintain breathing at 14 to 20 times/min. The experimental group was treated with vascular active drugs after adequate rehydration, and the control group only received adequate rehydration. There were extremely significant differences (p<0.01) in the total effective rate of each group. There were significant differences in the hemodynamic indexes in each group (p<0.05). There was a significant difference in total 24-hour bile output (p<0.01). There were significant differences in liver function and blood lipid values in patients (p<0.01). There were significant differences in the repair of epithelial injury at 0 hour, 48 hours and 96 hours (p<0.01). There were significant differences in the transmembrane resistance of monolayer cells (p<0.01). The expression differences of three proteins ZO-1, occludin and β-actin were also significant, among which the three proteins in the control group were weak, while those in groups A and B were strong. The expression of tight junction protein in monolayer cells was weakly positive in expression and strong in other proteins. In conclusion, vasoactive drugs had significant effects on hepatic and intestinal circulation and intestinal barrier in patients with septic shock.
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http://dx.doi.org/10.1136/jim-2020-001685 | DOI Listing |
J Med Internet Res
January 2025
Institute of Medical Teaching and Medical Education Research, University Hospital Würzburg, Würzburg, Germany.
Background: Objective structured clinical examinations (OSCEs) are a widely recognized and accepted method to assess clinical competencies but are often resource-intensive.
Objective: This study aimed to evaluate the feasibility and effectiveness of a virtual reality (VR)-based station (VRS) compared with a traditional physical station (PHS) in an already established curricular OSCE.
Methods: Fifth-year medical students participated in an OSCE consisting of 10 stations.
Medicine (Baltimore)
January 2025
Department of Hematology, Tongde Hospital of Zhejiang Province, Hangzhou, P.R. China.
Rationale: Carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infections are a severe complication resulting from granulocyte deficiency following chemotherapy for hematologic malignancies and have a high mortality rate. However, reports of disseminated organ infections secondary to bloodstream infections are rare.
Patient Concerns And Diagnoses: We report 2 cases of patients with acute lymphoblastic leukemia who both developed CRKP bloodstream infections during the granulocyte deficiency stage following chemotherapy, with 1 case of secondary bacterial liver abscess and 1 case of secondary septic arthritis.
Eur J Trauma Emerg Surg
January 2025
Institute for Research in Operative Medicine (IFOM), Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany.
Purpose: Our aim was to generate evidence- and consensus-based recommendations for the management of mass casualty incidents (MCIs) based on current evidence. This guideline topic is part of the 2022 update of the German guideline on the treatment of patients with severe/multiple injuries.
Methods: MEDLINE and Embase were systematically searched to August 2021.
Crit Care Explor
January 2025
Department of Pediatrics, Johns Hopkins University, Baltimore, MD.
Objectives: Exploiting the complete blood count (CBC) with differential (CBC-diff) for early sepsis detection has practical value for emergency department (ED) care, especially for those without obvious presentations. The objective of this study was to develop the CBC Sepsis Index (CBC-SI) that incorporates monocyte distribution width (MDW) to enhance rapid sepsis screening.
Design: A retrospective observational study.
Med Care
February 2025
University of Pennsylvania School of Nursing, NewCourtland Center for Transitions and Health, Philadelphia, PA.
Objective: To examine the characteristics and risk factors associated with 30-day readmissions, including the impact of home health care (HHC), among older sepsis survivors transitioning from hospital to home.
Research Design: Retrospective cohort study of the Medical Information Mart for Intensive Care (MIMIC)-IV data (2008-2019), using generalized estimating equations (GEE) models adjusting for patient sociodemographic and clinical characteristics.
Subjects: Sepsis admission episodes with in-hospital stays, aged over 65, and discharged home with or without HHC were included.
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