Search results for "Shock"

Plasma derived protein C in severe sepsis: report of two cases

2008

Severe sepsis is defined as sepsis-associated organ dysfunction, (arterial hypoxemia, acute oliguria, coagulation abnormalities, thrombocytopenia, hyperbilirubinemia), hypoperfusion (hyperlactatemia) and arterial hypotension (mean arterial pressure \70 mmHg, or a systolic blood pressure decrease[40 mmHg) [3, 4]. Septic shock [3, 4] is defined as acute circulatory failure induced by sepsis with hypotension despite adequate fluid resuscitation. A dysfunction of the protein C (PC) pathway is always present in severe sepsis and contributes to the development of coagulopathy and necrosis [12, 13]. This decrease is caused by consumption of protein C during systemic activation of blood coagulation…

PGC-1α: a master gene that is hard to master

2012

Peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) is a transcriptional coactivator that favorably affects mitochondrial function. This concept is supported by an increasing amount of data including studies in PGC-1α gene-deleted mice, suggesting that PGC-1α is a rescue factor capable of boosting cell metabolism and promoting cell survival. However, this view has now been called into question by a recent study showing that adeno-associated virus-mediated PGC-1α overexpression causes overt cell degeneration in dopaminergic neurons. How is this to be understood, and can these seemingly conflicting findings tell us something about the role of PGC-1α in cell stress and in cont…

2015

OBJECTIVES: To update the epidemiology of S. aureus bloodstream infection (SAB) in a high-income country and its link with infective endocarditis (IE).METHODS: All consecutive adult patients with incident SAB (n = 2008) were prospectively enrolled between 2009 and 2011 in 8 university hospitals in France. RESULTS: SAB was nosocomial in 54%, non-nosocomial healthcare related in 18% and community-acquired in 26%. Methicillin resistance was present in 19% of isolates. SAB Incidence of nosocomial SAB was 0.159/1000 patients-days of hospitalization (95% confidence interval [CI] 0.111-0.219). A deep focus of infection was detected in 37%, the two most frequent were IE (11%) and pneumonia (8%). Th…

Predictors and prognosis for complex coronary lesions in patients with acute myocardial infarction

2007

Background We aimed to investigate the determinants and outcomes of multiple complex lesions (MCLs) on coronary angiography in patients with an acute myocardial infarction. Methods One thousand one hundred fifty-two consecutive nonselected myocardial infarction patients who underwent coronary angiography within 24 hours after admission were analyzed. A complex lesion was defined by the presence of thrombus, ulceration, irregular plaque, and flow impairment. Patients with ≤1 complex lesion were considered with single complex lesion (SCL), and patients with >1 complex lesions with MCLs. Results Multiple complex lesions were identified in 360 patients (31%). Patients from the MCL group were ol…

ESWL Prediction of outcome and failure Prevention

2007

Based on our own experiences and a review of the recent literature, this article evaluates recent developments in predicting outcomes and failures of shockwave lithotripsy when treating patients with urinary tract stones. After a detailed MEDLINE research, the authors identified several variables that influence and predict extracorporeal shockwave lithotripsy (ESWL) success. These variables may be categorized as stone variables, patient variables and operator variables. Only multivariate analysis on a large number of homogenous patients may offer an objective evaluation of the factors conditioning ESWL outcome.

Prognostic value of blood lactate in critically ill patients

1984

Hyperlactatemia is frequently observed in critically ill patients. A correlation of blood lactate concentrations and outcome of patients has been proven in circulatory shock, circulatory arrest, acute myocardial infarction, acute hypnotic drug poisoning and severe pancreatitis. However, the prognostic relevance of hyperlactatemia yields from statistical examinations in larger groups of patients. It should not be misused as a reliable prognostic sign in the individual patient, but is of high value in comparing groups of patients. In individual patients, hyperlactatemia is a useful indicator pointing to the severity of illness and to superimposed complications. Blood lactate is of considerabl…

Concomitant use of veno-arterial extracorporeal membrane oxygenation and Impella in the intensive care unit: a case report of fulminant myocarditis w…

2020

1232 Acute myocarditis: prognostic role of speckle tracking echocardiography and cardiac magnetic resonance

2020

Abstract Background Myocarditis is an inflammatory disease of the myocardium predominantly caused by infection with subsequent immunological response. Cardiac magnetic resonance (CMR) is the currently best imaging modality to confirm a suspected diagnosis of myocarditis. Conventional echocardiography can detect regional or global wall motion abnormalities but it could also be negative. Speckle tracking echocardiography can help to identify subtle systolic dysfunction, in patients with myocardits and apparently negative echocardiogram. Purpose the aim of this study was to identify cardiac imaging parameters predictive of cardiovascular events in patients with acute myocarditis. Methods a pro…

Focus on right ventricular outflow tract septal pacing

2013

SummaryExperimental and clinical studies have shown that right ventricular apical pacing may result in long-term deleterious effects on account of its negative impact on left ventricular remodeling through desynchronization. This risk appears more pronounced in patients with even moderate left ventricular dysfunction and generally occurs after at least 1 year of pacing. As right ventricular apical pacing may be associated with the development of organic mitral insufficiency, other sites that allow for more physiological stimulation, such as right ventricular outflow tract septal pacing, have been developed, with good feasibility and reproducibility. However, the prospective randomized studi…

Temporal trends in postinfarction ventricular septal rupture: the CIVIAM Registry

2020

Abstract Introduction and objectives Postinfarction ventricular septal rupture is a rare but severe complication of myocardial infarction with high mortality rates. Our goal was to analyze which factors could have an impact on mortality due to this entity over the past decade, including those related to mechanical circulatory support . Methods The CIVIAM registry is an observational, retrospective, multicenter study carried out in Spain. We designed a comparative analysis, focused on description of in-hospital management and in-hospital and 1-year total mortality as the primary endpoints, dividing the total observation time into 2 equal temporal periods (January 2008 to June2013 and July 20…