Search results

1

Septic shock in the course of liver abscess rescued with percutaneous drainage – a literature review and case report

100%

Snarska J., Michalak M., Masiulaniec P., Jacyna K., Zalewski A.

Polish Journal of Surgery

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2016

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vol. 88(5)

496-503

EN

This study presented a septic shock occurring with striking speed during the percutaneous drainage of a large abscess of the liver in an 18-year-old female patient after an appendectomy performed 3 months earlier using the laparoscopic method because of its phlegmonous and gangraenosus inflammation. The post-operative course was complicated by increased suppuration in places after removal of the trocars. After including the intravenous antibiotic therapy and under the USG control, the percutaneous drainage of the abscess was performed. While withdrawing the guide of the drainage catheter set, the symptoms of septic shock occurred. The pharmacological treatment was applied with continuation of the antibiotic therapy till a negative result of microbiological tests was obtained and the normalization of life parameters. The patient was not qualified for treatment in the ICU. She was discharged in a generally good condition after 24 days of hospitalization. In the case of this patient, the drain covered with the content of the abscess may have contact with the adjacent tiny blood vessels, which may have contributed to the systemic inflammatory response syndrome that was linked with fast-developing sceptic shock.

2

Implantable cardiac electronic device infections: single center study

100%

Sławiński G., Kempa M., Lewicka E. K., Budrejko S., Królak T., Raczak G.

European Journal of Translational and Clinical Medicine

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2018

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vol. 1

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issue 1

57-62

EN

Implantable cardiac electronic device (ICED) infections include- lead infection (ICED-LI), device pocket infection (PI) and infective endocarditis (ICED-IE). The aim of this study is to analyze the records of patients with ICED, who developed implantable device-related infections. We analyzed retrospectively the records of the University Clinical Centre (Gdańsk) patients who in 2012-2018 underwent transvenous lead extraction (TLE) due to infections. In order to identify potential ICED infection risk factors we included patients who underwent any electrotherapy procedure within 2 years prior to the TLE. ICED infections that led to septic shock were defined as severe. The analyzed sample included 59 patients with infectious complications (37 male and 22 female) with median age of 74. The in-hospital mortality was 8.5%. All patients with severe ICED infection were diagnosed with ICED-LI, whereas the rest of the sample was diagnosed mostly with PI (p<0.001). The most commonly cultured pathogens were S. aureus and S. epidermidis. In the analyzed sample, the most common infectious complication related to the ICED was PI and the most common etiological agents were S. aureus and S. epidermidis. Severe ICED infections that present with septic shock are associated with a 50% in-hospital mortality rate.

3

Implantable cardiac electronic device infections: single center study

100%

Sławiński G., Kempa M., Lewicka E. K., Budrejko S., Królak T., Raczak G.

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2018

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vol. 1

|

issue 1

57-62

EN

Implantable cardiac electronic device (ICED) infections include- lead infection (ICED-LI), device pocket infection (PI) and infective endocarditis (ICED-IE). The aim of this study is to analyze the records of patients with ICED, who developed implantable device-related infections. We analyzed retrospectively the records of the University Clinical Centre (Gdańsk) patients who in 2012-2018 underwent transvenous lead extraction (TLE) due to infections. In order to identify potential ICED infection risk factors we included patients who underwent any electrotherapy procedure within 2 years prior to the TLE. ICED infections that led to septic shock were defined as severe. The analyzed sample included 59 patients with infectious complications (37 male and 22 female) with median age of 74. The in-hospital mortality was 8.5%. All patients with severe ICED infection were diagnosed with ICED-LI, whereas the rest of the sample was diagnosed mostly with PI (p<0.001). The most commonly cultured pathogens were S. aureus and S. epidermidis. In the analyzed sample, the most common infectious complication related to the ICED was PI and the most common etiological agents were S. aureus and S. epidermidis. Severe ICED infections that present with septic shock are associated with a 50% in-hospital mortality rate.

4

X-band and S-band EPR detection of nitric oxide in murine endotoxaemia using spin trapping by ferro-di(N-(dithiocarboxy)sarcosine).

75%

Plonka P. M., Wisniewsk M., Chlopicki S., Elas M., Rosen G. M.

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2003

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vol. 50

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issue 3

799-806

EN

Ammonium salt of N-(dithiocarboxy)sarcosine (DTCS) chelated to ferrous salt was tested as an NO-metric spin trap at room temperature for ex vivo measurement of g·NO production in murine endotoxaemia. In a chemically defined in vitro model system EPR triplet signals of NO-Fe(DTCS)g2 were observed for as long as 3 hours, only if samples were reduced with sodium dithionite. This procedure was not necessary for the ex vivo detection of ·NO in endotoxaemic liver homogenates at X-band or in the whole intact organs at S-band, whereas only a weak signal was observed in endotoxaemic lung. These results suggest that in endotoxaemia not only high level of ·NO, but also the redox properties of liver and lung might determine the formation of complexes of ·NO with a spin trap. Nevertheless, both S- and X-band EPR spectroscopy is suitable for ·NO-metry at room temperature using Fe(DTCS)2 as the spin trapping agent. In particular, S-band EPR spectroscopy enables the detection of ·NO production in a whole organ, such as murine liver.

5

Kinetics of increased generation of ·NO in endotoxaemic rats as measured by EPR.

75%

Plonka P. M., Chlopicki S., Wisniewska M., Plonka B. K.

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2003

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vol. 50

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issue 3

807-813

EN

Ferrous-diethyldithiocarbamate (Fe(DETC)2) chelate is a lipophilic spin trap developed for g·NO detection by electron paramagnetic resonance (EPR) spectroscopy. Using this spin trap we investigated the kinetics of ·NO production in endotoxaemia in rats induced by lipopolysaccharide (Escherichia coli, 10 mg/kg). The NO-Fe(DETC)2 complex was found to give a characteristic EPR signal, and the amplitude of the 3rd (high-field) component of its hyperfine splitting was used to monitor the level of ·NO. We found that in blood, kindey, liver, heart and lung ·NO production starts to increase as early as 2 h after LPS injection, reaches the maximum 6 h after LPS injection and then returns to basal level within further 12-18 h. Interestingly, in the eye bulb the maximum of ·NO production was detected 12 h after LPS, and the signal was still pronounced 24 h after LPS. In brief, the highly lipophilic exogenous spin trap, Fe(DETC)2 is well suited for assessment of ·NO production in endotoxaemia. We demonstrated that the kinetics of increased production of ·NO in endotoxaemic organs, with the notable exception of the eye, do not follow the known pattern of NOS-2 induction under those conditions. Accordingly, only in early endotoxaemia a high level of ·NO is detected, while in late endotoxaemia ·NO detectability is diminished most probably due to concomitant oxidant stress.

6

Rehabilitation and prosthesis after four-limb amputation – case description

45%

Pirowska A., Vincent T., Clotilde-Trotel J., Voiry C., Joannot E., Vu Tri D., Chiesa G.

Medical Rehabilitation

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2015

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vol. 19(4)

34-45

PL

Amputację czterech kończyn przeprowadza się rzadko. Do potrzeby jej wykonania, w stanie zagrożenia życia chorego, doprowadzić może wystąpienie wstrząsu septycznego rozwijającego się z ciężkiej sepsy, jak również jej nieczęsto pojawiającego się powikłania – plamicy piorunującej. Te skrajnie niebezpieczne ogólnoustrojowe reakcje organizmu mogą się rozwinąć w wyniku zakażenia bakteriami: Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae typu b, Legionella pneumophila, meningokokami – Neisseria meningitidis. Średni czas pobytu chorych po amputacji czterokończynowej w Institut Robert Merle d’Aubigné wynosi około sześciu miesięcy. W tym czasie pacjenci uczestniczą w kompleksowych zajęciach rehabilitacji, ergoterapii, sportowo-rekreacyjnych, protezowania, czyli produkcji i adaptacji protez kończyn dolnych i górnych, korzystają także z pomocy psychologa i asystenta socjalnego. Podczas całego pobytu są objęci na miejscu opieką lekarzy specjalistów: angiologa, diabetologa, kardiologa, podologa, psychiatry, specjalistów rehabilitacji, a także korzystają z niezbędnych medycznych konsultacji prowadzonych we współpracy z innymi szpitalami i klinikami. Opis przypadku obrazuje stan kliniczny 35-letniego mężczyzny po urazie czaszki powikłanym wstrząsem hemodynamicznym i ostrym zakrzepowym dystalnym niedokrwieniem czterech kończyn, w konsekwencji czego amputowano mu wszystkie kończyny. Praca przedstawia etapy przeprowadzonej rehabilitacji, ergoterapii i protezowania, których celem było odzyskanie możliwie jak największej sprawności i samodzielności przez chorego oraz efektywne nauczenie go wykonywania codziennych czynności w przygotowaniu do niezależnego życia. Przedstawiony opis przypadku dowodzi, że nawet chory z tak ciężkim wywiadem klinicznym, po przejściu wstrząsu z zagrożeniem utraty życia i po amputacji czterech kończyn, może powrócić do sprawności i znowu zacząć żyć samodzielnie.

EN

Four-limb amputation is carried out rarely. In life-threatening conditions of the patient, the need for its implementation may result in the occurrence of septic shock evolving with severe sepsis, as well as other rarely occurring complications – purpura fulminans (PF). These extremely dangerous systemic reactions of the organism may develop as a result of bacterial infection: Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae type b, Legionella pneumophila, meningococcas – Neisseria meningitidis. The average stay of patients after four-limb amputation at the Institut Robert Merle d’Aubigné is about six months. During this time, patients participate in complex rehabilitation therapy, ergotherapy, sport and recreational therapy, prosthetic fitting, thus the production and adaptation of upper – and lower-limb prosthetics, and they are also under the care of a psychologist and a social assistant. During the entire stay, they are subject to on-site supervision of medical specialists: angiologist, diabetologist, cardiologist, podologist, psychiatrist, rehabilitation specialists, and undergo necessary medical consultations conducted in cooperation with other hospitals and clinics. This case description illustrates the clinical condition of a 35-year-old man following a skull injury complicated by hemodynamic shock and acute thrombotic distal ischemia of four limbs, which were amputated as a result of these complications. The paper illustrates the steps of rehabilitation that were carried out, as well as ergotherapy and prosthesis, the purpose of which was recovering efficiency and independence of the patient as much as possible, and to efficiently teach him how to perform daily activities in preparation for independent living. The presented case description shows that even a patient with such a difficult clinical interview, after passage of the initial shock of the near death experience and four-limb amputation, may return to being fit and start to live independently again.

Refine search results

Septic shock in the course of liver abscess rescued with percutaneous drainage – a literature review and case report

Implantable cardiac electronic device infections: single center study

Implantable cardiac electronic device infections: single center study

X-band and S-band EPR detection of nitric oxide in murine endotoxaemia using spin trapping by ferro-di(N-(dithiocarboxy)sarcosine).

Kinetics of increased generation of ·NO in endotoxaemic rats as measured by EPR.

Rehabilitation and prosthesis after four-limb amputation – case description