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[PMID]: 29524240
[Au] Autor:Onwuemene OA; Grambow SC; Patel CB; Mentz RJ; Milano CA; Rogers JG; Metjian AD; Arepally GM; Ortel TL
[Ad] Address:Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, North Carolina.
[Ti] Title:Indications for and outcomes of therapeutic plasma exchange after cardiac transplantation: A single center retrospective study.
[So] Source:J Clin Apher;, 2018 Mar 10.
[Is] ISSN:1098-1101
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Limited data are available describing indications for and outcomes of therapeutic plasma exchange (TPE) in cardiac transplantation. METHODS: In a retrospective study of patients who underwent cardiac transplantation at Duke University Medical Center from 2010 to 2014, we reviewed 3 TPE treatment patterns: a Single TPE procedure within 24 h of transplant; Multiple TPE procedures initiated within 24 h of transplant; and 1 or more TPE procedures beginning >24 h post-transplant. Primary and secondary outcomes were overall survival (OS) and TPE survival (TS), respectively. RESULTS: Of 313 patients meeting study criteria, 109 (35%) underwent TPE. TPE was initiated in 82 patients within 24 h, 40 (37%) receiving a single procedure (Single TPE), and 42 (38%) multiple procedures (Multiple TPE). Twenty-seven (25%) began TPE >24 h after transplant (Delayed TPE). The most common TPE indication was elevated/positive panel reactive or human leukocyte antigen antibodies (32%). With a median follow-up of 49 months, the non-TPE treated and Single TPE cohorts had similar OS (HR 1.08 [CI, 0.54, 2.14], P = .84), while the Multiple and Delayed TPE cohorts had worse OS (HR 2.62 [CI, 1.53, 4.49] and HR 1.98 [CI, 1.02, 3.83], respectively). The Multiple and Delayed TPE cohorts also had worse TS (HR 2.59 [CI, 1.31, 5.14] and HR 3.18 [CI, 1.56, 6.50], respectively). Infection rates did not differ between groups but was independently associated with OS (HR 2.31 [CI, 1.50, 3.54]). CONCLUSIONS: TPE is an important therapeutic modality in cardiac transplant patients. Prospective studies are needed to better define TPE's different roles in this patient population.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher
[do] DOI:10.1002/jca.21622

  2 / 11760 MEDLINE  
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[PMID]: 29519170
[Au] Autor:Behera SK; Das S; Xavier AS; Selvarajan S
[Ad] Address:a Department of Clinical Pharmacology , Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Puducherry , India.
[Ti] Title:DRESS syndrome: a detailed insight.
[So] Source:Hosp Pract (1995);, 2018 Mar 08.
[Is] ISSN:2154-8331
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a serious and potentially fatal adverse effect to therapeutic medications. The incidence of this condition varies among different ethnicities because of the difference in the genetic makeup. Though fever, rash and eosinophilia are essential features for the diagnosis of this syndrome, these vary from patient to patient along with the involvement of various organs such as liver, kidney, lungs, pancreas, etc. Some of the atypical features are dysphagia, agranulocytosis, and chylous ascites. Phenytoin, phenobarbitone, carbamazepine, and allopurinol are the most common drugs responsible for developing this syndrome, although the list is fairly long. Among the criteria used for the diagnosis of DRESS syndrome, European Registry of Severe Cutaneous Adverse Reactions to Drugs and Collection of Biological Samples (RegiSCAR) criteria is the most commonly used one. The management of this syndrome involves early removal of the causative agent and treatment with anti-histamines and emollients in the mild form, corticosteroids in the moderate form and plasmapheresis in the severe form along with other alternatives drugs. Healthcare professionals should be more vigilant about the early manifestations of this syndrome, as early diagnosis and treatment improve outcomes considerably.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1080/21548331.2018.1451205

  3 / 11760 MEDLINE  
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[PMID]: 29418067
[Au] Autor:Sauer M; Richter G; Altrichter J; Wild T; Doß F; Mencke T; Ehler J; Doß S; Koch S; Schubert A; Nöldge-Schomburg G; Mitzner SR
[Ad] Address:Department of Anesthesiology and Intensive Care Medicine, University Hospital of Rostock, Rostock, Germany.
[Ti] Title:Effects of Bioreactor-Oxygenation During Extracorporeal Granulocytes Treatment in Septic Patients.
[So] Source:Ther Apher Dial;, 2018 Feb 08.
[Is] ISSN:1744-9987
[Cp] Country of publication:Australia
[La] Language:eng
[Ab] Abstract:A granulocyte bioreactor for the extracorporeal treatment was developed to enhance the immune cell function in patients with severe sepsis. The influence of oxygenation on the used cells was tested in a prospective clinical study. Ten patients with severe sepsis were treated twice with the granulocyte bioreactor. The used cells were screened for functionality; values of blood gases, glucose and lactate were obtained from the recirculating bioreactor circuit. Five patients were treated with an oxygenator setup (Oxy group), five without oxygenator (Non-Oxy group). The overall in-hospital mortality was 50%. Significantly lower values of oxygen saturation, partial oxygen pressure, lactate, oxyburst and phagocytosis were seen in the Non-Oxy group compared with the Oxy group in the bioreactor circuit. Further studies with this approach are encouraged and should focus on the influence of oxygenation on production of reactive oxygen species and cytokines of used cells.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1111/1744-9987.12657

  4 / 11760 MEDLINE  
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[PMID]: 27778443
[Au] Autor:Krawczyk M; Liebe R; Wasilewicz M; Wunsch E; Raszeja-Wyszomirska J; Milkiewicz P
[Ad] Address:Laboratory of Metabolic Liver Diseases, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
[Ti] Title:Plasmapheresis exerts a long-lasting antipruritic effect in severe cholestatic itch.
[So] Source:Liver Int;37(5):743-747, 2017 May.
[Is] ISSN:1478-3231
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND & AIMS: The amelioration of refractory cholestatic pruritus after plasmapheresis has been reported in single patients. Here, we analyse the efficacy of plasmapheresis in a cohort of patients with primary biliary cholangitis (PBC). METHODS: Seventeen consecutive patients with PBC (age range 39-85 years, 16 females, 9 with cirrhosis) and refractory pruritus underwent 129 plasmapheresis procedures during 40 admissions. Pruritus was quantified by the 10-point numeric rating scale (NRS) before and after plasmapheresis, as well as ~30 and ~90 days later. RESULTS: The mean pruritus before plasmapheresis did not differ between patients with and without cirrhosis (P>.05). Cirrhotics presented, however, with significantly higher serum alanine aminotransferase (ALT), aspartate transaminase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP) and bilirubin before plasmapheresis. Plasmapheresis decreased itching to NRS≤5 in all but five admissions: Mean pruritus decreased from 8.3±1.4 to 3.1±2.2 (P<.0001) in the entire cohort. It also led to a significant decrease in serum ALT, ALP, AST, GGT (all P<.001) and bilirubin (P=.002). Antipruritic effect persisted throughout the 90-days follow-up (P<.0001). The amelioration of pruritus was not affected by the presence of cirrhosis. CONCLUSIONS: Plasmapheresis is a promising method for reducing intractable itch in a significant proportion of PBC patients regardless of liver fibrosis. Long-lasting improvement of symptoms requires repeated procedures.
[Mh] MeSH terms primary: Cholestasis/complications
Liver Cirrhosis, Biliary/complications
Plasmapheresis
Pruritus/therapy
[Mh] MeSH terms secundary: Adult
Aged
Aged, 80 and over
Alkaline Phosphatase/blood
Aspartate Aminotransferases/blood
Bilirubin/blood
Female
Humans
Liver/pathology
Male
Middle Aged
Poland
Pruritus/blood
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:EC 2.6.1.1 (Aspartate Aminotransferases); EC 3.1.3.1 (Alkaline Phosphatase); RFM9X3LJ49 (Bilirubin)
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[Js] Journal subset:IM
[Da] Date of entry for processing:161026
[St] Status:MEDLINE
[do] DOI:10.1111/liv.13281

  5 / 11760 MEDLINE  
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[PMID]: 29503131
[Au] Autor:Apaydin S
[Ad] Address:University of Health Sciences, Medical Faculty, Internal Medicine, Bakirkoy Dr. Sadi Konuk Training and Research Center, Nephrology Department, Istanbul, Turkey. Electronic address: suheyla.apaydin1@saglik.gov.tr.
[Ti] Title:The treatment of ANCA-associated rapidly-progressive glomerulonephritis and Goodpasture syndrome with therapeutic apheresis.
[So] Source:Transfus Apher Sci;, 2018 Feb 20.
[Is] ISSN:1473-0502
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Therapeutic plasma aphresis (plasmapheresis) is one form of treatment that is frequently used in practice of Nephrology. Plasmapheresis is the most important part of the therapies for Goodpasture's syndrome and anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis which are causes of rapidly progressive glomerulonephritis. The reason why the effectiveness of plasmapheresis therapy cannot be clearly demonstrated in renal involvement in these diseases is that it does not appear to be possible to recruit an adequate number of patients and plasmapheresis is not effective in advanced disease if early treatment is not initiated.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:Publisher

  6 / 11760 MEDLINE  
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[PMID]: 29390386
[Au] Autor:Nusshag C; Morath C; Zeier M; Weigand MA; Merle U; Brenner T
[Ad] Address:Department of Nephrology.
[Ti] Title:Hemophagocytic lymphohistiocytosis in an adult kidney transplant recipient successfully treated by plasmapheresis: A case report and review of the literature.
[So] Source:Medicine (Baltimore);96(50):e9283, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease entity primarily described in children, but not less relevant in adults. It is characterized by a misdirected activation of the immune system, resulting in an uncontrolled cytokine release from macrophages and cytotoxic T-cells (CTLs). Primary HLH relies on a genetic predisposition, whereas secondary HLH develops in the context of infections, malignancies or autoimmune diseases. However, the awareness and therapeutic knowledge for HLH in adulthood is limited. Most therapy protocols are almost exclusively validated in pediatric cohorts and for primary HLH. Their transferability to adult individuals with mostly secondary HLH is doubtful. Especially the high liver and bone marrow toxicity of applied etoposide-based protocols is discussed controversially and connected to overwhelming infections and death. PATIENT CONCERN: A 51-year old, male, kidney transplant recipient was admitted to our center suffering from diarrhea, fever, nausea, hyponatremia, kidney graft failure, disorientation, progressive hemodynamic instability, and multiorgan failure. DIAGNOSES: Clinical and laboratory findings resembled those of a septic shock. Ferritin and soluble interleukin-2 receptor (sCD25) levels were disproportionally elevated. Only a mild hepatosplenomegaly was diagnosed in a CT scan. A T2-weighted, fluid-attenuated inversion recovery MRI showed marked, bilateral and periventricular white matter hyperintensities. The cerebrospinal fluid (CSF) analysis showed a moderately elevated protein content and cell count. There was no evidence of any bacterial, viral, or parasitic infection. The diagnosis of HLH was made. INTERVENTIONS & OUTCOMES: The patient was successfully treated by a combined approach consisting of plasma exchange (PE), corticosteroids, anakinra, and cyclosporine (CsA). LESSONS: HLH is an important differential diagnosis in critically ill patients. Its unspecific clinical picture complicates an early diagnosis and may be misclassified as sepsis. A combination of plasma exchange (PE), corticosteroids, anakinra, and cyclosporine (CsA) may be a promising and less toxic approach for HLH therapy in adults.
[Mh] MeSH terms primary: Kidney Transplantation
Lymphohistiocytosis, Hemophagocytic/therapy
Plasmapheresis
[Mh] MeSH terms secundary: Adrenal Cortex Hormones/therapeutic use
Antirheumatic Agents/therapeutic use
Combined Modality Therapy
Cyclosporine/therapeutic use
Diagnosis, Differential
Diagnostic Imaging
Humans
Immunosuppressive Agents/therapeutic use
Interleukin 1 Receptor Antagonist Protein/therapeutic use
Lymphohistiocytosis, Hemophagocytic/etiology
Male
Middle Aged
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Name of substance:0 (Adrenal Cortex Hormones); 0 (Antirheumatic Agents); 0 (Immunosuppressive Agents); 0 (Interleukin 1 Receptor Antagonist Protein); 83HN0GTJ6D (Cyclosporine)
[Em] Entry month:1802
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009283

  7 / 11760 MEDLINE  
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[PMID]: 29466971
[Au] Autor:Katayama K; Higuchi A; Yamamoto H; Ikeda A; Kikuchi S; Shiozawa M
[Ad] Address:Cancer Prevention and Control Division, Kanagawa Cancer Center Research Institute, 2-3-2, Nakao, Yokohama City, Asahi-ku, 241-8515, Japan. katayama@gancen.asahi.yokohama.jp.
[Ti] Title:Perioperative dynamics and significance of plasma-free amino acid profiles in colorectal cancer.
[So] Source:BMC Surg;18(1):11, 2018 Feb 21.
[Is] ISSN:1471-2482
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: For early detection of cancer, we have previously developed the AminoIndex Cancer Screening (AICS) system, which quantifies 6 plasma-free amino acids (PFAAs) in blood samples. Herein, we examined the usefulness of the AICS in patients with colorectal cancer (CRC) by comparing the preoperative and postoperative PFAA profiles. METHODS: Our study cohort consisted of 62 patients who had undergone curative resection for CRC at our cancer center, with no recurrence at the time of the study. Blood samples were collected from fasted patients within 1 week before the resection and at 0.5-6.5 years post-resection. Following plasmapheresis, the PFAA levels were measured via liquid chromatography/mass spectrometry, and the AICS values were computed (the higher the value, the greater the probability of cancer). Risk was calculated from the AICS value and ranked as A, B, or C, with rank C representing the highest risk. All patients in our study were rank B + C. RESULTS: The postoperative AICS value was lower than the preoperative value in 57 of the 62 patients; the rank was also lower postoperatively (49 patients, p < 0.001). The decline in both was stage-independent, even occurring in patients with right-sided tumors or poorly differentiated adenocarcinomas. For comparative purposes, the levels of 2 tumor markers (carbohydrate antigen 19-9 and carcinoembryonic antigen) were also examined; these were within the reference ranges in 70-80% of patients preoperatively and in 80-90% postoperatively. CONCLUSION: We suggest that tumor-bearing conditions alter the PFAA profiles, which may be used to predict prognosis and monitor for recurrence in CRC patients after tumor resection. TRIAL REGISTRATION: This trial has been retrospectively registered at UMIN-CTR R000028005 , Oct 06, 2016.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[St] Status:In-Process
[do] DOI:10.1186/s12893-018-0344-0

  8 / 11760 MEDLINE  
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[PMID]: 29477943
[Au] Autor:Kalayoglu-Besisik S
[Ad] Address:Istanbul University, Istanbul Medical Faculty, Department of Internal Medicine, Division of Hematology, Therapeutic Apheresis Unit and Blood Bank, Istanbul, Turkey. Electronic address: sevgikalayoglu@istanbul.edu.tr.
[Ti] Title:The use of emergency apheresis in the management of plasma cell disorders.
[So] Source:Transfus Apher Sci;, 2018 Feb 20.
[Is] ISSN:1473-0502
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Hyperviscosity syndrome (HVS) develops most commonly in Waldenström's macroglobulinemia (WM) and multiple myeloma (MM). Plasmapheresis is the immediate therapy and very effective at relieving symptoms by removing paraprotein. The most commonly used replacement fluid is 4%-5% human albumin in physiologic saline. FFP may be used in patients with coagulation abnormalities. Plasmapheresis should be continued until acute symptoms abate. Hyperviscosity impairs the circulation in the retina and causes hemorrhages around the small retinal vessels. Early diagnosis and urgent plasmapheresis may reduce blindness caused by retinal hemorrhages and/or retinal detachment. In HCV related mixed cryoglobulinemias, plasmapheresis is indicated if rapidly evolving life-threatening disease with immunosuppressive agent exists. In non-infectious mixed cryoglobulinemia plasmapheresis is indicated when the disease manifestations are severe, as a second line option. In WM patients with hyperviscosity symptoms and IgM > 4 g/dL, preemptive plasmapheresis is recommended to prevent an IgM flare with rituximab. Certain IgG/A MGUS-associated neuropathy patients may benefit from plasmapheresis. For cast nephropathy (suspected or biopsy proven), plasmapheresis is recommended when the sFLC ≥ 500 mg/l and as early as possible (<1 month with kidney injury). Theoretically, extracorporeal removal alone, without efficient tumor killing, could not reduce sFLC due to high production by the tumor mass and rapid rebound between compartments.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180225
[Lr] Last revision date:180225
[St] Status:Publisher

  9 / 11760 MEDLINE  
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[PMID]: 29364102
[Au] Autor:Uyar S; Harmandar F; Kök M; TaÈ™ Z; Dolu S; Tokuç A; Köker G; Görar S; Çekin AH
[Ti] Title:Management of hypertriglyceridemia induced acute pancreatitis and therapeutic plasmapheresis : Report of nine cases and review of literature.
[So] Source:Acta Gastroenterol Belg;80(1):71-74, 2017 Jan-Mar.
[Is] ISSN:1784-3227
[Cp] Country of publication:Belgium
[La] Language:eng
[Ab] Abstract:Hypertriglyceridemia is one of the rare causes of the acute pancreatitis. The prevalance of hypertriglyceridemia has increased recently due to the changing eating habits, sedentary lifestyle, alcohol consumption, obesity and concomitant diabetes mellitus. Therefore, the frequency of the acute pancreatitis due to hypertriglyceridemia may increase in coming years. Diagnosis of the acute pancreatitis by hypertriglyceridemia can be overlooked easily and may be very severe if untreated accurately on time. In addition to the standard management of pancreatitis, specific treatment for hypertriglyceridemia that is insulin, heparin and anti-hypertriglyceridemic drugs are used. Therapeutic plasmapheresis is the last treatment option and seems the most effective one in this subject through developing device and membrane technologies when we review the current literature. Not only triglycerides but also proinflammatory cytokines and adhesion molecules that play an active role in pathogenesis are removed by plasmapheresis. So, the effectiveness of treatment appears promising. However, the exact pathophysiology of hypertriglyceridemia-induced pancreatitis could not be fully understood and the majority of published experience comes from the case reports and the benefit of randomized clinical trials is not available. Therefore, there are no data about what are the exact indications and when we start therapeutic plasmapheresis in literature. This manuscript describes our hospital experience with treatment options and analyzes reports published recently about plasmapheresis as a treatment modality for hypertriglyceridemia induced acute pancreatitis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:In-Process

  10 / 11760 MEDLINE  
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[PMID]: 29473497
[Au] Autor:Wang H
[Ad] Address:National Chiao Tung University Taiwan, Institute of Statistics, Hsin-chu. Taiwan.
[Ti] Title:Anti-NMDA Receptor Encephalitis: Efficacy of Treatment for Male Patients and miRNA Biomarker.
[So] Source:Curr Med Chem;, 2018 Feb 21.
[Is] ISSN:1875-533X
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:Treatments for the anti-NMDA receptor encephalitis usually include steroids, intravenous immunoglobulin, plasma exchange, plasmapheresis, rituximab, cyclophosphamide and tumor resection. We aimed to compare the efficacy of the treatments including intravenous immunoglobulin, plasma exchange, plasmapheresis, rituximab or cyclophosphamide for male anti-NMDA receptor encephalitis patients without tumor and to discuss potential biomarkers for this disease. The Fisher exact test and the contingency table analysis were used to analyze the treatment efficacy for both male and female these patients. A hierarchical tree method was adopted to analyze the difference of the treatment efficacy between male and female patients. The results revealed that the efficacy rate of plasmapheresis (or plasma exchange) is not inferior to those of intravenous immunoglobulin and rituximab (or cyclophosphamide) for male patients without tumor. In addition, B-cell attracting C-X-C motif chemokine 13 (CXCL13) and microRNA let-7b are potential to be treatment response biomarkers for anti-NMDA receptor encephalitis. But they may not be useful prognostic biomarkers for this encephalitis unless they are not biomarkers for other autoimmune encephalitides.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180223
[Lr] Last revision date:180223
[St] Status:Publisher
[do] DOI:10.2174/0929867325666180221142623


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