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https://www.readbyqxmd.com/read/28642454/inclusion-body-myositis-a-case-presenting-with-respiratory-failure-and-autopsy-findings-leading-to-the-hypothesis-of-a-paraneoplastic-cause
#1
Christopher Dardis, Ariel Antezana, Kurenai Tanji, Paul J Maccabee
BACKGROUND Sporadic inclusion body myositis (IBM) is the most common acquired myopathy seen in adults aged over 50 years, with a prevalence estimated at between 1 and 70 per million. Weakness of the diaphragm with loss of vital capacity is almost universal in IBM. This is almost always asymptomatic. When respiratory complications occur, they are most often due to aspiration. Respiratory failure due to diaphragmatic weakness is exceptionally rare, particularly as the presenting symptom of the disease. It is not currently considered to be a paraneoplastic syndrome...
June 23, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28634220/tidal-changes-on-ct-and-progression-of-ards
#2
Maurizio Cereda, Yi Xin, Hooman Hamedani, Giacomo Bellani, Stephen Kadlecek, Justin Clapp, Luca Guerra, Natalie Meeder, Jennia Rajaei, Nicholas J Tustison, James C Gee, Brian P Kavanagh, Rahim R Rizi
BACKGROUND: Uncertain prediction of outcome in acute respiratory distress syndrome (ARDS) impedes individual patient management and clinical trial design. OBJECTIVES: To develop a radiological metric of injurious inflation derived from matched inspiratory and expiratory CT scans, calibrate it in a model of experimental lung injury, and test it in patients with ARDS. METHODS: 73 anaesthetised rats (acid aspiration model) were ventilated (protective or non-protective) for up to 4 hours to generate a spectrum of lung injury...
June 20, 2017: Thorax
https://www.readbyqxmd.com/read/28633725/well-differentiated-neuroendocrine-tumor-a-low-b-grade-tumor-s-aggressive-course-and-dismal-outcome-a-case-report
#3
Dinesh Atwal, Krishna Prasad Joshi, Susanne Jeffus, James Ntambi, Fade Mahmoud
INTRODUCTION: Incidence of well-differentiated neuroendocrine tumors (NETs) of the colon and rectum is increasing and is now approximately 1 per 100,000 in the US. NETs are either well-differentiated (indolent) or poorly differentiated (aggressive). The majority of these tumors are found incidentally during screening colonoscopies and rarely are associated with symptoms of hormonal syndrome, even during the advanced stage. Metastatic well-differentiated NETs of the colon and rectum are incurable, hard to treat, and associated with a poor prognosis and survival rates similar to colorectal adenocarcinoma survival...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28633639/fusobacterial-liver-abscess-a-case-report-and-review-of-the-literature
#4
Dilip Jayasimhan, Linus Wu, Paul Huggan
BACKGROUND: Fusobacteriae are facultative anaerobic gram-negative bacilli which cause a range of invasive infections, amongst which pyogenic liver abscesses are rare. We describe a case of Fusobacterium nucleatum liver abscess and review the relevant literature. CASE PRESENTATION: A 51-year-old lady presented with a 4-day history of abdominal pain, diarrhoea, fever, rigors, and lethargy. Imaging revealed an abscess which was drained. Cultures of the blood and abscess aspirate grew Fusobacterium nucleatum and Prevotella pleuritidis respectively...
June 20, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28627978/scarf-pin-related-hijab-syndrome-a-new-name-for-an-unusual-type-of-foreign-body-aspiration
#5
Aram Baram, Fahmi H Kakamad, Delan Ahmed Bakir
Background Foreign body aspiration refers to the inhalation of an object into the respiratory system and is a serious and potentially fatal event. A distinct group of patients has recently been recognized among Muslim nations. These patients include women who wear headscarves and place the safety pin in their mouth prior to securing the veils, leading to accidental foreign body aspiration. The aim of this study was to analyze the main presentation, diagnosis, treatment, and outcome of patients with scarf pin aspiration...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28626188/discoid-lupus-erythematosus-complicated-with-pregnancy-induced-hemophagocytic-syndrome
#6
Hideto Takada, Naoki Kimura, Yoko Yoshihashi-Nakazato, Kimito Kawahata, Hitoshi Kohsaka
A 35-year-old woman with discoid lupus erythematosus (DLE) was admitted at 11 weeks' gestation with a persistent fever. Laboratory studies revealed pancytopenia, elevated liver enzymes, and hyperferritinemia. Bone marrow aspiration confirmed the diagnosis of hemophagocytic syndrome (HPS). She had no findings of infection or active systemic lupus erythematosus. The administration of high-dose corticosteroids resolved the clinical and laboratory findings. She delivered a healthy baby at 35 weeks' gestation. This case suggests that DLE can be a predisposing factor for pregnancy-induced HPS...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28621297/endoscopic-ultrasound-with-or-without-fine-needle-aspiration-has-a-meaningful-impact-on-clinical-care-in-the-pediatric-population
#7
Amit Raina, Maire A Conrad, Benjamin Sahn, Alireza Sedarat, Gregory G Ginsberg, Nuzhat A Ahmad, Vinay Chandrasekhara, Petar Mamula, Michael L Kochman
BACKGROUND AND OBJECTIVES: The safety and utility of endoscopic ultrasound (EUS) for the evaluation and management of gastrointestinal (GI) tract disorders among adults has been established. The literature on safety and efficacy in a pediatric referral population (under 21 years of age) is limited. We hypothesized that EUS is safe and useful in the pediatric population. We reviewed the pediatric EUS experience at a single tertiary-care system. We describe the indications, findings, safety, technical success rate, and impact on clinical outcomes...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28620501/efficacy-of-lenvatinib-in-a-patient-with-anaplastic-thyroid-cancer
#8
Kazuyuki Oishi, Daisuke Takabatake, Yuichi Shibuya
We experienced a case of an 82-year-old woman who presented to our hospital with a 1-month history of dysphagia and dyspnea. Cervical contrast-enhanced computed tomography revealed diffuse thyroid neoplasms causing significant tracheal stenosis with tumors, particularly of the superior mediastinum, which were associated with an embolism of the brachiocephalic vein and suspected invasion to the bilateral common carotid arteries. Anaplastic thyroid cancer (ATC) was diagnosed by fine-needle aspiration; thus, emergency tracheostomy and gastrostomy were performed...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28608650/comparison-of-different-dosing-strategies-of-intratracheally-instilled-budesonide-on-meconium-injured-piglet-lungs
#9
Chih-Hsueh Lin, Mei-Jy Jeng, Yi-Chiang Yang, Yu-Hsuan Hsiao, Yu Ru Kou
BACKGROUND: Severe inflammation plays a vital role in the pathogenesis of meconium aspiration syndrome (MAS). Intratracheal (IT) instillation of corticosteroids may be beneficial for MAS in optimizing local effect and reducing systemic adverse effects, but the optimum dosing course remains open to question. METHODS: Thirty meconium-injured newborn piglets were enrolled into six study groups. The first four groups consisted of the IT instillation of 0.25/0.5 mg/kg using either one (IT-B251/IT-B501) or two (IT-B252/IT-B502) doses of budesonide, while the other two groups were the intravenous (IV) dexamethasone (0...
July 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28604336/characteristics-of-dysphagia-in-infants-with-microcephaly-caused-by-congenital-zika-virus-infection-brazil-2015
#10
Mariana C Leal, Vanessa van der Linden, Thiago P Bezerra, Luciana de Valois, Adriana C G Borges, Margarida M C Antunes, Kátia G Brandt, Catharina X Moura, Laura C Rodrigues, Coeli R Ximenes
We summarize the characteristics of dysphagia in 9 infants in Brazil with microcephaly caused by congenital Zika virus infection. The Schedule for Oral Motor Assessment, fiberoptic endoscopic evaluation of swallowing, and the videofluoroscopic swallowing study were used as noninstrumental and instrumental assessments. All infants had a degree of neurologic damage and showed abnormalities in the oral phase. Of the 9 infants, 8 lacked oral and upper respiratory tract sensitivity, leading to delays in initiation of the pharyngeal phase of swallowing...
August 15, 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28603862/graft-reduction-using-a-powered-stapler-in-pediatric-living-donor-liver-transplantation
#11
Koichiro Yoshimaru, Toshiharu Matsuura, Yoshiaki Kinoshita, Makoto Hayashida, Yoshiaki Takahashi, Yusuke Yanagi, Norifumi Harimoto, Toru Ikegami, Hideaki Uchiyama, Tomoharu Yoshizumi, Yoshihiko Maehara, Tomoaki Taguchi
Large-for-size syndrome is defined by inadequate tissue oxygenation, which results in vascular complications and graft compression after abdominal closure in living donor liver transplantation recipients. An accurate graft reduction that matches the optimal liver volume for the recipient is essential. We herein initially present the feasibility and safety of graft reduction using a powered stapler to obtain an optimal graft size. From October 1996 to October 2015, a total of eight graft reductions were performed using a powered stapler (group A; n=4) or by the conventional method using a cavitron ultrasonic surgical aspirator and portal triad suturing (group B; n=4)...
June 11, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28596003/empty-follicle-syndrome-revisited-definition-incidence-aetiology-early-diagnosis-and-treatment
#12
REVIEW
Alberto Revelli, Andrea Carosso, Giuseppina Grassi, Gianluca Gennarelli, Stefano Canosa, Chiara Benedetto
In this review, the definition, incidence and possible causes of empty follicle syndrome (EFS), including molecular mechanisms that may underlie the syndrome, are discussed, along with prevention and treatment options. EFS is the complete failure to retrieve oocytes after ovarian stimulation, despite apparently normal follicle development and adequate follicular steroidogenesis. Two variants of EFS have been described: the 'genuine' form (gEFS), which occurs in the presence of adequate circulating HCG levels at the time of oocyte aspiration, and the 'false' form (f-EFS), which is associated with circulating HCG below a critical threshold...
May 23, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/28594680/antibiotic-therapy-in-comatose-mechanically-ventilated-patients-following-aspiration-differentiating-pneumonia-from-pneumonitis
#13
Jean Baptiste Lascarrou, Floriane Lissonde, Aurélie Le Thuaut, Konstantinos Bachoumas, Gwenhael Colin, Matthieu Henry Lagarrigue, Isabelle Vinatier, Maud Fiancette, Jean Claude Lacherade, Aihem Yehia, Aurélie Joret, Christine Lebert, Sandra Bourdon, Laurent Martin Lefèvre, Jean Reignier
OBJECTIVES: To determine the proportion of patients with documented bacterial aspiration pneumonia among comatose ICU patients with symptoms suggesting either bacterial aspiration pneumonia or non-bacterial aspiration pneumonitis. DESIGN: Prospective observational study. SETTING: University-affiliated 30-bed ICU. PATIENTS: Prospective cohort of 250 patients admitted to the ICU with coma (Glasgow Coma Scale score ≤ 8) and treated with invasive mechanical ventilation...
June 7, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28592332/the-negative-effect-of-initial-high-dose-methylprednisolone-and-tapering-regimen-for-acute-respiratory-distress-syndrome-a-retrospective-propensity-matched-cohort-study
#14
Makoto Takaki, Kazuya Ichikado, Kodai Kawamura, Yasuhiro Gushima, Moritaka Suga
BACKGROUND: The efficacy of corticosteroid use in acute respiratory distress syndrome (ARDS) remains controversial. Generally, short-term high-dose corticosteroid therapy is considered to be ineffective in ARDS. On the other hand, low-dose, long-term use of corticosteroids has been reported to be effective since they provide continued inhibition of the systemic inflammatory response syndrome (SIRS) that accompanies ARDS. Thus far, no reports have been published on the efficacy of initiating treatment with a high-dose corticosteroid regimen with tapering...
June 8, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28588153/gastric-dilatation-and-abdominal-compartment-syndrome-in-a-child-with-prader-willi-syndrome
#15
Clara Blat, Elisenda Busquets, Teresa Gili, Assumpta Caixàs, Elisabeth Gabau, Raquel Corripio
BACKGROUND Prader-Willi syndrome (PWS) is a genetic disorder characterized by initial muscular hypotonia and feeding difficulties, and later an insatiable appetite, hyperphagia and obesity along with mild to moderate intellectual impairment. Affected individuals' food-seeking behavior and suspected delayed gastric emptying can lead to gastric dilatation with subsequent necrosis and perforation. CASE REPORT We present the case of a 5-year-old boy diagnosed with Prader-Willi syndrome at neonatal age due to muscular hypotonia, who started growth hormone therapy at 20 months...
June 7, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28583555/veno-arterial-venous-hybrid-mode-of-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome-combined-with-septic-shock-in-a-liver-transplant-patient-a-case-report
#16
J-I Park, B-H Jung, S-G Lee
BACKGROUND: Post-operative respiratory failure is common in liver transplant patients, with a direct effect on graft and recipient outcomes. We present a case of successful treatment for a patient who had acute respiratory distress syndrome combined with septic shock after living-donor liver transplantation with veno-arterial-venous hybrid mode of extracorporeal membrane oxygenation (ECMO) support. METHODS: A 49-year-old male patient underwent successful emergency living-donor liver transplantation for acute-on-chronic liver failure associated with alcoholic liver cirrhosis...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28567102/neonatal-respiratory-distress-syndrome-chest-x-ray-or-lung-ultrasound-a-systematic-review
#17
REVIEW
Matthew Hiles, Anne-Marie Culpan, Catriona Watts, Theresa Munyombwe, Stephen Wolstenhulme
BACKGROUND AND AIM: Neonatal respiratory distress syndrome is a leading cause of morbidity in preterm new-born babies (<37 weeks gestation age). The current diagnostic reference standard includes clinical testing and chest radiography with associated exposure to ionising radiation. The aim of this review was to compare the diagnostic accuracy of lung ultrasound against the reference standard in symptomatic neonates of ≤42 weeks gestation age. METHODS: A systematic search of literature published between 1990 and 2016 identified 803 potentially relevant studies...
May 2017: Ultrasound: Journal of the British Medical Ultrasound Society
https://www.readbyqxmd.com/read/28560784/reversible-and-cachexia-associated-feline-skin-fragility-syndrome-in-three-cats
#18
Nicla Furiani, Ilaria Porcellato, Chiara Brachelente
BACKGROUND: Feline skin fragility syndrome (FSFS) is an acquired disorder characterized by altered collagen production resulting in an extremely thin and fragile skin. FSFS is associated with diseases characterized by excessive steroidal hormones that can inhibit collagen synthesis. It is also described concomitantly with severe inflammatory, infectious or neoplastic conditions where the pathogenesis remains largely unknown. OBJECTIVES: To describe three cases of FSFS in cats that become cachectic secondary to different causes without glucocorticoid involvement...
May 31, 2017: Veterinary Dermatology
https://www.readbyqxmd.com/read/28555948/a-suspected-case-of-intermediate-syndrome-in-a-dog-with-carbamate-toxicosis
#19
E Tinson, E Boller, M Davis
CASE REPORT: A 7-year-old female spayed Labrador Retriever was managed for suspected carbamate toxicosis after confirmed ingestion of a large amount of methiocarb. Therapy included decontamination, supportive care and management for aspiration pneumonia. On the third day of hospitalisation, after an initial clinical improvement, the dog developed respiratory muscle weakness, inspiratory dyspnoea and pronounced cervical muscle weakness. These delayed clinical signs were consistent with the 'intermediate syndrome' described in some cases of organophosphate and carbamate toxicoses in humans and also described in one case of organophosphate toxicosis in the dog...
June 2017: Australian Veterinary Journal
https://www.readbyqxmd.com/read/28545548/circulating-microparticle-levels-are-reduced-in-patients-with-ards
#20
Ciara M Shaver, Justin Woods, Jennifer K Clune, Brandon S Grove, Nancy E Wickersham, J Brennan McNeil, Gregory Shemancik, Lorraine B Ware, Julie A Bastarache
BACKGROUND: It is unclear how to identify which patients at risk for acute respiratory distress syndrome (ARDS) will develop this condition during critical illness. Elevated microparticle (MP) concentrations in the airspace during ARDS are associated with activation of coagulation and in vitro studies have demonstrated that MPs contribute to acute lung injury, but the significance of MPs in the circulation during ARDS has not been well studied. The goal of the present study was to test the hypothesis that elevated levels of circulating MPs could prospectively identify critically ill patients who will develop ARDS and that elevated circulating MPs are associated with poor clinical outcomes...
May 25, 2017: Critical Care: the Official Journal of the Critical Care Forum
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