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shock diagnosis

Xiaojing Wang, Fan Ping, Cuijuan Qi, Xinhua Xiao
BACKGROUND: Autoimmune polyglandular syndrome type 2 (APS-2), also known as Schmidt's syndrome, is an uncommon disorder characterized by the coexistence of Addison's disease with thyroid autoimmune disease and/or type 1 diabetes mellitus. Addison's disease as the obligatory component is potentially life-threatening. Unfortunately, the delayed diagnosis of Addison's disease is common owing to its rarity and the nonspecific clinical manifestation. METHODS: Here we reported a case of 38-year-old female patient who presented with 2 years' history of Hashimoto's thyroiditis and received levothyroxine replacement...
October 2016: Medicine (Baltimore)
D B Kadam, Sonali Salvi, Ajay Chandanwale
The World Health Organization (WHO) has coined the term expanded dengue to describe cases which do not fall into either dengue shock syndrome or dengue hemorrhagic fever. This has incorporated several atypical findings of dengue. Dengue virus has not been enlisted as a common etiological agent in several conditions like encephalitis, Guillain Barre syndrome. Moreover it is a great mimic of co-existing epidemics like Malaria, Chikungunya and Zika virus disease, which are also mosquito-borne diseases. The atypical manifestations noted in dengue can be mutisystemic and multifacetal...
July 2016: Journal of the Association of Physicians of India
Tanveer Ahmad, Shankaragouda Patil, Ashwini Kumar Pasarad, Nandakumar Neralakere Maheshwarappa, Kolkebaile Sadanand Kishore
Paragangliomas, extra-adrenal pheochromocytomas, are rare catecholamine-secreting tumor. A 34-year-old lady admitted with diagnosis of ST elevation acute myocardial infarction with cardiogenic shock. Left ventricular function, severely depressed, returned to normal after initial stabilization. Coronary angiogram was normal. A para-aortic paraganglioma was diagnosed during the patient's work-up with biochemical studies, computed tomography of abdomen and functional radioisotopes imaging and was eventually surgically resected...
September 2016: Indian Heart Journal
Ruixue Miao, Zhiling Wang, Qin Guo, Yang Wen, Qiong Liao, Yu Zhu, Min Shu, Chaomin Wan
BACKGROUND: Visceral Leishmaniasis (VL) is a life-threatening parasitic infection transmitted by phlebotomine sandflies. We undertook this study to analyze the clinical features of pediatric VL in a population of Chinese children. METHODS: A retrospective study was performed with pediatric patients (≤14years) diagnosed with VL based on bone-marrow biopsy, serology and diagnosis based on clinical manifestation and the improvement after the experimental drug when negative bone marrow and serology results were shown...
September 30, 2016: Pediatric Infectious Disease Journal
Antoinette S Birs, Jose A Perez, Mark A Rich, Hubert S Swana
Iatrogenic bladder injuries have been reported in the neonate during umbilical artery/vein catheterization, voiding cystourethrogram, urinary catheterizations, and overwhelming hypoxic conditions. Patients with iatrogenic bladder perforations can present with acute abdomen indicating urinary peritonitis, septic-uremic shock, or subtle symptoms like abdominal distension, pain, hematuria, uremia, electrolyte imbalances, and/or difficulty urinating. The following neonatal case report of perforated bladder includes a review of the signs, symptoms, diagnostic tools, and management of bladder injury in neonates...
2016: Case Reports in Urology
Michael L Rigby
Major congenital or acquired heart disease in neonates presents with cyanosis, hypoxia, acute circulatory failure or cardiogenic shock. Antenatal diagnosis is made in up to 50% but heart disease is unanticipated in the remainder. The presence of significant heart disease in premature infants is also frequently not suspected at first; in general, whatever the underling cardiac anomaly, the clinical condition is worse, deteriorates more quickly and carries a poorer prognosis in premature and low birth weight infants...
October 13, 2016: Early Human Development
Andrés M Bur, Jason A Brant, Carolyn L Mulvey, Elizabeth A Nicolli, Robert M Brody, John P Fischer, Steven B Cannady, Jason G Newman
Importance: Unplanned hospital readmission is costly and in recent years has become a focus of health care legislation intended to reduce health care expenditures. Greater understanding of which perioperative complications are associated with hospital readmission after surgery for head and neck cancer is needed to reduce unplanned readmissions. Objective: To determine which clinical risk factors and complications are associated with 30-day unplanned readmission after surgery for malignant neoplasms of the head and neck...
October 13, 2016: JAMA Otolaryngology—Head & Neck Surgery
Marloes Visser, Jeroen F van der Heijden, Jasper J van der Smagt, Pieter A Doevendans, Arthur A Wilde, Peter Loh, Rutger J Hassink
BACKGROUND: Idiopathic ventricular fibrillation (IVF) is a rare cause of sudden cardiac arrest. Limited data are available on the long-term outcome of IVF patients. METHODS AND RESULTS: In this retrospective cohort study, 107 consecutive patients with an initial diagnosis of IVF were analyzed (age at index event 40.4 years, 60% male). Missing diagnostic data were acquired during follow-up, including genetic testing, to exclude underlying disease. A specific diagnosis was revealed in 22 of 107 patients (21%) during a median follow-up of 10...
October 2016: Circulation. Arrhythmia and Electrophysiology
Yen-Man Lu, Tsu-Ming Chien, Yii-Her Chou, Wen-Jeng Wu, Chun-Nung Huang
INTRODUCTION: Shock wave lithotripsy (SWL) is widely used. However, several studies have reported increased blood pressure immediately after SWL. Until now, the association between SWL and new-onset hypertension has been a topic of discussion. This study is aimed at determining whether SWL leads to new-onset hypertension. METHODS: Data were sourced from the Longitudinal Health Insurance Database 2000 of Taiwan, Republic of China, which was compiled from 1996 to 2010 using National Health Insurance data...
October 13, 2016: Urologia Internationalis
Sarah Meaney, Paul Corcoran, Keelin O'Donoghue
BACKGROUND: Perinatal death is one of the most difficult bereavements due to the shock and profound grief experienced by parents. It has been established that such bereavement has a life-lasting impact. Twin pregnancy is associated with increased perinatal risk, with higher rates of perinatal mortality than in singleton pregnancy. OBJECTIVES: To date, few studies have examined the effect of the loss of one twin diagnosed with a congenital abnormality during pregnancy...
October 11, 2016: Journal of Palliative Medicine
Min-Zhu Zhao, Yong-Guo Li, Peng Zhang, Jin-Cheng Xiong, Shi-Sheng Zhu, Xuan Xiao, Jian-Bo Li
In forensic medicine, the diagnosis of death due to neurogenic shock is considered to be an aporia, as lacking objective indicators and presenting atypical symptoms in autopsy. Medico-legal disputes and complaints occasionally result from this ambiguity. To explore potential objective indicators of neurogenic shock, we set up a model of neurogenic shock by applying an external mechanical force on the carotid sinus baroreceptor in rabbits. The serum atrial natriuretic peptide (ANP) level was measured by radioimmunoassay in the control group (n = 8), survival group (n = 15) and death group (n = 5) both before and after the insult...
October 10, 2016: International Journal of Legal Medicine
O O Ayandipo, O O Afuwape, D O Irabor, A I Abdurrazzaaq, N A Nwafulume
BACKGROUND: Peritonitis is a life-threatening condition and requires urgent surgical management. Despite improvements in the care of patients with peritonitis, its management is still challenging and associated with significant morbidity and mortality. The aim of this study was to determine factors influencing the outcome in patients managed for peritonitis in a tertiary health institution in Nigeria. METHOD: A retrospective study involving 302 patients managed for peritonitis over a 3- year period...
June 2016: Annals of Ibadan Postgraduate Medicine
Mathieu Jozwiak, Xavier Monnet, Jean-Louis Teboul
Sepsis bundles represent key elements of care regarding the diagnosis and treatment of patients with septic shock and allow ones to convert complex guidelines into meaningful changes in behavior. Sepsis bundles endorsed the early goal-directed therapy (EGDT) and their implementation resulted in an improved outcome of septic shock patients. They induced more consistent and timely application of evidence-based care and reduced practice variability. These benefits mainly depend on the compliance with sepsis bundles, highlighting the importance of dedicated performance improvement initiatives, such as multifaceted educational programs...
September 2016: Annals of Translational Medicine
Emine Alp
Septic shock is still a lethal disease in intensive care units (ICU). The mortality can exceed 40% even with therapeutic management. The high mortality is clearly associated with the delay of appropriate antimicrobial therapy. Early diagnosis and identification of infectious source is the mainstay of optimal therapeutic management. On the other hand, source control and optimize antibiotic dosing according to pharmacokinetics (PK)/pharmacodynamics (PD) properties of antibiotics and organ dysfunction of patients are required to get the best clinical outcome...
September 2016: Annals of Translational Medicine
Francisco Valenzuela-Sánchez, Blanca Valenzuela-Méndez, Juan Francisco Rodríguez-Gutiérrez, Ángel Estella-García, María Ángela González-García
Mid-regional pro-adrenomedullin (MR-proADM) has a good biomarker profile: its half-life is several hours, and its plasma concentrations can be determined in clinical practice, it is essentially irrelevant, but proportionally represents the levels and activity of adrenomedullin (ADM). ADM synthesis is widely distributed in tissues, including bone, adrenal cortex, kidney, lung, blood vessels and heart. Its fundamental biological effects include vasodilator, positive inotropic, diuretic, natriuretic and bronchodilator...
September 2016: Annals of Translational Medicine
Amalia Katafigioti, Ioannis Katafigiotis, Stavros Sfoungaristos, Christos Alamanis, Konstantinos Stravodimos, Ioannis Anastasiou, Eleni Roumelioti, Mordechai Duvdevani, Constantinos Constantinides
OBJECTIVE: To search which category of proteins can be detected in urine in order to examine subsequently its ability to improve our accuracy for the diagnosis of Prostate Cancer (PCa) as biomarkers in clinical useful fluids like urine and serum. Material and method(s): Urine samples of 127 patients were obtained after a vigorous transrectal prostatic massage to both lobes. The patients were considered to have a high risk for PCa according to their PSA (> 4 ng/ml), their digital rectal examination (DRE) (positive for suspicious prostatic lesions) or to their abnormal PSA kinetics (PSA velocity (PSAV > 0...
October 5, 2016: Archivio Italiano di Urologia, Andrologia
M Hückstädt, G O Hofmann, T Mendel, R Stuttmann, P Hilbert-Carius
BACKGROUND: Sepsis and septic shock are major contributors to morbidity and mortality in intensive care patients. Early identification and adequate therapy are of utmost importance to reduce the still high mortality in patients with severe sepsis. Many of the pathophysiologic changes are nonspecific. Thus, a combination of symptoms and laboratory results are necessary to confirm the diagnosis. Impairment of the Horovitz index is identified as being a primal prognostic criterion for early diagnosis in serious progression of sepsis, after exclusion of a few differential diagnoses...
October 5, 2016: Der Anaesthesist
Maïté Micaelo, Pascal Rasmy, Marlène Amara, Juliette Lambert, Aymeric Coutard, Béatrice Pangon
Erysipelothrix rhusiopathiae, a Gram-positive bacillus, is reported to cause for cutaneous infections and endocarditis. We report a case of E. rhusiopathiae bacteremia without severe clinical illness. The patient, a 74-year-old man, is suffering from a chronic lymphoid leukemia (LLC). Following a trauma, the patient developed a bruise on the left inch. Because the site of shock seemed clinically infected, oral amoxicilline-acid clavulanic (AAC) treatment was started after withdrawn 1 set of blood cultures. These blood culture specimens yielded a Gram-positive bacillus identified as E...
October 1, 2016: Annales de Biologie Clinique
Maria K Abril, Adam S Barnett, Kara Wegermann, Eric Fountain, Andrew Strand, Benjamin M Heyman, Britton A Blough, Aparna C Swaminathan, Batu Sharma-Kuinkel, Felicia Ruffin, Barbara D Alexander, Chad M McCall, Sylvia F Costa, Murat O Arcasoy, David K Hong, Timothy A Blauwkamp, Michael Kertesz, Vance G Fowler, Bryan D Kraft
We report the case of a 60-year-old man with septic shock due to Capnocytophaga canimorsus that was diagnosed in 24 hours by a novel whole-genome next-generation sequencing assay. This technology shows great promise in identifying fastidious pathogens, and, if validated, it has profound implications for infectious disease diagnosis.
September 2016: Open Forum Infectious Diseases
Bernd Saugel, Wolfgang Huber, Axel Nierhaus, Stefan Kluge, Daniel A Reuter, Julia Y Wagner
In patients with sepsis and septic shock, the hemodynamic management in both early and later phases of these "organ dysfunction syndromes" is a key therapeutic component. It needs, however, to be differentiated between "early goal-directed therapy" (EGDT) as proposed for the first 6 hours of emergency department treatment by Rivers et al. in 2001 and "hemodynamic management" using advanced hemodynamic monitoring in the intensive care unit (ICU). Recent large trials demonstrated that nowadays protocolized EGDT does not seem to be superior to "usual care" in terms of a reduction in mortality in emergency department patients with early identified septic shock who promptly receive antibiotic therapy and fluid resuscitation...
2016: BioMed Research International
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