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Septic Shock From Pan-Spinal Epidural Abscess Attributed to Recent Acupuncture and Trigger Point Injections for Acute Lower Back Pain in a Previously Undiagnosed Diabetic Patient: A Case Report
We report the case of a 60-year-old woman with undiagnosed diabetes mellitus who presented to the hospital with a complaint of progressive altered mental status for the past two days. Eight days prior to presentation, the patient tripped over a pillow at home and developed mildly nagging, acute lower back pain. Upon the recommendation of her friends, she underwent two sessions of acupuncture around the lumbar area on days six and five prior to being brought to the hospital. She also saw her primary care physician on day three prior to presentation, who performed a history and physical examination and, after feeling that sh...
Source: Pain Physician - June 9, 2023 Category: Anesthesiology Authors: Shaheryar Usman Faraz Badar Carlos Collado Andrew Weber Alan Kaell Source Type: research

Hospital outcomes for patients with pulmonary arterial hypertension in sepsis and septic shock.
Background: Pulmonary arterial hypertension (PAH) is associated with increased morbidity and mortality risk. The risk for adverse outcomes in patients with PAH in sepsis or septic shock (SSS) is uncertain. Methods: Adult patients diagnosed with SSS were identified in the National Readmissions Database over the years 2016-2017. A 2:1 ratio nearest propensity matching method was employed for several demographic, social, and clinical variables. In-hospital outcomes were compared between patients with PAH and those without, using t-test and chi-squared test as appropriate. Patients with cardiogenic shock were excluded. Releva...
Source: Current Awareness Service for Health (CASH) - October 7, 2022 Category: Consumer Health News Source Type: news

Approaches in Prehospital Sepsis Screening
Discussion In the United States, sepsis is one of the leading causes of death, which requires timely identification and proper treatment (CDC, 2019; Guerra et al., 2020; Polito et al., 2015). Based upon a review of literature conducted from 2014 to 2018, the primary investigators could locate five prehospital EMS screening tools to assist EMS providers in identifying at-risk sepsis patients. The researchers explored how the modified SIRS and qSOFA scoring systems were used in hospital settings in addition to these five prehospital EMS screening tools. The Bas 90-30-90, Guerra, PRESEP, PRESS, and Robson tools have ove...
Source: JEMS Operations - January 5, 2021 Category: Emergency Medicine Authors: JEMS Staff Tags: Exclusives Patient Care EMS EMT Paramedic Prehospital Sepsis Source Type: news

Fluid Response Evaluation in Sepsis Hypotension and Shock: A Randomized Clinical Trial.
Abstract BACKGROUND: Fluid and vasopressor management in septic shock remains controversial. In this randomized controlled trial, we evaluated the efficacy of dynamic measures (stroke volume change during passive leg raise) to guide resuscitation and improve patient outcome. RESEARCH QUESTION: Will resuscitation guided by dynamic assessments of fluid responsiveness in patients with septic shock improve patient outcomes? STUDY DESIGN: and Methods: Prospective, multicenter, randomized clinical trial at 13 hospitals in the United States and United Kingdom. Patients presented to Emergency Rooms with sepsis a...
Source: Chest - April 26, 2020 Category: Respiratory Medicine Authors: Douglas IS, Alapat PM, Corl KA, Exline MC, Forni LG, Holder AL, Kaufman DA, Khan A, Levy MM, Martin GS, Sahatjian JA, Seeley E, Self WH, Weingarten JA, Williams M, Hansell DM Tags: Chest Source Type: research

A Blood Filter Fights Deadly Inflammatory Response
A new blood filtration technology may prove to be life-saving for patients whose normally healthy inflammatory response to injury or illness has gone into overdrive, resulting in fatally high levels of cytokines in their blood. In an interview with MD+DI, Dr. Phillip Chan, MD, PhD, CEO of CytoSorbents Corp., explained that inflammation, and the production of substances called cytokines that drive inflammation, are the body’s natural response to heal injury or infection. But sometimes, the inflammatory response is so severe in such conditions as sepsis and infection, burn injuries, trauma, pancreatitis, li...
Source: MDDI - October 9, 2019 Category: Medical Devices Authors: Susan Shepard Tags: Cardiovascular Source Type: news

Weight! Weight! … Don’t Tell Me!
Weight-based, lifesaving medications are commonly used in hospitals and routinely used in emergency departments.1 Many weight-based medications are listed in the Institute for Safe Medication Practices (ISMP) high-alert medication list. According to ISMP, “high-alert medications are drugs that bear a heightened risk of causing significant patient harm when they are used in error.”2 These frequently used medications include anticoagulants (eg, heparin and enoxaparin), antibiotics for septic shock (eg, vancomycin and tobramycin), fibrinolytic agent s for stroke (eg, alteplase), and antiepileptic drugs (eg, phenytoin and fosphenytoin).
Source: Journal of Emergency Nursing: JEN - August 22, 2019 Category: Nursing Authors: Avani Bhalodia, Mona Hammam, Susan F. Paparella Tags: Danger Zone Source Type: research

“A contemporary description of staphylococcus aureus prosthetic valve endocarditis. Differences according to the time elapsed from surgery”
Staphylococcus aureus prosthetic valve endocarditis (SAPVE) has a poor prognosis. There are no large series that accurately describe this entity. This is a retrospective observational study on a prospective cohort from 3 Spanish reference hospitals for cardiac surgery, including 78 definitive episodes of left SAPVE between 1996 and 2016. Fifty percent had a Charlson Index score>5; 53% were health care-related. Twenty percent did not present fever. Complications at diagnosis included: severe heart failure (HF, 29%), septic shock (SS, 17.9%), central nervous system abnormalities (19%), septic metastasis (4%). Hemorrhagic s...
Source: Medicine - August 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Pentraxin 3 in Cardiovascular Disease
Giuseppe Ristagno1*, Francesca Fumagalli1, Barbara Bottazzi2, Alberto Mantovani2,3,4, Davide Olivari1, Deborah Novelli1 and Roberto Latini1 1Department of Cardiovascular Research, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy 2Humanitas Clinical and Research Center-IRCCS, Milan, Italy 3Humanitas University, Milan, Italy 4The William Harvey Research Institute, Queen Mary University of London, London, United Kingdom The long pentraxin PTX3 is a member of the pentraxin family produced locally by stromal and myeloid cells in response to proinflammatory signals and microbial moieties. The p...
Source: Frontiers in Immunology - April 16, 2019 Category: Allergy & Immunology Source Type: research

A Study of Convulsive Status Epilepticus Cases in Indonesia
Publication date: Available online 14 March 2019Source: Epilepsy & Behavior Case ReportsAuthor(s): Machlusil Husna, K. Shahdevi Nandar, Risma Karlina Prabawati, Siti NurlaelaAbstractStatus epilepticus (SE) is a serious health issue in developing countries, with high morbidity and mortality rates of 3%–46%. There are two types of SE, convulsive status epilepticus (CSE) and non-convulsive status epilepticus. The most common type, CSE, is easy to detect but, in several cases, the patients are diagnosed too late to be properly treated and hospitalized. The present study therefore investigated the clinical manifestations of C...
Source: Epilepsy and Behavior Case Reports - March 16, 2019 Category: Neurology Source Type: research

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