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https://www.readbyqxmd.com/read/29679215/diagnostic-role-of-serum-tryptase-in-anaphylactic-deaths-in-forensic-medicine-a-systematic-review-and-meta-analysis
#1
REVIEW
Kai-Jian Sun, Jie-Tao He, Hong-Yan Huang, Ye Xue, Xiao-Li Xie, Qi Wang
Postmortem diagnosis of sudden death due to anaphylaxis can be very difficult due to the non-specific pathological findings in forensic practice. Postmortem serum tryptase has been used as an indicator of possible ante-mortem anaphylaxis. Though many previous studies have been conducted to explore the diagnostic significance of serum tryptase for lethal anaphylaxis, inconsistent results were documented. In this study, we made a retrospective study and presented a systematic review and meta-analysis that aims to summarize the diagnostic significance of postmortem serum tryptase in the deceased with and without anaphylactic shock and to calculate a cutoff value for future reference in the identification of deaths due to anaphylactic shock...
April 21, 2018: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/29676380/fatal-meningococcal-septicemia-without-meningeal-signs-contribution-of-the-peripheral-smear-in-diagnosis-report-of-a-case
#2
Deepti Mutreja, Nikhil Moorchung, S J Manasa, Jeenu Varghese
Acute meningococcemia is characterized by extensive purpurae consisting of both petechiae and ecchymoses. This condition can be rapidly fatal without treatment due to shock and severe consumptive coagulopathy. We report a case of fatal meningococcal septicemia in a military recruit who presented with fever and associated rapidly progressive purpuric rash (purpura fulminans) without any meningeal signs. Evaluation revealed evidence of disseminated intravascular coagulopathy and multiorgan failure. Diplococci were demonstrated in peripheral blood neutrophils and monocytes...
April 2018: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/29675258/livedo-reticularis-a-cutaneous-clue-to-an-underlying-endocrine-crisis
#3
Natasha Shrikrishnapalasuriyar, Mirena Noyvirt, Philip Evans, Bethan Gibson, Elin Foden, Atul Kalhan
A 54-year-old woman was admitted to hospital with a presumed allergic reaction to a single dose of amoxicillin given for a suspected upper respiratory tract infection. She complained of chest tightness although there was no wheeze or stridor. On examination, she was pyrexial, tachycardic, hypertensive and had a diffuse mottled rash on her lower limbs. Her initial investigations showed raised inflammatory markers. She was treated in the intensive care for a presumed anaphylactic reaction with an underlying sepsis...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29670781/-candida-krusei-empyema-thoracis-a-community-acquired-infection-requiring-a-high-index-of-suspicion
#4
Hazim Bukamur, Waseem Ahmed, Yazan Numan, Ibrahim Shahoub, Fuad Zeid
Empyema thoracis is a serious condition characterized by the accumulation of purulent fluid in the pleural cavity, typically following a pneumonia, subdiaphragmatic abscess, or esophageal rupture. Fungal empyema thoracis is a rare form of this condition with especially high mortality, in which the most frequently isolated fungus is Candida spp. This article presents a 74-year-old female with Candida krusei pneumonia and a complicated hospital course, initially presenting with nausea, vomiting, and dysphagia...
2018: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29666712/eustachian-valve-endocarditis-echocardiographic-diagnosis-in-a-critical-care-patient
#5
Mariana Alves, Rita Faria, António Messias, Carlos Meneses-Oliveira
Eustachian valve endocarditis is rare. A literature review revealed that only 29 cases have been reported and, among them, there is only one mention of an intensive care unit (ICU) admission. We present an 82-year-old man without previous medical records who presented with septic shock with multiple organ dysfunction. The patient was admitted to the ICU and deteriorated with combined shock (septic + cardiogenic). A second ultrasound screen detected a prominent Eustachian valve with mobile multilobulated vegetation attached...
2018: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29661445/epidemiologic-profile-of-patients-transplanted-with-hematopoietic-stem-cells-in-a-reference-service-in-the-state-of-rio-grande-do-norte-brazil
#6
I Campos de Azevedo, M A Ferreira Júnior, L A Pereira de Aquino, A A de Oliveira, G K P Cruz, A I de Queiroz Cardoso, M L Ivo, V E P Santos
BACKGROUND: Hematopoietic stem cell transplantation (HSCT) consists of the intravenous infusion of healthy hematopoietic stem cells to restore the medullary and immunologic function of patients affected by a series of hematologic, oncologic, immunologic, malignant and nonmalignant inherited or acquired diseases, with the possibility of cure or increase of disease-free survival. OBJECTIVE: To characterize the epidemiologic profile and the cases of death of patients who underwent HSCT...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29661236/clinical-analysis-of-50-patients-with-heterotopic-pregnancy-after-ovulation-induction-or-embryo-transfer
#7
Zaigui Wu, Xinmei Zhang, Ping Xu, Xiufeng Huang
OBJECTIVES: The purpose of this study was to evaluate the clinical characteristics, prenatal diagnosis, and management of patients with heterotopic pregnancy after ovulation induction or embryo transfer. METHODS: This was a retrospective study of fifty cases with heterotopic pregnancy, in which the fertilization way, type and number of embryo transferred, gestational age, clinical presentation and outcome of intrauterine, ultrasound presentation and site of ectopic pregnancy, bilateral fallopian tube and treatment were evaluated...
April 16, 2018: European Journal of Medical Research
https://www.readbyqxmd.com/read/29660298/postpartum-hemorrhage-new-insights-for-definition-and-diagnosis
#8
A Borovac-Pinheiro, R C Pacagnella, J G Cecatti, S Miller, A M El Ayadi, J P Souza, J Durocher, P D Blumenthal, B Winikoff
The current definition of postpartum hemorrhage (PPH) is inadequate for early recognition of this important cause of maternal mortality, responsible for more than 80,000 deaths worldwide in 2015. A stronger definition of PPH should include both blood loss and clinical signs of cardiovascular changes after delivery, which would help providers to more promptly and accurately identify PPH. Along with the amount of blood loss, clinical signs and specifically the Shock Index (heart rate divided by systolic blood pressure) appear to aid in more accurate diagnosis of PPH...
April 13, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29658864/right-ventricular-perforation-by-a-defibrillator-lead-migrating-to-the-left-breast
#9
Jerneja Tasic, Rok Zbacnik, Igor Zupan, Jus Ksela
Cardiac perforation after an ICD implantation is a rare complication, with a reported incidence between 0.6-5.2%. Its manifestation might be acute, subacute, or delayed, with an acute perforation occurring within the first 24 hours after implantation, frequently accompanied by severe clinical signs, while subacute and delayed perforations have a more benign progression. Here, we report a case of a 69-year old patient with an acute right ventricular perforation by a defibrillator lead migrating all the way through the pericardium and thoracic wall into the left breast, with an unusually mild and benign clinical course, delaying prompt diagnosis and postponing subsequent surgical treatment...
March 5, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29657730/lemierre-s-syndrome-presented-with-acute-pancreatitis
#10
Laura Garcia, Kaori Ito
Case: Lemierre's syndrome is a rare clinical condition that is characterized by infected internal jugular vein thrombosis with metastatic septicemia. The most common causative agent is Fusobacterium necrophorum . A previously healthy 37-year-old woman presented to our emergency department with nausea, vomiting, and diarrhea. She was admitted to the general practice unit with a diagnosis of acute pancreatitis then was subsequently transferred to the intensive care unit due to shock. Physical examination revealed tenderness on right side of the neck...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29656961/in-hospital-outcomes-of-percutaneous-ventricular-assist-devices-versus-intra-aortic-balloon-pumps-in-non-ischemia-related-cardiogenic-shock
#11
Gbolahan O Ogunbayo, Le Dung Ha, Qamar Ahmad, Naoki Misumida, Ayman Elbadawi, Odunayo Olorunfemi, Andrew Kolodziej, Adrian W Messerli, Ahmed Abdel-Latif, Claude S Elayi, Maya Guglin
INTRODUCTION: This study compared inpatient outcomes related to the use of these two devices among patients who developed cardiogenic shock not due to acute myocardial infarction or coronary revascularization. METHODS: We extracted admission-level records of patients with a diagnosis of cardiogenic shock who underwent either PVAD or IABP implantation from the National Inpatient Sample (NIS) database from 2010 to 2014. Our outcomes of interest were mortality and length of stay...
April 12, 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29650839/-a-case-of-splenic-metastasis-from-serous-surface-papillary-carcinoma-of-the-peritoneum-treated-by-laparoscopic-splenectomy
#12
Yongkook Kim, Tomoki Hata, Takayuki Ogino, Hiromitsu Hoshino, Junji Kawada, Miho Okano, Masaki Okuyama, Takeshi Yokoi, Masaru Yamasaki, Toshimasa Tsujinaka
A 50-year-old woman with abdominal fullness, lower abdominal pain, elevated serum CA125, and ascites, underwent neoadjuvant chemotherapy with 6 courses of PTX/CBDCA followed by total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and intrapelvic peritoneal stripping based on a diagnosis of serous surface papillary carcinoma(SSPC) of the peritoneum. Complete response(CR)was shown after adjuvant chemotherapy with 3 courses of the same regimen. After 6 months, serum CA125 level re-increased and abdominal CT showed small low density areas in the patient's spleen and the perisplenic fat tissue...
April 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29649938/preoperative-physiology-imaging-and-management-of-interrupted-aortic-arch
#13
Kevin Friedman
Interrupted aortic arch (IAA) is a rare form of critical neonatal heart disease in which there is lack of continuity between the ascending aorta and the descending thoracic aorta. In the absence of prenatal diagnosis, patients with IAA present in shock when the patent ductus arteriosus closes. Diagnosis can generally be made by echocardiography, and initiation of prostaglandin E1 infusion allows for adequate lower body perfusion prior to surgical repair. Full neonatal repair can be achieved with good outcomes in most cases...
April 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29649820/accuracy-of-acid-base-diagnoses-using-the-central-venous-blood-gas-in-the-medical-intensive-care-unit
#14
Sarah J Schrauben, Dan Negoianu, Cristiana Costa, Raphael M Cohen, Stanley Goldfarb, Barry D Fuchs, Jeffrey S Berns
BACKGROUND: Acid-base disturbances are frequent in critically ill patients. Arterial blood gas (ABG) is the gold standard in the diagnosis of these disturbances, but it is invasive with potential hazards. For patients with a central venous catheter, venous blood gas (VBG) sampling may be an alternative, less-invasive diagnostic tool. However, the accuracy of a central VBG-based acid-base disorder diagnosis compared to an ABG is unknown. The primary objective of this study was to assess the accuracy of a central VBG-based acid-base disorder diagnosis compared to the "gold standard" ABG in critically ill patients...
April 12, 2018: Nephron
https://www.readbyqxmd.com/read/29644505/cardiotoxicity-of-immunotherapy-incidence-diagnosis-and-management
#15
REVIEW
Aarti Asnani
PURPOSE OF REVIEW: This review describes cardiotoxicity associated with adoptive T cell therapy and immune checkpoint blockade. RECENT FINDINGS: Cardiotoxicity is a rare but potentially fatal complication associated with novel immunotherapies. Both affinity-enhanced and chimeric antigen receptor T cells have been reported to cause hypotension, arrhythmia, and left ventricular dysfunction, typically in the setting of cytokine release syndrome. Immune checkpoint inhibitors are generally well-tolerated but have the potential to cause myocarditis, with clinical presentations ranging from asymptomatic cardiac biomarker elevation to heart failure, arrhythmia, and cardiogenic shock...
April 11, 2018: Current Oncology Reports
https://www.readbyqxmd.com/read/29643888/spectrum-of-complications-of-severe-dka-in-children-in-pediatric-intensive-care-unit
#16
Qalab Abbas, Saba Arbab, Anwar Ul Haque, Khadija Nuzhat Humayun
Objectives: To describe the spectrum of complications of Diabetic Ketoacidosis (DKA) observed in children admitted with severe DKA. Methods: Retrospective review of the medical records of all children admitted with the diagnosis of severe DKA in Pediatric Intensive Care Unit (PICU) of the Aga Khan University Hospital, from January 2010 to December 2015 was done. Data was collected on a structured proforma and descriptive statistics were applied. Results: Total 37 children were admitted with complicated DKA (1...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29643139/pseudoaneurysm-of-the-gastroduodenal-artery-an-unusual-cause-for-hyperamylasaemia
#17
Vasileios Galanakis
A 79-year-old man was admitted electively for investigation of weight loss. While he was an inpatient, he developed severe epigastric pain and an initial blood test revealed an acutely raised amylase (>2000) and deranged liver function tests. A contrast CT angiography showed a large haematoma adjacent to the duodenum, spreading in the retroperitoneal space, arising from a 2 cm bleeding pseudoaneurysm in the region of the gastroduodenal artery. Due to his underlying comorbidities, he was deemed unfit for surgical repair and he had coil embolisation with successful haemostasis...
April 11, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29642928/diagnostic-and-management-of-life-threatening-adult-onset-still-disease-a-french-nationwide-multicenter-study-and-systematic-literature-review
#18
Antoine Néel, Anaïs Wahbi, Benoit Tessoulin, Julien Boileau, Dorothée Carpentier, Olivier Decaux, Laurence Fardet, Guillaume Geri, Pascal Godmer, Cécile Goujard, Hervé Maisonneuve, Arnaud Mari, Jacques Pouchot, Jean-Marc Ziza, Cédric Bretonnière, Mohamed Hamidou
BACKGROUND: Adult-onset Still disease (AOSD) is a rare systemic inflammatory disorder. A few patients develop organ complications that can be life-threatening. Our objectives were to describe the disease course and phenotype of life-threatening AOSD, including response to therapy and long-term outcome. METHODS: A multicenter case series of intensive care medicine (ICU) patients with life-threatening AOSD and a systematic literature review. RESULTS: Twenty patients were included...
April 11, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29628475/prognostic-improvement-of-acute-necrotizing-eosinophilic-myocarditis-anem-through-a-rapid-pathological-diagnosis-and-appropriate-therapy
#19
Akihiko Yonenaga, Eriko Hasumi, Katsuhito Fujiu, Aya Ushiku, Masaru Hatano, Jiro Ando, Hiroyuki Morita, Masafumi Watanabe, Issei Komuro
We present the case of a patient with acute necrotizing eosinophilic myocarditis (ANEM) who rapidly recovered after receiving high-dose corticosteroid therapy. A previously healthy 29-year-old woman presented to our hospital with abdominal pain, nausea, and fever that had lasted for two days. Her clinical condition progressively declined and she ultimately presented with cardiogenic shock due to fulminant heart failure and atrioventricular dissociation due to sinus bradycardia, which required inotropic and ventilatory support...
April 6, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29628470/a-rare-case-of-rush-progression-of-purulent-pericarditis-by-escherichia-coli-in-a-patient-with-malignant-lymphoma
#20
Shunpei Horii, Hirotaka Yada, Kei Ito, Ayumu Osaki, Atsushi Sato, Toyokazu Kimura, Risako Yasuda, Takumi Toya, Takayuki Namba, Nobuyuki Masaki, Takeshi Adachi
Purulent pericarditis is a rare disease in the antibiotic era. The common pathogens of purulent pericarditis are gram-positive species such as Staphylococcus aureus. Streptococcus pneumoniae, Salmonella, Haemophilus, fungal pathogens/tuberculosis can also result in purulent pericarditis. We report an old male case of purulent pericarditis by Escherichia coli. He came to our hospital suffering from leg edema for 3 months. Echocardiography revealed the large amount of pericardial effusion, and he was admitted to test the cause of pericardial effusion without high fever, tachycardia, and shock vital signs...
April 6, 2018: International Heart Journal
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