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Paradoxical worsening

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https://www.readbyqxmd.com/read/28197071/chemosensitivity-of-u251-cells-to-the-co-treatment-of-d-penicillamine-and-copper-possible-implications-on-wilson-disease-patients
#1
Meghri Katerji, Kassem Barada, Mustapha Jomaa, Firas Kobeissy, Ahmad-Kareem Makkawi, Wassim Abou-Kheir, Julnar Usta
D-Penicillamine (PA), a copper chelator, and one of the recommended drugs for treatment of Wilson disease (WD) has been reported to worsen the symptoms of patients with neurologic presentations. However, the cause of this paradoxical response has not been fully elucidated and requires further investigations. Accordingly, we have studied the in vitro effect of Copper (Cu) and/or PA treatment on human glioblastoma U251 cells as an in vitro model of Cu cytotoxicity. Treatment of U251 cells with either Cu or PA exerted no significant effect on their morphology, viability or ROS level...
2017: Frontiers in Molecular Neuroscience
https://www.readbyqxmd.com/read/28195521/a-computational-model-of-perceptual-and-mnemonic-deficits-in-medial-temporal-lobe-amnesia
#2
Patrick S Sadil, Rosemary A Cowell
Damage to the medial temporal lobe (MTL) has long been known to impair declarative memory, and recent evidence suggests that it also impairs visual perception. A theory termed the representational-hierarchical account explains such impairments by assuming that MTL stores conjunctive representations of items and events, and that individuals with MTL damage must rely upon representations of simple visual features in posterior visual cortex, which are inadequate to support memory and perception under certain circumstances...
February 14, 2017: Journal of Cognitive Neuroscience
https://www.readbyqxmd.com/read/28187801/management-of-acute-neuromuscular-disorders
#3
E F M Wijdicks
Imminent neuromuscular respiratory failure is recognized by shortness of breath, restlessness, and tachycardia and is often followed by tachypnea, constantly interrupting speech, asynchronous breathing and sometimes paradoxical breathing and use of scalene and sternocleidomastoid muscles. Once a patient presents with such a constellation of signs, there are some difficult decisions to be made and include assessment of the severity of respiratory failure and in particular when to intubate. Failure of the patient to manage secretions as a result of oropharyngeal weakness rather than neuromuscular respiratory weakness may be another reason for acute intubation...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28163944/immune-reconstitution-inflammatory-syndrome-opening-pandora-s-box
#4
Mariana Meireles, Conceição Souto Moura, Margarida França
One of the purposes of antiretroviral therapy (ART) is to restore the immune system. However, it can sometimes lead to an aberrant inflammatory response and paradoxical clinical worsening known as the immune reconstitution inflammatory syndrome (IRIS). We describe a 23-year-old male, HIV1 infected with a rapid progression phenotype, who started ART with TCD4+ of 53 cells/mm(3) (3,3%) and HIV RNA = 890000 copies/mL (6 log). Four weeks later he was admitted to the intensive care unit with severe sepsis...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28162926/-effectiveness-of-an-intervention-to-improve-safety-culture-less-is-more
#5
J J López-Picazo, P Ferrer-Bas, B Garrido-Corro, V Pujalte-Ródenas, P de la Cruz Murie, M Blázquez-Pedrero, S Sánchez-Lorca, P Soler-Gallego, C Albacete-Moreno, T Alcaraz-Pérez, S Pérez-Romero
OBJECTIVE: To assess the impact of a long-term initiative to improve safety culture among professionals working in a Health Area, and to know their perceived usefulness. MATERIAL AND METHODS: An uncontrolled intervention study was designed in a public health care organization including a 3rd level hospital and 5,000 professionals. To measure the impact, the AHRQ Survey was conducted by telephone. A total of 7 dimensions of culture were measured, before starting the project (2012, n=100) and 3 years later (2015, n=207)...
February 2, 2017: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
https://www.readbyqxmd.com/read/28151866/acute-arterial-embolism-of-left-lower-extremity-caused-by-paradoxical-embolism-in-ebstein-s-anomaly-a-case-report
#6
Jun-Sheng Li, Jie Ma, Zi-Xing Yan, Dong-Ming Cheng, Liang Chang, Hai-Chun Zhang, Jiang-Yan Liu
INTRODUCTION: Ebstein's anomaly is a benign and stable congenital heart disease for asymptomatic patients. Despite a low incidence of Ebstein's anomaly (EA), patients' quality of life can be badly affected by EA without positive surgical intervention. Especially EA is associated with other congenital heart disease, such as the atrial septal defect, patent foramen ovale, and arterial embolism exclude other reasons, it is often considered to be the consequence of paradoxical embolism, and surgical intervention must be conducted...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28148461/measuring-quality-of-life-in-pediatric-paradoxical-vocal-fold-motion-using-the-sf-36v2
#7
Kershena S Liao, Paul E Kwak, Hazel Hewitt, Sarah Hollas, Julina Ongkasuwan
OBJECTIVES: Paradoxical vocal fold motion (PVFM) consists of intermittent adduction of the vocal folds during inspiration, resulting in stridor and worsened by anxiety and stress. The purpose of this study was to assess the impact of PVFM on quality of life in our pediatric patient population. STUDY DESIGN: This is a prospective, descriptive survey study. METHODS: Thirty-nine consecutive patients (ages 12-17 years) presenting with a PVFM diagnosis for respiratory retraining sessions with speech-language pathology were recruited...
January 30, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28134599/new-onset-or-worsening-of-psoriasis-following-biologic-therapy-a-case-series
#8
Vincenzo Bruzzese, Vincenzo De Francesco, Cesare Hassan, Roberto Lorenzetti, Palma Scolieri, Cinzia Marrese, Angelo Zullo
Biologic therapies may cause so-called "paradoxical side-effects," that is, the onset or exacerbation of new symptoms/diseases for which biological treatment should be effective. Among these, psoriatic skin lesions have been described. We report a case series of ten patients with either new onset (seven cases) or worsening (three cases) of psoriasis occurring during a biologic therapy. Six patients were receiving a biologic monotherapy, while four patients were in combination treatment with methotrexate (MTX)...
January 1, 2017: International Journal of Immunopathology and Pharmacology
https://www.readbyqxmd.com/read/28098596/erythema-nodosum-leprosum-like-lesions-are-a-histopathologic-pattern-in-whipple-s-disease-and-a-sign-of-the-immune-reconstitution-inflammatory-syndrome-a-case-series-and-review-of-the-literature
#9
Julia Liersch, Agnès Carlotti, Anne Theunis, Alexandra Leonard, Mary Barrett, John Andrew Carlson, Jörg Schaller
Inflammatory and subcutaneous nodules can arise in treated and untreated cases of Whipple disease (WD). The inflammatory immune reconstitution syndrome describes paradoxical clinical inflammatory worsening of a preexisting condition because of a return of immune function. Clinicopathologic examination of 4 patients with WD who presented with erythema nodosum leprosum (ENL)-like lesions and the findings of a systematic review of this phenomenon revealed that ENL-like lesions occurred in predominantly middle-aged male patients who suffered from WD, mostly on the legs...
January 10, 2017: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/28086758/toxoplasmosis-associated-iris-involving-the-cns-a-case-report-with-longitudinal-analysis-of-t-cell-subsets
#10
Rita Rb-Silva, Claudia Nobrega, Eugénia Reiriz, Soraia Almeida, Rui Sarmento-Castro, Margarida Correia-Neves, Ana Horta
BACKGROUND: HIV-infected patients may present an unforeseen clinical worsening after initiating antiretroviral therapy known as immune reconstitution inflammatory syndrome (IRIS). This syndrome is characterized by a heightened inflammatory response toward infectious or non-infectious triggers, and it may affect different organs. Diagnosis of IRIS involving the central nervous system (CNS-IRIS) is challenging due to heterogeneous manifestations, absence of biomarkers to identify this condition, risk of long-term sequelae and high mortality...
January 13, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28062372/uric-acid-may-be-protective-against-cognitive-impairment-in-older-adults-but-only-in-those-without-cardiovascular-risk-factors
#11
Busra Tuven, Pinar Soysal, Gulcin Unutmaz, Derya Kaya, Ahmet Turan Isik
Uric acid (UA) may not only prevent development of cognitive dysfunction owing to its antioxidant efficacy, but also may worsen cognitive functions by gaining pro-oxidant character. The present study attempts to uncover this paradoxical association between UA and cognitive impairment in elderly. 1374 elderly patients were retrospectively evaluated and included in the study. Participants underwent determination of circulating UA levels and comprehensive geriatric assessment. A serum UA concentration≥7.0mg/dL in males and ≥5...
January 4, 2017: Experimental Gerontology
https://www.readbyqxmd.com/read/28058156/paradoxical-worsening-of-tubercular-serpiginous-like-choroiditis-after-initiation-of-antitubercular-therapy
#12
Ebru Esen, Selçuk Sızmaz, Zeynep Kunt, Nihal Demircan
In this study, a case with tubercular choroiditis showing severe macular edema and progression of choroidal lesions following initiation of antitubercular treatment is presented and the management of posterior uveitis associated with tuberculosis is evaluated. A 40-year-old female patient was admitted with decreased vision in her right eye and her fundoscopic examination revealed serpiginous choroiditis. It was learned from her medical history that she had taken antitubercular therapy 9 years ago. Mantoux tuberculin skin test showed an area of induration measuring 15 mm and a positive interferon-gamma release assay was documented...
August 2016: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/28003028/worsening-cholestasis-and-possible-cefuroxime-induced-liver-injury-following-successful-therapeutic-endoscopic-retrograde-cholangiopancreatography-for-a-distal-common-bile-duct-stone-a-case-report
#13
Madunil Anuk Niriella, Ravindu Sujeewa Kumarasena, Anuradha Supun Dassanayake, Aloka Pathirana, Janaki de Silva Hewavisenthi, Hithanadura Janaka de Silva
BACKGROUND: Cefuroxime very rarely causes drug-induced liver injury. We present a case of a patient with paradoxical worsening of jaundice caused by cefuroxime-induced cholestasis following therapeutic endoscopic retrograde cholangiopancreatography for a distal common bile duct stone. CASE PRESENTATION: A 51-year-old, previously healthy Sri Lankan man presented to our hospital with obstructive jaundice caused by a distal common bile duct stone. Endoscopic retrograde cholangiopancreatography with stone extraction, common bile duct clearance, and stenting failed to improve the cholestasis, with paradoxical worsening of his jaundice...
December 21, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27998382/the-ptsd-osa-paradox-they-are-commonly-associated-and-they-worsen-outcomes-but-treatment-nonadherence-is-common-and-the-therapeutic-effect-limited-what-are-clinicians-to-do
#14
Christopher J Lettieri, Scott G Williams
No abstract text is available yet for this article.
January 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27936971/drug-reaction-with-eosinophilia-and-systemic-symptoms-dress-incidence-pathogenesis-and-management
#15
Tetsuo Shiohara, Yoko Kano
Drug-induced hypersensitivity syndrome(DiHS), often referred to as drug reaction with eosinophilia and systemic symptoms (DRESS), is a life-threatening multi-organ system reaction induced by drugs and associated with sequential reactivations of herpesviruses. This syndrome has several unique features, creating uncertainty over whether it represents true drug eruption. Areas covered: A literature review of all the cases was made by a Pub Med search. The delayed onset, paradoxical worsening of clinical symptoms after withdrawal of the causative drug and unexplained cross-reactivity to multiple drugs are unique features of this syndrome, which could prompt infection to be an initial consideration...
February 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27931553/change-in-left-ventricular-systolic-function-in-patients-with-st-elevation-myocardial-infarction-evidence-for-smoker-s-paradox-or-pseudo-paradox
#16
Burak Acar, Ozcan Ozeke, Sefa Unal, Mustafa Karakurt, Meryem Kara, Ozgur Kirbas, Fatih Sen, Ahmet Korkmaz, Dursun Aras, Sinan Aydogdu
BACKGROUND: The 'smoker's paradox' refers to the observation of favorable prognosis in current smokers following an acute ST elevation myocardial infarction (STEMI) in the era of fibrinolysis, however, several STEMI studies have demonstrated conflicting results in patients undergoing primary percutaneous coronary intervention (p-PCI). OBJECTIVE: Aim of the current study was to evaluate the impact of cigarette smoking on left ventricular function in STEMI patients undergoing p-PCI...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27914574/biological-therapies-immunomodulatory-drugs-worsening-of-psoriasis-and-rebound-effect-new-evidence-of-similitude
#17
REVIEW
Marcus Zulian Teixeira
BACKGROUND: Employing the secondary action or adaptative reaction of the organism as therapeutic response, homeopathy uses the treatment by similitude (similia similibus curentur) administering to sick individuals the medicines that caused similar symptoms in healthy individuals. Such homeostatic or paradoxical reaction of the organism is scientifically explained through the rebound effect of drugs, which cause worsening of symptoms after withdrawal of several palliative treatments. Despite promoting an improvement in psoriasis at the beginning of the treatment, modern biological therapies provoke worsening of the psoriasis (rebound psoriasis) after discontinuation of drugs...
2016: Homeopathy: the Journal of the Faculty of Homeopathy
https://www.readbyqxmd.com/read/27904430/natalizumab-related-progressive-multifocal-leukoencephalopathy-immune-reconstitution-inflammatory-syndrome-a-case-report-highlighting-clinical-and-mri-features
#18
Bela Purohit, Eranga Ganewatte, Spyros S Kollias
Multiple sclerosis (MS) patients treated with natalizumab often face the uncommon but severe complication of developing progressive multifocal leukoencephalopathy (PML). PML may be further complicated by immune reconstitution inflammatory syndrome (IRIS) after the removal of the drug. Since both PML and IRIS are associated with high morbidity and mortality rates, early clinical and radiological diagnosis of these complications is of paramount importance. Here, we report a case of an adult male patient who was diagnosed with PML after receiving natalizumab therapy for 6 years for the treatment of MS...
September 2016: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/27865719/pre-load-induced-changes-in-forward-lv-stroke-and%C3%A2-functional-mitral%C3%A2-regurgitation-echocardiographic-detection-of-the-descending-limb%C3%A2-of%C3%A2-starling-s-curve
#19
Yukio Abe, Kanako Akamatsu, Atsuko Furukawa, Kazato Ito, Yoshiki Matsumura, Kazuo Haze, Takahiko Naruko, Minoru Yoshiyama, Junichi Yoshikawa
OBJECTIVES: To clarify the prognostic significance of diagnosing whether the failing heart is functioning on the descending limb of the Starling curve by using echocardiography with passive leg lifting (PLL). BACKGROUND: Patients with advanced heart failure can shift to the descending limb of the Starling curve, in which pre-load does not lead to an expected increase in forward left ventricular stroke volume (LVSV). METHODS: Thirty-five consecutive patients with left ventricular (LV) ejection fraction of <40% underwent echocardiography at rest during baseline and during PLL to increase pre-load...
November 10, 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27856941/the-quest-to-extend-health-services-to-vulnerable-substance-users-in-rio-de-janeiro-brazil-in-the-context-of-an-unfolding-economic-crisis
#20
Noa Krawczyk, Deanna Kerrigan, Francisco Inácio Bastos
Calls to address crack-cocaine use in Brazil among homeless and street-frequenting populations who are in urgent need of health services have questioned the capacity of the Brazilian Unified Health System to attend to the nation's most marginalized citizens. In recent years, Brazil has launched several actions to escalate care for substance users, yet many obstacles hindering accessibility and effectiveness of services remain. Paradoxically, these actions have been implemented in the context of a growing economic crisis, and expanding services for a population of poor and stigmatized substance users while cutting other government programs tends to elicit harsh criticism from citizens...
November 16, 2016: International Journal of Health Services: Planning, Administration, Evaluation
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