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Multisystem organ failure

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https://www.readbyqxmd.com/read/28609366/visceral-adiposity-predicts-severity-of-acute-pancreatitis
#1
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
#2
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
#3
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-long-term-deleterious-effect-on-physical-quality-of-life
#4
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 quality of life (QOL). We aimed to determine the long-term independent effect of AP on physical and mental QOL. METHODS: We analyzed data from 91 patients (mean age, 52 year; 54% female) admitted with AP to the University of Pittsburgh Medical Center from 2011 through 2015 who responded to telephone surveys at a median of 14 months after hospital discharge (interquartile range, 12-16 months)...
June 1, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28577200/anca-associated-vasculitis-presenting-as-severe-pulmonary-hypertension-and-right-heart-failure
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/28405984/a-prospective-study-of-acute-kidney-injury-according-to-kdigo-definition-and-its-mortality-predictors
#9
Rakesh Bhadade, Rosemarie De'Souza, Minal J Harde, Kalpana S Mehta, Prabhat Bhargava
BACKGROUND: Acute kidney injury is no longer considered to be an innocent bystander merely reflecting co-existent pathologies but an independent risk factor for mortality in the ICU. AIMS AND OBJECTIVES: To study clinical profile and correlation of patients with acute kidney injury (AKI) according to KDIGO definition with respect to incidence, outcome and different causes of AKI in critical care unit. STUDY DESIGN AND SETTING: It is a prospective observational study; and was carried out in the ICU of a tertiary care, teaching, public hospital...
December 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28303605/performance-of-scoring-systems-to-predict-mortality-of-patients-with-acute-on-chronic-liver-failure-a-systematic-review-and-meta-analysis
#10
Yi-Xiang Zheng, Xiao Zhong, Ya-Jun Li, Xue-Gong Fan
BACKGROUND: Acute-on-chronic liver failure (ACLF) has characteristic feature of multisystem organ failure, rapid progression and low early transplant-free survival. AIM: We performed a meta-analysis to determine the accuracy of five scoring systems in predicting mortality of ACLF patients. METHODS: A systematic database search was performed and retrieved articles were graded according to methodological quality. Collated data was meta-analyzed by hierarchical summarized receiver operating characteristic (HSROC) model and bivariate model to evaluate the diagnostic accuracy of scoring systems RESULT: Of 4223 studies identified, 26 studies involving 4732 ACLF patients were included...
March 16, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28127473/hemadsorption-with-adult-cytosorb%C3%A2-in-a-low-weight-pediatric-case
#11
Catalin Gabriel Cirstoveanu, Ileana Barascu, Samantha Mc Kenzie Stancu
Cytokine adsorber (CytoSorb) has been used successfully as adjunctive treatment for adult patients with elevated cytokine levels in the setting with severe sepsis and septic shock and to reduce blood myoglobin, unconjugated bilirubin, and conjugated bilirubin. In this article we present the case of a nine-month-old male infant who was admitted to the NICU due to sepsis after cardiac surgery, Fallot tetralogy, and multisystem organ failure (MSOF) including liver failure and renal failure which was successfully treated by a combination of continuous hemodiafiltration (HDF) and hemadsorption with CytoSorb...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28098544/fatal-emmonsia-sp-infection-and-fungemia-after-orthotopic-liver-transplantation
#12
Shanthi Kappagoda, Jason Y Adams, Robert Luo, Niaz Banaei, Waldo Concepcion, Dora Y Ho
We report a fatal case of disseminated Emmonsia sp. infection in a 55-year-old man who received an orthotopic liver transplant. The patient had pneumonia and fungemia, and multisystem organ failure developed. As human habitats and the number of immunocompromised patients increase, physicians must be aware of this emerging fungal infection.
February 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28041799/eif2b-related-multisystem-disorder-in-two-sisters-with-atypical-presentations
#13
Jin Sook Lee, Sangmoon Lee, Murim Choi, Byung Chan Lim, Jieun Choi, Ki Joong Kim, Jung-Eun Cheon, In-One Kim, Jong-Hee Chae
BACKGROUND: Vanishing white matter disease (VWM) is a chronic progressive leukoencephalopathy that is characterized by cerebellar ataxia and spasticity, together with cystic degeneration of the cerebral white matter as evidenced by brain magnetic resonance imaging (MRI). Here, we report two sisters with EIF2B2 variants, who presented with delayed development and failure to thrive before 1 year of age, developed cataracts, and showed diffuse leukoencephalopathy. CASE PRESENTATION: The index case had a history of hepatomegaly and intermittent vomiting after upper respiratory infection at 11 months of age...
March 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/27932175/first-attempt-of-sequential-living-donor-liver-and-hematopoietic-stem-cell-transplantation-in-a-child-with-advanced-hepatocellular-carcinoma-case-report
#14
J A Picoraro, N Ovchinsky, M Martinez, S J Lobritto, P Satwani, R Ramphal, M S Cairo, T Kato
Effective therapeutic options for advanced hepatocellular carcinoma are limited. Hematopoietic stem cell transplantation may offer a graft-versus-tumor effect. Combined liver and hematopoietic stem cell transplantation from the same donor with preparatory conditioning may promote tolerogenicity to the liver allograft and offers the potential for immunosuppression withdrawal. We report our experience with the use of this approach in a pediatric patient with invasive hepatocellular carcinoma and pulmonary metastases who underwent a living-donor liver transplantation followed by reduced-toxicity myeloablative conditioning and hematopoietic stem cell transplant from the same parental donor...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27927857/novel-clinical-and-pathologic-findings-in-a-heartland-virus-associated-death
#15
Mary-Margaret A Fill, Margaret L Compton, Edward C McDonald, Abelardo C Moncayo, John R Dunn, William Schaffner, Julu Bhatnagar, Sherif R Zaki, Timothy F Jones, Wun-Ju Shieh
We describe an investigation into a Heartland virus (HRTV)-associated death in Tennessee with novel clinical and pathologic findings. HRTV can cause rapidly fatal, widely disseminated infection with multisystem organ failure in patients without substantial comorbidities. We identified viral antigen in multiple organ tissues where it was not detected previously.
February 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27887788/hospital-admission-volume-does-not-impact-the-in-hospital-mortality-of-acute-pancreatitis
#16
Ayesha Kamal, Amitasha Sinha, Susan M Hutfless, Elham Afghani, Mahya Faghih, Mouen A Khashab, Anne Marie Lennon, Dhiraj Yadav, Martin A Makary, Dana K Andersen, Anthony N Kalloo, Vikesh K Singh
BACKGROUND: Multiple factors influence mortality in Acute Pancreatitis (AP). METHODS: To evaluate the association of demographic, clinical, and hospital factors with the in-hospital mortality of AP using a population-based administrative database. The Maryland HSCRC database was queried for adult (≥18 years) admissions with primary diagnosis of AP between 1/94-12/10. Organ failure (OF), interventions, hospital characteristics and referral status were evaluated...
November 23, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27881386/ppar%C3%AE-augments-heart-function-and-cardiac-fatty-acid-oxidation-in-early-experimental-polymicrobial-sepsis
#17
Stephen Wade Standage, Brock G Bennion, Taft Olpin Knowles, Dolena R Ledee, Michael A Portman, John K McGuire, W Conrad Liles, Aaron K Olson
Children with sepsis and multisystem organ failure have downregulated leukocyte gene expression of PPARα, a nuclear hormone receptor transcription factor that regulates inflammation and lipid metabolism. Mouse models of sepsis have likewise demonstrated that the absence of PPARα is associated with decreased survival and organ injury, specifically of the heart. Using a clinically relevant mouse model of early sepsis, we found that heart function increases in wild type (WT) mice over the first 24 hours of sepsis, but that mice lacking PPARα (Ppara(-/-)) cannot sustain the elevated heart function necessary to compensate for sepsis pathophysiology...
November 23, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27880753/notes-from-the-field-community-based-prevention-of-rocky-mountain-spotted-fever-sonora-mexico-2016
#18
Anne Straily, Naomi Drexler, Denica Cruz-Loustaunau, Christopher D Paddock, Gerardo Alvarez-Hernandez
Rocky Mountain spotted fever (RMSF), a life-threatening tickborne zoonosis caused by Rickettsia rickettsii, is a reemerging disease in Mexico (1,2). R. rickettsii is an intracellular bacterium that infects vascular endothelium and can cause multisystem organ failure and death in the absence of timely administration of a tetracycline-class antibiotic, typically doxycycline. Epidemic RMSF, as described in parts of Arizona and Mexico, is associated with massive local infestations of the brown dog tick (Rhiphicephalus sanguineus sensu lato) on domestic dogs and in peridomestic settings that result in high rates of human exposure; for example, during 2003-2012, in Arizona the incidence of RMSF in the three most highly affected communities was 150 times the U...
November 25, 2016: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/27826760/myotonic-dystrophy-type-1-management-and-therapeutics
#19
REVIEW
Cheryl A Smith, Laurie Gutmann
Myotonic dystrophy (DM1) is the most common form of adult muscular dystrophy. It is a multisystem disorder with a complex pathophysiology. Although inheritance is autosomal dominant, disease variability is attributed to anticipation, a maternal expansion bias, variable penetrance, somatic mosaicism, and a multitude of aberrant pre-mRNA splicing events. Patient presentations range from asymptomatic or mild late onset adult to severe congenital forms. Multiple organ systems may be affected. Patients may experience early cataracts, myotonia, muscle weakness/atrophy, fatigue, excessive daytime sleepiness, central/obstructive apnea, respiratory failure, cardiac arrhythmia, insulin resistance, dysphagia, GI dysmotility, cognitive impairment, Cluster C personality traits, and/or mood disorders...
December 2016: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/27795844/hyaluronic-acid-in-vascular-and-immune-homeostasis-during-normal-pregnancy-and-preeclampsia
#20
M M Ziganshina, S V Pavlovich, N V Bovin, G T Sukhikh
Preeclampsia (PE) is a multisystem pathologic state that clinically manifests itself after the 20th week of pregnancy. It is characterized by high maternal and perinatal morbidity and mortality. According to modern concepts, the impairment of trophoblast invasion into maternal spiral arteries, leading to the development of ischemia in placenta, is considered to be the major pathogenetic factor of PE development. Ischemic lesions initiate the development of a systemic inflammatory response (SIR) and endothelial dysfunction, which is the main cause of the multiple organ failure in PE...
July 2016: Acta Naturae
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