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https://www.readbyqxmd.com/read/28533993/bilateral-external-ventricular-drain-placement-and-intraventricular-irrigation-combined-with-concomitant-serial-prone-patient-positioning-a-novel-treatment-for-gravity-dependent-layering-in-bacterial-ventriculitis
#1
Andrew K Chan, Harjus S Birk, John K Yue, Ethan A Winkler, Michael W McDermott
A feared complication of ventricular access for drainage or shunting is ventriculitis. Early diagnosis and treatment is vital to prevent morbidity and mortality. Efficacy of directed antibiotic therapy in ventriculitis is limited by increasing multidrug resistant microorganisms and insufficient systemic antibiotic absorption into the cerebrospinal fluid. Treatment may involve intravenous and/or intrathecal antibiotics as well as external ventricular drainage. We present the first case report suggesting a potential role of a novel technique - direct ventricular catheter-mediated continuous saline irrigation and serial prone patient positioning - to treat a fulminant bacterial ventriculitis...
April 18, 2017: Curēus
https://www.readbyqxmd.com/read/28529027/management-of-postneurosurgical-meningitis-narrative-review
#2
REVIEW
Khetam Hussein, Roni Bitterman, Ben Shofty, Mical Paul, Ami Neuberger
BACKGROUND: Infections complicating neurosurgery pose unacceptable mortality and morbidity. AIMS: To summarize what is known about the epidemiology, diagnosis and treatment of post-neurosurgical meningitis (PNM). SOURCES: PubMed, references of identified studies and reviews, and personal experience when evidence was lacking. CONTENT: The incidence and pathogen distribution of PNM is highly variable. A shift towards Gram-negative bacteria has been observed with use of antibiotic prophylaxis and antibiotic-coated devices directed mainly against Gram-positive bacteria...
May 18, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28528188/the-impact-of-perioperative-fluid-therapy-on-short-term-outcomes-and-5-year-survival-among-patients-undergoing-colorectal-cancer-surgery%C3%A2-a-prospective-cohort-study-within-an-eras-protocol
#3
D Asklid, J Segelman, C Gedda, F Hjern, K Pekkari, U O Gustafsson
BACKGROUND: Restricted perioperative fluid therapy is one of several interventions in the enhanced recovery after surgery (ERAS) protocol, designed to reduce morbidity and hospital stay after surgery. The impact of this single intervention on short and long term outcome after colorectal surgery is unknown. PATIENTS AND METHODS: This cohort study includes all consecutive patients operated with abdominal resection of colorectal cancer 2002-2007 at Ersta Hospital, Stockholm, Sweden...
May 3, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28515805/is-computed-tomography-defined-obstruction-a-predictor-of-urological-intervention-in-emergency-department-patients-presenting-with-renal-colic
#4
Peter Alexander Massaro, Avinash Kanji, Paul Atkinson, Ryan Pawsey, Tom Whelan
INTRODUCTION: Our objective was to determine whether unilateral calculus-induced ureteric obstruction on computed tomography (CT) was independently associated with the need for urological intervention and 30-day return to the emergency department (ED). METHODS: We performed a retrospective cohort study of patients with symptomatic urinary calculi diagnosed by unenhanced helical CT. Stepwise regression analysis was used to determine the predictors of urological intervention and 30-day return to the ED...
March 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28513810/epstein-barr-virus-encephalitis-in-solid-organ-transplantation
#5
Jillian S Y S Y, Zhi Mei Low, Iain Abbott, Lani Shochet, John Kanellis, Richard A Kitching, Tony M Korman
Epstein-Barr virus (EBV) is typically associated with post transplant lymphoproliferative disease (PTLD) after solid organ and stem cell transplantation. However, it is rarely associated with neurological complications. We report a case of severe encephalitis complicating primary EBV infection six months post renal transplantation, and review the literature on EBV encephalitis in solid organ transplantation in adults. A 55-year-old male presented 6 months post cadaveric renal transplant with headache, fever and confusion...
May 17, 2017: New Microbiologica
https://www.readbyqxmd.com/read/28509132/transient-fanconi-syndrome-in-two-preterm-infants-with-hydronephrosis-and-urinary-tract-infection
#6
Takahiro Tominaga, Takeshi Sato, Yosuke Ichihashi, Naoko Amano, Yasuaki Kobayashi, Midori Awazu
Type IV renal tubular acidosis is known to occur in obstructive uropathy with urinary tract infection. Fanconi syndrome, however, has not been described in these settings. We report two preterm infants who developed Fanconi syndrome associated with hydronephrosis and urinary tract infection. Patient 1 is a boy with 21 trisomy, bilateral renal hypoplasia and bilateral vesicoureteral reflux delivered at 35 weeks' gestation. At postnatal day 42, he developed Fanconi syndrome after urinary tract infection, which persisted until the surgical correction of vesicoureteral reflux...
May 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28507171/first-in-man-demonstration-of-direct-endothelin-mediated-natriuresis-and-diuresis
#7
Robert W Hunter, Rebecca Moorhouse, Tariq E Farrah, Iain M MacIntyre, Takae Asai, Peter J Gallacher, Debbie Kerr, Vanessa Melville, Alicja Czopek, Emma E Morrison, Jess R Ivy, James W Dear, Matthew A Bailey, Jane Goddard, David J Webb, Neeraj Dhaun
Endothelin (ET) receptor antagonists are potentially novel therapeutic agents in chronic kidney disease and resistant hypertension, but their use is complicated by sodium and water retention. In animal studies, this side effect arises from ETB receptor blockade in the renal tubule. Previous attempts to determine whether this mechanism operates in humans have been confounded by the hemodynamic consequences of ET receptor stimulation/blockade. We aimed to determine the effects of ET signaling on salt transport in the human nephron by administering subpressor doses of the ET-1 precursor, big ET-1...
May 15, 2017: Hypertension
https://www.readbyqxmd.com/read/28506529/guillain-barr%C3%A3-syndrome-in-a-patient-with-renal-cell-carcinoma-following-the-first-course-of-pazopanib-therapy
#8
Hiroaki Koshikawa, Tomomi Tsukie, Akira Kurita, Mikio Fujikura, Megumi Suzuki, Kazuhiro Araki
Pazopanib, one of the antiangiogenic drugs, has recently become a first-line treatment for metastatic renal cell carcinoma. The most common adverse effects of pazopanib include diarrhea, fatigue, and nausea, but neuropathic complication has not been documented. Here, we report the first case of a patient with metastatic renal cell carcinoma who developed acute neuropathy mimicking Guillain-Barré syndrome following the first course of pazopanib therapy. A 75-year-old man with a metastatic renal cell carcinoma was admitted for rapidly progressive weakness and numbness in the extremities after the first course of pazopanib therapy...
May 12, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28506136/predictors-to-intravenous-fluid-responsiveness
#9
Jorge Iván Alvarado Sánchez, William Fernando Amaya Zúñiga, Manuel Ignacio Monge García
Management with intravenous fluids can improve cardiac output in some surgical patients. Management with static preload indicators, such as central venous pressure and pulmonary artery occlusion pressure, has not demonstrated a suitable relationship with changes in the cardiac output induced by intravenous fluid therapy. Dynamic indicators, such as the variability of arterial pulse pressure or stroke volume variation, have demonstrated a suitable relationship. Since improvement in cardiac output does not guarantee an adequate perfusion pressure, in patients with hypotension, it is also necessary to know whether arterial pressure will also increase with intravenous fluid therapy...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28498260/combined-gene-therapy-using-adsvegfr2-and-adstie2-with-chemotherapy-reduces-the-growth-of-human-ovarian-cancer-and-formation-of-ascites-in-mice
#10
Laura Tuppurainen, Hanna Sallinen, Anni Karvonen, Elina Valkonen, Hanne Laakso, Timo Liimatainen, Elisa Hytönen, Kirsi Hämäläinen, Veli-Matti Kosma, Maarit Anttila, Seppo Ylä-Herttuala
OBJECTIVES: Ovarian cancer is highly dependent on tumor microvessels and angiogenesis regulated by vascular endothelial growth factors (VEGFs) and their receptors (VEGFRs) and angiopoietins (Ang) and their Tie receptors. We studied the efficacy of adenoviral (Ad) gene therapy with soluble VEGFR2 and Tie2 combined with paclitaxel and carboplatin for the treatment of ovarian cancer. METHODS: An intraperitoneal human ovarian cancer xenograft model in nude mice (n = 44) was used in this study...
June 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28484814/contemporary-approaches-to-perioperative-iv-fluid-therapy
#11
REVIEW
Paul S Myles, Sam Andrews, Jonathan Nicholson, Dileep N Lobo, Monty Mythen
BACKGROUND: Intravenous fluid therapy is required for most surgical patients, but inappropriate regimens are commonly prescribed. The aim of this narrative review was to provide evidence-based guidance on appropriate perioperative fluid management. METHOD: We did a systematic literature search of the literature to identify relevant studies and meta-analyses to develop recommendations. RESULTS: Of 275 retrieved articles, we identified 25 articles to inform this review...
May 8, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28484199/two-cases-of-perforated-duodenal-diverticulum-successfully-treated-using-conservative-therapy
#12
Masayasu Ohmori, Ryo Harada, Kenji Hashimoto, Shoko Inoo, Hitomi Himei, Junichi Toshimori, Motoi Asano, Reijiro Maeshima, Masafumi Inoue, Haruhiko Kobashi
We encountered two cases of perforated duodenal diverticulum successfully treated with conservative therapy. The first case involved a 72-year-old man who presented with abdominal pain and fever. An abdominal computed tomography revealed pneumoretroperitoneum. The second case involved a 90-year-old woman who presented with abdominal pain, vomiting, and fever. An abdominal computed tomography also revealed pneumoretroperitoneum and fluid collection. In both the cases, we initiated conservative therapy with parenteral nutrition and intravenous antibiotic therapy because the patients' general condition was good and the pneumoretroperitoneum was localized...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28481451/treatment-of-ibuprofen-intoxication-in-a-dog-via-therapeutic-plasma-exchange
#13
Stuart Walton, Kirk A Ryan, Jennifer L Davis, Mark Acierno
OBJECTIVE: To describe the treatment of ibuprofen intoxication with therapeutic plasma exchange in a dog (TPE). SUMMARY: A 13-year-old male neutered mixed breed dog presented after ingesting approximately 200 mg/kg of ibuprofen. Treatment consisted of supportive medical therapy with IV fluids, gastrointestinal protectants, antiemetics and prostaglandin analogs, and TPE. A cycle of TPE was performed over 180 minutes, achieving 1.5 plasma volume exchanges. During therapy, heparinized blood and effluent samples were collected...
May 8, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28480854/unusual-manifestation-of-neuroboreliosis-case-report
#14
M Beridze, N Khizanishvili, M Mdivani, O Samushia, N Gogokhia
The paper reported the verified case of neuroboreliosis with unusual clinical presentation of Parkinsonism. Study aimed at establishing the significance of a precise differential diagnosis with substantial analysis of the symptoms of several diseases to avoid the false diagnosis and to conduct the opportune and adequate therapeutic management. We described the case of the diagnosed neuroboreliosis with clinical expression of Multiple Sclerosis (MS) and Parkinsonism. A 44 years old man was diagnosed as MS according to the McDonald's Criteria, who within two years developed typical clinical signs of Parkinsonism...
March 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28480291/fatal-eastern-equine-encephalitis-in-a-patient-on-maintenance-rituximab-a-case-report
#15
Isaac H Solomon, Pedro D S C Ciarlini, Sandro Santagata, Asim A Ahmed, Umberto De Girolami, Sashank Prasad, Shibani S Mukerji
A 63-year-old woman on rituximab maintenance for follicular lymphoma presented with headaches, vomiting, and fever, and was diagnosed with eastern equine encephalomyelitis by cerebrospinal fluid polymerase chain reaction. Eastern equine encephalomyelitis immunoglobulin (Ig)G/IgM remained negative due to rituximab treatment, and magnetic resonance imaging showed minimal abnormalities, making this a diagnostically challenging case. Despite therapy with intravenous Ig, the patient rapidly declined and died on hospital day 12...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28468013/translating-our-current-understanding-of-ascites-management-into-new-therapies-for-patients-with-cirrhosis-and-fluid-retention
#16
Elisa Pose, Andres Cardenas
Ascites is the most common complication associated with cirrhosis resulting in poor quality of life, high risk of development of other complications of cirrhosis, increased morbidity and mortality associated with surgical interventions, and poor long-term outcome. Patients with cirrhosis and a first onset of ascites, have a probability of survival of 85% during the first year and 56% at 5 years without liver transplantation. Ascites is caused due to increased renal sodium retention as a result of increased activity of the renin-angiotensin-aldosterone system in response to marked vasodilation of the splanchnic circulation...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/28459732/goal-directed-fluid-therapy-does-not-reduce-primary-postoperative-ileus-after-elective-laparoscopic-colorectal-surgery-a-randomized-controlled-trial
#17
Juan C Gómez-Izquierdo, Alessandro Trainito, David Mirzakandov, Barry L Stein, Sender Liberman, Patrick Charlebois, Nicolò Pecorelli, Liane S Feldman, Franco Carli, Gabriele Baldini
BACKGROUND: Inadequate perioperative fluid therapy impairs gastrointestinal function. Studies primarily evaluating the impact of goal-directed fluid therapy on primary postoperative ileus are missing. The objective of this study was to determine whether goal-directed fluid therapy reduces the incidence of primary postoperative ileus after laparoscopic colorectal surgery within an Enhanced Recovery After Surgery program. METHODS: Randomized patient and assessor-blind controlled trial conducted in adult patients undergoing laparoscopic colorectal surgery within an Enhanced Recovery After Surgery program...
May 1, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28457860/assessment-of-healthcare-personnel-knowledge-of-stroke-care-at-a-large-referral-hospital-in-sub-saharan-africa-a-survey-based-approach
#18
Chen Lin, Ravi Vakani, Peter Kussin, Mary Guhwe, Alfredo E Farjat, Kingshuk Choudhury, David Renner, Chrispine Oduor, Carmelo Graffagnino
There is no published literature regarding sub-Saharan health-care providers' understanding of stroke management patterns. Understanding current stroke management knowledge is important in formulating future education opportunities for providers to optimize patient outcomes. A cross-sectional survey of acute stroke diagnosis, hospital management, and secondary prevention questions was administered to health-care providers working in one large Kenyan acute referral hospital. Due to the prevalence of medical students (61...
April 27, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28454572/invasive-pulmonary-mucormycosis-rare-presentation-with-pulmonary-eosinophilia
#19
Taizou Hirano, Mitsuhiro Yamada, Kei Sato, Koji Murakami, Tokiwa Tamai, Yoshiya Mitsuhashi, Tsutomu Tamada, Hisatoshi Sugiura, Naomi Sato, Ryoko Saito, Junya Tominaga, Akira Watanabe, Masakazu Ichinose
BACKGROUND: Fungi can cause a variety of infectious diseases, including invasive mycosis and non-invasive mycosis, as well as allergic diseases. The different forms of mycosis usually have been described as mutually exclusive, independent entities, with few descriptions of overlapping cases. Here, we describe the first reported case of a patient with the complication of pulmonary eosinophilia in the course of invasive mucormycosis. CASE PRESENTATION: A 74-year-old Japanese man with asthma-COPD overlap underwent emergency surgery for a ruptured abdominal aortic aneurysm...
April 28, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28452888/the-impact-of-patient-weight-on-burn-resuscitation
#20
Nehemiah T Liu, Craig A Fenrich, Maria L Serio-Melvin, Wylan C Peterson, Leopoldo C Cancio, José Salinas
INTRODUCTION: Optimal fluid resuscitation of burn patients with burns greater than 20% total body surface area (TBSA) is critical to prevent burn shock during the initial 24 to 48 hours post burn. Currently, most resuscitation formulas incorporate the patient's weight when estimating 24-hour fluid requirements. The objective of this study was to determine the impact of weight on fluid resuscitation requirements and outcomes during the initial 24 hours after admission. METHODS: We performed a retrospective review of patients admitted to our burn intensive care unit from December 2007 to April 2013, resuscitated with a computerized decision support system...
April 27, 2017: Journal of Trauma and Acute Care Surgery
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