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The article focuses on the impact of the COVID-19 infection on the immune system. It is noted that in some COVID patients, an unbridled immune response causes damage to the body including heart damage and even organ failure. The authors' found that in most COVID patients, the immune system performs to disarm and kill SARS-CoV-2. It describes three ways COVID-19 undermines the Immune System. INSET: Our Lab's Makeover.

This article tells the story of Danielle Crook and her two sons, Lennox and Sonny, who were both born with serious heart conditions. Lennox was diagnosed with aortic stenosis shortly after birth and underwent multiple surgeries. When Danielle was pregnant with her second son, Sonny, it was discovered that he had hypoplastic left heart syndrome, a more severe condition. Sonny also underwent open heart surgery as a newborn. Despite the challenges they face, the family remains hopeful and proud of their sons. They have found support through a charity called Tiny Tickers and are expecting a third child. [Extracted from the article]

Researchers at Danylo Halytsky Lviv National Medical University in Lviv, Ukraine, have reported new data on Boerhaave syndrome, a rare condition with a high mortality rate due to late diagnosis and treatment difficulties. The study aims to highlight the diverse clinical manifestations of the syndrome, which can complicate early diagnosis and decision-making for healthcare providers. Clinical observations of two patients with Boerhaave's syndrome are presented, emphasizing the importance of timely diagnosis and treatment to prevent severe complications and mortality. [Extracted from the article]

Researchers at the University of Pittsburgh have conducted a study on therapeutic plasma exchange to reverse plasma failure in multiple organ dysfunction syndrome. The study highlights the importance of maintaining a well-functioning plasma regulatory milieu to control coagulation and inflammation. Therapeutic plasma exchange is identified as a unique method to remove harmful factors and replete exhausted components, restoring appropriate regulation of coagulation and inflammation. The research was supported by the NIH National Institute of General Medical Sciences and has been peer-reviewed for publication in the Journal of Clinical Apheresis. [Extracted from the article]

A 31-year-old man with embryonal rhabdomyosarcoma (ERMS) experienced lack of efficacy during treatment with multiple drugs, including vincristine, actinomycin-D, cyclophosphamide, ifosfamide, and epirubicin. He initially presented with dysuria and acute urine retention, leading to surgical drainage of a prostatic abscess. Despite receiving chemotherapy, radiotherapy, and IMRT for prostate ERMS, the man experienced rapid deterioration and eventually died of distant metastasis and multiple organ failure one year after initial presentation. [Extracted from the article]

A middle-aged man undergoing immunosuppressant therapy with mycophenolate-mofetil and tacrolimus developed a severe case of crusted scabies infestation after a kidney transplant. Initially misdiagnosed as xerosis cutis, his condition worsened, leading to polymicrobial sepsis and multisystem organ failure. Treatment with permethrin and ivermectin eventually resulted in complete resolution of his condition. [Extracted from the article]

A 22-year-old man experienced an allergic skin reaction while being treated with meropenem for Raoultella ornithinolytica infection. He also showed treatment non-compliance with ursodeoxycholic-acid for Caroli's disease. Despite initial complications, his condition improved after switching to imipenem/cilastatin and receiving appropriate care. The man had a history of Caroli's disease since childhood but had stopped following up with treatment, leading to his hospitalization. [Extracted from the article]

A recent study conducted at Yenepoya Medical College in Karnataka, India, focused on a 57-year-old male patient with eosinophilic granulomatosis with polyangiitis (Churg-Strauss disease) who experienced a fatal outcome within two weeks of diagnosis. The patient presented with various symptoms, including dyspnea, cough, fever, myalgia, and pedal edema, along with cutaneous manifestations of small vessel vasculitis. The research findings were published in the Clinical Dermatology Review, highlighting the unusual and catastrophic outcome in this particular case. For more information, readers can access the full article at https://doi.org/10.4103/cdr.cdr_131_23. [Extracted from the article]

Researchers from Juntendo University in Tokyo, Japan, have highlighted the increasing issue of heat-related illness and heat-induced coagulopathy due to global warming. The study emphasizes the role of platelets in these conditions, detailing how hyperthermia affects platelet function and can lead to disseminated intravascular coagulation (DIC) and multiple organ failure. Despite the severity of these conditions, therapeutic options targeting platelets are limited. The research aims to enhance understanding of platelet involvement in heat-related illness for improved diagnosis and management. [Extracted from the article]

Research from the University of Opole delves into Pulmonary-Renal Syndrome, a condition characterized by alveolar hemorrhage and glomerulonephritis. The study highlights the importance of immunosuppressive therapy in managing the disease, which can range from mild inflammation to life-threatening multi-organ complications. The case report of a 72-year-old man underscores the challenges of treating elderly patients with comorbidities, emphasizing the need to reevaluate immunosuppressive protocols for better outcomes in this demographic. [Extracted from the article]

Three patients with microscopic polyangiitis and granulomatosis developed serious adverse events, including cerebral infarction, multiple organ failure, and gastrointestinal bleeding while receiving rituximab treatment. Unfortunately, all three patients ultimately passed away as a result of these complications. The study highlights the potential risks associated with rituximab therapy for these conditions, emphasizing the importance of monitoring and managing adverse effects. [Extracted from the article]

A 42-year-old man experienced lack of efficacy when treated with insulin and heparin for hypertriglyceridaemia-induced acute pancreatitis. Despite initial improvements in triglyceride levels, his condition worsened, leading to necrotizing pancreatitis, acute respiratory distress syndrome, aspiration pneumonia, acute renal failure, and abdominal compartment syndrome. Despite early treatment with insulin and heparin, the patient ultimately died due to multi-organ failure. [Extracted from the article]

A retrospective cohort study examined 13 patients who underwent allogeneic stem cell transplantation and received cyclophosphamide, mycophenolate, and tacrolimus for graft versus host disease prophylaxis. Despite treatment, patients experienced various complications such as fever, cytokine release syndrome, encephalopathy, pulmonary syndrome, and other serious conditions. Tragically, all patients eventually succumbed to complications like acute cardiac failure, multi-organ failure, and other severe outcomes. The study highlights the challenges and complexities involved in managing post-transplant complications despite standard prophylactic treatments. [Extracted from the article]

A 40-year-old woman experienced various toxicities, including acute kidney injury, haemophagocytic lymphohistiocytosis, and cytokine release syndrome, while undergoing antiviral therapy with aciclovir, treatment with pembrolizumab for breast cancer, and sedation with propofol. She initially presented with left axillary tenderness and was diagnosed with breast cancer, starting treatment with pembrolizumab. Subsequently, she developed complications leading to multiorgan failure, requiring intensive care and treatment with immunosuppressants. Despite initial stabilization, she later experienced cytokine release syndrome, which was managed with additional medications, ultimately resulting in an improvement in her clinical status. [Extracted from the article]

Researchers from the Datta Meghe Institute of Medical Sciences in Maharashtra, India, have conducted a narrative review on the utilization of the Atlanta Classification for detecting local complications and severity of Acute Pancreatitis (AP). The study highlights the importance of classifying patients based on severity to determine appropriate treatment plans, with the revised Atlanta classification (2012) being a significant milestone in this regard. The research emphasizes the role of this classification system in evaluating the type of pancreatitis, presence of organ failure, local complications, and assessing patient prognosis. This study provides valuable insights for clinicians and surgeons in managing AP cases effectively. [Extracted from the article]

Researchers at Wuhan University in Hubei, China, have conducted a study on acute-on-chronic liver failure (ACLF), a severe clinical syndrome associated with high mortality rates. The research focused on the metabolic and immune status of ACLF patients, highlighting the importance of understanding energy metabolism pathways and metabolite imbalances for developing effective treatment strategies. This peer-reviewed study provides novel perspectives on immune regulation and therapeutic management of liver failure, offering valuable insights for medical professionals and researchers in the field of hepatology. [Extracted from the article]

An 88-year-old woman developed nocardiosis while being treated for nephrotic syndrome, longitudinal rheumatoid arthritis, or minor change disease with prednisolone, tacrolimus, and methylprednisolone. Despite treatment with various antibiotics, including linezolid, meropenem, levofloxacin, tedizolid, and cotrimoxazole, she exhibited lack of efficacy and ultimately succumbed to septic shock and multiple organ failure. The autopsy revealed brain abscesses, inflammatory cell accumulation, renal amyloidosis, and other complications, highlighting the complex nature of her medical condition and treatment challenges. [Extracted from the article]

A woman in her late 30s with COVID-19 exhibited a lack of efficacy during treatment with multiple antibiotics and antifungals for bacterial and fungal infections. Despite receiving various treatments, including off-label IV corticosteroids and SC heparin for COVID-19, she developed multidrug-resistant sepsis and multiple organ failure, ultimately leading to her death on day 36 in the ICU. The case highlights the challenges of treating complex infections in critically ill patients, emphasizing the importance of early and effective interventions to improve outcomes. [Extracted from the article]

A 28-year-old woman experienced an anaphylactoid reaction while undergoing immunosuppressive treatment with tocilizumab for presumed paraneoplastic fever. She had been diagnosed with angiomatoid fibrous histiocytoma (AFH) and later developed recurrence and metastatic disease to various organs. Despite treatment with various therapies, including tocilizumab, encorafenib, and binimetinib, she ultimately succumbed to metastatic disease. The woman's journey highlights the challenges of managing complex cancer cases and the potential complications associated with immunosuppressive treatments. [Extracted from the article]

A 63-year-old man with a history of morbid obesity, type 2 diabetes mellitus, and other health conditions developed necrotizing pancreatitis while being treated with semaglutide. He presented to the emergency department with severe symptoms and was found to have acute necrotizing pancreatitis. Despite medical intervention, his condition deteriorated rapidly, leading to multi-organ failure and ultimately death. The acute pancreatitis was considered to be a result of the semaglutide treatment. [Extracted from the article]

A 77-year-old man experienced lack of efficacy while being treated with norepinephrine for high-output heart failure. Despite having multiple health issues including cirrhosis and thrombocytopenia, he presented with symptoms such as shortness of breath, rigor, nausea, and chills. Unfortunately, his condition deteriorated rapidly, leading to multiple organ failure, and he passed away after his family chose comfort measures. The case highlights the challenges in managing complex medical conditions and the importance of considering individual patient factors in treatment decisions. [Extracted from the article]

A 66-year-old man with a history of COPD experienced a lack of efficacy while being treated with oseltamivir for influenza A virus infection and voriconazole for invasive pulmonary aspergillosis. Despite initial improvements with voriconazole, the man's condition deteriorated, leading to multiorgan failure and the decision to withdraw care. The case highlights the challenges of treating complex respiratory infections and the importance of monitoring patient response to medications closely. [Extracted from the article]

A 49-year-old woman with a history of diamond blackfan anaemia and a peripheral blood stem cell transplant exhibited lack of efficacy during treatment with rituximab for Epstein-Barr viraemia and unspecified steroids and nivolumab for haemophagocytic lymphohistiocytosis. Despite aggressive measures, she experienced worsening organ failure and shock, ultimately leading to her death. The case highlights the challenges in treating complex medical conditions and the limitations of certain therapies in specific cases. [Extracted from the article]

A 56-year-old woman developed a nontuberculous mycobacterium (NTM) infection and septic shock while being treated with mycophenolate-mofetil for lupus erythematous with glomerulonephritis. Despite presenting with dyspnoea and a painful skin rash, she initially showed signs of improvement before experiencing multisystem organ failure and ultimately succumbing to refractory septic shock. The woman underwent prolonged hospitalization and treatment with anti-mycobacterial medications, but unfortunately, she did not survive the illness. [Extracted from the article]

A 66-year-old man with T-cell lymphocytic leukemia and chronic immunosuppression experienced lack of efficacy during treatment with multiple drugs for haemophagocytic lymphohistiocytosis (HLH). Despite receiving empiric therapy with meropenem, vancomycin, fluconazole, atovaquone, and unspecified steroids, his condition worsened, leading to multiorgan failure and ultimately death. The patient's complex medical history and treatment course highlight the challenges in managing HLH in immunocompromised individuals, underscoring the need for further research and tailored therapeutic approaches in such cases. [Extracted from the article]

A man developed leukocytoclastic vasculitis while being treated with terbinafine and itraconazole for dermatophyte infections. Despite receiving immune-globulin and unspecified steroids, he did not respond to treatment and ultimately passed away due to the vasculitis. The vasculitis was believed to be a result of the medications he was taking. [Extracted from the article]

A 66-year-old woman developed BRASH syndrome while being treated with flecainide for atrial fibrillation and metoprolol for atrial fibrillation and hypertension. She had a history of diabetes, hypertension, and atrial fibrillation, and presented with vomiting, diarrhea, and weakness. The syndrome led to bradycardia, trifascicular block, acute colitis, hyperkalemia, and hypovolemic shock, resulting in renal failure and multi-organ failure. Treatment involved discontinuing flecainide and metoprolol, starting amiodarone and heparin, and providing fluid resuscitation and renal replacement therapy. [Extracted from the article]

A 32-year-old man experienced lack of efficacy during treatment with epinephrine and norepinephrine for cardiogenic shock. He presented with symptoms such as cough, shortness of breath, and diarrhea, and was diagnosed with multilobar pneumonia due to Legionella infection. Despite receiving high dose norepinephrine and epinephrine therapy, his condition worsened, leading to the need for veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Tragically, he developed multiple organ failure and ultimately passed away after ECMO support was withdrawn. [Extracted from the article]

A 41-year-old man developed methaemoglobinaemia while being treated with rasburicase for tumour lysis syndrome. Despite receiving ascorbic-acid for the methaemoglobinaemia, the treatment showed lack of efficacy. The man's condition deteriorated, leading to acute respiratory failure, renal failure, and ultimately succumbing to metastatic sarcoma with high lactic acidosis, shock, and multi-organ failure. The development of methaemoglobinaemia was attributed to rasburicase, and the man was also found to have glucose-6-phosphate-dehydrogenase deficiency. [Extracted from the article]

A 58-year-old woman with a history of chronic obstructive pulmonary disease exhibited lack of efficacy during treatment with vancomycin, cefepime, doxycycline, and immune-globulin for Streptococcal toxic shock syndrome. Despite receiving various treatments, including oseltamivir for influenza A and a switch to linezolid, her clinical condition continued to deteriorate. Tragically, she passed away due to fulminant multi-organ failure secondary to Streptococcal toxic shock syndrome. [Extracted from the article]

A 54-year-old man experienced lack of effectiveness with various antibiotics while being treated for a Neisseria gonorrhoeae infection following inguinal hernia repair. Despite receiving vancomycin, piperacillin/tazobactam, cefepime, metronidazole, and ceftriaxone, his condition worsened, leading to multisystem organ failure and ultimately death. The patient's case highlights the challenges of treating infections effectively and the need for further research and interventions in such cases. [Extracted from the article]

A 48-year-old man with lupus and end-stage renal disease experienced lack of efficacy during treatment with amphotericin-B for pulmonary blastomycosis and methylprednisolone for acute respiratory distress syndrome. Despite prompt treatment, his respiratory status declined, leading to acute respiratory distress syndrome and multisystem organ failure. The family ultimately decided to transition to comfort care due to worsening lactic acidosis and increasing vasopressor requirements. [Extracted from the article]

A 46-year-old man with uncontrolled diabetes and polysubstance abuse exhibited lack of efficacy during treatment with amphotericin-B for pulmonary mucormycosis. Initially treated for MRSA pneumonia, he experienced complications including cardiac arrest and bronchopleural fistula. Despite treatment, his condition worsened, leading to multiorgan failure and ultimately death, indicating a lack of efficacy of amphotericin-B in this case. [Extracted from the article]

A clinical trial, NCT06615128, has been launched to assess the serum level of sCD25 in systemic sclerosis (SSc) patients with or without interstitial lung disease (ILD) and its correlation with disease activity. SSc is a systemic autoimmune disease that affects multiple organs, including the lungs. ILD is a common complication of SSc and is a major prognostic factor for patients. The trial aims to investigate the role of sCD25 in SSc and ILD and its potential as a diagnostic marker or therapeutic target. The trial is currently in the recruitment phase and is expected to be completed by July 2027. [Extracted from the article]

A recent study conducted at Sichuan University in China explored the effectiveness of integrated traditional Chinese medicine (TCM) and Western medicine (WM) for the treatment of acute pancreatitis (AP). The study compared patients who received TCM&WM treatment to those who received WM treatment alone. The results showed that the TCM&WM group had a lower mortality rate, lower risk of organ failure and infection, shorter hospital stays, and lower hospital costs compared to the WM group. The study suggests that TCM&WM treatment may be a promising alternative for AP patients in real-world settings. [Extracted from the article]

A recent study conducted at Washington University in St. Louis, Missouri, focused on the challenges of diagnosing biliary disease, specifically cholecystitis. The researchers emphasized the importance of establishing a specific diagnosis to prevent complications and ensure appropriate management. The study highlighted various scenarios that can complicate the diagnosis, such as atypical manifestations, inflammatory reactions, dropped gallstones, and recurrent cholecystitis after cholecystectomy. The researchers aimed to share the lessons learned from multidisciplinary conferences and provide tips for radiologists to enhance their contribution to patient management. This research has been peer-reviewed and published in Abdominal Radiology. [Extracted from the article]

A new report from the University of Toledo discusses the increasing incidence of pressure injuries (PI) in the aging population. The report highlights that while most PIs can be prevented with appropriate interventions, there are instances where skin failure becomes unavoidable, particularly in critically ill patients. Factors such as prolonged immobility, mechanical ventilation, acute respiratory distress syndrome, COVID-19, sepsis, and multiorgan system dysfunction contribute to skin deterioration in these patients. The report aims to provide an overview of the circumstances that decrease tissue tolerance and lead to PI development in critically ill patients, despite preventive measures. [Extracted from the article]

Vivacelle Bio, a biopharma company, is supporting the Sepsis Alliance in raising awareness about sepsis, which is the leading cause of death in U.S. hospitals. Sepsis is an overwhelming immune response to an infection or insult and is responsible for 6% of hospitalizations and 35% of in-hospital deaths in the U.S. Vivacelle Bio is developing a Phase 3 treatment called VBI-S, which uses phospholipid nanoparticles to expand intravascular volume and redistribute nitric oxide to reverse organ failure in septic shock patients. The company's research is funded by the Naval Medical Research Command. [Extracted from the article]

A recent report from Wenzhou Medical University in Zhejiang, China discusses the case of a 30-year-old man who was initially diagnosed with a perianal abscess but was later found to have perianal embryonal rhabdomyosarcoma (ERMS), a rare and highly malignant form of cancer. The patient underwent emergency surgery but did not receive postoperative radiotherapy or chemotherapy and died six months later from multiple metastases and organ failure. The researchers emphasize the importance of improving preoperative diagnostic tests to prevent misdiagnoses and highlight the challenges in diagnosing this rare disease. This study provides valuable insights into the clinical manifestations and prognosis of perianal ERMS. [Extracted from the article]

Researchers at Huazhong University of Science and Technology in Wuhan, China have conducted a review on the pharmacological effects of specialized pro-resolving mediators (SPMs) in sepsis-induced organ dysfunction. Sepsis is a life-threatening syndrome characterized by uncontrolled inflammation and immune dysregulation. SPMs, such as lipoxins, resolvins, protectins, and maresins, have been shown to suppress inflammation and promote the resolution of inflammation. The researchers aim to provide a theoretical basis for the future clinical application of SPMs in sepsis treatment. [Extracted from the article]

A study conducted by Universitas Sumatera Utara in Medan, Indonesia aimed to assess the effectiveness of the pediatric risk of mortality (PRISM IV) score in predicting mortality among critically ill pediatric patients in the pediatric intensive care unit (PICU). The study collected demographic, clinical, and laboratory data from 35 pediatric patients in the PICU and analyzed the PRISM IV scores within the first 24 and 72 hours of hospitalization. The results showed that the PRISM IV scores in both time periods were not reliable in predicting mortality. The researchers suggest further studies to validate these findings. [Extracted from the article]

An 80-year-old man developed Saccharomyces cerevisiae fungemia, a fungal infection, while receiving probiotic treatment with saccharomyces-boulardii. The man had a complex medical history and multiple comorbidities, and was admitted to the hospital for a foot wound. After three days of admission, he started receiving the probiotic treatment and was later intubated and moved to the ICU. Blood cultures showed the presence of Saccharomyces cerevisiae, indicating the fungemia was caused by the probiotic. Despite treatment, the man's condition worsened, and he ultimately passed away. [Extracted from the article]

A 52-year-old woman with a history of chronic kidney disease and systemic lupus erythematosus (SLE) developed trichosporonosis while being treated with mycophenolic-acid and prednisone. She exhibited lack of efficacy during treatment with methylprednisolone, amphotericin-B, and voriconazole for trichosporonosis or SLE. Despite receiving treatment, her condition worsened, leading to refractory septic shock and multi-organ failure, ultimately resulting in her death. The case highlights the challenges in treating trichosporonosis and the potential lack of efficacy of certain medications in this context. [Extracted from the article]

A 21-year-old woman with ataxia telangiectasia (AT) and IgA and IgG deficiencies developed candidemia while being treated with methylprednisolone for interstitial lung disease (ILD). She had presented to the emergency department with worsening dyspnea and respiratory failure, and was initially treated with antibiotics. After a multidisciplinary conference, she was started on IV methylprednisolone for ILD, but subsequently developed candidemia. Her methylprednisolone therapy was discontinued, and she underwent intubation and tracheostomy due to respiratory failure. She later developed ventilator-associated pneumonia and multi-organ failure, and unfortunately passed away. [Extracted from the article]

In a multicentric retrospective non-interventional study, three patients with pleural mesothelioma developed serious adverse reactions while receiving treatment with nivolumab and ipilimumab. The reactions included hepatic cytolysis, acute myocarditis, and septic shock with multiorgan failure, and all three patients died as a result. The study highlights the potential risks associated with this treatment regimen for pleural mesothelioma. [Extracted from the article]

A 30-year-old woman experienced a lack of efficacy while being treated with etoposide for haemophagocytic lymphohistiocytosis (HLH). She had respiratory failure and bilateral lung nodules with infiltration, and was admitted to the ICU where she required mechanical ventilation. She had a history of uncontrolled relapsing inflammatory bowel disease and was receiving suppressive steroid therapy. During her hospitalization, she developed severe septic shock, multiorgan failure, pancytopenia, metabolic acidosis, and pulmonary aspergillosis. Despite receiving treatment with etoposide, her condition worsened and she ultimately died from HLH. [Extracted from the article]

A 43-year-old woman with Group A Streptococcal Meningitis exhibited lack of efficacy during treatment with ceftriaxone and linezolid. She initially presented to the emergency department with flu-like symptoms and earache, and was found unresponsive at home. Despite receiving ceftriaxone and linezolid, her condition worsened and she experienced respiratory failure, shock, multiorgan failure, and ultimately brain death. The cause of death was determined to be Group A Streptococcal Meningitis and its complication of pseudo subarachnoid hemorrhage. [Extracted from the article]

A 78-year-old woman with a history of rheumatoid arthritis and pyoderma gangrenosum experienced a lack of efficacy during treatment for tuberculosis-immune reconstitution inflammatory syndrome (TB-IRIS). She presented with symptoms such as weakness, fever, cough, and shortness of breath, and was initially treated with steroids for pyoderma gangrenosum. However, her condition worsened, and she was diagnosed with disseminated mycobacterium tuberculosis. Despite treatment with hydrocortisone, antibiotics, and antituberculosis drugs, her condition deteriorated further, leading to multiorgan failure. Her family ultimately decided to withdraw her care. [Extracted from the article]

A 47-year-old man with pulmonary coccidioidomycosis exhibited lack of efficacy during treatment with amphotericin-B and isavuconazole. He had a history of poorly controlled type 2 diabetes and was admitted to the hospital due to acute respiratory failure. Despite receiving amphotericin-B and isavuconazole, his condition worsened, leading to multi-organ failure and ultimately death. A positive coccidioidomycosis test was obtained 10 days after his passing. [Extracted from the article]