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https://www.readbyqxmd.com/read/29150972/patient-level-factors-and-the-quality-of-care-delivered-in-pediatric-emergency-departments
#1
James P Marcin, Patrick S Romano, Parul Dayal, Madan Dharmar, James M Chamberlain, Nanette Dudley, Charles G Macias, Lise E Nigrovic, Elizabeth C Powell, Alexander J Rogers, Meridith Sonnett, Leah Tzimenatos, Elizabeth R Alpern, Rebecca Andrews-Dickert, Dominic A Borgialli, Erika Sidney, T Charles Casper, J Michael Dean, Nathan Kuppermann
OBJECTIVE: Quality of care delivered to adult patients in the emergency department (ED) is often associated with demographic and clinical factors such as a patient's race/ethnicity and insurance status. We sought to determine whether the quality of care delivered to children in the ED was associated with a variety of patient-level factors. METHODS: This was a retrospective, observational cohort study. Pediatric patients (<18 years) who received care between January 2011 and December 2011 at one of twelve EDs participating in the Pediatric Emergency Care Applied Research Network (PECARN) were included...
November 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29150356/cryptococcosis-manifesting-as-isolated-biliary-infection-case-report-and-brief-review-of-literature
#2
Hua-Ying Zhou, Xiao-Bo Zeng, Sheng-Long Shi, Min Wang, Da-Min Li
BACKGROUND: Biliary cryptococci infection is rare, which is frequently diagnosed by exploratory laparotomy, preoperative diagnosis is difficult. CASE PRESENTATION: A 14-year-old girl presented with intermittent jaundice for 6 years. She had no pruritus, anorexia, nausea or vomiting, fever, abdominal pain, or clay stools. Laboratory tests showed obstructive jaundice, eosinophilia, and increased IgE levels. The patient was ultimately diagnosed as Cryptococcal infection by bone marrow culture...
November 14, 2017: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/29149266/association-between-prior-antibiotic-therapy-and-subsequent-risk-of-community-acquired-infections-a-systematic-review
#3
Umer Malik, David Armstrong, Mark Ashworth, Alex Dregan, Veline L'Esperance, Lucy McDonnell, Mariam Molokhia, Patrick White
Background: Antibiotic use can have negative unintended consequences including disruption of the human microbiota, which is thought to protect against pathogen overgrowth. We conducted a systematic review to assess whether there is an association between exposure to antibiotics and subsequent risk of community-acquired infections. Methods: We searched MEDLINE, EMBASE and Web of Science for studies published before 30 June 2017, examining the association between antibiotic use and subsequent community-acquired infection...
November 14, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29148036/function-and-mechanism-of-the-pyrin-inflammasome
#4
REVIEW
Rosalie Heilig, Petr Broz
Pyrin, encoded by the MEFV gene, is an intracellular pattern recognition receptor that assembles inflammasome complexes in response to pathogen infections. Mutations in the MEFV gene have been linked to autoinflammatory diseases such as Familial Mediterranean Fever (FMF) or pyrin-associated autoinflammation with neutrophilic dermatosis (PAAND). Recent insights have now revealed how pyrin is activated during infection, providing a molecular basis for the understanding of such disease-causing mutations in pyrin...
November 16, 2017: European Journal of Immunology
https://www.readbyqxmd.com/read/29145776/role-of-computed-tomography-of-abdomen-in-difficult-to-diagnose-typhoid-fever-a-case-series
#5
Wajid Hafeez, S Rajalakshmi, S Sripriya, M Madhu Bashini
Background and Aim Diagnosis of typhoid is challenging when blood cultures fail to isolate Salmonella species. We report our experience with interpreting computed tomography (CT) abdomen findings in a case series of typhoid fever. Methods The case series consisted of patients who had a CT abdomen done as part of their investigations and a final diagnosis of typhoid fever. The CT films were reviewed and findings evaluated for distinctive features. Results During 2011-2017, 11 patients met the inclusion criteria...
January 1, 2017: Tropical Doctor
https://www.readbyqxmd.com/read/29145324/a-rare-case-of-merkel-cell-carcinoma-presenting-as-a-giant-intra-thoracic-mass-a-case-report-and-review-of-the-literature
#6
Feng-Wei Kong, Miao Zhang, Heng Wang, Cun-Tao Lu, Wen-Bin Wu, Yuan-Yuan Liu
RATIONALE: Merkel cell carcinoma (MCC) is an aggressive neuroendocrine-derived cutaneous cancer. Ectopic or single metastatic MCC located in thorax is extremely rare; meanwhile, its definite management has not been elucidated yet. PATIENT CONCERNS: A 64-year-old female patient with a giant mass located in her left thorax was presented for stuffy pain of left chest for 6 months and fever for half a month. She underwent radical resection of vulvar MCC 10 years ago...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145310/successful-treatment-with-rivaroxaban-of-cerebral-venous-thrombosis-and-bone-marrow-necrosis-induced-by-pegaspargase-a-case-report-and-literature-review
#7
Jingrui Sui, Yongming Zhang, Liqing Yang, Hui Wang, Junqing Xu, Rongxia Wei, Yaping Hao, Xiaolei Wang, Jun Peng, Junjie Ma
RATIONALE: Pegaspargase has been used in the treatment of acute lymphoblastic leukemia with promising results. However, it has also been associated with several potentially serious complications, including thrombosis. Pegaspargase-induced cerebral venous thrombosis and bone marrow necrosis are very rare. PATIENT CONCERNS: A 50-year-old female developed headache, weakness of the right lower extremity, fever, and bone pain after chemotherapy including pegaspargase for the treatment of acute lymphoblastic leukemia...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144565/rethinking-status-dystonicus
#8
REVIEW
Marta Ruiz-Lopez, Alfonso Fasano
Status dystonicus is a movement disorder emergency that has been a source of controversy in terms of terminology, phenomenology, and management since it was first described in 1982. Here we argue that the current use of the term status dystonicus falls well short of the precision needed for either clinical or academic use. We performed a critical review on this topic, describing possible pathophysiological mechanisms and areas of uncertainties. This review also addresses the problems derived by the extreme clinical heterogeneity of this condition, as the lack of an objective criterion useful for the definition, or the fact that status dystonicus may present not only in the context of a known dystonic syndrome...
November 16, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29141266/-impact-of-abdominal-ultrasound-on-the-identification-of-the-site-of-infection-in-the-emergency-department-analysis-whether-it-makes-sense-to-perform-abdominal-ultrasound-examination-for-the-identfication-of-the-site-of-infection-if-medical-history-and-clinical
#9
Barbara Werkmeister, Julia Langgartner, Doris Schacherer, Arno Mohr
Introduction A very high number of patients presenting in emergency departments suffer from an unknown infection or rather fever. If diagnostic imaging is necessary ultrasound can be performed. Whether ultrasound is superior to medical history and clinical examination considering the significantly enhanced technology in recent years and hence has to be performed in patients without abdominal symptoms with non-obvious focus cannot be answered by review of the literature. The objective of this study was to evaluate the relevance of abdominal ultrasound in the determination of the site of infection and to analyse whether an abdominal ultrasound for the identification of the source of infection is dispensable in patients in whom history and clinical examination do not indicate an abdominal focus...
November 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29140934/response-of-symptomatic-persistent-chronic-disseminated-candidiasis-to-corticosteroid-therapy-in-immunosuppressed-pediatric-patients-case-study-and-review-of-the-literature
#10
Vered Shkalim-Zemer, Itzhak Levi, Salvador Fischer, Hannah Tamary, Joanne Yakobovich, Gali Avrahami, Gil Gilad, Sara Elitzur, Isaac Yaniv, Ronit Elhasid, Michal Manistersky, Itamar Shalit
BACKGROUND: Chronic disseminated candidiasis (CDC) is a severe invasive fungal infection principally observed during neutrophil recovery in patients with acute leukemia treated with intensive chemotherapy. Its pathophysiology remains unclear. We describe the management of six children with symptomatic CDC who did not respond to antifungal therapy. METHODS: The databases of the hematology-oncology departments of two tertiary pediatric medical centers were searched for all patients diagnosed with CDC from 2003 to 2015 who responded to corticosteroids after failing antifungal therapy...
November 14, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29140515/surveillance-for-q-fever-endocarditis-in-the-united-states-1999-2015
#11
Anne Straily, F Scott Dahlgren, Amy Peterson, Christopher D Paddock
Background: Q fever is a worldwide zoonosis caused by Coxiella burnetii. In some persons, particularly those with cardiac valve disease, infection with C. burnetii can cause a life-threatening infective endocarditis. There are few descriptive analyses of Q fever endocarditis in the United States. Methods: Q fever case report forms submitted during 1999-2015 were reviewed to identify reports describing endocarditis. Cases were categorized as confirmed or probable using criteria defined by the Council for State and Territorial Epidemiologists (CSTE)...
November 13, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29138043/non-traumatic-limping-in-paediatric-emergencies-epidemiology-evaluation-and-results
#12
M I Lázaro Carreño, R Fraile Currius, A García Clemente
INTRODUCTION: Non-traumatic limping is a common reason for consultation in paediatric emergencies. Although transient synovitis of the hip (TS) is the most frequent diagnosis, there are cases of limping secondary to serious pathologies. The aim of this review is to describe the variables related to non-traumatic limp that come to the paediatric emergency department to establish the best management protocol, making the most of resources and speeding up emergency care. MATERIAL AND METHOD: A prospective study was conducted, selecting all children less than 15 years old who consulted aspaediatric emergencies for non-traumatic limping during the 2014...
November 11, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29137905/emergency-department-chest-radiography-for-children-with-asthma-exacerbation-is-infrequently-associated-with-change-of-management
#13
Evan H Allie, Henry E Dingle, William N Johnson, Jeffrey R Birnbaum, Melissa A Hilmes, Sudha P Singh, Donald H Arnold
BACKGROUND: Acute asthma exacerbations (AAE) account for many Pediatric Emergency Department (PED) visits. Chest radiography (CXR) is often performed in these patients to identify practice-changing findings such as pneumonia (PNA). Limited knowledge exists to balance the cost and radiation dose of CXR with expected yield of clinically meaningful information. OBJECTIVE: To determine in children with AAE with CXR, whether patient characteristics are associated with radiographic PNA; and significant practice change by initiation of antibiotic...
October 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29137664/therapeutic-efficacy-of-artemether-lumefantrine-in-the-treatment-of-uncomplicated-plasmodium-falciparum-malaria-in-ethiopia-a-systematic-review-and-meta-analysis
#14
REVIEW
Mohammed Biset Ayalew
BACKGROUND: As Ethiopia is one of the sub-Saharan countries with a great burden of malaria the effectiveness of first line anti-malarial drugs is the major concern. The aim of this study was to synthesize the available evidence on the efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Ethiopia. This was done by performing a meta-analysis of recent studies conducted in the country on this topic. METHODS: Studies published between January 2010 and January 2017 that reported on the efficacy of artemether-lumefantrine in the treatment of P...
November 15, 2017: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/29132996/q-vax-q-fever-vaccine-failures-victoria-australia-1994-2013
#15
Katherine A Bond, Lucinda J Franklin, Brett Sutton, Simon M Firestone
Q-Vax®, a whole cell formalin inactivated vaccine, is currently the only licensed Q fever vaccine for humans world-wide. Efficacy is high, although vaccine failures have been described for those vaccinated within the incubation of a naturally acquired infection. In Australia, it is widely used to prevent occupational acquisition of Q fever and is the mainstay for outbreak control. A retrospective review of all notified cases of acute Q fever to the Victorian department of health, 1993-2013, revealed 34 of 659 cases were previously vaccinated and 10 cases were positive on pre-vaccination screening, precluding vaccination...
November 10, 2017: Vaccine
https://www.readbyqxmd.com/read/29132483/glanular-hypospadias-management-with-modified-circumcision-and-firlit-procedure
#16
Nadeem Iqbal, Ijaz Hussain, Muneeb Ahmad Cheema, Muhammad Taimur Hijazi, Meherunnisa Asif Khan, Omair Ul Haq Lodhi, Saeed Akhter
OBJECTIVE: To document the results of using simple technique of Firlit procedure with modified circumcision for treatment of glanular hypospadias. STUDY DESIGN: Descriptive case series. PLACE AND DURATION OF STUDY: Department of Urology, Shifa International Hospital, Islamabad, from January 2011 till May 2017. METHODOLOGY: The subjects included pediatric patients who underwent repair of glanular hypospadias by using modified circumcision and Firlit procedure...
November 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29132344/tubeless-versus-standard-percutaneous-nephrolithotomy-an-update-meta-analysis
#17
Yang Xun, Qing Wang, Henglong Hu, Yuchao Lu, Jiaqiao Zhang, Baolong Qin, Yudi Geng, Shaogang Wang
BACKGROUND: To update a previously published systematic review and meta-analysis on the efficacy and safety of tubeless percutaneous nephrolithotomy (PCNL). METHODS: A systematic literature search of EMBASE, PubMed, Web of Science, and the Cochrane Library was performed to confirm relevant studies. The scientific literature was screened in accordance with the predetermined inclusion and exclusion criteria. After quality assessment and data extraction from the eligible studies, a meta-analysis was conducted using Stata SE 12...
November 13, 2017: BMC Urology
https://www.readbyqxmd.com/read/29131924/when-an-orbital-infection-isn-t-infectious-at-all-a-review-of-orbital-inflammatory-syndrome
#18
Sadie A LaPonsie, Peter K Rabiah
Orbital inflammatory syndrome (OIS) includes a wide range of clinical manifestations and may initially be misdiagnosed as orbital cellulitis due similar symptoms of fever, periorbital swelling, and pain with eye movements. A diagnosis of OIS requires evaluation for underlying systemic disorders including autoimmune disorders and thyroid disease. Symptoms typically improve rapidly after initiation of steroid therapy, although recurrence can occur. This article presents an illustrative case of a 13-year-old girl with OIS...
November 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/29131357/zika-virus-what-we-need-to-know
#19
REVIEW
Farakh Javed, Khanzadi N Manzoor, Mubashar Ali, Irshad U Haq, Abid A Khan, Assad Zaib, Sobia Manzoor
Zika virus is one of the emerging viruses and is of significant threat to human health globally. It is a mosquito borne flavivirus similar to dengue, yellow fever, and West Nile viruses. It was reported about 5 decades ago and then it spreads to different parts of the world. Large outbreaks were reported on Yap Islands in 2007. Now it has gained wide attention globally by health communities. Major vector for virus transmission is Aedes aegypti mosquito. ZIKV infection is mostly asymptomatic but it is also responsible to cause mild influenza like illness to serious manifestations...
November 13, 2017: Journal of Basic Microbiology
https://www.readbyqxmd.com/read/29130141/sj%C3%A3-gren-s-syndrome-initially-presented-as-thrombotic-thrombocytopenic-purpura-in-a-male-patient-a-case-report-and-literature-review
#20
REVIEW
Xiaohan Xu, Tienan Zhu, Di Wu, Lu Zhang
Thrombotic thrombocytopenic purpura (TTP) is a potentially lethal multisystem disorder which could be caused by autoimmune diseases. However, the concomitant occurrence of TTP and Sjögren's syndrome (SS) is an extremely uncommon scenario, especially in male patients. A 56-year-old Chinese male was admitted for the appearance of diffuse ecchymosis. Then he gradually developed transient slurred speech, progressive confusion, agitation, extremity weakness, and fever. Laboratory investigations suggested anemia, thrombocytopenia, significantly increased lactic dehydrogenase, schistocytes in peripheral blood smear, and a disintegrin-like metalloproteinase with thrombospondin motif type 1 member 13 (ADAMTS13) activity deficiency with high inhibitor titers...
November 13, 2017: Clinical Rheumatology
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