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https://www.readbyqxmd.com/read/28214296/abnormally-high-and-heterogeneous-bone-matrix-mineralization-after-childhood-solid-organ-transplantation-a-complex-pathology-of-low-bone-turnover-and-local-defects-in-mineralization
#1
Nadja Fratzl-Zelman, Helena Valta, Renata C Pereira, Barbara M Misof, Paul Roschger, Hannu Jalanko, Kathrine Wesseling-Perry, Klaus Klaushofer, Outi Mäkitie
Chronic renal, liver and heart failure in children associates with multiple skeletal complications. Increased fracture incidence often persists after transplantation and could be related to alterations in bone material properties. In the present cohort study we evaluated bone mineralization density distribution (BMDD) by quantitative backscattered electron imaging (qBEI) in 23 pediatric solid organ allograft recipients with suspected osteoporosis. We measured BMDD in the entire cross-sectional area of transiliac bone biopsies obtained from kidney (n = 9), liver (n = 9) and heart (n = 5) transplant recipients (aged 7...
February 18, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28212163/multiple-organ-dysfunction-in-children-mechanically-ventilated-for-acute-respiratory-failure
#2
Scott L Weiss, Lisa A Asaro, Heidi R Flori, Geoffrey L Allen, David Wypij, Martha A Q Curley
OBJECTIVES: The impact of extrapulmonary organ dysfunction, independent from sepsis and lung injury severity, on outcomes in pediatric acute respiratory failure is unclear. We sought to determine the frequency, timing, and risk factors for extrapulmonary organ dysfunction and the independent association of multiple organ dysfunction syndrome with outcomes in pediatric acute respiratory failure. DESIGN: Secondary observational analysis of the Randomized Evaluation of Sedation Titration for Respiratory Failure cluster-randomized prospective clinical trial conducted between 2009 and 2013...
February 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28210926/a-fatal-suppurative-pneumonia-in-piglets-caused-by-a-pathogenic-coagulase-positive-strain-of-staphylococcus-hyicus
#3
Mingyue Wang, Junying Hu, Lisai Zhu, Chunguang Guo, Haibing Lu, Changming Guo, Xin Li, Xinping Wang
Staphylococcus hyicus is one of the opportunistic pathogens that cause infections to animals. Early studies have demonstrated that S. hyicus is the causative agents of exudative epidermitis in pigs, arthritis in horses and chicken, mastitis in cow, and bacteremia, sepsis and multiple organ failure in humans. Here, we report the isolation and identification of a representative S. hyicus isolate, named JLHN15, from a pig farm with a disease characterized by bacteremia, suppurative pneumonia and fibrinous pericarditis...
February 16, 2017: Veterinary Research Communications
https://www.readbyqxmd.com/read/28210759/-acute-on-chronic-liver-failure-a%C3%A2-diagnostic-and-therapeutic-challenge-for-intensive-care
#4
REVIEW
P Hübener, G Braun, V Fuhrmann
Acute-on-chronic liver failure (ACLF) is an emerging clinical syndrome in patients with underlying liver disease that is usually triggered by one or multiple insults and characterized by progressive hepatic and nonhepatic organ failure, a significant risk of infections, and high short-term mortality rates. Despite our incomplete understanding of the underlying pathophysiology, ACLF requires timely diagnostic and therapeutic measures aiming at the identification and elimination of causative factors as well as the prevention of complications to improve the prognosis of affected patients...
February 16, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28208200/massive-pulmonary-embolism-extracorporeal-membrane-oxygenation-and-surgical-pulmonary-embolectomy
#5
Aaron Weinberg, Victor F Tapson, Danny Ramzy
Massive pulmonary embolism (PE) refers to large emboli that cause hemodynamic instability, right ventricular failure, and circulatory collapse. According to the 2016 ACCP Antithrombotic Guidelines, therapy for massive PE should include systemic thrombolytic therapy in conjunction with anticoagulation and supportive care. However, in patients with a contraindication to systemic thrombolytics or in those who fail the above interventions, extracorporeal membrane oxygenation (ECMO) and/or surgical embolectomy may be used to improve oxygenation, achieve hemodynamic stability, and successfully treat massive PE...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28203342/optimizing-current-and-emerging-therapies-in-multiple-myeloma-a-guide-for-the-hematologist
#6
REVIEW
Shahzad Raza, Rachael A Safyan, Evan Rosenbaum, Alex S Bowman, Suzanne Lentzsch
Multiple myeloma (MM) is the second most common hematologic malignancy. The diagnosis of MM requires ⩾10% clonal plasma cells in the bone marrow or biopsy-proven plasmacytoma, plus evidence of end-organ damage (hypercalcemia, renal failure, anemia, and lytic bone lesions). The definition of MM has recently been expanded to include a ⩾60% clonal plasma cell burden in the bone marrow, serum involved/uninvolved light chain ratio of ⩾100, or more than one focal lesion on magnetic resonance imaging ⩾5 mm in the absence of end-organ damage...
February 2017: Therapeutic Advances in Hematology
https://www.readbyqxmd.com/read/28202119/-acute-renal-failure-caused-by-rhabdomyolysis-in-children-a-clinical-analysis-of-26-cases
#7
Fan-Ying Meng, Xiao-Rong Liu, Qian Fu
OBJECTIVE: To investigate the clinical features and prognosis of acute renal failure (ARF) caused by rhabdomyolysis (RM) in children. METHODS: A retrospective analysis was performed for the clinical data, laboratory examination, and prognosis of 26 RM children with ARF. RESULTS: The causes for all 26 RM children with ARF were non-traumatic diseases, and the three most common causes were infection (69%), diabetes (12%), and metabolic disease (8%)...
February 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28201995/zoonotic-necrotizing-myositis-caused-by-streptococcus-equi-subsp-zooepidemicus-in-a-farmer
#8
Bård Reiakvam Kittang, Veronika Kuchařová Pettersen, Oddvar Oppegaard, Dag Harald Skutlaberg, Håvard Dale, Harald G Wiker, Steinar Skrede
BACKGROUND: Streptococcus equi subsp. zooepidemicus is a beta-hemolytic group C streptococcus mainly causing infections in domesticated animals. Here we describe the first case of zoonotic necrotizing myositis caused by this bacterium. CASE PRESENTATION: The patient was a 73-year-old, previously healthy farmer with two asymptomatic Shetland ponies in his stable. After close contact with the ponies while feeding them, he rapidly developed erythema of his left thigh and sepsis with multiple organ failure...
February 15, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28198397/cystinosis-ctns-zebrafish-mutant-shows-pronephric-glomerular-and-tubular-dysfunction
#9
Mohamed A Elmonem, Ramzi Khalil, Ladan Khodaparast, Laleh Khodaparast, Fanny O Arcolino, Joseph Morgan, Anna Pastore, Przemko Tylzanowski, Annelii Ny, Martin Lowe, Peter A de Witte, Hans J Baelde, Lambertus P van den Heuvel, Elena Levtchenko
The human ubiquitous protein cystinosin is responsible for transporting the disulphide amino acid cystine from the lysosomal compartment into the cytosol. In humans, Pathogenic mutations of CTNS lead to defective cystinosin function, intralysosomal cystine accumulation and the development of cystinosis. Kidneys are initially affected with generalized proximal tubular dysfunction (renal Fanconi syndrome), then the disease rapidly affects glomeruli and progresses towards end stage renal failure and multiple organ dysfunction...
February 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28195969/acute-mesenteric-ischemia-among-postcardiac-surgery-patients-presenting-with-multiple-organ-failure
#10
Alexis Guillaume, Sébastien Pili-Floury, Sidney Chocron, Eric Delabrousse, Bénédicte De Parseval, Stephane Koch, Emmanuel Samain, Gilles Capellier, Gaël Piton
BACKGROUND: Acute mesenteric ischemia (AMI) is a rare but severe complication after cardiac surgery. However, AMI is likely to be more frequent in the subgroup of patients presenting with multiple organ failure after a cardiac surgery. The primary objective of this study was to identify AMI risk factors among patients requiring intensive care unit (ICU) admission after cardiac surgery. METHODS: Retrospective observational study of all the patients requiring admission to two ICUs in a large university hospital after a cardiac surgery procedure...
March 2017: Shock
https://www.readbyqxmd.com/read/28191323/autonomic-imbalance-captures-maternal-and-fetal-circulatory-response-to-pre-eclampsia
#11
Igor Lakhno
BACKGROUND: Pre-eclampsia (PE) is a gestational disease featured by hypertension, arterial systemic vasculopathy, multiple organ failure and fetal compromise. The aim of the investigation was to determine the role of maternal respiratory sinus arrhythmia (RSA) in regulation of the fetal circulatory system in case of healthy pregnancy and in PE. METHODS: The investigation of maternal and fetal HRV and fetal CTG variables in 106 patients at 34-40 weeks of gestation was performed...
2017: Clinical Hypertension
https://www.readbyqxmd.com/read/28183359/unexpected-extrapyramidal-symptoms-and-pulmonary-aspergillosis-in-exertional-heatstroke-with-fulminant-liver-failure-a-case-report
#12
Jie Jiao, Feihu Zhou, Hongjun Kang, Chao Liu, Mengmeng Yang, Jie Hu
BACKGROUND: Exertional heatstroke is a life-threatening condition with high mortality because of the rapid progress of multiple organ dysfunction syndrome even if aggressive treatments are initiated rapidly. Mild to moderate hepatic injury is common in exertional heatstroke, while fulminant liver failure is rare. Extrapyramidal symptoms and pulmonary aspergillosis secondary to liver failure induced by exertional heatstroke have never been reported in prior cases. CASE PRESENTATION: A 25-year-old Han Chinese man presented with exertional heatstroke with fulminant liver failure, subsequent pulmonary aspergillosis, and extrapyramidal symptoms...
February 10, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28183143/rapid-documented-growth-of-aneurysm-bleb-led-to-rupture-of-an-incidental-intracranial-anterior-communicating-artery-aneurysm
#13
Jan-Karl Burkhardt, Jorn Fierstra, Giuseppe Esposito, Gerasimos Baltsavias, Oliver Bozinov, Luca Regli
Background A major challenge in the management of patients with unruptured intracranial aneurysms (UIAs) is to identify criteria indicating a higher risk of future UIA rupture. We report a rare patient with documented short-term bleb growth of an UIA followed by a fatal aneurysm rupture supporting the high risk of rupture of short-term shape changes in UIAs. Case Description A 72-year-old man with an incidental unruptured anterior communicating artery aneurysm of 9 mm showed a bleb growth on the aneurysm sac at 6-week follow-up computed tomography angiography (CTA)...
February 9, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28178160/extracorporeal-membrane-oxygenation-support-in-post-traumatic-cardiopulmonary-failure-a-10-year-single-institutional-experience
#14
Chun-Yu Lin, Feng-Chun Tsai, Hsiu-An Lee, Yuan-His Tseng
Patients with multiple traumas associated with cardiopulmonary failure have a high mortality rate; however, such patients can be temporarily stabilized using extracorporeal membrane oxygenation (ECMO), providing a bridge to rescue therapy. Using a retrospective study design, we aimed to clarify the prognostic factors of post-traumatic ECMO support.From March 2006 to July 2016, 43 adult patients (mean age, 37.3 ± 15.2 years; 7 females [16.3%]) underwent ECMO because of post-traumatic cardiopulmonary failure...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28178077/glucocorticoid-receptor-polymorphisms-and-outcomes-in-pediatric-septic-shock
#15
Natalie Z Cvijanovich, Nick Anas, Geoffrey L Allen, Neal J Thomas, Michael T Bigham, Scott L Weiss, Julie Fitzgerald, Paul A Checchia, Keith Meyer, Michael Quasney, Rainer Gedeit, Robert J Freishtat, Jeffrey Nowak, Shekhar S Raj, Shira Gertz, Jocelyn R Grunwell, Amy Opoka, Hector R Wong
OBJECTIVE: Polymorphisms of the glucocorticoid receptor gene are associated with outcome and corticosteroid responsiveness among patients with inflammatory disorders. We conducted a candidate gene association study to test the hypothesis that these polymorphisms are associated with outcome and corticosteroid responsiveness among children with septic shock. DESIGN: We genotyped 482 children with septic shock for the presence of two glucocorticoid receptor polymorphisms (rs56149945 and rs41423247) associated with increased sensitivity and one glucocorticoid receptor polymorphism (rs6198) associated with decreased sensitivity to corticosteroids...
February 7, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28175954/multiple-resistance-to-carcinogens-and-xenobiotics-p-glycoproteins-as-universal-detoxifiers
#16
REVIEW
Thomas Efferth, Manfred Volm
The detoxification of toxic substances is of general relevance in all biological systems. The plethora of exogenous xenobiotic compounds and endogenous toxic metabolic products explains the evolutionary pressure of all organisms to develop molecular mechanisms to detoxify and excrete harmful substances from the body. P-glycoprotein and other members of the ATP-binding cassette (ABC) transporter family extrude innumerous chemical compounds out of cells. Their specific expression in diverse biological contexts cause different phenotypes: (1) multidrug resistance (MDR) and thus failure of cancer chemotherapy, (2) avoidance of accumulation of carcinogens and prevention of carcinogenesis in healthy tissues, (3) absorption, distribution, metabolization and excretion (ADME) of pharmacological drugs in human patients, (4) protection from environmental toxins in aquatic organisms (multi-xenobiotic resistance, MXR)...
February 7, 2017: Archives of Toxicology
https://www.readbyqxmd.com/read/28174772/collagen-peptides-ameliorate-intestinal-epithelial-barrier-dysfunction-in-immunostimulatory-caco-2-cell-monolayers-via-enhancing-tight-junctions
#17
Qianru Chen, Oliver Chen, Isabela M Martins, Hu Hou, Xue Zhao, Jeffrey B Blumberg, Bafang Li
Dysfunction of the intestinal barrier plays a key role in the pathogenesis of inflammatory bowel disease (IBD) and multiple organ failure. The effect of Alaska pollock skin-derived collagen and its 3 tryptic hydrolytic fractions, HCP (6 kDa retentate), MCP (3 kDa retentate) and LCP (3 kDa permeate) on TNF-α induced barrier dysfunction was investigated in Caco-2 cell monolayers. TNF-α induced barrier dysfunction was significantly attenuated by the collagen and its peptide fractions, especially LCP, compared to TNF-α treated controls (P < 0...
February 8, 2017: Food & Function
https://www.readbyqxmd.com/read/28174597/cd4%C3%A2-%C3%A2-cd25%C3%A2-%C3%A2-cd127-high-cells-as-a-negative-predictor-of-multiple-organ-failure-in-acute-pancreatitis
#18
Wei Wang, He-Ping Xiang, Hui-Ping Wang, Li-Xin Zhu, Xiao-Ping Geng
BACKGROUND: It has been suggested that severity of the immune response induced by immune cells is associated with morbidity and mortality from acute pancreatitis. The authors investigated and evaluated the relationship between distinct peripheral lymphocyte subsets at admission and clinical outcome prior to hospital discharge so as to find a predictor to the prognosis of acute pancreatitis in lymphocyte profile. METHODS: Lymphocyte subsets in admission peripheral venous blood were tested through flow cytometry on 48 patients with acute pancreatitis...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28166447/nutrition-support-for-persistent-inflammation-immunosuppression-and-catabolism-syndrome
#19
Frederick A Moore, Stuart Phillips, Craig McClain, Jayshil J Patel, Robert Martindale
Despite tremendous advances in critical care, multiple-organ failure continues to be a significant problem. However, in recent years, far fewer patients with multiple-organ failure die early, but many experience ongoing immune dysregulation and are developing persistent inflammation, immunosuppression, and catabolism syndrome (PICS). Most PICS patients are discharged to nonhome destinations, fail to rehabilitate, and succumb to indolent death. From a nutrition perspective, patients with PICS experience persistent inflammation-induced cachexia despite evidenced-based recommended intensive care unit nutrition support...
February 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28161219/terlipressin-in-refractory-shock-induced-by-diltiazem-poisoning
#20
Claire Ragot, Edouard Gerbaud, Alexandre Boyer
Poisoning caused by calcium-channels blockers (CCB) can cause refractory vasoplegic shock, resulting in multiple-organ failure and death despite maximal therapy including high doses of vasopressors. We report one CCB-induced refractory shock complicated with lactate acidosis despite very high doses of epinephrine and norepinephrine. The hemodynamic status of the patient dramatically improved after intermittent boluses of terlipressin, which corrected the acidosis.
January 27, 2017: American Journal of Emergency Medicine
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