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systolic blood pressure and abdominal pain

E M Dauchy, M Modica, N Masri
CASE: A 54 year old woman with hypothyroidism presented with right flank pain that began acutely one week prior to presentation. She was told initially she had a urinary tract infection and treatment resulted in mild symptomatic improvement. The pain returned and she presented to another Emergency Department (ED); and was told the pain was due to constipation. She returned to the ED the next day when her pain worsened and her labs were notable for WBC of 19,000/uL, BUN/Cr of 28/0.75 mg/dL, AST of 31 U/L, ALT of 92 U/L and total bilirubin of 0...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Jeffrey R Strawn, Scott N Compton, Brigitte Robertson, Anne Marie Albano, Mohamed Hamdani, Moira A Rynn
OBJECTIVE: This is a feasibility study evaluating the safety, tolerability, and potential anxiolytic efficacy of the α2 agonist guanfacine extended-release (GXR) in children and adolescents with generalized anxiety disorder (GAD), separation anxiety disorder (SAD), or social phobia/social anxiety disorder. METHODS: Youth aged 6-17 years with a primary diagnosis of GAD, SAD, and/or social anxiety disorder were treated with flexibly dosed GXR (1-6 mg daily, n = 62) or placebo (n = 21) for 12 weeks...
February 2017: Journal of Child and Adolescent Psychopharmacology
Vahid Mohammad Karimi, Amir Anushiravani, Mohammad Hossein Dabbaghmanesh, Massood Hosseinzadeh, Ali Reza Rasekhi, Mahmoud Zamirian, Amir Anushiravani
The Budd-Chiari syndrome (BCS) is a rare disorder caused by the obstruction of the hepatic veins or the inferior vena cava (IVC) at the suprahepatic level. This syndrome is developed by either hepatic vein thrombosis or mechanical venous obstruction and leads to centrilobular hepatic congestion with the subsequent development of fibrosis and cirrhosis. Intracardiac tumors have been rarely reported as a cause of the BCS. These tumors usually originate from the atrial septum. Very rarely, they arise either from the junction of the IVC and the right atrium or from the Eustachian valve...
July 6, 2016: Journal of Tehran Heart Center
Deborah Hl Ng, Joshua Gx Wong, Tun-Linn Thein, Yee-Sin Leo, David C Lye
Dengue fever is gaining importance in Singapore with an increase in the number of cases and mortality in recent years. Although prolonged and saddleback fever have been reported in dengue fever, there are no specific studies on their significance in dengue. This study aims to examine the prevalence of prolonged and saddleback fever in dengue as well as their associations with dengue severity. A total of 2843 polymerase-chain reaction (PCR) confirmed dengue patients admitted to Tan Tock Seng Hospital from 2004 to 2008 were included in the study...
2016: PloS One
Rikard Ambrus, Rune B Strandby, Niels H Secher, Kim Rünitz, Morten B S Svendsen, Lonnie G Petersen, Michael P Achiam, Lars B Svendsen
BACKGROUND: Thoracic epidural analgesia (TEA) is used for pain relief during and after abdominal surgery, but the effect of TEA on the splanchnic microcirculation remains debated. We evaluated whether TEA affects splanchnic microcirculation in the pig. METHODS: Splanchnic microcirculation was assessed in nine pigs prior to and 15 and 30 min after induction of TEA. Regional blood flow was assessed by neutron activated microspheres and changes in microcirculation by laser speckle contrast imaging (LSCI)...
October 6, 2016: BMC Anesthesiology
Miguel Manzur, Sukgu M Han, Joie Dunn, Ramsey S Elsayed, Fernando Fleischman, Yolee Casagrande, Fred A Weaver
OBJECTIVE: The objective of this study was to describe the outcomes of patients with acute aortic syndrome (AAS) during and after transfer to a regional aortic center by a rapid transport system. METHODS: Review of patients with AAS who were transferred by a rapid transport system to a regional aortic center was performed. Data regarding demographics, diagnosis, comorbidities, transportation, and hospital course were acquired. Severity of existing comorbidities was determined by the Society for Vascular Surgery Comorbidity Severity Score (SVSCSS)...
January 2017: Journal of Vascular Surgery
G S Kew, J Cho, A Lateef
We describe a gravid 37-year-old Chinese lady with known triple positive primary antiphospholipid syndrome with previous recurrent deep vein thrombosis and early spontaneous miscarriages. She was managed with low-molecular weight heparin, aspirin, hydroxychloroquine, prednisolone and monthly intravenous immunoglobulin.She presented with recurrent per-vaginal bleeding at 22 weeks of gestation and was found to have abruptio placentae. Anti-coagulation was held off. She subsequently delivered a stillborn at 24 weeks and anti-coagulation was restarted...
October 1, 2016: Lupus
Jayashamani Tamibmaniam, Narwani Hussin, Wee Kooi Cheah, Kee Sing Ng, Prema Muninathan
BACKGROUND: WHO's new classification in 2009: dengue with or without warning signs and severe dengue, has necessitated large numbers of admissions to hospitals of dengue patients which in turn has been imposing a huge economical and physical burden on many hospitals around the globe, particularly South East Asia and Malaysia where the disease has seen a rapid surge in numbers in recent years. Lack of a simple tool to differentiate mild from life threatening infection has led to unnecessary hospitalization of dengue patients...
2016: PloS One
Sayed Mahdi Marashi, Zeynab Nasri Nasrabadi, Mostafa Jafarzadeh, Sogand Mohammadi
A 40-year-old male patient with suicidal ingestion of one tablet of aluminium phosphide was referred to the department of toxicology emergency of Baharloo Hospital, Tehran, Iran. The garlic odor was smelled from the patient and abdominal pain and continuous vomiting as well as agitation and heartburn were the first signs and symptoms. Systolic and diastolic blood pressures at the arrival time were 95 and 67 mmHg, respectively. Gastric lavage with potassium permanganate (1:10,000), and 2 vials of sodium bicarbonate through a nasogastric tube was started for the patient and the management was continued with free intravenous infusion of 1 liter of NaCl 0...
July 2016: Acta Medica Iranica
Soichiro Yamashita, Takako Yokouchi, Makoto Tanaka
STUDY OBJECTIVES: To evaluate whether intraoperative high-dose remifentanil infusion increased local anesthetic consumption in postoperative epidural analgesia and postoperative pain scores compared with low-dose remifentanil infusion. DESIGN: Prospective, randomized controlled study. SETTING: Operating room, university hospital. PATIENTS: Thirty female patients scheduled for elective gynecological abdominal surgery...
August 2016: Journal of Clinical Anesthesia
Mathieu Raillard, Julien Michaut-Castrillo, Damien Spreux, Olivier Gauthier, Gwenola Touzot-Jourde, Delphine Holopherne-Doran
OBJECTIVE: To compare the effects of intravenous (IV) medetomidine-morphine and medetomidine-methadone on preoperative sedation, isoflurane requirements and postoperative analgesia in dogs undergoing laparoscopic surgery. STUDY DESIGN: Randomized, crossover trial. ANIMALS: Twelve adult Beagle dogs weighing 15.1 ± 4.1 kg. METHODS: Dogs were administered medetomidine (2.5 μg kg(-1) ) IV 5 minutes before either methadone (MET) or morphine (MOR) (0...
June 9, 2016: Veterinary Anaesthesia and Analgesia
Lei Zhao, Zhuang Tian, Quan Fang
OBJECTIVE: To summarize the clinical characteristics and cardiac imaging features by focusing the diagnostic value of MRI in patients with cardiac amyloidosis (CA). METHODS: A total of 31 cases with pathologically proven CA from January 2013 to December 2014 were included in this retrospective study. RESULTS: Patients expressed typical disease manifestations at a late age (54±11) years. Majority patients were male (20 cases, 64.5%) in this cohort...
November 2015: Zhonghua Xin Xue Guan Bing za Zhi
Joshua G X Wong, Tun Linn Thein, Yee-Sin Leo, Junxiong Pang, David C Lye
BACKGROUND: Clinically significant bleeding is important for subsequent optimal case management in dengue patients, but most studies have focused on dengue severity as an outcome. Our study objective was to identify differences in admission parameters between patients who developed clinically significant bleeding and those that did not. We sought to develop a model for discriminating between these patients. METHODS: We conducted a retrospective study of 4,383 adults aged >18 years who were hospitalized with dengue infection at Tan Tock Seng Hospital, Singapore from 2005 to 2008...
2016: PloS One
Dmitry M Davydov, Bruce Naliboff, Leila Shahabi, David Shapiro
OBJECTIVE: This study was conducted to present evidence of differences in autonomic regulation of cardiovascular activity and its role in the severity of specific (disease-related) and non-specific (negative affect and chronic pain-related) symptoms in individuals with Irritable Bowel Syndrome (IBS). METHODS: Seventy-eight female patients with IBS and 27 healthy women age 18-62 years were assessed for IBS symptoms, negative affect, and baroreceptor sensitivity (BRS), blood pressure (BP), heart rate, and heart rate variability (HRV) at rest...
April 1, 2016: Physiology & Behavior
Mahin Seyedhejazi, Majed Mashhoori, Rasoul Azarfarin, Daryoush Shekhzadeh, Nasrin Taghizadieh
BACKGROUND: The aim of the present study is to compare the success rate and complications of caudal epidural bupivacaine alone or in combination with intravenous (IV) midazolam and ketamine in awake infants undergoing lower abdominal surgery. MATERIALS AND METHODS: In this double-blind, clinical trial study, 90 infants (aged below 3 months and weight below 5 kg) with American Society of Anaesthesiologists I-II, were divided into three groups of each 30: Group 1 received bupivacaine 0...
October 2015: African Journal of Paediatric Surgery: AJPS
Kenji Miura, Toru Kanno, Keichiro Nakamae, Masashi Kubota, Ryuichi Nishiyama, Takashi Okada, Yoshihito Higashi, Hitoshi Yamada
Pheochromocytoma crisis is a life-threatening situation. Herein we report a case of catecholamineinduced crisis caused by the rupture of cystic pheochromocytoma. A 76-year-old man with hypertension was referred to our hospital because of a cystic tumor in the retroperitoneal space adjacent to the aorta, which was suspicious of pheochromocytoma. Two days after admission, lower abdominal pain suddenly appeared, followed by hypertension with systolic pressure of 260 mmHg. Computed tomography revealed that the cystic tumor was ruptured spontaneously, leading to diagnosis of pheochromocytoma crisis...
November 2015: Hinyokika Kiyo. Acta Urologica Japonica
Kanae Suu, Takao Kato, Moriaki Inoko
A 79-year-old man was referred to the emergency room following a sudden episode of 'spitting blood', with a blood pressure of 128 (systolic) and 75 mm Hg (diastolic) and a heart rate of 60 bpm. His medical history included the treatment of gastric cancer and untreated hypertension. At that time, his symptoms were limited without any chest, back or abdominal pain. After a presentation of haemoptysis was confirmed, a chest radiograph revealed an air-fluid level (a 'niveau') that was continuous towards the enlarged thoracic aorta and the thoracic cavity...
July 6, 2015: BMJ Case Reports
Alaa A Abd-Elsayed, Maged Guirguis, Mark S DeWood, Sherif S Zaky
BACKGROUND: Alpha-2 adrenergic agonists produce safe and effective analgesia, but most investigations studying the analgesic effect of alpha-2 adrenoceptor agonists postoperatively included previous or concomitant administration of other analgesics. Because clonidine potentiates the effect of these drugs, its own intrinsic analgesic effect has been difficult to establish. This study was designed to compare the intraoperative and postoperative effects of epidural clonidine vs bupivacaine for patients undergoing lower abdominal surgery...
2015: Ochsner Journal
Athanasios Marinis, Mavroudis Voultsos, Argyrios Foteinos, Paraskevi Tselioti, Alexandra Avraamidou, Nikolaos Paschalidis, Spyros Rizos
Necrotizing soft tissue infections (NSTIs) of the abdominal wall usually occur when either a common superficial soft tissue infection progresses down to, or an injury (e.g. knife stab) penetrates, the investing muscle fascia, or an intra-abdominal infection spreads directly to the muscle layers of the abdominal wall. These infections are severe and associated with significant morbidity and mortality. We present an 83-year-old female diabetic patient who was admitted to the surgical emergency department complaining of right abdominal pain after a fall to the floor...
June 2015: Le Infezioni in Medicina
Lorenzo Rafer, Flower Austin, Jessica Frey, Christie Mulvey, Sonia Vaida, Jansie Prozesky
CONTEXT: Anesthesiologists use various medications to provide surgical patients with pain relief in the postoperative period. Other modalities, such as music, could be used in conjunction with opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) to decrease pain and lower heart rate and blood pressure. Our hypothesis was that patients listening to jazz in a postanesthesia care unit (PACU) would have lower heart rates and blood pressures and reduced pain and anxiety. OBJECTIVE: The study objective was to determine if listening to jazz music in the PACU, when compared to wearing noise-canceling headphones with no music playing, would decrease heart rate, blood pressure, pain, or anxiety in patients undergoing a hysterectomy...
2015: Advances in Mind-body Medicine
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