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sepsis and thrombocytopenia

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https://www.readbyqxmd.com/read/27902585/long-term-complications-of-splenectomy-in-adult-immune-thrombocytopenia
#1
Lan-Huong Thai, Matthieu Mahévas, Françoise Roudot-Thoraval, Nicolas Limal, Laetitia Languille, Guillaume Dumas, Mehdi Khellaf, Philippe Bierling, Marc Michel, Bertrand Godeau
The recent large decrease in splenectomy use for chronic immune thrombocytopenia (ITP) is partly due to still-unsolved questions about long-term safety. We performed the first single-center exposed/unexposed cohort study evaluating the long-term incidence of splenectomy complications in patients with primary ITP. Overall, 83 patients who underwent splenectomy more than 10 years ago (exposed) were matched with 83 nonsplenectomized patients (unexposed) on the date of ITP diagnosis ±5 years, age and gender. After a median follow-up of 192 months (range 0...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27885699/strains-of-group-b-streptococci-from-septic-patients-induce-platelet-activation-via-toll-like-receptor-2
#2
Xiaoyan Liu, Hongyun Liu, Xianming Luo, Ping Zhang, Yanmin Gao, Shuangfeng Xie, Kang Xu, Jianxing Chang, Liping Ma
Group B Streptococcus (GBS) causes life-threatening bacterial sepsis, especially in newborns and pregnant women. Patients suffering from sepsis often display low platelet counts, characterized by thrombocytopenia, because of platelet activation. In the present study, the roles of six GBS strains from septic patients in platelet aggregation, as well as the underlying mechanisms, were investigated. Incubation of platelets with three of the strains induced platelet aggregation, increased the secretion of cellular adhesin molecule CD62P and activation of GPIIb/IIIa...
November 25, 2016: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/27849621/vancomycin-induced-thrombocytopenia-in-a-newborn
#3
Kunal Kalra, Hema Gupta Mittal, Arti Maria
Neonatal thrombocytopenia is common and is frequently seen in neonatal sepsis. Drug-induced thrombocytopenia is likely to be missed unless a high index of suspicion is present. Changing of antibiotics for assumed nonresolution of sepsis may lead to persistent thrombocytopenia in a neonate if drug-induced thrombocytopenia is missed. Vancomycin-induced neonatal thrombocytopenia is rarely described in scientific literature. We describe a newborn who was diagnosed with early onset sepsis and vancomycin-induced thrombocytopenia...
December 1, 2016: Drug Metabolism and Personalized Therapy
https://www.readbyqxmd.com/read/27834985/clinical-outcome-of-critically-ill-patients-with-thrombocytopenia-and-hypophosphatemia-in-the-early-stage-of-sepsis
#4
Evgeni Brotfain, Andrei Schwartz, Avi Boniel, Leonid Koyfman, Matthew Boyko, Ruslan Kutz, Moti Klein
BACKGROUND: Hypophosphatemia and thrombocytopenia may both be independent risk factors for the development of multiple organ failure and correlate well with the severity of sepsis. In the present study we wanted to analyze the potential clinical role and prognostic significance of both early hypophosphatemia and thrombocytopenia on clinical outcomes of critically ill ICU patients with severe sepsis METHODS: We analyzed the clinical data, including the outcome of critically ill ICU patients with severe sepsis who presented during a 5 year period with early hypophosphatemia and thrombocytopenia...
November 11, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27822747/venovenous-extracorporeal-membrane-oxygenation-for-ards-outcome-analysis-of-a-croatian-referral-center-for-respiratory-ecmo
#5
Marko Kutleša, Anđa Novokmet, Renata Josipović Mraović, Bruno Baršić
BACKGROUND: The use of venovenous extracorporeal membrane oxygenation (VV-ECMO) as a rescue therapy in severe acute respiratory distress syndrome (ARDS) has become well established; however, the affirmation of evidence on VV-ECMO application and the analysis of patient outcomes after VV-ECMO treatment for ARDS continues. The aim of the study is to identify variables that affected the outcome of patients treated with VV-ECMO for severe ARDS outside a major ECMO center. METHODS: The study included adult patients with severe ARDS treated with ECMO at a tertiary care hospital in Zagreb, Croatia between October 2009 and July 2014...
November 7, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27807846/borderline-operability-in-hepatectomy-patients-is-associated-with-higher-rates-of-failure-to-rescue-after-severe-complications
#6
Bradford J Kim, Ching-Wei D Tzeng, Amanda B Cooper, Jean-Nicolas Vauthey, Thomas A Aloia
BACKGROUND/OBJECTIVE: To understand the influence of age and comorbidities, this study analyzed the incidence and risk factors for post-hepatectomy morbidity/mortality in patients with "borderline" (BL) operability, defined by the preoperative factors: age ≥75 years, dependent function, lung disease, ascites/varices, myocardial infarction, stroke, steroids, weight loss >10%, and/or sepsis. METHODS: All elective hepatectomies were identified in the 2005-2013 ACS-NSQIP database...
November 3, 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27774886/the-clinico-hematological-features-and-management-outcome-in-neonatal-malaria-a-nine-years-analysis-from-north-india
#7
Kriti Mohan
BACKGROUND: Malaria is an important cause of death and illness in children worldwide. Most cases of neonatal malaria are misdiagnosed because of the lack of specific symptoms and a general lack of awareness. Nothing much is known in literature about the haematological changes during malaria infection and outcome of disease in neonates. Neonatal malaria is an underdiagnosed entity. So this hospital based observational study aims to assess diagnostic features of neonatal malaria. METHODS: From August 2004 to August 2013, information of all slide positive for malaria cases aged 0 to 28 days admitted to our pediatric hospital was collected and analysed...
October 20, 2016: Infectious Disorders Drug Targets
https://www.readbyqxmd.com/read/27761292/pediatric-fulminant-leptospirosis-complicated-by-pericardial-tamponade-macrophage-activation-syndrome-and-sclerosing-cholangitis
#8
Osman Yeşilbaş, Hasan Serdar Kıhtır, Hamdi Murat Yıldırım, Nevin Hatipoğlu, Esra Şevketoğlu
BACKGROUND: Leptospirosis is a zoonotic infectious disease caused by pathogenic spirochetes of the genus Leptospira. Although it is usually asymptomatic and self-limited, severe potentially fatal illness accompanied by multi-organ failure may occur. CASE REPORT: Here we report an unusual case of severe leptospirosis successfully treated with continuous venovenous hemofiltration (CVVHF) and therapeutic plasma exchange (TPE). The patient presented with pericardial tamponade, renal failure and macrophage activation syndrome, and later suffered prolonged jaundice and sclerosing cholangitis during hospitalization in the pediatric intensive care unit (PICU)...
September 2016: Balkan Medical Journal
https://www.readbyqxmd.com/read/27751206/-research-advances-in-breast-milk-acquired-cytomegalovirus-infection-in-premature-infants
#9
Li-Hong Ran, Lei Bao
Breast milk is considered ideal food for premature infants, but it can also be the main source of cytomegalovirus (CMV) infection in premature infants. CMV infection may cause serious clinical symptoms, such as sepsis-like syndrome, thrombocytopenia, neutropenia, jaundice, hepatitis, and pneumonitis. This article reviews the research advances in symptoms, treatment strategies, prognosis and the prevention of breast milk-acquired CMV infection in premature infants.
October 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/27745820/carboplatin-and-pemetrexed-with-or-without-pembrolizumab-for-advanced-non-squamous-non-small-cell-lung-cancer-a-randomised-phase-2-cohort-of-the-open-label-keynote-021-study
#10
Corey J Langer, Shirish M Gadgeel, Hossein Borghaei, Vassiliki A Papadimitrakopoulou, Amita Patnaik, Steven F Powell, Ryan D Gentzler, Renato G Martins, James P Stevenson, Shadia I Jalal, Amit Panwalkar, James Chih-Hsin Yang, Matthew Gubens, Lecia V Sequist, Mark M Awad, Joseph Fiore, Yang Ge, Harry Raftopoulos, Leena Gandhi
BACKGROUND: Limited evidence exists to show that adding a third agent to platinum-doublet chemotherapy improves efficacy in the first-line advanced non-small-cell lung cancer (NSCLC) setting. The anti-PD-1 antibody pembrolizumab has shown efficacy as monotherapy in patients with advanced NSCLC and has a non-overlapping toxicity profile with chemotherapy. We assessed whether the addition of pembrolizumab to platinum-doublet chemotherapy improves efficacy in patients with advanced non-squamous NSCLC...
October 10, 2016: Lancet Oncology
https://www.readbyqxmd.com/read/27730774/infections-and-thrombocytopenia
#11
Falguni Parikh
Febrile patient with thrombocytopenia is commonly encountered by physicians especially during monsoon and perimonsoon period. Infections with protozoa, bacteria and viruses can cause thrombocytopenia with or without disseminated intravascular coagulation. Commonly dengue, malaria, scrub typhus and other rickettsial infections, meningococci, leptospira and certain viral infections present as fever with thrombocytopenia. Occasionally these patients can go on to develop a stormy course with multiorgan dysfunction requiring intensive care unit admission associated with high morbidity and mortality...
February 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27704515/prevalence-and-outcomes-of-thrombocytopenia-in-a-neonatal-intensive-care-unit
#12
Imene Dahmane Ayadi, Emira Ben Hamida, Asma Youssef, Yosra Sdiri, Zahra Marrakchi
Background Thrombocytopenia is a common clinical problem in neonatal intensive care units, affecting about 20 to 35% of all admitted neonates. Even most episodes are mild or moderate, severe episodes could be life-threatening or responsible for sequelae. Objectives The aims of this study were to describe the prevalence, clinical diagnoses, and to determine risk factors for poor prognosis of thrombocytopenia in a neonatal intensive care unit. Methods We carried out a retrospective study in the neonatal intensive care unit of Charles Nicolle Hospital of Tunis, a tertiary neonatal care center, over a four years period (January 2010 to December 2013)...
April 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/27694537/microangiopathic-antiphospholipid-antibody-associated-syndrome-in-a-pregnant-lady
#13
G S Kew, J Cho, A Lateef
We describe a gravid 37-year-old Chinese lady with known triple positive primary antiphospholipid syndrome with previous recurrent deep vein thrombosis and early spontaneous miscarriages. She was managed with low-molecular weight heparin, aspirin, hydroxychloroquine, prednisolone and monthly intravenous immunoglobulin.She presented with recurrent per-vaginal bleeding at 22 weeks of gestation and was found to have abruptio placentae. Anti-coagulation was held off. She subsequently delivered a stillborn at 24 weeks and anti-coagulation was restarted...
October 1, 2016: Lupus
https://www.readbyqxmd.com/read/27688833/economic-burden-of-toxicities-associated-with-treating-metastatic-melanoma-in-the-united-states
#14
S Pinar Bilir, Qiufei Ma, Zhongyun Zhao, Elizabeth Wehler, Julie Munakata, Beth Barber
BACKGROUND: Little has been reported on the costs of managing the adverse events (AEs) associated with current therapies for patients with regional or distant metastatic melanoma. OBJECTIVES: To identify treatment-related AEs in patients with metastatic melanoma and to estimate the associated costs of treating these AEs in the United States. METHODS: A cost-estimation study for AEs associated with treatment of metastatic melanoma was conducted from 2012 to 2013 by identifying grades 3 and 4 AEs through the use of a comprehensive search of drug labels and English-language, published phase 2/3 studies in PubMed, conference abstracts, and the National Comprehensive Cancer Network guidelines...
June 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/27681010/preterm-thrombocytopenia-and-delay-of-ductus-arteriosus-closure
#15
Vinay Vamadev Kulkarni, Sourabh Dutta, Venkataseshan Sundaram, Shiv Sajan Saini
OBJECTIVES: To evaluate whether preterm thrombocytopenia within 24 hours of birth is associated with delayed closure of patent ductus arteriosus (PDA) and higher proportion of hemodynamically significant PDA (Hs-PDA). METHODS: Neonates (gestation 26(0/7)-33(6/7) weeks, age <24 hours) with known platelet count and PDA on echocardiogram were prospectively enrolled. Asphyxia, congenital infections, structural heart disease, major malformations and clinical sepsis were exclusions...
September 28, 2016: Pediatrics
https://www.readbyqxmd.com/read/27631399/aggressive-posterior-retinopathy-of-prematurity-is-associated-with-multiple-infectious-episodes-and-thrombocytopenia
#16
Pia Lundgren, Linnea Lundberg, Gunnel Hellgren, Gerd Holmström, Anna-Lena Hård, Lois E Smith, Agneta Wallin, Boubou Hallberg, Ann Hellström
BACKGROUND: The most severe form of rapidly progressing retinopathy of prematurity (ROP) is termed aggressive posterior ROP (APROP). APROP frequently causes severe visual impairment in affected preterm infants despite timely and appropriate laser treatment. OBJECTIVES: We investigated the postnatal characteristics associated with APROP development in a national Swedish cohort. METHODS: This retrospective, 1:1 matched case-control study included all infants that developed APROP in zone 1 (n = 9) between 2008 and 2012...
September 16, 2016: Neonatology
https://www.readbyqxmd.com/read/27610316/transmission-of-enterobacter-aerogenes-septicemia-in-healthcare-workers
#17
Piyush Jha, Choon-Mee Kim, Dong-Min Kim, Jong-Hoon Chung, Na-Ra Yoon, Babita Jha, Seok Won Kim, Sook Jin Jang, Young-Joon Ahn, Jae Keun Chung, Doo Young Jeon
Enterobacter aerogenes is recognized as an important bacterial pathogen in hospital-acquired infections. This report describes two unusual cases of septicemia caused by E. aerogenes in immunocompetent healthcare workers. E. aerogenes was isolated from blood cultures of the two patients experiencing septicemia. The clinical isolates were initially identified as E. aerogenes using a VITEK II automated system and 16S rRNA sequence analysis, and; both isolates involved in the outbreak shared a common pulse-field gel electrophoresis pattern...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27596084/-clinical-efficacy-and-safety-of-vancomycin-compared-with-linezolid-for-the-treatment-of-neonatal-gram-positive-bacterial-sepsis
#18
L Tang, J Fang, S N Wang, X H Weng, J J Li, E N Shang
OBJECTIVE: To evaluate the clinical efficacy and safety of vancomycin and linezolid for the treatment of gram-positive neonatal bacterial sepsis. METHOD: The data of neonates diagnosed as gram-positive bacterial sepsis in neonatology department of Suzhou Municipal Hospital from June 2009 to December 2015 were retrospectively collected. These neonates were divided into vancomycin group and linezolid group. Propensity score matching (PSM) on baseline variables was used to balance the two groups by identifying a comparable group of neonates who received vancomycin and linezolid therapy...
September 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/27513537/pediatric-sepsis-biomarker-risk-model-ii-redefining-the-pediatric-sepsis-biomarker-risk-model-with-septic-shock-phenotype
#19
Hector R Wong, Natalie Z Cvijanovich, Nick Anas, Geoffrey L Allen, Neal J Thomas, Michael T Bigham, Scott L Weiss, Julie Fitzgerald, Paul A Checchia, Keith Meyer, Michael Quasney, Mark Hall, Rainer Gedeit, Robert J Freishtat, Jeffrey Nowak, Shekhar S Raj, Shira Gertz, Kelli Howard, Kelli Harmon, Patrick Lahni, Erin Frank, Kimberly W Hart, Trung C Nguyen, Christopher J Lindsell
OBJECTIVE: The Pediatric Sepsis Biomarker Risk Model (PERSEVERE), a pediatric sepsis risk model, uses biomarkers to estimate baseline mortality risk for pediatric septic shock. It is unknown how PERSEVERE performs within distinct septic shock phenotypes. We tested PERSEVERE in children with septic shock and thrombocytopenia-associated multiple organ failure (TAMOF), and in those without new onset thrombocytopenia but with multiple organ failure (MOF). DESIGN: PERSEVERE-based mortality risk was generated for each study subject (n = 660)...
November 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27504630/igm-enriched-immunoglobulin-attenuates-systemic-endotoxin-activity-in-early-severe-sepsis-a-before-after-cohort-study
#20
Saskia Wand, Matthias Klages, Christin Kirbach, Joanna Warszawska, Patrick Meybohm, Kai Zacharowski, Alexander Koch
INTRODUCTION: Sepsis remains associated with a high mortality rate. Endotoxin has been shown to influence viscoelastic coagulation parameters, thus suggesting a link between endotoxin levels and the altered coagulation phenotype in septic patients. This study evaluated the effects of systemic polyspecific IgM-enriched immunoglobulin (IgM-IVIg) (Pentaglobin® [Biotest, Dreieich, Germany]) on endotoxin activity (EA), inflammatory markers, viscoelastic and conventional coagulation parameters...
2016: PloS One
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