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https://www.readbyqxmd.com/read/28741278/italian-intersociety-consensus-on-prevention-diagnosis-and-treatment-of-delirium-in-hospitalized-older-persons
#1
Giuseppe Bellelli, Alessandro Morandi, Marco Trabucchi, Guido Caironi, Daniele Coen, Carlo Fraticelli, Ciro Paolillo, Carolina Prevaldi, Angela Riccardi, Gianfranco Cervellin, Corrado Carabellese, Salvatore Putignano, Stefania Maggi, Antonio Cherubini, Paola Gnerre, Andrea Fontanella, Nicola Latronico, Concezione Tommasino, Antonio Corcione, Giovanni Ricevuti, Nicola Ferrara, Francesco De Filippi, Alberto Ferrari, Mario Guarino, Maria Pia Ruggieri, Pietro Amedeo Modesti, Carlo Locatelli, Patrizia Hrelia, Marco Otto Toscano, Emi Bondi, Antonio Tarasconi, Luca Ansaloni, Francesco Perticone
Delirium is a severe neuropsychiatric syndrome characterized by inattention and global cognitive dysfunction in the setting of an acute medical illness, medical complication, drug intoxication, or drug withdrawal. The most important risk factors are advanced age and dementia, whereas pain, dehydration, infections, stroke, metabolic disturbances, and surgery are the most common triggering factors. Although delirium is a common clinical syndrome in different settings of care (acute care hospitals, inpatient rehabilitation facilities, nursing homes, and hospices), it often remains under-recognized, poorly understood, and inadequately managed...
July 24, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28739565/unusual-genitourinary-tract-activity
#2
Eoin MacCraith, Niall F Davis, James Forde
A 23-year-old woman presented to the emergency department after manually inserting foreign bodies into the urinary bladder through her urethra. A plain abdominal film of the kidneys, ureters and bladder confirmed three radio-opaque densities in the urinary bladder. She was taken to the operating room where cystourethroscopy was performed. At cystoscopy 2 'corn-on-the-cob' skewers and 1 battery were identified but were too large to be retrieved safely with a grasper through the protective sheath. The objects were grasped with a 'sponge-holding forceps' (placed alongside the cystoscope) and extracted one at a time...
July 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28737525/death-by-snow-a-fatal-forensic-case-of-cocaine-leakage-in-a-drug-mule-on-postmortem-computed-and-magnetic-resonance-tomography-compared-with-autopsy
#3
Patricia Mildred Flach, Dominic Gascho, René Fader, Rosita Martinez, Michael J Thali, Lars C Ebert
This forensic case presents unique postmortem imaging of a "drug mule" with fatal intoxication due to cocaine leakage on postmortem computed and magnetic resonance (MR) tomography compared with autopsy.Imaging by postmortem computed and MR tomography was performed before autopsy, histology, and toxicology were commissioned. Forensic imaging revealed 91 hyperdense, uniformly shaped body packs with signs of leakage, which was confirmed by autopsy. Postmortem MR imaging displayed the rarely described hypointense appearance of the body packs in T1- and T2-weighted sequences...
July 22, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28735669/lethal-gastric-mucosal-necrosis-due-to-administration-of-oral-ferrous-bisglycinate-chelate-to-suckling-piglets
#4
N Stokar-Regenscheit, T Sydler, E Bürgi, A Lippuner, H Naegeli, X Sidler
The oral application of a newly developed ferrous bisglycinate paste for suckling piglets at a dose of 180 mg/kg body weight led to increased death rates in 10% (n = 10) of Swiss test pig breeding farms (n = 100). Necropsy examination of suckling piglets (n = 12), selected randomly from the test farms with increased death rates, demonstrated severe gastric mucosal ulceration and necrosis. Due to the presence of crystalline iron surface coating within the gastric lesions, the iron was considered as the toxic principle and cause of death...
July 2017: Journal of Comparative Pathology
https://www.readbyqxmd.com/read/28734988/can-adverse-effects-of-excessive-vitamin-d-supplementation-occur-without-developing-hypervitaminosis-d
#5
REVIEW
Mohammed S Razzaque
Vitamin D is a fat-soluble hormone that has endocrine, paracrine and autocrine functions. Consumption of vitamin D-supplemented food & drugs have increased significantly in the last couple of decades due to campaign and awareness programs. Despite such wide use of artificial vitamin D supplements, serum levels of 25 hydroxyvitamin D [25(OH)D] does not always reflect the amount of uptake. In contrast to the safe sunlight exposure, prolonged and disproportionate consumption of vitamin D supplements may lead to vitamin D intoxication, even without developing hypervitaminosis D...
July 19, 2017: Journal of Steroid Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/28733094/isolated-non-cardiogenic-pulmonary-edema-a-rare-complication-of-mdma-toxicity
#6
Astrid Haaland, Elliot Warman, Illya Pushkar, Antonios Likourezos, Matt S Friedman
This is a case of a 19-year-old male who presented to the medical tent at an outdoor electronic dance music festival (EDMF) due to an altered mental state in the setting of acute 3,4-methylenedioxymethamphetamine (MDMA) intoxication. He was noted to be in severe respiratory distress, required endotracheal intubation in the field and subsequently developed Acute Respiratory Distress Syndrome (ARDS) without other acute organ dysfunction. He was hospitalized for 5days requiring endotracheal intubation and mechanical ventilation...
June 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28730575/the-effect-of-chronic-fluorosis-on-calcium-ions-and-camkii%C3%AE-and-c-fos-expression-in-the-rat-hippocampus
#7
Yao Teng, Jing Zhang, Zigui Zhang, Juan Feng
This study investigated neurotoxicity of chronic fluorosis in the rat hippocampus. Newly weaning, male, Sprague-Dawley (SD) rats were administered 15, 30, and 60 mg/L sodium fluoride (NaF) solution (fluorine ion concentration 8.25, 16.50, and 33.00 mg/L, respectively), and tap water, for 18 months. The neurotoxicological mechanism was examined with a focus on intracellular calcium overload. Results showed that as the fluoride concentration increased, calcium ion concentration [Ca(2+)], the expression of calcium/calmodulin-dependent protein kinase II α (CaMKIIα), and the expression of catus proto-oncogene protein c-fos (c-fos) all tend to increase...
July 20, 2017: Biological Trace Element Research
https://www.readbyqxmd.com/read/28728841/redox-imbalance-in-a-model-of-rat-mimicking-hutchinson-gilford-progeria-syndrome
#8
Manoj Kumar Chaudhary, Sandeep Singh, Syed Ibrahim Rizvi
Although several etiological factors contribute to the complexity of the aging process, the ultimate component of macromolecular damage and consequent cell death involves the altered redox balance inclined towards increased ROS production and/or decreased antioxidant protection. Given that, the chronic dihydrotachysterol (DHT) intoxication in rats induce Hutchinson Gilford progeria like syndrome, the present study provides the evidence for altered redox balance as evidenced by alteration in parameters of oxidative stress in blood plasma and erythrocytes including MDA, GSH, FRAP AOPP PMRS, AGEs, AChE and osmotic fragility which substantiate the suitability of the model for aging studies...
July 17, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28728000/tailor-made-purified-human-platelet-lysate-concentrated-in-neurotrophins-for-treatment-of-parkinson-s-disease
#9
Ming-Li Chou, Joe-Wei Wu, Flore Gouel, Aurélie Jonneaux, Kelly Timmerman, Ting-Yi Renn, Charlotte Laloux, Hung-Ming Chang, Liang-Tzung Lin, Jean-Christophe Devedjian, David Devos, Thierry Burnouf
Human platelet lysates (PLs), which contain multiple neurotrophins, have been proposed for treating neurodegenerative disorders, including Parkinson's disease (PD). However, current PLs suspended in plasma have high protein content and contain fibrinogen/fibrin and, following activation, also proteolytic and thrombogenic enzymes. Upon brain administration, such PLs may saturate the cerebrospinal fluid and exert neurotoxicity. We assessed whether purified PLs, concentrated in neurotrophins, protected dopaminergic neurons in PD models...
July 12, 2017: Biomaterials
https://www.readbyqxmd.com/read/28725569/psychiatric-adult-onset-of-urea-cycle-disorders-a-case-series
#10
Adrien Bigot, Paul Brunault, Christian Lavigne, François Feillet, Sylvie Odent, Elsa Kaphan, Christel Thauvin, Vanessa Leguy, Pierre Broué, Michel C Tchan, François Maillot
Adult onset urea cycle disorders (UCD) may present with psychiatric symptoms, occasionally as the initial presentation. We aimed to describe the characteristics of patients presenting with a psychiatric adult-onset of UCDs, to discuss which signs could suggest this diagnosis in such a situation, and to determine which tests should be conducted. A survey of psychiatric symptoms occurring in teenagers or adults with UCD was conducted in 2010 among clinicians involved in the French society for the study of inborn errors of metabolism (SFEIM)...
September 2017: Molecular Genetics and Metabolism Reports
https://www.readbyqxmd.com/read/28724413/smoking-related-general-and-cause-specific-mortality-in-estonia
#11
Gea Kõks, Krista Fischer, Sulev Kõks
BACKGROUND: Tobacco smoking is known to be the single largest cause of premature death worldwide. The aim of present study was to analyse the effect of smoking on general and cause-specific mortality in the Estonian population. METHODS: The data from 51,756 adults in the Estonian Genome Center of the University of Tartu was used. Information on dates and causes of death was retrieved from the National Causes of Death Registry. Smoking status, general survival, general mortality and cause-specific mortality were analysed using Kaplan-Meier estimator and Cox proportional hazards models...
July 19, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28724276/fatal-small-intestinal-ischemia-due-to-methamphetamine-intoxication-report-of-a-case-with-autopsy-results
#12
Hamid Attaran
Methamphetamine is one of the most common abused drugs, so its various effects on different body organs should be familiar to all physicians. Regarding its gastrointestinal sequels, there are few reports of ischemic colitis induced by its vasoconstrictive effects. This is the first report of isolated small intestinal infarction resulting in death following methamphetamine toxicity. A 40-year-old woman with a past history of medical treatment for obesity referred to hospital with severe chest and back pain, perspiration, nausea, agitation, high blood pressure, bradycardia and subsequent lethargy and vasomotor instability...
May 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28724204/gait-and-balance-impairment-after-acute-methanol-poisoning
#13
Kamila Peterová, Hana Brožová, Jiří Klempíř, Irena Lišková, Ondřej Bezdíček, Petr Ridzoň, Manuela Vaněčková, Sergej Zakharov, Daniela Pelclová, Michal Miovský, Evžen Růžička
Neurological sequelae including gait impairment were reported in survivors after methanol intoxication; however, no systematic study has been published so far. We aimed to analyse gait and balance impairment in a group of Czech methanol poisoning survivors. We examined 43 patients (age 46±13 years) 2-8 months after methanol poisoning and 43 healthy controls. Investigations contained a shortened version of Falls Efficacy Scale (FES), clinical tests of gait and balance including Timed Up and Go test (TUG) and gait analysis using GaitRite(®) system, neurological and neuropsychological examination, brain imaging, EMG and tests of alcohol consumption...
July 19, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28724162/-psychosis-intoxication-or-serotonin-syndrome-a-20-year-old-male-with-ziprasidone-und-sertraline
#14
Sven Speerforck, Deborah Janowitz, Georg Schomerus, Hans J Grabe
A young male with schizophrenia, dependence syndrome (multiple drug use) and a severe depressive episode develops a serotonin syndrome with Sertraline and Ziprasidone. Making the correct diagnosis, although potentially challenging, remains vital.
July 19, 2017: Psychiatrische Praxis
https://www.readbyqxmd.com/read/28723840/cervical-spine-evaluation-and-clearance-in-the-intoxicated-patient-a-prospective-western-trauma-association-multi-institutional-trial-and-survey
#15
Matthew J Martin, Lisa D Bush, Kenji Inaba, Saskya Byerly, Martin Schreiber, Kimberly A Peck, Galinos Barmparas, Jay Menaker, Joshua P Hazelton, Raul Coimbra, Martin D Zielinski, Carlos V R Brown, Chad G Ball, Jill R Cherry-Bukowiec, Clay Cothren Burlew, Julie Dunn, C Todd Minshall, Matthew M Carrick, Gina M Berg, Demetrios Demetriades, William Long
INTRODUCTION: Intoxication often prevents clinical clearance of the cervical spine (Csp) after trauma leading to prolonged immobilization even with a normal CT scan. We evaluated the accuracy of CT at detecting clinically significant Csp injury, and surveyed participants on related opinions and practice. METHODS: A prospective multicenter study (2013-2015) at 17 centers. All adult blunt trauma patients underwent structured clinical examination and imaging including a Csp CT, with follow-up thru discharge...
July 19, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28723276/can-an-app-help-identify-psychomotor-function-impairments-during-drinking-occasions-in-the-real-world-a-mixed-method-pilot-study
#16
Brian Suffoletto, Akash Goyal, Juan Carlos Puyana, Tammy Chung
BACKGROUND: Being able to measure the acute effects of alcohol consumption on psychomotor functions in natural settings could be useful in injury prevention interventions. This study examined the feasibility and acceptability of collecting app-based measures of information processing, working memory and gait stability during times of typical alcohol consumption among young adults. METHODS: Ten young adults (aged 21-26) with hazardous drinking completed a baseline assessment and ecological momentary assessments (EMA) on 4 consecutive Fridays and Saturdays, every hour from 8pm to 12am...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28722512/in-silico-and-in-vitro-evaluation-of-two-novel-oximes-k378-and-k727-in-comparison-to-k27-and-pralidoxime-against-paraoxon-ethyl-intoxication
#17
Maria Chaudhry, Muhammad Qaiser Fatmi, Kamil Musilek, Alamdar Hussain, Kamil Kuca, Georg Petroianu, Huba Kalasz, Syed Muhammad Nurulain
Organophosphate (OP) poisoning is a major global health issue; while compounds from this group have been used intensively over the last century, an effective antidote is still lacking. Oxime-type AChE reactivators are used to reactivate the OP inhibited AChE. Pralidoxime is the only US Food and Drug Administration, (FDA) approved oxime for therapeutic use but its efficacy has been disappointing. Two novel oximes (K378 and K727) were investigated in silico and in vitro and compared with an experimental oxime (kamiloxime; K-27) and pralidoxime...
July 19, 2017: Toxicology Mechanisms and Methods
https://www.readbyqxmd.com/read/28721543/-decision-aids-in-complex-polypharmacy-medication-data-bases-and-counselling-by-clinical-pharmacists
#18
REVIEW
W Weinrebe, R Preda, S Bischoff, D Nussbickel, M Humm, K Jeckelmann, S Goetz
The number of older people with polypharmacy (more than six drugs taken simultaneously) is increasing. The greatest proportion consists of guideline drugs, analgesics and psychopharmaceuticals because in many cases of geriatric multimorbidity several underlying main diseases are present which must be treated according to the guidelines. Polypharmacy is a complex and difficult situation for all treating physicians because substantial side effects and intoxication can be induced but it can also be very difficult to recognize which drug was at fault and how a reduction can be safely made...
July 18, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28720405/persistent-cognitive-and-morphological-alterations-induced-by-repeated-exposure-of-adolescent-rats-to-the-abused-inhalant-toluene
#19
K M Braunscheidel, J T Gass, P J Mulholland, S B Floresco, J J Woodward
While thepsychoactive inhalant toluene causes behavioral effects similarto those produced by other drugs of abuse, the persistent behavioral and anatomical abnormalities induced by toluene exposure are not well known. To mimic human "binge-like" inhalant intoxication, adolescent, male Sprague-Dawley rats were exposed to toluene vapor (57,000ppm) twice daily for five consecutive days. These rats remained in their home cages until adulthood (P60), when they were trained in operant boxes to respond to a palatable food reward and then challenged with several different cognitive tasks...
July 15, 2017: Neurobiology of Learning and Memory
https://www.readbyqxmd.com/read/28719733/characterizing-a-mouse-model-for-evaluation-of-countermeasures-against-hydrogen-sulfide-induced-neurotoxicity-and-neurological-sequelae
#20
Poojya Anantharam, Elizabeth M Whitley, Belinda Mahama, Dong-Suk Kim, Paula M Imerman, Dahai Shao, Monica R Langley, Arthi Kanthasamy, Wilson K Rumbeiha
Hydrogen sulfide (H2 S) is a highly neurotoxic gas. It is the second most common cause of gas-induced deaths. Beyond mortality, surviving victims of acute exposure may suffer long-term neurological sequelae. There is a need to develop countermeasures against H2 S poisoning. However, no translational animal model of H2 S-induced neurological sequelae exists. Here, we describe a novel mouse model of H2 S-induced neurotoxicity for translational research. In paradigm I, C57/BL6 mice were exposed to 765 ppm H2 S for 40 min on day 1, followed by 15-min daily exposures for periods ranging from 1 to 6 days...
July 18, 2017: Annals of the New York Academy of Sciences
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