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https://www.readbyqxmd.com/read/29052830/diaphragmatic-rupture-a-single-institution-experience-and-literature-review
#1
Carlo Corbellini, Stefano Costa, Tiberio Canini, Roberta Villa, Ettore Contessini Avesani
BACKGROUND: Diaphragmatic rupture (DR) is a rare and potentially life-threatening event caused by trauma or spontaneously. DR occasionally occurs several months after the injury. Chest X-ray and computed tomography are the most effective diagnostic methods. Delay in DR diagnosis occurs frequently. This study aimed to examine and improve our understanding of the etiology, clinical presentation, and management of DR. METHODS: This study was performed at the Emergency and General Surgery Department of Fondazione I...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29049743/additional-veno-venous-gas-exchange-as-a-problem-solving-strategy-for-an-oxygenator-not-transferring-oxygen-in-paediatric-cardiopulmonary-bypass
#2
Wolfgang Boettcher, Nicodème Sinzobahamvya, Frank Dehmel, Andreas Matschke, Andre Iben, Mi-Young Cho, Mathias Redlin, Joachim Photiadis
OBJECTIVES: Oxygenator failure during cardiopulmonary bypass constitutes a life-threatening event, especially when perfusion is conducted under normothermia. An alternative solution to emergency oxygenator changeover is described. METHODS: A supplementary oxygenator is added in the venous line without interrupting perfusion. De-airing is achieved through the cardiotomy reservoir. Oxygen supply is adapted to ensure physiologic partial oxygen pressure. RESULTS: On 5 occasions in the past 4 years, Capiox Baby FX 05 oxygenator ( n  = 4) and Capiox FX15 ( n  = 1) failed to exchange blood gases after bypass run ranging from 290 min to 563 min...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049672/high-mortality-in-patients-with-tracheoarterial-fistulas-clinical-experience-and-treatment-recommendations
#3
Brigitte Reger, Reiner Neu, Hans-Stefan Hofmann, Michael Ried
OBJECTIVES: A tracheoarterial fistula (TAF) is an uncommon but a critical complication of tracheostomy and represents a surgical emergency. Surgical therapy with ligation of the brachiocephalic trunk can be considered as the first choice of treatment to control massive and life-threatening haemorrhage. METHODS: We describe 3 cases of TAF in patients who had long-term placement of a tracheostomy tube and the occurrence of a severe massive haemorrhage caused by an injured brachiocephalic trunk...
July 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29048149/management-of-inflammatory-bowel-disease-flares-in-the-emergency-department
#4
Michael D. Burg, Steven T. Riccoboni
Because of the chronic relapsing nature of inflammatory bowel disease (IBD), emergency clinicians frequently manage patients with acute flares and complications. IBD patients present with an often-broad range of nonspecific signs and symptoms, and it is essential to differentiate a mild flare from a life-threatening intra-abdominal process. Recognizing extraintestinal manifestations and the presence of infection are critical. This issue reviews the literature on management of IBD flares in the emergency department, including laboratory testing, imaging, and identification of surgical emergencies, emphasizing the importance of coordination of care with specialists on treatment plans and offering patients resources for ongoing support...
November 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29047014/a-callosal-catastrophe-toxic-leukoencephalopathy-associated-with-thermogenic-weight-loss-supplement-use
#5
Zakraus K Mahdavi, Ram Narayan, Shraddha Mainali, Benjamin M Greenberg, Venkatesh Aiyagari, David L McDonagh
BACKGROUND: The use of weight loss drugs and dietary supplements is common, but safety profiles for these drugs are largely unknown. Reports of toxicity have been published, and the use of these agents should be considered in clinical differential diagnoses. METHODS: We report the case of a patient with toxic leukoencephalopathy and hyponatremia associated with oral consumption of a thermogenic dietary supplement and essential oils. RESULTS: A 30-year-old woman presented after 2 days of headache, blurred vision, photophobia, vomiting, and hand spasms...
October 18, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29046934/-knowledge-of-the-population-about-leading-symptoms-of-cardiovascular-emergencies-and-the-responsibility-and-accessibility-of-medical-facilities-in-emergencies-results-of-the-kzen-study-in-western-palatinate
#6
T Luiz, S Dittrich, G Pollach, C Madler
BACKGROUND: The Westpfalz is a mainly rural region in the southwestern part of the German state of Rhineland-Palatinate with 527,000 inhabitants and demonstrates a higher than average cardiovascular mortality compared to the rest of Germany. The reasons are not known. Our study attempted to investigate whether significant deficits in knowledge of the population on cardiovascular emergencies, the accessibility of emergency medical services (EMS) or the different responsibilities and abilities of the medical facilities could be held responsible for this...
October 18, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29046870/salmonella-populations-inside-host-cells
#7
REVIEW
Sónia Castanheira, Francisco García-Del Portillo
Bacteria of the Salmonella genus cause diseases ranging from gastroenteritis to life-threatening typhoid fever and are among the most successful intracellular pathogens known. After the invasion of the eukaryotic cell, Salmonella exhibits contrasting lifestyles with different replication rates and subcellular locations. Although Salmonella hyper-replicates in the cytosol of certain host cell types, most invading bacteria remain within vacuoles in which the pathogen proliferates at moderate rates or persists in a dormant-like state...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/29046758/coronary-artery-ectasia-presenting-with-acute-inferior-wall-myocardial-infarction-in-a-young-adult
#8
Htun Latt, Sammy Aung, Kyaw Kyaw, Richard Seher
Coronary artery ectasia (CAE), a variant of coronary artery anomalies, is a rare clinical entity. Although atherosclerotic coronary artery disease (CAD) is the most common cause of acute coronary syndrome (ACS), CAE also conveys a relatively high risk for potentially life-threatening cardiac events. We report a case of a 35-year-old male with two-vessel CAE, who presented with acute inferior wall ST election myocardial infarction (STEMI). After initiating medical therapy including bivalirudin, emergent percutaneous coronary intervention (PCI) with stenting of postero-lateral branch of right coronary artery (RCA) was performed...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29045097/management-of-airway-obstruction-and-stridor-in-pediatric-patients
#9
Ashley Marchese, Melissa L. Langhan
Stridor is a result of turbulent air-flow through the trachea from upper airway obstruction, and although in children it is often due to croup, it can also be caused by noninfectious and/or congenital conditions as well as life-threatening etiologies. The history and physical examination guide initial management, which includes reduction of airway inflammation, treatment of bacterial infection, and, less often, imaging, emergent airway stabilization, or surgical management. This issue discusses the most common as well as the life-threatening etiologies of acute and chronic stridor and its management in the emergency department...
November 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29042291/micrornas-as-biomarkers-for-liver-injury-current-knowledge-challenges-and-future-prospects
#10
REVIEW
Haixia Lin, Laura E Ewing, Igor Koturbash, Bill J Gurley, Isabelle R Miousse
MicroRNAs (miRNAs) are short regulatory RNAs that are involved in various biological processes that regulate gene expression posttranscriptionally. Changes in miRNA expression can be detected in many physiological and pathological events, such as liver injury. Drug induced liver injury is a life threatening condition that frequently requires organ transplantation. Hepatotoxicity is also one of the major causes of drug failure in clinical trials and of drug withdrawal from the market. The profiling of miRNA expression shows great promise in monitoring liver injury, in the prediction of outcome in patients, and in the identification of liver-reactive compounds in toxicological assessment...
October 14, 2017: Food and Chemical Toxicology
https://www.readbyqxmd.com/read/29040243/toxic-shock-syndrome-still-a-timely-diagnosis
#11
Kira L Gossack-Keenan, April J Kam
BACKGROUND: Toxic shock syndrome (TSS) is an acute, severe, toxin-mediated disease, characterized by fever, hypotension, and multiorgan system involvement. Toxic shock syndrome has made headlines because of its high associated morbidity and mortality rate in previously healthy young females. Incidence peaked in the early 1980s owing to increased usage of ultra-absorbent tampons. After improved patient education and tampon labeling, the incidence of menstrual TSS has declined. CASE: A previously healthy 14-year-old girl presented to an urgent care center with a 2-day history of fever, erythematous maculopapular rash, vomiting, diarrhea, and malaise...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29040036/septic-thrombosis-of-cavernous-sinus-extended-to-the-ipsilateral-internal-jugular-vein-and-transversal-sinus-with-favorable-outcome-clinical-and-radiological-features-of-a-lemierre-syndrome
#12
Arnaud Martel
An 86-year-old patient was hospitalized for fever and left acute orbital syndrome (red eye with moderate visual impairment, chemosis, ophthalmoplegia without proptosis, or any fundus involvement). CT scan showed superior ophthalmic vein and cavernous sinus enlargement complicating ipsilateral sphenoidal sinusitis. Magnetic resonance imaging (MRI) demonstrated the left cavernous sinus thrombosis extended to the ipsilateral jugular vein and transversal sinus (Lemierre syndrome). Intravenous broad-spectrum antibiotics and curative anticoagulation were prescribed...
October 17, 2017: Orbit
https://www.readbyqxmd.com/read/29038262/severe-infusion-related-adverse-events-and-renal-failure-in-patients-receiving-high-dose-intravenous-polymyxin-b
#13
Josiane F John, Diego R Falci, Maria Helena Rigatto, Renata D Oliveira, Thaysa G Kremer, Alexandre P Zavascki
Very high doses of polymyxin B (PMB) have been addressed in in vitro experiments against carbapenem-resistant Gram-negative bacilli as a strategy to improve bacterial killing and suppress resistance emergence. However, the toxicities of very high doses in patients are unknown. This is a retrospective cohort study assessing patients receiving >3mg/kg/day or a total dose ≥250mg/day of PMB. The main outcomes were severe infusion-related adverse event according to Common Terminology Criteria for Adverse Criteria and renal failure category of RIFLE criteria for acute kidney injury (AKI) during treatment...
October 16, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29035901/ce-preeclampsia-current-approaches-to-nursing-management
#14
Cindy M Anderson, Mandy J Schmella
A clinical review of risk factors, diagnostic criteria, and patient care. ABSTRACT: Preeclampsia, one of four hypertensive disorders of pregnancy, has traditionally been characterized as new-onset hypertension and proteinuria developing after 20 weeks' gestation. It is, however, now understood to be a complex, progressive, multisystem disorder with a highly variable presentation and a number of potentially life-threatening complications. The American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy has refined preeclampsia diagnostic criteria accordingly, and as the disorder's pathogenesis has been more clearly defined, new targets for screening, diagnosis, prevention, and treatment have emerged...
October 13, 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/29033340/nonepileptic-seizure-provoked-by-cardiac-dysrhythmia-a-case-of-st-elevation-myocardial-infarction
#15
A Pourmand, S Davis, K Yensen
Acute seizures represent 1% of all visits to emergency departments in the United States. While many acute seizures are correctly attributable to underlying epilepsy, approximately one-third of acute seizures are provoked by underlying and potentially life-threatening acute conditions. Many clinical syndromes associated with seizure-like activity are well-established and readily identified in the acute setting. Cardiac dysrhythmias are known causes of acute seizure-like activity and, if transient and not captured by electrocardiogram tracings during acute episodes, may be incorrectly diagnosed as epileptic seizures...
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29033151/is-it-adequate-to-carry-out-a-chest-ct-in-patients-with-mild-moderate-chest-trauma
#16
V García de Pereda de Blas, M Carreras Aja, S Carbajo Azabal, E Arana-Arri
Mild-moderate blunt chest trauma is defined as a blunt chest trauma that is not caused by a high-energy mechanism, causing thoracic tenderness with or without rib fractures and that has no immediate life-threatening consequences for the patient. It is a frequent clinical situation in the emergency department. The most common radiological techniques that are used in this context are chest X-ray and thoracic computed tomography (CT). The CT scan is set as the gold standard. However, there are no current clinical-radiological guidelines that establish the adequacy of the requests of the CT scan...
October 12, 2017: Radiología
https://www.readbyqxmd.com/read/29029405/sox7-promotes-the-maintenance-and-proliferation-of-b-cell-precursor-acute-lymphoblastic-cells
#17
Sara Cuvertino, Genny Filiciotto, Ashish Masurekar, Vaskar Saha, Georges Lacaud, Valerie Kouskoff
B cell precursor acute lymphoblastic leukemia (BCP-ALL) is the most frequent type of cancer in children. Despite progresses in curative treatment, intensive chemotherapy regimens still cause life threatening complications. A better understanding of the molecular mechanisms underlying the emergence and maintenance of BCP-ALL is fundamental for the development of novel therapies. Here, we establish that SOX7 is frequently and specifically expressed in BCP-ALL and that the expression of this transcription factor does not correlate with any specific cytogenetic abnormalities...
September 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/29026889/study-design-of-real-world-evidence-for-treatment-of-hyperkalemia-in-the-emergency-department-reveal-ed-a-multicenter-prospective-observational-study
#18
Zubaid Rafique, Mikhail Kosiborod, Carol L Clark, Adam J Singer, Stewart Turner, Joseph Miller, Douglas Char, W Frank Peacock
OBJECTIVE: Hyperkalemia affects up to 10% of hospitalized patients and, if left untreated, can lead to serious cardiac arrhythmias or death. Although hyperkalemia is frequently encountered in the emergency department (ED), and is potentially life-threatening, standard of care for the treatment is poorly defined, with little supporting evidence. The main objectives of this observational study are to define the overall burden of hyperkalemia in the ED setting, describe its causes, the variability in treatment patterns and characterize the effectiveness and safety of ED standard of care therapies used in the United States...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29026470/major-determinants-of-maternal-near-miss-and-mortality-at-the-maternity-teaching-hospital-erbil-city-iraq
#19
Vian Sabri Akrawi, Tariq Salman Al-Hadithi, Namir Ghanim Al-Tawil
OBJECTIVES: To find out the major determinants of maternal near-miss (NM)and maternal deaths (MDs) in Erbil city, Iraq, by comparative analysis of maternal NMs and MDs. METHODS: We conducted a hospital-based cross-sectional study in the Maternity Teaching Hospital in Erbil city from 1 June to 31 December 2013. All MDs and NMs that occurred in the hospital during the study period were included in the study. Systematic identification of all eligible women was done...
September 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/29025482/tb-and-hiv-stigma-compounded-by-threatened-masculinity-implications-for-tb-health-care-seeking-in-malawi
#20
J Chikovore, G Hart, M Kumwenda, G Chipungu, N Desmond, E L Corbett
SETTING: Urban Blantyre, Malawi. OBJECTIVE: To understand why men with tuberculosis (TB) in the community remain undiagnosed. DESIGN: A multi-method qualitative study applying a modified grounded theory approach. Data were gathered from March 2011 to March 2012 from 134 men and women taking part in 1) focus group discussions with community members (n = 6) and health care workers (n = 2), and 2) in-depth interviews with TB patients (n = 20, females n = 14) and chronic coughers (n = 20, women n = 8)...
November 1, 2017: International Journal of Tuberculosis and Lung Disease
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