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https://www.readbyqxmd.com/read/28270944/ischaemic-priapism-a-clinical-review
#1
REVIEW
Joanne Ridgley, Nicholas Raison, M Iqbal Sheikh, Prokar Dasgupta, M Shamim Khan, Kamran Ahmed
OBJECTIVE: Ischaemic priapism is a rare condition characterised by little or no cavernosal blood flow, pain and rigidity of the penis. Immediate intervention is required to restore blood flow, prevent necrosis and erectile dysfunction. This review was conducted to determine the best course of treatment and identify areas in current guidelines to which improvements could be made. MATERIAL AND METHODS: PubMed, Ovid, MEDLINE (1946-December 2016) and the Cochrane Library were searched as sources for literature...
March 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/28264690/presentations-to-an-urban-emergency-department-in-bern-switzerland-associated-with-acute-recreational-drug-toxicity
#2
Evangelia Liakoni, Sabine Müller, Adrian Stoller, Meret Ricklin, Matthias E Liechti, Aristomenis K Exadaktylos
BACKGROUND: Although the recreational use of psychoactive substances is common there is only limited systematic collection of data on acute drug toxicity or hospital presentations. Currently, data from Switzerland are only available from the University Hospital of Basel. The present study aimed to describe the presentations due to recreational drug use at an emergency department in Bern, Switzerland during a 4 year period. METHODS: Retrospective analysis of cases presenting from May 2012 to April 2016 at the emergency department of the University Hospital of Bern, Switzerland, with symptoms/signs consistent with acute toxicity of recreational drug use...
March 7, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28262132/ischemic-stroke-associated-with-the-use-of-a-synthetic-cannabinoid-spice
#3
Sebastian Moeller, Caroline Lücke, Tobias Struffert, Bernhard Schwarze, Stefan T Gerner, Stefan Schwab, Martin Köhrmann, Kristin Machold, Alexandra Philipsen, Helge H Müller
Synthetic cannabinoids, i.e. "spice", are psychoactive drugs with increasing use worldwide. Spice may have harmful neuropsychiatric and physical side effects. Here, we present the case of a 25-year-old man with ischemic stroke after smoking spice on the previous evening. Diagnostic work-up was negative for other common causes of stroke. Toxicology screen unveiled the cannabimimetic ADB-FUBINACA in the drug sample and in patient's urine. The cardiac sympathomimetic effect of spice might have triggered an unnoticed episode of tachyarrhythmia and resulted in stroke via cardioembolic etiology...
February 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/28256347/right-coronary-dissection-and-left-anterior-descending-thrombus-dual-dilemma-in-a-young-cardiac-arrest-survivor
#4
Holly Morgan, Michael McCann, Alan Whelan, Richard Clugston
BACKGROUND: ST-elevation myocardial infarction (STEMI) leading to cardiac arrest is an exceptionally rare occurrence in young adults. Those affected tend to abuse sympathomimetic drugs, have strong family histories, or have a significant burden of cardiac risk factors. Another uncommon cause of STEMI is coronary artery dissection, which overwhelmingly affects middle- and older-aged women with few cardiac risk factors. CASE REPORT: A 22-year-old athlete with no medical history was admitted to our institution post-cardiac arrest with an anterior STEMI and concomitant right coronary dissection...
February 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28243503/hemorrhagic-primary-cns-angiitis-and-vasoconstrictive-drug-exposure
#5
Mehmet A Topcuoglu, Ruchira M Jha, Jacob George, Matthew P Frosch, Aneesh B Singhal
BACKGROUND: Primary angiitis of the CNS (PACNS) typically manifests with accumulating neurologic deficits from ischemic strokes. Intracerebral hemorrhage (ICH) is an uncommon complication. There is limited knowledge about the risk factors and features of hemorrhagic PACNS. METHODS: We identified 49 patients (20 biopsy-proven) with PACNS diagnosed at our hospital from 1993 to 2015. We compared the features of hemorrhagic and nonhemorrhagic PACNS and analyzed the hemorrhagic PACNS cases in detail...
February 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28209155/intranasal-oxytocin-reduces-provoked-symptoms-in-female-patients-with-posttraumatic-stress-disorder-despite-exerting-sympathomimetic-and-positive-chronotropic-effects-in-a-randomized-controlled-trial
#6
M Sack, D Spieler, L Wizelman, G Epple, J Stich, M Zaba, U Schmidt
BACKGROUND: Posttraumatic stress disorder (PTSD) is a severe psychiatric disease accompanied by neuroendocrine changes such as adrenergic overdrive and hence an elevated cardiovascular morbidity. Current pharmacotherapeutic options for PTSD are less than suboptimal, necessitating the development of PTSD-specific drugs. Although the neuropeptide oxytocin has been repeatedly suggested to be effective in PTSD treatment, there are, to our knowledge, only three studies that have assessed its efficacy on the intensity of PTSD symptoms in PTSD patients - among them one symptom provocation study in male veterans...
February 17, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28190432/acute-neurotoxicology-of-drugs-of-abuse
#7
S J Traub, M D Levine
Many substances can affect the central nervous system, and may cause patients to become critically ill. Acute central neurotoxicologic syndromes associated with drugs of abuse are usually caused by an overdose of sedative-hypnotic agents (including alcohol) or opioids, withdrawal from sedative-hypnotic agents, or an overdose of anticholinergic or sympathomimetic agents. Clinical findings are often syndromic, making physical examination the most important diagnostic tool in the approach to the patient with an unknown ingestion...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28178047/takotsubo-syndrome-after-cardiopulmonary-resuscitation-during-emergency-cesarean-delivery
#8
Katrina Kraft, Matthias Graf, Martin Karch, Ricardo Felberbaum
BACKGROUND: Takotsubo syndrome is a rare, stress-related, and reversible form of acute heart failure primarily affecting postmenopausal women. It is characterized by left ventricular dysfunction with a classic apical and midventricular wall motion abnormality (apical ballooning). CASE: A 28-year-old woman, gravida 2 para 1, at 30 4/7 weeks of gestation was admitted with fetal bradycardia, a fully dilated cervix, and breech presentation. During emergency cesarean delivery, the patient had intraoperative cardiac arrest...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28092986/a-review-of-the-treatment-of-primary-orthostatic-hypotension
#9
Genevieve M Hale, Jose Valdes, Michael Brenner
OBJECTIVE: To review the efficacy and safety of pharmacological and nonpharmacological strategies used to treat primary orthostatic hypotension (OH). DATA SOURCES: A literature review using PubMed and MEDLINE databases searching hypotension, non-pharmacological therapy, midodrine, droxidopa, pyridostigmine, fludrocortisone, atomoxetine, pseudoephedrine, and octreotide was performed. STUDY SELECTION AND DATA EXTRACTION: Randomized or observational studies, cohorts, case series, or case reports written in English between January 1970 and November 2016 that assessed primary OH treatment in adult patients were evaluated...
January 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28075189/11-analytically-confirmed-cases-of-mexedrone-use-among-polydrug-users
#10
Liam Roberts, Loretta Ford, Neel Patel, J Allister Vale, Sally M Bradberry
INTRODUCTION: Mexedrone, 3-methoxy-2-(methylamino)-1-(4-methylphenyl)propan-1-one, is the alpha-methoxy-derivative of mephedrone (4-methyl-N-methyl cathinone). Mexedrone inhibits the re-uptake of serotonin and dopamine in a dose-dependent manner and has affinity for serotonin and dopamine membrane transporters and receptors (5-HT2 and D2 receptors), producing sympathomimetic effects similar to amfetamines. To date there are no published clinical reports on mexedrone use that are analytically confirmed...
March 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28058460/-risk-assessment-of-synephrine-in-dietary-supplements
#11
Nadiya Bakhyia, Birgit Dusemund, Klaus Richter, Oliver Lindtner, Karen Ildico Hirsch-Ernst, Bernd Schäfer, Alfonso Lampen
Synephrine is a sympathomimetic phenylethylamine derivative that occurs naturally in citrus fruits. It is often added to dietary supplements intended for weight loss and enhancement of sports performance, typically in the form of Citrus aurantium extracts and in many cases in combination with caffeine. The health risks of synephrine were evaluated on the basis of the available toxicological data and in accordance to the EFSA guidance on the safety assessment of botanicals and botanical preparations intended for use in food supplements...
January 5, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/28027457/emergency-department-management-of-priapism
#12
REVIEW
Gregory S Podolej, Christine Babcock
Priapism is a genitourinary emergency that demands a thorough, time-sensitive evaluation. There are 3 types of priapism: ischemic, nonischemic, and recurrent ischemic priapism; ischemic priapism accounts for 95% of cases. Ischemic priapism must be treated within 4 to 6 hours to minimize morbidity, including impotence. The diagnosis of ischemic priapism relies heavily on the history and physical examination and may be facilitated by penile blood gas analysis and penile ultrasound. This issue reviews current evidence regarding emergency department treatment of ischemic priapism using a stepwise approach that begins with aspiration of cavernosal blood, cold saline irrigation, and penile injection with sympathomimetic agents...
January 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/27995106/comparing-prophylactic-effect-of-phenylephrine-and-ephedrine-on-hypotension-during-spinal-anesthesia-for-hip-fracture-surgery
#13
Rahman Abbasivash, Shahryar Sane, Mitra Golmohammadi, Shahram Shokuhi, Fereshteh Danaye Toosi
BACKGROUND: Spinal anesthesia is an accepted technique in hip fracture surgery and prevention of this complication by sympathomimetic agents is of potential clinical significance. The aim of this study is to compare the effect of prophylactic phenylephrine versus ephedrine in the prevention of hypotension during spinal anesthesia in hip fracture surgery. MATERIALS AND METHODS: Ninety-two patients undergoing hip fracture surgery with the American Society of Anesthesiologists I and II were randomized to receive prophylaxis with ephedrine or phenylephrine immediately before the spinal anesthesia...
2016: Advanced Biomedical Research
https://www.readbyqxmd.com/read/27984052/beta-adrenergic-receptor-blockers-in-hypertension-alive-and-well
#14
William H Frishman
Beta-adrenergic receptor blockers (β-blockers) are an appropriate treatment for patients having systemic hypertension (HTN) who have concomitant ischemic heart disease (IHD), heart failure, obstructive cardiomyopathy, aortic dissection or certain cardiac arrhythmias. β-Blockers can be used in combination with other antiHTN drugs to achieve maximal blood pressure control. Labetalol can be used in HTN emergencies and urgencies. β-Blockers may be useful in HTN patients having a hyperkinetic circulation (palpitations, tachycardia, HTN, and anxiety), migraine headache, and essential tremor...
November 2016: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/27974306/common-eye-diseases-in-older-adults-of-southern-germany-results-from-the-kora-age-study
#15
Peter Reitmeir, Birgit Linkohr, Margit Heier, Sophie Molnos, Ralf Strobl, Holger Schulz, Michaela Breier, Theresa Faus, Dorothea M Küster, Andrea Wulff, Harald Grallert, Eva Grill, Annette Peters, Jochen Graw
PURPOSE: a population-based study in the region of Augsburg (Germany, KORA) was used to identify the prevalence of eye diseases and their risk factors in a sample of aged individuals. METHODS: data originated from the KORA-Age study collected in 2012 and 822 participants (49.6% women, 50.4% men, aged 68-96 years) were asked standardised questions about eye diseases. Positive answers were validated and specified by treating ophthalmologists. Additional information came from laboratory data...
December 14, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27927933/disparities-and-guideline-adherence-in-drugs-of-abuse-screening-in-intracerebral-hemorrhage
#16
Laura M Tormoehlen, Ashley D Blatsioris, Elizabeth A S Moser, Ravan J L Carter, Alec Stevenson, Susan Ofner, Abigail L Hulin, Darren P O'Neill, Aaron A Cohen-Gadol, Thomas J Leipzig, Linda S Williams, Jason Mackey
OBJECTIVE: To characterize the pattern of urine drug screening in a cohort of intracerebral hemorrhage (ICH) patients at our academic centers. METHODS: We identified cases of primary ICH occurring from 2009 to 2011 in our academic centers. Demographic data, imaging characteristics, processes of care, and short-term outcomes were ascertained. We performed logistic regression to identify predictors for screening and evaluated preguideline and postguideline reiteration screening patterns...
January 17, 2017: Neurology
https://www.readbyqxmd.com/read/27911431/-o%C3%B1-umethyl-in-the-treatment-of-allergic-diseases-of-eyelids-and-conjunctiva
#17
N R Marchenko
Treatment of allergic diseases of eyelids and conjunctiva (conjunctivites and blepharoconjunctivites) often presents difficulties due to peculiarities of their pathogenesis - allergic and vascular reactions, disorder of lacrimal production, meibomian gland dysfunction, and possible bacterial contamination. It has been suggested to use Ocumethyl, which contains zinc sulfate (binding, drying, anti-inflammatory, and antiseptic effect), diphenhydamine hydrochloride (an Н1-antihistamine that decreases capillary permeability and helps resolve conjunctival and eyelid edema), naphazoline hydrochloride (a sympathomimetic notable for its strong, rapid, and long-lasting vasoconstrictive effect), and methylene blue (antiseptic effect, disintoxication, and antioxidant activity)...
2016: Vestnik Oftalmologii
https://www.readbyqxmd.com/read/27910802/near-infrared-spectroscopy-evaluated-cerebral-oxygenation-during-anesthesia
#18
REVIEW
Henrik Sørensen
Likely, maintained organ and notably cerebral perfusion, secures rapid recovery following anesthesia. To secure cerebral blood flow (CBF) at least mean arterial pressure (MAP) and the arterial carbon dioxide tension (PaCO2) need to be considered. CBF is "autoregulated", i.e. stays more or less stable within a MAP of 50-150 mmHg, but the lower limit appears to depend on the central blood volume and/or cardiac output, illustrated by a decrease in CBF at a MAP of 80 mmHg with a compromised central blood volume, while CBF remains constant with a MAP < 40 mmHg, if the central blood volume is maintained...
December 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27890755/predictors-of-shunt-insertion-in-aneurysmal-subarachnoid-hemorrhage
#19
Rouzbeh Motiei-Langroudi, Nimer Adeeb, Paul M Foreman, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Beverly C Walters, Shane R Tubbs, Mohammadali M Shoja, Justin M Moore, Raghav Gupta, Christopher S Ogilvy, Ajith J Thomas, Christoph J Griessenauer
OBJECTIVE: Hydrocephalus is a common complication of aneurysmal subarachnoid hemorrhage (aSAH), requiring permanent cerebrospinal fluid (CSF) diversion in up to two thirds of patients. Factors that predict permanent CSF diversion are not well established. METHODS: An exploratory analysis of 149 patients enrolled in the CARAS (Cerebral Aneurysm Renin Angiotensin System) study was performed in an effort to identify factors predictive of permanent CSF diversion after aSAH; only the 135 patients surviving the initial hospitalization were included in the present study...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27884871/simultaneous-liquid-chromatographic-determination-of-ebastine-with-two-sympathomimetic-drugs-using-a-monolithic-column
#20
F Ibrahim, M E K Wahba
Ebastine (EBS) has been assayed in its laboratory-prepared co-formulated tablets with either pseudoephedrine hydrochloride (PSU) or phenylephrine hydrochloride (PHR) using isocratic reversed-phase chromatography. Separation was conducted using a 50 mm × 4.6 mm i.d., Chromolith(®) SpeedROD RP-18 end-capped column at ambient temperature. A mobile phase composed of water:acetonitrile in a ratio of 25:75 having a pH of 3.2, has been utilized at 1 mL/min with UV detection at 254 nm for both EBS and PSU and 274 nm for PHR which in turn increased the sensitivity of the proposed method significantly...
November 24, 2016: Journal of Chromatographic Science
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