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Multisystem organ failure

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https://www.readbyqxmd.com/read/28923988/contemporary-management-of-cardiogenic-shock-a-scientific-statement-from-the-american-heart-association
#1
REVIEW
Sean van Diepen, Jason N Katz, Nancy M Albert, Timothy D Henry, Alice K Jacobs, Navin K Kapur, Ahmet Kilic, Venu Menon, E Magnus Ohman, Nancy K Sweitzer, Holger Thiele, Jeffrey B Washam, Mauricio G Cohen
Cardiogenic shock is a high-acuity, potentially complex, and hemodynamically diverse state of end-organ hypoperfusion that is frequently associated with multisystem organ failure. Despite improving survival in recent years, patient morbidity and mortality remain high, and there are few evidence-based therapeutic interventions known to clearly improve patient outcomes. This scientific statement on cardiogenic shock summarizes the epidemiology, pathophysiology, causes, and outcomes of cardiogenic shock; reviews contemporary best medical, surgical, mechanical circulatory support, and palliative care practices; advocates for the development of regionalized systems of care; and outlines future research priorities...
September 18, 2017: Circulation
https://www.readbyqxmd.com/read/28923819/geriatric-anorexia-nervosa
#2
Moaweya Zayed, Joseph P Garry
Eating disorders are not commonly diagnosed in individuals aged >50 years, yet they are associated with significant psychiatric comorbidities and overall morbidity. Anorexia nervosa is the most common eating disorder among this age group, and women are affected most often. We present the fatal case of a 66-year old woman with severe malnutrition and newly diagnosed anorexia nervosa. Inpatient refeeding was unsuccessful, and she succumbed to multisystem organ failure. The timely recognition of eating disorders among older people is important for family physicians who care for patients across the life spectrum...
September 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28905470/outcomes-of-berlin-heart-excor-%C3%A2-pediatric-ventricular-assist-device-support-in-patients-with-restrictive-and-hypertrophic-cardiomyopathy
#3
Jennifer A Su, Jondavid Menteer
The outcomes of pediatric ventricular assist device support in patients with diastolic heart failure have not been well described. This study reviews the North American experience with Berlin Heart EXCOR(®) ventricular assist device implants in children with such physiology. The Berlin Heart clinical database was reviewed. Patients with primary diastolic dysfunction are included in this study. Twenty pediatric patients with restrictive cardiomyopathy (n = 13), hypertrophic cardiomyopathy (n = 3), or congenital heart disease with restrictive physiology (n = 4) who were supported with EXCOR(®) were identified...
September 14, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28861330/a-plasma-cell-dyscrasia-presenting-as-amyloid-cardiomyopathy-and-autonomic-dysfunction-in-a-healthy-patient
#4
Rabih Tabet, Julie Zaidan, Boutros Karam, Samer Saouma, Foad Ghavami
Systemic amyloidosis is a rare multisystem disease caused by incorrectly folded proteins that deposit pathologically in different tissues and organs of the human body. It has a very wide spectrum of clinical presentations according to the affected organ(s), and its diagnosis is commonly delayed. Cardiac involvement is the leading cause of morbidity and mortality and carries a poor prognosis, especially in primary light chain amyloidosis. Therefore any delay in the diagnosis can result in devastating outcomes for the patient...
June 29, 2017: Curēus
https://www.readbyqxmd.com/read/28753141/atrial-esophageal-fistula-secondary-to-ablation-for-atrial-fibrillation-a-case-series-and-review-of-the-literature
#5
Lily K Fatula, William D Bolton, Allyson L Hale, Barry R Davis, James E Stephenson, Sharon Ben-Or
This article describes 2 patients who presented to our institution with left atrial esophageal fistula after atrial fibrillation ablation; it also compares our experience with other atrial esophageal fistula cases reported in the literature. We performed a retrospective review of 2 patients who presented to our hospital between July 2015 and September 2015 with atrial esophageal fistula. Patient A, a 57-year-old man, presented 31 days postablation with a fever and right-sided weakness. A chest computed tomography showed gas in the left atrium and esophagus; an echocardiogram confirmed the diagnosis of atrial esophageal fistula...
July 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28728200/-heart-failure-a-model-for-multimorbidity
#6
REVIEW
Gülmisal Güder, Georg Ertl
Heart failure frequently is the consequence of different cardiac diseases and is associated with multiple cardiac and non-cardiac co-morbidities. It may be exemplary for multi-morbidity in the elderly, has negative impact on various organ systems and may induce further comorbidities. The following article addresses heart failure as a multisystem disorder.
July 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28707773/sudden-onset-of-pheochromocytoma-multisystem-crisis-at-38%C3%A2-weeks-of-gestation-resulted-in-intrauterine-fetal-death-a-case-report
#7
Jun Iwase, Michiko Yamanaka
A 24-year-old woman at 38 weeks of gestation with no past medical history was transferred to our hospital because of acute onset of severe dyspnea. Her conscious level was E4V2M5 on the Glasgow Coma Scale and she displayed stress cardiomyopathy (Takotsubo cardiomyopathy) with multiple organ failure. Intrauterine fetal death was confirmed. After immediate application of intubated ventilation, percutaneous cardiopulmonary support and hemodialysis, she was diagnosed with pheochromocytoma multisystem crisis. After multidisciplinary team discussion, surgical resection of the left pheochromocytoma was performed on the same day...
July 14, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28703109/comparative-analysis-of-immediate-postoperative-complications-following-total-gastrectomy
#8
Samantha McKenzie Stancu, Bogdan Popescu
INTRODUCTION: Total gastrectomy (TG), despite disrupting the continuity of the alimentary tract and accounting for significant postoperative complications, is the procedure of choice for curative resection of gastric carcinoma. The objectives of this study were to report the rate of postoperative complications following TG, to analyze adverse postoperative outcomes, and to determine which of the two techniques - the Roux-en-Y esophagojejunostomy and Omega-Braun TG, is safer. MATERIALS AND METHODS: A retrospective, observational study was conducted among patients diagnosed with gastric carcinoma who underwent TG between January 1st, 2010 and December 31st, 2012 in the Surgery Department of the Bucharest Clinical Emergency Hospital...
June 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28697152/transcutaneous-endoscopic-necrosectomy-for-walled-off-pancreatic-necrosis-in-the-paracolic-gutter
#9
Monica Saumoy, Nikhil A Kumta, Amy Tyberg, Elizabeth Brown, Micheal D Lieberman, Soumitra R Eachempati, Ronald S Winokur, Monica Gaidhane, Reem Z Sharaiha, Michel Kahaleh
BACKGROUND: Walled-off pancreatic necrosis (WON) is a sequelae of acute pancreatitis that requires debridement, once infected. Recently, endoscopic necrosectomy has become the mainstay for management. However, peripancreatic collections that extend to the paracolic gutter or lesser sac, are more challenging to treat endoscopically. We report an endoscopic method for management of necrotic collections that extend into the paracolic gutter. METHODS: Consecutive patients, with symptomatic WON extending into the retroperitoneum, were included in a prospective registry...
July 10, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28686648/increased-levels-of-soluble-forms-of-e-selectin-and-icam-1-adhesion-molecules-during-human-leptospirosis
#10
Loic Raffray, Claude Giry, Yoga Thirapathi, Anne-Hélène Reboux, Marie-Christine Jaffar-Bandjee, Philippe Gasque
Leptospirosis is a multisystemic zoonotic disease with infiltration of visceral organs by Leptospira. The capacity of the vascular endothelium to grant immune cell recruitment and activation in target organs during the disease course remains poorly characterized. We ascertained the levels of expression of several soluble cell adhesion molecules (CAM) notably expressed by endothelial cells in human leptospirosis. We prospectively enrolled 20 hospitalized patients and compared them to 10 healthy controls. Disease severity was defined by one or more organ failures, or death...
2017: PloS One
https://www.readbyqxmd.com/read/28668140/clinical-features-diagnosis-and-management-of-patients-with-anderson-fabry-cardiomyopathy
#11
REVIEW
Haran Yogasundaram, Daniel Kim, Omar Oudit, Richard B Thompson, Frank Weidemann, Gavin Y Oudit
Anderson-Fabry disease (AFD) is an X-linked recessive, multisystem disease of lysosomal storage. A mutation in the gene encoding the hydrolase enzyme α-galactosidase A results in its deficiency, or complete absence of activity. Subsequent progressive intracellular accumulation of glycosphingolipids, predominantly globotriaosylceramide, in various tissues, results in progressive organ dysfunction and failure, most commonly affecting the kidneys, nervous system, skin, eyes, vascular endothelium, and the heart...
July 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28650394/visceral-adiposity-predicts-severity-of-acute-pancreatitis
#12
Ashwinee Natu, Tyler Stevens, Lorna Kang, Scott Yasinow, Emad Mansoor, Rocio Lopez, Brooke Glessing, Erick Remer, Tyler Richards, Amit Gupta, Amitabh Chak, Peter J W Lee
OBJECTIVES: The aim of this study was to determine the association of visceral adiposity with severe outcomes in acute pancreatitis (AP). METHODS: This retrospective study included consecutive patients with AP admitted to a tertiary care hospital between January 2010 and January 2015 who underwent a computed tomography scan. The visceral adipose tissue (VAT) volume was estimated using the method of Linder and colleagues. Multivariable logistic regression analysis was conducted to assess VAT as a predictor of severe AP compared with other validated predictors of severity...
June 22, 2017: Pancreas
https://www.readbyqxmd.com/read/28609366/visceral-adiposity-predicts-severity-of-acute-pancreatitis
#13
Ashwinee Natu, Tyler Stevens, Lorna Kang, Scott Yasinow, Emad Mansoor, Rocio Lopez, Brooke Glessing, Erick Remer, Tyler Richards, Amit Gupta, Amitabh Chak, Peter J W Lee
OBJECTIVES: The aim of this study was to determine the association of visceral adiposity with severe outcomes in acute pancreatitis (AP). METHODS: This retrospective study included consecutive patients with AP admitted to a tertiary care hospital between January 2010 and January 2015 who underwent a computed tomography scan. The visceral adipose tissue (VAT) volume was estimated using the method of Linder and colleagues. Multivariable logistic regression analysis was conducted to assess VAT as a predictor of severe AP compared with other validated predictors of severity...
July 2017: Pancreas
https://www.readbyqxmd.com/read/28585138/assessment-of-complications-after-liver-surgery-two-novel-grading-systems-applied-to-patients-undergoing-hepatectomy
#14
Li-Ning Xu, Bo Yang, Gui-Ping Li, De-Wei Gao
Although quality assessment is gaining increasing attention, there is still no consensus on how to define and grade postoperative complications. The absence of a definition and a widely accepted ranking system to classify surgical complications has hampered proper interpretation of the surgical outcome. This study aimed to define and search the simple and reproducible classification of complications following hepatectomy based on two therapy-oriented severity grading system: Clavien-Dindo classification of surgical complications and Accordion severity grading of postoperative complications...
June 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/28580217/silence-pancreatitis-in-systemic-lupus-erythematosus
#15
Ervin Alibegovic, Admir Kurtcehajic, Ismar Hasukic, Ahmed Hujdurovic, Jasmin A Fejzic, Dzenita Kurtcehajic
We present here a systemic lupus erythematosus (SLE) related biochemically silent pancreatitis which was assessed via computed tomography in a 35-year-old woman. A patient with a twelve-year history of SLE presented with exacerbation of symptoms of the basic disease, with SLE Disease Activity Index > 15. She was referred to inpatient care. Dosage of corticosteroid and azathioprine for SLE was increased; subclinically and biochemically silent pancreatitis had developed, and was not diagnosed within an appropriate time...
May 2017: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/28579182/acute-pancreatitis-has-a-long-term-deleterious-effect-on-physical-health-related-quality-of-life
#16
Jorge D Machicado, Amir Gougol, Kimberly Stello, Gong Tang, Yongseok Park, Adam Slivka, David C Whitcomb, Dhiraj Yadav, Georgios I Papachristou
BACKGROUND & AIMS: It is not clear how acute pancreatitis (AP) affects health related quality of life (HRQOL). We aimed to determine the long-term independent effect of AP on physical and mental HRQOL. METHODS: We analyzed data from 91 patients (mean 52 years of age, 54% women) admitted with AP to the University of Pittsburgh Medical Center from 2011 to 2015 who responded to telephone surveys at a median of 14 months after hospital discharge (interquartile range, 12-16 months)...
September 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28577200/anca-associated-vasculitis-presenting-as-severe-pulmonary-hypertension-and-right-heart-failure
#17
Rakesh Kumar Pilania, Sumeet R Dhawan, Joseph L Mathew, Surjit Singh, K S Sodhi, Meenu Singh
Microscopic polyangiitis (MPA) is a small vessel multisystemic disorder characterised by necrotising small vessel vasculitis without any immune deposits. Kidney and lung are the predominant organs affected in MPA. Skin, gastrointestinal and neurological findings are also described. Isolated pulmonary manifestations are rare. The authors describe a two-year girl who presented with right heart failure and was subsequently diagnosed as ANCA-associated vasculitis. This case report is intended to sensitise pediatricians to consider systemic vasculitis with pulmonary hemorrhage in children with pulmonary hypertension even in the absence of severe pallor...
June 2, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28576239/inhalation-injury-pathophysiology-diagnosis-and-treatment
#18
REVIEW
Samuel W Jones, Felicia N Williams, Bruce A Cairns, Robert Cartotto
The classic determinants of mortality from severe burn injury are age, size of injury, delays of resuscitation, and the presence of inhalation injury. Of the major determinants of mortality, inhalation injury remains one of the most challenging injuries for burn care providers. Patients with inhalation injury are at increased risk for pneumonia (the leading cause of death) and multisystem organ failure. There is no consensus among leading burn care centers in the management of inhalation injury. This article outlines the current treatment algorithms and the evidence of their efficacy...
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28453098/-causes-of-death-from-breast-cancer-in-colombia
#19
Mario A González-Mariño
Objective To review the direct causes of death from breast cancer in Colombia according to data from death certificates in 2008. Material and Methods We reviewed the direct causes of death in patients whose code of underlying cause of death was malignant tumor of the breast according to the National Statistics Department of Colombia's (DANE from Spanish initials) records of death in 2008. Distribution is evaluated by diagnostic code, age, educational level, marital status, social security and place of death...
June 2016: Revista de Salud Pública
https://www.readbyqxmd.com/read/28416934/sepsis-and-septic-shock-current-treatment-strategies-and-new-approaches
#20
REVIEW
Gizem Polat, Rustem Anil Ugan, Elif Cadirci, Zekai Halici
Sepsis is a complex condition characterized by the simultaneous activation of inflammation and coagulation in response to microbial insult. These events manifest as systemic inflammatory response syndrome or sepsis symptoms through the release of proinflammatory cytokines, procoagulants, and adhesion molecules from immune cells and/or damaged endothelium. Today, sepsis is a severe multisystem disease with difficult treatments for its manifestations and high mortality rates. In the last two decades in particular, many studies have been conducted on sepsis that cause shock, multiorgan dysfunction, and organ failure by especially leading to hemodynamic changes...
February 2017: Eurasian Journal of Medicine
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