China
Africa
Explore chapters and articles related to this topic
Fulminant Colitis
Published in Stephen M. Cohn, Alan Lisbon, Stephen Heard, 50 Landmark Papers, 2021
Michael F. Musso, Adrian W. Ong
In a patient with colitis, the term “fulminant” denotes a rapidly deteriorating condition with systemic toxicity and progression to multiorgan failure and, possibly, death if not managed aggressively. Although general treatment principles are the same, the lack of standardized criteria for defining what constitutes fulminant colitis (FC) makes it difficult to compare outcomes from different studies and across disease processes. From the provider's standpoint, the lack of a standardized definition of FC might result in uncertainty as to how, and when, treatments should be initiated or escalated.
Optical Spectroscopy for the Detection of Necrotizing Enterocolitis
Published in David J. Hackam, Necrotizing Enterocolitis, 2021
The fulminant nature of NEC is a hurdle to major breakthroughs in treatment, and preventive strategies have remained elusive despite decades of risk factor research. Early diagnosis should be considered a cornerstone of future disease management advances. Prompt identification of NEC may avoid the need for laparotomy or peritoneal drainage, which are major drivers of morbidity, cost, and hospital stay among this group of neonates (9). Optical spectroscopy, especially of a broadband variety, is a safe, noninvasive technology with physiologic rationale that has demonstrated promise in early prediction capability. If this is confirmed in larger clinical trials, one could imagine an additional light-based vitals sign collected for these fragile premature infants at risk for such a devastating condition.
Acquired Encephalopathies
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Herman Sullivan, Muhammad U. Farooq
Acute fulminant liver failure: Cytotoxic brain edema (BBB intact), raised intracranial pressure (ICP), herniation.Loss of non-N-methyl-d-aspartate (NMDA) glutamate receptors in the brain.
Cytomegalovirus induced hemophagocytic lymphohistiocytosis: diagnostic and treatment challenges for the future
Published in Expert Review of Hematology, 2022
Linn Åsholt Rolsdorph, Knut Anders Mosevoll, Håkon Reikvam
Increased use of immunomodulating treatment in IBD and other autoimmune diseases, in malignant diseases, and in the setting of organ and allogeneic hematopoietic stem cell transplantation (allo-HSCT) creates patient groups more vulnerable to complications related to CMV infection and thereby a small, but significant, secondary increased risk of HLH development. As CMV-associated HLH is a rare complication, adequate immunosuppressive treatment of the primary condition should be prioritized. Monitoring for CMV activation by measuring CMV-DNA transcript by PCR techniques is considered mandatory in some settings, such as allo-HSCT [22]. However, an important measure to prevent CMV-associated HLH is awareness of the correlation, to ensure early recognition of CMV disease and HLH development in immunocompromised patients. This is perhaps the best way to reduce development of fulminant disease with high mortality rates in risk patients.
All for one, though not one for all: team players in normal tissue radiobiology
Published in International Journal of Radiation Biology, 2022
Marjan Boerma, Catherine M. Davis, Isabel L. Jackson, Dörthe Schaue, Jacqueline P. Williams
In general, radiation oncologists consider the lung to be an acutely radiosensitive organs, with clinical manifestations taking weeks to months to appear. Early clinical symptoms range from mild dyspnea, nonproductive cough, chest discomfort, and low grade fever to respiratory insufficiency, cyanosis, and fulminant organ failure in the most extreme cases (Davis et al. 1992). In addition, focal to diffuse ground-glass opacification and increased lung density, observed by computed tomography (CT) and single photon-emission computed tomography (SPECT)-defined reductions in lung ventilation and perfusion, are common during the symptomatic phase (Marks et al. 2003). In contrast, the late phase of chronic lung fibrosis is a progressive disease that occurs months to years after treatment. The disease tends to stabilize approximately 2 years post-treatment, although lung volumes may continue to retract until ∼5 years post-exposure; of note, fibrosis can develop in patients who have not presented with the acute clinical symptoms of radiation pneumonitis (Movsas et al. 1997). Corresponding characterization of lung changes in animal models have been made by multiple preclinical researchers, with the seminal work from Elizabeth Travis requiring specific mention (Travis 1980; Travis et al. 1980).
Evaluating the relationship between myocarditis and mRNA vaccination
Published in Expert Review of Vaccines, 2022
The majority of myocarditis cases observed were described as mild (76%), and another 22% described as moderate in severity [41,42]. These findings are consistent with those described in another study evaluating the same vaccine and population catchment, which found 95% of myocarditis cases subsequent to Pfizer vaccination were mild [45]. These large cohort studies of the Pfizer vaccine, administered in Israel, found that in 2.5–5 million vaccinated people, 54–136 developed myocarditis. The overall risk difference between doses as 1.76 per 100,000 persons (95% confidence interval [CI], 1.33 to 2.19), suggesting that in general, administration of a second dose significantly increased the risk of myocarditis [45]. Of note, the greatest difference in risk between the first and second doses occurred in males aged 16–19 (difference, 13.73 per 100,000 persons; 95% CI, 8.11 to 19.46). One identified case was fulminant and fatal. A case report of two other cases of fulminant myocarditis following Pfizer vaccination found them characterized by systemic hyperinflammatory syndrome, very high ferritin, macrophage activation syndrome, and requiring oxygen support [46]. These cases rapidly progressed into multiorgan failure and shock, requiring mechanical cardiac support and immunosuppressive intervention to resolve. While the authors note that these are abnormally severe manifestations of disease, it remains important to consider the possible increased risks of myocardial injury related to systemic hyperinflammatory responses.