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https://www.readbyqxmd.com/read/29652753/hybrid-extracorporeal-therapies-as-a-bridge-to-pediatric-liver-transplantation
#1
Ayse Akcan Arikan, Poyyapakkam Srivaths, Ryan W Himes, Naile Tufan Pekkucuksen, Fong Lam, Trung Nguyen, Tamir Miloh, Michael Braun, John Goss, Moreshwar S Desai
OBJECTIVES: Standard intensive care treatment is inadequate to keep children with liver failure alive without catastrophic complications to ensure successful transplant, as accumulation of endogenous protein-bound toxins often lead to hepatic encephalopathy, hepatorenal syndrome, cardiovascular instability, and multiple organ failure. Given paucity of proven treatment modalities for liver failure, blood purification using different extracorporeal treatments as a bridge to transplantation is used, but studies evaluating the safety and efficacy of combination of these therapies, especially in pediatric liver failure, are lacking...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29651510/-vomiting-and-collapse-of-a-28-year-old-male-long-distance-runner-in-middle-european-summer
#2
J Herold, A Mitrasch, E Lorenz, U Lodes, I Tanev, R Braun-Dullaeus, F Meyer
BACKGROUND: Hyperthermia often ends fatally and must therefore be promptly recognized and adequately treated. CASE: A 28-year-old man participated in a long-distance race (3 km) on a hot summer day (28 °C). The runner collapsed, had to vomit but continued the run and reached the finish. Neurologically, the patient presented with intermittent cerebral seizures. External cooling batteries were immediately applied and cold infusions were started. The patient was admitted to the intensive care unit of the university hospital (body temperature 40...
April 12, 2018: Der Internist
https://www.readbyqxmd.com/read/29650544/evaluation-and-management-of-right-sided-heart-failure-a-scientific-statement-from-the-american-heart-association
#3
REVIEW
Marvin A Konstam, Michael S Kiernan, Daniel Bernstein, Biykem Bozkurt, Miriam Jacob, Navin K Kapur, Robb D Kociol, Eldrin F Lewis, Mandeep R Mehra, Francis D Pagani, Amish N Raval, Carey Ward
BACKGROUND AND PURPOSE: The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality...
April 12, 2018: Circulation
https://www.readbyqxmd.com/read/29644541/prevalence-of-the-systemic-inflammatory-response-syndrome-in-patients-who-underwent-orthognathic-surgery
#4
Magno Liberato Silva, Andréia Ferreira Ribeiro, Fábio Ricardo Loureiro Sato, Roger William Fernandes Moreira
PURPOSE: The systemic inflammatory response syndrome (SIRS) is the body's response to an insult, such as infection, trauma, burn, and surgical stress linked to several factors deemed potential for multiple organ failure if left untreated. Thus, the aim of this paper was a prospective study to examine the incidence of SIRS in postoperative patients who underwent orthognathic surgery from June/2013 to July/2016. METHODS: The sample consisted of 80 patients who underwent bimaxillary orthognathic surgery, with data on vital signs and white blood cell count collected preoperatively, and the same data collected in the immediate postoperative period, in addition to CO2 pressure in arterial blood by blood gas analysis...
April 11, 2018: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29644391/analysis-on-sarcoglycans-expression-as-markers-of-septic-cardiomyopathy-in-sepsis-related-death
#5
Elvira Ventura Spagnolo, Cristina Mondello, Debora Di Mauro, Giovanna Vermiglio, Alessio Asmundo, Elena Filippini, Angela Alibrandi, Giuseppina Rizzo
The post-mortem assessment of sepsis-related death can be carry out by many methods recently suggested as microbiological and biochemical investigations. In these cases, the cause of death is a multiple organ dysfunction due to a dysregulated inflammatory response occurring after the failure of infection control process. It was highlighted also that the heart can be a target organ in sepsis which determines the so-called septic cardiomyopathy characterized by myocardial depression. Several mechanisms to explain the pathophysiology of septic cardiomyopathy were suggested, but very few studies about the structural alterations of cardiac cells responsible for myocardial depression were carried out...
April 11, 2018: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/29642928/diagnostic-and-management-of-life-threatening-adult-onset-still-disease-a-french-nationwide-multicenter-study-and-systematic-literature-review
#6
Antoine Néel, Anaïs Wahbi, Benoit Tessoulin, Julien Boileau, Dorothée Carpentier, Olivier Decaux, Laurence Fardet, Guillaume Geri, Pascal Godmer, Cécile Goujard, Hervé Maisonneuve, Arnaud Mari, Jacques Pouchot, Jean-Marc Ziza, Cédric Bretonnière, Mohamed Hamidou
BACKGROUND: Adult-onset Still disease (AOSD) is a rare systemic inflammatory disorder. A few patients develop organ complications that can be life-threatening. Our objectives were to describe the disease course and phenotype of life-threatening AOSD, including response to therapy and long-term outcome. METHODS: A multicenter case series of intensive care medicine (ICU) patients with life-threatening AOSD and a systematic literature review. RESULTS: Twenty patients were included...
April 11, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29626051/access-to-palliative-care-by-disease-trajectory-a-population-based-cohort-of-ontario-decedents
#7
Hsien Seow, Erin O'Leary, Richard Perez, Peter Tanuseputro
OBJECTIVES: To examine access to palliative care between different disease trajectories and compare to other geographic areas. DESIGN: A retrospective population-based decedent cohort study using linked administrative data. SETTING: Ontario, Canada. PARTICIPANTS: Ontario decedents between 1 April 2010 and 31 December 2012. Patients were categorised into disease trajectories: terminal illness (eg, cancer), organ failure (eg, chronic heart failure), frailty (eg, dementia), sudden death or other...
April 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29624025/hepatic-encephalopathy-and-cirrhotic-cardiomyopathy-in-intensive-care-unit
#8
Giuliana Scarpati, Edoardo DE Robertis, Ciro Esposito, Ornella Piazza
Acute and chronic liver diseases may escalate to hepatic encephalopathy (HE) and multiple organ failure, requiring admission and organ support in Intensive Care Unit (ICU). Hepatic dysfunction in ICU is a broad and complex topic; unfortunately, up to now, the understanding of its underlying pathophysiology is far from complete. HE and cirrhotic cardiomyopathy (CCM) need timely diagnostic and therapeutic measures aiming at the identification and elimination of causative factors, to improve patients' prognosis...
April 5, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29622763/esophageal-mucosal-calcinosis-a-rare-site-of-gastrointestinal-mucosal-calcinosis
#9
Aaron R Huber, Brandon S Sprung, John Miller, Jennifer J Findeis-Hosey
BACKGROUND Gastrointestinal tract mucosal calcinosis (MC) tends to affect the gastric mucosa, while esophageal involvement is rare. Gastric MC may be seen with solid organ transplantation, use of aluminum-containing antacids or sucralfate, malignancy, and chronic renal failure. While the incidence of gastric MC in renal transplant patients undergoing gastric biopsy is common (between 15-29%), to our knowledge esophageal MC has only been previously reported 3 times. CASE REPORT A 68-year-old male dialysis-dependent end stage renal disease status-post deceased donor kidney transplant underwent an esophagogastroduodenoscopy (EGD) for dysphagia and diffuse esophageal wall thickening seen on imaging studies...
April 6, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29622425/myocardial-regeneration-therapy-in-heart-failure-current-status-and-future-therapeutic-implications-in-clinical-practice
#10
Marko Banovic, Maja Pusnik-Vrckovnik, Eleni Nakou, Panos Vardas
Despite multiple treatment regimens the morbidity and mortality of patients with advanced heart failure (HF) have reached pandemic proportions. In an effort to address the root cause of the problem, curative strategies are increasingly being considered. A case in point is the evolution of regenerative medicine technologies aiming to halt or even reverse progressive organ deterioration in the HF setting. The prevailing unmet clinical needs in HF therapy have provided a major incentive for the development of cell-based treatment strategies, which have shown encouraging results in experimental studies...
June 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29621990/risk-factors-for-long-term-mortality-in-patients-admitted-with-severe-infection
#11
J Francisco, I Aragão, T Cardoso
BACKGROUND: Severe infection is a main cause of mortality. We aim to describe risk factors for long-term mortality among inpatients with severe infection. METHODS: Prospective cohort study in a 600-bed university hospital in Portugal including all patients with severe infection admitted into intensive care, medical, surgical, hematology and nephrology wards over one-year period. The outcome of interest was 5-year mortality following infection. Variables of patient background and infectious episode were studied in association with the main outcome through multiple logistic regression...
April 5, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29620646/multiple-metastases-of-clear-cell-renal-cell-carcinoma-to-different-region-of-the-nasal-cavity-and-paranasal-sinus-3-times-successively-a-case-report-and-literature-review
#12
Na Zhang, Bing Zhou, Qian Huang, Xiaohong Chen, Shunjiu Cui, Zhenxiao Huang, Yan Sun
RATIONALE: Distant metastasis of clear-cell renal cell carcinoma (ccRCC) to the nasal cavity and paranasal sinus is rare. Endoscopic biopsy used to be performed for diagnosis when it is difficult for complete resection due to intense bleeding during surgery. According to previous literature, the outcomes of metastasis after endoscopic surgery remain unclear. PATIENT CONCERNS: A 62-year-old man with a history of epistaxis was referred to our institution. The clinical, computed tomography (CT) and magnetic resonance imaging (MRI) examination indicate metastasis to sinonasal sinuses...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29619932/mortality-and-morbidity-in-patients-with-osteogenesis-imperfecta-in-denmark
#13
Lars Folkestad
Ostegenesis imperfecta (OI) is a hereditary disease of the connective tissue caused by mutations to, mainly, the genes that are involved in the biosynthesis of collagen type 1. Patients are grouped according to clinical severity and mode of inheritance according to Sillence's classification (originally 1979, updated 2014). According to our data, the population prevalence of OI in Denmark was 10.3 per 100,000, with 575 patients registered with an OI diagnosis in the National Patient Register and alive at the end of 2012 out of a total population of 5,602,628 persons...
April 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29619033/triggering-receptor-expressed-on-myeloid-cells-1-signaling-protective-and-pathogenic-roles-on-streptococcal-toxic-shock-like-syndrome-caused-by-streptococcus-suis
#14
REVIEW
Li Han, Lei Fu, Yongbo Peng, Anding Zhang
Streptococcus suis infections can cause septic shock, which is referred to as streptococcal toxic-shock-like syndrome (STSLS). The disease is characterized by a severe inflammatory response, multiple organ failure, and high mortality. However, no superantigen that is responsible for toxic shock syndrome was detected in S. suis , indicating that the mechanism underlying STSLS is different and remains to be elucidated. Triggering receptor expressed on myeloid cells-1 (TREM-1), belonging to the Ig superfamily, is an activating receptor expressed on myeloid cells, and has been recognized as a critical immunomodulator in several inflammatory diseases of both infectious and non-infectious etiologies...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29616752/adrenal-hemorrhage-a-single-center-experience-and-literature-review
#15
Izabela M Karwacka, Łukasz Obołończyk, Krzysztof Sworczak
BACKGROUND: Adrenal hemorrhage (AH) is a rare condition that can lead to acute adrenal insufficiency and may be fatal. The risk factors of AH include focal adrenal lesion, abdominal trauma and anticoagulation therapy. The clinical manifestation of AH varies widely; the symptoms may be related to adrenal insufficiency or may reflect multiple organ failure. However, in many cases, the course of AH is asymptomatic. OBJECTIVES: The study is a retrospective analysis of 23 cases of AH, whose aim is to discuss the etiology and the management of selected patients, as well as a literature review...
March 27, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29614572/-four-cases-of-acute-respiratory-distress-syndrome-patients-transported-with-veno-venous-extracorporeal-membrane-oxygenation
#16
Z Zhao, X Y Hong, Y Y Liu, X J Zhang, L S Bao, H T Gao, X H Liu, Z C Feng
Objective: To retrospectively review 4 cases diagnosed with pediatric acute respiratory distress syndrome (ARDS) who were transported with veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) from April 2016 to March 2017. Methods: Four patients were transported to Bayi Children's Hospital Afflicted to the PLA Army General Hospital, with V-V ECMO. Their vital signs, blood-gas analysis and chest X-ray before and after transportation were compared. The length of ECMO, pediatric intensive care unit (PICU) stay and hospitalization, and the prognosis were analyzed...
April 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29613958/the-impact-of-age-on-the-innate-immune-response-and-outcomes-after-severe-sepsis-septic-shock-in-trauma-and-surgical-intensive-care-unit-patients
#17
Scott C Brakenridge, Philip A Efron, Julie A Stortz, Teczan Ozrazgat-Baslanti, Gabriela Ghita, Zhongkai Wang, Azra Bihorac, Alicia M Mohr, Babette A Brumback, Lyle L Moldawer, Frederick A Moore
INTRODUCTION: Advancing age is a strong risk factor for adverse outcomes across multiple disease processes. However, septic surgical and trauma patients are unique in they incur two or more inflammatory insults. The effects of advanced age on sepsis pathophysiology and outcomes remain unclear. METHODS: We performed a single center, prospective observational cohort study of Surgical ICU patients with severe sepsis/septic shock. Peripheral blood was collected for genomic, cytokine and biomarker analysis at 0...
April 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29610593/immunological-evaluation-of-surgical-stress-in-liver-resections
#18
Alexandru Munteanu, Gabriel Samasca, Iulia Lupan, Cornel Iancu
Surgery has its origins in caring for patients suffering from injury or infection. In the last decade, a huge amount of published data has been describing a wide range of conditions resulting from trauma or infection, from minor, local reactions to a surgical operation and leading to a systemic stress response, systemic inflammatory response and finally to multiple organ failure. Our aim was to highlight the main immunological aspects of liver resections. There are many types of liver resections, ranging from small, isolated resections for benign diseases (e...
December 2017: Mædica
https://www.readbyqxmd.com/read/29609853/risk-factors-for-sepsis-morbidity-in-a-rural-hospital-population-a-case-control-study
#19
Peter D Ahiawodzi, Kimberly Kelly, Alyssa Massengill, Dorothea K Thompson
BACKGROUND: The aim of the study was to identify risk factors for sepsis morbidity in a rural hospital population. METHODS: We used a case-control study design. Patients included adult admissions to a rural health system between January 1, 2012, and December 31, 2015. Case selection was by electronic medical record search for codes of the ICD-9-CM. Cases were validated against Quick Sequential Organ Failure Assessment criteria. Multiple logistic regression modeling was performed to determine which predefined variables were significantly associated with sepsis diagnosis...
March 30, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29607328/maternal-fetal-and-neonatal-outcomes-in-pregnant-dengue-patients-in-mexico
#20
Carlos Machain-Williams, Eric Raga, Carlos M Baak-Baak, Sungmin Kiem, Bradley J Blitvich, Celso Ramos
To increase our understanding of the consequences of dengue virus infection during pregnancy, a retrospective analysis was performed on the medical records of all completed pregnancies (live births and pregnancy losses) at nine public hospitals in the Gulf of Mexico from January to October 2013. Eighty-two patients developed clinical, laboratory-confirmed dengue virus infections while pregnant. Of these, 54 (65.9%) patients were diagnosed with dengue without warning signs, 15 (18.3%) patients were diagnosed with dengue with warning signs, and 13 (15...
2018: BioMed Research International
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