Fibrinolytic Alterations in Sepsis: Biomarkers and Future Treatment Targets

2021 ◽  
Author(s):  
Julie Brogaard Larsen ◽  
Anne-Mette Hvas
Keyword(s):  
Immune Response ◽  
Disseminated Intravascular Coagulation ◽  
Clinical Setting ◽  
Fibrinolytic System ◽  
Future Perspectives ◽  
Potential Value ◽  
Laboratory Markers ◽  
Threatening Condition ◽  
The Face ◽  
Life Threatening

AbstractSepsis is a life-threatening condition which develops as a dysregulated immune response in the face of infection and which is associated with profound hemostatic disturbances and in the most extreme cases disseminated intravascular coagulation (DIC). In addition, the fibrinolytic system is subject to alterations during infection and sepsis, and impaired fibrinolysis is currently considered a key player in sepsis-related microthrombus formation and DIC. However, we still lack reliable biomarkers to assess fibrinolysis in the clinical setting. Furthermore, drugs targeting the fibrinolytic system have potential value in sepsis patients with severe fibrinolytic disturbances, but these are still being tested in the preclinical stage. The present review provides an overview of key fibrinolytic changes in sepsis, reviews the current literature on potential laboratory markers of altered fibrinolysis in adult sepsis patients, and discusses future perspectives for diagnosis and treatment of fibrinolytic disturbances in sepsis patients.

Openness of Health Professionals about Death and Terminal Illness in a Nigerian Teaching Hospital

1997 ◽  
Vol 36 (1) ◽  
pp. 23-32 ◽  
Author(s):  
Kemi Adamolekun
Keyword(s):  
Terminal Illness ◽  
Terminally Ill ◽  
Developed Countries ◽  
Terminally Ill Patients ◽  
Aids Epidemic ◽  
Diagnosis And Prognosis ◽  
Threatening Condition ◽  
The Face ◽  
Life Threatening ◽  
Doctors And Nurses

Most physicians in developed countries are reported to have a sense of responsibility to inform a patient about the facts of his or her life-threatening condition. This study reports doctors' and nurses' responsibility to their terminally ill patients in an African environment. Since, by local tradition, doctors are not supposed to convey bad news and the patients do not see themselves as dying of illness, the doctors are not enthusiastic about informing the patients that their disease is terminal. Though doctors and nurses are of the opinion that patients or relatives should be informed of patients' diagnoses, the majority of these professionals do not discuss the prognosis with terminally ill patients. The need to discuss the diagnosis and prognosis according to the desire of each patient was examined. This is more relevant to the practice of medicine in the developing countries with the likelihood that more terminally ill patients would use the hospitals in the face of HIV/AIDS epidemic.

Necrotizing fasciitis of the face: a life-threatening condition

2009 ◽  
Vol 21 (4-5) ◽  
pp. 358-362 ◽  
Author(s):  
Ilenia Pepe ◽  
Lucio Lo Russo ◽  
Valentina Cannone ◽  
Anna Giammanco ◽  
Fortunato Sorrentino ◽  
...  
Keyword(s):  
Necrotizing Fasciitis ◽  
Threatening Condition ◽  
The Face ◽  
Life Threatening

scholarly journals Repeated Sepsis in an 83-Year-Old Man With Cancer With Long-Lasting Invasive Treatments

2020 ◽  
Author(s):  
Masoomeh Imanipour ◽  
Nasrin Rasoulzadeh ◽  
Amin Hosseini
Keyword(s):  
Risk Factors ◽  
Immune Response ◽  
Immune System ◽  
Antibiotic Therapy ◽  
Major Trauma ◽  
Fluid Replacement ◽  
Underlying Condition ◽  
Threatening Condition ◽  
Life Threatening ◽  
Inflammatory Immune Response

Sepsis is a life-threatening condition that arises when the body's response to infection damages its own tissues and organs. Sepsis is caused by an inflammatory immune response triggered by an infection. Its risk factors include aging, weak immune system, major trauma, or burns. Treatment of sepsis is often based on fluid replacement and antibiotic therapy. In this study, an 83-year-old man is reported with two times of diagnosis of sepsis during three years. The first sepsis was due to an infection of the colostomy and the second one followed an infection at tracheostomy site. It seems that the disease and the underlying condition of the patient contribute to the occurrence of sepsis. The patient each time was discharged from the hospital after successful response to the treatment

Parenting in the face of childhood life-threatening conditions: The ordinary in the context of the extraordinary

2015 ◽  
Vol 14 (3) ◽  
pp. 187-198 ◽  
Author(s):  
Kim Mooney-Doyle ◽  
Janet A. Deatrick
Keyword(s):  
Decision Making ◽  
Health Policy ◽  
Clinical Practice ◽  
Parenting Strategies ◽  
The Everyday ◽  
Healthy Siblings ◽  
Threatening Condition ◽  
The Face ◽  
Life Threatening ◽  
Qualitative Descriptive

AbstractObjective:Uncovering what it means to be a parent during the extraordinary time of a child's life-threatening condition (LTC) is important for understanding family goals, decision making, and the work of parenting within this context.Method:Qualitative descriptive methods were employed to describe the everyday experience of parenting both children who have an LTC and their healthy siblings.Results:Some 31 parents of 28 children with an LTC who have healthy siblings participated in our study. Four themes emerged from the data that describe a parental desire to maintain emotional connection with all of their children, how parents use cues from their children to know them better and develop parenting strategies, how parents change as a result of caring for a child with an LTC, and how they strive to decrease suffering for all of their children.Significance of results:The findings of our study have implications for clinical practice, family-focused research, and health policy pertaining to families of children with life-threatening conditions.

scholarly journals Haemolytic uraemic syndrome, E. coli O157 infection, and antimicrobial therapy – clinical management in the face of scientific uncertainty

2002 ◽  
Vol 6 (37) ◽  
Author(s):  
K Mølbak ◽  
◽  
Keyword(s):  
Haemolytic Uraemic Syndrome ◽  
Antimicrobial Agents ◽  
Gastrointestinal Illness ◽  
Scientific Uncertainty ◽  
Microangiopathic Hemolytic Anemia ◽  
E Coli ◽  
Threatening Condition ◽  
The Face ◽  
Life Threatening ◽  
Bloody Stools

The use of antimicrobial agents in the management of patients with E. coli O157 infection is controversial. Verocytotoxigenic Escherichia coli (VTEC), including E. coli O157:H7, is an important cause of gastrointestinal illness. Infection typically presents as a diarrhoeal illness, often with bloody stools. In approximately 8% of patients with E. coli O157:H7, infection progresses to hemolytic-uraemic syndrome (HUS), a life threatening condition characterised by microangiopathic hemolytic anemia, thrombocytopenia, and renal failure. HUS is also associated with VTEC belonging to other E. coli serogroups, although less common than in E. coli O157.

May-Thurner syndrome – Are we aware enough?

VASA ◽  
2019 ◽  
Vol 48 (5) ◽  
pp. 381-388 ◽  
Author(s):  
Katalin Mako ◽  
Attila Puskas
Keyword(s):  
Contraceptive Use ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Compression Syndrome ◽  
Threatening Condition ◽  
Life Threatening ◽  
Iliac Vein Compression ◽  
Iliac Vein Compression Syndrome ◽  
The Right

Summary. Iliac vein compression syndrome (May-Thurner syndrome – MTS) is an anatomically variable clinical condition in which the left common iliac vein is compressed between the right common iliac artery and the underlying spine. This anatomic variant results in an increased incidence of left iliac or iliofemoral vein thrombosis. It predominantly affects young women in the second or third decades of life with preponderance during pregnancy or oral contraceptive use. Although MTS is rare, its true prevalence is underestimated but it can be a life-threatening condition due to development of pulmonary embolism (PE). In this case based review the authors present three cases of MTS. All patients had been previously confirmed with PE, but despite they were admitted to hospital, diagnosed and correctly treated for PE and investigated for thrombophilia, the iliac vein compression syndrome was not suspected or investigated. With this presentation the authors would like to emphasize that MTS is mostly underdiagnosed, and it needs to be ruled out in left iliofemoral vein thrombosis in young individuals.

Severe Alveolar Hemorrhage – What’s in it for the Gastroenterologist?

2016 ◽  
Vol 25 (4) ◽  
pp. 555-558
Author(s):  
Alina Popp
Keyword(s):  
Celiac Disease ◽  
International Normalized Ratio ◽  
Gluten Free Diet ◽  
Alveolar Hemorrhage ◽  
Severe Anemia ◽  
Gluten Free ◽  
Pulmonary Infiltrates ◽  
Pulmonary Hemosiderosis ◽  
Threatening Condition ◽  
Life Threatening

Background: Alveolar hemorrhage is a potentially life-threatening condition which is usually managed by the pulmonologist. When considering its etiology, there is a rare association that sets the disease into the hands of the gastroenterologist. Case presentation: We report the case of a 48 year-old female who was admitted to the intensive care unit for severe anemia and hemoptysis. On imaging, diffuse pulmonary infiltrates suggestive of alveolar hemorrhage were detected and a diagnosis of pulmonary hemosiderosis was made. She received cortisone therapy and hematologic correction of anemia, with slow recovery. In search of an etiology for the pulmonary hemosiderosis, an extensive workup was done, and celiac disease specific serology was found positive. After confirmation of celiac disease by biopsy, a diagnosis of Lane-Hamilton syndrome was established. The patient was recommended a gluten-free diet and at 6 months follow-up, resolution of anemia and pulmonary infiltrates were observed. Conclusion: Although the association is rare, celiac disease should be considered in a patient with idiopathic pulmonary hemosiderosis. In our case, severe anemia and alveolar infiltrates markedly improved with glucocorticoids and gluten-free diet. Abbreviations: APTT: activated partial thromboplastin time; BAL: bronchoalveolar lavage; CD: celiac disease; Cd: crypt depth; GFD: gluten-free diet; GI: gastrointestinal; IEL: intraepithelial lymphocyte; INR: international normalized ratio; IPH: idiopathic pu

LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE CHOLECYSTITIS: A PROSPECTIVE STUDY.

2019 ◽  
Author(s):  
Madan Goyal ◽  
R K Goel
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Critical View Of Safety ◽  
Recent Onset ◽  
Conversion To Open Cholecystectomy ◽  
Threatening Condition ◽  
Life Threatening ◽  
Fluid Collections ◽  
A Prospective Study

Acute cholecystitis (AC) is a potentially life-threatening condition. LC was initially considered to be a relative contraindication for laparoscopic cholecystectomy (LC), but with increase in general expertise, early LC was recommended in selected patients1. Aprospective study of LC in grade 1 and 2 AC patients with mild to moderate inflammatory changes in the gallbladder and no significant organ dysfunction, was performed during October 2016 to July 2019. A total of 78 patients, out of 408 cholecystectomies performed during this period, were included in this study. Criteria for diagnosing AC was, recent onset of pain in right hypochondrium, fever, leucocytosis, pericholecystic fluid collections, subserosal oedema on ultrasound, pyocele and other pathological evidence of AC. Patients presented and operated within 4 days of onset of symptoms showed better results as compared to those who could be operated after 4 days and within 14 days. Five patients required conversion to open cholecystectomy because of complex adhesions in 2, critical view of safety was unachievable in 2 and in 1 for troublesome bleeding.

PRO–CF–MED, Clinical Proof of concept for a RNA–targeting Oligonucleotide for a Cystic fibrosis–F508del MEDication, Horizon2020

Impact ◽  
2018 ◽  
Vol 2018 (3) ◽  
pp. 52-54
Author(s):  
Nicolas Lamontagne
Keyword(s):  
Cystic Fibrosis ◽  
Transmembrane Conductance Regulator ◽  
Transmembrane Conductance ◽  
Rna Targeting ◽  
Threatening Condition ◽  
Life Threatening ◽  
Cftr Protein ◽  
Disease Modifying ◽  
Cystic Fibrosis Transmembrane ◽  
Specific Challenge

Cystic fibrosis (CF) is a progressive life–shortening disease caused by a mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene leading to a dysfunctional CFTR protein. The disease affects over 70,000 patients worldwide and while many mutations are known, the F508del mutation affects 90% of all patients. The absence of CFTR in the plasma membrane leads to a dramatic decrease in chloride efflux, resulting in viscous mucus that causes severe symptoms in vital organs like the lungs and intestines. For CF patients that suffer from the life threatening F508del mutation only palliative treatment exist. PRO–CF–MED addresses the specific challenge of this call by introducing the first disease modifying medication for the treatment of the CF patients with F508del mutation. The PRO–CF–MED project has been designed to assess the potential clinical efficacy of QR–010, an innovative disease modifying oligonucleotide–based treatment for F508del patients. Partners within PRO–CF–MED have generated very promising preclinical evidence for QR–010 which allows for further clinical assessment of QR–010 in clinical trials. PRO–CF–MED will enable the fast translation of QR–010 towards clinical practice and market authorisation. PRO–CF–MED has the potential to transform this life–threatening condition into a manageable one.

Advanced care planning: thinking ahead for parents, carers, children, and young people

2018 ◽  
Author(s):  
Angela Thompson
Keyword(s):  
Spiritual Needs ◽  
Care Planning ◽  
Best Interest ◽  
Social Emotional ◽  
Children And Young People ◽  
Adult Services ◽  
Active Approach ◽  
Threatening Condition ◽  
Life Threatening ◽  
Advance Care

Advance care planning (ACP) in paediatrics applies from the diagnosis of a life-limiting/life-threatening condition onwards. It encompasses the management of intermittent potentially reversible episodes through to end-of-life care in keeping with the child’s best interest. It is an active approach to managing care and acknowledges the child’s and family’s broader social, emotional, and spiritual needs and keeps the child central and paramount to all planning. It requires transparent discussions and effectively documented agreements that are well communicated, readily accessible, and immediately identifiable. It is essential to regularly review and amend as necessary. They describe the care agreed at that point in time in the child’s best interest, in line with RCPCH guidance. Challenges may particularly occur at the time of transition to adult services.

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