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https://www.readbyqxmd.com/read/28229983/establishment-and-application-of-early-risk-stratification-method-for-acute-abdominal-pain-in-adults
#1
Yu Wang, Hong Zhao, Zhen Zhou, Ci Tian, Hong-Li Xiao, Bao-En Wang
BACKGROUND: Acute abdominal pain is a common symptom of emergency patients. The severity was always evaluated based on physicians' clinical experience. The aim of this study was to establish an early risk stratification method (ERSM) for addressing adults with acute abdominal pain, which would guide physicians to take appropriate and timely measures following the established health-care policies. METHODS: In Cohort 1, the records of 490 patients with acute abdominal pain that developed within the past 72 h were enrolled in this study...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28228343/ultrasound-guided-femoral-nerve-blockage-in-a-patellar-dislocation-an-effective-technique-for-emergency-physicians
#2
Sami Eksert, Sinan Akay, Murtaza Kaya, Ali Kantemir, Kenan Keklikci
BACKGROUND: Patellar dislocation is an orthopedic emergency and its reduction can be painful. The aim of this case is to show that the ultrasound-guided femoral nerve blockage can be effectively used in the pain management of patellar reduction in the emergency department (ED). CASE REPORT: A 21-year-old man was admitted to our ED after suffering a fall down a flight of stairs. The initial physical examination and plain radiography showed a patellar dislocation in the right knee...
February 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28225374/characterizing-the-toxicity-and-dose-effect-profile-of-tramadol-ingestions-in-children
#3
Gina L Stassinos, Lawrence Gonzales, Wendy Klein-Schwartz
OBJECTIVES: Tramadol can cause life-threatening toxicity in overdose; however, data on its toxicity in children are lacking. This study investigates toxicity associated with tramadol ingestions in children. The hypothesis is that children will experience dose-related central nervous system and respiratory depression and seizures. METHODS: A retrospective evaluation of cases from the National Poison Center Data System between January 1, 2000, and December 31, 2013, was performed...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28224456/zinc-toxicosis-in-a-boxer-dog-secondary-to-ingestion-of-holiday-garland
#4
Karyn Bischoff, Anne Chiapella, Jaime Weisman, Lisa M Crofton, Joseph Hillebrandt
INTRODUCTION: Increased admissions occur in small animal veterinary emergency clinics during some holidays, and some of the increased caseload is due to ingestion of toxic substances. This report documents zinc toxicosis contributing to the death of a dog after ingestion of holiday tinsel garland. CASE STUDY: A mature boxer dog presented with a 4-day history of vomiting and diarrhea. Radiodense foreign material was detected in the stomach and removed via gastrotomy...
February 21, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28222678/tracheal-extubation-in-deeply-anesthetized-pediatric-patients-after-tonsillectomy-a-comparison-of-high-concentration-sevoflurane-alone-and-low-concentration-sevoflurane-in-combination-with-dexmedetomidine-pre-medication
#5
Meiqin Di, Yuan Han, Zhuqing Yang, Huacheng Liu, Xuefei Ye, Hongyan Lai, Jun Li, Wangning ShangGuan, Qingquan Lian
BACKGROUND: Dexmedetomidine can facilitate a smooth extubation process and reduce the requirement of sevoflurane and emergence agitation when administrated perioperatively. We aimed to observe the extubation process and the recovery characteristics in pediatric patients undergoing tonsillectomy while anesthetized with either high-concentration sevoflurane alone or low-concentration sevoflurane combined with pre-medication of single dose of intravenous dexmedetomidine. METHODS: Seventy-five patients (ASA I or II, aged 3-7 years) undergoing tonsillectomy were randomized into three equal groups: to receive intravenous saline (Group D0), dexmedetomidine 1 μg/kg (Group D1), or dexmedetomidine 2 μg/kg (Group D2) approximately 10 min before anesthesia...
February 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28222456/nausea-vomiting-%C3%A2-tachycardia-%C3%A2-unintentional-weight-loss-%C3%A2-dx
#6
Daryl J Selen, Matthew P Gilbert
A 22-year-old woman presented to the emergency department (ED) with a 24-hour history of nausea, vomiting, diarrhea, generalized abdominal pain, and mild headache. She denied shortness of breath, chest pain, or anxiety, and didn't have a history of cardiac problems. The physical examination revealed tachycardia (heart rate, 135 beats/min) and a respiratory rate of 24 breaths per minute.
February 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28218203/cystic-dystrophy-of-the-duodenal-wall-a-rare-but-need-to-know-disease
#7
Lydia Plana Campos, Carlos Alventosa Mateu, Javier Sempere García-Argüelles, Ana Belén Durá Ayet, Inma Bort Pérez, Patricia Suárez Callol
Cystic dystrophy of the duodenal wall (CDDW) is a serious but uncommon complication of heterotopic pancreatic tissue characterized by increased duodenal wall thickness associated with intraparietal cystic lesions. It is mainly observed in middle-aged male patients with alcoholic chronic pancreatitis. Clinical symptoms are usually nonspecific and it is important to take them into account in patients with the abovementioned history. Imaging techniques have been useful for diagnosis, especially endoscopic ultrasound (EUS), to visualize cystic lesions in the wall...
January 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28217058/sub-tenon-s-injection-versus-paracetamol-in-pediatric-strabismus-surgery
#8
A N Ibrahim, T Shabana
BACKGROUND: Emergence agitation, vomiting, and oculocardiac reflex (OCR) in children undergoing strabismus surgery under general anesthesia are common problems. The purpose of this study was to determine whether the effect of analgesia can reduce the incidence of these problems. We compared the effects of sub-Tenon's injection versus intravenous (IV) and rectal paracetamol in this surgery. METHODS: In a prospective, randomized, double-blind study, ninety patients ranging in age from 4 to 8 years scheduled for extraocular muscle surgery for strabismus were included in this study...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28210514/hemorrhagic-colloid-cyst-presenting-with-acute-hydrocephaly
#9
Reza Akhavan, Behrouz Zandi, Masoud Pezeshki-Rad, Donya Farrokh, Bita Abbasi
Colloid cysts are benign slow-growing cystic lesions located on the roof of the third ventricle that usually present with symptoms related to gradual rise of intracranial pressure. They mostly remain asymptomatic and sometimes grow progressively and cause diverse symptoms associated with increased intracranial pressure such as headache, diplopia, and sixth cranial nerve palsy. Here we report a 47-year-old female who presented to the emergency department with acute severe headache and nausea/vomiting. On MRI examination acute hydrocephaly due to hemorrhagic colloid cyst was detected...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28209267/assessment-of-volume-status-and-appropriate-fluid-replenishment-in-the-setting-of-nephrotic-syndrome
#10
Pierluigi Marzuillo, Stefano Guarino, Andrea Apicella, Rosaria Marotta, Vincenzo Tipo, Laura Perrone, Angela La Manna, Giovanni Montini
BACKGROUND: When the permeability of the glomerular filtration barrier increases, leading to proteinuria, nephrotic syndrome (NS) occurs. First episodes or relapses of NS can be concurrent with acute gastroenteritis (AGE) infections. This condition can cause further deterioration of the hypovolemic state, as intravascular water is lost through both AGE-related vomiting/diarrhea and NS-related fluid shifting into the interstitium. In this case report, we wish to raise the issues about the difficult management of children presenting with both NS and AGE...
February 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28208976/dexamethasone-as-an-adjuvant-to-bupivacaine-in-supraclavicular-brachial-plexus-block-in-paediatrics-for-post-operative-analgesia
#11
Karl Sa Ribeiro, Anjali Ollapally, Julie Misquith
INTRODUCTION: Sensory blockade of the brachial plexus with local anaesthetics for perioperative analgesia leads to stable haemodynamics intraoperatively, smoother emergence from general anaesthesia and decreased need for supplemental analgesics or suppositories in the Post-operative period. However, increasing the duration of local anaesthetic action is often desirable because it prolongs surgical anaesthesia and analgesia. Various studies in adults prove that steroids increase the duration of action of local anaesthetics when used as adjuncts...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28197294/diagnostic-approach-to-myocarditis-mimicking-myocardial-infarction-at-initial-presentation
#12
Craig Basman, Pratik R Agrawal, Chad McRee, Louis Saravolatz, Carol Chen-Scarabelli, Tiziano M Scarabelli
We present a case of a 35-year-old male patient with a 12-hour history of sudden-onset, crushing chest pain and associated complaints of profuse diaphoresis, nausea and vomiting. The patient was transferred to our institution from an outside hospital for evaluation and possible emergent catheterization. Left heart catheterization was conclusive for normal coronary arteries and a ventriculogram revealed a left ventricular ejection fraction of approximately 45%. Due to a suspicion of myocarditis based on clinical history, pertinent serology tests were ordered, which were found to be negative...
December 2016: Cardiology Research
https://www.readbyqxmd.com/read/28194478/-diagnostic-investigation-in-emergency-medicine-why-case-history-is-crucial
#13
M Mirus, A R Heller
We present the preclinical case of a patient reporting chest pain. Pain impeded physical examination. Reviewing the patient's detailed medical history after analgesia revealed a connection between the reported pain and vomiting. This led to a suspicion of organ perforation. Thus, the patient was admitted to a surgical emergency room (ER) and Boerhaave's Syndrome was diagnosed. After deterioration in the ER, cardiopulmonal reanimation (CPR), and successful surgical treatment, the patient was transferred to the intensive care unit (ICU) seven hours after first contact...
February 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28191384/delayed-temporal-lobe-hemorrhage-after-initiation-of-acyclovir-in-an-immunocompetent-patient-with-herpes-simplex-virus-2-encephalitis-a-case-report
#14
Kyle Mueller, Joshua E Ryan, Alex Tai, Rocco A Armonda
Herpes simplex virus (HSV) is the most common cause of non-epidemic, sporadic, acute focal encephalitis in the United States. Inflammation of the vasculature makes them friable and susceptible to hemorrhage. Massive hemorrhage, though rare, can present in a delayed fashion after initiation of acyclovir and often requires surgical intervention. We report a unique case of delayed temporal lobe hemorrhage after initiation of acyclovir in an immunocompetent patient, specifically for its presentation, virology, and surgical management...
January 15, 2017: Curēus
https://www.readbyqxmd.com/read/28190665/intranasal-fentanyl-and-inhaled-nitrous-oxide-for-fracture-reduction-the-fan-observational-study
#15
J Hoeffe, E Doyon Trottier, B Bailey, D Shellshear, M Lagacé, C Sutter, G Grimard, R Cook, F E Babl
INTRODUCTION: Procedural sedation and analgesia (PSA) are frequently used for fracture reduction in pediatric emergency departments (ED). Combining intranasal (IN) fentanyl with inhalation of nitrous oxide (N2O) allow for short recovery time and obviates painful and time-consuming IV access insertions. METHODS: We performed a bicentric, prospective, observational cohort study. Patients aged 4-18years were included if they received combined PSA with IN fentanyl and N2O for the reduction of mildly/moderately displaced fracture or of dislocation...
January 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28186654/weight-gain-trajectories-in-hospital-based-treatment-of-anorexia-nervosa
#16
Saniha H Makhzoumi, Janelle W Coughlin, Colleen C Schreyer, Graham W Redgrave, Steven C Pitts, Angela S Guarda
Weight gain is a primary treatment goal for anorexia nervosa (AN); however little is known about heterogeneity in weight gain pattern during treatment. Preliminary evidence suggests weight gain trajectory is associated with treatment outcome. This study grouped patients using mixture modeling into weight gain trajectories, and compared predictors and treatment outcomes between trajectory groups. Women diagnosed with AN or subthreshold AN (N = 211) completed self-report measures at admission and six-months after discharge from an integrated inpatient (IP)-partial hospitalization (PH) behavioral specialty eating disorders program...
February 10, 2017: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/28156642/adherence-to-anti-emetic-guidelines-with-a-newly-approved-chemotherapy-agent-trifluridine-tipiracil-tas-102-a-single-institution-study
#17
Aminah Jatoi
: 221 Background: To our knowledge, no study has examined adherence to antiemetic guidelines with soon-to-be-approved or newly approved chemotherapy agents. In 2015, the Food and Drug Administration approved 18 cancer drugs, underscoring the timeliness of this topic. Here, we hypothesize that patients prescribed new drugs are at risk for poor guideline adherence, and we report on antiemetic prescribing practices and outcomes with TAS-102, a recently approved drug for metastatic colorectal cancer...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156640/efficacy-of-rolapitant-for-prevention-of-chemotherapy-induced-nausea-and-vomiting-cinv-in-patients-with-gastrointestinal-and-colorectal-cancers
#18
Karin Jordan, Bernardo Leon Rapoport, Ian D Schnadig, Martin Chasen, Sujata Arora, Daniel Powers, Lee Steven Schwartzberg
: 222 Background: Rolapitant (VARUBI) is a selective, long-acting neurokinin-1 receptor antagonist (RA) for the prevention of CINV. Rolapitant effectively prevented CINV in phase 3 trials of patients (pts) receiving highly or moderately emetogenic chemotherapy (HEC, MEC). While MEC and HEC regimens are commonly used to treat pts with gastrointestinal and colorectal cancers (GI/CRC), very few studies have evaluated the effectiveness of a neurokinin-1 RA regimen in these pts. We assessed the incidence of CINV and efficacy of rolapitant in a subset of pts with GI/CRC...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156638/rolapitant-for-control-of-chemotherapy-induced-nausea-and-vomiting-cinv-in-patients-with-gynecologic-cancer
#19
Lee Steven Schwartzberg, Sujata Arora, Daniel Powers, Karin Jordan, Rudolph M Navari
: 223 Background: Rolapitant, a long-acting neurokinin-1 receptor antagonist, protected against CINV in patients receiving highly or moderately emetogenic chemotherapy (HEC or MEC). METHODS: In 3 double-blind phase 3 studies, patients were randomized to receive oral rolapitant 180 mg or placebo before administration of HEC or MEC. All patients received a 5-hydroxytryptamine type 3 receptor antagonist and dexamethasone. In a post hoc analysis of 3 pooled studies (2 HEC and 1 MEC), we assessed the efficacy and safety of rolapitant in patients with gynecologic (ovarian, uterine, or cervical) cancer...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156587/palliative-outpatient-hot-clinic-rapid-access-for-oncology-patients-visiting-emergency-department-in-a-tertiary-hospital-in-singapore-a-1-year-experience
#20
Mervyn Yong Hwang Koh, Jia Fang Lee
: 137 Background: Oncology patients often present with symptoms at Emergency Department (ED). While most patients require admission for further management, some patients can be discharged from ED with outpatient follow-up. However, most patients were given 4 to 6 week appointment. In the light of this service gap, our department collaborated with ED to facilitate rapid access to Palliative Outpatient Hot Clinic (POHC) within 3 working days from ED visit in 2015. METHODS: We performed a retrospective review of all patients seen in the ED who satisfied the referral criteria to POHC...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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