Critical care medicine
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Critical care medicine · Mar 2014
Observational StudySerum Biomarkers of Brain Injury to Classify Outcome After Pediatric Cardiac Arrest.
Morbidity and mortality in children with cardiac arrest largely result from neurologic injury. Serum biomarkers of brain injury can potentially measure injury to neurons (neuron-specific enolase), astrocytes (S100b), and axons (myelin basic protein). We hypothesized that serum biomarkers can be used to classify outcome from pediatric cardiac arrest. ⋯ Preliminary data show that serum S100b, neuron-specific enolase, and myelin basic protein may aid in outcome classification of children surviving cardiac arrest.
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Critical care medicine · Mar 2014
Comparative StudySepsis Visits and Antibiotic Utilization in U.S. Emergency Departments.
To monitor the frequency of sepsis visits in U.S. emergency departments and assess the appropriateness of antibiotic utilization. ⋯ Explicitly diagnosed sepsis visits did not become more common during 1994-2009. Our data suggest that many emergency department patients with sepsis do not receive antibiotics until they arrive on the inpatient unit. When antibiotics are used among septic emergency department patients, drug-resistant bacteria are covered infrequently. These methods provide a simple approach to tracking the frequency with which sepsis is diagnosed among emergency department patients and to monitoring antibiotic therapy.
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Critical care medicine · Mar 2014
Mice Lacking the Lectin-Like Domain of Thrombomodulin Are Protected Against Melioidosis.
Thrombomodulin is a multidomain receptor primarily expressed by vascular endothelium. The lectin-like domain of thrombomodulin has anti-inflammatory properties. In this study, we investigated the role of the thrombomodulin lectin-like domain in the host response to Gram-negative sepsis caused by Burkholderia pseudomallei, a "Tier 1" biothreat agent and the causative agent of melioidosis, a common form of community-acquired sepsis in Southeast Asia. ⋯ This study reveals for the first time a detrimental role for the thrombomodulin lectin-like domain in the host response to sepsis caused by a clinically relevant Gram-negative pathogen.
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Critical care medicine · Mar 2014
The Role of Pancreatic Ductal Secretion in Protection Against Acute Pancreatitis in Mice.
A common potentially fatal disease of the pancreas is acute pancreatitis, for which there is no treatment. Most studies of this disorder focus on the damage to acinar cells since they are assumed to be the primary target of multiple stressors affecting the pancreas. However, increasing evidence suggests that the ducts may also have a crucial role in induction of the disease. To test this hypothesis, we sought to determine the specific role of the duct in the induction of acute pancreatitis using well-established disease models and mice with deletion of the Na/H exchanger regulatory factor-1 that have selectively impaired ductal function. ⋯ Our findings provide the first direct evidence for the crucial role of ductal secretion in protecting the pancreas from acute pancreatitis and strongly suggest that improved ductal function should be an important modality in prevention and treatment of the disease.