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Apparent Life Threatening Event

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https://www.readbyqxmd.com/read/29896847/advanced-chronic-kidney-disease-relationship-to-outcomes-post-tavr-a-meta-analysis
#1
REVIEW
Nader Makki, Scott M Lilly
OBJECTIVE: Chronic kidney (CKD) is associated with worse outcomes in high-surgical risk patients undergoing transcatheter aortic valve replacement (TAVR). However, it is unclear whether this relationship is apparent in lower surgical risk patients. Herein we sought to analyze existing literature to assess whether or not advanced CKD is associated with increased mortality, or a greater incidence of adverse events (specifically major stroke, bleeding and vascular complications). METHODS: We searched PubMed and EMBASE (2008-2017) for relevant studies...
June 12, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29804792/thoracoscopic-posterior-tracheopexy-during-primary-esophageal-atresia-repair-a-new-approach-to-prevent-tracheomalacia-complications
#2
Stefaan H A J Tytgat, Maud Y A van Herwaarden-Lindeboom, E Sofie van Tuyll van Serooskerken, David C van der Zee
BACKGROUND: Esophageal atresia (EA) is usually accompanied by some form of tracheomalacia (TM). During the early phases in life, excessive dynamic collapse of the trachea can cause a wide spectrum of symptoms ranging from mild complaints to apparent life-threatening events (ALTE's) or brief resolved unexplained events (BRUE's). Therapeutic strategies for severe TM include aortopexy to lift the anterior weakened cartilaginous rings or posterior tracheopexy of the floppy membranous tracheal intrusion...
April 27, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29761867/airway-physical-examination-tests-for-detection-of-difficult-airway-management-in-apparently-normal-adult-patients
#3
REVIEW
Dominik Roth, Nathan L Pace, Anna Lee, Karen Hovhannisyan, Alexandra-Maria Warenits, Jasmin Arrich, Harald Herkner
BACKGROUND: The unanticipated difficult airway is a potentially life-threatening event during anaesthesia or acute conditions. An unsuccessfully managed upper airway is associated with serious morbidity and mortality. Several bedside screening tests are used in clinical practice to identify those at high risk of difficult airway. Their accuracy and benefit however, remains unclear. OBJECTIVES: The objective of this review was to characterize and compare the diagnostic accuracy of the Mallampati classification and other commonly used airway examination tests for assessing the physical status of the airway in adult patients with no apparent anatomical airway abnormalities...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29735365/human-cd19-targeted-mouse-t-cells-induce-b-cell-aplasia-and-toxicity-in-human-cd19-transgenic-mice
#4
Christopher A Pennell, Jessie L Barnum, Cameron S McDonald-Hyman, Angela Panoskaltsis-Mortari, Megan J Riddle, Zhengming Xiong, Michael Loschi, Govindarajan Thangavelu, Heather M Campbell, Meghan D Storlie, Yosef Refaeli, Scott N Furlan, Michael C Jensen, Leslie S Kean, Jeffrey S Miller, Jakub Tolar, Mark J Osborn, Bruce R Blazar
The clinical success of chimeric antigen receptor (CAR) T cell therapy for CD19+ B cell malignancies can be limited by acute toxicities and immunoglobulin replacement needs due to B cell aplasia from persistent CAR T cells. Life-threatening complications include cytokine release syndrome and neurologic adverse events, the exact etiologies of which are unclear. To elucidate the underlying toxicity mechanisms and test potentially safer CAR T cells, we developed a mouse model in which human CD19 (hCD19)-specific mouse CAR T cells were adoptively transferred into mice whose normal B cells express a hCD19 transgene at hemizygous levels...
April 7, 2018: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/29718854/neurologic-manifestations-in-anaphylaxis-due-to-subcutaneous-allergy-immunotherapy-a-case-report
#5
Michelle Mangold, Mahboob Qureshi
RATIONALE: Life-threatening anaphylactic shock is a rare (1 in 1 million) but documented occurrence in response to subcutaneous immunotherapy. Immediate administration of Epinephrine (Epi) is critical to save lives in these situations. The current protocol for systemic reactions in immunotherapy is for the prescribing physician to reassess the dosing and schedule as well as the risk:benefit assessment for the therapy and determine whether or not to proceed. PATIENT CONCERNS: The patient revealed concerns regarding the neurologic sequela sustained after undergoinig life-threatening anaphylactic shock...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29679838/medico-legal-investigation-in-an-explicable-case-of-congenital-central-hypoventilation-syndrome-due-to-a-rare-variant-of-the-phox2b-gene
#6
Francesco Ventura, Rosario Barranco, Tiziana Bachetti, Paolo Nozza, Ezio Fulcheri, Antonella Palmieri, Isabella Ceccherini
The heterozygous PHOX2B gene mutation is related to congenital central hypoventilation syndrome (CCHS). It is characterized by defective autonomous nervous system development leading to inadequate breathing response to hypoxia and hypercapnia, leading to hypoventilation especially during non-REM sleep, but also during waking in the more severe cases. Herein we report a case of sudden death in a 28-day-old child. The mother reported the infant was found lying on her own bed in the prone position. The infant was wearing a romper and lying in her crib without any blanket or other objects...
April 17, 2018: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/29622326/what-to-do-when-babies-turn-blue-beyond-the-basic-brief-resolved-unexplained-event
#7
REVIEW
Anna McFarlin
The term "brief resolved unexplained event" was created to replace "apparent life-threatening event," narrowing the definition and providing evidence-based guidelines for management. The emphasis is placed on using clinical clues to classify patients as low risk or exclude them from the categorization altogether. Infants who meet low-risk classification can be briefly observed in the emergency department and be discharged home. Infants who demonstrate elements suggestive of a specific etiology should be evaluated and treated accordingly...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29398048/risk-of-death-in-infants-who-have-experienced-a-brief-resolved-unexplained-event-a-meta-analysis
#8
Donald A Brand, Melissa J Fazzari
OBJECTIVE: To estimate an upper bound on the risk of death after a brief resolved unexplained event (BRUE), a sudden alteration in an infant's breathing, color, tone, or responsiveness, previously labeled "apparent life-threatening event" (ALTE). STUDY DESIGN: The meta-analysis incorporated observational studies of patients with ALTE that included data on in-hospital and post-discharge deaths with at least 1 week of follow-up after hospital discharge. Pertinent studies were identified from a published review of the literature from 1970 through 2014 and a supplementary PubMed query through February 2017...
February 2, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29298792/lemierre-s-syndrome-a-pain-in-the-neck-with-far-reaching-consequences
#9
Thomas James Stubington, Paul James
Lemierre's syndrome is a potentially life-threatening consequence of oropharyngeal and ear infections and often results in critical care admission and even intubation. Due to the multisystem manifestation, multiple teams may initially be involved in the care, some of which may be unfamiliar with the features and usual clinical course. This report describes a case in a 36-year-old woman with the classic features of internal jugular vein thrombosis and septic emboli to the lungs secondary to an oropharyngeal infection...
January 3, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29233182/apparent-life-threatening-events-alte-italian-guidelines
#10
REVIEW
Raffaele Piumelli, Riccardo Davanzo, Niccolò Nassi, Silvia Salvatore, Cinzia Arzilli, Marta Peruzzi, Massimo Agosti, Antonella Palmieri, Maria Giovanna Paglietti, Luana Nosetti, Raffaele Pomo, Francesco De Luca, Alessandro Rimini, Salvatore De Masi, Simona Costabel, Valeria Cavarretta, Anna Cremante, Fabio Cardinale, Renato Cutrera
Five years after the first edition, we have revised and updated the guidelines, re-examining the queries and relative recommendations, expanding the issues addressed with the introduction of a new entity, recently proposed by the American Academy of Pediatrics: BRUE, an acronym for Brief Resolved Unexplained Events. In this manuscript we will use the term BRUE only to refer to mild, idiopathic cases rather than simply replace the acronym ALTE per se.In our guidelines the acronym ALTE is used for severe cases that are unexplainable after the first and second level examinations...
December 12, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29189923/congenital-myasthenic-syndrome-with-episodic-apnoea-clinical-neurophysiological-and-genetic-features-in-the-long-term-follow-up-of-19-patients
#11
Grace McMacken, Roger G Whittaker, Teresinha Evangelista, Angela Abicht, Marina Dusl, Hanns Lochmüller
BACKGROUND: Congenital myasthenic syndrome with episodic apnoea (CMS-EA) is a rare but potentially treatable cause of apparent life-threatening events in infancy. The underlying mechanisms for sudden and recurrent episodes of respiratory arrest in these patients are unclear. Whilst CMS-EA is most commonly caused by mutations in CHAT, the list of associated genotypes is expanding. METHODS: We reviewed clinical information from 19 patients with CMS-EA, including patients with mutations in CHAT, SLC5A7 and RAPSN, and patients lacking a genetic diagnosis...
January 2018: Journal of Neurology
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
#12
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)...
January 2018: 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
#13
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...
January 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29066639/idiopathic-catastrophic-thrombosis-with-happy-ending
#14
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/28923986/brief-resolved-unexplained-events-formerly-apparent-life-threatening-events-and-evaluation-of-lower-risk-infants
#15
Chris Tate, Rachel Sunley
No abstract text is available yet for this article.
April 2018: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/28822736/-rhinovirus-underestimated-pathogens-in-patients-during-the-neonatal-period
#16
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
#17
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...
2017: Reviews on Recent Clinical Trials
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
#18
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
https://www.readbyqxmd.com/read/28720729/inhibition-of-inflammasome-dependent-interleukin-1%C3%AE-production-by-streptococcal-nad-glycohydrolase-evidence-for-extracellular-activity
#19
Dóra Hancz, Elsa Westerlund, Benedicte Bastiat-Sempe, Onkar Sharma, Christine Valfridsson, Lena Meyer, John F Love, Maghnus O'Seaghdha, Michael R Wessels, Jenny J Persson
Group A Streptococcus (GAS) is a common human pathogen and the etiologic agent of a large number of diseases ranging from mild, self-limiting infections to invasive life-threatening conditions. Two prominent virulence factors of this bacterium are the genetically and functionally linked pore-forming toxin streptolysin O (SLO) and its cotoxin NAD+ -glycohydrolase (NADase). Overexpression of these toxins has been linked to increased bacterial virulence and is correlated with invasive GAS disease. NADase can be translocated into host cells by a SLO-dependent mechanism, and cytosolic NADase has been assigned multiple properties such as protection of intracellularly located GAS bacteria and induction of host cell death through energy depletion...
July 18, 2017: MBio
https://www.readbyqxmd.com/read/28711234/sleep-related-breathing-disorders-and-indications-for-polysomnography-in-preterm-infants
#20
Koen Joosten, Robbin de Goederen, Angelique Pijpers, Karel Allegaert
There is a range of breathing problems which occur and may persist in preterm infants, such as central apneas, obstructive apneas and periodic breathing. Preterm infants may also suffer from respiratory distress syndrome and chronic lung disease necessitating prolonged use of oxygen therapy after discharge from the hospital. Due to these persistent breathing pattern abnormalities in preterm infants, there is a higher risk of altered sleep and apparent life threatening events. Polysomnography can be a helpful tool to identify those infants who have abnormalities in their breathing pattern, to identify those infants who have an increased risk to get a sleep related breathing event at home and to decide about the discontinuation of oxygen therapy...
October 2017: Early Human Development
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