scholarly journals Hemoadsorption in a Case of Severe Septic Shock and Necrotizing Fasciitis Caused by Nontraumatic Renal Rupture due to Pyelonephritis with Obstructive Uropathy

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Lampros Kousoulas ◽  
Uwe Wittel ◽  
Stefan Fichtner-Feigl ◽  
Stefan Utzolino
Keyword(s):  
Septic Shock ◽  
Renal Function ◽  
Necrotizing Fasciitis ◽  
Lower Limb ◽  
Rescue Therapy ◽  
Obstructive Uropathy ◽  
Combined Treatment ◽  
Retroperitoneal Abscess ◽  
Renal Rupture ◽  
Severe Septic Shock

Background. Nontraumatic renal rupture due to pyelonephritis with obstructive uropathy is an uncommon but life-threatening situation. Case Presentation. A 25-year-old female presented to the emergency department with acute worsening of abdominal pain that began four weeks earlier. She was found to have peritonitis, leukocytosis, severe lactic acidosis, and a pronounced anemia and imaging was consistent with nontraumatic renal rupture with retroperitoneal abscess, perforation of the colon, and severe necrotizing fasciitis of the right lower limb. She underwent a right nephrectomy, a right hemicolectomy, surgical debridement of the retroperitoneum, and an upper thigh amputation. Due to severe septic shock and rhabdomyolysis with acute renal failure we performed a combined treatment of hemoadsorption using a Cytosorb hemoadsorber and continuous venovenous hemodialysis (CVVHD). Subsequently the patient recovered and was discharged home with no signs of infections and with normal renal function. Conclusion. We present a case of pyelonephritis with nontraumatic renal rupture leading to necrotizing fasciitis with osteomyelitis of the lower limb. The early treatment of the patient with a Cytosorb hemoadsorber led to a rapid hemodynamic and metabolic stabilization and preservation of the renal function, suggesting that hemoadsorption might be a rescue therapy in patients with severe septic shock and traumatic rhabdomyolysis.

The effects of vasopressin on hemodynamics and renal function in severe septic shock: a case series

2001 ◽  
Vol 27 (8) ◽  
pp. 1416-1421 ◽  
Author(s):  
Cheryl L. Holmes ◽  
Keith R. Walley ◽  
Dean R. Chittock ◽  
Tara Lehman ◽  
James A. Russell
Keyword(s):  
Septic Shock ◽  
Renal Function ◽  
Case Series ◽  
Severe Septic Shock

217 PLASMAPHERESIS AS RESCUE THERAPY IN SEVERE SEPTIC SHOCK

Shock ◽  
1995 ◽  
Vol 3 (5) ◽  
pp. 67
Author(s):  
E. P. Zilow ◽  
G. Zilow
Keyword(s):  
Septic Shock ◽  
Rescue Therapy ◽  
Severe Septic Shock

The effects of norepinephrine on hemodynamics and renal function in severe septic shock states

1993 ◽  
Vol 19 (3) ◽  
pp. 151-154 ◽  
Author(s):  
E. M. Redl-Wenzl ◽  
C. Armbruster ◽  
G. Edelmann ◽  
E. Fischl ◽  
M. Kolacny ◽  
...  
Keyword(s):  
Septic Shock ◽  
Renal Function ◽  
Severe Septic Shock

scholarly journals Relative Efficacy of Weight Management, Exercise, and Combined Treatment for Muscle Mass and Physical Sarcopenia Indices in Adults with Overweight or Obesity and Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1992
Author(s):  
Shu-Fen Chu ◽  
Tsan-Hon Liou ◽  
Hung-Chou Chen ◽  
Shih-Wei Huang ◽  
Chun-De Liao
Keyword(s):  
Randomized Controlled Trials ◽  
Weight Management ◽  
Muscle Mass ◽  
Lower Limb ◽  
Meta Analysis ◽  
Combined Treatment ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Standard Mean Difference ◽  
Evidence Database

Aging and osteoarthritis are associated with high risk of muscle mass loss, which leads to physical disability; this loss can be effectively alleviated by diet (DI) and exercise (ET) interventions. This study investigated the relative effects of different types of diet, exercise, and combined treatment (DI+ET) on muscle mass and functional outcomes in individuals with obesity and lower-limb osteoarthritis. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) examining the efficacy of DI, ET, and DI+ET in patients with obesity and lower-extremity osteoarthritis. The included RCTs were analyzed through network meta-analysis and risk-of-bias assessment. We finally included 34 RCTs with a median (range/total) Physiotherapy Evidence Database score of 6.5 (4–8/10). DI plus resistance ET, resistance ET alone, and aerobic ET alone were ranked as the most effective treatments for increasing muscle mass (standard mean difference (SMD) = 1.40), muscle strength (SMD = 1.93), and walking speed (SMD = 0.46). Our findings suggest that DI+ET is beneficial overall for muscle mass in overweight or obese adults with lower-limb osteoarthritis, especially those who are undergoing weight management.

Necrotizing Fasciitis Occurred in the Lymphedematous leg

2021 ◽  
pp. 153473462110230
Author(s):  
Hisako Hara ◽  
Makoto Mihara ◽  
Takeshi Todokoro
Keyword(s):  
Case Report ◽  
Necrotizing Fasciitis ◽  
Lower Limb ◽  
Gynecologic Cancer ◽  
Vital Signs ◽  
Ethics Committee ◽  
Secondary Lymphedema ◽  
Delayed Treatment ◽  
Institutional Ethics ◽  
Life Threatening

Lymphedema is a chronic edema that sometimes occurs after treatment of gynecologic cancer, and cellulitis often occurs concomitantly with lymphedema. On the other hand, necrotizing fasciitis (NF) is a relatively rare, but life-threatening disease. The symptoms in cellulitis and NF are very similar. In this case report, we describe a case in which the diagnosis of NF in a lymphedematous limb was difficult. A 70-year-old woman had secondary lymphedema in bilateral legs and consulted our department. On the first day of lymphedema therapy, the patient complained of vomiting, diarrhea, and fever (37.7 °C) without local fever in the legs. She was diagnosed with acute gastroenteritis. On the next day, swelling and pain in her left leg occurred and her blood pressure was 59/44 mmHg. She was diagnosed with cellulitis accompanied by lower limb lymphedema and septic shock. On the second day, blisters appeared on the left leg, and computed tomography showed NF. We performed debridement under general anesthesia and her vital signs improved postoperatively. Streptococcus agalactiae (B) was detected in blood culture, and we administered bixillin and clindamycin. Postoperatively, necrosis in the skin and fat around the left ankle gradually spread, and it took 5 months to complete epithelialization. The diagnosis was more difficult than usual NF because patients with lymphedema often experience cellulitis. Clinicians should always think of NF to avoid mortality due to delayed treatment. This case report was approved by the institutional ethics committee.

Necrotizing Fasciitis of the Lower Limb Following Rat Bites

2012 ◽  
Vol 11 (3) ◽  
pp. 169-170 ◽  
Author(s):  
Lofty-John Chukwuemeka Anyanwu ◽  
Ashuku Ahmed Yakubu
Keyword(s):  
Necrotizing Fasciitis ◽  
Lower Limb

Long-term follow-up of renal function in patients after surgery for obstructive uropathy

2008 ◽  
Vol 23 (6) ◽  
pp. 937-945 ◽  
Author(s):  
Daniela Miklovicova ◽  
Olga Cervenova ◽  
Andrea Cernianska ◽  
Zuzana Jancovicova ◽  
Ladislav Dedik ◽  
...  
Keyword(s):  
Renal Function ◽  
Obstructive Uropathy ◽  
Long Term Follow Up

scholarly journals A Rare Case of Inguinal Hernia with Complete Bladder Herniation

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Ayaaz Habib
Keyword(s):  
Renal Function ◽  
Inguinal Hernia ◽  
Complete Resolution ◽  
Rare Case ◽  
Obstructive Uropathy ◽  
Postoperative Recovery ◽  
Diagnosis And Management ◽  
Inguinoscrotal Hernia ◽  
Inguinal Hernias ◽  
Bladder Herniation

Involvement of the bladder in inguinal hernias is rare and occurs in less than 5% of the cases. The diagnosis and management of this condition may present a challenge to the surgeon. We present a case of an elderly gentleman who presented with a large left-sided inguinoscrotal hernia causing an obstructive uropathy which was surgically repaired. The patient made a quick postoperative recovery with complete resolution of renal function.

scholarly journals Effects of norepinephrine on hemodynamics, vascular elasticity, cardiac pump function, and inflammatory factors in patients with septic shock

2019 ◽  
Vol 17 ◽  
pp. 205873921983839
Author(s):  
Fengzhi Wang ◽  
Mancui Zhang ◽  
Xiujuan Wang ◽  
Xiaopeng Zhong ◽  
Po Ding
Keyword(s):  
Septic Shock ◽  
Blood Vessel ◽  
Inflammatory Factors ◽  
Control Group ◽  
Pump Function ◽  
Heart Pump ◽  
Cardiac Pump Function ◽  
Vascular Elasticity ◽  
Experimental Group ◽  
Severe Septic Shock

The effects of norepinephrine on hemodynamics, vascular elasticity, cardiac pump function, and inflammatory factors in patients with septic shock remained unknown. In this study, we included 124 cases of severe septic shock patients in our hospital. The patients were randomly divided into control group (treated with dopamine) and experimental group (treated with dopamine plus norepinephrine), while the hemodynamic index (heart rate (HR)), blood vessel elasticity index, heart pump function, and inflammatory factor index were recorded. After 12 h of treatment, both groups showed decreased HR, increased levels of cardiac index (CI), mean arterial pressure (MAP), central venous pressure (CVP), peripheral vascular resistance index (PVRI), and vascular elasticity ( P < 0.05). To date, lower HR, higher levels of CI, MAP, CVP, and PVRI were observed in the experimental group ( P < 0.05). Furthermore, the vascular elastic coefficient, stiffness index, arterial compliance, and the precursors of plasma amino-terminal brain natriuretic peptide were also significantly higher in the experimental group than those in the control group ( P < 0.05). However, inflammatory cell tumor necrosis factor alpha factor test group (TNF alpha), interleukin-1 (IL-1), and interleukin-6 (IL-6) concentrations were significantly lower than the control group ( P < 0.05), compared to experimental group ( P < 0.05). This research indicates that phenylephrine could significantly improve hemodynamics in patients with severe septic shock, by maintaining blood vessel elasticity, improving heart pump function, and reducing the inflammatory factors’ activities, and this method could be used as a line of vascular tension of the medications used in patients with septic shock.

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