O. Mahamat, Mbah Jerah Nchuikieh, Ebanga Echi Joan Eyong
{"title":"Entamoeba coli and Entamoeba histolytica infections as risk of allergic reactions: a case study of population of Bamenda, Cameroon","authors":"O. Mahamat, Mbah Jerah Nchuikieh, Ebanga Echi Joan Eyong","doi":"10.15761/jmt.1000145","DOIUrl":"https://doi.org/10.15761/jmt.1000145","url":null,"abstract":"","PeriodicalId":92664,"journal":{"name":"Journal of clinical medicine and therapeutics","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77765762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Maria Iannaccone, Simone De Falco, S. Iurassich
{"title":"MELAINOMANIA: Psychopathological mechanisms, physical and psychological diagnostic endpoints and psychotherapeutic model, based on a clinical study over 160 cases","authors":"Anna Maria Iannaccone, Simone De Falco, S. Iurassich","doi":"10.15761/jmt.1000148","DOIUrl":"https://doi.org/10.15761/jmt.1000148","url":null,"abstract":"","PeriodicalId":92664,"journal":{"name":"Journal of clinical medicine and therapeutics","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84767818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clostridioides difficile infection in children with Inflammatory Bowel Disease: challenges in diagnosis and management","authors":"S. Mohandas, Shaddy Farid, S. Michail","doi":"10.15761/jmt.1000147","DOIUrl":"https://doi.org/10.15761/jmt.1000147","url":null,"abstract":"","PeriodicalId":92664,"journal":{"name":"Journal of clinical medicine and therapeutics","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80712818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A neglected cause of uremic pruritus: Blastocystis hominis","authors":"Baloglu Ismail, Turkmen Kultigin","doi":"10.15761/jmt.1000143","DOIUrl":"https://doi.org/10.15761/jmt.1000143","url":null,"abstract":"","PeriodicalId":92664,"journal":{"name":"Journal of clinical medicine and therapeutics","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80244839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Pyar, Aung Si Myo, S. Hlaing, Zar Ni Htet Aung, N. Lin Maung, Aung Phyoe Kyaw, Min Lynn Zaw Oo, K. Zaya, Myo Thant Kyaw, Zay Phyo Aung, Chan Aye Aung
{"title":"Acute coronary syndrome with cardiogenic shock due to occlusion of right coronary artery in a young physician caring patients with COVID-19 infection: a case report","authors":"K. Pyar, Aung Si Myo, S. Hlaing, Zar Ni Htet Aung, N. Lin Maung, Aung Phyoe Kyaw, Min Lynn Zaw Oo, K. Zaya, Myo Thant Kyaw, Zay Phyo Aung, Chan Aye Aung","doi":"10.15761/jmt.1000146","DOIUrl":"https://doi.org/10.15761/jmt.1000146","url":null,"abstract":"","PeriodicalId":92664,"journal":{"name":"Journal of clinical medicine and therapeutics","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85976901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nicholas Maenza, Diana Koltovski, Joanne DiFrancisco-Donoghue, Patricia Happel
Objective: Recording calorie intake has been shown to assist in weight loss [1]. Today, smartphone applications enable patients to easily record calorie intake and are readily available. The purpose of this study is to evaluate the efficacy of utilizing a smartphone calorie calculator for weight loss, body composition metrics and body shape preoccupation when used alone or in conjunction with weekly email outreach to patients, encouraging them to remain compliant with a weight loss program. Methods: In this pilot study, fourteen college-aged women were recruited for the study on a rolling basis. Their weight was recorded, and their body composition was measured with the use of a dual-energy X-ray absorptiometry (DEXA scan). Their body-shape preoccupation was evaluated by the validated body shape questionnaire (BSQ)-16A survey, a self-report measure of body shape preoccupation typical of common eating disorders [2,3]. A daily calorie goal was set for each subject based on their calculated resting metabolic rate. All subjects were instructed to use a smartphone application to record their daily calorie intake. Nine intervention subjects were emailed weekly to self-report on how many days they used the application and their daily calorie intake. They were also offered encouragement to remain compliant with the program. Each intervention subject was re-evaluated after eight weeks. Five control subjects were not contacted weekly and were re-evaluated after eight weeks. Results: Both the intervention group and the control group showed a reduction in weight (6.52 ± 4.78 lbs vs 6.3 ± 1.18 lbs, p = 0.40) fat mass (0.23 ± 2.05 lbs vs 3.43 ± 2.99 lbs, p = 0.07), percent body fat (0.23 ± 1.11 vs 1.26 ± 0.48 lbs, p = 0.07) and visceral fat mass (VFM) (0.01 ± 0.18 vs 0.06 ± 0.22, p = 0.86). The Body Shape Questionnaire 16A (BSQ-16A) also indicated improvement in both groups for body shape preoccupation (6.14 ± 6.07 vs 18.6 ± 8.41, p = 0.19). Thus, use of the application benefitted both groups. Conclusion: The study’s results indicate that use of a smartphone calorie-counting application may have a positive effect on body composition metrics and may lower patients’ preoccupation with body image-with or without an additional intervention. *Correspondence to: Nicholas Maenza, New York Institute of Technology College of Osteopathic Medicine (NYIT-COM), Old Westbury, New York, USA, E-mail: nmaenza@nyit.edu
目的:记录卡路里摄入已被证明有助于减肥[1]。如今,智能手机应用程序使患者能够轻松记录卡路里摄入量,并且随时可用。本研究的目的是评估智能手机卡路里计算器在减肥、身体成分指标和体型关注方面的功效,当单独使用或与每周向患者发送电子邮件联系时,鼓励他们坚持减肥计划。方法:在这项初步研究中,14名大学年龄的女性被招募到滚动基础上进行研究。记录他们的体重,并使用双能x射线吸收仪(DEXA扫描)测量他们的身体成分。他们的体形关注程度通过有效体形问卷(BSQ)-16A进行评估,这是一种对常见饮食失调典型的体形关注程度的自我报告测量[2,3]。根据计算出的静息代谢率,为每位受试者设定了每日卡路里目标。所有受试者都被要求使用智能手机应用程序记录他们每天的卡路里摄入量。9名干预对象每周通过电子邮件自我报告他们使用应用程序的天数和每天的卡路里摄入量。他们还被鼓励继续遵守该计划。每个干预对象在8周后重新评估。5名对照受试者没有每周联系,并在8周后重新评估。结果:干预组和对照组的体重(6.52±4.78 lbs vs 6.3±1.18 lbs, p = 0.40)、脂肪量(0.23±2.05 lbs vs 3.43±2.99 lbs, p = 0.07)、体脂率(0.23±1.11 lbs vs 1.26±0.48 lbs, p = 0.07)和内脏脂肪量(VFM)(0.01±0.18 vs 0.06±0.22,p = 0.86)均有所减少。体形问卷16A (BSQ-16A)也显示两组对体形的关注有所改善(6.14±6.07 vs 18.6±8.41,p = 0.19)。因此,应用程序的使用使两组人都受益。结论:研究结果表明,使用智能手机卡路里计数应用程序可能对身体成分指标有积极影响,并可能降低患者对身体形象的关注——无论是否有额外的干预。*通讯:Nicholas Maenza,美国纽约州老韦斯特伯里纽约理工学院骨科医学院(nyit.com), E-mail: nmaenza@nyit.edu
{"title":"Assessing the efficacy of utilizing a smartphone calorie calculator for weight loss, body composition and body shape preoccupation","authors":"Nicholas Maenza, Diana Koltovski, Joanne DiFrancisco-Donoghue, Patricia Happel","doi":"10.15761/jmt.1000138","DOIUrl":"https://doi.org/10.15761/jmt.1000138","url":null,"abstract":"Objective: Recording calorie intake has been shown to assist in weight loss [1]. Today, smartphone applications enable patients to easily record calorie intake and are readily available. The purpose of this study is to evaluate the efficacy of utilizing a smartphone calorie calculator for weight loss, body composition metrics and body shape preoccupation when used alone or in conjunction with weekly email outreach to patients, encouraging them to remain compliant with a weight loss program. Methods: In this pilot study, fourteen college-aged women were recruited for the study on a rolling basis. Their weight was recorded, and their body composition was measured with the use of a dual-energy X-ray absorptiometry (DEXA scan). Their body-shape preoccupation was evaluated by the validated body shape questionnaire (BSQ)-16A survey, a self-report measure of body shape preoccupation typical of common eating disorders [2,3]. A daily calorie goal was set for each subject based on their calculated resting metabolic rate. All subjects were instructed to use a smartphone application to record their daily calorie intake. Nine intervention subjects were emailed weekly to self-report on how many days they used the application and their daily calorie intake. They were also offered encouragement to remain compliant with the program. Each intervention subject was re-evaluated after eight weeks. Five control subjects were not contacted weekly and were re-evaluated after eight weeks. Results: Both the intervention group and the control group showed a reduction in weight (6.52 ± 4.78 lbs vs 6.3 ± 1.18 lbs, p = 0.40) fat mass (0.23 ± 2.05 lbs vs 3.43 ± 2.99 lbs, p = 0.07), percent body fat (0.23 ± 1.11 vs 1.26 ± 0.48 lbs, p = 0.07) and visceral fat mass (VFM) (0.01 ± 0.18 vs 0.06 ± 0.22, p = 0.86). The Body Shape Questionnaire 16A (BSQ-16A) also indicated improvement in both groups for body shape preoccupation (6.14 ± 6.07 vs 18.6 ± 8.41, p = 0.19). Thus, use of the application benefitted both groups. Conclusion: The study’s results indicate that use of a smartphone calorie-counting application may have a positive effect on body composition metrics and may lower patients’ preoccupation with body image-with or without an additional intervention. *Correspondence to: Nicholas Maenza, New York Institute of Technology College of Osteopathic Medicine (NYIT-COM), Old Westbury, New York, USA, E-mail: nmaenza@nyit.edu","PeriodicalId":92664,"journal":{"name":"Journal of clinical medicine and therapeutics","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86525055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yanzhuo Maa, L. Ru, Hao-Jui Li, Gang Wang, L. Tang
Objective: It has been demonstrated that 4F child catheter could be inserted into the mother guiding catheter for back up support improvement, stent or balloon delivery, etc. Here, we aimed to determine the potential role of 4F child catheter in treating complex coronary lesions. Methods and results: We retrospectively analyzed 40 lesions treated by 4F child catheter. The 4F child catheter was beneficial to facilitate stent or balloon delivery, to aid guidewire crossing, to capture stent, or to pick up retrograde guidewire. For CTO PCI, picking up the retrograde guidewire using the advanced greeting technique accounted for 32.1%, indicating it was efficient for CTO revascularization. Lesion success was 95%, device success was 95%, and procedure success was 92.5%. One patient failed because of acute thrombosis after successful stent deployment, one failed due to the guidewire unable to cross the target lesion. There was one instance of stent dislodgment and one instance of little pericardial effusion. Conclusions: The 4F child catheter provided higher successful rate and it was a viable device in treating complex coronary lesions. *Correspondence to: Leisheng Ru, Department of Cardiology, Bethune International Peace Hospital, Shijiazhuang, Hebei, China, Tel: 86-031187978302; Fax: 86-031187978302; E-mail: muyeqiufeng2008@163.com
{"title":"Clinical experience of 4F child catheter in interventions of complex coronary lesions","authors":"Yanzhuo Maa, L. Ru, Hao-Jui Li, Gang Wang, L. Tang","doi":"10.15761/JMT.1000140","DOIUrl":"https://doi.org/10.15761/JMT.1000140","url":null,"abstract":"Objective: It has been demonstrated that 4F child catheter could be inserted into the mother guiding catheter for back up support improvement, stent or balloon delivery, etc. Here, we aimed to determine the potential role of 4F child catheter in treating complex coronary lesions. Methods and results: We retrospectively analyzed 40 lesions treated by 4F child catheter. The 4F child catheter was beneficial to facilitate stent or balloon delivery, to aid guidewire crossing, to capture stent, or to pick up retrograde guidewire. For CTO PCI, picking up the retrograde guidewire using the advanced greeting technique accounted for 32.1%, indicating it was efficient for CTO revascularization. Lesion success was 95%, device success was 95%, and procedure success was 92.5%. One patient failed because of acute thrombosis after successful stent deployment, one failed due to the guidewire unable to cross the target lesion. There was one instance of stent dislodgment and one instance of little pericardial effusion. Conclusions: The 4F child catheter provided higher successful rate and it was a viable device in treating complex coronary lesions. *Correspondence to: Leisheng Ru, Department of Cardiology, Bethune International Peace Hospital, Shijiazhuang, Hebei, China, Tel: 86-031187978302; Fax: 86-031187978302; E-mail: muyeqiufeng2008@163.com","PeriodicalId":92664,"journal":{"name":"Journal of clinical medicine and therapeutics","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91051909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Metabolic fluxes between mitochondria and endoplasmic reticulum appear today of first importance in normal and pathologic cellular physiology sustaining important regulation processes involved in mitochondrial biogenesis, homeostasis and stress responses. The basis of these interrelations is well described in yeast, the mechanism involved in higher eukaryotes and mammals is unknown. Here will be to present and emphasize on the role of a newly discovered protein, ATAD3, that may represent a molecular bridge between these compartments and essential link for associated exchanging processes.
{"title":"ATAD3 and endoplasmic reticulum to mitochondria connection: a main actor and interaction regarding pathogenesis","authors":"D. Rousseau","doi":"10.15761/JMT.1000139","DOIUrl":"https://doi.org/10.15761/JMT.1000139","url":null,"abstract":"Metabolic fluxes between mitochondria and endoplasmic reticulum appear today of first importance in normal and pathologic cellular physiology sustaining important regulation processes involved in mitochondrial biogenesis, homeostasis and stress responses. The basis of these interrelations is well described in yeast, the mechanism involved in higher eukaryotes and mammals is unknown. Here will be to present and emphasize on the role of a newly discovered protein, ATAD3, that may represent a molecular bridge between these compartments and essential link for associated exchanging processes.","PeriodicalId":92664,"journal":{"name":"Journal of clinical medicine and therapeutics","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79275189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pengjuan Cao, W. Lian, P. Hathurusinghe, Deepak Sharma, Cong-cong Han, Yanmin Xu
Atrial fibrillation (AF) is the most frequent cardiac arrhythmia seen in clinical practice and is associated with pronounced morbidity and mortality. It was demonstrated that AF is associated with altered miRNA levels in atrial tissue and plasma. The regulatory function of specific miRNAs has been studied in the structural and electrical remodeling underlying AF, ischemic heart disease, cardiac hypertrophy, ion channel modification and extracellular matrix (ECM) formation. Furthermore, circulating miRNAs associated with AF could serve as potential biomarkers of the disease, whereas specific tissue miRNAs could become targets for therapy. Although treatment of AF has sub stantially advanced in recent years, numerous problems re main, and a fundamental breakthrough has not been made in the treatment of AF. *Correspondence to: Yanmin XU, Department of Cardiology, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, PR China, Tel: 0086-13702029695; Fax: 0086-22-88328119; E-mail: xuyanminphdmd@sina.com
{"title":"Role of miRNA-21 expression in profibrillatory fibrotic remodeling and atrial fibrillation occurrence","authors":"Pengjuan Cao, W. Lian, P. Hathurusinghe, Deepak Sharma, Cong-cong Han, Yanmin Xu","doi":"10.15761/jmt.1000141","DOIUrl":"https://doi.org/10.15761/jmt.1000141","url":null,"abstract":"Atrial fibrillation (AF) is the most frequent cardiac arrhythmia seen in clinical practice and is associated with pronounced morbidity and mortality. It was demonstrated that AF is associated with altered miRNA levels in atrial tissue and plasma. The regulatory function of specific miRNAs has been studied in the structural and electrical remodeling underlying AF, ischemic heart disease, cardiac hypertrophy, ion channel modification and extracellular matrix (ECM) formation. Furthermore, circulating miRNAs associated with AF could serve as potential biomarkers of the disease, whereas specific tissue miRNAs could become targets for therapy. Although treatment of AF has sub stantially advanced in recent years, numerous problems re main, and a fundamental breakthrough has not been made in the treatment of AF. *Correspondence to: Yanmin XU, Department of Cardiology, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, PR China, Tel: 0086-13702029695; Fax: 0086-22-88328119; E-mail: xuyanminphdmd@sina.com","PeriodicalId":92664,"journal":{"name":"Journal of clinical medicine and therapeutics","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84270291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel E Salas, Emi Minejima, Joanna Wu, Chong Fang, Joshua Wang, Rosemary She, Paul Nieberg, Annie Wong-Beringer
Background: Limitations regarding the sensitivity and specificity of the systemic inflammatory response (SIRS) criteria prompted the recent revision in consensus definitions of sepsis and septic shock. We evaluated patients with Staphylococcus aureus bacteremia (SAB) who did not meet SIRS criteria for sepsis (SIRS-negative, SIRS-N) to compare host immune response and outcomes with SIRS-positive (P) patients.
Methods: A prospective observational study of patients hospitalized for SAB during 2012-2015 was conducted. Pro- (TNFα, IL6, IL8) and anti-inflammatory (IL10) cytokine levels (pg/mL) were compared between SIRS-N and SIRS-P patients. Outcome endpoints were day 4 persistence and 30-day mortality.
Results: Of the 353 study patients, 23% were SIRS-N. A similar proportion of SIRS-N and SIRS-P patients had an infection-related admitting diagnosis (70% vs. 66%, p=0.5946), and both groups received timely antibiotic administration. Less than 1/3 of SIRS-N group had abnormal WBC count, tachycardia, or tachypnea while <15% had fever/hypothermia or hypotension. Initial proand anti-inflammatory cytokine levels were significantly lower and in balance as indicated by IL10/TNF ratio in SIRS-N compared to SIRS-P patients. IL10/TNF ratio increased progressively in patients with increasing sepsis severity and mortality.
Conclusions: Clinical management of patients with SAB seemed driven largely by clinician assessment rather than SIRS criteria alone, with one in 4 patients not meeting SIRS criteria. Importantly, the severity of presentation and outcomes of SAB correspond well to the magnitude of underlying imbalance in pro- and anti-inflammatory cytokine levels, supporting the updated sepsis definition as "life-threatening organ dysfunction caused by a dysregulated host response to infection".
Key points: In a prospective observational study of 353 patients with Staphylococcus aureus bacteremia, 23% did not meet SIRS criteria for sepsis. Severity of sepsis and risk of death is supported by a dysregulated host cytokine response with progressively increasing IL10/TNF ratio.
{"title":"Staphylococcus aureus Bacteremia in Patients not Meeting Sepsis Criteria: Clinical Features, Host Immune Response and Outcomes.","authors":"Daniel E Salas, Emi Minejima, Joanna Wu, Chong Fang, Joshua Wang, Rosemary She, Paul Nieberg, Annie Wong-Beringer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Limitations regarding the sensitivity and specificity of the systemic inflammatory response (SIRS) criteria prompted the recent revision in consensus definitions of sepsis and septic shock. We evaluated patients with <i>Staphylococcus aureus</i> bacteremia (SAB) who did not meet SIRS criteria for sepsis (SIRS-negative, SIRS-N) to compare host immune response and outcomes with SIRS-positive (P) patients.</p><p><strong>Methods: </strong>A prospective observational study of patients hospitalized for SAB during 2012-2015 was conducted. Pro- (TNFα, IL6, IL8) and anti-inflammatory (IL10) cytokine levels (pg/mL) were compared between SIRS-N and SIRS-P patients. Outcome endpoints were day 4 persistence and 30-day mortality.</p><p><strong>Results: </strong>Of the 353 study patients, 23% were SIRS-N. A similar proportion of SIRS-N and SIRS-P patients had an infection-related admitting diagnosis (70% <i>vs</i>. 66%, p=0.5946), and both groups received timely antibiotic administration. Less than 1/3 of SIRS-N group had abnormal WBC count, tachycardia, or tachypnea while <15% had fever/hypothermia or hypotension. Initial proand anti-inflammatory cytokine levels were significantly lower and in balance as indicated by IL10/TNF ratio in SIRS-N compared to SIRS-P patients. IL10/TNF ratio increased progressively in patients with increasing sepsis severity and mortality.</p><p><strong>Conclusions: </strong>Clinical management of patients with SAB seemed driven largely by clinician assessment rather than SIRS criteria alone, with one in 4 patients not meeting SIRS criteria. Importantly, the severity of presentation and outcomes of SAB correspond well to the magnitude of underlying imbalance in pro- and anti-inflammatory cytokine levels, supporting the updated sepsis definition as \"life-threatening organ dysfunction caused by a dysregulated host response to infection\".</p><p><strong>Key points: </strong>In a prospective observational study of 353 patients with <i>Staphylococcus aureus</i> bacteremia, 23% did not meet SIRS criteria for sepsis. Severity of sepsis and risk of death is supported by a dysregulated host cytokine response with progressively increasing IL10/TNF ratio.</p>","PeriodicalId":92664,"journal":{"name":"Journal of clinical medicine and therapeutics","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6497173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37212823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}