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https://www.readbyqxmd.com/read/28538608/assessing-dehydration-employing-end-tidal-carbon-dioxide-in-children-with-vomiting-and-diarrhea
#1
Stephen B Freedman, David W Johnson, Alberto Nettel-Aguirre, Angelo Mikrogianakis, Sarah Williamson-Urquhart, Nicholas Monfries, Adam Cheng
OBJECTIVE: Serum bicarbonate reflects dehydration severity in children with gastroenteritis. Previous work in children receiving intravenous rehydration has correlated end-tidal carbon dioxide (EtCO2) with serum bicarbonate. We evaluated whether EtCO2 predicts weight change in children with vomiting and/or diarrhea. METHODS: A prospective cohort study was conducted. Eligible children were 3 months to 10 years old and presented for emergency department (ED) care because of vomiting and/or diarrhea...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28537937/dexmedetomidine-the-new-all-in-one-drug-in-paediatric-anaesthesia
#2
Cedric E Sottas, Brian J Anderson
PURPOSE OF REVIEW: Dexmedetomidine is a drug with sedative, anxiolytic, sympatholytic and analgesic properties, which is finding widespread practice in paediatric anaesthesia and related practices. The present review summarizes its pharmacology and current experience with the drug. RECENT FINDINGS: Dexmedetomidine is proving useful in many diverse areas in paediatric anaesthesia where its sedative properties are useful for premedication, fibreoptic intubation and radiologic procedures...
May 22, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28536229/cyclooxygenase-2-inhibitor-induced-acute-interstitial-nephritis
#3
Brittany Albrecht, Shelley Giebel, Michelle McCarron, Bhanu Prasad
A 64-year-old female patient presented to the emergency department with a 3-week history of persistent nausea and vomiting. Her serum creatine prior to admission was 118 µmol/L and on presentation was elevated to 420 µmol/L. On clinical history, she indicated that 3 weeks prior, she had been initiated on a cyclooygenase-2 (COX-2) inhibitor, celecoxib, for her osteoarthritis of her knees. Renal biopsy confirmed the diagnosis of acute interstitial nephritis (AIN). Celecoxib was discontinued and the patient's renal function improved to a discharge creatine of 205-220 µmol/L...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28535115/use-of-naloxone-nasal-spray-4%C3%A2-mg-in-the-community-setting-a-survey-of-use-by-community-organizations
#4
George K Avetian, Phillip Fiuty, Silvana Mazzella, Dave Koppa, Vivian Heye, Pratibha Hebbar
OBJECTIVE: Naloxone hydrochloride, an opioid antagonist, has been approved as a concentrated 4-mg dose intranasal formulation for the emergency treatment of known or suspected opioid overdose. This new formulation is easier to use and contains a higher dose of naloxone compared with earlier, unapproved kits. A survey of first responders and community-based organizations was conducted to understand initial real-world experiences with this new formulation for opioid overdose reversal. METHODS: In August 2016, 152 US organizations known to have received units of the approved 4-mg dose/unit naloxone nasal spray (NARCAN® Nasal Spray 4 mg [NNS]; Adapt Pharma, Inc...
May 23, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28525249/-a-less-known-cause-of-incoercible-vomiting
#5
S Guyoundouzian, R Attou, P Guérisse, T Préseau
Cannabis is a widely spread drug which chronic abuse may cause diverse adverse effects on the body, in the short and long term. Among these effects, we can cite digestive disorders, mainly characterized by the onset of cyclical vomiting illness. Vomiting symptoms can be temporarily relieved by hot water showers. As a matter of fact, many patients adopt a compulsive bathing behavior characterized by the irrepressible need of having showers or baths at a high temperature. We describe the case of two patients (22 and 23 years-old) who consume cannabis on a regular basis...
2017: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/28521036/a-novel-approach-of-navigation-assisted-flexible-neuroendoscopy
#6
Jaime G Torres-Corzo, Leonardo Rangel-Castilla, Mario Alberto Islas-Aguilar, Roberto Rodríguez-Della Vecchia
BACKGROUND AND IMPORTANCE: Neuronavigation-assisted endoscopy is commonly used for skull base and intraventricular surgery. Flexible neuroendoscopy offers certain advantages over rigid endoscopy; however, a major disadvantage of the flexible endoscope has been easy disorientation in the flexed position. Neuronavigation-assisted flexible neuroendoscopy was not available until now. This is the first report of the use of navigation-assisted flexible neuroendoscopy in a patient with hydrocephalus...
May 18, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28520711/inhalational-chlorine-injuries-at-public-aquatic-venues-california-2008-2015
#7
Jason A Wilken, Michele DiMaggio, Matthew Kaufmann, Kevin O'Connor, Svetlana Smorodinsky, Christina Armatas, Tracy Barreau, Richard Kreutzer, Lino Ancheta
In June 2015, personnel from California's Contra Costa Health Services Environmental Health and Hazardous Materials (hazmat) divisions were alerted to a possible chemical release at a swimming pool in an outdoor municipal water park. Approximately 50 bathers were in the pool when symptoms began; 34 (68%) experienced vomiting, coughing, or eye irritation. Among these persons, 17 (50%) were treated at the scene by Contra Costa's Emergency Medical Services (EMS) and released, and 17 (50%) were transported to local emergency departments; five patients also were evaluated later at an emergency department or by a primary medical provider...
May 19, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28514823/-fulminant-course-of-a-clostridium-perfringens-infection-with-pathognomonic-ct-finding
#8
Christoph Alexander Stückle, Christopher Sonntag, Magdalena Kulik, Thorsten Nitschke
History and clinical findings A 74-year old woman was accepted by the emergency room with severe chest and abdominal pain. She complained about regurgitation after ingestion of food followed by sharp pain in her breast. Investigations A first examination of the patient showed a tachypnoea und tachycardia up to 122 beats per minute, the body temperature measured on admission was 38.7 °C. Due to hemolysis only a few of the requested parameters could be evaluated. CRP was increased with 8.32 mg/dl. The hemoglobin dropped from 12...
May 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28506538/epitope-specific-immunotherapy-targeting-cd4-positive-t-cells-in-coeliac-disease-two-randomised-double-blind-placebo-controlled-phase-1-studies
#9
Gautam Goel, Tim King, A James Daveson, Jane M Andrews, Janakan Krishnarajah, Richard Krause, Gregor J E Brown, Ronald Fogel, Charles F Barish, Roger Epstein, Timothy P Kinney, Philip B Miner, Jason A Tye-Din, Adam Girardin, Juha Taavela, Alina Popp, John Sidney, Markku Mäki, Kaela E Goldstein, Patrick H Griffin, Suyue Wang, John L Dzuris, Leslie J Williams, Alessandro Sette, Ramnik J Xavier, Ludvig M Sollid, Bana Jabri, Robert P Anderson
BACKGROUND: A gluten-free diet is the only means to manage coeliac disease, a permanent immune intolerance to gluten. We developed a therapeutic vaccine, Nexvax2, designed to treat coeliac disease. Nexvax2 is an adjuvant-free mix of three peptides that include immunodominant epitopes for gluten-specific CD4-positive T cells. The vaccine is intended to engage and render gluten-specific CD4-positive T cells unresponsive to further antigenic stimulation. We assessed the safety and pharmacodynamics of the vaccine in patients with coeliac disease on a gluten-free diet...
May 11, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28500579/robotic-repair-of-a-right-sided-bochdalek-hernia-a-case-report-and-literature-review
#10
Amani Jambhekar, Shawn Robinson, Brian Housman, James Nguyen, Kevin Gu, Vadim Nakhamiyayev
BACKGROUND: Bochdalek hernias (BHs) are usually diagnosed in the neonatal period, occurring in 1/2200-1/12,500 live births. There are few reported cases of BHs in adults. Robotic repair has not been described in current literature as opposed to the laparoscopic approach. Here we present a case of an adult with clinical signs of bowel obstruction secondary to a BH which was repaired using a robotic approach. CASE REPORT: A 74-year-old gentleman with past medical history of benign prostatic hyperplasia presented to the emergency department with a 1-week history of nausea, vomiting, diarrhea, and decline in appetite...
May 12, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28497569/early-onset-of-efficacy-and-consistency-of-response-across-multiple-migraine-attacks-from-the-randomized-compass-study-avp-825-breath-powered-%C3%A2-exhalation-delivery-system-sumatriptan-nasal-powder-vs-oral-sumatriptan
#11
Stephen Silberstein, Paul K Winner, Peter J McAllister, Stewart J Tepper, Rashmi Halker, Ramy A Mahmoud, Joao Siffert
OBJECTIVE: To further characterize the clinical utility of AVP-825 based on additional prespecified outcomes and post hoc analyses of COMPASS, a Phase 3 comparative efficacy trial of AVP-825 vs 100 mg oral sumatriptan (NCT01667679). AVP-825 was approved in January 2016 by the US Food and Drug Administration under the name ONZETRA(®) Xsail(®) (sumatriptan nasal powder) for the acute treatment of migraine with or without aura in adults. BACKGROUND: AVP-825 is a delivery system that uses a patient's own breath to deliver low-dose sumatriptan powder to the upper posterior regions of the nasal cavity beyond the narrow nasal valve, areas lined with vascular mucosa conducive to rapid drug absorption into the systemic circulation...
May 11, 2017: Headache
https://www.readbyqxmd.com/read/28494898/the-effect-of-desflurane-versus-propofol-anesthesia-on-postoperative-delirium-in-elderly-obese-patients-undergoing-total-knee-replacement-a-randomized-controlled-double-blinded-clinical-trial
#12
Pedro Tanaka, Stuart Goodman, Barbara R Sommer, William Maloney, James Huddleston, Hendrikus J Lemmens
STUDY OBJECTIVE: The goal of this study was to investigate the incidence of delirium, wake-up times and early post-operative cognitive decline in one hundred obese elderly patients undergoing total knee arthroplasty. DESIGN: Prospective randomized trial. SETTINGS: Operating room, postoperative recovery area, hospital wards. PATIENTS: 100 obese patients (ASA II and III) undergoing primary total knee replacement under general anesthesia with a femoral nerve block catheter...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28494183/resolution-of-cannabis-hyperemesis-syndrome-with-topical-capsaicin-in-the-emergency-department-a-case-series
#13
Laurel Dezieck, Zachary Hafez, Albert Conicella, Eike Blohm, Mark J O'Connor, Evan S Schwarz, Michael E Mullins
BACKGROUND: Cannabinoid hyperemesis syndrome (CHS) is characterized by symptoms of cyclic abdominal pain, nausea, and vomiting in the setting of prolonged cannabis use. The transient receptor potential vanilloid 1 (TRPV1) receptor may be involved in this syndrome. Topical capsaicin is a proposed treatment for CHS; it binds TRPV1 with high specificity, impairing substance P signaling in the area postrema and nucleus tractus solitarius via overstimulation of TRPV1. This may explain its apparent antiemetic effect in this syndrome...
May 11, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28489170/modified-alvarado-score-in-children-with-diagnosis-of-appendicitis
#14
Mehran Peyvasteh, Shahnam Askarpour, Hazhir Javaherizadeh, Sepideh Besharati
Background: Appendicitis is one of the most common abdominal emergency. Some predictive scoring systems are recommended to decrease the rate of negative appendectomy. Aim: To evaluate sensitivity, specificity, positive predictive value, and negative predictive value of modified Alvarado score in children who underwent appendectomy. Methods: Four hundred children with initial diagnosis of appendicitis were randomly selected from patients who underwent appendectomy...
January 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28488360/cabazitaxel-in-patients-with-metastatic-castration-resistant-prostate-cancer-safety-and-quality-of-life-data-from-the-australian-early-access-program
#15
Phillip Parente, Siobhan Ng, Francis Parnis, Alex Guminski, Howard Gurney
AIM: Cabazitaxel is a next generation taxane that has been shown to improve overall survival in patients with metastatic castration-resistant prostate cancer (mCRPC) whose disease progressed during or after docetaxel-based therapy. A worldwide early access program (EAP) study was established to provide access to cabazitaxel ahead of commercial availability and to evaluate its safety and tolerability. The Australian EAP included patient-reported outcomes to evaluate the impact of cabazitaxel on quality of life (QoL)...
May 10, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28486012/adherence-to-and-implementation-of-asco-antiemetic-guidelines-in-routine-practice-in-a-tertiary-cancer-center-in-india
#16
Vijay M Patil, Vanita Noronha, Amit Joshi, Anant Ramaswamy, Sudeep Gupta, Arvind Sahu, Vipul Doshi, Tarachand Gupta, Sushmita Rath, Shripad Banavali, Kumar Prabhash
BACKGROUND: Nonadherence of antiemetic prescriptions to evidence-based antiemetic guidelines is associated with an increased proportion of chemotherapy-induced nausea and vomiting. The current project was carried out to improve the quality of antiemetic prescriptions at our institute. METHODS: We initially performed a retrospective analysis of 1,211 consecutive antiemetic prescription records of adult patients with solid tumors who received outpatient chemotherapy regimens...
May 9, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28484930/heart-shaped-bilateral-medullary-pyramidal-infarction-as-a-pathognomonic-finding-of-anterior-spinal-artery-occlusion
#17
Sammy Searcy, Oluwaseun O Akinduro, Andrew Spector, Jang W Yoon, Benjamin L Brown, William D Freeman
BACKGROUND: Unilateral anterior spinal artery (ASA) occlusion resulting in bilateral medullary pyramidal (BMP) infarction is a rare and devastating stroke subtype. We present two cases highlighting the diagnostic and clinical challenges of BMP infarction. METHODS: Case reports and literature review. RESULTS: A 57-year-old man rapidly had severe vomiting and diarrhea 2 h after a meal. Examination revealed bulbar weakness and areflexic tetraplegia...
May 8, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28484399/biochemical-benefits-diagnosis-and-clinical-risks-evaluation-of-kratom
#18
REVIEW
Dimy Fluyau, Neelambika Revadigar
BACKGROUND: Kratom (Mitragyna speciosa) is a tropical tree with a long history of traditional use in parts of Africa and Southeast Asia. Kratom is also known as Thom, Thang, and Biak. Its leaves and the teas brewed from them have long been used by people in that region to manage pain and opioid withdrawal and to stave off fatigue. Kratom is actually consumed throughout the world for its stimulant effects and as an opioid substitute (in form of tea, chewed, smoked, or ingested in capsules)...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28474320/large-hemobezoar-causing-acute-small-bowel-obstruction-after-roux-en-y-gastric-bypass-laparoscopic-management
#19
Emanuele Soricelli, Enrico Facchiano, Giovanni Quartararo, Benedetta Beltrame, Luca Leuratti, Marcello Lucchese
The present video shows the laparoscopic management of an acute small bowel obstruction (ASBO) after a Roux-en-Y Gastric Bypass (RYGBP), due to the development of an intraluminal hemobezoar involving the jejuno-jejunostomy (j-j). On the first postoperative day (POD), the patient presented persistent abdominal pain, sense of fullness, nausea, and vomiting with traces of blood. The abdominal tube drained a small amount of serous fluid, while blood tests revealed a mild leukocytosis and a slight decrease of the hemoglobin...
May 4, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28473359/pasteurella-multocida-meningoencephalitis-in-an-immunocompetent-adult-with-multiple-cat-scratches
#20
David Alistair Clarke, Angela Mcbride, Michael Kelsey, Ben Killingley
We present the case of a 49-year-old woman admitted to our Acute Medical Unit with a 2-day history of fever, vomiting and confusion. The patient was alcohol dependent and had sustained several scratches from her pet cat, which her pet dog had licked. She deteriorated in the Emergency Department-developing high fever, worsening confusion and meningism. Blood cultures were taken and broad spectrum antibiotics commenced prior to CT scanning and diagnostic lumbar puncture. Blood cultures and CSF 16S ribosomal PCR confirmed a diagnosis of Pasteurella multocida bacteraemia and meningoencephalitis...
May 3, 2017: BMJ Case Reports
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