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https://www.readbyqxmd.com/read/28239630/from-attachment-to-independence-stress-hormone-control-of-ecologically-relevant-emergence-of-infants-responses-to-threat
#1
Adrienne Santiago, Chiye Aoki, Regina M Sullivan
Young infant rat pups learn to approach cues associated with pain rather than learning amygdala-dependent fear. This approach response is considered caregiver-seeking and ecologically relevant within the context of attachment. With maturation, increases in the stress hormone corticosterone permit amygdala-dependent fear, which is crucial for survival during independent living. During the developmental transition from attachment to fear learning, maternal presence suppresses corticosterone elevation to block amygdala-dependent fear learning and re-engage the attachment circuitry...
April 2017: Current Opinion in Behavioral Sciences
https://www.readbyqxmd.com/read/28238778/fixed-spaced-stimulation-restores-adaptive-plasticity-within-the-spinal-cord-identifying-the-eliciting-conditions
#2
Kyle M Baumbauer, Joel D Turtle, James W Grau
Prior work has shown that neurons within the spinal cord are sensitive to temporal relations and that stimulus regularity impacts nociceptive processing and adaptive plasticity. Application of brief (80ms) shocks (180-900) in a variable manner induces a form of maladaptive plasticity that inhibits spinally-mediated learning and enhances nociceptive reactivity. In contrast, an extended exposure (720-900) to stimuli given at regular (fixed spaced) intervals has a restorative effect that counters nociceptive sensitization and enables learning...
February 23, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/28238501/is-tachycardia-at-discharge-from-the-pediatric-emergency-department-a-cause-for-concern-a%C3%A2-nonconcurrent-cohort-study
#3
Paria M Wilson, Todd A Florin, Guixia Huang, Matthew Fenchel, Matthew R Mittiga
STUDY OBJECTIVE: We evaluate the association between discharge tachycardia and (1) emergency department (ED) and urgent care revisit and (2) receipt of clinically important intervention at the revisit. METHODS: The study included a nonconcurrent cohort of children aged 0 to younger than 19 years, discharged from 2 pediatric EDs and 4 pediatric urgent care centers in 2013. The primary exposure was discharge tachycardia (last recorded pulse rate ≥99th percentile for age)...
February 23, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28238395/profound-hypotension-and-bradycardia-in-the-setting-of-synthetic-cannabinoid-intoxication-a-case-series
#4
David O Andonian, Shauna R Seaman, Elaine B Josephson
Cannabinoids are the most commonly used illegal substances in the world [1]. Synthetic Cannabinoids (SCB) are also known as "Spice", "K2", "Spike", "herbal incense", "Cloud 9", "Mojo" and many others are becoming a large public health concern due to their increasing use, unpredictable toxicity, and abuse potential [2]. The most common reported toxicities with SCB use based on studies using Texas Poison control record are tachycardia, agitation and irritability, drowsiness, hallucinations, delusions, hypertension, nausea, confusion, dizziness, vertigo, chest pain, acute kidney injury, seizures, heart attacks and both ischemic and hemorrhagic strokes [3]...
January 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28238384/abdominal-pain-in-the-post-menopausal-female-is-ovarian-torsion-in-the-differential
#5
Jason M Rotoli
BACKGROUND: Ovarian torsion is often thought of as a disease process of reproductive-aged women; however, it is also seen in the extremes of age. In post-menopausal women, it can be both a challenge to diagnose and associated with increased morbidity. CASE REPORT: We present a case of a 68-year-old woman with sudden onset of lower abdominal pain 6 h before arrival at the emergency department (ED). She was diagnosed with ovarian torsion, secondary to an ovarian mass, and underwent a full malignancy evaluation...
February 18, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28238158/acute-kidney-injury-during-a-pediatric-sickle-cell-vaso-occlusive-pain-crisis
#6
Sujatha Baddam, Inmaculada Aban, Lee Hilliard, Thomas Howard, David Askenazi, Jeffrey D Lebensburger
BACKGROUND: Patients who develop sickle cell disease (SCD) nephropathy are at a high risk for mortality. The pathophysiology of vaso-occlusive pain crisis may contribute to acute kidney injury (AKI). Non-steroidal anti-inflammatory drugs, known inducers of AKI, are used to treat pain crises. Multiple gaps exist in the knowledge about the impact of AKI in SCD. METHODS: We conducted a 2-year retrospective review of AKI events in patients admitted for vaso-occlusive crisis...
February 25, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28237737/data-from-the-german-chest-pain-unit-registry-the-well-known-gap-between-knowledge-and-practice
#7
EDITORIAL
Daniel Fernández-Bergés
In-hospital mortality of acute myocardial infarction with ST segment elevation remains high and is influenced by many factors, some of which are modifiable such as time to treatment initiation and modality of treatment. It is well established that reperfusion therapy is the gold-standard in the management of ST-elevation acute myocardial infarction. Despite recent developments and clear, comprehensible guidelines recommendations, it remains difficult to disseminate this knowledge to medical practitioners. The German Chest Pain Unit shows that the best door-to-balloon time is reached when patients contact the Emergency Medical Systems (EMS) directly, rather than when referred by the general practitioner (GP), or are transferred from another hospital, or present as a self-referral...
February 13, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28237735/emergency-medical-dispatch-priority-in-chest-pain-patients-due-to-life-threatening-conditions-a-cohort-study-examining-circadian-variations-and-impact-of-the-education
#8
Araz Rawshani, Nina Rawshani, Carita Gelang, Jan-Otto Andersson, Anna Larsson, Angela Bång, Johan Herlitz, Martin Gellerstedt
BACKGROUND AND AIMS: We examined the accuracy in assessments of emergency dispatchers according to their education and time of the day. We examined this in chest pain patients who were diagnosed with a potentially life-threatening condition (LTC) or died within 30days. METHODS: Among 2205 persons, 482 died, 1631 experienced an acute coronary syndrome (ACS), 1914 had a LTC. Multivariable logistic regression was used to study how time of the call and the dispatcher's education were associated with the risk of missing to give priority 1 (the highest)...
February 16, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28237612/effects-of-chondroitin-sulfate-on-brain-response-to-painful-stimulation-in-knee-osteoarthritis-patients-a-randomized-double-blind-placebo-controlled-functional-magnetic-resonance-imaging-study
#9
Jordi Monfort, Jesús Pujol, Oren Contreras-Rodríguez, Jone Llorente-Onaindia, Marina López-Solà, Laura Blanco-Hinojo, Josep Vergés, Marta Herrero, Laura Sánchez, Hector Ortiz, Francisco Montañés, Joan Deus, Pere Benito
INTRODUCTION: Knee osteoarthritis is causing pain and functional disability. One of the inherent problems with efficacy assessment of pain medication was the lack of objective pain measurements, but functional magnetic resonance imaging (fMRI) has emerged as a useful means to objectify brain response to painful stimulation. We have investigated the effect of chondroitin sulfate (CS) on brain response to knee painful stimulation in patients with knee osteoarthritis using fMRI. METHODS: Twenty-two patients received CS (800mg/day) and 27 patients placebo, and were assessed at baseline and after 4 months of treatment...
February 22, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28237610/visceral-and-bone-metastases-of-a-who-grade-2-meningioma-a-case-report-and-review-of-the-literature
#10
A Paix, W Waissi, D Antoni, R Adeduntan, G Noël
Meningiomas represent the most common tumours of the central nervous system in adults. Risk factors include ionizing radiation, female hormones exposure, head trauma, cell phone use, breast cancer and family history of meningioma. Despite complete surgical resection, natural history of meningiomas often includes local recurrence but very few metastatic meningiomas have been reported. Here, we report the case of a metastatic meningioma. A 43-year-old woman was firstly treated for a symptomatic parietal meningioma WHO grade II by surgical resection followed by an irradiation of the surgical bed...
February 22, 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28237189/ct-for-acute-nontraumatic-abdominal-pain-is-oral-contrast-really-required
#11
Rivka Kessner, Sophie Barnes, Pinchas Halpern, Vadim Makrin, Arye Blachar
RATIONALE AND OBJECTIVES: This study aims to compare the diagnostic performance of abdominal computed tomography (CT) performed with and without oral contrast in patients presenting to the emergency department (ED) with acute nontraumatic abdominal pain. MATERIALS AND METHODS: Between December 2013 and December 2014, 348 adult patients presenting to the ED of a large tertiary medical center with nontraumatic abdominal pain were evaluated. Exclusion criteria for the study were history of inflammatory bowel disease, recent abdominal operation and suspected renal colic, abdominal aortic aneurysm rupture, or intestinal obstruction...
February 22, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28236543/diagnostic-and-prognostic-values-of-the-v-index-a-novel-ecg-marker-quantifying-spatial-heterogeneity-of-ventricular-repolarization-in-patients-with-symptoms-suggestive-of-non-st-elevation-myocardial-infarction
#12
Roger Abächerli, Raphael Twerenbold, Jasper Boeddinghaus, Thomas Nestelberger, Patrick Mächler, Roberto Sassi, Massimo W Rivolta, Ebadollah Kheirati Roonizi, Luca T Mainardi, Nikola Kozhuharov, Maria Rubini Giménez, Karin Wildi, Karin Grimm, Zaid Sabti, Petra Hillinger, Christian Puelacher, Ivo Strebel, Janosch Cupa, Patrick Badertscher, Isabelle Roux, Ramun Schmid, Remo Leber, Stefan Osswald, Christian Mueller, Tobias Reichlin
BACKGROUND: The V-index is an ECG marker quantifying spatial heterogeneity of ventricular repolarization. We prospectively assessed the diagnostic and prognostic values of the V-index in patients with suspected non-ST-elevation myocardial infarction (NSTEMI). METHODS: We prospectively enrolled 497 patients presenting with suspected NSTEMI to the emergency department (ED). Digital 12-lead ECGs of five-minute duration were recorded at presentation. The V-index was automatically calculated in a blinded fashion...
February 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28236513/remote-management-of-low-to-intermediate-risk-chest-pain-a-case-series
#13
Alexander Chiu, Kathleen Shumaker, Christopher Del Corral, Blessy George, Michael Kasper, Elie Marie-Carmelle, Preeti Jois, Daniel Dipsia, Adam Ash
We report a case series of three low to intermediate risk chest pain patients who presented to the emergency department and were managed as outpatients via the Cellular Outpatient Twelve-Lead Telemetry with Emergency Response (COTTER™). This technology allows for certain chest pain patients to be managed remotely via telemedicine while receiving care comparable to that which would be available in a hospital or chest pain observation unit.
February 16, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28235778/clinical-evoked-potentials-in-neurology-a-review-of-techniques-and-indications
#14
REVIEW
Agustina M Lascano, Patrice H Lalive, Martin Hardmeier, Peter Fuhr, Margitta Seeck
Evoked potentials (EPs) are a powerful and cost-effective tool for evaluating the integrity and function of the central nervous system. Although imaging techniques, such as MRI, have recently become increasingly important in the diagnosis of neurological diseases, over the past 30 years, many neurologists have continued to employ EPs in specific clinical applications. This review presents an overview of the recent evolution of 'classical' clinical applications of EPs in terms of early diagnosis and disease monitoring and is an extension of a previous review published in this journal in 2005 by Walsh and collaborators...
February 24, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28235600/descending-facilitatory-pain-pathways-mediate-ongoing-pain-and-tactile-hypersensitivity-in-a-rat-model-of-trigeminal-neuropathic-pain
#15
C F M Nones, R F Claudino, L E N Ferreira, R C Dos Reis, T King, J G Chichorro
The Chronic Constriction Injury of the Infraorbital Nerve (CCI-ION) is a well-established model to study facial sensory changes related to trigeminal neuropathic pain. CCI-ION induces heat hypersensitivity that resolves within 2-3 weeks and a delayed mechanical hypersensitivity that emerges during the second week post-injury. The role of descending facilitatory pain pathways from the rostro ventromedial medulla (RVM) in mediating the heat and tactile hypersensitivity was examined. CCI-ION induced heat hypersensitivity observed 5days post-surgery was reversed by systemic, but not RVM lidocaine...
February 21, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28235546/non-traumatic-rhabdomyolysis-background-laboratory-features-and-acute-clinical-management
#16
REVIEW
Gianfranco Cervellin, Ivan Comelli, Mario Benatti, Fabian Sanchis-Gomar, Antonella Bassi, Giuseppe Lippi
Rhabdomyolysis is a relatively rare condition, but its clinical consequences are frequently dramatic in terms of both morbidity and mortality. Although no consensus has been reached so far about the precise definition of this condition, the term rhabdomyolysis describes a rapid breakdown of striated, or skeletal, muscle. It is hence characterized by the rupture and necrosis of muscle fibers, resulting in release of cell degradation products and intracellular elements within the bloodstream and extracellular space...
February 21, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28235512/transient-global-amnesia-in-immediate-postoperative-period-a-diagnostic-dilemma
#17
Anudeep Jafra, Tanvir Samra, Vasudha Gupta, M Seran Kumar Reddy
INTRODUCTION: Transient Global Amnesia (TGA) is short-term inability to form new memories despite otherwise normal neurological function. There is associated anterograde and retrograde amnesia. The memory loss is often accompanied by repetitive questioning and temporal disorientation while higher cognitive functions are preserved. The symptoms usually resolve by 24h. CASE REPORT: We present an interesting case of 31year old female who was planned for robotically assisted right sided pyeloplasty...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28229983/establishment-and-application-of-early-risk-stratification-method-for-acute-abdominal-pain-in-adults
#18
Yu Wang, Hong Zhao, Zhen Zhou, Ci Tian, Hong-Li Xiao, Bao-En Wang
BACKGROUND: Acute abdominal pain is a common symptom of emergency patients. The severity was always evaluated based on physicians' clinical experience. The aim of this study was to establish an early risk stratification method (ERSM) for addressing adults with acute abdominal pain, which would guide physicians to take appropriate and timely measures following the established health-care policies. METHODS: In Cohort 1, the records of 490 patients with acute abdominal pain that developed within the past 72 h were enrolled in this study...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28228912/anatomical-variation-t1-spina-bifida-occulta-radiological-findings
#19
Guglielmo Manenti, Riccardo Iundusi, Eliseo Picchi, Salvatore Marsico, Adolfo D'Onofrio, Giorgia Rossi, Umberto Tarantino, Roberto Floris
We report a 26-year-old male patient who was admitted to our emergency department after a traffic accident and who suffered from neck pain. We have found accidentally a dorsal spinous process schisis, a very rare vertebral abnormality, that we recognized in the X-rays imaging performed for the study of the lung parenchyma.
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28228898/disseminated-coccidioidomycosis-with-multifocal-musculoskeletal-disease-involvement
#20
Michael F McConnell, Ann Shi, Todd M Lasco, Luke Yoon
We report a rare case of disseminated coccidioidomycosis with multifocal musculoskeletal involvement. The patient presented to the emergency department with left shoulder pain and swelling. Magnetic resonance imaging of the left shoulder revealed enhancing soft tissue masses, bony lesions, and fluid collections in and around the glenohumeral joint with involvement of the proximal humerus, glenoid, and rotator cuff musculature. Multiple additional areas of involvement were subsequently discovered. Fungal cultures confirmed coccidioidomycosis infection at all surgical sites with superimposed polymicrobial bacterial infection in the left shoulder...
March 2017: Radiology case reports
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