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https://www.readbyqxmd.com/read/28620552/refractory-lactic-acidosis-in-small-cell-carcinoma-of-the-lung
#1
Daniel J Oh, Ellen Dinerman, Andrew H Matthews, Abraham W Aron, Katherine M Berg
BACKGROUND: Elevated lactate levels in critically ill patients are most often thought to be indicative of relative tissue hypoxia or type A lactic acidosis. Shock, severe anemia, and thromboembolic events can all cause elevated lactate due to tissue hypoperfusion, as well as the mitochondrial dysfunction thought to occur in sepsis and other critically ill states. Malignancy can also lead to elevation in lactate, a phenomenon described as type B lactic acidosis, which is much less commonly encountered in the critically ill...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28460507/-the-clinical-analyses-of-neuromyelitis-optica-spectrum-disorder-initially-presenting-with-area-postrema-syndrome-in-14-patients
#2
Q F Guo, D D Song, Q Q Wang, Z W Wang, J G Liu, X K Qi
Objective: To explore the clinical characteristics of the neuromyelitis optica spectrum disorders (NMOSD) with the area postrema syndrome as the initial symptom. Methods: A total of 14 cases were enrolled in the study with the diagnose of NMOSD and the area postrema syndrome as the initial symptom. All the clinical data and imaging profiles by the contrasted magnetic resonance imaging (MRI) of the head and spinal cord were collected and analyzed. Results: The median age of onset was (38.1±17.0) years old and the gender ratio of female to male was 10∶4...
May 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28445267/different-clinical-presentations-of-choledochal-cyst-among-infants-and-older-children-a-10-year-retrospective-study
#3
COMPARATIVE STUDY
Davoud Badebarin, Saeid Aslanabadi, Amir Teimouri-Dereshki, Masoud Jamshidi, Tuba Tarverdizadeh, Kaveh Shad, Kamyar Ghabili, Ghazal Khajir
Choledochal cyst is a rare and often benign congenital cystic dilation throughout the biliary tree. Due to the benign nature of choledochal cyst among early-diagnosed patients, the clinical assumption and diagnosis seem to be of utmost significance. Therefore, we sought to assess different clinical manifestations of choledochal cyst and relevant laboratory findings in infants and older children.Retrospectively, medical records of all patients with the diagnosis of choledochal cyst between 2005 and 2015 were reviewed...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28349993/cannabinoid-receptor-type-1-and-mu-opioid-receptor-polymorphisms-are-associated-with-cyclic-vomiting-syndrome
#4
Andrzej Wasilewski, Urszula Lewandowska, Paula Mosinska, Cezary Watala, Martin Storr, Jakub Fichna, Thangam Venkatesan
OBJECTIVES: Cyclic vomiting syndrome (CVS) is a disorder defined by recurrent, unexplained episodes of severe nausea and vomiting. Our aim was to investigate whether CVS and pathophysiological mechanisms underlying this condition are associated with selected variations in genes encoding the components of the endogenous cannabinoid and opioid systems. METHODS: This case-control study included 65 patients with CVS-16 male and 49 female, and 1,092 healthy controls-525 male and 567 female from the 1000 Genomes Project...
June 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28321346/a-perplexing-case-of-abdominal-pain-that-led-to-the-diagnosis-of-zollinger-ellison-syndrome
#5
Adrienne Lenhart, Mona Hassan, Alireza Meighani, Omar Sadiq, Yousuf Siddiqui
Zollinger-Ellison syndrome (ZES) is a rare clinical disorder, characterized by hypersecretion of gastric acid and multiple ulcers distal to the duodenal bulb. This occurs via the release of gastrin by neuroendocrine tumors known as gastrinomas. Patients with ZES present with nonspecific GI symptoms, which often leads to a delay in diagnosis. Our patient is a 55-year-old female with chronic abdominal pain, nausea, and diarrhea. She underwent EGD, EUS, MRCP, CT scans, and cholecystectomy, which did not reveal the cause of her symptoms...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28295826/prevalence-types-and-associations-of-medically-unexplained-symptoms-and-signs-a-cross-sectional-study-of-1023-adults-with-intellectual-disabilities
#6
M Osugo, J Morrison, L Allan, D Kinnear, S-A Cooper
BACKGROUND: Medically unexplained symptoms and signs are common in the general population and can respond to appropriate managements. We aimed to quantify the types and prevalence of unexplained symptoms and signs experienced by adults with ID and to determine the associated factors. METHOD: In a population-based study, 1023 adults with ID aged 16 and over had a detailed health assessment, which systematically considered symptoms and signs. Descriptive data were generated on their symptoms and signs...
March 9, 2017: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/28260390/angiotensin-converting-enzyme-inhibitors-induced-angioedema-of-the-small-bowel-mimicking-postoperative-complication
#7
Caroline Lorenzoni Almeida Ghezzi, Tiago Leal Ghezzi, Oly Campos Corleta
BACKGROUND: Angioedema of the small bowel (ASB) is an extremely rare side effect of the angiotensin-converting enzyme inhibitors (ACEI). We present a case of ACEI-induced ASB mimicking postoperative complication. CASE REPORT: a woman who restarted ACEI after laparoscopic abdominoperineal resection of the rectum and anal canal has presented complaints of abdominal pain, nausea and vomiting, and non-acceptance of oral and enteral feeding. Computed tomography scan was performed to rule out surgical complications and has demonstrated an unexplained wall thickening of the proximal small bowel...
March 6, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28127997/investigational-drug-therapies-for-the-treatment-of-gastroparesis
#8
REVIEW
Gareth J Sanger, Pankaj Jay Pasricha
Gastroparesis is defined by nausea, vomiting, pain, early satiety and bloating, and characterized by delayed gastric emptying without obvious structural abnormalities. Metoclopramide is widely used, increasing gastric emptying and inhibiting nausea and vomiting. Other drugs are available in certain countries and some are used 'off-label' because they increase gastric emptying or inhibit emesis. However, correlation between gastroparesis symptoms and rates of gastric emptying is poor. For anti-emetic drugs, dose-ranging and Phase III trials in gastroparesis are lacking...
March 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28101304/gastric-antral-webs-in-adults-a-case-series-characterizing-their-clinical-presentation-and-management-in-the-modern-endoscopic-era
#9
Shannon J Morales, Neha Nigam, Walid M Chalhoub, Dalia I Abdelaziz, James H Lewis, Stanley B Benjamin
AIM: To investigate the current management of gastric antral webs (GAWs) among adults and identify optimal endoscopic and/or surgical management for these patients. METHODS: We reviewed our endoscopy database seeking to identify patients in whom a GAW was visualized among 24640 esophagogastroduodenoscopies (EGD) over a seven-year period (2006-2013) at a single tertiary care center. The diagnosis of GAW was suspected during EGD if aperture size of the antrum did not vary with peristalsis or if a "double bulb" sign was present on upper gastrointestinal series...
January 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27941738/pattern-of-changes-in-the-findings-among-the-patients-undergoing-diagnostic-esophagogastroduodenoscopy-in-bangladesh
#10
C K Ghosh, M R Khan, F Alam, B C Shil, M S Kabir, M Mahmuduzzaman, S C Das, P K Roy
This cross-sectional observational study was conducted in the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Sir Salimullah Medical College and Mitford Hospital, Holy family Red Crescent Medical College and Hospital and Popular Diagnostic Centre, Shantinagar branch, Dhaka, Bangladesh from January 2012 to July 2013. Study subjects were included in the study irrespective of age and sex having different upper GI tract. Complaints like dysphagia, heart burn, abdominal pain/dyspepsia, nausea, vomiting, haematemesis and/or malena, anorexia, unexplained anemia, weight loss etc...
October 2016: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/27916937/the-emergence-and-epidemiology-of-haff-disease-in-china
#11
REVIEW
Thomas Y K Chan
Haff disease is a rare syndrome of unexplained myalgia and rhabdomyolysis occurring within 24 h of consumption of certain types of cooked freshwater fish or crustacean. It is caused by a yet unidentified heat-stable toxin. In the present review of published case studies and official press releases, the main objective is to report the emergence and epidemiology of Haff disease in China. Haff disease first occurred in Beijing in 2000 and in Lianzhou and Liannan, Guangdong Province in 2009. Subsequent outbreaks mostly occurred in the Jiangsu Province-Nanjing, Yangzhou, Huai'an, and Yancheng...
December 1, 2016: Toxins
https://www.readbyqxmd.com/read/27726068/newest-drugs-for-chronic-unexplained-nausea-and-vomiting
#12
REVIEW
William L Hasler
Chronic unexplained nausea and vomiting (CUNV) refers to a symptom complex defined by nausea and/or vomiting with normal diagnostic testing, including anatomic assessments (including upper endoscopy) and measures of upper gut function (e.g., gastric emptying testing). Nausea and vomiting in this condition are postulated to result from aberrant peripheral or central neurohumoral activity. A substantial subset of patients satisfies this diagnosis as more than half of individuals referred for scintigraphic testing exhibit normal gastric emptying rates...
December 2016: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/27722801/chronic-unexplained-nausea-and-vomiting-or-gastric-neuromuscular-dysfunction-gnd-an-update-on-nomenclature-pathophysiology-and-treatment-and-relationship-to-gastroparesis
#13
REVIEW
Kimberly N Harer, Pankaj J Pasricha
Chronic unexplained nausea and vomiting is a debilitating condition that dramatically decreases patient quality of life and creates diagnostic and treatment challenges for healthcare providers. Additionally, the significant overlap in symptoms between disorders such as chronic unexplained nausea and vomiting, gastroparesis, and functional dyspepsia has resulted in a blurring of diagnostic lines and added confusion to the therapeutic approach. The identified overlap in clinical symptoms also suggests a common underlying pathophysiological mechanism may drive these conditions, indicating they could possibly be part of a spectrum of gastric neuromuscular disorders instead of discrete processes...
December 2016: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/27696279/diet-and-complementary-medicine-for-chronic-unexplained-nausea-and-vomiting-and-gastroparesis
#14
REVIEW
Ekta Gupta, Linda A Lee
Chronic nausea and vomiting, whether or not associated with gastroparesis, are among the most difficult symptoms to manage. Patients typically undergo extensive evaluation and empiric treatment often with suboptimal results. Conventional therapies may not produce adequate symptom relief or may cause unacceptable side effects. Thus, it is not surprising that patients report a negative impact on well-being, since the intermittent or constant occurrence of these symptoms are a source of anxiety as they impact social interactions and ability to work...
December 2016: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/27678506/gastric-electrical-stimulation-for-gastroparesis-and-chronic-unexplained-nausea-and-vomiting
#15
REVIEW
John M Wo, Thomas V Nowak, Shamaila Waseem, Matthew P Ward
Gastroparesis is a heterogeneous clinical syndrome. Some patients have debilitating vomiting, weight loss, and dehydration, while others have effortless regurgitation of undigested foods or postprandial distress suggestive of functional dyspepsia. Gastric electrical stimulation (GES) has been proposed as an effective treatment option for patients with gastroparesis refractory to medical therapy. Evidence suggests that the clinically available device, a low-energy high-frequency GES, activates the vagal afferent pathways to influence the central control mechanisms for nausea and vomiting...
December 2016: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/27617209/coxsackie-b5-infection-in-an-adult-with-fever-truncal-rash-diarrhea-and-splenomegaly-with-highly-elevated-ferritin-levels
#16
Paul K Valestra, Scarlet Herrarte Fornos, John Gian, Burke A Cunha
Coxsackie viruses are enteroviruses most common in children. Coxsackie B viral infections often present with biphasic fever, headache, pharyngitis, nausea/vomiting, diarrhea and a maculopapular rash that spares the palms and soles. These clinical features may be present in other viral infections. We present a case of a hospitalized adult with rash and fever with highly elevated ferritin levels later found to be due to Coxsackie B5. We believe this is the first case of Coxsackie B infection with otherwise unexplained highly elevated ferritin levels...
2016: IDCases
https://www.readbyqxmd.com/read/27600059/eosinophilic-ascites-a-diagnostic-challenge
#17
Hesham Khalil, Moby Joseph
Eosinophilic ascites is a rare feature of eosinophilic gastroenteritis. We would like to highlight this increasingly recognised diagnosis in a case of unexplained ascites. We present a challenging case of a woman aged 25 years who presented with nausea, vomiting, diarrhoea, generalised abdominal pain and swelling 8-week following delivery of her first baby. Her symptoms were primarily aggravated by eating, and she had also noticed postprandial itching and self-limiting generalised rash. She had a strong history of atopy...
September 6, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27558216/signs-and-symptoms-associated-with-synthetic-cannabinoid-toxicity-systematic-review
#18
Julie Courts, Virginia Maskill, Andrew Gray, Paul Glue
AIMS: Use of synthetic cannabinoids is associated with significant physical and psychological harms. This research quantified reported toxicities from published reports and assessed the influence of size of the reported study population on rates of symptom reporting. METHODS: Systematic review of published case reports and case series of toxicity associated with use of synthetic cannabinoids. RESULTS: Symptoms associated with synthetic cannabinoid toxicity were reported for 3695 individuals, predominantly young males...
December 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27531591/osmotic-and-stimulant-laxatives-for-the-management-of-childhood-constipation
#19
REVIEW
Morris Gordon, John K MacDonald, Claire E Parker, Anthony K Akobeng, Adrian G Thomas
BACKGROUND: Constipation within childhood is an extremely common problem. Despite the widespread use of osmotic and stimulant laxatives by health professionals to manage constipation in children, there has been a long standing paucity of high quality evidence to support this practice. OBJECTIVES: We set out to evaluate the efficacy and safety of osmotic and stimulant laxatives used to treat functional childhood constipation. SEARCH METHODS: We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the Cochrane IBD Group Specialized Trials Register from inception to 10 March 2016...
August 17, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27353154/-mesenteric-venous-thrombosis-during-pregnancy-a-rare-cause-of-acute-ischaemia-of-the-small-intestine
#20
B M M Reiber, R R Gorter, M Tenhagen, H A Cense, A Demirkiran
BACKGROUND: Acute ischaemia of the small intestine is caused by mesenteric venous thrombosis in 5-15% of patients. The non-specific symptoms frequently lead to a diagnostic delay. CASE DESCRIPTION: A 30-year-old pregnant woman presented at the accident and emergency department with progressive abdominal pain, nausea and vomiting. During admission the patient developed signs of peritonitis. Diagnostic laparoscopy revealed a picture of mesenteric venous thrombosis, and we resected 170 cm ischemic small intestine...
2016: Nederlands Tijdschrift Voor Geneeskunde
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