Archives

Volume 4 Number 4 April 2018

Fatal Bilateral Strokes in a Child With Hemolytic Uremic Syndrome- A Potential Therapeutic Role of Eculizumab


Authors: Geetanjali S. Rathore M. D. ; Paul D. Larsen M. D.
Pages: 49-53
Abstract
Background: HUS is a life-threatening multisystem disease caused by uncontrolled complement activation. About 25 % of patients have CNS (Central nervous system) involvement, often leading to serious long-term disabilities in young children. Eculizumab, a humanized monoclonal antibody that targets the complement protein C5, has shown to improve the disease course in children with better neurological outcomes. Early use in disease course showed much better results and its potential use as a prophylactic therapy has been indicated. Scoring systems have been developed for prediction of CNS complications, which may help identify potential candidates for prophylactic Eculizumab therapy. Presentation:  We present a 3 year old child who presented with Shiga-Toxin Producing E coli Hemolytic-Uremic Syndrome (STEC-HUS) and seizures. One week into hospitalization he suddenly became unresponsive besides withdrawal to pain. Brain MRI revealed multifocal infarcts involving bilateral basal ganglia, thalami, dorsal brainstem, and cerebellar white matter with microhemorrhages. He was started on Eculizumab in an attempt to halt neurological decline.  In spite of starting Eculizumab therapy, our patient succumbed to a fatal cardiac arrest. Based on the SCWP ( sodium, CSR, white count and protein) scoring system our patient was at very high risk for developing neurological sequelae even at initial presentation. His therapy was not started until very late in the course of the disease which may have led to the unfavorable outcome Conclusion: Ecluzimab therapy should be initiated early in HUS patients with CNS involvement. Scoring systems may help identify at risk patients and potentially start prophylactic Eculizumab therapy to achieve improved neurological outcomes in children.


Design and Implementation of a New Wifi-Based Intelligent Alarm Device for the Elderly Bed-Wetting


Authors: Fen Lv ; Xu Liu ; Jing Gao ; Kun Fu ; Lin Miao ; Shun He ; Longcong Chen
Pages: 42-48
Abstract
In order to meet the needs of the real-time monitoring for the elderly bed-wetting and night sweats, we designed a new alarm device. In this device, conductive wire array sensor, made by ourselves, is applied to sense body fluid and urine of the elderly. And the single-chip is used to simultaneously realize mobile phone alarm and bedside alarm. Furthermore, nurses and relatives can be informed in the first time by this device and make corresponding treatment. Therefore, the device has the advantages of low cost, convenient use, strong practicality and so on.