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https://www.readbyqxmd.com/read/28549024/the-epidemiology-of-hospital-death-following-pediatric-severe-sepsis-when-why-and-how-children-with-sepsis-die
#1
Scott L Weiss, Fran Balamuth, Josey Hensley, Julie C Fitzgerald, Jenny Bush, Vinay M Nadkarni, Neal J Thomas, Mark Hall, Jennifer Muszynski
OBJECTIVE: The epidemiology of in-hospital death after pediatric sepsis has not been well characterized. We investigated the timing, cause, mode, and attribution of death in children with severe sepsis, hypothesizing that refractory shock leading to early death is rare in the current era. DESIGN: Retrospective observational study. SETTING: Emergency departments and ICUs at two academic children's hospitals. PATIENTS: Seventy-nine patients less than 18 years old treated for severe sepsis/septic shock in 2012-2013 who died prior to hospital discharge...
May 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28542914/efficacy-and-adverse-events-of-oral-isotretinoin-for-acne-a-systematic-review
#2
REVIEW
I A Vallerand, R T Lewinson, M S Farris, C D Sibley, M L Ramien, A G M Bulloch, S B Patten
Despite many years of clinical use of isotretinoin, a comprehensive review of evidence for isotretinoin therapy in acne patients is lacking. We searched MEDLINE, EMBASE, Cochrane Central, relevant webpages and bibliographies for randomized controlled trials for acne evaluating isotretinoin vs control (placebo or other therapy). Data were extracted and summarized descriptively. Eleven trials were identified (total n=760 patients randomized), containing mostly males. Mean treatment ages ranged from 18 to 47.9 years and participants generally had moderate-severe acne...
May 19, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28538134/trial-of-cannabidiol-for-drug-resistant-seizures-in-the-dravet-syndrome
#3
Orrin Devinsky, J Helen Cross, Linda Laux, Eric Marsh, Ian Miller, Rima Nabbout, Ingrid E Scheffer, Elizabeth A Thiele, Stephen Wright
BACKGROUND: The Dravet syndrome is a complex childhood epilepsy disorder that is associated with drug-resistant seizures and a high mortality rate. We studied cannabidiol for the treatment of drug-resistant seizures in the Dravet syndrome. METHODS: In this double-blind, placebo-controlled trial, we randomly assigned 120 children and young adults with the Dravet syndrome and drug-resistant seizures to receive either cannabidiol oral solution at a dose of 20 mg per kilogram of body weight per day or placebo, in addition to standard antiepileptic treatment...
May 25, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28538105/linezolid-induced-lactic-acidosis-the-thin-line-between-bacterial-and-mitochondrial-ribosomes
#4
Alessandro Santini, Dario Ronchi, Manuela Garbellini, Daniela Piga, Alessandro Protti
Introduction - Linezolid inhibits bacterial growth by targeting bacterial ribosomes and by interfering with bacterial protein synthesis. Lactic acidosis is a rare, but potentially lethal, side effect of linezolid. Areas covered - The pathogenesis of linezolid-induced lactic acidosis is reviewed with special emphasis on aspects relevant to the recognition, prevention and treatment of the syndrome. Expert opinion - Linezolid-induced lactic acidosis reflects the untoward interaction between the drug and mitochondrial ribosomes...
May 24, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28526391/withdrawal-from-high-carbohydrate-high-saturated-fat-diet-changes-saturated-fat-distribution-and-improves-hepatic-low-density-lipoprotein-receptor-expression-to-ameliorate-metabolic-syndrome-in-rats
#5
Ankita Hazarika, Himadri Kalita, Mohan Chandra Kalita, Rajlakshmi Devi
OBJECTIVE: The "lipid hypothesis" determined that saturated fatty acid (SFA) raises low-density lipoprotein cholesterol, thereby increasing the risk for metabolic syndrome (MetS). The aim of this study was to investigate the effect of subchronic withdrawal from a high-carbohydrate, high-saturated fat (HCHF) diet during MetS with reference to changes in deleterious SFA (C12:0, lauric acid; C14:0, myristic acid; C16:0, palmitic acid; C18:0, stearic acid) distribution in liver, white adipose tissue (WAT), and feces...
June 2017: Nutrition
https://www.readbyqxmd.com/read/28519244/neonatal-abstinence-syndrome-update-on-diagnostic-and-therapeutic-strategies
#6
Genny Raffaeli, Giacomo Cavallaro, K Karel Allegaert, Enno Diederik Wildschut, Monica Fumagalli, Massimo Agosti, Dick Tibboel, Fabio Mosca
Substance use among pregnant women is a major public health issue. Both prescription opioid use and illicit opioid abuse have increased dramatically in recent years. Prolonged in utero drug exposure may result in neonatal abstinence syndrome (NAS), an acute multisystemic clinical entity that occurs in the first days of life. This syndrome is caused by abrupt discontinuation of fetal exposure to licit or illicit drugs chronically consumed by the mother during pregnancy and transmitted to the fetus through the placenta...
May 18, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28512418/cushing-s-syndrome-cortisol-and-cognitive-competency-a-case-report
#7
Neil Oronsky, Bennett Thilagar, Carolyn M Ray, Scott Caroen, Michelle M C Lybeck, Lindsey Ferry, Ronald A Voves, Bryan Oronsky
Glucocorticoids are associated with immunosuppression and neuropsychiatric complications. We describe the case of a carcinoid patient with Cushing's syndrome (CS) and neurocognitive impairment due to ectopic ACTH production who developed sepsis and died because of his family's decision to withdraw antibiotic treatment. This report is presented to illustrate the importance of advanced-care planning in patients with CS.
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28509748/iatrogenic-withdrawal-syndrome-or-undiagnosed-delirium
#8
Chani Traube, Gabrielle Silver
No abstract text is available yet for this article.
June 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28508412/nicotine-withdrawal-syndrome-in-a-newborn-baby-after-maternal-use-of-oral-applied-moist-tobacco-snus-should-result-in-greater-awareness-to-the-use-of-snus-among-pregnant-women
#9
Dag Helge Frøisland
The harm that smoking causes the fetus are well known. Smoking by young men and women in Scandinavia has steadily declined in the last few decades and the use of snus - moist tobacco that is placed in the mouth - has increased. This patient history highlights the effects of using snus during pregnancy This article is protected by copyright. All rights reserved.
May 16, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28506439/clinical-review-loperamide-toxicity
#10
REVIEW
Peter E Wu, David N Juurlink
Loperamide is a nonprescription opioid widely used for the treatment of diarrhea. Although it is relatively safe at therapeutic doses, increasing reports describe its misuse and abuse at very high doses either for euphoric effects or to attenuate symptoms of opioid withdrawal. Life-threatening loperamide toxicity can result from the relatively new clinical syndrome of loperamide-induced cardiac toxicity. These patients are often young and may present in cardiac arrest or with unheralded, recurrent syncope in conjunction with ECG abnormalities, including marked QT-interval prolongation, QRS-interval widening, and ventricular dysrhythmias...
May 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28500629/early-prediction-tool-to-identify-the-need-for-pharmacotherapy-in-infants-at-risk-of-neonatal-abstinence-syndrome
#11
Barbara T Isemann, Elaina C Stoeckle, Afshin A Taleghani, Eric W Mueller
OBJECTIVE: To develop a tool to predict the need for pharmacologic treatment of neonatal abstinence syndrome (NAS) within 36 hours from birth in infants at risk for opioid withdrawal. STUDY DESIGN: Retrospective study of infants born at 34 weeks or later gestation with in utero exposure to opioids during two time periods from January 2013 through October 2016. Period 1 was used to develop a predictive tool for validation during Period 2. Birth weight, gestational age, four categories of opioid exposure, and individual scores for 21 withdrawal symptoms from the Modified Finnegan Score at 36 hours of life were recorded...
May 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28498560/deletion-of-%C3%AE-5-nicotine-receptor-subunits-abolishes-nicotinic-aversive-motivational-effects-in-a-manner-that-phenocopies-dopamine-receptor-antagonism
#12
Taryn E Grieder, Olivier George, Mandy Yee, Michael A Bergamini, Michal Chwalek, Geith Maal-Bared, Hector Vargas-Perez, Derek van der Kooy
Nicotine addiction is a worldwide epidemic that claims millions of lives each year. Genetic deletion of α5 nicotinic acetylcholine receptor (nAChR) subunits has been associated with increased nicotine intake, however, it remains unclear whether acute nicotine is less aversive or more rewarding, and whether mice lacking the α5 nAChR subunit can experience withdrawal from chronic nicotine. We used place conditioning and conditioned taste avoidance paradigms to examine the effect of α5 subunit-containing nAChR deletion (α5 -/-) on conditioned approach and avoidance behaviour in nondependent and nicotine-dependent and -withdrawn mice, and compared these motivational effects with those elicited after dopamine receptor antagonism...
May 12, 2017: European Journal of Neuroscience
https://www.readbyqxmd.com/read/28494557/-clinicopathologic-features-of-drug-induced-vanishing-bile-duct-syndrome
#13
L H Ye, C K Wang, H C Zhang, Z Q Liu, H W Zheng
Vanishing bile duct syndrome (VBDS) manifests as progressive destruction and disappearance of the intrahepatic bile duct caused by various factors and cholestasis. VBDS associated with drug-induced liver injury (D-VBDS) is an important etiology of VBDS, and immune disorder or immune imbalance may be the main pathogenesis. According to its clinical symptoms, serological markers, and course of the disease, D-VBDS is classified into major form and minor form, and its clinical features are based on various pathomorphological findings...
April 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28494389/breastfeeding-support-and-opiate-dependence-a-think-aloud-study
#14
Sonya MacVicar, Tracy Humphrey, Katrina E Forbes-McKay
OBJECTIVE: international guidelines recommend the promotion and protection of breastfeeding for the substance exposed mother and baby. Yet few studies have explored the facilitators, moderators and barriers to successful breastfeeding for women enrolled on opiate maintenance treatment, or suggested targeted support strategies. The aim of this study was to explore the views of women with opiate dependence on proposed elements for inclusion in a breastfeeding support intervention. DESIGN: a qualitative study using think aloud technique...
April 27, 2017: Midwifery
https://www.readbyqxmd.com/read/28492457/the-role-of-amantadine-withdrawal-in-3-cases-of-treatment-refractory-altered-mental-status
#15
Leah D Fryml, Kristen R Williams, Christopher G Pelic, James Fox, Gregory Sahlem, Sophie Robert, Gonzalo J Revuelta, Edward Baron Short
Amantadine, which was originally developed as an antiviral medication, functions as a dopamine agonist in the central nervous system and consequently is utilized in the treatment of Parkinson disease, drug-induced extrapyramidal reactions, and neuroleptic malignant syndrome. For reasons that are not entirely understood, abrupt changes in amantadine dosage can produce a severe withdrawal syndrome. Existing medical literature describes case reports of amantadine withdrawal leading to delirium, which at times has progressed to neuroleptic malignant syndrome...
May 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28491853/infection-associated-acute-interstitial-nephritis-a-case-report
#16
Rupesh Raina, Shirisha Ale, Tushar Chaturvedi, Luke Fraley, Robert Novak, Natthavat Tanphaichitr
BACKGROUND: Acute interstitial nephritis (AIN) is a clinico-pathological syndrome associated with a variety of infections, drugs, and sometimes with unknown causes. It is a common cause of acute kidney injury (AKI) and subsequent renal impairment, which often times is under-diagnosed. Infection-associated AIN occurs as a consequence of many systemic bacterial, viral, and parasitic infec-tions; however, its incidence has decreased significantly after the advent of antimicrobials. Infection-associated AIN presents with both oliguric or non-oliguric renal insufficiency, without the classical clinical triad of AIN (fever, rash, and arthralgia)...
March 2017: Journal of Nephropathology
https://www.readbyqxmd.com/read/28490916/the-cannabis-withdrawal-syndrome-current-insights
#17
REVIEW
Udo Bonnet, Ulrich W Preuss
The cannabis withdrawal syndrome (CWS) is a criterion of cannabis use disorders (CUDs) (Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition) and cannabis dependence (International Classification of Diseases [ICD]-10). Several lines of evidence from animal and human studies indicate that cessation from long-term and regular cannabis use precipitates a specific withdrawal syndrome with mainly mood and behavioral symptoms of light to moderate intensity, which can usually be treated in an outpatient setting...
2017: Substance Abuse and Rehabilitation
https://www.readbyqxmd.com/read/28489144/modified-simple-decompression-in-the-treatment-of-cubital-tunnel-syndrome-avoiding-ulnar-nerve-subluxation
#18
Marcus André Acioly, Amanda Mendes Soares, Mariana Lopes de Almeida, Renata Barbosa, Egon Daxbacher, Carlos Henrique Carvalho
Objective: In this study, we propose a modification to the simple decompression technique that contains the ulnar nerve in the cubital fossa, thus preventing subluxation during forearm flexion movements. Methods: Five consecutive patients with leprosy-associated cubital tunnel syndrome underwent surgery with the modified technique between July 2011 and October 2012. Results: The most common symptoms were neuropathic pain and sensory changes (both 60%)...
April 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28486709/anhedonia-its-dynamic-relations-with-craving-negative-affect-and-treatment-during-a-quit-smoking-attempt
#19
Jessica W Cook, Stephanie T Lanza, Wanghuan Chu, Timothy B Baker, Megan E Piper
Introduction: Research shows that abstinence from tobacco leads to a withdrawal-related decrement in responsivity to nondrug rewards (ie, anhedonia). However, it remains unclear how anhedonia relates to other key withdrawal symptoms and withdrawal-related constructs over time. We analyzed ecological momentary assessment data to examine whether a decrement in response to rewards during a 10-day period following quitting shows a pattern of associations with other variables (ie, treatment, tobacco dependence, negative affect, and craving) that is consistent with anhedonia being a tobacco withdrawal symptom...
June 1, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28484392/-late-withdrawal-syndrome-after-carbamazepine-in-utero-exposure-in-a-cyp2c9-slow-metabolizer-newborn
#20
Evangelia Passia, Nathalie Rock, Riccardo E Pfister, Kuntheavy R Ing Lorenzini, Jules Desmeules, Caroline F Samer
We report a case of carbamazepine withdrawal syndrome following in utero exposure to carbamazepine related to a pharmacogenetic predisposition factor. The infant was born at 37 1/7 weeks' gestation by cesarean section to a mother treated for epilepsy with carbamazepine. One hour and thirty minutes after birth, the infant presented a respiratory distress with severe oxygen desaturation requiring intubation 5 h after birth. On the third day of life the infant developed clinical signs of a withdrawal syndrome which resolved progressively after 16 days and symptomatic treatment...
2017: Frontiers in Pharmacology
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