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Apparent life threatening illness

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
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...
April 27, 2017: Clinical Toxicology
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
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
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
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
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)
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
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
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
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
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
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
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
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
Archwin Tanphaichitr, Pattraporn Tanphaichitr, Polporn Apiwattanasawee, Justin Brockbank, Michael J Rutter, Narong Simakajornboon
OBJECTIVE: To identify the prevalence of and risk factors for central sleep apnea (CSA) in infants who are diagnosed with laryngomalacia. STUDY DESIGN: Case series with chart review. SETTING: Quaternary care pediatric hospital. SUBJECTS AND METHODS: We performed a chart review in infants with laryngomalacia. All infants had diagnostic polysomnography (PSG) performed from 2003 to 2012. Infants who underwent supraglottoplasty or other upper airway surgery prior to PSG were excluded...
April 2014: Otolaryngology—Head and Neck Surgery
Devkumar Mustafi, Sheng-Ru Shiou, Xiaobing Fan, Erica Markiewicz, Gregory S Karczmar, Erika C Claud
Neonatal necrotizing enterocolitis (NEC) is a poorly understood life-threatening illness afflicting premature infants. Research is hampered by the absence of a suitable method to monitor disease progression noninvasively. The primary goal of this research was to test in vivo MRI methods for the noninvasive early detection and staging of inflammation in the ileum of an infant rat model of NEC. Neonatal rats were delivered by cesarean section at embryonic stage of day 20 after the beginning of pregnancy and stressed with formula feeding, hypoxia and bacterial colonization to induce NEC...
March 2014: NMR in Biomedicine
Nithin Karakala, Karthik Raghunathan, Andrew D Shaw
PURPOSE OF REVIEW: Septic shock is one of the most common and life-threatening conditions afflicting critically ill patients. Intravenous volume resuscitation is considered an initial and very important step in management. The most suitable fluid for volume expansion during septic shock remains unclear. In this review, we focus on the benefits and adverse effects of the most commonly used intravenous fluids in critically ill septic patients. RECENT FINDINGS: The debate about the benefits of colloids over crystalloids has been ongoing for the last few decades...
December 2013: Current Opinion in Critical Care
N Marin, E Valverde, F Cabañas
'Skin-to-skin' in healthy newborn infants is currently routine practice in Spanish maternity wards. This practice has shown benefits in increasing the duration of breast-feeding and maternal bonding behaviour with no significant adverse events. Early sudden deaths and severe apparent life-threatening events (ALTE) during the first 24 hours of life are infrequent, but well recognised. Risk factors during 'skin to skin' have been established. These events can lead to high neonatal morbidity and mortality. Hypothermia is now the standard of care for moderate to severe hypoxic-ischaemic encephalopathy and has shown to reduce mortality and neurological morbidity in children with hypoxic-ischaemic brain injury...
October 2013: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Kathryn B Metcalf, Andrew J Michaels, Richard F Edlich, William B Long
BACKGROUND: Sand aspiration occurs in situations of cave-in burial and near-drowning. Sand in the tracheobronchial airways adheres to the mucosa and can cause tracheal and bronchial obstruction, which can be life-threatening even with intensive management. In previous case reports of airway obstruction caused by sand aspiration, fiber optic or rigid bronchoscopy has been effective in removing loose sand, but removal of sand particles lodged in smaller airways has proven challenging and time-consuming...
September 2013: Journal of Emergency Medicine
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