Handling shock in idiopathic systemic capillary leak syndrome (Clarkson ’s disease): less is more

AbstractIdiopathic systemic capillary leak syndrome (ISCLS) presents with recurrent potentially life-threatening episodes of hypovolemic shock associated with severe hemoconcentration and hypoproteinemia. Timely recognition is of paramount importance because ISCLS, despite resembling other kinds of hypovolemic shock, requires a peculiar approach, to prevent life-threatening iatrogenic damage. Due to the rarity of this condition with only scattered cases described worldwide, evidence-based recommendations are still lacking. Here, we summarize our 40  years’ experience in treating shock in ISCLS patients to derive a therapeutic algorithm. Records from 12 ISCLS patients (mean follow-up is 6 years, with a mean age at symptoms’ onset of 51.5 years) were informative for treatment modalities and outcome of 66 episodes of shock. Episodes are di vided in three phases and treatment recommendations are the following: prodromal symptoms-signs (growing malaise, oligo-anuria, orthostatic dizziness) last 6–12 h and patients should maintain rigorous bed rest. The acute shock phase lasts 24–36 h. Patients should be admitted to ICU, placed on restrictive infusion of fluids favoring cautious boluses of high-molecular-weight plasma expanders when SAP 
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research

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ConclusionsThe overall VTE rate after CABG has been low. However, the condition has been associated with worse 30-day postoperative outcomes and complications. The independent predictors of VTE development included a history of bleeding disorders, congestive heart failure in the 30 days before surgery, and operative time of ≥310 minutes. Understanding these risk factors should aid physicians in the decisions regarding prophylaxis and treatment.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
Publication date: Available online 13 October 2019Source: Journal of Vascular Surgery: Venous and Lymphatic DisordersAuthor(s): Katherine L. Morrow, James Bena, Sean P. Lyden, Ezequiel Parodi, Christopher J. SmolockAbstractObjectiveInferior vena cava (IVC) filters have been commonly used to prevent pulmonary embolism in patients with deep vein thrombosis. However, IVC filters have been associated with risks, including IVC perforation, filter migration, fracture, and thrombosis. Filter retrieval has not always been successful. Our objective was to identify the factors associated with failure of retrieval of IVC filters.Meth...
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
AbstractA false-positive result of syphilis screening test (FPST) is a characteristic finding in patients with systemic lupus erythematosus (SLE). We evaluated the clinical characteristics of SLE patients with FPST at SLE diagnosis. We reviewed the medical records of patients with SLE who underwent the Venereal Disease Research Laboratory or Rapid Plasma Reagin tests at SLE diagnosis at Severance Hospital between 2006 and 2016. The baseline characteristics and clinical outcomes were compared between patients with FPST and those with a negative result of syphilis screening test. Of 145 patients with SLE, 20 patients showed ...
Source: Rheumatology International - Category: Rheumatology Source Type: research
U.S. FDA approves rivaroxaban to help prevent blood clots in acutely ill medical patientsA new oral option for patients in the U.S. with acute medical illnesses at risk for thromboembolic complications who are not at high risk of bleeding / Rivaroxaban is the only non vitamin K antagonist oral anticoagulant (NOAC) approved in the U.S for the continuum of venous thromboembolism (VTE) care, from prevention and treatment of initial VTE through extended prevention of recurrent VTEmehr ...
Source: Bayer IR Newsfeed: Events - Category: Pharmaceuticals Source Type: news
[Premium Times] Air travellers face increased risk of thrombosis and should pay more attention to condition that involves poor blood flow and clotting, a haematologist has said.
Source: AllAfrica News: Health and Medicine - Category: African Health Source Type: news
XARELTO ® provides a new oral option to help prevent venous thromboembolism (VTE) and VTE-related death during hospitalization and post-hospital discharge in acutely ill medical patients at risk for VTE and not at high risk of bleedingDespite being largely preventable, VTE, or blood clots, remains a signif icant risk for millions of Americans hospitalized with an acute medical illness
Source: Johnson and Johnson - Category: Pharmaceuticals Source Type: news
A new oral option for patients in the U.S. with acute medical illnesses at risk for thromboembolic complications who are not at high risk of bleeding / Rivaroxaban is the only non vitamin K antagonist oral anticoagulant (NOAC) approved in the U.S for the continuum of venous thromboembolism (VTE) care, from prevention and treatment of initial VTE through extended prevention of recurrent VTE
Source: Bayer Company News - Category: Pharmaceuticals Source Type: news
ConclusionsPhysicians should be alert of this tumor despite its rarity because diagnostic delays increase mortality. In this report, we summarize the features that differentiate PPAS from PE and the importance of imaging in diagnosing the tumor.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Publication date: Available online 12 October 2019Source: The Lancet Respiratory MedicineAuthor(s): Stefano Barco, Seyed Hamidreza Mahmoudpour, Luca Valerio, Frederikus A Klok, Thomas Münzel, Saskia Middeldorp, Walter Ageno, Alexander T Cohen, Beverley J Hunt, Stavros V KonstantinidesSummaryBackgroundEuropean estimates of the burden imposed by pulmonary embolism are not available to this date. We aimed to assess pulmonary embolism-related mortality and time trends in the WHO European Region.MethodsWe analysed vital registration data from the WHO Mortality Database (2000–15) covering subregions of the WHO Europea...
Source: The Lancet Respiratory Medicine - Category: Respiratory Medicine Source Type: research
AbstractA 35 ‐year‐old African American male with a history of seizures, presented with nausea, vomiting, abdominal pain, thrombocytopenia (platelet count of 48,000) and acute renal failure (BUN/creatinine – 30/5.6). Urinalysis showed mild proteinuria and microscopic hematuria. He was diagnosed with syste mic lupus erythematosus (SLE) on the basis of positive ANA, anti‐dsDNA, arthritis, thrombocytopenia and hypocomplementemia fulfilling 5 of 11 SLE criteria (1). He also was positive for antibodies to cardiolipin, beta2‐glycoprotein‐I and lupus anticoagulant. ADAMTS13 level was lower than norma l b...
Source: Arthritis and Rheumatology - Category: Rheumatology Authors: Tags: CLINICAL IMAGE Source Type: research
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