Impact on fluid balance of an optimized restrictive strategy targeting non-resuscitative fluids in intensive care patients with septic shock: a single-blind, multicenter, randomized, controlled, pilot study.

Background: In septic shock, the classic fluid resuscitation strategy can lead to a potentially harmful positive fluid balance. This multicenter, randomized, single-blind, parallel, controlled pilot study assessed the effectiveness of a restrictive fluid strategy aiming to limit daily volume.

Methods: Patients 18-85 years' old admitted to the ICU department of three French hospitals were eligible for inclusion if they had septic shock and were in the first 24 h of vasopressor infusion.

Use of vancomycin and acute kidney injury in critically ill patients with sepsis or septic shock: A retrospective observational cohort study.

Introduction: The independent association of vancomycin with Acute Kidney Injury (AKI) in the critically ill patient with sepsis or septic Shock is controversial. The aim of this study was to evaluate the incidence of AKI in a cohort of patients with sepsis or septic Shock with an adequate and strict monitoring of vancomycin, guided by the area under the concentration-time curve in relation to the minimum inhibitory concentration (AUC/MIC ratio).

Material And Methods: Retrospective cohort study on 106 patients admitted to the ICU with a diagnosis of sepsis or septic shock with vancomycin treatment, consecutively from January 2017 to December 2019.

Fulminant Edwardsiella tarda bacteremia following near-drowning episode in a patient without cirrhosis: A case report.

Edwardsiella tarda is a Gram-negative intracellular pathogen within the Enterobacterales order, recognized as a causative agent of hemorrhagic septicemia in fish but also pathogenic to humans. However, the clinical course and prognostic factors of E. tarda bacteremia are not fully understood.

The effect of minimally invasive surgery on thirty-day postoperative outcomes of frail patients undergoing emergency colon resections.

Background: Frail patients have poor outcomes after emergent colon surgery. While minimally invasive surgery has shown improved outcomes in the general patient population undergoing colectomy, the benefits in frail patients are unknown.

Methods: We identified frail patients who underwent urgent or emergent colon resections from 2017 to 2021 in the National Surgical Quality Improvement Program database.

Exploring the anti‑inflammatory activity of boron compounds through the miR‑21/PTEN/AKT pathway in cecal ligation and puncture‑induced sepsis.

The present study investigated the impact of boric acid (BA) and borax (BX) on markers of inflammation and modifications in miR‑21/PTEN/AKT pathway genes in the liver and kidney tissues of Sprague Dawley male rats with sepsis induced by cecal ligation and puncture (CLP). A total of 60 male Sprague Dawley rats were randomly divided into 6 groups, each containing 10 animals as follows: Control, CLP (where the model was created), 20 mg/kg BX (CLP + BX1), 40 mg/kg BX (CLP + BX2), 20 mg/kg BA (CLP + BA1) and 40 mg/kg BA (CLP + BA2). Liver and kidney tissues were analyzed for histopathological changes, immunopositivity for tumor necrosis factor‑α, interleukin (IL)‑6 and IL‑10, and gene expression of microRNA‑21 (miR‑21), phosphatase and tensin homolog (PTEN) and AKT.

Large Language Models for More Efficient Reporting of Hospital Quality Measures.

Hospital quality measures are a vital component of a learning health system, yet they can be costly to report, statistically underpowered, and inconsistent due to poor interrater reliability. Large language models (LLMs) have recently demonstrated impressive performance on health care-related tasks and offer a promising way to provide accurate abstraction of complete charts at scale. To evaluate this approach, we deployed an LLM-based system that ingests Fast Healthcare Interoperability Resources data and outputs a completed Severe Sepsis and Septic Shock Management Bundle (SEP-1) abstraction.

Case report: Chronic inflammatory demyelinating polyradiculoneuropathy with severe central nervous system demyelination: a clinicopathological study.

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune-mediated disease that mainly affects the peripheral nerves and nerve roots and typically presents with distal dominant motor and sensory disturbances as clinical symptoms. Central nervous system (CNS) demyelination with inflammation occurs infrequently in patients with CIDP. Here, we present a unique autopsy report of CIDP causing severe demyelination along the entire spinal cord.

Phlegmonous Gastritis With Streptococcal Toxic Shock Syndrome: A Rare Complication After Endoscopy.

Phlegmonous gastritis is a rare, suppurative bacterial infection of the gastric wall and one of the rarest complications after upper gastrointestinal endoscopy. The pathogenesis is not fully clear, but multiple risk factors have been described in literature as mucosal injury and achlorhydria. We report a case of a 76-year-old male with vomiting and epigastric pain, two days after an upper endoscopy, who presented in septic shock.

A Comparative Analysis of Nursing Care Needs Scores at Discharge and Transfer Among Survivors of Critical COVID-19 and Septic Shock: A Retrospective Observational Study Using Modified Poisson Regression From Japan.

Background Research on nursing care needs (NCNs) for critically ill patients at discharge is scarce. This study aimed to quantify and compare NCNs at discharge between patients with severe COVID-19 and septic shock and to identify factors associated with higher NCNs. Methodology We retrospectively analyzed data from the Diagnosis Procedure Combination database between April 1, 2020, and March 31, 2023, on patients requiring ventilators in the intensive care unit (ICU).

5-Aminolevulinic Acid (5-ALA) Plays an Important Role in the Function of Innate Immune Cells.

5-aminolevulinic acid (5-ALA) is an amino acid essential for the synthesis of heme, which is important for various cellular functions, including the mitochondrial electron transport chain. We previously established heterozygous knockout mice (Alas1) for 5-ALA synthase 1 (ALAS1), the rate-limiting enzyme for 5-ALA synthesis, and reported that the mice developed non-obese insulin-resistant diabetes. In the present study, we used these mice to analyze the role of 5-ALA in the immune system.

A fatal case of Vibrio cholerae-associated diarrhea and bacteremia in a 30-year-old carrier of beta-thalassemia.

Bacterial infections leading to bacteremia and septicemic shock constitute an emerging public health concern globally, especially in areas where sanitation is poor and safe drinking water is scarce. Enteric pathogens such as Vibrio cholerae are responsible for many deaths caused by contaminated food and water in these areas. While cholera is the prominent clinical threat posed by V.

Platelet distribution width in patients with influenza A virus-induced acute respiratory distress syndrome: An old indicator with promising clinical application.

This study aims to investigate the predictive value of platelet distribution width (PDW) in patients with influenza A virus (IAV) infection. The clinical data of 105 IAV-infected patients was collected and analyzed. We found that creatine kinase (CK), Acute Physiology and Chronic Health Evaluation (APACHE) II score, PDW, and red blood cell distribution width (RDW) were independent risk factors for acute respiratory distress syndrome (ARDS) development.

Higher Circulating ACE2 and DPP3 but Reduced ACE and Angiotensinogen in Hyperreninemic Sepsis Patients.

Sepsis and septic shock are global healthcare problems associated with high mortality rates.  Activation of the renin-angiotensin-aldosterone system (RAAS) is an early event in sepsis and elevated renin may be predictive of worse outcomes.  In a subset of sepsis patients enrolled in the Vitamin C, Thiamine, and Steroids in Sepsis (VICTAS) trial, active renin (median value > 189 pg/mL or 5.

Evaluation of the effect of BioFire FilmArray nested multiplex polymerase chain reaction method on rapid pathogen identification and antimicrobial stewardship in sepsis.

Objective: In this study, we aimed to assess the effect of the BioFire FilmArray Blood Culture Identification 2 panel on agent identification and antimicrobial stewardship in patients with a critical state of sepsis secondary to bloodstream infection.

Methods: This study was designed as a prospective observational study. Patients who developed sepsis and septic shock secondary to bloodstream infection in the intensive care unit were included in the study.

Necrotizing Fasciitis and Streptococcal Toxic Shock Syndrome: A Case Report.

Group A (GAS), particularly (), is a significant human pathogen responsible for infections often ranging from mild superficial conditions to severe, life-threatening diseases like necrotizing fasciitis (NF) and streptococcal toxic shock syndrome (STSS). This case report details the rapid deterioration of a previously healthy 49-year-old woman who presented with localized symptoms in her left thigh, later escalating to septic shock and multi-organ failure related to GAS infection. Initial evaluations indicated significant inflammation and acute kidney injury, prompting broad-spectrum antibiotic treatment.

[The value of coagulation indicators combined with sequential organ failure assessment in assessing disease severity and prognosis of elderly patients with sepsis].

Objective: To explore the value of coagulation indicators and related critical scores in evaluating the severity and prognosis of elderly sepsis patients.

Methods: Patients admitted to the intensive care unit (ICU) of General Hospital of Ningxia Medical University aged ≥60 years with a definite diagnosis of sepsis from May 2020 to May 2022 were retrospectively included. General epidemiological data, coagulation indices such as prothrombin time (PT), international normalized ratio (INR), prothrombin activity (PTA), activated partial thromboplastin time (APTT), prothrombin time (TT), fibrinogen (FIB), D-dimer, platelet count (PLT), and other laboratory indices within 24 hours of admission to the ICU, acute physiology and chronic health evaluation (APACHE), sequential organ failure assessment (SOFA), sepsis-related complications, and 28-day prognosis were collected.

[Establishment of a nomogram prediction model for 28-day mortality of septic shock patients based on routine laboratory data mining].

Objective: To construct a nomogram prediction model for 28-day mortality in septic shock patients based on routine laboratory data mining and verify its predictive value.

Methods: The clinical data of patients with septic shock admitted to Anhui Medical University Affiliated Fuyang Hospital from January 2018 to November 2023 were retrospectively analyzed. The patients were randomly divided into training set and validation set according to the ratio of 8 : 2.

Apoptotic body based biomimetic hybrid nanovesicles to attenuate cytokine storms for sepsis treatment.

Sepsis is a severe immune response to pathogens that is associated with high mortality rate and a paucity of efficacious treatment options. It is characterized by the hyperactivation of macrophages and the occurrence of cytokine storms. Given the anti-inflammatory properties of M2 macrophages and their derived apoptotic bodies (AB), as well as the specific uptake of these by macrophages, a novel approach was employed to combine AB with artificial liposomes to create apoptotic body based biomimetic hybrid nanovesicles (L-AB).

Liver abscess and splenic infarction due to Yersinia pseudotuberculosis bloodstream infection: a case report.

Background: Yersinia pseudotuberculosis is an emerging zoonotic intestinal pathogen primarily transmitted through contaminated food and water. Infections caused by Yersinia pseudotuberculosis are typically self-limiting, often presenting as gastroenteritis or "pseudoappendicitis," which is characterized by fever and abdominal pain. Although bloodstream infections with Yersinia pseudotuberculosis are rare, they can lead to multiple distant sites of infection, including abscesses in the liver, spleen, and kidneys, as well as in the hip and knee joints, particularly in individuals with underlying immunodeficiency.

Clinical significance of lactate-to-albumin ratio in patients with influenza A virus-induced acute respiratory distress syndrome: a single-center retrospective study.

Background: The lactate-to-albumin ratio (LAR) is predictive of disease prognosis in some cases. However, the clinical significance of LAR in patients with influenza A virus-induced acute respiratory distress syndrome (ARDS) has yet to be explored. This study aims to investigate whether LAR can be used as a predictor of influenza A virus-induced ARDS.

β3-Adrenergic receptor antagonism improves cardiac and vascular functions but did not modulate survival in a murine resuscitated septic shock model.

Background: Recent findings suggest that β3-adrenergic receptors (β3-AR) could play a role in the hemodynamic regulation, but their function in septic shock remains unclear. This study investigates the modulation of β3-AR in an experimental murine model of resuscitated septic shock on in vivo hemodynamic, ex vivo vasoreactivity, inflammation and survival.

Method: Wild-type mice were used, undergoing cecal ligation and puncture (CLP) to induce septic shock, with SHAM as controls.

Causes of mortality following PCI: the University of New Mexico hospital experience.

Background: Mortality after percutaneous coronary intervention (PCI) remains a problem. Clinical databases such as the American College of Cardiology National Cardiovascular Data CathPCI Registry do not contain enough information to determine the specific cause of death after PCI, and thus are not able to identify opportunities for improvement (OFIs) that might have prevented the death of specific patients. We reviewed cases of death after coronary intervention to identify specific OFIs.

Interventional Treatment of Acute Right Ventricular Outflow Tract Infectious Endocarditis: A Bridge to Surgical or Percutaneous Pulmonary Valve Replacement.

Background: Infective endocarditis (IE) poses significant risks following percutaneous pulmonary valve implantation (PPVI) or surgical replacement (PVR).

Aims: This study evaluates the effectiveness of emergency percutaneous treatment in stabilizing patients with severe right ventricular dysfunction or obstructive cardiac shock, allowing for delayed surgical or percutaneous valve replacement.

Methods: This retrospective study examines 16 patients (age 19.

Impact of renal-adjusted ceftazidime/avibactam in patients with KPC-producing bloodstream infection: a retrospective cohort study.

Background: Bloodstream infections (BSIs) caused by KPC-producing (KPC-Kp) are still associated with high mortality, and the game-changing drug ceftazidime/avibactam has shown suboptimal pharmacokinetics in some clinical settings. Ceftazidime/avibactam renal dose adjustment has recently been identified as an independent risk factor for mortality.

Objectives: To investigate the effect of ceftazidime/avibactam renal dose adjustment on mortality.