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multiorgan failure

Asuman Gürkan, Melahat Melek Oğuz, Esin Boduroğlu Cengiz, Saliha Şenel
Colchicine is an anti-inflammatory drug that has a narrow therapeutic index. Poisoning typically shows 3 phases with systemic symptoms. Gastrointestinal symptoms dominate in the first phase. Dermatologic manifestations usually appear, with skin eruptions in the second phase where multiorgan failure occurs and alopecia in the third phase where organ derangements resolve. Alopecia is a cardinal feature of the third phase, but there is no specifically defined eruption for toxication. Here, we report a case of colchicine intoxication in a 16-year-old girl with maculopapular/purpuric rash and alopecia...
June 14, 2018: Pediatric Emergency Care
Sandeep Donagaon, Mala Dharmalingam
Objectives: Glycemic excursions are commonly seen in patients admitted to the Intensive Care Unit (ICU) and are related to adverse outcomes. Glycemic gap is a marker of this excursion in patients with diabetes. It can be used to predict adverse outcomes in patients with diabetes admitted to the ICU. It is calculated by subtracting A1C-derived average glucose (ADAG) = ([28.7 × HbA1c]-46.7) from plasma glucose at admission. Objective of this study was to correlate glycemic gap and adverse outcomes in patients with type 2 diabetes mellitus (DM) admitted to the ICU...
March 2018: Indian Journal of Endocrinology and Metabolism
Alessandro Tomelleri, Giulio Cavalli, Giacomo De Luca, Corrado Campochiaro, Teresa D'Aliberti, Moreno Tresoldi, Lorenzo Dagna
Pericarditis is an inflammatory heart disease, which may be idiopathic or secondary to autoimmune or auto-inflammatory diseases and often leads to severe or life-threatening complications. Colchicine and non-steroidal anti-inflammatory drugs represent the mainstay of treatment, whereas use of corticosteroids is associated with recurrence of disease flares. While effective and safe anti-inflammatory therapies remain an unmet clinical need, emerging clinical and experimental evidence points at a promising role of inhibition of the pro-inflammatory cytokine interleukin-1 (IL-1)...
2018: Frontiers in Immunology
Arun Reghunathan, Jeffrey Forris Beecham Chick, Joseph J Gemmete, Anthony Hage, James Mahn, Minhaj S Khaja, Ravi N Srinivasa
As the creation and utilization of new implantable devices increases, so does the need for interventionalists to devise unique retrieval mechanisms. This report describes the first endovascular retrieval of a CardioMEMS heart failure monitoring device. A 20-mm gooseneck snare was utilized in conjunction with a 9-French sheath and Envoy catheter for retrieval. The patient suffered no immediate postprocedural complications but died 5 days after the procedure from multiorgan failure secondary to sepsis.
April 2018: Radiology Case Reports
Jill Yeager, Barbara Krenzer
A 61-year-old woman with rheumatoid arthritis on chronic immunosuppression presented with fever. Laboratory studies demonstrated multiorgan failure with pancytopenia, elevation in liver function studies, and an elevated ferritin level, with a diagnosis of hemophagocytic lymphohistiocytosis confirmed on bone marrow biopsy. After initial treatment with chemotherapy, fungal blood cultures grew Histoplasma , prompting initiation of antifungal therapy, which resulted in successful treatment of Histoplasma -associated hemophagocytic lymphohistiocytosis...
July 2018: Proceedings of the Baylor University Medical Center
Frederick J Flo, Obiajulu Kanu, Mohamed Teleb, Yuefeng Chen, Tariq Siddiqui
The abuse of anabolic androgenic steroids (AAS) has remained on the rise despite their well-known deleterious effects. We describe a case of AAS-induced multisystem failure following an extensive history of abuse in a 41-year-old bodybuilder. Furthermore, we review pertinent literature and discuss the different pathophysiologic mechanisms through which AAS affect the heart and other organs. This case points to the possibility of multiorgan involvement and severe cardiac effects of AAS abuse in young individuals who may not have any past medical history...
July 2018: Proceedings of the Baylor University Medical Center
Ramesh Holla, Bhagwan Darshan, Latika Pandey, Bhaskaran Unnikrishnan, Nithin Kumar, Rekha Thapar, Prasanna Mithra, Vaman Kulkarni
Background: Leptospirosis is a major neglected public health problem and is highly underreported in India. The spectrum of clinical features ranges from subclinical infection to multiorgan failure. The burden of leptospirosis is more in developing countries. Objective: The present study was designed to assess the sociodemographic characteristics, clinical feature, and outcome of leptospirosis patients. Methods: This record based retrospective study was conducted in hospitals affiliated to Kasturba Medical College, Mangalore...
2018: BioMed Research International
Aaron W Tustin, Dawn L Cannon, Sheila B Arbury, Richard J Thomas, Michael J Hodgson
OBJECTIVE: The aim of this study was to describe risk factors for heat-related illness (HRI) in U.S. workers. METHODS: We reviewed a subset of HRI enforcement investigations conducted by the Occupational Safety and Health Administration (OSHA) from 2011 through 2016. We assessed characteristics of the workers, employers, and events. We stratified cases by severity to assess whether risk factors were more prevalent in fatal HRIs. RESULTS: We analyzed 38 investigations involving 66 HRIs...
May 30, 2018: Journal of Occupational and Environmental Medicine
Thierry Bensignor, Jérémie H Lefevre, Ben Creavin, Najim Chafai, Thomas Lescot, Thévy Hor, Clotilde Debove, François Paye, Pierre Balladur, Emmanuel Tiret, Yann Parc
BACKGROUND: Postoperative peritonitis (POP) following gastrointestinal surgery is associated with significant morbidity and mortality, with no clear management option proposed. The aim of this study was to report our surgical management of POP and identify pre- and perioperative risk factors for morbidity and mortality. METHODS: All patients with POP undergoing relaparotomy in our department between January 2004 and December 2013 were included. Pre- and perioperative data were analyzed to identify predictors of morbidity and mortality...
May 30, 2018: World Journal of Surgery
Jaimin M Patel, Elizabeth Sapey, Dhruv Parekh, Aaron Scott, Davinder Dosanjh, Fang Gao, David R Thickett
Background: Neutrophil dysfunction in sepsis has been implicated in the pathogenesis of multiorgan failure; however, the role of neutrophil extracellular traps (NETs) remains uncertain. We aimed to determine the sequential changes in ex vivo NETosis and its relationship with mortality in patients with sepsis and severe sepsis. Methods: This was a prospective observational cohort study enrolling 21 healthy age-matched controls and 39 sepsis and 60 severe sepsis patients from acute admissions to two UK hospitals...
2018: Mediators of Inflammation
Juan G Ripoll, Mahrukh S Rizvi, Rebecca L King, Craig E Daniels
A previously healthy 67-year-old farmer presented to an outside hospital after a 2-week history of non-specific respiratory symptoms. A certain diagnosis was not initially apparent, and the patient was discharged home on a regimen for presumed chronic obstructive pulmonary disease exacerbation. He re-presented to the emergency department with shock and hypoxaemic respiratory failure requiring prompt intubation and fluid resuscitation. He was then transferred to our institution due to multiorgan failure. On arrival, the patient demonstrated refractory shock and worsening acute kidney injury, severe anaemia and thrombocytopaenia...
May 30, 2018: BMJ Case Reports
A L Booth, P Osehobo, D Rodgers-Soriano, A Lalarukh, M A Eltorky, H L Stevenson
Hemophagocytic lymphohistiocytosis (HLH) is an uncommon disease that often presents with nonspecific findings. A high index of suspicion is necessary to make a prompt diagnosis and prevent fatal disease. A 45-year-old man presented with fever, hypotension, abdominal pain, nausea, and vomiting. Imaging showed hepatosplenomegaly and laboratory tests revealed pancytopenia, increased ferritin, and a cholestatic pattern of injury with elevated alkaline phosphatase and total bilirubin. Due to a history of Crohn disease, systemic lupus erythematous, and rheumatoid arthritis, the patient was on immunosuppressants, including infliximab...
January 2018: Case Reports in Gastroenterology
Ericka Vargas-Quevedo, Eduardo Ordoñez-Gutiérrez, Jorge Enrique Trejo-Gómora, Lénica Anahí Chávez-Aguilar, Rubén Peña-Vélez
INTRODUCTION: The antiphospholipid syndrome is an acquired autoimmune thrombophilia, characterized by arterial and/or venous thrombosis. Rarely, this condition can have a catastrophic presenta tion, with high mortality, and presence of microangiopathy and involvement of three or more organs. OBJECTIVE: To describe the clinical presentation and evolution of a pediatric patient with catastrophic antiphospholipid syndrome, with a seronegative onset form, whose response to aggressive therapy was favorable...
April 2018: Revista Chilena de Pediatría
Serhat Oguz, Omer Salt, Abdil C Ibis, Saban Gurcan, Dogan Albayrak, Tulin Yalta, Tamer Sagiroglu, Cengiz Erenoglu
BACKGROUND Obstructive jaundice is a serious, life-threatening condition that can lead to death as a result of sepsis and multiorgan failure due to bacterial translocation. Treatment should be started as soon as possible after diagnosis. MATERIAL AND METHODS Forty 24-week-old male Sprague Dawley rats, with an average weight of 250 g to 300 g, were included in this study. The rats were randomly placed into five groups, each group consisted of eight rats. The sham group underwent only common bile duct (CBD) dissection and no ligation was performed...
May 22, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Dmytro A Skurupii, Evgeniy G Sonnyk, Vitaliy M Sizonenko
Protection of maternal health as well as protection of fetal and newborn health is a strategic objective in all countries. It ensures the formation of healthy generation as the basis of gene pool preservation and further development of the nation. It is known that the progress of critical conditions in newborns is different from classical concepts. Аnatomicofunctional features of the newborns (especially premature newborns), the effect of prenatal pathological factors are provocative and background factors of the multiorgan failure syndrome begining in these patients, which probably affects frequency of appearance of this syndrome, the mechanisms of development, clinical manifestations, the final of the disease and makes doctors to consider newborns in critical conditions as high-risk group for multiorgan failure syndrome appearance...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Ali Canbay, Meike N Müller, Stathis Philippou, Guido Gerken, Andreas Tromm
BACKGROUND Cholesteryl ester storage disease (CESD), also known as lysosomal acid lipase deficiency (LAL-D), is a rare autosomal-recessive inheritable lysosomal storage disease. Since 2015, a causal treatment with sebelipase alfa, which replaces the missing LAL enzyme, has been approved. We report a fatal course of LAL-D in a female patient. CASE REPORT In 1979, CESD was first diagnosed in a 13-year-old female with marked hepatomegaly. At that time, no specific treatment for CESD was available and the spontaneous course of the disease had to be awaited...
May 18, 2018: American Journal of Case Reports
Jiří Šrámek, Thomas Karvunidis, Daniel Lysák, Martin Harazim, Michal Karas, Pavel Jindra
Hemophagocytic lymfohistiocytosis (HLH) is rare, life-threatening condition, characterized by excessive activation of immune system with subsequent proinflammatory state resulting in multiorgan failure. Most frequently, it appears in infancy as a primary disorder caused by mutation of immune-regulatory genes. Increasingly, HLH is being diagnosed as a secondary - adult - form, which occurs as a result of aberrant immune response. Viral or bacterial systemic infections, malignancy with a predominance of lymphoproliferative disorders and autoimmune diseases are the most common triggers...
2018: Vnitr̆ní Lékar̆ství
Damaris Pena, Yaneidy Santana, Jose Perez Lara, Efrain Gonzalez, Misbahuddin Khaja
Introduction: Pasteurella multocida is a gram-negative coccobacillus pathogenic to animals. It can cause infection in humans by a bite, scratch, or lick from a cat or dog. P. multocida can cause a variety of infections in humans, including cellulitis, osteomyelitis, endocarditis, peritonitis, and septic shock. Case Presentation: A 56-year-old male presented to our hospital with a 2-day history of fever, abdominal pain, nausea, and vomiting. He denied exposure to cats, dogs or other pets...
2018: Case Reports in Infectious Diseases
Paola Eiben, Sancho Rodriguez-Villar
Periorbital necrotizing fasciitis (PNF) is a severe suppurative infection of the subcutaneous tissue and underlying fascia of the periorbital region. Typically, the course of PNF is milder and has a better prognosis than that of necrotizing fasciitis in other parts of the body. As such, this disease is thought to be associated with a significantly smaller risk of morbidity and mortality. Nevertheless, it is a rare and devastating condition that can lead to disfigurement, blindness and death. Early recognition is critical to improved patient outcomes...
April 2018: Journal of Surgical Case Reports
Janice R Safneck, Sherry Krawitz
Blastomyces species are thermally dimorphic fungi existing as yeast in tissue. We report an initially immunocompetent patient with orbital apex syndrome (OAS) whose presentation suggested giant cell arteritis. Subsequently, metastatic carcinoma was entertained as a cause of OAS until bronchoscopy yielded Blastomyces species. The patient rapidly succumbed with multiorgan failure despite Amphotericin B administration. At post-mortem, Blastomyces co-infection with fungal hyphae in keeping with Aspergillus species was found in cavernous sinus and in infarcted optic nerve...
January 2018: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
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