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https://www.readbyqxmd.com/read/28916403/a-case-of-severe-acquired-hypertriglyceridemia-in-a-7-year-old-girl
#1
Jessica S Lilley, MacRae F Linton, Jennifer C Kelley, T Brent Graham, Sergio Fazio, Hagai Tavori
We report a case of severe type I hyperlipoproteinemia caused by autoimmunity against lipoprotein lipase (LPL) in the context of presymptomatic Sjögren's syndrome. A 7-year-old mixed race (Caucasian/African American) girl was admitted to the intensive care unit at Vanderbilt Children's Hospital with acute pancreatitis and shock. She was previously healthy aside from asthma and history of Hashimoto's thyroiditis. Admission triglycerides (TGs) were 2191 mg/dL but returned to normal during the hospital stay and in the absence of food intake...
August 12, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28911514/defibrillation-for-ventricular-fibrillation-a-shocking-update
#2
REVIEW
Graham Nichol, Michael R Sayre, Federico Guerra, Jeanne Poole
Cardiac arrest is defined as the termination of cardiac activity associated with loss of consciousness, of spontaneous breathing, and of circulation. Sudden cardiac arrest and sudden cardiac death (SCD) are terms often used interchangeably. Most patients with out-of-hospital cardiac arrest have shown coronary artery disease or symptoms during the hour before the event. Cardiac arrest is potentially reversible by cardiopulmonary resuscitation, defibrillation, cardioversion, cardiac pacing, or treatments targeted at the underlying disease (e...
September 19, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28906284/effect-of-transfusion-on-mortality-and-other-adverse-events-among-critically-ill-septic-patients-an-observational-study-using-a-marginal-structural-cox-model
#3
Claire Dupuis, Maité Garrouste-Orgeas, Sébastien Bailly, Christophe Adrie, Dany Goldgran-Toledano, Elie Azoulay, Stéphane Ruckly, Guillaume Marcotte, Bertrand Souweine, Michael Darmon, Yves Cohen, Carole Schwebel, Guillaume Lacave, Lila Bouadma, Jean-Francois Timsit
OBJECTIVES: RBC transfusion is often required in patients with sepsis. However, adverse events have been associated with RBC transfusion, raising safety concerns. A randomized controlled trial validated the 7 g/dL threshold, but previously transfused patients were excluded. Cohort studies led to conflicting results and did not handle time-dependent covariates and history of treatment. Additional data are thus warranted to guide patient's management. DESIGN: To estimate the effect of one or more RBC within 1 day on three major outcomes (mortality, ICU-acquired infections, and severe hypoxemia) at day 30, we used marginal structural models...
September 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28904675/von-willebrand-s-disease-case-report-and-review-of-literature
#4
Hanae Echahdi, Brahim El Hasbaoui, Mohamed El Khorassani, Aomar Agadr, Mohamed Khattab
Von Willebrand Disease (VWD) is the most common human inherited bleeding disorder due to a defect of Von Willebrand Factor (VWF), which a glycoprotein crucial for platelet adhesion to the subendothelium after vascular injury. VWD include quantitative defects of VWF, either partial (type 1 with VWF levels < 50 IU/dL) or virtually total (type 3 with undetectable VWF levels) and also qualitative defects of VWF (type 2 variants with discrepant antigenic and functional VWF levels). The most bleeding forms of VWD usually do not concern type 1 patients with the mildest VWF defects (VWF levels between 30 and 50IU/dL)...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28901013/how-active-are-young-cardiac-device-patients-objective-assessment-of-activity-in-children-with-cardiac-devices
#5
Caridad M de la Uz, Ashley E Burch, Bruce Gunderson, Jodi Koehler, Samuel F Sears
BACKGROUND: The daily activity of pediatric patients with implantable cardiac devices provides behavioral evidence of functional outcomes. Modern devices provide continuous accelerometer data that is sensitive to movement, but normative values have not been published for pediatric activity rates. This study provides the first normative accelerometer data on activity rates in a large sample of pediatric cardiac device patients. METHODS: Patients were between 3 and 18 years old, (N = 1,905) and implanted with a cardiac device from a single device company, and enrolled in remote monitoring...
September 12, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28892428/successful-surgical-correction-of-a-mesenteric-volvulus-with-concurrent-foreign-body-obstruction-in-two-puppies
#6
Susan Jones, Steven G Friedenberg, Jason Callard, Leslie Abernathy, Julien Guillaumin
A 9 mo old female intact English mastiff (case 1) presented for anorexia and vomiting for 7 days. A 7 mo old male castrated American bulldog (case 2) presented for vomiting and anorexia for 2 days without diarrhea. Both dogs were diagnosed with mesenteric volvulus based on exploratory laparotomy, which also revealed an intestinal foreign body obstruction. Case 1 required critical care support during recovery but was ultimately discharged, whereas case 2 had an uncomplicated recovery. Both were reported to be back to normal 1 wk after surgery...
September 11, 2017: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/28887360/initial-clinical-experience-with-a-new-automated-antitachycardia-pacing-algorithm-feasibility-and-safety-in-an-ambulatory-patient-cohort
#7
Raymond Yee, John D Fisher, Ulrika Birgersdotter-Green, Timothy W Smith, David N Kenigsberg, Robert Canby, Troy Jackson, Robert Taepke, Paul DeGroot
BACKGROUND: Antitachycardia pacing (ATP) in implantable cardioverter-defibrillators (ICD) decreases patient shock burden but has recognized limitations. A new automated ATP (AATP) based on electrophysiological first principles was designed. The study objective was to assess the feasibility and safety of AATP in ambulatory ICD patients. METHODS AND RESULTS: Enrolled patients had dual chamber or cardiac resynchronization therapy ICDs, history of ≥1 ICD-treated ventricular tachycardias (VT)/ventricular fibrillation episode, or a recorded, sustained monomorphic VT...
September 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28884631/takotsubo-cardiomyopathy-associated-with-paragonimiasis-westermani
#8
Ryouhei Matsuoka, Jun Muneuchi, Yusaku Nagatomo, Daisuke Shimizu, Seigo Okada, Chiaki Iida, Hiromitsu Shirouzu, Mamie Watanabe, Yasuhiko Takahashi, Haruhiko Maruyama
An 11-year-old boy collapsed during morning assembly at his junior high school. The automated external defibrillator detected ventricular fibrillation and provided shock delivery. He was successfully resuscitated and reverted to sinus rhythm. Electrocardiography showed ST-T elevation in the precordial leads. Echocardiography and angiography demonstrated akinesia of the apex and mid-wall of the left ventricle with preserved contraction of the basal segments, which suggested Takotsubo cardiomyopathy. The patient and his family had often eaten uncooked crab, and his father had a past history of infection with Paragonimiasis westermani...
September 8, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28882472/overwhelming-streptococcus-pyogenes-sepsis-in-an-elderly-patient-with-septic-arthritis
#9
Aarti Chadha, Wafaa Jamal, Abdul Raouf Abdul Aziz, Vincent O Rotimi
INTRODUCTION: The signs of Streptococcus pyogenes, group A streptococci (GAS) bacteremia are non-specific and patients can have wide presentations ranging from flu-like symptoms to life-threatening toxic-shock syndrome in just a few hours. CASE PRESENTATION: We report a case of fulminant S. pyogenes sepsis in an elderly woman with septic arthritis and remarkable past medical history/risk factors. She was febrile, hypotensive and had a swollen and tender right knee...
September 4, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28879205/pediatric-burn-resuscitation-past-present-and-future
#10
REVIEW
Kathleen S Romanowski, Tina L Palmieri
Burn injury is a leading cause of unintentional death and injury in children, with the majority being minor (less than 10%). However, a significant number of children sustain burns greater than 15% total body surface area (TBSA), leading to the initiation of the systemic inflammatory response syndrome. These patients require IV fluid resuscitation to prevent burn shock and death. Prompt resuscitation is critical in pediatric patients due to their small circulating blood volumes. Delays in resuscitation can result in increased complications and increased mortality...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28878944/development-and-validation-of-a-clinical-risk-score-to-predict-mortality-after-percutaneous-coronary-intervention
#11
Joshua J S Wall, Javaid Iqbal, Michael Andrews, Dawn Teare, Mina Ghobrial, Thomas Hinton, Samuel Turton, Leila Quffa, Magdi El-Omar, Douglas G Fraser, Anjan Siotia, Julian Gunn
OBJECTIVE: To develop and validate a contemporary clinical risk score to predict mortality after percutaneous coronary intervention (PCI). METHODS: Using data collected from patients undergoing PCI at the South Yorkshire Cardiothoracic Centre, Sheffield, UK, between January 2007 and September 2013, a risk score was developed to predict mortality. Logistic regression was used to evaluate the effect of each variable upon 30-day mortality. A backwards stepwise logistic regression model was then used to build a predictive model...
2017: Open Heart
https://www.readbyqxmd.com/read/28878877/multiple-small-intestinal-perforations-in-a-patient-with-hepatitis-b-virus-associated-polyarteritis-nodosa
#12
Maria Isaia, Demetris Christou, Panayiotis Kallis, Panayiotis Georgiou, Nikolaos Nikolaou, Panayiotis Hadjicostas
We present the case of a 38-year-old patient with a history of Hepatitis B Virus-associated Polyarteritis Nodosa, who presented with acute abdomen and septic shock. The patient initially had three perforations of the small intestine that were treated with segmental enterectomy and anastomosis at two sites. During his postoperative course he continued to develop new perforations and necrotic lesions along the whole length of the small intestine, that mandated repetitive laparotomies and the technique of the open abdomen was employed...
March 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28871169/ancestry-molecular-evolutionary-analyses-of-heat-shock-protein-47%C3%A2-kda-hsp47-serpinh1
#13
Abhishek Kumar, Anita Bhandari, Sandeep J Sarde, Chandan Goswami
HSP47/SERPINH1 is key-regulator for collagen biosynthesis and its structural assembly. To date, there is no comprehensive study on the phylogenetic history of HSP47. Herein we illustrate the evolutionary history of HSP47/SERPINH1 along with sequence, structural and syntenic traits for HSP47/SERPINH1. We have identified ancestral HSP47/SERPINH1 locus in Japanese lamprey (Lethenteron japonicum). This gene remains on the same or similar locus for ~500 million years (MY), but chromosomal duplication was observed in ray-finned fishes, leading into three sets of three sets (I-III) of HSP47/SERPINH1...
September 4, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28867132/symbiont-dynamics-during-thermal-acclimation-using-cnidarian-dinoflagellate-model-holobionts
#14
Laura Núñez-Pons, Iacopo Bertocci, Garen Baghdasarian
Warming oceans menace reef ecosystems by disrupting symbiosis between cnidarians and Symbiodinium zooxanthellae, thus triggering bleach episodes. Temperature fluctuations promote adjustments in physiological variables and symbiont composition, which can cause stress responses, but can also yield adaptation if fitter host-symbiont homeostasis are achieved. To understand such processes manipulative studies are required, but many reef-building cnidarians pose limitations to experimental prospects. We exposed Exaiptasia anemones to Gradual Thermal Stress (GTS) and Heat Shock (HS) exposures and monitored chlorophyll and symbiont dynamics to test the phenotypic plasticity of these photosynthetic holobionts...
August 24, 2017: Marine Environmental Research
https://www.readbyqxmd.com/read/28864374/trends-in-the-incidence-and-in-hospital-outcomes-of-cardiogenic-shock-complicating-thyroid-storm
#15
Divyanshu Mohananey, Nathaniel Smilowitz, Pedro A Villablanca, Nirmanmoh Bhatia, Sahil Agrawal, Anushka Baruah, Muhammad S Ali, Sripal Bangalore, Harish Ramakrishna
BACKGROUND: Thyroid storm (TS) constitutes an endocrine emergency with an incidence of up to 10% of all admissions for thyrotoxicosis. Cardiogenic shock (CS) is a rare complication of TS and very limited data exists on its incidence and outcomes. We aimed to estimate the national trends in incidence and outcomes of CS among patients admitted to US hospitals with TS. MATERIALS AND METHODS: We queried the nationwide inpatient sample for patients with the discharge diagnosis of TS between the years of 2003 and 2011...
August 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28861302/factors-associated-with-postoperative-pain-after-retrograde-intrarenal-surgery-for-kidney-stones
#16
Ural Oğuz, Tolga Şahin, Çağrı Şenocak, Ekrem Özyuvalı, Ömer Faruk Bozkurt, Berkan Reşorlu, Ali Ünsal
OBJECTIVE: We aimed to investigate factors related to early postoperative pain after retrograde intrarenal surgery (RIRS). MATERIAL AND METHODS: A prospective data analysis of 250 patients who underwent RIRS due to kidney stones was performed. Postoperative pain was evaluated in all patients by using visual analogue scale (VAS). Patients with severe pain (VAS score ≥7) were separated and included in Group I (n=46). While patients without pain or with insignificant pain were included in Group II (n=204)...
September 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/28855396/increased-adaptive-immune-responses-and-proper-feedback-regulation-protect-against-clinical-dengue
#17
Etienne Simon-Lorière, Veasna Duong, Ahmed Tawfik, Sivlin Ung, Sowath Ly, Isabelle Casadémont, Matthieu Prot, Noémie Courtejoie, Kevin Bleakley, Philippe Buchy, Arnaud Tarantola, Philippe Dussart, Tineke Cantaert, Anavaj Sakuntabhai
Clinical symptoms of dengue virus (DENV) infection, the most prevalent arthropod-borne viral disease, range from classical mild dengue fever to severe, life-threatening dengue shock syndrome. However, most DENV infections cause few or no symptoms. Asymptomatic DENV-infected patients provide a unique opportunity to decipher the host immune responses leading to virus elimination without negative impact on an individual's health. We used an integrated approach of transcriptional profiling and immunological analysis to compare a Cambodian population of strictly asymptomatic viremic individuals with clinical dengue patients...
August 30, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28854641/conserved-transcription-factors-steer-growth-related-genomic-programs-in-daphnia
#18
Katina I Spanier, Mieke Jansen, Ellen Decaestecker, Gert Hulselmans, Dörthe Becker, John K Colbourne, Luisa Orsini, Luc De Meester, Stein Aerts
Ecological genomics aims to understand the functional association between environmental gradients and the genes underlying adaptive traits. Many genes that are identified by genome-wide screening in ecologically relevant species lack functional annotations. Although gene functions can be inferred from sequence homology, such approaches have limited power. Here, we introduce ecological regulatory genomics by presenting an ontology-free gene prioritization method. Specifically, our method combines transcriptome profiling with high-throughput cis-regulatory sequence analysis in the water fleas Daphnia pulex and Daphnia magna...
June 1, 2017: Genome Biology and Evolution
https://www.readbyqxmd.com/read/28853127/winging-of-the-scapula-diagnosed-as-parsonage-turner-syndrome-a-case-report
#19
Christine Carroll, Bill Bass
A 24-year-old active duty female Soldier complained of right shoulder burning, stinging, electrical shock-like pain with radiation to the right hand after completing a ruck march. She also complained of swelling and feelings of her cold right hand. Examination showed a deficit in the deltoid, upper trapezius, supraspinatus, and also right winging of the scapula. She also exhibited weakness to right arm, weak right hand grip, and decreased sensation over the dorsal right hand. The right hand was also noticed to be colder to touch than the left one...
July 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/28845316/acute-heart-failure-exacerbation-with-cardiogenic-shock-and-elevated-systemic-vascular-resistance-treated-with-a-combination-of-nicardipine-and-dobutamine-therapy
#20
Lydia E Issac, Setri Fugar, Naser Yamani, Burhan Mohamedali
Acute heart failure is a common reason for hospital admission and is usually caused by decreased cardiac output either as a result of an intrinsic cardiac issue or as a result of severe hypertension with elevated afterload. We present a patient with a history of HFrEF who presented with acute heart failure, found to have hypotension requiring Dobutamine support and an elevated systemic vascular resistance requiring Nicardipine drip, with subsequent recovery of cardiac function.
2017: Case Reports in Cardiology
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