1.Polymyxin B Immobilized Fiber Hemoperfusion in Refractory Intra-abdominal Septic Shock.
Hae Wone CHANG ; Young Jae CHO ; Sang Hyun PARK ; Moonsuk KIM
Korean Journal of Critical Care Medicine 2015;30(2):95-102
The effects of direct hemoperfusion with polymyxin B immobilized fiber (PMX) treatment for septic shock have been recently reported. However, little evidence of a true benefit on clinical outcomes, including mortality, is available. Herein, we report three cases of intra-abdominal infection associated with refractory septic shock Case 1 was Escherichia coli peritonitis after a colectomy. PMX treatment improved the hemodynamic parameters and lactic acid levels of the patient. In case 2, secondary peritonitis was associated with septic or cardiogenic shock. Septic cardiomyopathy was assumed to be the cause of shock. 24 hours after the use of PMX, cardiac contractility assessed by echocardiography returned to baseline. In case 3, a patient with Burkitt's lymphoma and neutropenia was found to be gastroenteritis and Klebsiella pneumoniae bacteremia. Intravenous meropenem was administered for 3 days. Hemodynamic parameters improve after the twice use of PMXOverall, the change of serial sequential organ failure assessment score (SOFA) was more significant in surgical cases as compared to the medical case at 72 hours after PMX administration. All patients were discharged from the hospital. In addition to early resuscitation efforts and infection source control, PMX treatment may be beneficial to patients with refractory intra-abdominal infection associated with septic shock.
Bacteremia
;
Burkitt Lymphoma
;
Cardiomyopathies
;
Colectomy
;
Echocardiography
;
Escherichia coli
;
Gastroenteritis
;
Hemodynamics
;
Hemoperfusion*
;
Humans
;
Intraabdominal Infections
;
Klebsiella pneumoniae
;
Lactic Acid
;
Mortality
;
Neutropenia
;
Peritonitis
;
Polymyxin B*
;
Resuscitation
;
Shock
;
Shock, Cardiogenic
;
Shock, Septic*
2.Antimicrobial Resistance and Treatment Update of Skin and Soft Tissue Infections.
Korean Journal of Medicine 2011;81(6):699-707
Soft tissue infections are common, generally of mild to moderate severity. The most common causative organisms of soft tissue infections are group A beta-hemolytic streptococci and Staphylococcus aureus. As the antimicrobial resistance pattern of these causative organisms has not been changed recently, the present recommendations for the treatment of soft tissue infections remain the same. In this review, we have presented extensive information on the clinical characteristics, diagnosis, and treatment of skin and soft tissue infections. We focused on two issues concerning antibiotic resistance; macrolide resistance of group A beta-hemolytic streptococci and the emergence of community-acquired methicillin-resistant Staphylococcus aureus.
Anti-Bacterial Agents
;
Methicillin-Resistant Staphylococcus aureus
;
Skin
;
Soft Tissue Infections
;
Staphylococcus aureus
3.Antimicrobial Resistance and Treatment Update of Skin and Soft Tissue Infections.
Korean Journal of Medicine 2011;81(6):699-707
Soft tissue infections are common, generally of mild to moderate severity. The most common causative organisms of soft tissue infections are group A beta-hemolytic streptococci and Staphylococcus aureus. As the antimicrobial resistance pattern of these causative organisms has not been changed recently, the present recommendations for the treatment of soft tissue infections remain the same. In this review, we have presented extensive information on the clinical characteristics, diagnosis, and treatment of skin and soft tissue infections. We focused on two issues concerning antibiotic resistance; macrolide resistance of group A beta-hemolytic streptococci and the emergence of community-acquired methicillin-resistant Staphylococcus aureus.
Anti-Bacterial Agents
;
Methicillin-Resistant Staphylococcus aureus
;
Skin
;
Soft Tissue Infections
;
Staphylococcus aureus
4.Inhalation of Clary Sage Oil before Chemotherapy Alleviates Anxiety and Stress without Changing Blood Pressure: A Randomized Controlled Trial
Moonsuk KIM ; You Kyoung SHIN ; Geun Hee SEOL
Journal of Korean Biological Nursing Science 2021;23(4):267-275
Purpose:
The purpose of this study was to evaluate the effects of inhaled clary sage (Salvia sclarea L.) oil or linalyl acetate on patients’ anxiety and stress levels before undergoing chemotherapy.
Methods:
Forty-five eligible participants were randomly assigned to inhale clary sage oil, or linalyl acetate, each at concentrations of 5% vol/vol in almond oil or pure almond oil (control). State-trait anxiety inventory (STAI), Stress rating scale, anxiety-visual analog scale (Anxiety-VAS), stress-visual analog scale (Stress-VAS), blood pressure, and heart rate were measured before and after the inhalation prior to undergoing chemotherapy.
Results:
Anxiety-VAS and StressVAS were significantly lower after than before inhalation of clary sage oil (p < .01 and p < .05, respectively) and linalyl acetate (p < .05 and p < .05, respectively), despite having no significant difference in the three groups compared with control group. Systolic (p < .05) and diastolic (p < .01) blood pressure before undergoing chemotherapy were significantly lower after than before inhalation of linalyl acetate, while there was no significant difference in after than before inhalation of clary sage oil, despite both reducing levels of anxiety and stress.
Conclusion
These findings suggest that linalyl acetate inhalation may be inappropriate in lowering anxiety and stress in patients undergoing chemotherapy, despite its anxiolytic and antistress effects, while clary sage oil inhalation may be useful in reducing anxiety and stress in patients undergoing chemotherapy, which has a risk of hypotensive side effects.
6.Polymyxin B Immobilized Fiber Hemoperfusion in Refractory Intra-abdominal Septic Shock
Hae Wone CHANG ; Young Jae CHO ; Sang Hyun PARK ; Moonsuk KIM
The Korean Journal of Critical Care Medicine 2015;30(2):95-102
The effects of direct hemoperfusion with polymyxin B immobilized fiber (PMX) treatment for septic shock have been recently reported. However, little evidence of a true benefit on clinical outcomes, including mortality, is available. Herein, we report three cases of intra-abdominal infection associated with refractory septic shock Case 1 was Escherichia coli peritonitis after a colectomy. PMX treatment improved the hemodynamic parameters and lactic acid levels of the patient. In case 2, secondary peritonitis was associated with septic or cardiogenic shock. Septic cardiomyopathy was assumed to be the cause of shock. 24 hours after the use of PMX, cardiac contractility assessed by echocardiography returned to baseline. In case 3, a patient with Burkitt's lymphoma and neutropenia was found to be gastroenteritis and Klebsiella pneumoniae bacteremia. Intravenous meropenem was administered for 3 days. Hemodynamic parameters improve after the twice use of PMXOverall, the change of serial sequential organ failure assessment score (SOFA) was more significant in surgical cases as compared to the medical case at 72 hours after PMX administration. All patients were discharged from the hospital. In addition to early resuscitation efforts and infection source control, PMX treatment may be beneficial to patients with refractory intra-abdominal infection associated with septic shock.
Bacteremia
;
Burkitt Lymphoma
;
Cardiomyopathies
;
Colectomy
;
Echocardiography
;
Escherichia coli
;
Gastroenteritis
;
Hemodynamics
;
Hemoperfusion
;
Humans
;
Intraabdominal Infections
;
Klebsiella pneumoniae
;
Lactic Acid
;
Mortality
;
Neutropenia
;
Peritonitis
;
Polymyxin B
;
Resuscitation
;
Shock
;
Shock, Cardiogenic
;
Shock, Septic
7.Serum Levels of Adipocyte Fatty Acid-Binding Protein Are Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Preserved Renal Function
Da Hea SEO ; Moonsuk NAM ; Mihye JUNG ; Young Ju SUH ; Seong Hee AHN ; Seongbin HONG ; So Hun KIM
Diabetes & Metabolism Journal 2020;44(S1):e37-
Background:
Recent studies have demonstrated that the levels of adipocyte fatty acid-binding protein (A-FABP) are closely associated with diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM). This study aimed to examine the association between serum A-FABP level and rapid renal function decline in patients with T2DM and preserved renal function.
Methods:
This was a prospective observational study of 452 patients with T2DM and preserved renal function who had serial measurements of estimated glomerular filtration rate (eGFR). Rapid renal function decline was defined as an eGFR decline of >4% per year. The association between baseline serum A-FABP level and rapid renal function decline was investigated.
Results:
Over a median follow-up of 7 years, 82 participants (18.1%) experienced rapid renal function decline. Median A-FABP levels were significantly higher in patients with rapid renal function decline, compared to non-decliners (20.2 ng/mL vs. 17.2 ng/ mL, P=0.005). A higher baseline level of A-FABP was associated with a greater risk of developing rapid renal function decline, independent of age, sex, duration of diabetes, body mass index, systolic blood pressure, history of cardiovascular disease, baseline eGFR, urine albumin creatinine ratio, total cholesterol, glycosylated hemoglobin, high-sensitivity C-reactive protein and use of thiazolidinedione, insulin, angiotensin-converting-enzyme inhibitors and angiotensin II-receptor blockers and statin (odds ratio, 3.10; 95% confidence interval, 1.53 to 6.29; P=0.002).
Conclusion
A high level of serum A-FABP is associated with an increased risk of rapid renal function decline in patients with T2DM and preserved renal function. This suggests that A-FABP could play a role in the progression of DKD in the early stages.
8.Serum Levels of Adipocyte Fatty Acid-Binding Protein Are Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Preserved Renal Function
Da Hea SEO ; Moonsuk NAM ; Mihye JUNG ; Young Ju SUH ; Seong Hee AHN ; Seongbin HONG ; So Hun KIM
Diabetes & Metabolism Journal 2020;44(6):875-886
Recent studies have demonstrated that the levels of adipocyte fatty acid-binding protein (A-FABP) are closely associated with diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM). This study aimed to examine the association between serum A-FABP level and rapid renal function decline in patients with T2DM and preserved renal function. This was a prospective observational study of 452 patients with T2DM and preserved renal function who had serial measurements of estimated glomerular filtration rate (eGFR). Rapid renal function decline was defined as an eGFR decline of >4% per year. The association between baseline serum A-FABP level and rapid renal function decline was investigated. Over a median follow-up of 7 years, 82 participants (18.1%) experienced rapid renal function decline. Median A-FABP levels were significantly higher in patients with rapid renal function decline, compared to non-decliners (20.2 ng/mL vs. 17.2 ng/mL, A high level of serum A-FABP is associated with an increased risk of rapid renal function decline in patients with T2DM and preserved renal function. This suggests that A-FABP could play a role in the progression of DKD in the early stages.
9.Alternating Linezolid-Vancomycin Therapy for Persistent Endovascular Methicillin-resistant Staphylococcus aureus Infection: A Case Report.
Nak Hyun KIM ; Moonsuk KIM ; Eun Sun JANG ; Yu Min KANG ; Gayeon KIM ; Hee Chang JANG ; Wan Beom PARK ; Eui Chong KIM ; Nam Joong KIM ; Myoung don OH
Infection and Chemotherapy 2009;41(6):371-374
Persistent Staphylococcus aureus bacteremia is frequently defined as bacteremia persisting for > or =7 days despite proper antibiotic therapy. Its treatment includes removal of all infection foci and proper antibiotic therapy. Vancomycin remains the antibiotic of choice in MRSA bacteremia. Alternative agents, linezolid or daptomycin, are available, but a consensus regarding management of persistent MRSA bacteremia on vancomycin failure is still lacking. We report a case of a 60-year-old male who received thoracoabdominal aorta replacement operation due to dissecting aneurysm of the ascending and descending aorta. Surgical site infection and bacteremia caused by MRSA occured, and wound debridement operations were performed. The patient was treated with vancomycin in therapeutic doses but MRSA bacteremia persisted for 168 days in a row. Although the inserted aortic graft was the most probable source of persistent bacteremia, surgical removal was impossible. Linezolid was administered as an alternative antibiotic but had to be discontinued from time to time due to thrombocytopenia induced by this agent. In the end, MRSA bacteremia was successfully managed by alternating vancomycin-linezolid therapy.
Acetamides
;
Aneurysm, Dissecting
;
Aorta
;
Aorta, Thoracic
;
Bacteremia
;
Consensus
;
Daptomycin
;
Debridement
;
Humans
;
Linezolid
;
Male
;
Methicillin Resistance
;
Methicillin-Resistant Staphylococcus aureus
;
Middle Aged
;
Oxazolidinones
;
Staphylococcus aureus
;
Thrombocytopenia
;
Transplants
;
Treatment Failure
;
Vancomycin
10.Alternating Linezolid-Vancomycin Therapy for Persistent Endovascular Methicillin-resistant Staphylococcus aureus Infection: A Case Report.
Nak Hyun KIM ; Moonsuk KIM ; Eun Sun JANG ; Yu Min KANG ; Gayeon KIM ; Hee Chang JANG ; Wan Beom PARK ; Eui Chong KIM ; Nam Joong KIM ; Myoung don OH
Infection and Chemotherapy 2009;41(6):371-374
Persistent Staphylococcus aureus bacteremia is frequently defined as bacteremia persisting for > or =7 days despite proper antibiotic therapy. Its treatment includes removal of all infection foci and proper antibiotic therapy. Vancomycin remains the antibiotic of choice in MRSA bacteremia. Alternative agents, linezolid or daptomycin, are available, but a consensus regarding management of persistent MRSA bacteremia on vancomycin failure is still lacking. We report a case of a 60-year-old male who received thoracoabdominal aorta replacement operation due to dissecting aneurysm of the ascending and descending aorta. Surgical site infection and bacteremia caused by MRSA occured, and wound debridement operations were performed. The patient was treated with vancomycin in therapeutic doses but MRSA bacteremia persisted for 168 days in a row. Although the inserted aortic graft was the most probable source of persistent bacteremia, surgical removal was impossible. Linezolid was administered as an alternative antibiotic but had to be discontinued from time to time due to thrombocytopenia induced by this agent. In the end, MRSA bacteremia was successfully managed by alternating vancomycin-linezolid therapy.
Acetamides
;
Aneurysm, Dissecting
;
Aorta
;
Aorta, Thoracic
;
Bacteremia
;
Consensus
;
Daptomycin
;
Debridement
;
Humans
;
Linezolid
;
Male
;
Methicillin Resistance
;
Methicillin-Resistant Staphylococcus aureus
;
Middle Aged
;
Oxazolidinones
;
Staphylococcus aureus
;
Thrombocytopenia
;
Transplants
;
Treatment Failure
;
Vancomycin