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https://www.readbyqxmd.com/read/27913483/atypical-hemolytic-uremic-syndrome
#1
Vahid Afshar-Kharghan
Atypical hemolytic uremic syndrome (aHUS) is a thrombotic microangiopathy (TMA) that affects multiple organs and the kidneys in particular. aHUS can be sporadic or familial and is most commonly caused by dysregulation of the alternative complement pathway. The initial attack of aHUS can occur at any age, and is associated with a high rate of progression to end stage renal disease. Many aHUS patients relapse in the native or transplanted kidneys, and require close monitoring and long-term management. Availability of anticomplement therapy has revolutionized the management of aHUS, and can change the natural course of aHUS by inducing hematologic remission, improving or stabilizing kidney functions, and preventing graft failure...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913229/a-single-arm-phase-iii-study-exploring-the-efficacy-and-safety-of-lng-ius-8-a-low-dose-levonorgestrel-intrauterine-contraceptive-system-total-content-13-5-mg-in-an-asia-pacific-population
#2
Guangsheng Fan, Sukho Kang, Mulan Ren, Edith Weisberg, Eeva Lukkari-Lax, Katrin Roth, SoYoung Shin
OBJECTIVE: To evaluate the efficacy and safety of a low-dose levonorgestrel intrauterine system with total content 13.5 mg (average approx. 8 μg/24 h over the first year; LNG-IUS 8; Jaydess®) in an Asia-Pacific population. STUDY DESIGN: An open-label, single-arm Phase III study conducted at 25 centers in China, Australia, and Korea assessed LNG-IUS 8 use over 3 years in nulliparous and parous women (N=1114) aged 18-40 years with regular menstrual cycles (21-35 days)...
November 29, 2016: Contraception
https://www.readbyqxmd.com/read/27912864/clinical-and-epidemiological-aspects-of-scorpionism-in-the-world-a-systematic-review
#3
REVIEW
Maria S V Santos, Cláudio G L Silva, Basílio Silva Neto, Cícero R P Grangeiro Júnior, Victor H G Lopes, Antônio G Teixeira Júnior, Deryk A Bezerra, João V C P Luna, Josué B Cordeiro, Jucier Gonçalves Júnior, Marcos A P Lima
OBJECTIVE: Scorpion stings are registered worldwide, but the incidence and the features of the envenomations vary depending on the region. The aim of this review was to summarize the epidemiological, clinical, diagnostic, and therapeutic data worldwide regarding humans stung by scorpions. METHODS: A systematic review of the literature was conducted through the online databases of the Virtual Health Library (VHL), which hosts Medline and the Latin American and Caribbean Center on Health Sciences Informational (LILACS) database...
December 2016: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/27912770/endometriosis-associated-clear-cell-carcinoma-arising-in-caesarean-section-scar-a-case-report-and-review-of-the-literature
#4
Gabriella Ferrandina, Eleonora Palluzzi, Francesco Fanfani, Stefano Gentileschi, Anna Lia Valentini, Maria Vittoria Mattoli, Ilaria Pennacchia, Giovanni Scambia, Gianfranco Zannoni
BACKGROUND: Malignant transformation has been reported in approximately 1% of the endometriosis cases; herein, we report a case of clear cell endometrial carcinoma arising from endometriosis foci located within a caesarean section scar. CASE PRESENTATION: In November 2014, a Caucasian, 44-year-old woman was transferred to our institution because of severe respiratory failure due to massive lung embolism and rapid enlargement of a subcutaneous suprapubic mass. Abdomino-pelvic magnetic resonance showed a 10...
December 3, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27910887/energy-metabolism-regulated-by-hdac-inhibitor-attenuates-cardiac-injury-in-hemorrhagic-rat-model
#5
Qiyuan Kuai, Chunyan Wang, Yanbing Wang, Weijing Li, Gongqing Zhang, Zhixin Qiao, Min He, Xuanlin Wang, Yu Wang, Xingwei Jiang, Lihua Su, Yuezhong He, Suping Ren, Qun Yu
A disturbance of energy metabolism reduces cardiac function in acute severe hemorrhagic patients. Alternatively, adequate energy supply reduces heart failure and increases survival. However, the approach to regulating energy metabolism conductive to vital organs is limited, and the underlying molecular mechanism remains unknown. This study assesses the ability of histone deacetylase inhibitors (HDACIs) to preserve cardiac energy metabolism during lethal hemorrhagic injury. In the lethally hemorrhagic rat and hypoxic myocardial cells, energy metabolism and heart function were well maintained following HDACI treatment, as evident by continuous ATP production with normal cardiac contraction...
December 2, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27909957/adaptive-radiation-therapy-in-head-and-neck-cancer-for-clinical-practice-state-of-the-art-and-practical-challenges
#6
REVIEW
Ovidiu Veresezan, Idriss Troussier, Alexis Lacout, Sarah Kreps, Sophie Maillard, Aude Toulemonde, Pierre-Yves Marcy, Florence Huguet, Juliette Thariat
Modern radiation therapy techniques are characterized by high conformality to tumor volumes and steep dose gradients to spare normal organs. These techniques require accurate clinical target volume definitions and rigorous assessment of set up uncertainties using image guidance, a concept called image-guided radiation therapy. Due to alteration of patient anatomy, changes in tissue density/volumes and tumor shrinkage over the course of treatment, treatment accuracy may be challenged. This may result in excessive irradiation of organs at risk/healthy tissues and undercoverage of target volumes with a significant risk of locoregional failure...
December 1, 2016: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/27909438/donor-specific-regulatory-t-cells-acquired-from-tolerant-mice-bearing-cardiac-allograft-promote-mixed-chimerism-and-prolong-intestinal-allograft-survival
#7
Xiao-Fei Shen, Jin-Peng Jiang, Jian-Jun Yang, Wei-Zhong Wang, Wen-Xian Guan, Jun-Feng Du
The induction of donor-specific transplant tolerance has always been a central problem for small bowel transplantation (SBT), which is thought to be the best therapy for end-stage bowel failure. With the development of new tolerance-inducing strategies, mixed chimerism induced by co-stimulation blockade has become most potent for tolerance of allografts, such as skin, kidney, and heart. However, a lack of clinically available co-stimulation blockers has hindered efficient application in humans. Furthermore, unlike those for other types of solid organ transplantation, strategies to induce robust mixed chimerism for intestinal allografts have not been fully developed...
2016: Frontiers in Immunology
https://www.readbyqxmd.com/read/27909060/cd6-regulates-intestinal-ischemia-reperfusion-induced-injury-by-modulating-natural-igm-producing-b1a-cell-self-renewal
#8
Gospel Enyindah-Asonye, Yan Li, Wei Xin, Nora Singer, Neetu Gupta, John Fung, Feng Lin
Intestinal ischemia/reperfusion (I/R) injury is a relatively common pathological condition that can lead to multi-organ failure and mortality. Regulatory mechanism for this disease is poorly understood, although it is established that circulating pathogenic natural IgM, which is primarily produced by B1a cells outside of the peritoneal cavity, are integrally involved. CD6 was originally identified as a marker for T cells and later found to be present on some subsets of B cells in humans, however, whether CD6 plays any role in intestinal I/R induced injury and if so, what are the underlying mechanisms, remain unknown...
December 1, 2016: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/27908943/planning-for-deactivation-of-implantable-cardioverter-defibrillators-at-the-end-of-life-in-patients-with-heart-failure
#9
Destiny R Brady
Implantable cardioverter defibrillators (ICDs) may be burdensome in end-stage heart failure. At the end of life, as many as one-fifth to one-third of patients experience an ICD shock. Critical care nurses should be aware of the potential burden of these shocks at the end of life as well as the ethics and organizational policies surrounding ICD deactivation. This literature review examines the issues surrounding ICD therapy at the end of life. Based on this author's findings, recommendations for discussing and implementing ICD deactivation are offered...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27908599/prospective-evaluation-of-a-new-biflanged-metal-stent-for-the-treatment-of-pancreatic-fluid-collections-with-videos
#10
Shuntaro Mukai, Takayoshi Tsuchiya, Takao Itoi, Shujiro Tsuji, Reina Tanaka, Ryosuke Tonozuka, Yuichi Nagakawa, Kazuhiko Kasuya, Masaaki Shimatani, Atsushi Sofuni
BACKGROUND AND AIMS: EUS-guided transluminal drainage (EUS-TD) and sequential direct endoscopic necrosectomy (DEN) for pancreatic fluid collections (PFCs) using a dedicated biflanged metal stent (BFMS) has been reported as a useful alternative to using plastic stents or a conventional metal stent. However, current dedicated BFMSs have limitations. Recently, a new BFMS with solidly constructed biflanges and various stent lengths matched to the PFC condition has been developed. Herein, we prospectively evaluated this new BFMS for the treatment of PFCs...
November 28, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27908391/prevalence-profile-and-prognosis-of-severe-obesity-in-contemporary-hospitalized-heart-failure-trial-populations
#11
Emer Joyce, Anuradha Lala, Susanna R Stevens, Lauren B Cooper, Omar F AbouEzzeddine, John D Groarke, Justin L Grodin, Eugene Braunwald, Kevin J Anstrom, Margaret M Redfield, Lynne W Stevenson
OBJECTIVES: This study evaluated the prevalence, profile, and prognosis of severe obesity in a large contemporary acute heart failure (AHF) population. BACKGROUND: Better prognosis has been reported for obese heart failure (HF) patients than nonobese HF patients, but in other cardiovascular populations, this effect has not been demonstrated for severely obese patients. METHODS: A cohort of 795 participants with body mass index (BMI) measured at time of admission and complete follow-up were identified from enrollment in 3 contemporary AHF trials (DOSE [Diuretic Strategies Optimization Evaluation], CARRESS-HF [Cardiorenal Rescue Study in Acute Decompensated Heart Failure], and ROSE [Renal Optimization Strategies Evaluation in Acute Heart Failure])...
December 2016: JACC. Heart Failure
https://www.readbyqxmd.com/read/27907964/critical-care-neurology-perspective-on-delirium
#12
Matthew B Maas, Andrew M Naidech
The evidence linking delirium to poor outcomes after critical illness is compelling, including higher mortality, prolonged mechanical ventilation, longer length of intensive care unit stay, and long-term cognitive impairments. The attitude toward delirium in the neurologic community is shifting away from viewing it as an unmodifiable, inevitable consequence of severe illness to treating it is as a neurologic emergency, akin to seizures or encephalitis. Delirium, like other manifestations of critical illness encephalopathy, is an organ dysfunction syndrome...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907062/sepsis-prevalence-and-outcome-on-the-general-wards-and-emergency-departments-in-wales-results-of-a-multi-centre-observational-point-prevalence-study
#13
Tamas Szakmany, Robert M Lundin, Ben Sharif, Gemma Ellis, Paul Morgan, Maja Kopczynska, Amrit Dhadda, Charlotte Mann, Danielle Donoghue, Sarah Rollason, Emma Brownlow, Francesca Hill, Grace Carr, Hannah Turley, James Hassall, James Lloyd, Llywela Davies, Michael Atkinson, Molly Jones, Nerys Jones, Rhodri Martin, Yousef Ibrahim, Judith E Hall
Data on sepsis prevalence on the general wards is lacking on the UK and in the developed world. We conducted a multicentre, prospective, observational study of the prevalence of patients with sepsis or severe sepsis on the general wards and Emergency Departments (ED) in Wales. During the 24-hour study period all patients with NEWS≥3 were screened for presence of 2 or more SIRS criteria. To be eligible for inclusion, patients had to have a high clinical suspicion of an infection, together with a systemic inflammatory response (sepsis) and evidence of acute organ dysfunction and/or shock (severe sepsis)...
2016: PloS One
https://www.readbyqxmd.com/read/27906910/progress-with-scale-up-of-hiv-viral-load-monitoring-seven-sub-saharan-african-countries-january-2015-june-2016
#14
Shirley Lecher, Jason Williams, Peter N Fonjungo, Andrea A Kim, Dennis Ellenberger, Guoqing Zhang, Christiane Adje Toure, Simon Agolory, Georgette Appiah-Pippim, Suzanne Beard, Marie Yolande Borget, Sergio Carmona, Geoffrey Chipungu, Karidia Diallo, Marie Downer, Dianna Edgil, Holly Haberman, Mackenzie Hurlston, Steven Jadzak, Charles Kiyaga, William MacLeod, Boniface Makumb, Hellen Muttai, Christina Mwangi, Jane W Mwangi, Michael Mwasekaga, Mary Naluguza, Lucy W Ng'Ang'A, Shon Nguyen, Souleymane Sawadogo, Katrina Sleeman, Wendy Stevens, Joel Kuritsky, Shannon Hader, John Nkengasong
The World Health Organization (WHO) recommends viral load testing as the preferred method for monitoring the clinical response of patients with human immunodeficiency virus (HIV) infection to antiretroviral therapy (ART) (1). Viral load monitoring of patients on ART helps ensure early diagnosis and confirmation of ART failure and enables clinicians to take an appropriate course of action for patient management. When viral suppression is achieved and maintained, HIV transmission is substantially decreased, as is HIV-associated morbidity and mortality (2)...
December 2, 2016: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/27906841/annexin-a5-in-treated-hypertensive-patients-and-its-association-with-target-organ-damage
#15
Alessandro Maloberti, Paolo Meani, Paola Vallerio, Marisa Varrenti, Francesca Casadei, Francesco Musca, Rita Facchetti, Anna M Di Blasio, Susanna Ravassa, Giuseppe Mancia, Cristina Giannattasio
OBJECTIVE: Annexin A5 (AnxA5) has been previously linked to the presence of carotid and cardiac target organ damage (TOD) in the context of heart failure and rheumatologic patients. However, information is scant in the context of hypertension. Aim of our study was to evaluate AnxA5 in treated hypertension patients compared with normotensive controls and to determine whether it is associated with vascular and heart TOD evaluated as arterial stiffness, carotid plaque and left ventricular hypertrophy...
January 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/27906828/presence-of-cytotoxic-extracellular-histones-in-machine-perfusate-of-donation-after-circulatory-death-kidneys
#16
Tim C van Smaalen, Daniëlle M H Beurskens, E R Pieter Hoogland, Bjorn Winkens, Maarten H L Christiaans, Chris P Reutelingsperger, L W Ernest van Heurn, Gerry A F Nicolaes
BACKGROUND: Extracellular histones are cytotoxic molecules that are related to cell stress and death. They have been shown to play a crucial role in multiple pathophysiologic processes like sepsis, inflammation, vascular dysfunction and thrombosis. Their role in organ donation and graft function and survival is still unknown. The aim of this study was to assess whether an association exists between the presence of extracellular histones in machine perfusates and deceased donor kidney viability...
December 1, 2016: Transplantation
https://www.readbyqxmd.com/read/27906824/selection-of-patients-for-initial-clinical-trials-of-solid-organ-xenotransplantation
#17
David K C Cooper, Martin Wijkstrom, Sundaram Hariharan, Joshua L Chan, Avneesh Singh, Keith Horvath, Muhammad Mohiuddin, Arielle Cimeno, Rolf N Barth, John C LaMattina, Richard N Pierson
Several groups have reported extended survival of genetically-engineered pig organs in nonhuman primates, varying from almost 10 months for life-supporting kidney grafts and >2 years for nonlife-supporting heart grafts to less than 1 month for life-supporting liver and lung grafts. We have attempted to define groups of patients who may not have an option to wait for an allograft. These include kidney, heart, and lung candidates who are highly-allosensitized. In addition, some kidney candidates (who have previously lost at least 2 allografts from rapid recurrence of native kidney disease) have a high risk of further recurrence and will not be offered a repeat allotransplant...
December 1, 2016: Transplantation
https://www.readbyqxmd.com/read/27905673/single-versus-multiple-visits-for-endodontic-treatment-of-permanent-teeth
#18
REVIEW
Maddalena Manfredi, Lara Figini, Massimo Gagliani, Giovanni Lodi
BACKGROUND: Root canal treatment (RoCT), or endodontic treatment, is a common procedure in dentistry. The main indications for RoCT are irreversible pulpitis and necrosis of the dental pulp caused by carious processes, tooth cracks or chips, or dental trauma. Successful RoCT is characterised by an absence of symptoms (i.e. pain) and clinical signs (i.e. swelling and sinus tract) in teeth without radiographic evidence of periodontal involvement (i.e. normal periodontal ligament). The success of RoCT depends on a number of variables related to the preoperative condition of the tooth, as well as the endodontic procedures...
December 1, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27905632/-co-infection-by-chikungunya-virus-chik-v-and-dengue-virus-den-v-during-a-recent-outbreak-in-cali-colombia-report-of-a-fatal-case
#19
Fernando Rosso, Robinson Pacheco, Sarita Rodríguez, Diego Bautista
The recent outbreaks of Chikungunya (CHIK-V) virus in endemic areas of dengue (DEN-V) could increase the risk of co-infection. CHIK infection has been considered not severe and with very unusual mortality, however DEN is associated with severe manifestations and increased mortality. Little is known about coinfection. It is possible that co-infection could generate severe cases. We present a case report of co-infection DEN-V -3 and CHIK-V in an elderly patient who developed acute renal failure, dengue shock syndrome (DSS), progresses to multiple organ failure and died...
August 2016: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/27905369/-systemic-disorders-management-in-patients-with-acute-pancreatic-necrosis
#20
G V Rodoman, T I Shalaeva, A B Bargandzhiya
AIM: To study the effectiveness of sulodexide for systemic disorders correction in patients with acute pancreatic necrosis. MATERIAL AND METHODS: The study included 60 patients with acute pancreatic necrosis who were divided into main and control groups by 30  patients. Their age varied from 27 to 79. Standard combined therapy with prevention of disseminated intravascular coagulation and thrombotic complications was recommended in all patients. In the control group enoxaparin therapy in prophylactic doses (4,000 IU (40 mg) per day) was used...
2016: Khirurgiia
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