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https://www.readbyqxmd.com/read/28634876/life-expectancy-gain-due-to-employment-status-depends-on-race-gender-education-and-their-intersections
#1
Shervin Assari
PURPOSE: Despite the well-established health effects of socioeconomic status (SES), SES resources such as employment may differently influence health outcomes across sub-populations. This study used a national sample of US adults to test if the effect of baseline employment (in 1986) on all-cause mortality over a 25-year period depends on race, gender, education level, and their intersections. METHODS: Data came from the Americans' Changing Lives (ACL) study, which followed 2025 Whites and 1156 Blacks for 25 years from 1986 to 2011...
June 20, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28632556/watertight-sealing-without-lumbar-drainage-for-incidental-ventral-dural-defect-in-transthoracic-spine-surgery-a-retrospective-review-of-53-cases
#2
Sang-Hyeop Jeon, Sang-Ho Lee, Yi Sheng Tsang, Tag-Geun Jung, Ki-Hyoung Moon, Gun Choi, Ketan D Dilip
STUDY DESIGN: A retrospective review. OBJECTIVES: To evaluate the therapeutic efficacy of the triple layer closure technique to establish watertight sealing without diversion of lumbar drainage, in preventing persistent incidental subarachnoid-pleural fistula and other neurological complications related to excessive drainage of cerebrospinal fluid (CSF) after dural defect in transthoracic ossified posterior longitudinal ligament (OPLL) surgery. SUMMARY OF BACKGROUND DATA: CSF leakage into the pleural cavity leads to unfavorable conditions for natural healing of incidental durotomy due to the negative pressure environment of the pleural space and lack of wound healing around the bony cavity near the decompressed spinal cord...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28628236/blastomyces-dermatitidis-peritonitis-complicating-peritoneal-dialysis
#3
Yogesh Sanghvi, Douglas Somers
Fungal peritonitis is an uncommon complication in peritoneal dialysis patients. We report a case of blastomyces dermatitis peritonitis in a nonimmunocompromised peritoneal dialysis patient, who initially presented with symptoms of lower extremity weakness and altered mental status. Peritoneal blastomycosis is rare condition and not previously reported in end stage renal disease patients on peritoneal dialysis. Fungal peritonitis can present with subtle clinical findings so a high index of suspicion is needed as early detection and treatment may decrease mortality and morbidity...
June 19, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28620491/pseudo-thrombotic-thrombocytopenic-purpura-presenting-as-multi-organ-dysfunction-syndrome-a-rare-complication-of-pernicious-anemia
#4
Saroj Kandel, Nibash Budhathoki, Shanta Pandey, Bikash Bhattarai, Aam Baqui, Ramesh Pandey, Divya Salhan, Danilo Enriquez, Joseph Quist, Frances M Schmidt
OBJECTIVE: We present a rare case of pernicious anemia presented as multi-organ dysfunction syndrome, later found to have pseudo-thrombotic thrombocytopenic purpura. METHODS: An 86-year-old female presented with respiratory distress, altered mental status, acute renal failure and was intubated in emergency room. She was found to have severe anemia, thrombocytopenia, high lactate, high lactate dehydrogenase and low haptoglobin. Peripheral smear revealed multilobulated neutrophils with schistocytes, poikilocytes and anisocytes...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28608527/perfect-storm-therapeutic-plasma-exchange-for-a-patient-with-thyroid-storm
#5
Andrea M McGonigle, Aaron A R Tobian, Jennifer L Zink, Karen E King
Thyroid storm is a potentially lethal complication of hyperthyroidism with increased thyroid hormones and exaggerated symptoms of thyrotoxicosis. First-line therapy includes methimazole (MMI) or propylthiouracil (PTU) to block production of thyroid hormones as a bridge toward definitive surgical treatment. Untreated thyroid storm has a mortality rate of up to 30%; this is particularly alarming when patients cannot tolerate or fail pharmacotherapy, especially if they cannot undergo thyroidectomy. Therapeutic plasma exchange (TPE) is an ASFA category III indication for thyroid storm, meaning the optimum role of this therapy is not established, and there are a limited number of cases in the literature...
June 13, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28608136/early-impairment-of-intracranial-conduction-time-predicts-mortality-in-deeply-sedated-critically-ill-patients-a-prospective-observational-pilot-study
#6
Eric Azabou, Benjamin Rohaut, Nicholas Heming, Eric Magalhaes, Régine Morizot-Koutlidis, Stanislas Kandelman, Jeremy Allary, Guy Moneger, Andrea Polito, Virginie Maxime, Djillali Annane, Frederic Lofaso, Fabrice Chrétien, Jean Mantz, Raphael Porcher, Tarek Sharshar
BACKGROUND: Somatosensory (SSEP) and brainstem auditory (BAEP) evoked potentials are neurophysiological tools which, respectively, explore the intracranial conduction time (ICCT) and the intrapontine conduction time (IPCT). The prognostic values of prolonged cerebral conduction times in deeply sedated patients have never been assessed. Sedated patients are at risk of developing new neurological complications, undetected. In this prospective observational bi-center pilot study, we investigated whether early impairment of SSEP's ICCT and/or BAEP's IPCT could predict in-ICU mortality or altered mental status (AMS), in deeply sedated critically ill patients...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28606830/safety-and-tolerability-of-topical-clonazepam-solution-for-management-of-oral-dysesthesia
#7
Michal Kuten-Shorrer, Nathaniel S Treister, Shannon Stock, John M Kelley, Yisi D Ji, Sook-Bin Woo, Mark A Lerman, Stefan Palmason, Stephen T Sonis, Alessandro Villa
OBJECTIVES: The aim of the study was to determine the absolute and relative safety of treatment with 2 concentrations of topical clonazepam solution (0.1 mg/mL, 0.5 mg/mL) for management of oral dysesthesia. STUDY DESIGN: The study was a retrospective chart review of patients diagnosed with oral dysesthesia and managed with topical clonazepam solution (swish and spit) between 2008 and 2015. The relative safety of the 2 concentrations was evaluated in terms of occurrence of adverse drug reactions (ADRs) and occurrence of change to treatment plan secondary to ADRs...
May 11, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28606772/dominance-status-alters-restraint-induced-neural-activity-in-brain-regions-controlling-stress-vulnerability
#8
Matthew A Cooper, Sahba Seddighi, Abigail K Barnes, J Alex Grizzell, Brooke N Dulka, Catherine T Clinard
Understanding the cellular mechanisms that control resistance and vulnerability to stress is an important step toward identifying novel targets for the prevention and treatment of stress-related mental illness. In Syrian hamsters, dominant and subordinate animals exhibit different behavioral and physiological responses to social defeat stress, with dominants showing stress resistance and subordinates showing stress vulnerability. We previously found that dominant and subordinate hamsters show different levels of defeat-induced neural activity in brain regions that modulate coping with stress, although the extent to which status-dependent differences in stress vulnerability generalize to non-social stressors is unknown...
June 9, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/28600751/central-and-peripheral-nervous-system-disorders-following-ivermectin-mass-administration-a-descriptive-study-based-on-the-democratic-republic-of-congo-pharmacovigilance-system
#9
Didier Nzolo, Francis Anto, Sarah Hailemariam, Didier Bakajika, Daniel Muteba, Jean-Claude Makenga, Gautier Mesia, Celestin Nsibu, Samuel Mampunza, Gaston Tona
INTRODUCTION: The mainstay of onchocerciasis control currently is mass administration of ivermectin; however, this may be associated with serious adverse events, including deaths, when administered in areas where onchocerciasis and loiasis are co-endemic. OBJECTIVES: The objective of the current study was to describe the central and peripheral nervous system disorders that occurred after mass administration of ivermectin in Democratic Republic of Congo (DRC). METHODS: This is a retrospective descriptive study involving a review of data on adverse events related to mass administration of ivermectin...
June 9, 2017: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/28599120/a-case-report-of-maternal-cerebral-hemorrhage-in-preterm-pregnancy
#10
Leah Stein-Fredbeck, Robert Rosenberg, Ralph Frank
Intracerebral hemorrhage is a rare event during pregnancy that can result in serious morbidity and mortality for the mother and infant. In this article, we describe a case involving a multiparous woman at 34 weeks gestation who presented with a 5-cm intracerebral bleed. Within 2 hours of presenting, she underwent an emergency cesarean and craniotomy to remove the hematoma. The woman's altered mental status fully abated, and she was discharged with minimal neurologic deficits. The newborn was born healthy.
June 6, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28590989/-it-s-not-a-tumor-a-rare-case-of-symptomatic-cerebellar-developmental-venous-anomaly
#11
Julie A Augenstein, Teresa Chapman, Michael J McNeil, Mark D Lo
Cerebral developmental venous anomalies (DVAs) are benign anatomical variants of the venous system and are commonly described as an incidental finding without clinical significance. Neurologic symptoms or abnormal examination findings are rare and usually attributed to hemorrhagic complications related to coexisting cavernous malformations. There have been limited case reports of symptomatic, uncomplicated DVAs described in the literature. The following case describes a previously healthy child who presented to the emergency department with an acute onset of altered mental status, headache, and focal neurologic examination abnormalities...
June 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28590798/beyond-ketamine-and-phencyclidine-analytically-confirmed-use-of-multiple-novel-arylcyclohexylamines
#12
Stephen Thornton, David Lisbon, Thomas Lin, Roy Gerona
BACKGROUND: Methoxetamine and 3-methoxy-phencyclidine are novel arylcyclohexylamines whose use and clinical toxicity are poorly reported in the medical literature. We report a case of analytically confirmed use of both methoxetamine and 3-methoxy-phencyclidine. CASE REPORT: A 27-year-old male presented 10 hours after insufflating an Internet-obtained powder. He was hypertensive, tachycardic, and demonstrated dissociated affect, a delayed verbal response to questions, ataxia, and vertical nystagmus...
June 7, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28583104/development-and-validation-of-a-claims-based-measure-as-an-indicator-for-disease-status-in-patients-with-multiple-sclerosis-treated-with-disease-modifying-drugs
#13
Michael Munsell, Molly Frean, Joseph Menzin, Amy L Phillips
BACKGROUND: Administrative healthcare claims data provide a mechanism for assessing and monitoring multiple sclerosis (MS) disease status across large, clinically representative "real-world" populations. The estimation of MS disease status using administrative claims can be a challenge, however, due to a lack of detailed clinical information. Retrospective claims analyses in MS have traditionally used rates of MS relapses to approximate disease status. Healthcare costs may be alternate, broader claims-based indicators of disease activity because costs reflect multiple facets of care of patients with MS, and there is a strong correlation between quality of life of patients with MS and costs of the disease...
June 5, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28571901/how-can-we-identify-patients-with-delirium-in-the-emergency-department-a-review-of-available-screening-and-diagnostic-tools
#14
Hidetaka Tamune, Daisuke Yasugi
Delirium is a widespread and serious but under-recognized problem. Increasing evidence argues that emergency health care providers need to assess the mental status of the patient as the "sixth vital sign". A simple, sensitive, time-efficient, and cost-effective tool is needed to identify delirium in patients in the emergency department (ED); however, a stand-alone measurement has not yet been established despite previous studies partly because the differential diagnosis of dementia and delirium superimposed on dementia (DSD) is too difficult to achieve using a single indicator...
May 22, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28571231/central-variant-of-posterior-reversible-encephalopathy-syndrome-a-rare-case-report
#15
K G Srinivasan, Padhmini Balasubramanian, K R Mayilvaganan, Usha Nandhini Kannan, Mohamed Bilal
Posterior Reversible Encephalopathy Syndrome (PRES) is a clinicoradiological condition associated with headache, altered mental status, dizziness and white matter vasogenic oedema in parieto-occipital region. It is often associated with hypertension but can also occur in diverse clinical settings like immunosuppression, eclampsia, etc. It is due to failure of autoregulatory mechanism of posterior circulation in response to change in blood pressure. We hereby report a rare case of central variant of PRES secondary to severe hypertension diagnosed with 3T MRI...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28571173/flat-foot-in-a-random-population-and-its-impact-on-quality-of-life-and-functionality
#16
Salvador Pita-Fernandez, Cristina Gonzalez-Martin, Francisco Alonso-Tajes, Teresa Seoane-Pillado, Sonia Pertega-Diaz, Sergio Perez-Garcia, Rocio Seijo-Bestilleiro, Vanesa Balboa-Barreiro
INTRODUCTION: Flat foot is a common deformity in adults. It is characterized by medial rotation and plantar flexion of the talus, eversion of the calcaneus, collapsed medial arch and abduction of the forefoot. AIM: The aim of this study was to determine the prevalence of flat foot and its impact on quality of life, dependence, foot pain, disability and functional limitation among random population of 40-year-old and above. MATERIALS AND METHODS: A cross-sectional study in a random population sample from Cambre (A Coruña-Spain) (n=835) was performed (α =0...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28567321/neuropsychiatric-manifestations-in-a-patient-with-panhypopituitarism
#17
Oluwole Jegede, Ajouka Jeyakumar, Thyarapan Balakumar, Alyssa Raghu, Katherine I Chang, Katarina Soewono, Mario Gustave, Ayodeji Jolayemi
We present a case of an incidental diagnosis of panhypopituitarism in a 68-year-old African American man admitted to our psychiatric inpatient unit with symptoms suggestive of schizophrenia. The case was unusual as a first-episode psychosis given the patient's age. In the course of his admission, the patient's clinical condition deteriorated culminating in a sudden altered mental status which prompted a transfer to the medical floors and further investigations. A head CT scan and a pituitary MRI revealed a near total resection of the pituitary while laboratory investigations revealed hyponatremia and a grossly low hormone profile...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/28565970/baclofen-systemic-toxicity-experimental-histopathological-and-biochemical-study
#18
S Y Issa, E M Hafez, A S El-Banna, S M Abdel Rahman, M K AlMazroua, M A El-Hamd
OBJECTIVE: The present study was designed to highlight the toxic impact of baclofen on both biochemical and histopathological aspects in rats' liver, gastric, lung, kidney, and brain tissues. METHODS: The study was performed on 30 healthy adult male albino rats divided into four groups with 5 rats in each control group, and 10 rats in either experimental groups (two experimental and two control groups). Five rats (negative control) were kept in a quite non-stressful environment, provided with food ad libitum and free access to water...
January 1, 2017: Human & Experimental Toxicology
https://www.readbyqxmd.com/read/28561149/-preoperative-evaluation-and-arrangements-the-elderly-patient
#19
Cynthia Olotu-Steffen, Simone Gurlit, Rainer Kiefmann
With a constantly growing portion of elderly within our population and the advances of modern medicine, surgery on aged and very aged patients has become a daily hospital routine. Due to the physical and mental features of ageing these patients face special perioperative risks. They display a higher rate of complications, morbidity and cognitive deficits which might in the end lead to persisting need of care. Even in the healthy elderly, most organ functions are "physiologically" instable or deficient and the homeostasis of health and disease is fragile...
May 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28557634/school-nurses-on-the-front-lines-of-medicine-uppers-and-downers-the-approach-to-the-student-with-altered-mental-status
#20
Kelly Patterson, Jodi Brady, Robert P Olympia
Although a student presenting with altered mental status due to substance use may occur infrequently in the school setting, it is of utmost importance to develop a differential diagnosis and to initiate stabilization of the student. This article describes the initial assessment and management of a student presenting with altered mental status, focusing on the differential diagnosis of altered mental status, on the varying presentations associated with common intoxications and ingestions, and on the screening tools available for the detection of depression and substance use...
May 1, 2017: NASN School Nurse
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