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Clinical Medicine & Research

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https://www.readbyqxmd.com/read/27777245/subacute-sclerosing-panencephalitis-in-a-child-with-hiv-co-infection
#1
Pradeep Kumar Maurya, Mayur Deepak Thakkar, Dinkar Kulshreshtha, Ajai Kumar Singh, Anup Kumar Thacker
Subacute sclerosing panencephalitis is a fatal infectious disease of childhood caused by persistence of the measles virus in the brain. The effect of human immunodeficiency virus (HIV) co-infection on subacute sclerosing panencephalitis remains elusive and rare. We report a child who developed subacute sclerosing panencephalitis following a short latency period and a rapidly progressive course with HIV co-infection.
October 24, 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/27630187/dietary-nitrate-acutely-and-markedly-increased-exhaled-nitric-oxide-in-a-cystic-fibrosis-case
#2
Conor P Kerley, Emma Kilbride, Peter Greally, Basil Elnazir
Airway nitric oxide (NO) is a ubiquitous signaling molecule with bronchoprotective, anti-inflammatory and anti-infective roles. Cystic fibrosis (CF) is a chronic lung condition associated with deceased exhaled NO. Strategies to increase exhaled NO in CF have yielded inconsistent results. A potential new method of increasing systemic NO involves ingestion of dietary, inorganic nitrate which is reduced to nitrite and NO. We present the case of a 12 year-old, athletic male with CF who demonstrated acute but marked increases in exhaled NO following dietary nitrate consumption compared to placebo...
September 14, 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/27573534/immune-mediated-necrotizing-myopathy-a-cause-of-isolated-myopathy-of-neck-extensor-muscle
#3
Rahul Sehgal, Rafael Medina-Flores, Ralph Yachoui, Charles Kenney
Immune mediated necrotizing myopathy (IMNM) is a unique form of myositis that is characterized by distinct muscle biopsy features including abundant myofiber necrosis, degeneration, and regeneration with only minimal, if any, inflammation on muscle biopsy. IMNM is clinically similar to idiopathic inflammatory myopathy (IIM); hence, muscle biopsy is essential to diagnose IMNM. Herein we describe a case of neck extensor weakness due to necrotizing myopathy. Isolated weakness of the neck extensor muscles is uncommon in IIM and IMNM...
August 29, 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/27565514/developing-research-priorities-for-prediction-and-prevention-of-preterm-birth
#4
William A Agger, Charles W Schauberger, James K Burmester, Sanjay K Shukla
No abstract text is available yet for this article.
August 26, 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/27503793/adverse-child-experiences-and-health-in-adulthood-in-a-rural-population-based-sample
#5
Kristen C Iniguez, Rachel V Stankowski
BACKGROUND: Adverse childhood experiences (ACEs), including emotional abuse, substance abuse in the household, separation or divorce, physical abuse, violence between adults, mental illness in the household, sexual abuse, or incarceration of a household member, have the potential to profoundly impact health and well-being in adulthood. To assess whether previously reported relationships between ACEs and health outcomes withstand validation, we conducted a community-based ACE study with the unique capacity to link self-reported ACEs and other survey results to validated health data in an electronic medical record (EMR)...
August 8, 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/27401794/bowel-in-chest-type-iv-hiatal-hernia
#6
William Krause, Jennifer Roberts, Romel J Garcia-Montilla
No abstract text is available yet for this article.
June 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/27256549/urological-procedures-in-urolithiasis-and-their-association-with-chronic-kidney-disease
#7
Matthew D'Costa, Radmila Savcic-Kos, Jingbo Huang, Andrew D Rule, Narayana Murali
BACKGROUND AND OBJECTIVES: Epidemiological evidence suggests that patients with urolithiasis are at increased risk for end-stage renal disease (ESRD). It is unclear if urological intervention impacts the progression of chronic kidney disease (CKD). METHODS: We conducted a retrospective observational cohort study of patients in the Marshfield Epidemiologic Study Area database between January 1991 and May 2007, where 1,340 patients diagnosed with urolithiasis were extracted...
June 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/27231118/central-venous-access-device-related-bacillus-cereus-endocarditis-a-case-report-and-review-of-the-literature
#8
William F Wright
Bacillus cereus typically presents as a gastrointestinal infection, but rarely manifests as systemic disease. This report describes a case of B. cereus-related endocarditis that presented as a sickle cell crisis and bacteremia. Initial clinical suspicion was for laboratory contamination of blood cultures. The case herein described is intended to demonstrate an uncommon presentation of B. cereus infection and highlights the value of an aggressive need to further investigate and interpret unexpected blood culture findings in clinical practice, early adequate antimicrobial therapy, prompt diagnosis, and consideration to urgent surgical interventions in such cases...
June 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/27231117/biochemical-testing-of-the-thyroid-tsh-is-the-best-and-oftentimes-only-test-needed-a-review-for-primary-care
#9
REVIEW
Michael T Sheehan
Disorders of thyroid function are common, and screening, diagnosis, and management are often performed by primary care providers. While management of significant biochemical abnormalities is reasonably straight forward, laboratory tests only slightly outside, or even within, the normal range are becoming more difficult to appropriately manage. A large part of this increasing difficulty in appropriate management is caused by patients requesting, and even demanding, certain tests or treatments that may not be indicated...
June 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/27231116/comparison-of-two-types-of-insoles-on-musculoskeletal-symptoms-and-plantar-pressure-distribution-in-a-work-environment-a-randomized-clinical-trial
#10
Josiane S Almeida, Franciele M Vanderlei, Eliane C Pastre, Rodrigo A D M Martins, Carlos R Padovani, Guaracy C Filho
BACKGROUND: The aim of the present study was to assess plantar pressure distribution and musculoskeletal symptoms following the use of customized insoles among female assembly line workers. METHODS: The study included 29 female assembly line workers (age, 29.76 ± 5.79 years; weight, 63.79 ± 12.11 kg) with musculoskeletal symptoms who work predominantly while standing. The Nordic Musculoskeletal Questionnaire was administered to the study population. Plantar pressure was determined using a computerized plantar pressure feedback system...
June 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/27231115/sitosterolemia-presenting-as-pseudohomozygous-familial-hypercholesterolemia
#11
Christian Renner, William E Connor, Robert D Steiner
A young girl, age 8.5 years, presented with profound hypercholesterolemia and early xanthomatosis, suggesting homozygous familial (or type II) hypercholesterolemia. The patient's low density lipoprotein (LDL) receptor function and parental lipoprotein profiles were determined to be normal, prompting revision of the initial diagnosis to pseudohomozygous familial hypercholesterolemia. When she subsequently presented with giant platelets, the case was presented to colleagues on an electronic mailing list. It was recommended that plasma and sterol analysis be performed, which led to a diagnosis of sitosterolemia...
June 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/26864506/the-stomatological-complications-of-diamond-blackfan-anemia-a-case-report
#12
Rita Fabiane Teixeira Gomes, Maria Cristina Munerato
Diamond-Blackfan Anemia (DBA) is a rare heterogeneous genetic disease characterized by severe anemia, reduction or absence of erythroid progenitors, and pro-apoptoptic hematopoiesis, which culminates in bone marrow failure. The disease generally manifests in infancy, as craniofacial, cardiac, genitourinary, and upper limb congenital anomalies. Therapy with corticoids is the treatment of choice, while blood transfusion is adopted during diagnosis and as a chronic approach if the patient does not respond to corticoids...
June 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/26864509/web-camera-use-in-the-neonatal-intensive-care-unit-impact-on-nursing-workflow
#13
Aditya Joshi, Po-Huang Chyou, Zoya Tirmizi, Jody Gross
BACKGROUND: Many neonatal intensive care units (NICU) are using web camera systems to allow virtual visitation of the infant by family members. Generally, families appreciate the web camera and utilize this service. However, no one has looked into the change on nursing workload after implementation of a web camera. OBJECTIVE: This study was designed to explore the perception of nurses and their workflow and identify determinants that may disrupt or facilitate the use of a commercially available camera service...
March 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/26864508/oral-manifestations-of-inflammatory-bowel-diseases-two-case-reports
#14
Manoela Seadi Pereira, Maria Cristina Munerato
Inflammatory bowel diseases (IBD) are known as chronic inflammatory disorders of the digestive tract, represented mainly by Crohn's disease (CD) and ulcerative colitis (UC). Among the main oral manifestations of IBD are cobblestoning of the oral mucosa, labial swellings with vertical fissures, pyostomatitis vegetans, angular cheilitis, perioral erythema, and glossitis. In this sense, understanding these nosological entities by dentists would help reach early and differential diagnosis. Thus, two case reports are presented and discussed based on theoretical references obtained by a literature review...
March 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/26864507/transient-hypothyroidism-after-radioiodine-for-graves-disease-challenges-in-interpreting-thyroid-function-tests
#15
Michael T Sheehan, Suhail A R Doi
Graves' disease is the most common cause of hyperthyroidism and is often managed with radioactive iodine (RAI) therapy. With current dosing schemes, the vast majority of patients develop permanent post-RAI hypothyroidism and are placed on life-long levothyroxine therapy. This hypothyroidism typically occurs within the first 3 to 6 months after RAI therapy is administered. Indeed, patients are typically told to expect life-long thyroid hormone replacement therapy to be required within this timeframe and many providers expect this post-RAI hypothyroidism to be complete and permanent...
March 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/26847482/trousseau-s-syndrome-in-cholangiocarcinoma-the-risk-of-making-the-diagnosis
#16
Matthew F Blum, Vincent Y Ma, Anthony M Betbadal, Robert A Bonomo, Rajeeva R Raju, Clifford D Packer
We report a case of Trousseau's syndrome with cholangiocarcinoma complicated by a fatal pulmonary embolism after liver biopsy. A 69-year-old man who presented with right upper quadrant pain was found to have portal vein thrombosis and nonspecific liver hypodensities after imaging by computerized tomography. Following four days of anticoagulation, heparin was held for percutaneous liver biopsy. After the biopsy, he developed acute hepatic failure, acute kidney injury, lactic acidemia, and expired. Autopsy revealed intrahepatic cholangiocarcinoma and a pulmonary embolism...
March 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/26847481/hypoxia-the-force-that-drives-chronic-kidney-disease
#17
REVIEW
Qiangwei Fu, Sean P Colgan, Carl Simon Shelley
In the United States the prevalence of end-stage renal disease (ESRD) reached epidemic proportions in 2012 with over 600,000 patients being treated. The rates of ESRD among the elderly are disproportionally high. Consequently, as life expectancy increases and the baby-boom generation reaches retirement age, the already heavy burden imposed by ESRD on the US health care system is set to increase dramatically. ESRD represents the terminal stage of chronic kidney disease (CKD). A large body of evidence indicating that CKD is driven by renal tissue hypoxia has led to the development of therapeutic strategies that increase kidney oxygenation and the contention that chronic hypoxia is the final common pathway to end-stage renal failure...
March 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/26847480/healthcare-workers-emotions-perceived-stressors-and-coping-strategies-during-a-mers-cov-outbreak
#18
Imran Khalid, Tabindeh J Khalid, Mohammed R Qabajah, Aletta G Barnard, Ismael A Qushmaq
OBJECTIVE: Healthcare workers (HCWs) are at high risk of contracting Middle East respiratory syndrome coronavirus (MERS-CoV) during an epidemic. We explored the emotions, perceived stressors, and coping strategies of healthcare workers who worked during a MERS-CoV outbreak in our hospital. DESIGN: A cross-sectional descriptive survey design. SETTING: A tertiary care hospital. PARTICIPANTS: HCWs (150) who worked in high risk areas during the April-May 2014 MERS-CoV outbreak that occurred in Jeddah, Saudi Arabia...
March 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/26387709/rare-case-of-vasculitis-of-the-hepatic-artery
#19
Padmavathi Mali, Sudheer R Muduganti, Jerry Goldberg
Vasculitis is an accumulation of inflammatory leucocytes in the blood vessels with reactive damage to mural structures. Isolated vasculitis of the gastrointestinal tract without systemic involvement is rare. We report a unique case of a female patient who presented with abdominal pain, and was found, on serology, to have elevated inflammatory markers without autoantibodies. A computed tomography scan of the abdomen and pelvis was suggestive of vasculitis of the hepatic artery. To the best of our knowledge, this is the first case, to date, of vasculitis of hepatic artery...
December 2015: Clinical Medicine & Research
https://www.readbyqxmd.com/read/26387708/understanding-decision-making-in-critical-care
#20
REVIEW
Geoffrey K Lighthall, Cristina Vazquez-Guillamet
BACKGROUND: Human decision making involves the deliberate formulation of hypotheses and plans as well as the use of subconscious means of judging probability, likely outcome, and proper action. RATIONALE: There is a growing recognition that intuitive strategies such as use of heuristics and pattern recognition described in other industries are applicable to high-acuity environments in medicine. Despite the applicability of theories of cognition to the intensive care unit, a discussion of decision-making strategies is currently absent in the critical care literature...
December 2015: Clinical Medicine & Research
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