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https://www.readbyqxmd.com/read/28938309/successful-treatment-with-dabigatran-for-consumptive-coagulopathy-associated-with-extensive-vascular-malformations
#1
Atsushi Yasumoto, Ryohei Ishiura, Mitsunaga Narushima, Yutaka Yatomi
: Vascular malformation is occasionally complicated by consumptive coagulopathy, known as localized intravascular coagulopathy (LIC), which is characterized by a reduced fibrinogen level, an elevated D-dimer level and a normal platelet count. We report the case of a 17-year-old Japanese girl who presented with LIC secondary to extensive vascular malformations, whose condition had progressed to disseminated intravascular coagulation (DIC). She suddenly presented with severe anaemia, despite the absence of obvious bleeding, and she began to require regular red blood cell (RBC) transfusions...
September 21, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28938291/feasibility-and-safety-of-controlled-active-hypothermia-treatment-during-transport-in-neonates-with-hypoxic-ischemic-encephalopathy
#2
Eniko Szakmar, Kata Kovacs, Unoke Meder, Agnes Nagy, Andras Szell, Bojan Bundzsity, Zsolt Somogyvari, Attila J Szabo, Miklos Szabo, Agnes Jermendy
OBJECTIVES: To evaluate the feasibility and safety of controlled active hypothermia versus standard intensive care during neonatal transport in patients with hypoxic-ischemic encephalopathy. DESIGN: Cohort study with a historic control group. SETTING: All infants were transported by Neonatal Emergency & Transport Services to a Level-III neonatal ICU. PATIENTS: Two hundred fourteen term newborns with moderate-to-severe hypoxic-ischemic encephalopathy...
September 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28938259/hepatic-legionella-pneumophila-infection-in-an-infant-with-severe-combined-immunodeficiency
#3
Rotem Lapidot, Laila Alawdah, J R Köhler, Vera Paulson, Ofer Levy
Rare cases of extrapulmonary involvement in Legionella spp. infections have been described, mostly in immunocompromised adults. We report a case of a 2 month old male with reticular dysgenesis variant of severe combined immune deficiency (SCID) with multiple liver lesions. Core-needle biopsies of one liver lesion demonstrated Gram-negative bacilli and a broad-spectrum polymerase chain reaction (PCR) assay detected Legionella pneumophilia.
September 20, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28938253/guidelines-for-the-diagnosis-and-management-of-critical-illness-related-corticosteroid-insufficiency-circi-in-critically-ill-patients-part-i-society-of-critical-care-medicine-sccm-and-european-society-of-intensive-care-medicine-esicm-2017
#4
Djillali Annane, Stephen M Pastores, Bram Rochwerg, Wiebke Arlt, Robert A Balk, Albertus Beishuizen, Josef Briegel, Joseph Carcillo, Mirjam Christ-Crain, Mark S Cooper, Paul E Marik, Gianfranco Umberto Meduri, Keith M Olsen, Sophia C Rodgers, James A Russell, Greet Van den Berghe
OBJECTIVE: To update the 2008 consensus statements for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in adult and pediatric patients. PARTICIPANTS: A multispecialty task force of 16 international experts in critical care medicine, endocrinology, and guideline methods, all of them members of the Society of Critical Care Medicine and/or the European Society of Intensive Care Medicine. DESIGN/METHODS: The recommendations were based on the summarized evidence from the 2008 document in addition to more recent findings from an updated systematic review of relevant studies from 2008 to 2017 and were formulated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology...
September 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28938252/emotional-impact-of-end-of-life-decisions-on-professional-relationships-in-the-icu-an-obstacle-to-collegiality
#5
Alexandra Laurent, Magalie Bonnet, Gilles Capellier, Pierre Aslanian, Paul Hebert
OBJECTIVES: End-of-life decisions are not only common in the ICU but also frequently elicit strong feelings among health professionals. Even though we seek to develop more collegial interprofessional approaches to care and health decision-making, there are many barriers to successfully managing complex decisions. The aim of this study is to better understand how emotions influence the end-of-life decision-making process among professionals working in ICU. DESIGN: Qualitative study with clinical interviews...
September 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28938251/critical-illness-related-corticosteroid-insufficiency-circi-a-narrative-review-from-a-multispecialty-task-force-of-the-society-of-critical-care-medicine-sccm-and-the-european-society-of-intensive-care-medicine-esicm
#6
Djillali Annane, Stephen M Pastores, Wiebke Arlt, Robert A Balk, Albertus Beishuizen, Josef Briegel, Joseph Carcillo, Mirjam Christ-Crain, Mark S Cooper, Paul E Marik, Gianfranco Umberto Meduri, Keith M Olsen, Bram Rochwerg, Sophia C Rodgers, James A Russell, Greet Van den Berghe
OBJECTIVE: To provide a narrative review of the latest concepts and understanding of the pathophysiology of critical illness-related corticosteroid insufficiency (CIRCI). PARTICIPANTS: A multi-specialty task force of international experts in critical care medicine and endocrinology and members of the Society of Critical Care Medicine and the European Society of Intensive Care Medicine. DATA SOURCES: Medline, Database of Abstracts of Reviews of Effects (DARE), Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Database of Systematic Reviews...
September 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28937998/selection-of-dna-aptamers-specific-for-live-pseudomonas-aeruginosa
#7
Jennifer Soundy, Darren Day
Pseudomonas aeruginosa is an opportunistic pathogen that causes significant morbidity and mortality in immunocompromised patients, particular cystic fibrosis sufferers, burns victims, diabetics and neonates. It thrives in moist places where it forms biofilms that are exceedingly difficult to eradicate on hospital surfaces, in water supplies and implanted biomaterials. Using a live cell SELEX approach we selected DNA aptamers to P. aeruginosa grown as biofilms in microfluidic cells. From a pool of aptamer candidates showing tight binding a stem-loop structure was identified as being important for binding...
2017: PloS One
https://www.readbyqxmd.com/read/28937853/assessment-of-microvascular-invasion-of-hepatocellular-carcinoma-with-diffusion-kurtosis-imaging
#8
Wen-Tao Wang, Li Yang, Zhao-Xia Yang, Xin-Xing Hu, Ying Ding, Xu Yan, Cai-Xia Fu, Robert Grimm, Meng-Su Zeng, Sheng-Xiang Rao
Purpose To evaluate the potential role of diffusion kurtosis imaging and conventional magnetic resonance (MR) imaging findings including standard monoexponential model of diffusion-weighted imaging and morphologic features for preoperative prediction of microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Materials and Methods Institutional review board approval and written informed consent were obtained. Between September 2015 and November 2016, 84 patients (median age, 54 years; range, 29-79 years) with 92 histopathologically confirmed HCCs (40 MVI-positive lesions and 52 MVI-negative lesions) were analyzed...
September 22, 2017: Radiology
https://www.readbyqxmd.com/read/28937572/obstetric-care-consensus-no-6-periviable-birth
#9
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937567/obstetric-care-consensus-no-6-summary-periviable-birth
#10
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937547/management-of-emergency-electroconvulsive-therapy-in-the-intensive-care-unit-for-life-threatening-psychiatric-conditions-a-case-series
#11
Samuel Bulteau, Edouard-Jules Laforgue, Loïc Chimot, Romain Dumont, Olivier Loutrel, François Etcheverrigaray, Caroline Victorri-Vigneau, Alexandre Massri, Jean-Marie Vanelle, Anne Sauvaget
Catatonia can lead to severe complications and may be lethal but is often underdiagnosed. The clinical presentation can be similar to coma. In these situations, electroconvulsive therapy (ECT) can be used as first-line treatment to enable extubation, recovery of autonomy, and rapid discharge from intensive care. We report 4 cases of patients hospitalized in the intensive care unit with comatose clinical presentation and life-threatening condition caused by catatonia. All patients received ECT sessions, after which the catatonic symptoms partially or fully remitted...
September 20, 2017: Journal of ECT
https://www.readbyqxmd.com/read/28937529/effects-of-propofol-on-wound-closure-and-barrier-function-of-cultured-endothelial-cells-an-in-vitro-experimental-study
#12
Karina Zitta, Lars Hummitzsch, Ole Broch, Matthias Gruenewald, Henning Ohnesorge, Kerstin Parczany, Markus Steinfath, Martin Albrecht
BACKGROUND: Propofol is widely used in routine clinical practice for the induction and maintenance of anaesthesia. Although propofol is regarded as a well tolerated anaesthetic, its effect on intact or damaged endothelial cells has not yet been elucidated. OBJECTIVE: The aim of this study was to investigate the effects of different concentrations of propofol on cell damage, metabolic activity, barrier function and wound healing capacity of human endothelial cells...
September 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28937407/time-course-of-septic-shock-in-immunocompromised-and-nonimmunocompromised-patients
#13
Matthieu Jamme, Fabrice Daviaud, Julien Charpentier, Nathalie Marin, Michaël Thy, Yannick Hourmant, Jean-Paul Mira, Frédéric Pène
OBJECTIVES: To address the impact of underlying immune conditions on the course of septic shock with respect to both mortality and the development of acute infectious and noninfectious complications. DESIGN: An 8-year (2008-2015) monocenter retrospective study. SETTING: A medical ICU in a tertiary care center. PATIENTS: Patients diagnosed for septic shock within the first 48 hours of ICU admission were included. Patients were classified in four subgroups with respect to their immune status: nonimmunocompromised and immunocompromised distributed into hematologic or solid malignancies and nonmalignant immunosuppression...
September 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28937369/study-of-association-of-epstein-barr-virus-in-lymphomas-by-epstein-barr-virus-encoded-rna-in-situ-hybridization-an-indian-perspective-from-a-tertiary-care-cancer-institute
#14
Roshani Gala, Jatin S Gandhi, Gurudutt Gupta, Shrruti K Grover, Anila Sharma, Sunil Pasricha, Anurag Mehta
BACKGROUND: The Epstein-Barr virus (EBV), also called human herpesvirus 4, is a virus of the herpes family. The EBV-associated lymphomas include Burkitt lymphoma, classic Hodgkin lymphoma (HL), lymphomas arising in immunocompromised individuals, peripheral T-cell lymphomas, angioimmunoblastic T-cell lymphoma, extranodal nasal-type natural killer/T-cell lymphoma, and other rare histotypes. OBJECTIVE: The present study evaluated the role of EBV as an etiologic agent in various lymphomas and determined an Indian perspective in a tertiary care cancer center compared to that of Western literature...
July 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28937325/revascularization-of-the-upper-posterior-circulation-with-the-anterior-temporal-artery-an-anatomical-feasibility-study
#15
Ali Tayebi Meybodi, Michael T Lawton, Dylan Griswold, Pooneh Mokhtari, Andre Payman, Halima Tabani, Sonia Yousef, Arnau Benet
OBJECTIVE In various disease processes, including unclippable aneurysms, a bypass to the upper posterior circulation (UPC) including the superior cerebellar artery (SCA) and posterior cerebral artery (PCA) may be needed. Various revascularization options exist, but the role of intracranial (IC) donors has not been scrutinized. The objective of this study was to evaluate the anatomical feasibility of utilizing the anterior temporal artery (ATA) for revascularization of the UPC. METHODS ATA-SCA and ATA-PCA bypasses were performed on 14 cadaver specimens...
September 22, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28937263/imaging-features-of-breast%C3%A2-cancers-on-digital%C3%A2-breast%C3%A2-tomosynthesis%C3%A2-according-to%C3%A2-molecular%C3%A2-subtype-association-with%C3%A2-breast%C3%A2-cancer%C3%A2-detection
#16
Su Hyun Lee, Jung Min Chang, Sung Ui Shin, A Jung Chu, Ann Yi, Nariya Cho, Woo Kyung Moon
OBJECTIVE: To evaluate imaging features of breast cancers on digital breast tomosynthesis (DBT) according to molecular subtype and to determine whether the molecular subtype affects breast cancer detection on DBT. METHODS: This was an institutional review board-approved study with a waiver of informed consent. DBT findings of 288 invasive breast cancers were reviewed according to BI-RADS lexicon. Detectability of breast cancer was quantified by the number of readers (0-3) who correctly detected the cancer in an independent blinded review...
September 13, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28937074/clinicoepidemiological-profile-of-peritonitis-complicating-acute-peritoneal-dialysis-a-single-center-experience
#17
Kunal Gandhi, Dharmendra Prasad, Vinay Malhotra, Dhananjai Agrawal, Pankaj Beniwal, Amith Vijay Leon Dsouza
A prospective observational study examining the incidence and microbiological aspects of peritonitis complicating acute intermittent peritoneal dialysis (IPD) was performed. A total of 145 acute IPD treatments were included involving 112 patients. The majority of patients suffered from acute kidney injury (72.3%) secondary to sepsis. Peritonitis occurred in 31 treatment sessions, giving a frequency of 21.4% of procedures performed. The mean interval between starting dialysis and the first sign of peritonitis was 2...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28937070/renal-transplantation-in-hiv-positive-patients-no-more-a-scare
#18
Eswarappa Mahesh, Manns Manohar John, Gurudev Channabasappa Konana, Rakesh Madhyastha Parampalli, Sujeeth Reddy Bande, Sarita Suryadevara
Human immunodeficiency virus (HIV) infection has posed as a major global health epidemic for almost three decades. With the advent of highly active antiretroviral therapy in 1996 and the application of prophylaxis and management of opportunistic infections, acquired immunodeficiency syndrome mortality has decreased markedly. The most aggressive HIV-related renal disease is end-stage renal disease due to HIV-associated nephropathy. Presence of HIV infection used to be viewed as a contraindication to renal transplantation for multiple reasons; concerns for exacerbation of an already immunocompromised state by administration of additional immunosuppressants; the use of a limited supply of donor organs with unknown long-term outcomes...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28937056/serum-cystatin-c-as-an-earlier-predictor-of-acute-kidney-injury-than-serum-creatinine-in-preterm-neonates-with-respiratory-distress-syndrome
#19
Noha Ahmed Abdelaal, Sherein Abdelhamid Shalaby, Abdelmoneim Kassem Khashana, Amina Mohamed Abdelwahab
In this study, we aimed to evaluate serum cystatin C (sCysC) as an early predictor of acute kidney injury (AKI) in preterm neonates with respiratory distress syndrome (RDS). Sixty preterm neonates diagnosed with RDS and 40 healthy controls (28-36 weeks) admitted to the neonatal Intensive Care Unit were investigated. AKI was defined on the 3rd day of life (DOL-3) as an increase in serum creatinine (sCr) of >0.3 mg/dL from baseline (the lowest previous sCr). sCysC levels were measured on DOL-1, -3 and -7. Of the 60 neonates with RDS, 24 (40%) developed AKI...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28936997/influence-of-age-and-gender-on-the-function-of-postganglionic-sympathetic-sudomotor-axons
#20
Kedar Mal, Hulegar A Abhishekh, Mahavir Prasad Chawla, Trichur R Raju, Talakad N Sathyaprabha
BACKGROUND: The quantitative sudomotor axon reflex test (QSART) is an autonomic function test to evaluate the function of postganglionic sympathetic sudomotor axons. The QSART is used for research and in clinical assessment of various neurological diseases, but few studies have assessed the influence of age, gender and reported a normative range. We assessed the influence of age and gender on QSART parameters. METHODS: We recruited 61 healthy volunteers (41 men and 20 women) after obtaining written informed consent...
May 2017: National Medical Journal of India
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