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Mark Haden, John R H Archer, Paul I Dargan, David M Wood
BACKGROUND: MDMB-CHMICA (methyl 2-[[1-(cyclohexylmethyl)indole-3-carbonyl]amino]-3,3-dimethylbutanoate) is a synthetic cannabinoid receptor agonist that has been detected in several recreational drug products in Europe since August 2014. OBJECTIVES: This article aims to describe the prevalence of use, availability, and desired and adverse effects of MDMB-CHMICA. METHODS: Data were collated from published scientific literature, and systematic searches were conducted of publically available Internet sources (the "gray literature"), including websites offering to sell MDMB-CHMICA and Internet discussion forums featuring user reports...
October 19, 2016: Substance Use & Misuse
R M Suresh, H C Lokesh, B S Harsha, Sri S Chandana
Pheochromocytoma, a neuroendocrine tumor of the adrenal medulla, arising from chromaffin cells, usually presents with the clinical triad of paroxysmal headache, profuse sweating and palpitations, associated with labile hypertension. Here, we present the case of an adult male with an unusual manifestation of pheochromocytoma in the form of acute pain abdomen with nausea and abdominal guarding, mimicking acute peritonitis. He had fluctuating blood pressure recordings. On subsequent investigation, a mass lesion in the left suprarenal area on an abdominal CT scan and a 24-hour urinary metanephrine assay confirmed the diagnosis of pheochromocytoma...
July 2016: Journal of the Association of Physicians of India
Sandeep Tak, Manoj Lakhotia, Alok Gupta, Amit Sagar, Gopal Bohra, Rajesh Bajari
A 55-year-old male presented with history of nausea, vomiting, palpitation paresthesis and profuse sweating in emergency department 2h after ingestion of "Bachnaag" (Aconite) root. Examination revealed shock with irregular pulses. Initial ECG showed frequent multifocal ventricular ectopics (VE), which later turned to short runs of ventricular tachycardia (VT). Immediate gastric lavage was done and activated charcoal given. Patient was treated with fluid resuscitation without any improvement in blood pressure...
September 2016: Indian Heart Journal
Hemant Chaturvedi, Rudra Dev Pandey, Krishna Kumar Sharma, Jitendra Singh Makkar, Sanjeev K Sharma
We present a patient with asymptomatic apical hypertrophic cardiomyopathy (AHCM) who recently developed cardiac arrhythmias, and shortly discuss the diagnostic modalities, differential diagnosis, and treatment strategy for this condition. AHCM is a rare form of hypertrophic cardiomyopathy, which usually involves the apex of the left ventricle. AHCM can occur with varied presentations such as chest pain, palpitations, dyspnea, syncope, atrial fibrillation, myocardial infarction, embolic events, ventricular fibrillation, and congestive heart failure...
September 2016: Indian Heart Journal
Jillian L Theobald, Rachel Spoelhof, Erin M Pallasch, Mark B Mycyk
Methemoglobinemia can result from ingestion of nitrite- or nitrate-containing foods. Here, we report a case where an adolescent girl and her father developed clinically significant methemoglobinemia after ingestion of "homemade" beef jerky prepared with sodium nitrate salt purchased at a local grocery store. Both had palpitations, dyspnea, and visible mucosal cyanosis. The daughter had a methemoglobin level of 44.2% and the father's methemoglobin level was 34.2%. Prompt recognition of methemoglobinemia is important for initiating antidotal therapy with methylene blue...
September 30, 2016: Pediatric Emergency Care
H M Le, G Carbutti, D Ilisei, E Bouccin, X Vandemergel
Pseudopheochromocytoma has a clinical presentation that is similar to pheochromocytoma. It manifests itself with paroxysmal hypertension crises, associated with various symptoms such as headaches, chest pain, nausea, palpitations, and dizziness. Patients are usually asymptomatic in between the crises. Unlike pheochromocytoma, there is no catecholamines overproduction in this pathology: hypertensive peaks are caused by a hyperactivation of the sympathetic nervous system, which is often triggered by a psychological trauma in the past...
2016: Case Reports in Cardiology
İlkay Erdoğan, Yelda Bilginer, Ali Düzova, Nesrin Beşbaş
Tacrolimus is a potent immunosuppressive agent widely used after organ transplantation. In this present study we present eight patients who complained of palpitation after kidney transplantation. Eight out of 31 patients who received tacrolimus after kidney transplantation suffered from tachycardia. Resting electrocardiography, 24 hours Holter monitorization, echocardiography were performed, and serum levels of cardiac troponin T, creatine kinase, CKMB, brain natriuretic peptide and tacrolimus were measured...
November 2015: Turkish Journal of Pediatrics
R Wells, A Tonkin
Patients with autonomic dysfunction may present with a variety of seemingly unrelated symptoms, both generalised and involving specific systems, including fatigue, difficulty concentrating, orthostatic intolerance, palpitations, constipation or diarrhoea, early satiety, urinary retention or incontinence and erectile dysfunction. Failure to connect the diverse symptoms with a single underlying mechanism may lead to incorrect diagnoses, inappropriate interventions and frustration on the part of both doctors and patients...
October 2016: Internal Medicine Journal
Nobumasa Ohara, Yasuyuki Uemura, Naomi Mezaki, Keita Kimura, Masanori Kaneko, Hirohiko Kuwano, Katsuya Ebe, Toshio Fujita, Takeshi Komeyama, Hiroyuki Usuda, Yuto Yamazaki, Takashi Maekawa, Hironobu Sasano, Kenzo Kaneko, Kyuzi Kamoi
BACKGROUND: Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors. Hypertension secondary to pheochromocytoma is often paroxysmal, and patients occasionally present with sudden attacks of alternating hypertension and hypotension. Spontaneous, extensive necrosis within the tumor that is associated with catecholamine crisis is an infrequent complication of adrenal pheochromocytoma, but its pathogenesis remains unclear. CASE PRESENTATION: A 69-year-old Japanese man developed acute-onset episodic headaches, palpitations, and chest pains...
October 12, 2016: Journal of Medical Case Reports
Rok Accetto, Irina Yevgenyevna Chazova, Yuriy Sirenko, Josip Vincelj, Jiri Widimsky, Breda Barbic Zagar
BACKGROUND AND AIM: The aim of the study was to establish the efficacy and safety of Valsacor® (valsartan) and Valsacombi® (combination of valsartan and hydrochlorothiazide) in wide populations of patients with mild to moderate arterial hypertension. METHODS: We performed an international, multicentre, open labelled, prospective trial. After one week of washout in previously treated patients, the patients were treated for 16 weeks according to the schedule. Naïve patients enter the treatment immediately...
October 7, 2016: Kardiologia Polska
Zhenyang Jiang, Harriet Butler-Bowen, Teresa Rodriguez, Marie C Garcon, Melissa Hennessey Smith, Valerie Relias, Muhammad Wasif Saif
BACKGROUND: Fatigue is a common but devastating symptom for advanced pancreatic cancer (APC) patients. To date, no proven treatment exists. Methylphenidate (MPH) showed inconsistent results in treating other cancer related fatigue. We performed a retrospective study to assess MPH in ameliorating fatigue in APC patients. METHODS: We retrospectively reviewed our clinic APC patients' records who visited from 06/2011 - 11/2014. Fatigue was assessed by Visual Analog Fatigue Scale (VAFS) and classified as grade 1 (VAFS 1-3), grade 2 (VAFS 4-6) and grade 3 (VAFS 7-10) to correspond with CTCAE V4...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Rob E Schmitt, Clifford J Buckley
We present the case of a 34-year-old man who presented to the emergency department with complaints of generalized fatigue and palpitations, with a heart rate of approximately 100 beats per minute and an orthostatic blood pressure of 80/30 mm Hg upon standing. A hemoglobin of 1.8 g/dL was discovered. A positive fecal occult blood test led to the diagnosis of colon cancer. Once the cancer was resected, the patient's anemia resolved.
October 2016: Proceedings of the Baylor University Medical Center
John E Madias
No abstract text is available yet for this article.
September 28, 2016: International Journal of Cardiology
Lani Zimmerman, Bunny Pozehl, Karen Vuckovic, Susan Barnason, Paula Schulz, Yaewon Seo, Catherine J Ryan, Julie J Zerwic, Holli A DeVon
The purpose of this review is to provide a guide for researchers and clinicians in selecting an instrument to measure four commonly occurring symptoms (dyspnea, chest pain, palpitations, and fatigue) in cardiac populations (acute coronary syndrome, heart failure, arrhythmia/atrial fibrillation, and angina, or patients undergoing cardiac interventions). An integrative review of the literature was conducted. A total of 102 studies summarizing information on 36 different instruments are reported in this integrative review...
September 26, 2016: Heart & Lung: the Journal of Critical Care
Mahmoud A Abdelsalam, Jeffrey B Geske
CLINICAL INTRODUCTION: A 77-year-old female was referred for evaluation of an episode of syncope while eating breakfast. There was no history of fall, syncope, prodrome, dyspnoea, chest discomfort or palpitations. Medical history was notable for hyperlipidaemia and treated hypertension. Blood pressure was 140/90 mm Hg, pulse 85  beats per minute (BPM). No murmurs were present on cardiac examination. ECG revealed normal sinus rhythm with left ventricular (LV) hypertrophy (see online supplementary figure S1)...
September 23, 2016: Heart: Official Journal of the British Cardiac Society
Scott D Cohen, Daniel Cukor, Paul L Kimmel
Anxiety is a common yet frequently overlooked psychiatric symptom in patients with ESRD treated with hemodialysis (HD). Anxiety is characterized by disruptive feelings of uncertainty, dread, and fearfulness. A variety of common medical complaints may be manifestations of an anxiety disorder, including palpitations, tremors, indigestion, numbness/tingling, nervousness, shortness of breath, diaphoresis, and fear. It is essential for the clinician to rule out specific medical conditions, including cardiovascular, pulmonary, and neurologic diseases, before ascribing these symptoms to an anxiety disorder...
September 22, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Sedat Yahsi, Senol Tonyali, Cavit Ceylan, Kenan Y Yildiz, Levent Ozdal
A 34 year-old woman was admitted to our hospital with left flank pain. A non-contrast enhanced computerized tomography (NCCT) revealed a 1.5x2cm left proximal ureter stone. Patient was scheduled for ureterorenoscopy (URS) and stone removal. She was submitted to retrograde intrarenal surgery (RIRS). At the postoperative 1st day, the patient began to suffer from left flank pain. A NCCT was taken, which revealed a subcapsular hematoma and perirenal fluid. The patient was managed conservatively with intravenous fluid, antibiotic and non-steroidal anti-inflammatory drug therapy and was discharged at the postoperative 6th day...
September 20, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Sandeep A Saha, Kousik Krishnan, Christopher Madias, Richard G Trohman
A 34-year-old man with Brugada syndrome (BrS) presented with electrical storm, manifested as multiple appropriate shocks from his implantable cardioverter-defibrillator over a period of 7 hours. He had not tolerated prior treatment with quinidine, and had self-discontinued cilostazol citing persistent palpitations. After stabilization with intravenous isoproterenol, an electrophysiology study was performed but no spontaneous or induced ventricular ectopic beats were identified. A three-dimensional (3D) endocardial electro-anatomic map of the right ventricular outflow tract (RVOT), pulmonic valve, and pulmonary artery, as well as a 3D epicardial map of the RVOT, were created...
September 19, 2016: Cardiology and Therapy
Natália Stela Sandes Ferreira, Tatiana La Croix Barros, Ronaldo Altenburg Gismondi
Arrhythmias are the most common cardiac complication during gestational period and may occur in women with or without known structural heart disease. Premature extra beats and sustained tachyarrhythmias are the most common arrhythmias in pregnancy. Symptomatic episodes occur in 20-44% of pregnant women, usually as palpitations, dizziness, or syncope. We searched on Pubmed for ventricular premature complexes (VPC) in pregnant women and found no case reporting increased incidence of this arrhythmia while supine...
2016: Case Reports in Medicine
Xiongfei Liang, Yifeng Yang
The clinical data for a patient with sick sinus syndrome was retrospectively analyzed. The patient was treated because of his heart palpitations and the increased chest pain. The patient admitted to the hospital under consideration for the left atrial tumor dependent on the echocardiography findings. After the CT scan and the dynamic ECG examination, the patient successfully underwent the left atrial tumor resection, atrial septal repair and cardiac pacing lead installation. The postoperative pathological diagnosis showed that the infective endocarditis and left atrial thrombus in left atrium was cured...
September 28, 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
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