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https://www.readbyqxmd.com/read/28445305/a-case-report-of-painless-type-a-aortic-dissection-with-intermittent-convulsive-syncope-as-initial-presentation
#1
Chun-Hsien Chen, Kuan-Ting Liu
RATIONALE: The initial presenting symptoms and signs of acute aortic dissection are so diverse that it makes early and accurate diagnosis arduous. Painless and convulsive syncope due to cardiac arrhythmia were not typical presentations of acute aortic dissection. PATIENT CONCERNS: A 61-year-old male presenting with transient consciousness loss and suspected seizure attack was sent to emergency room (ER) by ambulance. Consciousness loss accompanying with upward gaze and limb convulsion was noted in ER, and electrocardiogram monitor recorded a transient cardiac asystole then spontaneous recovery of sinus rhythm...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28441439/hemodynamics-and-gas-exchange-during-chest-compressions-in-neonatal-resuscitation
#2
Payam Vali, Praveen Chandrasekharan, Munmun Rawat, Sylvia Gugino, Carmon Koenigsknecht, Justin Helman, Bobby Mathew, Sara Berkelhamer, Jayasree Nair, Myra Wyckoff, Satyan Lakshminrusimha
PURPOSE: Current knowledge about pulmonary/systemic hemodynamics and gas exchange during neonatal resuscitation in a model of transitioning fetal circulation with fetal shunts and fluid-filled alveoli is limited. Using a fetal lamb asphyxia model, we sought to determine whether hemodynamic or gas-exchange parameters predicted successful return of spontaneous circulation (ROSC). METHODS: The umbilical cord was occluded in 22 lambs to induce asphyxial cardiac arrest...
2017: PloS One
https://www.readbyqxmd.com/read/28439158/trigemino-cardiac-reflex-a-phenomenon-neglected-in-maxillofacial-surgery
#3
Udupikrishna M Joshi, Ashwini Munnangi, Kundan Shah, Satishkumar G Patil, Nitin Thakur
BACKGROUND: Trigemino-cardiac reflex is a physiologic response of the body to pressure effects in the region of distribution of the trigeminal nerve. Oral and maxillofacial surgical procedures can induce the development of this reflex, which leads to significant changes in the heart rate and sinus rhythms. This study intends to evaluate the effects of this reflex in patients with facial fractures and its subsequent management. PATIENTS AND METHODS: A total of thirty-seven patients with facial fractures who reported to the Department of Oral and Maxillofacial Surgery at Basaveswar Teaching and General Hospital, Gulbarga during a period from July 2015-March 2016 were considered for the study...
June 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28430911/a-devices-game-of-thrones-cardiac-resynchronization-therapy-vs-pacemaker
#4
Sara Moura-Ferreira, Helena Gonçalves, Marco Oliveira, João Primo, Paulo Fonseca, José Ribeiro, Elisabeth Santos, Nuno Pelicano, Dinis Martins, Vasco Gama
Aims: Oversensing can interfere with biventricular pacing. Cardiac Resynchronization Therapy (CRT) output inhibition due to automatic brady mode change from a sensing to a pacing mode of a previously implanted pacemaker as it reached battery capacity depleted indicator has not been previously published in the medical literature. Methods and Results: We report the first case of CRT output inhibition in a pacemaker dependent patient due to electrical stimuli from a previously right-sided implanted pacemaker, after unaware reversion of OVO mode (O = no chambers paced; V = ventricular sensing; O = no response to sensing) to backup VVI (V = ventricular pacing; V = ventricular sensing; I = inhibitory response to sensing) when it reached the elective replacement interval...
April 18, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28412052/-the-relationship-between-preoperative-anxiety-levels-and-vasovagal-incidents-during-the-administration-of-spinal-anesthesia
#5
Mürsel Ekinci, Birzat Emre Gölboyu, Onur Dülgeroğlu, Murat Aksun, Pınar Karaca Baysal, Erkan Cem Çelik, Ayşe Nur Yeksan
BACKGROUND: It was aimed to investigate the relationship between preoperative anxiety and vasovagal symptoms observed during the administration of spinal anesthesia in patients undergoing surgery in the perianal and inguinal regions. METHODS: The study included patients with planned surgery for inguinal hernia repair, anal fissure, hemorrhoid and pilonidal sinus excision. The study included a total of 210 patients of ASA I-II, aged 18-65 years. Patients were evaluated in respect of demographic characteristics, smoking and alcohol consumption, ASA grade and educational level...
April 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28408236/unintentional-pediatric-cocaine-exposures-result-in-worse-outcomes-than-other-unintentional-pediatric-poisonings
#6
Patil Armenian, Michelle Fleurat, George Mittendorf, Kent R Olson
BACKGROUND: Unintentional pediatric cocaine exposures are rare but concerning due to potentially serious complications such as seizures, dysrhythmias, and death. OBJECTIVES: The objectives were to assess the demographic and clinical characteristics of pediatric cocaine exposures reported to the California Poison Control System. METHODS: This is a retrospective study of all confirmed pediatric (< 6 years of age) cocaine exposures reported to the California Poison Control System from January 1, 1997-September 30, 2010...
April 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28407020/mortality-after-out-of-hospital-cardiac-arrest-in-a-spanish-region
#7
Rosa Requena-Morales, Antonio Palazón-Bru, María Mercedes Rizo-Baeza, José Manuel Adsuar-Quesada, Vicente Francisco Gil-Guillén, Ernesto Cortés-Castell
AIMS: To determine out-of-hospital cardiac arrest mortality in the province of Alicante (Spain) and its associated factors. METHODS: Cross-sectional observational study of all patients who received cardiopulmonary resuscitation (CPR) by the Emergency Medical Services (EMS) (n = 422) in the province of Alicante in 2013. To determine associated factors, a binary logistic regression model was constructed. Primary outcome: death before arriving at the hospital. Predictive variables: gender, age, artificial respiration, prior functional status, asystole, cardiogenic aetiology, bystander CPR, time from the cardiac arrest to the arrival of the EMS and location of cardiac arrest...
2017: PloS One
https://www.readbyqxmd.com/read/28404198/molecular-fluorescence-guided-surgery-of-peritoneal-carcinomatosis-of-colorectal-origin-a-single-centre-feasibility-study
#8
Niels J Harlaar, Marjory Koller, Steven J de Jongh, Barbara L van Leeuwen, Patrick H Hemmer, Schelto Kruijff, Robert J van Ginkel, Lukas B Been, Johannes S de Jong, Gursah Kats-Ugurlu, Matthijs D Linssen, Annelies Jorritsma-Smit, Marleen van Oosten, Wouter B Nagengast, Vasilis Ntziachristos, Gooitzen M van Dam
BACKGROUND: Optimum cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is essential for the curative treatment of peritoneal carcinomatosis of colorectal origin. At present, surgeons depend on visual inspection and palpation for tumour detection. Improved detection of tumour tissue using molecular fluorescence-guided surgery could not only help attain a complete cytoreduction of metastatic lesions, but might also prevent overtreatment by avoiding resection of benign lesions...
December 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28403704/nursing-management-of-reflex-anoxic-seizures-in-children
#9
Neal Patel, Rowan Kerr-Liddell, Louise Challis, Siba Prosad Paul
Children who present with transient loss of consciousness (T-LOC) are often first seen in emergency departments (EDs). Reflex anoxic seizure (RAS), vasovagal syncope and prolonged respiratory apnoea are benign, syncopal events that can be generally managed by explanation and reassurance. RAS is a short, paroxysmal, self-reverting episode of asystole that is triggered by pain, fear or anxiety and is caused by increased vagal response. It is an important differential diagnosis in pre-school age children who present with T-LOC, but is often underdiagnosed and can sometimes be misdiagnosed as epilepsy...
April 13, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28392712/evaluation-of-the-cardiotoxicity-and-resuscitation-of-rats-of-a-newly-developed-mixture-of-a-qx-314-analog-and-levobupivacaine
#10
Qi Wang, Qinqin Yin, Jun Yang, Bowen Ke, Linghui Yang, Jin Liu, Wensheng Zhang
OBJECTIVE: This study was designed to evaluate the cardiotoxicity of a QX-314 analog (QX-OH) and a mixture of QX-OH and levobupivacaine (LL-1) and to compare the ability to resuscitate rats after asystole induced by levobupivacaine (Levo-BUP), QX-314, QX-OH, and LL-1. METHODS: First, we used the "up-and-down" method to determine median dose resulting in appearance of cardiotoxicity (CD50C) and asystole (CD50A) of Levo-BUP, QX-314, QX-OH, and LL-1 in rats. Safety index (SI; ratio of CD50C compared with 2-fold median effective dose needed to produce sensory blockade) of the 4 drugs was calculated...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28389438/management-and-investigation-of-neonatal-encephalopathy-2017-update
#11
Kathryn Martinello, Anthony R Hart, Sufin Yap, Subhabrata Mitra, Nicola J Robertson
This review discusses an approach to determining the cause of neonatal encephalopathy, as well as current evidence on resuscitation and subsequent management of hypoxic-ischaemic encephalopathy (HIE). Encephalopathy in neonates can be due to varied aetiologies in addition to hypoxic-ischaemia. A combination of careful history, examination and the judicious use of investigations can help determine the cause. Over the last 7 years, infants with moderate to severe HIE have benefited from the introduction of routine therapeutic hypothermia; the number needed to treat for an additional beneficial outcome is 7 (95% CI 5 to 10)...
April 6, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28386925/vagus-nerve-stimulation-surgical-technique-of-implantation-and-revision-and-related-morbidity
#12
Flavio Giordano, Anna Zicca, Carmen Barba, Renzo Guerrini, Lorenzo Genitori
Indications for vagus nerve stimulation (VNS) therapy include focal, multifocal epilepsy, drop attacks (tonic/atonic seizures), Lennox-Gastaut syndrome, tuberous sclerosis complex (TSC)-related multifocal epilepsy, and unsuccessful resective surgery. Surgical outcome is about 50-60% for seizures control, and may also improve mood, cognition, and memory. On this basis, VNS has also been proposed for the treatment of major depression and Alzheimer's' disease. The vagus nerve stimulator must be implanted with blunt technique on the left side to avoid cardiac side effects through the classic approach for anterior cervical discectomy...
April 2017: Epilepsia
https://www.readbyqxmd.com/read/28382198/adverse-drug-reactions-in-therapeutic-hypothermia-after-cardiac-arrest
#13
Robert Witcher, Amy L Dzierba, Catherine Kim, Pamela L Smithburger, Sandra L Kane-Gill
BACKGROUND: Therapeutic hypothermia (TH) improves survival and neurologic function in comatose survivors of cardiac arrest. Many medications used to support TH have altered pharmacokinetics and pharmacodynamics during this treatment. It is unknown if or at what frequency the medications used during TH cause adverse drug reactions (ADRs). METHODS: A retrospective chart review was conducted for patients admitted to an intensive care unit (ICU) after cardiac arrest and treated with TH from January 2009 to June 2012 at two urban, university-affiliated, tertiary-care medical centres...
March 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28381704/efficacy-of-precordial-percussion-pacing-assessed-in-a-cardiac-standstill-microminipig-model
#14
Takeshi Wada, Hiroshi Ohara, Yuji Nakamura, Xin Cao, Hiroko Izumi-Nakaseko, Kentaro Ando, Mitsuru Honda, Katsunori Yoshihara, Yuji Nakazato, Keith G Lurie, Atsushi Sugiyama
BACKGROUND: Potential cardiovascular benefits of precordial percussion pacing (PPP) during cardiac standstill are unknown.Methods and Results:A cardiac standstill model in amicrominipigwas created by inducing complete atrioventricular block with a catheter ablation technique (n=7). Next, the efficacy of cardiopulmonary resuscitation by standard chest compressions (S-CPR), PPP and ventricular electrical pacing in this model were analyzed in series (n=4). To assess the mechanism of PPP, a non-selective, stretch-activated channel blocker, amiloride, was administered during PPP (n=3)...
April 4, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28377313/conduction-disturbances-after-tavr-electrophysiological-studies-and-pacemaker-dependency
#15
Nader Makki, Jenn Dollery, Danielle Jones, Juan Crestanello, Scott Lilly
BACKGROUND: Permanent pacemaker (PPM) placement occurs in 5-20% of patients after transcatheter aortic valve replacement (TAVR). Although predictors of pacemaker implantation have been established, features that predispose patients to pacemaker utilization on follow up have not been widely reported. METHODS: We performed a retrospective review of patients undergoing commercial TAVR between 2011 and 2016. We collated patients that underwent in-hospital PPM implantation and had a follow up of at least 3months...
March 15, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28371771/ecg-based-classification-of-resuscitation-cardiac-rhythms-for-retrospective-data-analysis
#16
Ali Bahrami Rad, Trygve Eftestol, Kjersti Engan, Unai Irusta, Jan Terje Kvaloy, Jo Kramer-Johansen, Lars Wik, Aggelos K Katsaggelos
There is a need to monitor the heart rhythm in resuscitation to improve treatment quality. Resuscitation rhythms are categorized into: ventricular tachycardia (VT), ventricular fibrillation (VF), pulseless electrical activity (PEA), asystole (AS), and pulse-generating rhythm (PR). Manual annotation of rhythms is time-consuming and infeasible for large datasets. Our objective was to develop ECG-based algorithms for the retrospective and automatic classification of resuscitation cardiac rhythms. METHODS: The dataset consisted of 1631 3- second ECG segments with clinical rhythm annotations, obtained from 298 out-of-hospital cardiac arrest patients...
March 30, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28369968/asystole-during-pacemaker-magnet-application
#17
James E Ip, Todd J Liu, Carol L Chen, Bruce B Lerman
Pacemaker magnet application during surgery for patients who are pacemaker-dependent is often utilized to avoid peri-operative inhibition from electromagnetic interference. We present a case during which such routine magnet use resulted in an unexpected response and discuss the limitations and nuances of this common practice. This article is protected by copyright. All rights reserved.
March 31, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28343957/adult-out-of-hospital-cardiac-arrest-in-philadelphia-from-2008-2012-an-epidemiological-study
#18
David F Gaieski, Anish K Agarwal, Benjamin S Abella, Robert W Neumar, Crawford Mechem, Sarah Wallace Cater, Frances S Shofer, Marion Leary, William P Pajerowski, Lance B Becker, Brendan Carr, Raina Merchant, Roger A Band
BACKGROUND: Wide variation in out-of-hospital cardiac arrest (OHCA) survival has been reported, with low survival in urban settings. We sought to describe the epidemiology of OHCA in Philadelphia, Pennsylvania, the fifth largest U.S. city, and identify potential areas for targeted interventions to improve survival. METHODS AND RESULTS: Retrospective chart review of adult, non-traumatic, OHCA occurring in Philadelphia between 2008 and 2012. We determined incidence and epidemiological factors including: demographics, initial cardiac rhythm, bystander cardiopulmonary resuscitation, automated external defibrillator use, return of spontaneous circulation and 30-day survival...
March 24, 2017: Resuscitation
https://www.readbyqxmd.com/read/28325719/near-death-by-milk-of-magnesia
#19
Ahmed Alaini, Carlos A Roldan, Karen Servilla, Elizabeth Sage Colombo
We report a case of hypermagnesemia associated with the use of milk of magnesia in a male patient with end-stage renal disease. After experiencing nausea and vomiting, he developed severe bradycardia and then asystole. Resuscitation efforts were successful; however, he developed atrial fibrillation with severe widening of the QRS and diffuse ST elevation, hypothermia, hypotension and apnoea requiring intubation. Initial diagnoses included ST-elevation myocardial infarction, cardiogenic and/or septic shock and hyperkalaemia...
March 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28314170/-pseudo-subarachnoid-hemorrhage-sign-on-early-brain-computed-tomography-in-out-of-hospital-cardiac-arrest-survivors-receiving-targeted-temperature-management
#20
Byung Kook Lee, Youn-Jung Kim, Seung Mok Ryoo, Su Jin Kim, Dong Hun Lee, Kyung Woon Jeung, Won Young Kim
PURPOSE: Newly updated guidelines suggest brain computed tomography for out-of-hospital cardiac arrest survivors to identify a neurologic cardiac arrest cause. We hypothesized that the "pseudo-subarachnoid hemorrhage" (p-SAH) sign in cardiac arrest survivors is associated with poor outcome. MATERIALS AND METHODS: We retrospectively evaluated the registries of 2 tertiary hospitals, identifying 836 adult (≥18 years) patients achieving return of spontaneous circulation after out-of-hospital cardiac arrest...
February 16, 2017: Journal of Critical Care
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