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https://www.readbyqxmd.com/read/29313575/a-study-of-clinical-profile-of-patients-presenting-with-complications-of-acute-febrile-illnesses-during-monsoon
#1
Kaustubh Dilip Salagre, Ravindra Nath Sahay, Amar R Pazare, Abhishek Dubey, Kunal K Marathe
Background: The objective of this study was to describe clinico-laboratory profile and outcome of complicated acute febrile illnesses among inpatients in a tertiary care hospital during monsoon. Methods: This was an observational, prospective study conducted in a tertiary care hospital in Mumbai, India. Between July 2016 to October 2016, adult patients admitted to the hospital with complicated acute febrile illness were included. Demographic, clinical and laboratory data were collected and analyzed for each patient...
September 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29303029/the-use-of-ecmo-for-the-treatment-of-refractory-cardiac-arrest-or-postarrest-cardiogenic-shock-following-in-hospital-cardiac-arrest-a-10-year-experience
#2
Meshe Chonde, Penny Sappington, Robert Kormos, Andrew Althouse, Arthur Boujoukos
OBJECTIVES: Extracorporeal membrane oxygenation (ECMO) has been increasingly used in the treatment of refractory cardiac arrest (extracorporeal cardiopulmonary resuscitation [ECPR]) and postarrest cardiogenic shock (PACS). Our primary objective was to determine the 1-year survival of patients who were treated with ECMO for PACS or in ECPR. METHODS: We conducted a retrospective analysis of hospitalized patients in a tertiary care facility who underwent treatment with ECMO for ECPR or PACS...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29298896/mechanistic-insights-into-acephalic-spermatozoa-syndrome-associated-mutations-in-the-human-sun5-gene
#3
Yongliang Shang, Jie Yan, Wenhao Tang, Chao Liu, Sai Xiao, Yueshuai Guo, Li Yuan, Liang Chen, Hui Jiang, Xuejiang Guo, Jie Qiao, Wei Li
Acephalic spermatozoa syndrome has been reported for many decades; it is characterized by very few intact spermatozoa and tailless sperm heads in the semen and causes severe male infertility. The only gene whose mutations have been found to be associated with this syndrome encodes Sad1 and UNC84 domain-containing 5 (SUN5), a testis-specific nuclear envelope protein. The functional role of SUN5 has been well studied in mouse models, but the molecular basis for the pathogenic effects of mutations in the human SUN5 gene remain elusive...
January 3, 2018: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/29290506/thigh-emphysema-as-the-initial-presentation-of-colon-ischemia
#4
Chin-Chuan Hsu, Ping-Yuan Chen, Chih-Cheng Lai
The incidence of colon ischemia has increased in recent years, and is associated with high morbidity and mortality. The typical presentations of colon ischemia include abdominal pain, bloody diarrhea, and in severe case, ileus, fever and peritonitis. Here, we document a rare case of colon ischemia presenting with subcutaneous and intramuscular emphysema of the thigh. A 76-year-old woman presented to the emergency department for left thigh pain for three days. Physical examination revealed tenderness without obvious crepitus, erythema or swelling over the left groin area and a soft abdomen without tenderness...
December 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29276674/upfront-triple-combination-therapy-induced-pulmonary-edema-in-a-case-of-pulmonary-arterial-hypertension-associated-with-sjogren-s-syndrome
#5
Kimikazu Takeuchi, Kazuhiko Nakayama, Mitsumasa Okano, Naoki Tamada, Hideya Suehiro, Yuto Shinkura, Kenichi Yanaka, Hiroyuki Onishi, Hidekazu Tanaka, Toshiro Shinke, Noriaki Emoto, Ken-Ichi Hirata
Clinical efficacy of combination therapy using vasodilators for pulmonary arterial hypertension (PAH) is well established. However, information on its safety are limited. We experienced a case of primary Sjogren's syndrome associated with PAH where the patient developed pulmonary edema immediately after the introduction of upfront triple combination therapy. Although the combination therapy successfully stabilized her pre-shock state, multiple ground glass opacities (GGO) emerged. We aborted the dose escalation of epoprostenol and initiated continuous furosemide infusion and noninvasive positive pressure ventilation (NPPV), but this did not prevent an exacerbation of pulmonary edema...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29259861/inflammatory-fibroid-polyp-of-the-gastric-antrum-presenting-as-hypovolemic-shock-case-report-and-literature-review
#6
Kyle D Klingbeil, Alexandra Balaban, Raymond M Fertig, A Caresse Gamret, Yuna Gong, Carolyn Torres, Shevonne S Satahoo
Inflammatory fibroid polyps (IFP) are an extremely rare entity that arise within the submucosa of the gastrointestinal tract, and represent less than 0.1% of all gastric polyps. They are most commonly localized to the gastric antrum, small intestines and recto-sigmoid colon. IFPs are most commonly found incidentally upon endoscopic evaluation in the absence of symptoms. Presenting symptoms depend on the location of the tumor, although polyps located in the stomach most commonly present with epigastric pain and early satiety...
November 2017: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/29249687/male-incontinence-the-etiology-or-basis-of-treatment
#7
REVIEW
Austin G Hester, Alexander Kretschmer, Gopal Badlani
CONTEXT: Elderly men are an increasing proportion of the aging population in the 21st century. Urinary incontinence reduces the quality of life and increases the burden of care for the aging population. OBJECTIVE: The primary objective of this review is to explore the etiopathology of common causes of incontinence in aging male patients. The focus is on the algorithm of the initial evaluation of these patients from both a primary care and a urologic standpoint. EVIDENCE ACQUISITION: A nonsystematic review of the literature was performed in September 2017...
December 14, 2017: European Urology Focus
https://www.readbyqxmd.com/read/29238519/how-to-manage-anaphylaxis-in-primary-care
#8
REVIEW
Alberto Alvarez-Perea, Luciana Kase Tanno, María L Baeza
Anaphylaxis is defined as a severe life-threatening generalized or systemic hypersensitivity reaction characterized by rapidly developing airway and/or circulation problems. It presents with very different combinations of symptoms and apparently mild signs and can progress to fatal anaphylactic shock unpredictably. The difficulty in recognizing anaphylaxis is due, in part, to the variability of diagnostic criteria, which in turn leads to a delay in administration of appropriate treatment, thus increasing the risk of death...
2017: Clinical and Translational Allergy
https://www.readbyqxmd.com/read/29229737/the-superantigen-toxic-shock-syndrome-toxin-1-alters-human-aortic-endothelial-cell-function
#9
Katarina Kulhankova, Kyle J Kinney, Jessica M Stach, Françoise A Gourronc, Isabella M Grumbach, Aloysius J Klingelhutz, Wilmara Salgado-Pabón
Staphylococcus aureus infective endocarditis (IE) is a fast-progressing and tissue destructive infection of the cardiac endothelium. The superantigens (SAgs) toxic shock syndrome toxin-1 (TSST-1), staphylococcal enterotoxin C (SEC), and the enterotoxin gene cluster (egc) play a novel and essential role in the etiology of S. aureus IE. Recent studies indicate that SAgs act at the infection site to cause tissue pathology and promote vegetation growth. The underlying mechanism of SAg involvement has not been clearly defined...
December 11, 2017: Infection and Immunity
https://www.readbyqxmd.com/read/29227447/heat-shock-proteins-in-human-perilymph-implications-for-cochlear-implantation
#10
Heike Schmitt, Ariane Roemer, Carsten Zeilinger, Rolf Salcher, Martin Durisin, Hinrich Staecker, Thomas Lenarz, Athanasia Warnecke
OBJECTIVE: Biomarkers reflecting the etiology and pathophysiology of inner ear diseases are limited. Evaluation of proteins in the perilymph may improve our understanding of inner ear disease. Heat shock proteins (HSP) belong to a superfamily of stress proteins and promote refolding of denatured proteins. The aim of the study was to analyze HSP in human perilymph and to identify possible correlation with audiological and etiologic data. METHODS: Sampling of the perilymph was performed during cochlear implantation and vestibular schwannoma removal...
January 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29221681/hypercalcemic-crisis-and-primary-hyperparathyroidism-cause-of-an-unusual-electrical-storm
#11
Tatiana Guimarães, Miguel Nobre Menezes, Diogo Cruz, Sónia do Vale, Armando Bordalo, Arminda Veiga, Fausto J Pinto, Dulce Brito
Hypercalcemia is a known cause of heart rhythm disorders, however its association with ventricular arrhythmias is rare. The authors present a case of a fifty-three years old male patient with a ischemic and ethanolic dilated cardiomyopathy, and severely reduced ejection fraction, carrier of cardiac resynchronization therapy (CRT) with cardioverter defibrillator (ICD), admitted in the emergency department with an electrical storm, with multiple appropriated ICD shocks, refractory to antiarrhythmic therapy. In the etiological investigation was documented severe hypercalcemia secondary to primary hyperparathyroidism undiagnosed until then...
December 5, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29206763/association-of-clinical-hypoperfusion-variables-with-lactate-clearance-and-hospital-mortality
#12
Jessica Londoño, César Niño, James Díaz, Carlos Morales, Jimmy León, Elisa Bernal, Cesar Vargas, Leonardo Mejía, Carolina Hincapié, Johana Ascuntar, Alba León, Fabián Jaimes
BACKGROUND: lactate has shown utility in assessing the prognosis of patients admitted to the hospital with confirmed or suspected shock. Some findings of the physical examination might replace it as screening tool. We asked to determine the correlation and association between clinical perfusion parameters and lactate at the time of admission; the correlation between the change in clinical parameters and lactate clearance after 6 and 24 hours of resuscitation and; the association between clinical parameters, lactate and mortality...
December 4, 2017: Shock
https://www.readbyqxmd.com/read/29196880/role-of-intestinal-hsp70-in-barrier-maintenance-contribution-of-milk-to-the-induction-of-hsp70-2
#13
Rebecca M Rentea, Yuee Guo, Xiaorong Zhu, Mark W Musch, Eugene B Chang, David M Gourlay, Jennifer L Liedel
BACKGROUND: Necrotizing enterocolitis (NEC) is a gastrointestinal disease of complex etiology resulting in devastating systemic inflammation and often death in premature newborns. We previously demonstrated that formula feeding inhibits ileal expression of heat shock protein-70 (Hsp70), a critical stress protein within the intestine. Barrier function for the premature intestine is critical. We sought to determine whether reduced Hsp70 protein expression increases neonatal intestinal permeability...
December 1, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/29189604/2017-military-supplement-to-shock-journal-perftorantm-vidaphortm-introduction-to-western-medicine
#14
Gary W Latson
Perftoran, which has been re-branded as Vidaphorfor marketing in North America, is an emulsion of perfluorocarbons in a surfactant and electrolyte mixture. It was developed in Russia as an oxygen-carrying intravenous plasma additive for hemorrhagic anemia and ischemic conditions from various etiologies. It was approved for clinical use in Russia in 1996 and used by the Russian Armed Forces and in civilian medical care. It was also approved in Mexico from 2005 to 2010. It has been reportedly administered to over 35,000 patients with significant evidence of benefit and relatively mild and manageable adverse effects...
November 20, 2017: Shock
https://www.readbyqxmd.com/read/29177981/long-term-incidence-of-inappropriate-shocks-in-patients-with-implantable-cardioverter-defibrillators-in-clinical-practice-an-underestimated-complication
#15
Daniel Hofer, Jan Steffel, David Hürlimann, Laurent Haegeli, Thomas F Lüscher, Firat Duru, Urs Eriksson, Nazmi Krasniqi
BACKGROUND: Implantable cardioverter defibrillators (ICD) are life-saving device therapy, and patients often carry devices for decades with interim pulse generator exchanges. Inappropriate shocks are associated with impaired quality of life and increased mortality, but available data on their incidence and etiology outside of clinical trials is limited and usually restricted to the lifespan of a singular device. We hypothesized that the incidence in clinical practice is underestimated and aimed this study to retrospectively assess the long-term incidence and etiology of inappropriate shocks in a real-world cohort of patients with multiple ICDs over a long follow-up period...
November 25, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29173076/non-occlusive-mesenteric-ischemia-two-case-reports-and-a-short-review-of-the-literature
#16
Georges Versyck, Charles de Gheldere, Patrick Vanclooster
INTRODUCTION: Non-occlusive mesenteric ischemia (NOMI) is an infrequent cause of acute mesenteric ischemia with atypical symptoms and a high mortality. PATIENTS AND METHODS: We report two cases of NOMI characterized by their difference in etiology, treatment and outcome. RESULTS: In the first case, the patient developed NOMI after septic shock, she was successfully treated with surgery. The second patient experienced two episodes of cardiac arrest followed by NOMI...
November 25, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/29171458/symmetrical-peripheral-gangrene-and-tuberculosis-a-rare-kinship
#17
Tushar Patial, Kanika Sharma, Aditya Singh Jaswal, Vikrant Thakur, Sunil Negi
Symmetrical peripheral gangrene (SPG) is a rare clinical syndrome characterized by ischemic necrosis of 2 or more limbs, without involvement of large vessels. It is often associated with disseminated intravascular coagulation and septic shock. Usually caused by Gram-positive and Gram-negative organisms, tuberculosis as a cause is extremely rare. We present the case of a 46-year-old man, who initially presented with signs and symptoms suggestive of tuberculosis but later developed SPG along with septic shock after his initial visit...
October 2017: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/29169658/-symmetrical-peripheral-gangrene-4%C3%A2-cases
#18
F Smaoui, M Koubaa, K Rekik, Y Mejdoub, S Mezghani, I Maaloul, A Hammami, C Marrakchi, M Ben Jemaa
BACKGROUND: Symmetric peripheral gangrene (SPG) is a symmetrical distal ischemic lesion on at least 2 or more extremities in the absence of proximal arterial obstruction and vasculitis. It is a rare and severe clinical entity. The aim of this study was to describe clinical symptoms, etiological agents and the management of SPG through a series of 4 cases. PATIENTS AND METHODS: We included all cases of SPG hospitalized between 2000 and 2014. The inclusion criterion was the presence of distal ischemic damage at two or more sites in the absence of large vessel obstruction...
November 20, 2017: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/29140803/use-of-postmortem-computed-tomography-to-detect-bowel-obstruction-and-its-relationship-to-the-cause-of-death
#19
Dominic Gascho, Sarah Schaerli, Lucile Tuchtan-Torrents, Michael J Thali, Guillaume Gorincour
Bowel distension frequently indicates bowel obstruction, which is a common diagnosis in clinical radiology. Typically, symptoms and complaints lead to radiological examinations and the detection of the etiology. Untreated intestinal obstructions can lead to a fatal outcome through cardiac failure due to septic shock. Certain of these cases undergo medicolegal investigations depending on the case history, the condition of the decedent, the location of the finding, or recent visits to medical professionals. Computed tomography (CT) is a recommended method in clinical radiology for the detection of bowel obstruction, which is indicated by bowel distension and further radiological signs (eg, the whirl sign, which indicates a volvulus)...
November 15, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29123868/cardiocerebral-and-cardiopulmonary-resuscitation-2017-update
#20
REVIEW
Gordon A Ewy
Sudden cardiac arrest is a major public health problem in the industrialized nations of the world. Yet, in spite of recurrent updates of the guidelines for cardiopulmonary resuscitation and emergency cardiac care, many areas have suboptimal survival rates. Cardiocerebral resuscitation, a non-guidelines approach to therapy of primary cardiac arrest based on our animal research, was instituted in Tucson (AZ, USA) in 2002 and subsequently adopted in other areas of the USA. Survival rates of patients with primary cardiac arrest and a shockable rhythm significantly improved wherever it was adopted...
July 2017: Acute Medicine & Surgery
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