keyword
https://read.qxmd.com/read/38444598/from-terminal-ileum-to-terminal-diagnosis-the-critical-role-of-terminal-ileum-intubation-in-diagnosing-langerhans-cell-histiocytosis-in-a-patient-with-tar-syndrome
#1
Mena Louis, Chad Copper, Elaine Lelli, Joseph Conway, Daniel Sarmiento, Hardeep Singh
The co-occurrence of Thrombocytopenia with Absent Radius (TAR) syndrome and Langerhans Cell Histiocytosis (LCH) is exceedingly rare, with scant documentation in existing medical literature. This case report aims to shed light on this unique intersection of conditions, emphasizing the diagnostic and therapeutic challenges it presents. A 27-year-old female with a history of TAR syndrome presented with microcytic anemia, hip pain, and gastrointestinal symptoms. Terminal ileum intubation during colonoscopy revealed superficial ulcerations, leading to a biopsy that confirmed LCH...
May 2024: Radiology Case Reports
https://read.qxmd.com/read/38361908/antepartum-hemorrhage-and-its-maternal-and-perinatal-outcome-an-experience-at-a-hospital-in-north-india
#2
JOURNAL ARTICLE
Sakshi Agarwal, Mamta Ranjan, Shikha Sachan, Lalit Kumar
INTRODUCTION AND AIM: Antepartum hemorrhage (APH) is one of the deadliest complications in obstetrics. It can complicate about 2-5% of pregnancies. It contributes significantly to maternal and perinatal mortality and morbidity during pregnancy and childbearing worldwide. The aim of this study was to determine maternal and fetal outcomes in patients presenting with APH. MATERIALS AND METHODS: This was a retrospective study. Pregnant women with >28 weeks gestation reporting to the Department of Obstetrics and Gynecology from May 2021 to April 2022 were included in the study...
December 2023: Journal of Family Medicine and Primary Care
https://read.qxmd.com/read/38344512/urgent-cesarean-section-in-a-patient-on-venovenous-extracorporeal-membrane-oxygenation
#3
Daniela Havens-Lastarria, Sara K Biladeau, Daniel Haines, Ryan Grell
A G7P6 40-year-old female at 20 weeks gestation, with a history of polysubstance use disorder and hepatitis C, presented to the emergency department with severe shortness of breath and hypoxia requiring intubation. After a thorough workup, she was diagnosed with aspiration pneumonitis and was treated with a course of antibiotics. After progressing well, she was soon extubated and transferred to a subacute rehabilitation facility (SAR). There, she acutely decompensated, requiring readmission, reintubation, and venovenous extracorporeal membrane oxygenation (ECMO) cannulation...
January 2024: Curēus
https://read.qxmd.com/read/38036800/predictors-of-mortality-in-chronic-subdural-hematoma-evacuation
#4
JOURNAL ARTICLE
Rahman Sayed, Suzanne Gross, Aroosa Zamarud, Linda Nie, Gagandeep Mudhar, Matthias Eikermann, Samuel Rupp, Jinu Kim, Mustufa Babar, Mudaser Basam, Reza Yassari, Yaroslav Gelfand
Chronic subdural hematoma (cSDH) is one of the most common types of intracranial hemorrhages, particularly in the elderly. Despite extensive research regarding cSDH diagnosis and treatment, there is conflicting data on predictors of postoperative mortality (POM). We conducted a large retrospective review of patients who underwent a cSDH evacuation at a single urban institution between 2015 and 2022. Data were collected from the electronic medical record on prior comorbidities, anticoagulation use, mental status on presentation, preoperative labs, and preoperative/postoperative imaging parameters...
December 1, 2023: Neurosurgical Review
https://read.qxmd.com/read/37942383/effects-of-single-course-betamethasone-on-the-outcomes-of-late-preterm-neonates
#5
JOURNAL ARTICLE
Farinaz Rahimi, Nastaran Safavi Ardabili, Homeira Asgharpoor, Fatemeh Darsareh
Background Prenatal glucocorticoids are commonly used in pregnancies before 34 weeks of gestation in women at risk of preterm delivery; however, the effects of these drugs on late preterm infants (those born after the 34th week of pregnancy) are controversial. As a result, we aimed to investigate the effect of a single course of betamethasone (two doses of betamethasone every 24 hours) on the neonatal outcome of late preterm births. Methods We retrospectively assessed all spontaneous late preterm births (34-36+6 weeks of gestation) at a tertiary hospital in Iran over a period of two and a half years...
October 2023: Curēus
https://read.qxmd.com/read/37837449/respiratory-failure-in-systemic-sclerosis
#6
REVIEW
Joaquim Ivo Vasques Dantas Landim, Andre Silva Franco, Percival Degrava Sampaio-Barros, Renata Miossi, Ana Cristina Medeiros-Ribeiro, Rosa Maria R Pereira, Ana Paula Luppino Assad
Systemic sclerosis (SSc) can lead to dyspnea and respiratory failure through multiple mechanisms, making a precise diagnosis particularly challenging, especially amid the current COVID-19 pandemic. In this report, we present a case involving a 26-year-old female who had previously undiagnosed SSc. She experienced acute respiratory failure necessitating orotracheal intubation. Following an extensive evaluation, the patient exhibited skin thickening, kidney failure, thrombocytopenia, microangiopathic anemia, and an antinuclear antibody with a nuclear fine speckled pattern at a titer of 1:320...
October 14, 2023: Rheumatology International
https://read.qxmd.com/read/37706419/disease-patterns-among-saudi-children-undergoing-colonoscopy-for-lower-gastrointestinal-bleeding-single-tertiary-care-center-experience
#7
JOURNAL ARTICLE
Sami Alrashidi, Tarig AlAmery, Abdullah Alshanbary, Eman Aljohani, Salman M Bashir, Bader Alsaleem, Ali Asery, Abdulrahman Al-Hussaini
BACKGROUND: : The yield of colonoscopy in cases presenting with lower gastrointestinal bleeding (LGIB) in previously published studies varies according to several factors, including endoscopic skills, histopathological experience, and pattern of colonic pathology in different countries. The local literature is limited to a single small 20-year-old study. Our objective was to provide updated data on the diagnostic yield of colonoscopy in Saudi children with LGIB in Saudi Arabia. METHODS: : This was a retrospective analysis of pediatric patients (0-14 years of age) who underwent colonoscopy for LGIB at the King Fahad Medical City (KFMC), from 2008 to 2018...
September 6, 2023: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://read.qxmd.com/read/37664295/a-simple-vitamin-deficiency-with-life-threatening-complications-a-case-of-b12-deficiency-and-hyperhomocysteinemia-induced-thrombosis
#8
Laiba Khaliq, Kaiser F Kabir, Khin Pyai, Tarik Hadid, Benjamin Collins-Hamel
While macrocytic anemia is common in vitamin B12 deficiency, rarely, pancytopenia and hemolytic anemia can occur. Homocysteine levels are elevated in severe B12 deficiency, and this is linked to thrombus formation with potentially life-threatening complications. We present a patient with severe vitamin B12 deficiency complicated by hyperhomocysteinemia and obstructive shock from pulmonary embolism. A 56-year-old male with no medical history presented to the hospital with altered mentation. The patient's family stated he was experiencing bilateral paresthesias of his lower extremities, progressive depression, anxiety, and insomnia...
August 2023: Curēus
https://read.qxmd.com/read/37619776/the-us-haea-scientific-registry-hereditary-angioedema-demographics-disease-severity-and-comorbidities
#9
JOURNAL ARTICLE
Sandra C Christiansen, Joyce Wilmot, Anthony J Castaldo, Bruce L Zuraw
BACKGROUND: Hereditary Angioedema (HAE) and idiopathic non-histaminergic angioedema (INHA) are ultra-rare diseases whose natural histories and comorbidities are incompletely understood. OBJECTIVE: To develop a national patient-centric registry to address these deficiencies in our knowledge and improve our ability to assess the real-world impact of therapeutic interventions. METHODS: Data from members of the US HAE Association were collected into an online registry between 2009 and April 7, 2021...
August 22, 2023: Annals of Allergy, Asthma & Immunology
https://read.qxmd.com/read/37600405/intraoperative-accidental-hypothermia-as-a-probable-cause-of-malignant-ventricular-arrhythmias-in-an-elderly-patient-undergoing-transurethral-resection-of-prostate-a-case-report
#10
Li Li, Weibin Ye, Yongxing Li, Yingzhen Chen, Jianfeng Zeng
BACKGROUND: Intraoperative hypothermia is a common but severe condition that is defined as a core body temperature below 36 °C. Accidental hypothermia can produce coagulopathy, immunosuppression and peripheral hypoperfusion that can ultimately lead to life-threatening ventricular arrhythmias and vital organ injury, and it is significantly associated with perioperative complications and mortality. CASE DESCRIPTION: We report the case of an 82-year-old man who presented with persistent ventricular tachycardia intraoperatively due to accidental hypothermia...
August 2023: Heliyon
https://read.qxmd.com/read/37598776/adult-onset-botulism-in-a-japanese-woman-with-prolonged-spore-excretion
#11
Keigo Kihara, Yuta Kajiyama, Yasuyoshi Kimura, Shuhei Okazaki, Naoya Esa, Ryosuke Nobe, Kentaro Shimizu, Kiyoshi Ohno, Daisuke Motooka, Takuhiro Matsumura, Takeshi Shimazu, Shota Nakamura, Yukako Fujinaga, Hideki Mochizuki
We report a case of an 80-year-old woman with botulism from 2020 in Osaka, Japan. The patient complained of dysarthria and dizziness. On the same day, the patient developed respiratory failure, and was intubated and placed on mechanical ventilation. Subsequently, ophthalmoparesis and quadriparesis progressed rapidly. Ten days after onset, the patient failed to respond to any external stimulation. Blood tests showed anemia, and computed tomography revealed undiagnosed cervical cancer. Initially, diagnosis of neuromuscular junction disorder and acute motor neuropathy, including paraneoplastic syndrome, were considered...
August 18, 2023: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://read.qxmd.com/read/37566593/regadenoson-for-the-treatment-of-covid-19-a-five-case-clinical-series-and-mouse-studies
#12
JOURNAL ARTICLE
Joseph Rabin, Yunge Zhao, Ezzat Mostafa, Manal Al-Suqi, Emily Fleischmann, Mark R Conaway, Barbara J Mann, Preeti Chhabra, Kenneth L Brayman, Alexander Krupnick, Joel Linden, Christine L Lau
BACKGROUND: Adenosine inhibits the activation of most immune cells and platelets. Selective adenosine A2A receptor (A2AR) agonists such as regadenoson (RA) reduce inflammation in most tissues, including lungs injured by hypoxia, ischemia, transplantation, or sickle cell anemia, principally by suppressing the activation of invariant natural killer T (iNKT) cells. The anti-inflammatory effects of RA are magnified in injured tissues due to induction in immune cells of A2ARs and ecto-enzymes CD39 and CD73 that convert ATP to adenosine in the extracellular space...
2023: PloS One
https://read.qxmd.com/read/37483265/severe-forms-of-influenza-infections-admitted-in-intensive-care-units-analysis-of-mortality-factors
#13
JOURNAL ARTICLE
Victor Verdier, François Lilienthal, Arnaud Desvergez, Virgile Gazaille, Arnaud Winer, Fabrice Paganin
BACKGROUND: The severe forms of influenza infection requiring intensive care unit (ICU) admission remain a medical challenge due to its high mortality. New H1N1 strains were hypothesized to increase mortality. The studies below represent a large series focusing on ICU-admitted influenza patients over the last decade with an emphasis on factors related to death. METHODS: A retrospective study of patients admitted in ICU for influenza infection over the 2010-2019 period in Réunion Island (a French overseas territory) was conducted...
July 2023: Influenza and Other Respiratory Viruses
https://read.qxmd.com/read/37400755/myasthenia-gravis-and-independent-risk-factors-for-recurrent-infection-a-retrospective-cohort-study
#14
JOURNAL ARTICLE
Chia-Yin Chien, Chun-Wei Chang, Ming-Feng Liao, Chun-Che Chu, Long-Sun Ro, Yih-Ru Wu, Kuo-Hsuan Chang, Chiung-Mei Chen, Hung-Chou Kuo
BACKGROUND: Approximately 10% to 20% of myasthenia gravis (MG) patients have experienced a myasthenic crisis (MC), which contributes to morbidity and mortality. MC triggered by infection is associated with poor outcomes. However, there is a lack of prognostic factors that clinicians can utilize to target interventions for preventing recurrent infection-triggered MC. This study aimed to characterize clinical manifestations, comorbidities, and biochemical profiles associated with recurrent infection-triggered MC in MG patients...
July 3, 2023: BMC Neurology
https://read.qxmd.com/read/37038584/thrombotic-thrombocytopenic-purpura-without-evidence-of-microangiopathic-hemolytic-anemia-a-case-report
#15
Rachaita Lakra, James Lopez, Christopher Graham
Diagnosis of thrombotic thrombocytopenic purpura (TTP) is challenging due to varied clinical presentations and is primarily based on ADAMTS13 activity assay, however clinical suspicion to include TTP as a potential diagnosis relies on multiple scoring systems all involving hemolysis as a prime feature. Here, we report a case of TTP without any evidence of microangiopathic hemolytic anemia (MAHA). A 65-year-old male admitted with a Glasglow come scale of 3 was intubated and sedated on admission. Complete blood count was concerning for a hemoglobin (Hb) of 5...
March 2023: Curēus
https://read.qxmd.com/read/37022313/bilateral-proliferative-retinopathy-as-the-initial-presentation-of-atypical-hemolytic-uremic-syndrome-a-case-report
#16
JOURNAL ARTICLE
Alexandria J Marshall, Eliza L Barnwell, Margaret A Greven
In this case report, we describe a 34-year-old male patient who presented with vision loss and was found to have profound occlusive retinal vasculopathy. His initial laboratory studies were unremarkable, but five weeks after his ocular symptoms began, he developed acute multi-organ failure and was ultimately diagnosed with atypical hemolytic uremic syndrome (aHUS). His course was complicated by a stroke, respiratory distress requiring intubation, long-term hemodialysis, and eventually death. Occlusive retinal vasculopathy may be the presenting finding in aHUS, although thrombotic microangiopathy syndromes typically present with acute kidney injury and or failure, hemolytic anemia, and thrombocytopenia...
April 1, 2023: Ophthalmic Surgery, Lasers & Imaging Retina
https://read.qxmd.com/read/37010181/lethality-analysis-in-patients-with-acute-small-bowel-obstruction-adverse-factors-and-possible-ways-to-eliminate-them
#17
JOURNAL ARTICLE
Volodymyr V Benedykt, Larysa R Korobko, Borys Z Chyzhyshyn, Liubov Y Viitovych, Iryna M Nikitina
OBJECTIVE: The aim: To determine obstruction factors that can lead to lethal consequences for patients with acute small intestine in order to develop possible directions for their prevention. PATIENTS AND METHODS: Materials and methods: During the retrospective analysis of 30 patients with acute small bowel obstruction, the causes and contributing factors of mortality were determined. RESULTS: Results: The cause of mortality in the $rst three days of the postoperative period was the progression of the phenomena of intoxication, which led to the appearance of the syndrome of enteric insu%ciency and the development of multiple organ dysfunction...
2023: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://read.qxmd.com/read/36921732/remarkable-107-year-old-kidney-with-a-49-year-of-long-term-allograph-survival-through-continuous-azathioprine-monotherapy
#18
JOURNAL ARTICLE
Evaldo Nascimento, Abrahão Salomão Filho, Fernando das M Lucas-Junior, Luiz F J Jobim, Marcus F Lasmar, Hélcio A Tavares-Filho, Raquel A Fabreti-Oliveira
BACKGROUND: The main goal of kidney allograft transplantation is to improve survival in patients with end-stage kidney failure. Herein, we report a 49-year long-term allograft survival with non-identical human leukocyte antigens (HLA). The purpose of this study was to report the successful clinical outcome of 49 years of transplant survival in a 79-year-old patient with a 107-year-old kidney undergoing continued immunosuppressive monotherapy. MATERIAL AND METHODS: The patient was evaluated clinically and immunologically with HLA typing and anti-HLA antibodies before transplantation...
March 13, 2023: Transplant Immunology
https://read.qxmd.com/read/36874730/a-rare-case-of-cyclophosphamide-induced-posterior-reversible-encephalopathy-syndrome-in-a-patient-with-acute-lupus-nephritis-flare
#19
Mpey K Tabot Tabot, Priscilla A Ababio, Shervonne Waldron, Lamiaa Rougui, Alem Mehari
Posterior reversible encephalopathy syndrome (PRES) is a syndrome encompassing both clinical and radiological manifestations with white matter vasogenic edema predominantly of the posterior and parietal lobes of the brain. It may accompany several medical conditions including immunosuppressive/cytotoxic drugs. We present a case of cyclophosphamide-induced PRES in a patient treated for acute lupus flare with biopsy-proven lupus nephritis. A 23-year-old African American female presented with non-specific symptoms over a six-month period on a medical background of systemic lupus erythematosus and biopsy-proven focal lupus nephritis class III on hydroxychloroquine, prednisone, and mycophenolate mofetil for which she was non-compliant...
January 2023: Curēus
https://read.qxmd.com/read/36874675/profound-hyperkalemia-and-anemia-in-a-dialysis-patient-with-a-gastrointestinal-bleed
#20
Sara Biladeau, Ryan Grell
An 80-year-old male receiving dialysis three times per week presented to the emergency room with general malaise after missing four consecutive dialysis appointments. During his workup, he was noted to have a potassium of 9.1 mmol/L, hemoglobin of 4.1 g/dL, and an electrocardiogram showing a first-degree atrioventricular (AV) block, a right bundle branch block, peaked T waves, and a wide QRS complex. During emergent dialysis and resuscitation, the patient suffered respiratory failure and was intubated...
January 2023: Curēus
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