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https://www.readbyqxmd.com/read/29054234/coronary-dissection-discovered-during-ex%C3%A2-vivo-organ-preservation-avoiding-a%C3%A2-fatal-complication
#1
Sandro Sponga, Dave Napgal, Antonio Paolo Beltrami, Veronica Ferrara, Sandro Nalon, Nicoletta Finato, Ugolino Livi
This report describes the case of undiagnosed posttraumatic coronary artery dissection in a young multiorgan donor. Ex vivo preservation with the Organ Care System (TransMedics, Inc, Andover, MA) revealed the presence of coronary disease and avoided transplantation of an organ at high risk for failure.
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29047100/mitochondrial-and-metabolic-drivers-of-pulmonary-vascular-endothelial-dysfunction-in-pulmonary-hypertension
#2
Qiujun Yu, Stephen Y Chan
Pulmonary hypertension (PH) is a deadly and increasingly prevalent vascular disease characterized by excessive pulmonary vascular remodeling and right ventricular dysfunction which leads to right heart failure, multiorgan dysfunction, and premature death. The cause of the vascular remodeling in PH remains elusive, and thus current treatments are marginally effective and prognosis of PH remains poor. Increasing evidence indicates the pathogenic importance of endothelial dysfunction in PH. However, the underlying mechanisms of such dysfunction are not well described...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29045747/extracorporeal-membrane-oxygenation-support-for-right-ventricular-failure-after-left-ventricular-assist-device-implantation
#3
Julia Riebandt, Thomas Haberl, Dominik Wiedemann, R Moayedifar, Thomas Schloeglhofer, Stéphane Mahr, Kamen Dimitrov, Philipp Angleitner, Guenther Laufer, Daniel Zimpfer
OBJECTIVES: Right ventricular (RV) failure complicating left ventricular assist device implantation is associated with increased mortality. Despite a lack of supporting evidence, venoarterial extracorporeal membrane oxygenation (ECMO) support is increasingly being used as an alternative to traditional temporary RV support. We report our institutional experience with ECMO-facilitated RV support after left ventricular assist device implantation. METHODS: We retrospectively reviewed the concept of temporary ECMO support for perioperative RV failure in 32 consecutive left ventricular assist device (mean age 52 ± 14 years; male 84...
October 16, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29044341/the-use-of-antimicrobials-in-septic-patients-with-acute-kidney-injury
#4
Fernanda Moreira de Freitas, Welder Zamoner, Durval Sampaio de Souza Garms, Mariele Gobo de Oliveira, André Luis Balbi, Daniela Ponce
Sepsis is the most common cause of death in critically ill patients and it may be associated with multiorgan failure, including acute kidney injury (AKI). This situation can require acute renal support and increase mortality. Therefore, it is essential to administrate antimicrobials in dosis to achieve adequate serum levels, preventing overdosis and drug toxicity or underdosing and risk for resistance to antibiotics and higher mortality. To date, there aren't validated guidelines on antibiotic dosis adjustment in septic patients with AKI and the recommendations are extrapolated from studies conducted in non-critical patients with chronic kidney disease in end stage receiving chronic renal replacement therapy...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29040030/nivolumab-plus-ipilimumab-in-patients-with-advanced-melanoma-updated-survival-response-and-safety-data-in-a-phase-i-dose-escalation-study
#5
Margaret K Callahan, Harriet Kluger, Michael A Postow, Neil H Segal, Alexander Lesokhin, Michael B Atkins, John M Kirkwood, Suba Krishnan, Rafia Bhore, Christine Horak, Jedd D Wolchok, Mario Sznol
Purpose The clinical activity observed in a phase I dose-escalation study of concurrent therapy with nivolumab (NIVO) and ipilimumab (IPI) in patients with previously treated or untreated advanced melanoma led to subsequent clinical development, including randomized trials. Here, we report long-term follow-up data from study CA209-004, including 3-year overall survival (OS). Patients and Methods Concurrent cohorts 1, 2, 2a, and 3 received escalating doses of NIVO plus IPI once every 3 weeks for four doses, followed by NIVO once every 3 weeks for four doses, then NIVO plus IPI once every 12 weeks for eight doses...
October 17, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28991291/catastrophic-antiphospholipid-syndrome-case-report-and-literature-review
#6
Luis Del Carpio Orantes, Chantall Citlally Anaya Martínez, Elías Bonilla Casas
The present document is the report of a case of a very rare clinical entity, which presents with acute multiorganic failure after a thrombotic storm related to antiphospholipid antibodies, the so-called catastrophic antiphospholipid syndrome, which began as a recurrent picture of mesenteric thrombosis, with a previous history of venous insufficiency and distal ulcers probably associated with an unidentified antiphospholipid; deserving management in intensive care and the consultation by the world expert, Dr...
2017: Gaceta Médica de México
https://www.readbyqxmd.com/read/28988256/primary-leiomyosarcoma-of-the-atrium-with-heterologous-differentiation
#7
Shaesta Zaidi, Sufia Husain, Dona Barakah
We report a case of a 47-year-old female who presented with breathlessness and palpitations for two weeks. On clinical evaluation, bilateral pedal edema was noticed. A CT pulmonary angiogram showed a mass in the left atrium causing significant obstruction to cardiovascular outflow. After extensive work-up, the mass was surgically resected. Histopathological findings from the acquired specimen revealed a high-grade leiomyosarcoma with extensive necrosis and heterologous (cartilaginous) differentiation. The early postoperative period was complicated by cardiac tamponade and the patient died on the second postoperative day due to ventricular arrhythmia, shock and multiorgan failure...
September 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28988226/severe-complications-after-initial-management-of-hyperglycemic-hyperosmolar-syndrome-and-diabetic-ketoacidosis-with-a-standard-diabetic-ketoacidosis-protocol
#8
Bimota Nambam, Emily Menefee, Neslihan Gungor, Robert Mcvie
Hyperglycemic hyperosmolar syndrome (HHS) is a clinical entity not identical to diabetic ketoacidosis (DKA), and with a markedly higher mortality. Children with HHS can also present with concomitant DKA. Patients with HHS (with or without DKA) are profoundly dehydrated but often receive inadequate fluid resuscitation as well as intravenous insulin therapy based on traditional DKA protocols, and this can lead to devastating consequences. In this article, we briefly review HHS along with a report of an adolescent who presented with HHS and DKA and was initially managed as DKA...
October 9, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28966500/chromobacterium-violaceum-induced-sepsis-and-multiorgan-dysfunction-resembling-melioidosis-in-an-elderly-diabetic-patient-a-case-report-with-review-of-literature
#9
Sagar Khadanga, Tadepalli Karuna, Dharmendra Dugar, Shakti Prasad Satapathy
An elderly diabetic farmer presented with chronic nonhealing ulcer over the left foot, multiple liver abscesses, and right-sided pleural effusion. The patient developed septicemia and multiorgan failure. The pus grew pigment producing Chromobacterium violaceum. He was treated successfully with ciprofloxacin for a total duration of 15 days. This case is reported for its rare clinical presentation and resemblance with melioidosis. Of the 200 C. violaceum cases reported across the globe, this is the 14(th) case from India and the oldest in the literature...
October 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28963742/transfusion-acquired-hepatitis-e-infection-misdiagnosed-as-severe-critical-illness-polyneuromyopathy-in-a-heart-transplant-patient
#10
Julie Belliere, Florence Abravanel, Marie Béatrice Nogier, Salima Martinez, Pascal Cintas, Sébastien Lhomme, Laurence Lavayssière, Olivier Cointault, Stanislas Faguer, Jacques Izopet, Nassim Kamar
This is the case of a 56-year-old man who underwent heart transplantation. Within the first postoperative days, his respiratory and limb muscles weakened, which was attributed to critical illness polyneuromyopathy (CIPM). At day 70 post transplantation, he had increased liver enzyme levels and acute hepatitis E virus (HEV) infection was diagnosed. HEV RNA was found in the serum, stools, and cerebrospinal fluid. Results of further investigations suggested a possible HEV-related polyradiculoneuropathy. At transplantation, the patient was negative for immunoglobulin (Ig)G, IgM, and HEV RNA...
September 29, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28948808/-legionellosis-and-its-diagnosis
#11
M Kotrbancová, M Špaleková, M Fulová, K Trnková, J Perželová
The diagnosis of legionellosis, especially of its severe, life-threatening form, Legionnaires' disease, is complicated, primarily because of non-typical symptoms of the infection, not always dominating atypical pneumonia, and often a very dramatic septic course of the disease with multiorgan failures. The diagnosis of the acute phase of the disease can be established by the detection of Legionella antigen in urine and by PCR/real-time PCR detection of Legionella DNA in serum and lower respiratory tract and urine samples...
2017: Epidemiologie, Mikrobiologie, Imunologie
https://www.readbyqxmd.com/read/28948175/evidence-of-high-mortality-and-increasing-burden-of-sepsis-in-a-regional-sample-of-the-new-zealand-population
#12
Paul J Huggan, Anita Bell, James Waetford, Zuzanna Obertova, Ross Lawrenson
BACKGROUND: Sepsis is a life-threatening complication of infection. The incidence of sepsis is thought to be on the increase, but estimates making use of administrative data in the United States may be affected by administrative bias. METHODS: We studied the population-based incidence of sepsis in the Waikato region of New Zealand from 2007 to 2012 using International Classification of Diseases, Tenth Revision, Australian Modification, which lacks a specific code for sepsis...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28945001/organ-on-a-chip-technology-for-reproducing-multiorgan-physiology
#13
REVIEW
Seung Hwan Lee, Jong Hwan Sung
In the drug development process, the accurate prediction of drug efficacy and toxicity is important in order to reduce the cost, labor, and effort involved. For this purpose, conventional 2D cell culture models are used in the early phase of drug development. However, the differences between the in vitro and the in vivo systems have caused the failure of drugs in the later phase of the drug-development process. Therefore, there is a need for a novel in vitro model system that can provide accurate information for evaluating the drug efficacy and toxicity through a closer recapitulation of the in vivo system...
September 25, 2017: Advanced Healthcare Materials
https://www.readbyqxmd.com/read/28943826/the-use-of-daptomycin-to-treat-methicillin-resistant-staphylococcus-epidermidis-bacteremia-in-a-critically-ill-child-with-renal-failure
#14
Stephen Morris, Kate Gould, Lee P Ferguson
Daptomycin is excreted primarily unchanged by the kidney. Dosage regimens in children with renal failure remain to be determined. We report the case of an 8-year-old child with multiorgan failure undergoing continuous peritoneal dialysis, successfully treated with intravenous daptomycin for methicillin-resistant Staphylococcus epidermidis bacteremia. A dosage of 8 mg/kg every 48 hour was used. Plasma peak and trough concentrations of daptomycin were 68 mg/L and 14.6 mg/L, respectively, on day 6 of treatment...
July 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28940869/cytopathological-and-immunocytochemical-findings-of-pancreatic-anaplastic-carcinoma-with-zeb1-expression-by-means-of-touch-imprint-cytology
#15
Yoshiki Naito, Akihiko Kawahara, Tomoki Taira, Yorihiko Takase, Kazuya Murata, Yusuke Ishida, Yoshinobu Okabe, Masahiko Tanigawa, Yutaro Mihara, Masamichi Nakayama, Kazuhide Shimamatsu, Hirohisa Yano, Jun Akiba
Pancreatic anaplastic carcinoma (PAC) is rare and has an aggressive clinical course. We report an autopsy case of PAC focusing on the cytopathological characteristics of the tumor and immunocytochemical staining for vimentin, E-cadherin, and zinc finger E-box binding homeobox 1 (ZEB1), which markers are associated with epithelial markers of epithelial-mesenchymal transition (EMT). A 50-year-old woman presented to our hospital with a chief complaint of jaundice. A pancreatic head tumor and multiple liver nodules were detected on abdominal computed tomography...
September 23, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28937780/-isolated-infectious-endocarditis-of-the-pulmonary-valve-a%C3%A2-case-report
#16
Jan Hrudka, Monika Grussmannová, Václav Mandys
Isolated infectious endocarditis of the pulmonary valve is a rare condition and represents 1,5-2% of all cases of infectious endocarditis. We present a case of a 37year-old woman without any relevant medical history. The woman was hospitalized with hallmarks of severe sepsis and bilateral pneumonia; she died several hours after admission with progressive multiorgan failure and disseminated intravascular coagulopathy. Microbiologic examination approved Staphylococcus aureus as the etiological agent. The autopsy showed isolated endocarditis of the pulmonary valve, without any known predisposing factor...
2017: Ceskoslovenská Patologie
https://www.readbyqxmd.com/read/28932651/extracorporeal-membrane-oxygenation-ecmo-and-the-critical-cardiac-patient
#17
REVIEW
David A Baran
PURPOSE OF REVIEW: This review is to summarize the basics of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) as it is utilized for critically ill cardiac patients. RECENT FINDINGS: ECMO may be instituted in a variety of health care settings, from the emergency room to the operating room. The types of patients who may benefit from ECMO are reviewed in detail. The complications of ECMO are reviewed, including access-related issues and hematologic and neurologic problems...
2017: Current Transplantation Reports
https://www.readbyqxmd.com/read/28932489/the-impact-of-cardiac-resynchronization-therapy-on-routine-laboratory-parameters
#18
András Mihály Boros, Péter Perge, Klaudia Vivien Nagy, Astrid Apor, Zsolt Bagyura, Endre Zima, Levente Molnár, Tamás Tahin, Dávid Becker, László Gellér, Béla Merkely, Gábor Széplaki
BACKGROUND: Cardiac resynchronization therapy (CRT) in chronic heart failure has been shown to improve mortality and morbidity. However, comprehensive data are not available as concerns how circulating biomarkers reflecting different organ functions, such as serum uric acid, blood urea nitrogen (BUN), albumin, cholesterol, or various liver enzymes, change over time as a consequence of CRT. The aim of this prospective study was to overview these possible changes. METHODS: A total of 20 routine laboratory parameters were measured in 122 control subjects and in 129 patients with chronic heart failure before CRT, 6 months, and 2 years later...
March 2017: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28925053/extracorporeal-membrane-oxygenation-can-save-lives-in-children-with-heart-or-lung-failure-after-liver-transplantation
#19
Sandrine Jean, Christophe Chardot, Mehdi Oualha, Carmen Capito, Olivier Bustarret, Philippe Pouard, Sylvain Renolleau, Florence Lacaille, Laurent Dupic
The risk of cardiac or lung failure after liver transplantation (LT) is significant. In rare cases, the usual intensive care techniques fail to maintain organ oxygenation with a risk of multiorgan dysfunction. Although extracorporeal membrane oxygenation (ECMO) is a difficult and risky procedure, it can be proposed as life-saving. Four children with either acute pulmonary (three) or cardiac (one) failure after LT, and the criteria that decided the use of ECMO (level of ventilation and results, dosage of inotropic drugs, cardiac ultrasound, blood lactate) were retrospectively reported...
September 2017: Artificial Organs
https://www.readbyqxmd.com/read/28924018/ibrutinib-for-chronic-graft-versus-host-disease-after-failure-of-prior-therapy
#20
David Miklos, Corey S Cutler, Mukta Arora, Edmund K Waller, Madan Jagasia, Iskra Pusic, Mary E Flowers, Aaron C Logan, Ryotaro Nakamura, Bruce R Blazar, Yunfeng Li, Stephen Chang, Indu Lal, Jason Dubovsky, Danelle F James, Lori Styles, Samantha Jaglowski
Chronic graft-versus-host disease (cGVHD) is a serious complication of allogeneic stem cell transplantation with few effective options available after failure of corticosteroids. B and T cells play a role in the pathophysiology of cGVHD. Ibrutinib inhibits Bruton's tyrosine kinase in B cells and interleukin-2-inducible T-cell kinase in T cells. In preclinical models, ibrutinib reduced severity of cGVHD. This multicenter, open-label study evaluated the safety and efficacy of ibrutinib in patients with active cGVHD with inadequate response to corticosteroid-containing therapies...
September 18, 2017: Blood
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