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https://www.readbyqxmd.com/read/29770431/outcome-in-lacunar-stroke-a-cohort-study
#1
V Mantero, C Scaccabarozzi, E Botto, G Giussani, A Aliprandi, A Lunghi, E Ciusani, G Brenna, A Salmaggi
OBJECTIVES: We evaluated a prospective cohort of 150 patients under observation in our centre for lacunar strokes. The purpose of this study was to evaluate the outcome at time of discharge and 6 months after lacunar stroke, as well as the correlation with cardiovascular risk factors and selected biochemical parameters already evaluated on admission. Focus was to identify possible prognostic factors, which might be targeted through appropriate intervention concentrating on reduction in the incidence and impact of early clinical deterioration...
May 16, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29769151/real-time-automated-detection-of-ventilator-associated-events-avoiding-missed-detections-misclassifications-and-false-detections-due-to-human-error
#2
Erica S Shenoy, Eric S Rosenthal, Yu-Ping Shao, Siddharth Biswal, Manohar Ghanta, Erin E Ryan, Dolores Suslak, Nancy Swanson, Valdery Moura Junior, David C Hooper, M Brandon Westover
OBJECTIVETo validate a system to detect ventilator associated events (VAEs) autonomously and in real time.DESIGNRetrospective review of ventilated patients using a secure informatics platform to identify VAEs (ie, automated surveillance) compared to surveillance by infection control (IC) staff (ie, manual surveillance), including development and validation cohorts.SETTINGThe Massachusetts General Hospital, a tertiary-care academic health center, during January-March 2015 (development cohort) and January-March 2016 (validation cohort)...
May 17, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29766137/after-the-embo-predicting-non-hemorrhagic-indications-for-splenectomy-after-angioembolization-in-patients-with-blunt-trauma
#3
John F Bilello, Victoria L Sharp, Rachel C Dirks, Krista L Kaups, James W Davis
Background: Successful non-operative management (NOM) of blunt splenic trauma is enhanced with splenic angioembolization (SAE). Patients may still require splenectomy post-SAE for splenic infarction/necrosis. Prior studies have used white blood cell count (WBC), platelet count (PLT), and PLT:WBC ratio after splenectomy to predict complications, but none have evaluated these findings prior to splenectomy in patients who have undergone SAE. Changes in these values may indicate clinically significant splenic infarction, facilitating management of these patients...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29757891/spinal-epidural-abscess-in-an-infant-presenting-as-fever-and-respiratory-distress
#4
Katherine M Gupta, Khoon-Yen Tay
A 9-month-old healthy female presented during winter to the emergency department with a chief complaint of fever and prominent respiratory symptoms. She was discharged on oseltamivir with a presumptive diagnosis of influenza. She returned to the emergency department 2 days later with continued fever and more upper respiratory symptoms. She was admitted for intravenous hydration to the observation unit with a diagnosis of viral illness (with viral testing that returned positive for adenovirus) and dehydration...
May 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29752277/the-highly-metastatic-nature-of-uterine-cervical-endometrial-cancer-displaying-tumor-related-leukocytosis-clinical-and-preclinical-investigations
#5
Tomoyuki Sasano, Seiji Mabuchi, Katsumi Kozasa, Hiromasa Kuroda, Mahiru Kawano, Ryoko Takahashi, Naoko Komura, Eriko Yokoi, Yuri Matsumoto, Kae Hashimoto, Kenjiro Sawada, Eiichi Morii, Tadashi Kimura
PURPOSE: The aim of this study was to investigate the metastatic potential of uterine cervical and endometrial cancer displaying tumor-related leukocytosis (TRL). EXPERIMENTAL DESIGN: Clinical data on uterine cervical (N=732) and endometrial cancer (N=900) were collected, and the metastatic potential of TRL-positive cancer was evaluated in univariate and multivariate analyses. Tumor and blood samples obtained from cervical cancer patients, cervical cancer cell lines, and a mouse model of cervical cancer were employed to examine the mechanisms underlying the highly metastatic nature of TRL-positive cancer, focusing on tumor-derived granulocyte-colony stimulating factor (G-CSF) and the myeloid-derived suppressor cells (MDSC)-mediated premetastatic niche...
May 11, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29750636/outcomes-of-very-elderly-treated-with-dialysis-for-acute-kidney-injury
#6
Ezra Gabbay, Yehudit Zangi, Alon Bnayah, Jawad Atrash, Itzchak Slotki, Linda Shavit
BACKGROUND: The factors that determine prognosis in elderly patients with dialysis-requiring acute kidney injury (AKI-D) is uncertain. The purpose of this study was to examine predictors of in-hospital mortality in these patients. MATERIALS AND METHODS: A retrospective, single-center study of hospitalized patients ≥ 70 years old with AKI-D. Clinical and demographic variables were compared between survivors and non-survivors, independent predictors of hospital mortality were identified by logistic regression...
May 11, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29749938/impact-of-abandoned-leads-on-cardiovascular-implantable-electronic-device-infections-a-propensity-matched-analysis-of-medic-multicenter-electrophysiologic-device-infection-cohort
#7
Thomas A Boyle, Daniel Z Uslan, Jordan M Prutkin, Arnold J Greenspon, Larry M Baddour, Stephan B Danik, Jose M Tolosana, Katherine Le, Jose M Miro, James E Peacock, Muhammad R Sohail, Holenarasipur R Vikram, Roger G Carrillo
OBJECTIVES: This study sought to evaluate the impact of abandoned cardiovascular implantable electronic device (CIED) leads on the presentation and management of device-related infections. BACKGROUND: Device infection is a serious consequence of CIEDs and necessitates removal of all hardware for attempted cure. The merits of extracting or retaining presumed sterile but nonfunctioning leads is a subject of ongoing debate. METHODS: The MEDIC (Multicenter Electrophysiologic Device Infection Cohort) prospectively enrolled patients with CIED infections at 10 institutions in the United States and abroad between January 1, 2009, and December 31, 2012...
February 2018: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29746946/pneumonic-and-non-pneumonic-exacerbations-in-bronchiectasis-clinical-and-microbiological-differences
#8
Eva Polverino, Edmundo Rosales-Mayor, Mariana Benegas, Rosario Menendez, Victoria Alcaraz-Serrano, Emilio Ansotegui, Beatriz Montull, Rosa María Girón, Carolina Cisneros, Montserrat Vendrell, Gerard Muñoz, María Angeles Marcos, Marcelo Sanchez, Antoni Torres
OBJECTIVES: Despite the clinical relevance of exacerbations in bronchiectasis (BE), little is known about the microbiology and outcomes of pneumonic (CAP) vs. non-pneumonic (NOCAP) exacerbations. METHODS: This study compares clinical and microbiological characteristics of CAP vs. NOCAP in adults with BE. We performed a multicenter prospective observational study of consecutive cases of NOCAP and CAP from four Spanish hospitals (2011-2015). RESULTS: We recruited 144 patients, 47 of them CAP (33%) cases...
May 7, 2018: Journal of Infection
https://www.readbyqxmd.com/read/29746437/hematologic-findings-of-inherited-metabolic-disease-they-are-more-than-expected
#9
Ertan Sal, Idil Yenicesu, Ilyas Okur, Zuhre Kaya, Fatih S Ezgu, Ulker Kocak, Leyla Tumer, Turkiz Gursel, Alev Hasanoglu
Inherited metabolic diseases are pathologic conditions that generally develop as a result of impairment of the production or breakdown of protein, carbohydrate, and fatty acids. Early determination of hematological findings has a positive effect on the prognosis of metabolic diseases. Three hundred eighteen patients who were being followed-up within the previous 6 months at Department of Pediatric Nutrition and Metabolism, Gazi University, Turkey, were included in the study. The hematological findings were classified under 7 main groups: anemia of chronic disease, iron deficiency anemia, vitamin B12 deficiency anemia, hemophagocytosis, leukocytosis, and thrombocytosis...
May 9, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29744372/recent-advances-in-drug-induced-hypersensitivity-syndrome-drug-reaction-with-eosinophilia-and-systemic-symptoms
#10
REVIEW
Hideaki Watanabe
Drug-induced hypersensitivity syndrome (DIHS), also termed as drug reaction with eosinophilia and systemic symptoms (DRESS), is a multiorgan systemic reaction characterized by a close relationship with the reactivation of herpes virus. Published data has demonstrated that among patients with DIHS/DRESS, 75-95% have leukocytosis, 18.2-90% show atypical lymphocytes, 52-95% have eosinophilia, and 75-100% have hepatic abnormalities. Histologically, eosinophils were observed less frequently than we expected (20%)...
2018: Journal of Immunology Research
https://www.readbyqxmd.com/read/29744086/a-typical-atypical-chronic-myeloid-leukemia
#11
Andrea Gilioli, Ambra Paolini, Goretta Bonacorsi, Mario Luppi
In the context of leukocytosis due to increased number of neutrophils and their precursors, with significant dysgranulopoiesis and no or minimal basophilia and no or minimal monocytosis, the typical feature of "clumped" chromatin, in irregularly coarse compacted nuclei, should lead to suspect the diagnosis of atypical chronic myeloid leukemia.
May 2018: Clinical Case Reports
https://www.readbyqxmd.com/read/29743761/predictors-of-mortality-in-acute-kidney-injury-patients-admitted-to-medicine-intensive-care-unit-in-a-rural-tertiary-care-hospital
#12
Amrish Saxena, Shrikant V Meshram
Background: Acute kidney injury (AKI) is a challenging problem faced by intensive care clinicians worldwide, and it is associated with high morbidity and mortality, especially in critically ill patients. Materials and Methods: A hospital-based prospective, observational study was conducted in patients of AKI admitted to the Intensive Care Unit (ICU) of the Department of Medicine in a rural tertiary care hospital located in central India. Data of all consecutive AKI inpatients related to demographic variables, clinical profile, and laboratory investigations were collected from patient's medical records...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29742588/derivation-and-validation-of-a-biomarker-based-clinical-algorithm-to-rule-out-sepsis-from-noninfectious-systemic-inflammatory-response-syndrome-at-emergency-department-admission-a-multicenter-prospective-study
#13
Filippo Mearelli, Nicola Fiotti, Carlo Giansante, Chiara Casarsa, Daniele Orso, Marco De Helmersen, Nicola Altamura, Maurizio Ruscio, Luigi Mario Castello, Efrem Colonetti, Rossella Marino, Giulia Barbati, Andrea Bregnocchi, Claudio Ronco, Enrico Lupia, Giuseppe Montrucchio, Maria Lorenza Muiesan, Salvatore Di Somma, Gian Carlo Avanzi, Gianni Biolo
OBJECTIVES: To derive and validate a predictive algorithm integrating a nomogram-based prediction of the pretest probability of infection with a panel of serum biomarkers, which could robustly differentiate sepsis/septic shock from noninfectious systemic inflammatory response syndrome. DESIGN: Multicenter prospective study. SETTING: At emergency department admission in five University hospitals. PATIENTS: Nine-hundred forty-seven adults in inception cohort and 185 adults in validation cohort...
May 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29733017/zenker-diverticulum-treatment-endoscopic-or-surgical
#14
Diana Ciuc, Rodica Birlă, Eugenia Panaitescu, Marcel Tanţău, Silviu Constantinoiu
Introduction: The Zenker Diverticulum is a rare pathology, the selection of patients for invasive treatments is questionable, as well as the applied therapeutic method. The aim of the study is to evaluate the main methods of classical and endoscopic surgical treatment in this pathology and to correlate pathophysiological aspects with clinical consequences. MATERIAL AND METHOD: We included 36 patients with Zenker hypopharyngeal diverticulum treated in 2010/2017 in two university clinics: 7 patients by classical surgical approach at the General and Esophageal Surgery Clinic of St...
March 2018: Chirurgia
https://www.readbyqxmd.com/read/29725528/-blastoid-variant-of-burkitt-lymphoma-with-additional-partial-1q-tetrasomy
#15
Ahsan Siddiqi, Sheshadri Madhusudhana, Alexey Glazyrin
Burkitt lymphoma is cytogenetically characterized by t(8;14)(q24;q32) translocation, sometimes accompanied by additional cytogenetic abnormalities. These abnormalities usually result in more aggressive clinical presentation and morphology of the disease. The current report presens a case of Burkitt lymphoma with t(8;14)(q24;q32) accompanied by partial tetrasomy of chromosome 1(47,XY,+1,i(1)(q10),t(8;14)(q24;q32)[2]/46,XY[18]). The patient was a 59-year-old male who presented with abdominal pain, leukocytosis and tumor lysis syndrome...
May 2018: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29725401/rapid-progression-of-a-granulocyte-colony-stimulating-factor-producing-liver-tumor-metastasized-from-esophagogastric-junction-cancer-a-case-report-and-literature-review
#16
Sojun Hoshimoto, Nobuo Hoshi, Iwao Ozawa, Moriaki Tomikawa, Hirofumi Shirakawa, Takeshi Fujita, Saho Wakamatsu, Sayuri Hoshi, Kaoru Hirabayashi, Shoichi Hishinuma, Yoshiro Ogata
The current study presents the case of a 72-year-old woman with a rapidly enlarged liver metastasis from esophagogastric junction (EGJ) cancer, accompanied by progressive leukocytosis (47,680/µl) and elevated serum granulocyte colony-stimulating factor (G-CSF; 779 pg/ml). The patient underwent right hemihepatectomy 26 months after a total gastrectomy. On the seventh post-operative day the patient's leukocyte count and serum G-CSF level decreased to 4,280/µl and ≤19.5 pg/ml, respectively. Histologically, the lesion was a well to moderately differentiated adenocarcinoma similar to the primary lesion...
May 2018: Oncology Letters
https://www.readbyqxmd.com/read/29723378/oral-mucosa-lesions-as-atypical-manifestation-of-adult-onset-still%C3%A2-s-disease
#17
María Lorena Brance, Eldo Luis Neffen
Adult-onset Still's disease is a systemic inflammatory disorder of unknown etiology, characterized by skin rash, spiking fever, arthralgias or arthritis, and leukocytosis. The typical skin rash is evanescent, salmon-pink, nonpruritic and maculopapular, predominantly on the extremities. It is considered one of the major Yamaguchi's criteria in adult-onset Still's disease. However, atypical skin lesions are also described. Here, a 61-year-old woman with sore throat, spiking fever, polyarthritis and evanescent salmon-pink nonpruritic maculopapular skin rash on the extremities was diagnosed with adult-onset Still's disease...
March 2018: Anais Brasileiros de Dermatologia
https://www.readbyqxmd.com/read/29717985/-calcitriol-induced-hypercalcemia-in-a-hunting-dog-with-a-disseminated-paecilomyces-variotii-infection
#18
C Weingart, J Raila, A Lübke-Becker, O Kershaw, M Brunnberg, B Kohn
A 5-year old hunting dog was presented with reduced appetite, weight loss and polyuria/polydipsia. Hematology and clinical chemistry revealed anemia, leukocytosis, increased liver enzymes, hypoalbuminemia and hypercalcemia. The cytological, pathohistological and microbiological examination identified a disseminated infection with the saprophytic mould fungus Paecilomyces variotii in the biopsies of the spleen and a lymph node. Determination of vitamin D metabolites confirmed a calcitriol induced hypercalcemia...
May 2018: Schweizer Archiv Für Tierheilkunde
https://www.readbyqxmd.com/read/29708633/utility-of-the-immature-granulocyte-percentage-for-diagnosing-acute-appendicitis-among-clinically-suspected-appendicitis-in-adult
#19
Jae-Sang Park, June-Sung Kim, Youn-Jung Kim, Won Young Kim
BACKGROUND: Acute appendicitis is the most common cause of abdominal surgical emergencies that present at the emergency department (ED). Although early phase of acute appendicitis cannot induce systemic inflammatory responses, it may induce proliferation immature granulocyte before leukocytosis is occurred. Based on this, we hypothesized that IG% may be beneficial for detecting appendicitis, in addition to classic inflammatory markers including the WBC count, a left shift in neutrophils, and CRP, at no additional cost...
April 30, 2018: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29689521/ingested-foreign-body-mimicking-acute-appendicitis
#20
Jeremy M Reeves, Michael D Wade, John Edwards
INTRODUCTION: The incidence of acute appendicitis is approximately 250,000 cases per year in the United States with a lifetime risk of 7% (Gupta & Dupuy, 1997). However, despite strongly associated clinical signs, diagnostic accuracy based on history and physical exam alone is only 70% (Jess et al., 1981). This is in large part due to the multitude of mimics found in the differential diagnosis of appendicitis. As a result highly sensitive imaging such as computed tomography scan has become standard of care...
April 9, 2018: International Journal of Surgery Case Reports
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