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https://www.readbyqxmd.com/read/28445305/a-case-report-of-painless-type-a-aortic-dissection-with-intermittent-convulsive-syncope-as-initial-presentation
#1
Chun-Hsien Chen, Kuan-Ting Liu
RATIONALE: The initial presenting symptoms and signs of acute aortic dissection are so diverse that it makes early and accurate diagnosis arduous. Painless and convulsive syncope due to cardiac arrhythmia were not typical presentations of acute aortic dissection. PATIENT CONCERNS: A 61-year-old male presenting with transient consciousness loss and suspected seizure attack was sent to emergency room (ER) by ambulance. Consciousness loss accompanying with upward gaze and limb convulsion was noted in ER, and electrocardiogram monitor recorded a transient cardiac asystole then spontaneous recovery of sinus rhythm...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28444167/electrical-cardiac-injuries-current-concepts-and-management
#2
Victor Waldmann, Kumar Narayanan, Nicolas Combes, Daniel Jost, Xavier Jouven, Eloi Marijon
Electrical injuries are a commonly encountered hazard in both the home and workplace. However, clinicians are often uncomfortable when faced with the patient who presents with an electric shock due to sparse literature and lack of systematic recommendations on this topic. Electrical injuries can range from minor skin burns to life threatening internal organ damage. A thorough clinical assessment to ascertain the path of current through the body and possible internal injury is essential. The main concern in an apparently stable individual after an electric shock is the potential for delayed occurrence of cardiac arrhythmias which will require monitoring in the intensive care setting...
April 20, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28439288/systemic-mastocytosis-with-kit-v560g-mutation-presenting-as-recurrent-episodes-of-vascular-collapse-response-to-disodium-cromoglycate-and-disease-outcome
#3
Iolanda Conde-Fernandes, Rita Sampaio, Filipa Moreno, José Palla-Garcia, Maria Dos Anjos Teixeira, Inês Freitas, Esmeralda Neves, Maria Jara-Acevedo, Luis Escribano, Margarida Lima
BACKGROUND: Mastocytosis are rare diseases characterized by an accumulation of clonal mast cells (MCs) in one or multiple organs or tissues. Patients with systemic mastocytosis (SM), whose MCs frequently arbor the activating D816V KIT mutation, may have indolent to aggressive diseases, and they may experience MC mediator related symptoms. Indolent SM with recurrent anaphylaxis or vascular collapse in the absence of skin lesions, ISMs(-), is a specific subtype indolent SM (ISM), and this clonal MC activation disorder represents a significant fraction of all MC activation syndromes...
2017: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/28438554/interleukin-17f-and-interleukin-6-gene-polymorphisms-in-asian-indian-patients-with-takayasu-arteritis
#4
Debashish Danda, Ruchika Goel, Sumita Danda, Hindhumathi Mohan, George Joseph, Jayakanthan Kabeerdoss, Swapan K Nath
OBJECTIVES: To assess genetic association between single nucleotide polymorphisms (SNPs) in genes encoding T-helper cytokines and Takayasu Arteritis (TA) susceptibility in Indian population. METHODS: In Phase-1, the genomic DNA of 120 TA patients and 119 healthy controls were genotyped for SNPs rs1800795 (interleukin (IL)-6), rs763780 (IL-17F), rs1800871, rs1800872, rs1800896 (IL-10) and rs1800468, rs1800469, rs1800470 (transforming growth factor-β). Allele frequencies between cases and controls were compared using chi-squared test and also reassessed empirically (pe) by 10,000 permutations...
April 21, 2017: Human Immunology
https://www.readbyqxmd.com/read/28431063/left-ventricular-dysfunction-is-associated-with-frequent-premature-ventricular-complexes-and-asymptomatic-ventricular-tachycardia-in-children
#5
R A Bertels, L M Harteveld, L H Filippini, S A Clur, N A Blom
Aims: To assess the risk factors for left ventricular (LV) dysfunction in a paediatric population with idiopathic frequent premature ventricular contractions (PVCs) and asymptomatic ventricular tachycardias (VTs). Methods and Results: Paediatric patients with the diagnosis of idiopathic frequent PVCs and asymptomatic VTs were retrospectively evaluated. Frequent PVCs were defined as ≥5% on 24 h Holter recording. Left ventricular dysfunction was defined as a shortening fraction of ≤28%...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28431056/long-term-outcome-of-transvenous-pacemaker-implantation-in-infants-a-retrospective-cohort-study
#6
Laura M Vos, Janneke A E Kammeraad, Matthias W Freund, Andreas C Blank, Johannes M P J Breur
Aim: Evaluation of long-term outcome of transvenous pacemaker (PM) implantation in infants. Methods and Results: A retrospective analysis of all transvenous PM implantations in infants <10 kg between September 1997 and October 2001 was made. Indications for PM implantation, age at implantation, and determinants of long-term outcome including cardiac function, PM function, and PM (system) complications were noted. Seven patients underwent transvenous VVI(R) PM implantation...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28429690/-our-experience-in-the-diagnosis-and-treatment-of-postural-orthostatic-tachycardia-syndrome-vasovagal-syncope-and-inappropriate-sinus-tachycardia-in-children
#7
Sezen Ugan Atik, Reyhan Dedeoğlu, Aida Koka, Funda Öztunç
OBJECTIVES: The aim of this study was to share our experience in the diagnosis and treatment of patients who presented at our clinic with syncope, pre-syncope, dizziness, and palpitations. STUDY DESIGN: Patients who were treated at pediatric cardiology clinic for complaints of syncope, dizziness, and palpitations between 2014 and 2016 were enrolled in the study. Detailed history of the patients, physical examination findings, laboratory and electrocardiogram results were recorded...
April 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28426120/a-phase-ii-study-of-a-human-anti-pdgfr%C3%AE-monoclonal-antibody-olaratumab-imc-3g3-in-previously-treated-patients-with-metastatic-gastrointestinal-stromal-tumors
#8
A J Wagner, H Kindler, H Gelderblom, P Schöffski, S Bauer, P Hohenberger, H-G Kopp, J A Lopez-Martin, M Peeters, P Reichardt, A Qin, J Nippgen, R L Ilaria, P Rutkowski
Background: This study evaluated tumor response to olaratumab (an anti-PDGFRα monoclonal antibody) in previously treated patients with metastatic gastrointestinal stromal tumor (GIST) with or without PDGFRα mutations (cohorts 1 and 2, respectively). Patients and methods: Patients received olaratumab 20 mg/kg intravenously every 14 days until disease progression, death, or intolerable toxicity occurred. Outcome measures were 12-week tumor response, progression-free survival (PFS), overall survival (OS), and safety...
March 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28425226/a-review-of-pediatric-pulmonary-hypertension-with-new-guidelines
#9
Serdar Kula, Ayhan Pektaş
This study aims to review pediatric pulmonary hypertension (PH) by comparing the guidelines of the European Society of Cardiology (ESC)/European Respiratory Society (ERS), the American Heart Association (AHA)/American Thoracic Society (ATS), and the European Pediatric Pulmonary Vascular Disease Network (EPPVDN). All three sets of guidelines define PH as having a mean pulmonary artery pressure of ≥25 mmHg and accept the validity of the World Health Organization (WHO) classification system. Every child with a high index of suspicion for PH should undergo an initial work-up of chest X-rays, electrocardiography, and echocardiography...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28422759/ryr2r420q-catecholaminergic-polymorphic-ventricular-tachycardia-mutation-induces-bradycardia-by-disturbing-the-coupled-clock-pacemaker-mechanism
#10
Yue Yi Wang, Pietro Mesirca, Elena Marqués-Sulé, Alexandra Zahradnikova, Olivier Villejoubert, Pilar D'Ocon, Cristina Ruiz, Diana Domingo, Esther Zorio, Matteo E Mangoni, Jean-Pierre Benitah, Ana María Gómez
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a lethal genetic arrhythmia that manifests syncope or sudden death in children and young adults under stress conditions. CPVT patients often present bradycardia and sino-atrial node (SAN) dysfunction. However, the mechanism remains unclear. We analyzed SAN function in two CPVT families and in a novel knock-in (KI) mouse model carrying the RyR2R420Q mutation. Humans and KI mice presented slower resting heart rate. Accordingly, the rate of spontaneous intracellular Ca2+ ([Ca2+]i) transients was slower in KI mouse SAN preparations than in WT, without any significant alteration in the "funny" current (If )...
April 20, 2017: JCI Insight
https://www.readbyqxmd.com/read/28422288/general-dentists-awareness-of-how-to-cope-with-medical-emergencies-in-paediatric-dental-patients
#11
Ivana Čuković-Bagić, Sandra Hrvatin, Jesenka Jeličić, Dubravka Negovetić Vranić, Mirjana Kujundžić Tiljak, Hrvoje Pezo, Luc Marks
BACKGROUND: General dentists (GDs) should be aware of the symptoms, signs, diagnoses and treatment of medical emergencies in paediatric patients. AIM: To evaluate the knowledge of GDs in coping with medical emergencies, and to identify whether they are confident to diagnose and treat medical emergencies in paediatric patients. DESIGN: The questionnaire was conducted immediately before the beginning of national dental meetings and continuing education seminars in Croatia, attended by the GDs, in order to obtain a representative sample...
April 19, 2017: International Dental Journal
https://www.readbyqxmd.com/read/28420655/syncope-and-its-impact-on-occupational-accidents-and-employment-a-danish-nationwide-retrospective-cohort-study
#12
Anna-Karin Numé, Kristian Kragholm, Nicolas Carlson, Søren L Kristensen, Henrik Bøggild, Mark A Hlatky, Christian Torp-Pedersen, Gunnar Gislason, Martin H Ruwald
BACKGROUND: First-time syncopal episodes usually occur in adults of working age, but their impact on occupational safety and employment remains unknown. We examined the associations of syncope with occupational accidents and termination of employment. METHODS AND RESULTS: Through linkage of Danish population-based registers, we included all residents 18 to 64 years from 2008 to 2012. Among 3 410 148 eligible individuals, 21 729 with a first-time diagnosis of syncope were identified, with a median age 48...
April 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28408232/a-novel-case-of-splenic-injury-after-shockwave-lithotripsy
#13
David Zodda, Meta Haley, Rocky Sayegh
BACKGROUND: Emergency departments (EDs) are gateways for patients presenting after minor surgical procedures, particularly shockwave lithotripsy. Complications include renal and extrarenal tissue injuries, with the latter having potentially serious consequences if not detected early. CASE REPORT: We describe a 70-year-old male presenting to the ED for syncope. The patient underwent shockwave lithotripsy (SWL) for left kidney stones 1 day prior. Upon initial evaluation, the patient had normal vital signs and a normal physical examination, without complaints of abdominal pain...
April 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28407228/deleterious-protein-altering-mutations-in-the-scn10a-voltage-gated-sodium-channel-gene-are-associated-with-prolonged-qt
#14
Maen D Abou Ziki, Sara B Seidelmann, Emily Smith, Gourg Atteya, Yuexin Jiang, Rodolfo Gil Fernandes, Mark A Marieb, Joseph G Akar, Arya Mani
Long QT syndrome (LQT) is a pro-arrhythmogenic condition with life threatening complications. Fifteen genes have been associated with congenital LQT however, the genetic causes remain unknown in more than 20% of cases. Eighteen patients with history of palpitations, presyncope, syncope and prolonged QT were referred to the Yale Cardiovascular Genetics Program. All subjects underwent whole exome sequencing (WES) followed by confirmatory Sanger sequencing. Mutation burden analysis was carried out using WES data from sixteen subjects with no identifiable cause of LQT...
April 13, 2017: Clinical Genetics
https://www.readbyqxmd.com/read/28407148/effects-of-closed-loop-stimulation-vs-ddd-pacing-on-haemodynamic-variations-and-occurrence-of-syncope-induced-by-head-up-tilt-test-in-older-patients-with-refrac-tory-cardioinhibitory-vasovagal-syncope-the-tilt-test-induced-response-in-closed-loop-stimulation
#15
Pietro Palmisano, Gabriele Dell'Era, Vincenzo Russo, Maria Zaccaria, Rolando Mangia, Miriam Bortnik, Federica De Vecchi, Ailia Giubertoni, Fabiana Patti, Andrea Magnani, Gerardo Nigro, Anna Rago, Eraldo Occhetta, Michele Accogli
Aims: Closed-loop stimulation (CLS) seemed promising in preventing the recurrence of vasovagal syncope (VVS) in patients with a cardioinhibitory response to head-up tilt test (HUTT) compared with conventional pacing. We hypothesized that the better results of this algorithm are due to its quick reaction in high-rate pacing delivered in the early phase of vasovagal reflex, which increase the cardiac output and the blood pressure preventing loss of consciousness. Methods and results: This prospective, randomized, single-blind, multicentre study was designed as an intra-patient comparison and enrolled 30 patients (age 62...
April 12, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28403704/nursing-management-of-reflex-anoxic-seizures-in-children
#16
Neal Patel, Rowan Kerr-Liddell, Louise Challis, Siba Prosad Paul
Children who present with transient loss of consciousness (T-LOC) are often first seen in emergency departments (EDs). Reflex anoxic seizure (RAS), vasovagal syncope and prolonged respiratory apnoea are benign, syncopal events that can be generally managed by explanation and reassurance. RAS is a short, paroxysmal, self-reverting episode of asystole that is triggered by pain, fear or anxiety and is caused by increased vagal response. It is an important differential diagnosis in pre-school age children who present with T-LOC, but is often underdiagnosed and can sometimes be misdiagnosed as epilepsy...
April 13, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28401854/inappropriate-implantable-cardioverter-defibrillator-shocks-in-brugada-syndrome-pattern-in-primary-and-secondary-prevention
#17
Aimé Bonny, Mohammed A Talle, Thibaut Vaugrenard, Jérôme Taieb, Marcus Ngantcha
BACKGROUND: Inappropriate implantable cardioverter-defibrillator (ICD) shocks is a common complication in Brugada syndrome. However, the incidence in recipients of ICD for primary and secondary prevention is unknown. METHOD AND RESULTS: We compared the rate of inappropriate shocks in patients with Brugada syndrome that had an ICD for primary and secondary prevention. We studied 51 patients, 86.5% of whom were males. Their mean age at diagnosis was 47 ± 11 years...
January 2017: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/28400822/pacemaker-placement-in-patients-with-stroke-mediated-autonomic-dysregulation
#18
Ali A Alsaad, Christopher O Austin, Maisha T Robinson, Michael B Phillips
Lateral medullary syndrome (LMS) is an ischemic disease of the medulla oblongata, which involves the territory of the posterior inferior cerebellar artery. Lateral medullary syndrome is often missed as the cause of autonomic dysregulation in patients with recent brain stem stroke. Due to the location of the baroreceptor regulatory center in the lateral medulla oblongata, patients with LMS occasionally have autonomic dysregulation-associated clinical manifestations. We report a case of LMS-associated autonomic dysregulation...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28398383/-right-atrial-appendage-thrombosis-during-atrial-fibrillation-an-element-to-look-for
#19
Giovanni Barbati, Renato De Domenico, Stefania Rossi, Elena Vecchiato, Roberto Zeppellini
Oral anticoagulant therapy (OAT) is a mainstay of atrial fibrillation (AF) pharmacological treatment. Left atrial appendage closure is a possible treatment, when feasible, in patients with intracerebral hemorrhage during OAT. We report a case of right atrial appendage thrombosis in a patient with chronic AF admitted for syncope due to diuretic-induced orthostatic hypotension. Two years previously, he had undergone left atrial appendage closure with the Amplatzer Cardiac Plug device because of intracerebral hemorrhage during OAT...
March 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28395095/comparison-of-inflight-first-aid-performed-by-cabin-crew-members-and-medical-volunteers
#20
Jung Ha Kim, Smi Choi-Kwon, Young Hwan Park
Background: Since the number of air travellers, including the elderly and passengers with an underlying disease, is increasing every year, the number of inflight emergency patients is expected to increase as well. We attempted to identify the incidence and types of reported inflight medical incidents and analyse the first aid performed by cabin crew members or medical volunteers in flights by an Asian airline. We also investigated the cases of inflight deaths and aircraft diversions. Methods: We reviewed the cabin reports and medical records submitted by cabin crew members and inflight medical volunteers from 2009 to 2013...
March 1, 2017: Journal of Travel Medicine
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