vitamin-k-semiquinone-radical and Sepsis

Topics: Abruptio Placentae; Blood Coagulation; Blood Coagulation Disorders; Blood Coagulation Factors; Blood Coagulation Tests; Blood Platelet Disorders; Blood Transfusion; Disseminated Intravascular Coagulation; Embolism, Amniotic Fluid; Factor XIII Deficiency; Female; Fetal Death; Fetal Diseases; Fibrin; Fibrinogen; Fibrinolysis; Hemophilia A; Humans; Liver Diseases; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Hematologic; Sepsis; Uterine Hemorrhage; Vitamin K

In recent years, observational studies have been conducted to investigate the potential impact of vitamins on sepsis. However, many of these studies have produced inconsistent results. Our Mendelian randomization (MR) study aims to evaluate the causality between vitamins and sepsis from a genetic perspective.. Our MR study was designed following the STROBE-MR guidelines. Genetic instrumental variables for vitamins including folate, vitamin B12, B6, A (Retinol), C, D, and K were obtained from previous genome-wide association studies (GWAS) and MR studies. Five different sepsis severity levels were included in the analysis. The genetic instrumental variables were screened for potential confounders using PhenoScanner V2. MR analysis was performed using MR-egger, inverse-variance weighted multiplicative random effects (IVW-RE), inverse-variance weighted multiplicative fixed-effects (IVW-FE), and wald ratio methods to assess the relationship between vitamins and sepsis. Sensitivity analysis was performed using the MR-egger_intercept method, and the MR-PRESSO package and Cochran's Q test were used to evaluate the heterogeneity of the instrumental variables.. Our MR study found no statistically significant association between vitamins and sepsis risk, regardless of the type of vitamin (P-value > 0.05). The odds ratios (ORs) for folate, vitamin B6, vitamin B12, vitamin A, vitamin D, vitamin K, and vitamin C were 1.164 (95% CI: 0.895-1.514), 0.987 (95% CI: 0.969-1.005), 0.975 (95% CI: 0.914-1.041), 0.993 (95% CI: 0.797-1.238), 0.861 (95% CI: 0.522-1.42), 0.955 (95% CI: 0.86-1.059), and 1.049 (95% CI: 0.911-1.208), respectively. Similar results were observed in subgroups of different sepsis severity levels.. Our MR study found no evidence of a causal association between vitamins and sepsis risk from a genetic perspective. Further randomized controlled trials are necessary to confirm these results.

Topics: Folic Acid; Genome-Wide Association Study; Humans; Mendelian Randomization Analysis; Sepsis; Vitamin A; Vitamin B 12; Vitamin K; Vitamins

Hospital mortality of severe sepsis and septic shock is still around 40 % according to recent studies. In accordance to the current sepsis definition, sepsis is a life-threatening organ dysfunction caused by a dysregulated response of the organism to infection. Septic shock is defined by vasopressor-dependent circulatory failure and lactic acidosis. Patients with sepsis and septic shock are often old and/or characterized by severe comorbidities, e. g. tumor or liver disease. These factors also predispose to malnutrition and hence to a corresponding deficiency of essential nutritional components e. g. vitamins. A number of recent studies and reviews have addressed the question whether deficiencies in certain vitamins may facilitate the transition from infection to septic shock. In addition, studies have investigated the effect of high-dose vitamin therapies on sepsis mortality and sepsis-associated organ dysfunctions. This article would like to summarize this current discussion with a focus on vitamin B. Vitamin C besitzt multiple biologische Funktionen, die sich im Rahmen einer Sepsis günstig auswirken könnten. Die Applikation von hochdosiertem Vitamin C in Kombination mit Thiamin und Hydrokortison war in einer viel diskutierten, 2017 veröffentlichten klinischen Studie mit einer drastischen Senkung der Sepsisletalität assoziiert. In mehreren prospektiven randomisierten Studien wird die Wirksamkeit dieses Therapiekonzepts derzeit unabhängig voneinander überprüft.. Auch der Einsatz von Vitamin D

Topics: Ascorbic Acid; Avitaminosis; Humans; Sepsis; Vitamin D; Vitamin K

Calciphylaxis is a rare disorder of small-vessel calcification and cutaneous infarction associated with chronic renal failure. Rare cases of calciphylaxis not associated with chronic renal failure have been reported with breast cancer, hyperparathyroidism, and alcoholic cirrhosis. To our knowledge, we report the first case of calciphylaxis without chronic renal failure associated with cholangiocarcinoma and the first attempt to treat calciphylaxis with vitamin K. A 56-year-old woman presented with necrotic leg ulceration. She was treated initially with low-molecular-weight heparin, with no effect. A coagulation work-up showed vitamin K deficiency. During vitamin K therapy, the patient had fulminant progression of the calciphylaxis. She died, and an autopsy showed metastatic cholangiocarcinoma. Thrombosis and protein C deficiency have been implicated in the pathophysiology of calciphylaxis. Functional protein C deficiency may be one of several factors contributing to the development of calciphylaxis. Vitamin K therapy was ineffective in our patient and may have been detrimental.

Topics: Adenocarcinoma; Anticoagulants; Bile Duct Neoplasms; Bile Ducts, Intrahepatic; Biopsy; Calciphylaxis; Cholangiocarcinoma; Fatal Outcome; Female; Heparin, Low-Molecular-Weight; Humans; Leg Ulcer; Liver Neoplasms; Lung Neoplasms; Middle Aged; Necrosis; Neoplasms, Multiple Primary; Prognosis; Sepsis; Vitamin K; Vitamin K Deficiency

Coagulation studies were performed on 16 children with gram-negative septicemia without the complications of septic shock, liver disease, malnutrition, or laboratory evidence of classic disseminated intravascular coagulation (DIC). Ten (63%) of the 16 cases were found to have abnormal partial thromboplastin and/or prothrombin times. The coagulopathy was caused by a reduction in the vitamin K-dependent coagulation factors. The mechanism that produced this coagulopathy was not known, but evidence was found that suggested that endotoxin may interfere with the vitamin K-carboxylation reaction. The data indicated that abnormal coagulation screening test results in children with gram-negative septicemia were not specific for DIC and that a significant number of patients had a coagulopathy not related to DIC.

Topics: Blood Coagulation Disorders; Blood Coagulation Factors; Child; Child, Preschool; Gram-Negative Bacteria; Humans; Sepsis; Vitamin K; Vitamin K Deficiency

A patient with acute renal failure and gram-negative septicemia developed hypoprothrombinemia during treatment with cefoperazone. The coagulation defect was corrected by vitamin K administration. A multifactorial pathogenetic mechanism of vitamin K deficiency that developed during treatment with parenteral antibiotics is presented.

Topics: Cefoperazone; Humans; Hypoprothrombinemias; Male; Middle Aged; Sepsis; Vitamin K; Vitamin K Deficiency

Five patients developed vitamin K-related abnormalities in blood coagulation during treatment with parenteral cephalosporin or cephamycin antibiotics. All the patients had significantly impaired renal function and complicated medical problems. The coagulation defect was corrected with vitamin K therapy.

Topics: Adult; Aged; Cephalosporins; Female; Humans; Kidney Diseases; Kidney Failure, Chronic; Male; Middle Aged; Sepsis; Urinary Tract Infections; Vitamin K; Vitamin K Deficiency

Topics: Blood Coagulation Disorders; Blood Coagulation Factors; Blood Coagulation Tests; Disseminated Intravascular Coagulation; Escherichia coli Infections; Factor IX; Factor VII; Factor X; Female; Gastroenteritis; Heparin; Humans; Infant; Infant, Newborn; Liver Diseases; Male; Prothrombin; Sepsis; Vitamin K; Vitamin K Deficiency

Topics: Adolescent; Adult; Anticoagulants; Blood Coagulation Tests; Child; Female; Heart Valve Diseases; Heart Valve Prosthesis; Hemodynamics; Hemolysis; Heparin; Humans; Male; Middle Aged; Mitral Valve; Postoperative Complications; Sepsis; Thromboembolism; Vitamin K

Topics: Animals; Chlortetracycline; Epinephrine; Hyaluronic Acid; Hyaluronoglucosaminidase; Mice; Rabbits; Radiation Injuries, Experimental; Sepsis; Vitamin K