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https://www.readbyqxmd.com/read/29341498/review-article-sepsis-in-the-emergency-department-part-2-investigations-and-monitoring
#1
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/29333884/use-of-tidal-breathing-curves-for-evaluating-expiratory-airway-obstruction-in-infants
#2
Avigdor Hevroni, Aliza Goldman, Miriam Blank-Brachfeld, Wiessam Abu Ahmad, Lior Ben-Dov, Chaim Springer
OBJECTIVE: To evaluate tidal breathing (TB) flow-volume and flow-time curves for identification of expiratory airway obstruction in infants. METHODS: Pulmonary function tests were analyzed retrospectively in 156 infants aged 3-24 months with persistent or recurrent respiratory complaints. Parameters derived from TB curves were compared to maximal expiratory flow at functional residual capacity ([Formula: see text]maxFRC) measured by rapid thoracoabdominal compression technique...
January 15, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29330699/accounting-of-ghg-emissions-and-removals-from-forest-management-a-long-road-from-kyoto-to-paris
#3
REVIEW
Joachim H A Krug
BACKGROUND: Forests have always played an important role in agreeing on accounting rules during the past two decades of international climate policy development. Starting from activity-based gross-net accounting of selected forestry activities to mandatory accounting against a baseline-rules have changed quite rapidly and with significant consequences for accounted credits and debits. Such changes have direct consequences on incentives for climate-investments in forestry. There have also been strong arguments not to include forests into the accounting system by considering large uncertainties, procedural challenges and a fear of unearned credits corrupting the overall accounting system, among others...
January 3, 2018: Carbon Balance and Management
https://www.readbyqxmd.com/read/29323690/premature-adrenarche
#4
Laura Novello, Phyllis W Speiser
Adrenarche is when a child's adrenal cortex starts to secrete adrenal androgen precursors. Dehydroepiandrosterone (DHEA) is the most abundant product of the adrenal cortex, and is a weak androgen agonist thought to be responsible for the clinical signs of pubarche by conversion to more potent androgens, testosterone, and dihydrotestosterone. DHEA's extra-adrenal sulfation product, dehydroepiandrosterone sulfate, is a stable marker for adrenal androgenic activity. Pubarche is the physical manifestation of androgenic hormone production, and includes the development of pubic and axillary hair, adult body odor, and acne...
January 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29321025/diagnostic-challenges-of-prolonged-post-treatment-clearance-of-plasmodium-nucleic-acids-in-a-pre-transplant-autosplenectomized-patient-with-sickle-cell-disease
#5
Paul M Luethy, Sean C Murphy, Annette M Seilie, Yingda L Xie, Chuen-Yen Lau, John F Tisdale, Matthew M Hsieh, Jessica L Reinhardt, Anna F Lau, Gary A Fahle
BACKGROUND: Autosplenectomy, as a result of sickle cell disease, is an important risk factor for severe malaria. While molecular methods are helpful in providing rapid and accurate infection detection and species identification, the effect of hyposplenism on result interpretation during the course of infection should be carefully considered. CASE PRESENTATION: A 32-year old autosplenectomized Nigerian male with severe sickle cell disease was referred to the National Institutes of Health for allogenic hematopoietic stem cell transplant...
January 10, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29316329/rapid-and-safe-discharge-from-the-emergency-department-a-single-troponin-to-exclude-acute-myocardial-infarction
#6
Lisa Brichko, Hans G Schneider, William Chan, Jarrel Seah, De Villiers Smit, Anthony Dart, Jeremy P Stevens, Biswadev Mitra
OBJECTIVE: To determine variables that could facilitate safe discharge from the ED following a single high-sensitivity troponin I (HsTnI) result to exclude acute myocardial infarction (AMI). METHODS: A retrospective cohort study was performed at a tertiary hospital of all patients that had serial HsTnI performed within 12 h of arrival to the ED over a 3 year period. The primary exposure variable of interest was a very low troponin initial result (HsTnI <5 ng/L)...
January 8, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29310343/cerebrospinal-fluid-real-time-quaking-induced-conversion-test-for-sporadic-creutzfeldt-jakob-disease-in-an-18-year-old-woman-a-case-report
#7
Yuan Yao, Xiaoping Dong, Hongzhi Guan, Qiang Lu
RATIONALE: Sporadic Creutzfeldt-Jakob disease (sCJD) mainly occurs in the elderly, with the peak age of onset ranging from 55 to 75 years. The symptoms of sCJD are not unique, and laboratory tests such as magnetic resonance imaging (MRI), electroencephalogram (EEG) and cerebrospinal fluid (CSF)14-3-3 protein have low sensitivity or specificity. Therefore, excluding treatable diseases and establishing a diagnosis could be difficult in young patients with suspected sCJD. Recently, real-time quaking-induced conversion (RT-QuIC) has been used in the diagnosis of sCJD, with more than 95% sensitivity and 100% specificity...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29302647/detection-of-canine-parvovirus-antigen-in-dogs-in-kumasi-ghana
#8
R D Folitse, D O Kodie, E Amemor, D Dei, W Tasiame, V Burimuah, B O Emikpe
Background: Canine Parvovirus (CPV) in dogs has been documented in many countries. However, evidence of the infection is scanty in Ghana. This study was conducted to detect canine parvovirus antigen in dogs presented with diarrhoea to the Government Veterinary Clinic in Kumasi, Ghana. Materials and Methods: Faecal samples from 72 dogs presented with diarrhoea were tested for the presence of canine parvovirus antigen using commercially available rapid test kit (BIT® Rapid Colour Canine Parvovirus Ag Test Kit, BIOINDIST Co...
2018: African Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29300866/diagnostic-utility-of-molecular-and-imaging-biomarkers-in-cytological-indeterminate-thyroid-nodules
#9
Elizabeth J de Koster, Lioe-Fee de Geus-Oei, Olaf M Dekkers, Ilse van Engen-van Grunsven, Jaap Hamming, Eleonora P M Corssmit, Hans Morreau, Abbey Schepers, Jan Smit, Wim J G Oyen, Dennis Vriens
Indeterminate thyroid cytology (Bethesda III and IV) corresponds to follicular-patterned benign and malignant lesions, which are particularly difficult to differentiate on cytology alone. As approximately 25% of these nodules harbor malignancy, diagnostic hemithyroidectomy is still custom. However, advanced preoperative diagnostics are rapidly evolving.This review provides an overview of additional molecular and imaging diagnostics for indeterminate thyroid nodules in a pre-operative clinical setting, including considerations regarding cost-effectiveness, availability, and feasibility of combining techniques...
January 2, 2018: Endocrine Reviews
https://www.readbyqxmd.com/read/29298259/the-accuracy-of-the-alpha-defensin-lateral-flow-device-for-diagnosis-of-periprosthetic-joint-infection-comparison-with-a-gold-standard
#10
Thorsten Gehrke, Christian Lausmann, Mustafa Citak, Tommaso Bonanzinga, Lars Frommelt, Akos Zahar
BACKGROUND: Alpha defensin is a new biomarker that has been shown to have a very high accuracy to rule out periprosthetic joint infection. Recently, a new rapid lateral flow version of the alpha defensin test was developed and introduced to detect high levels of alpha defensin in synovial fluid quickly and with ease. We conducted a single-center prospective clinical study to compare the results of the Synovasure Alpha Defensin Test with those of the Musculoskeletal Infection Society (MSIS) criteria, which are considered to be the gold standard for diagnosing periprosthetic joint infection...
January 3, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29285754/oral-anticoagulation-in-people-with-cancer-who-have-no-therapeutic-or-prophylactic-indication-for-anticoagulation
#11
REVIEW
Lara A Kahale, Maram B Hakoum, Ibrahim G Tsolakian, Charbel F Matar, Maddalena Barba, Victor E D Yosuico, Irene Terrenato, Francesca Sperati, Holger Schünemann, Elie A Akl
BACKGROUND: Oral anticoagulants may improve the survival of people with cancer through both an antitumor effect and antithrombotic effect, yet increase the risk of bleeding. OBJECTIVES: To evaluate the efficacy and safety of oral anticoagulants in ambulatory people with cancer undergoing chemotherapy, hormonal therapy, immunotherapy or radiotherapy, but otherwise have no standard therapeutic or prophylactic indication for anticoagulation. SEARCH METHODS: We conducted a comprehensive literature search in February 2016 that included a major electronic search of Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 1), MEDLINE (Ovid) and Embase (Ovid); handsearching of conference proceedings; checking of references of included studies; a search for ongoing studies; and using the 'related citation' feature in PubMed...
December 29, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29279701/a-rare-case-of-docetaxel-induced-hydrocephalus-presenting-with-gait-disturbances-mimicking-and-coexisting-with-taxane-associated-polyneuropathy-the-relevance-of-differential-diagnosis-clinical-assessment-and-response-to-ventriculoperitoneal-shunt
#12
Lucas Ezequiel Serrano Sponton, Elke Januschek
Docetaxel constitutes a widely used chemotherapeutic agent as a first-line treatment for several neoplastic diseases. One of the most common side effects induced by this drug is polyneuropathy, which among other symptoms can cause gait disbalance. However, in exceptional cases gait disturbances could be related to docetaxel-induced hydrocephalus, a rare event that up to the present has been overseen throughout the medical literature and should be meticulously differentiated from polyneuropathy, since its clinical features, treatment, and prognosis differ drastically...
September 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/29279597/severe-asymptomatic-hypophosphataemia-in-a-child-with-t-acute-lymphoblastic-leukaemia
#13
N H Zakaria, P Sthaneshwar, H Shanmugam
Hypophosphataemia is a metabolic disorder that is commonly encountered in critically ill patients. Phosphate has many roles in physiological functions, thus the depletion of serum phosphate could lead to impairment in multiple organ systems, which include the respiratory, cardiovascular, neurological and muscular systems and haematological and metabolic functions. Hypophosphataemia is defined as plasma phosphate level below 0.80 mmol per litre (mmol/L) and can be further divided into subgroups of mild (plasma phosphate of 0...
December 2017: Malaysian Journal of Pathology
https://www.readbyqxmd.com/read/29273310/evaluation-of-fimc-and-bdha-based-duplex-pcr-for-specific-identification-and-differentiation-of-burkholderia-pseudomallei-from-near-neighbor-burkholderia-species
#14
Bhavani V Peddayelachagiri, Soumya Paul, Madhurjya Gogoi, Murali H Sripathy, Harsh V Batra
Assays for the rapid detection and accurate differentiation of Burkholderia pseudomallei from near-neighbor species are urgently needed in melioidosis endemic regions due to the high associated mortality and biowarfare importance of the pathogen. PCR-based methods have revolutionized this field due to the accuracy, sensitivity, and specificity that are achievable in a rapid way. In this study, a compound molecular detection system, consisting of a duplex PCR assay, was developed for the specific identification of Burkholderia pseudomallei and differentiation from other Burkholderia species...
November 28, 2017: International Journal of Medical Microbiology: IJMM
https://www.readbyqxmd.com/read/29273259/contemporary-application-of-point-of-care-echocardiography-in-the-emergency-department
#15
REVIEW
Jordan Chenkin, Clare L Atzema
Point-of-care echocardiography is revolutionizing the management of patients presenting with undifferentiated shock and cardiac arrest in the emergency department (ED). Its primary purpose is to aid the clinician in rapidly ruling in and ruling out life-threatening diagnoses at the bedside. In addition, it has become an important component of the clinical examination for stable patients seen in the ED with nonspecific signs and symptoms such as shortness of breath or syncope. Although first described to facilitate the diagnosis of pericardial effusions and cardiac standstill, ED echocardiography has since evolved and is now widely used by emergency physicians to help diagnose other important cardiovascular pathologic conditions that may be contributing to undifferentiated shock, such as left ventricular failure and right ventricular dilatation resulting from pulmonary embolism...
September 1, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29260069/atypical-intravitreal-growth-of-retinoblastoma-with-a-multi-branching-configuration
#16
Sachiko Nishina, Satoshi Katagiri, Atsuko Nakazawa, Chikako Kiyotani, Tadashi Yokoi, Noriyuki Azuma
Purpose: To report the clinical and histopathological findings of atypical intravitreal growth of a retinoblastoma with a multi-branching configuration. Observations: A 7-month-old boy was referred to our hospital due to leukocoria in the right eye. Ophthalmic examinations identified multi-branching vessels surrounded by diaphanous tissue behind the lens in the right eye. Imaging modalities showed microphthalmos, band-shaped calcification, and cystic lesions in that eye...
September 2017: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29251718/a-role-for-2-cys-peroxiredoxins-in-facilitating-cytosolic-protein-thiol-oxidation
#17
Sarah Stöcker, Michael Maurer, Thomas Ruppert, Tobias P Dick
Hydrogen peroxide (H2O2) acts as a signaling messenger by triggering the reversible oxidation of redox-regulated proteins. It remains unclear how proteins can be oxidized by signaling levels of H2O2 in the presence of peroxiredoxins, which are highly efficient peroxide scavengers. Here we show that the rapid formation of disulfide bonds in cytosolic proteins is enabled, rather than competed, by cytosolic 2-Cys peroxiredoxins. Under the conditions tested, the combined deletion or depletion of cytosolic peroxiredoxins broadly frustrated H2O2-dependent protein thiol oxidation, which is the exact opposite of what would be predicted based on the assumption that H2O2 oxidizes proteins directly...
December 18, 2017: Nature Chemical Biology
https://www.readbyqxmd.com/read/29248334/diagnostic-accuracy-of-a-new-high-sensitivity-troponin-i-assay-and-five-accelerated-diagnostic-pathways-for-ruling-out-acute-myocardial-infarction-and-acute-coronary-syndrome
#18
Jaimi H Greenslade, Edward W Carlton, Christopher Van Hise, Elizabeth Cho, Tracey Hawkins, William A Parsonage, Jillian Tate, Jacobus Ungerer, Louise Cullen
STUDY OBJECTIVE: This diagnostic accuracy study describes the performance of 5 accelerated chest pain pathways, calculated with the new Beckman's Access high-sensitivity troponin I assay. METHODS: High-sensitivity troponin I was measured with presentation and 2-hour blood samples in 1,811 patients who presented to an emergency department (ED) in Australia. Patients were classified as being at low risk according to 5 rules: modified accelerated diagnostic protocol to assess patients with chest pain symptoms using troponin as the only biomarker (m-ADAPT), the Emergency Department Assessment of Chest Pain Score (EDACS) pathway, the History, ECG, Age, Risk Factors, and Troponin (HEART) pathway, the No Objective Testing Rule, and the new Vancouver Chest Pain Rule...
December 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29246478/a-phase-iii-diagnostic-accuracy-study-of-a-rapid-diagnostic-test-for-diagnosis-of-second-stage-human-african-trypanosomiasis-in-the-democratic-republic-of-the-congo
#19
Marleen Boelaert, Deby Mukendi, Emmanuel Bottieau, Jean Roger Kalo Lilo, Kristien Verdonck, Luigi Minikulu, Barbara Barbé, Philippe Gillet, Cédric P Yansouni, François Chappuis, Pascal Lutumba
OBJECTIVES: To estimate the diagnostic accuracy of HAT Sero K-SeT for the field diagnosis of second-stage human African trypanosomiasis (HAT). DESIGN: A phase III diagnostic accuracy design. Consecutive patients with symptoms clinically suggestive of HAT were prospectively enrolled. We compared results of the index test HAT Sero K-SeT with those of a composite reference standard: demonstration of trypanosomes in cerebrospinal fluid (CSF), or trypanosomes detected in any other body fluid AND white blood cell count in CSF >5/μl...
December 6, 2017: EBioMedicine
https://www.readbyqxmd.com/read/29237894/j-b-s-haldane-s-passage-to-india-reconfiguring-science
#20
Gordon Mcouat
In 1957, John Burdon Sanderson (JBS) Haldane (1892-1964), the world's leading population geneticist, committed political radical and one of the three 'founders' of neo-Darwinian 'Modern Synthesis' of twentieth century biology (Sarkar 1995; Haldane 1932; Cain 2009; Smocovitis 1996), ostentatiously renounced both his British citizenship and his prestigious chair at University College London. In a decisively and very public anti-imperial gesture, ostensibly played out as a reaction to the Suez crisis (although his discontent was simmering for quite some time), Haldane, and his partner, geneticistHelen Spurway (1917-1977), turned their backs on Britain and set off to India to offer their considerable scientific prestige, their inexhaustible organisational abilities, along with their leading Journal of Genetics, behind the efforts to build a 'modern', democratic India emerging out of the ashes of colonial rule...
November 2017: Journal of Genetics
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