Clofarabine has shown impressive response rates in patients with acute leukemias. In vitro investigations with clofarabine in combination with cyclophosphamide in primary cellshavedemonstratedsynergisticcytotoxicity and inhibition of DNA repair. Based on these clinical and laboratory observations, we designed a mechanism-based combination protocol with clofarabine and cyclophosphamide for patie...

BACKGROUND Thrombotic microangiopathy (TMA) is a serious, sometimes life-threatening disorder marked by the presence of endothelial injury and microvascular thrombi. Drug-induced thrombotic microangiopathy (DI-TMA) is one specific TMA syndrome that occurs following drug exposure via drug-dependent antibodies or direct tissue toxicity. Common examples include calcineurin inhibitors Tacrolimus an...

Clofarabine has shown impressive response rates in patients with acute leukemias. In vitro investigations with clofarabine in combination with cyclophosphamide in primary cells have demonstrated synergistic cytotoxicity and inhibition of DNA repair. Based on these clinical and laboratory observations, we designed a mechanism-based combination protocol with clofarabine and cyclophosphamide for p...

OBJECTIVE To determine whether a rapid qualitative assay for the detection of circulating endotoxin (SimpliRED Endotoxin Test [SRE]; AGEN, Inc; Brisbane, Australia) can predict the occurrence of multiorgan dysfunction and hospital mortality. To compare the SRE to the limulus amebocyte lysate (LAL) assay as a predictor of clinical outcomes. DESIGN Prospective, blinded, single-center study. S...

Melatonin, widely used to counter transatlantic travel jet lag and insomnia, is synthesized in the suprachiasmatic nucleus of the anterior pituitary gland. Its release into the circulation is stimulated by the onset of darkness, followed by a progressive decrease in blood levels with the onset of dawn. Melatonin administration can maintain the quality of sleep and help to counteract age-induced...

case presentation a 52-year-old malay gentleman, with hepatitis c virus and hiv infection was admitted to the intensive care unit for severe lactic acidosis, with concurrent escherichia coli bacteremia with multiorgan dysfunction. the patient was started on highly active antiretroviral therapy, which included tenofovir, 5 weeks before presentation. antimicrobial therapy, continuous veno-venous ...

Sepsis is the most common cause of death in critically ill patients and is associated with multiorgan failure, including acute kidney injury (AKI). This situation can require acute renal support and increase mortality. Therefore, it is essential to administer antimicrobials in doses that achieve adequate serum levels, avoiding both overdosing and drug toxicity as well as underdosing and the ris...