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https://www.readbyqxmd.com/read/29327522/clinical-profile-and-outcome-of-pregnant-patients-with-acute-hev-hepatitis-during-water-borne-epidemic-in-himachal-pradesh-a-hospital-based-study
#1
Asha Ranjan, Surinder Thakur, Jatinder Mokta, Rajesh Bhawani, Varsha Ranjan
Background: Recent outbreak of HEV hepatitis epidemic in Himachal Pradesh in Shimla caused significant morbidity and mortality especially among pregnant patients. Overall mortality is 0.5- 4% in patients developing acute hepatic failure (ALF) and is significantly higher in pregnant patients (20%). Present study conducted to observe clinical profile and outcome in pregnant patients. Methodology: this is a retrospective observational study done on admitted pregnant and post partum patients with acute HEV hepatitis during 3 months periods...
December 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29326859/severe-hyponatremia-presenting-with-minimal-symptoms
#2
Anita Lwanga, Amira Mohamed, Mayank Patel, Andres Serrano
Hyponatremia is a common electrolyte abnormality, however, encountering a patient with serum sodium level below 100 mEq/L and minimal symptoms is unusual. We present the case of an 86-year-old woman who was found to have serum sodium levels of 99 mEq/L. Her only complaint was difficulty in walking. On admission, and throughout her hospital stay, she did not have altered mental status, focal neurological deficits, or adverse outcomes. Her history, blood work, and urine studies pointed towards a diagnosis of thiazide-associated hyponatremia...
November 8, 2017: Curēus
https://www.readbyqxmd.com/read/29324911/psychological-consideration-in-patients-with-cerebral-gliomas-candidates-for-intra-operative-radiation-therapy-based-on-tumor-location
#3
Tohid Emami Meybodi, Masoumeh Najafi, Ali Keipourfard, Amir Nikouei, Afsoun Seddighi
OBJECTIVE: Intra-operative Radiation Therapy (IORT) is gaining popularity as an adjuvant option to surgical resection, in treatment of glioblastoma multiforme (GBM) for increasing survival rate, which a highly aggressive cerebral tumor with poor prognosis. Τhe authors plan to investigate the effects of IORT combined with surgical resection on the psychological status of these patients based on tumor location. SUBJECT AND METHODS: From December 2013 to February 2017, we have enrolled 109 patients with high grade cerebral gliomas, documented by Magnetic Resonance Spectroscopy (MRS)...
September 2017: Hellenic Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/29311436/legionnaires-disease-as-an-occupational-risk-related-to-decontamination-work-after-the-fukushima-nuclear-disaster-a-case-report
#4
Toyoaki Sawano, Masaharu Tsubokura, Akihiko Ozaki, Claire Leppold, Shigeaki Kato, Toshiyuki Kambe
OBJECTIVES: Legionnaires' disease (LD), which is atypical pneumonia with a broad variety of clinical symptoms, can lead to death despite its low incidence. There are multiple risk factors for LD, yet little information is available concerning what kind of environmental factors are linked to higher risk of LD development. We have experienced a fatal case of LD, which occurred in a decontamination worker after the Fukushima nuclear disaster. CASE: A 53-year-old Japanese male visited our hospital with symptoms of fever, vomiting, diarrhea, and altered mental status, but not with respiratory manifestations...
December 28, 2017: Journal of Occupational Health
https://www.readbyqxmd.com/read/29302151/cryptococcal-meningitis-masquerading-as-normal-pressure-hydrocephalus-in-an-immune-competent-adult
#5
Hitesh Raheja, Ankur Sinha, Pavan Kumar Irukulla, Yizhak Kupfer
We report a case of acute cryptococcal meningitis (CM) masquerading as normal pressure hydrocephalus (NPH) in an immune-competent female. An 85-year-old human immunodeficiency virus-negative female presented to the emergency room for altered mental status and difficulty walking. She was increasingly lethargic, with urinary incontinence and gait instability. A previous computed tomography was reported to have ventricular dilatation out of proportion to the degree of cortical atrophy. Magnetic resonance scan of the brain revealed ventricular dilatation and subtle debris layering the occipital horns of the lateral ventricles...
October 2017: Journal of Global Infectious Diseases
https://www.readbyqxmd.com/read/29298795/cardiac-tamponade-causing-severe-reversible-hyponatraemia
#6
Tarun Dalia, Reza Masoomi, Kamal Kant Sahu, Kamal Gupta
Severe hyponatraemia in setting of cardiac tamponade is very rare and only few case reports have been reported so far. This case report highlights pericardial tamponade as a rare but easily treatable cause of severe hyponatraemia. Pertinent literature is also reviewed. A 70-year-old woman presented to the emergency department with altered mental status. She was tachycardic and hypotensive with cardiomegaly on a chest X-ray. Serum sodium was severely low at 109 mmol/L and was identified as the likely cause for her abnormal mentation...
January 3, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29298243/adolescent-coping-strategies-in-the-emergency-department
#7
Allison Cheng, Rita Manfredi, Gia Badolato, Monika Goyal
OBJECTIVES: The objective of this study was to describe coping mechanisms used by adolescents during emergency treatment. METHODS: A convenience sample of adolescent patients (aged 12-18 years) was surveyed in our large (87,000 annual visits) urban academic pediatric emergency department (ED) with an adapted Adolescent Coping Orientation for Problem Experiences survey. Parents were surveyed about their perceptions of their child's coping mechanisms. Participants were excluded if they were non-English speaking, in police custody, had altered mental status, or were hemodynamically unstable...
January 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29297739/measuring-a-crisis-questioning-the-use-of-naloxone-administrations-as-a-marker-for-opioid-overdoses-in-a-large-u-s-ems-system
#8
Joseph M Grover, Taibah Alabdrabalnabi, Mehul D Patel, Michael W Bachman, Timothy F Platts-Mills, Jose G Cabanas, Jefferson G Williams
OBJECTIVE: The United States is currently experiencing a public health crisis of opioid overdoses. To determine where resources may be most needed, many public health officials utilize naloxone administration by EMS as an easily-measured surrogate marker for opioid overdoses in a community. Our objective was to evaluate whether naloxone administration by EMS accurately represents EMS calls for opioid overdose. We hypothesize that naloxone administration underestimates opioid overdose...
January 3, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29284225/correlation-between-the-single-high-dose-of-ingested-baclofen-and-clinical-symptoms
#9
Jacek Sein Anand, Maciej Zając, Wojciech Waldman, Andrzej Wojtyła, Przemysław Biliński, Barbara Jaworska-Łuczak
INTRODUCTION AND OBJECTIVES: Baclofen is a drug used mainly to treat muscle spasticity. Its overdose can lead to life-threatening clinical symptoms, including acute respiratory failure requiring mechanical ventilation. The aim of this study was to assess the prevalence of selected clinical symptoms associated with baclofen poisoning comparing to an ingested dose. MATERIAL AND METHODS: 60 cases of oral baclofen poisoning were analyzed. Gender, age distribution, and correlation between the dose of ingested baclofen were studied, as well as and following clinical parameters: degree of altered consciousness, heart rate, blood pressure, presence of acute respiratory failure, duration of mechanical ventilation, and presence of psychotic symptoms...
December 23, 2017: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/29282389/listeria-monocytogenes-brain-abscess-in-crohn-s-disease-treated-with-adalimumab
#10
Amporn Atsawarungruangkit, Fernando Dominguez, Gustavo Borda, Nikolaos Mavrogiorgos
Listeria monocytogenes is a gram-positive bacterium that causes listeriosis. Brain abscess is a very uncommon manifestation of listeriosis and has not been reported to be associated with adalimumab (humira), one of the approved medications for treating Crohn's disease. A 45-year-old female with Crohn's disease presented with sudden onset of fever, headache, nausea, vomiting, and altered mental status for 1 day. She was on prednisone and 6-mercaptopurine. She had started taking adalimumab 17 days prior to admission...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29279777/ornithine-transcarbamylase-deficiency-if-at-first-you-do-not-diagnose-try-and-try-again
#11
Christan D Santos, Robert A Ratzlaff, Jennifer C Meder, Paldeep S Atwal, Nicole E Joyce
Ornithine transcarbamylase (OTC) deficiency is well known for its diagnosis in the neonatal period. Presentation often occurs after protein feeding and manifests as poor oral intake, vomiting, lethargy progressing to seizure, respiratory difficulty, and eventually coma. Presentation at adulthood is rare (and likely underdiagnosed); however, OTC deficiency can be life-threatening and requires prompt investigation and treatment. Reports and guidelines are scarce due to its rarity. Here, we present a 59-year-old woman with a past history of irritable bowel syndrome who underwent a reparative operation for rectal prolapse and enterocele...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29279239/retinal-and-optic-disc-vasculitis-in-susac-s-syndrome
#12
J L Sánchez-Vicente, F E Molina-Sócola, A Medina-Tapia, A Moruno-Rodríguez, S Gálvez-Carvajal, F López-Herrero
CASE REPORT: The case is presented of 42 year-old woman with no significant medical history, with severe headaches, nausea and vomiting, hearing loss, and alteration of mental status with disorientation and confusion. Ophthalmic examination showed optic disc hyperaemia in right eye, and focal areas of arteriolar occlusion in both eyes. Audiometry demonstrated bilateral neurosensory hypoacusis. Magnetic Resonance Imaging showed multiple small round hyperintense lesions located in the splenium, corpus callosum, basal ganglia, and white matter...
December 23, 2017: Archivos de la Sociedad Española de Oftalmología
https://www.readbyqxmd.com/read/29275390/hhv-8-associated-haemophagocytic-lymphohistiocytosis-in-a-patient-with-advanced-aids
#13
Saroja Bangaru, Amanda Strickland, Dominick Cavuoti, Nainesh Shah
We present a patient with advanced AIDS admitted with recurrent shock of unclear aetiology, fevers, altered mental status and refractory cytopenias. His case posed a diagnostic challenge because evaluation of septic shock in the setting of advanced AIDS requires a time-consuming work-up for broad infectious aetiologies that can delay consideration of other diagnoses, including primary or secondary haemophagocytic lymphohistiocytosis (HLH). After this patient did not improve with supportive care and empiric antimicrobials, there was concern for HLH given that he met ≥5 of the HLH consortium criteria...
December 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29260037/cefepime-induced-neurotoxicity-a-case-series-and-review-of-the-literature
#14
Cigdem Isitan, Andrew Ferree, Anna DePold Hohler
Cefepime is a fourth generation cephalosporin which is bactericidal for broad spectrum of organisms. This is a case-series of three patients who presented to our hospital with confusion secondary to cefepime use to treat urinary tract infection (UTI) and health care associated pneumonia (HCAP), after excluding other common etiologies of altered mental status (AMS). Of these three patients, one had progressive expressive aphasia and the other two demonstrated asynchronous myoclonic activity of the limbs. The symptoms were seen within four to five days of initiating the treatment and resolved within three days of discontinuation of cefepime...
September 2017: ENeurologicalSci
https://www.readbyqxmd.com/read/29244985/malignancy-related-hypercalcemia-in-advanced-solid-tumors-survival-outcomes
#15
Ricardo Emanuel de Oliveira Ramos, Milena Perez Mak, Michel Fabiano Silva Alves, Gustavo Henrique Munhoz Piotto, Tiago Kenji Takahashi, Leonardo Gomes da Fonseca, Marina Cavalcanti Maroja Silvino, Paulo Marcelo Hoff, Gilberto de Castro
Purpose Malignancy-related hypercalcemia (MRH) is associated with a dismal prognosis. The widespread use of bisphosphonates (BPs), availability of more effective drugs in cancer treatment, and improvement in supportive care might have attenuated its impact. Patients and Methods To assess overall survival (OS) of patients with MRH in a contemporary setting, we conducted a retrospective analysis of 306 patients with solid cancer hospitalized for symptomatic hypercalcemia. A multivariable Cox proportional hazards regression model was performed to evaluate possible prognostic factors associated with MRH...
December 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/29244058/antidepressant-use-and-cognitive-outcomes-in-very-old-women
#16
Yue Leng, Susan J Diem, Katie L Stone, Kristine Yaffe
Background: Antidepressant use is very common in the elderly, but the effects of antidepressants on cognition in the elderly are controversial with some studies suggesting harm and others protection. We aimed to investigate the association between different antidepressant use and change in cognition and risk of mild cognitive impairment (MCI) or dementia in very old women. Methods: We examined 1,234 community-dwelling women (mean age 83.2 years) from the Study of Osteoporotic Fractures...
December 12, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29242011/altered-mental-status-in-an-elderly-male
#17
Paul S Jansson, Christopher Kabrhel, Emily S Miller
No abstract text is available yet for this article.
December 11, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29226040/creutzfeldt-cell-rich-glioblastoma-a-diagnostic-dilemma
#18
Zain Boghani, William J Steele, Matthew D Cykowski, Leomar Y Ballester, Gavin Britz
Differentiating demyelinating conditions from neoplastic conditions can pose a significant challenge. There are a number of reports in the literature of large ring-enhancing, space-occupying lesions that were initially considered neoplastic or infectious but, on further review, were deemed demyelinating. Creutzfeldt-Peters cells (CPC) are reactive astrocytes with fragmented nuclear inclusions that are routinely seen in multiple sclerosis (MS) and generally exclude the diagnosis of glioblastoma (GB). The patient is a 78-year-old man with a history of prostate cancer, which was treated with radiation therapy, who presented with altered mental status...
October 5, 2017: Curēus
https://www.readbyqxmd.com/read/29224663/obstruction-of-the-biliary-and-urinary-system
#19
William O'Connell, Jay Shah, Jason Mitchell, J David Prologo, Louis Martin, Michael J Miller, Jonathan G Martin
Biliary and urinary obstructions can be managed endoscopically or cystoscopically, surgically or by percutansous intervention or drainage. If the obtructed system is infected, emergent decompression is needed. Early recognition and treatment is paramount in both conditions. Acute cholangitis can present many different ways, from mild symptoms to fulminant sepsis. It is usually a result of ascending bacterial colonization and biliary obstruction resulting in bacterial overgrowth. Therefore, those patients with recent biliary instrumentation or previous biliary modification are at higher risk...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29224257/models-of-care-for-non-invasive-ventilation-in-the-acute-copd-comparison-of-three-tertiary-hospitals-act3-study
#20
Kerry Parker, Vara Perikala, Ali Aminazad, Zheng Deng, Brigitte Borg, Catherine Buchan, Jo Toghill, Louis B Irving, Jeremy Goldin, David Charlesworth, Ajay Mahal, Suhith Illesinghe, Matthew T Naughton, Alan Young
BACKGROUND AND OBJECTIVE: Non-invasive ventilation (NIV) improves clinical outcomes in hypercapnic acute exacerbations of COPD (AECOPD), but the optimal model of care remains unknown. METHODS: We conducted a prospective observational non-inferiority study comparing three models of NIV care: general ward (Ward) (1:4 nurse to patient ratio, thrice weekly consultant ward round), a high dependency unit (HDU) (1:2 ratio, twice daily ward round) and an intensive care unit (ICU) (1:1 ratio, twice daily ward round) model in three similar teaching tertiary hospitals...
December 10, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
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