المساهمون: Mun Chae Choi, Eun-Ki Min, Seung Hyuk Yim, Jae Geun Lee, Bon-Nyeo Koo, Hyohyun Kim, Hye Won Lee, Dong Jin Joo, Myoung Soo Kim, Ku, Bon Nyo

مصطلحات موضوعية: Extracorporeal Membrane Oxygenation* / methods, Humans, Liver Transplantation* / adverse effects, Living Donors, Multiple Organ Failure / etiology, Multiple Organ Failure / therapy, Respiratory Distress Syndrome* / etiology, Respiratory Distress Syndrome* / therapy, Respiratory Insufficiency* / therapy

الوصف: Extracorporeal membrane oxygenation (ECMO) has emerged as an alternative treatment to con-ventional ventilation maneuvers in the nontransplantation literature to support acute respiratory distress syndrome. However, the role of ECMO in transplant is unclear, and few case reports have described using ECMO pretransplant. We discuss the successful use of veno-arteriovenous ECMO as a bridge therapy to deceased donor liver transplant (LT) in acute respiratory distress syndrome. Because the incidence of severe pulmonary complications resulting in acute respira-tory distress syndrome with multiorgan failure is rare before LT, determining the usefulness of ECMO is challenging. However, in acute but reversible respiratory failure and cardiovascular failure, veno-arteriovenous ECMO provides a useful therapeutic option as a bridge for patients awaiting LT and should be considered if available even in multiorgan failure. ; open

وصف الملف: application/pdf

العلاقة: TRANSPLANTATION PROCEEDINGS; J02755; OAK-2023-01903; OAK-2023-01904; OAK-2023-01905; OAK-2023-01906; OAK-2023-01907; OAK-2023-01908; https://ir.ymlib.yonsei.ac.kr/handle/22282913/195488Test; T202303359; TRANSPLANTATION PROCEEDINGS, Vol.55(3) : 684-686, 2023-04

الإتاحة: https://doi.org/10.1016/j.transproceed.2023.02.023Test
https://ir.ymlib.yonsei.ac.kr/handle/22282913/195488Test

المساهمون: Yura Kim, Jae Hwa Jung, Ga Eun Kim, Mireu Park, Myeongjee Lee, Soo Yeon Kim, Min Jung Kim, Yoon Hee Kim, Kyung Won Kim, Myung Hyun Sohn, Kim, Soo Yeon

مصطلحات موضوعية: Child, Humans, Hypoxia, Multiple Organ Failure* / etiology, Oxygen, Respiration, Artificial / methods, Respiratory Distress Syndrome* / therapy, Retrospective Studies

الوصف: Hypoxemia and multiple organ dysfunction are significant contributors to mortality in patients with pediatric acute respiratory distress syndrome (PARDS). P50, the oxygen tension at which hemoglobin is 50% saturated, is a measure of hemoglobin-oxygen affinity, and its alteration might have implications for tissue hypoxia and organ dysfunction. The purpose of this single-center, retrospective study was to evaluate P50 levels in PARDS and to determine the association between P50 and clinical outcomes. The study included 212 children diagnosed with PARDS according to the Pediatric Acute Lung Injury Consensus Conference definition who required invasive mechanical ventilation and had arterial blood gas results of hemoglobin oxygen saturation < 97% at the time of diagnosis. P50 levels were calculated using Doyle's method, and organ dysfunction was assessed using the Pediatric Logistic Organ Dysfunction-2 score. Most patients exhibited more than one dysfunctional extrapulmonary organ at PARDS onset. P50 increased with increasing PARDS severity (mild (26.6 [24.9-29.6]), moderate (26.8 [25.0-29.5]), and severe PARDS (29.1 [26.1-32.4] mmHg; P = 0.025). Moreover, P50 demonstrated a significant positive association with extrapulmonary organ dysfunction score (β = 0.158, P = 0.007) and risk of mortality (adjusted hazard ratio, 1.056; 95% confidence interval, 1.015-1.098; P = 0.007), irrespective of initial PARDS severity. The relationship between P50 and mortality was largely mediated by extrapulmonary organ dysfunction. A high P50 value at the time of PARDS diagnosis may be associated with mortality via dysfunctional extrapulmonary organs. Future studies should consider P50 as a potential candidate index for risk stratification of PARDS patients. ; open

العلاقة: SCIENTIFIC REPORTS; J02646; OAK-2022-07297; OAK-2022-07298; OAK-2022-07299; OAK-2022-07300; OAK-2022-07314; OAK-2022-07320; OAK-2022-07321; https://ir.ymlib.yonsei.ac.kr/handle/22282913/191898Test; T202203877; SCIENTIFIC REPORTS, Vol.12(1) : 136666, 2022-08

الإتاحة: https://doi.org/10.1038/s41598-022-18038-6Test
https://ir.ymlib.yonsei.ac.kr/handle/22282913/191898Test

المؤلفون: Fan, Bowen, Klatt, Juliane, Moor, Michael M, Daniels, Latasha A, Sanchez-Pinto, Lazaro N, Agyeman, Philipp K A, Schlapbach, Luregn J, Borgwardt, Karsten M, Swiss Pediatric Sepsis Study

المساهمون: Posfay Barbe, Klara

المصدر: ISSN: 1367-4803 ; Bioinformatics, vol. 38 (2022) p. i101-i108.

مصطلحات موضوعية: info:eu-repo/classification/ddc/618, Child, Cohort Studies, Humans, Intensive Care Units, Pediatric, Multiple Organ Failure / diagnosis, Multiple Organ Failure / etiology, ROC Curve, Sepsis / complications, Sepsis / diagnosis

الوصف: Motivation: Sepsis is a leading cause of death and disability in children globally, accounting for ∼3 million childhood deaths per year. In pediatric sepsis patients, the multiple organ dysfunction syndrome (MODS) is considered a significant risk factor for adverse clinical outcomes characterized by high mortality and morbidity in the pediatric intensive care unit. The recent rapidly growing availability of electronic health records (EHRs) has allowed researchers to vastly develop data-driven approaches like machine learning in healthcare and achieved great successes. However, effective machine learning models which could make the accurate early prediction of the recovery in pediatric sepsis patients from MODS to a mild state and thus assist the clinicians in the decision-making process is still lacking. Results: This study develops a machine learning-based approach to predict the recovery from MODS to zero or single organ dysfunction by 1 week in advance in the Swiss Pediatric Sepsis Study cohort of children with blood-culture confirmed bacteremia. Our model achieves internal validation performance on the SPSS cohort with an area under the receiver operating characteristic (AUROC) of 79.1% and area under the precision-recall curve (AUPRC) of 73.6%, and it was also externally validated on another pediatric sepsis patients cohort collected in the USA, yielding an AUROC of 76.4% and AUPRC of 72.4%. These results indicate that our model has the potential to be included into the EHRs system and contribute to patient assessment and triage in pediatric sepsis patient care.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/35758775; https://archive-ouverte.unige.ch/unige:176911Test; unige:176911

الإتاحة: https://doi.org/10.1093/bioinformatics/btac229Test
https://archive-ouverte.unige.ch/unige:176911Test

المؤلفون: Haupt, Julian, Krysiak, Niels, Unger, Marina, Bogner-Flatz, Viktoria, Biberthaler, Peter, Hanschen, Marc, van Griensven, Martijn, Haug, Alexander T.

المصدر: http://lobid.org/resources/99370670379406441Test#!, 26(1):38.

مصطلحات موضوعية: Systemic Inflammatory Response Syndrome/diagnosis [MeSH], Multiple trauma, Adipokines, Resistin, Multiple Organ Failure/etiology [MeSH], Systemic Inflammatory Response Syndrome/blood [MeSH], Systemic Inflammatory Response Syndrome/etiology [MeSH], Male [MeSH], Multiple Trauma/complications [MeSH], Case-Control Studies [MeSH], Interleukin-33, Multiple organ dysfunction syndrome, Interleukin-17A, Adolescent [MeSH], Female [MeSH], Follow-Up Studies [MeSH], Multiple Organ Failure/blood [MeSH], Leptin, Adult [MeSH], Biomarkers/blood [MeSH], Humans [MeSH], Middle Aged [MeSH], Multiple organ failure, ROC Curve [MeSH], Research, Prognosis [MeSH], Young Adult [MeSH], Multiple Organ Failure/diagnosis [MeSH], Adipokines/blood [MeSH]

الوصف: Background!#!Multiple organ dysfunction syndrome (MODS) and the consecutive multiple organ failure (MOF) are severe and dreaded complications with a high mortality in multiple trauma patients. The aim of this study was to investigate the potential of the adipokines leptin, resistin, interleukin-17A and interleukin-33 as possible biomarkers in the early posttraumatic inflammatory response and for identifying severely traumatized patients at risk of developing MODS.!##!Methods!#!In total, 14 multiple trauma patients with an injury severity score (ISS) ≥ 16 as well as a control group of 14 non-multiple trauma patients were included in this study and blood samples were taken at the time points 0, 6, 24, 48 and 72 h after admission. For the trauma patients, the SIRS and Denver MOF score were determined daily. The quantitative measurement of the plasma concentrations of the adipokines was performed using ELISA.!##!Results!#!In the statistical analysis, the multiple trauma patients showed statistically significant higher plasma concentrations of leptin, resistin, IL-17A and IL-33 compared to the control group. In addition, there was a statistically significant positive correlation between the concentrations of resistin, IL-17A and IL-33 and the corresponding SIRS scores and between the concentrations of resistin, IL-17A and IL-33 and the corresponding Denver MOF scores. Finally, ROC curve analysis revealed that the adipokines leptin and IL-17A are suitable diagnostic markers for the discrimination between multiple trauma patients with and without MOF.!##!Conclusions!#!Leptin and IL-17A could be suitable diagnostic markers to identify severely injured patients with a developing SIRS and MOF earlier, to adjust surgical therapy planning and intensive care.

العلاقة: https://repository.publisso.de/resource/frl:6464387Test; https://doi.org/10.1186/s40001-021-00511-zTest; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8086117Test/

الإتاحة: https://doi.org/10.1186/s40001-021-00511-zTest
https://repository.publisso.de/resource/frl:6464387Test
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8086117Test/

المؤلفون: Turski, Waldemar A, Wnorowski, Artur, Turski, Gabrielle N, Turski, Christopher A, Turski, Lechoslaw

المصدر: Restorative neurology and neuroscience 38(4), 343 - 354 (2020). doi:10.3233/RNN-201042

مصطلحات موضوعية: info:eu-repo/classification/ddc/610, COVID-19 Drug Treatment, Air Pollutants: adverse effects, Betacoronavirus: physiology, COVID-19, Calcitriol: therapeutic use, Coronavirus Infections: complications, Coronavirus Infections: drug therapy, Coronavirus Infections: physiopathology, Dexamethasone: therapeutic use, Exercise, Feedback, Physiological, Female, Fibrosis: etiology, Gene Expression Regulation: drug effects, Humans, Indoleamine-Pyrrole 2,3,-Dioxygenase: biosynthesis, Indoleamine-Pyrrole 2,3,-Dioxygenase: genetics, Indoleamine-Pyrrole 2,3,-Dioxygenase: physiology, Inflammation: etiology, Kynurenine: physiology, Male, Molecular Targeted Therapy, Multiple Organ Failure: etiology, Obstetric Labor, Premature: etiology, Pandemics, Pneumonia, Viral: complications

جغرافية الموضوع: DE

الوصف: Covid-19 is the acute illness caused by SARS-CoV-2 with initial clinical symptoms such as cough, fever, malaise, headache, and anosmia. After entry into cells, corona viruses (CoV) activate aryl hydrocarbon receptors (AhRs) by an indoleamine 2,3-dioxygenase (IDO1)-independent mechanism, bypassing the IDO1-kynurenine-AhR pathway. The IDO1-kynurenine-AhR signaling pathway is used by multiple viral, microbial and parasitic pathogens to activate AhRs and to establish infections. AhRs enhance their own activity through an IDO1-AhR-IDO1 positive feedback loop prolonging activation induced by pathogens. Direct activation of AhRs by CoV induces immediate and simultaneous up-regulation of diverse AhR-dependent downstream effectors, and this, in turn, results in a 'Systemic AhR Activation Syndrome' (SAAS) consisting of inflammation, thromboembolism, and fibrosis, culminating in multiple organ injuries, and death. Activation of AhRs by CoV may lead to diverse sets of phenotypic disease pictures depending on time after infection, overall state of health, hormonal balance, age, gender, comorbidities, but also diet and environmental factors modulating AhRs. We hypothesize that elimination of factors known to up-regulate AhRs, or implementation of measures known to down-regulate AhRs, should decrease severity of infection. Although therapies selectively down-regulating both AhR and IDO1 are currently lacking, medications in clinical use such as dexamethasone may down-regulate both AhR and IDO1 genes, as calcitriol/vitamin D3 may down-regulate the AhR gene, and tocopherol/vitamin E may down-regulate the IDO1 gene. Supplementation of calcitriol should therefore be subjected to epidemiological studies and tested in prospective trials for prevention of CoV infections, as should tocopherol, whereas dexamethasone could be tried in interventional trials. Because lack of physical exercise activates AhRs via the IDO1-kynurenine-AhR signaling pathway increasing risk of infection, physical exercise should be encouraged during quarantines ...

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/pmid:32597823; info:eu-repo/semantics/altIdentifier/issn/0922-6028; info:eu-repo/semantics/altIdentifier/issn/1878-3627; https://pub.dzne.de/record/154482Test; https://pub.dzne.de/search?p=id:%22DZNE-2021-00259%22Test

الإتاحة: https://doi.org/10.3233/RNN-201042Test
https://pub.dzne.de/record/154482Test
https://pub.dzne.de/search?p=id:%22DZNE-2021-00259%22Test

المؤلفون: Moreira Marques, T, Nascimento, P, Almeida, A, Tosatto, V

مصطلحات موضوعية: HSM MED, Adult, Humans, Male, Administration, Intravenous, Anti-Bacterial Agents / administration & dosage, Ceftriaxone / administration & dosage, Critical Care / methods, Diagnosis, Differential, Environmental Exposure* / adverse effects, Environmental Exposure* / analysis, Fluid Therapy / methods, Homeless Persons, Kidney Function Tests, Leptospira interrogans / isolation & purification, Liver Function Tests, Multiple Organ Failure* / diagnosis, Multiple Organ Failure* / etiology, Thrombocytopenia* / diagnosis, Thrombocytopenia* / etiology, Treatment Outcome, Weil Disease* / blood, Weil Disease* / diagnosis, Weil Disease* / therapy, Weil Disease* / drug therapy

الوصف: Leptospirosis is a zoonotic disease of worldwide distribution caused by infection with Leptospira genus bacteria, a pathogenic spirochaete. We present the case of a 29-year-old man admitted to our hospital with fever and multiorgan failure. He provided poor information about his symptoms. No recent travel or occupational history was reported and his clinical presentation did not suggest any infectious foci. His relatives later disclosed that he had been homeless for 3 weeks in the context of behavioural changes, obtaining foodstuff from waste containers and water from rain puddles. In the setting of this epidemiology, his presentation of fever, jaundice, acute renal injury and thrombocytopaenia suggested leptospirosis. Prompt empirical antimicrobial coverage was started, alongside organ support therapy. The diagnosis was later confirmed through microscopical and molecular methods. The patient made a full recovery. Leptospirosis should be considered early in the diagnostic work-up of any patient with acute febrile illness with multiorgan system involvement, with the identification of risk factors being essential to treat early in development of the disease. ; info:eu-repo/semantics/publishedVersion

العلاقة: BMJ Case Rep. 2020 Jun 11;13(6):e233543.; http://hdl.handle.net/10400.17/4050Test

الإتاحة: http://hdl.handle.net/10400.17/4050Test

المؤلفون: Putowski, Zbigniew, Czok, Marcelina, Polok, Kamil, Guidet, Bertrand, Jung, Christian, Bruno, Raphael Romano, de Lange, Dylan, Leaver, Susannah, Moreno, Rui, Wernly, Bernhard, Flaatten, Hans, Szczeklik, Wojciech

المساهمون: Medische Staf Intensive Care, NVIC bedrijfsvoering, Brain, Infection & Immunity

مصطلحات موضوعية: Aged, COVID-19, Hospital Mortality, Hospitalization, Humans, Intensive Care Units, Multiple Organ Failure/etiology, Organ Dysfunction Scores, Prognosis, Retrospective Studies, Journal Article

الوصف: Background: The Sequential Organ Failure Assessment (SOFA) score is the sum of 6 components, each representing one organ system with dysfunction classified on a 4-point scale. In research, usually by default, the total SOFA score is taken into account, but it may not reflect the severity of the condition of the individual organs. Often, these values are expected to predict mortality. Methods: In this study, we reanalysed 2 cohorts of critically ill elderly patients to explore the distribution of SOFA subscores and to assess the between-group differences. Both cohorts were adjusted to maintain similarity in terms of age and the primary cause of admission (respiratory cause). Results: In total, 910 (non-COVID-19 cohort) and 551 patients (COVID-19 cohort) were included in the analysis. Both cohorts were similar in terms of the total SOFA score (median 5 vs. 5 points); however, the groups differed significantly in 4/6 SOFA subscores (respiratory, neurological, cardiovascular, and coagulation subscores). Moreover, the cohorts had different fractions of organ failures (defined as a SOFA subscore ≥ 3). Conclusions: This analysis revealed significant differences in SOFA subscores between the COVID-19 and non-COVID-19 respiratory cohorts, highlighting the importance of considering individual organ dysfunction rather than relying solely on the total SOFA score when reporting organ dysfunction in clinical research.

وصف الملف: application/pdf

العلاقة: https://dspace.library.uu.nl/handle/1874/451267Test

الإتاحة: https://dspace.library.uu.nl/handle/1874/451267Test

المؤلفون: Ödemark, Elin, Koht, Jeanette

المصدر: Tidsskrift for Den Norske Laegeforening. 137(12-13):890

المؤلفون: Tan, Ming, De Muckadell, Ove B Schaffalitzky, Borbjerg Laursen, Stig

المصدر: Ugeskrift for Laeger. 180(7):595

المؤلفون: Kristiansen, Steinar, Madsen, Marie Rönning, Steen, Rolf, Nielsen, Erik Waage

المصدر: Tidsskrift for Den Norske Laegeforening. 138(8):740