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https://www.readbyqxmd.com/read/28921613/voxel-based-multi-model-fitting-method-for-modelling-time-activity-curves-in-spect-images
#1
David Sarrut, Adrien Halty, Jean-Noel Badel, Ludovic Ferrer, Manuel Bardiès
PURPOSE: Estimating the biodistribution and the pharmacokinetics from timesequence SPECT images on a per-voxel basis is useful for studying activity nonuniformity or computing absorbed dose distributions by convolution of voxel kernels or Monte-Carlo radiation transport. Current approaches are either region-based, thus assuming uniform activity within the region, or voxel-based but using the same fitting model for all voxels. METHODS: We propose a voxel-based multi-model fitting method (VoMM) that estimates a fitting function for each voxel by automatically selecting the most appropriate model among a predetermined set with Akaike criteria...
September 17, 2017: Medical Physics
https://www.readbyqxmd.com/read/28918190/autophagy-inflammation-and-immune-dysfunction-in-the-pathogenesis-of-pancreatitis
#2
REVIEW
Anna S Gukovskaya, Ilya Gukovsky, Hana Algül, Aida Habtezion
Pancreatitis is a common disorder with significant morbidity and mortality, yet little is known about its pathogenesis and there is no specific or effective treatment. Its development involves dysregulated autophagy and unresolved inflammation, demonstrated by studies in genetic and experimental mouse models. Disease severity depends on whether the inflammatory response resolves or amplifies, leading to multi-organ failure. Dysregulated autophagy might promote the inflammatory response in the pancreas. We discuss the roles of autophagy and inflammation in pancreatitis, mechanisms of deregulation, and connections among disordered pathways...
September 13, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28912916/acute-liver-failure-in-a-patient-travelling-from-asia-the-other-face-of-the-coin-of-infectious-disease
#3
Balen Abdulrahman, Mohamed H Ahmed, John Ramage
We present a case of a 63-year-old male who had travelled from South India to United Kingdom (UK) visiting relatives. He had developed episodes of diarrhea, vomiting and fevers while travelling and on assessment in hospital, mild abdominal distension was noted with rapid deterioration to hypovolemic shock. Initial blood test showed a low platelet count with deranged liver function tests (LFTs). It was noted that during admission to intensive care unit (ICU), blood continued to ooze from a previous surgical laparoscopy wound, central and arterial line access sites...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28911947/albumin-prevents-infections-in-patients-with-chronic-liver-failure-in-a-single-arm-feasibility-trial
#4
Louise China, Simon S Skene, Zainib Shabir, Alexander Maini, Yvonne Sylvestre, Kate Bennett, Scott Bevan, James O'Beirne, Ewan Forrest, Jim Portal, Steve Ryder, Gavin Wright, Derek W Gilroy, Alastair O'Brien
BACKGROUND & AIMS: Infections are life threatening to patients with acute decompensation and acute-on-chronic liver failure (AD/ACLF). Patients with AD/ACLF have prostaglandin E2-mediated immune suppression, which can be reversed by administration of albumin; infusion of 20% human albumin solution (HAS) might improve outcomes of infections. We performed a feasibility study to determine optimal trial design, assess safety, and validate laboratory assessments of immune function to inform design of a phase 3 trial...
September 11, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28906499/-incomplete-poems-syndrome-with-multicentric-castleman-s-disease
#5
P González de la Aleja, M García-Navarro, R Sánchez-Rodríguez, J M Ramos-Rincón
Castleman's disease (CD) is an atypical lymphoproliferative disorder of unknown cause, characterized by non-clonal nodal hyperplastic growth. Two forms of clinical presentation are currently recognized, one localized and the other multicentric, and four histopathologic variants. It is characterized by generalized lymphadenopathy, hepatosplenomegaly, fever and night sweats. CD may present severe pancytopenia, multi-organ failure, lymphoma evolution and it can sometimes be associated with paraneoplastic syndromes such as POEMS syndrome...
September 14, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28903084/sepsis-mortality-score-for-the-prediction-of-mortality-in-septic-patients
#6
Wan Fadzlina Wan Muhd Shukeri, Azrina Md Ralib, Nor Zamzila Abdulah, Mohd Basri Mat-Nor
PURPOSE: To derive a prediction equation for 30-day mortality in sepsis using a multi-marker approach and compare its performance to the Sequential Organ Failure Assessment (SOFA) score. METHODS: This study included 159 septic patients admitted to an intensive care unit. Leukocytes count, procalcitonin (PCT), interleukin-6 (IL-6), and paraoxonase (PON) and arylesterase (ARE) activities of PON-1 were assayed from blood obtained on ICU presentation. Logistic regression was used to derive sepsis mortality score (SMS), a prediction equation describing the relationship between biomarkers and 30-day mortality...
September 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28901345/-acute-alcoholic-hepatitis
#7
Gianni Testino, Emanuele Scafato, Valentino Patussi
Chronic alcohol related liver disease is characterized by a cascade of events defined as follows: steatosis, steatohepatitis/steatofibrosi, cirrhosis and hepatocellular carcinoma. On one of these histologic patterns may overlap acute alcoholic hepatitis (AAE) (mild, moderate, severe). Severe AAE can cause a severe clinical picture: jaundice with a duration of less than three months, jaundice in the first decompensation event, serum bilirubin higher than 5 mg/dL, ratio AST/ALT >2:1, AST less than 500 IU/L ALT <300 IU/L, neutrophil leukocytosis and increased GGT...
September 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28893325/the-most-commonly-used-disease-severity-scores-are-inappropriate-for-risk-stratification-of-older-emergency-department-sepsis-patients-an-observational-multi-centre-study
#8
Bas de Groot, Frank Stolwijk, Mats Warmerdam, Jacinta A Lucke, Gurpreet K Singh, Mo Abbas, Simon P Mooijaart, Annemieke Ansems, Laura Esteve Cuevas, Douwe Rijpsma
BACKGROUND: Sepsis recognition in older emergency department (ED) patients is difficult due to atypical symptom presentation. We therefore investigated whether the prognostic and discriminative performance of the five most commonly used disease severity scores were appropriate for risk stratification of older ED sepsis patients (≥70 years) compared to a younger control group (<70 years). METHODS: This was an observational multi-centre study using an existing database in which ED patients who were hospitalized with a suspected infection were prospectively included...
September 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28892185/prevalence-comorbidities-and-mortality-of-toxic-shock-syndrome-in-united-states-children-and-adults
#9
Mark A Strom, Derek Y Hsu, Jonathan I Silverberg
Toxic Shock Syndrome (TSS) is a superantigen-mediated illness characterized by rash, hypotension and multi-organ dysfunction. The predictors of TSS and related morbidity and mortality are poorly defined. We analyzed data on 61,959,084 hospitalizations from the 2003-2012 Nationwide Inpatient Sample, a 20% stratified sample of US hospitalizations. ICD-9-CM coding was used to identify 4,491 hospitalizations with a diagnosis of TSS. Incidence, in-hospital mortality rate, comorbidities, length of stay and costs of care due to TSS were determined...
September 11, 2017: Microbiology and Immunology
https://www.readbyqxmd.com/read/28888855/cytomegalovirus-associated-severe-pneumonia-multi-organ-failure-and-ganciclovir-associated-arrhythmia-in-immunocompetent-child
#10
Ayman A Al-Eyadhy, Gamal Hasan, Rolan Bassrawi, Muneera Al-Jelaify, Mohamad-Hani Temsah, Ali Alhaboob, Fahad Al-Sohime, Majed Alabdulhafid
Cytomegalovirus (CMV) can rarely cause severe manifestations in immunocompetent individuals. Hereby, we report a twelve-year-old boy who presented with tachycardia, tachypnea, fever and leukocytosis, which progressed to hypoxemic respiratory failure and severe acute respiratory distress syndrome (ARDS). Subsequently, he developed multi-organ failure despite the ongoing full supportive care and empiric broad spectrum antibiotics. Cytomegalovirus infection was diagnosed by Polymerase Chain Reaction (PCR) in blood and histopathological examination of lung biopsy...
September 6, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28887029/urocortins-actions-in-health-and-heart-failure
#11
REVIEW
Miriam T Rademaker, A Mark Richards
The urocortins (Ucns), endogenous peptides belonging to the corticotropin-releasing factor (CRF) family, are increasingly recognized as having diverse and important multi-system functions, especially within the cardiovascular system. The biological actions of the three Ucns (Ucn1, Ucn2, Ucn3) are mediated via G-protein-coupled CRF receptors, with both peptides and receptors widely distributed throughout tissues and organs contributing to pressure/volume homeostasis including the heart, vasculature, kidneys and adrenals...
September 5, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28886074/unique-transcriptomic-response-to-sepsis-is-observed-among-patients-of-different-age-groups
#12
Steven L Raymond, María Cecilia López, Henry V Baker, Shawn D Larson, Philip A Efron, Timothy E Sweeney, Purvesh Khatri, Lyle L Moldawer, James L Wynn
Sepsis is a major cause of morbidity and mortality, especially at the extremes of age. To understand the human age-specific transcriptomic response to sepsis, a multi-cohort, pooled analysis was conducted on adults, children, infants, and neonates with and without sepsis. Nine public whole-blood gene expression datasets (636 patients) were employed. Age impacted the transcriptomic host response to sepsis. Gene expression from septic neonates and adults was more dissimilar whereas infants and children were more similar...
2017: PloS One
https://www.readbyqxmd.com/read/28883389/septic-shock-with-multi-organ-failure-due-to-fluoroquinolones-resistant-campylobacter-jejuni
#13
Filippo Mearelli, Chiara Casarsa, Andrea Breglia, Gianni Biolo
BACKGROUND Campylobacter jejuni infections are typically self-limited, and severe extra-intestinal complications are uncommon. CASE REPORT We report a case of a man with septic shock due to fluoroquinolones resistant Campylobacter jejuni. CONCLUSIONS This manuscript emphasizes the potential lethality of fluorquinolones resistant Campylobacter jejuni bacteremia.
September 8, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28881905/perforated-esophageal-intervention-focus-perf-study-a-multi-center-examination-of-contemporary-treatment
#14
J T Ali, R D Rice, E A David, J D Spicer, J J Dubose, L Bonavina, S Siboni, T A O'Callaghan, X Luo-Owen, S Harrison, C G Ball, J Bini, G A Vercruysse, D Skarupa, C C Miller Iii, A L Estrera, K G Khalil
The treatment of esophageal perforation (EP) remains a significant clinical challenge. While a number of investigators have previously documented efficient approaches, these were mostly single-center experiences reported prior to the introduction of newer technologies: specifically endoluminal stents. This study was designed to document contemporary practice in the diagnosis and management of EP at multiple institutions around the world and includes early clinical outcomes. A five-year (2009-2013) multicenter retrospective review of management and outcomes for patients with thoracic or abdominal esophageal perforation was conducted...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28881652/predictors-of-acute-kidney-injury-after-paraquat-intoxication
#15
Cheng-Hao Weng, Hui-Hsiang Chen, Ching-Chih Hu, Wen-Hung Huang, Ching-Wei Hsu, Jen-Fen Fu, Wey-Ran Lin, I-Kwan Wang, Tzung-Hai Yen
Paraquat intoxication is characterized by multi-organ failure, causing substantial mortality and morbidity. Many paraquat patients experience acute kidney injury (AKI), sometimes requiring hemodialysis. We observed 222 paraquat-intoxicated patients between 2000 and 2012, and divided them into AKI (n = 103) and non-AKI (n = 119) groups. The mortality rate was higher for AKI than non-AKI patients (70.1% vs. 40.0%, P < 0.001). Patients with AKI had a longer time to hospital arrival (P = 0.003), lower PaO2 (P = 0...
August 1, 2017: Oncotarget
https://www.readbyqxmd.com/read/28879449/prognostic-factors-of-mortality-in-iranian-patients-with-systemic-lupus-erythematosus-admitted-to-intensive-care-unit
#16
Alimohammad Fatemi, Somayeh Shamsaee, Ahmad Raeisi, Zahra Sayedbonakdar, Abbas Smiley
The aim was to determine the course, outcome, and determinants of mortality in patients with systemic lupus erythematosus (SLE) in intensive care unit (ICU). SLE patients admitted to ICU from 2004 to 2015 were recruited retrospectively. Demographic data, disease characteristics, causes of admission, baseline SLE disease activity index-2K (SLEDAI-2K) and Acute Physiologic and Chronic Health Evaluation II (APACHE) score, the outcome, and the causes of death were recorded. Predictors of mortality were compared between alive and dead patients by Cox regression analysis...
September 6, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28874293/a-plea-for-an-early-ultrasound-clinical-integrated-approach-in-patients-with-acute-heart-failure-a-proactive-comment-on-the-esc-guidelines-on-heart-failure-2016
#17
G Tavazzi, A N Neskovic, A Hussain, G Volpicelli, G Via
BACKGROUND: The European Association of Cardiology (ESC) Guidelines on the diagnosis and treatment of acute heart failure (AHF) indicate prompt therapy initiation and performance of relevant investigations as paramount. Specifically, echocardiography prior to treatment is advocated only with hemodynamic instability, and the evaluation of clinical signs of peripheral perfusion and congestion is suggested as guidance for early interventions. Given the growing body of evidence on the diagnostic/monitoring capabilities of bedside ultrasound (including focused cardiac ultrasound, comprehensive echocardiography, lung ultrasound), we discuss the potential benefit of an integrated clinical/ultrasound approach at the very early stages of acute heart failure...
October 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28871581/a-case-of-overwhelming-postsplenectomy-infection-caused-by-streptococcus-pneumoniae-with-fulminant-purpura
#18
Masamichi Komatsu, Toru Ishihara, Saki Manabe, Kosuke Kuwano, Masayuki Oki, Hidetaka Yanagi, Hideki Ozawa, Atsushi Takagi
Severe infection in patients who have lost splenic function is called overwhelming postsplenectomy infection (OPSI). Untimely treatment of patients with OPSI results in critical conditions with mortality rates as high as 50 %-70 %. For patients who undergo a splenectomy, vaccination is recommended for the prevention of OPSI. However, in Japan, the vaccination utilization rates are low. Herein, we report a case of OPSI caused by Streptococcus pneumoniae with a fulminant purpura resulting in multi-organ failure, which could be reversed by intensive care...
September 20, 2017: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/28870776/consensus-report-by-palisi-and-pbmtc-joint-working-committees-supportive-care-guidelines-for-management-of-vod-in-children-and-adolescents-part-3-focus-on-cardio-respiratory-dysfunction-infections-liver-dysfunction-and-delirium
#19
Nadia Ovchinsky, Warren Frazier, Jeffery J Auletta, Christopher C Dvorak, Monica Ardura, Enkyung Song, Jennifer McArthur, Asumthia Jeyapalan, Robert Tamburro, Kris M Mahadeo, Chani Traube, Christine N Duncan, Rajinder P S Bajwa
Some patients with veno-occlusive disease (VOD) have multi-organ dysfunction (MOD) and multiple teams are involved in their daily care in the pediatric intensive care units (PICU). Cardio-respiratory dysfunction is critical in these patients as it needs immediate action. Whether to use non-invasive or invasive ventilation strategy may be a difficult decision in the setting of mucositis or other comorbidities in patients with VOD. Similarly monitoring of their organ functions could be very challenging; they may have fulminant hepatic failure with or without hepatic encephalopathy complicated by delirium and/or infections...
September 1, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28869492/the-lactate-albumin-ratio-a-valuable-tool-for-risk-stratification-in-septic-patients-admitted-to-icu
#20
Michael Lichtenauer, Bernhard Wernly, Bernhard Ohnewein, Marcus Franz, Bjoern Kabisch, Johanna Muessig, Maryna Masyuk, Alexander Lauten, Paul Christian Schulze, Uta C Hoppe, Malte Kelm, Christian Jung
The lactate/albumin ratio has been reported to be associated with mortality in pediatric patients with sepsis. We aimed to evaluate the lactate/albumin ratio for its prognostic relevance in a larger collective of critically ill (adult) patients admitted to an intensive care unit (ICU). A total of 348 medical patients admitted to a German ICU for sepsis between 2004 and 2009 were included. Follow-up of patients was performed retrospectively between May 2013 and November 2013. The association of the lactate/albumin ratio (cut-off 0...
September 2, 2017: International Journal of Molecular Sciences
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