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https://www.readbyqxmd.com/read/28331448/antibody-mediated-rejection-a-review
#1
Jorge Carlos Garces, Sixto Giusti, Catherine Staffeld-Coit, Humberto Bohorquez, Ari J Cohen, George E Loss
BACKGROUND: Chronic antibody injury is a serious threat to allograft outcomes and is therefore the center of active research. In the continuum of allograft rejection, the development of antibodies plays a critical role. In recent years, an increased recognition of molecular and histologic changes has provided a better understanding of antibody-mediated rejection (AMR), as well as potential therapeutic interventions. However, several pathways are still unknown, which accounts for the lack of efficacy of some of the currently available agents that are used to treat rejection...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28329394/intermediate-follow-up-of-pediatric-patients-with-hemolytic-uremic-syndrome-during-the-2011-outbreak-caused-by-e-coli-o104-h4
#2
Sebastian Loos, Wiebke Aulbert, Bernd Hoppe, Thurid Ahlenstiel-Grunow, Birgitta Kranz, Charlotte Wahl, Hagen Staude, Alexander Humberg, Kerstin Benz, Martin Krause, Martin Pohl, Max C Liebau, Raphael Schild, Johanna Lemke, Ortraud Beringer, Dominik Müller, Christoph Härtel, Marianne Wigger, Udo Vester, Martin Konrad, Dieter Haffner, Lars Pape, Jun Oh, Markus J Kemper
Background.: In 2011 Escherichia coli O104:H4 caused an outbreak with over 800 cases of hemolytic uremic syndrome (HUS) in Germany, including 90 children. Data on the intermediate outcome in children after HUS due to E. coli O104:H4 have been lacking. Methods.: Follow-up data were gathered retrospectively from the medical records of patients who had been included in the German Pediatric HUS Registry during the 2011 outbreak. Results.: A total of 72/89 (81%) of the patients was included after a median follow-up of 3...
March 13, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28329382/systemic-immunomodulating-therapies-for-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-a-systematic-review-and-meta-analysis
#3
Stefanie Zimmermann, Peggy Sekula, Moritz Venhoff, Edith Motschall, Jochen Knaus, Martin Schumacher, Maja Mockenhaupt
Importance: Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are rare but severe adverse reactions with high mortality. There is no evidence-based treatment, but various systemic immunomodulating therapies are used. Objectives: To provide an overview on possible immunomodulating treatments for SJS/TEN and estimate their effects on mortality compared with supportive care. Data Sources: A literature search was performed in December 2012 for articles published in MEDLINE, MEDLINE Daily, MEDLINE Inprocess, Web of Science, EMBASE, Scopus, and the Cochrane Library (Central) from January 1990 through December 2012, and updated in December 2015, in the English, French, Spanish, and German languages looking for treatment proposals for SJS/TEN...
March 22, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28317619/membranoproliferative-glomerulonephritis-in-pregnancy
#4
Devika Nair, Laura Kidd, N Kevin Krane
BACKGROUND: Membranoproliferative glomerulonephritis (MPGN) is an uncommon form of glomerulonephritis and it can be particularly difficult to predict outcomes and manage women with this disorder during pregnancy. MATERIALS AND METHODS: The management of 3 successful pregnancies in women with MPGN from 1 center and previously described cases from the world literature are reviewed. This includes a number of large studies of pregnancy in women with underlying glomerular disease as well as small case series and individual reports...
April 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28293919/-extracorporeal-liver-support-of-liver-failure
#5
Hans Ulrich Gerth, Michele Pohlen, Hermann Pavenstädt, Hartmut Schmidt
Extracorporeal liver support can be classified into cell-free, artificial methods (artificial liver support, ALS) and cell-based bioartificial methods (bioartificial liver support, BLS). ALS improves biochemical parameters of liver failure by the simultaneous removal of protein-bound and water-soluble substances. Here, the MARS therapy belongs to the most studied methods with a proved beneficial effect on hepatic encephalopathy (HE), hepatorenal syndrome (HRS) or hyperbilirubinemia. However, a general survival advantage of any liver support for liver failure has not been shown yet and is restricted to meta-analyses or patient subgroups...
March 14, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28291241/efficacy-and-safety-of-direct-acting-antivirals-for-the-treatment-of-mixed-cryoglobulinemia
#6
Joel S Emery, Magdalena Kuczynski, Danie La, Saeed Almarzooqi, Matthew Kowgier, Hemant Shah, David Wong, Harry L A Janssen, Jordan J Feld
OBJECTIVES: Mixed cryoglobulinemia is strongly associated with hepatitis C virus (HCV) infection and ranges from being asymptomatic to causing life-threatening vasculitis. In those with symptoms, treatment with pegylated interferon (pegIFN) and ribavirin (RBV) reduces mortality. However, few data are available on the safety and efficacy of antiviral therapy with direct acting antivirals (DAAs) in the treatment of HCV-related cryoglobulinemia. METHODS: Patients treated for HCV-related cryoglobulinemia with DAA±pegIFN were retrospectively evaluated at a tertiary care center...
March 14, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28289874/renal-vasculitis-presenting-with-acute-kidney-injury
#7
Javier Villacorta, Francisco Diaz-Crespo, Mercedes Acevedo, Teresa Cavero, Carmen Guerrero, Manuel Praga, Gema Fernandez-Juarez
Renal failure secondary to ANCA-associated vasculitis represents a clinical and therapeutic challenge. In this study, we aimed to assess the treatment response rates and long-term outcomes of vasculitis patients presenting with renal failure. This retrospective study included 151 patients with renal vasculitis from three hospitals who underwent a renal biopsy between 1997 and 2014. Patients with renal failure which required dialysis at the onset were compared to those presenting with more preserved renal function...
March 13, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28289605/a-wolf-in-another-wolf-s-clothing
#8
Amrit Lamba, Meghan Kapp, Paisit Paueksakon, Parth J Parekh
This case of infective endocarditis masquerading as mixed cryoglobulinemia in a man with a history of intravenous drug use (IVDU) and hepatitis C virus (HCV) highlights the importance of maintaining a broad differential and continually re-evaluating the working diagnosis as new information presents itself. The patient presented to an outside hospital and was treated for presumptive mixed cryoglobulinemia with corticosteroid therapy. When the patient did not improve, he was transferred to a tertiary care center for possible Rituximab and/or plasmapheresis...
2017: IDCases
https://www.readbyqxmd.com/read/28280663/management-of-toxic-epidermal-necrolysis-with-plasmapheresis-and-cyclosporine-a-our-10-years-experience
#9
Giuseppe Giudice, Giulio Maggio, Loredana Bufano, Giuseppe Memeo, Michelangelo Vestita
BACKGROUND: The management of toxic epidermal necrolysis (TEN) is controversial and there is no uniform strategy. OBJECTIVE: To share our 10 years' experience in treating severe TEN with a novel protocol based on the association of cyclosporine A and plasmapheresis. METHODS: In this case series, we retrospectively collected and assessed the 12 cases of severe TEN treated from 2005 to 2015 at the Burn Unit of the University of Bari Policlinico hospital...
February 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28280630/the-role-of-chemotherapy-in-gastric-cancer-related-microangiopathic-haemolytic-anaemia
#10
Monica Tang, David Goldstein
We report a case of a previously well 46-year-old man who presented with microangiopathic haemolytic anaemia (MAHA) of unknown origin. After extensive investigations, he was diagnosed with cancer-related microangiopathic haemolytic anaemia (CR-MAHA) secondary to gastric adenocarcinoma. Initial treatment with plasmapheresis was ineffective, but the patient's haematological abnormalities improved markedly with chemotherapy directed against his gastric cancer. Our case amplifies previous experience of gastric cancer-associated MAHA which responded to treatment with chemotherapy...
February 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28272192/optic-neuropathy-associated-with-primary-sj%C3%A3-gren-s-syndrome-a-case-series
#11
Eunoo Bak, Hee Kyung Yang, Jeong-Min Hwang
PURPOSE: To determine the diverse clinical features of optic neuropathy associated with primary Sjögren's syndrome in Korean patients. METHODS: Five women with acute and/or chronic optic neuropathy who were diagnosed as primary Sjögren's syndrome were retrospectively evaluated. Primary Sjögren's syndrome was diagnosed by signs and symptoms of keratoconjunctivitis sicca, positive serum anti-Ro/SSA and/or anti-La/SSB antibodies, and/or minor salivary gland biopsy...
March 7, 2017: Optometry and Vision Science: Official Publication of the American Academy of Optometry
https://www.readbyqxmd.com/read/28267083/toxic-epidermal-necrolysis-like-reaction-after-hematopoietic-stem-cell-transplantation-in-children
#12
Maura Faraci, Stefano Giardino, Edoardo Lanino, Giuseppe Morreale, Emilia Ghibaudo, Monica Francesia Berta, Marco Risso, Elio Castagnola, Mimmo Ripaldi, Andrea Moscatelli, Giovanni Ghigliotti
This study report clinical course, etiology, management, and long-term outcome of children who developed toxic epidermal necrolysis-like reaction (TEN-LR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). We retrospectively collected children with TEN-LR occurring after allo-HSCT performed in 2 pediatric bone marrow units between 2005 and 2014. We identified 6 cases of TEN-LR of 322 patients (1.8%). Possible triggers of TEN included antibiotics, antiepileptics, antimycotics, and Mycoplasma infection...
March 6, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28260483/evaluation-of-indication-biopsies-%C3%A2-5-years-after-kidney-transplant-a-single-center-experience
#13
Erhan Tatar, Cenk Simsek, Funda Tasli, Veli Kursat Cayhan, Murat Karatas, Adam Uslu
OBJECTIVES: Rejection is a common cause of late graft dysfunction seen on biopsy studies. The aim of this study was to evaluate indication biopsy findings ? 5 years after kidney transplant and to assess the effectiveness of applied treatments. MATERIALS AND METHODS: Between January 2013 and December 2015, 30 patients who underwent renal transplant indication biopsies and were followed up for ≥ 6 months were evaluated retrospectively. A >30% increase in serum creatinine and/or development of > 1 g/day proteinuria was considered an acceptable indication for biopsy...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260477/doppler-ultrasonography-findings-during-recovery-period-of-transplanted-kidney-after-infarction-and-necrosis-due-to-renal-vein-thrombosis-a-case-report
#14
Funda Ulu Ozturk, Nihal Uslu, Eda Yilmaz Akcay, Mehmet Haberal
A 47-year-old male patient underwent living-related renal transplant. On day 3 posttransplant, without evidence of associated clinical symptoms, the patient's serum creatinine levels had increased. The patient was given immunosuppressive medication, and a followup Doppler ultrasonography revealed hypoechoic areas in the inferior pole of the renal parenchyma. Eventually, on day 25, there was no perfusion in the superior and inferior poles of the transplanted kidney. No venous flow was shown in the middle segment, and only arterial vascularization with a high resistive index and negative diastolic phase was observed...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28259531/plasmapheresis-in-severe-methemoglobinemia-following-occupational-exposure
#15
Wassim Shatila, Amanda Verma, Soheir Adam
Ferrous iron can be converted to ferric iron by oxidative stress which results in the formation of methemoglobin. Consequently, the oxygen dissociation curve is shifted to the left, which leads to tissue hypoxia and ultimately may cause death. Acquired methemoglobinemia can be due to a host of offending agents and chemicals including nitrites, local anesthetics, aniline and antimalarial drugs. There are several approaches to the management of methemoglobinemia. The first step is to stop the offending agent and initiate supportive measures...
February 20, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28255562/treatment-of-antibody-mediated-renal-allograft-rejection-improving-step-by-step
#16
Nils Lachmann, Michael Duerr, Constanze Schönemann, Axel Pruß, Klemens Budde, Johannes Waiser
Throughout the past years we stepwise modified our immunosuppressive treatment regimen for patients with antibody-mediated rejection (ABMR). Here, we describe three consecutive groups treated with different regimens. From 2005 until 2008, we treated all patients with biopsy-proven ABMR with rituximab (500 mg), low-dose (30 g) intravenous immunoglobulins (IVIG), and plasmapheresis (PPH, 6x) (group RLP, n = 12). Between 2009 and June 2010, patients received bortezomib (1.3 mg/m(2), 4x) together with low-dose IVIG and PPH (group BLP, n = 11)...
2017: Journal of Immunology Research
https://www.readbyqxmd.com/read/28255478/myelodysplastic-syndrome-clinically-presenting-with-the-classic-ttp-pentad
#17
Santiago Fabián Moscoso Martínez, Evelyn Carolina Polanco Jácome, Elizabeth Guevara, Vijay Mattoo
The clinical presentation of myelodysplastic syndrome (MDS) is not specific. Many patients can be asymptomatic and can be detected only due to an abnormal complete blood cell count (CBC) on routine exam or for other reasons while others can be symptomatic as a consequence of underlying cytopenias. Thrombotic thrombocytopenic purpura (TTP) usually is suspected under the evidence of microangiopathic hemolytic anemia (MAHA) and thrombocytopenia and because it is a life-threatening condition (medical emergency) immediate initiation of plasmapheresis could be life-saving...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28255377/pathophysiological-changes-of-inflammatory-syndrome-in-multiple-sclerosis-after-instituting-therapeutic-plasmapheresis
#18
S Vlaic, V Poalelungi, M Bălăeţ, V L Purcărea, C Bălăeţ, B I Coculescu
In autoimmune conditions affecting the central and peripheral CNS as well as in multiple sclerosis (MS), the inflammatory syndrome is present with the onset of this disease. The present paper aimed to highlight the inflammatory syndrome based on the leukergia test, the total blood viscosity test, blood filterability test as well as on other tests. The early instituting of the therapeutic plasmapheresis beneficially modified the clinical status, the biological and pathophysiological behavior of the patient's illness...
January 2017: Journal of Medicine and Life
https://www.readbyqxmd.com/read/28228569/no-evidence-of-beneficial-effects-of-plasmapheresis-in-natalizumab-associated-pml
#19
Doriana Landi, Nicola De Rossi, Sara Zagaglia, Cristina Scarpazza, Luca Prosperini, Maria Albanese, Fabio Buttari, Francesco Mori, Girolama Alessandra Marfia, Maria Pia Sormani, Ruggero Capra, Diego Centonze
OBJECTIVE: To examine retrospectively the effects of plasmapheresis (PLEX) on the survival and clinical outcomes of patients with multiple sclerosis (MS) and natalizumab (NTZ)-associated progressive multifocal leukoencephalopathy (PML). METHODS: The medical literature was searched for the terms natalizumab and progressive multifocal leukoencephalopathy. A total of 193 international and 34 Italian NTZ-PML cases were included. Clinical outcome was determined by comparing the patients' clinical status at PML diagnosis with status after PML resolution...
February 22, 2017: Neurology
https://www.readbyqxmd.com/read/28228112/three-case-reports-of-post-immunization-and-post-viral-bullous-pemphigoid-looking-for-the-right-trigger
#20
Luca Baroero, Paola Coppo, Laura Bertolino, Stefano Maccario, Francesco Savino
BACKGROUND: Bullous pemphigoid (BP) is a blistering skin disorder infrequent in infancy and rarely reported in medical literature. CASE PRESENTATION: Here we describe three cases of BP which were referred to our department in the last 15 years. Two of them developed an eruption of bullous lesions just a few days after vaccination for diphtheria, tetanus, pertussis, poliomyelitis, hepatitis B and Haemophilus influenzae B. The third patient developed the same blistering lesions shortly after herpetic stomatitis...
February 23, 2017: BMC Pediatrics
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