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https://www.readbyqxmd.com/read/29657372/targeted-interventions-in-critically-ill-children-with-severe-dengue
#1
Suchitra Ranjit, Gokul Ramanathan, Balasubramaniam Ramakrishnan, Niranjan Kissoon
Background: The World Health Organization guidelines provide suggestions on early recognition and treatment of severe dengue (SD); however, mortality in this group can be high and is related both to disease severity and the treatment complications. Subjects and Methods: In this prospective observational study, we report our results where standard therapy (ST) was enhanced by Intensive Care Unit (ICU) supportive measures that have proven beneficial in other conditions that share similar pathophysiology of capillary leak and fluid overload...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29619573/-idiopathic-systemic-capillary-leak-syndrome-clarkson-disease-a-rare-cause-of-recurrent-life-threatening-edema
#2
REVIEW
S Dasdelen, S-O Grebe
This case report describes the episodic occurrence of severe generalized edema in a young female patient, who developed hypertension with a massive hemoconcentration (hematocrit >0.5, hemoglobin >20g/dl) and hypoalbuminemia during the course of these acute disease phases. After the first two disease exacerbations were overcome, there was a complete regression of symptoms. After a long symptom-free interval, a new exacerbation occurred as a result of which critical organ ischemia occurred due to the severe hypotension and massive edema...
April 4, 2018: Der Internist
https://www.readbyqxmd.com/read/29584906/capillary-leak-syndrome-in-daboia-russelii-bite-a-complication-associated-with-poor-outcome
#3
Pradip P Kendre, Manoj P Jose, Abraham M Varghese, Jaideep C Menon, Joseph K Joseph
Background: Capillary leak syndrome (CLS) has been previously observed as a complication of Daboia russelii bite but not clearly defined or studied in length. This observational case-control study evaluates the mortality along with associated clinical and laboratory features. Methods: Twenty-five patients who developed CLS were compared with 25 patients without CLS following Daboia russelii (Russell's viper) bite. Results: Development of CLS is associated with a significantly high risk of mortality; 11 (44%) patients with CLS died compared with 1 (4%) control (odds ratio 18...
March 23, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29564922/recognition-and-management-of-idiopathic-systemic-capillary-leak-syndrome-an-evidence-based-review
#4
Noor Ul-Ain Baloch, Marvi Bikak, Abdul Rehman, Omar Rahman
INTRODUCTION: Idiopathic systemic capillary leak syndrome (SCLS) is a unique disorder characterized by episodes of massive systemic leak of intravascular fluid leading to volume depletion and shock. A typical attack of SCLS consists of prodromal, leak and post-leak phases. Complications, such as compartment syndrome and pulmonary edema, usually develop during the leak and post-leak phases respectively. Judicious intravenous hydration and early use of vasopressors is the cornerstone of management in such cases...
March 22, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29559757/successful-use-of-extracorporeal-life-support-in-a-hematopoietic-stem-cell-transplant-patient-with-neuroblastoma
#5
Feifei Z Williams, Atul Vats, Thomas Cash, James D Fortenberry
Respiratory failure associated with hematopoietic stem cell transplantation (HSCT) has been considered a contraindication for use of extracorporeal membrane oxygenation (ECMO) at many centers. We describe a child with neuroblastoma and hypoxemic respiratory failure following HSCT who was successfully managed with veno-venous (VV) ECMO. The patient was an 18-month-old female with high-risk neuroblastoma status post tumor resection, chemotherapy, autologous HSCT, and primary site radiation. On day 113 posttransplant while receiving maintenance immunotherapy, she had an acute respiratory decompensation because of rhinovirus, aspiration pneumonia, and capillary leak syndrome...
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29501285/impact-and-safety-of-open-lung-biopsy-in-patients-with-acute-respiratory-distress-syndrome-ards
#6
G Ortiz, M Garay, D Mendoza, P Cardinal-Fernández
INTRODUCTION: Acute respiratory distress syndrome (ARDS) is an inflammatory lung disorder, and its pathological hallmark is diffuse alveolar damage (DAD). Given that open lung biopsy (OLB) can sometimes result in severe side effects, it is rarely performed in patients with ARDS. AIM: The aims of this study were to describe: (a) the rate of treatment change associated with the histological result; and (b) the incidence of side effects induced by OLB. DESIGN AND PATIENTS: A retrospective, single-center, descriptive observational study was carried out in Hospital Santa Clara (Bogotá, Colombia) from February 2007 to January 2014...
February 28, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29449526/raised-serum-levels-of-syndecan-1-cd138-in-a-case-of-acute-idiopathic-systemic-capillary-leak-syndrome-scls-clarkson-s-disease
#7
Ole Wilhelm Bøe, Kjell Sveen, Magne Børset, Kirk M Druey
BACKGROUND Systemic capillary leak syndrome (SCLS) (Clarkson's disease) is a rare disorder of unknown etiology, characterized by transient episodes of hypotension, and the microvascular leak of fluids into the peripheral tissues, resulting in edema. Between 80-90% of patients with SCLS have a concomitant monoclonal gammopathy. Although translational in vitro studies have implicated vascular endothelial barrier dysfunction in the etiology of SCLS, the etiology and disease associations in clinical cases remain unknown...
February 16, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29402721/optimized-administration-of-hetil-15-expands-lymphocytes-and-minimizes-toxicity-in-rhesus-macaques
#8
Cristina Bergamaschi, Dionysios C Watson, Antonio Valentin, Jenifer Bear, Cody J Peer, William D Figg, Barbara K Felber, George N Pavlakis
The common γ-chain cytokine interleukin-15 (IL-15) plays a significant role in regulating innate and adaptive lymphocyte homeostasis and can stimulate anti-tumor activity of leukocytes. We have previously shown that the circulating IL-15 in the plasma is the heterodimeric form (hetIL-15), produced upon co-expression of IL-15 and IL-15 Receptor alpha (IL-15Rα) polypeptides in the same cell, heterodimerization of the two chains and secretion. We investigated the pharmacokinetic and pharmacodynamic profile and toxicity of purified human hetIL-15 cytokine upon injection in rhesus macaques...
February 2, 2018: Cytokine
https://www.readbyqxmd.com/read/29364440/how-relevant-are-vascular-endothelial-growth-factor-and-intercellular-adhesion-molecule-in-the-systemic-capillary-leak-syndrome-of-psoriasis
#9
REVIEW
Aline Lopes Bressan, Daniele Pereira, Paula Mota Medeiros, Sueli Carneiro, Luna Azulay-Abulafia
Psoriasis is a chronic disease, characterized by erythematous scaly lesions, presented in eight different forms: plaques, guttate, pustular, erythrodermic, inverse, nail and scalp psoriasis, and psoriatic arthritis. Its development depends on genetic factors, external stimulus and immune response alteration.1 Proinflammatory cytokines such as TNF-alpha, IL-12 and 23 may also be involved. In the worst cases, systemic complications linked to endothelial alterations may occur. A literature review was conducted for a better understanding of what roles VEGF (vascular endothelial growth factor) and ICAM-1 (intercellular adhesion molecule) have, among other cytokines, in systemic capillary leak syndrome, involved in erythrodermic and pustular psoriasis, the most unstable forms of the disease...
November 2017: Anais Brasileiros de Dermatologia
https://www.readbyqxmd.com/read/29360169/adrenomedullin-surges-are-linked-to-acute-episodes-of-the-systemic-capillary-leak-syndrome-clarkson-disease
#10
Zhihui Xie, Wei-Sheng Chen, Yuzhi Yin, Eunice C Chan, Kaoru Terai, Lauren M Long, Timothy G Myers, Arkadiusz Z Dudek, Kirk M Druey
BACKGROUND: Systemic Capillary Leak Syndrome (SCLS) is an extremely rare and life-threatening vascular disorder of unknown etiology. SCLS is characterized by abrupt and transient episodes of hypotensive shock and edema due to plasma leakage into peripheral tissues. The disorder has garnered attention recently because its initial presentation resembles more common vascular disorders including systemic anaphylaxis, sepsis, and acute infections with the Ebola/Marburg family of filoviruses...
April 2018: Journal of Leukocyte Biology
https://www.readbyqxmd.com/read/29360075/-hemophagocytosis-secondary-to-dengue-fever
#11
María L Rosenberg, Gonzalo L Echavarría, Ana V Ludueña, Gabriela Estrada, María M Molina
Dengue virus infection constitutes a major public health problem worldwide. It is caused by a virus belonging to the Flaviviridae family. It produces a wide range of clinical presentations, from asymptomatic infection to severe forms of the disease with hemorrhagic fever or shock secondary to capillary leak syndrome. Four serotypes have been described; serotype 2 and serotype 3 are associated with the most severe forms of the disease. The diagnosis is based on laboratory tests aimed to detect antibodies, viral RNA, or antigens in serum...
2018: Medicina
https://www.readbyqxmd.com/read/29344912/capillary-leak-syndrome-as-a-complication-of-antibody-mediated-rejection-treatment-a-case-report
#12
Juan C Ramirez-Sandoval, Ricardo Varela-Jimenez, Luis E Morales-Buenrostro
We report a case of capillary leak that developed during treatment of antibody-mediated rejection in a kidney transplant recipient. A 53-year-old female transplant recipient experienced an increase in serum creatinine from 1.1 to 1.8 mg/dL. Antibody-mediated rejection was diagnosed by graft biopsy. She was treated with five plasmapheresis sessions (on alternate days with albumin replacement), five doses of immunoglobulin (5 g/dose at 100 mg/kg), a single dose of rituximab (500 mg), and four doses of bortezomib on days 1, 4, 7, and 10 (1...
January 17, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29318579/evaluation-of-icam-1-expression-and-vascular-changes-in-the-skin-of-patients-with-plaque-pustular-and-erythrodermic-psoriasis
#13
Aline L Bressan, Bruna L S Picciani, Luna Azulay-Abulafia, Anna K Fausto-Silva, Paula N Almeida, Karin S G Cunha, Eliane P Dias, Sueli Carneiro
BACKGROUND: Psoriasis is a chronic inflammatory disease. Pustular, erythrodermic, and extensive plaque psoriasis are responsible for systemic complications. Systemic capillary leak syndrome is the complication with greater progression to death and occurs due to vascular changes. PURPOSE: The aim of this study was to evaluate vascular changes through the expression of CD34 and ICAM-1 in plaque, pustular, and erythrodermic psoriasis. METHODS: The sample consisted of seven patients with erythrodermic psoriasis, 24 with moderate-severe plaque psoriasis, 14 with mild plaque psoriasis and 13 with pustular psoriasis...
February 2018: International Journal of Dermatology
https://www.readbyqxmd.com/read/29206762/soluble-epoxide-hydrolase-plays-a-vital-role-in-angiotensin-ii-induced-lung-injury-in-mice
#14
Wei Tao, Ping-Song Li, Gang Xu, Yi Luo, Yu-Sheng Shu, Yong-Zhong Tao, Liu-Qing Yang
BACKGROUND: Angiotensin II plays a vital role in the pathogenesis of acute respiratory distress syndrome (ARDS). However, its mechanism is not well defined. Angiotensin II up-regulates the expression of soluble epoxide hydrolase (sEH; Ephx2). sEH is suggested as a potential pharmacologic target for ARDS. The present study investigates whether the sEH is involved in the angiotensin II triggered pulmonary inflammation and edema using an angiotensin II-induced lung injury animal model. METHODS: Lung injury was induced by angiotensin II intratracheally instillation in wild-type or Ephx2 deficient mice...
December 4, 2017: Shock
https://www.readbyqxmd.com/read/29172983/a-comparison-of-brand-and-biosimilar-granulocyte-colony-stimulating-factors-for-prophylaxis-of-chemotherapy-induced-febrile-neutropenia
#15
COMPARATIVE STUDY
Andrea G Douglas, Phil Schwab, Daniel Lane, Kenneth Kennedy, S Lane Slabaugh, Andy Bowe
BACKGROUND: Filgrastim-sndz, a granulocyte-colony stimulating factor (G-CSF), was introduced as a biosimilar to filgrastim in 2015, but real-world comparative effectiveness for filgrastim versus filgrastim-sndz has not been reported to date. OBJECTIVES: To (a) compare the incidence of febrile neutropenia for patients taking filgrastim versus those taking filgrastim-sndz and (b) compare the incidence of a potential serious adverse event for filgrastim versus filgrastim-sndz...
December 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29156206/cytokine-release-syndrome-who-is-at-risk-and-how-to-treat
#16
REVIEW
Noelle Frey
T-cell engaging therapies such as blinatumomab and anti-CD19 chimeric antigen receptor (CAR) T cells have revolutionized our approach to patients with relapsed and refractory acute lymphoblastic leukemia (ALL). However, the immune activation responsible for high remission rates is also responsible for the unique treatment-related toxicity of cytokine release syndrome (CRS). The clinical signs of CRS include fever, hemodynamic instability, and capillary leak, which correlate with T-cell activation and elevated cytokine levels...
December 2017: Best Practice & Research. Clinical Haematology
https://www.readbyqxmd.com/read/29142382/capillary-leak-syndrome-following-snakebite-envenomation
#17
REVIEW
V Udayabhaskaran, E T Arun Thomas, Bhagya Shaji
Capillary leak syndrome is a unique complication that follows Russell's viper envenomation. This syndrome has a very high fatality rate and is characterized by parotid swelling, chemosis, periorbital edema, hypotension, albuminuria, hypoalbuminemia, and hemoconcentration. This syndrome is frequently recognized from the southern parts of India, especially from the state of Kerala. It has been postulated that a vascular apoptosis inducing component of Russell's viper venom that is not neutralized by the commercially available anti-snake venom (ASV) is responsible for this complication as it occurs even after adequate doses of ASV administration in most cases...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29111390/treatment-of-peritoneal-carcinomatosis-with-photodynamic-therapy-systematic-review-of-current-evidence
#18
REVIEW
Muhammad Qutayba Almerie, Gemma Gossedge, Kathleen E Wright, David G Jayne
BACKGROUND: Peritoneal carcinomatosis results when tumour cells implant and grow within the peritoneal cavity. Treatment and prognosis vary based on the primary cancer. Although therapy with intention-to-cure is offered to selective patients using cytoreductive surgery with chemotherapy, the prognosis remains poor for most of the patients. Photodynamic therapy (PDT) is a cancer-therapeutic modality where a photosensitiser is administered to patients and exerts a cytotoxic effect on cancer cells when excited by light of a specific wavelength...
December 2017: Photodiagnosis and Photodynamic Therapy
https://www.readbyqxmd.com/read/29097442/a-p190brhogap-mutation-and-prolonged-rhob-activation-in-fatal-systemic-capillary-leak-syndrome
#19
Richard W Pierce, Jonathan Merola, John Paul Lavik, Martin S Kluger, Anita Huttner, Mustafa K Khokha, Jordan S Pober
We describe a fatal case of pediatric systemic capillary leak (Clarkson's disease) associated with a point mutation in p190BRhoGAP. Dermal microvascular endothelial cells (ECs) isolated from this patient form monolayers with similar levels and distribution of junctional proteins and transendothelial electrical resistance compared with normal human dermal microvascular ECs. However, patient-derived ECs demonstrate a greater increase in permeability and impaired recovery of barrier function in response to tumor necrosis factor (TNF) compared with normal donor EC cultures...
December 4, 2017: Journal of Experimental Medicine
https://www.readbyqxmd.com/read/29049135/early-identification-of-the-patient-with-endotheliopathy-of-trauma-by-arrival-serum-albumin
#20
Erika Gonzalez Rodriguez, Jessica C Cardenas, Ernesto Lopez, Bryan A Cotton, Jeffrey S Tomasek, Sisse R Ostrowski, Lisa A Baer, Jakob Stensballe, John B Holcomb, Pär I Johansson, Charles E Wade
OBJECTIVE: Traumatic endotheliopathy (EoT) is associated with glycocalyx breakdown and capillary leak resulting in the extravasation of proteins. We hypothesized that lower serum albumin levels are associated with EoT, poor outcomes, and can be used for early EoT screening in trauma patients. METHODS: We enrolled severely injured trauma patients with serum albumin levels available on admission. Syndecan-1 and soluble thrombomodulin were quantified from plasma by ELISA...
October 18, 2017: Shock
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