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Aggressive Central Nervous System Relapse after Autologous Stem Cell Transplant in Multiple Myeloma: Case Reports and Literature Review.

Extramedullary disease is an aggressive presentation at diagnosis and relapse for multiple myeloma (MM) patients. Central nervous system (CNS) is a very rare manifestation of the extramedullary disease, accounting for less than 1% of MM on diagnosis and relapse. Neurological symptoms are unspecific and usually attributed to other causes. We present two patients with CNS-MM at relapse after autologous stem cell transplant highlighting the importance of clinical suspicion and interdisciplinarity at diagnostic workup as well as the need for intensive therapeutic options on such rare and aggressiv

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… Nine months after the second ASCT, he was admitted to the emergency room in a comatose status (Glasgow Coma Scale 9). His blood workup was normal without anemia, hypercalcemia, or acute renal failure. …

Cutaneous Squamous Cell Carcinoma Producing Granulocyte Colony-stimulating Factor and Parathyroid Hormone-related Protein: A Case Report and Literature Review.

We herein report a case of cutaneous squamous cell carcinoma (SCC) characterized by paraneoplastic hypercalcemia-leukocytosis syndrome. The patient presented with systemic symptoms, including anorexia, a fever, and a tumoral lesion on the upper arm. Laboratory test results revealed hypercalcemia and leukocytosis. A tissue biopsy confirmed SCC, and further investigation revealed elevated parathyroid hormone-related protein (PTHrP) and granulocyte-colony stimulating factor (G-CSF) levels. Immunostaining demonstrated G-CSF production by the tumor cells. Radiation therapy was administered, which i

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… On admission, he was alert and oriented, with a Glasgow Coma Scale score of 15, indicating full consciousness. His vital signs were as follows: heart rate, 92 beats/min; body temperature, 38.2℃; blood pressure, 151/87 mmHg; and oxygen saturation, 99% on ambient air. …

Diffuse large B cell lymphoma originating from the maxillary sinus with skin metastases: A case report and review of literature.

BackgroundDiffuse large B-cell lymphoma (DLBCL) is the most common type of malignant lymphoma (ML), accounting for 30%-40% of cases of non-Hodgkin's lymphoma (NHL) in adults. Primary paranasal sinus lymphoma is a rare presentation of extranodal NHL that accounts for only 0.17% of all lymphomas. ML from the maxillary sinus (MS) is a particularly rare presentation, and is thus often difficult to diagnose. We have reported the first known case of DLBCL originating from the MS with rapidly occurrent multiple skin metastasis.Case summaryAn 81-year-old Japanese man visited our hospital due to contin

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… His vital signs were normal, with blood pressure of 137/82 mmHg, heart rate of 75 regular beats/min, body temperature of 36.1 °C, oxygen saturation of 98% in ambient air, and respiratory rate of 16/min; his Glasgow Coma Scale score was 15 points (E4V5M6). …

Improved intensive care unit survival for critically ill allogeneic haematopoietic stem cell transplant recipients following reduced intensity conditioning.

The use of allogeneic haematopoietic stem cell transplantation (Allo-HSCT) is a standard treatment option for many patients with haematological malignancies. Historically, patients requiring intensive care unit (ICU) admission for transplant-related toxicities have fared extremely poorly, with high ICU mortality rates. Little is known about the impact of reduced intensity Allo-HSCT conditioning regimens in older patients on the ICU and subsequent long-term outcomes. A retrospective analysis of data collected from 164 consecutive Allo-HSCT recipients admitted to ICU for a total of 213 admission

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… Neurological : Admissions with a Glasgow Coma Scale (GCS) score of 8 or less. …

45th International Symposium on Intensive Care & Emergency Medicine.

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… Data collected included demographics, Sequential Organ Failure Assessment (SOFA), and repeated measurements of Glasgow Coma Scale (GCS) and respiratory parameters during the first 7 days. The primary outcome was weaning failure. … Clinical variables (Glasgow Coma Scale (GCS), cough strength and swallowing ability), nurse-assessed extubation risk (5-likert scale) and bedside clinical signs were assessed before SBT or extubation. …

Abstracts - IANCON 2025

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… Functional outcomes were assessed using the modified Rankin Scale (mRS), Glasgow Coma Scale (GCS), and MRC sum score at discharge and 3-month follow-up. Results: Abnormal TCD findings suggestive of vasculopathy were observed in over 30% of patients, with MCA involvement being the most frequent. …

Management of Potential Organ Donor: Indian Society of Critical Care Medicine-Position Statement.

This position statement is documented based on the input from all contributing coauthors from the Indian Society of Critical Care Medicine (ISCCM), following a comprehensive literature review and summary of current scientific evidence. Its objective is to provide the standard perspective for the management of potential organ/tissue donors after brain death (BD) in adults only, regardless of the availability of technology. This document should only be used for guidance only and is not a substitute for proper clinical decision making in particular circumstances of any case. Endorsement by the IS

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… Intensivists play a vital role in the following ways: Early recognition of potential donor: Critically ill patients with low Glasgow Coma Scale (GCS <4) due to head trauma, stroke (ischemic and bleeding), or loss of blood flow to the brain after cardiac arrest are usually admitted to critical units. …

Распространяется жизнь, угрожая вирусом Нокардии отитидискавиарум у молодой женщины с недавно диагностированным системным волшебством эритематос, отчетом по делу и анализом литературы.

По сообщениям, инфекция, вызванная нокардией, наблюдается главным образом у иммунокомпромиссированных пациентов. Обычно он представляет собой легочную или распространенную болезнь с предрасположенностью к мозгу. Инфекции - это редкая этиология внутричерепной сосудистой аневризмы. В этой связи мы сообщаем о случае распространения Nocardia otitidiscaviarum (N. otitidiscaviarum) у молодой женщины, у которой недавно был диагностирован системный волчан (SLE), осложняемый развитием инфекционной внутричерепной аневризмы. Насколько нам известно, это четвертый случай внутричерепной аневризмы, связанной

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… Three days later, the patient’s condition rapidly deteriorated with a decrease in her level of consciousness with a Glasgow coma scale (GCS) of 6/15, there was no neurologic deficit. Elective intubation was performed, and she was put on mechanical ventilation. …

Therapeutic plasma exchange as rescue therapy in severe sepsis and septic shock: retrospective observational single-centre study of 23 patients.

BackgroundSeveral case series and small randomized controlled trials suggest that therapeutic plasma exchange (TPE) improves coagulation, hemodynamics and possibly survival in severe sepsis. However, the exact role of TPE in modern sepsis therapy remains unclear.MethodsWe performed a retrospective observational single-centre study on the use of TPE as rescue therapy in 23 consecutive patients with severe sepsis or septic shock from 2005 to 2012. Main surrogate markers of multiple organ failure (MOF) before, during and after TPE as well as survival rates are reported.ResultsAt baseline, mean SO

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… Median Glasgow coma scale of non-ventilated patients at ICU admission was 14 (IQR 14–15). Norepinephrine was required by 21 (91%) during the ICU stay, vasopressin/terlipressin by 7 (30%), dobutamine by 7 (30%), and levosimendan by 1 patient (4%). …

Risk of malignancy in adult patients with congenital heart disease: a clinical practice review.

This paper presents case studies of adult patients with congenital heart disease (CHD) who developed cancer and also discusses relevant epidemiological studies, risk factors, and reports on early detection. Herein, we describe three cases: a 63-year-old man with an atrial septal defect and multiple myeloma; a 48-year-old man with tetralogy of Fallot and colorectal cancer; and a 25-year-old man with Fontan circulation and hepatocellular carcinoma (HCC). Previous studies have found that the incidence of cancer in adult patients with CHD is higher than that in the general population. The manageme

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… Assessments showed a Glasgow Coma Scale of 15 and oxygen saturation of 93% on room air. Blood tests revealed mild anemia and elevated liver enzymes and bilirubin levels, and he was negative for hepatitis B virus surface antigen (HBs-Ag) and hepatitis C virus antibody (HCV-Ab) ( Table 3 ). …

Characteristics and Outcomes of Intracranial Hemorrhage in Cancer Patients Visiting the Emergency Department.

Intracranial hemorrhage (ICH) is a dreaded complication of both cancer and its treatment. To evaluate the characteristics and clinical outcomes of cancer patients with ICH, we identified all patients with ICH who visited The University of Texas MD Anderson Cancer Center emergency department between 1 September 2006 and 16 February 2016. Clinical and radiologic data were collected and compared. Logistic regression analyses were used to determine the association between clinical variables and various outcomes. During the period studied, 704 confirmed acute ICH cases were identified. In-hospital,

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… We had only surrogate markers for severity of neurologic dysfunction upon presentation, and because this was a retrospective study, the Glasgow Coma Scale or Rankin scores for objectively measuring the clinical severity of the bleed were not consistently available, we could only report on mortality with …

Neurosurgical management of brain metastases in the elderly: a prospective study on adverse event prevalence and predictors.

The management of brain metastases (BM) in geriatric patients poses significant challenges in the context of an aging population and advances in systemic cancer treatment. This study provides insights into the prevalence and nature of adverse events (AEs) following intracranial surgery in patients aged 65 years and older. It highlights the complexities and implications of treating this demographic patient population and identifies risk factors associated with AEs. This prospective study includes patients aged 65 years and older with BM who underwent surgery between January 2022 and December 20

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… Additionally, four patients exhibited Grade 2 deficits, characterized by a significant decrease in Glasgow Coma Scale (GCS) scores to 12, due to increased postoperative edema as observed in CT scans. However, none required additional surgical treatment. …

Ход работы 34th Симпозиум ESVN-ECVN 23rd-24th сентябрь 2022.

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Rapidly Progressive Merkel Cell Carcinoma with Atypical Metastatic Pattern-A Case Report and Brief Literature Review.

Background and Clinical Significance: Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine cutaneous malignancy with increasing incidence among elderly, immunocompromised patients or individuals exposed to ultraviolet radiation. Case Presentation: We present the case of an 84-year-old Caucasian male with no history of immunosuppression, who was admitted for asthenia, dysphagia, weight loss, and generalized weakness. Clinical and imaging investigations revealed a violaceous tumor on the right arm and disseminated metastases affecting the liver, spleen, bones and lymph nodes. A liver

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… The patient developed atrial fibrillation with a rapid ventricular rate, refractory to conversion therapy and continuous antiarrhythmic infusion, followed by progressive neurological decline to a Glasgow Coma Scale score of 7–8. …

Abstracts of the ICARE 2024 78th SIAARTI National Congress

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Предлагаемый протокол наблюдений для ранней дифференциации синдрома высвобождения цитокина и сепсиса в реципиентах CAR-T с гематологическими аномалиями с использованием IL-6Соотношение ПХТ: исследование ДРАКАРИС.

Терапия антигенного рецептора T-клеток (CAR-T) произвела революцию в лечении гематологических магнатов, продемонстрировав замечательную эффективность в лейкемиях B-клеток, лимфомах и множестве миелом. Однако синдром сильного токсина, особенно синдрома цитокина (CRS) и сепсиса, сопряженный с серьезными клиническими проблемами. Оба эти условия имеют совпадающие черты, включая лихорадку, гипотенцию и многоорганическую дисфункцию, что делает важную роль своевременной и точной дифференциации. В основе ДУС лежит чрезмерное высвобождение цитокина, главным образом IL-6, и лечится IL-6 Блокада рецептор

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… When primary measures are unavailable, we will use validated surrogates: SpO 2 /FiO 2 may substitute for PaO 2 /FiO 2 in the respiratory component; AVPU (Alert, Voice, Pain, Unresponsive) to GCS (Glasgow Coma Scale) mapping is permitted for the CNS component (A = 15, V = 12, P = 8, U = 3). …

Characteristics and outcomes of hospital admissions for COVID-19 and influenza in the Toronto area.

BackgroundPatient characteristics, clinical care, resource use and outcomes associated with admission to hospital for coronavirus disease 2019 (COVID-19) in Canada are not well described.MethodsWe described all adults with COVID-19 or influenza discharged from inpatient medical services and medical-surgical intensive care units (ICUs) between Nov. 1, 2019, and June 30, 2020, at 7 hospitals in Toronto and Mississauga, Ontario. We compared patient outcomes using multivariable regression models, controlling for patient sociodemographic factors and comorbidity level. We validated the accuracy of 7

Epidemiology, Risk Factors, and Outcomes of Neutropenic Enterocolitis in Onco-Hematological Patients According to Chemotherapy Regimen.

BackgroundWhile neutropenic enterocolitis (NEC) is a well-known life-threatening complication during intensive chemotherapy, its incidence, impact, and outcome on specific at-risk populations remain ill defined.MethodsWe report 178 NEC episodes during 1963 myeloablative chemotherapy courses among 1259 adult patients with acute myeloid (AML) or lymphoblastic (ALL) leukemia or receiving autologous hematopoietic stem cell transplantation (auto-HCT) for lymphoma or multiple myeloma. Risk factors were assessed by multivariate logistic regression models.ResultsMost NEC cases (93.3%) occurred during

Assessment of Psychiatric Disorders in Consultation-Liaison Setting.

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Hyponatraemia and the syndrome of inappropriate antidiuresis (SIAD) in cancer.

Hyponatraemia is a common electrolyte abnormality seen in a wide range of oncological and haematological malignancies and confers poor performance status, prolonged hospital admission and reduced overall survival, in patients with cancer. Syndrome of inappropriate antidiuresis (SIAD) is the commonest cause of hyponatraemia in malignancy and is characterised by clinical euvolaemia, low plasma osmolality and concentrated urine, with normal renal, adrenal and thyroid function. Causes of SIAD include ectopic production of vasopressin (AVP) from an underlying tumour, cancer treatments, nausea and p