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https://www.readbyqxmd.com/read/28820175/noninvasive-mechanical-ventilation-in-early-acute-respiratory-distress-syndrome
#1
Alice Grassi, Giuseppe Foti, John G Laffey, Giacomo Bellani
Non invasive ventilation (NIV) has a well established role in the treatment of acute-on-chronic respiratory failure and cardiogenic pulmonary oedema. Its role in acute hypoxaemic respiratory failure has been increasingly investigated, but its impact on the management and the outcome of the subset of patients affected by acute respiratory distress syndrome (ARDS) is still to be determined. ARDS could be a risk factor for NIV failure and in these patient delayed endotracheal intubation can lead to an increased mortality...
August 17, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28818763/the-qualitative-and-quantitative-image-analysis-of-mr-imaging-in-patients-with-acute-on-chronic-liver-failure
#2
Tae Wook Kang, Mimi Kim, Young Kon Kim, Seong Hyun Kim, Dong Hyun Sinn, Kyunga Kim
PURPOSE: To evaluate the distinctive features of ACLF and chronic liver disease (CLD) on MR images using quantitative and qualitative analyses. METHODS: Twelve patients with ACLF and 36 patients with CLD who had undergone MR images were included. MR imaging findings from both groups were assessed. RESULTS: Gallbladder edema, esophageal varix, and ascites were significantly more prevalent in the ACLF group (all P-values <0.05). The liver to muscle SI ratio on T2-WI was significantly higher in the ACLF group (P=0...
August 10, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28818164/outcome-in-chronic-subdural-hematoma-after-subdural-vs-subgaleal-drain
#3
Asim Ishfaq
OBJECTIVE: To compare the outcome after surgery for chronic subdural hematoma when the drain is placed in subdural space or subgaleal space. STUDY DESIGN: Quasi experimental study. PLACE AND DURATION OF STUDY: Combined Military Hospital, Lahore, from July 2015 to June 2016. METHODOLOGY: Patients with chronic subdural hematoma of both genders and age, ranging between 55 to 85 years, were included. Patients on antiplatelet/anticoagulant therapy and acute on chronic subdural hematoma were excluded...
July 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28811718/chronic-liver-failure-consortium-acute-on-chronic-liver-failure-and-acute-decompensation-scores-predict-mortality-in-brazilian-cirrhotic-patients
#4
Rafael Veiga Picon, Franciele Sabadin Bertol, Cristiane Valle Tovo, Ângelo Zambam de Mattos
AIM: To validate prognostic scores for acute decompensation of cirrhosis and acute-on-chronic liver failure in Brazilian patients. METHODS: This is a prospective cohort study designed to assess the prognostic performance of the chronic liver failure-consortium (CLIF-C) acute decompensation score (CLIF-C AD) and CLIF-C acute-on-chronic liver failure score (CLIF-C ACLF), regarding 28-d and 90-d mortality, as well as to compare them to other prognostic models, such as Model for End-Stage Liver Disease (MELD), MELD Sodium (MELD-Na), Child-Pugh (CP) score, and the CLIF-C Organ Failure score (CLIF-C OF)...
July 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28808210/acute-on-chronic-liver-failure-recent-update
#5
Azeem Alam, Ka Chun Suen, Daqing Ma
Acute on chronic liver failure (ACLF) was first described in 1995 as a clinical syndrome distinct to classic acute decompensation. Characterized by complications of decompensation, ACLF occurs on a background of chronic liver dysfunction and is associated with high rates of organ failure and significant short-term mortality estimated between 45% and 90%. Despite the clinical relevance of the condition, it still remains largely undefined with continued disagreement regarding its precise etiological factors, clinical course, prognostic criteria and management pathways...
January 19, 2017: Journal of Biomedical Research
https://www.readbyqxmd.com/read/28808200/acute-on-chronic-liver-failure-recent-update
#6
Azeem Alam, Ka Chun Suen, Daqing Ma
Acute on chronic liver failure (ACLF) was first described in 1995 as a clinical syndrome distinct to classic acute decompensation. Characterized by complications of decompensation, ACLF occurs on a background of chronic liver dysfunction and is associated with high rates of organ failure and significant short-term mortality estimated between 45% and 90%. Despite the clinical relevance of the condition, it still remains largely undefined with continued disagreement regarding its precise etiological factors, clinical course, prognostic criteria and management pathways...
July 13, 2017: Journal of Biomedical Research
https://www.readbyqxmd.com/read/28796408/use-of-the-anion-gap-and-intermittent-hemodialysis-following-continuous-hemodiafiltration-in-extremely-high-dose-acute-on-chronic-lithium-poisoning-a-case-report
#7
Yohei Komaru, Ryota Inokuchi, Yoshihiro Ueda, Masaomi Nangaku, Kent Doi
A 35-year-old woman intentionally took 40,000 mg of lithium carbonate, and she was transferred to our hospital with nausea, vomiting, and diarrhea. She was diagnosed as having bipolar disorder 10 years ago and was receiving oral lithium therapy. Blood test results on arrival were remarkable for a negative anion gap of -2.1 and later, the serum lithium level turned out to be as high as 15.4 mEq/L. Intubation was required because of disrupted consciousness, and continuous hemodiafiltration (CHDF) was immediately started in the intensive care unit to obtain constant removal of lithium...
August 10, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28790094/gallstone-ileus-of-the-duodenum-an-unexpected-presentation-of-bouveret-s-syndrome
#8
Neil Tindell, Kayla Holmes, David Marotta
This report describes a patient who presented with a large gallstone obstructing the duodenal bulb, with the chief complaint of acute on chronic abdominal pain. Classically, this is known as Bouveret's syndrome or a gallstone ileus of the duodenum. Our patient's current health status presented a challenge, with the presence of several comorbidities, particularly a large abdominal aortic aneurism. We chose an open procedure for this reason. The stone was removed through a laparotomy, and the cholecystoduodenal fistula that the stone used to pass into the small bowel was repaired...
August 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28780608/sx-ella-stent-danis-effectively-controls-refractory-variceal-bleed-in-patients-with-acute-on-chronic-liver-failure
#9
Rakhi Maiwall, Kapil Dev Jamwal, Ankit Bhardwaj, Ajeet Singh Bhadoria, Jaswinder Singh Maras, Guresh Kumar, Ankur Jindal, Ashok Choudhury, Lovkesh Anand, Amrish Sahney, Awinash Kumar, Manoj Kumar Sharma, Barjesh Chander Sharma, Shiv Kumar Sarin
BACKGROUND AND AIMS: Almost 10% of bleeding episodes are refractory to combination of vasoactive agent and endotherapy, and are associated with a mortality up to 50%. Severity of liver disease and high portal pressure are mainly responsible for it. TIPS cannot be used in these patients due to high MELD score. We aimed to evaluate the efficacy of self-expandable DE stents for control of refractory variceal bleeds in patients with ACLF. METHODS: Acute-on-chronic liver failure patients (n = 88, mean age 47...
August 5, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28772056/right-ventricular-temporal-assist-device-for-cardiac-recompensation
#10
Isabell Yan, Hanno Grahn, Stefan Blankenberg, Dirk Westermann
In this case report, we discuss treatment of a 66-year-old patient with right heart failure due to chronic left heart failure caused by ischemic cardiomyopathy. We decided to manage this patient by implanting a temporary right ventricular assist device (Impella RP®) as a novel therapeutic option for acute on chronic right heart decompensation.
August 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28764249/bile-duct-adenocarcinoma-with-acute-on-chronic-pancreatitis-a-rare-complication-of-long-standing-choledochal-cyst
#11
Ashish Gupta, Lileswar Kaman
No abstract text is available yet for this article.
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28763848/-clinical-significance-of-peripheral-cortisol-level-in-patients-with-hepatitis-b-virus-related-acute-on-chronic-liver-failure
#12
F R Jie, R J Zheng, Z R Deng, K J Pan, L B Y Luli, L Tang, X B Lu
No abstract text is available yet for this article.
May 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28751632/extracorporeal-membrane-oxygenation-support-for-rituximab-induced-acute-respiratory-distress-syndrome-in-an-abo-incompatible-living-donor-liver-transplant-recipient-successful-management-of-a-rare-complication-and-a-review-of-the-literature
#13
Ping-Chun Li, Ashok Thorat, Shih-Chao Hsu, Kin-Shing Poon, Horng-Ren Yang, Te-Hung Chen, Chun-Chieh Yeh, Long-Bin Jeng
BACKGROUND Rituximab is commonly used to reduce the agglutinin titer in ABO-incompatible liver transplant recipients. Although well-tolerated, rituximab infusion therapy may result in severe pulmonary adverse effects such as drug-induced pneumonitis, leading to acute respiratory distress syndrome (ARDS), which has a high mortality rate. Management of such rare cases in an ABO-incompatible patient has never been described before. Herein, we present successful use of extracorporeal membrane oxygenation (ECMO) support for rituximab-induced ARDS in an ABO-incompatible living donor liver transplantation (LDLT) recipient...
July 28, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28750542/clinical-presentation-predictors-and-outcomes-among-mineralocorticoid-receptor-antagonist-mra-eligible-acute-heart-failure-patients-in-the-heart-function-assessment-registry-trial-in-saudi-arabia-hearts
#14
Mostafa Q AlShamiri, Khalid F AlHabib, Waleed AlHabeeb, Ismail R Raslan, Anhar Ullah, Abdelfatah A Elasfar, Fayez Alshaer, Hanan Albackr, Layth Mimish, Ali Almasood, Saleh AlGhamdi, Abdullah Ghabashi
Mineralocorticoid receptor antagonist (MRA) therapy is indicated after myocardial infarction in patients with acute heart failure (AHF) with an ejection fraction ≤40% and lacking contraindications. We analyzed clinical presentations, predictors, and outcomes of MRA-eligible patients within a prospective registry of patients with AHF from 18 hospitals in Saudi Arabia, from 2009 to 2010. For this subgroup, mortality rates were followed until 2013, and the clinical characteristics, management, predictors, and outcomes were compared between MRA-treated and non-MRA-treated patients...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28737066/%C3%AE-blockade-in-heart-failure-with-reduced-ejection-fraction-does-heart-rate-control-influence-readmissions
#15
Ryan E Owens, Jennifer D Twilla, Timothy H Self, Abdulrahman I Alshaya, Carlvin J Metra, Carolyn Cummings, Carrie S Oliphant
BACKGROUND: Raised resting heart rate (HR), >70 beats per minute (bpm), has been shown to be a risk factor for adverse cardiovascular outcomes and hospital readmissions, specifically in patients with heart failure with reduced ejection fraction (HF rEF). Given their mortality benefit, β-blockers are recommended in HF rEF, with a goal to titrate to a maximum tolerated dose rather than a specific HR target. OBJECTIVE: To determine the impact of optimal HR control achievement prior to hospital discharge on hospital readmissions in patients with HF rEF receiving β-blockade...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28734330/acute-on-chronic-retinal-artery-occlusion-following-retinal-vein-occlusion
#16
Kelly Z Young, Vaidehi S Dedania, Rajesh C Rao
No abstract text is available yet for this article.
August 2017: Ophthalmology
https://www.readbyqxmd.com/read/28733221/incidence-predictors-and-outcomes-of-acute-on-chronic-liver-failure-in-outpatients-with-cirrhosis
#17
Salvatore Piano, Marta Tonon, Elia Vettore, Marialuisa Stanco, Chiara Pilutti, Antonietta Romano, Sara Mareso, Carmine Gambino, Alessandra Brocca, Antonietta Sticca, Silvano Fasolato, Paolo Angeli
BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) is the most life-threatening complication of cirrhosis. Prevalence and outcomes of ACLF have been recently described in hospitalized patients with cirrhosis. However, no data is currently available on the prevalence and the risk factors of ACLF in outpatients with cirrhosis. The aim of this study was to evaluate incidence, predictors and outcomes of ACLF in a large cohort of outpatients with cirrhosis. METHODS: 466 patients with cirrhosis consecutively evaluated in a tertiary hospital outpatient clinic were included and followed up until death and/or liver transplantation for a mean of 45±44 months...
July 18, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28730699/elevated-cardiac-troponin-t-in-cirrhotic-patients-with-emergency-care-admissions-is-associated-with-mortality
#18
Mayada Elnegouly, Katrin Umgelter, Wajima Safi, Alexander Hapfelmeier, Roland M Schmid, Andreas Umgelter
BACKGROUND & AIMS: Mortality of cirrhotic patients after emergency care admission is high and prognostic factors can help in prioritizing patients. The aim of our study was to assess the association between levels of cardiac Troponin T (cTnT) and one-year mortality in patients with liver cirrhosis without known cardiac disease, who were admitted to the emergency department (ED). METHODS: All patients with cirrhosis presented to the ED from October 2009 until August 2015 who had an initial cTnT value measured with the first lab-panel were retrospectively analyzed with a follow-up of 365 days...
July 20, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28724791/mitochondrial-dna-enriched-microparticles-promote-acute-on-chronic-alcoholic-neutrophilia-and-hepatotoxicity
#19
Yan Cai, Ming-Jiang Xu, Erik H Koritzinsky, Zhou Zhou, Wei Wang, Haixia Cao, Peter St Yuen, Ruth A Ross, Robert A Star, Suthat Liangpunsakul, Bin Gao
Over the last several years, one of the major advances in the field of alcoholic liver disease research was the discovery that binge alcohol consumption induced neutrophilia and hepatic neutrophil infiltration in chronically ethanol-fed mice and human subjects with excessive alcohol use (EAU); however, the underlying mechanisms remain obscure. Here, we demonstrated that chronic EAU patients with a history of recent excessive drinking (EAU + RD) had higher serum levels of mitochondrial DNA (mtDNA)-enriched microparticles (MPs) than EAU without recent drinking (EAU - RD) and healthy controls, which correlated positively with circulating neutrophils...
July 20, 2017: JCI Insight
https://www.readbyqxmd.com/read/28706962/posttransplant-lymphoproliferative-disorder-of-the-small-bowel-as-an-unexpected-cause-of-iron-deficiency-anemia-decades-after-heart-transplantation
#20
Amanda Siegel, Justin Boike, Itishree Trivedi, Rena Yadlapati
Although rare, gastrointestinal posttransplant lymphoproliferative disorder (PTLD) can lead to abdominal pain or gastrointestinal bleeding in patients with a history of solid-organ transplantation. We describe a case of isolated gastrointestinal PTLD in a patient who presented with acute on chronic iron deficiency anemia 26 years after heart transplant. A comprehensive endoscopic evaluation with video capsule endoscopy and small bowel enteroscopy revealed a large cratered ulceration in the small bowel with abnormal mucosal changes, which led to the diagnosis of PTLD...
2017: ACG Case Reports Journal
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