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https://www.readbyqxmd.com/read/28431064/is-mortality-a-useful-parameter-for-public-reporting-in-pacemaker-implantation-results-of-an-obligatory-external-quality-control-programme
#1
Bernd Nowak, Björn Misselwitz, Oliver Przibille, Rajendra H Mehta
Aims: To evaluate if public reporting of pacemaker implantation-associated mortality is meaningful in a large contemporary patient cohort. Methods and Results: The database of the obligatory external quality control programme in the Federal State of Hessen, Germany, of patients undergoing permanent pacemaker (PPM) implantation was evaluated retrospectively. We compared the baseline features of patients who died compared with those who did not during hospitalization after PPM...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28427767/%C3%AE-arrestins-negatively-control-human-adrenomedullin-type-1-receptor-internalization
#2
Kenji Kuwasako, Kazuo Kitamura, Sayaka Nagata, Toshio Sekiguchi, Jiang Danfeng, Manabu Murakami, Yuichi Hattori, Johji Kato
Adrenomedullin (AM) is a potent hypotensive peptide that exerts a powerful variety of protective effects against multiorgan damage through the AM type 1 receptor (AM1 receptor), which consists of the calcitonin receptor-like receptor (CLR) and receptor activity-modifying protein 2 (RAMP2). Two β-arrestin (β-arr) isoforms, β-arr-1 and β-arr-2, play a central role in the agonist-induced internalization of many receptors for receptor resensitization. Notably, β-arr-biased agonists are now being tested in phase II clinical trials, targeting acute pain and acute heart failure...
April 17, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28426914/recommended-dose-of-idarucizumab-may-not-always-be-sufficient-for-sustained-reversal-of-dabigatran
#3
Alexander Simon, Hans Domanovits, Cihan Ay, Gürkan Sengölge, Jerrold H Lewy, Alexander O Spiel
Idarucizumab is a monoclonal antibody fragment designed for reversing the anticoagulant effects of dabigatran. Administration is recommended as two intravenous boluses of 2.5 g within 15 minutes of each other or as a single 5 g bolus. However, in certain situations a second dose of the drug could be necessary. We report the case of a 77-year old man, treated with dabigatran for paroxysmal atrial fibrillation. He presented at our department with acute renal failure, concomitant massive dabigatran accumulation, and subsequent acute gastrointestinal bleeding...
April 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28422850/tuberculosis-associated-hemophagocytic-lymphohistiocytosis-with-initial-presentation-of-fever-of-unknown-origin-in-a-general-hospital-an-analysis-of-8-clinical-cases
#4
Yun Zhang, Guangyu Liang, Hongli Qin, Yuanjie Li, Xuejun Zeng
The study aimed to investigate the clinical features and prognoses of patients with tuberculosis (TB) who had secondary hemophagocytic lymphohistiocytosis (HLH).Patients first presenting with fever of unknown origin, who were ultimately diagnosed with TB-associated secondary HLH, were assessed retrospectively. We summarized and analyzed clinical manifestations, laboratory examinations, diagnoses, treatments, and prognoses of patients using clinical data, outpatient follow-up, and telephone follow-up in combination with literature review...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28416934/sepsis-and-septic-shock-current-treatment-strategies-and-new-approaches
#5
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/28409501/successful-treatment-of-fulminant-lyme-myocarditis-with-mechanical-circulatory-support-in-a-young-male-adult-a-case-report
#6
Željko Župan, Dino Mijatović, Igor Medved, Snježana Kraljić, Jurica Juranić, Berislav Barbalić, Marin Oštrić
We describe the case of fulminant myocarditis due to Lyme disease and use of mechanical circulatory support (MCS) for the treatment of the Lyme carditis associated with refractory cardiogenic shock. Fulminant Lyme myocarditis in young adult male patient led to a sudden onset of acute, severe biventricular heart failure with progressive cardiogenic shock, and multiorgan failure immediately after admission.
April 14, 2017: Croatian Medical Journal
https://www.readbyqxmd.com/read/28407445/lethal-bentazone-intoxication-a-report-of-two-cases
#7
Petar Škavić, Zijad Duraković, Marina Nestić
This study presents two cases of lethal bentazone poisonings, their clinical presentation, the course of the disease and the autopsy findings. The first is a 50-year-old male who had sprayed corn with a solution of bentazone and was admitted to the hospital with sweating, fever, nausea, vomiting of aqueous and hemorrhagic content, and bloody, watery stools. He was treated according to the symptoms including extracorporeal hemodialysis, but eventually suffered from multiorgan failure (acute respiratory failure, acute liver failure, coagulopathy, acute renal failure, metabolic acidosis, and gastrointestinal bleeding) and died 11...
April 13, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28401622/predicting-mortality-in-the-emergency-department-external-validation-and-derivation-of-a-clinical-prediction-tool
#8
Rajat N Moman, Caitlin Loprinzi Brauer, Katherine M Kelsey, Rachel D Havyer, Christine M Lohse, M Fernanda Bellolio
BACKGROUND: he Choosing Wisely campaign has called for better engagement of palliative and hospice care services for patients in the emergency department (ED). PREDICT is a clinical prediction tool that was derived in an Australian ED cohort. It assesses a patient's risk of mortality at one year to select those who would benefit from advanced care planning. Such goals of care discussion can improve patients' ability to communicate what they want out of their healthcare and, in cases of end-of-life, potentially reduce the number of futile interventions...
April 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28395880/treatment-of-metastatic-uveal-melanoma-with-adoptive-transfer-of-tumour-infiltrating-lymphocytes-a-single-centre-two-stage-single-arm-phase-2-study
#9
Smita S Chandran, Robert P T Somerville, James C Yang, Richard M Sherry, Christopher A Klebanoff, Stephanie L Goff, John R Wunderlich, David N Danforth, Daniel Zlott, Biman C Paria, Arvind C Sabesan, Abhishek K Srivastava, Liqiang Xi, Trinh H Pham, Mark Raffeld, Donald E White, Mary Ann Toomey, Steven A Rosenberg, Udai S Kammula
BACKGROUND: Uveal melanoma is a rare tumour with no established treatments once metastases develop. Although a variety of immune-based therapies have shown efficacy in metastatic cutaneous melanoma, their use in ocular variants has been disappointing. Recently, adoptive T-cell therapy has shown salvage responses in multiple refractory solid tumours. Thus, we sought to determine if adoptive transfer of autologous tumour-infiltrating lymphocytes (TILs) could mediate regression of metastatic uveal melanoma...
April 7, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28394553/drug-induced-oral-ulcerations-case-report
#10
Vanja Vučičević Boras, Snježana Židovec-Lepej, Branka Marinović, Sven Seiwerth, Ivana Škrinjar, Dražen Pulanić, Danica Vidović Juras
A 70-year-old patient was admitted to the Department of Oral Medicine for multiple oral ulcerations on the left buccal mucosa, around 0.5 cm in diameter, as well as on the gingiva. Otherwise, the patient suffered from chronic lymphocytic leukemia, hypogammaglobulinemia, chronic renal insufficiency, with complete afunction of the right kidney, asthma, hypertension, gastritis and prostate hyperplasia. Differential diagnosis of oral ulcerations included drug induced oral ulcerations, paraneoplastic pemphigus, viral ulcerations (cytomegalovirus, herpes simplex viruses), fungal ulcerations (candidiasis, aspergillosis, histoplasmosis, cryptococcosis) and bacterial ulcerations, as well as neutropenic ulcers...
June 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/28357636/probable-catastrophic-antiphospholipid-syndrome-with-intracerebral-hemorrhage-secondary-to-epstein-barr-viral-infection
#11
Mark P Plummer, Adam M H Young, Ronan O'Leary, Maxwell S Damian, Andrea Lavinio
BACKGROUND: Catastrophic antiphospholipid syndrome (CAPS) is a rare, severe variant of antiphospholipid syndrome with a high mortality rate. We report a unique case of CAPS secondary to Epstein-Barr viral (EBV) infection complicated by pulmonary and intracerebral hemorrhage. A review of the CAPS literature relevant to intensive care practice is used to outline a rational approach to diagnosis and management. METHODS: All data are from a single patient admitted to the Neurosciences Critical Care Unit in Addenbrooke's Hospital, Cambridge, in March 2016...
March 29, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28356254/haemophagocytic-lymphohistiocytosis-associated-with-fulminant-hepatitis-and-multiorgan-failure-following-primary-epstein-barr-virus-and-herpes-simplex-virus-type-1-infection
#12
Claudia Honsig, Sandra Beinhardt, Josef Tomasits, Hans Peter Dienes
We present a case of severe fatal hepatitis in a young patient presumably triggered by two ubiquitous viral diseases which occurred in close succession. This case is unusual because of the exceptional chronological sequence of primary Epstein-Barr virus and herpes simplex virus type 1 infection causing systemic immune dysregulation associated with rapidly developing liver failure and consecutive multiorgan failure. Clinical, laboratory and histopathological findings indicated the development of secondary haemophagocytic lymphohistiocytosis triggered by these closely succeeding viral primary infections...
March 29, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28329452/effect-of-prime-blood-storage-duration-on-clinical-outcome-after-pediatric-cardiac-surgery
#13
Arvind Kumar Bishnoi, Pankaj Garg, Kartik Patel, Parth Solanki, Jigar Surti, Atul Solanki, Komal Shah, Sanjay Patel
BACKGROUND: In this study, we tested the hypothesis that in pediatric patients undergoing cardiac surgery using cardiopulmonary bypass (CPB) with blood prime, the storage duration of the packed red blood cells (PRBCs) used in prime led to differences in postoperative complications and metabolic profiles of the patients. METHODS: For this prospective observational study we included 400 pediatric patients undergoing cardiac operations using CPB and requiring PRBCs prime...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28318752/cystathionine-gamma-lyase-deficient-mice-are-protected-against-the-development-of-multiorgan-failure-and-exhibit-reduced-inflammatory-response-during-burn
#14
Akbar Ahmad, Nadiya Druzhyna, Csaba Szabo
Considering the role of H2S in critical illness, the aim of this study was to compare the outcome of burn in wild-type mice and in mice deficient in CSE, one of the principal mammalian H2S-generating enzymes. Animals were subjected to scald burn. Outcome variables included indices of organ injury, clinical chemistry parameters and plasma levels of inflammatory mediators. Plasma levels of H2S significantly increased in response to burn in wild-type mice, but remained unchanged in CSE(-/-) mice. Expression of the three H2S-producing enzymes (CSE, CBS and 3-MST) in the lung and liver, and the capacity of tissue homogenates to produce H2S, however, was not affected by burn...
March 15, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28296134/predicting-primary-nonfunction-of-liver-transplants-with-laboratory-values-can-it-be-done
#15
EDITORIAL
R S Sung
No abstract text is available yet for this article.
March 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28285867/a-modified-lung-and-cardiac-ultrasound-protocol-saves-time-and-rules-in-the-diagnosis-of-acute-heart-failure
#16
Frances M Russell, Robert R Ehrman
BACKGROUND: Multiorgan ultrasound (US), which includes evaluation of the lungs and heart, is an accurate method that outperforms clinical gestalt for diagnosing acutely decompensated heart failure (ADHF). A known barrier to ultrasound use is the time needed to perform these examinations. OBJECTIVE: The primary goal of this study was to determine the test characteristics of a modified lung and cardiac US (LuCUS) protocol for the accurate diagnosis of ADHF. METHODS: This was a secondary analysis of a prospective observational study that enrolled adult patients presenting to the emergency department with undifferentiated dyspnea...
March 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28282398/association-of-serum-lactate-with-outcome-after-out-of-hospital-cardiac-arrest-treated-with-therapeutic-hypothermia
#17
Jean-Christophe Orban, Michaël Novain, Florian Cattet, Rémi Plattier, Mohamed Nefzaoui, Hervé Hyvernat, Olivier Raguin, Michel Kaidomar, Sébastien Kerever, Carole Ichai
AIMS: Lactate reflects hypoxic insult in many conditions and is considered as a prognosis factor. But, after cardiac arrest, its interest is still debated. Our study aimed to assess the prognosis value of lactate in out-of-hospital cardiac arrest patients treated with therapeutic hypothermia. METHODS: This retrospective observational study included out-of-hospital cardiac arrest patients treated with therapeutic hypothermia in four ICUs. Lactate levels were compared at different times during the first 24 hours according to outcome at ICU discharge and to the type of death (multiorgan or neurologic failure)...
2017: PloS One
https://www.readbyqxmd.com/read/28275016/gastric-volvulus-a-potentially-fatal-cause-of-acute-abdominal-pain
#18
A Sleiwah, G Thomas, I Crawford, A Stanek
A woman aged 67 years attended the emergency department with acute abdominal and back pain of 1-day duration with associated vomiting. The patient had multiorgan failure. Resuscitation was started with intravenous fluids and vasopressors. An abdominal CT scan was completed which confirmed the diagnosis of acute gastric volvulus. The patient was successfully resuscitated from a cardiorespiratory arrest during transfer to the operating theatre. The patient subsequently underwent a total gastrectomy with stapling of the oesophageal and duodenal stumps...
March 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28272093/elevated-procalcitonin-is-associated-with-bacterial-infection-during-acute-liver-failure-only-when-unrelated-to-acetaminophen-intoxication
#19
Maxime Mallet, Maela Haq, Simona Tripon, Maguy Bernard, Hedi Benosman, Dominique Thabut, Marika Rudler
AIM: The aim of this study was to evaluate the accuracy of procalcitonin (PCT) in predicting bacterial infection and survival without transplantation upon admission in the ICU for acute liver failure (ALF). PATIENTS AND METHODS: From January 2009 until October 2015, all cases of ALF patients admitted in our ICU were retrospectively reviewed and included in the study if the PCT level upon admission was available. Patients with pre-existing liver pathology or ALF in a context of already advanced multiorgan failure were excluded...
March 7, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28261505/augmenting-function-for-infarction-from-infection-impella-2-5-for-ischemic-cardiogenic-shock-complicating-sepsis
#20
Praveen George, Mukta C Srivastava, Jonathan Ludmir, Robert M Reed, Semhar Z Tewelde, Anuj Gupta, Michael T McCurdy
Cardiac dysfunction is a common complication of sepsis in individuals with preexisting coronary disease and portends a poor prognosis when progressing to ischemic cardiogenic shock. In this setting, maximal medical therapy in isolation is often inadequate to maintain cardiac output for patients who are poor candidates for immediate revascularization. Furthermore, the use of vasopressors and inotropes increases myocardial demand and may lead to further injury. Percutaneous ventricular assist devices provide a viable option for management of severe shock with multiorgan failure...
2017: Case Reports in Cardiology
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