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https://www.readbyqxmd.com/read/28629239/cortisol-precursors-in-neonates-with-vasopressor-resistant-hypotension-in-relationship-to-demographic-characteristics
#1
Abdelmoneim Khashana, Hoda Ahmed, Amal Ahmed, Amina Abdelwahab, Timo Saarela, Mika Rämet, Mikko Hallman
OBJECTIVE: To correlate between cortisol precursors in neonates with vasopressor resistant hypotension and demographic characteristics. METHODS: We investigated 48 neonates with vasopressor-resistant hypotension. Gestation at birth ranged from 34 to 42 weeks and postnatal age from 4 to 14 days. Cortisol and precursor steroids were measured soon after the onset of volume expansion and inotropes for treatment of shock. Their concentrations were determined using liquid chromatography-mass spectrometry...
June 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28617889/erdheim-chester-disease-presenting-with-histiocytic-colitis-and-cytokine-storm
#2
George P Christophi, Yeshika Sharma, Quader Farhan, Umang Jain, Ted Walker, Gregory S Sayuc, Deborah C Rubin
BACKGROUND: Non-Langerhans histiocytosis is a group of inflammatory lymphoproliferative disorders originating from non-clonal expansion of hematopoietic stem cells into cytokine-secreting dendritic cells or macrophages. Erdheim-Chester Disease (ECD) is a rare type of non-Langerhans cell histiocytosis characterized by tissue inflammation and injury caused by macrophage infiltration and histologic findings of foamy histiocytes. Often ECD involves the skeleton, retroperitoneum and the orbits...
June 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28602048/injected-corticosteroids-for-treating-plantar-heel-pain-in-adults
#3
REVIEW
Judy A David, Venkatesan Sankarapandian, Prince Rh Christopher, Ahana Chatterjee, Ashish S Macaden
BACKGROUND: Plantar heel pain, commonly resulting from plantar fasciitis, often results in significant morbidity. Treatment options include nonsteroidal anti-inflammatory drugs (NSAIDs), orthoses, physical therapy, physical agents (e.g. extracorporeal shock wave therapy (ESWT), laser) and invasive procedures including steroid injections. OBJECTIVES: To assess the effects (benefits and harms) of injected corticosteroids for treating plantar heel pain in adults. SEARCH METHODS: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials (the Cochrane Library), MEDLINE, Embase, CINAHL, clinical trials registries and conference proceedings...
June 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28588863/hemodynamic-collapse-due-to-the-stenosis-of-four-pulmonary-veins-in-a-patient-with-mediastinal-tumor
#4
Kentaro Yoshida, Fumie Fujisawa, Hiroshi Kojima, Noriyuki Takeyasu
Cardiogenic shock can occur due to compression of the four pulmonary veins and the left atrium by a mediastinal tumor. Steroid infusion can be a temporary alternative therapy before obtaining a definite diagnosis and performing an intervention with stents to dilate the pulmonary veins.
June 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28583781/-macrophage-activation-syndrome-and-kawasaki-disease-four-new-cases
#5
B Dumont, P Jeannoel, L Trapes, E Rolland, C Gay, J-L Stephan
Macrophage activation syndrome (MAS) is a rarely reported complication of Kawasaki disease (KD). It must be sought during KD with unusual clinical signs, such as enlargement of the liver or spleen, cytopenia (including thrombocytopenia), and elevated serum triglycerides. Here, we report four cases from a single center. The first is the description of a case of KD occurring in an 11-month-old child 15 days after the occurrence of infectious spondylitis. For the second, acute myocarditis heralded KD in a 5-year-old child...
June 2, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28575284/role-of-heat-shock-factor-1-in-conserving-cholesterol-transportation-in-leydig-cell-steroidogenesis-via-steroidogenic-acute-regulatory-protein
#6
Shintaro Oka, Koji Shiraishi, Mitsuaki Fujimoto, Arpit Katiyar, Ryosuke Takii, Akira Nakai, Hideyasu Matsuyama
Testicular testosterone synthesis begins with cholesterol transport into mitochondria via steroidogenic acute regulatory protein (StAR) in Leydig cells. Acute heat stress is known to obstruct testicular steroidogenesis by transcriptional repression of StAR. In contrast, chronic heat stress such as cryptorchidism or varicocele generally does not affect testicular steroidogenesis, suggesting that Leydig cells adapt to heat stress and retain their steroid synthesis ability. However, the mechanisms of the stress response in steroid-producing cells are unclear...
May 29, 2017: Endocrinology
https://www.readbyqxmd.com/read/28567214/surgical-treatment-of-piriformis-syndrome
#7
Suk Ku Han, Yong Sik Kim, Tae Hyeon Kim, Soo Hwan Kang
BACKGROUND: Piriformis syndrome (PS) is an uncommon disease characterized by symptoms resulting from compression/irritation of the sciatic nerve by the piriformis muscle. Uncertainty and controversy remain regarding the proper diagnosis and most effective form of treatment for PS. This study analyzes the diagnostic methods and efficacy of conservative and surgical treatments for PS. METHODS: From March 2006 to February 2013, we retrospectively reviewed 239 patients who were diagnosed with PS and screened them for eligibility according to our inclusion/exclusion criteria...
June 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28558852/-no-glucocorticoids-for-treatment-of-sepsis-unless%C3%A2
#8
M J A Kamps, D Kiers, P Pickkers
Steroids influence the immune response and blood pressure in patients with septic shock. Many trials have evaluated a putative positive effect of steroids as an adjuvant therapy in patients with sepsis and septic shock, with contradictory outcomes. As a consequence, the use of steroids in sepsis patients varies widely. A recently published randomized clinical trial has demonstrated that treatment with hydrocortisone does not delay or prevent progress to septic shock in patients with sepsis. Based on the current available data, the use of steroids in sepsis should be reserved for those patients who remain severely hemodynamic unstable after fluid resuscitation and vasopressor therapy, or those with a separate indication for steroid therapy...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28533998/ipilimumab-as-a-cause-of-severe-pan-colitis-and-colonic-perforation
#9
Raj Shah, Danielle Witt, Talal Asif, Fahad F Mir
Ipilimumab is a human monoclonal antibody that functions as a cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor that is used to treat malignant melanoma. Due to ipilimumab's removal of immune regulation, specifically through the inactivation of CTLA-4, it is commonly associated with inflammatory and autoimmune events. Gastrointestinal (GI) related immune-related adverse events such as diarrhea occur in 29% of patients with 7.6% of patients specifically suffering from colitis. We describe a case of colonic perforation with ipilimumab use...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28531762/high-dose-testosterone-enanthate-supplementation-boosts-oxidative-stress-but-exerts-little-effect-on-the-antioxidant-barrier-in-sedentary-adolescent-male-rat-liver
#10
Ewa Sadowska-Krępa, Barbara Kłapcińska, Sławomir Jagsz, Anna Nowara, Izabela Szołtysek-Bołdys, Małgorzata Chalimoniuk, Józef Langfort, Stanisław J Chrapusta
BACKGROUND: Anabolic-androgenic steroids abuse is on the rise among adolescent boys and young men, mostly in those seeking a 'shortcut' to an improved body image. This approach is associated with the risk of severe adverse health effects, some of which involve the liver and are linked to hepatic oxidative stress. Testosterone and its esters is a cornerstone of most anabolic-androgenic steroid stacking protocols. METHODS: We assessed and compared several hepatotoxicity and liver oxidative stress indices, as well as the contents of some components of the hepatic antioxidant barrier between sedentary adolescent male rats given a 6-week course of weekly im testosterone enanthate (TE, 8 or 80mg/kgBW/week) or vehicle (sesame oil) injections...
March 11, 2017: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/28523249/risk-factors-clinical-presentation-and-outcome-of-acinetobacter-baumannii-bacteremia
#11
Tala Ballouz, Jad Aridi, Claude Afif, Jihad Irani, Chantal Lakis, Rakan Nasreddine, Eid Azar
Infections caused by Acinetobacter baumannii (AB), an increasingly prevalent nosocomial pathogen, have been associated with high morbidity and mortality. We conducted this study to analyze the clinical features, outcomes, and factors influencing the survival of patients with AB bacteremia. We retrospectively examined the medical records of all patients developing AB bacteremia during their hospital stay at a tertiary care hospital in Beirut between 2010 and 2015. Ninety episodes of AB bacteremia were documented in eighty-five patients...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28509137/successful-treatment-by-tocilizumab-without-steroid-in-a-very-severe-case-of-tafro-syndrome
#12
Tamami Fujiki, Suguru Hirasawa, Seishi Watanabe, Shunsuke Iwamoto, Ryoichi Ando
Successful use of tocilizumab (TCZ) to treat TAFRO syndrome has recently been reported. In those cases, TCZ was used with steroid. We present herein the case of a 59-year-old man with very severe TAFRO syndrome who was successfully treated using TCZ without steroid. He showed rapidly progressive anasarca, acute renal failure and very severe thrombocytopenia. We initially used steroid, but its efficacy was limited. Moreover, steroid use had to be stopped as soon as possible, because hemorrhagic shock developed due to severe duodenal ulcer...
May 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28500507/impact-of-severe-hematological-abnormalities-in-the-outcome-of-hospitalized-patients-with-influenza-virus-infection
#13
A Lalueza, H Trujillo, J Laureiro, B Ayuso, P Hernández-Jiménez, C Castillo, M Torres, D Folgueira, O Madrid, C Díaz-Pedroche, E Arrieta, C Arévalo, C Lumbreras
Although hematological abnormalities have been described among patients with influenza virus infection, little is known about their impact on the outcome of the patients. The aim of this study was to assess the frequency and clinical impact of severe hematological abnormalities in patients with confirmed influenza virus infection. This was an observational retrospective study including all adult patients with diagnosis of influenza virus infection hospitalized from January to May 2016 in our institution. Influenza virus infection was diagnosed by means of rRT-PCR assay performed on respiratory samples...
May 13, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28496024/a-survival-case-of-fulminant-right-side-dominant-eosinophilic-myocarditis
#14
Keishi Moriwaki, Kaoru Dohi, Taku Omori, Muneyoshi Tanimura, Emiyo Sugiura, Shiro Nakamori, Toshiki Sawai, Kyoko Imanaka-Yoshida, Norikazu Yamada, Masaaki Ito
A 59-year-old Japanese woman was admitted to a nearby hospital with dyspnea and general malaise. Transthoracic echocardiography revealed right ventricular (RV) dilatation with severely reduced systolic function and leftward shift of the intraventricular septum. She was initially diagnosed with acute right heart failure, and fell into cardiogenic shock requiring an intra-aortic balloon pump and inotropic agents. An endomyocardial biopsy (EMB) demonstrated extensive interstitial edema, infiltration of inflammatory cells including numerous eosinophils, and myocytolysis with eosinophil degranulation...
May 12, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28492295/elderly-versus-non-elderly-patients-with-intra-abdominal-candidiasis-in-the-icu
#15
George Dimopoulos, Dimitrios K Matthaiou, Elda Righi, Maria Merelli, Matteo Bassetti
BACKGROUND: Intra-abdominal candidiasis (IAC) has a considerable cost in terms of mortality and morbidity. We sought to study the epidemiology, characteristics and outcome of elderly (>75 years old) versus non-elderly patients with IAC and risk factors for mortality in elderly patients. METHODS: Post-hoc analysis of a retrospective multinational cohort study over a 3- year period (2011-2013). RESULTS: Of 482 patients, 124 (25.7%) were elderly and 358 (74...
May 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28472612/acidemia-and-blood-free-fatty-acids-analysis-of-cardiovascular-risk-factors-in-a-new-context
#16
António Heitor Reis
Following a hypothesis developed in an earlier paper, here it is discussed how deviations of blood pH from the normal range (namely states of acidemia) together with high blood levels of free fatty acids (FFA) may offer a rationale for many important risk factors for cardiovascular diseases (CVD) by shaping a context for formation of fatty acid micelles and vesicles with an acidic core, which fuse with the endothelia, disrupt vital cell processes, and thereby may initiate atherosclerotic plaque formation. Acidemia may arise primarily from dysregulation of the systemic buffers that control blood pH, chronic diseases of kidneys and lungs, inappropriate diet, or may be induced by some common drugs...
March 2017: Discovery Medicine
https://www.readbyqxmd.com/read/28461784/retrospective-evaluation-of-the-effectiveness-of-radiotherapy-in-patients-with-plantar-fascitis-heel-spurs
#17
Piotr Kędzierawski, Rafał Stando, Paweł Macek
AIM: The aim of the study was the evaluation of the effectiveness of radiotherapy in patients with the feet pain caused by heel spurs. BACKGROUND: Treatment options for patients reporting these symptoms include use of suitable orthopedic footwear, the use of general or topical non-steroidal anti-inflammatory drugs or steroids, physiotherapy, manual therapy, shock wave or appropriate surgical procedures. Radiotherapy is one of the method used in patients with chronic pain syndrome...
May 2017: Reports of Practical Oncology and Radiotherapy
https://www.readbyqxmd.com/read/28424084/durable-complete-remission-with-aromatase-inhibitor-therapy-in-a-patient-with-metastatic-uterine-carcinosarcoma-with-poor-performance-status-and-coagulation-disorders-a-case-report
#18
P Martin-Romano, M Jurado, M A Idoate, L Arbea, J L Hernandez-Lizoain, D Cano, J A Paramo, S Martin-Algarra
BACKGROUND: Chemotherapy is considered the most appropriate treatment for metastatic uterine sarcoma, despite its limited efficacy. No other treatment has been conclusively proved to be a real alternative, but some reports suggest that anti-hormonal therapy could be active in a small subset of patients. We report the case of a patient with metastatic uterine carcinosarcoma with positive hormonal receptors and a complete pathological response. CASE PRESENTATION: A 54-year-old white woman presented to our emergency room with hypovolemic shock and serious vaginal bleeding...
April 19, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28406862/a-randomized-controlled-trial-of-corticosteroids-in-pediatric-septic-shock-a-pilot-feasibility-study
#19
Kusum Menon, Dayre McNally, Katharine O'Hearn, Anand Acharya, Hector R Wong, Margaret Lawson, Tim Ramsay, Lauralyn McIntyre, Elaine Gilfoyle, Marisa Tucci, David Wensley, Ronald Gottesman, Gavin Morrison, Karen Choong
OBJECTIVE: To determine the feasibility of conducting a randomized controlled trial of corticosteroids in pediatric septic shock. DESIGN: Randomized, double-blind, placebo controlled trial. SETTING: Seven tertiary level PICUs in Canada. PATIENTS: Children newborn to 17 years old inclusive with suspected septic shock. INTERVENTION: Administration of IV hydrocortisone versus placebo until hemodynamic stability is achieved or for a maximum of 7 days...
June 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28343834/evaluating-the-impact-of-obesity-on-safety-and-efficacy-of-weight-based-norepinephrine-dosing-in-septic-shock-a-single-center-retrospective-study
#20
Paul J Wong, Komal A Pandya, Alexander H Flannery
OBJECTIVE: Norepinephrine is the first-line vasopressor recommended for patients in septic shock. Weight-based dosing may increase drug exposure and the risk of adverse effects in obese patients. The objective was to evaluate the safety and efficacy of weight-based norepinephrine dosing using actual body weight in the morbidly obese compared with normal weight patients. METHODS: This was a single centre, retrospective study of adult patients admitted with septic shock requiring norepinephrine for at least 12hours...
March 23, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
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