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https://www.readbyqxmd.com/read/29145289/mercury-poisoning-through-intravenous-administration-two-case-reports-with-literature-review
#1
Qiuying Lu, Zilong Liu, Xiaorui Chen
RATIONALE: Metallic mercury poisoning through intravenous injection is rare, especially for a homicide attempt. Diagnosis and treatment of the disease are challenging. PATIENT CONCERNS: A 34-year-old male presented with pyrexia, chill, fatigue, body aches, and pain of the dorsal aspect of right foot. Another case is that of a 29-year-old male who committed suicide by injecting himself metallic mercury 15 g intravenously and presented with dizzy, dyspnea, fatigue, sweatiness, and waist soreness...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29141797/diagnosis-and-management-of-neuromyelitis-optica-spectrum-disorder-nmosd-in-iran-a-consensus-guideline-and-recommendations
#2
REVIEW
Mohammad Ali Sahraian, Abdorreza Naser Moghadasi, Amir Reza Azimi, Nasrin Asgari, Fahimeh H Akhoundi, Roya Abolfazli, Shekoofeh Alaie, Fereshteh Ashtari, Hormoz Ayromlou, Seyed Mohammad Baghbanian, Nahid Beladi Moghadam, Farzad Fatehi, Mohsen Foroughipour, Hamidreza Ghalyanchi Langroodi, Nastaran Majdinasab, Alireza Nickseresht, Abbas Nourian, Vahid Shaygannejad, Hamid Reza Torabi
Neuromyelitis Optica Spectrum Disorder (NMOSD) is a relapsing neuro inflammatory disease of the central nervous system that typically presents with optic neuritis or myelitis and may cause severe disability. The diagnostic criteria have been updated and several immunosuppressive agents have been demonstrated to prevent acute exacerbations. As the disease rarely develops in a progressive course, management of acute attacks and proper prevention of exacerbations may change the long term out-come and prevent future disability...
November 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29139162/epidemiology-of-therapeutic-apheresis-with-a-multidisciplinary-approach-at-a-high-volume-pediatric-center
#3
Rachel M Sirignano, Matthew L Paden, Ross Fasano, Erin K Meyer
INTRODUCTION: Therapeutic apheresis (TA) is used inconsistently in pediatric populations. We seek to define our multidisciplinary institutional practice. METHODS: We conducted a retrospective chart review of patients receiving TA from January 1, 2012 through October 31, 2015. Data collected included demographics, American Society of Apheresis (ASFA) indication, complications, and mortality. RESULTS: Over 46 months, 1198 TA procedures were conducted on 289 patients ranging in age from 5 months to 21 years with weights ranging from 4...
November 15, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29135832/prognostic-value-of-the-persistence-of-c1q-binding-anti-hla-antibodies-in-acute-antibody-mediated-rejection-in-kidney-transplantation
#4
Elodie Bailly, Dany Anglicheau, Gilles Blancho, Philippe Gatault, Vincent Vuiblet, Valérie Chatelet, Emmanuel Morelon, Paolo Malvezzi, Anne Parissiadis, Jérôme Tourret, Gwendaline Guidicelli, Johnny Sayegh, Christiane Mousson, Philippe Grimbert, Isabelle Top, Moglie Le Quintrec, Raj Purgus, Pierre François Westeel, Barbara Proust, Valérie Chabot, Yvon Lebranchu, Frédéric Dehaut, Matthias Büchler
BACKGROUND: The differential pathogenicity of anti-HLA donor-specific antibodies (DSAs) is not fully understood. The presence of complement-binding DSAs help better defining the prognosis of acute antibody-mediated rejection (ABMR). The evolution of these antibodies after the treatment of ABMR is unknown. METHODS: We included patients from the French multicenter RITUX ERAH study diagnosed with acute antibody-mediated rejection (ABMR) within the first year of renal transplantation, with circulating anti-HLA DSAs and treated randomly by rituximab or placebo (and intravenous immunoglobulins, plasma exchange)...
November 13, 2017: Transplantation
https://www.readbyqxmd.com/read/29130141/sj%C3%A3-gren-s-syndrome-initially-presented-as-thrombotic-thrombocytopenic-purpura-in-a-male-patient-a-case-report-and-literature-review
#5
REVIEW
Xiaohan Xu, Tienan Zhu, Di Wu, Lu Zhang
Thrombotic thrombocytopenic purpura (TTP) is a potentially lethal multisystem disorder which could be caused by autoimmune diseases. However, the concomitant occurrence of TTP and Sjögren's syndrome (SS) is an extremely uncommon scenario, especially in male patients. A 56-year-old Chinese male was admitted for the appearance of diffuse ecchymosis. Then he gradually developed transient slurred speech, progressive confusion, agitation, extremity weakness, and fever. Laboratory investigations suggested anemia, thrombocytopenia, significantly increased lactic dehydrogenase, schistocytes in peripheral blood smear, and a disintegrin-like metalloproteinase with thrombospondin motif type 1 member 13 (ADAMTS13) activity deficiency with high inhibitor titers...
November 13, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/29124560/maintenance-treatment-using-the-purine-synthesis-inhibitor-mizoribine-in-a-patient-with-relapsing-thrombotic-thrombocytopenic-purpura
#6
Tetsuya Kawamura, Joichi Usui, Kei Nagai, Kentaro Sakai, Itaru Ebihara, Kunihiro Yamagata
Thrombotic thrombocytopenic purpura (TTP) is a rare but life-threatening disease. Although plasma exchange (PE) therapy and corticosteroids are standard remission induction and maintenance therapies, some patients are easily refractory and frequently relapse under treatment with this therapy, and require additional treatment. However, there are limited data about additional treatment interventions. We report a case of 56-year-old man who was hospitalized for fever, general fatigue and hemoglobinuria. Owing to the symptoms and the laboratory findings of hemolysis, he was diagnosed with TTP...
November 9, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/29123842/severe-sepsis-caused-by-capnocytophaga-canimorsus-complicated-by-thrombotic-microangiopathy-in-an-immunocompetent-patient
#7
Shota Maezawa, Daisuke Kudo, Keiichiro Asanuma, Daisuke Takekoshi, Ryuichiro Egashira, Shigeki Kushimoto
Case: A 61-year-old man with an unremarkable medical history was admitted with fever 7 days after being bitten by his dog. On day 3, he showed altered mental status, and laboratory data showed progressive hemolytic anemia, thrombocytopenia, hyperbilirubinemia, renal dysfunction, coagulopathy, and schistocytosis. Severe sepsis complicated with thrombotic microangiopathy caused by Capnocytophaga canimorsus was suspected. Outcome: Plasma exchange was applied to treat the thrombotic microangiopathy and resulted in platelet count increase and improved renal function, hyperbilirubinemia, and schistocytosis...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123569/diagnostic-dilemma-severe-thrombotic-microangiopathy-in-pregnancy
#8
Sarah Birkhoelzer, Alexandra Belcher, Helen Peet
A diagnostic dilemma occurred when thrombotic microangiopathy developed during pregnancy. The diagnostic criteria of thrombotic microangiopathy include thrombocytopenia (platelets <100) and microangiopathic haemolytic anaemia (including thrombotic thrombocytopenic purpura and haemolytic-uraemic syndrome). An urgent interdisciplinary approach is required to treat thrombotic microangiopathy in pregnancy to differentiate between thrombotic microangiopathy and HELLP syndrome (haemolysis, elevated liver enzymes, low platelets)...
November 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29117665/application-of-therapeutic-plasma-exchange-in-patients-having-severe-fever-with-thrombocytopenia-syndrome
#9
Jeong Rae Yoo, Sun Hyung Kim, Young Ree Kim, Keun Hwa Lee, Won Sup Oh, Sang Taek Heo
Background/Aims: Severe fever with thrombocytopenia syndrome (SFTS) is a viral hemorrhagic fever with a high fatality rate. However, effective treatments for SFTS cases not responded to supportive therapy have not been established. Herein, we introduced the therapeutic plasma exchange (TPE) in SFTS patients in a tertiary hospital between 2013 and 2015. Methods: TPE was performed in patients with rapidly progressing SFTS. Clinical, laboratory, and virological parameters were compared before and after TPE...
November 10, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29115027/clinical-features-of-pediatric-autoimmune-hepatitis-in-japan-a-nationwide-survey
#10
Tsuyoshi Sogo, Atsushi Takahashi, Ayano Inui, Tomoo Fujisawa, Hiromasa Ohira, Hajime Takikawa
AIM: The purpose of this study was to determine the characteristics of children with autoimmune hepatitis (AIH) in Japan. METHODS: Questionnaires, which asked about patients newly diagnosed with AIH from 2009 to 2013 were sent to hospitals certified as training facilities for pediatrics in January 2015. RESULTS: A total of 35 patients were enrolled. The median age at diagnosis was 10 years (ranging from 3 months to 15 years), and the male-to-female ratio was 2:3...
November 8, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29109928/ventriculoperitoneal-shunt-associated-vancomycin-resistant-meningitis-complicating-a-patient-undergoing-plasmapheresis-for-presumed-systemic-lupus-erythematosus-associated-transverse-myelitis
#11
Adam John Covach, William Nicholas Rose
Objectives  We report a patient who had a working diagnosis of transverse myelitis secondary to a lupus exacerbation. As his clinical course evolved, continued vigilance clarified that he was in fact suffering from a nosocomial infection caused by vancomycin-resistant Enterococcus (VRE). Methods  We performed a retrospective review of the patient's medical record. Results  Despite radiographic improvement, he did not improve clinically following immunosuppressive therapy including plasma exchange. Once meningitis was diagnosed and treated, he improved rapidly...
October 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/29103007/anti-lgi1-encephalitis-causing-faciobrachial-dystonic-seizures
#12
Stamatios Zouras, Jeffrey W Stephens, Srinivasa Rao Abburu, Chika Emelle
Anti-leucine-richglioma inactivated protein 1 (LGI1) encephalitis has an autoimmune origin and can be reversed with immunotherapy. It is obvious that identifying and treating this condition early is of paramount importance. We present the case of a 69-year-old man who was admitted to hospital with faciobrachial dystonic seizures and was found to have antibodies to LGI1. His symptoms started approximately 3 months prior admission to the hospital. There had also been some subtle cognitive impairment. He was treated with two courses of intravenous immunoglobulin and commenced on prednisolone 50 mg daily and clonazepam 500 µg at night...
November 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29102655/amotosalen-inactivated-plasma-is-as-equally-well-tolerated-as-quarantine-plasma-in-patients-undergoing-large-volume-therapeutic-plasma-exchange
#13
C Guignier, A Benamara, P Oriol, P Coppo, C Mariat, O Garraud
A retrospective - single center - survey compared tolerance of individual donor therapeutic plasma in a series of 88 patients principally presenting with thrombotic microangiopathy; all patients underwent therapeutic plasma exchange (TPE) performed with more than 90% of either of two types of plasma preparations. One plasma type used in TPE was prepared with pathogen reduction by amotosalen addition and UVA illumination, and the other one was non-manipulated (quarantine plasma). Both types of plasma were single donor...
November 1, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/29101274/myasthenia-gravis-impairment-index-responsiveness-meaningful-change-and-relative-efficiency
#14
Carolina Barnett, Vera Bril, Moira Kapral, Abhaya V Kulkarni, Aileen M Davis
OBJECTIVE: To study responsiveness and meaningful change of the Myasthenia Gravis Impairment Index (MGII) and its relative efficiency compared to other measures. METHODS: We enrolled 95 patients receiving prednisone, IV immunoglobulin (IVIg), or plasma exchange (PLEX) and 54 controls. Patients were assessed with the MGII and other measures-including the Quantitative Myasthenia Gravis Score, Myasthenia Gravis Composite, and Myasthenia Gravis Activities of Daily Living-at baseline and 3-4 weeks after treatment...
November 3, 2017: Neurology
https://www.readbyqxmd.com/read/29096852/therapeutic-plasma-exchange-in-a-rare-case-myasthenic-crisis-after-botox-injection
#15
Azita Chegini
BACKGROUND AND AIMS: Botulinum toxin (Botox) injections are used as a cosmetic treatment to decrease wrinkles in face and chin. Being a neurotoxic agent it minimizes muscle activity, while side effects are usually rare. This article subsequently presents one case of these rare effects. CASE: A 30-year-old woman presenting with ptosis, diplopia, dysarthria, dysphagia and muscle weakness was admitted to our hospital. She had no history of disease. For cosmetic reasons, she had three Botox injections during the preceding months...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096850/low-rate-of-infectious-complications-following-immunoadsorption-therapy-without-regular-substitution-of-intravenous-immunoglobulins
#16
Sergey Tselmin, Ulrich Julius, Stefan R Bornstein, Bernd Hohenstein
INTRODUCTION: Immunoadsorption (IA) is increasingly used instead of plasma exchange due to lower risk of side effects and a higher selectivity. As a consequence of the reduction of immunoglobulins (Ig), the rate of infectious complications might increase in those patients. We therefore aimed to investigate the infection rate following IA without intravenous IG (IVIG) substitution in our apheresis center, where patients do not receive IVIG on a regular basis. MATERIAL AND METHODS: We conducted a retrospective analysis of the IA treatments performed between 2010 and 2015 without IVIG substitution and collected data on patient age, diagnosis, number of IA treatments, serum levels of Ig, total protein, albumin, C-reactive protein (CRP) and infectious complications that occurred within 2 months after the IA treatment cycle...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096847/immunoadsorption-for-autoimmune-encephalitis
#17
Cordula Fassbender, Reinhard Klingel, Wolfgang Köhler
Autoimmune encephalitis is a severe inflammatory disorder of the brain. The discovery that several non-infectious forms of encephalitis are associated with autoantibodies was a breakthrough in the care of this previously untreatable group of patients. The correlation of antibody type and titer with pattern and severity of symptoms was essential for the initiation of immunotherapies. First line therapy consists of steroids, intravenous immunoglobulins, plasma exchange or immunoadsorption. Rapid elimination of autoantibodies using selective immunoadsorption and avoiding the disadvantage of plasma substitution is a pathophysiologically guided therapeutic approach, and has been proven to be an effective therapeutic option as part of multimodal immunotherapy...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096846/comparing-the-efficacy-of-three-techniques-to-reduce-isoagglutinin-titers-in-ab0-incompatible-kidney-transplant-recipients
#18
S P Parmentier, E Rosenkranz, H Schirutschke, M Opgenoorth, C Quick, K Hoelig, A Rosner, B Hohenstein, C Hugo, J Passauer
ABO incompatible (ABOi) organ transplantation requires pre-transplant reduction of the recipient's IgG and IgM isoagglutinin titer against the donor to prevent hyperacute rejection. Over the past four years we primarily used unspecific IgG immunoadsorption (IA) for this purpose and combined this selectively with membrane filtration (IAc) to reduce IgM isoagglutinines. In patients with an initial IgG titer against donor below 1:64, plasma exchange (PE) was initiated. In this retrospective analysis covering January 2012 to August 2015 we compared how efficiently IgG and IgM isoagglutinines in a total of 22 ABOi kidney transplant recipients were reduced by either IA (n = 75 sessions), IAc (n = 14 sessions) or PE (n = 40 sessions)...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096842/safety-aspects-of-lipidapheresis-using-dali-and-monet-multicenter-observational-study
#19
Justyna Kozik-Jaromin, Eberhard Röseler, Franz Heigl, Ralf Spitthöver, Jens Ringel, Gerd Schmitz, Rainer Heinzler, Nadim Abdul-Rahman, Frank Leistikow, Frido Himmelsbach, Volker Schettler, Ingrid Uhlenbusch-Körwer, Wolfgang Ramlow
BACKGROUND: Lipidapheresis was introduced for intractable hyperlipidemia as a more selective therapy than plasma exchange aiming to enhance efficacy and limit side-effects. Although this therapy is regarded safe, multicenter data from routine application are limited. We investigated direct adsorption of lipoproteins (DALI) and lipofiltration (MONET) regarding the short and the long-term safety aspects. METHODS: This multicenter observational study prospectively evaluated 2154 DALI and 1297 MONET sessions of 122 patients during a period of 2 years...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29083113/hydroxyethyl-starch-and-kidney-function-a-retrospective-study-in-patients-undergoing-therapeutic-plasma-exchange
#20
Muthuchellappan Radhakrishnan, Akshay Batra, Sundar Periyavan, Mariamma Philip, Vivek Anand
PURPOSE: Hydroxyethyl starch (HES) and albumin are used as replacement fluids during therapeutic plasma exchange (TPE). HES solutions are no longer recommended in critically ill patients due to its effect on kidneys and coagulation. In this retrospective study, we tried to look at the association between cumulative HES administration and kidney function in patients undergoing TPE. METHODS: Transfusion medicine department register was scrutinized to identify adult patients who had completed at least 5 cycles of TPE during the period June 2014-May 2015...
October 30, 2017: Journal of Clinical Apheresis
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