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  1. Article: Determining the Association Between the Origin of Sepsis and the Severity of Sepsis in Intensive Care Unit (ICU) Patients Using Acute Physiology and Chronic Health Evaluation (APACHE) IV.

    Arumairaj, Antony J / Habtes, Imnett / Park, Hansang / Valencia-Manrique, Julio C / Arzu, Jennifer / Mattana, Joseph / Chaudhari, Shobhana / Trenard, Natoushka / Newman, Thomas

    Cureus

    2024  Volume 16, Issue 2, Page(s) e54653

    Abstract: ... in critically ill adult patients who were admitted with sepsis to the ICU from July 2017 until July 2019. Acute ...

    Abstract Objective The objective of this study is to compare the outcomes of hospital mortality, the requirement of invasive ventilation, vasopressor requirement, duration of vasopressor requirement, and duration of intensive care unit (ICU) stay among the different causes of sepsis and to determine which cause of sepsis had the most severe outcomes. Methods A retrospective chart review was done in critically ill adult patients who were admitted with sepsis to the ICU from July 2017 until July 2019. Acute Physiology and Chronic Health Evaluation (APACHE) IV scores were calculated on patients admitted to ICU on day one of ICU admission. Each patient was then evaluated for outcomes of hospital mortality, need for invasive ventilation, requirement of vasopressors, duration of vasopressors, and duration of ICU stay. The outcomes were then compared between the different sources of sepsis to determine which source of sepsis had the highest severity. Results In total, 176 patients were included in the study. Ninety-three patients were admitted with respiratory sepsis, 26 patients were admitted with gastrointestinal sepsis, 31 patients were admitted with urosepsis, and 26 patients were admitted with other miscellaneous causes of sepsis. The hospital mortality was highest in the respiratory sepsis group at 32%, with a trend towards statistical significance with a P value of 0.057. ICU stay duration was highest in patients with respiratory sepsis at six days, with a statistically significant P value of < 0.001. The need for invasive ventilation was highest in patients with respiratory sepsis at 64%, with a statistically significant P value of < 0.001. The requirement of vasopressor support was highest in patients with respiratory sepsis at 47% and the duration of vasopressors was highest in both respiratory and gastrointestinal sepsis at three days, however, there was no statistical significance. Conclusion Among the different origins of sepsis, the patients with respiratory sepsis had the most severe outcomes, with the highest need for invasive ventilation and the highest ICU stay duration.
    Language English
    Publishing date 2024-02-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.54653
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Anticardiolipin antibodies and COVID-19-A case report from America.

    Valencia Manrique, Julio / Ghosh, Kuldeep / Boma, Noella

    Journal of medical virology

    2020  Volume 93, Issue 1, Page(s) 76–77

    MeSH term(s) Antibodies, Anticardiolipin ; COVID-19 ; Humans ; Immunoglobulin M ; Ischemia ; SARS-CoV-2
    Chemical Substances Antibodies, Anticardiolipin ; Immunoglobulin M
    Keywords covid19
    Language English
    Publishing date 2020-06-16
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 752392-0
    ISSN 1096-9071 ; 0146-6615
    ISSN (online) 1096-9071
    ISSN 0146-6615
    DOI 10.1002/jmv.26135
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: A 64-Year-Old Man Hospitalized for COVID-19 Pneumonia and Treated with Tocilizumab Who Developed Chronic Cavitary Pulmonary Aspergillosis.

    Adetiloye, Adebola Oluwabusayo / Alladin, Farhana / Alaameri, Rasha / Valencia-Manrique, Julio C / Badero, Olurotimi / Poor, Armeen

    The American journal of case reports

    2023  Volume 24, Page(s) e938359

    Abstract: BACKGROUND The management of (Coronavirus disease 2019) COVID-19 pneumonia is ever-evolving. Tocilizumab, a monoclonal antibody against interleukin-6 (IL-6) receptor, have known mortality benefit in severe COVID-19 pneumonia, but data are limited ... ...

    Abstract BACKGROUND The management of (Coronavirus disease 2019) COVID-19 pneumonia is ever-evolving. Tocilizumab, a monoclonal antibody against interleukin-6 (IL-6) receptor, have known mortality benefit in severe COVID-19 pneumonia, but data are limited regarding safety. Attributable to the immunomodulatory nature of this medication, patients may be at risk for opportunistic infections, including chronic cavitary pulmonary aspergillosis (CPPA), a slowly progressive disease characterized pulmonary infiltrates and often a newly-formed cavity. However, current guidelines do not emphasize post-treatment surveillance of patients for opportunistic infections, including CPPA. CASE REPORT We present a particular case of a 64-year-old man treated for COVID-19 pneumonia with Tocilizumab and dexamethasone who developed cavitary pulmonary aspergillosis. He presented to the emergency department with hemoptysis, associated with worsening productive cough, shortness of breath, and weight loss. Computed tomography (CT) of the chest showed areas of focal consolidation and a cavitary lung lesion within the left upper lobe. Sputum culture was positive for Aspergillus niger. The patient received a long course of oral triazole therapy for CPPA, with clinical improvement. CT scan of the chest at 9 months showed that the Itraconazole therapy was effective in resolving the extensive airspace disease and decreasing the size of the upper-lobe cavity and fungal ball. CONCLUSIONS This article illustrates the possibility of a serious infection such as CCPA as an adverse effect of Tocilizumab treatment, especially with concurrent immunosuppressive therapy. Furthermore, this case highlights the importance of regular monitoring of patients who have received Tocilizumab therapy to ensure that early signs of opportunistic infections such as CPPA are detected and treated promptly to prevent permanent lung damage.
    MeSH term(s) Male ; Humans ; Middle Aged ; COVID-19 ; COVID-19 Drug Treatment ; Pulmonary Aspergillosis/drug therapy ; Opportunistic Infections/drug therapy
    Chemical Substances tocilizumab (I031V2H011)
    Language English
    Publishing date 2023-03-16
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2517183-5
    ISSN 1941-5923 ; 1941-5923
    ISSN (online) 1941-5923
    ISSN 1941-5923
    DOI 10.12659/AJCR.938359
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Anticardiolipin antibodies and COVID‐19—A case report from America

    Valencia Manrique, Julio / Ghosh, Kuldeep / Boma, Noella

    Journal of Medical Virology ; ISSN 0146-6615 1096-9071

    2020  

    Keywords Virology ; Infectious Diseases ; covid19
    Language English
    Publisher Wiley
    Publishing country us
    Document type Article ; Online
    DOI 10.1002/jmv.26135
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article: Antineutrophil Cytoplasmic Antibody-Associated Glomerulonephritis in a Case of Scleroderma After Recent Diagnosis With COVID-19.

    Jalalzadeh, Mojgan / Valencia-Manrique, Julio C / Boma, Noella / Chaudhari, Ashok / Chaudhari, Shobhana

    Cureus

    2021  Volume 13, Issue 1, Page(s) e12485

    Abstract: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a rare occurrence in systemic sclerosis (SSc) patients. AAV is an inflammatory disease that can lead to kidney failure due to the infiltration of mononuclear cells and the ... ...

    Abstract Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a rare occurrence in systemic sclerosis (SSc) patients. AAV is an inflammatory disease that can lead to kidney failure due to the infiltration of mononuclear cells and the destruction of blood vessels. Also, crescentic glomerulonephritis (GN) has rarely been reported with coronavirus disease 2019 (COVID-19) and acute tubular injury is the most common renal pathology lesion in these patients. We present a rare case of a 46-year-old woman with SSc with new onset of renal failure after a recent diagnosis of COVID-19. Her serology was positive for p-ANCA and myeloperoxidase antibodies. Kidney biopsy was done and showed crescentic GN. We suggest during this pandemic, patients with an immunological disorder that are infected with COVID-19 be closely monitored for any organ involvement.
    Language English
    Publishing date 2021-01-04
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.12485
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Posterior Reversible Encephalopathy Syndrome Presenting Atypically as a Non-Convulsive Seizure.

    Adetiloye, Adebola Oluwabusayo / Valencia Manrique, Julio / Victoria, Ana / Haider, Haider / Al-Juboori, Mohammed T

    The American journal of case reports

    2021  Volume 22, Page(s) e933667

    Abstract: BACKGROUND Posterior reversible encephalopathy syndrome (PRES), also known as reversible posterior leukoencephalopathy, is a neurotoxic state with multiple etiologies characterized by altered mental state, headaches, visual abnormalities, and seizures. ... ...

    Abstract BACKGROUND Posterior reversible encephalopathy syndrome (PRES), also known as reversible posterior leukoencephalopathy, is a neurotoxic state with multiple etiologies characterized by altered mental state, headaches, visual abnormalities, and seizures. This clinico-radiological syndrome is rare, and a high index of suspicion is needed to diagnose, provide adequate treatment, and prevent irreversible neurological sequelae. CASE REPORT We present a case of a woman with end-stage renal disease (ESRD) who presented with acute confusion and non-convulsive seizures and was later diagnosed with PRES. In this case, altered mental status was initially thought to be secondary to uremic encephalopathy. A diagnosis of PRES was subsequently made after she had several sessions of HD without significant improvement in her mental state, prompting magnetic resonant imaging (MRI) for further evaluation. Specific risk factors for PRES, including blood pressure fluctuations, were targeted and she made significant clinical recovery but had residual functional impairment. CONCLUSIONS This case underscores the need for a high index of suspicion, especially in cases with atypical presentation, as delayed diagnosis can lead to suboptimal outcomes.
    MeSH term(s) Diagnostic Imaging ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Posterior Leukoencephalopathy Syndrome/diagnosis ; Posterior Leukoencephalopathy Syndrome/etiology ; Risk Factors ; Seizures/etiology
    Language English
    Publishing date 2021-11-05
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2517183-5
    ISSN 1941-5923 ; 1941-5923
    ISSN (online) 1941-5923
    ISSN 1941-5923
    DOI 10.12659/AJCR.933667
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Non-Bleeding Colonic Ulcer as Initial Manifestation of Disseminated Cryptococcosis in a Patient With Human Immunodeficiency Virus.

    Valencia-Manrique, Julio C / Adetiloye, Adebola / Alaameri, Rasha / Flores, Jose / Ibarra, Gabriel / Achuo-Egbe, Yvette / Harley, Jennifer / Sandhu, Jagbir

    Cureus

    2021  Volume 13, Issue 8, Page(s) e17298

    Abstract: Cryptococcosis is an invasive mycosis caused by Cryptococcus sp. Its presence is described closely with immunosuppressive states. Once it has reached the body, it has shown a predilection for two sites: the lungs and the central nervous system. ... ...

    Abstract Cryptococcosis is an invasive mycosis caused by Cryptococcus sp. Its presence is described closely with immunosuppressive states. Once it has reached the body, it has shown a predilection for two sites: the lungs and the central nervous system. Nonetheless, since it has hematogenous dissemination, it can colonize and yield disease at any organ. Hence, a patient will typically present with constitutional symptoms including fever, malaise, and weight loss, associated with cough, shortness of breath, chest pain, or associated headache, drowsiness, and meningeal irritation signs. We illustrate here one of the uncommon non-pulmonary non-cerebral forms of the disease of cryptococcosis, a newly diagnosed HIV/AIDS patient with a non-bleeding colon ulcer, who lacks respiratory or central nervous system (CNS)-related symptoms but endorses non-specific gastrointestinal complaints. The first evidence of the disease was the elevated cryptococcal antigen (CrAg). The direct visualization of the spores in the biopsy confirmed the infection.
    Language English
    Publishing date 2021-08-19
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.17298
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Clozapine-Induced Myocarditis in a Young Man with Refractory Schizophrenia: Case Report of a Rare Adverse Event and Review of the Literature.

    Adetiloye, Adebola Oluwabusayo / Abdelmottaleb, Wael / Ahmed, Mirza Fawad / Victoria, Ana Maria / Ozbay, Mustafa Bilal / Valencia Manrique, Julio C / Alaameri, Rasha / Badero, Olurotimi / Mushiyev, Savi

    The American journal of case reports

    2022  Volume 23, Page(s) e936306

    Abstract: BACKGROUND Myocarditis is cardiac muscle inflammation caused by infectious or noninfectious agents. Rarely, clozapine, an atypical antipsychotic drug used to treat resistant schizophrenia, has been reported to cause myocarditis, as we report in this case. ...

    Abstract BACKGROUND Myocarditis is cardiac muscle inflammation caused by infectious or noninfectious agents. Rarely, clozapine, an atypical antipsychotic drug used to treat resistant schizophrenia, has been reported to cause myocarditis, as we report in this case. CASE REPORT A 29-year-old man, who was known to have schizophrenia and was on olanzapine therapy, presented in our Emergency Department with active psychosis, and was subsequently admitted to the psychiatric ward for refractory schizophrenia. He was started on clozapine, which was cross-titrated with olanzapine. On day 20 of being treated with clozapine, he developed a high-grade fever and chest pain. EKG demonstrated new-onset prolonged QT corrected for heart rate (QTc), premature ventricular contractions, ST-T wave changes with an increased ventricular rate, and ventricular bigeminy with elevated troponin and inflammatory markers. Echocardiography showed a reduced left ventricular ejection fraction. Coronary angiography showed normal coronary arteries, low cardiac output, and cardiac index consistent with cardiogenic shock was also observed. Other pertinent laboratory results included negative respiratory viral panel, including COVID-19 PCR, negative blood cultures, and negative stool screen for ova and parasite. Clozapine was discontinued and the patient received management for heart failure with reduced ejection fraction. He improved clinically with return of EKG to normal sinus rhythm and improved left ventricular ejection fraction on repeat echocardiogram. CONCLUSIONS Acute myocarditis can occur due to a myriad of causes, both infectious and noninfectious; thus, determining the lesser-known causes, such as drug-related etiology, is essential to provide appropriate treatment for patients.
    MeSH term(s) Adult ; COVID-19 ; Clozapine/adverse effects ; Humans ; Male ; Myocarditis/chemically induced ; Myocarditis/diagnosis ; Olanzapine/adverse effects ; Schizophrenia/drug therapy ; Schizophrenia, Treatment-Resistant ; Stroke Volume ; Ventricular Function, Left
    Chemical Substances Clozapine (J60AR2IKIC) ; Olanzapine (N7U69T4SZR)
    Language English
    Publishing date 2022-07-06
    Publishing country United States
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 2517183-5
    ISSN 1941-5923 ; 1941-5923
    ISSN (online) 1941-5923
    ISSN 1941-5923
    DOI 10.12659/AJCR.936306
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Estudio piloto de las alteraciones metabólicas y síndrome metabólico inducidas por la terapia antirretroviral en pacientes con VIH del Hospital Nacional Azobispo Loayza, Lima, Perú

    Braulio M. Valencia Arroyo / Claudia P. Taramona Espinoza / Helard Manrique Hurtado

    Acta Médica Peruana, Vol 25, Iss

    2008  Volume 3

    Abstract: ... un estudio piloto de corte transversal entre noviembre del 2006 y julio del 2007 en pacientes del Servicio ...

    Abstract Introducción: la infección por el Virus de Inmunodeficiencia Humana (VIH) es unproblema importante de salud pública. Si bien la terapia antiretroviral de gran actividad (TARGA) ha mejorado la sobrevida de los pacientes, existen complicaciones metabólicas secundarias importantes. Objetivos: describir las características epidemiológicas, alteraciones metabólicas y frecuencia de síndrome metabólico en los pacientes infectados con el Virus de Inmunodeficiencia Humana (VIH) en terapia Antiretroviral así como la existencia de asociación estadística entre estas alteraciones y el esquema que reciben. Material y método: se realizó un estudio piloto de corte transversal entre noviembre del 2006 y julio del 2007 en pacientes del Servicio de Infectología del HNAL tanto varones como mujeres entre los 18 y 40 años, con diagnóstivo de infección por VIH confirmado (ELISA + Western blot), con conteo de CD4 y carga viral de no más de 6 meses de antigüedad y al menos seis meses de TARGA con esquemas definidos. Se valoró el peso, talla y perímetro abdominal, dosándose además niveles séricos en ayuno de colesterol total, HDL, LDL, triglicéridos, glicemia e insulina. Resultados: se estudiaron 36 pacientes, el 5,6 % de ellos presentaba síndrome metabólico; la hipertrigliceridemia y niveles bajos de Lipoproteína de alta densidad fueron las alteraciones metabólicas más frecuentes. Se encontró diferencia estadística al evaluar los valores de trigliceridemia y glicemia con respecto al esquema TARGA (p = 0,0094 y p = 0,0019 respectivamente) encontrándose los más altos en el Esquema III (p = 0,01 y p = 0,002 respectivamente) que incluía estavudina, lamivudina y nevirapina. Conclusiones: a hipertrigleridemia y el colesterol HDL disminuido fueron las alteraciones más frecuentes, encontrándose diferencia estadística al relacionarlos con TARGA. Es importante el hallazgo de que dichas alteraciones son mayores en pacientes recibiendo algún esquema conteniendo nevirapina, dado que este fármaco se ha usado ampliamente como sustituto de los ...
    Keywords Dislipidemia ; Hiperglicemia ; SIDA ; TARGA ; Medicine ; R
    Language English
    Publishing date 2008-09-01T00:00:00Z
    Publisher Colegio Médico del Perú
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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