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https://www.readbyqxmd.com/read/27925849/development-and-prospective-federal-state-wide-evaluation-of-a-device-for-height-based-dose-recommendations-in-prehospital-pediatric-emergencies-a-simple-tool-to-prevent-most-severe-drug-errors
#1
Jost Kaufmann, Bernhard Roth, Thomas Engelhardt, Alex Lechleuthner, Michael Laschat, Christoph Hadamitzky, Frank Wappler, Martin Hellmich
OBJECTIVE: Drug dosing errors pose a particular threat to children in prehospital emergency care. With the Pediatric emergency ruler (PaedER), we developed a simple height-based dose recommendation system and evaluated its effectiveness in a pre-post interventional trial as the Ethics Committee disapproved randomization due to the expected positive effect of the PaedER on outcome. METHODS: Pre-interventional data were retrospectively retrieved from the electronic records and medical protocols of the Cologne Emergency Medical Service over a two-year period prior to the introduction of the PaedER...
December 7, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27923204/case-report-of-the-surgical-management-of-small-bowel-and-colonic-ischaemia-associated-with-anorexia-nervosa-binge-purge-subtype
#2
Ann T Foran, Cillian Clancy, Tom F Gorey
INTRODUCTION: Anorexia Nervosa affects up to 1% of the population and can present with binge/purge episodes. A paucity of literature exists regarding small bowel and colonic ischaemia relating to this common condition. We report our own experience and management of a patient with anorexia nervosa binge/purge subtype with small bowel and colon ischaemia and review existing cases in the literature. PRESENTATION OF CASE: A 32year old female self-presented to the emergency department complaining of abdominal pain, abdominal distension and vomiting on a background history of binge/purge subtype eating disorder, following consumption of a large amount of carbohydrates...
August 25, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27921321/from-paperwork-to-parenting-experiences-of-professional-staff-in-student-support
#3
Wendy C Y Hu, Eleanor Flynn, Rebecca Mann, Robyn Woodward-Kron
CONTEXT: For academic staff, responding to student concerns is an important responsibility. Professional staff, or non-academic staff who do administrative work in medical schools, are often the first to be approached by students, yet there is little research on how they manage student issues. Informed by the conceptual framework of emotional labour, we examined the experiences of professional staff, aiming to identify theoretical and practical insights for improving the provision of student support...
December 5, 2016: Medical Education
https://www.readbyqxmd.com/read/27920694/pancreatic-and-hepatic-metastasis-of-an-undiagnosed-choriocarcinoma-an-exceptional-cause-of-haemoperitoneum-in-young-women-report-of-a-rare-case
#4
Nishat Fatema, Neeru Vinod Arora, Fatma Majid Al Abri, Yaseer Muhammad Tareq Khan
Haemoperitoneum in women of reproductive age usually suggests either ruptured ectopic pregnancy or ruptured ovarian cysts. Metastatic choriocarcinoma is considered the least common cause of haemoperitoneum in women of childbearing age. We report a rare case of pancreatic and hepatic metastasis of choriocarcinoma in a young, 30-year-old female who had delivered 10 months prior at term gestation with no previous history of gestational trophoblastic disease or molar pregnancy. She had a short history of fever and pain in the right hypochondrium, with findings of hypovolaemic shock due to intraperitoneal haemorrhage...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27920592/left-main-coronary-ostial-stenosis-after-aortic-valve-replacement-a-case-report
#5
Munish Sharma, Daniel Mascarenhas
Coronary ostial stenosis is a rare but potentially life-threatening complication of aortic valve replacement (AVR). It can present potential complications such as acute coronary syndrome, left ventricular failure, ventricular arrhythmias, or sudden death. Exact pathogenetic mechanism is not known, but a few hypotheses have been proposed. We present a case of left main coronary stenosis 11 months after AVR was done for symptomatic critical aortic stenosis. High index of clinical suspicion and timely coronary angiography helped to determine the exact etiology...
2016: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/27917666/safety-of-out-of-hours-operating-in-trauma-and-orthopaedics-at-a-district-general-hospital
#6
M A Gulamhussein, S Chaudhry, S Noor, T Chaudhry, A Guha, R Knebel
INTRODUCTION According to the National Confidential Enquiry into Perioperative Deaths (NCEPOD), out-of-hours operating in trauma and orthopaedics should be reserved for life or limb threatening cases only. The aim of our study was to determine the nature of non-emergency work carried out in our trust at night in 2015. The overall efficacy and clinical safety of the services provided was evaluated. METHODS Surgical activity undertaken after 9pm was reviewed along with patient ASA (American Society of Anesthesiologists) grade, grade of operating surgeon and any complications that occurred following the procedure...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27913093/genome-of-the-carbapenemase-producing-clinical-isolate-elizabethkingia-miricola-em_chuv-and-comparative-genomics-with-elizabethkingia-meningoseptica-and-elizabethkingia-anophelis-evidence-for-intrinsic-multidrug-resistance-trait-of-emerging-pathogens
#7
Onya Opota, Seydina M Diene, Claire Bertelli, Guy Prod'hom, Philippe Eckert, Gilbert Greub
Elizabethkingia miricola is a Gram-negative non-fermenting rod emerging as a life-threatening human pathogen. The multidrug-resistant (MDR) carbapenemase-producing clinical isolate E. miricola EM_CHUV was recovered in the setting of severe nosocomial pneumonia. In this study, the genome of E. miricola EM_CHUV was sequenced and a functional analysis was performed, including a comparative genomic study with Elizabethkingia meningoseptica and Elizabethkingia anophelis. The resistome of EM_CHUV revealed the presence of a high number of resistance genes, including the presence of the blaGOB-13 and blaB-9 carbapenemase-encoding genes...
November 15, 2016: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/27913079/rash-decisions-an-approach-to-dangerous-rashes-based-on-morphology
#8
Jamie Santistevan, Brit Long, Alex Koyfman
BACKGROUND: Rash is a common complaint in the emergency department. Many causes of rash are benign; however, some patients may have a life-threatening diagnosis. OBJECTIVE: This review will present an algorithmic approach to rashes, focusing on life-threatening causes of rash in each category. DISCUSSION: Rash is common, with a wide range of etiologies. The differential is broad, consisting of many conditions that are self-resolving. However, several conditions associated with rash are life threatening...
November 29, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27911896/different-mutations-in-a-p-type-atpase-transporter-in-leishmania-parasites-are-associated-with-cross-resistance-to-two-leading-drugs-by-distinct-mechanisms
#9
Christopher Fernandez-Prada, Isabel M Vincent, Marie-Christine Brotherton, Mathew Roberts, Gaétan Roy, Luis Rivas, Philippe Leprohon, Terry K Smith, Marc Ouellette
Leishmania infantum is an etiological agent of the life-threatening visceral form of leishmaniasis. Liposomal amphotericin B (AmB) followed by a short administration of miltefosine (MF) is a drug combination effective for treating visceral leishmaniasis in endemic regions of India. Resistance to MF can be due to point mutations in the miltefosine transporter (MT). Here we show that mutations in MT are also observed in Leishmania AmB-resistant mutants. The MF-induced MT mutations, but not the AmB induced mutations in MT, alter the translocation/uptake of MF...
December 2016: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/27911233/elevated-preoperative-neutrophil-to-lymphocyte-ratio-as-a-predictor-of-worse-survival-after-resection-in-patients-with-brain-metastasis
#10
Koichi Mitsuya, Yoko Nakasu, Takeshi Kurakane, Nakamasa Hayashi, Hideyuki Harada, Kazuhiko Nozaki
OBJECTIVE The median postoperative survival duration of patients with brain metastases who undergo tumor resection is 12 months. Most of these patients die of systemic metastases or the progression of primary cancer but not brain metastases. The criteria for indicating resection are still controversial. Systemic assessment is restricted, especially in patients who need emergent management for their large-size or life-threatening brain metastases. The neutrophil-to-lymphocyte ratio (NLR) is reported to correlate with survival time or progression-free survival in patients with various cancers...
December 2, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27911143/factors-predicting-life-threatening-infections-with-respiratory-syncytial-virus-in-adult-patients
#11
Se Yoon Park, Taeeun Kim, Young Rock Jang, Min-Chul Kim, Yong Pil Chong, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Jun Hee Woo, Sung-Han Kim
BACKGROUND: Respiratory syncytial virus (RSV) is a significant cause of acute respiratory illness with a clinical spectrum ranging from self-limiting upper respiratory infection to severe lower respiratory infection in elderly persons as well as young children. However, there are limited data on risk factors for life-threatening infections that could guide the appropriate use of antiviral agents in adult patients with RSV. METHODS: We conducted a retrospective cohort study from October 2013 to September 2015...
December 2, 2016: Infectious Diseases
https://www.readbyqxmd.com/read/27909067/concept-and-evaluation-of-the-german-war-surgery-course-einsatzchirurgie-kurs-der-bundeswehr
#12
David A Back, K Waldmann, T Hauer, N Huschitt, M W Bowyer, U Wesemann, A Lieber, C Willy
INTRODUCTION: Military surgeons must be prepared to care for severe and complex life-threatening injuries rarely seen in the civilian setting. Typical civilian training and practice do not provide adequate exposure to the broad set of surgical skills required. The German Bundeswehr Medical Service has developed and refined the War Surgery Course (WSC) to meet this training gap. This article describes the recent experience with this readiness curriculum. METHODS: Run annually since 1998, WSC consists nowadays of 5 days with 20 theoretical modules...
December 1, 2016: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27908315/-life-threatening-ketoacidosis-in-a-25-year-old-woman-treated-with-sodium-glucose-cotransporter-2-inhibitor
#13
Mats Jacob Hermansson Lindberg, Frans Brandt Kristensen, Alev Yildiz
We report a case of atypical ketoacidosis in a patient treated with a sodium-glucose cotransporter- (SGLT) 2 inhibitor. The 25-year-old woman, who one year earlier had been prescribed dapagliflozin for presumed Type 2 diabetes, came to the emergency department in a state of severe ketoacidosis, pH 6.85, and a plasma glucose level of 14.3 mmol/l. She received standard treatment and recovered. We discuss the increasing evidence for atypical ketoacidosis being a serious side effect of the SGLT2 inhibitors.
November 21, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27907878/ultrasound-in-cardiac-trauma
#14
Theodosios Saranteas, Andreas F Mavrogenis, Christina Mandila, John Poularas, Fotios Panou
In the perioperative period, the emergency department or the intensive care unit accurate assessment of variable chest pain requires meticulous knowledge, diagnostic skills, and suitable usage of various diagnostic modalities. In addition, in polytrauma patients, cardiac injury including aortic dissection, pulmonary embolism, acute myocardial infarction, and pericardial effusion should be immediately revealed and treated. In these patients, arrhythmias, mainly tachycardia, cardiac murmurs, or hypotension must alert physicians to suspect cardiovascular trauma, which would potentially be life threatening...
November 5, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27904545/treatment-of-recurrent-prosthetic-mitral-valve-thrombosis-with-reteplase-a-report-of-four-cases
#15
Neda Behzadnia, Babak Sharif Kashani, Arda Kiani, Atefe Abedini, Seyed Reza Seyedi, Hossein Zargham Ahmadi, Farah Naghash Zadeh, Atefeh Fakharian
Thrombosis is a life threatening complications of prosthetic mitral valves and is associated with high morbidity and mortality. Even in presence of systemic anticoagulation prosthetic valve thrombosis has an incidence of 0.5% to 8%. Recurrent prosthetic valve thrombosis and the resulting thrombotic occlusion require re-establishment of blood flow across the valve. While surgical repair is considered the classic first line treatment option for prosthetic valve thrombosis, intravenous thrombolysis has emerged as an acceptable alternative for the first episode of prosthetic valve thrombosis...
2016: Tanaffos
https://www.readbyqxmd.com/read/27903701/can-multi-generational-exposure-to-ocean-warming-and-acidification-lead-to-the-adaptation-of-life-history-and-physiology-in-a-marine-metazoan
#16
Emma M Gibbin, Leela J Chakravarti, Michael D Jarrold, Felix Christen, Vincent Turpin, Gloria Massamba N'Siala, Pierre U Blier, Piero Calosi
Ocean warming and acidification are concomitant global drivers that are currently threatening the survival of marine organisms. How species will respond to these changes depends on their capacity for plastic and adaptive responses. Little is known about the mechanisms that govern plasticity and adaptability or how global changes will influence these relationships across multiple generations. Here, we exposed the emerging model marine polychaete Ophryotrocha labronica to conditions simulating ocean warming and acidification, in isolation and in combination over five generations to identify: (i) how multiple versus single global change drivers alter both juvenile and adult life-traits; (ii) the mechanistic link between adult physiological and fitness-related life-history traits; (iii) whether observed phenotypic changes observed over multiple generations are of plastic and/or adaptive origin...
November 30, 2016: Journal of Experimental Biology
https://www.readbyqxmd.com/read/27902953/rectal-free-perforation-after-stapled-hemorrhoidopexy-a-case-report-of-laparoscopic-peritoneal-lavage-and-repair-without-stoma
#17
Seokyong Ryu, Byung-Noe Bae
INTRODUCTION: Stapled hemorrhoidopexy is widely performed for treatment of prolapsed hemorrhoids because of advantages, including shorter hospital stay and less discomfort, compared with conventional hemorrhoidectomy. However, it can have severe adverse effects, such as rectal bleeding, perforation, and sepsis. PRESENTATION OF CASE: We report the case of a healthy 28-year-old man who presented to the emergency department with sudden-onset diffuse abdominal pain and hematochezia...
November 21, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27902848/topiramate-in-migraine-prevention-a-2016-perspective
#18
Stephen D Silberstein
BACKGROUND: In evidence-based guidelines published in 2000, topiramate was a third-tier migraine preventive with no scientific evidence of efficacy; recommendation for its use reflected consensus opinion and clinical experience. Its neurostabilizing activity, coupled with its favorable weight profile, made topiramate an attractive alternative to other migraine preventives that caused weight gain. When guidelines for migraine prevention in episodic migraine were published in 2012, topiramate was included as a first-line option based on double-blind, randomized controlled trials involving nearly 3000 patients...
November 30, 2016: Headache
https://www.readbyqxmd.com/read/27902157/pulmonary-oedema
#19
Monica Thompson
What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice? The CPD article discussed acute pulmonary oedema, which is the build-up of excess fluid in the lungs. It is a life-threatening illness that should be treated as a medical emergency.
November 30, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27896151/alimentary-tract-atresias-associated-with-anorectal-malformations-10-years-experience
#20
Manoj Saha
Anorectal malformation (ARM) is one of the most common congenital anomaly that requires emergency surgery in the neonatal period. ARMs are frequently associated with other life threatening congenital anomalies. Commonly associated anomalies are genito-urinary, cardiovascular, gastro-intestinal, skeletal and spinal. Alimentary tract anomalies are frequently masked by the intestinal obstruction produced by the anorectal atresia. This retrospective study was carried out to find out the incidence of associated alimentary tract atresias with ARM...
October 2016: Journal of Neonatal Surgery
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