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https://www.readbyqxmd.com/read/28426384/a-2-year-old-boy-with-circulatory-failure-owing-to-streptococcal-toxic-shock-syndrome-case-report
#1
Werner Keenswijk, Johan Vande Walle
A 2-year-old boy presented with severe hypotension and acute kidney injury after a prodrome of non-bloody diarrhoea and fever in the preceding 3 days. He had a mild Ebstein cardiac anomaly but otherwise a normal past history and growth. On examination, he looked ill, his temperature was 37.5 °C, circulation was poor, and there were several purpuric lesions on the face, hands and scrotum. Haemoglobin was 7.8 g/dL (11-14), total white cell count 27 × 10(9)/L, platelets 62 × 10(9)/L, blood urea nitrogen 20...
April 20, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28265980/outcomes-in-elderly-patients-admitted-to-the-intensive-care-unit-with-solid-tumors
#2
Edouard Auclin, Anaïs Charles-Nelson, Baptiste Abbar, Emmanuel Guérot, Stéphane Oudard, Caroline Hauw-Berlemont, Constance Thibault, Alexandra Monnier, Jean-Luc Diehl, Sandrine Katsahian, Jean-Yves Fagon, Julien Taieb, Nadia Aissaoui
BACKGROUND: As the population ages and cancer therapies improve, there is an increased call for elderly cancer patients to be admitted to the intensive care unit (ICU). This study aimed to assess short-term survival and prognostic factors in critically ill patients with solid tumors aged ≥65 years. METHODS: We conducted a retrospective study. The primary endpoint was ICU mortality. Resumption of anticancer therapy in patients who survived the ICU stay and 90-day mortality were secondary endpoints...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28141912/high-volume-haemofiltration-for-sepsis-in-adults
#3
REVIEW
Emma Mj Borthwick, Christopher J Hill, Kannaiyan S Rabindranath, Alexander P Maxwell, Danny F McAuley, Bronagh Blackwood
BACKGROUND: Severe sepsis and septic shock are leading causes of death in the intensive care unit (ICU), despite advances in the treatment of patients with severe sepsis and septic shock, including early recognition, appropriate treatment with antibiotics and support of organs that may have been affected by the illness. High-volume haemofiltration (HVHF) is a blood purification technique that may improve outcomes in severe sepsis or septic shock. The technique of HVHF has evolved from renal replacement therapies used in the ICU to treat critically ill patients with acute kidney injury (AKI)...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27998917/national-trends-and-impact-of-acute-kidney-injury-requiring-hemodialysis-in-hospitalizations-with-atrial-fibrillation
#4
Lili Chan, Swati Mehta, Kinsuk Chauhan, Priti Poojary, Sagar Patel, Sumeet Pawar, Achint Patel, Ashish Correa, Shanti Patel, Pranav S Garimella, Narender Annapureddy, Shiv Kumar Agarwal, Umesh Gidwani, Steven G Coca, Girish N Nadkarni
BACKGROUND: Atrial fibrillation (AF) is a common cause for hospitalization, but there are limited data regarding acute kidney injury requiring dialysis (AKI-D) in AF hospitalizations. We aimed to assess temporal trends and outcomes in AF hospitalizations complicated by AKI-D utilizing a nationally representative database. METHODS AND RESULTS: Utilizing the Nationwide Inpatient Sample, AF hospitalizations and AKI-D were identified using diagnostic and procedure codes...
December 20, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27867668/a-rare-clinical-course-of-seronegative-pulmonary-renal-syndrome
#5
M Fröhlich-Gildhoff, W J Jabs, C Berhold, M K Kuhlmann, U Ketterer, S Kische, H Ince
Purpose. Pulmonary-renal syndrome (PRS) is characterized by diffuse alveolar hemorrhage and rapidly progressive glomerulonephritis mainly due to autoimmune etiologies. Seronegative PRS is a challenging entity to the clinician, since early diagnosis may be missed leading to delayed appropriate treatment. Materials and Methods. We present the clinical course of a 77-year-old patient who was admitted under the suspected diagnosis of pneumogenic sepsis and septic renal failure with fever, dyspnea, and elevated CRP levels...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27866651/cardiac-surgery-in-patients-with-previous-hepatic-or-renal-transplantation-a%C3%A2-pair-matched-study
#6
Mina Farag, Marina Nikolic, Rawa Arif, Bastian Schmack, Anton Sabashnikov, Mohamed Zeriouh, Aron-Frederik Popov, Arjang Ruhparwar, Matthias Karck, Alexander Weymann
BACKGROUND: The objective of this study was to compare outcomes of patients with previous solid organ transplant with those of a pair-matched population. METHODS: Data from our prospectively maintained cardiac surgery registry were obtained and identified 70 transplant recipients (21 hepatic, 49 renal) who were operated on at our department of cardiac surgery between 2000 and 2013; they formed the transplant group. Those patients were pair-matched regarding age, sex, and cardinal cardiac risk factors to form the pair-matched group...
November 17, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27738086/peritoneal-dialysis-related-peritonitis-due-to-melioidosis-a-potentially-devastating-condition
#7
Talerngsak Kanjanabuch, Nuttha Lumlertgul, Lachlan J Pearson, Tanittha Chatsuwan, Krit Pongpirul, Asada Leelahavanichkul, Nisa Thongbor, Gunticha Nuntawong, Laksamon Praderm, Pantiwa Wechagama, Surapong Narenpitak, Apinya Wechpradit, Worauma Punya, Guttiga Halue, Phetpailin Naka, Somboon Jeenapongsa, Somchai Eiam-Ong
♦ Background: Melioidosis, an infectious disease caused by Burkholderia pseudomallei, is endemic in Southeast Asia and Northern Australia. Although a wide range of clinical manifestations from this organism are known, peritonitis associated with peritoneal dialysis (PD) has rarely been reported. ♦ Patients and Methods: Peritoneal dialysis patients from all regions in Thailand were eligible for the study if they had peritonitis and either peritoneal fluid or effluent culture positive for B.pseudomallei Patient data obtained included baseline characteristics, laboratory investigations, treatments, and clinical outcomes...
October 13, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27611620/acute-kidney-injury-in-burn-patients-clinically-significant-over-the-initial-hospitalization-and-1-year-after-injury-an-original-retrospective-cohort-study
#8
Samih Z Thalji, Anai N Kothari, Paul C Kuo, Michael J Mosier
OBJECTIVE: To examine the development of acute kidney injury (AKI) after burn injury as an independent risk factor for increased morbidity and mortality over initial hospitalization and 1-year follow-up. BACKGROUND: Variability in fluid resuscitation and difficulty recognizing early sepsis are major barriers to preventing AKI after burn injury. Expanding our understanding of the burden AKI has on the clinical course of burn patients would highlight the need for standardized protocols...
September 8, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27487001/hemodiafiltration-decreases-serum-levels-of-inflammatory-mediators-in-severe-leptospirosis-a-prospective-study
#9
Sérgio Aparecido Cleto, Camila Eleutério Rodrigues, Ceila Maria Malaque, Jaques Sztajnbok, Antônio Carlos Seguro, Lúcia Andrade
BACKGROUND: Leptospirosis is a health problem worldwide. Its most severe form is a classic model of sepsis, provoking acute respiratory distress syndrome (ARDS) and acute kidney injury (AKI), with associated mortality that remains unacceptably high. We previously demonstrated that early initiation of sustained low-efficiency dialysis (SLED) followed by daily SLED significantly decreases mortality. However, the mode of clearance can also affect dialysis patient outcomes. Therefore, the objective of this study was to compare the effects of SLED with traditional (diffusive) clearance, via hemodialysis, and SLED with convective clearance, via hemodiafiltration (SLEDf), in patients with severe leptospirosis...
2016: PloS One
https://www.readbyqxmd.com/read/27461794/impact-of-body-mass-index-on-outcomes-in-cardiac-surgery
#10
Mei Gao, Jianzhong Sun, Nilas Young, Douglas Boyd, Zane Atkins, Zhongmin Li, Qian Ding, James Diehl, Hong Liu
OBJECTIVES: Body mass index (BMI) commonly is used in obesity classification as a surrogate measure, and obesity is associated with a cluster of risk factors for cardiovascular disease. The aim of this study was to investigate the impact of BMI on short-term outcomes after cardiac surgery. DESIGN: A retrospective cohort study. SETTING: University teaching hospital, 2 centers. PARTICIPANTS: The study comprised 4,740 patients who underwent cardiac surgery at 2 hospitals-from July 1, 2001, to June 30, 2013, in 1 hospital and from September 1, 2003, to August 31, 2014, in a second hospital...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27443245/calciphylaxis-a-case-study-in-a-patient-with-maori-heritage
#11
Lawrence Kingi, Roger Grech, Michael Lam, Ajith Dissanayake, Simon Otter
This case history describes a rare complaint - Calciphylaxis, seen in a New Zealand Maori patient undergoing renal dialysis. This condition causes non-healing tissue ulceration, typically with sepsis and is associated with a very high mortality rate. The need for vigilance among health professionals is highlighted, including the risk factors that may faciliate an early diagnosis; together with the value associated with a multi-disciplinary team approach to management.
November 2016: Journal of Tissue Viability
https://www.readbyqxmd.com/read/26785992/fulminant-hepatic-and-multiple-organ-failure-following-acute-viral-tonsillitis-a-case-report
#12
Ursina Bechtel-Grosch, Charles Beguelin, Sabina Berezowska, Jean-Francois Dufour, Jukka Takala, Joerg C Schefold
BACKGROUND: Pyogenic tonsillitis may often be observed in the general Western population. In severe cases, it may require antibiotic treatment or even hospitalization and often a prompt clinical response will be noted. Here we present an unusual case of progressive multiple organ failure including fulminant liver failure following acute tonsillitis initially mistaken for "classic" pyogenic (that is bacterial) tonsillitis. CASE PRESENTATION: A 68-year-old previously healthy white man was referred with suspicion of pyogenic angina...
January 20, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/26785093/adolescent-presents-with-altered-mental-status-and-elevated-anion-gap-after-suicide-attempt-by-ethylene-glycol-ingestion
#13
Jessica C Schoen, Meghan R Cain, Jeffrey A Robinson, Brenda M Schiltz, Mark S Mannenbach
We report the case of a 16-year-old healthy adolescent male who presented to the local emergency department with altered mental status. En route to a tertiary care facility, he began to decompensate and was found to be markedly acidotic. Further investigation revealed an elevated anion gap, and physical examination showed only abdominal pain and decreased level of consciousness. A broad differential diagnosis was considered at the time of the patient's presentation at the tertiary care center including ingestion of a volatile alcohol, sepsis, and an abdominal catastrophe...
October 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/26629810/neutrophil-gelatinase-associated-lipocalin-ngal-in-leptospirosis-acute-kidney-injury-a-multicenter-study-in-thailand
#14
MULTICENTER STUDY
Nattachai Srisawat, Kearkiat Praditpornsilpa, Kanitha Patarakul, Malee Techapornrung, Tinnapop Daraswang, Theerapon Sukmark, Kamol Khositrangsikun, Apinya Fakthongyoo, Petchdee Oranrigsupak, Laksamon Praderm, Ummarit Suwattanasilpa, Sadudee Peerapornratana, Passisd Loahaveeravat, Nattachai Suwachittanont, Thaksa-on Wirotwan, Chayanat Phonork, Sarinya Kumpunya, Khajohn Tiranathanagul, Chintana Chirathaworn, Somchai Eiam-ong, Kriang Tungsanga, Visith Sitprija, John A Kellum, Natavudh Townamchai
AKI is one of the most serious complications of leptospirosis, an important zoonosis in the tropics. Recently, NGAL, one of the novel AKI biomarkers, is extensively studied in various specific settings such as sepsis, cardiac surgery, and radiocontrast nephropathy. In this multicenter study, we aimed to study the role of NGAL as an early marker and an outcome predictor of leptospirosis associated AKI. Patients who presented with clinical suspiciousness of leptospirosis were prospectively enrolled in 9 centers from August 2012 to November 2014...
2015: PloS One
https://www.readbyqxmd.com/read/26613028/plasma-exchange-for-paediatric-kidney-disease-indications-and-outcomes-a-single-centre-experience
#15
Sudheer Kumar Reddy, Afsana Jahan, Swasti Chaturvedi, Indira Agarwal
BACKGROUND: Outcome data in paediatrics regarding the use of plasmapheresis for immunological kidney disease are scarce. OBJECTIVES: We aimed to evaluate the role of plasmapheresis in children presenting with severe renal impairment secondary to immunological kidney diseases. METHODS: A retrospective chart review of children admitted between January 2009 and August 2013 to the Paediatric Nephrology Unit, Christian Medical College, Vellore, India, and requiring plasma exchange was undertaken...
December 2015: Clinical Kidney Journal
https://www.readbyqxmd.com/read/26557553/analysis-of-vascular-access-in-haemodialysis-patients-single-center-experience
#16
R Hemachandar
BACKGROUND: Vascular access is the key in successful management of chronic haemodialysis (HD) patients. Though native arteriovenous fistula (AVF) is considered the access of choice, many patients in our country initiate haemodialysis through central venous catheter (CVC). There is paucity of data on vascular access in haemodialysis patients from southern India. AIM: Aim of the present study was to review our experience of vascular access in Haemodialysis patients (both central venous catheters and arteriovenous fistula) and to assess its success rate and common complications...
October 2015: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/26479450/acute-renal-failure-in-critically-ill-newborns-increases-the-risk-of-death-a-prospective-observational-study-from-india
#17
Ankur Patel, Deepak Sharma, Sweta Shastri, Pradeep Sharma
OBJECTIVE: To determine the incidence and risk factors of acute renal failure (ARF) in hospitalized critically ill neonates and analyze outcome of all neonates with renal failure in relation to risk factors. MATERIAL & METHODS: In this prospective observational study 815 infants were enrolled. Renal profile (blood urea and serum creatinine) was done after 12 h of life (or at the time of admission for outborn babies) and then every 12 hourly. Daily 24 h urine output was evaluated...
September 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/26184753/a-multicenter-experience-with-the-surgical-treatment-of-infected-abdominal-aortic-endografts
#18
MULTICENTER STUDY
Victor J Davila, William Stone, Audra A Duncan, Emily Wood, William D Jordan, Nicholas Zea, W Charles Sternbergh, Samuel R Money
OBJECTIVE: Single-center experiences with the treatment of infected endografts after endovascular aortic repair (I-EVAR) have been reported. We performed a multicenter review of the surgical care of these patients to elucidate short-term and long-term outcomes. METHODS: A retrospective analysis of all EVAR explants from 1997 to 2014 at four institutions was performed. Patients with I-EVAR undergoing surgical treatment were reviewed. Data were obtained detailing preoperative demographics, and postoperative morbidity and mortality...
October 2015: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/26180157/arterial-switch-for-transposition-of-the-great-arteries-with-large-ventricular-septal-defect-and-for-taussig-bing-anomaly-experience-from-a-tertiary-care-center-in-the-developing-world
#19
Mohammad Eliyas Patwary, Mohammad Shahbaz Khan, Ashutosh Marwah, Vishal Singh, Sudhir Shekhawat, Rajesh Sharma
BACKGROUND: Results of the arterial switch operation (ASO) for transposition of the great arteries (TGA) with large ventricular septal defect (VSD) and for Taussig Bing anomaly (TBA) in a tertiary care center of a developing country were retrospectively analyzed. METHODS: From January 2007 through June 2013, a total of 30 patients with TBA and 54 patients having TGA with large VSD underwent ASO with VSD closure. Age at surgery for TBA was 27 days to 7 years (median age 3 months) and for TGA with VSD it was 1 day to 6 years (median age 2 months)...
July 2015: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/25994843/-mortality-of-hematology-oncology-patients-with-neutropenia-in-intensivecare
#20
I Suárez, B Böll, A Shimabukuro-Vornhagen, G Michels, M von Bergwelt-Baildon, M Kochanek
BACKGROUND: Febrile neutropenia remains one of the most common reasons for hospital admission of patients with underlying oncologic disease. These patients have an up to 10-fold increased risk of developing sepsis, which often leads to these patients being transferred to the intensive care unit (ICU). The survival of neutropenic patients with sepsis in particular has improved in recent years, due to advanced therapy in intensive care (surviving sepsis campaign); however few large international studies of neutropenic cancer patients in the ICU are available...
March 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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