scholarly journals Time to clearance of abdominal septic focus and mortality in patients with sepsis

2020 ◽  
Vol 32 (2) ◽  
Author(s):  
Rafael Barberena Moraes ◽  
Thiago Ferreira Serafini ◽  
Josi Vidart ◽  
Miriane Melo Silveira Moretti ◽  
Jaqueline Sangiogo Haas ◽  
...  
Keyword(s):  
Septic Focus

scholarly journals SARS-CoV-2-associated gastrointestinal and liver diseases: what is known and what is needed to explore

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dina Sweed ◽  
Eman Abdelsameea ◽  
Esraa A. Khalifa ◽  
Heba Abdallah ◽  
Heba Moaz ◽  
...  
Keyword(s):  
English Language ◽  
Data Extraction ◽  
Oral Route ◽  
Main Body ◽  
Disease Manifestation ◽  
Gi Symptoms ◽  
Septic Focus ◽  
Pubmed Search ◽  
Risk Patients ◽  
Respiratory Droplets

Abstract Background The pandemic of COVID19 which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first described in China as an unexplained pneumonia transmitted by respiratory droplets. Gastrointestinal (GI) and liver injury associated with SARS-CoV-2 infection were reported as an early or sole disease manifestation, mainly outside China. The exact mechanism and incidence of GI and liver involvement are not well elucidated. Main body We conducted a PubMed search for all articles written in the English language about SARS-CoV-2 affecting the GI and liver. Following data extraction, 590 articles were selected. In addition to respiratory droplets, SARS-CoV-2 may reach the GI system through the fecal-oral route, saliva, and swallowing of nasopharyngeal fluids, while breastmilk and blood transmission were not implicated. Moreover, GI infection may act as a septic focus for viral persistence and transmission to the liver, appendix, and brain. In addition to the direct viral cytopathic effect, the mechanism of injury is multifactorial and is related to genetic and demographic variations. The most frequently reported GI symptoms are diarrhea, nausea, vomiting, abdominal pain, and bleeding. However, liver infection is generally discovered during laboratory testing or a post-mortem. Radiological imaging is the gold standard in diagnosing COVID-19 patients and contributes to understanding the mechanism of extra-thoracic involvement. Medications should be prescribed with caution, especially in chronic GI and liver patients. Conclusion GI manifestations are common in COVID-19 patients. Special care should be paid for high-risk patients, older males, and those with background liver disease.

scholarly journals Technetium-99m ceftizoxime kit preparation

2005 ◽  
Vol 48 (spe2) ◽  
pp. 89-96 ◽  
Author(s):  
Simone Odília Fernandes Diniz ◽  
Cristiano Ferrari Siqueira ◽  
David Lee Nelson ◽  
Josep Martin-Comin ◽  
Valbert Nascimento Cardoso
Keyword(s):  
Biological Activity ◽  
Gamma Camera ◽  
Wistar Rats ◽  
Sodium Dithionite ◽  
Regions Of Interest ◽  
Infection Model ◽  
Cellulose Ester ◽  
E Coli ◽  
Septic Focus ◽  
The One

The aim of this work was to prepare a kit of 99mTc-ceftizoxime (99mTc-CFT), with stability and biological activity preserved, able to identify a septic focus (E. coli) in the experimental infection model in rats. The preparation of the CFT kit involved the use of lyophilized solutions containing the antibiotic ceftizoxime and the sodium dithionite reducing agent (6.0 mg/mL). After lyophilization, the kit was reconstituted with 1.0 mL of sodium 99mTc-pertechnetate solution (Na99mTcO4-) with an activity of 370 MBq. The solution was boiled for 10 min and filtered through a cellulose ester filter. The labeling efficiency was on the order of 92%, remaining stable for six hours and the kit remained stable for two months. The biological activity of the 99mTc-CFT was evaluated by diffusion in agar impregnated with E.coli and S. aureus. Seven Wistar rats, weighing from 200 to 250 g, were used for the development of the septic focus. After 24 hours from the induction of the infectious site (E.coli), the animals were anesthetized and 0.1 mL of 99mTc-CFT (37 MBq) was injected into the tail veins of the animals. The images were obtained with a gamma camera one, two and six hours after injection and the regions of interest (ROIs) were calculated. The diameters of the inhibition halos for 99mTc-CFT were 27.16 ± 0.23 and 27.17 ± 0.20 for S.aureus and E.coli, respectively, while those for the unlabeled CFT were 30.4 ± 0.33 and 29.43 ± 0.26, respectively. The results for the biodistribution of 99mTc-CFT in infected animals furnished a ratio of 1.97 ± 0.31, 2.10 ± 0.42 and 2.01 ± 0.42 for cpm-target/cpm-no target for the one, two and six-hour periods, respectively. The images showed a clear uptake of labeled antibiotic (99mTc-CFT) by the infectious site during the experiment. The results attest to the viability of producing a kit with 99m technetium-labeled ceftizoxime for the investigation of infectious processes.

Structural basis for blood stream invasion byPseudomonas aeruginosa from the primary septic focus

1985 ◽  
Vol 100 (1) ◽  
pp. 905-908
Author(s):  
N. V. Panova ◽  
B. V. Vtyurin ◽  
N. D. Skuba ◽  
I. P. Bochkareva
Keyword(s):  
Blood Stream ◽  
Structural Basis ◽  
Septic Focus

SURGICAL OPTIONS IN ACUTE DIVERTICULITIS: VALUE OF SlGMOlD RESECTION IN DEALING WITH THE SEPTIC FOCUS

1988 ◽  
Vol 58 (12) ◽  
pp. 955-959 ◽  
Author(s):  
George J. Kourtesis ◽  
Russell A. Williams ◽  
Samuel E. Wilson
Keyword(s):  
Acute Diverticulitis ◽  
Septic Focus ◽  
Surgical Options

scholarly journals Special aspects of systemic inflammation course in animals

2019 ◽  
Vol 12 (7) ◽  
pp. 932-937 ◽  
Author(s):  
Svetlana Vladimirovna Chernigova ◽  
Yury Vladimirovich Chernigov ◽  
Yury Anatolyevich Vatnikov ◽  
Evgeny Vladimirovich Kulikov ◽  
Irina Anatolyevna Popova ◽  
...  
Keyword(s):  
Lipid Peroxidation ◽  
Glutathione Reductase ◽  
Systemic Inflammation ◽  
Inflammatory Process ◽  
Unsaturated Fatty Acids ◽  
Control Group ◽  
Symptomatic Therapy ◽  
Membrane Structures ◽  
Pharmacological Agents ◽  
Septic Focus

Aim: In this study, we identified characteristics of systemic inflammation associated with surgical sepsis in animals. We evaluated the role of purine metabolism, functionally associated lipoperoxidation processes of membrane structures, and the antioxidant system in the development of surgical sepsis in dogs. Materials and Methods: Dogs with a provisional exclusion of sepsis were included in the study. The control group (Group 1) included clinically healthy dogs (n=5), and medium-breed dogs with systemic inflammation response syndrome (n=30) were categorized in the experimental group (Group 2). Along with hemogram and biochemical analysis, we determined the amount of malondialdehyde, glutathione, superoxide dismutase, catalase, glutathione reductase, and glucose-6-phosphate dehydrogenase on the 1st and 14th day of the study. Treatment included a thorough reorganization of the septic focus, followed by antibacterial therapy. Sick animals were injected with a drug (dexamethasone) that suppresses the synthesis and inhibits the action of inflammatory mediators. Decompensation of the functions of organs and systems was carried out using symptomatic therapy. Results: We found that enhanced lipid peroxidation of unsaturated fatty acids of membrane structures stimulates the generalization of inflammatory process, as evidenced by the significant deviation from the physiologically normal values of lipid peroxidation, C-reactive protein, blood cell count, etc. The course of systemic inflammation associated with surgical sepsis in animals can be attributed to several consistently developing processes that function as a result of increased purine mononucleotide catabolism, peroxide compound formation, and their excessive breakdown in reactions associated with the consumption of glutathione due to the insufficient recovery of glutathione disulfide. Conclusion: The amount of uric acid, glycosaminoglycans, hyaluronic acid in blood plasma, and the content of malondialdehyde, glutathione, and glutathione reductase in erythrocytes should be considered when assessing the severity of the systemic inflammatory process. The increased glutathione requirement in dogs with surgical sepsis requires intervention with pharmacological agents, and further research is needed in this aspect.

scholarly journals Septic Hip Arthritis in Patients with Osteonecrosis of Femoral Head: Two Cases Report and Review of the Literature

2020 ◽  
Author(s):  
Zhiping Zhao ◽  
Xiangyu Wang ◽  
Changyao Wang ◽  
Yingzhen Wang ◽  
Yongtao Zhang
Keyword(s):  
Femoral Head ◽  
Septic Arthritis ◽  
Clinical Manifestations ◽  
Joint Fluid ◽  
Osteonecrosis Of Femoral Head ◽  
Reactive Protein ◽  
Intravenous Antibiotics ◽  
Hip Infection ◽  
Septic Focus ◽  
Magnetic Resonance Imaging Mri

Abstract Background: In patients with osteonecrosis of femoral head (ONFH), septic arthritis of the hip is rare, especially in the absence of factors likely to cause infection, which are often ignored by surgeons. Methods: Two patients seen at our hospital who had ONFH and concomitant septic arthritis of the hip joint were selected for inclusion in the study. Results: The clinical course suggests that ONFH developed prior to the hip infection. The two patients were not immune-compromised, and no remote septic focus was identified. The 2 patients, clinical manifestations of infection included fever and elevated white blood cell count. Elevated levels of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were observed in all 2 patients. In all patients, the results of hip magnetic resonance imaging (MRI) indicated hip infection. For 1 patients, culturing joint fluid revealed the presence of bacteria. In the second case, joint fluid was not cultured. In each case, the hip was debrided, and a spacer made of bone cement and containing vancomycin was implanted in the hip. Intravenous antibiotics were administered for 6 weeks postoperatively. There was no recurrence of infection, and total hip arthroplasty (THA) was performed 6 months after the operation. Conclusions: Septic hip is rare but exist in patients with ONFH. Elevated ESR and CRP contributed to the initial diagnosis; the results of hip MRI help to confirm the diagnosis. Overall, THA was an effective treatment.

scholarly journals Cerebellar Abscess Mimicking Recurrent Pilocytic Astrocytoma: A Case Report

2016 ◽  
Vol 12 (2) ◽  
pp. 85-87
Author(s):  
Harihar Devkota ◽  
Rajiv Jha
Keyword(s):  
Case Report ◽  
Children And Adolescents ◽  
Pilocytic Astrocytoma ◽  
Preoperative Diagnosis ◽  
Rare Condition ◽  
Final Diagnosis ◽  
Cerebellar Abscess ◽  
Septic Focus ◽  
Operative Findings ◽  
Space Occupying Lesion

Cerebellar abscess is a rare condition occurring more commonly in children and adolescents usually caused by otitis media. They can occur following trauma or surgery or from septic focus directly or hematologically. It is sometime hard to distinguish from other space occupying lesion clinically or by imaging modalities. We report a case of an eight year boy who had undergone craniotomy and excision of a pilocytic astrocytoma two years back and now presented with headache and preoperative diagnosis of recurrent pilocytic astrocytoma was made. But, to our surprise, the operative findings showed an abscess which was confirmed with histopathology. The final diagnosis of cerebellar abscess was made.Nepal Journal of Neuroscience 12:85-87, 2015

Surgical Management of Non-Malignant Esophageal Perforations: A Single-Center Analysis Over a 15-Year Period

2019 ◽  
Vol 37 (4) ◽  
pp. 302-311
Author(s):  
Karl-Frederick Karstens ◽  
Eugen Bellon ◽  
Michael Tachezy ◽  
Jakob R. Izbicki ◽  
Tarik Ghadban ◽  
...  
Keyword(s):  
Surgical Management ◽  
Treatment Options ◽  
Multivariate Logistic Regression Analysis ◽  
Critically Ill Patient ◽  
High Morbidity ◽  
Asa Score ◽  
Septic Focus ◽  
Tertiary Center ◽  
Esophageal Perforations ◽  
The Impact

Purpose: Esophageal perforations are associated with high morbidity and mortality. Different nonoperative and operative treatment options have been proposed. This study focuses on the impact of different surgical treatments in nonmalignant esophageal perforations and tries to identify predictors of mortality in a single tertiary center over a 15-year period. Methods: From 2002 to 2017, patients with surgically managed esophageal perforation were identified from our database. Patients with esophageal malignancies were excluded. Etiology, clinical data, treatment, and outcome were analyzed. A multivariate logistic regression analysis was performed to investigate the impact on mortality. Results: A total of 72 patients were identified. The majority of perforations were iatrogenic (54.2%) followed by Boerhaave’s syndrome (23.6%). Most ruptures were found in the distal third of the esophagus (59.7%) measuring <3 cm (61.1%). Patients were treated with exploration and drainage (8.3%), primary suture and patch reinforcement (36.1%), resection and restoration of continuity (25.0%), or resection without restoration of continuity (30.6%). Delayed therapy significantly correlated with sepsis (p < 0.0001) and mortality (p = 0.032). A correlation between an increasing perforation length with sepsis (p = 0.012) was observed. A higher Perforation Severity Score (PSS; OR 4.430; 95% CI 1.143–17.174; p = 0.031) and a higher American Society of Anesthesiologists (ASA) score (OR 2.923; 95% CI 1.011–8.448; p = 0.048) were associated with mortality in multivariate analysis. Conclusion: Esophageal perforations are associated with high mortality, and larger ruptures are associated with worse outcome. Rapid diagnosis and treatment are crucial for patient survival. Hence, PSS and ASA score help to identify high-risk patients. The advantage of surgical management lies in the rapid control of the septic focus in an already critically ill patient. Though, the kind of surgical technique needs to be adjusted to the individual situation.

Mechanical Bridge to Transplantation with the Vienna Heart in TAH and LVAD Configuration

1992 ◽  
Vol 15 (3) ◽  
pp. 147-167 ◽  
Author(s):  
A. Moritz ◽  
A. Rokitansky ◽  
H. Schima ◽  
A. Prodinger ◽  
G. Laufer ◽  
...  
Keyword(s):  
Artificial Heart ◽  
Clinical Problem ◽  
Left Ventricular ◽  
Total Artificial Heart ◽  
Circulatory Support ◽  
Ventricular Assist ◽  
Septic Focus ◽  
Left Ventricular Assist ◽  
Liver And Kidney ◽  
Kidney Insufficiency

The Vienna heart uses a vacuum formed, pellethane pulsatile ventricle and is available in left ventricular assist (LVAD) and total artificial heart (TAH) configurations. This device was used as mechanical support of the failing heart in nine patients intended for heart transplantation. In two patients with cardiomyopathy an orthotopic TAH was implanted; one survived despite severe preoperative ischemic liver damage, and the other died of sepsis. In seven patients an atrio-aortic LVAD was implanted; six had suffered an acute myocardial infarction with cardiogenic shock, and one could not be weaned off bypass. Three patients survived. These included one 65-year-old with incipient ARDS at operation, and a 40-year-old with preoperative liver and kidney insufficiency who was transplanted in septicemia. In this patient the septic focus, natural and artificial heart, were removed at transplantation. Four patients died. In one we were unable to establish satisfactory circulation, one died after failure of the transplanted heart, one suffered a lethal cerebral embolism and one developed multi-organ failure after repeated attacks of ventricular fibrillation. With the Vienna heart sufficient circulatory support could be established with cardiac outputs between 6 and 8 l/min for the TAH and 3.5 to 4.5 I/min for the LVAD. With this type of support an overall survival rate of 44% could be achieved. Mechanical hemolysis was not a clinical problem and no device failure occurred.

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