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Apparent Life Threatening

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https://www.readbyqxmd.com/read/29141761/leptospirosis-cases-infected-with-uncommon-serogroups-puerto-rico-2013-2015
#1
Hector Gorbea, Enid J Garcia-Rivera, Hilda Torres, Olga D Lorenzi, Aidsa Rivera, Renee L Galloway, Tyler M Sharp
Leptospirosis is an emerging bacterial zoonosis that is endemic but underrecognized throughout the tropics. Through prospective surveillance for acute febrile illness (AFI) among patients who presented to the emergency department of a hospital located in an urban region of Puerto Rico, four patients with laboratory-confirmed leptospirosis were identified. All patients had signs and symptoms of AFI, including fever, headache, and dehydration. Three patients had leukocytosis with thrombocytopenia and were admitted to the hospital...
November 6, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29140515/surveillance-for-q-fever-endocarditis-in-the-united-states-1999-2015
#2
Anne Straily, F Scott Dahlgren, Amy Peterson, Christopher D Paddock
Background: Q fever is a worldwide zoonosis caused by Coxiella burnetii. In some persons, particularly those with cardiac valve disease, infection with C. burnetii can cause a life-threatening infective endocarditis. There are few descriptive analyses of Q fever endocarditis in the United States. Methods: Q fever case report forms submitted during 1999-2015 were reviewed to identify reports describing endocarditis. Cases were categorized as confirmed or probable using criteria defined by the Council for State and Territorial Epidemiologists (CSTE)...
November 13, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29128761/inborn-errors-of-immunity-underlying-fungal-diseases-in-otherwise-healthy-individuals
#3
REVIEW
Juan Li, Donald C Vinh, Jean-Laurent Casanova, Anne Puel
It has been estimated that there are at least 1.5 million fungal species, mostly present in the environment, but only a few of these fungi cause human disease. Most fungal diseases are self-healing and benign, but some are chronic or life-threatening. Acquired and inherited defects of immunity, including breaches of mucocutaneous barriers and circulating leukocyte deficiencies, account for most severe modern-day mycoses. Other types of infection typically accompany these fungal infections. More rarely, severe fungal diseases can strike otherwise healthy individuals...
November 9, 2017: Current Opinion in Microbiology
https://www.readbyqxmd.com/read/29120450/apnea-bradycardia-and-desaturation-spells-in-premature-infants-impact-of-a-protocol-for-the-duration-of-spell-free-observation-on-interprovider-variability-and-readmission-rates
#4
P Chandrasekharan, M Rawat, A M Reynolds, K Phillips, S Lakshminrusimha
OBJECTIVE: To study the impact of implementing a protocol to standardize the duration of observation in preterm infants with apnea/bradycardia/desaturation spells before hospital discharge on length of stay (LOS) and readmission rates. STUDY DESIGN: A protocol to standardize the duration of in-hospital observation for preterm infants with apnea, bradycardia and desaturation spells who were otherwise ready for discharge was implemented in December 2013. We evaluated the impact of this protocol on the LOS and readmission rates of very low birth weight infants (VLBW)...
November 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29110977/clinical-mimics-an-emergency-medicine-focused-review-of-syncope-mimics
#5
Diana K Coleman, Brit Long, Alex Koyfman
BACKGROUND: Syncope is an event that causes a transient loss of consciousness (LOC) secondary to global cerebral hypoperfusion. The transient nature of the event can make diagnosis in the emergency department (ED) difficult, as symptoms have often resolved by time of initial presentation. The symptoms and presentation of syncope are similar to many other conditions, which can lead to difficulty in establishing a diagnosis in the ED. OBJECTIVE: This review evaluates patients presenting with a history concerning for possible syncope, mimics of syncope, and approach to managing syncope mimics...
October 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29090269/a-rash-decision-the-hazards-of-the-wrongful-use-of-adrenaline
#6
Madalena Coutinho Cruz, Ramiro Sá Carvalho, Pedro Modas Daniel, Rui Cruz Ferreira
Anaphylaxis is life-threatening and should be addressed urgently. Its treatment is not without side effects and an accurate diagnosis must be made to prevent potential harm by the wrongful use of medication. A 46-year-old woman with hypertension treated with angiotensin converting enzyme inhibitor (ACEI) presented to the emergency department with non-pitting oedema of the face and limbs. A hasty diagnosis of anaphylaxis was made and intravenous adrenaline administered. The patient developed a myocardial infarction caused by coronary artery spasm that required invasive intervention...
October 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/29066639/idiopathic-catastrophic-thrombosis-with-happy-ending
#7
Julia Heid, Andreas Greinacher, Hugo A Katus, Oliver J Müller
A 59-year-old male patient suffered three life-threatening instent thromboses after an initial resuscitation due to an ST-segment elevation myocardial infarction of the anterior cardiac wall. With a high-risk profile for heparin-induced thrombocytopenia (HIT), he was placed on argatroban after the second reinfarction. Under this apparently appropriate treatment, a third reinfarction occurred, and the patient had to undergo high-risk cardiac bypass surgery. Later on, a deep vein thrombosis and an intracardiac thrombus formed...
October 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28982960/management-of-endocrine-disease-flushing-current-concepts
#8
REVIEW
Isabel Huguet, Ashley Grossman
OBJECTIVE: Flushing can be defined as a sensation of warmth accompanied by erythema that most commonly is seen on the face and which occurs in episodic attacks. Such a problem can be clinically problematic, since many conditions and drugs can be related to flushing, and while often there appears to be no underlying organic disease, it is important to exclude disorders since they may be life-threatening conditions. DESIGN AND METHODS: We performed a search in MEDLINE using the terms 'flushing' in combination with 'carcinoid syndrome', 'pheochromocytoma', 'mastocytosis', 'menopausal hot flush' and 'treatment'...
November 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28945755/estimating-the-burden-of-scrub-typhus-a-systematic-review
#9
REVIEW
Ana Bonell, Yoel Lubell, Paul N Newton, John A Crump, Daniel H Paris
BACKGROUND: Scrub typhus is a vector-borne zoonotic disease that can be life-threatening. There are no licensed vaccines, or vector control efforts in place. Despite increasing awareness in endemic regions, the public health burden and global distribution of scrub typhus remains poorly known. METHODS: We systematically reviewed all literature from public health records, fever studies and reports available on the Ovid MEDLINE, Embase Classic + Embase and EconLit databases, to estimate the burden of scrub typhus since the year 2000...
September 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28928269/perturbed-cd8-t-cell-immunity-across-universal-influenza-epitopes-in-the-elderly
#10
Thi H O Nguyen, Sneha Sant, Nicola L Bird, Emma J Grant, E Bridie Clemens, Marios Koutsakos, Sophie A Valkenburg, Stephanie Gras, Martha Lappas, Anthony Jaworowski, Jane Crowe, Liyen Loh, Katherine Kedzierska
Influenza epidemics lead to severe illness, life-threatening complications, and deaths, especially in the elderly. As CD8(+) T cells are associated with rapid recovery from influenza, we investigated the effects of aging on antigen-specific CD8(+) T cells across the universal influenza epitopes in humans. We show that aging is characterized by altered frequencies in T cell subsets, with naive T cells being partially replaced by activated effector/memory populations. Although we observed no striking differences in TCR signaling capacity, T cells in the elderly had increased expression of transcription factors Eomes and T-bet, and such changes were most apparent in CD8(+) T cells...
September 19, 2017: Journal of Leukocyte Biology
https://www.readbyqxmd.com/read/28923986/brief-resolved-unexplained-events-formerly-apparent-life-threatening-events-and-evaluation-of-lower-risk-infants
#11
REVIEW
Chris Tate, Rachel Sunley
No abstract text is available yet for this article.
September 18, 2017: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/28917061/use-of-lipid-emulsion-therapy-in-local-anesthetic-overdose
#12
Ozgur Karcioglu
The use of intravenous lipid emulsion (ILE) therapy as antidote in systemic toxicity of certain agents has gained widespread support. There are increasing data suggesting use of ILE in reversing from local anesthetic-induced systemic toxicity severe, life-threatening cardiotoxicity, although findings are contradictory. Efficiency of ILE was demonstrated in animal studies in the treatment of severe impairment of cardiac functions, via a mechanism for trapping lipophilic drugs in an expanded plasma lipid compartment ("lipid sink")...
October 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28887737/child-with-vomiting
#13
REVIEW
Madhusudan Samprathi, Muralidharan Jayashree
Vomiting is a common problem in children for which parents seek health care consultation. It has a varied etiology encompassing many organ systems, ranging from a benign physiological behavior to a life-threatening systemic disease. Most often, it is benign and self-limiting. Infections within and outside the gastrointestinal tract are the commonest causes. A good history and meticulous physical examination can discern the cause and help in delineating the benign cause from the sinister. Red flags include unstable vital signs, acidotic breathing, presence of bile or blood stained vomitus, features of gastrointestinal (GI) obstruction, encephalopathy and papilledema...
October 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28822736/-rhinovirus-underestimated-pathogens-in-patients-during-the-neonatal-period
#14
S Zacharie, A Vabret, B Guillois, C Dupont, J Brouard
INTRODUCTION: In recent years, developments in virological tools have led to the easy detection of rhinoviruses and enteroviruses (E/RV). Their detection is very frequent in cases of airway involvement in children and their demonstrated causality. But the morbidity of E/RV in the neonatal period is unknown due to lack of epidemiological data. The objective of this study was to evaluate the incidence and clinical characteristics of these infections in hospitalized neonates. MATERIALS AND METHODS: We retrospectively analyzed the virology specimens of all neonates hospitalized at the Caen University Hospital between 2006 and 2011...
September 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28814262/update-on-the-evaluation-and-management-of-brief-resolved-unexplained-events-previously-apparent-life-threatening-events
#15
Eric Zwemer, Ilene Claudius, Joel Tieder
BACKGROUND: The thirty-year-old term "apparent life-threatening event" (ALTE) is difficult to apply in clinical practice and research. The American Academy of Pediatrics now defines these events as brief resolved unexplained events (BRUEs), stratifies infants based on the risk of recurrence or of a serious underlying condition, and offers evidence-based management recommendations for infants at lower-risk. OBJECTIVE: To review recent ALTE literature as it relates to BRUEs...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28798922/practical-approach-to-the-patient-with-acute-neuromuscular-weakness
#16
REVIEW
Rajeev Nayak
Acute neuromuscular paralysis (ANMP) is a clinical syndrome characterized by rapid onset muscle weakness progressing to maximum severity within several days to weeks (less than 4 wk). Bulbar and respiratory muscle weakness may or may not be present. It is a common neurological emergency which requires immediate and careful investigations to determine the etiology because accurate diagnosis has significant impact on therapy and prognosis. Respiratory failure caused by neuromuscular weakness is considered as more critical than lung disease because its development may be insidious or subtle until sudden decompensation leads to life threatening hypoxia...
July 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28775221/in-situ-medical-simulation-for-pre-implementation-testing-of-clinical-service-in-a-regional-hospital-in-hong-kong
#17
P P Chen, N Tk Tsui, A Sw Fung, A Hf Chiu, W Cw Wong, H T Leong, P Sf Lee, J Yw Lau
The implementation of a new clinical service is associated with anxiety and challenges that may prevent smooth and safe execution of the service. Unexpected issues may not be apparent until the actual clinical service commences. We present a novel approach to test the new clinical setting before actual implementation of our endovascular aortic repair service. In-situ simulation at the new clinical location would enable identification of potential process and system issues prior to implementation of the service...
August 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28752002/changing-definitions-of-sepsis
#18
REVIEW
Fethi Gül, Mustafa Kemal Arslantaş, İsmail Cinel, Anand Kumar
Sepsis is one of the main causes of morbidity and mortality in critically ill patients despite the use of modern antibiotics and resuscitation therapies. Outcomes in sepsis have improved overall, probably because of an enhanced focus on early diagnosis and other improvements in supportive care, but mortality rates still remain unacceptably high. The diagnosis and definition of sepsis is a critical problem due to the heterogeneity of this disease process. Although it is apparent that much more needs to be done to advance our understanding, sepsis and related terms remain difficult to define...
June 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28751565/incidence-and-outcome-of-acquired-aplastic-anemia-real-world-data-from-patients-diagnosed-in-sweden-from-2000-2011
#19
Krista Vaht, Magnus Göransson, Kristina Carlson, Cecilia Isaksson, Stig Lenhoff, Anna Sandstedt, Bertil Uggla, Jacek Winiarski, Per Ljungman, Mats Brune, Per-Ola Andersson
A plastic anemia is a rare life-threatening disease. However, since the introduction of immunosuppressive therapy and allogeneic stem cell transplantation, the outcome has improved considerably, and the 5-year survival is reported to be 70-80% in selected patient cohorts. Yet, contemporary population-based data on incidence and survival are lacking. We performed a national retrospective study to determine the incidence, treatment, and survival of patients with aplastic anemia diagnosed in Sweden from 2000-2011...
October 2017: Haematologica
https://www.readbyqxmd.com/read/28737312/life-after-the-event-a-review-of-basic-life-support-training-for-parents-following-apparent-life-threatening-events-and-their-experience-and-practices-following-discharge
#20
W L Macken, N Clarke, M Nadeem, D Coghlan
Apparent Life-Threatening Events (ALTEs) are a common presentation to paediatric hospitals and represent a significant cause of parental anxiety. Basic Life Support (BLS) training is recommended for all caregivers following ALTEs. This study aimed to assess the rate of caregiver BLS training and reviewed parents experience following discharge. Parents were interviewed by phone following discharge. Over the study period 25 children attended the Emergency Department with ALTE, 17/25 (68%) were trained and 13/17 (76%) were contactable for interview...
May 10, 2017: Irish Medical Journal
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