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Multi organ dysfunction

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https://www.readbyqxmd.com/read/28798922/practical-approach-to-the-patient-with-acute-neuromuscular-weakness
#1
REVIEW
Rajeev Nayak
Acute neuromuscular paralysis (ANMP) is a clinical syndrome characterized by rapid onset muscle weakness progressing to maximum severity within several days to weeks (less than 4 wk). Bulbar and respiratory muscle weakness may or may not be present. It is a common neurological emergency which requires immediate and careful investigations to determine the etiology because accurate diagnosis has significant impact on therapy and prognosis. Respiratory failure caused by neuromuscular weakness is considered as more critical than lung disease because its development may be insidious or subtle until sudden decompensation leads to life threatening hypoxia...
July 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28797314/intravenous-sotalol-use-in-a-complex-critically-ill-child-balancing-the-systems-in-choosing-antiarrhythmic-medication
#2
Michele M Pasierb, Stephen P Seslar
In critically ill children, multi-organ-system disease can influence the choice of antiarrhythmic medication. Intravenous therapy is often necessary. There is a scarcity of paediatric critical-care cases demonstrating the dosing, monitoring, and efficacy of intravenous sotalol. This case demonstrates the effective use of intravenous sotalol in an adolescent with renal, hepatic, and haematological dysfunctions.
August 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28795840/a-complete-histologic-approach-to-gastrointestinal-biopsy-from-hematopoietic-stem-cell-transplant-patients-with-evidence-of-transplant-associated-gastrointestinal-thrombotic-microangiopathy
#3
Mikako Warren, Sonata Jodele, Christopher Dandoy, Kasiani C Myers, Gregory Wallace, Adam Nelson, Javier El-Bietar
CONTEXT: - Transplant-associated thrombotic microangiopathy is a serious complication of hematopoietic stem cell transplant that may progress to multi-organ dysfunction. Transplant-associated thrombotic microangiopathy may involve the intestinal vasculature (intestinal transplant-associated thrombotic microangiopathy [iTMA]), causing patients to experience debilitating symptoms of ischemic colitis, including disproportionately severe abdominal pain and gastrointestinal bleeding, requiring heavy narcotic use and frequent transfusion support...
August 10, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28794962/a-case-of-atrio-esophageal-fistula-masquerading-as-upper-gi-bleed
#4
Parth Rali, Mayur Rali, Khalid Malik
We represent a fatal case of atrio esophageal fistula that presented as upper GI bleed. The case was complicated by rapidly progressing multi organ dysfunction syndrome and eventual death. This was an iatrogenic complication of an elective procedure.
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28794847/neuro-otological-and-peripheral-nerve-involvement-in-fabry-disease
#5
Sergio Carmona, Romina Weinschelbaum, Ana Pardal, Cintia Marchesoni, Paz Zuberbuhler, Patricia Acosta, Guillermo Cáceres, Isaac Kisinovsky, Luciana Bayón, Ricardo Reisin
Fabry disease (FD) is an X-linked lysosomal storage disease, with multisystemic glycosphingolipids deposits. Neuro-otological involvement leading to hearing loss and vestibular dysfunctions has been described, but there is limited information about the frequency, site of lesion, or the relationship with peripheral neuropathy. The aim was to evaluate the presence of auditory and vestibular symptoms, and assess neurophysiological involvement of the VIII cranial nerve, correlating these findings with clinical and neurophysiological features of peripheral neuropathy...
July 18, 2017: Audiology Research
https://www.readbyqxmd.com/read/28766002/similar-survival-outcomes-in-patients-with-biclonal-versus-monoclonal-myeloma-a-multi-institutional-matched-case-control-study
#6
Artur Jurczyszyn, Alessandro Gozzetti, Joanna Gdula-Argasińska, Jacek Czepiel, Ravi Vij, Mark Fiala, Davila Julio Valls, Krzysztof Mądry, Anna Waszczuk-Gajda, Sebastian Grosicki, Agnieszka Barchnicka, Edvan Crusoe, Vania Hungria, Massimo Gentile, Giuseppe Mele, Marcin Ksieniewicz, David H Vesole, Jorge J Castillo
Multiple myeloma is a plasma cell malignancy characterized by clonal proliferation of plasma cells in the bone marrow and associated organ damage. Usually, patients with myeloma present with a single monoclonal protein in serum and/or urine constituted by one heavy chain and one light chain. In less than 5% of the patients, more than one monoclonal protein can be identified. The aim of our retrospective multicenter matched case-control study was to describe the characteristics of cases with biclonal myeloma and compare them against a control group of monoclonal myeloma patients matched by age, sex, and year of diagnosis...
August 1, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28759025/diagnosis-and-severity-criteria-for-sinusoidal-obstruction-syndrome-veno-occlusive-disease-in-pediatric-patients-a-new-classification-from-the-european-society-for-blood-and-marrow-transplantation
#7
S Corbacioglu, E Carreras, M Ansari, A Balduzzi, S Cesaro, J-H Dalle, F Dignan, B Gibson, T Guengoer, B Gruhn, A Lankester, F Locatelli, A Pagliuca, C Peters, P G Richardson, A S Schulz, P Sedlacek, J Stein, K-W Sykora, J Toporski, E Trigoso, K Vetteranta, J Wachowiak, E Wallhult, R Wynn, I Yaniv, A Yesilipek, M Mohty, P Bader
The advances in hematopoietic cell transplantation (HCT) over the last decade have led to a transplant-related mortality below 15%. Hepatic sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) is a life-threatening complication of HCT that belongs to a group of diseases increasingly identified as transplant-related, systemic endothelial diseases. In most cases, SOS/VOD resolves within weeks; however, severe SOS/VOD results in multi-organ dysfunction/failure with a mortality rate >80%. A timely diagnosis of SOS/VOD is of critical importance, given the availability of therapeutic options with favorable tolerability...
July 31, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28757259/endotoxemia-induces-lung-brain-coupling-and-multi-organ-injury-following-cerebral-ischemia-reperfusion
#8
Nguyen Mai, Landa Prifti, Aric Rininger, Hannah Bazarian, Marc W Halterman
Post-ischemic neurodegeneration remains the principal cause of mortality following cardiac resuscitation. Recent studies have implicated gastrointestinal ischemia in the sepsis-like response associated with the post-cardiac arrest syndrome (PCAS). However, the extent to which the resulting low-grade endotoxemia present in up to 86% of resuscitated patients affects cerebral ischemia-reperfusion injury has not been investigated. Here we report that a single injection of low-dose lipopolysaccharide (50μg/kg, IP) delivered after global cerebral ischemia (GCI) induces blood-brain barrier permeability, microglial activation, cortical injury, and functional decline in vivo, compared to ischemia alone...
July 28, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28754544/consensus-report-by-pediatric-acute-lung-injury-and-sepsis-investigators-and-pediatric-blood-and-marrow-transplantation-consortium-joint-working-committees-supportive-care-guidelines-for-management-of-veno-occlusive-disease-in-children-and-adolescents-part
#9
REVIEW
Rajinder P S Bajwa, Kris M Mahadeo, Benjamin H Taragin, Christopher C Dvorak, Jennifer McArthur, Asumthia Jeyapalan, Christine N Duncan, Robert Tamburro, Alison Gehred, Leslie Lehman, Paul Richardson, Jeffery J Auletta, Ann E Woolfrey
Veno-occlusive disease (VOD) is a common and potentially fatal complication in children undergoing hematopoietic cell transplantation (HCT). It occurs in about one-third of all patients undergoing transplantation and is fatal in 50% of patients with severe disease. Early intervention and specific treatment with defibrotide are associated with improved outcomes. However, there is a lack of supportive care guidelines for management of the multiorgan dysfunction seen in most cases. There is high variability in the management of VOD, which may contribute to the increased morbidity and mortality...
July 25, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28747721/downregulation-of-interferon-%C3%AE-and-inhibition-of-tlr3-expression-are-associated-with-fatal-outcome-of-severe-fever-with-thrombocytopenia-syndrome
#10
Peixin Song, Nan Zheng, Li Zhang, Yong Liu, Taoyu Chen, Changjun Bao, Zhifeng Li, Wei Yong, Yongyang Zhang, Chao Wu, Zhiwei Wu
Severe Fever with Thrombocytopenia Syndrome (SFTS) is an emerging infectious disease with high mortality and increasing prevalence in the East Asia. Though the etiological agent has been identified as a novel Bunyavirus, cellular mechanisms of viral pathogenesis and host immune response to SFTS virus infection remain unknown. A comprehensive study was conducted on a cohort of 70 patients on clinical manifestations, viral loads, modulation of cytokines, serum interferon level, immune related gene expression in peripheral blood cells, and dynamic changes of circulating dendritic cells during the acute phase of SFTSV infection...
July 26, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28743338/-clinical-characteristics-and-prognosis-in-patients-with-high-plasma-level-of-procalcitonin-an-analysis-in-188-patients
#11
Chuli Pan, Wei Cui, Feifei Zhou, Junwei Tu, Xiuhui Lin, Libin Li, Gensheng Zhang
OBJECTIVE: To investigate the clinical characteristics and prognosis of patients with high level of plasma procalcitonin (PCT > 100 μg/L), and to improve the clinician's understanding, diagnosis and treatment of this kind of patients. METHODS: A retrospective study was conducted. The clinical data of patients with plasma PCT over 100 μg/L within 48 hours of admission admitted to Second Affiliated Hospital of Zhejiang University School of Medicine from February 2013 to December 2016 were collected, and the clinical characteristics were analyzed...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28733263/consolidation-therapy-for-newly-diagnosed-pediatric-patients-with-high-risk-neuroblastoma-using-busulfan-melphalan-autologous-hematopoietic-cell-transplantation-anti-gd2-antibody-granulocyte-macrophage-colony-stimulating-factor-interleukin-2-and-haploidentical
#12
Aimee C Talleur, Brandon M Triplett, Sara Federico, Ewelina Mamcarz, William Janssen, Jianrong Wu, David Shook, Wing Leung, Wayne L Furman
The treatment of pediatric high-risk neuroblastoma is intensive and multimodal. Despite the introduction of immunotherapy for minimal residual disease, survival rates remain suboptimal and new therapies are needed. As part of a phase 2 trial, we are using a consolidation therapy regimen that combines a busulfan/melphalan conditioning schema, autologous hematopoietic cell transplantation (AHCT), and experimental immunotherapy with hu14.18K322A (a humanized anti-GD2 monoclonal antibody), granulocyte-macrophage colony-stimulating factor (GM-CSF), and IL-2, with or without the adoptive transfer of haploidentical natural killer cells (NKs)...
July 18, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28732007/a-data-driven-modeling-approach-to-identify-disease-specific-multi-organ-networks-driving-physiological-dysregulation
#13
Warren D Anderson, Danielle DeCicco, James S Schwaber, Rajanikanth Vadigepalli
Multiple physiological systems interact throughout the development of a complex disease. Knowledge of the dynamics and connectivity of interactions across physiological systems could facilitate the prevention or mitigation of organ damage underlying complex diseases, many of which are currently refractory to available therapeutics (e.g., hypertension). We studied the regulatory interactions operating within and across organs throughout disease development by integrating in vivo analysis of gene expression dynamics with a reverse engineering approach to infer data-driven dynamic network models of multi-organ gene regulatory influences...
July 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/28727609/atrial-natriuretic-peptide-a-potential-early-therapy-for-the-prevention-of-multiple-organ-dysfunction-syndrome-following-severe-trauma
#14
Rong-Wei Zhang, Li-Li Liu, Lan-Lan Zeng, Rui-Jie Li, Ye-Hua Shen, Bin Zhang, Zi-Zhuo Liu, Meng-Fei Chen, Sheng-Mao Jiang, Li-Bing Jiang, Xiao-Gang Zhao, Shou-Yin Jiang
Trauma remains a tremendous medical burden partly because of increased expenditure for the management of multiple organ dysfunction syndrome (MODS) developed during hospital stay. The intestinal barrier injury continues to be a second insult resulting in MODS which currently lacks efficient strategies for prevention. Recent studies have uncovered multi-organ protective benefits of atrial natriuretic peptide (ANP) in cardiovascular disease. However, the role of ANP in prevention of MODS following severe trauma has not been understood...
July 19, 2017: Shock
https://www.readbyqxmd.com/read/28720429/stable-isotope-based-flux-studies-in-nonalcoholic-fatty-liver-disease
#15
REVIEW
Arthur McCullough, Stephen Previs, Takhar Kasumov
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease and is associated with the worldwide epidemics of obesity, diabetes and cardiovascular diseases. NAFLD ranges from benign fat accumulation in the liver (steatosis) to non-alcoholic steatohepatitis (NASH), and cirrhosis which can progress to hepatocellular carcinoma and liver failure. Mass spectrometry and magnetic resonance spectroscopy-coupled stable isotope-based flux studies provide new insights into the understanding of NAFLD pathogenesis and the disease progression...
July 15, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28718263/multi-organ-dysfunction-secondary-to-yellow-scorpion-sting
#16
Muhammad Faisal Khan, Hameed Ullah
Scorpion stings are common in tropical and subtropical regions. The history and clinical manifestation warrant urgent recognition and treatment. The incidence of scorpion stings in Pakistan is not known as there is no published data available in literature. We report our experience of a yellow scorpion sting victim who required intensive care admission after developing multi-organ dysfunction.
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28709158/dexmedetomidine-protects-against-multi-organ-dysfunction-induced-by-heatstroke-via-sustaining-the-intestinal-integrity
#17
Zhen-Na Xia, Ying Zong, Zi-Teng Zhang, Ji-Kuai Chen, Xiu-Juan Ma, Yan-Gang Liu, Li-Jun Zhao, Guo-Cai Lu
Previous studies have indicated that gut-derived endotoxin played a pivotal role for aggravating systemic inflammatory response to multi-organ dysfunction under heatstroke. Dexmedetomidine (DEX) could protect against inflammation and multi-organ injury in various scenarios. The aim of this study was to explore the protective effect of DEX on heatstroke and the mechanism involved. Male C57BL/6 mice were placed in a controlled climate chamber (40 ± 1°C) until the maximum core temperature (Tc, Max) of 42...
August 2017: Shock
https://www.readbyqxmd.com/read/28700619/intra-operative-multi-site-stimulation-expanding-methodology-for-cortical-brain-mapping-of-language-functions
#18
Tal Gonen, Tomer Gazit, Akiva Korn, Adi Kirschner, Daniella Perry, Talma Hendler, Zvi Ram
Direct cortical stimulation (DCS) is considered the gold-standard for functional cortical mapping during awake surgery for brain tumor resection. DCS is performed by stimulating one local cortical area at a time. We present a feasibility study using an intra-operative technique aimed at improving our ability to map brain functions which rely on activity in distributed cortical regions. Following standard DCS, Multi-Site Stimulation (MSS) was performed in 15 patients by applying simultaneous cortical stimulations at multiple locations...
2017: PloS One
https://www.readbyqxmd.com/read/28688155/critical-care-management-of-the-cirrhotic-patient-awaiting-liver-transplant-in-the-intensive-care-unit
#19
REVIEW
J C Olson, C J Karvellas
Patients with cirrhosis who are awaiting liver transplantation are at high risk for development of critical illness. Current liver allocation policies which dictate a "sickest first" approach coupled with a mismatch between need and availability of organs results in longer wait times and thus, patients are becoming increasingly ill while awaiting organ transplantation. Even patients with well compensated cirrhosis may suffer acute deterioration, the syndrome of acute-on-chronic liver failure (ACLF) results in multi-system organ dysfunction and a marked increase in associated short-term morbidity and mortality...
July 8, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28676332/circulating-exosomes-in-obstructive-sleep-apnea-as-phenotypic-biomarkers-and-mechanistic-messengers-of-end-organ-morbidity
#20
REVIEW
Abdelnaby Khalyfa, Leila Kheirandish-Gozal, David Gozal
Obstructive sleep apnea (OSA), the most severe form of sleep disordered breathing, is characterized by intermittent hypoxia during sleep (IH), sleep fragmentation, and episodic hypercapnia. OSA is associated with increased risk for morbidity and mortality affecting cardiovascular, metabolic, and neurocognitive systems, and more recently with non-alcoholic fatty liver disease (NAFLD) and cancer-related deaths. Substantial variability in OSA outcomes suggests that genetically-determined and environmental and lifestyle factors affect the phenotypic susceptibility to OSA...
July 1, 2017: Respiratory Physiology & Neurobiology
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