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https://www.readbyqxmd.com/read/28820041/a-report-of-7-year-experience-on-pediatric-continuous-renal-replacement-therapy
#1
Ayse Filiz Yetimakman, Selman Kesici, Murat Tanyildiz, Umut Selda Bayrakci, Benan Bayrakci
BACKGROUND: Continuous renal replacement therapies (CRRTs) either as continuous venovenous hemofiltration (CVVH) or hemodiafiltration (CVVHD) are used frequently in critically ill children. Many clinical variables and technical issues are known to affect the result. The factors that could be modified to increase the survival of renal replacement are sought. As a contribution, we present the data on 104 patients who underwent CRRT within a 7-year period. MATERIALS AND METHOD: A total of 104 patients admitted between 2009 and 2016 were included in the study...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28808366/clinical-features-and-outcomes-of-patients-with-posterior-reversible-encephalopathy-syndrome
#2
M S Kalaiselvan, M K Renuka, A S Arunkumar
AIMS: The aim of this study was to study the clinical features and outcomes of patients with posterior reversible encephalopathy syndrome (PRES) admitted to the Intensive Care Unit (ICU). SUBJECTS AND METHODS: All adult patients admitted to our ICU with acute onset neurologic symptoms with focal vasogenic edema on magnetic resonance imaging (MRI) were included in the study. Data were collected on demography, coexisting illness, admission severity of illness, neurological symptoms, blood pressure, treatment initiated, and MRI findings...
July 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28795138/retransplantation-in-late-hepatic-artery-thrombosis-graft-access-and-transplant-outcome
#3
Bettina M Buchholz, Shakeeb Khan, Miruna D David, Bridget K Gunson, John R Isaac, Keith J Roberts, Paolo Muiesan, Darius F Mirza, Dhiraj Tripathi, M Thamara P R Perera
BACKGROUND: Definitive treatment for late hepatic artery thrombosis (L-HAT) is retransplantation (re-LT); however, the L-HAT-associated disease burden is poorly represented in allocation models. METHODS: Graft access and transplant outcome of the re-LT experience between 2005 and 2016 was reviewed with specific focus on the L-HAT cohort in this single-center retrospective study. RESULTS: Ninety-nine (5.7%) of 1725 liver transplantations were re-LT with HAT as the main indication (n = 43; 43%) distributed into early (n = 25) and late (n = 18) episodes...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28774273/thrombotic-microangiopathy-associated-with-valproic-acid-toxicity
#4
Sean A Hebert, Timothy P Bohan, Christian L Erikson, Rita D Swinford
BACKGROUND: Thrombotic microangiopathy (TMA) is a serious, sometimes life-threatening disorder marked by the presence of endothelial injury and microvascular thrombi. Drug-induced thrombotic microangiopathy (DI-TMA) is one specific TMA syndrome that occurs following drug exposure via drug-dependent antibodies or direct tissue toxicity. Common examples include calcineurin inhibitors Tacrolimus and Cyclosporine and antineoplastics Gemcitabine and Mitomycin. Valproic acid has not been implicated in DI-TMA...
August 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28761772/a-rare-case-of-aortoatrial-fistula-from-streptococcal-endocarditis
#5
Hammad Arshad, Meilin Young, Parth Rali
We represent an unfortunate case of postinfluenza streptococcal endocarditis in a 34-year-old healthy male. He presented with hypoxic respiratory failure and was found to have mitral and aortic valve vegetation. Hospital course was complicated by the presence of an aortoatrial fistula from an aortic root abscess, persistent septic shock, and multiorgan failure.
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28760295/diagnostic-challenges-of-hemophagocytic-lymphohistiocytosis
#6
REVIEW
Zaher K Otrock, Naval Daver, Hagop M Kantarjian, Charles S Eby
Hemophagocytic lymphohistiocytosis (HLH) is a syndrome characterized by excessive activation of the immune system, resulting in overproduction of inflammatory cytokines. Patients usually present with high fever, cytopenias, hyperferritinemia, and hepatosplenomegaly, and their disease process ranges from mild to fatal multiorgan failure. HLH is a heterogeneous group of disorders that can be triggered by infections, neoplasms, or autoimmune diseases. The HLH diagnosis can be difficult to confidently confirm in critically ill patients while waiting for pathology or reference laboratory results to return, delaying the diagnosis with significantly worsened outcomes...
July 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/28754750/postoperative-gluteal-compartment-syndrome-following-microsurgical-free-flap-hand-reconstruction-the-importance-of-early-recognition-and-treatment
#7
Umran Sarwar, Jason Ting
Compartment syndrome, a surgical emergency, is caused by an increase in pressure within a closed osseofascial space, often due to trauma. This causes a decrease in tissue perfusion and ultimately tissue necrosis and multiorgan failure if not treated in a timely fashion. Gluteal compartment syndrome is a rare variant and often caused by a period of immobilisation secondary to intoxication with alcohol or drugs or during long operations, typically in the supine position. We report on a case of gluteal compartment syndrome developing in a patient postoperatively following a long microsurgical procedure to a hand, which has not been documented before...
July 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28747077/sandwich-technique-for-endovascular-repair-of-acute-type-a-aortic-dissection
#8
Feng Gao, Qian Zeng, Fangming Lin, Xiaohu Ge
OVERVIEW: To describe a new endovascular procedure for acute type A aortic dissection (TAAD) repair. METHODS: Between 2013 and 2016, 12 patients (average age 54±9.6 years; 10 men) with acute TAAD (mean EURO score 11.4%±3.2%, range 5-17) and unfit for surgery underwent thoracic endovascular aortic repair (TEVAR) with 2 periscope grafts to preserve blood supply to supra-aortic branches plus bypass grafting as needed. If the ascending aorta was dilated to >40 mm, sternotomy was performed to wrap the ascending aorta and reduce its diameter to accommodate the aortic stent-grafts...
July 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28744284/safety-and-side-effects-of-using-placenta-derived-decidual-stromal-cells-for-graft-versus-host-disease-and-hemorrhagic-cystitis
#9
Arjang Baygan, Wictor Aronsson-Kurttila, Gianluca Moretti, Babylonia Tibert, Göran Dahllöf, Lena Klingspor, Britt Gustafsson, Bita Khoein, Guido Moll, Charlotta Hausmann, Britt-Marie Svahn, Magnus Westgren, Mats Remberger, Behnam Sadeghi, Olle Ringden
Mesenchymal stromal cells (MSCs) are increasingly used in regenerate medicine. Placenta-derived decidual stromal cells (DSCs) are a novel therapy for acute graft-versus-host-disease (GVHD) and hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplantation (HSCT). DSCs are more immunosuppressive than MSCs. We assessed adverse events and safety using DSCs among 44 treated patients and 40 controls. The median dose of infused cells was 1.5 (range 0.9-2.9) × 10(6) DSCs/kg. The patients were given 2 (1-5) doses, with a total of 82 infusions...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28736085/low-cardiac-output-syndrome-in-the-postoperative-period-of-cardiac-surgery-profile-differences-in-clinical-course-and-prognosis-the-esbaga-study
#10
J L Pérez Vela, J J Jiménez Rivera, M Á Alcalá Llorente, B González de Marcos, H Torrado, C García Laborda, M D Fernández Zamora, F J González Fernández, J C Martín Benítez
OBJECTIVES: An analysis is made of the clinical profile, evolution and differences in morbidity and mortality of low cardiac output syndrome (LCOS) in the postoperative period of cardiac surgery, according to the 3 diagnostic subgroups defined by the SEMICYUC Consensus 2012. DESIGN: A multicenter, prospective cohort study was carried out. SETTING: ICUs of Spanish hospitals with cardiac surgery. PATIENTS: A consecutive sample of 2,070 cardiac surgery patients was included, with the analysis of 137 patients with LCOS...
July 20, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28731923/human-bocavirus-can-it-trigger-hemophagocytic-lymphohistiocytosis
#11
Sevgen Tanir Basaranoglu, Kubra Aykac, Yasemin Ozsurekci, Inci Bajin, Betul Tavil, Fatma Gumruk, Mehmet Ceyhan
With improvements in molecular diagnostic methods, report of Human bocavirus (HBoV) as an etiologic agent in many studies on viral respiratory and gastrointestinal infections has been increasing. Two pediatric patients who presented with secondary hemophagocytic lymphohistiocytosis were examined for etiologic causes, including viruses. Whole bacterial and fungal cultures and viral serological studies were negative. Viral polymerase chain reaction of nasopharyngeal secretions showed HBoV. One was successfully treated with intravenous immunoglobulins, whereas the other died with multiorgan failure...
July 20, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28723951/cd8-t-cells-provide-immune-protection-against-murine-disseminated-endotheliotropic-orientia-tsutsugamushi-infection
#12
Guang Xu, Nicole L Mendell, Yuejin Liang, Thomas R Shelite, Yenny Goez-Rivillas, Lynn Soong, Donald H Bouyer, David H Walker
Scrub typhus, caused by a Gram-negative obligately intracellular coccobacillus, Orientia tsutsugamushi, is a long neglected but important tropical disease. Orientia tsutsugamushi causes illness in one million people each year, and 1 billion people are at risk. Without appropriate diagnosis and treatment, the disease can cause severe multiorgan failure with a case fatality rate of 7-15%. The current gaps in knowledge of immunity include the unknown mechanisms of host immunity to O. tsutsugamushi. Using an intravenous (i...
July 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28721569/management-of-enterocutaneous-fistula-outcomes-in-276-patients
#13
Martha Quinn, Stuart Falconer, Ruth F McKee
OBJECTIVE: To assess the outcomes of patients with type II intestinal failure due to enterocutaneous fistulae in a tertiary referral centre over a 15 year period. Intestinal failure secondary to enterocutaneous fistula (ECF) requires multidisciplinary management at significant cost. Mortality and morbidity are high. METHODS: Patients were identified from a prospectively collected database of patients requiring inpatient parenteral nutrition (1998-2013). Data collected included: demographics, mode of admission, pathological grouping and outcome...
July 18, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28717524/anasarca-fever-thrombocytopenia-organomegaly-and-multiorgan-failure-in-a-24-year-old-pregnant-woman
#14
Guillaume Morel, Joy Mootien, Philippe Guiot, Khaldoun Kuteifan
TAFRO syndrome is a distinct idiopathic multicentric Castleman disease characterized by the association of thrombocytopenia, anasarca, fever, reticulin fibrosis, and organomegaly. We report the first case occurring in a Caucasian pregnant woman. At 34 weeks of gestation, our patient presented with all clinical and biological symptoms compatible with a TAFRO syndrome. Tough quick cesarean section was performed as symptoms got worse with onset of multiorgan failure requiring mechanical ventilation for acute respiratory distress, continuous renal replacement, and vasopressors...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28716776/increased-risk-for-thionamide-induced-agranulocytosis-in-elderly-patients-a-case-presentation-and-literature-review
#15
Sumera Bukhari, Muhammad Khan, Naresh Kumar, Vinuta Mohan
Thionamides, such as methimazole and propylthiouracil, are used for the management of hyperthyroidism. Agranulocytosis is a rare adverse effect of thionamides and elderly patients are especially vulnerable. Here we discuss a case of an 80-year-old woman who developed agranulocytosis and pneumonia approximately 4 weeks after starting low dose methimazole therapy. Despite aggressive treatment with broad-spectrum antibiotics and granulocyte colony stimulating factor, she developed multiorgan failure and died. Our goals are to identify risk factors common to elderly patients and hopefully improve outcomes in this population when prescribed thionamides...
July 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28712173/surgical-site-infection-in-orthopaedic-implants-and-its-common-bacteria-with-their-sensitivities-to-antibiotics-in-open-reduction-internal-fixation
#16
Muhammad Qaisar Shah, Muhammad Shoib Zardad, Alamzeb Khan, Sajjad Ahmed, Abdus Saboor Awan, Taj Mohammad
BACKGROUND: Surgical site infection in orthopaedic implants is a major problem, causing long hospital stay, cost to the patient and is a burden on health care facilities. It increases rate of nonunion, osteomyelitis, implant failure, sepsis, multiorgan dysfunction and even death. Surgical site infection is defined as pain, erythema, swelling and discharge from wound site. Surgical site infection in orthopaedic implants is more challenging to the treating orthopaedic surgeon as the causative organism is protected by a biofilm over the implant's surface...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28701845/fatal-postoperative-hemolysis-due-to-severe-falciparum-malaria
#17
Amol T Kothekar, Vijaya Patil, Nambiraj Konar, Jigeeshu Divatia
A 60-year-old apparently healthy female patient underwent mastectomy for breast cancer. She had sinus tachycardia and no other abnormal finding in the preoperative period. However, the immediate postoperative course was stormy with the development of anemia, thrombocytopenia, hemolysis, and renal failure with severe metabolic acidosis. Peripheral blood smear revealed the presence of ring forms of Plasmodium falciparum. Multiorgan failure and death occurred within 36 h of surgery in spite of initiation of antimalarial agents...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28701841/continuous-renal-replacement-therapy-applications-on-extracorporeal-membrane-oxygenation-circuit
#18
Ayse Filiz Yetimakman, Murat Tanyildiz, Selman Kesici, Esra Kockuzu, Benan Bayrakci
BACKGROUND AND AIMS: Continuous venovenous hemofiltration or hemodiafiltration is used frequently in pediatric patients, but experience of continuous renal replacement therapy (CRRT) application on extracorporeal membrane oxygenation (ECMO) circuit is still limited. Among several methods used for applying CRRT on ECMO patients, we aim to share our experience on inclusion of a CRRT device in the ECMO circuit which we believe is easier and safer to apply. MATERIALS AND METHODS: The data were collected on demographics, outcomes, and details of the treatment of ECMO patients who had CRRT...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28692440/cefepime-associated-with-phenytoin-induced-stevens-johnson-syndrome
#19
José Marco-Del Río, Esther Domingo-Chiva, Pablo Cuesta-Montero, Ana Valladolid-Walsh, Eva María García-Martínez
We describe a recent case of Stevens-Johnson Syndrome. A 49-year-old man was admitted to the Intensive Care Unit of an Anaesthesia and Resuscitation Department because of a Fournier gangrene that derived in a sepsis, ventilator-associated pneumonia, and renal failure. He was under treatment with cefepime and suffered a generalized status epilepticus, so started treatment with phenytoin. The next day he developed a "maculous cutaneous eruption in trunk and lower limbs" compatible with a Stevens-Johnson Syndrome...
July 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28683053/assessing-the-safety-of-expanded-polytetrafluoroethylene-synthetic-grafts-in-living-donor-liver-transplantation-graft-migration-into-hollow-viscous-organs-diagnosis-and-treatment-options
#20
Shih-Chao Hsu, Ashok Thorat, Horng-Ren Yang, Kin-Shing Poon, Ping-Chun Li, Chun-Chieh Yeh, Te-Hung Chen, Long-Bin Jeng
BACKGROUND Our recent studies have highlighted the importance and safety of backtable venoplasty for middle hepatic vein (MHV) and inferior right hepatic veins (IRHV) reconstruction using expanded polytetrafluoroethylene (ePTFE) vascular grafts. In this study, we aim to analyze the complications associated with ePTFE graft use and discuss the management of the rare, but, potentially life threatening complications directly related to ePTFE conduits. MATERIAL AND METHODS From January 2012 to October 2015 a total of 397 patients underwent living donor liver transplantation (LDLT)...
July 6, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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