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Multisystem organ failure

Rafael Coimbra Ferreira Beltrame, Maurício Friderichs, Bárbara Rayanne Fior, Pedro Guilherme Schaefer, Gustavo Gomes Thomé, Dirceu Reis da Silva, Elvino José Guardão Barros, Renato Seligman, Francisco Veríssimo Veronese
The IgG4-related disease has a wide clinical spectrum where multiple organs can be affected, and the diagnosis depends on typical histopathological findings and an elevated IgG4 expression in plasma cells in the affected tissue. We describe the clinical presentation and evolution of a patient with acute tubulointerstitial nephritis, severe kidney failure and systemic manifestations such as lymphadenomegaly and chronic pancreatitis. The diagnosis was confirmed by the clinical picture and kidney and lymph node histopathology, in which immunohistochemistry of the lymphoid tissue showed policlonality and increased expression of IgG4, with a IgG4/total IgG ratio > 80%...
July 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Aditya Bansal, Jay K Bhama, Rajan Patel, Sapna Desai, Stacy A Mandras, Hamang Patel, Tyrone Collins, John P Reilly, Hector O Ventura, P Eugene Parrino
BACKGROUND: Outcomes of traditional mechanical support paradigms (extracorporeal membrane oxygenation, intraaortic balloon pump [IABP], and permanent left ventricular assist device [LVAD]) in acute decompensated heart failure have generally been suboptimal. Novel approaches, such as minimally invasive LVAD therapy (Impella 5.0 device), promise less invasive but equivalent hemodynamic support. However, it is yet unknown whether the outcomes with such devices support widespread acceptance of this new technology...
2016: Ochsner Journal
N D B Ehelepola, S M A N Samaranayake, B M L S Basnayake, C G K Amiyangoda, D M U C B Dhanapala, K L R Kalupahana
BACKGROUND: Snakebites cause considerable morbidity and mortality in tropical and subtropical countries even though existing treatment methods can prevent most deaths if presentation occurs early to hospitals. Envenomation by unidentified snakes is common in central Sri Lanka. Management of such patients is challenging especially if presentation is late. CASE PRESENTATION: Here, we report a case of a 52-year-old man from central Sri Lanka who presented late after being bitten by an unidentified snake...
2016: Tropical Medicine and Health
S Lowell Kahn, Jonathan McClain, Jeffrey L Kaufman
A 66-year-old man, with an abnormal porta hepatis, consistent with tumor or inflammation, developed massive bleeding from one of numerous hepatic artery aneurysms, and coil embolization achieved control of bleeding. He died of subsequent multisystem organ failure, and the most likely diagnosis was either polyarteritis nodosa or segmental arterial mediolysis. Although the dual hepatic blood supply allows a degree of arterial embolization, this case demonstrates the risks associated with large territory hepatic arterial embolization in the presence of hemodynamic instability...
October 2016: Vascular and Endovascular Surgery
Rahul Ojha, Asuri N Prasad
Disorders of copper homeostasis are currently recognized across the life span. Their recognition and links to human disease have spanned several decades, beginning with the recognition of a degenerative disorder in the offspring of sheep grazing in copper-deficient pastures, through to the description of infants suffering from a progressive neurodegenerative disorder characterized by epileptic seizures, developmental regression, failure to thrive, and an unusual hair quality (giving the condition its distinctive label of "kinky hair disease")...
2016: Journal of Multidisciplinary Healthcare
Adán Pérez-Arredondo, Eduardo Cázares-Ramírez, Paul Carrillo-Mora, Marina Martínez-Vargas, Noemí Cárdenas-Rodríguez, Elvia Coballase-Urrutia, Radamés Alemón-Medina, Aristides Sampieri, Luz Navarro, Liliana Carmona-Aparicio
Traumatic brain injury (TBI) is an alteration in brain function, caused by an external force, which may be a hit on the skull, rapid acceleration or deceleration, penetration of an object, or shock waves from an explosion. Traumatic brain injury is a major cause of morbidity and mortality worldwide, with a high prevalence rate in pediatric patients, in which treatment options are still limited, not available at present neuroprotective drugs. Although the therapeutic management of these patients is varied and dependent on the severity of the injury, general techniques of drug types are handled, as well as physical and surgical...
August 25, 2016: Clinical Neuropharmacology
Meera C Viswanathan, Anna C Blice-Baum, Tzu-Kang Sang, Anthony Cammarato
Valosin-containing protein (VCP) is a highly conserved mechanoenzyme that helps maintain protein homeostasis in all cells and serves specialized functions in distinct cell types. In skeletal muscle, it is critical for myofibrillogenesis and atrophy. However, little is known about VCP's role(s) in the heart. Its functional diversity is determined by differential binding of distinct cofactors/adapters, which is likely disrupted during disease. VCP mutations cause multisystem proteinopathy (MSP), a pleiotropic degenerative disorder that involves inclusion body myopathy...
June 2016: Journal of Cardiovascular Development and Disease
Aleksandra Leligdowicz, William A Fischer, Timothy M Uyeki, Thomas E Fletcher, Neill K J Adhikari, Gina Portella, Francois Lamontagne, Christophe Clement, Shevin T Jacob, Lewis Rubinson, Abel Vanderschuren, Jan Hajek, Srinivas Murthy, Mauricio Ferri, Ian Crozier, Elhadj Ibrahima, Marie-Claire Lamah, John S Schieffelin, David Brett-Major, Daniel G Bausch, Nikki Shindo, Adrienne K Chan, Tim O'Dempsey, Sharmistha Mishra, Michael Jacobs, Stuart Dickson, G Marshall Lyon, Robert A Fowler
As of 20 May 2016 there have been 28,646 cases and 11,323 deaths resulting from the West African Ebola virus disease (EVD) outbreak reported to the World Health Organization. There continue to be sporadic flare-ups of EVD cases in West Africa.EVD presentation is nonspecific and characterized initially by onset of fatigue, myalgias, arthralgias, headache, and fever; this is followed several days later by anorexia, nausea, vomiting, diarrhea, and abdominal pain. Anorexia and gastrointestinal losses lead to dehydration, electrolyte abnormalities, and metabolic acidosis, and, in some patients, acute kidney injury...
2016: Critical Care: the Official Journal of the Critical Care Forum
Jacques Rizkallah, Vikas Kuriachan, L Brent Mitchell
BACKGROUND: Dronedarone is a benzofuran derivative resembling amiodarone that was intended to reduce the iodine-associated tissue deposition and organ toxicity seen with the latter. The utility of dronedarone for patients with ventricular arrhythmias has not been thoroughly evaluated. We present our experience with its use to treat refractory ventricular tachycardia storm and review the literature. CASE PRESENTATION: An 85 year-old gentleman with multiple medical comorbidities including ischemic and non-ischemic cardiomyopathy with severe biventricular systolic dysfunction presented with ventricular tachycardia storm...
2016: BMC Research Notes
Allen O Applegate, Vanessa C Fong, Kara Tardivel, Susan A Lippold, Sheilah Zarate
On June 2, 2015, CDC was notified that a male airline passenger, aged 41 years, with a fever of 105.4°F, headache, nausea, photophobia, diarrhea, and vomiting, which began approximately 3 hours after departure, was arriving to San Francisco, California, on a flight from Frankfurt, Germany. His symptoms reportedly started with neck stiffness 1 day earlier. Upon arrival, the patient was immediately transported to a local hospital, where he was in septic shock, which was followed by multisystem organ failure...
2016: MMWR. Morbidity and Mortality Weekly Report
Zhihai Chen, Lin Liu, Yanning Lv, Wei Zhang, Jiandong Li, Yi Zhang, Tian Di, Shuo Zhang, Jingyuan Liu, Jie Li, Jing Qu, Wenhao Hua, Chuan Li, Peng Wang, Quanfu Zhang, Yanli Xu, Rongmeng Jiang, Qin Wang, Lijuan Chen, Shiwen Wang, Xinghuo Pang, Mifang Liang, Xuejun Ma, Xingwang Li, Quanyi Wang, Fujie Zhang, Dexin Li
Yellow fever (YF) is a viral disease endemic to the tropical regions of Africa and South America. An outbreak of YF has been occurring in Angola, since the beginning of 2016. In March 2016, a 32-year-old Chinese man who returned from Angola was hospitalized and diagnosed with the first case of imported YF in China. Clinical observations, blood viral RNA detection, serological testing and treatments for the patient were performed daily. The virus was isolated in Vero cells, and the complete viral genome was sequenced and analyzed using the next-generation genomic sequencing platform...
2016: Emerging Microbes & Infections
Miroslav Marković, Ivan Tomić, Nikola Ilić, Marko Dragaš, Igor Končar, Zoran Bukumirić, Miloš Sladojević, Lazar Davidović
BACKGROUND: Mortality after open repair of ruptured abdominal aortic aneurysms (RAAA) remains high. The purpose of this study is to present the results of open RAAA treatment observing two different ten-year periods in a single high-volume centre and to consider the possibilities of result improvement in the future. MATERIAL AND METHODS: Retrospective analysis of 729 RAAA patients that were treated through 1991-2001 (229 pts, group A) and 2002-2011 (500 pts, group B) was performed...
July 6, 2016: Annals of Vascular Surgery
Dina M Filiberto, Adam D Fox
Significant pelvic ring fractures are usually secondary to high-energy trauma, and, when associated with other life-threatening injuries and hemodynamic instability, result in high mortality rates ranging from 40 to 60%. The major cause of death during the first 24 h after pelvic trauma is attributed to acute blood loss, with later mortality secondary to multisystem organ failure. In a majority of patients, the source of pelvic bleeding is from disruption of the presacral venous plexus and bony fracture sites, while arterial injury is present in only 10-15%...
July 1, 2016: International Journal of Surgery
Ahmed Abd El Basset Abo El Ezz, Maher Ahmed Abd El Hafez, Doaa Mohamed El Amrousy, Ghada Abd El Momen Suliman
OBJECTIVE: Von Willebrand factor antigen (VWF-Ag) is proved to be a marker for pulmonary endothelial injury in acute lung injury (ALI). We aimed to evaluate the predictive value of VWF-Ag plasma levels in children with ALI. METHODS: Prospective controlled study included 40 children with ALI as a patient group, 40 healthy children as a control group. Plasma VWF Ag level was measured at days 1 and 3 in patient group and measured once for control group. RESULTS: The commonest cause of ALI was pneumonia (35%)...
June 30, 2016: Pediatric Pulmonology
Hsiang-Yu Lin, Chih-Kuang Chuang, Yu-Hsiu Huang, Ru-Yi Tu, Fang-Ju Lin, Shio Jean Lin, Pao Chin Chiu, Dau-Ming Niu, Fuu-Jen Tsai, Wuh-Liang Hwu, Yin-Hsiu Chien, Ju-Li Lin, Yen-Yin Chou, Wen-Hui Tsai, Tung-Ming Chang, Shuan-Pei Lin
BACKGROUND: Mucopolysaccharidosis type II (MPS II) is an X-linked recessive, multisystemic lysosomal storage disorder caused by a deficiency of iduronate-2-sulfatase. MPS II has a variable age of onset and variable rate of progression. In Asian countries, there is a relatively higher incidence of MPS II compared to other types of MPS. METHODS: A retrospective analysis was carried out of 34 Taiwanese MPS II patients who died between 1995 and 2012. The clinical characteristics, medical records, age at death, and cause of death were evaluated to better understand the natural progression of this disease...
2016: Orphanet Journal of Rare Diseases
Philip Blasto Ooko, Seno Saruni, Mark Oloo, Hillary Mariko Topazian, Russell White
INTRODUCTION: Ileo-sigmoid knotting (ISK) is a rare cause of bowel obstruction in which the ileum twists around the sigmoid colon. It is associated with rapid bowel gangrene and a high mortality rate. Little has been published about this condition in Kenya. The objective was to determine the presentation, management, and outcome of patients with ISK. METHODS: A seven year (January 2008-December 2014) retrospective chart review of patients managed for ISK at Tenwek Hospital in Bomet, Kenya...
2016: Pan African Medical Journal
Silvia Borghini, Denise Ferrera, Ignazia Prigione, Michele Fiore, Chiara Ferraris, Valentina Mirisola, Adriana Amaro, Ilaria Gueli, Luca Zammataro, Marco Gattorno, Ulrich Pfeffer, Isabella Ceccherini
OBJECTIVES: Tumor necrosis factor (TNF) receptor-associated periodic syndrome (TRAPS) is a multisystemic autoinflammatory condition associated with heterozygous TNFRSF1A mutations, presenting with a variety of clinical symptoms, many of which yet unexplained. In this work, we aimed at deepening into TRAPS pathogenic mechanisms sustained by monocytes. METHODS: Microarray experiments were conducted to identify genes whose expression results altered in patients compared to healthy individuals, both under basal condition and following LPS stimulation...
June 16, 2016: Clinical and Experimental Rheumatology
Pooja Prathapan Sarada, Krishnaswamy Sundararajan
Guillain-Barré syndrome (GBS) is an acute demyelinating polyneuropathy, usually evoked by antecedent infection. Sarcoidosis is a multisystem chronic granulomatous disorder with neurological involvement occurring in a minority. We present a case of a 43-year-old Caucasian man who presented with acute ascending polyradiculoneuropathy with a recent diagnosis of pulmonary sarcoidosis. The absence of acute flaccid paralysis excluded a clinical diagnosis of GBS in the first instance. Subsequently, a rapid onset of proximal weakness with multi-organ failure led to the diagnosis of GBS, which necessitated intravenous immunoglobulin and plasmapheresis to which the patient responded adequately, and he was subsequently discharged home...
April 2016: Indian Journal of Critical Care Medicine
Andrew S Griffin, Matthew D Crawford, Rajan T Gupta
Gas gangrene is a rare but often fatal soft-tissue infection. Because it is uncommon and the classic symptom of crepitus does not appear until the infection is advanced, prompt diagnosis requires a high index of suspicion. We present a case report of a middle-aged man who presented with acute onset lower-extremity pain that was initially thought to be due to deep vein thrombosis. After undergoing workup for pulmonary embolism, he was found to have massive gas gangrene of the lower extremity secondary to an occult colon adenocarcinoma and died within hours of presentation from multisystem organ failure...
June 2016: Radiology case reports
Carolin Trepesch, Ramona Nitzsche, Aenne Glass, Bernd Kreikemeyer, Jochen K Schubert, Sonja Oehmcke-Hecht
BACKGROUND: Sepsis is associated with coagulation abnormalities, and a high content of intravascular tissue factor (TF) may contribute to the development of multisystem organ failure. Circulating microvesicles (MVs) are increased during sepsis and characterized by their phosphatidylserine content. It is unclear whether MVs-as a part of the host response to the infection-are beneficial or rather contribute to systemic complications in sepsis. In the present prospective clinical pilot study, we investigated whether plasma TF and MVs are associated with the risk of multiple organ failure and mortality...
2016: Journal of Intensive Care
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