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https://www.readbyqxmd.com/read/29774053/postherpes-simplex-encephalitis-a-case-series-of-viral-triggered-autoimmunity-synaptic-autoantibodies-and-response-to-therapy
#1
Harry Alexopoulos, Sofia Akrivou, Sotiria Mastroyanni, Maria Antonopoulou, Argirios Dinopoulos, Melpo Giorgi, Kostas Konstantinou, Evangelos Kouremenos, Maria Lariou, Dimitrios Naoumis, Efterpi Pavlidou, Evaggelos Pavlou, Konstantinos Voudris, Panayotis Vlachoyiannopoulos, Marinos C Dalakas
Background: Recent evidence suggests that patients with herpes simplex virus (HSV) encephalitis may relapse because of autoimmunity against the N-methyl-D-aspartate receptor (NMDAR). We present a case series of post-HSV relapsing encephalopathy associated with antibodies to central nervous system (CNS) synaptic antigens. Patient/Methods: Sera and cerebrospinal fluid (CSF) from five patients with HSV encephalitis who relapsed after antiviral therapy were tested for anti-NMDAR, gamma-aminobutyric acid b receptor (GABAbR), α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR), Leucine-rich, glioma inactivated 1 (LGI1), anti -contactin-associated protein-like 2 (CASPR2) and dipeptidyl-peptidase-like protein-6 (DDPX) antibodies using cell-based assays...
2018: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/29770221/risperidone-induced-type-2-diabetes-presenting-with-diabetic-ketoacidosis
#2
Clarissa Ern Hui Fang, Mohammed Faraz Rafey, Aine Cunningham, Sean F Dinneen, Francis M Finucane
A 28-year-old male presented with 2 days of vomiting and abdominal pain, preceded by 2 weeks of thirst, polyuria and polydipsia. He had recently started risperidone for obsessive-compulsive disorder. He reported a high dietary sugar intake and had a strong family history of type 2 diabetes mellitus (T2DM). On admission, he was tachycardic, tachypnoeic and drowsy with a Glasgow Coma Scale (GCS) of 10/15. We noted axillary acanthosis nigricans and obesity (BMI 33.2 kg/m2 ). Dipstick urinalysis showed ketonuria and glycosuria...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29767451/feline-ureteral-obstructions-part-1-medical-management
#3
REVIEW
D L Clarke
Feline ureteral obstructions are an increasingly recognised and challenging diagnostic and management problem. Many cats with ureteral obstructions are critically ill at the time of diagnosis, especially if there is dysfunction of the contralateral kidney. They may present with varying severities of acute kidney injury, electrolyte disturbances, and may have comorbidities such as heart disease that complicate perioperative and long-term management. Medical management, which may consist of rehydration and restoration of intravascular volume with intravenous fluid therapy, osmotic diuresis, ureteral muscle relaxation, and antimicrobials for infection, is important in feline ureteral obstruction patients...
May 16, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29760854/peritoneal-dialysis-in-austere-environments-an-emergent-approach-to-renal-failure-management
#4
REVIEW
Chad Gorbatkin, John Bass, Fredric O Finkelstein, Steven M Gorbatkin
Peritoneal dialysis (PD) is a means of renal replacement therapy (RRT) that can be performed in remote settings with limited resources, including regions that lack electrical power. PD is a mainstay of end-stage renal disease (ESRD) therapy worldwide, and the ease of initiation and maintenance has enabled it to flourish in both resource-limited and resource-abundant settings. In natural disaster scenarios, military conflicts, and other austere areas, PD may be the only available life-saving measure for acute kidney injury (AKI) or ESRD...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29760719/ifn-%C3%AE-expressing-amniotic-fluid-derived-mesenchymal-stem-cells-migrate-to-and-suppress-hela-cell-derived-tumors-in-a-mouse-model
#5
Jun Zhou, Tian Liang, Dejun Wang, Liru Li, Yan Cheng, Qiuyan Guo, Guangmei Zhang
Background: Immunotherapy for cervical cancer with type I interferon (IFN) is limited because of the cytotoxicity that accompanies the high doses that are administered. In this study, we investigated the utilization of amniotic fluid-derived mesenchymal stem cells (AF-MSCs) as a means for delivering IFN α to local tumor sites for the suppression of cervical cancer in a mouse model using HeLa cell xenografts. Methods: The tumor tropism ability of AF-MSCs and AF-MSCs genetically modified to overexpress IFN α (IFN α -AF-MSCs) was examined through Transwell in vitro and through fluorescent images and immunohistochemistry in a mouse model...
2018: Stem Cells International
https://www.readbyqxmd.com/read/29753517/liberal-versus-restrictive-intravenous-fluid-therapy-for-early-septic-shock-rationale-for-a-randomized-trial
#6
Wesley H Self, Matthew W Semler, Rinaldo Bellomo, Samuel M Brown, Bennett P deBoisblanc, Matthew C Exline, Adit A Ginde, Colin K Grissom, David R Janz, Alan E Jones, Kathleen D Liu, Stephen P J Macdonald, Chadwick D Miller, Pauline K Park, Lora A Reineck, Todd W Rice, Jay S Steingrub, Daniel Talmor, Donald M Yealy, Ivor S Douglas, Nathan I Shapiro
Prompt intravenous fluid therapy is a fundamental treatment for patients with septic shock. However, the optimal approach for administering intravenous fluid in septic shock resuscitation is unknown. Two competing strategies are emerging: a liberal fluids approach, consisting of a larger volume of initial fluid (50 to 75 mL/kg [4 to 6 L in an 80-kg adult] during the first 6 hours) and later use of vasopressors, versus a restrictive fluids approach, consisting of a smaller volume of initial fluid (≤30 mL/kg [≤2 to 3 L]), with earlier reliance on vasopressor infusions to maintain blood pressure and perfusion...
May 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29750688/feasibility-of-fully-automated-hypnosis-analgesia-and-fluid-management-using-2-independent-closed-loop-systems-during-major-vascular-surgery-a-pilot-study
#7
Alexandre Joosten, Vincent Jame, Brenton Alexander, Thierry Chazot, Ngai Liu, Maxime Cannesson, Joseph Rinehart, Luc Barvais
Automated titration of intravenous anesthesia and analgesia using processed electroencephalography monitoring is no longer a novel concept. Closed-loop control of fluid administration to provide goal-directed fluid therapy has also been increasingly described. However, simultaneously combining 2 independent closed-loop systems together in patients undergoing major vascular surgery has not been previously detailed. The aim of this pilot study was to evaluate the clinical performance of fully automated hypnosis, analgesia, and fluid management using 2 independent closed-loop controllers in patients undergoing major vascular surgery before implementation within a larger study evaluating true patient outcomes...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29742967/restrictive-versus-liberal-fluid-therapy-for-major-abdominal-surgery
#8
Paul S Myles, Rinaldo Bellomo, Tomas Corcoran, Andrew Forbes, Philip Peyton, David Story, Chris Christophi, Kate Leslie, Shay McGuinness, Rachael Parke, Jonathan Serpell, Matthew T V Chan, Thomas Painter, Stuart McCluskey, Gary Minto, Sophie Wallace
Background Guidelines to promote the early recovery of patients undergoing major surgery recommend a restrictive intravenous-fluid strategy for abdominal surgery. However, the supporting evidence is limited, and there is concern about impaired organ perfusion. Methods In a pragmatic, international trial, we randomly assigned 3000 patients who had an increased risk of complications while undergoing major abdominal surgery to receive a restrictive or liberal intravenous-fluid regimen during and up to 24 hours after surgery...
May 9, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29732161/rapid-onset-diabetic-ketoacidosis-secondary-to-nivolumab-therapy
#9
Senhong Lee, Aparna Morgan, Sonali Shah, Peter R Ebeling
We report a case of a 67-year-old man with type 2 diabetes presented with diabetic ketoacidosis, two weeks after his first dose of nivolumab therapy for non-small-cell lung carcinoma. He was started on empagliflozin two days prior in the setting of hyperglycaemia after the initiation of nivolumab therapy. Laboratory evaluation revealed an undetectable C-peptide and a positive anti-glutamic acid decarboxylase (GAD) antibody. He was treated with intravenous fluids and insulin infusion and was subsequently transitioned to subcutaneous insulin and discharged home...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29729030/treating-pediatric-post-tonsillectomy-pain-and-nausea-with-complementary-and-alternative-medicine
#10
REVIEW
Katherine R Keefe, Kevin J Byrne, Jessica R Levi
OBJECTIVES: Although tonsillectomy is a common and largely safe procedure, pain management in children remains a controversial topic. In addition to the challenge of choosing appropriate analgesia, there is often low parent and child adherence. This article presents a review, and evaluates the potential role, of a range of complementary and alternative therapies that may be sought out by parents. METHODS: A literature review of complementary and alternative interventions performed using PubMed, Cochrane Library, and EMBASE, supplemented by searches from Google and hand searches of cross-references of selected articles, yielded 32 studies for qualitative analysis...
May 4, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29720516/seminal-siv-in-chronically-infected-cynomolgus-macaques-is-dominated-by-virus-originating-from-multiple-genital-organs
#11
Laurent Houzet, Marcos Pérez-Losada, Giulia Matusali, Claire Deleage, Nathalie Dereuddre-Bosquet, Anne-Pascale Satie, Florence Aubry, Emmanuelle Becker, Bernard Jégou, Roger Le Grand, Brandon F Keele, Keith A Crandall, Nathalie Dejucq-Rainsford
The sexual transmission of viruses is responsible for the spread of multiple infectious diseases. Although the HIV/AIDS pandemic remains fueled by sexual contacts with infected semen, the origin of virus in semen is still unknown. In a substantial number of HIV- infected men, viral strains present in semen differ from the ones in blood, suggesting that HIV is locally produced within the genital tract. Such local production may be responsible for the persistence of HIV in semen despite effective antiretroviral therapy...
May 2, 2018: Journal of Virology
https://www.readbyqxmd.com/read/29712574/durable-regression-of-medulloblastoma-after-regional-and-intravenous-delivery-of-anti-her2-chimeric-antigen-receptor-t-cells
#12
Anandani Nellan, Christopher Rota, Robbie Majzner, Cynthia M Lester-McCully, Andrea M Griesinger, Jean M Mulcahy Levy, Nicholas K Foreman, Katherine E Warren, Daniel W Lee
BACKGROUND: Standard-of-care therapies for treating pediatric medulloblastoma have long-term side effects, even in children who are cured. One emerging modality of cancer therapy that could be equally effective without such side effects would be chimeric antigen receptor (CAR) T cells. Knowing that human epidermal growth factor receptor 2 (HER2) is overexpressed in many medulloblastomas and has been used as a CAR T target before, we sought to evaluate the efficacy of more sophisticated anti-HER2 CAR T cells, as well as the feasibility and efficacy of different routes of delivering these cells, for the treatment of pediatric medulloblastoma...
April 30, 2018: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/29702489/what-s-new-in-short-bowel-syndrome
#13
Lore Billiauws, Olivier Corcos, Francisca Joly
PURPOSE OF REVIEW: Short bowel syndrome (SBS) is a rare disease but with many complications due to intestinal failure, parenteral nutrition and underlying disease. A better prevention, comprehension and treatment could improve the outcome of these patients. RECENT FINDINGS: Recent studies have been published on acute intestinal failure, first cause of SBS, and gives us strategy to avoid extended intestinal resection and thus SBS. There has been progress in the comprehension of intestinal adaptation, characterized by improvements in intestinal absorption, changes on hormonal secretion, development of a hyperphagia and dysbiosis of the gut microbiota...
April 26, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29692956/toward-non-invasive-and-automatic-intravenous-infiltration-detection-evaluation-of-bioimpedance-and-skin-strain-in-a-pig-model
#14
A Ozan Bicen, Leanne L West, Liliana Cesar, Omer T Inan
Intravenous (IV) therapy is prevalent in hospital settings, where fluids are typically delivered with an IV into a peripheral vein of the patient. IV infiltration is the inadvertent delivery of fluids into the extravascular space rather than into the vein (and requires urgent treatment to avoid scarring and severe tissue damage), for which medical staff currently needs to check patients periodically. In this paper, the performance of two non-invasive sensing modalities, electrical bioimpedance (EBI), and skin strain sensing, for the automatic detection of IV infiltration was investigated in an animal model...
2018: IEEE Journal of Translational Engineering in Health and Medicine
https://www.readbyqxmd.com/read/29673370/early-versus-standard-initiation-of-renal-replacement-therapy-in-furosemide-stress-test-non-responsive-acute-kidney-injury-patients-the-fst-trial
#15
Nuttha Lumlertgul, Sadudee Peerapornratana, Thananda Trakarnvanich, Wanjak Pongsittisak, Kajbundit Surasit, Anan Chuasuwan, Pleumjit Tankee, Khajohn Tiranathanagul, Kearkiat Praditpornsilpa, Kriang Tungsanga, Somchai Eiam-Ong, John A Kellum, Nattachai Srisawat
BACKGROUND: The timing of initiation of renal replacement therapy (RRT) in severe acute kidney injury (AKI) remains controversial, with early initiation resulting in unnecessary therapy for some patients while expectant therapy may delay RRT for other patients. The furosemide stress test (FST) has been shown to predict the need for RRT and therefore could be used to exclude low-risk patients from enrollment in trials of RRT timing. We conducted this multicenter pilot study to determine whether FST could be used to screen patients at high risk for RRT and to determine the feasibility of incorporating FST into a trial of early initiation of RRT...
April 19, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29666121/clinical-features-and-visual-outcomes-of-111-patients-with-new-onset-acute-vogt-koyanagi-harada-disease-treated-with-pulse-intravenous-corticosteroids
#16
Makiko Nakayama, Hiroshi Keino, Takayo Watanabe, Annabelle A Okada
PURPOSE: To describe the clinical features, treatment and visual outcomes of Japanese patients with new-onset acute Vogt-Koyanagi-Harada (VKH) disease. METHODS: Clinical records of 111 patients who presented between 1999 and 2015 to the Ocular Inflammation Service of the Kyorin Eye Center, Tokyo, were reviewed. RESULTS: Of the 111 patients (68 women, 43 men), 16 had complete, 90 had incomplete and 5 had probable VKH disease. The median follow-up period was 36 months (4-175 months)...
April 17, 2018: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29664502/hospital-acquired-hyponatremia-does-the-type-of-fluid-therapy-affect-children-admitted-to-intensive-care
#17
Pilar Velasco, Andrés J Alcaraz, Niki Oikonomopoulou, Marina Benito, Raquel Moya, Álvaro Sánchez
INTRODUCTION: The objective of this study was to evaluate the association between the type of initial fluid therapy used (isotonic or hypotonic solutions) and the development of hyponatremia, the plas ma chlorine values and the tolerance of venous access. PATIENTS AND METHOD: Retrospective cohort study in a Pediatric Intensive Care Unit (PICU) of a high complexity hospital. There were included children younger than 15 years old hospitalized during the first semester of 2010 and 2013 who recei ved intravenous maintenance fluid therapy, excluding patients undergoing cardiac surgery, kidney transplant and admissions that lasted less than 24 hours...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29657879/primary-hyperparathyroidism-and-gougerot-disease
#18
Toumader Bouziane, Nadia Belmahi, Hanan El Ouahabi
Primary hyperparathyroidism (PHPT) is a common endocrine disorder caused by the overactivation of the parathyroid glands due to the autonomous production of the parathyroid hormone (PTH). The resultant hypercalcemia leads to a myriad of symptoms. Here we report the case of a 54-year-old female with a previous diagnosis of Gougerot disease, in whom clinical (diffuse bone pain, asthenia polydipsia, and polyuria) and laboratory features (calcium level, 3.1 mmol/L; phosphate level, 0.55 mmol/L; alkaline phosphatase level, 70 U/L; and intact PTH level, 1028...
March 2018: European Journal of Rheumatology
https://www.readbyqxmd.com/read/29629201/anesthesia-and-fast-track-in-video-assisted-thoracic-surgery-vats-from-evidence-to-practice
#19
REVIEW
Marzia Umari, Stefano Falini, Matteo Segat, Michele Zuliani, Marco Crisman, Lucia Comuzzi, Francesco Pagos, Stefano Lovadina, Umberto Lucangelo
In thoracic surgery, the introduction of video-assisted thoracoscopic techniques has allowed the development of fast-track protocols, with shorter hospital lengths of stay and improved outcomes. The perioperative management needs to be optimized accordingly, with the goal of reducing postoperative complications and speeding recovery times. Premedication performed in the operative room should be wisely administered because often linked to late discharge from the post-anesthesia care unit (PACU). Inhalatory anesthesia, when possible, should be preferred based on protective effects on postoperative lung inflammation...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29628846/intraoperative-fluid-management-past-and-future-where-is-the-evidence
#20
REVIEW
Abdulmohsin A Al-Ghamdi
Currently, there is no consensus about the optimum intraoperative fluid therapy strategy. There is growing body of evidence supports the beneficial effects of adopting "Goal-directed therapy" over either the "liberal" or "restrictive" fluid therapy strategies. In this narrative review, we have presented the evidence to support the optimum strategy for intraoperative therapy. In conclusion, whatever the intravenous fluid replacement strategy used, the anesthesiologist must be prepared to adjust the composition and rate of the fluids administered to provide sufficient intravascular fluid volume for adequate perfusion of vital organs without overwhelming the glycocalyx function with fluid overloads...
April 2018: Saudi Journal of Anaesthesia
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