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https://www.readbyqxmd.com/read/29243899/discussing-a-serious-illness-with-a-patient-and-family
#1
Hannu Laaksovirta
Learning of a serious illness is unique news. Nothing certain can be known about how it will affect the hearer's outlook on the future before a conception is established about the hearer's expectations and how he/she has understood the issue. For example, a person who has been expecting muscle tension to be an explanation for back pain but hearing that a cancer metastasis is the underlying cause, will inevitably be in shock. The healthcare system is not able to influence everything, but is usually given one possibility to make a good first impression when telling about a serious diagnosis...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29239466/rupture-of-the-myocardium-in-autopsied-mi-hearts
#2
Valesca Bizinoto Monteiro, Bianca Gonçalves Silva Torquato, Guilherme Ribeiro Juliano, Bárbara Cecílio da Fonseca, Flávia Aparecida de Oliveira, Daniel Ferreira da Cunha, Camila Lourencini Cavellani, Luciano Alves Matias da Silveira, Mara Lúcia da Fonseca Ferraz, Vicente de Paula Antunes Teixeira, Edson Luiz Fernandes
Although myocardial rupture occurs in only 2% to 4% of cases of acute myocardial infarction (AMI), there is a high mortality rate due to acute cardiogenic shock. We present the anatomopathological findings of three cases of myocardial rupture in autopsied hearts in the last 30 years, with a diagnosis of cardiac rupture in acute myocardial infarction. In these 30 years the percentage of AMI with myocardial rupture was 0.2%. Risk factors for post-AMI myocardial rupture include older age, atherosclerosis, diabetes mellitus and systemic arterial hypertension...
September 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/29238519/how-to-manage-anaphylaxis-in-primary-care
#3
REVIEW
Alberto Alvarez-Perea, Luciana Kase Tanno, María L Baeza
Anaphylaxis is defined as a severe life-threatening generalized or systemic hypersensitivity reaction characterized by rapidly developing airway and/or circulation problems. It presents with very different combinations of symptoms and apparently mild signs and can progress to fatal anaphylactic shock unpredictably. The difficulty in recognizing anaphylaxis is due, in part, to the variability of diagnostic criteria, which in turn leads to a delay in administration of appropriate treatment, thus increasing the risk of death...
2017: Clinical and Translational Allergy
https://www.readbyqxmd.com/read/29228412/a-case-of-eosinophilic-myocarditis-associated-with-cardiogenic-shock
#4
Hideki Ozawa, Akiko Taoda, Takuma Shinoda, Hidetaka Yanagi, Masayuki Oki, Atsushi Takagi
The patient was a 32-year-old man with a previous history of bronchial asthma. He was admitted with chief complaints of dyspnea and skin rash associated with itching of the palms and soles of the feet, which began 2 weeks earlier. Because of the presence of cardiac failure and increase in the peripheral blood eosinophil count, eosinophilic myocarditis (EM) was suspected. His blood pressure gradually decreased and the patient went into cardiogenic shock. Therefore, endomyocardial biopsy was performed and was immediately followed by corticosteroid therapy and intra-aortic balloon pump (IABP) placement...
December 20, 2017: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/29225011/effect-of-platelet-lymphocyte-ratio-and-lactate-levels-obtained-on-mortality-with-sepsis-and-septic-shock
#5
Ebru Biyikli, Afsin Emre Kayipmaz, Cemil Kavalci
BACKGROUND: Sepsis is a potentially fatal condition with high treatment costs, and is especially common among the elderly population. The emergency management of septic patients has gained importance. OBJECTIVE: Herein, we investigated the effect of admission lactate levels and the platelet-lymphocyte ratio (PLR) on the 30-day mortality among patients older than 65years who were diagnosed with sepsis and septic shock according to the qSOFA criteria at our hospital's emergency department...
December 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29224568/internal-herniation-through-lesser-omentum-hiatus-and-gastrocolic-ligament%C3%A2-with-malrotation-a-case-report
#6
Ang Li, Renwang Hu, Dong Zhou, Senmao Li, Dan Huang, Xin Wei, Zhixin Cao
BACKGROUND: Internal herniation through lesser omentum hiatus and gastrocolic ligament with malrotation is extremely rare. This type of internal hernia has rarely been described before. Preoperative diagnosis is difficult and prone to misdiagnosis. CASE PRESENTATION: A 38-year-old Chinese woman was an emergency admission to our hospital with a sudden onset of acute epigastralgia for the past 14 hours. We made a presumptive diagnosis of gastrointestinal perforation and septic shock...
December 11, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29221616/dengue-fever-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#7
REVIEW
Pravin Amin, Özlem Acicbe, Jorge Hidalgo, Juan Ignacio Silesky Jiménez, Tim Baker, Guy A Richards
Dengue is an arbovirus affecting humans and spread by mosquitoes. Severe dengue follows a secondary infection with a different virus serotype. The problem is truly global as it is endemic in over 100 countries. Severe dengue can be a life-threatening because of increased vascular permeability, resulting in leakage of fluid from the intravascular compartment to the extravascular space. When major bleeding does occur, it is almost invariably combined with profound shock since this, in combination with thrombocytopenia, hypoxia, and acidosis, can lead to multiple organ failure and disseminated intravascular coagulation...
November 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29221333/successful-treatment-of-a-ruptured-left-internal-mammary-artery-aneurysm-with-a-delayed-diagnosis-of-type-i-neurofibromatosis
#8
Do Wan Kim, In Seok Jeong, Kook Joo Na, Bong Suk Oh, Byung Hee Ahn, Sang Yun Song
Neurofibromatosis type I (NF-1) induced vasculopathy is rare but catastrophic complication after aneurysmal rupture. We present the case of a 55-year-old female who developed hypovolemic shock because of left internal mammary artery (IMA) pseudoaneurysm rupture associated with NF-1. Even she was not detected NF-1 at the time of arrival in emergency room. We decided to perform percutaneous embolization instead of surgical approach. In this case, after intervention, the ruptured left IMA aneurysm was well treated...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29217889/spontaneous-splenic-haematoma-in-a-patient-on-hemodialysis-a-case-report
#9
J Pandiaraja
Spontaneous splenic hematoma is one of the rare and life-threatening complications of chronic renal failure. The diagnosis of splenic hematoma is mostly made by imaging such as ultrasound or computed tomography. The management of spontaneous splenic hematoma is not standardized till now due to the rarity of this condition. Splenectomy is recommended in hemodynamically unstable patients with features of shock. This is a case report of spontaneous splenic hematoma in a patient with chronic renal failure. This case is reported due to the rarity with renal failure...
November 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/29216952/-sepsis-induced-cardiomyopathy-complicated-with-cardiogenic-shock-patients-supported-with-extracorporeal-membrane-oxygenation
#10
Changzhi Liu, Ruiqiu Zhu, Zhujiang Zhou, Haifeng Liu, Jingcheng Lin, Shuchao Wen, Liuer Zuo
Sepsis-induced cardiomyopathy is a reversible myocardial dysfunction due to sepsis, which may be severe enough to complicate cardiogenic shock, and without effective drug and with high mortality during the acute phase. A case of sepsis-induced cardiomyopathy complicated with cardiogenic shock was treated in the intensive care unit (ICU) of Shunde Hospital Southern Medical University. A 37 years old female patient was admitted because she had suffered repeated fever for 5 days, chest tightness and abdominal pain for 3 days...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29216937/-significance-of-peripheral-perfusion-index-in-early-diagnosis-and-goal-directed-therapy-of-septic-shock-patients-a-prospective-single-blind-randomized-controlled-trial
#11
Yuanfeng Shi, Ruihong Yin, Yanli Wang, Jiguang Li, Xiaobing Chen, Yongpeng Xie, Caihong Gu, Xiuzhen Zou, Kexi Liu
OBJECTIVE: To investigate the application of peripheral perfusion index (PPI) in early diagnosis and goal-directed therapy of septic shock, and to provide reference for the early clinical diagnosis and treatment of septic shock. METHODS: A prospective single-blind randomized controlled trial (RCT) was conducted. Adult patients with sepsis admitted to emergency medical department and intensive care unit (ICU) of the First People's Hospital of Lianyungang City in Jiangsu Province from January 2013 to December 2016 were enrolled...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29216679/the-role-of-extracorporeal-membrane-oxygenator-therapy-in-the-setting-of-type-a-aortic-dissection
#12
Ibrahim Sultan, Andreas Habertheuer, Tyler Wallen, Mary Siki, Wilson Szeto, Joseph E Bavaria, Matthew Williams, Prashanth Vallabhajosyula
BACKGROUND AND AIM: Patients presenting with type A aortic dissection (TAAD) present with a wide clinical spectrum ranging from hemodynamic stability to multiorgan malperfusion with cardiovascular collapse. Extracorporeal membrane oxygenator (ECMO) therapy is increasingly being utilized as salvage therapy in patients with acute cardiopulmonary failure and for post-cardiotomy shock. We sought to determine the utility of ECMO implementation post-TAAD repair. METHODS: The Pennsylvania Health Care Cost Containment Council (PHC4) database, maintained by an independently functioning state agency, was retrospectively reviewed from 2004 to 2014...
December 7, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29214053/severe-carvedilol-toxicity-without-overdose-caution-in-cirrhosis
#13
Satish Maharaj, Karan Seegobin, Julio Perez-Downes, Belinda Bajric, Simone Chang, Pramod Reddy
Background: Carvedilol is used in the management of hypertension, ischemic heart disease, heart failure and most recently, portal hypertension. It has been associated with improved outcomes regarding variceal bleeding, hepatic decompensation and death when compared to propranolol and endoscopic band ligation. The main cause of portal hypertension is cirrhosis and therefore carvedilol is increasingly used in these patients. Due to its extensive hepatic metabolism, carvedilol is contraindicated in severe hepatic impairment...
2017: Clinical Hypertension
https://www.readbyqxmd.com/read/29211743/symptoms-associated-with-adverse-dengue-fever-prognoses-at-the-time-of-reporting-in-the-2015-dengue-outbreak-in-taiwan
#14
Chun-Yin Yeh, Po-Lin Chen, Kun-Ta Chuang, Yu-Chen Shu, Yu-Wen Chien, Guey Chuen Perng, Wen-Chien Ko, Nai-Ying Ko
BACKGROUND: Tainan experienced the most severe dengue epidemic in Taiwan in 2015. This study investigates the association between the signs and symptoms at the time of reporting with the adverse dengue prognoses. METHODS: A descriptive study was conducted using secondary data from the Dengue Disease Reporting System in Tainan, Taiwan, between January 1 and December 31, 2015. A multivariate stepwise logistic regression was used to identify the risk factors for the adverse prognoses: ICU admissions and mortality...
December 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29211186/epidemiology-of-acute-kidney-injury-and-chronic-kidney-disease-in-the-intensive-care-unit
#15
Darwin Tejera, Fernanda Varela, Daniela Acosta, Stephanie Figueroa, Sebastián Benencio, Cristina Verdaguer, Mauricio Bertullo, Federico Verga, Mario Cancela
OBJECTIVE: To describe the epidemiology of acute kidney injury, its relationship to chronic kidney disease, and the factors associated with its incidence. METHODS: A cohort study and follow-up were conducted in an intensive care unit in Montevideo, Uruguay. We included patients admitted between November 2014 and October 2015 who were older than 15 years of age and who had at least two measurements of serum creatinine. We excluded patients who were hospitalized for less than 48 hours, patients who died at the time of hospitalization, and patients with chronic renal disease who were on hemodialysis or peritoneal dialysis...
November 30, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29209989/pancreaticoduodenal-artery-aneurysms-due-to-median-arcuate-ligament-syndrome-what-we-need-to-know
#16
A Peyrottes, D Mariage, P Baqué, D Massalou
Median arcuate ligament (MAL) syndrome is a rare and poorly known cause of abdominal pain. MAL narrows the celiac artery (CA), resulting in true distal aneurysms, including pancreaticoduodenal artery (PDA) aneurysms. These aneurysms often have an aggressive course, as rupture can result in hemorrhagic shock. CT scan appears to be the most effective investigation for the diagnosis of PDA aneurysms and may reveal possible celiac artery compression. In this series, we describe four cases of PDA aneurysm: two ruptured aneurysms treated by an endovascular procedure and two non-ruptured aneurysms treated by surgery...
December 5, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29209145/altered-neuroendocrine-immune-responses-a-two-sword-weapon-against-traumatic-inflammation
#17
REVIEW
Ce Yang, Jie Gao, Juan Du, Xuetao Yang, Jianxin Jiang
During the occurrence and development of injury (trauma, hemorrhagic shock, ischemia and hypoxia), the neuroendocrine and immune system act as a prominent navigation leader and possess an inter-system crosstalk between the reciprocal information dissemination. The fundamental reason that neuroendocrinology and immunology could mix each other and permeate toward the field of traumatology is owing to their same biological languages or chemical information molecules (hormones, neurotransmitters, neuropeptides, cytokines and their corresponding receptors) shared by the neuroendocrine and immune systems...
2017: International Journal of Biological Sciences
https://www.readbyqxmd.com/read/29208210/evaluation-of-the-delta-neutrophil-index-from-an-automated-blood-cell-analyser-in-septic-dogs
#18
R Troìa, C Agnoli, S Calipa, S Segalina, E Murgia, M Gruarin, F Dondi, M Giunti
Immature granulocytes (IG) are a marker of severe inflammatory states in human beings and animals, and have been linked to a diagnosis of sepsis and poor prognosis. The delta neutrophil index (DNI), automatically calculated by a haematological analyser, provides an estimate of circulating IG. In particular, an increased DNI value has been associated with the severity of sepsis, and mortality, in critically ill human beings. The aims of this study were to determine the DNI reference interval (RI) in healthy dogs, and to evaluate its diagnostic and prognostic significance in dogs with sepsis...
December 2017: Veterinary Journal
https://www.readbyqxmd.com/read/29207057/molecular-mechanism-and-targeted-therapy-of-hsp90-involved-in-lung-cancer-new-discoveries-and-developments-review
#19
Biaoxue Rong, Shuanying Yang
The exploration of the molecular mechanisms and signaling pathways on lung cancer is very important for developing new strategies of diagnosis and treatment to this disease, such as finding valuable lung cancer markers and molecularly targeted therapies. Previously, a number of studies disclose that heat shock protein 90 (Hsp90) is upregulated in cancer cells, tissues and serum of lung cancer patients, and its upregulation intimately correlates with the occurrence, development and outcome of lung cancer. On the contrary, inhibition of Hsp90 can suppress cell proliferation, motility and metastasis of lung cancer and promote apoptosis of lung cancer cells via complex signaling pathways...
November 29, 2017: International Journal of Oncology
https://www.readbyqxmd.com/read/29203045/anaphylactic-shock-with-an-ultrasound-contrast-agent
#20
S Coudray, C Fabre, I Aichoun, A Perez-Martin
Echo contrast agents, such as SonoVue®, (Bracco, Milan, Italy) are often used to enhance diagnosis. Although their use is safe, some rare side effects could be severe or even fatal. We are reporting a case of severe systemic allergic reaction after infusion of SonoVue®. After a brief review of the literature, the aim of this paper is to draw attention to this risk and recall the safety instructions coming with the use of ultrasound contrast agents.
December 2017: Journal de Médecine Vasculaire
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