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Stephan Knöchner, K Kronberg, U Schumann
ANAMNESIS:  A 47-year-old recreational sportsman showed in a routine ergometry polymorphic ventricular extrasystoles with good physical performance. INVESTIGATIONS:  In resting ECG impressed ventricular extrasystoles (VES) predominantly right-hand-block-like with superior axis, a long-term ECG yielded up to 100 VES per hour. Echocardiographically imposing 4 - 5 trabeculae, feathered, reticular structures apically in the left and lower in the right ventricle...
February 2018: Deutsche Medizinische Wochenschrift
Karl-Michael Derwahl
Whereas in regions with sufficient iodide intake treatment of thyroid nodules with levothyroxine has been almost completely abandoned and is also not further recommended by guidelines, medical treatment may be still indicated in Germany as recently demonstrated by randomized, placebo-controlled LISA study.A major reason for this is mild iodide deficiency in patients with thyroid nodules. In LISA study a combined therapy of levothyroxine and iodide resulted in an at least 50 % reduction of nodular volume in 21,6 % of treated patient compared to in only 5,2 % of placebo-treated patients...
February 2018: Laryngo- Rhino- Otologie
Asaad G Beshish, Allison Weinberg, Waseem Ostwani, Gabe E Owens
We describe the use of extracorporeal cardiopulmonary resuscitation (E-CPR) to transiently stabilize a 3-month-old patient who presented with ventricular tachyarrhythmias leading to spontaneous cardiac arrest. The patient required 4 days of extracorporeal life support (ECLS) where he was diagnosed with probable Brugada syndrome (BS). The patient was discharged home in stable condition after implantable cardioverter defibrillator placement. This case highlights the importance of early transfer to extracorporeal membrane oxygenation (ECMO) center in the setting of unexplained cardiac arrhythmia in a pediatric patient...
December 2017: Journal of Extra-corporeal Technology
A Cepiel, A Noszczyk-Nowak, A Cekiera, J Popiel, U Pasławska
The aim of the study was to analyse the influence of enrofloxacin and pradofloxacin administered orally for 14 days on the ECG in dogs. The ECG was performed before and after a 14 day period of quinolone administration. There was an increase in the QTc and the TpTe interval in the group treated with quinolones. QTc was prolonged by 24 ms (p=0.001). The TpTe interval was shortened, on average, by 6.55 ms (p=0.048). In the group treated with enrofloxacin, QTc was prolonged by 16.27 ms (p=0.006) and the TpTe interval was shortened by 9...
September 26, 2017: Polish Journal of Veterinary Sciences
Maryam Balke, Helmar C Lehmann, Gereon R Fink, Gilbert Wunderlich
History A 30-year-old man presented with a history of progressive muscle weakness, difficulty in concentrating, and a slender habitus since early childhood. Marfan syndrome was suspected since the age of 14. Examinations 13 years later he was examined by Marfan experts and by genetic testing and Marfan syndrome could not be confirmed. Further neurological examination revealed the suspected diagnosis of myotonic dystrophy type 1, which was confirmed by genetic testing. Treatment and course Similar to Marfan syndrome, myotonic dystrophy is a multisystemic disorder with the risk of cardiac arrythmias...
July 2017: Deutsche Medizinische Wochenschrift
Laurie Laugier, Amanda Farage Frade, Frederico Moraes Ferreira, Monique Andrade Baron, Priscila Camillo Teixeira, Sandrine Cabantous, Ludmila Rodrigues Pinto Ferreira, Laurence Louis, Vagner Oliveira Carvalho Rigaud, Fabio Antônio Gaiotto, Fernando Bacal, Pablo Pomerantzeff, Edimar Bocchi, Jorge Kalil, Ronaldo Honorato Barros Santos, Edecio Cunha-Neto, Christophe Chevillard
Background: Chagas disease, caused by the protozoan Trypanosoma cruzi, is endemic in Latin America and affects 10 million people worldwide. Approximately 12,000 deaths attributable to Chagas disease occur annually due to Chagas disease cardiomyopathy (CCC), an inflammatory cardiomyopathy presenting with heart failure and arrythmia; 30% of infected subjects develop CCC years after infection. Genetic mechanisms play a role in differential progression to CCC, but little is known about the role of epigenetic modifications in pathological gene expression patterns in CCC patients' myocardium...
May 30, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Fanny Vardon Bounes, Elsa Tardif, Stéphanie Ruiz, Jean-Christophe Gallart, Jean-Marie Conil, Clément Delmas
CONTEXT: Yew intoxication has been known for many years; high dose ingestion of Taxus baccata leads to cardiac toxicity mediated by calcium and sodium channel blocking properties. We present a case report of a patient who attempted suicide after T. baccata ingestion, causing refractory cardiogenic shock requiring temporary circulatory assistance by veno-arterial extra corporeal membrane oxygenation (VA ECMO). CASE DETAILS: A 28-year-old man was admitted to the critical care unit of a university hospital for arrhythmia after ingestion of self-made T...
September 2017: Clinical Toxicology
Yichun Sun, Baimei Li, Xiaoting Lin, Juan Xue, Zhibin Wang, Hongwei Zhang, Hai Jiang, Qiuhong Wang, Haixue Kuang
INTRODUCTION: Aralia elata leaves are known to have several biological activities, including anti-arrythmia, antitumor, anti-inflammatory, anti-fatigue, antimicrobial and antiviral effects. Our previous study found that triterpenoid saponins from the leaves of A. elata had antitumor effects. Quantification of the triterpenoids is important for the quality control of A. elata leaves. OBJECTIVE: To establish high-performance liquid chromatography coupled with evaporative light scattering detection (HPLC-ELSD) for the simultaneous determination of four major triterpenoid saponins, including Aralia-saponin IV, Aralia-saponin VI, 3-O-β-d- glucopyranosyl-(1 → 3)-β-d-glucopyranosyl-(1 → 3)-β-d-glucopyranosyl oleanolic acid 28-O-β-d-glucopyranoside (Aralia-saponin TTP)and Aralia-saponin V...
May 2017: Phytochemical Analysis: PCA
Renata Pomahačová, Jana Zamboryová, Josef Sýkora, Petra Paterová, Karel Fiklík, Tomáš Votava, Zdeňka Černá, Petr Jehlička, Václav Lád, Ivan Šubrt, Jiří Dort, Eva Dortová
Thiamine-responsive megaloblastic anemia (TRMA) is a rare autosomal recessive disorder caused by mutations in the SLC19A2 gene. To date at least 43 mutations have been reported for the gene encoding a plasma membrane thiamine transporter protein (THTR-1). TRMA has been reported in less than 80 cases worldwide. Here, we illustrate 2 female patients with TRMA first diagnosed in the Czech Republic and in central Europe being confirmed by sequencing of the THTR-1 gene SLC19A2. Both subjects are compound heterozygotes with 3 different mutations in the SLC19A2 gene...
December 2017: Pediatric Diabetes
Megan Daniel, Samantha Gee, Michael Becknell, Jill Fitch, Glenn Burns, Richard Fernandez, Mark Hall, Hannah Hays
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Karolina Adamczyk, Beata Średniawa, Katarzyna Mitręga, Stanisław Morawski, Agata Musialik-Łydka, Zbigniew Kalarus
Symptoms such as palpitations, fainting, dizziness and unexplained loss of consciousness are often notified by patients in clinical practice. Cardiological causes of these ailments could be various, inter alia, atriaventricular conduction disorders, supraventricular arrythmias or more life-threatening ventricular arrythmias. Diagnostics of these disorders includes a series of basic non-invasive research and more advanced specialistic methods. Presented case report shows problems of arrythmias diagnostics and imperfections of avaible methods...
September 29, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
John H Boyd, Demetrios Sirounis, Julien Maizel, Michel Slama
BACKGROUND: In critically ill patients at risk for organ failure, the administration of intravenous fluids has equal chances of resulting in benefit or harm. While the intent of intravenous fluid is to increase cardiac output and oxygen delivery, unwelcome results in those patients who do not increase their cardiac output are tissue edema, hypoxemia, and excess mortality. Here we briefly review bedside methods to assess fluid responsiveness, focusing upon the strengths and pitfalls of echocardiography in spontaneously breathing mechanically ventilated patients as a means to guide fluid management...
September 4, 2016: Critical Care: the Official Journal of the Critical Care Forum
Abhilasha Thanvi, Udita Naithani, Sneha Arun Betkekar, Devendra Verma, Basant Kumar Dindor
Acute hypocalcaemia is a medical emergency that can have catastrophic implications like tetany, seizures, cardiac arrythmias or laryngospasm if left untreated. We are presenting a case of a 30-year-old female patient undergoing total abdominal hysterectomy with bilateral salpingoopherectomy under spinal anaesthesia. She developed unexpected bilateral carpal spasm intraoperatively which was promptly diagnosed and successfully managed with intravenous calcium administration. We conclude that the anaesthetist should be aware of the clinical presentation of acute hypocalcaemia, its causes and emergency management in the perioperative period to prevent any adverse outcomes...
January 2016: Journal of Clinical and Diagnostic Research: JCDR
Silje Hugin, Egil Johnson, Hans-Olaf Johannessen, Bjørn Hofstad, Kjell Olafsen, Harald Mellem
INTRODUCTION: Myotonic dystrophies are inherited multisystemic diseases characterized by musculopathy, cardiac arrythmias and cognitive disorders. These patients are at increased risk for fatal post-surgical complications from pulmonary hypoventilation. We present a case with myotonic dystrophy and esophageal cancer who had a minimally invasive esophagectomy complicated with gastrobronchial fistulisation. PRESENTATION OF CASE: A 44-year-old male with myotonic dystrophy type 1 and esophageal cancer had a minimally invasive esophagectomy performed instead of open surgery in order to reduce the risk for pulmonary complications...
2015: International Journal of Surgery Case Reports
Kanako Noritake, Toshihiko Aki, Takeshi Funakoshi, Kana Unuma, Koichi Uemura
Direct exposure of cardiomyocytes to ethanol causes cardiac damage such as cardiac arrythmias and apoptotic cell death. Cardiomyocytes are connected to each other through intercalated disks (ID), which are composed of a gap junction (GJ), adherens junction, and desmosome. Changes in the content as well as the subcellular localization of connexin43 (Cx43), the main component of the cardiac GJ, are reportedly involved in cardiac arrythmias and subsequent damage. Recently, the hippo-YAP signaling pathway, which links cellular physical status to cell proliferation, differentiation, and apoptosis, has been implicated in cardiac homeostasis under physiological as well as pathological conditions...
2015: PloS One
Stéphane Manzo-Silberman
Palpitations: frequent reason for referral to a cardiologist. Arrythmia: rare, mostly benign. Premature extra-beats and sustained tachy-arrhythmias: more frequent or revealed during pregnancy. Hemodynamic changes in expectant women favor an environment conducive to arrhythmogenesis. AF and flutter: very rare unless structural heart disease or hyperthyroidism. Drugs: careful monitoring of the patient and dose adjustments. Cardioversion: only in case of severe symptoms or hemodynamically unstable.
July 2015: La Presse Médicale
Jharendra Rijal, Smith Giri, Sumesh Khanal, Khagendra Dahal
BACKGROUND: Brugada Syndrome (BS) is an inherited ion channelopathy characterized by an electrocardiographic (ECG) pattern of a coved type ST segment elevation in right precordial leads with or without right bundle branch block. CASE PRESENTATION: A 23-year old male presented with right lower quadrant abdominal pain. Further evaluation revealed a diagnosis of acute appendicitis. The patient developed a febrile episode on second post-operative day of laparoscopic appendectomy...
2015: Caspian Journal of Internal Medicine
Parminder S Chaggar, Steven M Shaw, Simon G Williams
BACKGROUND: Digoxin is the oldest known treatment for heart failure (HF) and has been demonstrated to reduce admissions for worsening heart failure in a large randomized trial recruiting patients in sinus rhythm with heart failure and ejection fraction <45%. This study forms the basis for current international guidelines recommending that digoxin should be considered in patients with symptomatic HF despite optimal doses of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, β-blockers, and mineralocorticoid receptor antagonists in addition to device therapy, if indicated...
August 2015: Cardiovascular Therapeutics
Mishal Shah, Sanjeev Patni, Rajeev Bagarahatta
Central venous access devices are routinely used in oncology for delivering chemotherapy of which implantable chemoports are the most common. Spontaneous breakage and migration of the catheters is a very rare but known complication of the procedure. Patients will usually present with cardiac manifestations in form of chest pain or arrythmias. Herein we report a case of spontaneous breakage and cardiac migration in which the patient was asymptomatic. Patient was successfully managed by an interventional cardiologist...
December 2014: Indian Journal of Surgical Oncology
Kenneth P Chen, Joon Lee, Roger G Mark, Mengling Feng, Leo A Celi, Brian E Malley, John Danziger
Hypomagnesemia can lead to cardiac arrythmias. Recently, observational data have linked chronic proton pump inhibitor (PPI) exposure to hypomagnesemia. Whether PPI exposure increases the risk for arrhythmias has not been well studied. Using a large, single-center inception cohort of critically ill patients, we examined whether PPI exposure was associated with admission electrocardiogram readings of a cardiac arrhythmia in more than 8000 patients. There were 25.4% PPI users, whereas 6% were taking a histamine 2 antagonist...
July 2015: Journal of Clinical Pharmacology
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