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  1. Article ; Online: The Role of Biomarkers in the Diagnosis and Management of Pneumonia.

    Sungurlu, Sarah / Balk, Robert A

    Infectious disease clinics of North America

    2024  Volume 38, Issue 1, Page(s) 35–49

    Abstract: Biomarkers are used in the diagnosis, severity determination, and prognosis for patients with community-acquired pneumonia (CAP). Selected biomarkers may indicate a bacterial infection and need for antibiotic therapy (C-reactive protein, procalcitonin, ... ...

    Abstract Biomarkers are used in the diagnosis, severity determination, and prognosis for patients with community-acquired pneumonia (CAP). Selected biomarkers may indicate a bacterial infection and need for antibiotic therapy (C-reactive protein, procalcitonin, soluble triggering receptor expressed on myeloid cells). Biomarkers can differentiate CAP patients who require hospital admission and severe CAP requiring intensive care unit admission. Biomarker-guided antibiotic therapy may limit antibiotic exposure without compromising outcome and thus improve antibiotic stewardship. The authors discuss the role of biomarkers in diagnosing, determining severity, defining the prognosis, and limiting antibiotic exposure in CAP and ventilator-associated pneumonia patients.
    MeSH term(s) Humans ; Calcitonin ; Biomarkers ; Pneumonia/diagnosis ; Pneumonia/drug therapy ; Prognosis ; Pneumonia, Ventilator-Associated/diagnosis ; Pneumonia, Ventilator-Associated/drug therapy ; Community-Acquired Infections/diagnosis ; Community-Acquired Infections/drug therapy ; Anti-Bacterial Agents/therapeutic use
    Chemical Substances Calcitonin (9007-12-9) ; Biomarkers ; Anti-Bacterial Agents
    Language English
    Publishing date 2024-01-25
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1077676-x
    ISSN 1557-9824 ; 0891-5520
    ISSN (online) 1557-9824
    ISSN 0891-5520
    DOI 10.1016/j.idc.2023.12.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Book ; Conference proceedings: Antiepileptic drugs

    Balk, Robert A.

    mechanisms, modalities and clinical benefits ; proceedings of a symposium ... held at the Dead Sea, Israel, on 17 June 2000

    (International congress and symposium series ; 248)

    2001  

    Author's details ed. by C. J. Woolf
    Series title International congress and symposium series ; 248
    International congress and symposium series / Royal Society of Medicine
    Collection International congress and symposium series / Royal Society of Medicine
    Keywords Anticonvulsants / pharmacology ; Anticonvulsants / therapeutic use ; Epilepsie ; Pharmakotherapie
    Subject Arzneimitteltherapie ; Arzneitherapie ; Medikamentöse Therapie ; Fallsucht
    Language English
    Size VIII, 50 S. : Ill., graph. Darst.
    Publisher Royal Soc. of Med. Press
    Publishing place London u.a.
    Publishing country Great Britain
    Document type Book ; Conference proceedings
    HBZ-ID HT013394669
    ISBN 1-85315-476-8 ; 978-1-85315-476-8
    Database Catalogue ZB MED Medicine, Health

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    Shelf markLoan statusLocation
    2003 A 3598 order for loan Magazin

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  3. Book: Sepsis and septic shock

    Balk, Robert A.

    (Critical care clinics ; 16,2)

    2000  

    Author's details Robert A. Balk ..., guest ed
    Series title Critical care clinics ; 16,2
    Collection
    Language English
    Size VIII S., S. 179 - 371 : Ill.
    Publisher Saunders
    Publishing place Philadelphia u.a.
    Publishing country United States
    Document type Book
    HBZ-ID HT011269117
    Database Catalogue ZB MED Medicine, Health

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    Se 990 -16,2- verfügbar in Königswinter Königswinter

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  4. Book: Septic shock

    Balk, Robert A.

    (Critical care clinics ; 5,1)

    1989  

    Author's details Robert A. Balk ... , guest ed
    Series title Critical care clinics ; 5,1
    Collection
    Keywords Shock, Septic
    Size IX, 194 S. : graph. Darst.
    Publisher Saunders
    Publishing place Philadelphia u.a.
    Publishing country United States
    Document type Book
    HBZ-ID HT003296277
    Database Catalogue ZB MED Medicine, Health

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  5. Article ; Online: The Role of Biomarkers in the Diagnosis and Management of Pneumonia.

    Sungurlu, Sarah / Balk, Robert A

    Clinics in chest medicine

    2018  Volume 39, Issue 4, Page(s) 691–701

    Abstract: Biomarkers are used in the diagnosis, severity determination, and prognosis for patients with community-acquired pneumonia (CAP). Selected biomarkers may indicate a bacterial infection and need for antibiotic therapy (C-reactive protein, procalcitonin, ... ...

    Abstract Biomarkers are used in the diagnosis, severity determination, and prognosis for patients with community-acquired pneumonia (CAP). Selected biomarkers may indicate a bacterial infection and need for antibiotic therapy (C-reactive protein, procalcitonin, soluble triggering receptor expressed on myeloid cells). Biomarkers can differentiate CAP patients who require hospital admission and severe CAP requiring intensive care unit admission. Biomarker-guided antibiotic therapy may limit antibiotic exposure without compromising outcome and thus improve antibiotic stewardship. The authors discuss the role of biomarkers in diagnosing, determining severity, defining the prognosis, and limiting antibiotic exposure in CAP and ventilator-associated pneumonia patients.
    MeSH term(s) Biomarkers/metabolism ; Calcitonin/pharmacology ; Calcitonin/therapeutic use ; Female ; Humans ; Male ; Pneumonia/diagnosis ; Pneumonia/pathology ; Pneumonia/therapy ; Prognosis ; Severity of Illness Index
    Chemical Substances Biomarkers ; Calcitonin (9007-12-9)
    Language English
    Publishing date 2018-11-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 447455-7
    ISSN 1557-8216 ; 0272-5231
    ISSN (online) 1557-8216
    ISSN 0272-5231
    DOI 10.1016/j.ccm.2018.07.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Roger C. Bone, MD and the evolving paradigms of sepsis.

    Balk, Robert

    Contributions to microbiology

    2011  Volume 17, Page(s) 1–11

    Abstract: Severe sepsis and septic shock are frequent causes of ICU admission, commonly encountered complications during the course of hospitalization, and among the most common causes of death in the noncoronary ICU. Dr. Roger C. Bone was a pioneer in our ... ...

    Abstract Severe sepsis and septic shock are frequent causes of ICU admission, commonly encountered complications during the course of hospitalization, and among the most common causes of death in the noncoronary ICU. Dr. Roger C. Bone was a pioneer in our struggles to improve the early recognition and management of severe sepsis and septic shock. Through his leadership and guidance, great strides were made to develop a uniform definition and to ensure the comparability of clinical research trials to evaluate new therapeutic strategies and antimediator agents. Dr. Bone also helped shape our understanding of the various stages or physiologic alterations that occur in the septic patient which also drove forward the development of new therapeutic strategies. This chapter briefly reviews the impact Roger Bone has had on our current understanding and approach to the septic patient.
    MeSH term(s) Clinical Trials as Topic ; History, 20th Century ; Humans ; Sepsis/complications ; Sepsis/diagnosis ; Sepsis/pathology ; Sepsis/therapy ; Systemic Inflammatory Response Syndrome/diagnosis ; Systemic Inflammatory Response Syndrome/pathology ; Systemic Inflammatory Response Syndrome/therapy ; Treatment Outcome ; United States
    Language English
    Publishing date 2011-06-09
    Publishing country Switzerland
    Document type Biography ; Historical Article ; Journal Article
    ISSN 1662-291X ; 1420-9519
    ISSN (online) 1662-291X
    ISSN 1420-9519
    DOI 10.1159/000323970
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Role of Antithrombin III and Tissue Factor Pathway in the Pathogenesis of Sepsis.

    Sungurlu, Sarah / Kuppy, Jessica / Balk, Robert A

    Critical care clinics

    2020  Volume 36, Issue 2, Page(s) 255–265

    Abstract: The pathobiology of the septic process includes a complex interrelationship between inflammation and the coagulations system. Antithrombin (AT) and tissue factor are important components of the coagulation system and have potential roles in the ... ...

    Abstract The pathobiology of the septic process includes a complex interrelationship between inflammation and the coagulations system. Antithrombin (AT) and tissue factor are important components of the coagulation system and have potential roles in the production and amplification of sepsis. Sepsis is associated with a decrease in AT levels, and low levels are also associated with the development of multiple organ failure and death. Treatment strategies incorporating AT replacement therapy in sepsis and septic shock have not resulted in an improvement in survival or reversal of disseminated intravascular coagulation.
    MeSH term(s) Antithrombin III/metabolism ; Critical Illness ; Humans ; Multiple Organ Failure/etiology ; Multiple Organ Failure/prevention & control ; Sepsis/metabolism ; Sepsis/physiopathology ; Sepsis/therapy ; Shock, Septic/metabolism ; Shock, Septic/physiopathology ; Shock, Septic/therapy ; Thromboplastin/metabolism
    Chemical Substances Antithrombin III (9000-94-6) ; Thromboplastin (9035-58-9)
    Language English
    Publishing date 2020-01-31
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1006423-0
    ISSN 1557-8232 ; 0749-0704
    ISSN (online) 1557-8232
    ISSN 0749-0704
    DOI 10.1016/j.ccc.2019.12.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Systemic inflammatory response syndrome (SIRS): where did it come from and is it still relevant today?

    Balk, Robert A

    Virulence

    2013  Volume 5, Issue 1, Page(s) 20–26

    Abstract: The concept of a systemic inflammatory response syndrome (SIRS) to describe the complex pathophysiologic response to an insult such as infection, trauma, burns, pancreatitis, or a variety of other injuries came from a 1991 consensus conference charged ... ...

    Abstract The concept of a systemic inflammatory response syndrome (SIRS) to describe the complex pathophysiologic response to an insult such as infection, trauma, burns, pancreatitis, or a variety of other injuries came from a 1991 consensus conference charged with the task of developing an easy-to-apply set of clinical parameters to aid in the early identification of potential candidates to enter into clinical trials to evaluate new treatments for sepsis. There was recognition that a diverse group of injuries produced a common inflammatory response in the host and provided attractive targets for new anti-inflammatory molecules designed to prevent further propagation and/or provide specific treatment. Effective application of these new anti-inflammatory strategies necessitated identification of early clinical markers that could be assessed in real-time and were likely to define a population of patients that would have a beneficial response to the targeted intervention. It was felt that early clinical manifestations might be more readily available to clinicians than more sophisticated and specific assays for inflammatory substances that were systemically released by the network of injurious inflammatory events. Therefore, the early definition of a systemic inflammatory response syndrome (SIRS) was built upon a foundation of basic clinical and laboratory abnormalities that were readily available in almost all clinical settings. With further refinement, it was hoped, that this definition would have a high degree of sensitivity, coupled with a reasonable degree of specificity. This manuscript reviews the derivation, application, utilization, potential benefits, and speculation regarding the future of the SIRS definition.
    MeSH term(s) Anti-Inflammatory Agents/therapeutic use ; Humans ; Sepsis/diagnosis ; Sepsis/therapy ; Systemic Inflammatory Response Syndrome/diagnosis ; Systemic Inflammatory Response Syndrome/therapy
    Chemical Substances Anti-Inflammatory Agents
    Language English
    Publishing date 2013-11-13
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2657572-3
    ISSN 2150-5608 ; 2150-5594
    ISSN (online) 2150-5608
    ISSN 2150-5594
    DOI 10.4161/viru.27135
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Identification and Prevention of Extubation Failure by Using an Automated Continuous Monitoring Alert Versus Standard Care.

    Kaur, Ramandeep / Vines, David L / Harnois, Lauren J / Elshafei, Ahmad / Johnson, Tricia / Balk, Robert A

    Respiratory care

    2022  Volume 67, Issue 10, Page(s) 1282–1290

    Abstract: Background: Postextubation monitoring helps identify patients at risk of developing respiratory failure. This study aimed to evaluate the effect of our standard respiratory therapist (RT) assessment tool versus an automated continuous monitoring alert ... ...

    Abstract Background: Postextubation monitoring helps identify patients at risk of developing respiratory failure. This study aimed to evaluate the effect of our standard respiratory therapist (RT) assessment tool versus an automated continuous monitoring alert to initiate postextubation RT-driven care on the re-intubation rate.
    Methods: This was a single-center randomized clinical trial from March 2020 to September 2021 of adult subjects who received mechanical ventilation for > 24 h and underwent planned extubation in the ICU. The subjects were assigned to the standard RT assessment tool or an automated monitoring alert to identify the need for postextubation RT-driven care. The primary outcome was the need for re-intubation due to respiratory failure within 72 h. Secondary outcomes included re-intubation within 7 d, ICU and hospital lengths of stay, hospital mortality, ICU cost, and RT time associated with patient assessment and therapy provision.
    Results: Of 234 randomized subjects, 32 were excluded from the primary analysis due to disruption in RT-driven care during the surge of patients with COVID-19, and 1 subject was excluded due to delay in the automated monitoring initiation. Analysis of the primary outcome included 85 subjects assigned to the standard RT assessment group and 116 assigned to the automated monitoring alert group to initiate RT-driven care. There was no significant difference between the study groups in re-intubation rate, median length of stay, mortality, or ICU costs. The RT time associated with patient assessment (
    Conclusions: In subjects who received mechanical ventilation for > 24 h, there were no significant outcome or cost differences between our standard RT assessment tool or an automated monitoring alert to initiate postextubation RT-driven care. Using an automated continuous monitoring alert to initiate RT-driven care saved RT time. (ClinicalTrials.gov registration NCT04231890).
    MeSH term(s) Adult ; Airway Extubation/adverse effects ; COVID-19 ; Humans ; Intensive Care Units ; Respiration, Artificial/adverse effects ; Respiratory Insufficiency/diagnosis ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/therapy ; Ventilator Weaning
    Language English
    Publishing date 2022-03-28
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 603252-7
    ISSN 1943-3654 ; 0098-9142 ; 0020-1324
    ISSN (online) 1943-3654
    ISSN 0098-9142 ; 0020-1324
    DOI 10.4187/respcare.09860
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Respiratory Musculature Evaluated by Computed Tomography in the Setting of Prolonged Mechanical Ventilation.

    Wakefield, Connor J / Jochum, Sarah B / Hejna, Emily E / Peterson, Sarah B / Vines, David L / Shah, Palmi N / Hayden, Dana M / Balk, Robert A

    Respiratory care

    2023  Volume 68, Issue 8, Page(s) 1106–1111

    Abstract: Background: Diaphragm atrophy has been observed in subjects who undergo invasive mechanical ventilation. We propose a new method to assess for respiratory muscle (RM) changes in subjects who undergo invasive mechanical ventilation by assessing for ... ...

    Abstract Background: Diaphragm atrophy has been observed in subjects who undergo invasive mechanical ventilation. We propose a new method to assess for respiratory muscle (RM) changes in subjects who undergo invasive mechanical ventilation by assessing for changes in respiratory muscles through computed tomography (CT).
    Methods: A retrospective case series study was conducted on subjects who underwent invasive mechanical ventilation and received at least 2 chest CT scans during admission. Exclusion criteria included history of chronic mechanical ventilation dependence and neuromuscular disease. Respiratory muscle cross-sectional area (CSA) was measured at the T6 vertebrae.
    Results: Fourteen subjects were included: mean (± SD) age, BMI, and admission APACHE II scores were 54.0 y (± 14.9), 32.6 kg/m
    Conclusions: We demonstrated that serial analysis of respiratory muscle CSA through CT chest scans can be a method to assess for respiratory muscle atrophy in subjects undergoing mechanical ventilation. Future prospective studies involving larger populations are needed to better understand how this method can be used to predict outcomes in mechanically ventilated patients.
    MeSH term(s) Humans ; Male ; Female ; Respiration, Artificial/adverse effects ; Respiration, Artificial/methods ; Prospective Studies ; Retrospective Studies ; Respiratory Muscles ; Tomography, X-Ray Computed ; Atrophy ; Tomography
    Language English
    Publishing date 2023-04-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603252-7
    ISSN 1943-3654 ; 0098-9142 ; 0020-1324
    ISSN (online) 1943-3654
    ISSN 0098-9142 ; 0020-1324
    DOI 10.4187/respcare.09491
    Database MEDical Literature Analysis and Retrieval System OnLINE

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