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https://www.readbyqxmd.com/read/28538425/a-young-man-with-recurrent-paralysis
#1
Magdalena Chavez, Jeffrey Williams
Hypokalemia can cause reactions from mild muscular cramping to life-threatening paralysis and cardiac dysrhythmias. This article describes a patient whose unusual, recurrent muscular symptoms and electrolyte abnormalities were eventually identified as Gitelman syndrome, a rare genetic disorder resulting in severe refractory hypokalemia.
June 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28509704/effectiveness-of-2-hour-troponin-in-high-risk-patients-with-suspected-acute-coronary-syndrome
#2
Joseph Bove, Steven Hochman, Jacob Miller, Stephen Artim
BACKGROUND: Research has shown the safety and effectiveness of drawing a standard troponin level at presentation and again at 2 hours in only low-risk patients. Because high-sensitivity troponins are not currently approved in the United States, we studied the utility of a standard troponin that is presently in use. Our goal was to determine if 2-hour standard troponin would be safe and effective in the evaluation of a high-risk cohort of patients never studied previously. METHODS: We conducted a single-center prospective observational study of adult patients presenting to the emergency department with signs and symptoms suggestive of acute coronary syndrome...
June 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28507627/prenatally-diagnosis-and-outcome-of-fetuses-with-cardiac-rhabdomyoma-single-centre-experience
#3
Ramush Bejiqi, Ragip Retkoceri, Hana Bejiqi
BACKGROUND: Cardiac rhabdomyoma (CRs) are the most common primary tumour of the heart in infants and children. Usually are multiple and, basing on the location can cause a haemodynamic disturbance, dysrhythmias or heart failure during the fetal and early postnatal period. CRs have a natural history of spontaneous regression and are closely associated with tuberous sclerosis complex (TSC). It has an association with tuberous sclerosis (TS), and in those, the tumour may regress and disappear completely, or remain consistent in size...
April 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28506439/clinical-review-loperamide-toxicity
#4
REVIEW
Peter E Wu, David N Juurlink
Loperamide is a nonprescription opioid widely used for the treatment of diarrhea. Although it is relatively safe at therapeutic doses, increasing reports describe its misuse and abuse at very high doses either for euphoric effects or to attenuate symptoms of opioid withdrawal. Life-threatening loperamide toxicity can result from the relatively new clinical syndrome of loperamide-induced cardiac toxicity. These patients are often young and may present in cardiac arrest or with unheralded, recurrent syncope in conjunction with ECG abnormalities, including marked QT-interval prolongation, QRS-interval widening, and ventricular dysrhythmias...
May 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28501383/intentional-misuse-and-abuse-of-loperamide-a-new-look-at-a-drug-with-low-abuse-potential
#5
Stephen W Borron, Susan H Watts, Jonathan Tull, Salvador Baeza, Stephanie Diebold, Alison Barrow
BACKGROUND: Despite its opioid properties, loperamide has long been thought to have low abuse potential due to its poor absorption from the gastrointestinal tract and limited potential to cross the blood-brain barrier. A recent patient reportedly taking loperamide to avoid heroin withdrawal symptoms, at doses approximately 100 times those recommended, directed our attention to this issue. OBJECTIVES: 1) Investigate number of cases of intentional loperamide abuse and misuse reported to poison centers between 2009 and 2015; 2) Compile reports of clinical effects of loperamide abuse; and 3) Search for evidence of increasing Internet interest in the central opioid effects of loperamide...
May 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28496494/effect-of-inhalation-of-lavender-essential-oil-on-vital-signs-in-open-heart-surgery-icu
#6
Armaiti Salamati, Soheyla Mashouf, Faraz Mojab
This study evaluated the effects of inhalation of Lavender essential oil on vital signs in open heart surgery ICU. The main complaint of patients after open-heart surgery is dysrhythmia, tachycardia, and hypertension due to stress and pain. Due to the side effects of chemical drugs, such as opioids, use of non-invasive methods such as aromatherapy for relieving stress and pain parallel to chemical agents could be an important way to decrease the dose and side effects of analgesics. In a multicenter, single-blind trial, 40 patients who had open-heart surgery were recruited...
2017: Iranian Journal of Pharmaceutical Research: IJPR
https://www.readbyqxmd.com/read/28487389/normalization-of-testosterone-levels-after-testosterone-replacement-therapy-is-associated-with-decreased-incidence-of-atrial-fibrillation
#7
Rishi Sharma, Olurinde A Oni, Kamal Gupta, Mukut Sharma, Ram Sharma, Vikas Singh, Deepak Parashara, Surineni Kamalakar, Buddhadeb Dawn, Guoqing Chen, John A Ambrose, Rajat S Barua
BACKGROUND: Atrial fibrillation (AF) is the most common cardiac dysrhythmia associated with significant morbidity and mortality. Several small studies have reported that low serum total testosterone (TT) levels were associated with a higher incidence of AF. In contrast, it is also reported that anabolic steroid use is associated with an increase in the risk of AF. To date, no study has explored the effect of testosterone normalization on new incidence of AF after testosterone replacement therapy (TRT) in patients with low testosterone...
May 9, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28486870/long-term-cardiac-morbidity-and-mortality-in-patients-with-aortic-valve-disease-following-liver-transplantation-a-case-matching-study
#8
Ramona Nicolau-Raducu, Thomas Marshall, Hamang Patel, Kelly Ural, Joseph Koveleskie, Susan Smith, Donald Ganier, Bryan Evans, Brian Fish, William Daly, Ari J Cohen, George Loss, Amjad Bokhari, Bobby Nossaman
INTRODUCTION: This retrospective study examined the role of aortic valve (AV) disease in patients who underwent orthotopic liver transplantation (OLT) to determine the incidence of postoperative cardiac morbidity and mortality when compared with a matched control group without AV disease. METHODS: Patients were included in the AV group if diagnosed with aortic stenosis (AS) or aortic regurgitation or had received AV replacement prior to OLT. The AV group (n = 53) was matched to a control group (n = 212) with the following preoperative variables: type of organ transplanted, age, gender, race, body mass index, MELD, redo-transplantation, preoperative renal replacement therapy, nonalcoholic steatohepatitis, viral hepatitis, diabetes, and coronary artery disease...
May 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28466690/a-unique-intracardiac-shunt-identifying-complex-anatomy-in-reoperative-adult-congenital-heart-disease
#9
Billie-Jean Martin, Ivan M Rebeyka, Jeffrey F Smallhorn, Dylan A Taylor, Isabelle F Vonder Muhll
Adult patients with repaired congenital heart disease are presenting with previously unseen types of residual lesions and consequences of prior repair. Patients with d-transposition of the great arteries repaired with atrial switch operations are returning with dysrhythmias and atrioventricular valve disease requiring intervention. We present the challenging case of a young adult with a residual shunt identified on preoperative three-dimensional transthoracic echocardiography, the precise anatomy of which was only characterized intraoperatively...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28463866/a-case-of-exertional-rhabdomyolysis-when-exertion-exceeds-capacity
#10
Kathleen S Jordan, Sarah E Mannle
The purpose of this article is to present a discussion of a young adult patient with exertional rhabdomyolysis. Rhabdomyolysis is the process of muscle tissue destruction and damage to the cell membrane, with subsequent release of the intracellular myocyte contents into the systemic circulation. This leads to the potential for the life-threatening systemic complications of electrolyte abnormalities, cardiac dysrhythmias, acute kidney injury, compartment syndrome, and disseminated intravascular coagulopathy...
April 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/28460803/an-unexpected-presentation-of-sick-sinus-syndrome-isolated-ventricular-asystole
#11
Harun Gunes, Feruza Turan Sonmez, Halit Berk Canga, Ayhan Saritas
Sick sinus syndrome is a disorder of sinus node function characterized by various dysrhythmias such as sinus bradycardia or pause, paroxysmal regular or irregular atrial tachycardia, tachycardiabradycardia attacks or atrial fibrillation with slow ventricular response. Ventricular asystole with preserved atrial electrical activity is a rarely seen presenting rhythm in the ED and an extremely rare cause of syncope. A 67-year-old male having a syncope attack was admitted to the emergency department. His Glasgow coma scale score was 15 on admission...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28458933/an-exceptional-case-of-diabetic-ketoacidosis
#12
Celine Van de Vyver, Jorn Damen, Carl Haentjens, Dominique Ballaux, Benoit Bouts
We present a case of diabetic ketoacidosis, known as one of the most serious metabolic complications of diabetes. We were confronted with rapid neurological deterioration and unseen glycaemic values, which reached almost 110 mmol/L, subsequently resulting in hyperkalaemia and life-threatening dysrhythmias. This is the first reported live case with such high values of blood glucose and a favourable outcome.
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28457241/development-of-tachyarrhythmias-late-after-the-fontan-procedure-the-role-of-ablative-therapy
#13
REVIEW
Natasja M S de Groot, Ad J J C Bogers
Patients with a Fontan circulation are at a high risk of developing a variety of cardiac dysrhythmias after cardiac surgery. These dysrhythmias are most often supraventricular tachyarrhythmias (SVT), but ventricular tachyarrhythmias (VT) may also occur. Mechanisms underlying SVT are variable, including both ectopic activity and reentry. Over time, successive SVT may be caused by different mechanisms. The acute success rate of ablative therapy of atrial tachyarrhythmias is considerably high yet during long-term follow-up 'recurrences' frequently occur...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28453224/a-reappraisal-of-the-mechanisms-underlying-the-cardiac-complications-of-sickle-cell-anemia
#14
REVIEW
Parul Rai, Omar Niss, Punam Malik
Anemia, hemolysis-driven vasculopathy, and intrinsic myocardial injury have been proposed as predisposing factors to cardiac disease in sickle cell anemia (SCA). The individual impact of these mechanisms on the cardiac features of SCA and the way they influence complications such as sudden death and dysrhythmias have been unclear. Recent findings of an acquired restrictive SCA-related cardiomyopathy, driven by myocardial fibrosis, may explain some of these cardiac features. Given the complexity of cardiac pathology in SCA, using additional parameters to tricuspid regurgitant jet velocity (left atrial volume, diastolic parameters, NT-proBNP) may improve the accuracy of noninvasive screening for cardiopulmonary complications in SCA...
April 28, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28450068/a-theoretical-analysis-of-anatomical-and-functional-intestinal-slow-wave-re-entry
#15
Peng Du, Gregory O'Grady, Leo K Cheng
Intestinal bioelectrical slow waves are a key regulator of intestinal motility. Peripheral pacemakers, ectopic initiations and sustained periods of re-entrant activities have all been experimentally observed to be important factors in setting the frequency of intestinal slow waves, but the tissue-level mechanisms underpinning these activities are unclear. This theoretical analysis aimed to define the initiation, maintenance, and termination criteria of two classes of intestinal re-entrant activities: anatomical re-entry and functional re-entry...
April 25, 2017: Journal of Theoretical Biology
https://www.readbyqxmd.com/read/28444664/endocrine-complications-of-surgical-treatment-of-thyroid-cancer-an-update
#16
Pedro Iglesias, Juan José Díez
Postoperative hypoparathyroidism (HypoPT) and hypothyroidism (HypoT) are the main endocrine complications after the surgical treatment for thyroid cancer. Postsurgical HypoPT can be transient, protracted or permanent. Its frequency varies according to the underlying cervical pathology, surgical technique, and mainly the experience of the surgeon. Risk factors for HypoPT include aggressiveness of the tumor, extent of surgery, the presence of parathyroid gland in the pathologic specimen, and surgeon experience...
April 25, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28440361/the-role-of-echocardiography-in-fetal-tachyarrhythmia-diagnosis-a-burden-for-the-pediatric-cardiologist-and-a-review-of-the-literature
#17
Liliana Gozar, Claudiu Marginean, Rodica Toganel, Iolanda Muntean
Supraventricular tachyarrhythmia represents the most frequent fetal dysrhythmia. In the lack of diagnosis and treatment these fetuses may develop hydrops and even death. For the therapeutic approach it is important to establish the diagnosis of the type of supraventricular tachycardia. In this paper we report 29 cases with different types of supraventricular tachycardia in which the diagnosis was established using our own protocol, which allowed us to make the difference between the types of tachycardia (atrioventricular reentry tachycardia due to the accessory pathway, atrial ectopic tachycardia and permanent junctional reciprocal tachycardia)...
April 22, 2017: Medical Ultrasonography
https://www.readbyqxmd.com/read/28421842/the-management-of-ventricular-dysrhythmia-in-aconite-poisoning
#18
REVIEW
James M Coulson, Thomas M Caparrotta, John P Thompson
INTRODUCTION: Aconite poisoning is relatively rare but is frequently complicated by ventricular dysrhythmias, which may be fatal. Molecular basis of aconite alkaloid ventricular arrhythmogenicity: Aconite exerts its toxic effects due to the presence of an admixture of alkaloids present in all parts of the plant. The major target of these aconite alkaloids is the fast voltage-gates sodium channel, where they cause persistent activation. This blockade of the channel in the activated state promotes automaticity within the ventricular myocardium and the generation of ventricular arrhythmias...
June 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28420358/healthcare-utilization-in-older-patients-using-personal-emergency-response-systems-an-analysis-of-electronic-health-records-and-medical-alert-data-brief-description-a-longitudinal-retrospective-analyses-of-healthcare-utilization-rates-in-older-patients-using
#19
Stephen Agboola, Sara Golas, Nils Fischer, Mariana Nikolova-Simons, Jorn Op den Buijs, Linda Schertzer, Joseph Kvedar, Kamal Jethwani
BACKGROUND: Personal Emergency Response Systems (PERS) are traditionally used as fall alert systems for older adults, a population that contributes an overwhelming proportion of healthcare costs in the United States. Previous studies focused mainly on qualitative evaluations of PERS without a longitudinal quantitative evaluation of healthcare utilization in users. To address this gap and better understand the needs of older patients on PERS, we analyzed longitudinal healthcare utilization trends in patients using PERS through the home care management service of a large healthcare organization...
April 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28409167/changes-in-daily-life-of-iranian-patients-with-implantable-cardioverter-defibrillator-a-qualitative-study
#20
Nilofar Pasyar, Farkhondeh Sharif, Mahnaz Rakhshan, Mohammad Hossein Nikoo, Elham Navab
BACKGROUND: Although Implantable Cardioverter Defibrillator (ICD) saves the life of patients with life-threatening ventricular dysrhythmias, it causes various challenges in their life span. Considering the increase in the number of ICD users, more knowledge is required regarding changes in the patients' life after device implantation. The aim of this study was description of changes in daily life of patients after ICD implantation. METHODS: This qualitative study was conducted through content analysis method...
April 2017: International Journal of Community Based Nursing and Midwifery
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