Successful treatment of uterine torsion and fetal retention in a postparturient Great Pyrenees bitch with septic peritonitis and prothrombotic complications

1997 ◽  
Vol 33 (6) ◽  
pp. 537-539 ◽  
Author(s):  
MG Ritt ◽  
TW Fossum
Keyword(s):  
Septic Shock ◽  
Medical Therapy ◽  
Successful Treatment ◽  
Successful Outcome ◽  
Gravid Uterus ◽  
Medical Complications ◽  
Uterine Torsion ◽  
Septic Peritonitis ◽  
Threatening Condition ◽  
Life Threatening

The treatment and favorable outcome of a bitch with uterine torsion and two retained fetuses are described. The condition was corrected surgically by ovariohysterectomy. Complications (i.e., septic shock, peritonitis, and hemostatic abnormalities) were managed with aggressive medical therapy. Torsion of the gravid uterus in dogs is a life-threatening condition which can have a successful outcome if medical complications encountered in the pre- and postoperative periods are treated quickly and effectively.

Assessment and care of the patient with sepsis

2020 ◽  
pp. 225-257
Author(s):  
Kevin Barrett
Keyword(s):  
Septic Shock ◽  
Early Recognition ◽  
Scoring Systems ◽  
Cardiovascular Responses ◽  
Physiological Changes ◽  
Assessment Framework ◽  
Threatening Condition ◽  
Life Threatening ◽  
Support Mechanisms ◽  
Sepsis And Septic Shock

There has been considerable recent focus on sepsis in both the clinical arena and within the general public to raise awareness of the importance of early recognition of this potentially life-threatening condition. The early recognition of sepsis by ward nurses can both reduce progression of this lethal disease and improve survival for patients in hospital. This chapter focuses on definitions of sepsis and septic shock, physiological changes associated with inflammatory and cardiovascular responses to sepsis, and a clinical assessment framework to guide practice. There is also a discussion of the use of scoring systems and how to escalate support mechanisms for patients with sepsis and septic shock.

scholarly journals Favorable 90-Day Mortality in Obese Caucasian Patients with Septic Shock According to the Sepsis-3 Definition

2019 ◽  
Vol 9 (1) ◽  
pp. 46 ◽  
Author(s):  
Caspar Mewes ◽  
Carolin Böhnke ◽  
Tessa Alexander ◽  
Benedikt Büttner ◽  
José Hinz ◽  
...  
Keyword(s):  
Septic Shock ◽  
Protective Effect ◽  
Cox Regression ◽  
Obese Patients ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Threatening Condition ◽  
Life Threatening ◽  
Caucasian Patients ◽  
Patient Prognosis

Septic shock is a frequent life-threatening condition and a leading cause of mortality in intensive care units (ICUs). Previous investigations have reported a potentially protective effect of obesity in septic shock patients. However, prior results have been inconsistent, focused on short-term in-hospital mortality and inadequately adjusted for confounders, and they have rarely applied the currently valid Sepsis-3 definition criteria for septic shock. This investigation examined the effect of obesity on 90-day mortality in patients with septic shock selected from a prospectively enrolled cohort of septic patients. A total of 352 patients who met the Sepsis-3 criteria for septic shock were enrolled in this study. Body-mass index (BMI) was used to divide the cohort into 24% obese (BMI ≥ 30 kg/m2) and 76% non-obese (BMI < 30 kg/m2) patients. Kaplan-Meier survival analysis revealed a significantly lower 90-day mortality (31% vs. 43%; p = 0.0436) in obese patients compared to non-obese patients. Additional analyses of baseline characteristics, disease severity, and microbiological findings outlined further statistically significant differences among the groups. Multivariate Cox regression analysis estimated a significant protective effect of obesity on 90-day mortality after adjustment for confounders. An understanding of the underlying physiologic mechanisms may improve therapeutic strategies and patient prognosis.

scholarly journals Spontaneous heterotopic pregnancy with tubal rupture

2017 ◽  
Vol 6 (11) ◽  
pp. 5148 ◽  
Author(s):  
Spandana J. C. ◽  
Suresh S. Kanakannavar ◽  
Umashankar K. M. ◽  
Manuja N.
Keyword(s):  
Maternal Morbidity ◽  
Surgical Intervention ◽  
Heterotopic Pregnancy ◽  
Successful Outcome ◽  
Intrauterine Pregnancy ◽  
Pregnant Females ◽  
Maternal Morbidity And Mortality ◽  
Threatening Condition ◽  
Life Threatening ◽  
Ultrasound Assessment

Heterotopic pregnancy is the coexistence of intrauterine pregnancy (IUP) and extrauterine gestation. It is a rare and dangerous life-threatening condition that is difficult to diagnose and easily missed. The incidence in the general population is estimated to be 1 in 30,000. We report a case of a 24-year-old multigravida who was seen in the emergency department with a diagnosis of a ruptured ectopic pregnancy. A careful ultrasound assessment led to the diagnosis of a heterotopic pregnancy despite lack of any notable risk factors. Immediate surgical intervention with supportive measures resulted in a successful outcome. An obstetrician should keep in mind the occurrence of a heterotopic pregnancy while dealing with pregnant females. It also demonstrates that early diagnosis is essential in order to salvage the intrauterine pregnancy and avoid maternal morbidity and mortality.

scholarly journals Importance of haemodynamic stability and adjuvant therapy in the treatment of patients with sepsis and septic shock

2020 ◽  
Vol 45 (4) ◽  
pp. 153-158
Author(s):  
Vesna Marjanović ◽  
Ivana Budić ◽  
Saša Ignjatijević ◽  
Marija Stević ◽  
Dušica Simić
Keyword(s):  
Septic Shock ◽  
Adjuvant Therapy ◽  
Isotonic Saline ◽  
Fluid Replacement ◽  
Initial Assessment ◽  
Hemodynamic Stability ◽  
Threatening Condition ◽  
Life Threatening ◽  
Sepsis And Septic Shock ◽  
Vasoactive Medications

Sepsis represents a life-threatening condition that requires prompt recognition, detailed initial assessment and energetic administration of therapy. Guidelines published in 2016 emphasized the importance of early fluids replacement and infection control together with assessment based on laboratory parameters and precise monitoring of hemodynamic status of septic patients within the first 3-6 hours after diagnosis. Revision that followed in 2018 stressed that all therapeutic actions should be initiated within the first hour after diagnosis. Urgent administration of isotonic saline and balanced crystalloids in a dose of 30ml/kg should provide adequate hemodynamic stability of septic patients. If the fluid replacement fails to achieve hemodynamic stability and mean arterial pressure >65 mmHg, addition of vasopressors is mandatory. The vasopressor of choice for septic patients is norepinephrine. It may be used alone or in combination with other vasopressors such as epinephrine, vasopressin, terlipresine or phenylephrine. Septic patients with inadequate cardiac output after fluid replacement, and cardiomyopathy induced by sepsis or those with combined shock may need treatment with inotropic medication such as epinephrine or dobutamine. Adjuvant therapy with steroids, immunoglobulins, anticoagulants, statins, vitamin C and Bl, may be useful, but no benefit regarding the overall outcome was observed. In conclusion, early detection of sepsis and septic shock within the first hour and immediate adequate fluid administration with vasoactive medications to maintain hemodynamic stability, are crucial for achievement of better outcome of these patients.

scholarly journals Torsion of Non-gravid Uterus: A Life-Threatening Condition in a Postmenopausal Lady

2020 ◽  
Vol 70 (5) ◽  
pp. 393-396
Author(s):  
Vaishali B. Nagose ◽  
Reny Sadanandan Rosemary ◽  
Rakesh C. Anandrajan ◽  
Nita Hubert ◽  
Reethu Raj
Keyword(s):  
Gravid Uterus ◽  
Threatening Condition ◽  
Life Threatening

Comparison of Initial and Postlavage Bacterial Culture Results of Septic Peritonitis in Dogs and Cats

2018 ◽  
Vol 54 (5) ◽  
pp. 257-266
Author(s):  
Sarah Ruth Kalafut ◽  
Pamela Schwartz ◽  
Rachael Leigh Currao ◽  
Andrew Scott Levien ◽  
George E. Moore
Keyword(s):  
Peritoneal Lavage ◽  
Positive Culture ◽  
Source Control ◽  
Bacterial Isolates ◽  
Common Life ◽  
Significant Difference ◽  
Septic Peritonitis ◽  
Threatening Condition ◽  
Life Threatening ◽  
Susceptibility Profiles

ABSTRACT Septic peritonitis is a common, life-threatening condition encountered in dogs and cats. Efficacy of peritoneal lavage has not been proven in veterinary studies. Our objective was to evaluate differences in bacterial identity and susceptibility in samples obtained pre- and postlavage in animals who underwent laparotomy for treatment of septic peritonitis and to assess the effect of empirical antimicrobial selection on survival. Culture samples were collected from the peritoneal surface pre- and postlavage from dogs and cats treated surgically for septic peritonitis. Culture results were compared for each patient with regard to bacterial isolates and bacterial susceptibility profiles. Survival to discharge was evaluated. Microbial growth occurred in at least one culture in 88.6% of patients. There was no significant difference in bacterial isolates or susceptibility profiles pre- versus postlavage. Positive culture pre- or postlavage and appropriate antimicrobial selection did not significantly affect survival. For individual animals, culture results differed between pre- and postlavage samples, although no definitive effect of peritoneal lavage was seen for the population as a whole. Antimicrobials most commonly effective against isolates were Cefotaxime, Ceftazidime, and Imipenem. If prompt surgical source control is employed, antibiotic choice may not affect clinical outcome.

scholarly journals Erastin Inhibits Septic Shock and Inflammatory Gene Expression via Suppression of the NF-κB Pathway

2019 ◽  
Vol 8 (12) ◽  
pp. 2210 ◽  
Author(s):  
Byung Moo Oh ◽  
Seon-Jin Lee ◽  
Gyoung Lim Park ◽  
Yo Sep Hwang ◽  
Jeewon Lim ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Septic Shock ◽  
Inflammatory Response ◽  
Nuclear Translocation ◽  
Cecal Ligation ◽  
Abnormal Immune Response ◽  
Iκb Kinase ◽  
Tnf Α ◽  
Threatening Condition ◽  
Life Threatening

Sepsis is a life-threatening condition that is caused by an abnormal immune response to infection and can lead to tissue damage, organ failure, and death. Erastin is a small molecule capable of initiating ferroptotic cell death in cancer cells. However, the function of erastin in the inflammatory response during sepsis remains unknown. Here, we showed that erastin ameliorates septic shock induced by cecal ligation and puncture or lipopolysaccharides (LPS) in mice, which was associated with a reduced production of inflammatory mediators such as nitric oxide, tumor necrosis factor (TNF)-α, and interleukin (IL)-1β. Pretreatment with erastin in bone marrow-derived macrophages (BMDMs) significantly attenuated the expression of inducible nitric oxide synthase, cyclooxygenase-2, TNF-α, and IL-1β mRNA in response to LPS treatment. Furthermore, we also showed that erastin suppresses phosphorylation of IκB kinase β, phosphorylation and degradation of IκBα, and nuclear translocation of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) in LPS-stimulated BMDMs. Our findings suggest that erastin attenuates the inflammatory response by suppressing the NF-κB signaling pathway, resulting in inhibition of sepsis development. This study provides new insights regarding the potential therapeutic properties of erastin in sepsis.

scholarly journals Emphysematous Pyelonephritis Caused by a Giant Fecaloma

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Mikael Abi Abdallah ◽  
Nehme Raad ◽  
Naim Yarak ◽  
Jean Paul Noujeim ◽  
Antoine Noujeim
Keyword(s):  
Septic Shock ◽  
Fecal Impaction ◽  
Routine Clinical Practice ◽  
Rapid Progression ◽  
Aggressive Treatment ◽  
Emphysematous Pyelonephritis ◽  
First Case ◽  
Threatening Condition ◽  
Life Threatening ◽  
High Index Of Suspicion

Emphysematous pyelonephritis (EPN) is a gas-producing necrotizing bacterial infection that involves the renal parenchyma and perirenal tissue. It is a life-threatening condition that requires a high index of suspicion, an early diagnosis and an aggressive treatment. Rapid progression to septic shock may occur. We report, to the best of our knowledge, the first case of obstructive EPN caused by a giant fecaloma. The patient was successfully treated with percutaneous drainage and broad-spectrum antibiotics, in addition to fecaloma evacuation using fleet enemas and oral laxatives. This shows how fecal impaction, a common pathology in routine clinical practice, can cause some serious complications if left untreated, including extrinsic ureteral compression.

Anaphylaxis and other allergic reactions to food: a global challenge

2020 ◽  
Vol 13 (5) ◽  
pp. e231425
Author(s):  
Antonio Jose Reyes ◽  
Amanda Sheena Hosein ◽  
Kanterpersad Ramcharan ◽  
Sean Perot
Keyword(s):  
Early Recognition ◽  
Public Awareness ◽  
Successful Outcome ◽  
Allergic Reactions ◽  
Global Challenge ◽  
Link Type ◽  
Preventative Measures ◽  
Appropriate Treatment ◽  
Threatening Condition ◽  
Life Threatening

We describe a case of a biphasic anaphylactic reaction that occurred in a young woman soon after the ingestion of soy milk that led to her hospitalisation. Early recognition and appropriate treatment led to a successful outcome of this life-threatening condition. Challenges encountered in the care of this common illness are highlighted. There is a need for an increase in public awareness on dangerous allergic reactions caused by allergens present in food products in public use, thereby facilitating primary preventative measures to minimise its occurrence. Healthcare stakeholders need to implement measures of contemporary preventative medicine and efficient therapeutic protocols to safeguard the public welfare concerning this global health problem where appropriate interventions can reduce morbidity and mortality. Trial registration numbers NCT02991885 and NCT02851277.

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