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https://www.readbyqxmd.com/read/28441242/identifying-undiagnosed-pediatric-mental-illness-in-the-emergency-department
#1
La Vonne A Downey, Leslie S Zun
BACKGROUND: It is well known that pediatric psychiatric patients frequent emergency department (ED), but the number of patients with undiagnosed psychiatric illness presenting to an ED is not well known. Identification and referral of these patients may provide an opportunity for improved patient care. The primary study objective was to identify a tool that can screen for unsuspected psychiatric illness in pediatric patients who present to the ED with non-psychiatric-related complaints...
April 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28440863/fewdon-mnd-syndrome-finger-extension-weakness-and-downbeat-nystagmus-a-novel-motor-neuron-disorder
#2
Aline Delva, Nimish Thakore, Erik Pioro, Koen Poesen, Rachel Saunders-Pullman, Inge A Meijer, Janet C Rucker, John T Kissel, Philip Van Damme
Introduction Disturbances of eye movements are infrequently encountered in motor neuron diseases or motor neuropathies, and there is no known syndrome that combines progressive muscle weakness with downbeat nystagmus. Methods To describe the core clinical features of a syndrome of motor neuron disease associated with downbeat nystagmus, clinical features were collected from 6 patients. Results All patients had slowly progressive muscle weakness and wasting, in combination with downbeat nystagmus, which was clinically most obvious in downward and lateral gaze...
April 25, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28440259/persistent-unilateral-nictitating-membrane-in-a-9-year-old-girl-a-rare-case-report
#3
Mallikarjun Heralgi, Ashok Thallangady, Kavitha Venkatachalam, Hariprasad Vokuda
We report a case of persisting nictitating membrane in a 9-year-old girl presenting to us with the complaints of fleshy mass in the medial part of the left eye since birth, which was nonprogressive. On examination, her left eye was amblyopic with a vision of 20/500. The membrane was continuous with the medial canthus and was spread in a horizontal fashion, covering the underlying bulbar conjunctiva and one-third of the cornea. The globe however moved freely underneath the membrane, indicating no attachment between the globe and overlying membrane...
March 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28439389/management-of-a-viable-cesarean-scar-pregnancy-a-case-report
#4
Mini Mammen Roy, Forough Radfar
The incidence of cesarean scar pregnancy (CSP), which was extremely rare till recent times, has been rising steadily. We have more of such cases being published in medical literature now. A 38-year-old woman with a past history of previous three cesarean sections presented with five weeks pregnancy and complaints of bleeding per vaginum associated with mild lower abdominal discomfort. The diagnosis of CSP with a live fetus within the gestational sac was made on a transvaginal ultrasound examination and later confirmed with a magnetic resonance imaging (MRI)...
March 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28437498/superior-mesenteric-artery-syndrome-as-a-complication-of-scoliosis-surgery
#5
Philip K Louie, Bryce A Basques, Adam Bitterman, Shalin Shah, Kishan Patel, Isaac Abramchayev, Jonathan Lewin
Superior mesenteric artery (SMA) syndrome is a rare and potentially life-threatening complication of scoliosis surgery. The anatomical relationship of the duodenum and the superior mesenteric artery, the correction of angular deformity of the spine, and the normal adolescent growth spurt all contribute to the condition. We report the case of a 14-year-old boy who had a history of idiopathic scoliosis and presented with bilious vomiting that had persisted for 7 days after posterior T9-L4 fusion with instrumentation...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437349/a-new-navigational-tool-for-pedicle-screw-placement-in-patients-with-severe-scoliosis-a-pilot-study-to-prove-feasibility-accuracy-and-identify-operative-challenges
#6
Michael Putzier, Patrick Strube, Riccardo Cecchinato, Claudio Lamartina, Eike K Hoff
STUDY DESIGN: Pilot study. OBJECTIVE: To develop and validate the feasibility and accuracy of a newly designed navigational spinal instrument guiding tool for patient-matched thoracic and lumbar pedicle screw placement in patients with severe scoliosis, and to identify intraoperative challenges that may be relevant. SUMMARY OF BACKGROUND DATA: Pedicle screw placement is challenging in severely rotated scoliotic spine with small diameters and asymmetrical shape of the pedicles and vertebrae...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28437270/surgical-resolution-of-bilateral-hypertrophy-of-masseter-muscle-through-intraoral-approach
#7
Guilherme Dos Santos Trento, Leonardo Silva Benato, Nelson Luis Barbosa Rebellato, Leandro Eduardo Klüppel
Masseter muscle hypertrophy is an untypical anomaly with no definite cause and its diagnosis is easily completed through physical examination and imaging examinations. In some cases, patient may report signs and symptoms of well-localizated pain. However, it is generally asymptomatic and patient's chief complaint is about esthetic because of facial asymmetry. In this case, surgery is carefully indicated. The aim of this article is to report a case of a male patient with no painful and functional complaints but an important unease over his facial asymmetry...
April 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28437210/factors-associated-with-length-of-stay-at-home-in-the-final-month-of-life-among-advanced-cancer-patients-a-retrospective-chart-review
#8
Masatomo Otsuka
BACKGROUND: Living at home is an important factor for maintaining high quality of life among patients. Many studies have discussed parameters associated with place of death, but no studies have yet clarified which factors influence the length of stay at home during the end of life. OBJECTIVE: The aim of this study was to identify factors influencing the amount of time spent at home during the final month of life among patients with advanced cancer. METHODS: A retrospective chart review was conducted for 415 patients with advanced cancer...
February 28, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28436710/ischemic-ulcer-pain-is-both-nociceptive-and-neuropathic-pain-based-on-a-discriminant-function-analysis-using-the-mcgill-pain-questionnaire
#9
Takamichi Kogure, Masahiko Sumitani, Hiroaki Abe, Jun Hozumi, Reo Inoue, Kazuhito Mietani, Kazuo Kawahara, Yoshitsugu Yamada
The McGill Pain Questionnaire (MPQ) is composed of 78 words reflecting the mechanisms underlying chronic pain conditions. Ischemic ulcer pain is generally regarded as a nociceptive and inflammatory pain condition. However, it is sometimes refractory to nonsteroidal anti-inflammatory drug (NSAID) and opioid treatment. We categorized ischemic pain into nociceptive/inflammatory pain (NocP) or neuropathic pain (NeP), on the basis of patients' descriptions of their pain using the MPQ. We investigated pain characteristics of 365 patients with NeP and 124 with NocP using the 78 words of the MPQ...
April 24, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28436607/visual-complaints-in-intracranial-germinomas
#10
Didier Frappaz, Claire Pedone, Philippe Thiesse, Alexandru Szathmari, Cécile Faure Conter, Carmine Mottolese, Christian Carrie
OBJECTIVE: Patients with brain tumors often report having visual complaints. This may be due to increased intracranial pressure, compression/invasion of the optic pathway or diplopia. We assessed the incidence and the etiology of visual symptoms in patients with intracranial germinoma tumors (ICGTs). METHODS AND MATERIALS: We performed a blinded retrospective review of the clinical charts and the initial magnetic resonance imaging (MRI) of 28 patients with ICGT...
April 24, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28436317/endoureteral-coil-embolization-of-an-ureteral-arterial-fistula
#11
Pavel Kibrik, Justin Eisenberg, Marc A Bjurlin, Natalie Marks, Anil Hingorani, Enrico Ascher
Background Ureteral arterial fistulas are rare but potentially life threatening. We present a female who developed a ureteral arterial fistula following a right robotic nephrectomy. After several endovascular interventions to control the bleeding had failed, we approached the fistula through the right ureteral stump with coil embolization. Methods Coil embolization of the right ureteral stump was performed. We utilized a 6Fr × 45 cm sheath inserted through one of the cystoscope channels to cannulate the right ureteral orifice...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28436130/sleep-complaints-associated-with-wish-to-die-after-a-suicide-crisis-an-exploratory-study
#12
Anca Mirsu-Paun, Isabelle Jaussent, Giovanni Komar, Philippe Courtet, Jorge Lopez-Castroman
The present study explores whether sleep concerns are associated with wish to die throughout a 1-month time interval following a suicide crisis. Sixty-eight patients admitted to the emergency department of a general or psychiatric hospital were enrolled. Sleep difficulties were assessed using the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale, self-reported satisfaction with sleep and time in bed. Suicidal ideation was assessed through the presence of a wish to die at 1 month following a suicide crisis...
April 24, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28435742/immobilisation-induced-hypercalcemia-following-spinal-cord-injury-affecting-the-kidney-function-in-two-young-native-greenlanders
#13
Michael V Linstow, Fin Biering-Sørensen
INTRODUCTION: Immobilisation-induced hypercalcemia following SCI affecting the kidney function, is a rare but potentially serious condition. We report immobilisation-induced hypercalcemia affecting the kidney function in two young native Greenlanders with spinal cord injury (SCI). CASE PRESENTATIONS: Two 15- and 24-year-old male native Greenlanders, both with traumatic C5 SCI were admitted to our spinal cord unit. They were non-smokers without history of daily alcohol intake pre- or immediately post-injury...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28435653/paroxysmal-nocturnal-hemoglobinuria-in-the-differential-diagnosis-of-thrombocytopenia
#14
Fusun Gediz, Bahriye Kadriye Payzin, Ozlem Zekiye Cakmak, Yusuf Uzum, Damla Ernur, Fahri Sahin
Paroxysmal nocturnal hemoglobinuria (PNH) is a disease which diagnosis may be delayed due to variable clinical findings. We describe herein a case of PNH in a 21 year old woman who admitted with complaints of chronic weakness, intermittent spontaneous ecchymoses, and an intermittent abdominal pain. On laboratory tests thrombocytopenia and iron deficiency anemia without any clinical findings were found. Flow cytometric evaluations showed a PNH clone of 15% for erythrocytes, 64% for monocytes, and 60% for granulocytes...
February 23, 2017: Hematology Reports
https://www.readbyqxmd.com/read/28435501/impact-of-clinical-decision-support-on-radiography-for-acute-ankle-injuries-a-randomized-trial
#15
Shahein Tajmir, Ali S Raja, Ivan K Ip, James Andruchow, Patricia Silveira, Stacy Smith, Ramin Khorasani
INTRODUCTION: While only 15-20% of patients with foot and ankle injuries presenting to urgent care centers have clinically significant fractures, most undergo radiography. We examined the impact of electronic point-of-care clinical decision support (CDS) on adherence to the Ottawa Ankle Rules (OAR), as well as use and yield of foot and ankle radiographs in patients with acute ankle injury. METHODS: We obtained institutional review board approval for this randomized controlled study performed April 18, 2012-December 15, 2013...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435487/randomized-trial-of-adding-parenteral-acetaminophen-to-prochlorperazine-and-diphenhydramine-to-treat-headache-in-the-emergency-department
#16
Stefan H Meyering, Ryan W Stringer, Matthew K Hysell
INTRODUCTION: Headaches represent over three million emergency department (ED) visits per year, comprising 2.4% of all ED visits. There are many proposed methods and clinical guidelines of treating acute headache presentations. However, data on intravenous acetaminophen usage in these settings are lacking. In this study, we sought to determine the efficacy of intravenous (IV) acetaminophen as an adjunct to a standard therapy for the treatment of patients who present to the ED with a chief complaint of "headache...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435330/first-case-of-imported-chikungunya-infection-in-croatia-2016
#17
Boris Luksic, Nenad Pandak, Edita Drazic-Maras, Svjetlana Karabuva, Mislav Radic, Andrea Babic-Erceg, Ljubo Barbic, Vladimir Stevanovic, Tatjana Vilibic-Cavlek
In recent years, several European countries reported cases of imported chikungunya infection. We present the first imported clinically manifested chikungunya fever in Croatia. A 27-year-old woman returned to Croatia on 21 March 2016, after she stayed in Costa Rica for two months where she had noticed a mosquito bite on her left forearm. Five days after the mosquito bite she developed severe arthralgias, fever and erythematous papular rash. In next few days symptoms gradually subsided. After ten days she felt better, but arthralgias re-appeared accompanied with morning stiffness...
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/28434204/positive-airway-pressure-adherence-and-mask-interface-in-the-setting-of-sinonasal-symptoms
#18
Amy E Schell, Ryan J Soose
OBJECTIVES/HYPOTHESIS: Despite reports of lower positive pressure adherence rates with oronasal masks, patients with sinonasal problems are often prescribed this interface over a nasal interface. The aim of this study was to characterize the relationship between mask type and therapy adherence in the setting of sinonasal symptoms. STUDY DESIGN: Retrospective case series with chart review. METHODS: We reviewed 328 patients who underwent positive pressure titration between January 2012 and May 2015...
April 22, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28434139/neurological-manifestations-of-atypical-celiac-disease-in-childhood
#19
Çiğdem Genç Sel, Erhan Aksoy, Ayşe Aksoy, Deniz Yüksel, Ferda Özbay
Various typical and atypical neurological manifestations can be seen as the initial symptoms of celiac disease (CD). We suggest that gluten toxicity is the most suspicious triggering risk factor for probable pathophysiological pathways of neurological involvement in atypical CD. The medical charts of 117 patients diagnosed with atypical CD were retrieved from a tertiary center in Ankara, Turkey. Eight patients reported as having neurologic manifestations as initiating symptoms were evaluated in detail. The initial neurological manifestations of CD in our study included atypical absence, which was reported first in this study, generalized tonic-clonic seizures, complex partial seizures, severe axial hypotonia and down phenotype, multifocal leukoencephalopathy, mild optic neuritis, attention deficit hyperactivity disorder, and short duration headaches...
April 22, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28433477/novel-mutations-in-the-c-terminal-region-of-gmppb-causing-limb-girdle-muscular-dystrophy-overlapping-with-congenital-myasthenic-syndrome
#20
Sushan Luo, Shuang Cai, Susan Maxwell, Dongyue Yue, Wenhua Zhu, Kai Qiao, Zhen Zhu, Lei Zhou, Jianying Xi, Jiahong Lu, David Beeson, Chongbo Zhao
Mutations in the GMPPB gene may underlie both limb girdle muscular dystrophy (LGMD) and congenital myasthenic syndrome (CMS). Forty-one cases have been reported to date and hotspot mutations are emerging in the Caucasian population. Clinical and pathological features of 5 patients with compound heterozygous GMPPB mutations were collected and retrospectively reviewed. In vitro functional analysis was performed to investigate the pathogeneity of GMPPB variants. The patients presented with proximal limb weakness in their first to second decades...
March 10, 2017: Neuromuscular Disorders: NMD
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