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https://www.readbyqxmd.com/read/29054943/non-infectious-aortitis-in-an-immunosuppressed-renal-transplant-recipient-with-iga-nephropathy
#1
Charlotte M Snead, Stephen C Crockett, Phillippa K Bailey
A 54-year-old woman presented with atypical chest pain, fever and malaise. She was immunosuppressed with three agents following a living-donor kidney transplant 1 year previously. Her native kidney failure was secondary to biopsy-demonstrated crescentic IgA nephropathy, with systemic involvement. A CT pulmonary angiogram revealed an inflammatory cuff of soft tissue around the descending thoracic aorta suggesting aortitis. Inflammatory markers were elevated. Given her immunosuppression, the patient was screened extensively for infective causes and was empirically commenced on intravenous meropenem...
October 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29054907/secondary-aortoduodenal-fistula-and-the-unrecognised-herald-bleed
#2
Francesc Simó Alari, Esther Molina González, Israel Gutierrez, Aïcha Ahamdanech-Idrissi
A 65-year-old man with history of aortobifemoral surgery 4 years ago was admitted to hospital after sudden abdominal pain. Initially misdiagnosed as renal colic, he was treated with analgesics, and while on observation he started with haematemesis, rapidly responding to volume infusion. Upper gastrointestinal endoscopy showed fresh blood in the stomach with no visible active bleeding. CT scan showed an important contrast extravasation from the aorta to the third duodenal portion, restarting haemodynamic instability and a cardiac arrest...
October 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29054555/evidence-based-guidelines-for-supportive-care-of-patients-with-ebola-virus-disease
#3
François Lamontagne, Robert A Fowler, Neill K Adhikari, Srinivas Murthy, David M Brett-Major, Michael Jacobs, Timothy M Uyeki, Constanza Vallenas, Susan L Norris, William A Fischer, Thomas E Fletcher, Adam C Levine, Paul Reed, Daniel G Bausch, Sandy Gove, Andrew Hall, Susan Shepherd, Reed A Siemieniuk, Marie-Claude Lamah, Rashida Kamara, Phiona Nakyeyune, Moses J Soka, Ama Edwin, Afeez A Hazzan, Shevin T Jacob, Mubarak Mustafa Elkarsany, Takuya Adachi, Lynda Benhadj, Christophe Clément, Ian Crozier, Armando Garcia, Steven J Hoffman, Gordon H Guyatt
The 2013-16 Ebola virus disease outbreak in west Africa was associated with unprecedented challenges in the provision of care to patients with Ebola virus disease, including absence of pre-existing isolation and treatment facilities, patients' reluctance to present for medical care, and limitations in the provision of supportive medical care. Case fatality rates in west Africa were initially greater than 70%, but decreased with improvements in supportive care. To inform optimal care in a future outbreak of Ebola virus disease, we employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to develop evidence-based guidelines for the delivery of supportive care to patients admitted to Ebola treatment units...
October 17, 2017: Lancet
https://www.readbyqxmd.com/read/29054186/isolated-coronary-artery-ectasia-clinical-angiographic-and-follow-up-characteristics
#4
Amit Malviya, Pravin K Jha, Animesh Mishra
BACKGROUND: Isolated Coronary artery ectasia (CAE) is considered an uncommon angiographic finding with varying patterns of presentation and carries significant morbidity burden to the patient. Our objective was to evaluate the prevalence of this condition, to analyse its clinical, angiographic, and follow up characteristics. PATIENTS AND METHODS: Coronary angiography was performed in 4950 patients from January 2009 to August 2014. The epidemiological, clinical, angiographic, and follow up characteristics of 52 patients with isolated CAE were examined...
September 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29053883/pharmacokinetics-of-inorganic-cobalt-and-a-vitamin-b12-supplement-in-the-thoroughbred-horse-differentiating-cobalt-abuse-from-supplementation
#5
L L Hillyer, Z Ridd, S Fenwick, P Hincks, S W Paine
BACKGROUND: Whilst cobalt is an essential micronutrient for vitamin B12 synthesis in the horse, at supra-physiological concentrations it has been shown to enhance performance in humans and rats and there is evidence that its administration in high doses to horses poses a welfare threat. Animal sport regulators currently control cobalt abuse via international race day thresholds, but since cobalt may be present in physiological concentrations this work was initiated to explore means of potentially adding to application of those thresholds...
October 20, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/29052805/sublingual-buprenorphine-efficacy-in-renal-colic-pain-relief-a-randomized-placebo-controlled-clinical-trial
#6
Javad Mozafari, Kambiz Masoumi, Arash Forouzan, Hassan Motamed, Malehi Amal Saki, Marzieh Dezham
INTRODUCTION: This study was designed to compare the analgesic efficacy of sublingual (SL) buprenorphine and intravenous (IV) ketorolac for renal colic pain relief. METHODS: The present study was carried out as a double-blind, double-dummy randomized clinical trial in patients diagnosed with acute renal colic attending the emergency department. The study subjects were 63 patients with confirmed renal stones. The subjects were randomly divided into two groups. One group, which included 32 patients, received SL buprenorphine tablets (2 mg) with an IV placebo, and another group, including 31 patients, received ketorolac tromethamine (30 mg) with a SL placebo...
October 20, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29051881/fracture-management-in-pyknodysostosis-a-rare-case-report
#7
G Subramanya Gandhi, V Vijayanarasimhan, Lionel John, S Kailash, E Sathish Balaji
INTRODUCTION: Pyknodysostosis is congenital osteosclerotic skeletal dysplasia of a rare entity. It is an autosomal recessive disease which presents with short stature and generalized osteosclerosis of skeleton as result of decreased bone turnover. Here, the authors report a case of pyknodysostosis who presented to our emergency room with a pathological fracture in the shaft of the femur for which operative intervention was carried out. CASE REPORT: A 30-year-old female presented to our emergency room with a history of trivial injury to right thigh region and was diagnosed as fracture in her right femur shaft region...
May 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29051401/symptomatic-pile-tailored-procedure-a-new-perspective-for-hemorrhoidal-disease-treatment
#8
Claudio Elbetti, Iacopo Giani, Eugenio Novelli, Jacopo Martellucci, Francesco Feroci
AIM: Aim of the present paper was to evaluate the role of tailored different single pile treatment in the clinical outcome of hemorrhoids. MATERIAL OF STUDY: The surgical strategy considered to treat only pathological piles with different procedure according to each pathological Goligher's degree, presence of fibrous, inelastic redundant internal pile(F) and presence of external pathological pile (external pile congestion or subversion of dental line (E) and skin tag not tolerated from the patient (S))...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29050722/adjacent-segment-disease-44-years-following-posterior-spinal-fusion-for-congenital-lumbar-kyphosis
#9
Avionna Baldwin, Addisu Mesfin
STUDY DESIGN: Case report. OBJECTIVE: To report the clinical and imaging findings of a patient with lumbar stenosis 44 years after posterior spinal fusion for congenital lumbar kyphosis. SUMMARY OF BACKGROUND DATA: To our knowledge, there are no long-term follow-up reports after posterior spine fusion (PSF) for congenital kyphosis. Congenital kyphosis is an uncommon deformity with the potential to progress rapidly and result in deformity and neurologic deficits...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29049196/three-dimensional-reduction-and-finite-element-analysis-improves-the-treatment-of-pelvic-malunion-reconstructive-surgery-a-case-report
#10
Sascha Kurz, Philipp Pieroh, Maximilian Lenk, Christoph Josten, Jörg Böhme
RATIONALE: Pelvic malunion is a rare complication and is technically challenging to correct owing to the complex three-dimensional (3D) geometry of the pelvic girdle. Hence, precise preoperative planning is required to ensure appropriate correction. Reconstructive surgery is generally a 2- or 3-stage procedure, with transiliac osteotomy serving as an alternative to address limb length discrepancy. PATIENT CONCERNS: A 38-year-old female patient with a Mears type IV pelvic malunion with previous failed reconstructive surgery was admitted to our department due to progressive immobilization, increasing pain especially at the posterior pelvic arch and a leg length discrepancy...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29049165/effects-of-different-methods-of-general-anesthesia-on-intraoperative-awareness-in-surgical-patients
#11
Haijiao Yu, Di Wu
The purpose of the study was to investigate the effects of total intravenous anesthesia (TIVA) and combined of intravenous and inhaled anesthesia (CIIA) on intraoperative awareness in surgical patients.A total of 678 patients were recruited in the CIIA group, while TIVA group included 566 patients. The clinical characteristics and the occurrence of intraoperative awareness were compared between the groups. Mini-Mental State Examination, Generalized Anxiety Disorder 7, and Patient Health Questionnaire 9 tests were performed to estimate cognitive and psychological functions of the patients...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29049110/evidence-for-the-efficacy-of-systemic-opioid-sparing-analgesics-in-pediatric-surgical-populations-a-systematic-review
#12
Alyssa Zhu, Hubert A Benzon, T Anthony Anderson
While a large number of studies has examined the efficacy of opioid-sparing analgesics in adult surgical populations, fewer studies are available to guide postoperative pain treatment in pediatric patients. We systematically reviewed available publications on the use of systemic nonopioid agents for postoperative analgesia in pediatric surgical populations. A comprehensive literature search identified meta-analyses and randomized controlled trials (RCTs) assessing the effects of systemic, nonopioid agents on postoperative narcotic requirements or pain scores in pediatric surgical populations...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049039/serum-cyclosporine-levels-the-influence-of-the-time-interval-between-interrupting-the-infusion-and-obtaining-the-samples-a-randomized-clinical-trial
#13
Livia Maria Garbin, Belinda Pinto Simões, Ana Carolina de Jesus Vieira Curcioli, Emilia Campos de Carvalho
BACKGROUND: There are controversies regarding the best way to collect blood samples for cyclosporine A (CsA) serum levels when this immunosuppressant is administered continuously through a silicone central venous catheter (CVC) to hematopoietic stem cell transplant recipients. OBJECTIVE: The aim of this study was to verify the effect of the time elapsed between the interruption of a continuous intravenous CsA infusion and the collection of blood samples on CsA serum levels...
October 18, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/29046771/a-comparison-of-palonosetron-and-dexamethasone-for-postoperative-nausea-and-vomiting-in-orthopedic-patients-receiving-patient-controlled-epidural-analgesia
#14
Byung-Gun Kim, Hyunzu Kim, Hyun-Kyoung Lim, Chunwoo Yang, Sora Oh, Byung-Wook Lee
BACKGROUND: Postoperative nausea and vomiting (PONV) is one of the major concerns after anesthesia and surgery, and it may be more frequent in orthopedic patients receiving patient-controlled epidural analgesia (PCEA). The purpose of this study was to compare the effect of palonosetron and dexamethasone on the prevention of PONV in patients undergoing total joint arthroplasty and receiving PCEA. METHODS: Patients scheduled for total hip or knee arthroplasty under spinal anesthesia/PCEA were randomly allocated to receive either intravenous palonosetron (0...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29045967/-early-surgical-treatment-of-multi-segmet-intramedullary-cervical-spinal-cord-ependymoma
#15
C C Ma, G Z Lin, Z Y Wang
OBJECTIVE: To investigate the early clinical treatment and prognosis of multi-segment intramedullary cervical ependymoma. METHODS: Twenty patients with multi-segment (more than 3 segments) intramedullary spinal ependymoma (McCormic grade I) were microsurgically treated with assistance of intraoperative neuroelectrophysiological monitoring. None of them received postoperative radiotherapy. Preoperatively all the patients underwent MRI examination and their neurologically function was assessed by McCormic classification method...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29044790/acute-appendicitis
#16
REVIEW
Mark D Stringer
Acute appendicitis is the most common reason for abdominal surgery in children. Luminal obstruction of the appendix progresses to suppurative inflammation and perforation, which causes generalised peritonitis or an appendix mass/abscess. Classical features include periumbilical pain that migrates to the right iliac fossa, anorexia, fever, and tenderness and guarding in the right iliac fossa. Atypical presentations are particularly common in preschool children. A clinical diagnosis is possible in most cases, after a period of active observation if necessary; inflammatory markers and an ultrasound scan are useful investigations when the diagnosis is uncertain...
October 17, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29043146/calciphylaxis-in-a-nondialysis-patient-treated-with-sodium-thiosulfate-and-high-dose-of-oxygen
#17
Anawin Sanguankeo, Natanong Thamcharoen, Sikarin Upala
BACKGROUND: Calciphylaxis in a nondialysis patient is a rare condition and is characterized by calcific deposition in tissue. We present a case of calciphylaxis in a nondialysis patient who was diagnosed by clinical presentation and skin biopsy and was treated with sodium thiosulfate with improvement of skin lesions. CASE: A 43-year-old female with type 2 diabetes and atrial fibrillation taking oral anticoagulation medication presented with reddish drainage from the right buttock...
2017: Clin Nephrol Case Stud
https://www.readbyqxmd.com/read/29042911/nalbuphine-analgesic-and-anti-inflammatory-effects-on-patients-undergoing-thoracoscopic-lobectomy-during-the-perioperative-period
#18
Yang Zhang, Qi Jiang, Tao Li
This study sought to investigate the analgesic effects of nalbuphine on patients undergoing thoracoscopic lobectomy during the perioperative period, as well as its effects on inflammatory cytokines. We selected 92 patients with early lung cancer who were admitted to Xiangyang No. 1 People's Hospital between January 2016 and December 2016. The patients were randomly divided into control and observation groups (n=46 each). All patients underwent thoracoscopic lobectomy, with those in the observation group receiving intravenous nalbuphine hydrochloride prior to induction (the control group received saline)...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29042835/double-blind-randomized-placebo-controlled-trial-of-single-dose-intravenous-acetaminophen-for-pain-associated-with-adenotonsillectomy-in-pediatric-patients-with-sleep-disordered-breathing
#19
Arlyne K Thung, Charles A Elmaraghy, N'Diris Barry, Dmitry Tumin, Kris R Jatana, Julie Rice, Vidya Raman, Tarun Bhalla, David P Martin, Marco Corridore, Joseph D Tobias
OBJECTIVES: Adequate pain control is an important component in the postoperative outcome for pediatric adenotonsillectomy patients with sleep-disordered breathing (SDB). Intravenous acetaminophen appears to be a favorable analgesic adjunct owing to its predictable pharmacokinetics and opioid-sparing effects; however, its role in pediatric adenotonsillectomy pain management remains unclear. METHODS: In this prospective, randomized, double-blinded, controlled study, subjects with the diagnosis of SDB, aged 2 to 8 years, who required extended postoperative admission, received intravenous acetaminophen (15 mg/kg) or saline placebo intraoperatively in addition to morphine (0...
September 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29042333/postoperative-intravenous-acetaminophen-for-craniotomy-patients-a-randomized-controlled-trial
#20
Steven Greenberg, Glenn S Murphy, Michael J Avram, Torin Shear, Jessica Benson, Kruti N Parikh, Aashka Patel, Rebecca Newmark, Vimal Patel, Julian Bailes, Joseph W Szokol
OBJECTIVE: To determine whether opioids during the first 24 postoperative hours were significantly altered when receiving intravenous (IV) acetaminophen during that time compared to those receiving placebo (normal saline). METHODS: One hundred forty patients undergoing any craniotomy were randomly assigned to receive either 1g of IV acetaminophen or placebo upon surgical closure, and every six hours thereafter, up to 18 hours postoperatively. Analgesic requirements for the first 24 hours postoperatively were recorded...
October 14, 2017: World Neurosurgery
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