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https://www.readbyqxmd.com/read/28901251/case-report-severe-hematological-muscle-and-liver-toxicity-caused-by-drugs-and-artichoke-infusion-interaction-in-an-elderly-polymedicated-patient
#1
M G Campos, J Machado, M L Costa, S Lino, F Correia, F Maltez
Case report, in a patient with a history of diabetes and hypertension, treated with metformin, gliclazide, enalapril + hydrochlorothiazide, amlodipine, aspirin and diazepam, recently medicated for a gouty crisis with colchicine and clonixin without improvement. Believing it could help in the treatment of gouty crisis symptoms he took about 1.5 L of artichoke infusion (Cynara cardunculus). He felt better and did agriculture work but developed a distal muscle pain, severe anemia, standard biochemical liver cholestasis, increase of alkaline phosphatase and marked increase of inflammatory parameters (hyperleucocytosis) and enters in the emergency department at the hospital...
September 12, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28901005/delivery-arrangements-for-health-systems-in-low-income-countries-an-overview-of-systematic-reviews
#2
REVIEW
Agustín Ciapponi, Simon Lewin, Cristian A Herrera, Newton Opiyo, Tomas Pantoja, Elizabeth Paulsen, Gabriel Rada, Charles S Wiysonge, Gabriel Bastías, Lilian Dudley, Signe Flottorp, Marie-Pierre Gagnon, Sebastian Garcia Marti, Claire Glenton, Charles I Okwundu, Blanca Peñaloza, Fatima Suleman, Andrew D Oxman
BACKGROUND: Delivery arrangements include changes in who receives care and when, who provides care, the working conditions of those who provide care, coordination of care amongst different providers, where care is provided, the use of information and communication technology to deliver care, and quality and safety systems. How services are delivered can have impacts on the effectiveness, efficiency and equity of health systems. This broad overview of the findings of systematic reviews can help policymakers and other stakeholders identify strategies for addressing problems and improve the delivery of services...
September 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28895757/intoxications-in-the-strida-project-involving-a-panorama-of-psychostimulant-pyrovalerone-derivatives-mdpv-copycats
#3
Olof Beck, Matilda Bäckberg, Patrick Signell, Anders Helander
CONTEXT: An increasing number of new psychoactive substances (NPS) of different chemical classes have become available through marketing and sale over the Internet. This report from the Swedish STRIDA project presents the prevalence, laboratory results, and clinical features in intoxications involving 11 stimulant pyrovalerone NPS derivatives over a 5-year period. STUDY DESIGN: Case series of consecutive patients with admitted or suspected intake of NPS presenting to Swedish hospitals for emergency treatment from January 2011 to March 2016...
September 12, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28884028/spontaneous-coronary-artery-dissection-a-rare-manifestation-of-alport-syndrome
#4
Amornpol Anuwatworn, Prince Sethi, Kelly Steffen, Orvar Jonsson, Marian Petrasko
Alport syndrome (AS) is a genetic disorder due to inheritance of genetic mutations which lead to production of abnormal type IV collagen. AS has been associated with renal, auditory, and ocular diseases due to the presence of abnormal alpha chains of type IV collagen in the glomerulus, cochlea, cornea, lens, and retina. The resulting disorder includes hereditary nephritis, corneal opacities, anterior lenticonus, fleck retinopathy, temporal retinal thinning, and sensorineural deafness. Aortic and aortic valve pathologies have been described as extrarenal manifestations of AS in multiple case reports...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28884026/idiopathic-intracranial-hypertension-prognostic-factors-and-multidisciplinary-management
#5
Claire Chagot, Marie Blonski, Jean-Loup Machu, Serge Bracard, Jean-Christophe Lacour, Sébastien Richard
BACKGROUND: Idiopathic intracranial hypertension (IIH) mostly affects young obese women and can lead to permanent visual impairment. However, prognostic factors and therapeutic strategy remain unclear. METHODS: We retrospectively collected data from all patients diagnosed and managed for IIH in our university center from January 2001 to December 2016. RESULTS: Seventy-nine patients were diagnosed with IIH. Bilateral transverse sinus stenosis (TSS) was found in 74% of the population...
2017: Journal of Obesity
https://www.readbyqxmd.com/read/28882173/risk-factors-for-chronic-periodontitis-in-sri-lankan-adults-a-population-based-case-control-study
#6
Nimali Wellapuli, Lilani Ekanayake
OBJECTIVE: To determine risk factors for chronic periodontitis in 30-60 year olds in Sri Lanka. Cases and controls for this population based unmatched case-control study were identified from a broader cross-sectional study which was conducted to determine the prevalence of chronic periodontitis in 30-60 year old adults in Colombo district Sri Lanka. The study included 694 cases and 706 controls. Data were collected by means of a pre-tested interviewer administered questionnaire to obtain information about socio-demographic and behavioural factors, a physical examination to record anthropometric measurements and an oral examination...
September 7, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28882128/institutional-maternal-and-perinatal-deaths-a-review-of-40-low-and-middle-income-countries
#7
Patricia E Bailey, Wasihun Andualem, Michel Brun, Lynn Freedman, Sourou Gbangbade, Malick Kante, Emily Keyes, Edwin Libamba, Allisyn C Moran, Halima Mouniri, Dahada Ould El Joud, Kavita Singh
BACKGROUND: Understanding the magnitude and clinical causes of maternal and perinatal mortality are basic requirements for positive change. Facility-based information offers a contextualized resource for clinical and organizational quality improvement. We describe the magnitude of institutional maternal mortality, causes of death and cause-specific case fatality rates, as well as stillbirth and pre-discharge neonatal death rates. METHODS: This paper draws on secondary data from 40 low and middle income countries that conducted emergency obstetric and newborn care assessments over the last 10 years...
September 7, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28875096/narrow-complex-ventricular-tachycardia
#8
Murtaza Sundhu, Mehmet Yildiz, Sajjad Gul, Mubbasher Syed, Idrees Azher, Robert Mosteller
Myocardial infarctions are frequently complicated by tachyarrhythmias, which commonly have wide QRS complexes (QRS duration > 120 milliseconds). Many published criteria exist to help differentiate between ventricular and supraventricular mechanisms. We present a case of a 61-year-old male with a history of hypertension, hyperlipidemia and coronary artery disease with prior stenting of the right coronary artery (RCA). He had been noncompliant with his antiplatelet medication and presented with cardiac arrest secondary to in-stent thrombosis...
July 4, 2017: Curēus
https://www.readbyqxmd.com/read/28861837/cardiovascular-effects-of-the-mek-inhibitor-trametinib-a-case-report-literature-review-and-consideration-of-mechanism
#9
REVIEW
Mary Banks, Karen Crowell, Amber Proctor, Brian C Jensen
The MEK inhibitor trametinib was approved in 2013 for the treatment of unresectable or metastatic melanoma with a BRAF V600E mutation, the most common pathogenic mutation in melanoma. Trametinib blocks activation of ERK1/2, inhibiting cell proliferation in melanoma. ERK1/2 also protects against multiple types of cardiac insult in mouse models. Trametinib improves survival in melanoma patients, but evidence of unanticipated cardiotoxicity is emerging. Here we describe the case of a patient with metastatic melanoma who developed acute systolic heart failure after trametinib treatment and present the results of the literature review prompted by this case...
August 31, 2017: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/28858182/metabolic-syndrome-and-30-day-outcomes-in-elective-lumbar-spinal-fusion
#10
Andrew S Chung, David Campbell, Robert Waldrop, Dennis Crandall
STUDY DESIGN: Retrospective cohort study OBJECTIVE.: To evaluate the effect of MetS on 30-day morbidity and mortality following elective lumbar spinal fusion SUMMARY OF BACKGROUND DATA.: Metabolic syndrome (MetS) is a variable combination of hypertension, obesity, elevated fasting plasma glucose, and dyslipidemia.MetS has been associated with an increased risk of post-operative morbidity and mortality in multiple surgical settings. To our knowledge, the effect of MetS on 30-day outcomes following elective lumbar spinal fusion has not been well studied...
August 29, 2017: Spine
https://www.readbyqxmd.com/read/28854899/reverse-epidemiology-of-elevated-blood-pressure-among-chronic-hemodialysis-black-patients-with-stroke-a-historical-cohort-study
#11
Yannick Nlandu, François Lepira, Jean-Robert Makulo, Yannick Engole, Ernest Sumaili, Marie-Noelle Wameso, Vieux Mokoli, Jeannine Luse, Augustin Longo, Chantal Zinga, Pierre Akilimali, Aliocha Nkodila, Mélanie Bavassa, François Kajingulu, Justine Bukabau, Nazaire Nseka
BACKGROUND: Stroke is the third leading cause of cardiovascular mortality in dialysis patients. The objective of this study was to assess the extent of stroke in chronic hemodialysis patients. METHODS: Historical cohort of patients enrolled in two hemodialysis (HD) centers from January 1, 2010 to December 31, 2011, including 191 patients (mean age 52 years, 68% men). Incidence curves and survival time analysis between the first day of HD and the end of the study were described by the Kaplan-Meier method...
August 30, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28842086/comparison-of-time-to-operation-and-efficacies-of-ultrasound-guided-nerve-block-and-general-anesthesia-in-emergency-external-fixation-of%C3%A2-lower-leg-fractures-ao-42-43-44
#12
Chan Kang, Sang-Bum Kim, Youn-Moo Heo, You-Gun Won, Byung-Hak Oh, June-Bum Jun, Gi-Soo Lee
The present randomized controlled trial evaluated the usefulness of ultrasound (US)-guided nerve block (NB) for emergency external fixation of lower leg fractures, by investigating the time required before surgery and the clinical results stratified by the anesthesia method (US-guided NB or general anesthesia [GA]). From June 2014 to April 2016, 40 patients who had undergone emergency surgery for external fixator application were enrolled in the present study. We measured the lead time before the start of surgery after the decision to perform emergency surgery in both groups...
September 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28840065/management-of-acute-subdural-hematoma-in-a-patient-with-portopulmonary-hypertension-on-prostanoid-therapy
#13
Richard Rammo, Adam Robin, Jessin John, Aqueel Pabaney, Panayiotis Varelas, Max Kole
BACKGROUND: Treprostinil is a prostacyclin analog used to treat portopulmonary hypertension (PPHTN) and is one of several drugs shown to increase survival, but results in platelet dysfunction. Little is known about the management of patients on treprostinil who present with an acute subdural hematoma (aSDH). We describe such a case and offer our recommendations on management based on our experience and review of the literature. CASE DESCRIPTION: A 63-year-old, right-handed female with a history of PPHTN presented with severe headache and was found to have a large left aSDH with midline shift on imaging...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28830535/association-of-bariatric-surgery-with-risk-of-acute-care-use-for-hypertension-related-disease-in-obese-adults-population-based-self-controlled-case-series-study
#14
Yuichi J Shimada, Yusuke Tsugawa, Hiroyasu Iso, David F M Brown, Kohei Hasegawa
BACKGROUND: Hypertension carries a large societal burden. Obesity is known as a risk factor for hypertension. However, little is known as to whether weight loss interventions reduce the risk of hypertension-related adverse events, such as acute care use (emergency department [ED] visit and/or unplanned hospitalization). We used bariatric surgery as an instrument for investigating the effect of large weight reduction on the risk of acute care use for hypertension-related disease in obese adults with hypertension...
August 23, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28828053/ultrasound-prenatal-diagnosis-and-emergency-interventional-radiologic-therapy-of-galen-aneurysmal-malformation-in-a-newborn
#15
Roxana Elena Bohiltea, Natalia Turcan, Cristian Mihalea, Bogdan Dorobat, Eliza Elena Cinteza, Adriana Dan, Magdalena Mihai, Adela Dimitriade, Cristian Boros, Mircea Dumitru, Ionut Gobej, Octavian Munteanu, Monica Mihaela Cirstoiu
Located under the cerebral hemispheres and draining the anterior and central regions of the brain into the sinus of the posterior cerebral fossa, the vein of Galen aneurysmal malformation is considered to be a rare cause of hydrocephaly. The presence of this condition in the neonatal period typically includes intractable heart failure and a poor prognosis. We report a case of aneurysm of the vein of Galen diagnosed prenatally at 28 weeks of gestation, with the delivery at term by caesarean section of a female infant...
December 2016: Mædica
https://www.readbyqxmd.com/read/28828046/modern-use-of-echocardiography-in-transcatheter-aortic-valve-replacement-an-up-date
#16
Cristina Caldararu, Serban Balanescu
Echocardiography is the cornerstone in the diagnosis of any valvular heart disease. The accurate diagnosis of aortic stenosis, the left ventricle function and the other heart valves evaluation are currently done by ultrasound alone. Prosthetic valve choice and dimensions prior to implantation can be done solely by proper use of echocardiography. The emergence of new methods to cure aortic stenosis such as trans-catheter aortic valve replacement (TAVR) emphasized the diagnostic value of cardiac ultrasound. The usefulness of echocardiography in TAVR can be divided in the baseline assessment (common to patients treated by conventional surgery), intra-procedural guidance of valve deployment and post-procedural follow-up...
December 2016: Mædica
https://www.readbyqxmd.com/read/28826583/successful-resection-of-a-growing-distal-medial-lenticulostriate-artery-pseudoaneurysm-presenting-with-isolated-intraventricular-hemorrhage
#17
Yosuke Sato, Kazuhiro Ando, Makoto Kawaguchi, Kenichi Kakinuma
INTRODUCTION: Distal medial lenticulostriate artery (LSA) aneurysms associated with isolated intraventricular hemorrhage (IVH) are extremely rare. We report a very rare case of the isolated IVH due to the rupture of the distal medial LSA pseudoaneurysm that was not visible at the initial angiography but later emerged and grew. CASE REPORT: A 61-year-old woman with a history of hypertension had sudden onset of severe headache and mild consciousness disturbance. The computed tomography scan revealed the IVH, but the initial angiographies showed no evidence of aneurysm...
August 17, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28819362/recurrent-csf-rhinorrhea-misdiagnosed-as-chronic-allergic-rhinitis-with-subsequent-development-of-bacterial-meningitis
#18
Michael T Ulrich, Lawrence K Loo, Michael B Ing
INTRODUCTION: Cerebrospinal fluid (CSF) rhinorrhea results from an abnormal communication of the dura mater to the nasal mucosa. The majority of cases of CSF rhinorrhea are the result of trauma or surgery involving the skull base. Spontaneous CSF rhinorrhea is a rare clinical entity with increased risk of ascending infection. Delay in diagnosis places the patient at risk of developing meningitis. CASE PRESENTATION: A 36-year-old African American female with significant medical history of obesity and hypertension presented to the emergency department with headache, altered level of consciousness, fever, and neck stiffness...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28816935/perimesencephalic-nonaneurysmal-subarachnoid-hemorrhage-caused-by-transverse-sinus-thrombosis-a-case-report-and-review-of-literature
#19
Fang-Wang Fu, Jie Rao, Yuan-Yuan Zheng, Liang Song, Wei Chen, Qi-Hui Zhou, Jian-Guang Yang, Jiang-Qiong Ke, Guo-Qing Zheng
RATIONALE: Perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSAH) is characterized by a pattern of extravasated blood restricted to the perimesencephalic cisterns, normal angiographic findings, and an excellent prognosis with an uneventful course and low risks of complication. The precise etiology of bleeding in patients with PNSAH has not yet been established. The most common hypothesis is that PNSAH is venous in origin. Intracranial venous hypertension has been considered as the pivotal factor in the pathogenesis of PNSAH...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28814122/flibanserin-toxicity-in-a-toddler-following-ingestion
#20
Nicholas Granzella, Betty C Chen, Geoffrey S Baird, Matthew Valento
INTRODUCTION: Flibanserin is a medication recently approved by the FDA for treatment of generalized hypoactive sexual desire disorder (HSDD) in premenopausal women. Its mechanism of action is not fully understood but is thought to modulate serotonin receptors and increase levels of norepinephrine and dopamine. While much is known about toxicity of other drugs which affect these systems, there is little information about toxicity of flibanserin at this time. CASE: We present a case of a 2-year-old boy who ingested an estimated 600 mg of his mother's flibanserin...
August 17, 2017: Clinical Toxicology
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