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https://www.readbyqxmd.com/read/28720552/autoimmune-limbic-encephalitis-associated-with-type-1-diabetes-mellitus
#1
Onur Akın, Aylin Kılınç Uğurlu, Emine Demet Akbaş, Esra Döğer, Yılmaz Akbaş, Aysun Bideci, Özge Yüce, Kıvılcım Gücüyener, Orhun Çamurdan, Neşe Karabacak, Peyami Cinaz
Glutamic acid decarboxylase (GAD) antibodies can participate in the pathogenesis of both type 1 diabetes mellitus (T1DM) and limbic encephalitis (LE). However, an association between T1DM and LE is very rare. We report a patient who was diagnosed with type 1 diabetes mellitus six months after encountering limbic encephalitis. A 16-year-old boy was admitted with behavioral changes, confusion, and headache. He was diagnosed with LE. Anti-GAD levels were high. He was treated with pulse methylprednisolone. During the steroid treatment, neurological symptoms improved but hyperglycemia occurred...
July 17, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/28719458/acupuncture-for-chronic-pain-an-update-and-critical-overview
#2
Changshik Yin, Thomas E Buchheit, Jongbae J Park
PURPOSE OF REVIEW: Acupuncture is now recommended for several chronic pain conditions. Despite supportive evidence of its effectiveness, this ancient approach is often misunderstood, and may still be underused in mainstream practice. A critical review on its effectiveness and practice integration, and mechanisms of action is essential to the medical community that is continuing to seek nonopioid therapies for chronic pain. RECENT FINDINGS: Mounting evidence supports the effectiveness of acupuncture to treat chronic low back, neck, shoulder, and knee pain, as well as headaches...
July 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28719089/development-and-implementation-of-an-emergency-department-telephone-follow-up-system
#3
O John Ma, Mary Tanski, Beech Burns, Elizabeth F Spizman, James A Heilman
Implementing a telephone follow-up system after a patient's emergency department (ED) visit is challenging, but it may improve patient safety and care. This study's objective was to describe the development and implementation of a comprehensive ED telephone follow-up system over a 9-year period. Discharged patients who received a follow-up telephone call within 48 hours of their ED visit included all pediatric patients, those who left without being seen by a provider, and any adult patient with a "high-risk chief complaint," which was defined as a headache, visual problem, chest pain, dyspnea, abdominal pain, syncope, trauma, and neurological-related problems...
July 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28712074/efficacy-and-safety-of-shp465-mixed-amphetamine-salts-in-the-treatment-of-attention-deficit-hyperactivity-disorder-in-adults-results-of-a-randomized-double-blind-placebo-controlled-forced-dose-clinical-study
#4
Richard H Weisler, Michael Greenbaum, Valerie Arnold, Ming Yu, Brian Yan, Margo Jaffee, Brigitte Robertson
OBJECTIVE: The objective of this randomized, double-blind, placebo-controlled study was to evaluate the efficacy and safety of SHP465 mixed amphetamine salts (MAS) in adults with attention-deficit/hyperactivity disorder (ADHD). METHODS: Eligible adults [aged 18-55 years; meeting the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ADHD criteria; baseline ADHD Rating Scale with Adult Prompts (ADHD-RS-AP) total scores ≥28] were randomized 1:1:1 to placebo or forced-dose SHP465 MAS (12...
July 15, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28711127/care-of-neurologic-conditions-in-an-observation-unit
#5
REVIEW
Matthew A Wheatley, Michael A Ross
As a group, neurologic conditions represent a substantial portion of emergency department (ED) visits. Cerebrovascular disease, headache, vertigo and seizures are all common reasons for patients to seek care in the ED. Patients being treated for each of these conditions are amenable to care in an ED observation unit (EDOU) if they require further diagnostic or therapeutic interventions beyond their ED stay. EDOUs are the ideal setting for patients who require advanced imaging such as MRIs, frequent neuro checks or specialist consultation in order to determine if they require admission or can be discharged home...
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28705754/progression-of-lyme-disease-to-bell-s-palsy-despite-treatment-with-doxycycline
#6
Luis A Marcos, Zengmin Yan
A 54 year-old healthy woman presented to the emergency department with a right sided facial paralysis. About 3 weeks ago, she woke up and noticed an attached engorged tick in her right lower extremity. A week later, she noticed a mild to moderate right jaw pain which progressed to a severe right facial pain so she visited her doctor. On physical, II to XII cranial nerve examination was unremarkable. Doppler ultrasound did not show any vascular abnormalities in temporal artery. Her inflammatory markers were within normal limits (C-reactive protein:0...
July 10, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28704270/impact-of-ramadan-on-emergency-department-visits-and-on-medical-emergencies
#7
Reem G Al Assaad, Rana Bachir, Mazen J El Sayed
BACKGROUND: Fasting during Ramadan is important to Muslims. This study describes changes in emergency department (ED) visits and in frequencies of emergency conditions and impact on clinical outcomes during Ramadan in a tertiary care center in Beirut, Lebanon. PATIENTS AND METHODS: Patients presenting to ED during Ramadan 1 month before and 1 month after Ramadan over a 3-year period with specific conditions (acute coronary syndrome, stroke, seizure, diabetes, renal colic, headache or hypertension) were included...
July 12, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28704229/treatment-of-hyponatremic-encephalopathy-in-the-critically-ill
#8
Steven G Achinger, Juan Carlos Ayus
OBJECTIVES: Hyponatremic encephalopathy, symptomatic cerebral edema due to a low osmolar state, is a medical emergency and often encountered in the ICU setting. This article provides a critical appraisal and review of the literature on identification of high-risk patients and the treatment of this life-threatening disorder. DATA SOURCES, STUDY SELECTION, AND DATA EXTRACTION: Online search of the PubMed database and manual review of articles involving risk factors for hyponatremic encephalopathy and treatment of hyponatremic encephalopathy in critical illness...
July 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28698750/the-relationship-between-risk-factors-of-head-trauma-with-ct-scan-findings-in-children-with-minor-head-trauma-admitted-to-hospital
#9
Babak Masoumi, Farhad Heydari, Hamidreza Hatamabadi, Reza Azizkhani, Zahra Yoosefian, Majid Zamani
BACKGROUND: In emergency medicine for determining the intracranial injury (ICI) in children with head trauma, usually brain CT scan is performed. Since brain CT scan, especially in children, has some disadvantages, it is better to find a procedure which could help to choose only the children with real head trauma injury for brain CT scan. AIMS: The aim of this study is to find such procedure. This study was descriptive, analytic and non-interventional. METHODS: We reviewed the archived files of children with head trauma injuries referred to the emergency department of Imam Hossein Hospital within two years...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28697164/the-use-safety-and-efficacy-of-olanzapine-in-a-level-i-pediatric-trauma-center-emergency-department-over-a-10-year-period
#10
Jon B Cole, Lauren R Klein, Ashley M Strobel, Stephane R Blanchard, Rebecca Nahum, Marc L Martel
OBJECTIVES: Olanzapine is a second-generation antipsychotic increasingly used in emergency medicine for many indications. Literature on its use in children is sparse. Our objectives were to describe the use, safety, and efficacy of olanzapine in pediatric emergency patients. METHODS: A structured chart review was performed of patients 18 years old or younger receiving olanzapine from 2007 to 2016 in the emergency department of a pediatric level I trauma center. RESULTS: A total of 285 children received olanzapine...
July 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28681550/comparison-of-long-term-safety-of-fixed-dose-combinations-azilsartan-medoxomil-chlorthalidone-vs-olmesartan-medoxomil-hydrochlorothiazide
#11
Joel M Neutel, William C Cushman, Eric Lloyd, Bruce Barger, Alison Handley
This 52-week, randomized, open-label study evaluated long-term safety/tolerability of fixed-dose combination azilsartan medoxomil/chlorthalidone (AZL-M/CLD) vs fixed-dose combination olmesartan medoxomil/hydrochlorothiazide (OLM/HCTZ) in patients with essential hypertension (stage 2; clinic systolic blood pressure 160-190 mm Hg). Initial AZL-M/CLD 40/12.5 mg/d (n=418) or OLM/HCTZ 20/12.5 mg/d (n=419) could be uptitrated during weeks 4 to 52 (AZL-M/CLD to 80/25 mg; OLM/HCTZ to 40/25 mg [United States] or 20/25 mg [Europe]) to meet blood pressure targets...
July 6, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28670086/posterior-reversible-leukoencephalopathy-syndrome-after-kratom-ingestion
#12
Austin Castillo, J Drew Payne, Kenneth Nugent
Posterior reversible encephalopathy syndrome has been associated with hypertension, preeclampsia, cancer chemotherapy, and drugs of abuse, such as amphetamine and methamphetamine. We report a young man who suddenly developed severe headache, disorientation, and aphasia following ingestion of kratom and Adderall. Computed tomography and magnetic resonance imaging of his head revealed foci of vasogenic edema in the posterior occipital lobes, frontal lobes, and brainstem. In addition, he had a small area of hemorrhage in the left posterior occipital lobe...
July 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28667569/long-term-safety-and-efficacy-of-lisdexamfetamine-dimesylate-in-children-and-adolescents-with-adhd-a-phase-iv-2-year-open-label-study-in-europe
#13
David R Coghill, Tobias Banaschewski, Peter Nagy, Isabel Hernández Otero, César Soutullo, Brian Yan, Beatriz Caballero, Alessandro Zuddas
BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is increasingly recognized as a persistent disorder requiring long-term management. OBJECTIVES: Our objective was to evaluate the 2-year safety and efficacy of lisdexamfetamine dimesylate (LDX) in children and adolescents with ADHD. METHODS: Participants (aged 6-17 years) with ADHD received open-label, dose-optimized LDX 30, 50, or 70 mg/day for 104 weeks. Safety monitoring included treatment-emergent adverse events (TEAEs), vital signs, electrocardiography, and growth...
June 30, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28664015/central-hypoventilation-syndrome-complicated-with-lateral-medullary-infarction-after-endovascular-treatment-of-the-vertebral-artery-dissecting-aneurysm-a-case-report
#14
Katsuhiro Tanaka, Hideki Kanamaru, Atsunori Morikawa, Kenji Kawaguchi
Lateral medullary infarction rarely leads to central hypoventilation syndrome (CHS). CHS is a life-threatening disorder characterized by hypoventilation during sleep. We report the first case of CHS as a complication of lateral medullary infarction after endovascular treatment. A 65-year-old man presented twice with severe headache. Computed tomography revealed subarachnoid hemorrhage and cerebral angiography showed a right vertebral dissecting aneurysm involving the posterior inferior cerebellar artery. After emergent endovascular patent artery occlusion, he developed Wallenberg syndrome and experienced apnea and a conscious disturbance episode due to CHS on postoperative days 6 and 16...
October 2016: NMC Case Rep J
https://www.readbyqxmd.com/read/28663006/effect-of-an-emergency-department-opioid-prescription-policy-on-prescribing-patterns
#15
Jerel Chacko, Josh Greenstein, Brahim Ardolic, Nicole Berwald
BACKGROUND: Staten Island University Hospital is located in NYC, where the opioid epidemic has resulted in significant mortalities from unintentional overdoses. In 2013 as a response to the rising threat to our community, our Emergency Department (ED) administration adopted a clinical practice policy focused on decreasing the prescription of controlled substances. The effects of this policy on our provider prescription patterns are presented here. METHODS: A retrospective chart review of patients prescribed opioids from the ED before and after policy implementation was performed...
June 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28653967/exercise-associated-hyponatremia-in-a-lactating-female
#16
Zach Bailowitz, Raymond Grams, David Teeple, Tamara Hew-Butler
A 37-year-old woman presented to the emergency department with severe headache, which quickly progressed to altered mental status and seizure activity in hospital. Her initial serum sodium concentration ([Na]) was 126 mmol/L. In the 24 hours before admission, she exercised vigorously for 120 minutes (interval training plus yoga) and also consumed more than 4 liters of fluid during that time to both stay hydrated and facilitate milk production because she was actively nursing 2 children. Her serum [Na] and altered mental status corrected slowly over the next 48 hours with furosemide, hypertonic saline, and fluid restriction...
July 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/28653646/early-predictors-of-outcome-after-mild-traumatic-brain-injury-upfront-an-observational-cohort-study
#17
Joukje van der Naalt, Marieke E Timmerman, Myrthe E de Koning, Harm J van der Horn, Myrthe E Scheenen, Bram Jacobs, Gerard Hageman, Tansel Yilmaz, Gerwin Roks, Jacoba M Spikman
BACKGROUND: Mild traumatic brain injury (mTBI) accounts for most cases of TBI, and many patients show incomplete long-term functional recovery. We aimed to create a prognostic model for functional outcome by combining demographics, injury severity, and psychological factors to identify patients at risk for incomplete recovery at 6 months. In particular, we investigated additional indicators of emotional distress and coping style at 2 weeks above early predictors measured at the emergency department...
July 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28653520/-pseudotumor-cerebri-due-to-taking-minocycline
#18
M Kaabour, F Guerisse, P Mols, S Levy
The cerebral pseudotumor (PTC) is defined by the increase in cerebrospinal fluid (CSF) pressure, a normal composition of the latter in the absence of identified intracranial structural abnormalities, in particular by neuroimaging. The pathophysiology of PTC is poorly understood although its diagnostic criteria are well established. Drugs such as minocycline, tetracycline and doxycycline have been repeatedly implicated as a causative factor in PTC. The prognosis of PTC related to minocycline, reported in the literature is quite variable...
2017: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/28646567/severe-menses-associated-hypertension-successfully-treated-with-gonadotropin-releasing-hormone-agonist
#19
Luke J Laffin, Munnam S Jafar, George L Bakris
A case of a 32-year-old nulliparous white woman referred for a 5-year history of severe hypertension, hypokalemia, and resultant systolic dysfunction is presented. She additionally had a left ventricular ejection fraction of 30% including left ventricular dilation and normal left ventricular mass index, as measured by cardiac magnetic resonance imaging when she initially presented to us. Her history revealed that her severe hypertension episodes were monthly and would occur around the catamenial (menses-associated) time...
June 23, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28645559/multicenter-prevalence-of-opioid-medication-use-as-abortive-therapy-in-the-emergency-department-treatment-of-migraine-headaches
#20
Neil Young, Daniel Silverman, Heather Bradford, Jeffrey Finkelstein
Despite a range of therapeutic options for treating acute migraine headaches, the use of opioids is still reported to be common practice. This study describes treatment practices in regards to migraines in the ED. It characterizes the prevalence of opioid orders during visits in three different settings, an academic medical center, a non-academic urban ED, and a community ED. Fourteen months of consecutive migraine visits were identified. All medications ordered were separated into first-line and rescue medications...
June 16, 2017: American Journal of Emergency Medicine
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