Abstract:
BACKGROUND:Ventilator-associated pneumonia (VAP) is one of the most frequent infections in intensive care units (ICUs), and nearly 50% of patients with VAP develop septic shock. Septic shock is an independent predictor for mortality in these patients. OBJECTIVE:To investigate the predictors for septic shock in VAP patients receiving appropriate antibiotic therapy. METHODS:Eighty-nine patients with microbiologically confirmed VAP who were receiving appropriate antibiotic therapy were included in the study. They were divided into two groups according to the existence of septic shock. Clinical, hematological, biochemical and microbiological characteristics were compared. RESULTS:Thirty-seven percent of the patients developed septic shock. Advanced age (OR 1.07, 95% CI 1.02-1.13, P = 0.009), lymphocytopenia (<1000/mm3) (OR 7.48, 95% CI 1.91-29, P = 0.004), high blood glucose levels >120 mg/dL (OR 4.75, 95% CI 1.38-16, P = 0.014), and increased clinical pulmonary infection scores (CPIS) (OR 1.64, 95% CI 1.16-2.33, P = 0.006) were identified as independent predictors for the development of septic shock. CONCLUSION:Some clinical parameters such as lymphocytopenia, blood glucose >120 mg/dL, increasing age, and CPIS can predict septic shock during VAP, but large randomized controlled studies are needed to confirm these results.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Aydogdu M,Gursel Gdoi
10.1097/SMJ.0b013e3181827891subject
Has Abstractpub_date
2008-12-01 00:00:00pages
1222-6issue
12eissn
0038-4348issn
1541-8243journal_volume
101pub_type
杂志文章abstract::The diagnosis of intestinal obstruction is readily made when a patient presents with typical history and signs, and when plain films of the abdomen display characteristic findings. Some patients, however, constitute diagnostic problems because abdominal roentgenograms are still equivocal, even after repetition in four...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197912000-00008
更新日期:1979-12-01 00:00:00
abstract::Computed tomography is widely used to diagnose acute pancreatitis. Iodinated contrast medium lengthens the duration of pancreatitis and may increase the incidence of local or systemic complications. Total parenteral nutrition including IV lipid emulsion plays an important role in the management of patients with pancre...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000047667.00302.CD
更新日期:2003-01-01 00:00:00
abstract::In a patient with an asymptomatic left upper lobe pulmonary arteriovenous fistula, preoperative chest roentgenograms simulated bronchogenic carcinoma, but no overt feeding vessel was demonstrated. Intraoperatively no lesion could be palpated. Postoperative evaluation revealed a pulmonary arteriovenous fistula. This en...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198307000-00017
更新日期:1983-07-01 00:00:00
abstract::We have described the radiographic features of a case of solitary giant hepatocellular carcinoma in a noncirrhotic liver. It was angiographically avascular and resembled a massive metastatic tumor. Most hepatocellular carcinomas appear highly vascular on angiography. Hypovascularity may sometimes be encountered in the...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198310000-00027
更新日期:1983-10-01 00:00:00
abstract::Pentazocine (Talwin) originally was believed to be a safe, nonaddictive analgesic, but further experience has shown that severe mental and emotional disturbance, as well as addiction, may occur. This survey documents the experience in the Texas Medical Center and elsewhere. The accumulated data show the following: (1)...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197507000-00004
更新日期:1975-07-01 00:00:00
abstract::We have described a patient who had lung carcinoma, syndrome of inappropriate antidiuretic hormone, and central pontine myelinolysis (CPM). Although this association is well-known, it appears to be the first report having radiographic documentation of both the intracranial and intrathoracic abnormalities. When searchi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199204000-00019
更新日期:1992-04-01 00:00:00
abstract::We describe a case of an adrenal incidentalomas in the setting of congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. The adrenal mass was shown to be a cavernous hemangioma. Such neoplasms are rare but have the risk of retroperitoneal hemorrhage and may be difficult to differentiate from malignant ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1998-08-01 00:00:00
abstract::Acute calcareous deposits of the hand and wrist have been infrequently reported. A review of the literature and five recent cases indicate that these painful lesions will respond rapidly to immobilization and medication. Differentiation from infection is important. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198002000-00009
更新日期:1980-02-01 00:00:00
abstract:BACKGROUND:Conventional magnetic resonance imaging (MRI) of complex cervical spine disorders may underestimate the magnitude of structural disease because imaging is performed in a nondynamic non-weight-bearing manner. Myelography provides additional information but requires an invasive procedure. METHODS:This was a p...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章
doi:10.1097/00007611-200405000-00008
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVES:Adherence to National Comprehensive Cancer Network (NCCN) guidelines for ovarian cancer treatment improves patient outcomes. The aim of this study was to assess disparities associated with ovarian cancer treatment in the state of Kentucky and central Appalachia. METHODS:Data on patients diagnosed as having ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000821
更新日期:2018-06-01 00:00:00
abstract::A patient was referred for evaluation of obstructive uropathy after treatment with 10% formalin to control recurrent hemorrhagic radiation cystitis. Progressive bilateral ureteral, pelvic, and renal parenchymal destruction occurred despite ileal ureteral replacement. This complication of therapy reinforces the concept...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197809000-00029
更新日期:1978-09-01 00:00:00
abstract::We found magnetic resonance imaging helpful in the localization of both an adrenal and an extra-adrenal pheochromocytoma, since these tumors produced a high-intensity "light bulb" image. MRI is an excellent method for localizing pheochromocytomas because it detects adrenal and extra-adrenal pheochromocytomas missed by...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198911000-00017
更新日期:1989-11-01 00:00:00
abstract::With the apparent indefinite postponement of the release of chymopapain for lumbar disk disorders, it seems appropriate to review critically the proliferation of proposed methods of management of this common complaint, particularly the numerous exercise regimens which have been set forth as helpful. A critical review ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-197603000-00027
更新日期:1976-03-01 00:00:00
abstract::Between 1975 and 1978, over 200 knee arthroscopies were performed at the Emory University Hospitals; the findings were totally correct in 91%. During the same period, arthrograms were performed on 79 different patients, 39 of whom had confirming arthrotomies. The arthrograms were totally correct in 38%. Fifteen totall...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198111000-00009
更新日期:1981-11-01 00:00:00
abstract::The study goals were to document the incidence of elevated blood pressure (BP) values in public high school students in Tulsa, Oklahoma; to determine whether age and sex are risk factors; and to encourage adolescents with abnormal screening BP values to seek medical care. Over a 2-year period, 5537 adolescents aged 14...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199205000-00007
更新日期:1992-05-01 00:00:00
abstract::As residency programs adapt to the need to promote primary care, the importance of quantitating qualitative issues increases. In this study, a questionnaire based on reported residency stressors was answered by 238 internal medicine residents. The Profile of Mood States (POMS) was also completed by 64. Factor analysis...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199507000-00010
更新日期:1995-07-01 00:00:00
abstract::Patent ductus arteriosus (PDA) is a malady usually identified during childhood. Prompt surgical correction provides definitive therapy with long-term survival. When not corrected, PDA leads to significant morbidity and mortality, making it a rare condition in the adult population. We report the case of a 44-year-old m...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2001-03-01 00:00:00
abstract::The subsequent misuse and abuse of sedatives and hypnotics prescribed to 190 patients of the family practice program at the Medical University of South Carolina was investigated by medical record abstract and patient interviews. Results indicated little misuse and no abuse, with most respondents indicating they took f...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198406000-00003
更新日期:1984-06-01 00:00:00
abstract::A case of Wuchereria bancrofti filariasis was recently seen in a Haitian immigrant in Charleston, SC. The Caribbean area is a known endemic focus for this organism. With the increased numbers of immigrants from that area, it is likely that other such cases will be seen in the US. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198504000-00032
更新日期:1985-04-01 00:00:00
abstract::Giant cell arteritis has been thought to occur only in white patients. There have been several recent reports of this disorder to blacks, however, and this case of biopsy-proven giant cell arteritis in a black patient indicates the diagnosis should be considered in any elderly patient with typical symptoms regardless ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197909000-00045
更新日期:1979-09-01 00:00:00
abstract:OBJECTIVES:To explore temporal trends and geographic variations in mortality from prescription opioids from 1999 to 2016. METHODS:Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death files were used to calculate age-adjusted rates and 95% confidence int...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000001074
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) was investigated at a tertiary care hospital, and relationship was made between the clinical and genetic definitions of community- and healthcare-associated MRSA. METHODS:Nonduplicate isolates of S. aureus were collected during 2004. Iso...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e31815d3fce
更新日期:2008-01-01 00:00:00
abstract::The majority of abnormalities at the foramen of Monro identified by computed tomography (CT) are colloid cysts, but a number of other diseases in this location may produce a similar CT appearance. In a series of 21 patients the radiologic findings included six colloid cysts, two neoplasms, five vascular lesions, three...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198312000-00016
更新日期:1983-12-01 00:00:00
abstract::Shoulder pain is a frequent clinical problem facing primary care physicians. Despite its common occurrence, many clinicians are unfamiliar with the diagnosis and treatment of many common shoulder ailments. Because therapy for most shoulder disorders can be made at the initial consultation, a good history and physical ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e3181f5e85f
更新日期:2010-11-01 00:00:00
abstract::A woman with stable diabetes presented with hypoglycemia and decreased insulin requirement. Further history suggested decreasing pituitary function. Laboratory tests confirmed pituitary deficiencies, associated with her increased insulin sensitivity. It may be helpful to be aware of this syndrome when dealing with dia...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198001000-00033
更新日期:1980-01-01 00:00:00
abstract::The macerated stillborn fetus represents at least one third of all perinatal deaths. Microscopic examination of these specimens is often unrewarding. We have reported a clinically unsuspected cytomegalovirus infection in a second trimester macerated fetus. Cells suggestive of CMV inclusions were identified by light mi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199011000-00036
更新日期:1990-11-01 00:00:00
abstract::Mesenteric lipodystrophy (ML) is a rare condition characterized by a nonspecific inflammatory process that involves the root of the mesentery in a lipoma-like lesion. Presenting features of ML include abdominal pain, weight loss, nausea, vomiting, diarrhea, and constipation. This case illustrates that ML should be inc...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199905000-00013
更新日期:1999-05-01 00:00:00
abstract::The association of hypercoagulation and cancer, a well established pattern of disease, often leads to pulmonary emboli in an already compromised patient. Anticoagulation therapy in these patients is occasionally complicated by several factors including thrombocytopenia, which may result in a life-threatening situation...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章
doi:
更新日期:1987-10-01 00:00:00
abstract::Increasingly the courts are expanding the scope of viable causes of action and the nature of damages, as well as the spectrum of plaintiffs to include the unborn. Generally the courts accept medically established standards of care, but on occasion courts create the standard of care. Predicated on this type of scenario...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1980-10-01 00:00:00
abstract::To date, screening has largely failed to fulfill the hope that early detection would lead to more effective early treatment and to improved health status in the population served. The future role of screening can be much more positive but only if (1) screening is directed only at diseases and conditions for which earl...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1977-10-01 00:00:00