These updated definitions and clinical criteria should replace previous definitions, offer greater consistency for epidemiologic studies and clinical trials, and facilitate earlier recognition and more timely management of patients with sepsis or at risk of developing sepsis. Continue reading
Reported symptoms have included fever in 90% of cases, fatigue and a dry cough in 80%, and shortness of breath in 20%, with respiratory distress in 15%. Chest x-rays have revealed signs in both lungs. Vital signs were generally stable at the time of admission of those hospitalised. Blood tests have commonly shown low white blood cell counts (leucopenia and lymphopenia). Continue reading
Hypertensive disorders are common during pregnancy and can be classified into four pregnancy-associated categories: (1) chronic hypertension, (2) gestational hypertension, (3) preeclampsia, and (4) chronic hypertension with superimposed preeclampsia. In addition, non-pregnancy associated hypertensive emergencies can occur in the pregnant patient. Continue reading
With the introduction of more sensitive cardiac biomarkers, the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) collaborated to redefine MI using a biochemical and clinical approach, and reported that myocardial injury detected by abnormal biomarkers in the setting of acute myocardial ischaemia should be labelled as MI. Continue reading
Clostridium difficile (C. difficile) is a Gram-positive, sporeforming bacterium usually spread by the fecal-oral route. It is non-invasive and produces toxins A and B that cause disease, ranging from asymptomatic carriage, to mild diarrhea, to colitis, or pseudomembranous colitis. CDI is defined as the acute onset of diarrhea with documented toxigenic C. difficile or its toxin and no other documented cause for diarrhea.
The recommended classification is unchanged from the 2003 and 2007 ESH/ESC guidelines. Hypertension is defined as values >/=140 mmHg systolic blood pressure (SBP) and/or >/=90 mmHg diastolic blood pressure (DBP), based on the evidence from randomized controlled trials (RCTs) that in patients with these blood pressure (BP) values treatment-induced BP reductions are beneficial.
The tumor lysis syndrome is the most common disease-related emergency encountered by physicians caring for children or adults with hematologic cancers. This syndrome occurs when tumor cells release their contents into the bloodstream, either spontaneously or in response to therapy, leading to the characteristic findings of hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. These electrolyte and metabolic disturbances can progress to clinical toxic effects, including renal insufficiency, cardiac arrhythmias, seizures, and death due to multiorgan failure.
A 1992 American College of Chest Physicians/Society of Critical Care Medicine consensus panel defined the following terms which are relevant to the discussion of septic shock:
Infection: Infection is a microbial phenomenon characterized by an inflammatory response to the presence of microorganisms or the invasion of normally sterile host tissue by those organisms.
Bacteremia: Bacteremia refers to the presence of viable bacteria in the blood.
Systemic inflammatory response syndrome: Systemic inflammatory response syndrome (SIRS) is a widespread inflammatory response to a variety of severe clinical insults. This syndrome is clinically recognized by the presence of two or more of the following:
Names and definitions of vasculitis adopted by the Chapel Hill Consensus Conference on the nomenclature of systemic vasculitis