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https://www.readbyqxmd.com/read/28938048/a-predictive-score-for-hypotension-in-patients-with-confirmed-dengue-fever-in-cayenne-hospital-french-guiana
#1
Félix Djossou, Guillaume Vesin, Narcisse Elenga, Magalie Demar, Loïc Epelboin, Gaëlle Walter, Philippe Abboud, Thierry Le-Guen, Dominique Rousset, Brigitte Moreau, Aba Mahamat, Denis Malvy, Mathieu Nacher
Background: Identifying patients at risk of developing severe dengue is challenging. The objective of the present study was to determine the incidence of hypotension and its predictive factors during the Dengue 2 epidemic in 2013. Methods: In 2013, a longitudinal study was performed using data from all confirmed cases of dengue seen in Cayenne General Hospital. The analysis used Cox proportional modeling to obtain adjusted hazards ratios for hypotension. Results: A total of 806 confirmed patients were included 78 (9...
December 1, 2016: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28933137/rectal-perforation-in-a-42-year-old-woman-due-to-henoch-sch%C3%A3-nlein-purpura-a-case-report
#2
F Almassinokiani, A Mehdizadeh Kashi, A Musavi, S Khodaverdi, K Tahermanesh, S Ariana
Henoch-Schönlein purpura (HSP) is caused by deposition of IgA-containing immune complexes within the blood vessels. HSP mostly occurs in children and is less common in adults. In addition to palpable purpura, arthritis or arthralgia, renal disease and abdominal pain, gastrointestinal symptoms occur in 50% of children. These can be caused by gastrointestinal hemorrhage, bowel ischemia and necrosis, intussusception, and bowel perforation. In adults, intussusception is less frequent than in children. We report a 42-year-old woman referred to our hospital with acute abdominal pain...
September 21, 2017: Reumatismo
https://www.readbyqxmd.com/read/28932128/a-suspected-case-of-autoinduction-of-voriconazole-metabolism-in-a-patient-with-cerebral-aspergillosis
#3
Martin J Ferguson, Maria L Randles, Declan G de Freitas
OBJECTIVE: This study aims to report a case of accelerated metabolism of voriconazole in a patient with cerebral aspergillosis. CASE SUMMARY: A 36-year-old woman developed cerebral aspergillosis after immunosuppressive treatment for suspected atypical hemolytic uremic syndrome/thrombotic thrombocytopenic purpura. She was treated with voriconazole using therapeutic drug monitoring to guide dosing. After an initial high level, her dose was reduced, but over the following weeks, she required several dose increases in order to achieve a voriconazole level within the target range...
2017: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/28930759/intravenous-immunoglobulin-induced-profound-bradycardia-in-a-patient-with-idiopathic-thrombocytopenic-purpura
#4
Hitesh Raheja, Vivek Kumar, Gerald Hollander, Jacob Shani, Yisachar Greenberg
No abstract text is available yet for this article.
September 7, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28930575/the-role-of-t-cells-in-the-development-of-henoch-schonlein-purpura
#5
Yanlin Li, Yiping Zhou, Diqing Zhu, Yongqing Wang
Henoch-Schonlein purpura (HSP) is an IgA-mediated disorder that most commonly occurs in children. Its etiology and pathogenesis remain unknown. In recent years, numerous studies have pointed to a dysfunction of T cells in the pathogenesis of HSP. Here, we will review the epidemiology, clinical and molecular characteristics of HSP, as well as abnormalities of Th cell subsets in this disorder. Finally, we will discuss the key factors that are involved in Th cell differentiation as potential novel targets for the prevention and treatment of HSP...
January 1, 2018: Frontiers in Bioscience (Landmark Edition)
https://www.readbyqxmd.com/read/28929493/pediatric-vasculitis-a-single-center-experience
#6
Alexios Alexopoulos, Maria Dakoutrou, Kalliopi Stefanaki, George Chrousos, Talia Kakourou
BACKGROUND: Existing studies of children with vasculitis are limited. The aim of this study was to assess the epidemiology, clinical manifestations, laboratory findings, course, and outcome of Greek children presenting with vasculitic rash. METHODS: The relevant data included in the study were collected retrospectively using a standardized form from children who were admitted into our department between 2003 and 2013, with the provisional diagnosis of vasculitis of the skin...
September 19, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28919104/elevated-urinary-monocyte-chemoattractant-protein-1-levels-in-children-with-henoch-schonlein-purpura-nephritis
#7
Jiapei Wang, Qianqian Ying, Shiling Zhong, Yuanling Chen, Yazhen Di, Xiahua Dai, Jika Zheng, Mengjiao Shen
BACKGROUND: Chemokine monocyte chemoattractant protein-1 (MCP-1) has been proved as a potential urinary biomarker in nephropathies. The aim of this study was to investigate the urinary monocyte chemoattractant protein-1 (MCP-1) levels and clinical significance in Henoch-Schonlein purpura (HSP) children with and without nephritis and determine the association of MCP-1 with proteinuria. METHODS: A total of 261 HSP children-with or without nephritis-and 84 healthy control children were enrolled in this study...
August 26, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28918161/clinical-and-pathological-significance-of-cutaneous-manifestations-in-anca-associated-vasculitides
#8
REVIEW
Laure Frumholtz, Sara Laurent-Roussel, Olivier Aumaître, François Maurier, Guillaume Le Guenno, Agnes Carlotti, Alexiane Dallot, Jean Louis Kemeny, Laurent Antunes, Nicolas Froment, Sylvie Fraitag, Jonathan London, Alice Berezne, Benoît Terris, Claire Le Jeunne, Luc Mouthon, Selim Aractingi, Loïc Guillevin, Nicolas Dupin, Benjamin Terrier
OBJECTIVES: Cutaneous manifestations (CM) in ANCA-associated vasculitides (AAV) are frequent, but data on clinical significance and clinical-pathological correlations are lacking. METHODS: We conducted a multicenter, retrospective study including 1553 AAV patients. Clinical, biological and pathological features have been analyzed, and tissue samples from 46 biopsies were reviewed in a blind manner. RESULTS: CM were more frequent in EGPA (53...
September 14, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28915952/iga-nephropathy-during-treatment-with-tnf-alpha-blockers-could-it-be-predicted
#9
Vito Di Lernia
Immunoglobulin A (IgA) nephropathy (IgAN) may sometimes be related to exposure to pharmacological agents, among which anti-Tumor Necrosis Factor (TNF)-alpha agents. The characteristic pathological feature is a deposition of IgA-containing immune complexes in vessel walls in the kidney mesangium. The link between TNF-alpha blockers and IgAN may be hypothesized examining diseases which share pathologic features. In this respect, idiopathic IgAN and Henoch Schonlein Purpura have been the object of studies revealing a pathogenetic role of aberrant glycosylation of IgA1 molecules...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28915308/mutilating-purpura-fulminans-in-an-adult-with-meningococcal-sepsis
#10
María Elena Arnáiz-García, Ana María Arnáiz-García, Francisco Gutierrez-Diez, Juan Francisco Nistal, Jose María González-Santos, Ivana Pulitani, Carlos Amado-Diago, Javier Arnáiz
We report a dramatic case of meningococcal sepsis manifesting as purpura fulminans in an elderly diabetic woman. Hemodynamic instability and severe bilateral cutaneous lesions involving her hands and feet developed rapidly. Specific antibiotic therapy and the administration of inotropic and vasopressor drugs were initiated. The severity and extension of the cutaneous lesions (attributed to purpura fulminans) worsened because of the need for vasoconstrictors for the treatment of septic shock. Bilateral transmetatarsal and metacarpal amputations were required to stabilize the patient...
September 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28913747/primary-sj%C3%A3-gren-s-syndrome-extraglandular-manifestations-and-hydroxychloroquine-therapy
#11
J Demarchi, S Papasidero, M A Medina, D Klajn, R Chaparro Del Moral, O Rillo, V Martiré, G Crespo, A Secco, A Catalan Pellet, C Amitrano, C Crow, C Asnal, P Pucci, F Caeiro, N Benzanquen, J P Pirola, M Mayer, F Zazzetti, S Velez, J Barreira, N Tamborenea, L Santiago, L Raiti
The use of hydroxychloroquine (HCQ) in Primary Sjögren's Syndrome (pSS) has been assessed in different studies over the last years, with conflicting results regarding its efficacy in sicca syndrome and extraglandular manifestations (EGM). The goal of this study was to compare the incidence rate of EGM in pSS patients with and without HCQ therapy.We performed a multicenter retrospective study, including patients with pSS (European classification criteria) with at least 1 year of follow-up. Subjects with concomitant fibromyalgia, autoimmune hepatitis, primary biliary cirrhosis, and primary sclerosing cholangitis were excluded...
September 14, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28906353/immunomodulatory-treatments-for-persistent-and-chronic-immune-thrombocytopenic-purpura-a-prisma-compliant-systematic-review-and-meta-analysis-of-28-studies
#12
REVIEW
Emmanuelle Weber, Quitterie Reynaud, Romain Fort, Stéphane Durupt, Pascal Cathébras, Isabelle Durieu, Jean-Christophe Lega
BACKGROUND: Corticosteroid sparing is required in 15% to 40% of adults with persistent or chronic primary immune thrombocytopenic purpura (ITP). Herein, the efficacy of immunomodulatory drugs (dapsone, interferon alpha, danazol, and hydroxychloroquine as second-third-line therapies in ITP is investigated. METHODS: MEDLINE was searched for studies that included patients with persistent or chronic primary ITP and published before the end of December 2014. Two investigators independently extracted data regarding study design, patient characteristics, dosage schedule, time to response, and occurrence of adverse events...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28905155/association-of-tlr4-gene-polymorphisms-with-childhood-henoch-sch%C3%A3-nlein-purpura-in-a-chinese-population
#13
Hui Xu, Guizhen Jiang, Hongqiang Shen, Wei Li, Jianhua Mao, Yanxiang Pan
Recent studies demonstrated that aberrant activation of Toll-like receptor (TLR) 4 was involved in the pathogenesis of Henoch-Schönlein purpura (HSP). In this study, we evaluated the association between TLR4 gene polymorphisms and the risk of childhood HSP in a Chinese population. A total of 175 HSP patients and 186 controls were recruited in this case-control study. Three single-nucleotide polymorphisms of the TLR4 gene (rs1927914, rs10759932 and rs1927907) were genotyped using the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and Sequenom MassARRAY system...
September 13, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28904490/dengue-and-thrombotic-thrombocytopenic-purpura
#14
Viroj Wiwanitkit
No abstract text is available yet for this article.
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28904488/thrombotic-thrombocytopenic-purpura-or-disseminated-intravascular-coagulation
#15
Ashok Kumar Pannu, Atul Saroch
No abstract text is available yet for this article.
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28900445/anaphylactoid-purpura-associated-with-streptococcal-cellulitis-a-case-report-and-literature-review
#16
Yuko Saito, Susumu Ookawara, Hisataka Uchima, Takeshi Ishida, Masafumi Kakei, Hitoshi Sugawara
A 54-year-old Japanese man noticed painful swelling and redness of his left leg. He was admitted for treatment of cellulitis, which was accompanied with increased anti-streptolysin O and anti-streptokinase titers in his clinical course. After Piperacillin/Tazobactam administration, the skin lesion resolved. However, the patient then developed arthritis, palpable purpura, and intermittent abdominal pain, later found to be secondary to a severe duodenal ulcer. He was diagnosed with cellulitis-associated anaphylactoid purpura and was given prednisolone, which dramatically improved his symptoms...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28899471/-a-report-of-two-children-with-fever-headache-and-purpura
#17
Hong-Bo Xu, Mei Tan, Jian Lu, Mao-Qiang Tian, Yan Chen
In this study, two school-aged children had an acute onset in spring and had the manifestations of fever, headache, vomiting, disturbance of consciousness, purpura and ecchymosis, and positive meningeal irritation sign. There were increases in peripheral white blood cells and neutrophils, but reductions in the hemoglobin level and platelet count in the two children. They had a significant increase in C-reactive protein. There were hundreds or thousands of white blood cells in the cerebrospinal fluid, mainly neutrophils...
September 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28895035/splenectomy-vs-rituximab-as-a-second-line-therapy-in-immune-thrombocytopenic-purpura-a-single-center-experience
#18
Ahmed S Al Askar, Naila A Shaheen, Mohsen Al Zahrani, Mohammed G Al Otaibi, Bader S Al Qahtani, Faris Ahmed, Mohand Al Zughaibi, Ismat Kamran, May Anne Mendoza, Altaf Khan
Immune thrombocytopenic purpura (ITP) is a common hematological disease treated primarily by corticosteroids. The aim of the present study was to compare response rate between patients, underwent splenectomy vs. rituximab as second-line therapy. Adult patients diagnosed with ITP who did not respond to corticosteroids or relapsed during the period 1990-2014 were included in a quasi-experimental study. Categorical variables were compared using Fisher exact test. Response to treatment was compared using logistic regression...
September 11, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28894769/severe-mitral-regurgitation-in-a-child-with-henoch-sch%C3%A3-nlein-purpura-and-pulmonary-hemorrhage
#19
Cornelius A James, Ismael Gonzalez, Paras Khandhar, Bishara J Freij
Introduction: Henoch-Schönlein purpura (HSP) is the most common vasculitis of childhood. The classic triad of HSP consists of nonthrombocytopenic purpura, arthritis/arthralgia, and gastrointestinal complaints. Pulmonary hemorrhage and cardiac involvement are rare complications of HSP. Case Report: We report the case of a 10-year-old girl with HSP complicated by both severe mitral regurgitation and pulmonary hemorrhage. Discussion: HSP is typically a self-limited illness with an excellent prognosis in children...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28893804/immune-thrombocytopenic-purpura-associated-with-fingolimod
#20
Hiu Lam Agnes Yuen, Susan Brown, Noel Chan, George Grigoriadis
Fingolimod is an oral sphingosine-1-phosphate receptor modulator which causes lymphocyte sequestration in lymph nodes and is approved for relapsing multiple sclerosis. The Therapeutic Goods Administration of Australia is aware of only one case where fingolimod preceded immune thrombocytopenic purpura (ITP) by 5 weeks. Here we report three such cases.None were on any medications known to cause ITP and routine investigations were unremarkable. All cases were treated with immunosuppression. Case 1 successfully weaned prednisolone after fingolimod cessation whereas case 2 weaned slowly while continuing fingolimod therapy...
September 11, 2017: BMJ Case Reports
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