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https://www.readbyqxmd.com/read/29342449/increased-use-of-adrenaline-in-the-management-of-childhood-anaphylaxis-over-the-last-decade
#1
Kristina Rueter, Brennan Ta, Natasha Bear, Michaela Lucas, Meredith L Borland, Susan L Prescott
BACKGROUND: We recently determined that allergy training programs have improved physician recognition and diagnosis of pediatric anaphylaxis in the last decade. OBJECTIVE: To investigate for changes in management, in particular the appropriate use of adrenaline for the treatment of anaphylaxis in a tertiary pediatric emergency department (PED). METHODS: We conducted a retrospective case note study including children aged 0 to 16 years coded and verified for anaphylaxis comparing cases in years 2003/2004 with 2012...
January 13, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29342243/devices-in-heart-failure-diagnosis-detection-and-disease-modification
#2
John Gierula, Mark T Kearney, Klaus K Witte
Introduction/background: Implantable cardiac devices are widely used in chronic heart failure (CHF) therapy. This review covers current CHF treatment with electronic cardiac devices, areas of discussion and emerging technologies. Sources of data: A comprehensive search of available literature resources including Pubmed, MEDLINE and EMBASE was performed. National and international guidelines were accessed. Areas of agreement: Excessive right ventricular pacing is detrimental to cardiac function...
January 12, 2018: British Medical Bulletin
https://www.readbyqxmd.com/read/29341941/cauda-equina-syndrome-due-to-lumbar-disc-herniation-a-review-of-literature
#3
Stylianos Kapetanakis, Constantinos Chaniotakis, Constantinos Kazakos, Jannis V Papathanasiou
Cauda equina syndrome (CES) is a rare neurologic condition that is caused by compression of the cauda equina. Cauda equina consists of spinal nerves L2-L5, S1-S5 and the coccygeal nerve. The compression of these nerve roots can be caused mainly by lumbar disc herniation (45% of all causes). The diagnosis consists of two critical points: a) detailed history and physical examination and b) MRI or CT. The gold standard of the treatment of this syndrome is the surgical approach in combination with the timing of onset of symptoms...
December 20, 2017: Folia Medica
https://www.readbyqxmd.com/read/29341786/unscheduled-adolescents-return-to-the-emergency-department-following-acute-concussion
#4
Dana Baron Shahaf, Sapir Bar, Ronit Leiba, Vered Dvir, Itai Shavit
OBJECTIVE: Emergency department (ED) visits due to concussion have increased over recent years. We aimed to identify variables associated with unscheduled adolescents return to the ED. METHODS: A retrospective cohort study was conducted. All children aged 11 to 18 years who were admitted to the ED due to concussion between 2011 and 2016 were included. Multivariable logistic regression was performed to identify predictors of ED return. RESULTS: Overall, 616 adolescents were admitted to the ED due to concussion...
January 17, 2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29341498/review-article-sepsis-in-the-emergency-department-part-2-investigations-and-monitoring
#5
REVIEW
Amith Shetty, Stephen Pj Macdonald, Gerben Keijzers, Julian M Williams, Benjamin Tang, Bas de Groot, Kelly Thompson, John F Fraser, Simon Finfer, Rinaldo Bellomo, Jonathan Iredell
Sepsis is characterised by organ dysfunction resulting from infection, with no reliable single objective test and current diagnosis based on clinical features and results of investigations. In the ED, investigations may be conducted to diagnose infection as the cause of the presenting illness, identify the source, distinguish sepsis from uncomplicated infection (i.e. without organ dysfunction) and/ or risk stratification. Appropriate sample collection for microbiological testing remains key for subsequent confirmation of diagnosis and rationalisation of antimicrobials...
January 16, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29341227/pet-radiometals-for-antibody-labeling
#6
Eduardo Aluicio-Sarduy, Paul A Ellison, Todd E Barnhart, Weibo Cai, Robert Jerry Nickles, Jonathan W Engle
Recent advances in molecular characterization of tumors have made possible the emergence of new types of cancer therapies where the traditional cytotoxic drugs and nonspecific chemotherapy can be complemented with targeted molecular therapies. One of the main revolutionary treatments is the use of monoclonal antibodies (mAbs) that selectively target the disseminated tumor cells while sparing normal tissues. mAbs and related therapeutics can be efficiently radiolabeled with a wide range of radionuclides to facilitate preclinical and clinical studies...
January 17, 2018: Journal of Labelled Compounds & Radiopharmaceuticals
https://www.readbyqxmd.com/read/29340693/can-granulomatosis-with-polyangiitis-be-diagnosed-earlier-in-primary-care-a-case-control-study
#7
F A Pearce, R B Hubbard, M J Grainge, R A Watts, A Abhishek, P C Lanyon
Background: People with granulomatosis with polyangiitis (GPA) commonly described long delays before diagnosis. Aim: To study the natural history of GPA prior to diagnosis using primary care data, and determine whether clinical features could be identified to help earlier diagnosis. Design: Case-control study using the Clinical Practice Research Datalink. Methods: We compared primary care activity and clinical features between cases and 10 matched controls...
January 1, 2018: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29340490/accuracy-of-closed-pleural-biopsy-in-the-diagnosis-of-malignant-pleural-effusion
#8
Renata Báez-Saldaña, Uriel Rumbo-Nava, Araceli Escobar-Rojas, Patricia Castillo-González, Santiago León-Dueñas, Teresa Aguirre-Pérez, María Eugenia Vázquez-Manríquez
OBJECTIVE: Previous studies have demonstrated that closed pleural biopsy (CPB) has a sensitivity of less than 60% for diagnosing malignancy. Therefore, controversy has recently emerged regarding the value of CPB as a diagnostic test. Our objective was to assess the accuracy of CPB in diagnosing malignancy in patients with pleural effusion. METHODS: This was a prospective 8-year study of individuals who underwent CPB to establish the etiology of pleural effusion...
November 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/29340276/clinical-value-of-ultrasonography-in-diagnosis-of-pulmonary-embolism-in-critically-ill-patients
#9
Ran Zhu, Xiao-Chun Ma
Pulmonary embolism (PE) is a clinical emergency that will increase the mortality if complicated with unstable hemodynamics. Because of its nonspecific clinical symptoms, it's a great challenge to make a PE diagnosis. The golden standard to diagnose PE is computed tomography of pulmonary artery (CTPA), but a diagnosis of PE also composed of evaluation of PE risk factors, possibilities, and risk stratification. Ultrasonography may detect right ventricle strain related to hemodynamic change, intravascular thrombosis, thrombosis in right heart or pulmonary arteries, pulmonary infarction, and local pleural effusion...
December 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/29340263/diagnostic-delay-for-imported-malaria-a-case-of-plasmodium-falciparum-malaria-misdiagnosed-as-common-cold
#10
Ryota Hase
A 37-year-old Japanese man experienced fever and headache 8 days after returning to Japan following a 6-month stay in Nigeria. He visited two clinics but was sent home from each with a diagnosis of common cold. He was eventually brought to the emergency department with an altered mental status. Severe P. falciparum malaria was confirmed; his initial parasitemia index was 5.4%. He recovered fully with antimalarial treatment. This case suggests that primary care physicians should obtain recent travel history and consider malaria for any febrile patient who has returned from a malaria-endemic area...
January 2018: Journal of General and Family Medicine
https://www.readbyqxmd.com/read/29340167/subcutaneous-glucagon-infusion-and-continuous-glucose-monitoring-enable-effective-management-of-hypoglycemia-in-a-patient-with-igf-2-producing-hemangiopericytoma
#11
Eric D Buras, Emily Weatherup, Jennifer Wyckoff
Background: Ectopic insulin-like growth factor (IGF)-2 production is a rare complication of an array of epithelial and mesenchymal tumors, and can clinically manifest as life-threatening hypoglycemia. Case presentation: A 49-year-old woman with 13-year history of metastatic hemangiopericytoma, previously treated with multiple rounds of chemotherapy and palliative radiation, presented to the emergency department after a hypoglycemic seizure. On arrival, glucose was 18 mg/dL (1...
2018: Clinical Diabetes and Endocrinology
https://www.readbyqxmd.com/read/29339536/length-of-stay-and-hospital-revisit-after-bacterial-tracheostomy-associated-respiratory-tract-infection-hospitalizations
#12
Christopher J Russell, Mary R Mamey, Joyce Y Koh, Sheree M Schrager, Michael N Neely, Susan Wu
OBJECTIVES: To identify factors associated with longer length of stay (LOS) and higher 30-day hospital revisit rates for children hospitalized with bacterial tracheostomy-associated respiratory tract infections (bTARTIs). METHODS: This was a multicenter, retrospective cohort study using administrative data from the Pediatric Health Information System database between 2007 and 2014 of patients 30 days to 17 years old with a principal discharge diagnosis of bTARTI or a principal discharge diagnosis of bTARTI symptoms with a secondary diagnosis of bTARTI...
January 16, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29339224/emerging-souvenirs-clinical-presentation-of-the-returning-traveller-with-imported-arbovirus-infections-in-europe
#13
Isabella Eckerle, Violeta Briciu, Onder Ergonul, Mihaela Lupse, Anna Papa, Amanda Radulescu, Sotirios Tsiodras, Christine Tsitou, Christian Drosten, Véronique Nussenblatt, Chantal Reusken, Louise Sigfrid, Nick J Beeching
BACKGROUND: Arboviruses are an emerging group of viruses that are causing increasing health concerns globally, including in Europe. Clinical presentation usually consists of a non-specific febrile illness that may be accompanied by rash, arthralgia and arthritis and/or with neurological or haemorrhagic syndromes. The range of differential diagnoses of other infectious and non-infectious aetiologies is broad, presenting a challenge for physicians. While knowledge of the geographic distribution of pathogens and the current epidemiological situation, incubation periods, exposure risk factors and vaccination history can help guide the diagnostic approach, the non-specific and variable clinical presentation can delay final diagnosis...
January 12, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29338987/update-on-the-epidemiology-of-scorpion-envenomation-in-the-south-of-tunisia
#14
Olfa Chakroun-Walha, Rim Karray, Mouna Jerbi, Abdennour Nasri, Fadhila Issaoui, Ben Rebeh Amine, Mabrouk Bahloul, Mounir Bouaziz, Hichem Ksibi, Noureddine Rekik
INTRODUCTION: Scorpion envenomation is still a frequent occurance in tropical and subtropical regions. In Tunisia, multiple studies on scorpion envenoming have contributed to an improved understanding of cardiac dysfunction and factors predictive of poor prognosis. These previous studies have contributed to the current standardized management of envenomed patients. However, the epidemiology of scorpion envenoming in Tunisia has not been updated for more than 10 years. The aim of this study was to report an update of the epidemiological features of scorpion envenomation in the southern region of Tunisia...
January 12, 2018: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/29338966/family-history-of-venous-thromboembolism-predicts-the-diagnosis-of-acute-pulmonary-embolism-in-the-emergency-department
#15
Christopher Kelly, Chad Agy, Margaret Carlson, Jacob Steenblik, Joseph Bledsoe, Stephen Hartsell, Troy Madsen
BACKGROUND: Pulmonary embolism (PE) clinical decision rules do not consider a patient's family history of venous thromboembolism (VTE). We evaluated whether a family history of VTE predicts acute PE in the emergency department (ED). METHODS: Over a 5.5-year study period, we enrolled a prospective convenience sample of patients presenting to an academic emergency department with chest pain and/or shortness of breath. We defined a family history of VTE as a first-degree relative with previous PE or deep vein thrombosis (DVT)...
January 6, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29338905/posterior-reversible-encephalopathy-syndrome-a-rare-childhood-case-with-unconsciousness
#16
Akira Komori, Daisuke Mizu, Koichi Ariyoshi
BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is a condition characterized by seizures, altered consciousness, visual disturbances, and headache. Characteristic findings on neuroimaging include cerebral edema, typically involving the parieto-occipital white matter. PRES has been associated with hypertension, autoimmune disease, and Henoch-Schölein purpura (HSP), but few cases have been reported, and fewer cases of PRES have been reported in children. CASE REPORT: We report the case of a 4-year-old girl who presented with blindness and semi-consciousness...
January 12, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29338688/transurethral-resection-of-the-prostate-provides-more-favorable-clinical-outcomes-compared-with-conservative-medical-treatment-in-patients-with-urinary-retention-caused-by-benign-prostatic-obstruction
#17
Yu-Hsiang Lin, Chen-Pang Hou, Tien-Hsing Chen, Horng-Heng Juang, Phei-Lang Chang, Pei-Shan Yang, Chien-Lun Chen, Ke-Hung Tsui
BACKGROUND: To evaluate the long-term surgical outcomes of patients with urinary retention (UR) caused by a benign prostatic obstruction (BPO) who underwent transurethral resection of the prostate (TURP), and compare their outcomes with those of patients who received medication without surgical intervention. METHODS: This retrospective cohort study analyzed claims data collected during the period of 1997-2012 from Taiwan's National Health Insurance Research Database...
January 16, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29338452/an-update-on-diagnostic-and-prognostic-biomarkers-for-traumatic-brain-injury
#18
Kevin K Wang, Zhihui Yang, Tian Zhu, Yuan Shi, Richard Rubenstein, J Adrian Tyndall, Geoff T Manley
Traumatic brain injury (TBI) is a major worldwide neurological disorder of epidemic proportions. To date, there are still no FDA-approved therapies to treat any forms of TBI. Encouragingly, there are emerging data showing that biofluid-based TBI biomarker tests have the potential to diagnose the presence of TBI of different severities including concussion, and to predict outcome. Area covered: The authors provide an update on the current knowledge of TBI biomarkers, including protein biomarkers for neuronal cell body injury (UCH-L1, NSE), astroglial injury (GFAP, S100B), neuronal cell death (αII-spectrin breakdown products), axonal injury (NF proteins), white matter injury (MBP), post-injury neurodegeneration (total Tau and phospho-Tau), post-injury autoimmune response (brain antigen-targeting autoantibodies), and other emerging non-protein biomarkers...
January 17, 2018: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/29338163/kounis-syndrome-induced-by-oral-intake-of-diclofenac-potassium
#19
Harun Gunes, Feruza Turan Sonmez, Ayhan Saritas, Yasin Koksal
An acute coronary syndrome (ACS) occurring during the course of an allergic reaction is called Kounis syndrome (KS). The second case of KS induced by diclofenac potassium (DP) is presented in this report. A 67-year-old man was brought to our emergency department with the possible diagnosis of anaphylactic shock by the ambulance staff. It emerged that widespread erythema and pruritus developed after taking DP. Then, he lost consciousness. Diffuse urticarial lesions were detected on physical examination at the emergency department...
December 2017: Iranian Journal of Allergy, Asthma, and Immunology
https://www.readbyqxmd.com/read/29337602/defining-the-learning-curve-for-hip-arthroscopy-a-threshold-analysis-of-the-volume-outcomes-relationship
#20
Nabil Mehta, Peter Chamberlin, Robert G Marx, Chisa Hidaka, Yile Ge, Danyal H Nawabi, Stephen Lyman
BACKGROUND: Hip arthroscopy has emerged as a successful option for the treatment of femoroacetabular impingement and related hip disorders, but the procedure is technically challenging. PURPOSE: To define the learning curve through which surgeons become proficient at hip arthroscopy. STUDY DESIGN: Cohort study; level of evidence, 3. METHODS: The authors identified hip arthroscopy procedures performed by surgeons through a New York State database (Statewide Planning and Research Cooperative System) and followed those cases for additional hip surgery (total hip arthroplasty, hip resurfacing, or ipsilateral hip arthroscopy) within 5 years of the original procedure...
January 1, 2018: American Journal of Sports Medicine
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