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etiology of shock

Sander Bekeschus, Jan-Wilm Lackmann, Denis Gümbel, Matthias Napp, Anke Schmidt, Kristian Wende
Non-healing wounds continue to be a clinical challenge for patients and medical staff. These wounds have a heterogeneous etiology, including diabetes and surgical trauma wounds. It is therefore important to decipher molecular signatures that reflect the macroscopic process of wound healing. To this end, we collected wound sponge dressings routinely used in vacuum assisted therapy after surgical trauma to generate wound-derived protein profiles via global mass spectrometry. We confidently identified 311 proteins in exudates...
March 7, 2018: International Journal of Molecular Sciences
Tae Soo Kang, Byung Soo Ko, Stavros G Drakos, Josef Stehlik, Steven I Bott, Antigone Koliopoulou, Joseph E Tonna, Megan E Bowen, Kathleen Stoddard, Craig H Selzman, Stephen H McKellar
BACKGROUND: Acute mechanical circulatory support (aMCS) can be a lifesaving therapy for patients with refractory cardiogenic shock. As device safety and technology improve, so will the ability to extend aMCS to patients at remote hospitals. The Intermountain West is unique because of the large geographical area, making transport of critically ill patients a logistical challenge. METHODS: We reviewed our experience of transporting patients in cardiogenic shock over long distances who had already been placed on aMCS: Impella and extracorporeal membrane oxygenator devices...
April 2018: Journal of Surgical Research
Adriana M Pedraza Bermeo, Ana María Ortiz Zableh, Mariangel Castillo, Jaime Francisco Pérez Niño
INTRODUCTION: Postobstructive diuresis (POD) is a polyuric state in which large quantities of salt and water are eliminated after solving a urinary tract obstruction. These patients are at increased risk of severe dehydration, electrolytic disturbances, hypovolemic shock, and death. Ureteropelvic junction obstruction (UPJO) is the most common etiology of collecting system dilatation in the fetal kidney, and a significant number of patients require pyeloplasty. There are limited data regarding prognostic risk factors for POD in this scenario...
February 20, 2018: Journal of Pediatric Urology
Vijeta Pamudurthy, Raju Z Abraham, Thomas Betlej, Ashish Shah, Dong Kim, Brian Sasso, Abraham Chacko
Background and study aims  Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive diagnostic and interventional procedure used in conditions related to the pancreas and biliary tract. It has a complication rate ranging from 4 % to 10 %. Severe complications are few with the most common of them being post-ERCP pancreatitis, post-sphincterotomy bleeding, and perforation. A rare, but potentially life-threatening complication of ERCP is splenic injury. We report the case of a 60-year-old female with choledocholithiasis who sustained splenic decapsulation following ERCP...
March 2018: Endoscopy International Open
Mehmet Beyazal, Münevver Serdaroglu Beyazal, Ekrem Kara, Hatice Beyazal Polat, Fatma Beyazal Çeliker, Şaban Ergene
Isolated spontaneous renal artery dissection (RAD) without known trauma is rare, and its etiology has not been determined. However, notable risk factors including hypertension, strenuous exercise, connective tissue disorders, atherosclerosis, extracorporeal shock wave lithotripsy, and cocaine abuse have been reported. To the best of our knowledge, isolated RAD caused by lumbar vertebra osteophytes in patients with degenerative lumbar scoliosis has not been reported in the literature. In this article, we present a case of RAD caused by lumbar vertebra osteophyte in a patient with degenerative scoliosis and discuss the management of the disease...
January 1, 2018: Vascular and Endovascular Surgery
Nicholas R Zessis, Jennifer L Nicholas, Stephen I Stone
Bilateral adrenal hemorrhages rarely occur during the neonatal period and are often associated with traumatic vaginal deliveries. However, the adrenal gland has highly regenerative capabilities and adrenal insufficiency typically resolves over time. We evaluated a newborn female after experiencing fetal macrosomia and a traumatic vaginal delivery. She developed acidosis and acute renal injury. Large adrenal hemorrhages were noted bilaterally on ultrasound, and she was diagnosed with adrenal insufficiency based on characteristic electrolyte changes and a low cortisol (4...
2018: Endocrinology, Diabetes & Metabolism Case Reports
K Murray, C Reardon
Inflammatory bowel disease negatively affects the quality of life of millions of patients around the world. Although the precise etiology of the disease remains elusive, aberrant immune system activation is an underlying cause. As such, therapies that selectively inhibit immune cell activation without broad immunosuppression are desired. Inhibition of immune cell activation preventing pro-inflammatory cytokine production through neural stimulation has emerged as one such treatment. These therapeutics are based on the discovery of the cholinergic anti-inflammatory pathway, a reflex arc that induces efferent vagal nerve signaling to reduce immune cell activation and consequently mortality during septic shock...
March 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Richard Lee, David Carr
Cardiac emergencies in pregnancy and the postpartum period are rare but often life-threatening. An emergency physician's differential diagnosis for chest pain in the peripartum patient often includes serious etiologies such as pulmonary embolism or myocardial infarction (MI). A lesser-known but important consideration on the differential for MI is that of a spontaneous coronary artery dissection (SCAD). SCAD is defined as an intramural hematoma within the coronary artery that compresses the true lumen. Expansion by increased pressures may lead to subsequent myocardial ischemia and infarction...
February 22, 2018: CJEM
Kirti Gupta, Charul S Purani, Anirban Mandal, Amitabh Singh
Introduction: Acute febrile encephalopathy (AFE) in children is a medical emergency and could be a manifestation of many systemic and central nervous system pathologies. The clinical features of AFE are nonspecific and etiological spectrum variable depending on the studied population. Materials and Methods: A prospective, observational study was carried out including children aged between 1 month and 12 years with AFE admitted to the Pediatric Intensive Care Unit of a tertiary care hospital in Western India...
January 2018: Journal of Neurosciences in Rural Practice
Zhongyang Xu, Xiuyu Wang, Yanping Zheng
Ankylosing spondylitis (AS) is a chronic inflammatory arthritis and autoimmune disease, the etiology and pathogenesis of which remain largely unknown. In the present study, blood samples were harvested from patients with AS and from healthy volunteers as a normal control (NC) for RNA-sequencing. Differentially expressed genes (DEGs) in the AS group compared with the NC group were identified, and gene ontology (GO) term and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were subsequently performed...
February 2018: Experimental and Therapeutic Medicine
Caíque Bueno Terhoch, Henry Fukuda Moreira, Silvia Moreira Ayub-Ferreira, Germano Emilio Conceição-Souza, Vera Maria Cury Salemi, Paulo Roberto Chizzola, Mucio Tavares Oliveira, Silvia Helena Gelas Lage, Edimar Alcides Bocchi, Victor Sarli Issa
AIMS: Explore the association between clinical findings and prognosis in patients with acute decompensated heart failure (ADHF) and analyze the influence of etiology on clinical presentation and prognosis. METHODS AND RESULTS: Prospective cohort of 500 patients admitted with ADHF from Aug/2013-Feb/2016; patients were predominantly male (61.8%), median age was 58 (IQ25-75% 47-66 years); etiology was dilated cardiomyopathy in 141 (28.2%), ischemic heart disease in 137 (27...
February 2018: PLoS Neglected Tropical Diseases
Yangxin Xie, Bo Tu, Xin Zhang, Jingfeng Bi, Lei Shi, Peng Zhao, Weiwei Chen, Suxia Liu, Dongping Xu, Enqiang Qin
Objective: The study aimed at analyzing the epidemiology and outcomes of liver cirrhosis patients undergoing gram-negative bacterial bloodstream infection. Results: Totally 508 eligible patients were collected, with 25.79% 30-day mortality, and 58.86% patients were confirmed as nosocomial infection. The most common isolates were Escherichia coli (48.29%) and Klebsiella pneumoniae (19.29%), and multidrug-resistant isolates accounted for 36.61%. The bacterial distributions were similar between survivors and non-survivors (P>0...
January 9, 2018: Oncotarget
Rody C Kingston, Michael Smith, Tiara Lacey, Malcolm Edwards, Janae N Best, Chris M Markham
Exposure to social stressors can cause profound changes in an individual's well-being and can be an underlying factor in the etiology of a variety of psychopathologies, such as post-traumatic stress disorder (PTSD). In Syrian hamsters, a single social defeat experience results in behavioral changes collectively known as conditioned defeat (CD), and includes an abolishment of territorial aggression and the emergence of high levels of defensive behaviors. In contrast, voluntary exercise has been shown to promote stress resilience and can also have anxiolytic-like effects...
February 5, 2018: Physiology & Behavior
Leila Bond, Kamren Bernhardt, Priyank Madria, Katherine Sorrentino, Hailee Scelsi, Cassie S Mitchell
Oxidative stress, induced by an imbalance of free radicals, incites neurodegeneration in Amyotrophic Lateral Sclerosis (ALS). In fact, a mutation in antioxidant enzyme superoxide dismutase 1 (SOD1) accounts for 20% of familial ALS cases. However, the variance among individual studies examining ALS oxidative stress clouds corresponding conclusions. Therefore, we construct a comprehensive, temporal view of oxidative stress and corresponding antioxidant therapy in preclinical ALS by mining published quantitative experimental data and performing metadata analysis of 41 studies...
2018: Frontiers in Neuroscience
Mutsumi Fujii, Miki Ohgushi, Takaaki Chin
A 16-year-old boy presented with multiple posterior circulation ischemic strokes resulting from vertebral artery (VA) dissection. Three-dimensional computed tomography showed aberrant sub-occipital bone protuberance, proximal to the VA dissection. Since the patient was a habitual neck cracker, VA dissection was thought to result from the impact shock of the rotational head movement. This could be due to either the osseous prominence or the compression between the prominence and the C1. Although it is a rare etiology of Bow Hunter's syndrome, VA dissection due to sub-occipital bone spur because of neck cracking should be considered in the diagnosis of Bow Hunter's syndrome in juvenile patients...
February 6, 2018: British Journal of Neurosurgery
Felix Zubia-Olaskoaga, Enrique Maraví-Poma, Iratxe Urreta-Barallobre, María-Rosario Ramírez-Puerta, Mónica Mourelo-Fariña, María-Pilar Marcos-Neira, Miguel Ángel García-García
BACKGROUND/OBJECTIVES: Development and validation of a multivariate prediction model for patients with acute pancreatitis (AP) admitted in Intensive Care Units (ICU). METHODS: A prospective multicenter observational study, in 1 year period, in 46 international ICUs (EPAMI study). PATIENTS: adults admitted to an ICU with AP and at least one organ failure. INTERVENTIONS: Development of a multivariate prediction model, using the worst data of the stay in ICU, based in multivariate analysis, simple imputation in a development cohort...
March 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Venkatesh Thammishetti, Anupama Kaul, Dharmendra S Bhadauria, Karthikeyan Balasubramanian, Narayan Prasad, Amit Gupta, Raj K Sharma
BACKGROUND: Refractory peritonitis is defined as failure of clearance of peritoneal fluid despite 5 days of appropriate antibiotic therapy. Catheter removal decreases morbidity and mortality. Data on the outcomes of refractory peritonitis and of reinitiation of peritoneal dialysis (PD) in this group of patients are sparse. The present study analyzed etiology, outcomes, and prognostic factors of refractory peritonitis as well as survival of the reinitiation of the technique. METHODS: This was a single-center retrospective study that included 90 patients of refractory continuous ambulatory PD (CAPD) peritonitis at a tertiary care center in North India...
January 31, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Zheng-Hao Huang, Yu-Chen Chiu, Li-Lu Ho, Hsiu-Lung Fan, Chun-Chi Lu
RATIONALE: Adult-onset Still disease (AOSD) is a rare systemic inflammatory disease of unknown etiology characterized by evanescent salmon-pink rash, spiking fever, arthralgia/ arthritis, and lymphadenopathy. AOSD sometimes was fatal when it is complicated by macrophage activation syndrome (MAS) or hemophagocytic lymphohistiocytosis (HLH). Nonetheless, the literature provides no recommendations for treatment of AOSD patients with severe sepsis. PATIENT CONCERNS: A previously healthy 65-year-old man with history of AOSD was referred to our hospital for persistent right lower quadrant abdominal pain for 2 days...
February 2018: Medicine (Baltimore)
Alexey V Baldin, Andrey A Zamyatnin, Alexandr V Bazhinc, Wan-Hai Xu, Lyudmila Savvateeva
Current advances in cancer treatment are based on the recent discoveries of molecular mechanisms of tumour maintenance. It was shown that heat shock proteins (HSPs) play a crucial role in the development of the immune response against tumours. Thus, HSPs represents multifunctional agents not only with chaperone functions, but that also possess immunomodulatory properties. These properties are exploited for the development of HSP-based anticancer vaccines aimed to induce cytotoxic responses against tumours. To date a number of strategies have been suggested to facilitate HSP-based vaccine production and to increase its effectiveness...
January 28, 2018: Current Medicinal Chemistry
Jéssica Luana Chechi, Tarsila Franckin, Lidiane Nunes Barbosa, Fernanda Cristina Bérgamo Alves, Aline de Lima Leite, Marília Afonso Rabelo Buzalaf, Lucilene Delazari Dos Santos, Sandra de Moraes Gimenes Bosco
Pythium insidiosum is the etiologic agent of pythiosis, a life-threatening disease that affects human and animals, has difficult diagnosis, and therapy. Studies on protein characterization of P. insidiosum are scarce, so we aimed to determine the protein profile of P. insidiosum by mass spectrometry and bioinformatics strategies targeting in proteins that may act as putative virulence factors. Therefore, an extraction protocol was standardized to obtain the total proteins of P. insidiosum. By the analysis of Image Master 2D Platinum software, it was found that 186 spots ranging between 12 and 89 KDa and isoelectric point from 4 to 7...
January 23, 2018: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
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