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https://www.readbyqxmd.com/read/28638723/low-dose-methotrexate-in-sickle-cell-disease-a-pilot-study-with-rationale-borrowed-from-rheumatoid-arthritis
#1
Silvia R Brandalise, Rosemary Assis, Angelo B A Laranjeira, José Andrés Yunes, Pedro O de Campos-Lima
BACKGROUND: Inflammation is a major feature of sickle cell disease (SCD). Low-dose methotrexate (MTX) has long been used in chronic inflammatory diseases. This pilot study examined the MTX effect on acute vaso-occlusive pain crises (VOC) in SCD patients. METHODS: Fourteen adults on hydroxyurea with severe and refractory VOC received one intramuscular injection of 10 mg of MTX per week for 12 weeks. A single weekly dose of 5 mg of leucovorin was administered orally 48 h after each MTX injection...
2017: Experimental Hematology & Oncology
https://www.readbyqxmd.com/read/28634523/mallory-weiss-tear-after-violent-hiccups-a-rare-association
#2
Sankalp Dwivedi, Hussein Al-Hamid, Bradley J Warren
We present an unusual case of a 44-year-old male who developed violent hiccups soon after a ureteroscopy for nephrolithiasis; later, the forceful hiccups were followed by hematemesis. Upper esophagogastroduodenoscopy revealed Mallory-Weiss tears and esophageal erosions in the lower esophagus. Esophageal biopsy was unremarkable. The patient did not have a prior history of the gastrointestinal disorder. Although extracorporeal shock wave lithotripsy has on rare occasion been implicated in the development of gastrointestinal erosions, no such correlation exists for ureteroscopy and upper gastrointestinal bleeding in the management of nephrolithiasis...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28631879/context-dependent-effects-of-cold-stress-on-behavioral-physiological-and-life-history-traits-of-the-red-flour-beetle
#3
Inon Scharf, Keren-Or Wertheimer, Joy Lim Xin, Tomer Gilad, Inna Goldenberg, Aziz Subach
Animals are exposed in nature to a variety of stressors. While stress is generally harmful, mild stress can also be beneficial and contribute to reproduction and survival. We studied the effect of five cold shock events vs. a single cold shock and a control group, representing three levels of stress (harsh, mild, and no stress), on behavioral, physiological, and life-history traits of the red flour beetle (Tribolium castaneum, Herbst 1797). Beetles exposed to harsh cold stress were less active than a control group: they moved less and failed more frequently to detect a food patch...
June 20, 2017: Insect Science
https://www.readbyqxmd.com/read/28616176/adaptation-to-fluctuating-environments-in-a-selection-experiment-with-drosophila-melanogaster
#4
Olga I Kubrak, Sören Nylin, Thomas Flatt, Dick R Nässel, Olof Leimar
A fundamental question in life-history evolution is how organisms cope with fluctuating environments, including variation between stressful and benign conditions. For short-lived organisms, environments commonly vary between generations. Using a novel experimental design, we exposed wild-derived Drosophila melanogaster to three different selection regimes: one where generations alternated between starvation and benign conditions, and starvation was always preceded by early exposure to cold; another where starvation and benign conditions alternated in the same way, but cold shock sometimes preceded starvation and sometimes benign conditions; and a third where conditions were always benign...
June 2017: Ecology and Evolution
https://www.readbyqxmd.com/read/28599052/tccc-updates-two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#5
Frank K Butler
BACKGROUND: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of bestpractice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the US Military. METHODS: In the two ensuing decades, which included the longest continuous period of armed conflict in our nation's history, TCCC steadily evolved as the prehospital trauma care evidence base was augmented and as feedback from user medics, corpsmen, and pararescuemen was obtained...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28599038/albumin-for-prehospital-fluid-resuscitation-of-hemorrhagic-shock-in-tactical-combat-casualty-care
#6
Nicholas M Studer, Michael D April, F Bowling, Paul D Danielson, Andrew P Cap
Optimal fluid resuscitation on the battlefield in the absence of blood products remains unclear. Contemporary Combat medics are generally limited to hydroxyethyl starch or crystalloid solutions, both of which present significant drawbacks. Obtaining US Food and Drug Administration (FDA)-approved freeze-dried plasma (FDP) is a top casualty care research priority for the US Military. Interest in this agent reflects a desire to simultaneously expand intravascular volume and address coagulopathy. The history of FDP dates to the Second World War, when American expeditionary forces used this agent frequently...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28598064/emphysematous-gastritis-with-air-in-portal-venous-system
#7
Omesh Goyal, Ajesh Bansal, Prerna Goyal
Emphysematous gastritis is a rare but severe form of phlegmonous gastritis caused by gastric mucosal disruption and infection of stomach wall by gas-forming bacteria. Ingestion of corrosive substances is the most common predisposing factor, followed by alcohol abuse, abdominal surgery, diabetes and immunosuppression. Patients usually present with abdominal pain, vomiting, diarrhea, constipation and/or gastro-intestinal hemorrhage. Characteristic radiological findings include presence of gas in the gastric wall...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28591393/the-relationship-between-the-first-world-war-and-neurology-100-years-of-shell-shock
#8
José Luiz Pedroso, Stefanie C Linden, Orlando G Barsottini, Péricles Maranhão, Andrew J Lees
The First World War was a global war, beginning on 28 July 1914, until 11 November 1918. Soon after the beginning of the war, there was an "epidemic" of neurological conversion symptoms. Soldiers on both sides started to present in large numbers with neurological symptoms, such as dizziness, tremor, paraplegia, tinnitus, amnesia, weakness, headache and mutism of psychosomatic origin. This condition was known as shell shock, or "war neurosis". Because medically unexplained symptoms remain a major challenge, and considering the close relationship of symptoms described in shell shock with clinical neurology, we should study their history in order to improve future care...
May 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28591216/modification-effects-of-genetic-polymorphisms-in-fto-il-6-and-hspd1-on-the-associations-of-diabetes-with-breast-cancer-risk-and-survival
#9
Rui-Mei Zhu, Wei Lin, Wei Zhang, Jun-Ting Ren, Yi Su, Jian-Rong He, Ying Lin, Feng-Xi Su, Xiao-Ming Xie, Lu-Ying Tang, Ze-Fang Ren
The contribution of diabetes to breast cancer remains uncertain among Chinese females, which may result from different genetic factors. We evaluated the associations of diabetes, combined with the polymorphisms in the genes of fat mass and obesity-associated gene (FTO), interleukin 6 (IL-6), and heat shock protein 60 (HSPD1), with breast cancer risk and survival in a Chinese Han population. The information on the history of diabetes was collected from 1551 incident breast cancer cases and 1605 age-frequency matched controls in Guangzhou, China...
2017: PloS One
https://www.readbyqxmd.com/read/28588172/primary-angioplasty-for-the-treatment-of-acute-st-elevated-myocardial-infarction-single-centre-experience
#10
K N Khan, M H Khan, R Rahman, M A Rashid, S Z Haque, Z Zakia
Worldwide primary angioplasty is a recommended strategy of reperfusion in patient with acute myocardial infarction as because it ensures reperfusion of the infarct-related vessels more than 90% whereas, with thrombolytics it is only 60-70%. This retrospective observational study includes all patients treated with primary angioplasty at United Hospital from Between March 2007 to January 2011. Total 114 consecutive patients with acute myocardial infarction were treated with primary angioplasty included. Those presented beyond 12 hours of onset of chest pain, in cardiogenic shock, resuscitate and intubated before the procedure were excluded from the study...
April 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28585049/characteristics-and-in-hospital-outcomes-in-young-patients-presenting-with-acute-coronary-syndrome-treated-by-percutaneous-coronary-intervention
#11
Yukiho Hirota, Mitsuaki Sawano, Yohei Numasawa, Ikuko Ueda, Shigetaka Noma, Masahiro Suzuki, Kentaro Hayashida, Shinsuke Yuasa, Yuichiro Maekawa, Shun Kohsaka, Keiichi Fukuda
There is a growing interest in the optimizing care of acute coronary syndrome (ACS) in young patients, largely owing to their potential for longer life expectancy. Herein, we aimed to investigate the clinical characteristics and outcome of young ACS patients (e.g. under 60 year old) from a Japanese multicenter percutaneous coronary intervention (PCI) registry (KiCS-PCI). KiCS-PCI registered consecutive ACS patients from 15 institutions, and 1560 (24.0%) out of 6499 ACS-related PCI involved patients aged <60 years...
June 5, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28544618/a-method-for-maintaining-vascular-access-when-impella-exchange-is-required
#12
B Scott Cook, Cleve Wilson, Brooke Kaiser, Raj Baljepally
A 45-year old male with no prior cardiac history, presented with cardiogenic shock in the setting of an anterolateral ST elevation myocardial infarction. We first placed a 2.5 Impella for hemodynamic support, and proceeded with emergent percutaneous coronary intervention to the proximal LAD. Several hours following percutaneous coronary intervention (PCI), the patient became acutely hypotensive and an echocardiogram revealed the Impella catheter was kinked within the left ventricle. The patient was taken back to the cath lab for Impella adjustment; however, damage to the distal catheter required the Impella be exchanged...
May 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28543421/foreign-relations
#13
Alejandro De La Hoz, Eduardo Díaz, Max Moses Feinstein
In a large Colombian teaching hospital, a fifty-five-year-old woman complaining of stomach pain is examined by a foreign-exchange medical student from the United States. Speaking in Spanish, the student elicits a medical history that suggests a possible recurrence of gallstones, but nothing further. Upon discussing the patient's case in private with the attending physician, the student is shocked to learn that the patient is suffering from terminal, metastatic gastric cancer but is unaware of her diagnosis...
May 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28543045/colonic-or-ileocecocolic-volvulus-in-13-dogs-2005-2016
#14
Tanja Plavec, Stefan Rupp, Martin Kessler
OBJECTIVE: To describe the clinical and clinicopathological features of colonic or ileocecocolic volvulus (CV/ICV) in dogs. STUDY DESIGN: Retrospective case series. ANIMALS: Thirteen dogs with surgically confirmed CV/ICV. METHODS: Medical records were reviewed for signalment, medical history, clinical signs, laboratory data, radiographic findings, treatment, and outcome. RESULTS: All cases consisted of large-breed dogs (median weight 37...
May 20, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28542662/-dengue-with-unusual-clinical-features-in-an-infant-case-report
#15
Nina Méndez-Domínguez, Kikey Achach-Medina, Yareni María Morales-Gual, Salvador Gómez-Carro
The state of Yucatan, in Mexico, is an endemic area for dengue. During 2015, there was an unpredicted increase in the number of expected cases of dengue fever. OBJECTIVE: To describe and analyse the clinical presentation, progress, and management of a case of dengue infection with non-specific clinical manifestations in an infant which resulted in a dengue shock syndrome. CASE REPORT: One month old infant admitted to hospital with a generalised rash and a history of being bitten by an insect...
April 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28540396/-anaphylactic-reactions-to-vaccines-chicken-egg-allergy-and-the-influenza-h1n1-vaccination
#16
L Klimek, S Wicht-Langhammer, L von Bernus, C Thorn, D Cazan, O Pfaar, K Hörmann
BACKGROUND: Allergic reactions to influenza vaccinations are a well-known phenomenon; however, only a few published statistics give information on the risks. Patients with a chicken egg allergy must be particularly carefully handled during an influenza epidemic where vaccines produced using embryonated chicken eggs are primarily employed. METHODS: A selective literature review and analysis of the problem of allergic reactions to vaccinations was performed. RESULTS: The two most common relative contraindications among patients to be vaccinated are the presence of an egg allergy and a previous anaphylactic reaction to vaccination...
May 24, 2017: HNO
https://www.readbyqxmd.com/read/28537090/-i-think-a-little-bit-of-a-kick-is-sometimes-what-you-need-women-s-accounts-of-whole-body-scanning-and-likely-impact-on-health-related-behaviours
#17
Sarah Grogan, Mariyah A Siddique, Simeon Gill, Kathryn Brownbridge, Emma Storey, Christopher J Armitage
OBJECTIVE: This study was designed to investigate whether whole-body scanning might promote healthy eating and physical activity in women, and to explore the effects of scanning on body image. DESIGN: Fourteen women aged 22-45 years without histories of eating disorders or whole-body scanning took part in semi-structured interviews before and after scanning. Data were analysed using inductive thematic analysis. RESULTS: Scans did not look as expected, and participants expressed 'surprise' and 'shock'...
May 24, 2017: Psychology & Health
https://www.readbyqxmd.com/read/28536660/sorafenib-associated-heart-failure-complicated-by-cardiogenic-shock-after-treatment-of-advanced-stage-hepatocellular-carcinoma-a-clinical-case-discussion
#18
Candace Wu, Kamal Shemisa
Background. Sorafenib, an oral tyrosine kinase inhibitor (TKI), targets multiple tyrosine kinase receptors (TKRs) involved in angiogenesis and tumor growth. Studies suggest that inhibition of TKR impacts cardiomyocyte survival. Inhibition of VEGF signaling interrupts angiogenesis and is associated with the development of hypertension and compensatory hypertrophy. Compensated hypertrophy ultimately leads to heart failure. Case Description. A 76-year-old man with a past medical history of systolic heart failure due to ischemic cardiomyopathy and stage IIIC hepatocellular carcinoma (HCC) presented with symptoms of decompensated heart failure...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28536215/sesamoid-osteonecrosis-treated-with-radial-extracorporeal-shock-wave-therapy
#19
Dawn Thompson, Nikos Malliaropoulos, Nat Padhiar
Sesamoid osteonecrosis is a disabling condition resulting in severe forefoot pain, for which there are limited treatment options. We present a 52-year-old man with 1-year history of pain, aggravated by walking and playing tennis. On examination, pain was localised to plantar aspect of the first metatarsophalangeal joint. Imaging revealed evolving end-stage avascular necrosis of lateral sesamoid with early secondary degenerative changes. Previous exhaustive conservative treatment had been unsuccessful in alleviating his pain...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28533998/ipilimumab-as-a-cause-of-severe-pan-colitis-and-colonic-perforation
#20
Raj Shah, Danielle Witt, Talal Asif, Fahad F Mir
Ipilimumab is a human monoclonal antibody that functions as a cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor that is used to treat malignant melanoma. Due to ipilimumab's removal of immune regulation, specifically through the inactivation of CTLA-4, it is commonly associated with inflammatory and autoimmune events. Gastrointestinal (GI) related immune-related adverse events such as diarrhea occur in 29% of patients with 7.6% of patients specifically suffering from colitis. We describe a case of colonic perforation with ipilimumab use...
April 20, 2017: Curēus
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