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https://www.readbyqxmd.com/read/29774628/efficacy-and-safety-of-brexpiprazole-for-the-treatment-of-acute-schizophrenia-in-japan-a-6-week-randomized-double-blind-placebo-controlled-study
#1
Jun Ishigooka, Shuichi Iwashita, Yoshihiro Tadori
AIMS: This study aimed to evaluate the efficacy, safety, and tolerability of brexpiprazole compared to placebo in Japanese patients with acute schizophrenia. METHODS: We conducted a 6-week, multicenter, double-blind, placebo-controlled, phase 2/3 study in Japan. Patients with acute schizophrenia were randomized (1:1:1:1) to receive brexpiprazole 1, 2, or 4 mg or placebo once a day. The primary endpoint was the change from baseline to week 6 in Positive and Negative Syndrome Scale (PANSS) total scores...
May 18, 2018: Psychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/29771860/emergency-department-chief-complaints-among-children-with-cancer
#2
Megan D Burcham, Anneli R Cochrane, Seethal A Jacob, Aaron E Carroll, Emily L Mueller
Children with cancer have high emergency department (ED) utilization, but little is known about their chief complaints. A retrospective chart review of ED chief complaints for children with cancer (actively receiving therapy) at Riley Hospital for Children from January 2014 to December 2015 was performed. Proportions of visits and disposition for top 5 chief complaints were determined. Multivariate logistic regression analyzed factors associated with admission. There were 598 encounters by 231 children with cancer...
May 16, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29770221/risperidone-induced-type-2-diabetes-presenting-with-diabetic-ketoacidosis
#3
Clarissa Ern Hui Fang, Mohammed Faraz Rafey, Aine Cunningham, Sean F Dinneen, Francis M Finucane
A 28-year-old male presented with 2 days of vomiting and abdominal pain, preceded by 2 weeks of thirst, polyuria and polydipsia. He had recently started risperidone for obsessive-compulsive disorder. He reported a high dietary sugar intake and had a strong family history of type 2 diabetes mellitus (T2DM). On admission, he was tachycardic, tachypnoeic and drowsy with a Glasgow Coma Scale (GCS) of 10/15. We noted axillary acanthosis nigricans and obesity (BMI 33.2 kg/m2 ). Dipstick urinalysis showed ketonuria and glycosuria...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29769346/porcine-deltacoronavirus-accessory-protein-ns6-antagonizes-ifn-%C3%AE-production-by-interfering-with-the-binding-of-rig-i-mda5-to-double-stranded-rna
#4
Puxian Fang, Liurong Fang, Jie Ren, Yingying Hong, Xiaorong Liu, Yunyang Zhao, Dang Wang, Guiqing Peng, Shaobo Xiao
Porcine deltacoronavirus (PDCoV) has recently emerged as an enteric pathogen that can cause serious vomiting and diarrhea in suckling piglets. The first outbreak of PDCoV occurred in the United States in 2014 and was followed by reports of PDCoV in South Korea, China, Thailand, Lao people's Democratic Republic, and Vietnam, leading to economic losses for pig farms and posing considerable threat to the swine industry worldwide. Our previous studies have shown that PDCoV encodes three accessory proteins, NS6, NS7, and NS7a, but the functions of these proteins in viral replication, pathogenesis, and immune regulation remain unclear...
May 16, 2018: Journal of Virology
https://www.readbyqxmd.com/read/29768651/cannabinoid-hyperemesis-syndrome-reports-of-fatal-cases
#5
Mahra Nourbakhsh, Angela Miller, Jeff Gofton, Graham Jones, Bamidele Adeagbo
Cannabinoid hyperemesis syndrome (CHS) is one of the more clinically challenging effects of cannabis consumption. It is characterized by cyclic attacks of nausea and vomiting in chronic cannabinoid users and learned behavior of compulsive hot bathing. The deaths of a 27-year-old female, a 27-year-old male, and a 31-year-old male with a history of CHS are reported. The decedents had a history of cyclical nausea and vomiting, chronic cannabinoid use and negative laboratory, radiological and endoscopic findings...
May 16, 2018: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/29768359/case-report-of-gastric-distension-due-to-superior-mesenteric-artery-syndrome-mimicking-hollow-viscus-perforation-considerations-in-critical-care-ultrasound
#6
Yan-Mei Feng, Dong Wan, Rui Guo
RATIONALE: Critical care ultrasound identifies the signs of free intraperitoneal air and echogenic free fluid always indicates hollow viscus perforation (HVP) and needs immediate surgical interventions. However, in rare cases, these classic signs may also mislead proper clinical decisions. We report perforated viscus associated large peritoneal effusion with initial critical care ultrasound findings, whereas computed tomography (CT) examination confirmed a giant stomach due to superior mesenteric artery syndrome (SMAS)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29765783/multiorgan-failure-and-refractory-lactic-acidosis-due-to-pasteurella-multocida-septicemia-in-a-patient-with-no-animal-exposure
#7
Damaris Pena, Yaneidy Santana, Jose Perez Lara, Efrain Gonzalez, Misbahuddin Khaja
Introduction: Pasteurella multocida is a gram-negative coccobacillus pathogenic to animals. It can cause infection in humans by a bite, scratch, or lick from a cat or dog. P. multocida can cause a variety of infections in humans, including cellulitis, osteomyelitis, endocarditis, peritonitis, and septic shock. Case Presentation: A 56-year-old male presented to our hospital with a 2-day history of fever, abdominal pain, nausea, and vomiting. He denied exposure to cats, dogs or other pets...
2018: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29764844/second-look-laparostomy-for-perforated-gangrenous-gastric-volvulus-to-prevent-total-gastrectomy
#8
Paul K Okeny, Omar Abbassi, Ali Warsi
A 42-year-old Caucasian woman presented to the emergency department with severe upper abdominal pain and vomiting. Clinically, she was septic, and abdominal examination suggested peritonitis. Following immediate resuscitation, the patient was stabilised and underwent urgent contrast-enhanced CT of the abdomen and pelvis. This revealed a mesenteroaxial gastric volvulus with traction on the mesentery and a small volume of free fluid. She underwent laparotomy revealing gangrenous gastric fundus perforation complicated by persistent intraoperative hypotension...
May 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29764832/large-bowel-obstruction-in-a-27-year-old-woman-caused-by-a-sigmoid-faecal-bolus
#9
Radford Arran James Smith, Muhammad Abdalkoddus, Robert Bethune
A 27-year-old woman presented to the emergency department with a 24-hour history of severe left iliac fossa pain associated with vomiting. She reported a history of ovarian cysts and was provisionally diagnosed with a ruptured ovarian cyst and admitted under the obstetrics and gynaecology team for further investigation. 24 hours later, she became haemodynamically unstable with increasing abdominal distention and developed a metabolic acidosis. A CT scan revealed large bowel obstruction (LBO) secondary to a faecal bolus in the sigmoid colon with appearances suggestive of adult-onset Hirschsprung's disease...
May 14, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29764827/not-so-mass-effect-finding-of-a-remarkable-incidentaloma-in-a-teenager-with-neurofibromatosis
#10
Daniel John Keen, Hannah Norman-Bruce, Salah Mansy
A 13-year-old boy with neurofibromatosis type 1 presented to the emergency department twice in a fortnight with moderate intermittent abdominal pain, radiating to the back and associated with nausea and vomiting. He examined as a well child with a soft abdomen and minimal tenderness. A history of constipation was identified but he failed to respond to a trial of laxatives. Subsequent ultrasound abdomen demonstrated a large mass surrounding the porta hepatis. MRI further characterised a focal, non-aggressive lesion extending from his liver, encapsulating his pancreas, portal vessels and laterally displacing his spleen and left kidney...
May 14, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29755909/malrotation-of-the-gut-in-adults-an-often-forgotten-entity
#11
Sushant Bhatia, Sudhir Jain, Chandra B Singh, Lovenish Bains, Rohit Kaushik, Nishant S Gowda
Malrotation of the gut is a common paediatric condition that usually presents in the first month of life. However, presentation in adults is rare, and as a diagnostic dilemma quite often surprises the surgeon intraoperatively. If this condition is not timely recognized, it may result in disastrous consequences, such as gangrene of the small gut. We present the case of a 21-year-old male who presented to the emergency room with recurrent episodes of colicky abdominal pain and bilious vomiting. Contrast-enhanced computerized tomography (CT) revealed malrotation of the gut...
March 12, 2018: Curēus
https://www.readbyqxmd.com/read/29749881/reversible-ventriculoperitoneal-shunt-dysfunction-and-chronic-constipation-case-report
#12
Barbara A Morais, Daniel D Cardeal, Fernanda G Andrade, Wellingson S Paiva, Hamilton Matushita, Manoel J Teixeira
Constipation can cause transient malfunction of the ventriculoperitoneal shunt (VPS). Patients with myelomeningocele or cerebral palsy are often diagnosed with hydrocephalus and constipation due to neurogenic bowel. These patients are more prone to VPS dysfunction, often requiring surgical revision. The authors report the case of a 6-year-old girl with a VPS that had been implanted due to hydrocephalus secondary to myelomeningocele. The patient was brought to the emergency department with intermittent headache, vomiting, constipation, and abdominal distension and pain...
May 11, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29748750/clinical-and-laboratory-features-of-children-with-community-acquired-pneumonia-are-associated-with-distinct-radiographic-presentations
#13
Oana G Falup-Pecurariu, Javier Diez-Domingo, Susanna Esposito, Adam Finn, Fernanda Rodrigues, Vana Spoulou, George A Syrogiannopoulos, Vytautas Usonis, David Greenberg
Chest radiographs from children with community-acquired pneumonia (CAP) were categorized into three distinct presentations and each presentation was correlated to clinical and laboratory findings. Children < 59 months with CAP presenting to pediatric emergency rooms during two years were enrolled prospectively in eight centers across Europe. Clinical and laboratory data were documented and radiographs obtained from patients. Of the 1107 enrolled patients, radiographs were characterized as 74.9% alveolar CAP, 8...
May 11, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29747958/emergency-department-intubation-success-with-succinylcholine-versus-rocuronium-a-national-emergency-airway-registry-study
#14
Michael D April, Allyson Arana, Daniel J Pallin, Steven G Schauer, Andrea Fantegrossi, Jessie Fernandez, Joseph K Maddry, Shane M Summers, Mark A Antonacci, Calvin A Brown
STUDY OBJECTIVE: Although both succinylcholine and rocuronium are used to facilitate emergency department (ED) rapid sequence intubation, the difference in intubation success rate between them is unknown. We compare first-pass intubation success between ED rapid sequence intubation facilitated by succinylcholine versus rocuronium. METHODS: We analyzed prospectively collected data from the National Emergency Airway Registry, a multicenter registry collecting data on all intubations performed in 22 EDs...
May 7, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29743472/a-case-of-perforated-jejunal-diverticulum-an-unexpected-cause-of-pneumoperitoneum-in-a-patient-presenting-with-an-acute-abdomen
#15
Bruno Augusto Alves Martins, Rosana Rodrigues Galletti, Júlio Marinho Dos Santos Neto, Caroline Neiva Mendes
BACKGROUND Jejunal diverticulosis is a rare clinical condition, and the majority of patients are asymptomatic. However, some patients can develop serious complications, including perforation. We report the case of a 74-year-old female patient with a perforated jejunal diverticulum who presented with an 'acute abdomen' and with pneumoperitoneum on X-ray radiography. CASE REPORT A 74-year-old female patient presented to the emergency department with a 24-hour history of acute onset of diffuse abdominal pain associated with nausea and vomiting...
May 10, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29742696/acute-starvation-ketoacidosis-in-pregnancy-with-severe-hypertriglyceridemia-a-case-report
#16
Li Hui, Li Shuying
RATIONALE: Pregnant women are more prone to ketosis due to the relative insulin resistance, accelerated lipolysis and increased free fatty acids. PATIENT CONCERNS: We report a pregnant woman with hyperlipidemia, who experienced severe metabolic acidosis after a short period of starvation. DIAGNOSES: Based on her clinical symptoms, exclusion diagnosis and therapeutic diagnosis, her condition was diagnosed as starvation ketoacidosis. INTERVENTIONS: An emergency caesarean section under general anesthesia was implemented 2 hours after her admission...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29738037/clinical-and-laboratory-features-of-urinary-tract-infections-in-young-infants
#17
Denise Swei Lo, Larissa Rodrigues, Vera Hermina Kalika Koch, Alfredo Elias Gilio
INTRODUCTION: Urinary tract infection (UTI) is the most common serious bacterial infection in young infants. Signs and symptoms are often nonspecific. OBJECTIVES: To describe clinical, demographic and laboratory features of UTI in infants ≤ 3 months old. METHODS: Cross-sectional study of infants ≤ 3 months old with UTI diagnosed in a pediatric emergency department, for the period 2010-2012. UTI was defined as ≥ 50,000 colony-forming units per milliliter of a single uropathogen isolated from bladder catheterization...
April 26, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29731834/diagnosis-and-treatment-of-postoperative-intestinal-perforation-in-infants-and-young-children-with-congenital-heart-disease-a-report-of-three-cases
#18
Yong-Hong Zhang, Zhen-Liang Chen, Lei Shi, Zhong-Jian Chen, Xiang-Yang Dong, Bo Zhai
The aim of the present study was to analyze risk factors of intestinal perforation following surgery for the treatment of congenital heart disease in infants and young children, and to summarize experiences of diagnosis and treatment. A total of 3,270 children, who underwent congenital heart disease surgery under extracorporeal circulation from January 2010 to July 2015, were retrospectively analyzed. Among these children, three (0.09%) developed postoperative intestinal perforation. Primary diseases were Tetralogy of Fallot (two cases) and ventricular septal defect combined with atrial septal defect (one case)...
May 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29722791/phase-3-safety-study-of-intravenous-nepa-a-novel-fixed-antiemetic-combination-of-fosnetupitant-and-palonosetron-in-patients-receiving-highly-emetogenic-chemotherapy
#19
L Schwartzberg, E Roeland, Z Andric, D Kowalski, J Radic, D Voisin, G Rizzi, R Navari, R J Gralla, Meinolf Karthaus
Background: NEPA, an oral fixed combination of the NK1RA netupitant (300mg) and clinically/pharmacologically distinct 5-HT3RA palonosetron (PALO, 0.50mg), is the first fixed antiemetic combination to have been approved. A single oral NEPA capsule plus dexamethasone (DEX) given prior to AC and non-AC highly emetogenic chemotherapy (HEC) showed superior prevention of chemotherapy-induced nausea and vomiting (CINV) over PALO plus DEX for 5 days post-chemotherapy. The safety of NEPA was well-established in the Phase 2/3 clinical program in 1169 NEPA-treated patients...
May 2, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29719745/acute-acalculous-cholecystitis-in-the-setting-of-negative-ultrasound-and-computed-tomography-scan-of-the-abdomen
#20
Muhammad Shafiq, Yousaf Zafar
Acute acalculous cholecystitis (AAC) is most commonly seen after surgery in critically ill patients. Early diagnosis and treatment is the key in the management of AAC. Ultrasound is the commonly used first modality for right upper quadrant (RUQ) pain with sensitivity equal to or greater than 80% for AAC. Computed tomography (CT) scan is reported to have a sensitivity close to 90% and if both the ultrasound and CT scan are combined, it further increases the sensitivity for the diagnosis of AAC. It is unlikely for AAC to be present in the setting of both negative ultrasound and CT scan of the abdomen...
February 28, 2018: Curēus
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