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https://www.readbyqxmd.com/read/28936072/alleviating-stress-response-to-tracheal-extubation-in-neurosurgical-patients-a-comparative-study-of-two-infusion-doses-of-dexmedetomidine
#1
Ankur Luthra, Hemanshu Prabhakar, Girija Prasad Rath
BACKGROUND: Tracheal extubation is almost always associated with increase in sympathoadrenal activity may result in hypertension, tachycardia, and arrhythmias. Attempts have been made to oppose the pressor response by the use of various drugs. Dexmedetomidine decreases norepinephrine which reduces the blood pressure and the heart rate (HR). We hypothesize that the infusion of dexmedetomidine may produce more stable hemodynamics during extubation as compared to boluses. MATERIALS AND METHODS: Ninety adult patients aged 18-65 years, the American Society of Anesthesiologists Grade I-II undergoing intracranial surgeries for various neurologic problem at All India Institute of Medical Sciences were enrolled in this randomized controlled trial...
August 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28932257/a-novel-method-for-multiple-bowel-injuries-a-pilot-canine-experiment
#2
Jun Ke, Weihang Wu, Nan Lin, Weijin Yang, Zhicong Cai, Wei Wu, Dongsheng Chen, Yu Wang
BACKGROUND: Intestinal ligation is the cornerstone for damage control in abdominal emergency, yet it may lead to bowel ischemia. Although intestinal ligation avoids further peritoneal cavity pollution, it may lead to an increased pressure within the bowel segments and rapid bacterial translocation. In this study, we showed that severed intestine could be readily reconnected by using silicon tubes and be secured by using rubber bands in a canine model. METHODS: Adult Beagle dogs, subject to multiple intestinal transections and hemorrhagic shock by exsanguination, randomly received conventional ligation vs...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28930006/fatal-rocky-mountain-spotted-fever-along-the-united-states-mexico-border-2013-2016
#3
Naomi A Drexler, Hayley Yaglom, Mariana Casal, Maria Fierro, Paula Kriner, Brian Murphy, Anne Kjemtrup, Christopher D Paddock
Rocky Mountain spotted fever (RMSF) is an emerging public health concern near the US-Mexico border, where it has resulted in thousands of cases and hundreds of deaths in the past decade. We identified 4 patients who had acquired RMSF in northern Mexico and subsequently died at US healthcare facilities. Two patients sought care in Mexico before being admitted to US-based hospitals. All patients initially had several nonspecific signs and symptoms, including fever, headache, nausea, vomiting, or myalgia, but deteriorated rapidly without receipt of a tetracycline-class antimicrobial drug...
October 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28926507/point-of-care-ultrasound-could-streamline-the-emergency-department-workflow-of-clinically-nonspecific-intussusception
#4
Jung Heon Kim, Jeong-Yong Lee, Jae Hyun Kwon, Hyung-Rae Cho, Jong Seung Lee, Jeong-Min Ryu
OBJECTIVES: The aim of this study was to evaluate whether point-of-care ultrasound (POCUS) for intussusception screening streamlines the workflow of clinically nonspecific intussusception (CNI), an intussusception presenting with only 1 manifestation of the classic triad, and/or vomiting. METHODS: We reviewed 274 consecutive children with intussusception, aged 6 years or younger, who visited a tertiary care hospital emergency department between May 2012 and April 2016...
September 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28923678/a-case-report-on-gastric-volvulus-of-a-17-years-old-boy-from-bangladesh
#5
M Tasdik Hasan, S M Tajdit Rahman, Hasan M Shihab, Hassan Rushekh Mahmood, Tanni Chowdhury, Quamrul Akhtar Sanju
INTRODUCTION: Gastric volvulus is a rare and true surgical emergency which is life threatening if not recognized and treated quickly. There have been approximately 300 reported cases globally till now. This condition most often occurs during 5th decade of life but there are over 100 reported pediatric cases also. This following rare incidence was such a case of a young patient in Bangladesh. It was the first case of gastric volvulus managed by the surgery department of the concerned hospital...
September 7, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28916971/emergency-room-visits-and-readmissions-following-implementation-of-an-enhanced-recovery-after-surgery-ieras-program
#6
Trevor Wood, Mary-Anne Aarts, Allan Okrainec, Emily Pearsall, J Charles Victor, Marg McKenzie, Ori Rotstein, Robin S McLeod
BACKGROUND: Enhanced Recovery After Surgery (ERAS) guidelines have been widely promoted and supported largely due to several studies showing decreased post-operative complications and length of stay. The objective of this study was to review the emergency room (ER) visits and readmission rates and reasons for both in patients who were part of the Implementation of an Enhanced Recovery After Surgery (iERAS) program for colorectal surgery. METHODS: All patients having elective colorectal surgery at 15 academic hospitals were enrolled in the iERAS program...
September 15, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28910926/-survey-on-a-public-health-emergency-event-caused-by-norovirus
#7
Y Xing, C Jiang, W Y Hua, F Liu, Z Zhao, Y J Ding, L Wang, J Li
Objective: To study the epidemiological characteristics of an outbreak caused by norovirus infection in a school in Haidian district, Beijing. Methods: Basic information of the school and data related to patients in the fields survey were collected and analyzed descriptively. Laboratory tests were performed to test the stool and anal swab specimens of both patients and cooks as well as the environmental specimens. Risk factors related to the incidence were analyzed through a case-control study. Results: A total number of 119 patients were identified in the school...
September 10, 2017: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
https://www.readbyqxmd.com/read/28906561/bioequivalence-of-intravenous-and-oral-rolapitant-results-from-a-randomized-open-label-pivotal-study
#8
Xiaodong Wang, Zhi-Yi Zhang, Daniel Powers, Jing Wang, Sharon Lu, Sujata Arora, Lorraine Hughes, Jennifer Christensen, Vikram Kansra
Rolapitant, a selective and long-acting neurokinin-1 receptor antagonist, is approved in an oral formulation for the prevention of delayed chemotherapy-induced nausea and vomiting in adults. The objective of this pivotal study was to assess the bioequivalence of a single intravenous infusion of rolapitant versus a single oral dose of rolapitant. In this randomized, open-label phase 1 study, healthy volunteers were administered rolapitant as a 180-mg oral dose or a 30-minute 166.5-mg intravenous infusion. Blood samples for pharmacokinetic analysis were collected predose and at points up to 912 hours postdose...
September 14, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28906253/latest-insights-on-food-protein-induced-enterocolitis-syndrome-an-emerging-medical-condition
#9
REVIEW
L Vila Sexto
Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated gastrointestinal food hypersensitivity, characterized by profuse vomiting, frequently associated to pallor or/and lethargy that appears within 1 to 3 hours after ingestion of the offending food. There is a less frequent chronic form of FPIES, presenting with protracted vomiting, diarrhea or both, accompanied by poor growth. Although FPIES is considered a rare allergic disorder, in the last few years there have been an increasing number of reports about it indicating if not a real increase in incidence, at least an increased awareness of this condition by pediatricians...
August 29, 2017: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/28895149/efficacy-of-dexmedetomidine-for-perioperative-morbidities-in-pediatric-tonsillectomy-a-metaanalysis
#10
REVIEW
Hye Kyung Cho, Ho Young Yoon, Ho Jun Jin, Se Hwan Hwang
OBJECTIVES: This study aimed to assess the effects of perioperative dexmedetomidine as an adjuvant to tonsillectomy compared with opioid or sham in children. DATA SOURCE: Five databases (PubMed, SCOPUS, Embase, Web of Science, and Cochrane Central Register of Controlled Trials) were searched from inception of article collections to April 2017. REVIEW METHODS: Prospective, randomized controlled studies that compared outcomes between children who underwent tonsillectomy plus dexmedetomidine administration (intervention) and children who underwent tonsillectomy with placebo or opioid (control) were systemically and independently reviewed by two researchers...
September 12, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28888914/acute-diffuse-peritonitis-due-to-spontaneous-rupture-of-a-primary-gastrointestinal-stromal-tumor-of-the-jejunum-a-case-report
#11
Koki Sato, Hirofumi Tazawa, Seiji Fujisaki, Sotaro Fukuhara, Koki Imaoka, Yuzo Hirata, Mamoru Takahashi, Saburo Fukuda, Yoshio Kuga, Toshihiro Nishida, Hideto Sakimoto
INTRODUCTION: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Overt peritonitis caused by GIST rupture is very uncommon. Three types of GIST rupture have been described: closed perforation due to abscess (abscess type), hemoperitoneum leading to rupture of the hematoma capsule in the tumor (hemoperitoneum type), and perforation of the digestive tract via a fistula leading to central necrosis of the tumor (bowel perforation type)...
August 23, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28882877/clinical-pathway-produces-sustained-improvement-in-acute-gastroenteritis-care
#12
Lori Rutman, Eileen J Klein, Julie C Brown
BACKGROUND AND OBJECTIVES: Despite widespread use of the rotavirus vaccine in the last decade, dehydrating illnesses impact almost 2 billion children worldwide annually. Evidence supports oral rehydration therapy as a first-line treatment of mild to moderate dehydration. Ondansetron has proven to be a safe and effective adjunct in children with vomiting. We implemented a clinical pathway in our pediatric emergency department (ED) in January 2005 to improve care for this common condition...
September 7, 2017: Pediatrics
https://www.readbyqxmd.com/read/28882436/antitumor-activity-and-safety-of-the-parp-inhibitor-rucaparib-in-patients-with-high-grade-ovarian-carcinoma-and-a-germline-or-somatic-brca1-or-brca2-mutation-integrated-analysis-of-data-from-study-10-and-ariel2
#13
Amit M Oza, Anna V Tinker, Ana Oaknin, Ronnie Shapira-Frommer, Iain A McNeish, Elizabeth M Swisher, Isabelle Ray-Coquard, Katherine Bell-McGuinn, Robert L Coleman, David M O'Malley, Alexandra Leary, Lee-May Chen, Diane Provencher, Ling Ma, James D Brenton, Gottfried E Konecny, Cesar M Castro, Heidi Giordano, Lara Maloney, Sandra Goble, Kevin K Lin, James Sun, Mitch Raponi, Lindsey Rolfe, Rebecca S Kristeleit
OBJECTIVE: An integrated analysis was undertaken to characterize the antitumor activity and safety profile of the oral poly(ADP-ribose) polymerase inhibitor rucaparib in patients with relapsed high-grade ovarian carcinoma (HGOC). METHODS: Eligible patients from Study 10 (NCT01482715) and ARIEL2 (NCT01891344) who received a starting dose of oral rucaparib 600mg twice daily (BID) with or without food were included in these analyses. The integrated efficacy population included patients with HGOC and a deleterious germline or somatic BRCA1 or BRCA2 (BRCA1/2) mutation who received at least two prior chemotherapies and were sensitive, resistant, or refractory to platinum-based chemotherapy...
September 4, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28881493/safety-tolerability-and-pharmacokinetics-of-therapeutic-and-supratherapeutic-doses-of-tramadol-hydrochloride-in-healthy-adults-a-randomized-double-blind-placebo-controlled-multiple-ascending-dose-study
#14
Byron DeLemos, Henry M Richards, Joris Vandenbossche, Jay Ariyawansa, Jaya Natarajan, Binu Alexander, Tage Ramakrishna, Thomas Murtaugh, Hans-Jürgen Stahlberg
This randomized, double-blind, parallel-group multiple-ascending-dose study evaluated the safety, tolerability, and pharmacokinetics of tramadol hydrochloride in healthy adults to inform dosage and design for a subsequent QT/QTc study. Healthy men and women, 18 to 45 years old (inclusive), were sequentially assigned to the tramadol 200, 400, or 600 mg/day treatment cohort and within each cohort, randomized (4:1) to either tramadol or placebo every 6 hours for 9 oral doses. Of the 24 participants randomized to tramadol (n = 8/cohort), 22 (91...
September 7, 2017: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/28881334/antegrade-jejunojejunal-intussusception-inside-a-retrograde-jejunogastric-intussusception-double-intussusception-a-rare-case-report
#15
Samson Ravirajendran, Sinduja Munnamgi, Akmal Abdul
INTRODUCTION: Jejunogastric intussusception through a gastrojejunal stoma along with a jejunojejunal intussusception (intussusception within an intussusception) is a rare but serious complication of previous gastric surgery such as gastrojejunostomy and Billroth II gastrectomy. The incidence of which is less than 0.1%. CASE PRESENTATION: An elderly male presented with an abdominal lump, diffuse abdominal pain and vomiting for one-day duration. Ultrasound and CECT abdomen revealed dilated stomach with jejunojejunal intussusception herniating into stomach...
August 24, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28872734/xenon-as-an-adjuvant-to-sevoflurane-anesthesia-in-children-younger-than-4%C3%A2-years-of-age-undergoing-interventional-or-diagnostic-cardiac-catheterization-a-randomized-controlled-clinical-trial
#16
Sarah Devroe, Roselien Meeusen, Marc Gewillig, Bjorn Cools, Koen Poesen, Robert Sanders, Steffen Rex
BACKGROUND: Xenon has repeatedly been demonstrated to have only minimal hemodynamic side effects when compared to other anesthetics. Moreover, in experimental models, xenon was found to be neuroprotective and devoid of developmental neurotoxicity. These properties could render xenon attractive for the anesthesia in neonates and infants with congenital heart disease. However, experience with xenon anesthesia in children is scarce. AIMS: We hypothesized that in children undergoing cardiac catheterization, general anesthesia with a combination of sevoflurane with xenon results in superior hemodynamic stability, compared to sevoflurane alone...
September 5, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28871560/oesophageal-coins-invisible-on-chest-radiography-a-case-report
#17
Jin Takahashi, Takashi Shiga, Hiraku Funakoshi
BACKGROUND: Coins are made of metal, which is generally radiopaque, and so physicians often have the misconception that all coins are detectable by radiography. Here, we report a case of intentionally swallowed coins in the oesophagus of an adult; the coins could not be detected on chest radiography but were detected using computed tomography (CT). CASE PRESENTATION: A 46-year-old woman with a history of depression presented to the emergency department after an intentional medication overdose and ingestion of two Japanese 1-yen coins...
September 5, 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28871358/chemotherapy-induced-nausea-and-vomiting-cinv-and-adherence-to-antiemetic-guidelines-results-of-a-survey-of-oncology-nurses
#18
Rebecca Clark-Snow, Mary Lou Affronti, Cynthia N Rittenberg
PURPOSE: Chemotherapy-induced nausea and vomiting (CINV) can be prevented in most patients with use of guideline-recommended antiemetic regimens. However, studies have suggested that adherence to antiemetic guidelines is suboptimal. Oncology nurses, as part of a multidisciplinary team, can help promote appropriate antiemetic prophylaxis. Therefore, nurses were surveyed to assess antiemetic guideline awareness and practice patterns of antiemetic use, determine adherence to guideline recommendations, and query barriers to adherence...
September 4, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28867601/hydralazine-vs-nifedipine-for-acute-hypertensive-emergency-in-pregnancy-a-randomized-controlled-trial
#19
Chanderdeep Sharma, Anjali Soni, Amit Gupta, Ashok Verma, Suresh Verma
OBJECTIVE: We sought to compare the efficacy of intravenously administered hydralazine and oral nifedipine for acute blood pressure control in acute hypertensive emergency of pregnancy. STUDY DESIGN: In this double-blind, randomized, controlled trial, pregnant women (≥24 weeks POG) with sustained increase in systolic blood pressure of ≥160 mm Hg or diastolic blood pressure of ≥110 mm Hg were randomized to receive intravenous hydralazine injection in doses of 5, 10, 10, and 10 mg and a placebo tablet or oral nifedipine (10 mg tablet up to 4 doses) and intravenous saline injection every 20 minutes until the target blood pressure of 150 mm Hg systolic and ≤100 mm Hg diastolic was achieved...
September 1, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28864027/efficacy-and-safety-of-tribendimidine-tribendimidine-plus-ivermectin-tribendimidine-plus-oxantel-pamoate-and-albendazole-plus-oxantel-pamoate-against-hookworm-and-concomitant-soil-transmitted-helminth-infections-in-tanzania-and-c%C3%A3-te-d-ivoire-a-randomised-controlled
#20
Wendelin Moser, Jean T Coulibaly, Said M Ali, Shaali M Ame, Amour K Amour, Richard B Yapi, Marco Albonico, Maxim Puchkov, Jörg Huwyler, Jan Hattendorf, Jennifer Keiser
BACKGROUND: Preventive chemotherapy is the current strategy to control soil-transmitted helminth infections (caused by Ascaris lumbricoides, hookworm, and Trichuris trichiura). But, to improve efficacy and avoid emerging resistance, new drugs are warranted. Tribendimidine has shown good anthelmintic efficacy and is therefore a frontrunner for monotherapy and combination chemotherapy. METHODS: We did a randomised, controlled, single-blinded, non-inferiority trial on Pemba Island, Tanzania, and in Côte d'Ivoire...
August 29, 2017: Lancet Infectious Diseases
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