Correlation between urinary biomarker and organ failure in patients with sepsis and patients after esophagectomy: a prospective observational study

AbstractBackgroundNeutrophil gelatinase-associated lipocalin (NGAL) is a diagnostic marker for acute kidney injury (AKI). NGAL expression is highly induced not only in kidney injury but also in bacterial infection, inflammation, and cancer. The factors regulating NGAL expression are proinflammatory cytokines, and plasma NGAL levels have been increased in septic shock. However, there are no reports of urine neutrophil gelatinase-associated lipocalin (uNGAL) levels after open esophagectomy.MethodsWe prospectively enrolled critically ill patients, including patients with sepsis (n = 45) and patients who underwent open esophagectomy (n = 40). We compared vital signs, PaO2/FIO2, serum C-reactive protein (CRP) levels, acute physiology and chronic health evaluation (APACHE) II score, sequential organ failure assessment (SOFA) score, and uNGAL levels between the sepsis group and the esophagectomy group. Then, we investigated whether uNGAL is associated with the severity of illness and organ failure, and whether uNGAL is a reliable screening test for AKI.ResultsThe median uNGAL levels, APACHE II score, SOFA score, and serum CRP levels were significantly (p 
Source: Journal of Intensive Care - Category: Intensive Care Source Type: research

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Conclusions: Sepsis affects a fifth of patients admitted to ICUs in mainland China with a 90-day mortality rate of 35.5%. Our findings indicate that a large burden of sepsis, and we need to focus on sepsis as a quality improvement target in China given the high mortality. In addition, further studies are needed to delineate the epidemiology of sepsis outside the ICU.
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research
Conclusions: A sepsis inpatient admission is associated with marked increase in risk of death that is comparable to the risks associated with inpatient admissions for other common and serious chronic illnesses. The aggregate costs of sepsis care for Medicare beneficiaries will continue to increase.
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Late Breaker Articles Source Type: research
This study was undertaken to find out the usefulness of Absolute eosinophil count as a biomarker for sepsis, especially in Indian settings where cost constraints are the rule.MethodsA prospective observational study was carried out over a period of one year in KIMS Al Shifa Super Speciality Hospital which is a tertiary care referral hospital in Malabar region of Kerala. Patients admitted in the ICU with a diagnosis of Systemic Inflammatory Response Syndrome(SIRS) were included except those with hematological cancer, HIV infection, previous eosinophilia due to any cause, trauma patients or those on long term systemic steroi...
Source: Clinical Epidemiology and Global Health - Category: Epidemiology Source Type: research
Abstract OBJECTIVE: To evaluate risk factors for 30-day unplanned readmission and increased length of stay (LOS) following minimally invasive surgery (MIS) for endometrial cancer. METHODS: This was a retrospective, case-control study using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). Multivariable logistic regression was used to assess perioperative variables associated with readmission and increased LOS after MIS for endometrial cancer. RESULTS: The study population included 10,840 patients who met the criteria of having undergone MIS with a resultant endom...
Source: Gynecologic Oncology - Category: Cancer & Oncology Authors: Tags: Gynecol Oncol Source Type: research
CONCLUSION: The standard treatment of hormone receptor positive and HER-2 negative metastatic breast cancer is everolimus together with exemestane. Due to the immunosuppressive effects of everolimus, the medication may cause invasive fungal infection or other opportunistic infections. Such infections are serious and may even be fatal. In this case, we did not consider CMV infection until rectovaginal fistula formation. Thus, for solid cancer patients presented with fever of unknown origin, clinicians should consider potential complications of CMV infection. PMID: 31773503 [PubMed - as supplied by publisher]
Source: Breast Cancer - Category: Cancer & Oncology Authors: Tags: Breast Cancer Source Type: research
Conclusions: In cancer patients with septic shock, vasopressin as first-line vasopressor therapy was not superior to norepinephrine in reducing 28-day mortality rate.
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Clinical Investigations Source Type: research
Conclusion: We report a first case of systemic bacterial infection in a patient with anti-IL6 autoantibodies. Disturbed IL-6 signaling, whether iatrogenic by targeted IL-6 blockade or endogenous due to the presence of autoantibodies against IL-6, represents a risk factor for increased infectious susceptibility. Patients with severe bacterial infection without elevation of CRP should be examined for the presence of anti-IL6 autoantibodies.
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
The gasdermins are a family of pore-forming proteins recently implicated in the immune response. One of these proteins, gasdermin D (GSDMD), has been identified as the executioner of pyroptosis, an inflammatory form of lytic cell death that is induced upon formation of caspase-1–activating inflammasomes. The related proteins GSDME and GSDMA have also been implicated in autoimmune diseases and certain cancers. Most gasdermin proteins are believed to have pore-forming capabilities. The best-studied member, GSDMD, controls the release of the proinflammatory cytokines IL-1ß and IL-18 and pyroptotic cell death. Beca...
Source: The Journal of Experimental Medicine - Category: Internal Medicine Authors: Tags: Innate Immunity and Inflammation, Infectious Disease and Host Defense Review Source Type: research
Beclin 1 (Becn1) is a key molecule in the autophagy pathway and has been implicated in cancer development. Due to the embryonic lethality of homozygous Becn1-deficient mice, the precise mechanisms and cell type–specific roles of Becn1 in regulating inflammation and cancer immunity remain elusive. Here, we report that myeloid-deficient Becn1 (Becn1ΔM) mice developed neutrophilia, were hypersusceptible to LPS-induced septic shock, and had a high risk of developing spontaneous precursor B cell (pre-B cell) lymphoma with elevated expressions of immunosuppressive molecules programmed death ligand 1 (PD-L1) and IL-10...
Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
Abstract Background/Aims: Among patients with febrile neutropenia that developed after chemotherapy, high-risk patients, such as those having clinical instability or Multinational Association of Supportive Care in Cancer score of
Source: The Korean Journal of Internal Medicine - Category: Internal Medicine Authors: Tags: Korean J Intern Med Source Type: research
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