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https://www.readbyqxmd.com/read/28821420/hyperglycemia-in-young-adults-seen-in-the-emergency-department-a-health-records-review
#1
Justin W Yan, Alexandra L Hamelin, Katherine M Gushulak, Kristine Van Aarsen, Melanie P Columbus, Ian G Stiell
Patients with diabetes who are in emerging adulthood, defined as the life stage between 18 and 29 years of age, have unique challenges in managing their illness and are at risk for acute complications and loss to follow up. This study's objective was to describe emergency department (ED) utilization because of hyperglycemia in emerging adults with diabetes and to characterize 30-day outcomes, including return visits and admission for hyperglycemia. This was a health-records review of emerging adults presenting over a 1-year period to 4 tertiary care EDs; the patients had known histories of diabetes and final diagnoses of hyperglycemia, diabetic ketoacidosis or hyperosmolar hyperglycemia...
August 15, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28820870/controversies-in-the-identification-and-management-of-acute-pulmonary-hypertension-in-preterm-neonates
#2
REVIEW
Regan E Giesinger, Kiran More, Jodie Odame, Amish Jain, Robert P Jankov, Patrick J McNamara
It is increasingly recognized that the abnormal physiologic consequences of pulmonary hypertension (PH) may contribute to poor cardiopulmonary health in premature babies. Conflicting literature has led to clinical uncertainty, pathological misinterpretation and variability in treatment approaches among practitioners. There are several disorders with overlapping and interrelated presentations and other disorders with a similar clinical phenotype but diverse pathophysiological contributors. In this review, we provide a diagnostic approach for acute HRF in the preterm neonate, outline the pathophysiological conditions that may present as acute PH and discuss the implications of high pulmonary vascular resistance (PVR) on the cardiovascular system...
August 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28820712/scrub-typhus-as-an-etiology-of-acute-febrile-illness-in-gorakhpur-uttar-pradesh-india-2016
#3
Jeromie Wesley Vivian Thangraj, Mahima Mittal, Valsan Philip Verghese, C P Girish Kumar, Winsley Rose, R Sabarinathan, Ashok Kumar Pandey, Nivedita Gupta, Manoj Murhekar
Seasonal outbreaks of acute encephalitis syndrome (AES) with high mortality occur every year in Gorakhpur region of Uttar Pradesh, India. Earlier studies indicated the role of scrub typhus as the important etiology of AES in the region. AES cases were hospitalized late in the course of their illness. We established surveillance for acute febrile illness (AFI) (fever ≥ 4 days duration) in peripheral health facilities in Gorakhpur district to understand the relative contribution of scrub typhus. Of the 224 patients enrolled during the 3-month period corresponding to the peak of AES cases in the region, about one-fifth had immunoglobulin M (IgM) antibodies against Orientia tsutsugamushi...
August 14, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28820609/cardio-pulmonary-interactions-physiologic-basis-and-clinical-applications
#4
Michael R Pinsky
The hemodynamic effects of ventilation can be grouped into three concepts: 1) spontaneous ventilation is exercise; 2) changes in lung volume alter autonomic tone, pulmonary vascular resistance, and can compress the heart in the cardiac fossa; 3) spontaneous inspiratory efforts decrease intrathoracic pressure (ITP) increasing venous return and impeding left ventricular (LV) ejection; whereas positive pressure ventilation decreases venous return and unloads LV ejection. Spontaneous inspiratory efforts may induce acute LV failure and cardiogenic pulmonary edema...
August 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28820041/a-report-of-7-year-experience-on-pediatric-continuous-renal-replacement-therapy
#5
Ayse Filiz Yetimakman, Selman Kesici, Murat Tanyildiz, Umut Selda Bayrakci, Benan Bayrakci
BACKGROUND: Continuous renal replacement therapies (CRRTs) either as continuous venovenous hemofiltration (CVVH) or hemodiafiltration (CVVHD) are used frequently in critically ill children. Many clinical variables and technical issues are known to affect the result. The factors that could be modified to increase the survival of renal replacement are sought. As a contribution, we present the data on 104 patients who underwent CRRT within a 7-year period. MATERIALS AND METHOD: A total of 104 patients admitted between 2009 and 2016 were included in the study...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28818213/the-natural-history-and-outcomes-of-line-associated-upper-extremity-deep-venous-thromboses-in-critically-ill-patients
#6
Joshua Underhill, Matthew A Sherman, Ryan Howard, Anthony Hage, Andrea Obi, Lena Napolitano, Dawn M Coleman
OBJECTIVE: Anticoagulation remains the standard of care for line-associated upper extremity deep venous thrombosis (UEDVT). This treatment carries the risk of hemorrhagic complications, possibly more so in surgical patients. Considering the low-risk profile of UEDVT-which is associated with fewer, less severe pulmonary emboli than lower extremity deep venous thrombosis-current UEDVT treatment guidelines may be overly aggressive. The goal of this study was to review outcomes of line-associated UEDVT in critically ill patients and to define the efficacy of current treatment protocols in pulmonary embolism (PE) prevention while avoiding hemorrhagic complications...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28818069/path-modeling-of-knowledge-attitude-and-practice-toward-palliative-care-consultation-service-among-taiwanese-nursing-staff-a-cross-sectional-study
#7
Hsueh-Hsing Pan, Hsiu-Ling Shih, Li-Fen Wu, Yu-Chun Hung, Chi-Ming Chu, Kwua-Yun Wang
BACKGROUND: The Taiwanese government has promoted palliative care consultation services (PCCS) to support terminally ill patients in acute ward settings to receive palliative care since 2005. Such an intervention can enhance the quality of life and dignity of terminally ill patients. However, research focusing on the relationship between the knowledge, attitude and practice of a PCCS using path modelling in nursing staff is limited. Therefore, the aim of this study was to elucidate the effect of path modeling on the knowledge, attitude and practice toward PCCS in Taiwanese nursing staff...
August 17, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28816920/similar-metabolic-innate-immunity-and-adipokine-profiles-in-adult-and-pediatric-sepsis-versus-systemic-inflammatory-response-syndrome-a-pilot-study
#8
Theonymfi Tavladaki, Anna Maria Spanaki, Helen Dimitriou, Efmorfia Kondili, Christianna Choulaki, Dimitris Georgopoulos, George Briassoulis
OBJECTIVES: To examine whether the septic profiles of heat shock protein 72, heat shock protein 90α, resistin, adiponectin, oxygen consumption, CO2 production, energy expenditure, and metabolic pattern, along with illness severity, nutritional, and inflammatory indices, differ between adult and pediatric patients compared with systemic inflammatory response syndrome and healthy controls. To evaluate whether these biomolecules may discriminate sepsis from systemic inflammatory response syndrome in adult and pediatric patients...
August 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28816883/cerebral-oxygen-saturation-during-electroconvulsive-therapy-a-secondary-analysis-of-a-randomized-crossover-trial
#9
Kamath Sriganesh, Tanmay Jadhav, Sudhir Venkataramaiah, Channaveerachari Naveen Kumar, Shyamsundar Armugham, Mariamma Philip, K R Madhusudan Reddy, Jagadisha Thirthalli, G S Umamaheswara Rao
BACKGROUND: Electroconvulsive therapy (ECT) causes acute changes in cerebral perfusion and oxygenation. Near-infrared spectroscopy is a novel, noninvasive technique to assess cerebral oxygen saturation (cSO2). We hypothesized that cSO2 increases during ECT and more so with atropine premedication and decreases when systemic desaturation (peripheral oxygen saturation <90%) occurs during ECT. METHODS: We performed a secondary analysis of a randomized trial of patients undergoing ECT for psychiatric illness during a 6-month period...
August 14, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28816212/scrub-typhus-a-prospective-observational-study-during-an-outbreak-in-rajasthan-india
#10
Rajendra Prasad Takhar, Moti Lal Bunkar, Savita Arya, Nitin Mirdha, Arif Mohd
BACKGROUND: Scrub typhus, a potentially fatal rickettsial infection, is common in India. It usually presents with acute febrile illness along with multi-organ involvement caused by Orientia tsutsugamushi. As there was an outbreak of scrub typhus in the Hadoti region of Rajasthan and there is a paucity of data from this region, we studied this entity to describe the diverse epidemiological, clinico-radiological, laboratory parameters and outcome profile of patients with scrub typhus in a tertiary care hospital...
March 2017: National Medical Journal of India
https://www.readbyqxmd.com/read/28815837/cost-of-asthma-in-children-a-nationwide-population-based-cost-of-illness-study
#11
Manuel José Ferreira de Magalhães, Rita da Silva Amaral, Ana Margarida Pereira, Ana Isabel Alves de Sá E Sousa Santos, Maria Inês Águeda de Azevedo, Luís Filipe Ribeiro de Azevedo, João Almeida Lopes Fonseca
BACKGROUND: Childhood asthma is very prevalent and costs can be high, especially in severe disease. This study aimed to estimate the cost of asthma in Portuguese children and the variations by level of asthma control. METHODS: A nationwide, population- and prevalence-based cost-of-illness study with a societal perspective was conducted. We measured direct and indirect costs using a bottom-up approach and a human capital method, respectively, for 208 children (<18 years), from two national repositories...
August 17, 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/28815092/zinc-chloride-smoke-inhalation-induced-severe-acute-respiratory-distress-syndrome-first-survival-in-the-united-states-with-extended-duration-five-weeks-therapy-with-high-dose-corticosteroids-in-combination-with-lung-protective-ventilation
#12
Hafiz Mahboob, Robert Richeson Iii, Robert McCain
Zinc chloride smoke bomb exposure is frequently seen in military drills, combat exercises, metal industry works, and disaster simulations. Smoke exposure presents with variety of pulmonary damage based on the intensity of the exposure. Smoke induced severe acute respiratory distress syndrome (ARDS) is often fatal and there are no standard treatment guidelines. We report the first survival of smoke induced severe ARDS in the United States (US) with prolonged use of high dose steroids (five weeks) and lung protective ventilation alone...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28814419/chronic-cough-postacute-respiratory-illness-in-children-a-cohort-study
#13
Kerry-Ann F O'Grady, Benjamin J Drescher, Vikas Goyal, Natalie Phillips, Jason Acworth, Julie M Marchant, Anne B Chang
OBJECTIVE: Data on the aetiology of persistent cough at the transitional stage from subacute to chronic cough (>4 weeks duration) are scarce. We aimed to (1) identify the prevalence of chronic cough following acute respiratory illness (ARI) and (2) determine the diagnostic outcomes of children with chronic cough. DESIGN: Prospective cohort study. SETTING: A paediatric emergency department (ED) in Brisbane, Australia. PATIENTS: Children aged <15 years presenting with an ARI with cough...
August 16, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28814347/early-troponin-i-in-critical-illness-and-its-association-with-hospital-mortality-a-cohort-study
#14
Annemarie B Docherty, Malcolm Sim, Joao Oliveira, Michael Adlam, Marlies Ostermann, Timothy S Walsh, John Kinsella, Nazir I Lone
BACKGROUND: Troponin I (TnI) is frequently elevated in critical illness, but its interpretation is unclear. Our primary objectives in this study were to evaluate whether TnI is associated with hospital mortality and if this association persists after adjusting for potential confounders. We also aimed to ascertain whether addition of TnI to the Acute Physiological and Chronic Health Evaluation II (APACHE II) risk prediction model improves its performance in general intensive care unit (ICU) populations...
August 16, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28814331/circulating-levels-of-soluble-fas-scd95-are-associated-with-risk-for-development-of-a-nonresolving-acute-kidney-injury-subphenotype
#15
Pavan K Bhatraju, Cassianne Robinson-Cohen, Carmen Mikacenic, Susanna Harju-Baker, Victoria Dmyterko, Natalie S J Slivinski, W Conrad Liles, Jonathan Himmelfarb, Susan R Heckbert, Mark M Wurfel
BACKGROUND: Critically ill patients with acute kidney injury (AKI) can be divided into two subphenotypes, resolving or nonresolving, on the basis of the trajectory of serum creatinine. It is unknown if the biology underlying these two AKI recovery patterns is different. METHODS: We measured eight circulating biomarkers in plasma obtained from a cohort of patients admitted to an intensive care unit (ICU) (n = 1241) with systemic inflammatory response syndrome...
August 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28812528/acute-leukemia-in-horses
#16
Carina J Cooper, Stefan M Keller, Luis G Arroyo, Joanne Hewson, Daniel Kenney, Dorothee Bienzle
Leukemia is broadly divided into acute and chronic lymphocytic and myeloid types based on the proportion of blasts, morphology of cells, and expression of specific antigens on neoplastic cells. Classifying leukemia in horses can be challenging if blasts predominate and since few antibodies to identify cell types are available. The objective of this study was to describe in detail the clinical and pathologic features of acute leukemia in horses. Twelve horses ranging from 0.2 to 25.9 years of age were diagnosed with acute leukemia...
January 1, 2017: Veterinary Pathology
https://www.readbyqxmd.com/read/28811858/effectiveness-of-ipragliflozin-for-reducing-hemoglobin-a1c-in-patients-with-a-shorter-type-2-diabetes-duration-interim-report-of-the-assign-k-study
#17
Kotaro Iemitsu, Takehiro Kawata, Takashi Iizuka, Masahiro Takihata, Masahiko Takai, Shigeru Nakajima, Nobuaki Minami, Shinichi Umezawa, Akira Kanamori, Hiroshi Takeda, Shogo Ito, Taisuke Kikuchi, Hikaru Amemiya, Mizuki Kaneshiro, Atsuko Mokubo, Tetsuo Takuma, Hideo Machimura, Keiji Tanaka, Taro Asakura, Akira Kubota, Sachio Aoyanagi, Kazuhiko Hoshino, Masashi Ishikawa, Yoko Matsuzawa, Mitsuo Obana, Nobuo Sasai, Hideaki Kaneshige, Fuyuki Minagawa, Tatsuya Saito, Kazuaki Shinoda, Masaaki Miyakawa, Yasushi Tanaka, Yasuo Terauchi, Ikuro Matsuba
BACKGROUND: Ipragliflozin is a selective sodium glucose co-transporter 2 inhibitor. The ASSIGN-K study is investigating the efficacy and safety of ipragliflozin for type 2 diabetes mellitus (T2DM) in the real-world clinical setting. METHODS: Japanese T2DM patients with inadequate glycemic control despite diet and exercise with/without pharmacotherapy were enrolled in an investigator-driven, multicenter, prospective, observational study examining the efficacy and safety of ipragliflozin treatment (50 mg/day for 52 weeks)...
September 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28811694/estimation-of-upper-limit-of-normal-for-serum-alanine-transaminase-in-healthy-south-indian-population
#18
Pazhanivel Mohan, Varun Sundar, Emmanuel Bhaskar, Syluvai Anthony
Alanine aminotransferase (ALT) is the most common and cost effective screening test for asymptomatic liver disease. There is paucity of data on normal ALT among healthy individuals in India. An observational cross sectional study was conducted from January to July 2013 to estimate the upper limit of normal for ALT in healthy south Indian population. Adults undergoing voluntary or pre-employment health screening were included. Those with current and past alcoholism or smoking, acute illness or hospitalization during preceding 12 months, non-steroidal anti-inflammatory or over the counter medication use within a month, current or past intake of herbal medications, any chronic medical illness, abnormal body mass index (BMI), fatty liver in ultrasound, abnormality in haemoglobin, platelet count, blood sugar, creatinine, lipid profile and thyroid function test and positive serology (Hepatitis B, C or HIV) were excluded...
July 2017: Indian Journal of Clinical Biochemistry: IJCB
https://www.readbyqxmd.com/read/28811122/acute-kidney-injury-after-computed-tomography-a-meta-analysis
#19
REVIEW
Ryan D Aycock, Lauren M Westafer, Jennifer L Boxen, Nima Majlesi, Elizabeth M Schoenfeld, Raveendhara R Bannuru
STUDY OBJECTIVE: Computed tomography (CT) is an important imaging modality used in the diagnosis of a variety of disorders. Imaging quality may be improved if intravenous contrast is added, but there is a concern for potential renal injury. Our goal is to perform a meta-analysis to compare the risk of acute kidney injury, need for renal replacement, and total mortality after contrast-enhanced CT versus noncontrast CT. METHODS: We searched MEDLINE (PubMed), the Cochrane Library, CINAHL, Web of Science, ProQuest, and Academic Search Premier for relevant articles...
August 12, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28810284/-development-of-non-arteritic-anterior-ischaemic-optic-neuropathy-in-the-initially-unaffected-fellow-eye-in-patients-treated-with-systemic-corticosteroids
#20
Artur Pahor, Dusica Pahor
Background The objective of this prospective pilot study was to evaluate the results of systemic corticosteroid therapy in patient with non-arteritic anterior ischaemic neuropathy of the optical nerve (NAION) for an observation period of one year and to measure the NAION incidence in the initially healthy contralateral eye of these patients. Patients and Methods All patients diagnosed with acute NAION who were admitted to our ward during 2014 and who fulfilled all inclusion criteria for systemic corticosteroid therapy were included in the study...
August 15, 2017: Klinische Monatsblätter Für Augenheilkunde
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