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https://www.readbyqxmd.com/read/29145467/adenosine-lidocaine-and-mg2-alm-fluid-therapy-attenuates-systemic-inflammation-platelet-dysfunction-and-coagulopathy-after-non-compressible-truncal-hemorrhage
#1
Hayley Letson, Geoffrey Dobson
BACKGROUND: Systemic inflammation and coagulopathy are major drivers of injury progression following hemorrhagic trauma. Our aim was to examine the effect of small-volume 3% NaCl adenosine, lidocaine and Mg2+ (ALM) bolus and 0.9% NaCl/ALM 'drip' on inflammation and coagulation in a rat model of hemorrhagic shock. METHODS: Sprague-Dawley rats (429±4 g) were randomly assigned to: 1) shams, 2) no-treatment, 3) saline-controls, 4) ALM-therapy, and 5) Hextend®. Hemorrhage was induced in anesthetized-ventilated animals by liver resection (60% left lateral lobe and 50% medial lobe)...
2017: PloS One
https://www.readbyqxmd.com/read/29142382/capillary-leak-syndrome-following-snakebite-envenomation
#2
REVIEW
V Udayabhaskaran, E T Arun Thomas, Bhagya Shaji
Capillary leak syndrome is a unique complication that follows Russell's viper envenomation. This syndrome has a very high fatality rate and is characterized by parotid swelling, chemosis, periorbital edema, hypotension, albuminuria, hypoalbuminemia, and hemoconcentration. This syndrome is frequently recognized from the southern parts of India, especially from the state of Kerala. It has been postulated that a vascular apoptosis inducing component of Russell's viper venom that is not neutralized by the commercially available anti-snake venom (ASV) is responsible for this complication as it occurs even after adequate doses of ASV administration in most cases...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29132842/-a-comparison-of-post-surgical-plasma-glucose-levels-in-patients-on-fluids-with-different-glucose-concentrations
#3
Isabel Martínez Carapeto, José Domingo López Castilla, Reyes Fresneda Gutiérrez
OBJECTIVE: To compare plasma glucose levels and incidence of hyperglycaemia in the post-operative period after general surgery using fluids with different glucose. METHODOLOGY: A randomised, open-label, non-blind, clinical trial was conducted on patients admitted to Paediatric Intensive Care Unit after elective surgery. The inclusion criteria were from 6 months to 14 years of age, with a weight greater than 6kg, onset glucose level >60mg/dL, and a signed informed consent, with no oral intake and maintenance intravenous fluid therapy using fluids with 3...
November 11, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29132768/pr%C3%A3-vention-et-prise-en-charge-de-l%C3%A2-infection-herp%C3%A3-tique-au-cours-de-la-grossesse-et-de-l%C3%A2-accouchement%C3%A2-recommandations-pour-la-pratique-clinique-%C3%A2-%C3%A2-texte-des-recommandations-texte-court
#4
M-V Sénat, O Anselem, O Picone, L Renesme, N Sananès, C Vauloup-Fellous, Y Sellier, J-P Laplace, L Sentilhes
OBJECTIVE: Identify measures to diagnose, prevent and treat genital herpes infection during pregnancy and childbirth and neonatal infection. METHODS: Bibliographic search from Medline, Cochrane Library databases and research of international clinical practice guidelines. RESULTS: Genital herpes lesion is most often due to HSV2 (LE2). The risk of HSV seroconversion during pregnancy is 1 to 5% (LE2). Genital herpes ulceration during pregnancy in a woman with history of genital herpes corresponds with a recurrence...
November 10, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29123419/encephalitis-treatment-a-case-report-with-long-term-follow-up-of-ebv-pcr-in-cerebrospinal-fluid
#5
Fnu Zarlasht, Mashal Salehi, Mohammad Abu-Hishmeh, Muzammil Khan
Background: Epstein-Barr virus (EBV) has been found to cause infectious mononucleosis multiple times, but has been associated rarely with EBV encephalitis. Also, whenever it is diagnosed, it is always treated symptomatically. Case report: A case of confirmed EBV encephalitis is presented, which was treated with antiviral therapy resulting in complete clearance of the virus in cerebrospinal fluid and minimal neurologic symptoms after hospital discharge. Conclusion: The Infectious Diseases Society of America guidelines state that intravenous acyclovir is not recommended for EBV-related encephalitis...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/29121319/should-we-use-hypotonic-or-isotonic-maintenance-intravenous-fluids-in-sick-patients-why-a-study-in-healthy-volunteers-will-not-provide-the-answer-response-to-effect-of-isotonic-versus-hypotonic-maintenance-fluid-therapy-on-urine-output-fluid-balance-and-electrolyte
#6
https://www.readbyqxmd.com/read/29119469/learning-to-prescribe-intravenous-fluids-a%C3%A2-scoping-review
#7
REVIEW
Richard F R McCrory, Gerard Joseph Gormley, Alexander Peter Maxwell, Tim Dornan
INTRODUCTION: Prescribing intravenous (IV) fluid therapy is a core skill expected of qualified doctors at the point of graduation, but medical graduates often feel ill-equipped to perform this task. This lack of preparedness contributes to treatment-related patient harm. This scoping review maps the current state of published evidence about how junior doctors prescribe IV fluid therapy and learn how to do it. METHODS: We searched five electronic databases and grey literature from 1994 until June 2016 for articles describing any aspect of IV fluid prescribing practice or its education...
November 8, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/29113731/oral-fexinidazole-for-late-stage-african-trypanosoma-brucei-gambiense-trypanosomiasis-a-pivotal-multicentre-randomised-non-inferiority-trial
#8
Victor Kande Betu Ku Mesu, Wilfried Mutombo Kalonji, Clélia Bardonneau, Olaf Valverde Mordt, Séverine Blesson, François Simon, Sophie Delhomme, Sonja Bernhard, Willy Kuziena, Jean-Pierre Fina Lubaki, Steven Lumeya Vuvu, Pathou Nganzobo Ngima, Hélène Mahenzi Mbembo, Médard Ilunga, Augustin Kasongo Bonama, Josué Amici Heradi, Jean Louis Lumaliza Solomo, Guylain Mandula, Lewis Kaninda Badibabi, Francis Regongbenga Dama, Papy Kavunga Lukula, Digas Ngolo Tete, Crispin Lumbala, Bruno Scherrer, Nathalie Strub-Wourgaft, Antoine Tarral
BACKGROUND: Few therapeutic options are available to treat late-stage human African trypanosomiasis, a neglected tropical disease caused by Trypanosoma brucei gambiense (g-HAT). The firstline treatment nifurtimox eflornithine combination therapy needs to be administered intravenously in a hospital setting by trained personnel, which is not optimal, given that patients often live in remote areas with few health resources. Therefore, we aimed to assess the safety and efficacy of an oral regimen of fexinidazole (a 2-substituted 5-nitroimidazole with proven trypanocidal activity) versus nifurtimox eflornithine combination therapy in patients with late-stage g-HAT...
November 3, 2017: Lancet
https://www.readbyqxmd.com/read/29110574/comparison-of-medical-therapy-alone-to-medical-therapy-with-surgical-treatment-of-peritonsillar-abscess
#9
Alex Battaglia, Raoul Burchette, Jacob Hussman, Matthew A Silver, Peter Martin, Paul Bernstein
Objective This study was performed to determine whether the efficacy and safety of medical management of uncomplicated peritonsillar abscess (PTA) presenting in the emergency department is equivalent to medical plus surgical therapy. Study Design Case series with chart review. Setting Southern California Permanente Medical Group (SCPMG). Subjects and Methods Upon successful completion of a prospective study comparing medical treatment (MT) to surgical treatment (ST) of PTA in 2008, MT was adopted by 12 SCPMG centers while 7 centers continued standard surgical drainage...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29109168/risk-factors-and-outcomes-for-ineffective-empiric-treatment-in-gram-negative-sepsis-stratification-by-onset-of-infection
#10
Scott T Micek, Nicholas Hampton, Marin Kollef
Sepsis and septic shock remain serious infections with reported mortality rates in excess of forty percent. Timely antibiotic therapy in sepsis and septic shock is recognized as an important determinant of outcome. However, the administration of ineffective empiric treatment (IET) (an initial antibiotic regimen that is not active against the identified pathogen(s) based on in vitro susceptibility testing) is associated with excess mortality compared to effective empiric treatment (EET). We examined all hospitalized patients between January 2010 and October 2015 at Barnes-Jewish Hospital with the presence of a sterile site (blood, or pleural, abdominal, cerebrospinal, synovial, and pericardial fluid) culture positive for Gram-negative (GN) bacteria combined with primary or secondary ICD-9-CM codes for severe sepsis (995...
November 6, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29102099/white-lipped-tree-viper-cryptelytrops-albolabris-envenomation-in-an-american-viper-keeper
#11
Spencer Greene, Laura Ann Galdamez, Richard Tomasheski
BACKGROUND: Snakebites are common in many regions of the United States. Bites from exotic species, however, are rare. The white-lipped tree viper, Cryptelytrops (formerly Trimeresurus) albolabris, is a pit viper native to Southeast Asia. Bites are common in countries such as Myanmar, India, Thailand, Indonesia, and China. In this report, we describe an envenomation in an American viper keeper. CASE REPORT: A healthy 28-year-old right-handed man who collects venomous snakes experienced a bite to the distal left thumb from a neonatal C...
October 25, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29098200/ureteral-obstruction-due-to-radiolucent-atazanavir-ureteral-stones
#12
Michael T Grant, Brian H Eisner, Seth K Bechis
Background: Protease inhibitors (PIs) are a well-documented cause of nephrolithiasis. Although medications such as indinavir are known to increase risk of stone formation, the association of newer HIV medications is not as well studied. In this study, we report a case of a patient who developed atazanavir stones. Case Presentation: A 74-year-old man with HIV on antiretroviral therapy-including atazanavir, a PI-presented with right flank pain. He previously had passed two ureteral stones that were not analyzed...
2017: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/29075916/a-novel-endoscopic-treatment-for-anastomotic-leakage-post-anterior-resection-padlock-over-the-scope-clip
#13
Callum Robertson, Francesca Savioli, Kawan Shalli
BACKGROUND: Anastomotic dehisense is a serious complication of anterior resections. We have had success in our centre utilising Endosponge therapy to salvage anastomotic leaks but this requires multiple endoscopic sessions and can take around 6 weeks to heal in some cases. This can delay further management such as chemotherapy. AIM: We describe the novel use of Padlock over the scope clips to manage patients with anastomotic dehisense post anterior resection. METHOD: Padlock over the scope clips were used to manage three patients who presented with anastomotic breakdown post laparoscopic anterior resection between February 2016 and July 2017...
October 26, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29073825/myasthenia-gravis-and-chronic-inflammatory-demyelinating-polyneuropathy-in-the-same-patient-a-case-report
#14
Weiwei Quan, Junhui Xia, Qiuling Tong, Jie Lin, Xiaolu Zheng, Xuezhi Yang, Dewei Xie, Yiyun Weng, Xu Zhang
We reported a misdiagnosed case of a 66-year-old man who concomitantly developed chronic inflammatory demyelinating polyneuropathy (CIDP) and myasthenia gravis (MG), which was rarely reported. This man presented with chronic progressive sensory symptoms, flaccid tetraparesis, areflexia and protein-cell dissociation of cerebrospinal fluid. Nerve conduction study was indicative of demyelinating neuropathy. He was suspected as CIDP and treated with high-dose glucocorticoids. However, his condition worsened. Four months later, he was admitted and was diagnosed as combination of CIDP and MG...
October 27, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/29072871/disseminated-intravascular-coagulation-in-an-under-recognised-zoonotic-infection
#15
Sarah Lawrence, Andrew Claxton, Mark Holland, Jack Hodd
A 51 year old man presented with severe sepsis, disseminated intravascular coagulation (DIC) and multiorgan dysfunction after a 24 hour history of diarrhoea and malaise. Despite fluid resuscitation and receiving a platelet transfusion, freshfrozen plasma and intravenous broad-spectrum antibiotics, he remained anuric with a worsening metabolic acidosis. He was transferred to critical care for organ support including renal replacement therapy. He subsequently developed purpura fulminans. Blood cultures were positive for Captocytophaga carnimorsis, a gram-negative canine zoonosis that is an underdiagnosed cause of severe sepsis, for which DIC at presentation is characteristic...
2017: Acute Medicine
https://www.readbyqxmd.com/read/29071559/successful-retinal-blood-flow-augmentation-after-extracranial-intracranial-bypass
#16
Tackeun Kim, Min Jai Cho, Sang Jun Park, Moon-Ku Han, Davendra Hari Ojar, Chang Wan Oh, Jae Seung Bang
A 61-year-old woman visited us with recent onset right-side weakness. Magnetic resonance imaging showed ischemic changes at the left internal border zone due to occlusive disease affecting the left proximal internal carotid artery. Prompt oral dual antiplatelet therapy and intravenous fluid were administered with subsequent induced hypertension and without reperfusion therapy. Although the hemiparesis was improved, she complained of a new-onset transient left-side monocular visual loss. Fluorescein angiography confirmed delayed perfusion in the left eye...
October 25, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29056746/disabling-outcomes-after-peripheral-vascular-catheter-insertion-in-a-newborn-patient-a-case-of-medical-liability
#17
Matteo Bolcato, Marianna Russo, Damiano Donadello, Daniele Rodriguez, Anna Aprile
BACKGROUND The positioning of peripheral venous catheters (PVC) is an invasive procedure commonly performed in pediatrics hospital wards to obtain vascular access for the administration of fluids, medications and other intravenous (IV) therapies. Many studies exist about management of peripheral venous access in adults. On the contrary, scientific evidence on the management of this procedure in children and newborns, especially regarding the optimal duration of infusion and the possible related side effects, is still poor...
October 23, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29056667/hyponatremia-as-the-presenting-feature-of-a-pituitary-abscess-in-a-calf
#18
Jamie L Stewart, Maria C Bates, B Wade Edwards, Brian M Aldridge
A 2-month-old Simmental heifer presented for acute onset of neurological behavior. Laboratory tests confirmed the presence of hyponatremia, hypochloremia, and hypokalemia that improved with intravenous fluid therapy. Despite an initial cessation of neurological signs, symptoms re-emerged, and the heifer was euthanized due to poor prognosis. A pituitary abscess (Trueperella pyogenes) was observed on gross necropsy, suggesting that the effects of panhypopituitarism (inappropriate anti-diuretic hormone (ADH), adrenocorticotropic hormone (ACTH), and/or thyroid-stimulating hormone (TSH) secretion) may have resulted in the clinical findings...
February 6, 2017: Veterinary Sciences
https://www.readbyqxmd.com/read/29055965/short-term-high-dose-steroid-therapy-in-a-case-of-rhabdomyolysis-refractory-to-intravenous-fluids
#19
Fnu Zarlasht, Mashal Salehi, Alamgir Sattar, Mohammad Abu-Hishmeh, Muzammil Khan
No abstract text is available yet for this article.
October 17, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29046194/the-role-of-intravenous-access-during-oral-food-challenges-in-food-protein-induced-enterocolitis-syndrome
#20
Laura E Pena, Danielle Guffey, Charles G Minard, Sara Anvari, Carla M Davis
BACKGROUND: Food protein-induced enterocolitis syndrome (FPIES) is a non-immunoglobulin E mediated food hypersensitivity syndrome characterized by profuse vomiting and diarrhea, which leads to lethargy, dehydration, and hypotension. Given the potential severity of reactions, resolution of FPIES is confirmed via oral food challenge (OFC) during which intravenous (IV) access is recommended to facilitate IV fluids (IVF) and steroid therapy. Risk factors for IV treatment are not well characterized...
November 1, 2017: Allergy and Asthma Proceedings:
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