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https://www.readbyqxmd.com/read/29055067/cutaneous-atypical-papular-cd8-lymphoproliferative-disorder-at-acral-sites-in-a-renal-transplant-patient
#1
C Baykal, N Büyükbabani, D Seçkin, A Polat Ekinci, Z Yılmaz, W Kempf
A 20-year-old woman presented with a 2-month history of an acute symmetrical eruption, manifesting as asymptomatic ill-defined erythematous macules and hyperkeratotic papules on the palms. The patient was a renal transplant recipient, and the lesions had developed 2 months post-transplantation. Histologically, the eruption shared features of a reactive inflammatory condition called papular eruption of atypical CD8+ lymphocytes as well as primary cutaneous acral CD8+ T-cell lymphoma (a provisional indolent entity in the new World Health Organisation classification of lymphoid neoplasms, 2016)...
October 20, 2017: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/29054070/bedside-implantation-of-a-new-temporary-vena-cava-inferior-filter-safety-and-efficacy-results-of-the-european-angel-registry
#2
Stefan Baumann, Tobias Becher, Konstantinos Giannakopoulos, Claude Jabbour, Marlon Rutsch, Christian Fastner, Ibrahim El-Battrawy, Uzair Ansari, Dirk Lossnitzer, Michael Behnes, Angelika Alonso, Thomas Kirschning, Guido Michels, Daniel Stern, Ruediger Dissmann, Olaf Kueck, Fabio Silvio Taccone, Carl Waldmann, Nicholas Bunker, Maurizio Postiglione, Martin Borggrefe, Ibrahim Akin
PURPOSE: Pulmonary embolism (PE) is a frequently occurring complication in critically ill patients. Simultaneous occurrence of PE and life-threatening bleeding, may render medical anticoagulation impossible. For these patients, inferior vena cava filters (IVCF) present a valuable therapeutic alternative. The Angel® catheter is a novel IVCF that provides temporary protection from PE and is implanted at bedside. The primary objective of the European Angel® catheter registry is to evaluate the safety and efficacy of this IVCF...
October 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29053987/the-role-of-executive-functions-and-psychiatric-symptom-severity-in-the-allen-cognitive-levels
#3
Sarah Schubmehl, Samuel H Barkin, Doug Cort
This study examined the relationship between Allen Cognitive Level (ACL) and psychiatric symptom severity, level of nursing support required to complete activities of daily living (ADLs), and post-hospitalization discharge disposition in a sample of 193 acute psychiatric inpatients. A subsample of 31 participants with acute psychotic disorders were administered three measures of executive functioning in order to examine the convergent validity between ACL and basic sequencing and shifting, phonemic fluency, and visuospatial construction...
October 12, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/29052706/association-of-an-electroencephalography-based-risk-score-with-seizure-probability-in-hospitalized-patients
#4
Aaron F Struck, Berk Ustun, Andres Rodriguez Ruiz, Jong Woo Lee, Suzette M LaRoche, Lawrence J Hirsch, Emily J Gilmore, Jan Vlachy, Hiba Arif Haider, Cynthia Rudin, M Brandon Westover
Importance: Continuous electroencephalography (EEG) use in critically ill patients is expanding. There is no validated method to combine risk factors and guide clinicians in assessing seizure risk. Objective: To use seizure risk factors from EEG and clinical history to create a simple scoring system associated with the probability of seizures in patients with acute illness. Design, Setting, and Participants: We used a prospective multicenter (Emory University Hospital, Brigham and Women's Hospital, and Yale University Hospital) database containing clinical and electrographic variables on 5427 continuous EEG sessions from eligible patients if they had continuous EEG for clinical indications, excluding epilepsy monitoring unit admissions...
October 9, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/29050793/anaplasmosis-in-pediatric-patients-case-report-and-review
#5
Vaka K Sigurjonsdottir, Henry M Feder, Gary P Wormser
Human granulocytic anaplasmosis (HGA) is a tick-borne infection, characterized as an acute and sometimes severe febrile illness which may be associated with leukopenia and thrombocytopenia. Most case reports of HGA have been in adults, with only 8 case reports of HGA in children. We add a ninth case of HGA, which occurred in a 5-year-old. The paucity of pediatric HGA case reports maybe because publication bias, or HGA in children is a mild illness and children with HGA are less likely than adults to seek medical care, or the diagnosis of HGA requires a blood draw and adults (versus children) are more likely to get diagnostic testing...
November 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/29050526/long-term-quality-of-life-after-extracorporeal-membrane-oxygenation-in-ards-survivors-systematic-review-and-meta-analysis
#6
M Elizabeth Wilcox, Valente Jaramillo-Rocha, Carol Hodgson, Michael S Taglione, Niall D Ferguson, Eddy Fan
PURPOSE: Extracorporeal membrane oxygenation (ECMO) is an increasingly prevalent treatment for acute respiratory failure (ARF). To evaluate the impact of ECMO support on long-term outcomes for critically ill adults with ARF. METHODS: We searched electronic databases 1948 through to November 30 2016; selected controlled trials or observational studies of critically ill adults with acute respiratory distress syndrome, examining long-term morbidity specifically health-related quality of life (HRQL); 2 authors independently selected studies, extracted data, and assessed methodological quality...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29049187/a-myeloid-sarcoma-involving-the-small-intestine-kidneys-mesentery-and-mesenteric-lymph-nodes-a-case-report-and-literature-review
#7
Ping Wang, Quan Li, Li Zhang, Hong Ji, Cheng-Zhou Zhang, Bin Wang
RATIONALE: Myeloid sarcomas (MSs) are rare malignant hematological tumors. They most commonly occur in patients with acute or chronic myeloid leukemia. A de novo MS with no evidence of blood system disease is rare, but may represent the first sign of a systemic illness that precedes a full-blown disease. Herein, we report the computed tomography (CT) findings of an extremely rare case of a nonleukemic MS that progressed to acute myelogenous leukemia (AML) and simultaneously involved the small intestine, kidneys, mesentery, and mesenteric lymph nodes...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29049134/in-trauma-patients-the-occurrence-of-early-onset-nosocomial-infections-is-associated-with-increased-plasma-concentrations-of-chromogranin-a
#8
Francis Schneider, Céline Marban, Gharib Ajob, Sophie Helle, Max Guillot, Anne Launoy, Quentin Maestraggi, Francesco Scavello, Olivier Rohr, Marie-Hélène Metz-Boutigue
In previously healthy persons suffering from acute illnesses, nosocomial infections are frequent. Their prevalence suggests the existence of as yet unknown conditions that may promote care-related infection. This study assessed whether 1) the measurement of plasma chromogranin A, a stress-related protein involved in innate defence, is related to nosocomial infection risk and 2) whether any chromogranin-A-derived fragment included in vasostatin-I displays immunosuppressive activities related to AP-1 or NF-kappa B down regulation...
October 18, 2017: Shock
https://www.readbyqxmd.com/read/29049042/atrial-fibrillation-occurring-transiently-with-stress
#9
William F McIntyre, Stuart J Connolly, Jeff S Healey
PURPOSE OF REVIEW: Atrial fibrillation may be detected in the setting of an acute stressor, such as medical illness or surgery. It is uncertain if atrial fibrillation detected in these settings (AFOTS: atrial fibrillation occurring transiently with stress) is secondary to a reversible trigger or is simply paroxysmal atrial fibrillation. This distinction is critical for clinicians, who must decide if AFOTS can be dismissed as a reversible phenomenon, or if it signals the need for chronic therapy; in particular, anticoagulation...
October 18, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29048277/retrospective-observational-study-of-atypical-winter-respiratory-illness-season-using-real-time-syndromic-surveillance-england-2014-15
#10
Sue Smith, Roger Morbey, Richard G Pebody, Thomas C Hughes, Simon de Lusignan, F Alex Yeates, Helen Thomas, Sarah J O'Brien, Gillian E Smith, Alex J Elliot
During winter 2014-15, England experienced severe strains on acute health services. We investigated whether syndromic surveillance could contribute to understanding of the unusually high level of healthcare needs. We compared trends for several respiratory syndromic indicators from that winter to historical baselines. Cumulative and mean incidence rates were compared by winter and age group. All-age influenza-like illness was at expected levels; however, severe asthma and pneumonia levels were above those expected...
November 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/29047411/mildly-elevated-lactate-levels-are-associated-with-microcirculatory-flow-abnormalities-and-increased-mortality-a-microsoap-post-hoc-analysis
#11
Namkje A R Vellinga, E Christiaan Boerma, Matty Koopmans, Abele Donati, Arnaldo Dubin, Nathan I Shapiro, Rupert M Pearse, Peter H J van der Voort, Arjen M Dondorp, Tony Bafi, Michael Fries, Tulin Akarsu-Ayazoglu, Andrius Pranskunas, Steven Hollenberg, Gianmarco Balestra, Mat van Iterson, Farid Sadaka, Gary Minto, Ulku Aypar, F Javier Hurtado, Giampaolo Martinelli, Didier Payen, Frank van Haren, Anthony Holley, Hernando Gomez, Ravindra L Mehta, Alejandro H Rodriguez, Carolina Ruiz, Héctor S Canales, Jacques Duranteau, Peter E Spronk, Shaman Jhanji, Sheena Hubble, Marialuisa Chierego, Christian Jung, Daniel Martin, Carlo Sorbara, Jan Bakker, Can Ince
BACKGROUND: Mildly elevated lactate levels (i.e., 1-2 mmol/L) are increasingly recognized as a prognostic finding in critically ill patients. One of several possible underlying mechanisms, microcirculatory dysfunction, can be assessed at the bedside using sublingual direct in vivo microscopy. We aimed to evaluate the association between relative hyperlactatemia, microcirculatory flow, and outcome. METHODS: This study was a predefined subanalysis of a multicenter international point prevalence study on microcirculatory flow abnormalities, the Microcirculatory Shock Occurrence in Acutely ill Patients (microSOAP)...
October 18, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29047353/precision-medicine-for-all-challenges-and-opportunities-for-a-precision-medicine-approach-to-critical-illness
#12
REVIEW
Christopher W Seymour, Hernando Gomez, Chung-Chou H Chang, Gilles Clermont, John A Kellum, Jason Kennedy, Sachin Yende, Derek C Angus
All of medicine aspires to be precise, where a greater understanding of individual data will lead to personalized treatment and improved outcomes. Prompted by specific examples in oncology, the field of critical care may be tempted to envision that complex, acute syndromes could bend to a similar reductionist philosophy-where single mutations could identify and target our critically ill patients for treatment. However, precision medicine faces many challenges in critical care. These include confusion about terminology, uncertainty about how to divide patients into discrete groups, the challenges of multi-morbidity, scale, and the need for timely interventions...
October 18, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29047023/heparin-binding-protein-hbp-improves-prediction-of-sepsis-related-acute-kidney-injury
#13
Jonas Tverring, Suvi T Vaara, Jane Fisher, Meri Poukkanen, Ville Pettilä, Adam Linder
BACKGROUND: Sepsis-related acute kidney injury (AKI) accounts for major morbidity and mortality among the critically ill. Heparin-binding protein (HBP) is a promising biomarker in predicting development and prognosis of severe sepsis and septic shock that has recently been proposed to be involved in the pathophysiology of AKI. The objective of this study was to investigate the added predictive value of measuring plasma HBP on admission to the intensive care unit (ICU) regarding the development of septic AKI...
October 18, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29046755/some-neck-swellings-are-serious-a-case-of-lemierre-s-syndrome
#14
Ali Raza Ghani, Mohsin Hamid, Ahsan Raza, Rizwan Naseer, Joseph Crocetti
Lemierre's syndrome also termed post-anginal septicemia, is a disease characterized by internal jugular septic thrombophlebitis leading to Fusobacterium septicemia with multiple metastatic foci following an oropharyngeal infection. Diagnosis and management is challenging and can result in fatal consequences due to potential multisystem involvement and multiple complications. We describe here a case of Lemierre's syndrome with multifocal pneumonia, acute renal failure and protracted course of illness over forty days with successful recovery...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046178/a-psychiatric-formulary-for-long-duration-spaceflight
#15
Eric Friedman, Brian Bui
Behavioral health is essential for the safety, well-being, and performance of crewmembers in both human spaceflight and Antarctic exploration. Over the past five decades, psychiatric issues have been documented in orbital spaceflight. In Antarctica, literature suggests up to 5% of wintering crewmembers could meet criteria for a psychiatric illness, including mood disorders, stressor-related disorders, sleep-wake disorders, and substance-related disorders. Experience from these settings indicates that psychiatric disorders on deep space missions must be anticipated...
November 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/29046107/determinants-of-endotracheal-intubation-in-critically-ill-patients-undergoing-gastrointestinal-endoscopy-under-conscious-sedation
#16
Nathan J Smischney, Mohamed O Seisa, Mukesh Kumar, Jillian Deangelis, Darrell R Schroeder, Daniel A Diedrich
OBJECTIVES: Our primary aim was to determine the factors leading to prophylactic endotracheal intubation in intensive care unit (ICU) patients undergoing gastrointestinal endoscopy. Secondary aims were to determine the rate of unplanned endotracheal intubations during endoscopy and to determine the rate of aspiration following endoscopy for patients admitted to the ICU. METHODS: Critically ill adult (≥18 years) patients who underwent upper and lower endoscopic procedures from January 2012 to July 2016 in a medical/surgical ICU were included...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29045692/seasonal-variation-and-weather-changes-related-to-the-occurrence-and-severity-of-acute-hematogenous-osteomyelitis-in-children
#17
Eduardo A Lindsay, Naureen Tareen, Chan-Hee Jo, Lawson A Copley
Background: Acute hematogenous osteomyelitis (AHO) demonstrates regional variability in incidence and severity. In this study, we evaluated seasonal variations of AHO and assessed the effects of weather trends on the occurrence and severity of illness in affected children. Methods: National Weather Service data from the dates of symptom onset and of admission of children with AHO were gathered. Seasonal occurrence rates and the weather patterns were studied according to severity-of-illness category...
October 13, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/29045690/clinical-characteristics-of-hospitalized-infants-with-laboratory-confirmed-pertussis-in-guatemala
#18
Varun K Phadke, John P McCracken, Jennifer L Kriss, Maria R Lopez, Kim A Lindblade, Joe P Bryan, Miguel E Garcia, Carlos E Funes, Saad B Omer
Background: Pertussis is an important cause of hospitalization and death in infants too young to be vaccinated (aged <2 months). Limited data on infant pertussis have been reported from Central America. The aim of this study was to characterize acute respiratory illnesses (ARIs) attributable to Bordetella pertussis among infants enrolled in an ongoing surveillance study in Guatemala. Methods: As part of a population-based surveillance study in Guatemala, infants aged <2 months who presented with ARI and required hospitalization were enrolled, and nasopharyngeal and oropharyngeal swab specimens were obtained...
October 13, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/29045192/a-dna-vaccine-delivered-by-dermal-electroporation-fully-protects-cynomolgus-macaques-against-lassa-fever
#19
Kathleen A Cashman, Eric R Wilkinson, Carl I Shaia, Paul R Facemire, Todd M Bell, Jeremy J Bearss, Joshua D Shamblin, Suzanne E Wollen, Kate E Broderick, Niranjan Y Sardesai, Connie S Schmaljohn
Lassa virus (LASV) is an ambisense RNA virus in the Arenaviridae family and is the etiological agent of Lassa fever, a severe hemorrhagic disease endemic to West and Central Africa (1,2) . There are no U.S. Food and Drug Administration (FDA)-licensed vaccines available to prevent Lassa fever (1,2) . in our previous studies, we developed a gene-optimized DNA vaccine that encodes the glycoprotein precursor gene of LASV (Josiah strain) and demonstrated that three vaccinations accompanied by dermal electroporation protected guinea pigs from LASV-associated illness and death...
October 18, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/29044341/the-use-of-antimicrobials-in-septic-patients-with-acute-kidney-injury
#20
Fernanda Moreira de Freitas, Welder Zamoner, Durval Sampaio de Souza Garms, Mariele Gobo de Oliveira, André Luis Balbi, Daniela Ponce
Sepsis is the most common cause of death in critically ill patients and it may be associated with multiorgan failure, including acute kidney injury (AKI). This situation can require acute renal support and increase mortality. Therefore, it is essential to administrate antimicrobials in dosis to achieve adequate serum levels, preventing overdosis and drug toxicity or underdosing and risk for resistance to antibiotics and higher mortality. To date, there aren't validated guidelines on antibiotic dosis adjustment in septic patients with AKI and the recommendations are extrapolated from studies conducted in non-critical patients with chronic kidney disease in end stage receiving chronic renal replacement therapy...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
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