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https://www.readbyqxmd.com/read/28798922/practical-approach-to-the-patient-with-acute-neuromuscular-weakness
#1
REVIEW
Rajeev Nayak
Acute neuromuscular paralysis (ANMP) is a clinical syndrome characterized by rapid onset muscle weakness progressing to maximum severity within several days to weeks (less than 4 wk). Bulbar and respiratory muscle weakness may or may not be present. It is a common neurological emergency which requires immediate and careful investigations to determine the etiology because accurate diagnosis has significant impact on therapy and prognosis. Respiratory failure caused by neuromuscular weakness is considered as more critical than lung disease because its development may be insidious or subtle until sudden decompensation leads to life threatening hypoxia...
July 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28762591/ean-consensus-review-on-prevention-diagnosis-and-management-of-tick-borne-encephalitis
#2
REVIEW
P Taba, E Schmutzhard, P Forsberg, I Lutsar, U Ljøstad, Å Mygland, I Levchenko, F Strle, I Steiner
BACKGROUND AND PURPOSE: Tick-borne encephalitis (TBE) is an infection of the central nervous system (CNS) caused by tick-borne encephalitis virus (TBEV) and transmitted by ticks, with a variety of clinical manifestations. The incidence of TBE in Europe is increasing due to an extended season of the infection and the enlargement of endemic areas. Our objectives are to provide recommendations on the prevention, diagnosis and management of TBE, based on evidence or consensus decisions. METHODS: For systematic evaluation, the literature was searched from 1970 to 2015 (including early online publications of 2016), and recommendations were based on evidence or consensus decisions of the Task Force when evidence-based data were not available...
August 1, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28724042/hyperglycemia-in-critical-patients-determinants-of-insulin-dose-choice
#3
Aline Klitzke Paliosa, Cassiano Teixeira, Regis Goulart Rosa, Carine Raquel Blatt
Objective: To identify factors that can determine the choice of intermittent subcutaneous regular insulin dose in critically ill patients with hyperglycemia. Method: Cross-sectional study in a general adult ICU with 26 beds, data collected between September and October 2014. The variables analyzed were: sex, age, previous diagnosis of diabetes mellitus, use of corticosteroids, use of lactulose, sepsis, fasting, enteral nutrition, use of dextrose 5% in water, NPH insulin prescription and blood glucose level...
May 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28714111/room-for-improvement-in-breast-milk-feeding-after-very-preterm-birth-in-europe-results-from-the-epice-cohort
#4
Emilija Wilson, Anna-Karin Edstedt Bonamy, Mercedes Bonet, Liis Toome, Carina Rodrigues, Elizabeth A Howell, Marina Cuttini, Jennifer Zeitlin
Breast milk feeding (BMF) is associated with lower neonatal morbidity in the very preterm infant (<32 weeks gestation) and breastfeeding is beneficial for maternal health. Previous studies show large variations in BMF after very preterm birth and recognize the need for targeted breastfeeding support in the neonatal intensive care units (NICU). In a European collaboration project about evidence-based practices after very preterm birth, we examined the association between maternal, obstetric, and infant clinical factors; neonatal and maternal care unit policies; and BMF at discharge from the NICU...
July 17, 2017: Maternal & Child Nutrition
https://www.readbyqxmd.com/read/28705304/clinical-practice-of-acute-respiratory-distress-syndrome-in-japan-a-nationwide-survey-and-scientific-evidences
#5
Sadatomo Tasaka, Koichiro Tatsumi
BACKGROUND: There has been limited information about epidemiology and clinical practice of acute respiratory distress syndrome (ARDS) in Japan. METHODS: An invitation letter to the web-based survey was mailed to all 871 board certified hospitals of the Japanese Respiratory Society. The questionnaires were designed to collect data on epidemiology and clinical practice of ARDS, including diagnostic measures and therapeutics. RESULTS: Within 4 months of the survey period, valid responses were obtained from 296 (34%) hospitals...
July 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28688239/successful-treatment-of-toxic-epidermal-necrolysis-using-plasmapheresis-a-prospective-observational-study
#6
Feng Han, Jingjing Zhang, Qi Guo, Yanjing Feng, Ya Gao, Litao Guo, Yanli Hou, Jingang An, Xiaopeng Wang, Bin Yan, Yan Zheng, Jingchun Song, Manxiang Li, Gang Wang
Toxic epidermal necrolysis (TEN) is a rare, severe, life-threatening skin disease and it requires urgent critical care, including admission to the intensive care unit (ICU). It is characterized by fatal sequelae and high mortality. Currently, insufficient evidence exists to support the use of any systemic adjuvant therapy, such as cyclophosphamide, intravenous immunoglobulin (IVIg), or corticosteroids. However, plasmapheresis has been increasingly valued by clinicians due to its significant efficacy and little adverse side effects...
July 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28671616/incidence-of-ventilator-associated-pneumonia-in-critically-ill-children-undergoing-mechanical-ventilation-in-pediatric-intensive-care-unit
#7
Ali Amanati, Abdollah Karimi, Alireza Fahimzad, Ahmad Reza Shamshiri, Fatemeh Fallah, Alireza Mahdavi, Mahshid Talebian
BACKGROUND: Among hospital-acquired infections (HAIs) in children, ventilator-associated pneumonia (VAP) is the most common after blood stream infection (BSI). VAP can prolong length of ventilation and hospitalization, increase mortality rate, and directly change a patient's outcome in Pediatric Intensive Care Units (PICU). OBJECTIVES: The research on VAP in children is limited, especially in Iran; therefore, the identification of VAP incidence and mortality rate will be important for both clinical and epidemiological implications...
July 3, 2017: Children
https://www.readbyqxmd.com/read/28639958/pediatric-jellyfish-envenomation-in-the-mediterranean-sea
#8
Miguel Glatstein, Dikla Adir, Bella Galil, Dennis Scolnik, Ayelet Rimon, Dikla Pivko-Levy, Christopher Hoyte
BACKGROUND: Several species of jellyfish native to the western Indian Ocean have entered the Mediterranean Sea through the Suez Canal. Since the late 1980s, each summer Rhopilema nomadica forms swarms as long as 100 km in the southeastern Levant and since the millennium aggregations of additional nonnative jellyfish have been sighted. The aim of this study was to evaluate children seen in the emergency department after jellyfish envenomations and to establish patterns of toxicity associated with this organism...
June 20, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28638278/lifespan-and-associated-factors-of-peripheral-intravenous-cannula-among-infants-admitted-in-public-hospitals-of-mekelle-city-tigray-ethiopia-2016
#9
Eskedar Birhane, Kalayou Kidanu, Mekuria Kassa, Dawit Gerezgiher, Lidia Tsegay, Brhanu Weldu, Genet Kidane, Hadgu Gerensea
BACKGROUND: Peripheral Intravenous cannula (IV) is the most common vascular access device used to administer medications with the exception of medication or fluid with high or low PH or hyperosmolarity which may cause severe damage to small veins. The insertion of a peripheral intravenous cannula in newborn infants can be difficult. Appropriate veins with sufficient capacity to insert a cannula become less available throughout the hospital stay. Once a peripheral intravenous cannula is inserted, it is desirable that its patency can be maintained as long as possible...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28631531/interleukin-1-receptor-antagonist-anakinra-intravenous-immunoglobulin-and-corticosteroids-in-the-management-of-critically-ill-adult-patients-with-hemophagocytic-lymphohistiocytosis
#10
Philipp Wohlfarth, Hermine Agis, Guido A Gualdoni, Johannes Weber, Thomas Staudinger, Peter Schellongowski, Oliver Robak
BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) causes multiple organ dysfunction frequently leading to intensive care unit (ICU) referral and/or death. We report on a series of critically ill adult patients treated with a non-etoposide-based regimen including interleukin 1 antagonist anakinra, intravenous immunoglobulin (IVIG), and/or corticosteroids (CS) for HLH. METHODS: Eight adult (≥18 years) ICU patients having received treatment with anakinra ± IVIG ± CS for HLH between March 2014 and March 2016 at a large tertiary care university hospital (Medical University of Vienna, Vienna, Austria) were retrospectively analyzed...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28619722/corticosteroid-therapy-during-acute-bronchiolitis-in-patients-who-later-develop-asthma
#11
Steven L Shein, Alexandre T Rotta, Richard Speicher, Katherine N Slain, Benjamin Gaston
BACKGROUND AND OBJECTIVE: Meta-analyses show that corticosteroids are not effective in patients with bronchiolitis. However, risk factors for asthma such as eczema or familial atopy prompt some practitioners to prescribe corticosteroids for bronchiolitis. We assessed if corticosteroid prescription is associated with shorter hospitalization for bronchiolitis among patients who later develop asthma. METHODS: The Pediatric Health Information System database was interrogated for patients with bronchiolitis aged <2 years hospitalized between 2006 and 2015...
July 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28617807/treatment-with-macrolides-and-glucocorticosteroids-in-severe-community-acquired-pneumonia-a-post-hoc-exploratory-analysis-of-a-randomized-controlled-trial
#12
Adrian Ceccato, Catia Cilloniz, Otavio T Ranzani, Rosario Menendez, Carles Agusti, Albert Gabarrus, Miquel Ferrer, Oriol Sibila, Michael S Niederman, Antoni Torres
BACKGROUND: Systemic corticosteroids have anti-inflammatory effects, whereas macrolides also have immunomodulatory activity in addition to their primary antimicrobial actions. We aimed to evaluate the potential interaction effect between corticosteroids and macrolides on the systemic inflammatory response in patients with severe community-acquired pneumonia to determine if combining these two immunomodulating agents was harmful, or possibly beneficial. METHODS: We performed a post-hoc exploratory analysis of a randomized clinical trial conducted in three tertiary hospitals in Spain...
2017: PloS One
https://www.readbyqxmd.com/read/28615145/early-initiation-of-low-dose-hydrocortisone-treatment-for-septic-shock-in-adults-a-randomized-clinical-trial
#13
Qing-Quan Lv, Xiao-Hua Gu, Qi-Hong Chen, Jiang-Quan Yu, Rui-Qiang Zheng
BACKGROUND: Physiologic dose hydrocortisone is part of the suggested adjuvant therapies for patients with septic shock. However, the association between the corticosteroid therapy and mortality in patients with septic shock is still not clear. Some authors considered that the mortality is related to the time frame between development of septic shock and start of low dose hydrocortisone. Thus we designed a placebo-controlled, randomized clinical trial to assess the importance of early initiation of low dose hydrocortisone for the final outcome...
June 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28598781/health-care-utilisation-before-and-after-intensive-care-unit-admission-in-rheumatoid-arthritis
#14
Ruth Ann Marrie, Carol A Hitchon, Christine A Peschken, Hui Chen, Charles N Bernstein, Allan Garland
OBJECTIVES: We evaluated the incidence of intensive care unit (ICU) admission in a rheumatoid arthritis (RA) population according to health care utilisation and use of immune therapies in the year preceding admission. Also, we compared health care utilisation after ICU admission in persons with and without RA. METHODS: We identified all persons with RA in Manitoba, Canada using population-based administrative data, and controls matched by age, sex, and region of residence...
June 5, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28560041/severe-acute-asthma-caused-by-chlamydophila-pneumoniae-infection
#15
Yoshinari Endo, Toshihiro Shirai, Mika Saigusa, Eisuke Mochizuki
Asthma exacerbation is associated with respiratory infections, including those by viruses and atypical bacteria. We herein report a case of severe acute asthma in an adult caused by Chlamydophila pneumoniae (C. pneumoniae) infection. A 39-year-old woman without a history of asthma reported to the emergency department with progressive worsening of cough, shortness of breath, and wheezing with low oxygen saturation. A computed tomography (CT) scan revealed patchy ground-glass opacity and bronchial wall thickening...
July 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28546381/adjunct-therapies-for-refractory-status-asthmaticus-in-children
#16
Kyle J Rehder
Asthma exacerbation is a common reason for children to present to the emergency department. If primary therapies fail to halt the progression of an asthma flare, status asthmaticus often leads to hospital, and potentially ICU, admission. Following the initial administration of inhaled β agonists and systemic corticosteroids, a wide array of adjunct medical therapies may be used to treat status asthmaticus. Unfortunately, the data supporting the use of these adjunct therapies are often unclear, conflicting, or absent...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28527272/-does-corticosteroid-treatment-during-the-pre-and-postnatal-periods-affect-the-neurodevelopmental-outcome-of-premature-newborns
#17
Marita Lardón, José Uberos, Eduardo Narbona
INTRODUCTION: Glucocorticoids, widely used in the perinatal period, may be associated with adverse neurodevelopmental effects. OBJECTIVES: To analyze neurodevelopmental outcomes in a cohort of very low birth weight newborns treated with antenatal and/or postnatal corticosteroids. MATERIALS AND METHODS: This was a prospective cohort study in which we included all very low birth weight babies admitted to the neonatal intensive care unit of a tertiary hospital between 2008 and 2013...
April 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28486361/universal-cervical-length-screening-and-antenatal-corticosteroid-timing
#18
Nicole Sahasrabudhe, Catherine Igel, Ghislaine C Echevarria, Peʼer Dar, Diana Wolfe, Peter S Bernstein, Robert Angert, Ashlesha Dayal, Patience Gallagher, Mara Rosner
OBJECTIVE: To evaluate the relationship between universal transvaginal screening for short cervical length in the second trimester and the timing of antenatal corticosteroids. METHODS: We performed a retrospective cohort study of patients with nonanomalous singleton gestations and spontaneous preterm birth between 24 and 34 weeks of gestation after the initiation of a universal transvaginal cervical length screening program between October 2012 and August 2015. Our primary outcome was antenatal corticosteroid administration to a delivery interval of fewer than 7 days...
June 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28444360/role-of-early-onset-neutropenia-in-development-of-candidemia-in-premature-infants
#19
Nermin Ramy, Mohamed Hashim, Heba Abou Hussein, Happy Sawires, Maha Gaafar, Ayat El Maghraby
Background: The aim of the study was to assess the effect of early-onset neutropenia (EON) on the development of candidemia in premature infants and evaluate other risk factors. Materials and Methods: This prospective study was carried out in a neonatal intensive care unit of Cairo University Hospital. Fifty neutropenic premature infants were matched to 50 non-neutropenics. Subjects were then regrouped into candidemics and non-candidemics to study other risk factors such as central venous catheters, mechanical ventilation, parenteral nutrition, drugs as corticosteroids and others...
April 24, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28440556/direct-hemoperfusion-with-polymyxin-b-immobilized-fibre-treatment-for-acute-exacerbation-of-interstitial-pneumonia
#20
Haruhiko Furusawa, Makiko Sugiura, Chieko Mitaka, Naohiko Inase
BACKGROUND AND OBJECTIVE: Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is recognized as an important cause of mortality. AE has also been reported in patients with other interstitial lung diseases such as idiopathic non-specific interstitial pneumonia (NSIP) and interstitial pneumonia associated with collagen vascular disease (CVD). Current therapies such as high-dose corticosteroid with immunosuppressive agents have provided little benefit for AE. Direct hemoperfusion (DHP) with a polymyxin B-immobilized fibre column (PMX) was originally developed for the treatment of endotoxaemia...
April 25, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
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