1
40
3
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
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<a href="http://doi.org/10.1586/eri.11.164" target="_blank" rel="noreferrer noopener">http://doi.org/10.1586/eri.11.164</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
197-205
Issue
2
Volume
10
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Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Serum procalcitonin in the diagnosis and management of intra-abdominal infections
Publisher
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Expert Review of Anti-Infective Therapy
Date
A point or period of time associated with an event in the lifecycle of the resource
2012
2012-02
Subject
The topic of the resource
acute; anti-thymocyte globulin; antibiotic-therapy; antibiotic-therapy; appendicitis; c-reactive protein; critically-ill patients; intensive-care units; international multicenter; liver-transplantation; liver-transplantation; major abdominal-surgery; pancreatitis; peritonitis; Pharmacology & Pharmacy; procalcitonin; sepsis; spontaneous bacterial
Creator
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Watkins R R; Lemonovich T L
Description
An account of the resource
The biomarker procalcitonin (PCT) has been used to diagnose and monitor a number of clinically significant infections. Serum levels of PCT are often increased in the presence of bacterial and fungal infections but not viral infections or noninfectious inflammation. Intra-abdominal infections (IAIs) are serious conditions that pose difficult challenges to physicians and the healthcare system. Researchers have evaluated PCT in the management of IAIs, both for diagnosis and for guiding antibiotic therapy. The studies have produced mixed results, leading to controversy on the utility of PCT in IAIs. PCT appears to be most useful in diagnosing postoperative infections and necrotizing pancreatitis. This review aims to summarize these data, explore the pathophysiology of PCT in sepsis from IAIs, discuss the strengths and weaknesses of PCT monitoring in IAIs, and provide guidance for the interpretation of PCT levels.
Identifier
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<a href="http://doi.org/10.1586/eri.11.164" target="_blank" rel="noreferrer noopener">10.1586/eri.11.164</a>
Format
The file format, physical medium, or dimensions of the resource
Journal Article
2012
acute
anti-thymocyte globulin
antibiotic-therapy
Appendicitis
C-Reactive Protein
critically-ill patients
Department of Internal Medicine
Expert review of anti-infective therapy
intensive-care units
international multicenter
Journal Article
Lemonovich T L
liver-transplantation
major abdominal-surgery
NEOMED College of Medicine
pancreatitis
peritonitis
Pharmacology & Pharmacy
procalcitonin
sepsis
spontaneous bacterial
Watkins R R
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
n/a
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
773-779
Issue
3
Volume
151
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<p>Users with a NEOMED Library login can search for full-text journal articles at the following url: <a href="https://libraryguides.neomed.edu/home">https://libraryguides.neomed.edu/home</a></p>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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N-ACETYLCYSTEINE PRESERVES OXYGEN-CONSUMPTION AND GASTRIC-MUCOSAL PH DURING HYPEROXIC VENTILATION
Publisher
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American Journal of Respiratory and Critical Care Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1995
1995-03
Subject
The topic of the resource
cardiac-output; critically-ill patients; endotoxin; gas-exchange; General & Internal Medicine; l-arginine; nitric-oxide synthesis; relaxing factor; Respiratory System; septic patients; skeletal-muscle; superoxide
Creator
An entity primarily responsible for making the resource
Reinhart K; Spies C D; Meierhellmann A; Bredle D L; Hannemann L; Specht M; Schaffartzik W
Description
An account of the resource
Hyperoxic ventilation, used to prevent hypoxemia during potential periods of hypoventilation, has been reported to paradoxically decrease whole body oxygen consumption (Vo(2)). Reduction in nutritive blood flow due to oxygen radical production is one possible mechanism. We investigated whether pretreatment with the sulfhydryl group donor and O-2 radical scavenger N-acetylcysteine (NAG) would preserve whole body Vo(2) and prevent deterioration of oxygenation in gastric mucosal tissue during hyperoxia. Thirty-eight patients, requiring hemodynamic monitoring (radial and pulmonary artery catheters) due to sepsis syndrome, were included in this randomized experiment. All patients exhibited stable clinical conditions (hemodynamics, body temperature, hemoglobin, Flo(2) < 0.5). A gastric tonometer was placed to measure the gastric intramucosal pH (pH(i)), which indirectly assesses nutritive blood flow to the mucosa. Cardiac output was determined by thermodilution and Vo(2) by cardiovascular Fick. After baseline measurements, patients randomly received either 150 mg . kg(-1) NAC (n = 19) or placebo (n = 19) in 250 ml 5% dextrose intravenously over a period of 15 min. Measurements were repeated 30 min after starting NAC or placebo infusion, 30 min after starting hyperoxia (Flo(2) = 1.0), and 60 min after resetting the original Flo(2). There were no significant differences between groups in any of the measurements before treatment and after the return to baseline Flo(2) at the end of the study. NAG, but not placebo infusion, caused a slight but significant increase in cardiac output and decrease in systemic vascular resistance. Significant differences between groups during hyperoxia were: Vo(2) (NAG: 114 +/- 9 mi min(-1) m(-2) versus placebo: 81 +/- 31 ml . min(-1) m(-2); p = 0.008) and oxygen extraction ratio (NAG: 21 +/- 6% versus placebo: 14 +/- 5%; p = 0.003). The mean decrease of Vo(2) was 11% in the NAC group versus 34% in the placebo group. The mean decrease of the oxygen extraction ratio was 12% in the NAC group versus 34% in the placebo group. NAC prevented a decrease in pH(i) in hyperoxia (NAG: 7.28 +/- 0.10 versus placebo: 7.14 +/- 0.18; p = 0.012). NAC helped preserve whole body oxygen uptake, oxygen extraction ratio, and pH(i) during brief hyperoxia in these septic patients. This suggests that pretreatment with NAC can attenuate impaired tissue oxygenation during hyperoxia.
Identifier
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n/a
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Journal Article
1995
American journal of respiratory and critical care medicine
Bredle D L
cardiac-output
critically-ill patients
endotoxin
gas-exchange
General & Internal Medicine
Hannemann L
Journal Article
l-arginine
Meierhellmann A
nitric-oxide synthesis
Reinhart K
relaxing factor
Respiratory System
Schaffartzik W
septic patients
skeletal-muscle
Specht M
Spies C D
superoxide
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
n/a
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
1738-1746
Issue
11
Volume
22
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The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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INFLUENCE OF N-ACETYLCYSTEINE ON INDIRECT INDICATORS OF TISSUE OXYGENATION IN SEPTIC SHOCK PATIENTS - RESULTS FROM A PROSPECTIVE, RANDOMIZED, DOUBLE-BLIND-STUDY
Publisher
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Critical Care Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1994
1994-11
Subject
The topic of the resource
blood gas analysis; critical illness; critically-ill patients; endotoxin; gastric mucosa; General & Internal Medicine; glutathione; intramural ph; l-arginine; multiple organ failure; n-acetylcysteine; nitric-oxide synthesis; organ failure; oxygen consumption; ph; relaxing factor; sepsis; septic; shock; skeletal-muscle; tissue oxygenation
Creator
An entity primarily responsible for making the resource
Spies C D; Reinhart K; Witt I; Meierhellmann A; Hannemann L; Bredle D L; Schaffartzik W
Description
An account of the resource
Objectives: Deactivation of endothelium-derived relaxing factor due to an increased oxygen radical load during sepsis may contribute to an impairment in microcirculatory blood flow. We investigated whether treatment with the sulfhydryl donor and oxygen radical scavenger, N-acetylcysteine, would improve whole-body oxygen consumption (Vo(2)), gastric intramucosal pH, and veno-arterial CO2 gradient (veno-arterial PCO2) during septic shock. Design: Prospective, randomized, double-blind study conducted over 2 yrs. Setting: Septic shock patients admitted to the intensive care unit. Patients: Fifty-eight patients requiring hemodynamic monitoring (radial and pulmonary artery catheters) due to septic shock, were included in this study. All patients were examined within 72 hrs after the onset of sepsis. They were optimally resuscitated by conventional means with volume and inotropic agents, and exhibited stable clinical conditions (hemodynamic values, body temperature, hemoglobin, FIO2). Interventions: A gastric tonometer was inserted to measure the gastric intramucosal pH. Subjects randomly received either 150 mg/kg of intravenous N-acetylcysteine or placebo over a 15-min period, then a continuous infusion of 12.5 mg/hr of N-acetylcysteine or placebo over similar to 90 mins. Measurements: Infusion measurements were begun 60 mins after the beginning of infusion and lasted similar to 30 mins. The infusion was then discontinued and 2 hrs later the final measurements were taken. Main Results: Basic patient characteristics (age, sex, Acute Physiology and Chronic Health Evaluation [APACHE] II scores, Multiple Organ Failure scores) did not differ significantly, nor did pre- and 2-hr postinfusion measurements differ between any of the groups. Thirteen (45%) patients responded (i.e., showed an increase in Vo(2) >10%, reaching a mean of 19%) to the N-acetylcysteine infusion. The N-acetylcysteine responders also showed an increase in gastric intramucosal pH, a decrease in veno-arterial PCO2, an increase in oxygen delivery, cardiac index, stroke index, and left ventricular stroke work index, as well as a significant decrease in systemic vascular resistance in comparison to baseline. The N-acetylcysteine nonresponders, as well as the patients in the placebo group, did not show any significant changes in any of these variables. The N-acetylcysteine responders had a higher survival rate (69%) than the nonresponders (19%) and were studied earlier after onset of sepsis (37 hrs) than the nonresponders (61 hrs). The only significant difference between the entire N-acetylcysteine group (which included responders plus nonresponders) and the placebo group was an increased 30, in the entire N-acetylcysteine group during infusion measurements. Conclusions: N-acetylcysteine provided a transient improvement in tissue oxygenation in about half of the septic shock patients, as indicated by an increase in Vo(2) and gastric intramucosal pH and a decrease in veno-arterial PCO2. The higher survival rate in the N-acetylcysteine responders and the fact that half of the patients receiving N-acetylcysteine did not respond, suggests that, in some patients, sepsis irreversibly damages the microvasculature to the extent that N-acetylcysteine has no effect. If analyzed by intention to treat, the N-acetylcysteine did not produce effects that were significantly different from the placebo. Whether the N-acetylcysteine challenge was merely diagnostic or whether N-acetylcysteine can be effective in the treatment of sepsis deserves further investigation.
Identifier
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n/a
Format
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Journal Article
1994
Blood Gas Analysis
Bredle D L
Critical care medicine
Critical Illness
critically-ill patients
endotoxin
gastric mucosa
General & Internal Medicine
Glutathione
Hannemann L
intramural ph
Journal Article
l-arginine
Meierhellmann A
multiple organ failure
n-acetylcysteine
nitric-oxide synthesis
organ failure
Oxygen Consumption
ph
Reinhart K
relaxing factor
Schaffartzik W
sepsis
septic
Shock
skeletal-muscle
Spies C D
tissue oxygenation
Witt I