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Apparent life threatening illness

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https://www.readbyqxmd.com/read/29141761/leptospirosis-cases-infected-with-uncommon-serogroups-puerto-rico-2013-2015
#1
Hector Gorbea, Enid J Garcia-Rivera, Hilda Torres, Olga D Lorenzi, Aidsa Rivera, Renee L Galloway, Tyler M Sharp
Leptospirosis is an emerging bacterial zoonosis that is endemic but underrecognized throughout the tropics. Through prospective surveillance for acute febrile illness (AFI) among patients who presented to the emergency department of a hospital located in an urban region of Puerto Rico, four patients with laboratory-confirmed leptospirosis were identified. All patients had signs and symptoms of AFI, including fever, headache, and dehydration. Three patients had leukocytosis with thrombocytopenia and were admitted to the hospital...
November 6, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28945755/estimating-the-burden-of-scrub-typhus-a-systematic-review
#2
REVIEW
Ana Bonell, Yoel Lubell, Paul N Newton, John A Crump, Daniel H Paris
BACKGROUND: Scrub typhus is a vector-borne zoonotic disease that can be life-threatening. There are no licensed vaccines, or vector control efforts in place. Despite increasing awareness in endemic regions, the public health burden and global distribution of scrub typhus remains poorly known. METHODS: We systematically reviewed all literature from public health records, fever studies and reports available on the Ovid MEDLINE, Embase Classic + Embase and EconLit databases, to estimate the burden of scrub typhus since the year 2000...
September 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28928269/perturbed-cd8-t-cell-immunity-across-universal-influenza-epitopes-in-the-elderly
#3
Thi H O Nguyen, Sneha Sant, Nicola L Bird, Emma J Grant, E Bridie Clemens, Marios Koutsakos, Sophie A Valkenburg, Stephanie Gras, Martha Lappas, Anthony Jaworowski, Jane Crowe, Liyen Loh, Katherine Kedzierska
Influenza epidemics lead to severe illness, life-threatening complications, and deaths, especially in the elderly. As CD8(+) T cells are associated with rapid recovery from influenza, we investigated the effects of aging on antigen-specific CD8(+) T cells across the universal influenza epitopes in humans. We show that aging is characterized by altered frequencies in T cell subsets, with naive T cells being partially replaced by activated effector/memory populations. Although we observed no striking differences in TCR signaling capacity, T cells in the elderly had increased expression of transcription factors Eomes and T-bet, and such changes were most apparent in CD8(+) T cells...
September 19, 2017: Journal of Leukocyte Biology
https://www.readbyqxmd.com/read/28798922/practical-approach-to-the-patient-with-acute-neuromuscular-weakness
#4
REVIEW
Rajeev Nayak
Acute neuromuscular paralysis (ANMP) is a clinical syndrome characterized by rapid onset muscle weakness progressing to maximum severity within several days to weeks (less than 4 wk). Bulbar and respiratory muscle weakness may or may not be present. It is a common neurological emergency which requires immediate and careful investigations to determine the etiology because accurate diagnosis has significant impact on therapy and prognosis. Respiratory failure caused by neuromuscular weakness is considered as more critical than lung disease because its development may be insidious or subtle until sudden decompensation leads to life threatening hypoxia...
July 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28752002/changing-definitions-of-sepsis
#5
REVIEW
Fethi Gül, Mustafa Kemal Arslantaş, İsmail Cinel, Anand Kumar
Sepsis is one of the main causes of morbidity and mortality in critically ill patients despite the use of modern antibiotics and resuscitation therapies. Outcomes in sepsis have improved overall, probably because of an enhanced focus on early diagnosis and other improvements in supportive care, but mortality rates still remain unacceptably high. The diagnosis and definition of sepsis is a critical problem due to the heterogeneity of this disease process. Although it is apparent that much more needs to be done to advance our understanding, sepsis and related terms remain difficult to define...
June 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28589296/-neglected-lonely-and-sick-the-social-breakdown-a%C3%A2-special-patient-group-in-the-emergency-department
#6
I Gräff, R C Dolscheid-Pommerich, S Ghamari, T Baehner, H Goost
BACKGROUND: The emergency department (ED) is increasingly becoming the primary care unit of patients who are no longer able to meet the necessary minimum requirements for a healthy life. In the emergency medical care of these patients, fixation errors and stereotyped thinking can distract from serious illnesses, which can be tended by emergency medicine. This group of patients, with their multifactorial problems, represents a special challenge for the staff of the ED. The aim of this study is to improve the quality of the care for a special patient group...
June 6, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28447886/drug-induced-hyperlactatemia
#7
REVIEW
Eike Blohm, Jeffrey Lai, Mark Neavyn
BACKGROUND: Hyperlactatemia is common in critically ill patients and has a variety of etiologies. Medication toxicity remains an uncommon cause that providers often fail to recognize. In this article, we review several medications that cause hyperlactatemia in either therapeutic or supratherapeutic dosing. When known, the incidence, mortality, pathophysiology, and treatment options are discussed. METHODS: We performed a literature search using PUBMED and Google Scholar for English language articles published after 1980 regarding medication induced hyperlactatemia and its management...
September 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28302076/uropathogenic-escherichia-coli-pathogenicity-islands-and-other-expec-virulence-genes-may-contribute-to-the-genome-variability-of-enteroinvasive-e-coli
#8
Laís Cristina da Silva, Ana Carolina de Mello Santos, Rosa Maria Silva
BACKGROUND: Enteroinvasive Escherichia coli (EIEC) may be the causative agent of part of those million cases of diarrhea illness reported worldwide every year and attributable to Shigella. That is because both enteropathogens have many common characteristics that difficult their identification either by traditional microbiological methods or by molecular tools used in the clinical laboratory settings. While Shigella has been extensively studied, EIEC remains barely characterized at the molecular level...
March 16, 2017: BMC Microbiology
https://www.readbyqxmd.com/read/27726123/psychological-therapies-for-children-and-adolescents-exposed-to-trauma
#9
REVIEW
Donna Gillies, Licia Maiocchi, Abhishta P Bhandari, Fiona Taylor, Carl Gray, Louise O'Brien
BACKGROUND: Children and adolescents who have experienced trauma are at high risk of developing post-traumatic stress disorder (PTSD) and other negative emotional, behavioural and mental health outcomes, all of which are associated with high personal and health costs. A wide range of psychological treatments are used to prevent negative outcomes associated with trauma in children and adolescents. OBJECTIVES: To assess the effects of psychological therapies in preventing PTSD and associated negative emotional, behavioural and mental health outcomes in children and adolescents who have undergone a traumatic event...
October 11, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26652074/acute-kidney-injury-recognition-and-management-a-review-of-the-literature-and-current-evidence
#10
REVIEW
Syed Raza Shah, Sameer Altaf Tunio, Mohammad Hussham Arshad, Zorays Moazzam, Komal Noorani, Anushe Mohsin Feroze, Maham Shafquat, Huma Syed Hussain, Syed Ali Hyder Jeoffrey
Acute renal failure is defined as a rapid decrease in the glomerular filtration rate, occurring over a period of hours to days and by the inability of the kidney to regulate fluid and electrolyte homeostasis appropriately. AKI is a catastrophic, life-threatening event in critically ill patients. AKI can be divided into pre-renal injury, intrinsic kidney disease (including vascular insults) and obstructive uropathies. The prognosis of AKI is highly dependent on the underlying cause of the injury. Children who have AKI as a component of multisystem failure have a much higher mortality rate than children with intrinsic renal disease...
September 18, 2015: Global Journal of Health Science
https://www.readbyqxmd.com/read/26608710/neurological-manifestations-of-medical-child-abuse
#11
REVIEW
Katharine Doughty, Corey Rood, Anup Patel, Jonathan D Thackeray, Farah W Brink
BACKGROUND: Medical child abuse occurs when a child receives unnecessary and harmful, or potentially harmful, medical care at the instigation of a caretaker through exaggeration, falsification, or induction of symptoms of illness in a child. Neurological manifestations are common with this type of maltreatment. OBJECTIVES: We sought to review common reported neurological manifestations that may alert the clinician to consider medical child abuse. In addition, the possible sequelae of this form of child maltreatment is discussed, as well as practice recommendations for establishing the diagnosis and stopping the abuse once it is identified...
January 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/26512363/infantile-apparent-life-threatening-events-an-educational-review
#12
REVIEW
Hamed Aminiahidashti
Many physicians have received a frantic call from anxious parents stating that their child had stopped breathing, become limp, or turned blue but then had recovered quickly. An apparent life-threatening event (ALTE) is defined as "an episode that is frightening to the observer, and is characterized by some combination of apnea, color change, marked change in muscle tone, choking, gagging, or coughing". The incidence of ALTE is reported to be 0.05% to 6%. The knowledge about the most common causes and factors associated with higher risk of ALTE could be resulted in a more purposeful approach, improving the decision making process, and benefiting both children and parents...
2015: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/26360420/beyond-critical-congenital-heart-disease-newborn-screening-using-pulse-oximetry-for-neonatal-sepsis-and-respiratory-diseases-in-a-middle-income-country
#13
Vida Jawin, Hak-Lee Ang, Asma Omar, Meow-Keong Thong
BACKGROUND: Studies on pulse oximetry screening for neonatal sepsis and respiratory disease in a middle-income country are lacking. Newborn screening for critical congenital heart disease (CCHD) using pulse oximetry is an effective and life-saving strategy in developed countries. While most studies have reported false-positive results during CCHD screening, they have not elaborated on the detected disease types. We studied the effectiveness and outcomes of pulse oximetry newborn screening for non-cardiac hypoxemic diseases such as neonatal sepsis, respiratory diseases, and CCHD in a middle-income country...
2015: PloS One
https://www.readbyqxmd.com/read/25861492/giant-thyroid-abscess-related-to-postpartum-brucella-infection
#14
Zülküf Akdemir, Erbil Karaman, Hüseyin Akdeniz, Cem Alptekin, Harun Arslan
Thyroid gland infection, although rare, may be a life threatening disease. Thyroid abscess, arising from acute suppurative thyroiditis (AST), is a rare clinic condition depending on widespread use of antibiotics. Infection may involve one or both lobes and abscess formation may not be apparent until late stage of the progress of illness. Thyroid left lobe is more often affected than the right one. Brucellosis, especially obvious in endemic areas, is a widely seen zoonosis around the world. Although brucella infection can affect many organs through various complications, thyroid gland infection is rare...
2015: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/25355482/extracorporeal-treatment-for-carbamazepine-poisoning-systematic-review-and-recommendations-from-the-extrip-workgroup
#15
REVIEW
Marc Ghannoum, Christopher Yates, Tais F Galvao, Kevin M Sowinski, Thi Hai Vân Vo, Andrew Coogan, Sophie Gosselin, Valery Lavergne, Thomas D Nolin, Robert S Hoffman
CONTEXT: The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup was created to provide evidence and consensus-based recommendations on the use of extracorporeal treatments (ECTRs) in poisoning. OBJECTIVES: To perform a systematic review and provide clinical recommendations for ECTR in carbamazepine poisoning. METHODS: After a systematic literature search, the subgroup extracted the data and summarized the findings following a pre-determined format...
December 2014: Clinical Toxicology
https://www.readbyqxmd.com/read/25029383/seriously-ill-patients-as-living-unspecified-kidney-donors-rationale-and-justification
#16
Yannick S Rakké, Willij C Zuidema, Medard T Hilhorst, Ruud A M Erdman, Emma K Massey, Michiel G H Betjes, Frank J M F Dor, Jan N M IJzermans, Willem Weimar
BACKGROUND: Between 2000 and December 2013, 106 live donor nephrectomies from anonymous living-donors were performed at the Erasmus MC Rotterdam; five of the donors (5.4%) had a life-threatening disease. The aim of the present report is to give the rational and justification for this procedure. METHODS: All five donors underwent the national standard living-donor screening procedure. Additionally, motivation to donate and psychologic stability were assessed by a psychologist using in-depth interview techniques and a psychologic complaints questionnaire...
January 2015: Transplantation
https://www.readbyqxmd.com/read/24936108/pharmacokinetic-properties-and-tolerability-of-single-dose-terbutaline-in-patients-with-severe-asthma-treated-in-the-pediatric-intensive-care-unit
#17
Daniel J Lebovitz, Paul G Smith, MaryAnn O'Riordan, Michael D Reed
BACKGROUND: Asthmatic children requiring treatment in the pediatric intensive care unit (PICU) receive aggressive drug therapy that may include IV administration of β 2-receptor agonists to prevent progression to life-threatening respiratory failure. The only pharmacologic agent in this class currently available for parenteral use in the United States is terbutaline. Study of IV dosing of terbutaline in the pediatric population has been limited. OBJECTIVE: The aim of this study was to determine the pharmacokinetic (PK) properties and tolerability of single-dose terbutaline in pediatric patients across a broad age range who were admitted to the PICU and were receiving maximal conventional asthma drug therapy...
January 2004: Current Therapeutic Research, Clinical and Experimental
https://www.readbyqxmd.com/read/24834606/apparent-life-threatening-events-in-children-practical-evaluation-and-management
#18
REVIEW
Mia Sarohia, Shari Platt
Apparent life-threatening events account for 0.6% to 0.8% of all emergency department visits for children aged < 1 year. Risk factors for serious underlying pathology in a well-appearing infant have been identified as prematurity, underlying medical conditions, age < 60 days (considered controversial), suspicion of child abuse, possible seizure activity, and recurrent apparent life-threatening events. A detailed history and physical examination is crucial for the management of these patients. Targeted testing is warranted, as there is little evidence to support routine testing...
April 2014: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/24681180/respiratory-events-in-infants-presenting-with-apparent-life-threatening-events-is-there-an-explanation-from-esophageal-motility
#19
Kathryn A Hasenstab, Sudarshan R Jadcherla
OBJECTIVE: To test the hypothesis that proximal aerodigestive clearance mechanisms mediated by pharyngoesophageal motility during spontaneous respiratory events (SREs) are distinct in infants with apparent life threatening events (ALTEs). STUDY DESIGN: Twenty infants (10 with proven ALTE, 10 healthy controls) had pharyngoesophageal manometry to investigate motility changes concurrent with respiratory events detected by respiratory inductance plethysmography and nasal thermistor methods...
August 2014: Journal of Pediatrics
https://www.readbyqxmd.com/read/24651217/prevalence-of-electrocardiogram-use-in-infants-with-apparent-life-threatening-events-a-multicenter-database-study
#20
MULTICENTER STUDY
Matthew D Elias, V Ramesh Iyer, Meryl S Cohen
OBJECTIVE: An apparent life-threatening event (ALTE) is a common diagnosis in pediatrics, but there is no standardized method to evaluate these patients. We sought to determine the prevalence of electrocardiogram (ECG) use in patients presenting to children's hospitals with an ALTE. METHODS: The data from the Pediatric Health Information System database from 43 children's hospitals were collected during a 15-month period between October 2009 and December 2010. Patients were included if they were younger than 1 year at the time of presentation...
April 2014: Pediatric Emergency Care
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