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https://www.readbyqxmd.com/read/29786953/iatrogenic-botulism-outbreak-in-egypt-due-to-a-counterfeit-botulinum-toxin-a-preparation-a-descriptive-series-of-patient-features-and-outcome
#1
Eman Abdel Monaem Abdel Rashid, Nashwa Mohamed El-Mahdy, Huda Shehata Kharoub, Ahmed Salah Gouda, Naglaa Ahmed ElNabarawy, Bruno Mégarbane
Iatrogenic botulism resulting from the substantial increase in use of botulinum neurotoxin type-A (BoNT-A) treatment is rarely reported. We aimed to describe a large iatrogenic botulism outbreak in Egypt in June-July 2017. Nine patients developed botulism after receiving intramuscular injections of BoNT-A (dose: 200-300 IU) to treat cerebral palsy (N=7), spastic dystonia (N=1), and hyperhidrosis (N=1). Detailed findings were available in 5/9 cases. Patients were admitted to the hospital 5-10 days after the BoNT-A injection...
May 22, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29786924/reproductive-ecology-of-ocotea-catharinensis-an-endangered-tree-species
#2
Tiago Montagna, Juliano Zago da Silva, Tiago Georg Pickart, Maurício Sedrez Dos Reis
Ocotea catharinensis (Lauraceae) is an endangered tree species from the Brazilian Atlantic Rainforest. Currently, little is known about the reproductive ecology of this species. Aiming to propose conservation measures, we described aspects related to phenology, floral biology, pollination, seed dispersal, and mating system of O. catharinensis. We conducted phenological observations in 62 individuals for two years. In one reproductive event, we evaluated nectar production, stigmatic receptivity, and pollen viability...
May 22, 2018: Plant Biology
https://www.readbyqxmd.com/read/29786869/rare-labial-ulcer-related-to-the-use-of-all-trans-retinoic-acid-in-a-patient-with-acute-promyelocytic-leukemia
#3
M P Buligon, J C Mielke, K L Ferrazzo, J Chiesa
Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia (AML). All-trans retinoic acid (ATRA) is the first-choice therapy for the treatment of this disease, but has been associated with side effects, the most serious of which is retinoic acid syndrome (RAS). RAS is characterized by unexplained fever, dyspnea, pulmonary infiltrate, leukocytosis and nephropathy. Genital ulcers have been described in some cases, but only two cases of oral ulcers related to this syndrome have been described in the literature...
May 22, 2018: Special Care in Dentistry
https://www.readbyqxmd.com/read/29786826/rare-case-of-bilateral-incarcerated-obturator-hernia-a-case-report
#4
Engin Hatipoğlu, Fatih Dal, Veysel Umman, Süleyman Demiryas, Oktay Demirkıran, Metin Ertem, Sabri Ergüney, Salih Pekmezci
Here, we report the case of an 84-year-old woman with acute mechanical intestinal obstruction (AMIO) who was admitted to our Emergency Department. Computed tomography (CT) scan revealed an incarcerated bilateral obturator hernia, and the defect was resolved using transabdominal preperitoneal (TAPP) technique with polypropylene mesh. The patient was administered an oral regimen two days after the operation. The patient stayed in the intensive care unit for 4 days and was uneventfully discharged on the 9th postoperative day...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29786112/ctla%C3%A2-4-interferes-with-the-hbv%C3%A2-specific-t-cell-immune-response-review
#5
Hui Cao, Ruiwen Zhang, Wei Zhang
Hepatitis B virus (HBV) infection is a major cause of hepatic inflammation. Successful HBV clearance in patients is associated with sustained viral control by effector T cells. Compared with acute hepatitis B, chronic HBV infection is associated with the depletion of T cells, resulting in weak or absent virus‑specific T cells reactivity, which is described as 'exhaustion'. This exhaustion is characterized by impaired cytokine production and sustained expression of multiple coinhibitory molecules. Cytotoxic T lymphocyte‑associated antigen‑4 (CTLA‑4) is one of many coinhibitory molecules that can attenuate T cell activation by inhibiting costimulation and transmitting inhibitory signals to T cells...
May 17, 2018: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/29786007/bilateral-acute-retinal-necrosis-associated-with-bilateral-uveal-effusion-in-an-immunocompetent-patient-a-challenging-association
#6
S Bala Murugan, Girish Bharat Velis, Manavi D Sindal
Bilateral uveal effusion syndrome associated with bilateral acute retinal necrosis is a diagnostic and therapeutic challenge. A 52 year old man presented with bilateral angle closure with choroidal detachment. With restricted fundus view, parenteral steroid was started. During close follow up bilateral discrete areas of peripheral retinitis were noted. Parenteral steroids were promptly stopped and parenteral antivirals with oral steroids were continued. It showed healing response with nil recurrences till last follow up...
June 2018: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29785886/treatment-of-homozygous-familial-hypercholesterolaemia-in-paediatric-patients-a-monocentric-experience
#7
Paola S Buonuomo, Marina Macchiaiolo, Giovanna Leone, Paola Valente, Gerarda Mastrogiorgio, Maria Gnazzo, Ippolita Rana, Michaela V Gonfiantini, Maria G Gagliardi, Francesca Romano, Andrea Bartuli
Background Homozygous familial hypercholesterolaemia is a rare life-threatening disease characterized by markedly elevated low-density lipoprotein cholesterol (LDL-C) concentrations and accelerated atherosclerosis. The presence of double gene defects in the LDL-Receptor, either the same defect (homozygous) or two different LDL-raising mutations (compound heterozygotes) or other variants, identify the homozygous phenotype (HopFH). Apheresis is a procedure in which plasma is separated from red blood cells before the physical removal of LDL-C or the LDL-C is directly removed from whole blood...
January 1, 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29785865/an-oesophageal-spring
#8
Elisabetta Calamelli, Tomasso Gargano, Sandra Brusa, Paolo Bottau, Mario Lima, Marcello Lanari
Oesophageal foreign bodies (OFBs) are a relatively common emergency in young children. OFBs are complicated by significant morbidity and mortality because their ingestion often occurs without witnesses, leading to a delay in diagnosis and treatment. We report an occult OFB in an 11-month-old infant who initially presented without any specific respiratory symptoms, mimicking a respiratory infection. Worsening of the patient's cough, which did not show any improvement, despite treatment, and progressive onset of gastrointestinal manifestations (dysphagia, vomiting, and drooling) led to the diagnosis of an OFB (metallic spring)...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29785455/robotic-assisted-laparoscopic-median-arcuate-ligament-release-7-year-experience-from-a-single-tertiary-care-center
#9
Usah Khrucharoen, Yen-Yi Juo, Yas Sanaiha, Yijun Chen, Juan C Jimenez, Erik P Dutson
BACKGROUND: Despite previous reports of robotic-assisted laparoscopic release for median arcuate ligament syndrome (MALS), the safety and efficacy profile of this approach has been difficult to establish due to the rarity of this diagnostic entity. We aim to present our experience from a tertiary minimally invasive surgery referral center. METHODS: A case series was performed whereby all patients who underwent robotic-assisted MAL release from July 2010 to July 2017 at our institution were included...
May 21, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29785406/fluid-extravasation-in-shoulder-arthroscopic-surgery-a-systematic-review
#10
REVIEW
Muzammil Memon, Jeffrey Kay, Arian Gholami, Nicole Simunovic, Olufemi R Ayeni
Background: Arthroscopic surgery of the shoulder joint has become increasingly more common given its advantages over open surgery; however, one rare but potentially life-threatening complication is fluid extravasation into the surrounding tissues, causing edema, respiratory compromise, abnormal results on laboratory blood tests, and possibly death. Currently, no systematic review exists that summarizes the existing clinical research on this topic. Purpose: To perform a systematic review on fluid extravasation as a complication of shoulder arthroscopic surgery, specifically assessing clinical presentation, risk factors, management, and outcomes...
May 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29785271/right-ventricular-dysfunction-and-pulmonary-hypertension-a-neglected-presentation-of-thyrotoxicosis
#11
Carolina Shalini Singarayar, Foo Siew Hui, Nicholas Cheong, Goay Swee En
Thyrotoxicosis is associated with cardiac dysfunction; more commonly, left ventricular dysfunction. However, in recent years, there have been more cases reported on right ventricular dysfunction, often associated with pulmonary hypertension in patients with thyrotoxicosis. Three cases of thyrotoxicosis associated with right ventricular dysfunction were presented. A total of 25 other cases of thyrotoxicosis associated with right ventricular dysfunction published from 1994 to 2017 were reviewed along with the present 3 cases...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29785146/provider-use-of-a-participatory-decision-making-style-with-youth-and-caregivers-and-satisfaction-with-pediatric-asthma-visits
#12
Betsy Sleath, Delesha M Carpenter, Imelda Coyne, Scott A Davis, Claire Hayes Watson, Ceila E Loughlin, Nacire Garcia, Daniel S Reuland, Gail E Tudor
Background: We conducted a randomized controlled trial to test the effectiveness of an asthma question prompt list with video intervention to engage the youth during clinic visits. We examined whether the intervention was associated with 1) providers including youth and caregiver inputs more into asthma treatment regimens, 2) youth and caregivers rating providers as using more of a participatory decision-making style, and 3) youth and caregivers being more satisfied with visits. Methods: English- or Spanish-speaking youth aged 11-17 years with persistent asthma and their caregivers were recruited from four pediatric clinics and randomized to the intervention or usual care groups...
2018: Patient related Outcome Measures
https://www.readbyqxmd.com/read/29785125/-znf418-overexpression-protects-against-gastric-carcinoma-and-prompts-a-good-prognosis
#13
Hong-Xia Hui, Zhong-Wu Hu, Chao Jiang, Jian Wu, Yong Gao, Xiao-Wei Wang
Background: This study aimed to investigate the prognostic power of zinc-finger protein 418 ( ZNF418 ) in gastric cancer (GC) and its potential role in GC development and progression. Patients and methods: A total of 10 GC patients' individual plasmas were collected and screened for dysregulated mRNA using human microarray. Among these dysregulated mRNAs, ZNF418 was found to be significantly downregulated in IIIA-IV stage GC patients compared to IA-IIA stage GC patients...
2018: OncoTargets and Therapy
https://www.readbyqxmd.com/read/29785116/myopathy-due-to-hmgcr-antibodies-in-adult-mimicking-muscular-dystrophy-associated-with-cancer-and-statin-exposure-narrative-review-of-the-literature-case-report
#14
Alzira Alves de Siqueira Carvalho, Vinicius Gomes da Silva, Edmar Zanoteli, David Feder
Necrotizing autoimmune myopathy is characterized by predominant muscle fiber necrosis and regeneration with little or no inflammation. We describe a 58-year-old woman with previous breast cancer and statin use who complained of rapidly progressive weakness of lower limbs without pain, making walking, running and climbing stairs difficult. The creatine kinase level was 2,843 U/L, and muscle biopsy showed a dystrophic pattern. The genetic test for muscular dystrophies was negative and for anti-3-hydroxy-3-methylglutaryl coenzyme A reductase was positive...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29785097/inter-gender-differences-of-balance-indicators-in-persons-60-90-years-of-age
#15
Ewa Puszczalowska-Lizis, Przemyslaw Bujas, Slawomir Jandzis, Jaroslaw Omorczyk, Marek Zak
Introduction: Precision of movements responsible for maintaining balance deteriorates with age due to natural involutionary processes, thus prompting a research question whether the values of gender-related stability indicators might differ significantly among the study subjects over 60 years of age. Methods: The study group comprised 136 seniors (89 women, 47 men; aged 60-90 years). The CQ-Stab 2P 2-platform posturograph was used as the main research device, whereas the Mann-Whitney U -test was used to evaluate the gender-related differences in the average level of variables...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29784845/interaction-of-bacterial-phenazines-with-colistimethate-in-bronchial-epithelial-cells
#16
Valeri V Mossine, Deborah L Chance, James K Waters, Thomas P Mawhinney
Multidrug-resistant bacterial infections are being increasingly treated in clinics with polymyxins, a class of antibiotics associated with adverse effects in the kidney, nervous system, or airways of a significant proportion of human and animal patients. Although many of the resistant pathogens display enhanced virulence, a hazard of cytotoxic interactions between polymyxin antibiotics and bacterial virulence factors (VFs) has not been assessed, to date. We report here on testing paired combinations of four Pseudomonas aeruginosa VF phenazine toxins, pyocyanin (PYO), 1-hydroxyphenazine (1-HP), phenazine-1-carboxylic acid (PCA), phenazine-1-carboxamide (PCN), and two commonly prescribed polymyxin drugs, colistimethate (CMS)/colistin and polymyxin B, in three human airway cell lines, BEAS-2B, HBE-1, and CFT-1...
May 21, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29784490/clinical-approach-to-patients-with-palpitations
#17
REVIEW
Franco Giada, Antonio Raviele
Palpitations are among the most common symptoms that prompt patients to consult a physician. In the diagnostic workup of patients with palpitations, the initial evaluation involves history, physical examination, and 12-lead electrocardiogram. These investigations yield a prognostic stratification of the patients, and a definitive suspected diagnosis of the cause of symptoms in a good proportion of cases. When the initial evaluation results are negative and the patient is suffering from heart disease, or if the palpitations are frequent or poorly tolerated and with a high probability of an arrhythmic origin, ambulatory electrocardiogram monitoring and/or electrophysiological study should be undertaken...
June 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29784219/an-attempt-to-stem-the-tide-exploring-the-effect-of-a-90-day-transitional-care-intervention-on-readmissions-to-an-acute-male-psychiatric-unit-in-south-africa
#18
Ulla A Botha, Marise Coetzee, Liezl Koen, Dana J H Niehaus
INTRODUCTION: Pressure on inpatient beds often results in premature discharges, which may precipitate early readmission. This has prompted an increased interest in transitional care interventions to bridge the gap between in- and outpatient care to reduce such readmissions. Our study aimed to assess the effect of a Transitional Care Service (TCS) on readmission rates in a high pressure inpatient service which utilizes a premature discharge policy to address bed pressures. METHODS: Sixty male patients identified for crisis discharge were offered a TCS for the first ninety days after discharge...
June 2018: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/29784062/multidrug-resistant-proteus-mirabilis-and-escherichia-coli-causing-fulminant-necrotising-fasciitis-a-case-report
#19
Eugene Vernyuy Yeika, Joyce Bei Foryoung, Derrick Tembi Efie, Eugene Adze Nkwetateba, Paul Nkemtendong Tolefac, Marcelin Ngowe Ngowe
BACKGROUND: Necrotizing fasciitis is a rare soft tissue infection characterized by rapid progressive necrosis with relative sparing of underlying muscles. This case is reported to highlight the emergence of multidrug resistant microbes in recent days which limits the use of empiric antibiotic therapy and necessitates early cultures and sensitivity enabling targeted antibiotic therapy. Factors that lead to antimicrobial resistance especially in sub-Saharan Africa have also been discussed...
May 21, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29783852/usefulness-of-the-surprise-question-on-an-inpatient-oncology-service
#20
Sarguni Singh, Adrian Rodriguez, Darrell Lee, Sung-Joon Min, Stacy Fischer
BACKGROUND: Prognostication of survival in patients with advanced cancer has been challenging and contributes to poor illness understanding. Prognostic disagreement occurs even among providers and is a less studied phenomenon. OBJECTIVE: We introduced the surprise question (SQ), "Would I be surprised if this patient died in the next 1 year, 6 months, and 1 month?," at multidisciplinary rounds to increase palliative care referrals through the introduction of this prognostic prompt...
January 1, 2018: American Journal of Hospice & Palliative Care
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