Articles: sepsis.
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Randomized Controlled Trial
Randomized controlled clinical trial evaluating multiplex polymerase chain reaction for pathogen identification and therapy adaptation in critical care patients with pulmonary or abdominal sepsis.
To determine whether a multiplex polymerase chain reaction (PCR)-based test could reduce the time required for initial pathogen identification in patients in an intensive care unit (ICU) setting. ⋯ The LightCycler® SeptiFast PCR test demonstrated a significant reduction in the time required for initial pathogen identification, compared with standard BC.
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Randomized Controlled Trial Multicenter Study Comparative Study Observational Study
Distinct molecular phenotypes of direct vs indirect ARDS in single-center and multicenter studies.
ARDS is a heterogeneous syndrome that encompasses lung injury from both direct and indirect sources. Direct ARDS (pneumonia, aspiration) has been hypothesized to cause more severe lung epithelial injury than indirect ARDS (eg, nonpulmonary sepsis); however, this hypothesis has not been well studied in humans. ⋯ Direct lung injury in humans is characterized by a molecular phenotype consistent with more severe lung epithelial injury and less severe endothelial injury. The opposite pattern was identified in indirect lung injury. Clinical trials of novel therapies targeted specifically at the lung epithelium or endothelium may benefit from preferentially enrolling patients with direct and indirect ARDS, respectively.
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Randomized Controlled Trial Multicenter Study
Trial of short-course antimicrobial therapy for intraabdominal infection.
The successful treatment of intraabdominal infection requires a combination of anatomical source control and antibiotics. The appropriate duration of antimicrobial therapy remains unclear. ⋯ In patients with intraabdominal infections who had undergone an adequate source-control procedure, the outcomes after fixed-duration antibiotic therapy (approximately 4 days) were similar to those after a longer course of antibiotics (approximately 8 days) that extended until after the resolution of physiological abnormalities. (Funded by the National Institutes of Health; STOP-IT ClinicalTrials.gov number, NCT00657566.).
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Arch. Dis. Child. Fetal Neonatal Ed. · May 2015
Randomized Controlled TrialEffect of emollient therapy on clinical outcomes in preterm neonates in Pakistan: a randomised controlled trial.
Newborn oil massage, a traditional community practice, could potentially benefit thermoregulation and skin barrier function, and prevent serious infections, morbidity and mortality in high-risk preterm infants, but has only been evaluated in limited studies in low income settings. ⋯ Topical emollient therapy was effective in maintaining skin integrity and reducing the risk of bloodstream infection in preterm infants in a tertiary hospital setting in Pakistan. The effectiveness of this approach in primary care settings needs to be further explored.
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Randomized Controlled Trial
Up-regulation of Programmed Cell Death 1 Ligand 1 on Neutrophils May Be Involved in Sepsis-induced Immunosuppression: An Animal Study and a Prospective Case-control Study.
Recent studies have shown that neutrophils may display an antigen-presenting function and inhibit lymphocyte proliferation by expressing programmed cell death 1 ligand 1 (PD-L1). The current study was performed to investigate the effect of neutrophils and their pathophysiological significance during sepsis. ⋯ PD-L1 is up-regulated on neutrophils during sepsis, which may be related to sepsis-induced immunosuppression.