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https://www.readbyqxmd.com/read/28096254/factors-predicting-antibiotic-prescription-and-referral-to-hospital-for-children-with-respiratory-symptoms-secondary-analysis-of-a-randomised-controlled-study-at-out-of-hours-services-in-primary-care
#1
Ingrid Keilegavlen Rebnord, Hogne Sandvik, Anders Batman Mjelle, Steinar Hunskaar
OBJECTIVES: Acute respiratory infections and fever among children are highly prevalent in primary care. It is challenging to distinguish between viral and bacterial infections. Norway has a relatively low prescription rate of antibiotics, but it is still regarded as too high as the antimicrobial resistance is increasing. The aim of the study was to identify predictors for prescribing antibiotics or referral to hospital among children. DESIGN: Secondary analysis of a randomised controlled study...
January 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28087916/-a-case-of-idiopathic-hypertrophic-cranial-pachymeningitis-presenting-as-chronic-subdural-hematoma
#2
Zhan He, Fang Ding, Jiandong Rong, Yongli Gan
A 26-year-old male presented with a 6-day history of paroxysmal headache which was worsen with nausea and vomiting for 1 day. Head CT on admission revealed left chronic subdural hematoma with midline shift. An emergency Burr hole drainage for hematoma was performed. Headache recurred 6 days later. MRI of the brain revealed a diffuse thickening and a gadolinium-enhancement of the falx, cranial dura mater and tentorium cerebelli on the left side with pia mater involved. Lumber puncture showed increased intracranial pressure and elevated IgG level in cerebrospinal fluid...
May 25, 2016: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
https://www.readbyqxmd.com/read/28087556/ahead-study-an-observational-study-of-the-management-of-anticoagulated-patients-who-suffer-head-injury
#3
Suzanne Mason, Maxine Kuczawski, M Dawn Teare, Matt Stevenson, Steve Goodacre, Shammi Ramlakhan, Francis Morris, Joanne Rothwell
OBJECTIVES: Management of anticoagulated patients after head injury is unclear due to lack of robust evidence. This study aimed to determine the adverse outcome rate in these patients and identify risk factors associated with poor outcome. DESIGN: Multicentre, observational study using routine patient records. SETTING: 33 emergency departments in England and Scotland. PARTICIPANTS: 3566 adults (aged ≥16 years) who had suffered blunt head injury and were currently taking warfarin...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28078865/parasympathetic-nervous-system-involvement-in-food-allergy-description-of-a-paediatric-case
#4
G Vitaliti, P Pavone, G R Giugno, M Vecchio, S Cocuzza, A Serra, L Maiolino, P Di Mauro, R Lubrano, R Falsaperla
The latest research data emphasize the interaction between the nervous and the immune systems. It has been demonstrated that the central nervous system (CNS) can be involved secondarily due to blood brain barrier (BBB) disruption via pro-inflammatory cytokines released in allergy. More recently it was demonstrated that the parasympathetic nervous system (PNS) could also be equally involved in models of peripheral inflammation such as food allergy; although this last clinical presentation has rarely been described...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28074994/-normoglycemic-diabetic-ketoacidosis-in-pregnancy-report-of-one-case
#5
Margarita Rivas M, Pamela Belmar Z, Pilar Durruty A, Lilian Sanhueza M, Gloria López S
Normoglycemic diabetic ketoacidosis should be suspected in pregnant women presenting nausea, vomiting, abdominal pain and anorexia. We report a 39 years old woman with a 32 weeks pregnancy who sought emergency care due to hyperemesis. She was hospitalized with the following diagnoses: pregnancy hypertension syndrome, gestational diabetes, morbid obesity and poor prenatal control. The evaluation of the feto-placental unit showed perception of fetal movements, non-reactive non-stress baseline record and a biophysical profile of 6/8...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28072812/is-kratom-the-new-legal-high-on-the-block-the-case-of-an-emerging-opioid-receptor-agonist-with-substance-abuse-potential
#6
George C Chang-Chien, Charles A Odonkor, Prin Amorapanth
Kratom is an unscheduled opioid receptor agonist that comes in the form of dietary supplements currently being abused by chronic pain patients on prescription opioids. Active alkaloids isolated from kratom such as mitragynine and 7-hydroxymitragynine are thought to act on mu- and delta-opioid receptors as well as alpha-2 adrenergic and 5-HT2A receptors. Animal studies suggest that kratom may be more potent than morphine. Consequently, kratom consumption produces analgesic and euphoric feelings among users. In particular, some chronic pain patients on opioids take kratom to counteract the effects of opioid withdrawal...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28072475/safety-of-sulfur-hexafluoride-microbubbles-in-sonography-of-abdominal-and-superficial-organs-retrospective-analysis-of-30-222-cases
#7
Chunlin Tang, Kejing Fang, Yanli Guo, Rui Li, Xiaozhou Fan, Ping Chen, Zhaohui Chen, Qiangwei Liu, Ye Zou
OBJECTIVES: The purpose of this study was to investigate the safety of the sulfur hexafluoride microbubble contrast agent SonoVue (Bracco SpA, Milan, Italy) and to implement precautions with the intent of further improving the safety of this contrast agent. METHODS: A total of 30,222 patients undergoing contrast-enhanced sonography of abdominal and superficial organs in our hospital from January 2005 to December 2014 were retrospectively investigated. SonoVue was used as the ultrasound contrast agent...
January 10, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28069882/linea-arcuate-hernia-disguised-as-pfannenstiel-incision-s-hernia-a-case-report-and-a-systemic-literature-review
#8
Veronica Vincelli, Cesare Marazzi, Alberto Posabella, Aurore Steiger
We report a rare case of a 46-year-old woman 2 weeks after a cesarean section with Pfannenstiel incision, who presented at the Emergency Department with a significant abdominal pain accompanied by two episodes of vomiting. After that a clinical examination and an abdominal computed tomography scan were completed, a visceral herniation through Pfannenstiel incision was suspected. The indication of surgical exploration was clear. Finally, the laparotomy revealed a linea arcuata hernia with a hernia of the small intestine...
January 8, 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28067671/a-fatal-case-of-coin-battery-ingestion-in-an-18-month-old-child-case-report-and-literature-review
#9
Francesco Ventura, Sara Candosin, Rosario Barranco, Alessandro Bonsignore, Luisa Andrello, Luca Tajana, Antonio Osculati
The ingestion of extraneous substances is quite common in clinical practice; it usually befalls in the pediatric age, mostly between 6 months and 6 years. In most cases, complications do not emerge, and the prognosis is considered favorable. However, when a case of battery ingestion occurs, serious adverse events may develop. The ingestion of these components is a potential life-threatening event for children.In this article, we report the case of an 18-month-old child who died from hemorrhagic shock due to an aortoesophageal fistula caused by a 20 mm lithium button battery lodged in the esophagus...
January 7, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28060696/acute-pancreatitis-and-posterior-reversible-encephalopathy-syndrome-a-case-report
#10
Vítor Magno Pereira, Luís Marote Correia, Tiago Rodrigues, Gorete Serrão Faria
The posterior reversible encephalopathy syndrome is a neurological syndrome characterized by headache, confusion, visual disturbances and seizures associated with identifiable areas of cerebral edema on imaging studies. The authors report the case of a man, 33 years-old, leukodermic with a history of chronic alcohol and tobacco consumption, who is admitted to the emergency department for epigastric pain radiating to the back and vomiting with about six hours of evolution and an intense holocranial headache for two hours...
September 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28057014/cocktail-treatment-with-egfr-specific-and-cd133-specific-chimeric-antigen-receptor-modified-t-cells-in-a-patient-with-advanced-cholangiocarcinoma
#11
Kai-Chao Feng, Ye-Lei Guo, Yang Liu, Han-Ren Dai, Yao Wang, Hai-Yan Lv, Jian-Hua Huang, Qing-Ming Yang, Wei-Dong Han
BACKGROUND: Cholangiocarcinoma (CCA) is one of the most fatal malignant tumors with increasing incidence, mortality, and insensitivity to traditional chemo-radiotherapy and targeted therapy. Chimeric antigen receptor-modified T cell (CART) immunotherapy represents a novel strategy for the management of many malignancies. However, the potential of CART therapy in treating advanced unresectable/metastatic CCA is uncharted so far. CASE PRESENTATION: In this case, a 52-year-old female who was diagnosed as advanced unresectable/metastatic CCA and resistant to the following chemotherapy and radiotherapy was treated with CART cocktail immunotherapy, which was composed of successive infusions of CART cells targeting epidermal growth factor receptor (EGFR) and CD133, respectively...
January 5, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/28052686/henoch-sch%C3%A3-nlein-purpura-as-a-rare-cause-of-an-acute-abdomen
#12
M Davies, M Nanda Kumar, V Shetty, P Mitchell
A 52-year-old man presented with a purpuric rash affecting his legs and hypertension. He was diagnosed with Henoch-Schönlein purpura and discharged with non-steroidal anti-inflammatory drugs. Three weeks later, he presented again with loss of appetite and vomiting before developing abdominal pain with pyrexia of 38.5°C and rigors. On examination, he was hypotensive with a distended abdomen and a national early warning score of 6. Computed tomography revealed enteropathy of Henoch-Schönlein purpura. The patient deteriorated and went for an emergency laparotomy, where 30cm of ischaemic small bowel was resected...
January 4, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28050790/first-in-human-study-of-the-antibody-dr5-agonist-ds-8273a-in-patients-with-advanced-solid-tumors
#13
Andres Forero, Johanna C Bendell, Prasanna Kumar, Linda Janisch, Michael Rosen, Qiang Wang, Catherine Copigneaux, Madhuri Desai, Giorgio Senaldi, Michael L Maitland
Background DR5 is a transmembrane receptor that transduces extracellular ligand-binding to activate apoptosis signaling cascades. This phase 1 study evaluated the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics of a new monoclonal antibody potent DR5 agonist, DS-8273a, in subjects with advanced solid tumors. Methods The study comprised dose escalation and dose expansion cohorts. The dose escalation cohorts intended to determine the safety and to identify the maximum tolerated dose (MTD) or maximum administered dose (MAD) and to characterize the pharmacokinetics and pharmacodynamics by a conventional 3 + 3 design (starting at 2 mg/kg and escalating through 8, 16 and 24 mg/kg once every 3 weeks)...
January 3, 2017: Investigational New Drugs
https://www.readbyqxmd.com/read/28050438/de-garengeot-s-hernia-a-diagnostic-and-therapeutic-challenge
#14
Arun Prasath Sinraj, Nagaraja Anekal, Surag Kajoor Rathnakar
De Garengeot's hernia is an eponym for femoral hernia containing vermiform appendix as its content and is named after Rene-Jacques croissant De Garengeot after he first described the condition in 1731. We present a case of a 38-year-old woman who presented with right inguinal swelling for 15 years associated with pain and vomiting for 2 days. Clinical examination revealed an irreducible femoral hernia. Emergency surgery was done and inflamed appendix was found as content of the sac. Appendectomy followed by mesh repair was done...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28042220/internal-carotid-artery-fibromuscular-dysplasia-in-a-child-incidental-postmortem-finding-after-head-injury
#15
Arulselvi Subramanian, Garima Aggarwal, Deepak Agarwal, Sanjeev Lalwani
Fibromuscular dysplasia (FMD) is a rare, segmental, nonatheromatous, and noninflammatory arterial disease of unknown etiology. It predominantly involves renal artery (60-75%) followed by extracranial part of the internal carotid artery and vertebral arteries (25-30%). The disease typically affects middle-aged women and involves intermediate-sized arteries throughout the body. There are rare case reports of extracranial FMD compounding a trauma case. A patient was brought to trauma center emergency with a history of fall from height...
January 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28038828/do-emergency-department-patients-with-nausea-and-vomiting-desire-request-or-receive-antiemetics
#16
Adam J Singer, Greg Garra, Henry C Thode
No abstract text is available yet for this article.
December 21, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28027808/-splenic-rupture-secondary-to-abscess-rare-cause-of-pneumoperitoneum-case-report
#17
Jorge Enrique Barrón-Reyes, Julio César Chávez-Galván, Jesús Alejandro Martínez-Peralta, Julio César López-Valdés
BACKGROUND: Splenic abscesses are rare entities; reports are commonly described in immunocompromised patients (72%) as: hematologic diseases, diabetes, endocarditis, acquired immunodeficiency syndrome, transplant patients and subjects who had abdominal trauma or splenic infarction. The main and most serious complication is the abscess rupture into the peritoneal cavity or adjacent organs (stomach or colon), which determines hemodynamic instability or septic state. CLINICAL CASE: Fifty-year-old man, who was admitted at Emergency Room due eight days' progressive, oppressive, and current pain; intensity 4/10, irradiated at hemi-back, which was higher intensity during the standing and decreased at supine position...
December 24, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28018330/porcine-epidemic-diarrhea-virus-shedding-and-antibody-response-in-swine-farms-a-longitudinal-study
#18
Cristina Bertasio, Enrico Giacomini, Massimiliano Lazzaro, Simona Perulli, Alice Papetti, Antonio Lavazza, Davide Lelli, Giovanni Alborali, Maria B Boniotti
The porcine epidemic diarrhea virus (PEDV) causes an acute and highly contagious enteric disease characterized by severe enteritis, vomiting, watery diarrhea, and a high mortality rate in seronegative neonatal piglets. In the last few years, PED had a large economic impact on the swine industries in Asia and the US, and in 2014, the PEDV also re-emerged in Europe. Two main PEDV variants circulate worldwide but only the S INDEL variant, considered a mild strain, is spreading in Europe. To gain insights into the pathogenicity of this variant, its viral load and temporal shedding pattern were evaluated in piglets from infected farms...
2016: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28012337/phytobezoar-impaction-in-a-meckel-s-diverticulum-a-rare-cause-of-bowel-obstruction-case-report-and-review-of-literature
#19
Bassem Abou Hussein, Ali Khammas, Labib Al-Ozaibi, Alyaa Abdallah, Hajer Busharar, Alya Al-Mazrouei, Faisal Badri
INTRODUCTION: Meckel's diverticulum is the most common anomaly of the gastrointestinal tract, occurring in 1-3% of the general population. The most common complication of Meckel's diverticulum is intestinal obstruction. In this report, we describe a rare cause of intestinal obstruction due to Meckel's; the phytobezoar. After thorough literature review, the authors found about ten individual reports of the same topic. In all these cases, diagnosis was established intra-operatively. CASE PRESENTATION: A forty-seven-year old male presented to the emergency department with a one-day history of abdominal pain associated with vomiting and constipation...
November 3, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28012333/a-case-report-of-small-bowel-obstruction-from-previously-undiagnosed-lobular-breast-carcinoma-first-in-australian-literature
#20
Adam Thomas Cristaudo, Katherine Jing Zhu
INTRODUCTION: This case report is the first in the Australian literature of a patient, without prior diagnosis, presenting with a bowel obstruction secondary to lobular breast cancer. This highlights a relatively rare cause of bowel obstruction, but also the importance of breast self-examination as a compliment to the current BreastScreen Australia program. PRESENTATION OF CASE: A 67-year-old female presented to the Emergency Department with a 48-h history of sharp, constant epigastric pain, vomiting and constipation...
November 30, 2016: International Journal of Surgery Case Reports
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