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2. Possibilities and limits of treatment in patients with thrombotic thrombocytopenic purpura

Author

Gasparovic, V., Radonic, R., Mejic, Stanka, Pisl, Z., and Radman, I.

Subjects
Steroids (Drugs) -- Dosage and administration, Steroids (Drugs) -- Complications and side effects, Thrombocytopenic purpura -- Risk factors, Thrombocytopenic purpura -- Diagnosis, Thrombocytopenic purpura -- Care and treatment, Health care industry
Abstract

Byline: V. Gasparovic (1), R. Radonic (1), Stanka Mejic (2), Z. Pisl (3), I. Radman (2) Keywords: TTP Plasma exchange Outcome Abstract: Results of treatment of 18 patients fulfilling the criteria for TTP are presented. Thrombocytopenia was present in all patients (100%). Sixteen of the 18 patients (88.8%) had mental status changes, and seven of the 18 patients (38.8%) had renal impairment. One patient had a secondary type of TTP, caused by non-Hodgkin's lymphoma of the large intestine (that was diagnosed later) and was excluded from the study. Immunosuppresive therapy with steroids, plasma exchange and replacement of removed volume with fresh frozen plasma in a dosage of 25 ml/kg body weight resulted in a statistically significant increase of platelet count (P=0.00222), and a significant improvement in consciousness defined by increased GCS after 2 weeks (P=0.00222). In two patients renal function recovered, and in one of them hemodialysis was no longer needed. This improvement in a small group of patients had no statistical significance. TTP recurred in seven patients. High doses of steroids caused serious side effects in two patients: in one patient, steroid diabetes, and in the other one, intestinal perforation. Author Affiliation: (1) Department of Emergency and Intensive Care Medicine, University Hospital Rebro, Zagreb, Croatia (2) Department of Hematology, University Hospital Rebro, Zagreb, Croatia (3) Department of Medical Research, University Hospital Rebro, Zagreb, Croatia Article History: Received Date: 13/01/2000 Accepted Date: 22/08/2000 Article note: Final revision received: 11 August 2000 Electronic Publication

Published
2000

4. 37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3)

Author

Rob, D., primary, Špunda, R., additional, Lindner, J., additional, Šmalcová, J., additional, Šmíd, O., additional, Kovárník, T., additional, Linhart, A., additional, Bìlohlávek, J., additional, Marinoni, M. M., additional, Cianchi, G., additional, Trapani, S., additional, Migliaccio, M. L., additional, Gucci, L., additional, Bonizzoli, M., additional, Cramaro, A., additional, Cozzolino, M., additional, Valente, S., additional, Peris, A., additional, Grins, E., additional, Kort, E., additional, Weiland, M., additional, Shresta, N. Manandhar, additional, Davidson, P., additional, Algotsson, L., additional, Fitch, S., additional, Marco, G., additional, Sturgill, J., additional, Lee, S., additional, Dickinson, M., additional, Boeve, T., additional, Khaghani, A., additional, Wilton, P., additional, Jovinge, S., additional, Ahmad, A. N., additional, Loveridge, R., additional, Vlachos, S., additional, Patel, S., additional, Gelandt, E., additional, Morgan, L., additional, Butt, S., additional, Whitehorne, M., additional, Kakar, V., additional, Park, C., additional, Hayes, M., additional, Willars, C., additional, Hurst, T., additional, Best, T., additional, Vercueil, A., additional, Auzinger, G., additional, Adibelli, B., additional, Akovali, N., additional, Torgay, A., additional, Zeyneloglu, P., additional, Pirat, A., additional, Kayhan, Z., additional, Schmidbauer, S. S., additional, Herlitz, J., additional, Karlsson, T., additional, Friberg, H., additional, Knafelj, R., additional, Radsel, P., additional, Duprez, F., additional, Bonus, T., additional, Cuvelier, G., additional, Mashayekhi, S., additional, Maka, M., additional, Ollieuz, S., additional, Reychler, G., additional, Mosaddegh, R., additional, Abbasi, S., additional, Talaee, S., additional, Zotzmann, V. Z., additional, Staudacher, D. S., additional, Wengenmayer, T. W., additional, Dürschmied, D. D., additional, Bode, C. B., additional, Nelskylä, A., additional, Nurmi, J., additional, Jousi, M., additional, Schramko, A., additional, Mervaala, E., additional, Ristagno, G., additional, Skrifvars, M., additional, Ozsoy, G., additional, Kendirli, T., additional, Azapagasi, E., additional, Perk, O., additional, Gadirova, U., additional, Ozcinar, E., additional, Cakici, M., additional, Baran, C., additional, Durdu, S., additional, Uysalel, A., additional, Dogan, M., additional, Ramoglu, M., additional, Ucar, T., additional, Tutar, E., additional, Atalay, S., additional, Akar, R., additional, Kamps, M., additional, Leeuwerink, G., additional, Hofmeijer, J., additional, Hoiting, O., additional, Van der Hoeven, J., additional, Hoedemaekers, C., additional, Konkayev, A., additional, Kuklin, V., additional, Kondratyev, T., additional, Konkayeva, M., additional, Akhatov, N., additional, Sovershaev, M., additional, Tveita, T., additional, Dahl, V., additional, Wihersaari, L., additional, Skrifvars, M. B., additional, Bendel, S., additional, Kaukonen, K. M., additional, Vaahersalo, J., additional, Romppanen, J., additional, Pettilä, V., additional, Reinikainen, M., additional, Lybeck, A., additional, Cronberg, T., additional, Nielsen, N., additional, Rauber, M., additional, Steblovnik, K., additional, Jazbec, A., additional, Noc, M., additional, Kalasbail, P., additional, Garrett, F., additional, Kulstad, E., additional, Bergström, D. J., additional, Olsson, H. R., additional, Schmidbauer, S., additional, Mandel, I., additional, Mikheev, S., additional, Podoxenov, Y., additional, Suhodolo, I., additional, Podoxenov, A., additional, Svirko, J., additional, Sementsov, A., additional, Maslov, L., additional, Shipulin, V., additional, Vammen, L. V., additional, Rahbek, S. R., additional, Secher, N. S., additional, Povlsen, J. P., additional, Jessen, N. J., additional, Løfgren, B. L., additional, Granfeldt, A. G., additional, Grossestreuer, A., additional, Perman, S., additional, Patel, P., additional, Ganley, S., additional, Portmann, J., additional, Cocchi, M., additional, Donnino, M., additional, Nassar, Y., additional, Fathy, S., additional, Gaber, A., additional, Mokhtar, S., additional, Chia, Y. C., additional, Lewis-Cuthbertson, R., additional, Mustafa, K., additional, Sabra, A., additional, Evans, A., additional, Bennett, P., additional, Eertmans, W., additional, Genbrugge, C., additional, Boer, W., additional, Dens, J., additional, De Deyne, C., additional, Jans, F., additional, Skorko, A., additional, Thomas, M., additional, Casadio, M., additional, Coppo, A., additional, Vargiolu, A., additional, Villa, J., additional, Rota, M., additional, Avalli, L., additional, Citerio, G., additional, Moon, J. B., additional, Cho, J. H., additional, Park, C. W., additional, Ohk, T. G., additional, Shin, M. C., additional, Won, M. H., additional, Papamichalis, P., additional, Zisopoulou, V., additional, Dardiotis, E., additional, Karagiannis, S., additional, Papadopoulos, D., additional, Zafeiridis, T., additional, Babalis, D., additional, Skoura, A., additional, Staikos, I., additional, Komnos, A., additional, Passos, S. Silva, additional, Maeda, F., additional, Souza, L. Silva, additional, Filho, A. Amato, additional, Granjeia, T. Araújo Guerra, additional, Schweller, M., additional, Franci, D., additional, De Carvalho Filho, M., additional, Santos, T. Martins, additional, De Azevedo, P., additional, Wall, R., additional, Welters, I., additional, Tansuwannarat, P., additional, Sanguanwit, P., additional, Langer, T., additional, Carbonara, M., additional, Caccioppola, A., additional, Fusarini, C. Ferraris, additional, Carlesso, E., additional, Paradiso, E., additional, Battistini, M., additional, Cattaneo, E., additional, Zadek, F., additional, Maiavacca, R., additional, Stocchetti, N., additional, Pesenti, A., additional, Ramos, A., additional, Acharta, F., additional, Toledo, J., additional, Perezlindo, M., additional, Lovesio, L., additional, Dogliotti, A., additional, Lovesio, C., additional, Schroten, N., additional, Van der Veen, B., additional, De Vries, M. C., additional, Veenstra, J., additional, Abulhasan, Y. B., additional, Rachel, S., additional, Châtillon-Angle, M., additional, Alabdulraheem, N., additional, Schiller, I., additional, Dendukuri, N., additional, Angle, M., additional, Frenette, C., additional, Lahiri, S., additional, Schlick, K., additional, Mayer, S. A., additional, Lyden, P., additional, Akatsuka, M., additional, Arakawa, J., additional, Yamakage, M., additional, Rubio, J., additional, Mateo-Sidron, J. A. Rubio, additional, Sierra, R., additional, Celaya, M., additional, Benitez, L., additional, Alvarez-Ossorio, S., additional, Fernandez, A., additional, Gonzalez, O., additional, Engquist, H., additional, Rostami, E., additional, Enblad, P., additional, Canullo, L., additional, Nallino, J., additional, Perreault, M., additional, Talic, J., additional, Frenette, A. J., additional, Burry, L., additional, Bernard, F., additional, Williamson, D. R., additional, Adukauskiene, D., additional, Cyziute, J., additional, Adukauskaite, A., additional, Malciene, L., additional, Luca, L., additional, Rogobete, A., additional, Bedreag, O., additional, Papurica, M., additional, Sarandan, M., additional, Cradigati, C., additional, Popovici, S., additional, Vernic, C., additional, Sandesc, D., additional, Avakov, V., additional, Shakhova, I., additional, Trimmel, H., additional, Majdan, M., additional, Herzer, G. H., additional, Sokoloff, C. S., additional, Albert, M., additional, Williamson, D., additional, Odier, C., additional, Giguère, J., additional, Charbonney, E., additional, Husti, Z., additional, Kaptás, T., additional, Fülep, Z., additional, Gaál, Z., additional, Tusa, M., additional, Donnelly, J., additional, Aries, M., additional, Czosnyka, M., additional, Robba, C., additional, Liu, M., additional, Ercole, A., additional, Menon, D., additional, Hutchinson, P., additional, Smielewski, P., additional, López, R., additional, Graf, J., additional, Montes, J. M., additional, Kenawi, M., additional, Kandil, A., additional, Husein, K., additional, Samir, A., additional, Heijneman, J., additional, Huijben, J., additional, Abid-Ali, F., additional, Stolk, M., additional, Van Bommel, J., additional, Lingsma, H., additional, Van der Jagt, M., additional, Cihlar, R. C., additional, Mancino, G., additional, Bertini, P., additional, Forfori, F., additional, Guarracino, F., additional, Pavelescu, D., additional, Grintescu, I., additional, Mirea, L., additional, Alamri, S., additional, Tharwat, M., additional, Kono, N., additional, Okamoto, H., additional, Uchino, H., additional, Ikegami, T., additional, Fukuoka, T., additional, Simoes, M., additional, Trigo, E., additional, Coutinho, P., additional, Pimentel, J., additional, Franci, A., additional, Basagni, D., additional, Boddi, M., additional, Anichini, V., additional, Cecchi, A., additional, Markopoulou, D., additional, Venetsanou, K., additional, Papanikolaou, I., additional, Barkouri, T., additional, Chroni, D., additional, Alamanos, I., additional, Cingolani, E., additional, Bocci, M. G., additional, Pisapia, L., additional, Tersali, A., additional, Cutuli, S. L., additional, Fiore, V., additional, Palma, A., additional, Nardi, G., additional, Antonelli, M., additional, Coke, R., additional, Kwong, A., additional, Dwivedi, D. J., additional, Xu, M., additional, McDonald, E., additional, Marshall, J. C., additional, Fox-Robichaud, A. E., additional, Liaw, P. C., additional, Kuchynska, I., additional, Malysh, I. R., additional, Zgrzheblovska, L. V., additional, Mestdagh, L., additional, Verhoeven, E. F., additional, Hubloue, I., additional, Ruel-laliberte, J., additional, Zarychanski, R., additional, Lauzier, F., additional, Bonaventure, P. Lessard, additional, Green, R., additional, Griesdale, D., additional, Fowler, R., additional, Kramer, A., additional, Zygun, D., additional, Walsh, T., additional, Stanworth, S., additional, Léger, C., additional, Turgeon, A. F., additional, Baron, D. M., additional, Baron-Stefaniak, J., additional, Leitner, G. C., additional, Ullrich, R., additional, Tarabrin, O., additional, Mazurenko, A., additional, Potapchuk, Y., additional, Sazhyn, D., additional, Tarabrin, P., additional, Pérez, A. González, additional, Silva, J., additional, Artemenko, V., additional, Bugaev, A., additional, Tokar, I., additional, Konashevskaya, S., additional, Kolesnikova, I. M., additional, Roitman, E. V., additional, Kiss, T. Rengeiné, additional, Máthé, Z., additional, Piros, L., additional, Dinya, E., additional, Tihanyi, E., additional, Smudla, A., additional, Fazakas, J., additional, Ubbink, R., additional, Boekhorst te, P., additional, Mik, E., additional, Caneva, L., additional, Ticozzelli, G., additional, Pirrelli, S., additional, Passador, D., additional, Riccardi, F., additional, Ferrari, F., additional, Roldi, E. M., additional, Di Matteo, M., additional, Bianchi, I., additional, Iotti, G. A., additional, Zurauskaite, G., additional, Voegeli, A., additional, Meier, M., additional, Koch, D., additional, Haubitz, S., additional, Kutz, A., additional, Bargetzi, M., additional, Mueller, B., additional, Schuetz, P., additional, Von Meijenfeldt, G., additional, Van der Laan, M., additional, Zeebregts, C., additional, Christopher, K. B., additional, Vernikos, P., additional, Melissopoulou, T., additional, Kanellopoulou, G., additional, Panoutsopoulou, M., additional, Xanthis, D., additional, Kolovou, K., additional, Kypraiou, T., additional, Floros, J., additional, Broady, H., additional, Pritchett, C., additional, Marshman, M., additional, Jannaway, N., additional, Ralph, C., additional, Lehane, C. L., additional, Keyl, C. K., additional, Zimmer, E. Z., additional, Trenk, D. T., additional, Ducloy-Bouthors, A. S., additional, Jonard, M. J., additional, Fourrier, F., additional, Piza, F., additional, Correa, T., additional, Marra, A., additional, Guerra, J., additional, Rodrigues, R., additional, Vilarinho, A., additional, Aranda, V., additional, Shiramizo, S., additional, Lima, M. R., additional, Kallas, E., additional, Cavalcanti, A. B., additional, Donoso, M., additional, Vargas, P., additional, McCartney, J., additional, Ramsay, S., additional, McDowall, K., additional, Novitzky-Basso, I., additional, Wright, C., additional, Medic, M Grgic, additional, Bielen, L, additional, Radonic, V, additional, Zlopasa, O, additional, Vrdoljak, N Gubarev, additional, Gasparovic, V, additional, Radonic, R, additional, Narváez, G., additional, Cabestrero, D., additional, Rey, L., additional, Aroca, M., additional, Gallego, S., additional, Higuera, J., additional, De Pablo, R., additional, González, L. Rey, additional, Chávez, G. Narváez, additional, Lucas, J. Higuera, additional, Alonso, D. Cabestrero, additional, Ruiz, M. Aroca, additional, Valarezo, L. Jaramillo, additional, De Pablo Sánchez, R., additional, Real, A. Quinza, additional, Wigmore, T. W., additional, Bendavid, I., additional, Cohen, J., additional, Avisar, I., additional, Serov, I., additional, Kagan, I., additional, Singer, P., additional, Hanison, J, additional, Mirza, U, additional, Conway, D, additional, Takasu, A., additional, Tanaka, H., additional, Otani, N., additional, Ohde, S., additional, Ishimatsu, S., additional, Coffey, F, additional, Dissmann, P, additional, Mirza, K, additional, Lomax, M, additional, Dissmann, P., additional, Coffey, F., additional, Mirza, K., additional, Lomax, M., additional, Miner, JR, additional, Leto, R, additional, Markota, AM, additional, Gradišek, PG, additional, Aleksejev, VA, additional, Sinkovič, AS, additional, Romagnoli, S., additional, Chelazzi, C., additional, Zagli, G., additional, Benvenuti, F., additional, Mancinelli, P., additional, Boninsegni, P., additional, Paparella, L., additional, Bos, A. T., additional, Thomas, O., additional, Goslar, T., additional, Martone, A., additional, Sandu, P. R., additional, Rosu, V. A., additional, Capilnean, A., additional, Murgoi, P., additional, Lecavalier, A., additional, Jayaraman, D., additional, Rico, P., additional, Bellemare, P., additional, Gelinas, C., additional, Nishida, T., additional, Kinoshita, T., additional, Iwata, N., additional, Yamakawa, K., additional, Fujimi, S., additional, Maggi, L., additional, Sposato, F., additional, Citterio, G., additional, Bonarrigo, C., additional, Rocco, M., additional, Zani, V., additional, De Blasi, R. A., additional, Alcorn, D, additional, Barry, L, additional, Riedijk, M. A., additional, Milstein, D. M., additional, Caldas, J., additional, Panerai, R., additional, Camara, L., additional, Ferreira, G., additional, Bor-Seng-Shu, E., additional, Lima, M., additional, Galas, F., additional, Mian, N., additional, Nogueira, R., additional, de Oliveira, G. Queiroz, additional, Almeida, J., additional, Jardim, J., additional, Robinson, T. G., additional, Gaioto, F., additional, Hajjar, L. A., additional, Zabolotskikh, I., additional, Musaeva, T., additional, Saasouh, W., additional, Freeman, J., additional, Turan, A., additional, Saseedharan, S., additional, Pathrose, E., additional, Poojary, S., additional, Messika, J., additional, Martin, Y., additional, Maquigneau, N., additional, Henry-Lagarrigue, M., additional, Puechberty, C., additional, Stoclin, A., additional, Martin-Lefevre, L., additional, Blot, F., additional, Dreyfuss, D., additional, Dechanet, A., additional, Hajage, D., additional, Ricard, J., additional, Almeida, E., additional, Landoni, G., additional, Fukushima, J., additional, Fominskiy, E., additional, De Brito, C., additional, Cavichio, L., additional, Almeida, L., additional, Ribeiro, U., additional, Osawa, E., additional, Boltes, R., additional, Battistella, L., additional, Hajjar, L., additional, Fontela, P., additional, Lisboa, T., additional, Junior, L. Forgiarini, additional, Friedman, G. F., additional, Abruzzi, F., additional, Primo, J. Azevedo Peixoto, additional, Filho, P. Marques, additional, de Andrade, J. Stormorvski, additional, Brenner, K. Matos, additional, boeira, M. Scorsato, additional, Leães, C., additional, Rodrigues, C., additional, Vessozi, A., additional, Machado, A. SantAnna, additional, Weiler, M., additional, Bryce, H., additional, Hudson, A., additional, Law, T., additional, Reece-Anthony, R., additional, Molokhia, A., additional, Abtahinezhadmoghaddam, F., additional, Cumber, E., additional, Channon, L., additional, Wong, A., additional, Groome, R., additional, Gearon, D., additional, Varley, J., additional, Wilson, A., additional, Reading, J., additional, Zampieri, F. G., additional, Bozza, F. A., additional, Ferez, M., additional, Fernandes, H., additional, Japiassú, A., additional, Verdeal, J., additional, Carvalho, A. C., additional, Knibel, M., additional, Salluh, J. I., additional, Soares, M., additional, Gao, J., additional, Ahmadnia, E., additional, Patel, B., additional, MacKay, A., additional, Binning, S., additional, Pugh, R. J., additional, Battle, C., additional, Hancock, C., additional, Harrison, W., additional, Szakmany, T., additional, Mulders, F., additional, Vandenbrande, J., additional, Dubois, J., additional, Stessel, B., additional, Siborgs, K., additional, Ramaekers, D., additional, Silva, U. V., additional, Homena, W. S., additional, Fernandes, G. C., additional, Moraes, A. P., additional, Brauer, L., additional, Lima, M. F., additional, De Marco, F., additional, Maric, N., additional, Mackovic, M., additional, Udiljak, N., additional, Bosso, CE, additional, Caetano, RD, additional, Cardoso, AP, additional, Souza, OA, additional, Pena, R, additional, Mescolotte, MM, additional, Souza, IA, additional, Mescolotte, GM, additional, Bangalore, H., additional, Borrows, E., additional, Barnes, D., additional, Ferreira, V., additional, Azevedo, L., additional, Alencar, G., additional, Andrade, A., additional, Bierrenbach, A., additional, Buoninsegni, L. Tadini, additional, Cecci, L., additional, Lindskog, J., additional, Rowland, K., additional, Sturgess, P., additional, Ankuli, A., additional, Rosa, R, additional, Tonietto, T, additional, Ascoli, A, additional, Madeira, L, additional, Rutzen, W, additional, Falavigna, M, additional, Robinson, C, additional, Salluh, J, additional, Cavalcanti, A, additional, Azevedo, L, additional, Cremonese, R, additional, Da Silva, D, additional, Dornelles, A, additional, Skrobik, Y, additional, Teles, J, additional, Ribeiro, T, additional, Eugênio, C, additional, Teixeira, C, additional, Zarei, M., additional, Hashemizadeh, H., additional, Eriksson, M., additional, Strandberg, G., additional, Lipcsey, M., additional, Larsson, A., additional, Lignos, M., additional, Crissanthopoulou, E., additional, Flevari, K., additional, Dimopoulos, P., additional, Armaganidis, A., additional, Golub, JG, additional, Stožer, AS, additional, Rüddel, H., additional, Ehrlich, C., additional, Burghold, C. M., additional, Hohenstein, C., additional, Winning, J., additional, Sellami, W., additional, Hajjej, Z., additional, Bousselmi, M., additional, Gharsallah, H., additional, Labbene, I., additional, Ferjani, M., additional, Sattler, J., additional, Steinbrunner, D., additional, Poppert, H., additional, Schneider, G., additional, Blobner, M., additional, Kanz, K. G., additional, Schaller, S. J., additional, Apap, K., additional, Xuereb, G., additional, Massa, L., additional, Delvau, N., additional, Penaloza, A, additional, Liistro, G, additional, Thys, F, additional, Delattre, I. K., additional, Hantson, P., additional, Roy, P. M., additional, Gianello, P., additional, Hadîrcă, L, additional, Ghidirimschi, A, additional, Catanoi, N, additional, Scurtov, N, additional, Bagrinovschi, M, additional, Sohn, Y. S., additional, Cho, Y. C., additional, Golovin, B., additional, Creciun, O., additional, Ghidirimschi, A., additional, Bagrinovschi, M., additional, Tabbara, R., additional, Whitgift, J. Z., additional, Ishimaru, A., additional, Yaguchi, A., additional, Akiduki, N., additional, Namiki, M., additional, Takeda, M., additional, Tamminen, J. N., additional, Uusaro, A., additional, Taylor, C. G., additional, Mills, E. D., additional, Mackay, A. D., additional, Ponzoni, C., additional, Rabello, R., additional, Serpa, A., additional, Assunção, M., additional, Pardini, A., additional, Shettino, G., additional, Corrêa, T., additional, Vidal-Cortés, P. V., additional, Álvarez-Rocha, L., additional, Fernández-Ugidos, P., additional, Virgós-Pedreira, A., additional, Pérez-Veloso, M. A., additional, Suárez-Paul, I. M., additional, Del Río-Carbajo, L., additional, Fernández, S. Pita, additional, Castro-Iglesias, A., additional, Butt, A., additional, Alghabban, A. A., additional, Khurshid, S. K., additional, Ali, Z. A., additional, Nizami, I. N., additional, Salahuddin, N. S., additional, Alshahrani, M., additional, Alsubaie, A. W., additional, Alshamsy, A. S., additional, Alkhiliwi, B. A., additional, Alshammari, H. K., additional, Alshammari, M. B., additional, Telmesani, N. K., additional, Alshammari, R. B., additional, Asonto, L. P., additional, Damiani, L. P., additional, Bozza, F, additional, El Khattate, A., additional, Bizrane, M., additional, Madani, N., additional, Belayachi, J., additional, Abouqal, R., additional, Ramnarain, D., additional, Gouw-Donders, B., additional, Benstoem, C., additional, Moza, A., additional, Meybohm, P., additional, Stoppe, C., additional, Autschbach, R., additional, Devane, D., additional, Goetzenich, A., additional, Taniguchi, L. U., additional, Araujo, L., additional, Salgado, G., additional, Vieira, J. M., additional, Viana, J., additional, Ziviani, N., additional, Pessach, I., additional, Lipsky, A., additional, Nimrod, A., additional, O´Connor, M., additional, Matot, I., additional, Segal, E., additional, Kluzik, A., additional, Gradys, A., additional, Smuszkiewicz, P., additional, Trojanowska, I., additional, Cybulski, M., additional, De Jong, A., additional, Sebbane, M., additional, Chanques, G., additional, Jaber, S., additional, Rosa, R., additional, Robinson, C., additional, Bessel, M., additional, Cavalheiro, L., additional, Madeira, L., additional, Rutzen, W., additional, Oliveira, R., additional, Maccari, J., additional, Falavigna, M., additional, Sanchez, E., additional, Dutra, F., additional, Dietrich, C., additional, Balzano, P., additional, Rezende, J., additional, Teixeira, C., additional, Sinha, S., additional, Majhi, K., additional, Gorlicki, J. G., additional, Pousset, F. P., additional, Kelly, J., additional, Aron, J., additional, Gilbert, A. Crerar, additional, Urankar, N. Prevec, additional, Irazabal, M., additional, Bosque, M., additional, Manciño, J., additional, Kotsopoulos, A., additional, Jansen, N., additional, Abdo, W., additional, Casey, Ú. M., additional, O’Brien, B., additional, Plant, R., additional, and Doyle, B., additional

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2017
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5. International standards for programmes of training in intensive care medicine in Europe

Author

Bullock, A, Wilde, J D, Bion, J F, Clutton-Brock, T, Flaatten, H, Mathy, B, van Mook, W, Schuwirth, L, Marsh, B, Phelan, D, Shippey, B, Nimmo, G, Castel, S, Hillion, Y, Bonnet, J, Chaumont, D, Rothen, H U, Reay, H, Krenn, C, Germann, P, Ferdinande, P, de Backer, D, Smilov, I, Keremidchieva, N, Gasparoviae, V, Radonic, R, Kyprianou, T, Kakas, M, Sramek, V, Rubertsson, Sten, m.fl., (et al), Bullock, A, Wilde, J D, Bion, J F, Clutton-Brock, T, Flaatten, H, Mathy, B, van Mook, W, Schuwirth, L, Marsh, B, Phelan, D, Shippey, B, Nimmo, G, Castel, S, Hillion, Y, Bonnet, J, Chaumont, D, Rothen, H U, Reay, H, Krenn, C, Germann, P, Ferdinande, P, de Backer, D, Smilov, I, Keremidchieva, N, Gasparoviae, V, Radonic, R, Kyprianou, T, Kakas, M, Sramek, V, Rubertsson, Sten, and m.fl., (et al)

Abstract

PURPOSE: To develop internationally harmonised standards for programmes of training in intensive care medicine (ICM). METHODS: Standards were developed by using consensus techniques. A nine-member nominal group of European intensive care experts developed a preliminary set of standards. These were revised and refined through a modified Delphi process involving 28 European national coordinators representing national training organisations using a combination of moderated discussion meetings, email, and a Web-based tool for determining the level of agreement with each proposed standard, and whether the standard could be achieved in the respondent's country. RESULTS: The nominal group developed an initial set of 52 possible standards which underwent four iterations to achieve maximal consensus. All national coordinators approved a final set of 29 standards in four domains: training centres, training programmes, selection of trainees, and trainers' profiles. Only three standards were considered immediately achievable by all countries, demonstrating a willingness to aspire to quality rather than merely setting a minimum level. Nine proposed standards which did not achieve full consensus were identified as potential candidates for future review. CONCLUSIONS: This preliminary set of clearly defined and agreed standards provides a transparent framework for assuring the quality of training programmes, and a foundation for international harmonisation and quality improvement of training in ICM.

Published
2011
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8. 37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3)

Author

Rob, D., Špunda, R., Lindner, J., Šmalcová, J., Šmíd, O., Kovárník, T., Linhart, A., Bìlohlávek, J., Marinoni, M. M., Cianchi, G., Trapani, S., Migliaccio, M. L., Gucci, L., Bonizzoli, M., Cramaro, A., Cozzolino, M., Valente, S., Peris, A., Grins, E., Kort, E., Weiland, M., Shresta, N. Manandhar, Davidson, P., Algotsson, L., Fitch, S., Marco, G., Sturgill, J., Lee, S., Dickinson, M., Boeve, T., Khaghani, A., Wilton, P., Jovinge, S., Ahmad, A. N., Loveridge, R., Vlachos, S., Patel, S., Gelandt, E., Morgan, L., Butt, S., Whitehorne, M., Kakar, V., Park, C., Hayes, M., Willars, C., Hurst, T., Best, T., Vercueil, A., Auzinger, G., Adibelli, B., Akovali, N., Torgay, A., Zeyneloglu, P., Pirat, A., Kayhan, Z., Schmidbauer, S. S., Herlitz, J., Karlsson, T., Friberg, H., Knafelj, R., Radsel, P., Duprez, F., Bonus, T., Cuvelier, G., Mashayekhi, S., Maka, M., Ollieuz, S., Reychler, G., Mosaddegh, R., Abbasi, S., Talaee, S., Zotzmann, V. Z., Staudacher, D. S., Wengenmayer, T. W., Dürschmied, D. D., Bode, C. B., Nelskylä, A., Nurmi, J., Jousi, M., Schramko, A., Mervaala, E., Ristagno, G., Skrifvars, M., Ozsoy, G., Kendirli, T., Azapagasi, E., Perk, O., Gadirova, U., Ozcinar, E., Cakici, M., Baran, C., Durdu, S., Uysalel, A., Dogan, M., Ramoglu, M., Ucar, T., Tutar, E., Atalay, S., Akar, R., Kamps, M., Leeuwerink, G., Hofmeijer, J., Hoiting, O., Van der Hoeven, J., Hoedemaekers, C., Konkayev, A., Kuklin, V., Kondratyev, T., Konkayeva, M., Akhatov, N., Sovershaev, M., Tveita, T., Dahl, V., Wihersaari, L., Skrifvars, M. B., Bendel, S., Kaukonen, K. M., Vaahersalo, J., Romppanen, J., Pettilä, V., Reinikainen, M., Lybeck, A., Cronberg, T., Nielsen, N., Rauber, M., Steblovnik, K., Jazbec, A., Noc, M., Kalasbail, P., Garrett, F., Kulstad, E., Bergström, D. J., Olsson, H. R., Schmidbauer, S., Mandel, I., Mikheev, S., Podoxenov, Y., Suhodolo, I., Podoxenov, A., Svirko, J., Sementsov, A., Maslov, L., Shipulin, V., Vammen, L. V., Rahbek, S. R., Secher, N. S., Povlsen, J. P., Jessen, N. J., Løfgren, B. L., Granfeldt, A. G., Grossestreuer, A., Perman, S., Patel, P., Ganley, S., Portmann, J., Cocchi, M., Donnino, M., Nassar, Y., Fathy, S., Gaber, A., Mokhtar, S., Chia, Y. C., Lewis-Cuthbertson, R., Mustafa, K., Sabra, A., Evans, A., Bennett, P., Eertmans, W., Genbrugge, C., Boer, W., Dens, J., De Deyne, C., Jans, F., Skorko, A., Thomas, M., Casadio, M., Coppo, A., Vargiolu, A., Villa, J., Rota, M., Avalli, L., Citerio, G., Moon, J. B., Cho, J. H., Park, C. W., Ohk, T. G., Shin, M. C., Won, M. H., Papamichalis, P., Zisopoulou, V., Dardiotis, E., Karagiannis, S., Papadopoulos, D., Zafeiridis, T., Babalis, D., Skoura, A., Staikos, I., Komnos, A., Passos, S. Silva, Maeda, F., Souza, L. Silva, Filho, A. Amato, Granjeia, T. Araújo Guerra, Schweller, M., Franci, D., De Carvalho Filho, M., Santos, T. Martins, De Azevedo, P., Wall, R., Welters, I., Tansuwannarat, P., Sanguanwit, P., Langer, T., Carbonara, M., Caccioppola, A., Fusarini, C. Ferraris, Carlesso, E., Paradiso, E., Battistini, M., Cattaneo, E., Zadek, F., Maiavacca, R., Stocchetti, N., Pesenti, A., Ramos, A., Acharta, F., Toledo, J., Perezlindo, M., Lovesio, L., Dogliotti, A., Lovesio, C., Schroten, N., Van der Veen, B., De Vries, M. C., Veenstra, J., Abulhasan, Y. B., Rachel, S., Châtillon-Angle, M., Alabdulraheem, N., Schiller, I., Dendukuri, N., Angle, M., Frenette, C., Lahiri, S., Schlick, K., Mayer, S. A., Lyden, P., Akatsuka, M., Arakawa, J., Yamakage, M., Rubio, J., Mateo-Sidron, J. A. Rubio, Sierra, R., Celaya, M., Benitez, L., Alvarez-Ossorio, S., Fernandez, A., Gonzalez, O., Engquist, H., Rostami, E., Enblad, P., Canullo, L., Nallino, J., Perreault, M., Talic, J., Frenette, A. J., Burry, L., Bernard, F., Williamson, D. R., Adukauskiene, D., Cyziute, J., Adukauskaite, A., Malciene, L., Luca, L., Rogobete, A., Bedreag, O., Papurica, M., Sarandan, M., Cradigati, C., Popovici, S., Vernic, C., Sandesc, D., Avakov, V., Shakhova, I., Trimmel, H., Majdan, M., Herzer, G. H., Sokoloff, C. S., Albert, M., Williamson, D., Odier, C., Giguère, J., Charbonney, E., Husti, Z., Kaptás, T., Fülep, Z., Gaál, Z., Tusa, M., Donnelly, J., Aries, M., Czosnyka, M., Robba, C., Liu, M., Ercole, A., Menon, D., Hutchinson, P., Smielewski, P., López, R., Graf, J., Montes, J. M., Kenawi, M., Kandil, A., Husein, K., Samir, A., Heijneman, J., Huijben, J., Abid-Ali, F., Stolk, M., Van Bommel, J., Lingsma, H., Van der Jagt, M., Cihlar, R. C., Mancino, G., Bertini, P., Forfori, F., Guarracino, F., Pavelescu, D., Grintescu, I., Mirea, L., Alamri, S., Tharwat, M., Kono, N., Okamoto, H., Uchino, H., Ikegami, T., Fukuoka, T., Simoes, M., Trigo, E., Coutinho, P., Pimentel, J., Franci, A., Basagni, D., Boddi, M., Anichini, V., Cecchi, A., Markopoulou, D., Venetsanou, K., Papanikolaou, I., Barkouri, T., Chroni, D., Alamanos, I., Cingolani, E., Bocci, M. G., Pisapia, L., Tersali, A., Cutuli, S. L., Fiore, V., Palma, A., Nardi, G., Antonelli, M., Coke, R., Kwong, A., Dwivedi, D. J., Xu, M., McDonald, E., Marshall, J. C., Fox-Robichaud, A. E., Liaw, P. C., Kuchynska, I., Malysh, I. R., Zgrzheblovska, L. V., Mestdagh, L., Verhoeven, E. F., Hubloue, I., Ruel-laliberte, J., Zarychanski, R., Lauzier, F., Bonaventure, P. Lessard, Green, R., Griesdale, D., Fowler, R., Kramer, A., Zygun, D., Walsh, T., Stanworth, S., Léger, C., Turgeon, A. F., Baron, D. M., Baron-Stefaniak, J., Leitner, G. C., Ullrich, R., Tarabrin, O., Mazurenko, A., Potapchuk, Y., Sazhyn, D., Tarabrin, P., Pérez, A. González, Silva, J., Artemenko, V., Bugaev, A., Tokar, I., Konashevskaya, S., Kolesnikova, I. M., Roitman, E. V., Kiss, T. Rengeiné, Máthé, Z., Piros, L., Dinya, E., Tihanyi, E., Smudla, A., Fazakas, J., Ubbink, R., Boekhorst te, P., Mik, E., Caneva, L., Ticozzelli, G., Pirrelli, S., Passador, D., Riccardi, F., Ferrari, F., Roldi, E. M., Di Matteo, M., Bianchi, I., Iotti, G. A., Zurauskaite, G., Voegeli, A., Meier, M., Koch, D., Haubitz, S., Kutz, A., Bargetzi, M., Mueller, B., Schuetz, P., Von Meijenfeldt, G., Van der Laan, M., Zeebregts, C., Christopher, K. B., Vernikos, P., Melissopoulou, T., Kanellopoulou, G., Panoutsopoulou, M., Xanthis, D., Kolovou, K., Kypraiou, T., Floros, J., Broady, H., Pritchett, C., Marshman, M., Jannaway, N., Ralph, C., Lehane, C. L., Keyl, C. K., Zimmer, E. Z., Trenk, D. T., Ducloy-Bouthors, A. S., Jonard, M. J., Fourrier, F., Piza, F., Correa, T., Marra, A., Guerra, J., Rodrigues, R., Vilarinho, A., Aranda, V., Shiramizo, S., Lima, M. R., Kallas, E., Cavalcanti, A. B., Donoso, M., Vargas, P., McCartney, J., Ramsay, S., McDowall, K., Novitzky-Basso, I., Wright, C., Medic, M Grgic, Bielen, L, Radonic, V, Zlopasa, O, Vrdoljak, N Gubarev, Gasparovic, V, Radonic, R, Narváez, G., Cabestrero, D., Rey, L., Aroca, M., Gallego, S., Higuera, J., De Pablo, R., González, L. Rey, Chávez, G. Narváez, Lucas, J. Higuera, Alonso, D. Cabestrero, Ruiz, M. Aroca, Valarezo, L. Jaramillo, De Pablo Sánchez, R., Real, A. Quinza, Wigmore, T. W., Bendavid, I., Cohen, J., Avisar, I., Serov, I., Kagan, I., Singer, P., Hanison, J, Mirza, U, Conway, D, Takasu, A., Tanaka, H., Otani, N., Ohde, S., Ishimatsu, S., Coffey, F, Dissmann, P, Mirza, K, Lomax, M, Dissmann, P., Coffey, F., Mirza, K., Lomax, M., Miner, JR, Leto, R, Markota, AM, Gradišek, PG, Aleksejev, VA, Sinkovič, AS, Romagnoli, S., Chelazzi, C., Zagli, G., Benvenuti, F., Mancinelli, P., Boninsegni, P., Paparella, L., Bos, A. T., Thomas, O., Goslar, T., Martone, A., Sandu, P. R., Rosu, V. A., Capilnean, A., Murgoi, P., Lecavalier, A., Jayaraman, D., Rico, P., Bellemare, P., Gelinas, C., Nishida, T., Kinoshita, T., Iwata, N., Yamakawa, K., Fujimi, S., Maggi, L., Sposato, F., Citterio, G., Bonarrigo, C., Rocco, M., Zani, V., De Blasi, R. A., Alcorn, D, Barry, L, Riedijk, M. A., Milstein, D. M., Caldas, J., Panerai, R., Camara, L., Ferreira, G., Bor-Seng-Shu, E., Lima, M., Galas, F., Mian, N., Nogueira, R., de Oliveira, G. Queiroz, Almeida, J., Jardim, J., Robinson, T. G., Gaioto, F., Hajjar, L. A., Zabolotskikh, I., Musaeva, T., Saasouh, W., Freeman, J., Turan, A., Saseedharan, S., Pathrose, E., Poojary, S., Messika, J., Martin, Y., Maquigneau, N., Henry-Lagarrigue, M., Puechberty, C., Stoclin, A., Martin-Lefevre, L., Blot, F., Dreyfuss, D., Dechanet, A., Hajage, D., Ricard, J., Almeida, E., Landoni, G., Fukushima, J., Fominskiy, E., De Brito, C., Cavichio, L., Almeida, L., Ribeiro, U., Osawa, E., Boltes, R., Battistella, L., Hajjar, L., Fontela, P., Lisboa, T., Junior, L. Forgiarini, Friedman, G. F., Abruzzi, F., Primo, J. Azevedo Peixoto, Filho, P. Marques, de Andrade, J. Stormorvski, Brenner, K. Matos, boeira, M. Scorsato, Leães, C., Rodrigues, C., Vessozi, A., Machado, A. SantAnna, Weiler, M., Bryce, H., Hudson, A., Law, T., Reece-Anthony, R., Molokhia, A., Abtahinezhadmoghaddam, F., Cumber, E., Channon, L., Wong, A., Groome, R., Gearon, D., Varley, J., Wilson, A., Reading, J., Zampieri, F. G., Bozza, F. A., Ferez, M., Fernandes, H., Japiassú, A., Verdeal, J., Carvalho, A. C., Knibel, M., Salluh, J. I., Soares, M., Gao, J., Ahmadnia, E., Patel, B., MacKay, A., Binning, S., Pugh, R. J., Battle, C., Hancock, C., Harrison, W., Szakmany, T., Mulders, F., Vandenbrande, J., Dubois, J., Stessel, B., Siborgs, K., Ramaekers, D., Silva, U. V., Homena, W. S., Fernandes, G. C., Moraes, A. P., Brauer, L., Lima, M. F., De Marco, F., Maric, N., Mackovic, M., Udiljak, N., Bosso, CE, Caetano, RD, Cardoso, AP, Souza, OA, Pena, R, Mescolotte, MM, Souza, IA, Mescolotte, GM, Bangalore, H., Borrows, E., Barnes, D., Ferreira, V., Azevedo, L., Alencar, G., Andrade, A., Bierrenbach, A., Buoninsegni, L. Tadini, Cecci, L., Lindskog, J., Rowland, K., Sturgess, P., Ankuli, A., Rosa, R, Tonietto, T, Ascoli, A, Madeira, L, Rutzen, W, Falavigna, M, Robinson, C, Salluh, J, Cavalcanti, A, Azevedo, L, Cremonese, R, Da Silva, D, Dornelles, A, Skrobik, Y, Teles, J, Ribeiro, T, Eugênio, C, Teixeira, C, Zarei, M., Hashemizadeh, H., Eriksson, M., Strandberg, G., Lipcsey, M., Larsson, A., Lignos, M., Crissanthopoulou, E., Flevari, K., Dimopoulos, P., Armaganidis, A., Golub, JG, Stožer, AS, Rüddel, H., Ehrlich, C., Burghold, C. M., Hohenstein, C., Winning, J., Sellami, W., Hajjej, Z., Bousselmi, M., Gharsallah, H., Labbene, I., Ferjani, M., Sattler, J., Steinbrunner, D., Poppert, H., Schneider, G., Blobner, M., Kanz, K. G., Schaller, S. J., Apap, K., Xuereb, G., Massa, L., Delvau, N., Penaloza, A, Liistro, G, Thys, F, Delattre, I. K., Hantson, P., Roy, P. M., Gianello, P., Hadîrcă, L, Ghidirimschi, A, Catanoi, N, Scurtov, N, Bagrinovschi, M, Sohn, Y. S., Cho, Y. C., Golovin, B., Creciun, O., Ghidirimschi, A., Bagrinovschi, M., Tabbara, R., Whitgift, J. Z., Ishimaru, A., Yaguchi, A., Akiduki, N., Namiki, M., Takeda, M., Tamminen, J. N., Uusaro, A., Taylor, C. G., Mills, E. D., Mackay, A. D., Ponzoni, C., Rabello, R., Serpa, A., Assunção, M., Pardini, A., Shettino, G., Corrêa, T., Vidal-Cortés, P. V., Álvarez-Rocha, L., Fernández-Ugidos, P., Virgós-Pedreira, A., Pérez-Veloso, M. A., Suárez-Paul, I. M., Del Río-Carbajo, L., Fernández, S. Pita, Castro-Iglesias, A., Butt, A., Alghabban, A. A., Khurshid, S. K., Ali, Z. A., Nizami, I. N., Salahuddin, N. S., Alshahrani, M., Alsubaie, A. W., Alshamsy, A. S., Alkhiliwi, B. A., Alshammari, H. K., Alshammari, M. B., Telmesani, N. K., Alshammari, R. B., Asonto, L. P., Damiani, L. P., Bozza, F, El Khattate, A., Bizrane, M., Madani, N., Belayachi, J., Abouqal, R., Ramnarain, D., Gouw-Donders, B., Benstoem, C., Moza, A., Meybohm, P., Stoppe, C., Autschbach, R., Devane, D., Goetzenich, A., Taniguchi, L. U., Araujo, L., Salgado, G., Vieira, J. M., Viana, J., Ziviani, N., Pessach, I., Lipsky, A., Nimrod, A., O´Connor, M., Matot, I., Segal, E., Kluzik, A., Gradys, A., Smuszkiewicz, P., Trojanowska, I., Cybulski, M., De Jong, A., Sebbane, M., Chanques, G., Jaber, S., Rosa, R., Robinson, C., Bessel, M., Cavalheiro, L., Madeira, L., Rutzen, W., Oliveira, R., Maccari, J., Falavigna, M., Sanchez, E., Dutra, F., Dietrich, C., Balzano, P., Rezende, J., Teixeira, C., Sinha, S., Majhi, K., Gorlicki, J. G., Pousset, F. P., Kelly, J., Aron, J., Gilbert, A. Crerar, Urankar, N. Prevec, Irazabal, M., Bosque, M., Manciño, J., Kotsopoulos, A., Jansen, N., Abdo, W., Casey, Ú. M., O’Brien, B., Plant, R., and Doyle, B.

Subjects
Critical Care and Intensive Care Medicine, Meeting Abstracts
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9. Angiotensin II administration in severe thrombocytopenia and chronic venous thrombosis: A case report.

Author

Vujaklija Brajkovic A, Markota A, Bielen L, Vujević A, Rora M, and Radonic R

Abstract

Background: The initial trials on angiotensin II (AT II) administration indicated a high incidence of thrombocytopenia and thrombosis, as well as a positive correlation between hyperreninemia and response to the medication., Case Summary: We describe a case of a patient presenting with catecholamine resistant septic shock, thrombocytopenia, deep vein thrombosis, and normal renin concentration who responded immediately to AT II treatment. We observed no worsening of thrombocytopenia and no progression of thrombosis or additional thromboses during treatment., Conclusion: Our case underscores the need for individualized assessment of patients for potential therapy with AT II., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Published
2024
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10. Coombs-positive refractory acquired thrombotic thrombocytopenic purpura in a patient with chronic myelomonocytic leukemia successfully treated with rituximab.

Author

Krecak I, Medic MG, Gveric-Krecak V, Roncevic P, Bašić Kinda S, Babel J, and Radonic R

Subjects
ADAMTS13 Protein immunology, Autoantibodies immunology, Coombs Test, Female, Glucocorticoids therapeutic use, Humans, Immunoglobulins, Intravenous therapeutic use, Methylprednisolone therapeutic use, Middle Aged, Purpura, Thrombotic Thrombocytopenic complications, Purpura, Thrombotic Thrombocytopenic immunology, Immunologic Factors therapeutic use, Leukemia, Myelomonocytic, Chronic complications, Plasmapheresis, Purpura, Thrombotic Thrombocytopenic therapy, Rituximab therapeutic use
Abstract

Objectives: Acquired thrombotic thrombocytopenic purpura (aTTP) is a rare autoimmune disorder characterized by auto-antibodies to Willebrand factor (vWF) cleaving enzyme (ADAMTS13), resulting in unusually large vWF multimers that lead to platelet aggregation, microthrombi formation and microangiopathic hemolytic anemia. Hemolysis in aTTP is mechanical; thus, direct antiglobulin test (Coombs test) is usually negative. Multiple autoimmune conditions and various auto-antibodies have been described in the context of chronic myelomonocytic leukemia (CMML). In this paper, we describe the first case of CMML with auto-antibodies to ADAMTS13, presenting initially as plasmapheresis-refractory Coombs-positive aTTP. Results: Although our patient was not treated for CMML, a complete remission of aTTP was eventually achieved with rituximab. Conclusion; We propose that aTTP should be in the differential diagnosis of CMML patients with thrombocytopenia and anemia (Coombs positive or not) who develop signs of thrombotic microangiopathy. Further studies are much needed to decipher the immune-mediated processes in CMML.

Published
2020
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11. Rib stress fracture in a male adaptive rower from the arms and shoulders sport class: case report.

Author

Smoljanovic T, Bojanic I, Pollock CL, and Radonic R

Subjects
Arm physiology, Equipment Design adverse effects, Fractures, Stress physiopathology, Humans, Male, Protective Devices, Young Adult, Fractures, Stress etiology, Ribs injuries, Ships, Shoulder physiology, Sports classification
Abstract

Adaptive rowing is rowing or sculling for rowers with a physical disability. It debuted at the Paralympic Games in 2008. In order to ensure an equitable playing field, rowers with similar levels of physical function and disability are classified into different sport classes for competition. Rowers with an inability to use a sliding seat and impaired trunk function resulting in an inability to perform trunk forward and backward lean via hip flexion/extension are assigned to the Arms and Shoulders (AS) class. AS rowers have to use a chest strap set immediately below the chest in order to localize any trunk movement in AS class. Conditions created by adaptations of rowing equipment and technique within the AS class create unique stresses on the upper thoracic region. The following case report demonstrates how etiology and management of a rib stress fracture in an AS rower differs in comparison to able-body rowers. Of significant importance were the limitations imposed on the rower's ability to maintain rowing-specific fitness, due to the nature of the rib stress fracture and requirement to decrease force transmission through the ribs for several weeks. The rower's gradual return to full training was further impacted by obligatory use of the chest strap, which directly applied pressure over the injured area. Protective orthosis for the chest was designed and applied in order to dissipate pressure of the chest strap over the thorax during rowing (most importantly at the catch position) both on the ergometer and in the boat.

Published
2011
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12. Survival after severe acute chromic acid poisoning complicated with renal and liver failure.

Author

Baresic M, Gornik I, Radonic R, Zlopasa O, Gubarev N, and Gasparovic V

Subjects
Acute Disease, Acute Kidney Injury therapy, Follow-Up Studies, Humans, Liver Failure therapy, Male, Middle Aged, Renal Dialysis methods, Survival, Acute Kidney Injury chemically induced, Acute Kidney Injury diagnosis, Chromates poisoning, Liver Failure chemically induced, Liver Failure diagnosis
Abstract

Chromic acid is a strong metal acid and acute poisoning is very rare, but very serious with severe skin injury, renal and liver failure. The majority of published cases were suicide attempts with lethal outcomes. We describe the case of a 55-year-old man who had accidentally taken a sip of 20% chromic acid (estimated chromium intake: 2.3 g). Renal and liver failure were not present at presentation, but appeared later in the course of disease. He was treated with hemodialysis, no chelating agents or other methods for enhancing elimination were used. Liver and renal function improved over the next 30 days and the patient was discharged after 45 days of hospitalization with no need for dialysis. In the follow-up period of eight months his renal function remained depressed, but stable.

Published
2009
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13. Familial acquired thrombotic thrombocytopenic purpura: ADAMTS13 inhibitory autoantibodies in identical twins.

Author

Studt JD, Kremer Hovinga JA, Radonic R, Gasparovic V, Ivanovic D, Merkler M, Wirthmueller U, Dahinden C, Furlan M, and Lämmle B

Subjects
ADAM Proteins, ADAMTS13 Protein, Adult, Autoantibodies blood, Female, Histocompatibility Testing, Humans, Metalloendopeptidases deficiency, Twins, Monozygotic genetics, Metalloendopeptidases genetics, Metalloendopeptidases immunology, Purpura, Thrombotic Thrombocytopenic genetics, Purpura, Thrombotic Thrombocytopenic immunology
Abstract

Thrombotic thrombocytopenic purpura (TTP) either occurs in a congenital form caused by ADAMTS13 gene mutations or it is acquired and most often due to ADAMTS13 inhibitory autoantibodies. In congenital TTP siblings are often affected, while acquired TTP occurs sporadically and familial clustering has not been described so far. We report identical twin sisters suffering from acquired TTP due to immunoglobulin G (IgG) autoantibodies inactivating ADAMTS13, suggesting an important role of hitherto unidentified genetic determinants of ADAMTS13 inhibitor formation. These cases also demonstrate that familial clustering is not sufficient for unambiguously diagnosing hereditary ADAMTS13 deficiency and congenital TTP.

Published
2004
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