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https://www.readbyqxmd.com/read/28095967/intravenous-immunoglobulin-therapy-in-pediatric-narcolepsy-a-nonrandomized-open-label-controlled-longitudinal-observational-study
#1
Michel Lecendreux, Johanna Berthier, Jennifer Corny, Olivier Bourdon, Claire Dossier, Christophe Delclaux
STUDY OBJECTIVES: Previous case reports of intravenous immunoglobulins (IVIg) in pediatric narcolepsy have shown contradictory results. METHODS: This was a nonrandomized, open-label, controlled, longitudinal observational study of IVIg use in pediatric narcolepsy with retrospective data collection from medical files obtained from a single pediatric national reference center for the treatment of narcolepsy in France. Of 56 consecutively referred patients with narcolepsy, 24 received IVIg (3 infusions administered at 1-mo intervals) in addition to standard care (psychostimulants and/or anticataplectic agents), and 32 continued on standard care alone (controls)...
January 11, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28095918/anti-staphylococcal-activity-resulting-from-epithelial-lining-fluid-elf-concentrations-of-amikacin-inhale-administered-via-the-pulmonary-drug-delivery-system
#2
Islam M Ghazi, Mordechai Grupper, David P Nicolau
BACKGROUND: Amikacin inhale (BAY41-6551), a unique drug-device combination of a specially formulated drug solution and a pulmonary drug delivery system device (AMK-I) is currently under phase III study as an adjunctive therapy to IV antibiotics for the treatment of Gram-negative pneumonia in mechanically ventilated patients. While the epidemiology of nosocomial pneumonia is predominated by Gram-negative pathogens such as Pseudomonas aeruginosa and the Enterobacteriaceae, Staphylococcus aureus is increasingly recognized as a pathogen of concern for these pulmonary based infections...
January 17, 2017: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/28094044/diagnosis-and-treatment-of-acute-retinal-necrosis-a-report-by-the-american-academy-of-ophthalmology
#3
Scott D Schoenberger, Stephen J Kim, Jennifer E Thorne, Prithvi Mruthyunjaya, Steven Yeh, Sophie J Bakri, Justis P Ehlers
PURPOSE: To evaluate the available evidence in peer-reviewed publications about the diagnosis and treatment of acute retinal necrosis (ARN). METHODS: Literature searches of the PubMed and Cochrane Library databases were last conducted on July 27, 2016. The searches identified 216 unique citations, and 49 articles of possible clinical relevance were reviewed in full text. Of these 49 articles, 27 were deemed sufficiently relevant or of interest, and they were rated according to strength of evidence...
January 13, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28092314/novel-technique-for-subretinal-fluid-drainage-with-chandelier-assisted-scleral-buckle-surgery-cannula-controlled-drainage
#4
Abdulelah A Al-Abdullah
PURPOSE: To report a novel technique for subretinal fluid drainage in scleral buckle surgery. METHODS: A 26-gauge intravenous cannula with its needle was used to puncture the sclera; then, the needle (metallic part) was withdrawn to further introduce the cannula into the subretinal space. In addition, we describe using the 25-gauge microcannula of the chandelier light to inject the balanced salt solution to help restore the intraocular pressure and push the subretinal fluid through the intravenous cannula under direct visualization...
January 13, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28090049/thyroid-storm-precipitated-by-diabetic-ketoacidosis-and-influenza-a-a-case-report-and-literature-review
#5
Toshiyuki Ikeoka, Hiroaki Otsuka, Naruhiro Fujita, Yukiko Masuda, Shigeto Maeda, Ichiro Horie, Takao Ando, Norio Abiru, Atsushi Kawakami
A 46-year-old woman with a history of Graves' disease presented with the chief complaints of appetite loss, weight loss, fatigue, nausea, and sweating. She was diagnosed with diabetic ketoacidosis (DKA), thyroid storm, and influenza A. She was treated with an intravenous insulin drip, intravenous fluid therapy, intravenous hydrocortisone, oral potassium iodine, and oral methimazole. As methimazole-induced neutropenia was suspected, the patient underwent thyroidectomy. It is important to maintain awareness that thyroid storm and DKA can coexist...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28076897/microrna-expression-shows-inflammatory-dysregulation-and-tumor-like-proliferative-responses-in-joints-of-patients-with-post-infectious-lyme-arthritis
#6
Robert B Lochhead, Klemen Strle, Nancy D Kim, Minna J Kohler, Sheila L Arvikar, John M Aversa, Allen C Steere
OBJECTIVE: Lyme arthritis (LA) is caused by infection with Borrelia burgdorferi and usually resolves following spirochetal killing with antibiotics. However, in some patients, arthritis persists after antibiotic therapy. To provide insights into underlying pathogenic processes associated with post-infectious LA, we analyzed differences in microRNA expression between LA patients with active infection compared with those with post-infectious LA. METHODS: MicroRNA expression was assayed in synovial fluid (SF) from LA patients before and after oral and IV antibiotic therapy, and from synovial tissue from post-infectious LA patients obtained months after antibiotic therapy...
January 11, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28072899/endoluminal-vacuum-therapy-as-treatment-for-anastomotic-colorectal-leakage
#7
Giovanni Milito, Giorgio Lisi, Dario Venditti, Michela Campanelli, Elena Aronadio, Simona Grande, Francesca Cabry, Michele Grande
BACKGROUND: The clinical leakage rate after anterior resection varies from 2.8-20%, with a 6-22% mortality rate and a 10-80% risk of permanent stoma. Endo-SPONGE® (B. Braun Melsungen AG, Melsungen, Germany) may treat extraperitoneal anastomotic leakage in the lesser pelvis. It consists of an open-pored sponge inserted into the cavity. A drainage tube fixed to a low vacuum drainage system is then connected to the sponge through the anus. MATERIAL AND METHODS: Between January 2007 and December 2014, 14 patients with anastomotic leakage following low anterior resection were treated with Endo-SPONGE® and were prospectively evaluated...
January 10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28050897/fluid-resuscitation-in-human-sepsis-time-to-rewrite-history
#8
REVIEW
Liam Byrne, Frank Van Haren
Fluid resuscitation continues to be recommended as the first-line resuscitative therapy for all patients with severe sepsis and septic shock. The current acceptance of the therapy is based in part on long history and familiarity with its use in the resuscitation of other forms of shock, as well as on an incomplete and incorrect understanding of the pathophysiology of sepsis. Recently, the safety of intravenous fluids in patients with sepsis has been called into question with both prospective and observational data suggesting improved outcomes with less fluid or no fluid...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28042062/end-of-life-care-and-quality-of-dying-in-twenty-three-acute-geriatric-hospital-wards-in-flanders-belgium
#9
Rebecca Verhofstede, Tinne Smets, Joachim Cohen, Kim Eecloo, Massimo Costantini, Nele Van Den Noortgate, Luc Deliens
OBJECTIVES: To describe the nursing and medical interventions performed in the last 48 hours of life and the quality of dying of patients dying in acute geriatric hospital wards. METHODS: Design: Cross-sectional descriptive study between October 1(st) 2012 and September 30(th) 2013. SETTING: Twenty-three acute geriatric wards in 13 hospitals in Flanders, Belgium. PARTICIPANTS: Patients hospitalized for more than 48 hours before dying in the participating wards...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28039243/electrical-impedance-tomography-for-non-invasive-assessment-of-stroke-volume-variation-in-health-and-experimental-lung-injury
#10
C J C Trepte, C Phillips, J Solà, A Adler, B Saugel, S Haas, S H Bohm, D A Reuter
BACKGROUND: Functional imaging by thoracic electrical impedance tomography (EIT) is a non-invasive approach to continuously assess central stroke volume variation (SVV) for guiding fluid therapy. The early available data were from healthy lungs without injury-related changes in thoracic impedance as a potentially influencing factor. The aim of this study was to evaluate SVV measured by EIT (SVVEIT) against SVV from pulse contour analysis (SVVPC) in an experimental animal model of acute lung injury at different lung volumes...
January 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28034813/is-first-line-vancomycin-still-the-best-option-to-treat-staphylococcus-healthcare-associated-meningitis
#11
Roman Mounier, David Lobo, Anne Hulin, Biba Nebbad, Fabrice Cook, Gilles Dhonneur
BACKGROUND: diffusion of vancomycin through the blood-brain barrier is poor but important inflammation improved it. Hence, vancomycin is recommended for the treatment of community meningitis. But what about mildly inflammatory healthcare associated meningitis (HAM). Our purpose was to evaluate the impact of cerebrospinal fluid (CSF) vancomycin diffusion in S.epidermidis healthcare-associated meningitis. CASES DESCRIPTION: retrospective study of all consecutive patients with S.epidermidis CSF shunt-associated infection which were treated by continuous intravenous vancomycin following standard of care (60 mg/Kg/d after a loading dose of 15 mg/Kg)...
December 27, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28025411/a-case-of-anti-neurofascin-155-antibody-positive-combined-central-and-peripheral-demyelination-successfully-treated-with-plasma-exchange
#12
Mikito Shimizu, Tohru Koda, Yuji Nakatsuji, Hidenori Ogata, Jun-Ichi Kira, Hideki Mochizuki
A 21-year-old man was admitted to our hospital in June 2015. He felt paresthesia of toes in April 2015, which had been spreading upward, and he became difficult to walk in June. Nerve conduction study showed peripheral demyelinating neuropathy that met the diagnostic criteria for chronic inflammatory demyelinating polyneuropathy (CIDP), and the cerebrospinal fluid (CSF) examination revealed the remarkably increased protein level. In addition, magnetic resonance imaging of his brain showed a few plaques in white matter, so he was finally diagnosed with combined central and peripheral demyelination (CCPD)...
December 23, 2016: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28025408/a-case-of-anti-aquapolin-4-antibody-positive-myelitis-with-hyperhidrosis-following-herpes-zoster
#13
Machiko Suda, Michiko Tsutsumiuchi, Yoshikazu Uesaka, Nobukazu Hayashi
We report an acute myelitis in a 53-year-old woman that occurred in 7 days after the diagnosis of Th5-6 herpes zoster. Clinical examination revealed hyperhidrosis of left side of her face, neck, arm and upper chest. She also had muscle weakness of her left leg and sensory impairment for light touch and temperature in her chest and legs. Spinal cord MRI demonstrated a longitudinal T2-hyperintense lesion extending from Th1 to 7. In the axial imaging, the lesion dominantly located in the left side gray matter...
December 23, 2016: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28018153/a-pediatric-diabetic-ketoacidosis-management-protocol-incorporating-a-two-bag-intravenous-fluid-system-decreases-duration-of-intravenous-insulin-therapy
#14
Megan Veverka, Kourtney Marsh, Susan Norman, Michael Alan Brock, Monica Peng, Jennifer Shenk, Jerome Gene Chen
OBJECTIVES: Diabetic ketoacidosis (DKA) is a leading cause of morbidity and mortality in children with type 1 diabetes. We implemented a standardized DKA management protocol by using a 2-bag intravenous (IV) fluid system. The purpose of the study was to examine if the protocol improved clinical outcomes and process efficiency. METHODS: This was a retrospective study of patients who did and did not undergo the protocol. Patients were included if they were 18 years of age or younger, were diagnosed with DKA, admitted to an intensive care unit or stepdown unit, and received continuous IV insulin...
November 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28006948/intravenous-dexamethasone-attenuated-inflammation-and-influenced-apoptosis-of-lung-cells-in-an-experimental-model-of-acute-lung-injury
#15
P Kosutova, P Mikolka, S Balentova, M Adamkov, M Kolomaznik, A Calkovska, D Mokra
Acute lung injury (ALI) is characterized by diffuse alveolar damage, inflammation, and transmigration and activation of inflammatory cells. This study evaluated if intravenous dexamethasone can influence lung inflammation and apoptosis in lavage-induced ALI. ALI was induced in rabbits by repetitive saline lung lavage (30 ml/kg, 9+/-3-times). Animals were divided into 3 groups: ALI without therapy (ALI), ALI treated with dexamethasone i.v. (0.5 mg/kg, Dexamed; ALI+DEX), and healthy non-ventilated controls (Control)...
December 22, 2016: Physiological Research
https://www.readbyqxmd.com/read/28006657/the-6-chromanol-derivate-sul-109-enables-prolonged-hypothermic-storage-of-adipose-tissue-derived-stem-cells
#16
Ghazaleh Hajmousa, Pieter Vogelaar, Linda A Brouwer, Adrianus C van der Graaf, Robert H Henning, Guido Krenning
Encouraging advances in cell therapy research with adipose derived stem cells (ASC) require an effective short-term preservation method that provides time for quality control and transport of cells from their manufacturing facility to their clinical destination. Hypothermic storage of cells in their specific growth media offers an alternative and simple preservation method to liquid nitrogen cryopreservation or commercial preservation fluids for short-term storage and transport. However, accumulation of cell damage during hypothermia may result in cell injury and death upon rewarming through the production of excess reactive oxygen species (ROS)...
March 2017: Biomaterials
https://www.readbyqxmd.com/read/27995500/adrenal-crises-perspectives-and-research-directions
#17
REVIEW
R Louise Rushworth, David J Torpy, Henrik Falhammar
Adrenal crises are life-threatening complications of adrenal insufficiency. These events have an estimated incidence of between 5 and 10  adrenal crises/100 patient years and are responsible for some of the increased morbidity and excess mortality experienced by patients with adrenal insufficiency. Treatment involves urgent administration of IV/IM hydrocortisone and IV fluids. Patient education regarding preventive measures, such as increasing the dose of replacement therapy ("stress dosing") when sick, using parenteral hydrocortisone as necessary and accessing medical assistance promptly, is still considered the best approach to averting the onset of an adrenal crisis at times of physiological stress, most commonly an infection...
December 19, 2016: Endocrine
https://www.readbyqxmd.com/read/27992666/lithium-toxicity-in-a-pregnant-woman
#18
Nasim Zamani, Maryam Paeezi, Hossein Hassanian-Moghaddam
Lithium is recommended in bipolar disorder and can be accompanied by significant toxicity in pregnant women. A 25-year-old single-gestation pregnant woman (28 weeks) was referred with suspicion of lithium toxicity. Serum lithium was 2.1 meq/L. Despite conservative therapy with intravenous fluids, lithium concentration increased to 5.0 meq/L 6 hr post admission mandating an emergent hemodialysis during which foetal heart rate decreased to 90 bpm. The gynaecologist ordered termination of pregnancy while the mother was still on hemodialysis...
December 19, 2016: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27974589/tigecycline-therapy-in-an-infant-for-ventriculoperitoneal-shunt-meningitis
#19
Melike Emiroglu, Gulsum Alkan, Hatice Turk Dagi
Shunt infections are seen in 3% to 20% of patients who have cerebrospinal fluid (CSF) shunts. Although the staphylococcal species are the most common cause of shunt-related infections, Gram-negative bacteria are increasingly reported with higher mortality rates. Tigecycline, a glycylcycline, is not approved for children. But in the era of nosocomial infections due to multidrug-resistant pathogens, it can be the life-saving option. We report an infant with ventriculoperitoneal shunt-related meningitis treated with a tigecycline combination regimen...
January 2017: Pediatrics
https://www.readbyqxmd.com/read/27968810/a-review-of-available-techniques-for-cardiac-output-monitoring
#20
REVIEW
Kristen Marshall, Elizabeth Thomovsky, Paula Johnson, Aimee Brooks
The main objective of fluid therapy is to increase cardiac output (CO). Large, rapidly administered volumes of fluids are the cornerstone of treating patients in shock to restore circulating volume and improve tissue perfusion. However, determining exactly how much fluid a given patient requires can be challenging. If enough fluid is not given, poor tissue perfusion can lead to ischemia, anaerobic metabolism, and ultimately cell and patient death. Conversely, increased morbidity and mortality associated with excessive intravenous fluid administration has been reported in the human literature in a wide variety of conditions...
September 2016: Topics in Companion Animal Medicine
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