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Mehruba Anwar, Matthew Turner, Natalija Farrell, Wendy B Zomlefer, Owen M McDougal, Brent W Morgan
INTRODUCTION: Steroidal alkaloids are found in plants of the genus Veratrum. Their toxicity manifests as gastrointestinal symptoms followed by a Bezold-Jarisch reflex: hypopnea, hypotension, and bradycardia. Some Veratrum steroidal alkaloids are also teratogens interfering with the hedgehog-2 signaling pathway, which causes cyclopsia and holoprosencephaly. We present a case of accidental poisoning from Veratrum parviflorum mistaken for the edible Allium tricoccum (ramps, wild leek). CASE HISTORY: A 27-year-old man and his 25-year-old wife presented to the emergency department with nausea, vomiting, hypotension, and bradycardia after foraging and ingesting plants that they believed to be a local native species of wild leek...
February 28, 2018: Clinical Toxicology
Alexandre F Cunha, Igor S A Felippe, Nilson C Ferreira-Junior, Leonardo B M Resstel, Daniela A M Guimarães, Vanessa Beijamini, Julian F R Paton, Karla N Sampaio
Although it is well-established that severe poisoning by organophosphorus (OP) compounds strongly affects the cardiorespiratory system, the effects of sub-lethal exposure to these compounds on the neural control of cardiovascular function are poorly explored. The aim of this study was to evaluate the effects of acute sub-lethal exposure to chlorpyrifos (CPF), a commonly used OP insecticide, on three basic reflex mechanisms involved in blood pressure regulation, the peripheral chemoreflex, the baroreflex and the Bezold-Jarisch reflex...
February 19, 2018: Toxicology
Nicole Sänger, Andrea Jarisch, Falk Ochsendorf, Thomas Klingebiel, Jana Liebenthron, Sabine Kliesch, Michael von Wolff
BACKGROUND: Due to rising survival rates in cancer and autoimmune diseases fertility preservation before gonadotoxic therapies has become increasingly important. Although fertility can be significantly affected by gonadotoxic therapies, the possibility of fertility preservation during childhood has not been sufficiently considered so far. METHODS: Selective literature research with presentation of fertility preservation methods, their indications, implementations, risks and efficacy...
February 8, 2018: Klinische Pädiatrie
Peter Bader, Zyrafete Kuçi, Shahrzad Bakhtiar, Oliver Basu, Gesine Bug, Michael Dennis, Johann Greil, Aniko Barta, Krisztián M Kállay, Peter Lang, Giovanna Lucchini, Raj Pol, Ansgar Schulz, Karl-Walter Sykora, Irene von Luettichau, Grit Herter-Sprie, Mohammad Ashab Uddin, Phil Jenkin, Abdulrahman Alsultan, Jochen Buechner, Jerry Stein, Agnes Kelemen, Andrea Jarisch, Jan Soerensen, Emilia Salzmann-Manrique, Martin Hutter, Richard Schäfer, Erhard Seifried, Thomas Klingebiel, Halvard Bonig, Selim Kuçi
The inability to generate mesenchymal stromal cells (MSCs) of consistent potency likely is responsible for inconsistent clinical outcomes of patients with aGvHD receiving MSC products. We developed a novel MSC manufacturing protocol characterized by high in vitro potency and near-identity of individual doses, referred to as "MSC-Frankfurt am Main (MSC-FFM)". Herein, we report outcomes of the 69 patients who have received MSC-FFM. These were 51 children and 18 adults with refractory aGvHD grade II (4%), III (36%) or IV (59%)...
January 29, 2018: Bone Marrow Transplantation
Wenbo He, Xiaoying Wang, Shan Liu, Xiaomei Yu, Zhibing Lu, Ruisong Ma, Da Luo, Jing Xie, Bo He, Hong Jiang
PURPOSE: Individuals predisposed to vasovagal syncope may have different autonomic nervous system control mechanisms from those without predisposition to vasovagal events. To test this hypothesis, we investigated different sympathetic responses in a canine model of vasovagal syncope. METHODS: Left thoracotomy was performed on 20 mongrel dogs. The heart was exposed and a bolus of veratridine (15 μg/kg), a neurotoxin which prevents the inactivation of sodium ion channels, was injected into the left atrium to induce a Bezold-Jarisch reflex-mediated vasovagal event, characterized by bradycardia, decreased inotropism, and hypotension...
January 24, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Yael Koton, Naiel Bisharat
No abstract text is available yet for this article.
January 2018: Israel Medical Association Journal: IMAJ
M S W Quaak, H H J Bavelaar, J Berkhout, G J Truin, E M Bijker
BACKGROUND: Neurobrucellosis is a rare complication of brucellosis, a bacterial zoonotic disease endemic in regions such as the Middle East. It is important to be alert for this imported disease in the Netherlands as well, especially among migrants. CASE DESCRIPTION: A 14-year-old boy from Syria presented with headache, vomiting and weight loss. Brucella melitensis was identified in the cerebrospinal fluid. The patient's condition deteriorated despite antibiotic treatment, particularly neurologically, and imaging revealed a newly developed hydrocephalus...
2017: Nederlands Tijdschrift Voor Geneeskunde
Sarah Micozzi, Patricia Rojas Perez-Ezquerra, Cristina Morales-Cabeza, Cristina Diez, Manuel De Barrio
BACKGROUND: HIV positive patients can suffer many complications due to infectious diseases. A severe reaction to some of the drugs involved in the treatment can overlap with the symptoms of infections, making diagnosis very difficult. We present the case of an HIV positive 28-year-old-man, , with secondary syphilis, who developed a Stevens Johnson Syndrome (SJS) caused by one of the many drugs he was receiving. The SJS overlapped with a possible Jarisch Herxheimer Reaction, which complicated diagnosis of the skin reaction...
October 26, 2017: Recent Patents on Inflammation & Allergy Drug Discovery
Yuping Cao, Xiaohong Su, Qianqiu Wang, Huazhong Xue, Xiaofeng Zhu, Chuanfu Zhang, Juan Jiang, Shuzhen Qi, Xiangdong Gong, Xiaofang Zhu, Min Pan, Hong Ren, Wenlong Hu, Zhiping Wei, Meihua Tian, Weida Liu
Background: The aim of this study was to assess the efficacy of ceftriaxone and benzathine penicillin G (BPG) in nonpregnant, immunocompetent adults with early syphilis because there is a lack of clinical evidence supporting ceftriaxone as an alternative treatment for early syphilis without an human immunodeficiency virus coinfection. Methods: A randomized, open-label controlled study evaluating the efficacy of ceftriaxone and BPG was conducted in 4 hospitals in Jiangsu Province...
October 30, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Kai-Ming Yuan, Shu-Ying Fu, Jun Li, Wang-Ning Shangguan, Qing-Quan Lian
RATIONALE: Bezold-Jarisch reflex (BJR) occurs when the cardioinhibitory receptors in the walls of ventricles are activated by various stimuli, with typical features of bradycardia, vasorelaxation, and hypotension. This reflex usually happens in parturient intrathecal anesthesia, as a result of decreased venous return by compression of inferior vena cava, but it is only rarely reported during general anesthesia. PATIENT CONCERNS: Severe bradycardia and hypotension, indicating BJR, occurred during the induction of general anesthesia in a 3-month-old female child with giant intra-abdominal teratoma...
October 2017: Medicine (Baltimore)
Toshio Machida, Yoshinori Higuchi, Shigeki Nakano, Satoshi Ishige, Junichiro Shimada, Koichi Honma
BACKGROUND: Hypotension is a significant risk factor for the development of ischemic complication following revascularization surgery for moyamoya disease (MMD). However, it is currently unknown whether autonomic dysfunction also plays a role. CASE DESCRIPTION: Here we report a case of MMD in which hypotension due to autonomic dysfunction caused postoperative cerebral ischemia. A 30-year-old female patient with MMD had a history of transient right hemiparesis following laughter...
January 2018: World Neurosurgery
Caiying Wang, Shuxin He, Hongling Yang, Yuhuan Liu, Yang Zhao, Lin Pang
OBJECTIVES: The objective of this retrospective study was to summarise the clinical manifestations of, and to analyse the incidence and risk factors of, Jarisch-Herxheimer reaction (JHR) during the treatment of children with symptomatic congenital syphilis. METHODS: Clinical data of 60 children with clinically and laboratory diagnosed congenital syphilis, hospitalised in Beijing Ditan Hospital between January 2010 and November 2015, were collected and analysed. RESULTS: A total of 11 patients with congenital syphilis (11/60, 18...
September 23, 2017: Sexually Transmitted Infections
Michael George Zaki Ghali
The sympathetic nervous system maintains and regulates arterial pressure and tissue perfusion, via control of cardiac output and vasomotor tone. Sympatho-vascular-mediated increases in blood pressure are effected by arterioloconstriction, which causes an increase in afterload, and/or venoconstriction, which increases venous return, left ventricular preload, and consequently, the force of cardiac contraction via Frank-Starling mechanisms; withdrawal of sympathetic drive elicits reciprocal effects. Spinalization reduces mammalian arterial pressure to 40-50 mm Hg consequent to the elimination of descending medullary pre-sympathetic bulbospinal drive to preganglionic sympathetic fibers in the intermediolateral cell column of the spinal cord...
2017: Journal of Integrative Neuroscience
Monish S Raut, Arun Maheshwari, Sumir Dubey
No abstract text is available yet for this article.
December 2017: Journal of Cardiothoracic and Vascular Anesthesia
A Balduzzi, J-H Dalle, K Jahnukainen, M von Wolff, G Lucchini, M Ifversen, K T Macklon, C Poirot, T Diesch, A Jarisch, D Bresters, I Yaniv, B Gibson, A M Willasch, R Fadini, L Ferrari, A Lawitschka, A Ahler, N Sänger, S Corbacioglu, M Ansari, R Moffat, A Dalissier, E Beohou, P Sedlacek, A Lankester, C D De Heredia Rubio, K Vettenranta, J Wachowiak, A Yesilipek, E Trigoso, T Klingebiel, C Peters, P Bader
Fertility preservation is an urgent challenge in the transplant setting. A panel of transplanters and fertility specialists within the Pediatric Diseases Working Party of the European Society for Blood and Marrow Transplantation (EBMT) and the International BFM Study Group provides specific guidelines. Patients and families should be informed of possible gender- and age-specific cryopreservation strategies that should be tailored according to the underlying disease, clinical condition and previous exposure to chemotherapy...
October 2017: Bone Marrow Transplantation
Randi Connor-Schuler, Anee Khan, Nikhil Goyal, Erin Zimny
We present a case of Weil's disease complicated by a Jarisch-Herxheimer reaction (JHR) after initiation of antibiotics while in the emergency department requiring invasive monitoring and vasopressor support. The case is followed by a brief review of the JHR which is rarely observed with treatment of leptospirosis. A healthy 28-year-old female who recently returned from the Caribbean presented to the emergency department with flu-like symptoms. The patient appeared jaundiced with conjunctival suffusion and was ultimately treated with the appropriate antibiotics for leptospirosis in the ED...
August 2017: American Journal of Emergency Medicine
Johann P Kuhtz-Buschbeck, Jochen Schaefer, Nicolaus Wilder
Scientific interest in mechanosensation likely commenced with Aristotle's description of the sense of touch in his treatise de Anima [On the Soul]. Considering touch as a vital sense distributed over the whole body, the philosopher outlined a "physiological concept" at the macro-level already 2400 years ago. From this starting point, we outline the onset of modern sensory physiology during the early 19th century. Physiologists distinguished between outer and inner senses at that time, without, however, referring to specific receptors or nerves...
November 2017: Progress in Biophysics and Molecular Biology
R Jarisch
No abstract text is available yet for this article.
April 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
M Walker, R Wisler, J Simmons, A Johnson
INTRODUCTION: Neurosyphilis is an infection of the central nervous system by Treponema pallidum, which can occur after the initial syphilis infection. Although commonly associated with late stage disease, patients with early neurosyphilis may present with acute syphilitic meningitis, meningovascular syphilis, or uveitis. CASE: A 28 year old man with a past medical history of HIV (CD4 364);, and recent diagnosis of uveitis presented to the Emergency Department with a positive RPR result...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Michelle DallaPiazza, Matthew Jiro Akiyama
Bacillary angiomatosis (BA) is a rare complication of human immune deficiency virus (HIV) infection in the post-antiretroviral therapy (ART) era, and few cases of BA-associated immune reconstitution inflammatory syndrome (IRIS) have been described. We report the case of a 50-year-old man who presented with mass lesions involving the skin, subcutaneous tissues, muscle, and bone. The diagnosis of Bartonella quintana BA was confirmed by serum polymerase chain reaction. The patient's treatment course was complicated by both IRIS and Jarisch-Herxheimer reaction...
July 2017: Journal of the International Association of Providers of AIDS Care
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