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Sample records for acute generalized exanthematous

  1. Acute generalized exanthematous pustulosis caused by daptomycin.

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    Leng, Teoh Yee; Aan, Mark Koh Jean; Chan, Michelle; Tsien, Liu Tsun

    2011-12-01

    Daptomycin, a lipopeptide antibiotic with similar action as vancomycin, is used to treat complicated skin and soft tissue infections caused by resistant Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus, penicillin-resistant streptococci, and vancomycin-resistant enterococci. Acute generalized exanthematous pustulosis (AGEP), characterized by acute onset of numerous sterile, nonfollicular pinhead sized pustules, is common secondary to drugs, in particular, antibiotics. We present the first case of AGEP following the use of daptomycin.

  2. Acute generalized exanthematous pustulosis induced by fexofenadine

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    Tanvi Gupta

    2016-01-01

    Full Text Available Acute generalized exanthematous pustulosis (AGEP is a skin eruption, frequently drug induced and characterized by the acute development of multiple sterile minute pustules on an erythematous base. There is no case of fexofenadine-induced AGEP in literature (PubMed search. A 40-year-old female presented to us with fever and sudden onset development of multiple discrete to coalescent 1–2 mm nonfollicular pustules on an erythematous base present mainly on her trunk and upper extremities for past 2 days. She had a history of use of fexofenadine 180 mg OD for rhinitis for 2 days. Gram's stain showed no organism and pus culture showed no growth. Histopathological examination revealed subcorneal pustules with epidermal spongiosis. Scattered neutrophils and eosinophils were noted in the dermis. During this period, she took fexofenadine 180 mg unknowingly once following which she developed similar episode within 24–48 h. After withdrawal of the drug, the lesions subsided with scaling in 8–10 days. To the best of our knowledge, this is the first reported case of AGEP induced by fexofenadine. Recognition of such a rare entity is important given the frequent usage of fexofenadine for allergic disorders.

  3. Acute Generalized Exanthematous Pustulosis Induced by Fexofenadine

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    Gupta, Tanvi; Garg, Vijay K; Sarkar, Rashmi; Madan, Anjali

    2016-01-01

    Acute generalized exanthematous pustulosis (AGEP) is a skin eruption, frequently drug induced and characterized by the acute development of multiple sterile minute pustules on an erythematous base. There is no case of fexofenadine-induced AGEP in literature (PubMed search). A 40-year-old female presented to us with fever and sudden onset development of multiple discrete to coalescent 1–2 mm nonfollicular pustules on an erythematous base present mainly on her trunk and upper extremities for past 2 days. She had a history of use of fexofenadine 180 mg OD for rhinitis for 2 days. Gram's stain showed no organism and pus culture showed no growth. Histopathological examination revealed subcorneal pustules with epidermal spongiosis. Scattered neutrophils and eosinophils were noted in the dermis. During this period, she took fexofenadine 180 mg unknowingly once following which she developed similar episode within 24–48 h. After withdrawal of the drug, the lesions subsided with scaling in 8–10 days. To the best of our knowledge, this is the first reported case of AGEP induced by fexofenadine. Recognition of such a rare entity is important given the frequent usage of fexofenadine for allergic disorders. PMID:27057044

  4. Acute generalized exanthematous pustulosis due to insect bites?

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    Yasmeen J Bhat

    2015-01-01

    Full Text Available Acute generalized exanthematous pustulosis is a rare severe cutaneous adverse reaction pattern that is mostly caused by the intake of drugs and rarely associated with viral infections, food allergens or toxins. Here we present the report of three patients who got admitted in our hospital for generalized pustulosis and fever after insect bites. The diagnosis of acute generalized exanthematous pustulosis was made by EuroSCAR scoring. The drug etiology was excluded and spider bite was implicated as the etiological agent in these cases of AGEP which are the first such reported cases in India.

  5. Acute generalized exanthematous pustulosis caused by terazosin hydrochloride.

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    Speck, Laura M; Wilkerson, Michael G; Perri, Anthony J; Kelly, Brent C

    2008-04-01

    Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous eruption mainly provoked by drugs. A case of AGEP in a 74-year-old male that was attributed to the ingestion of terazosin hydrochloride is presented. This is the first reported case of this association in medical literature. The history, clinical presentation, and pathogenesis of AGEP are discussed.

  6. Acute generalized exanthematous pustulosis induced by piroxicam: A case report

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    Y Cherif

    2014-01-01

    Full Text Available Acute generalized exanthematous pustulosis (AGEP is a severe adverse cutaneous reaction characterized by an acute episode of sterile pustules over erythematous-edematous skin. The main triggering drugs are antibiotics, mainly beta-lactam and macrolides. Non-steroid anti-inflammatory drugs may rarely be responsible. We describe a case of a woman with AGEP, who presented with generalized pustulosis lesions after the use of piroxicam for renal colic. The diagnosis was confirmed by the clinical and histological correlations and the dermatosis resolved after withdrawal of the drug.

  7. Acute generalized exanthematous pustulosis induced by piroxicam: a case report.

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    Cherif, Y; Jallouli, Moez; Mseddi, M; Turki, H; Bahloul, Z

    2014-01-01

    Acute generalized exanthematous pustulosis (AGEP) is a severe adverse cutaneous reaction characterized by an acute episode of sterile pustules over erythematous-edematous skin. The main triggering drugs are antibiotics, mainly beta-lactam and macrolides. Non-steroid anti-inflammatory drugs may rarely be responsible. We describe a case of a woman with AGEP, who presented with generalized pustulosis lesions after the use of piroxicam for renal colic. The diagnosis was confirmed by the clinical and histological correlations and the dermatosis resolved after withdrawal of the drug.

  8. [Acute generalized exanthematous pustulosis induced by piroxicam].

    Science.gov (United States)

    Bissinger, Ingrid; Matute-Turizo, Gustavo; Mejía-Barreneche, María Natalia

    2016-01-01

    Antecedentes: Entre 62 y 90% de los casos de pustulosis exantemática generalizada aguda son causados por medicamentos. Su inicio es rápido con pústulas generalizadas, fiebre, conteo de neutrófilos en sangre mayor de 7000; la resolución de las pústulas es espontánea en menos de 15 días. Se describe un caso asociado a piroxicam. Caso clínico: Hombre de 36 años de edad con eritema inicial en tórax y abdomen, acompañado de ardor, sin fiebre, que posteriormente se extendió a antebrazos, brazos y muslos; con edema de cara. Una semana antes había consumido piroxicam por dolor lumbar; al momento de su hospitalización recibía antihistamínicos, esteroides tópicos y sistémicos. El hemoleucograma mostró leucocitos de 8920, eosinófilos de 600, neutrófilos de 6600, IgE sérica total de 188 mg/L, proteína C reactiva de 2.9 mg/L, sin compromiso hepático, renal ni pulmonar. Se inició tratamiento con antihistamínicos y ranitidina intravenosos, solución salina, vaselina tópica más mupirocina tópica y esteroides sistémicos. Al segundo día de hospitalización, los neutrófilos aumentaron a 9000 y la proteína C reactiva a 3.3 mg/L. La puntuación para validar pustulosis exantemática aguda en el paciente fue de 8, indicativa de diagnóstico definitivo. Conclusiones: El diagnóstico diferencial debe establecerse principalmente con psoriasis pustulosa. El pronóstico en general es bueno, como sucedió con el caso informado.

  9. Acute generalized exanthematous pustulosis associated with spider bite*

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    Milman, Laura de Mattos; Müller, Giana Paula; Souza, Paulo Ricardo Martins; Grill, Aline Barcellos; Rhoden, Deise Louise Bohn; Mello-da-Silva, Carlos Augusto; Vettorato, Gerson

    2016-01-01

    Acute generalized exanthematous pustulosis (AGEP) is an acute febrile rash, usually induced by drugs, which recently has been linked to spider bite. We report a case of a male patient, 48 years old, with an erythematous rash accompanied by fever and small non-follicular pustules. He reported previous pain in the buttock with the onset of a necrotic plaque. The lesion was compatible with spider bite of the genus Loxosceles. According to the EuroSCAR group instrument, the patient scored +10 indicating definite diagnosis of AGEP. As the patient had a compatible lesion and had no other triggers of AGEP, in an Loxosceles endemic area, the AGEP would be associated with spider bite, as described in other publications. PMID:27579754

  10. Acute generalized exanthematous pustulosis (AGEP) induced by cefotaxime.

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    Chaabane, Amel; Aouam, Karim; Gassab, Lies; Njim, Leila; Boughattas, Naceur A

    2010-08-01

    We report a case of acute generalized exanthematous pustulosis (AGEP) after cefotaxime use confirmed by a positive patch test. A 30-year-old woman received cefotaxime, fosfomycin and ciprofloxacin for sinusitis. Twelve days after drug initiation, she developed an extending pustular erythema associated with fever. Laboratory investigations showed marked leukocytosis. His blood chemistry was normal. The histological examination showed parakeratosis, spongiosis and nonfollicular intra-epidermal pustules consistent with AGEP. All medications were withdrawn. The symptoms resolved within 11 days after cefotaxime discontinuation. Patch tests were positive to cefotaxime after 48 h, while ciprofloxacin and fosfomycin yielded negative findings. Based on the Naranjo algorithm, it is probable that AGEP reaction was caused by cefotaxime. To our knowledge, this is the first reported case of AGEP associated with positive cefotaxime patch testing.

  11. Acute Generalized Exanthematous Pustulosis Induced by Cefepime: A Case Report

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    L.F.F. Botelho

    2010-06-01

    Full Text Available Acute generalized exanthematous pustulosis (AGEP is a rare cutaneous rash characterized by widespread sterile nonfollicular pustules. Cefepime is a fourth generation cephalosporin, used to treat severe infections. A 67-year-old man was admitted with acute gastroenterocolitis. On the seventh day, the patient developed a nosocomial pneumonia and cefepime was initiated. On the fourth day of cephalosporin treatment, he presented with a maculopapular, pruritic eruption affecting the face, neck, abdomen and limbs. One day later he developed disseminated pustular lesions and his temperature was 37°C. Laboratory analysis evidenced leukocytosis and skin biopsy showed subcorneal pustule, edema in the papillary dermis, perivascular inflammatory infiltrate consisting of neutrophils, leukocytoclasia and red cell extravasation in the epidermis. Cefepime was suspended and within 4 days the non-follicular pustules cleared following a desquamation. AGEP is a disease attributed to a variety of causes, but in 90% of the cases it is due to an adverse drug reaction. Antibiotics are implicated in 80% of these cases, mostly penicillins and macrolides. There are few cases associated with cephalosporins. It is very important to consider AGEP in cases of acute pustular rashes and drugs should be investigated as causative agents.

  12. Five-Year Retrospective Review of Acute Generalized Exanthematous Pustulosis

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    Chitprapassorn Thienvibul

    2015-01-01

    Full Text Available Background. Acute generalized exanthematous pustulosis (AGEP is an acute pustular eruption characterized by widespread nonfollicular sterile pustules. The aim of this study is to characterize the etiology, clinical features, laboratory findings, management, and outcome of patients with AGEP in Asians. Patient/Methods. A retrospective analysis was performed on patient who presented with AGEP between August 2008 and November 2012 in a tertiary center in Thailand. Results. Nineteen patients with AGEP were included. AGEP was generally distributed in seventeen patients (89.5% and localized in two (10.5%. Fever and neutrophilia occurred in 52.6% and 68.4%, respectively. Hepatitis was found up to 26.3%. The most common etiology was drugs (94.7%, comprising of antibiotics (73.6%, proton pump inhibitors (10.5%, nonsteroidal anti-inflammatory drugs (5.3%, and herbal medicine (5.3%. Beta-lactams were the most common causal drug, particularly carbapenems and cephalosporins. This is the first report of Andrographis paniculata as an offending agent for AGEP. We found no differences between various treatment regimens (topical corticosteroid, systemic corticosteroid, and supportive treatment regarding the time from drug cessation to pustules resolution (P=0.171. Conclusions. We have highlighted the presentation of AGEP among Asians. We found high association with systemic drugs. Carbapenems were one of the leading culprit drugs. Finally, a localized variant was observed.

  13. The spectrum of histopathological features in acute generalized exanthematous pustulosis : a study of 102 cases

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    Halevy, S.; Kardaun, S. H.; Davidovici, B.; Wechsler, J.

    2010-01-01

    Background Acute generalized exanthematous pustulosis (AGEP) is a rare severe pustular reaction pattern with a typical clinical picture. Objectives To characterize the histopathological features of AGEP in a large series of cases with a validated diagnosis. Methods A multinational retrospective hist

  14. Hydroxychloroquine-induced acute generalized exanthematous pustulosis with positive patch-testing

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    Ons Charfi

    2015-01-01

    Full Text Available Acute generalized exanthematous pustulosis (AGEP is a severe cutaneous adverse reaction, mostly induced by drugs. Hydroxychloroquine have been rarely reported in literature as a causative drug of this reaction. We report a case of AGEP induced by hydroxychloroquine with systemic involvement and confirmed by positive patch testing.

  15. Acute Generalized Exanthematous Pustulosis Induced by Amoxicillin/Clavulanic Acid: Report of a Case Presenting With Generalized Lymphadenopathy.

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    Syrigou, Ekaterini; Grapsa, Dimitra; Charpidou, Andriani; Syrigos, Konstantinos

    2015-01-01

    Drug-induced acute generalized exanthematous pustulosis is a rare pustular skin reaction, most commonly triggered by antibiotics. Although its diagnosis is based primarily on the presence of specific clinical and histopathologic features, additional in vivo (patch testing) or in vitro testing may be required, especially in atypical cases, to more accurately determine the causative agent. The authors report a histologically confirmed case of acute generalized exanthematous pustulosis that was induced by amoxicillin/clavulanic acid, as documented by subsequent patch testing, and presented with generalized painful lymphadenopathy, mimicking an acute infectious process. This is a very rare and diagnostically challenging clinical presentation of acute generalized exanthematous pustulosis, which has been reported, to the best of our knowledge, only once previously.

  16. An Uncommon Side Effect of Bupropion: A Case of Acute Generalized Exanthematous Pustulosis

    OpenAIRE

    Hasan Tak; Cengiz Koçak; Gülben Sarıcı; Nazlı Dizen Namdar; Mehtap Kıdır

    2015-01-01

    Acute generalized exanthematous pustulosis (AGEP) is a rare inflammatory dermatosis characterized by multiple nonfollicular pustules that occur on erythematous skin. Despite its similarity to pustular psoriasis and association with fever and leukocytosis, AGEP typically heals quickly. Etiologically, drugs and viruses have been suspected in most cases. Here, we present a case of AGEP, in a woman, that developed 1 day after starting bupropion for smoking cessation, as a rare side effect of the ...

  17. An Uncommon Side Effect of Bupropion: A Case of Acute Generalized Exanthematous Pustulosis

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    Hasan Tak

    2015-01-01

    Full Text Available Acute generalized exanthematous pustulosis (AGEP is a rare inflammatory dermatosis characterized by multiple nonfollicular pustules that occur on erythematous skin. Despite its similarity to pustular psoriasis and association with fever and leukocytosis, AGEP typically heals quickly. Etiologically, drugs and viruses have been suspected in most cases. Here, we present a case of AGEP, in a woman, that developed 1 day after starting bupropion for smoking cessation, as a rare side effect of the treatment.

  18. Acute Generalized Exanthematous Pustulosis (AGEP Induced by Cetirizine in a Child A Case Report

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    Gunseli Pancar

    2014-12-01

    Full Text Available Acute Generalized Exanthematous Pustulosis (AGEP, is a rare cutaneous rash characterized by widespread sterile non-follicular pustules. AGEP is a rare disease in childhood and it is often due to drugs. Antibiotics, sulphanamides and antipyretic-analgesics are the main reasons of this drug reaction . Cetirizine is a second generation antihistamine is often used in the treatment of angioedema, atopic dermatitis and urticaria in children. Cetirizine induced AGEP was not reported in the literature. In this case a twelve year old child was admitted with urticarial plaques located on her trunk. She developed maculopapular lesions and pustular eruption with Cetirizine (once a day treatment. Cetirizine was stopped and the nonfollicular pustules cleared with a desquamation. The result of the oral challenge test was positive. We present this rare case to show that the antihistamines (cetirizine may cause AGEP in childhood.

  19. Acute Generalized Exanthematous Pustulosis (AGEP Induced by Cetirizine in a Child A Case Report

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    Gunseli Pancar

    2016-05-01

    Full Text Available Acute Generalized Exanthematous Pustulosis (AGEP, is a rare cutaneous rash characterized by widespread sterile non-follicular pustules. AGEP is a rare disease in childhood and it is often due to drugs. Antibiotics, sulphanamides and antipyretic-analgesics are the main reasons of this drug reaction . Cetirizine is a second generation antihistamine is often used in the treatment of angioedema, atopic dermatitis and urticaria in children. Cetirizine induced AGEP was not reported in the literature. In this case a twelve year old child was admitted with urticarial plaques located on her trunk. She developed maculopapular lesions and pustular eruption with Cetirizine (once a day treatment. Cetirizine was stopped and the nonfollicular pustules cleared with a desquamation. The result of the oral challenge test was positive. We present this rare case to show that the antihistamines (cetirizine may cause AGEP in childhood.

  20. Acute generalized exanthematous pustulosis induced by the essential oil of Pistacia lentiscus.

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    Zaraa, I; Ben Taazayet, S; Trojjet, S; El Euch, D; Chelly, I; Haouet, S; Mokni, M; Ben Osman, A

    2012-06-01

    Acute generalized exanthematous pustulosis (AGEP) is an uncommon pustular eruption characterized by small nonfollicular pustules on an erythematous background, sometimes associated with fever and neutrophilia. Over 90% of cases are drug-induced; however, it can be caused in rare cases by other agents. We report two cases of AGEP secondary to ingestion of Pistacia lentiscus essential oil, the first two such cases to our knowledge. The cutaneous morphology, disease course and histological findings were consistent with a definite diagnosis of AGEP, based on the criteria of the EuroSCAR study group. These two cases highlight the need to consider herbal extracts as a potential rare cause of AGEP and to ensure the safety of herbal medicines.

  1. Acute localized exanthematous pustulosis caused by cefoperazone and sodium sulbactam*

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    Qu, Yan-Jing; Jin, Shu-Bin; Han, Xiang-Chun; Zheng, Li-Qiang

    2016-01-01

    Acute localized exanthematous pustulosis is a localized variant of acute generalized exanthematous pustulosis, which is characterized by the eruption of multiple scattered pustules following drug administration. A 72-year-old woman presented with multiple erythematous pustules on her face, which had appeared two days after using cefoperazone and sodium sulbactam. Histopathological findings showed subcorneal pustules and mixed inflammatory cell infiltration in the dermis. The pustules resolved within about two weeks after the patient discontinued the antibiotics. This report discusses the case of a woman with a cutaneous drug reaction consistent with acute localized exanthematous pustulosis that occurred after cefoperazone and sodium sulbactam were administered. PMID:28099605

  2. Ciprofloxacin induced acute generallised exanthematous pustulosis

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    Caterina Foti; Paolo Romita; Giovanni Zanframundo; Mario Mastrolonardo; Gianni Angelini; Gianfranco Calogiuri; Eustacchio Nettis; Domenico Bonamonte

    2017-01-01

    Acute generalized exanthematous pustulosis (AGEP) is an uncommon and self-limiting skin rash commonly caused by drugs and is characterized by the acute onset of fever, pustulosis, and neutrophilia from 4 to 10 days after the drug intake. We describe a case of AGEP in a 61-year-old woman that was hospitalized for the acute onset of fever, erythroderma, and pustulosis. Clinical history revealed that she had been treating a bacterial inguinal intertrigo for 4 days with ciprofloxacin 500 mg table...

  3. Ciprofloxacin induced acute generallised exanthematous pustulosis

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    Caterina Foti

    2017-01-01

    Full Text Available Acute generalized exanthematous pustulosis (AGEP is an uncommon and self-limiting skin rash commonly caused by drugs and is characterized by the acute onset of fever, pustulosis, and neutrophilia from 4 to 10 days after the drug intake. We describe a case of AGEP in a 61-year-old woman that was hospitalized for the acute onset of fever, erythroderma, and pustulosis. Clinical history revealed that she had been treating a bacterial inguinal intertrigo for 4 days with ciprofloxacin 500 mg tablets twice daily and desloratadine 5 mg tablet once daily. To the best of our knowledge, this is the third reported case of AGEP caused by ciprofloxacin, supporting two other previous reports.

  4. Food-induced acute generalized exanthematous pustulosis in a pregnant woman.

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    Valkova, Sonya

    2006-01-01

    A 21-year-old woman of Romany origin, in the third trimester of her fourth pregnancy, was admitted to the hospital because of a generalized erythematous and pustular eruption and desquamation involving her face, neck, trunk, and extremities. The skin changes were accompanied by fever (100.4 degrees F [38 degrees C]) and malaise. The patient was convinced that the dermatitis was induced by the consumption of "spoilt" pork sausage (bad smell, changed taste) approximately 24 hours earlier. Clinical examination revealed a woman with phototype III skin, black eyes, and black hair, in good general health. Widespread, symmetrical, moderately intense erythema and isolated or coalescing targetoid lesions studded with discrete, pinhead-sized, nonfollicular pustules in the center or at the periphery were distributed over her face, trunk, groins, and upper and lower extremities (Figures 1). On the neck and abdomen, lamellar desquamation was observed (Figure 2). Palms, soles, scalp, mucous membranes, hair, and nails were not affected. Nikolsky's sign was negative. The patient complained of very slight skin burning and itching. The pregnancy was proceeding without any complications and her obstetric status was normal. The woman had neither any accompanying diseases, nor previous personal or family history of psoriasis, nor any known allergies. She had taken no systemic medication (not even vitamins). She had three pregnancies; two ended with the delivery of healthy babies and one of them was aborted at her will. Laboratory studies revealed leukocytosis (13.2 x 109/L), neutrophilia (8 x 109/L), anemia (hemoglobin, 108 g/L), and an elevated erythrocyte sedimentation rate (68-110 mm/h). The results from the following investigations were normal: urinalysis, renal and hepatic function, serum albumin, Ca, Na, K, aspartate aminotransferase titer, cryoprotein, hepatitis B surface antigen, and serum markers for syphilis. Bacterial and fungal cultures of pustular content were sterile. A

  5. Acute Generalized Exanthematous Pustulosis Induced by Erlotinib (Tarceva with Superimposed Staphylococcus aureus Skin Infection in a Pancreatic Cancer Patient: A Case Report

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    Egbert Liquete

    2012-05-01

    Full Text Available Acute generalized exanthematous pustulosis (AGEP is a rare acute reaction that is drug induced in 90% of the cases and characterized by a widespread, sterile pustular rash. Erlotinib, a small-molecule EGFR tyrosine kinase inhibitor, has been approved by the FDA for patients with pancreatic cancer and non-small cell lung cancer. Skin rash is a well-known side effect related with all EGFR blocking agents. It has been suggested that rash could be used as a surrogate marker for response and possibly be associated with prolonged survival. We report a case of rare presentation of AGEP involving an adverse effect of erlotinib. The commonly reported adverse effects of erlotinib are mild skin eruptions. However, our case describes the rare presentation of AGEP induced by erlotinib. The estimated incidence rate of AGEP is approximately 1–5 cases per million/year.

  6. Acute generalised exanthematous pustulosis secondary to cotrimoxazole or tenofovir

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    J Black

    2012-11-01

    Full Text Available Cutaneous adverse drug reactions are a common complication of antiretroviral therapy and of drugs used to treat opportunistic infections. We present a rare case of acute generalised exanthematous pustulosis secondary to cotrimoxazole or tenofovir.

  7. Pustulosis exántematica aguda generalizada: Presentación de un caso y revisión de la literatura Acute generalized exanthematous pustulosis: A case report and review of the literature

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    MS Meneses

    2012-03-01

    Full Text Available La pustulosis exantemática aguda generalizada (PEAG es una enfermedad poco frecuente, de patogenia desconocida, provocada generalmente por fármacos, entre los que se encuentran en primer lugar, los antibióticos del grupo de los betalactámicos. Se presenta el caso de una paciente con esta entidad, provocada por amoxicilina-clavulánico con gran extensión de las lesiones.Acute generalized exanthematous pustulosis (AGEP is a rare disease, with unknown pathogenesis, usually caused by drugs where we can find in the first place, antibiotics that are part of the betalactam group. A case of a patient with this entity, caused by amoxicillin-clavulanic with great extension of the lesions is reported.

  8. Pustulosis exantemática aguda generalizada asociada a Epstein Barr: A propósito de un caso. Acute generalized exanthematous pustulosis associated to Epstein Barr: A propose of a case

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    A L Scaglione

    2008-12-01

    Full Text Available La pustulosis exantemática aguda generalizada (PEAG es una rara afección de hipersensibilidad, inducida principalmente por drogas y se manifiesta por una erupción aguda de pústulas estériles, acompañada de fiebre, que regresa en pocos días luego de discontinuar el fármaco causante. Se comunica el caso de una paciente de 23 años de edad, sin antecedentes de psoriasis que consulta por fiebre y una erupción pustulosa generalizada, asociada a la ingesta previa de amoxicilina y ácido clavulánico en el contexto de una mononucleosis infecciosa, con resolución espontánea del cuadro. El cultivo microbiológico no objetivó gérmenes patógenos.Acute generalized exanthematous pustulosis (AGEP is a rare skin eruption most commonly caused by medications. It is characterized by an acute eruption of sterile pustules and it is accompanied by an episode of fever, which regresses a few days after discontinuation of the drug that caused the condition. We report a case 23 year-old woman without history of psoriasis, that consults for fever and an acute generalized pustular eruption after amoxicillin, with clavulanic acid administration in a mononucleosis infection context, which resolved spontaneously. The microbiologic culture was negative for pathogenic germens.

  9. Acute generalised exanthematous pustulosis and other severe drug eruptions from over the counter medications: A case report and review of the literature.

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    Kline, Amy; Fischer, Gayle

    2016-05-01

    We present a case of acute generalised exanthematous pustulosis in an 11-year-old girl who used Duro-Tuss, an over-the-counter cough mixture containing pholcodine, and present a comprehensive review of the literature on severe drug reactions resulting from using non-prescription medications. This case reinforces the importance of taking a complete medication history.

  10. Acute Generalized Exanthematous Pustulosis (AGEP Triggered by a Spider Bite

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    Michael Makris

    2009-01-01

    Discussion: A spider bite may represent a possible causative factor of AGEP. A spider's venom contains sphingomyelinase that stimulates the release of IL8 and GM-CSF, which are involved in AGEP pathogenesis. Whether or not the con-current use of antibiotics has an effect in AGEP appearance when combined with a spider's venom, cannot be excluded.

  11. Acute generalized exanthematous pustulosis caused by morphine, confirmed by positive patch test and lymphocyte transformation test

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    Kardaun, Sylvia H.; de Monchy, Jan G.

    2006-01-01

    Morphine, an opium alkaloid, frequently causes side effects such as hyperhidrosis and facial flushing, but serious cutaneous adverse drug reactions are seldom observed. Best known are Urticaria, erythema, and pruritus; sometimes pseudoallergic anaphylactoid reactions, and blisters are reported.

  12. Acute Paraplegia After General Anesthesia

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    Gholam Hossein Ghaedi

    2011-08-01

    Full Text Available Acute paraplegia is a rare but catastrophic complication of surgeries performed on aorta and corrective operations of vertebral column. Trauma to spinal cord after spinal anesthesia and ischemia of spinal cord also may lead to acute paraplegia. Acute paraplegia as a complication of general anesthesia in surgeries performed on sites other than aorta and vertebral column is very rare. Here we present a 56 year old woman with acute paraplegia due to spinal cord infarction after laparoscopic cholecystectomy under general anesthesia probably caused by atherosclerosis of feeding spinal arteries and ischemia of spinal cord after reduction of blood flow possibly due to hypotension during general anesthesia.

  13. Generalized pustular psoriasis induced by systemic steroid dose reduction*

    Science.gov (United States)

    Westphal, Danielle Cristine; Schettini, Antonio Pedro Mendes; de Souza, Petra Pereira; Castiel, Jessica; Chirano, Carlos Alberto; Santos, Mônica

    2016-01-01

    Generalized pustular psoriasis, or psoriasis of von Zumbusch, is an acute and severe clinical form of psoriasis, which usually occurs in patients with psoriasis undergoing aggravating factors. In this work, we report the case of a female patient, 70 years old, who developed generalized pustular psoriasis symptoms while reducing the dose of oral corticosteroids, improperly introduced for the treatment of alleged acute generalized exanthematous pustulosis. The differential diagnosis of generalized pustular psoriasis should be made with other pustular dermatoses, such as subcorneal pustulosis, IgA pemphigus and especially with acute generalized exanthematous pustulosis. Personal history of psoriasis and histopathological findings with psoriasiform changes and subcorneal pustule favored the diagnosis. She was treated with acitretin 30 mg / day, progressing to complete regression of the lesions. PMID:27828647

  14. Phenytoin/albendazole induced exanthematous eruptions: a case report

    Directory of Open Access Journals (Sweden)

    M. Ravishankar

    2015-06-01

    Full Text Available Exanthematous drug eruptions, often called and ldquo;drug rashes and rdquo; or and ldquo;maculopapular eruptions and rdquo; by non-dermatologists are the most common form of cutaneous drug eruption. Cutaneous reactions are among the most common adverse effects of drugs, including penicillins, cephalosporins, sulfonamides, and allopurinol (with an incidence of up to 50 cases per 1000 new users, and particularly the aromatic amine anti-seizure medications, including carbamazepine, phenytoin, and lamotrigine (with an incidence of up to 100 cases per 1000 new users. Phenytoin is a hydantoin derivative anticonvulsant drug used primarily in the management of complex partial seizures and generalized tonic-clonic seizures. Albendazole is a benzimidazole medication used for the treatment of a variety of parasitic worm infestations. Carbamazepine and phenytoin are among the most common causes of antiepileptic drug-related cutaneous adverse reactions. Manifestations range from a mild erythematous maculopapular rash to life-threatening Stevens-Johnson syndrome and toxic epidermal necrolysis. Albendazole induced rashes and urticaria have been reported in less than 1% of the patients. Here we present the case of a 12-year-old male patient who came to the dermatology outpatient department with complaints of itching and maculopapular eruptions all over the body. The patient gave a history of taking tablet phenytoin and tablet albendazole for neurocysticercosis since 1-week. There was no fever or any other systemic manifestations. There was no history of any other drug intake. A diagnosis of phenytoin/albendazole induced exanthematous eruptions was made. Both the medications were discontinued, and the patient was advised to take syrup sodium valproate 200 mg BD. For the rashes and itching, the patient was advised to take tablet hydroxyzine HCl 10 mg OD, tablet prednisolone and tablet levocetirizine for 5 days. Improvement was seen and the itching reduced

  15. Acute variceal bleeding: general management

    Institute of Scientific and Technical Information of China (English)

    David Patch; Lucy Dagher

    2001-01-01

    @@ TREATMENT STRATEGIES FOR ACUTE VARICEAL BLEEDING Backgound Acute variceal bleeding has a significant mortality which ranges form 5% to 50% in patients with cirrhosis[1].Overall survival is probably improving,because of new therapeutic approaches,and improved medical care.However,mortality is still closely related to failure to control hacmorrhage or carly rebleeding,which is a distinct characteristic of portal hypertensive bleeding and occures in as many as 50% of patients in the first days to 6 weeks after admission et al[2].

  16. Acute Neck Pain in General Practice

    NARCIS (Netherlands)

    C.J. Vos (Kees)

    2006-01-01

    textabstractWe performed a prospective cohort study with one-year follow-up of patients with acute neck pain in general practice. Patients above 18 years of age consulting their GP for non-specific acute neck pain lasting no longer than six weeks were invited to participate. Self-administered quest

  17. Acute Neck Pain in General Practice

    OpenAIRE

    2006-01-01

    textabstractWe performed a prospective cohort study with one-year follow-up of patients with acute neck pain in general practice. Patients above 18 years of age consulting their GP for non-specific acute neck pain lasting no longer than six weeks were invited to participate. Self-administered questionnaires were collected from patients at baseline and after 6, 12, 26 and 52 weeks. 187 patients were included and we have follow-up data of 138 patients (74%). After one-year 47% still reported ne...

  18. Acute vascular abdomen. General outlook and algorithms.

    Science.gov (United States)

    Miani, S; Boneschi, M; La Penna, A; Erba, M; De Monti, M; Giordanengo, F

    1999-09-01

    Acute vascular abdomen is a severe and life-threatening pathology due to arterial degeneration, leading to hemorrhage or arterial occlusion leading to ischemia. Differential diagnosis of patients with severe abdominal pain and/or shock include several vascular and traumatic diseases, the most common being rupture of abdominal aortic aneurysm (AAA), or less frequently rupture of visceral artery aneurysm. Also acute aortic dissection, iatrogenic injury and acute mesenteric ischemia may lead to acute vascular abdomen. Clinical evaluation of the haemodynamic status of the patient may be very difficult, and may require airway maintenance and ventilation with a rapid treatment of hemorrhagic shock. In the stable patient with an uncertain diagnosis, CT scan, NMR and selective angiography may be helpful in diagnosis before vascular repair. On the contrary, the unstable patient, after hemodynamic resuscitation, must be operated on expeditiously. We present our vascular algorithms, to assess timing of diagnosis and treatment of this severe acute disease.

  19. Time Lags between Exanthematous Illness Attributed to Zika Virus, Guillain-Barré Syndrome, and Microcephaly, Salvador, Brazil.

    Science.gov (United States)

    Paploski, Igor A D; Prates, Ana Paula P B; Cardoso, Cristiane W; Kikuti, Mariana; Silva, Monaise M O; Waller, Lance A; Reis, Mitermayer G; Kitron, Uriel; Ribeiro, Guilherme S

    2016-08-01

    Zika virus infection emerged as a public health emergency after increasing evidence for its association with neurologic disorders and congenital malformations. In Salvador, Brazil, outbreaks of acute exanthematous illness (AEI) attributed to Zika virus, Guillain-Barré syndrome (GBS), and microcephaly occurred in 2015. We investigated temporal correlations and time lags between these outbreaks to identify a common link between them by using epidemic curves and time series cross-correlations. Number of GBS cases peaked after a lag of 5-9 weeks from the AEI peak. Number of suspected cases of microcephaly peaked after a lag of 30-33 weeks from the AEI peak, which corresponded to time of potential infections of pregnant mothers during the first trimester. These findings support the association of GBS and microcephaly with Zika virus infection and provide evidence for a temporal relationship between timing of arboviral infection of pregnant women during the first trimester and birth outcome.

  20. Time Lags between Exanthematous Illness Attributed to Zika Virus, Guillain-Barré Syndrome, and Microcephaly, Salvador, Brazil

    Science.gov (United States)

    Paploski, Igor A.D.; Prates, Ana Paula P.B.; Cardoso, Cristiane W.; Kikuti, Mariana; Silva, Monaise M. O.; Waller, Lance A.; Reis, Mitermayer G.; Kitron, Uriel

    2016-01-01

    Zika virus infection emerged as a public health emergency after increasing evidence for its association with neurologic disorders and congenital malformations. In Salvador, Brazil, outbreaks of acute exanthematous illness (AEI) attributed to Zika virus, Guillain-Barré syndrome (GBS), and microcephaly occurred in 2015. We investigated temporal correlations and time lags between these outbreaks to identify a common link between them by using epidemic curves and time series cross-correlations. Number of GBS cases peaked after a lag of 5–9 weeks from the AEI peak. Number of suspected cases of microcephaly peaked after a lag of 30–33 weeks from the AEI peak, which corresponded to time of potential infections of pregnant mothers during the first trimester. These findings support the association of GBS and microcephaly with Zika virus infection and provide evidence for a temporal relationship between timing of arboviral infection of pregnant women during the first trimester and birth outcome. PMID:27144515

  1. Acute referral of patients from general practitioners

    DEFF Research Database (Denmark)

    Backer Mogensen, Christian; Mortensen, Anne Mette; Staehr, Peter B

    2011-01-01

    Surprisingly little is known about the most efficient organization of admissions to an emergency hospital. It is important to know, who should be in front when the GP requests an acute admission. The aim of the study was to analyse how experienced ED nurses perform when assessing requests...

  2. Management of acute rhinosinusitis in Danish general practice: a survey

    Directory of Open Access Journals (Sweden)

    Hansen JG

    2011-07-01

    Full Text Available Jens Georg HansenDepartment of Clinical Epidemiology, Aarhus University Hospital and Aalborg Hospital, Aalborg, DenmarkPurpose: To evaluate whether the ongoing debate over diagnostic problems and treatment choices for acute rhinosinusitis has had any influence on the management of the disease.Methods: We randomly selected 300 Danish general practitioners (GPs from the files of the Research Unit for General Practice at Aarhus University. Invitations to participate and a questionnaire were sent to the GPs by mail.Results: A total of 149 (49% GPs answered the questionnaire. When asked about symptoms, the highest priority was given to sinus pain and signs of tenderness. The most frequent examinations were objective examination of the ear-nose-throat (ENT, palpation of the maxillofacial area, and C-reactive protein point-of-care testing (or CRP rapid test. Nearly all GPs prescribed local vasoconstrictors, and in 70% of cases, antibiotics were prescribed. Phenoxymethylpenicillin was the preferred antibiotic. Use of the CRP rapid test, years in practice, or employment in an ENT department did not have a significant impact on the diagnostic certainty and antibiotic prescribing rate.Conclusion: The clinical diagnoses are based on a few symptoms, signs, and the CRP rapid test. Other examinations, including imaging techniques, are seldom used. Phenoxymethylpenicillin is the preferred antibiotic, and the GPs' diagnostic certainty was 70%.Keywords: general practice, acute rhinosinusitis, diagnosis, treatment, antibiotic

  3. Gout - a guide for the general and acute physicians.

    Science.gov (United States)

    Abhishek, Abhishek; Roddy, Edward; Doherty, Michael

    2017-02-01

    Gout is the most prevalent inflammatory arthritis and affects 2.5% of the general population in the UK. It is also the only arthritis that has the potential to be cured with safe, inexpensive and well tolerated urate-lowering treatments, which reduce serum uric acid by either inhibiting xanthine oxidase - eg allopurinol, febuxostat - or by increasing the renal excretion of uric acid. Of these, xanthine oxidase inhibitors are used first line and are effective in 'curing' gout in the vast majority of patients. Gout can be diagnosed on clinical grounds in those with typical podagra. However, in those with involvement of other joints, joint aspiration is recommended to demonstrate monosodium urate crystals and exclude other causes of acute arthritis, such as septic arthritis. However, a clinical diagnosis of gout can be made if joint aspiration is not feasible. This review summarises the current understanding of the pathophysiology, clinical presentation, investigations and treatment of gout.

  4. Mild forms of toxic shock syndrome toxin-1-mediated exanthematous disease related to Staphylococcus aureus infection.

    Science.gov (United States)

    Moriguchi, Naohiko; Kano, Tomowa; Yoshimatsu, Yutaka; Yanagida, Hidehiko

    2016-08-01

    The present report describes three patients with toxic shock syndrome toxin (TSST)-1-associated exanthematous disease. In all patients, fever and systemic erythema without hemodynamic disturbance occurred following cellulitis of the lower limbs. At the site of infection, TSST-1 producing Methicillin-susceptible Staphylococcus aureus was detected. They defervesced and erythema resolved in response to administration of an antimicrobial drug, thereby avoiding severe illness. These patients did not meet the criteria for a clinical diagnosis of toxic shock syndrome. Measurement of T-cell receptor Vβ2-positive T cells in the peripheral blood early after onset of symptoms was useful for diagnosis.

  5. Afectación oral de las enfermedades comunes en la infancia con carácter exantemático Oral implications of the common exanthematic illnesses in the childhood

    Directory of Open Access Journals (Sweden)

    A Bascones Martínez

    2006-06-01

    Full Text Available Determinadas enfermedades exantemáticas de la infancia pueden cursar con manifestaciones en la región oral, siendo en ocasiones pioneras al resto de las lesiones. Para evitar complicaciones que puedan retrasar la correcta evolución y recuperación de los pacientes, y dada la morbilidad con la que cursan algunas entidades a nivel oral, se presenta una revisión en la cual se insiste en la necesidad de hacer un adecuada exploración oral ante cualquier enfermedad infecciosa o exantemática, aún cuando no consulten por síntomas a dicho nivel, para poder diagnosticar y tratar de forma precoz las lesiones orales asociadas a estas entidades.Some exanthematic diseases in the childhood affect in more or less importance to the oral region and highly important to know the degree of affectation to set out the guidelines for a suitable treatment at a proper level, and to avoid further complications which may delay the good evolution and soon recovery that those patients use to show. It is stressed the importance of an acute exploration of the mouth in case of any infectious or exanthematic illness, even though the consultation is not made for oral symptoms.

  6. Treatment of acute otitis media in general practice

    DEFF Research Database (Denmark)

    Plejdrup Hansen, Malene; Jarbol, Dorte Ejg; Gahrn-Hansen, Bente;

    2012-01-01

    Recommendations for antibiotic treatment of acute otitis media (AOM) have changed over the years, and today many experts recommend initial observation. However, antibiotic prescribing should be considered in children aged......Recommendations for antibiotic treatment of acute otitis media (AOM) have changed over the years, and today many experts recommend initial observation. However, antibiotic prescribing should be considered in children aged...

  7. Sorafenib-triggered radiation recall dermatitis with a disseminated exanthematous reaction

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Dong Ryul; Park, Hee Chul; Lim, Ho Yeong; Yoo, Byung Chul [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2013-09-15

    Sorafenib is a multi-targeted kinase inhibitor, which is the current standard treatment for advanced hepatocellular carcinoma (HCC). Only one case of radiation recall dermatitis (RRD) associated with sorafenib has been reported so far. Our patient with recurrent HCC was treated with palliative radiotherapy (RT) for the chest wall mass. Sorafenib at 400 mg twice daily was begun on the day following RT. On the 14th day post-RT, an erythematous patch was observed on right chest wall which matched area previously irradiated. It was consistent with RRD. Ten days later, a disseminated exanthematous rash and severe pruritus occurred. Sorafenib was stopped and an oral antihistamine was prescribed to relieve symptoms. At the 1-week follow-up after the cessation of sorafenib, all symptoms were resolved. Physicians should be alert to this recall phenomenon as it can occur both in the skin and elsewhere and the occurrence of RRD may be unpredictable.

  8. Acute unilateral parotid gland swelling after lateral decubitus position under general anesthesia

    Directory of Open Access Journals (Sweden)

    Aysun Postaci

    2012-01-01

    Full Text Available Acute swelling of the parotid gland after general anesthesia (commonly known as anesthesia mumps or acute postoperative sialadenitis is a rare but declared complication of anesthesia. The etiology is not clear, but some possible causes such as obstruction of glandular excretory ducts caused by patient position and increase in the viscosity of the saliva because of acute dehydratation and/or medications like atropin have been proposed. We report a swelling in the left preauricular and postauricular region extending to the angle of the mandibule in a 35-year-old patient after left lateral decubitus position for laparoscopic nephrectomy.

  9. Acute unilateral parotid gland swelling after lateral decubitus position under general anesthesia.

    Science.gov (United States)

    Postaci, Aysun; Aytac, Ismail; Oztekin, Cetin Volkan; Dikmen, Bayazit

    2012-07-01

    Acute swelling of the parotid gland after general anesthesia (commonly known as anesthesia mumps or acute postoperative sialadenitis) is a rare but declared complication of anesthesia. The etiology is not clear, but some possible causes such as obstruction of glandular excretory ducts caused by patient position and increase in the viscosity of the saliva because of acute dehydratation and/or medications like atropin have been proposed. We report a swelling in the left preauricular and postauricular region extending to the angle of the mandibule in a 35-year-old patient after left lateral decubitus position for laparoscopic nephrectomy.

  10. Diagnostic labelling as determinant of antibiotic prescribing for acute respiratory tract episodes in general practice

    Science.gov (United States)

    van Duijn, Huug J; Kuyvenhoven, Marijke M; Tiebosch, Hanneke M; Schellevis, François G; Verheij, Theo JM

    2007-01-01

    Background Next to other GP characteristics, diagnostic labelling (the proportion of acute respiratory tract (RT) episodes to be labelled as infections) probably contributes to a higher volume of antibiotic prescriptions for acute RT episodes. However, it is unknown whether there is an independent association between diagnostic labelling and the volume of prescribed antibiotics, or whether diagnostic labelling is associated with the number of presented acute RT episodes and consequently with the number of antibiotics prescribed per patient per year. Methods Data were used from the Second Dutch National Survey of General Practice (DNSGP-2) with 163 GPs from 85 Dutch practices, serving a population of 359,625 patients. Data over a 12 month period were analysed by means of multiple linear regression analysis. Main outcome measure was the volume of antibiotic prescriptions for acute RT episodes per 1,000 patients. Results The incidence was 236.9 acute RT episodes/1,000 patients. GPs labelled about 70% of acute RT episodes as infections, and antibiotics were prescribed in 41% of all acute RT episodes. A higher incidence of acute RT episodes (beta 0.67), a stronger inclination to label episodes as infections (beta 0.24), a stronger endorsement of the need of antibiotics in case of white spots in the throat (beta 0.11) and being male (beta 0.11) were independent determinants of the prescribed volume of antibiotics for acute RT episodes, whereas diagnostic labelling was not correlated with the incidence of acute RT episodes. Conclusion Diagnostic labelling is a relevant factor in GPs' antibiotic prescribing independent from the incidence of acute RT episodes. Therefore, quality assurance programs and postgraduate courses should emphasise to use evidence based prognostic criteria (e.g. chronic respiratory co-morbidity and old age) as an indication to prescribe antibiotics in stead of single inflammation signs or diagnostic labels. PMID:17883832

  11. Diagnostic labelling as determinant of antibiotic prescribing for acute respiratory tract episodes in general practice

    Directory of Open Access Journals (Sweden)

    Schellevis François G

    2007-09-01

    Full Text Available Abstract Background Next to other GP characteristics, diagnostic labelling (the proportion of acute respiratory tract (RT episodes to be labelled as infections probably contributes to a higher volume of antibiotic prescriptions for acute RT episodes. However, it is unknown whether there is an independent association between diagnostic labelling and the volume of prescribed antibiotics, or whether diagnostic labelling is associated with the number of presented acute RT episodes and consequently with the number of antibiotics prescribed per patient per year. Methods Data were used from the Second Dutch National Survey of General Practice (DNSGP-2 with 163 GPs from 85 Dutch practices, serving a population of 359,625 patients. Data over a 12 month period were analysed by means of multiple linear regression analysis. Main outcome measure was the volume of antibiotic prescriptions for acute RT episodes per 1,000 patients. Results The incidence was 236.9 acute RT episodes/1,000 patients. GPs labelled about 70% of acute RT episodes as infections, and antibiotics were prescribed in 41% of all acute RT episodes. A higher incidence of acute RT episodes (beta 0.67, a stronger inclination to label episodes as infections (beta 0.24, a stronger endorsement of the need of antibiotics in case of white spots in the throat (beta 0.11 and being male (beta 0.11 were independent determinants of the prescribed volume of antibiotics for acute RT episodes, whereas diagnostic labelling was not correlated with the incidence of acute RT episodes. Conclusion Diagnostic labelling is a relevant factor in GPs' antibiotic prescribing independent from the incidence of acute RT episodes. Therefore, quality assurance programs and postgraduate courses should emphasise to use evidence based prognostic criteria (e.g. chronic respiratory co-morbidity and old age as an indication to prescribe antibiotics in stead of single inflammation signs or diagnostic labels.

  12. Role of general practitioner in the management of acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Beeleonie Beeleonie

    2005-12-01

    Full Text Available Acute myocardial infarction (AMI has been the leading cause of death in Western countries, as well as in Indonesia. Delay in diagnosis and incorrect early management often result in failure of thrombolytic reperfusion. General practitioner (GP as the primary care, needs to be equipped with the ability to diagnose and moreover to manage AMI. A case of fail thrombolytic management in a 47 years old man after seven hours of angina typical chest pain, after previously managed by GP, is being reported. (Med J Indones 2005; 14:249-52Keywords: acute myocardial infarction, reperfusion, general practitioner

  13. Mental function and morbidity after acute hip surgery during spinal and general anaesthesia.

    Science.gov (United States)

    Bigler, D; Adelhøj, B; Petring, O U; Pederson, N O; Busch, P; Kalhke, P

    1985-07-01

    Forty elderly patients (mean age 78.9 years) undergoing acute surgery for hip fracture were given at random either spinal analgesia with bupivacaine 0.75% or general anaesthesia with diazepam, fentanly and N2O/O2. Mental function was studied pre-operatively with an abbreviated mental test and 1 week and 3 months postoperatively in both groups. Mortality and number of complications was similar in the two groups, but a shorter time of ambulation was seen in the spinal group compared to the general anaesthetic group. No persistent impairment in mental function was found after acute hip surgery under spinal or general anaesthesia and the only advantage of regional technique was a shorter time of ambulation.

  14. Emergent management of postpartum hemorrhage for the general and acute care surgeon

    Directory of Open Access Journals (Sweden)

    Blankenship Charles L

    2009-11-01

    Full Text Available Abstract Background Postpartum hemorrhage is one of the rare occasions when a general or acute care surgeon may be emergently called to labor and delivery, a situation in which time is limited and the stakes high. Unfortunately, there is generally a paucity of exposure and information available to surgeons regarding this topic: obstetric training is rarely found in contemporary surgical residency curricula and is omitted nearly completely from general and acute care surgery literature and continuing medical education. Methods The purpose of this manuscript is to serve as a topic specific review for surgeons and to present a surgeon oriented management algorithm. Medline and Ovid databases were utilized in a comprehensive literature review regarding the management of postpartum hemorrhage and a management algorithm for surgeons developed based upon a collaborative panel of general, acute care, trauma and obstetrical surgeons' review of the literature and expert opinion. Results A stepwise approach for surgeons of the medical and surgical interventions utilized to manage and treat postpartum hemorrhage is presented and organized into a basic algorithm. Conclusion The manuscript should promote and facilitate a more educated, systematic and effective surgeon response and participation in the management of postpartum hemorrhage.

  15. Manifestações articulares nas viroses exantemáticas Joint complaints in exanthematic diseases

    Directory of Open Access Journals (Sweden)

    Solange Artimos de Oliveira

    1999-04-01

    Full Text Available A freqüência de manifestações articulares foi avaliada em 251 pacientes com diagnóstico clínico e laboratorial (detecção de IgM por ensaio imunoenzimático de virose exantemática. As artropatias (artralgia e/ou artrite foram mais observadas nos casos de dengue (49% e de rubéola (38,2% do que naqueles com parvovirose humana (30% e sarampo (28,1%. Com exceção do sarampo, as artropatias predominaram nos adultos (315 anos de idade, sendo tal diferença estatisticamente significativa. A ocorrência maior de artropatias em adultos foi mais evidente nos pacientes com parvovirose (75%, rubéola (65% e dengue (57,7% do que naqueles com sarampo (31%. As queixas articulares também predominaram nos pacientes do sexo feminino para todas as viroses avaliadas. Os resultados encontrados demonstram o freqüente acometimento articular nas doenças estudadas, e indicam a necessidade de comprovação laboratorial para o diagnóstico diferencial entre elas.The frequency of arthropathy was evaluated in 251 patients with clinical and serological diagnosis (specific IgM detection by enzyme immunoassay of exanthematic disease. Arthropathy (arthralgia and/or arthritis was more frequent in dengue fever (49% and rubella (38.2% cases than in human parvovirus (30% and measles (28.1% cases. Except for measles cases, joint complaints prevailed in adults (315 years of age and this difference was significant. The higher frequency of arthropathy in adults was more evident in human parvovirus (75%, rubella (65% and dengue fever (57.7% cases than in measles cases (31%. Arthropathy was also more frequent in females for all rash diseases studied. The results of this study showed the high occurrence of joint complaints in the diseases described here and the importance of laboratory confirmation for their differential diagnosis.

  16. Presentation and treatment of acute maxillary sinusitis in general practice: a French observational study.

    Science.gov (United States)

    Klossek, J M; Mesbah, K

    2011-03-01

    This survey-based study was conducted to determine the characteristics that influence the diagnosis and treatment patterns of acute maxillary sinusitis among general practitioners in France. Questionnaires were sent to 467 physicians and requested to be completed for the next 4 adult (≥ 15 years) patients diagnosed with acute maxillary sinusitis. A total of 397 physicians responded with eligible data on 1585 patients (57.5% female; mean age, 42.3 years). The most common presenting signs and symptoms were moderate-to-severe nasal obstruction (80.4%), pain on sinus palpitation (76.8%), facial pain (74.5%), rhinorrhea (70.4%), and headache (63.6%). Local treatments were prescribed in 93.2% of cases, including nasal lavage (52.1%), vasoconstrictors (42.2%), and intranasal corticosteroids (38.7%). Almost all patients (99%) were prescribed oral treatment including antibiotics (86.5%), analgesics (56.3%), antipyretics (53.7%), and expectorants/mucolytics (45.6%). Symptoms were indicated as having a moderate to very significant effect on quality of life areas including activities of daily living (71.6% of patients), leisure (63.1%), and professional/school activities (59.2%). The diagnosis and management patterns of acute maxillary sinusitis among general practitioners in France are generally consistent with the 2007 European Position Paper on Rhinosinusitis and Nasal Polyps (EP3OS) guidelines.

  17. [Acute edematous encephalopathy presenting with refractory generalized status epilepticus: an autopsy case].

    Science.gov (United States)

    Yamashita, M; Yamamoto, T; Yasuda, T

    2001-11-01

    A previously healthy, 29-year-old man developed generalized convulsion with disturbed consciousness 3 days after the flu-like symptoms. On the next day, his convulsion evolved into generalized status epilepticus (GSE) that was unresponsive to administration of various anticonvulsants. Then, intravenous anesthetic agents, including midazolam, propofol and vecuronium sodium, were continuously infused. During the following 9 days, despite of high-dose infusion of these anesthetic agents, his GSE could not be suppressed, and complex partial seizure with secondary generalization frequently occurred. The patient was comatose and mechanically ventilated, whereas the brainstem reflexes were preserved. Electroencephalogram revealed a diffuse slowing of the background activity and occasional focal spike and wave complexes with secondary generalization. Cerebrospinal fluid analysis showed pleocytosis and elevated protein concentration. Cranial CT scans obtained on day 8 demonstrated brain edema. On day 10, his GSE ceased with abolition of the brainstem reflexes, and he lapsed into brain death resulting from the progressive brain edema. Over the following six days, his systemic circulation gradually worsened, and he died on day 16. On postmortem examination, the brain was markedly edematous and showed the findings consistent with acute anoxic encephalopathy with extensive circulatory stasis. Mild gliosis was observed in the insular cortex, yet no evidence of inflammatory disease was found throughout the brain. This patient was characterized by acutely progressive severe brain edema without inflammatory changes, suggesting that his primary disease was acute toxic encephalopathy presumably induced by viral infection. His GSE was refractory and unresponsive to the intensive treatment with the intravenous anesthetic agents. This case epitomizes the difficulties in controlling refractory seizures in some patients with encephalopathy or encephalitis.

  18. Generalized Safety and Efficacy of Simplified Intravenous Thrombolysis Treatment (SMART) Criteria in Acute Ischemic Stroke

    DEFF Research Database (Denmark)

    Sørensen, Sigrid B; Barazangi, Nobl; Chen, Charlene;

    2016-01-01

    BACKGROUND: Common intravenous recombinant tissue plasminogen activator (IV rt-PA) exclusion criteria may substantially limit the use of thrombolysis. Preliminary data have shown that the SMART (Simplified Management of Acute stroke using Revised Treatment) criteria greatly expand patient...... eligibility by reducing thrombolysis exclusions, but they have not been assessed on a large scale. We evaluated the safety and efficacy of general adoption of SMART thrombolysis criteria to a large regional stroke network. METHODS: Retrospective analysis of consecutive patients who received IV thrombolysis...... application of SMART criteria is safe and effective. Widespread application of these criteria could substantially increase the proportion of patients who might qualify for treatment....

  19. Terapia ocupacional en un hospital general de pacientes agudos = Occupational therapy in a general hospital for acute pacients

    Directory of Open Access Journals (Sweden)

    Ocello, M. G

    2006-09-01

    Full Text Available RESUMEN Desde su creación, el Hospital Provincial “Dr. José María Cullen” posee la característica de ser un hospital de emergencias, sostenido por la Sociedad de Beneficencia y la Hermanas de la Caridad.Su funcionamiento responde a un Modelo Clínico-Asistencial, lo cual influye en la inserción de Terapia Ocupacional debiendo adaptar sus funciones a las características de la Institución.Los marcos de referencia teóricos y programas que se implementandeber ser acordes con las necesidades surgidas de un Hospital General de Agudos y de emergencias.En el Sector de Terapia Ocupacional se desarrolla la actividad docente cumpliendo con los requisitos reglamentados por el Ministerio de Salud de la Provincia de Santa Fe.ABSTRACT Ever since its start the Provincial Hospital “Dr. José María Cullen” is characterised for being an emergency hospital under the guidance of the Benfit Society of Hermanas de la Caridad.Its function responds to a Clinical Assistential Model, which influences the insertion of Occupational Therapy, adapting its functiones to the characteristics of the Institution as and when called for.The theoretical points of reference and programmes that are used must be in accordance with tehe necessities that appear in an Acute and Emergency General Hospital.In the Occupational Therapy Sector the teaching activity is developed as required by rules and regulations of the Ministry of Health for the Province of Santa Fe.

  20. INTRA-ABDOMINAL INFECTION AND ACUTE ABDOMEN-EPIDEMIOLOGY, DIAGNOSIS AND GENERAL PRINCIPLES OF SURGICAL MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Jovanović Dušan

    2015-03-01

    Full Text Available Intra-abdominal infections are multifactorial and present an complex inflammatory response of the peritoneum to microorganisms followed by exudation in the abdominal cavity and systemic response Despite advances in management and critical care of patients with acute generalized peritonitis due to hollow viscus perforation, prognosis is still very poor, with high mortality rate. Early detection and adequate treatment is essential to minimize complications in the patient with acute abdomen. Prognostic evaluation of complicated IAI by modern scoring systems is important to assess the severity and the prognosis of the disease. Control of the septic source can be achieved either by nonoperative or operative means. Nonoperative interventional procedures include percutaneous drainages of abscesses. The management of primary peritonitis is non-surgical and antibiotic- treatment. The management of secondary peritonitis include surgery to control the source of infection, removal of toxins, bacteria, and necrotic tissue, antibiotic therapy, supportive therapy and nutrition. "Source control" is sine qua non of success and adequate surgical procedure involves closure or resection of any openings into the gastrointestinal tract, resection of inflamed tissue and drainage of all abdominal and pelivic collections.

  1. Effectiveness of a clinical pathway for acute stroke care in a district general hospital: an audit

    Directory of Open Access Journals (Sweden)

    Siegert Richard J

    2006-02-01

    Full Text Available Abstract Background Organised stroke care saves lives and reduces disability. A clinical pathway might be a form of organised stroke care, but the evidence for the effectiveness of this model of care is limited. Methods This study was a retrospective audit study of consecutive stroke admissions in the setting of an acute general medical unit in a district general hospital. The case-notes of patients admitted with stroke for a 6-month period before and after introduction of the pathway, were reviewed to determine data on length of stay, outcome, functional status, (Barthel Index, BI and Modified Rankin Scale, MRS, Oxfordshire Community Stroke Project (OCSP sub-type, use of investigations, specific management issues and secondary prevention strategies. Logistic regression was used to adjust for differences in case-mix. Results N = 77 (prior to the pathway and 76 (following the pathway. The median (interquartile range, IQR age was 78 years (67.75–84.25, 88% were European NZ and 37% were male. The median (IQR BI at admission for the pre-pathway group was less than the post-pathway group: 6 (0–13.5 vs. 10 (4–15.5, p = 0.018 but other baseline variables were statistically similar. There were no significant differences between any of the outcome or process of care variables, except that echocardiograms were done less frequently after the pathway was introduced. A good outcome (MRS Conclusion A clinical pathway for acute stroke management appeared to have no benefit for the outcome or processes of care and may even have been associated with worse outcomes. These data support the conclusions of a recent Cochrane review.

  2. Difficulties encountered by general practitioners during acute behavioral disturbances of their dementia patients.

    Science.gov (United States)

    Campana, Marion; Bonin-Guillaume, Sylvie; Yagoubi, Ramzi; Berbis, Julie; Franqui, Caroline

    2016-06-01

    Alzheimer diseases and related disorders (ADRD) remain a major public health issue. The progression of the disease is dominated by behavioral and psychological symptoms of dementia (BPSD) which are frequent and burdensome for caregivers. The aim of our survey was to study how the general practionner managed these behavioral disturbances (particularly agitation and aggressiveness) in community living patients with ADRD and support of their main caregivers. We based our study on a medical survey sent to all general practitioners (GP) practicing in four districts in Marseille near from a secure unit. Ninety five out of 260 answered to the survey and 57 had already been exposed to patients' behavioral decompensation. For these BPSD management, atypical neuroleptics and benzodiazepines were mostly prescribed, and according to the literature and guidelines. Half of the GP's recognized the weak effectiveness of this strategy. Almost all of them are interested in having a document summarizing the main strategy to be set up or a possibility to call a specialized mobile team with doctors and professionals caregivers. A few dedicated consultations were devoted to informal caregivers whereas GP were aware of negative effects of these decompensations on them. This study point out difficulties for GP to provide appropriate management for their patients with ADRD living at home and for their informal caregivers, particularly during acute behavioral disturbance, despite their practical knowledges.

  3. An observational study in psychiatric acute patients admitted to General Hospital Psychiatric Wards in Italy

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    Margari Francesco

    2007-01-01

    Full Text Available Abstract Objectives this Italian observational study was aimed at collecting data of psychiatric patients with acute episodes entering General Hospital Psychiatric Wards (GHPWs. Information was focused on diagnosis (DSM-IV, reasons of hospitalisation, prescribed treatment, outcome of aggressive episodes, evolution of the acute episode. Methods assessments were performed at admission and discharge. Used psychometric scales were the Brief Psychiatric Rating Scale (BPRS, the Modified Overt Aggression Scale (MOAS and the Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30. Results 864 adult patients were enrolled in 15 GHPWs: 728 (320 M; mean age 43.6 yrs completed both admission and discharge visits. A severe psychotic episode with (19.1% or without (47.7% aggressive behaviour was the main reason of admission. Schizophrenia (42.8% at admission and 40.1% at discharge and depression (12.9% at admission and 14.7% at discharge were the predominant diagnoses. The mean hospital stay was 12 days. The mean (± SD total score of MOAS at admission, day 7 and discharge was, respectively, 2.53 ± 5.1, 0.38 ± 2.2, and 0.21 ± 1.5. Forty-four (6.0% patients had episodes of aggressiveness at admission and 8 (1.7% at day 7. A progressive improvement in each domain/item vs. admission was observed for MOAS and BPRS, while NOSIE-30 did not change from day 4 onwards. The number of patients with al least one psychotic drug taken at admission, in the first 7 days of hospitalisation, and prescribed at discharge, was, respectively: 472 (64.8%, 686 (94.2% and 676 (92.9%. The respective most frequently psychotic drugs were: BDZs (60.6%, 85.7%, 69.5%, typical anti-psychotics (48.3%, 57.0%, 49.6%, atypical anti-psychotics (35.6%, 41.8%, 39.8% and antidepressants (40.9%, 48.8%, 43.2%. Rates of patients with one, two or > 2 psychotic drugs taken at admission and day 7, and prescribed at discharge, were, respectively: 24.8%, 8.2% and 13.5% in mono-therapy; 22.0%, 20

  4. Chlamydia pneumoniae and mycoplasma pneumoniae in children with acute respiratory infection in general practices in the Netherlands.

    NARCIS (Netherlands)

    Tjhie, J.H.T.; Dorigo-Zetsma, J.W.; Roosendaal, R.; Brule, A.J.C. van den; Bestebroer, T.M.; Bartelds, A.I.M.; Vandenbroucke-Grauls, C.M.J.E.

    2000-01-01

    In this retrospective study Chlamydia pneumoniae and Mycoplasma pneumoniae infections were detected by polymerase chain reaction (PCR) in samples (n=457) from children presenting with acute respiratory infection to general practitioners during 1992-97. Samples were collected in autumn and winter, an

  5. Surveillance of acute respiratory infections in general practices - The Netherlands, winters 1998/1999 and 1999/2000

    NARCIS (Netherlands)

    Brandhof WE van den; Bartelds AIM; Wilbrink B; Verweij C; Bijlsma K; Nat H van der; Boswijk H; Pronk JDD; Dorigo-Zetsma JW; Heijnen MLA; NIVEL; CIE; LIS

    2001-01-01

    To provide insight into the virological aetiology of influenza-like illnesses and other acute respiratory infections, nose/throat swabs were taken by 30-35 general practitioners of the sentinel surveillance network of The Netherlands Institute of Health Services Research from a random selection of p

  6. Acute Gastroenteritis and Campylobacteriosis in Swiss Primary Care: The Viewpoint of General Practitioners

    Science.gov (United States)

    Bless, Philipp J.; Muela Ribera, Joan; Schmutz, Claudia; Zeller, Andreas; Mäusezahl, Daniel

    2016-01-01

    Acute gastroenteritis (AG) is frequently caused by infectious intestinal diseases (IID) including food- and waterborne pathogens of public health importance. Among these pathogens, Campylobacter spp. plays a major role. Many European countries monitor selected IIDs within disease surveillance systems. In Switzerland, the information on IIDs is restricted to limited surveillance data, while no data is available for AG. We conducted a qualitative study among Swiss general practitioners (GPs) to investigate the case management of AG and campylobacteriosis patients, the associated disease burden and the determinants leading to registration in the National Notification System for Infectious Diseases (NNSID). Interviews were conducted with a semi-structured questionnaire and underwent inductive content analysis based on Grounded Theory. The questionnaire was repeatedly adapted to capture emerging themes until the point of theoretical saturation. GPs perceived AG and campylobacteriosis of little relevance to their daily work and public health in general. According to GP self-estimates each consults about two cases of AG per week and diagnoses a median of five campylobacteriosis cases per year. A large proportion of AG cases receives telephone consultations only and gets medical advice from the practice nurse. Antibiotic therapy is considered useful and stool diagnostics are performed for about a fifth of consulting AG patients. Stool diagnostics (“test”) and antibiotic therapy (“treat”) are interrelated and follow four strategies: “Wait & See”, “Treat & See”, “Treat & Test”, and “Test & See”. AG case management is diverse and includes different triage steps. A small proportion of AG patients have stool diagnostics performed and only positive tested patients are reported to the NNSID. As a result severe cases and cases with a history of travel abroad are overrepresented in the NNSID. The use of multiplex PCR panels in routine diagnostics likely

  7. Acute Myocardial Infarction: A Comparison of the Risk between Physicians and the General Population

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    Yen-ting Chen

    2015-01-01

    Full Text Available Physicians in Taiwan have a heavy workload and a stressful workplace, both of which may contribute to cardiovascular disease. However, the risk of acute myocardial infarction (AMI in physicians is not clear. This population-based cohort study used Taiwan’s National Health Insurance Research Database. We identified 28,062 physicians as the case group and randomly selected 84,186 nonmedical staff patients as the control group. We used a conditional logistic regression to compare the AMI risk between physicians and controls. Subgroup analyses of physician specialty, age, gender, comorbidities, area, and hospital level were also done. Physicians have a higher prevalence of HTN (23.59% versus 19.06%, P<0.0001 and hyperlipidemia (21.36% versus 12.93%, P<0.0001 but a lower risk of AMI than did the controls (adjusted odds ratio (AOR: 0.57; 95% confidence interval (CI: 0.46–0.72 after adjusting for DM, HTN, hyperlipidemia, and area. Between medical specialty, age, and area subgroups, differences in the risk for having an AMI were nonsignificant. Medical center physicians had a lower risk (AOR: 0.42; 95% CI: 0.20–0.85 than did local clinic physicians. Taiwan’s physicians had higher prevalences of HTN and hyperlipidemia, but a lower risk of AMI than did the general population. Medical center physicians had a lower risk than did local clinic physicians. Physicians are not necessary healthier than the general public, but physicians, especially in medical centers, have a greater awareness of disease and greater access to medical care, which permits timely treatment and may prevent critical conditions such as AMI induced by delayed treatment.

  8. A Test of the Effects of Acute Sleep Deprivation on General and Specific Self-Reported Anxiety and Depressive Symptoms: An Experimental Extension

    OpenAIRE

    Babson, Kimberly A; Trainor, Casey D.; Feldner, Matthew T.; Blumenthal, Heidemarie

    2010-01-01

    Evidence indicates acute sleep deprivation affects negative mood states. The present study experimentally tested the effects of acute sleep deprivation on self-reported symptoms of state anxiety and depression as well as general distress among 88 physically and psychologically healthy adults. As hypothesized, the effects of acute sleep deprivation increased state anxiety and depression, as well as general distress, relative to a normal night of sleep control condition. Based on the tripartite...

  9. Acute exercise has a general facilitative effect on cognitive function: A combined ERP temporal dynamics and BDNF study.

    Science.gov (United States)

    Chang, Yu-Kai; Alderman, Brandon L; Chu, Chien-Heng; Wang, Chun-Chih; Song, Tai-Fen; Chen, Feng-Tzu

    2017-02-01

    This study examined whether acute moderate intensity exercise results in a general or selective improvement in cognitive function. In addition, multiple stimulus-locked ERP components and serum BDNF levels were assessed to investigate potential neurobiological mechanisms underlying acute exercise effects on select aspects of cognitive performance. Thirty young adults were recruited and participated in exercise and reading control sessions in a counterbalanced order. Following treatments, the Stroop task was administrated, and N1, N2, P3, and N450 components of the ERP waveform were recorded and analyzed. Additionally, blood samples were withdrawn immediately following exercise or rest conditions prior to administration of the Stroop task. Acute exercise facilitated response times for both Stroop congruent and incongruent task conditions, with a similar magnitude of improvement. Larger P3 and reduced N450 amplitudes as well as decreased N450 latency were observed following exercise, but no effects on N1 and N2 components were found. This dose of exercise also did not influence serum BDNF levels. These findings suggest that moderate intensity acute exercise results in a generalized rather than selective improvement in cognition. The facilitation may be related to an increase in attentional or neural resource allocation and conflict detection processes reflected by longer latency endogenous components (P3, N450), but is not influenced by earlier sensory and monitoring processes revealed by earlier ERP components or by serum levels of BDNF.

  10. DETECTION OF CASES OF PARVOVIRUS INFECTION IN THE SYSTEM FOR EPIDEMIOLOGICAL SURVEILLANCE OF EXANTHEMATIC DISEASES

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    I. N. Lavrentyeva

    2016-01-01

    Full Text Available The drastic decrease of the incidence of Measles and Rubella at the stage of elimination of these infections is notified on the territory of North- Western Federal Region (NWFR of Russia. At the same time the number of cases with the error clinical diagnosis of Measles and Rubella increased. The most frequent error is the infection caused by Parvovirus (PVI. The disease is of the independent particular medical and social significance for obstetrics, maternity and childhood protection, blood donation service, transplantation of organs/tissue etc. The aim of the current study was to estimate the prevalence of PVI on the territory of NWFR of Russia in different periods of 2009–2012 and 2015–2016. The data of the laboratory diagnosis of PVI for patients with exanthema were analyzed. Materials and methods. The serum specimens of patients with exanthema from bank of sera of St. Petersburg Subnational Measles/Rubella laboratory, collected in 2009–2012 (n = 495 and in 2015 (n = 336 as well as 69 sera of patients with exanthema from the “Infectious Disease Hospital N30” in St. Petersburg, collected in March-May, 2016 were studied. The specific IgM-PV B19 antibodies were determined by the «recomWELL Parvovirus B19 IgM» (MICROGEN GmbH, Germany ELISA test-system. The presen ce of the specific IgM-PV B19 antibodies in sera of patients was the evidence of the acute PVI. Results. The obtained results demonstrated the prevalence of PVI on the territory of NWFR. In 2009–2012 as well as in 2015 years PVI was revealed on the overwhelming majority (9 of 11 of administrative territories of the NWFR. The essential predominance of PVI was determined in St. Petersburg and bordering territories of NWFR (Kaliningrad Oblast’, Leningrad Oblast’, Republic of Karelia. In 2010, 2011 and 2015 years the part of sera detected as IgM-PV B19 positive on an average was equal to 14%. Meanwhile in 2012 the part of the detected IgM-PV B19 positive sera was

  11. Acute poststreptococcal glomerulo-nephritis in general practice: the contribution of infection to its onset and course.

    Science.gov (United States)

    Higgins, P M

    1996-04-01

    Twenty-one patients considered to have acute poststreptococcal glumerulo-nephritis were encountered during 35 years of general practice. In ten of them good evidence of active streptococcal infection at the time of discovery of nephritis was recorded. The more complete the data the more convincing was the evidence of active infection. In over half of those whose urine were routinely cultured pathogens were isolated and over a third were treated for infection of the urinary tract. Such infections were associated with adverse effects and prolonged illness. As compared with children, adults in general had a longer history of ill-health, were less likely to present with acute infections and more likely to have urinary tract infections and prolonged illness. Vigorous antistreptococcal treatment was followed by rapid recovery in those patients so treated whose illnesses were not complicated by urinary tract infections. Concurrent streptococcal infection and secondary infection of the urinary tract may contribute more to the onset of acute poststreptococcal glomerulo-nephritis and to its course than is currently believed.

  12. Pediatric acute respiratory distress syndrome: Host factors in Down syndrome and the general population

    NARCIS (Netherlands)

    M. Bruijn

    2013-01-01

    We find that Down syndrome is an important risk factor for developing acute respiratory distress syndrome (ARDS) in children, but the reason why remains to be elucidated. In addition, we find several differences between adult and pediatric ARDS. The association between C-reactive protein (CRP) level

  13. SPECTRUM OF ACUTE GLOMERULO NEPHRITIS IN CHILDREN AT GOVERNMENT GENERAL HOSPITAL, ANANTAPURAMU

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    Ravi Kumar

    2015-04-01

    Full Text Available AIM: Aim of the study is to study the spectrum of AGN in children and to assess the age, sex and seasonal incidence and prognostic factors. Acute glomerulonephritis is one of the most common condition seen in children. The study group included 50 children. In most of the children presenting complaints s of are puffiness of face, haematuria and oliguria. METHODS AND MATERIALS: Fifty children who were admitted in the government hospital during the period of September 2013 to January 2015 were included in the stud y. RESULTS: The maximum admissions were seen from the months of September to December. Common age group was between 3 and 8 years. Rare age group was below 2 years. Hypertension was noticed in 32 out of 50 children. Albuminuria and hematuria were commonest urinary abnormalities. CONCLUSION: acute glomerulonephritis is less common below 2 years. Hypertension was of varying degree. Cardiomegaly by x - ray was an added feature.

  14. Emergent Management of Postpartum Hemorrhage for the General and Acute Care Surgeon

    Science.gov (United States)

    2009-01-01

    uncommon, and is likely contributed to, at least in part, by the ability of healthy pregnant women to lose up one liter of blood acutely without a...the fetus), abnormal placentation (placenta previa, accreta or increta), oxytocin use, maternal obesity, and a distended uterus (from a large baby...patient [11]. A more accurate assessment of volume loss can be assessed by calculating the patient’s blood volume is (8.5-9% of a pregnant woman’s

  15. Management of the acute scrotum in a district general hospital: 10-year experience.

    LENUS (Irish Health Repository)

    Tajchner, Lukas

    2012-01-31

    The acutely painful scrotum is a common urologic emergency. The primary objective of management is to avoid testicular loss. This requires a high index of clinical suspicion and prompt surgical intervention. In our series conducted between January 1996 and December 2005, 119 patients (age range: 4-62 years) underwent emergency operative exploration for acute scrotal pain. The most common finding was torted cyst of Morgagni (63\\/119, 52.9%), followed by testicular torsion (41\\/119, 34.4%). The majority of testicular torsions occurred in the pubertal group (22\\/41, 53.6%). Only one patient in this group had an unsalvageable testis necessitating orchidectomy, a testicular loss rate in torsion of 2.4%. There were no postoperative wound infections or scrotal haematomas. Testicular salvage depends critically on early surgical intervention, so the delay incurred in diagnostic imaging may extend the period of ischaemia. Furthermore, all radiological investigations have a certain false-negative rate. We advocate immediate surgical exploration of the acute scrotum. We report a low orchidectomy rate (2.4%) in testicular torsion.

  16. EFFECTS OF IVIG TREATMENT UPON LOCAL AND GENERAL IMMUNITY STATE IN THE PATIENTS WITH ACUTE EPIGLOTTITIS

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    A. V. Savchenko

    2008-01-01

    Full Text Available Abstract. This study has shown that intravenous normal human immunoglobulin (IVIG, when included into combined therapy of acute epiglottitis, exerts positive effect upon clinical course of the disease and contributes to normalisation of immune status. Due to IVIG therapy, an increase in IgA and sIgA concentrations is observed in laryngopharynx secretions. Amounts and affinity of serum antibodies to common bacterial antigenic determinant are increased in blood, as well as opsonizing properties of blood serum. Moreover, a higher phagocytic and bactericidal activity of neutrophils is observed with such treatment. Inflammatory as well as degenerative and destructive processes in epiglottis seem to be preventable under the influence of IVIG therapy.

  17. Early crisis intervention to patients with acute stress disorder in general hospital.

    Science.gov (United States)

    Andoh, Hidehiro; Yamamoto, Kenji; Ichimura, Atsushi; Sato, Shinko; Teraoka, Naoko; Ozono, Hiroko; Kushino, Nobuhisa; Maruyama, Manabu; Matsumoto, Hideo; Yamazaki, Kosuke

    2003-04-01

    This report presents 2 patients who were diagnosed to have acute stress disorder (ASD), received early psychiatric intervention (crisis intervention as a short-term psychotherapy), and subsequently had good outcome. Encounter with an event that causes psychological trauma may induce post-traumatic stress disorder (PTSD). However, the 2 patients described here have shown no particular mental symptoms for more than 2 years after the event and are leading normal lives. Psychological debriefing as a group used to be regarded as effective for the prevention of PTSD, but early identification of the stress-related disorder and intensive treatment of individual patients is recently considered to be more necessary. Both of the 2 patients presented here showed good outcome, and early crisis intervention in individual patients is suggested to be effective for the treatment of stress-related disorders and prevention of PTSD.

  18. Generalization of the Right Acute Stroke Prevention Strategies in Reducing in-Hospital Delays.

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    Qiang Huang

    Full Text Available The aim of this study was to reduce the door-to-needle (DTN time of intravenous thrombolysis (IVT in acute ischemic stroke (AIS through a comprehensive, hospital-based implementation strategy. The intervention involved a systemic literature review, identifying barriers to rapid IVT treatment at our hospital, setting target DTN time intervals, and building an evolving model for IVT candidate selection. The rate of non-in-hospital delay (DTN time ≤ 60 min was set as the primary endpoint. A total of 348 IVT cases were enrolled in the study (202 and 146 in the pre- and post-intervention group, respectively. The median age was 61 years in both groups; 25.2% and 26.7% of patients in the pre- and post-intervention groups, respectively, were female. The post-intervention group had higher rates of dyslipidemia and minor stroke [defined as National Institutes of Health Stroke Scale (NIHSS ≤ 3]; less frequent atrial fibrillation; higher numbers of current smokers, heavy drinkers, referrals, and multi-model head imaging cases; and lower NIHSS scores and blood sugar level (all P 0.05. These findings indicate that it is possible to achieve a DTN time ≤ 60 min for up to 60% of hospitals in the current Chinese system, and that this logistical change can yield a notable improvement in the outcome of IVT patients.

  19. Doenças exantemáticas e primeira epidemia de dengue ocorrida em Manaus, Amazonas, no período de 1998-1999 Exanthematous diseases and the first epidemic of dengue to occur in Manaus, Amazonas State, Brazil, during 1998-1999

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    Regina Maria Pinto De Figueiredo

    2004-12-01

    Full Text Available Em 1998, a Fundação de Medicina Tropical/Instituto de Medicina Tropical do Amazonas implementou o sistema de vigilância para síndromes febris agudas indiferenciadas, com o propósito de manter vigilância ativa e passiva na Amazônia Ocidental, Brasil, permitindo identificar e diagnosticar os agentes etiológicos causadores de febres agudas. O diagnóstico foi realizado através de estudos sorológicos para a detecção de anticorpos IgM, utilizando-se técnicas de ELISA (Enzyme-linked-immunosorbent assay e kits ELISA comerciais. Foram analisadas 8.557 amostras de soros de pacientes com suspeita clínica de dengue, 40% dos soros foram ELISA positivos para o vírus da dengue e 26% dos soros foram ELISA positivos para outras doenças exantemáticas virais como rubéola, sarampo, parvovírus, oropouche e mayaro.In 1998, the FMT/IMT-AM foundation implemented the surveillance system to diagnose acute undifferentiated febrile syndromes, with the objective of active and passive surveillance in Brazilian western Amazonian rainforest to identify and diagnose the etiologic agents of acute fever. The diagnoses were performed using serological tests to detect IgM antibodies by ELISA (Enzyme-linked-immunosorbent assay CDC/OPAS or using commercial kits. A total of 8,557 serum samples obtained from patients with clinical suspicion of dengue virus were analyzed. ELISA positive reaction to dengue virus was presented by 40% of the serum samples and 26% of the serum samples had positive ELISA reactions to other exanthematous viral diseases, such as rubella, measles, parvovirus, Oropouche virus and Mayaro virus.

  20. Relationship between psychiatric nurse work environments and nurse burnout in acute care general hospitals.

    Science.gov (United States)

    Hanrahan, Nancy P; Aiken, Linda H; McClaine, Lakeetra; Hanlon, Alexandra L

    2010-03-01

    Following deinstitutionalization, inpatient psychiatric services moved from state institutions to general hospitals. Despite the magnitude of these changes, evaluations of the quality of inpatient care environments in general hospitals are limited. This study examined the extent to which organizational factors of the inpatient psychiatric environments are associated with psychiatric nurse burnout. Organizational factors were measured by an instrument endorsed by the National Quality Forum. Robust clustered regression analysis was used to examine the relationship between organizational factors in 67 hospitals and levels of burnout for 353 psychiatric nurses. Lower levels of psychiatric nurse burnout was significantly associated with inpatient environments that had better overall quality work environments, more effective managers, strong nurse-physician relationships, and higher psychiatric nurse-to-patient staffing ratios. These results suggest that adjustments in organizational management of inpatient psychiatric environments could have a positive effect on psychiatric nurses' capacity to sustain safe and effective patient care environments.

  1. A test of the effects of acute sleep deprivation on general and specific self-reported anxiety and depressive symptoms: an experimental extension.

    Science.gov (United States)

    Babson, Kimberly A; Trainor, Casey D; Feldner, Matthew T; Blumenthal, Heidemarie

    2010-09-01

    Evidence indicates acute sleep deprivation affects negative mood states. The present study experimentally tested the effects of acute sleep deprivation on self-reported symptoms of state anxiety and depression as well as general distress among 88 physically and psychologically healthy adults. As hypothesized, the effects of acute sleep deprivation increased state anxiety and depression, as well as general distress, relative to a normal night of sleep control condition. Based on the tripartite model of anxiety and depression, these findings replicate and extend prior research by suggesting sleep deprivation among individuals without current Axis I disorders increases both state symptoms of anxiety and depression specifically, and general distress more broadly. Extending this work to clinical samples and prospectively testing mechanisms underlying these effects are important future directions in this area of research.

  2. Collaboration between physicians and a hospital-based palliative care team in a general acute-care hospital in Japan

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    Nishikitani Mariko

    2010-06-01

    Full Text Available Abstract Background Continual collaboration between physicians and hospital-based palliative care teams represents a very important contributor to focusing on patients' symptoms and maintaining their quality of life during all stages of their illness. However, the traditionally late introduction of palliative care has caused misconceptions about hospital-based palliative care teams (PCTs among patients and general physicians in Japan. The objective of this study is to identify the factors related to physicians' attitudes toward continual collaboration with hospital-based PCTs. Methods This cross-sectional anonymous questionnaire-based survey was conducted to clarify physicians' attitudes toward continual collaboration with PCTs and to describe the factors that contribute to such attitudes. We surveyed 339 full-time physicians, including interns, employed in a general acute-care hospital in an urban area in Japan; the response rate was 53% (N = 155. We assessed the basic characteristics, experience, knowledge, and education of respondents. Multiple logistic regression analysis was used to determine the main factors affecting the physicians' attitudes toward PCTs. Results We found that the physicians who were aware of the World Health Organization (WHO analgesic ladder were 6.7 times (OR = 6.7, 95% CI = 1.98-25.79 more likely to want to treat and care for their patients in collaboration with the hospital-based PCTs than were those physicians without such awareness. Conclusion Basic knowledge of palliative care is important in promoting physicians' positive attitudes toward collaboration with hospital-based PCTs.

  3. Diagnostic accuracy on the management of acute paediatric urinary tract infection in a general paediatric unit

    Institute of Scientific and Technical Information of China (English)

    Fahisham Taib; Bakht Jamal

    2015-01-01

    Objective: To ascertain diagnostic accuracy of paediatric urinary tract infection (UTI) in a general paediatric unit of a district hospital. Methods: Retrospective case note review and comparing to the final computerised database of Human in-Patient Enquiry (HIPE) at Portiuncula Hospital, Galway, Ireland. All children from 0-16 years of age with the diagnosis of UTI were enrolled within the 3 year study period. The information was first retrieved from HIPE system to capture list of patients. Case notes revision was followed to extract data under standardized pro-forma for demography, accuracy of diagnosis, treatment instituted and investigation ordered. Patients’ data was reviewed according to updated definition. Results: There were 85 cases treated for UTI during the 3 year period, and only 45 cases were considered as genuine UTI according to diagnostic criteria. Out of 45 cases, 16 cases were considered as suspected UTI cases. Escherichia coli was noted to be the commonest organism. Cephradine has been used as the first line treatment as per local guideline;however, different antibiotic regimes were based on physician’s preferences. The sensitivity of the current method of UTI diagnosis remained at 64%when comparing final diagnosis in the HIPE system. Conclusions: UTI can be difficult to accurately diagnosis in certain clinical cases. Decisions made should be individualized and tailored according to clinical suspicion and presentation of the patients. Improvement to ensure accurate diagnosis is vital to ensure correct data capture in the HIPE system thus giving valuable information and resource for future care.

  4. Intra-abdominal pressure and abdominal compartment syndrome in acute general surgery.

    LENUS (Irish Health Repository)

    Sugrue, Michael

    2012-01-31

    BACKGROUND: Intra-abdominal pressure (IAP) is a harbinger of intra-abdominal mischief, and its measurement is cheap, simple to perform, and reproducible. Intra-abdominal hypertension (IAH), especially grades 3 and 4 (IAP > 18 mmHg), occurs in over a third of patients and is associated with an increase in intra-abdominal sepsis, bleeding, renal failure, and death. PATIENTS AND METHODS: Increased IAP reading may provide an objective bedside stimulus for surgeons to expedite diagnostic and therapeutic work-up of critically ill patients. One of the greatest challenges surgeons and intensivists face worldwide is lack of recognition of the known association between IAH, ACS, and intra-abdominal sepsis. This lack of awareness of IAH and its progression to ACS may delay timely intervention and contribute to excessive patient resuscitation. CONCLUSIONS: All patients entering the intensive care unit (ICU) after emergency general surgery or massive fluid resuscitation should have an IAP measurement performed every 6 h. Each ICU should have guidelines relating to techniques of IAP measurement and an algorithm for management of IAH.

  5. Simultaneous investigation of influenza and enteric viruses in the stools of adult patients consulting in general practice for acute diarrhea

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    Arena Christophe

    2012-06-01

    Full Text Available Abstract Background Gastrointestinal symptoms are not an uncommon manifestation of an influenza virus infection. In the present study, we aimed to investigate the presence of influenza viruses in the stools of adult patients consulting their general practitioner for uncomplicated acute diarrhea (AD and the proportion of concurrent infections by enteric and influenza viruses. Method A case-control study was conducted from December 2010 to April 2011. Stool specimens were collected and tested for influenza viruses A (seasonal A/H3N2 and pandemic A/H1N1 and B, and for four enteric viruses (astrovirus, group A rotavirus, human enteric adenovirus, norovirus of genogroups I – NoVGI - and genogroup II - NoVGII. Results General practitioners enrolled 138 cases and 93 controls. Of the 138 stool specimens collected, 92 (66.7% were positive for at least one of the four enteric viruses analysed and 10 (7.2% tested positive for one influenza virus. None of these 10 influenza positive patients reported respiratory symptoms. In five influenza-positive patients (3.6%, we also detected one enteric virus, with 4 of them being positive for influenza B (2 had co-detection with NoVGI, 1 with NoVGII, and 1 with astrovirus. None of the 93 controls tested positive for one of the enteric and/or other influenza viruses we investigated. Conclusions In this study we showed that the simultaneous detection of influenza and enteric viruses is not a rare event. We have also reported, for the first time in general practice, the presence of seasonal and pandemic influenza viruses in the stools of adult patients consulting for uncomplicated AD. A simultaneous investigation of enteric and influenza viruses in patients complaining of gastrointestinal symptoms could be useful for future studies to better identify the agents responsible for AD.

  6. Prediction of Upper Limb Recovery, General Disability, and Rehabilitation Status by Activity Measurements Assessed by Accelerometers or the Fugl-Meyer Score in Acute Stroke

    NARCIS (Netherlands)

    Gebruers, Nick; Truijen, Steven; Engelborghs, Sebastiaan; De Deyn, Peter P.

    2014-01-01

    Objective This study investigated the clinical predictive value of the Fugl-Meyer Assessment (FMA) arm score and the upper limb activity assessed by accelerometers in patients with hemiparesis after acute stroke. Design The prospective cohort (n = 129) was recruited from a general hospital; activity

  7. Increased Pro-inflammatory Cytokines (TNF-a and IL-6 and Anti-inflammatory Compounds (sTNFRp55 and sTNFRp75 in Brazilian Patients during Exanthematic Dengue Fever

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    Luzia MO Pinto

    1999-05-01

    Full Text Available Pro-inflammatory cytokines, tumor necrosis factor (TNF-a, interleukin-6 (IL-6 and interleukin-1b (IL-1b as well as anti-inflammatory compounds, soluble TNF-Receptor p55 (sTNFRp55, sTNFRp75 and IL-1 receptor antagonist (sIL-1Ra, were investigated in 34 Brazilian cases of dengue fever (DF originated from a study of exanthematic virosis. The presence of pro-inflammatory cytokines was detected in sera from these patients by ELISA. TNF-a and IL-6 levels were significantly higher than control subjects in 32% and 52% patients, respectively. To our knowledge this was the first time a receptor antagonist and soluble receptors for cytokines were detected in sera obtained during exanthematic DF without hemorrhagic manifestations. Both sTNFRp55 and sTNFRp75 were consistently elevated in 42% and 84% patients, respectively. Most patients had IL-1b levels not different from those of normal subjects, except for one case. Only 16% patients had altered levels of IL-1Ra. Previous studies in dengue hemorrhagic fever patients demonstrated production of these soluble factors; here we observed that they are found in absence of hemorrhagic manifestations. The possible role of these anti-inflammatory compounds in immune cell activation and in regulating cytokine-mediated pathogenesis during dengue infection is discussed.

  8. Anticonvulsant Effects of Combined Treatment with Citicoline and Valproate on the Model of Acute Generalized Convulsions Induced by Pentylenetetrazole in Wistar Rats.

    Science.gov (United States)

    Karpova, M N; Kuznetsova, L V; Zin'kovskii, K A; Klishina, N V

    2016-02-01

    We studied anticonvulsant effects of combined treatment with citicoline, a nootropic substance with neuroregenerative and neuroprotective activities, and valproate, an antiepileptic agent widely used in the treatment of epilepsy, on the model of pentylenetetrazole-induced (75 mg/kg, intraperitoneally) acute generalized convulsions in male Wistar rats. Combined treatment with citicoline and valproate in minimum effective doses (70 and 300 mg/kg, respectively) potentiated the anticonvulsant properties of both agents.

  9. Tissue-specific B-cell dysfunction and generalized memory B-cell loss during acute SIV infection.

    Directory of Open Access Journals (Sweden)

    Sandrine Peruchon

    Full Text Available BACKGROUND: Primary HIV-infected patients display severe and irreversible damage to different blood B-cell subsets which is not restored by highly efficient anti-retroviral therapy (HAART. Because longitudinal investigations of primary HIV-infection is limited by the availability of lymphoid organs, we studied the tissue-specific B-cell dysfunctions in acutely simian immunodeficiency virus (SIV mac251-infected Cynomolgus macaques. METHODS AND FINDINGS: Experiments were performed on three groups of macaques infected for 14, 21 or 28 days and on three groups of animals treated with HAART for two-weeks either initiated at 4 h, 7 or 14 days post-infection (p.i.. We have simultaneously compared changes in B-cell phenotypes and functions and tissue organization of B-cell areas in various lymphoid organs. We showed that SIV induced a steady decline in SIgG-expressing memory (SIgD(-CD27(+ B-cells in spleen and lymph nodes during the first 4 weeks of infection, concomitant to selective homing/sequestration of B-cells to the small intestine and spleen. SIV non-specific Ig production was transiently increased before D14p.i., whereas SIV-specific Ig production was only detectable after D14p.i., coinciding with the presence of CD8(+ T-cells and IgG-expressing plasma cells within germinal centres. Transient B-cell apoptosis on D14p.i. and commitment to terminal differentiation contributed to memory B-cell loss. HAART abrogated B-cell apoptosis, homing to the small intestine and SIV-specific Ig production but had minimal effect on early Ig production, increased B-cell proportions in spleen and loss of memory B-cells. Therefore, virus-B-cell interactions and SIV-induced inflammatory cytokines may differently contribute to early B-cell dysfunction and impaired SIV/HIV-specific antibody response. CONCLUSIONS: These data establish tissue-specific impairments in B-cell trafficking and functions and a generalized and steady memory B-cell loss in secondary lymphoid

  10. Akut generaliseret eksantematøs pustulose

    DEFF Research Database (Denmark)

    Comstedt, Lisbeth Rosholm; Gregersen, Janni Hjortlund; Bygum, Anette

    2010-01-01

    Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous drug reaction often caused by beta-lactam antibiotics. The reaction is characterized by sudden occurrence of a generalized exanthema, developing within 1-2 days. Hundreds of sterile pustules arise on an oedematous and erythemat......Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous drug reaction often caused by beta-lactam antibiotics. The reaction is characterized by sudden occurrence of a generalized exanthema, developing within 1-2 days. Hundreds of sterile pustules arise on an oedematous...

  11. Neurohistological Investiations on General Oxygen Deficiency of the Brain - The Morphological Behavior of the Ganglion Cells After Generalized Acute and Subacute Hypoxia

    Science.gov (United States)

    1951-02-01

    factitious- ness, it appears reasonable to apply the term mofpbotropic mortal necrobiosis also to ganglion cell changes after acute death« Consequently... necrobiosis can.b^ applied PROJEGT’ÜÜMBER 21-23-W4* REPORTNÜMjBER 1 in the present connection as well» Whenever a new term is introduced, one has to make...Occasionally, one can observe a mörphötropic necrobiosis of intravital origin within a morpbo- trppic mortal necrobiosis . We examined one case, for

  12. Neurohistological Investigations on General Oxygen Deficiency of the Brain. 2. The Behavior of Astocytes After Acute and Subacute Death

    Science.gov (United States)

    1951-03-01

    clasmatodendrosis might be explained as a con- deprived of the oxygen supply, causing the acute sequence of a necrobiosis caused by the arrest onset...odendrosis is a necrobiosis His opinion brief instant anoxia has not a deadly hut a stimo- rust now be modified to allow for the fact that ulative effect...in a strict sense does not exist. It is actually a necrobiosis of Astrocytes within a tissue infiltrate in a case of an the cells, which is

  13. 腹腔镜在普外急腹症的临床应用%Clinical application of laparoscopy in acute abdomen of general surgery

    Institute of Scientific and Technical Information of China (English)

    丁爱民

    2013-01-01

    Objective To investigate the effect of the laparoscopic technology in the treatment of acute abdomen. Methods 86 acute abdomen patients were diagnosed and treated by the laparoscopic technology.Results 85 patients underwent the laparoscopic surgery successfuly, the success rate was 98.8%, 1 patient was converted to laparotomy, no serious complications occurred.Conclusion There are obviously advantage and effect for the application of the laparoscopic techbology in diagnosis and treatment of acute abdomen in general surgery.%  目的观察普外科急腹症采用腹腔镜手术治疗的效果.方法选择86例急腹症患者采用腹腔镜技术诊断和治疗.结果85例患者在腹腔镜下完成手术,成功率98.8%,1例中转开腹,无严重并发症.结论普外科急腹症采用腹腔镜技术探查、诊断及治疗有优势且效果好.

  14. Reliability and responsiveness of the Dutch version of the Neck Disability Index in patients with acute neck pain in general practice.

    Science.gov (United States)

    Vos, Cees J; Verhagen, Arianne P; Koes, Bart W

    2006-11-01

    A prospective cohort study with a 1 week follow-up. To examine the reliability and responsiveness of the Dutch version of the Neck Disability Index (NDI) in patients with acute neck pain in general practice. An increasing number of studies on treatment options is published in which the NDI is used. Reports of the ability of the NDI to detect change over time, often called responsiveness, however have not yet been published. At baseline 187 patients (119 women, 68 men) were included. They completed a questionnaire on demographic variables, self-reported cause of their complaints and the NDI. After 1 week, 86 patients were sent the NDI again together with the perceived recovery scale which was used as our external criterion. The scale ranged from 1 (complete recovery) to 7 (complaints are worse than ever). Response rate was 93%. Test-retest scores on reliability were good (ICC = 0.90). A Bland and Altman plot and a graph of total sum score differences showed no visible tendency towards unequal spreading of the data. For patients that reported on the perceived recovery scale that they were "stable" we found a responsiveness ratio of 1.82. The standard error of measurement (SEM) was 0.60 what resulted in a minimal detectable change (MDC) of 1.66. The NDI has shown to be a reliable and responsive instrument in patients with acute neck pain in general practice.

  15. 全麻期间并发急性肺水肿(附5例报告)%Acute pulmonary edema during general anesthasia.

    Institute of Scientific and Technical Information of China (English)

    黄冰; 何并文; 赖恩华; 王建荔; 温文钊

    2001-01-01

    目的 探讨全麻期间急性肺水肿的发病、诊断、治疗和预后。方法 临床资料的回顾性分析。结果 全身麻醉期间发生急性肺水肿5例,发病机理可能为心源性肺水肿、负压性肺水肿和通透性肺水肿。预防及处理意见是:①严格控制输血输液量;②有胸水的病人在抽胸水时,首次量应控制在800ml左右;③胸科手术中,特别是双侧开胸手术者,避免单肺通气或对肺组织挤压、牵拉时间过长。结论 急性肺水肿是全身麻醉的严重并发症,须及时诊断和治疗%Objective To study the clinical feature,diagnosis,treatment andprognosis of acute pulmonary edema during general anesthasia.Methods The clinical material are retrospectively analysed.Results 5 cases Acute pulmonary edema are onset during general anesthasia.The provocation must possible was cardiogenic pulmonary edema,negative-pressure pulmonary edema and permeability pulmonary edema.The opinion of prevention and treatment was:①To control both transfusion volume of fluid and blood;②When you drew pleural fluid,for the patients with pleural fluid,the first volume have to control in 800 ml;③In thoracic surgery particular in both chest,you have to avoid one lung ventilation to much time and crushed or drag the lung tissues to much.Conclusion Acute pulmonary edema was the severity complication during general anesthasia.We have to diagnosis and treatment in time.

  16. Acute respiratory symptoms and general illness during the first year of life: a population-based birth cohort study

    DEFF Research Database (Denmark)

    von Linstow, Marie-Louise; Holst, Klaus Kähler; Larsen, Karina

    2008-01-01

    Respiratory symptoms are common in infancy. Most illnesses occurring among children are dealt with by parents and do not require medical attention. Nevertheless, few studies have prospectively and on a community-basis assessed the amount of respiratory symptoms and general illness in normal infants....... In this population-based birth cohort study, 228 healthy infants from Copenhagen, Denmark were followed from birth to 1 year of age during 2004-2006. Symptoms were registered using daily diaries and monthly home visits. Interviews were performed at inclusion and every second month. Risk factor analysis was carried...... out by multiple logistic regression analysis. On average, children had general symptoms for 3.5 months during their first year of life, nasal discharge being most frequent followed by cough. Frequency of all symptoms increased steeply after 6 months of age. Each child had on average 6.3 episodes...

  17. Evaluation of a theory-informed implementation intervention for the management of acute low back pain in general medical practice: the IMPLEMENT cluster randomised trial.

    Directory of Open Access Journals (Sweden)

    Simon D French

    Full Text Available INTRODUCTION: This cluster randomised trial evaluated an intervention to decrease x-ray referrals and increase giving advice to stay active for people with acute low back pain (LBP in general practice. METHODS: General practices were randomised to either access to a guideline for acute LBP (control or facilitated interactive workshops (intervention. We measured behavioural predictors (e.g. knowledge, attitudes and intentions and fear avoidance beliefs. We were unable to recruit sufficient patients to measure our original primary outcomes so we introduced other outcomes measured at the general practitioner (GP level: behavioural simulation (clinical decision about vignettes and rates of x-ray and CT-scan (medical administrative data. All those not involved in the delivery of the intervention were blinded to allocation. RESULTS: 47 practices (53 GPs were randomised to the control and 45 practices (59 GPs to the intervention. The number of GPs available for analysis at 12 months varied by outcome due to missing confounder information; a minimum of 38 GPs were available from the intervention group, and a minimum of 40 GPs from the control group. For the behavioural constructs, although effect estimates were small, the intervention group GPs had greater intention of practising consistent with the guideline for the clinical behaviour of x-ray referral. For behavioural simulation, intervention group GPs were more likely to adhere to guideline recommendations about x-ray (OR 1.76, 95%CI 1.01, 3.05 and more likely to give advice to stay active (OR 4.49, 95%CI 1.90 to 10.60. Imaging referral was not statistically significantly different between groups and the potential importance of effects was unclear; rate ratio 0.87 (95%CI 0.68, 1.10 for x-ray or CT-scan. CONCLUSIONS: The intervention led to small changes in GP intention to practice in a manner that is consistent with an evidence-based guideline, but it did not result in statistically significant

  18. Quetiapine monotherapy in acute treatment of generalized anxiety disorder: a systematic review and meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Maneeton N

    2016-01-01

    Full Text Available Narong Maneeton,1 Benchalak Maneeton,1 Pakapan Woottiluk,2 Surinporn Likhitsathian,1 Sirijit Suttajit,1 Vudhichai Boonyanaruthee,1 Manit Srisurapanont1 1Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Psychiatric Nursing Division, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand Background: Some studies have indicated the efficacy of quetiapine in the treatment of generalized anxiety disorder (GAD.Objective: The purpose of this study was to systematically review the efficacy, acceptability, and tolerability of quetiapine in adult patients with GAD.Methods: The SCOPUS, MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched in April 2015. All randomized controlled trials (RCTs of GAD were considered to be included in this meta-analysis. All RCTs of quetiapine in GAD patients providing endpoint outcomes relevant to severity of anxiety, response rate, remission rate, overall discontinuation rate, or discontinuation rate due to adverse events were included. The version reports from suitable clinical studies were explored, and the important data were extracted. Measurement for efficacy outcomes consisted of the mean-changed scores of the rating scales for anxiety, and response rate.Results: A total of 2,248 randomized participants in three RCTs were included. The pooled mean-changed score of the quetiapine-treated group was greater than that of the placebo-treated group and comparable to selective serotonin reuptake inhibitors (SSRIs. Unfortunately, the response and the remission rates in only 50 and 150 mg/day of quetiapine-XR (extended-release were better than those of the placebo. Their response and remission rates were comparable to SSRIs. The rates of pooled overall discontinuation and discontinuation due to adverse events of quetiapine-XR were greater than placebo. Only the overall discontinuation rate of quetiapine-XR at 50 and

  19. A UK general practice population cohort study investigating the association between lipid lowering drugs and 30-day mortality following medically attended acute respiratory illness.

    Science.gov (United States)

    Joshi, Roshni; Venkatesan, Sudhir; Myles, Puja R

    2016-01-01

    Background. Cholesterol lowering drugs HMG-CoA reductase inhibitors (statins) and PPARα activators (fibrates) have been shown to reduce host inflammation via non-disease specific immunomodulatory mechanisms. Recent studies suggest that commonly prescribed drugs in general practice, statins and fibrates, may be beneficial in influenza-like illness related mortality. This retrospective cohort study examines the association between two lipid lowering drugs, statins and fibrates, and all-cause 30-day mortality following a medically attended acute respiratory illness (MAARI). Methods. Primary care patient data were retrospectively extracted from the UK Clinical Practice Research Datalink (CPRD) database. The sample comprised 201,179 adults aged 30 years or older experiencing a MAARI episode. Patient exposure to statins or fibrates was coded as separate dichotomous variables and deemed current if the most recent GP prescription was issued in the 30 days prior to MAARI diagnosis. Multivariable logistic regression and Cox regression were used for analyses. Adjustment was carried out for chronic lung disease, heart failure, metformin and glitazones, comorbidity burden, socio-demographic and lifestyle variables such as smoking status and body mass index (BMI). Statistical interaction tests were carried out to check for effect modification by gender, body mass index, smoking status and comorbidity. Results. A total of 1,096 (5%) patients died within the 30-day follow up period. Of this group, 213 (19.4%) were statin users and 4 (0.4%) were fibrate users. After adjustment, a significant 35% reduction in odds [adj OR; 0.65 (95% CI [0.52-0.80])] and a 33% reduction in the hazard [adj HR: 0.67 (95% CI [0.55-0.83])] of all-cause 30-day mortality following MAARI was observed in statin users. A significant effect modification by comorbidity burden was observed for the association between statin use and MAARI-related mortality. Fibrate use was associated with a non

  20. Physiotherapy alone or in combination with corticosteroid injection for acute lateral epicondylitis in general practice: A protocol for a randomised, placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Holmedal Øystein

    2009-12-01

    Full Text Available Abstract Background Lateral epicondylitis is a painful condition responsible for loss of function and sick leave for long periods of time. In many countries, the treatment guidelines recommend a wait-and-see policy, reflecting that no conclusions on the best treatment can be drawn from the available research, published studies and meta-analyses. Methods/Design Randomized double blind controlled clinical trial in a primary care setting. While earlier trials have either compared corticosteroid injections to physical therapy or to naproxen orally, we will compare the clinical effect of physiotherapy alone or physiotherapy combined with corticosteroid injection in the initial treatment of acute tennis elbow. Patients seeing their general practitioner with lateral elbow pain of recent onset will be randomised to one of three interventions: 1: physiotherapy, corticosteroid injection and naproxen or 2: physiotherapy, placebo injection and naproxen or 3: wait and see treatment with naproxen alone. Treatment and assessments are done by two different doctors, and the contents of the injection is unknown to both the treating doctor and patient. The primary outcome measure is the patient's evaluation of improvement after 6, 12, 26 and 52 weeks. Secondary outcome measures are pain, function and severity of main complaint, pain-free grip strength, maximal grip strength, pressure-pain threshold, the patient's satisfaction with the treatment and duration of sick leave. Conclusion This article describes a randomized, double blind, controlled clinical trial with a one year follow up to investigate the effects of adding steroid injections to physiotherapy in acute lateral epicondylitis. Trial Registration ClinicalTrials.gov Identifier: NCT00826462

  1. Corticosteroids for acute rhinosinusitis

    NARCIS (Netherlands)

    Venekamp, R.P.

    2012-01-01

    Acute rhinosinusitis is a common reason for consultations in general practice, with typically 50 cases seen by a general practitioner annually. Traditionally, acute rhinosinusitis has been regarded as a bacterial infection of the paranasal sinuses. Therefore, numerous randomised controlled trials ha

  2. Toxic epidermal necrolysis, DRESS, AGEP : Do overlap cases exist?

    NARCIS (Netherlands)

    Bouvresse, Sophie; Valeyrie-Allanore, Laurence; Ortonne, Nicolas; Konstantinou, Marie Pauline; Kardaun, Sylvia H.; Bagot, Martine; Wolkenstein, Pierre; Roujeau, Jean-Claude

    2012-01-01

    Background: Severe cutaneous adverse reactions to drugs (SCARs) include acute generalized exanthematous pustulosis (AGEP), drug reaction with eosinophilia and systemic symptoms (DRESS) and epidermal necrolysis (Stevens-Johnson syndrome-toxic epidermal necrolysis [SJS-TEN]). Because of the varied ini

  3. Post-infective transverse myelitis following Streptococcus pneumoniae meningitis with radiological features of acute disseminated encephalomyelitis: a case report

    Directory of Open Access Journals (Sweden)

    Williams Thomas

    2012-09-01

    Full Text Available Abstract Introduction Post-infectious autoimmune demyelination of the central nervous system is a rare neurological disorder typically associated with exanthematous viral infections. We report an unusual presentation of the condition and a previously undocumented association with Streptococcus pneumonia meningitis. Case presentation A 50-year-old Caucasian woman presented to our facility with an acute myelopathy three days after discharge following acute Streptococcus pneumoniae meningitis. Imaging studies of the spine ruled out an infective focus and no other lesions were seen within the cord. Diffuse, bilateral white matter lesions were seen within the cerebral hemispheres, and our patient was diagnosed as having a post-infective demyelination syndrome that met the diagnostic criteria for an acute transverse myelitis. Our patient clinically and radiologically improved following treatment with steroids. Conclusions The novel association of a Streptococcus pneumoniae infection with post-infectious autoimmune central nervous system demyelination should alert the reader to the potentially causative role of this common organism, and gives insights into the pathogenesis. The unusual dissociation between the clinical presentation and the location of the radiological lesions should also highlight the potential for the condition to mimic the presentation of others, and stimulates debate on the definitions of acute transverse myelitis and acute disseminated encephalomyelitis, and their potential overlap.

  4. Accuracy of Neutrophil Gelatinase-Associated Lipocalin in Detecting Acute Kidney Injury after Urogenital Robotic Assisted Laparoscopic Surgery under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Orsolya MIHÁLY

    2012-06-01

    Full Text Available The aim of this study was to demonstrate the accuracy of NGAL in detecting acute kidney injury (AKI after urogenital robotic surgery in general anesthesia. Methods: A prospective longitudinal observational study, which included patients scheduled for elective robotic surgery under general anesthesia. The serum and urine NGAL at induction, 6 hours and 12 hours were determined. Serum creatinine was measured preoperatively and daily 4 days postoperatively. AKI was defined as the absolute growth of serum creatinine by 0.3 mg/dl over baseline within 48 hours postoperatively. Results: 24 patients were enrolled in the study. AKI occurred in 38% of patients. Serum NGAL increased significantly at 6 hours and 12h, compared to baseline, with a higher increase in the group of patents without AKI. There were no significant results for urine NGAL. A link was observed between the values of serum NGAL, with associated significance p<0.0001. The correlations between urine NGAL were not significant. The predictive value of NGAL, analyzed by cross-tabulation, OR was 3 for baseline value and 5.33 for the values measured at 6 hours and 12 hours, but with no statistical significance. Conclusions: The modifications of the NGAL levels, measured at 6 hours and 12 hours from the induction of anesthesia, were significant with more importance at 6 hours and in patients without AKI. Serum NGAL had no predictive value for AKI, but the risk to develop AKI was 3 times higher for baseline determination and 5 times at 6 and 12 hours.

  5. Introduction of a Microsoft Excel-based unified electronic weekend handover document in Acute and General Medicine in a DGH: aims, outcomes and challenges.

    Science.gov (United States)

    Kostelec, Pablo; Emanuele Garbelli, Pietro; Emanuele Garbelli, Pietro

    2017-01-01

    On-call weekends in medicine can be a busy and stressful time for junior doctors, as they are responsible for a larger pool of patients, most of whom they would have never met. Clinical handover to the weekend team is extremely important and any communication errors may have a profound impact on patient care, potentially even resulting in avoidable harm or death. Several senior clinical bodies have issued guidelines on best practice in written and verbal handover. These include: standardisation, use of pro forma documents prompting doctors to document vital information (such as ceiling of care/resuscitation status) and prioritisation according to clinical urgency. These guidelines were not consistently followed in our hospital site at the onset of 2014 and junior doctors were becoming increasingly dissatisfied with the handover processes. An initial audit of handover documents used across the medical division on two separate weekends in January 2014, revealed high variability in compliance with documentation of key information. For example, ceiling of care was documented for only 14-42% of patients and resuscitation status in 26-72% of patients respectively. Additionally, each ward used their own self-designed pro forma and patients were not prioritised by clinical urgency. Within six months from the introduction of a standardised, hospital-wide weekend handover pro forma across the medical division and following initial improvements to its layout, ceiling of therapy and resuscitation status were documented in approximately 80% of patients (with some minor variability). Moreover, 100% of patients in acute medicine and 75% of those in general medicine were prioritised by clinical urgency and all wards used the same handover pro forma.

  6. The General Public’s Awareness of Early Symptoms of and Emergency Responses to Acute Myocardial Infarction and Related Factors in South Korea: A National Public Telephone Survey

    Directory of Open Access Journals (Sweden)

    Hee-Sook Kim

    2016-05-01

    Full Text Available Background: Prompt treatment affects prognosis and survival after acute myocardial infarction (AMI onset. This study evaluated the awareness of early symptoms of AMI and knowledge of appropriate responses on symptom occurrence, along with related factors. Methods: Participants’ knowledge of the early symptoms of and responses to AMI onset were investigated using a random digit dialing survey. We included 9600 residents of 16 metropolitan cities and provinces in Korea. Results: The proportions of respondents who were aware of early symptoms of AMI ranged from 32.9% (arm or shoulder pain to 79.1% (chest pain and discomfort. Of the respondents, 67.0% would call an ambulance if someone showed signs of AMI, 88.7% knew ≥1 symptom, 10.9% knew all five symptoms, and 3.1% had excellent knowledge (correct identification of all five AMI symptoms, not answering “Yes” to the trap question, and correctly identifying calling an ambulance as the appropriate response when someone is exhibiting AMI symptoms. The odds ratio (OR for having excellent knowledge was significantly higher for those who graduated college or higher (OR 3.42; 95% confidence interval [CI], 1.09–10.76 than for those with less than a primary school education, as well as for subjects with AMI advertisement exposure (OR 1.49; 95% CI, 1.10–2.02 and with knowledge of AMI (OR 1.63; 95% CI, 1.16–2.27. The 60- to 79-year-old group had significantly lower OR for excellent knowledge than the 20- to 39-year-old group (OR 0.53; 95% CI, 0.28–0.99. Conclusions: Awareness of AMI symptoms and the appropriate action to take after symptom onset in South Korea was poor. Therefore, educational and promotional strategies to increase the overall awareness in the general public, especially in the elderly and those with low education levels, are needed.

  7. Efficacy of paracetamol, diclofenac and advice for acute low back pain in general practice: design of a randomized controlled trial (PACE Plus)

    NARCIS (Netherlands)

    M. Schreijenberg; P.A.J. Luijsterburg (Pim); Y. van Trier (Yvonne); D. Rizopoulos (Dimitris); M.A. Koopmanschap (Marc); L. Voogt; C. Maher (Chris); B.W. Koes (Bart)

    2017-01-01

    textabstractBackground: Low back pain is common and associated with a considerable burden to patients and society. There is uncertainty regarding the relative benefit of paracetamol and diclofenac and regarding the additional effect of pain medication compared with advice only in patients with acute

  8. Acute pancreatitis

    Science.gov (United States)

    ... its blood vessels. This problem is called acute pancreatitis. Acute pancreatitis affects men more often than women. Certain ... pancreatitis; Pancreas - inflammation Images Digestive system Endocrine glands Pancreatitis, acute - CT scan Pancreatitis - series References Forsmark CE. Pancreatitis. ...

  9. Cystitis - acute

    Science.gov (United States)

    Uncomplicated urinary tract infection; UTI - acute cystitis; Acute bladder infection; Acute bacterial cystitis ... cause. Menopause also increases the risk for a urinary tract infection. The following also increase your chances of having ...

  10. Acute Bronchitis

    Science.gov (United States)

    ... Smoking also slows down the healing process. Acute bronchitis treatment Most cases of acute bronchitis can be treated at home.Drink fluids, but ... bronchial tree. Your doctor will decide if this treatment is right for you. Living with acute bronchitis Most cases of acute bronchitis go away on ...

  11. Acute local radiation injuries

    Energy Technology Data Exchange (ETDEWEB)

    Gongora, R. (Institut Curie, 75 - Paris (France)); Jammet, H. (Commissariat a l' Energie Atomique, ISPN, 92 - Fontenay-aux-Roses (France))

    1983-01-01

    Local acute radiation injuries do not occur very often. Their origin is generally accidental. They show specific anatomo-clinical features. The clinical evolution and therapeutic behaviour are dependent on the dose level and topographical distribution. The dosimetric assessment requires physical methods and paraclinical investigations. From a study of 60 cases followed by the International Center of Radiopathology, the clinical symptomatology is described and the problems raised to the radiopathologist physician by local acute radiation injuries are stated.

  12. Treatment Option Overview (Adult Acute Myeloid Leukemia)

    Science.gov (United States)

    ... Childhood AML Treatment Research Adult Acute Myeloid Leukemia Treatment (PDQ®)–Patient Version General Information About Adult Acute ... bleeding and forming blood clots. Smoking, previous chemotherapy treatment, and exposure to radiation may affect the risk ...

  13. Treatment Options for Childhood Acute Lymphoblastic Leukemia

    Science.gov (United States)

    ... Childhood AML Treatment Research Childhood Acute Lymphoblastic Leukemia Treatment (PDQ®)–Patient Version General Information About Childhood Acute ... Myelogenous Leukemia Treatment Hairy Cell Leukemia Treatment Past treatment for cancer and certain genetic conditions affect the ...

  14. According to MIAMI and ISIS-I trials, can a general recommendation be given for beta blockers in acute myocardial infarction?

    Science.gov (United States)

    Kjekshus, J K

    1988-05-01

    The goal of early intervention of acute coronary occlusion by beta blockers is to reduce ultimate infarct size and to consequently reduce morbidity and mortality. Until 1986 small early intervention trials suggested that infarct size may be reduced by 25% if treatment was started within 6 to 10 hours after the onset of symptoms. At this time, an average of 80% of the infarct is fully developed. On the basis of previous trials, the reduction of infarct size has been associated with improvement of symptoms, prevention of infarct development, reduced occurrence of arrhythmias and reinfarctions, and earlier discharge from the hospital. Although the trials suggested some benefit in mortality, this issue has not been solved. The MIAMI trial randomized 5778 patients to blind treatment with metoprolol or placebo. ISIS-I randomized 16,027 patients to atenolol with an open label. No titration of the effect on lowering myocardial oxygen requirement was attempted. Both studies included less than 25% of all eligible patients. Exclusions were chiefly due to current beta blocker or calcium blocker treatment. Thus, the results obtained concern only a selected group of patients. In MIAMI only 15% received treatment within 6 hours, while in ISIS 38% were treated within 4 hours. It is therefore likely that in most patients the infarcts were completed before intervention was started. Thus, the two trials did not differentiate between primary and secondary effects on the acute myocardial infarct. Mortality was reduced by 13% (NS) and 15% (p less than 0.04), respectively, in MIAMI and ISIS.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Bo-Guang Fan

    2010-01-01

    Full Text Available Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions : Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  16. Acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Bo-Guang Fan

    2010-05-01

    Full Text Available Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions: Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  17. Acute cholecystitis

    OpenAIRE

    Halpin, Valerie

    2014-01-01

    Acute cholecystitis causes unremitting right upper quadrant pain, anorexia, nausea, vomiting, and fever, and if untreated can lead to perforations, abscess formation, or fistulae. About 95% of people with acute cholecystitis have gallstones.It is thought that blockage of the cystic duct by a gallstone or local inflammation can lead to acute cholecystitis, but we don't know whether bacterial infection is also necessary.

  18. Executive summary of the report by the WPA section on pharmacopsychiatry on general and comparative efficacy and effectiveness of antidepressants in the acute treatment of depressive disorders.

    Science.gov (United States)

    Baghai, Thomas C; Blier, Pierre; Baldwin, David S; Bauer, Michael; Goodwin, Guy M; Fountoulakis, Kostas N; Kasper, Siegfried; Leonard, Brian E; Malt, Ulrik F; Stein, Dan J; Versiani, Marcio; Möller, Hans-Jürgen

    2012-02-01

    Current gold standard in the treatment of depression includes pharmacotherapeutic and psychotherapeutic strategies together with social support. Due to the actually discussed controversies concerning the differential efficacy of antidepressants, a contribution to a comprehensive clarification seems to be necessary to avert further deterioration and uncertainty from patients, relatives, and their treating psychiatrists and general practitioners. Both efficacy and clinical effectiveness of antidepressants in the treatment of depressive disorders can be confirmed. Clinically meaningful antidepressant treatment effects were confirmed in different types of studies. Methodological issues of randomized controlled studies, meta-analyses, and effectiveness studies will be discussed. Furthermore, actual data about the differential efficacy and effectiveness of antidepressants with distinct pharmacodynamic properties and about outcome differences in studies using antidepressants and/or psychotherapy are discussed. This is followed by a clinically oriented depiction-the differential clinical effectiveness of different pharmacodynamic modes of action of antidepressants in different subtypes of depressive disorders. It can be summarized that the spectrum of different antidepressant treatments has broadened during the last decades. The efficacy and clinical effectiveness of antidepressants is statistically significant and clinically relevant and proven repeatedly. For further optimizing antidepressant treatment plans, clearly structured treatment algorithms and the implementation of psychotherapy seem to be useful. A modern individualized antidepressant treatment in most cases is a well-tolerated and efficacious tool to minimize the negative impact of the otherwise devastating and life-threatening outcome of depressive disorders.

  19. 某综合医院SARS暴发与控制%The emergence and containment of severe acute respiratory syndrome spreaded in a general hospital

    Institute of Scientific and Technical Information of China (English)

    WANG Shi-xin; TIAN Wen-feng; JIA Gang; LI Yu-ming; CHANG Ai-hua; GAO Xiu-xia; WEI Mao-ti; YANG Zhen; ZHANG Jian-peng; ZHANG Zhi-lun; SHEN Peng

    2003-01-01

    Objective:To investigate the SARS epidemic and the control effectiveness in a general hospital. Methods:Clinical and suspected cases of SARS were queried in the hospital, the emerging of the disease was described and the effectiveness of control measures were analyzed according to the rules and protective materials used during the epidemic. Results:The outbreak started with a patient from Beijing on 15 April. The disease spread quickly among the healthcare workers and the cohabit patients in the hospital which the first cases were admitted. By 17 May, 112 probable (clinical cases) and suspected cases had been reported with 14 deaths. 89 cases in the hospital were surely sourced from the index SARS patient whose admission for the sake of coronary heart disease caused the SARS outbreak. With the stringent control measures and the endeavors of the hospital staff, the epidemic was controlled successfully in a short period. From May 17 to now, no new cases occurred. Conclusion:Though with high infectivity, SARS can also be controlled with proper strategy and methods.

  20. ICAM-1 and Acute Pancreatitis Complicated by Acute Lung Injury

    Directory of Open Access Journals (Sweden)

    XiPing Zhang

    2009-01-01

    Full Text Available One of the most common complications of acute pancreatitis is acute lung injury, during which intercellular adhesion molecule-1 (ICAM-1 plays an important role by participating in leukocyte adhesion and activation as well as by inducing the “cascade effect” of inflammatory mediators, pulmonary microcirculation dysfunction and even acute respiratory distress syndrome, multiple organ failure or death. Although it is generally believed that the modulatory mechanism of ICAM-1 during this process is associated with the activation of nuclear transcription factor kappa B which is mediated by IL-1, IL-6, IL-18 and oxygen free radical, etc., further studies are still required to clarify it. Since the upregulation of ICAM-1 expression in the lung during acute lung injury is one of main pathogeneses, the early detection of the ICAM-1 expression level may contribute to the prevention and treatment of acute lung injury. Moreover, reducing pulmonary ICAM-1 expression levels through treatment with anti-ICAM-1 monoclonal antibody (aICAM-1 and antagonists of the neurokinin 1 receptor, etc., should have a positive effect on protecting the lungs during acute pancreatitis. This review aims to further clarify the relationship between ICAM-1 and acute pancreatitis complicated by acute lung injury, and therefore provides a theoretical basis for the formulation of corresponding therapeutic measures in clinical practice for acute pancreatitis.

  1. Acute Kidney Failure

    Science.gov (United States)

    ... out of balance. Acute kidney failure — also called acute renal failure or acute kidney injury — develops rapidly over ... 2015. Palevsky PM. Definition of acute kidney injury (acute renal failure). http://www.uptodate.com/home. Accessed April ...

  2. Acute Pancreatitis and Pregnancy

    Science.gov (United States)

    ... Pancreatitis Acute Pancreatitis and Pregnancy Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is defined as ... pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for almost 1 ...

  3. Acute pancreatitis in children

    Directory of Open Access Journals (Sweden)

    Jokić Radoica

    2012-01-01

    Full Text Available Introduction. Acute pancreatitis in children is mostly due to abdominal trauma, diseases or congenital anomalies of the biliary-pancreatic tree. Both exogenous and endogenous functions of the gland could be disturbed by various levels of damage. Clinical Finding and Diagnostics. Acute abdominal pain, gastrointestinal signs and general deterioration are the main clinical findings. The examination can be completed by blood and urine tests of amylase, electrolytes level, and the C-reactive protein. In addition to these tests, ultrasound, computed tomography and endoscopy are required as well. Therapeutic Methods. The therapy of choice is non-operative treatment using medicaments to control the pain, decrease the pancreatic activity and prevent further complications. If the conservative treatment fails, the surgical approach is necessary: drainage, resections, by-pass procedures, etc. Conclusion. Acute pancreatitis is a very serious disease in childhood. Clinical experience and rational approach are very important in the diagnostic and therapeutic methods.

  4. Evaluation of a Medical and Mental Health Unit compared with standard care for older people whose emergency admission to an acute general hospital is complicated by concurrent 'confusion': a controlled clinical trial. Acronym: TEAM: Trial of an Elderly Acute care Medical and mental health unit

    Directory of Open Access Journals (Sweden)

    Gladman John RF

    2011-05-01

    Full Text Available Abstract Background Patients with delirium and dementia admitted to general hospitals have poor outcomes, and their carers report poor experiences. We developed an acute geriatric medical ward into a specialist Medical and Mental Health Unit over an eighteen month period. Additional specialist mental health staff were employed, other staff were trained in the 'person-centred' dementia care approach, a programme of meaningful activity was devised, the environment adapted to the needs of people with cognitive impairment, and attention given to communication with family carers. We hypothesise that patients managed on this ward will have better outcomes than those receiving standard care, and that such care will be cost-effective. Methods/design We will perform a controlled clinical trial comparing in-patient management on a specialist Medical and Mental Health Unit with standard care. Study participants are patients over the age of 65, admitted as an emergency to a single general hospital, and identified on the Acute Medical Admissions Unit as being 'confused'. Sample size is 300 per group. The evaluation design has been adapted to accommodate pressures on bed management and patient flows. If beds are available on the specialist Unit, the clinical service allocates patients at random between the Unit and standard care on general or geriatric medical wards. Once admitted, randomised patients and their carers are invited to take part in a follow up study, and baseline data are collected. Quality of care and patient experience are assessed in a non-participant observer study. Outcomes are ascertained at a follow up home visit 90 days after randomisation, by a researcher blind to allocation. The primary outcome is days spent at home (for those admitted from home, or days spent in the same care home (if admitted from a care home. Secondary outcomes include mortality, institutionalisation, resource use, and scaled outcome measures, including quality of

  5. CLINICAL STUDY OF ACUTE POISONING

    Directory of Open Access Journals (Sweden)

    Panduranga

    2014-09-01

    Full Text Available BACKGROUND AND OBJECTIVE: Acute poisoning is an important medical emergency. Studies of this nature will be useful tool in planning, early diagnosis and management of acute poisoning cases. The objective of the study are to study the clinical features, diagnosis and management, morbidity and mortality of various acute poisoning. METHODOLOGY: This study comprises of 350 patients of acute poisoning admitted to Chigateri General Hospital and Bapuji Hospital attached to J. J. M. Medical College, Davangere, between 1st March 2011 to 31st October 2011. REUSLTS: Out of 350 cases of acute poisoning studied, there were 268 males and 82 females. Males comprised 76.57%and females 23.42% of the total, in this series, Organophosphorous compounds were the commonest (30%, majority of the patients hailed from rural area 70%. Mortality is 10.57%.

  6. Distribution of pathogens causing postoperative infections in acute intracerebral hemorrhage patients undergoing general anesthesia%急性脑出血全麻患者术后感染病原菌分析

    Institute of Scientific and Technical Information of China (English)

    陈洁; 王光磊; 王云; 张智卿; 白延仓

    2016-01-01

    OBJECTIVE To analyze the pathogen distribution and its effect on recognition function in acute intrace‐rebral hemorrhage patients with general anesthesia ,so as to provide reference for clinical treatment .METHODS A total of 170 cases of patients got infections after general anesthesia operation for the acute intracerebral hemorrhage in our hospital from Sep .2012 to Sep .2014 were enrolled as infected group .Another 170 cases of healthy subjects at the same period in our hospital were taken as control group .And another 170 cases of uninfected patients after general anesthesia operation for acute intracerebral hemorrhage were taken as uninfected group .The changes of recognition function , serum fibroblast growth factor and inflammatory factors were compared in these three groups .RESULTS A total of 170 strains of pathogens were isolated from the 170 cases of patients ,including 77 (45 .3% ) strains of gram‐positive bacteria ,mainly Staphylococcus aureus 18 (10 .6% ) strains , Staphylococcus saprophyticus 12(7 .1% ) strains ,and Enterococcus f aecalis 11(6 .5% ) strains .There were 93 (54 .7% ) strains of gram‐negative bacteria ,including Pseudomonas aeruginosa 18 (10 .6% ) strains , Enterobacter aerogenes 17 (10 .0% ) strains ,and Neisseria meningitides 16(9 .4% ) strains .The MMSE scores of infected patients were de‐creased obviously ,and catalase and superoxide dismutase in serum were lower than control group and uninfected group obviously ,but MDA ,IL2 ,IL10 and TNF‐α were increased significantly compared with control and unin‐fected groups (P<0 .05) .CONCLUSION There is big chance for acute intracerebral hemorrhage patients got infec‐ted ,and which could influence the cognition function of patients .%目的:研究急性脑出血全麻患者术后感染病原菌分布及对患者认知功能的影响,为临床治疗提供参考。方法选取医院2012年9月-2014年9月诊治的170例急性脑出血全麻术后感

  7. General Information about Childhood Acute Lymphoblastic Leukemia

    Science.gov (United States)

    ... available from the NCI website . Chimeric antigen receptor (CAR) T-cell therapy CAR T-cell therapy is ... of Health FOLLOW US Facebook Twitter Instagram YouTube Google+ LinkedIn GovDelivery RSS CONTACT INFORMATION Contact Us LiveHelp ...

  8. General Information about Adult Acute Lymphoblastic Leukemia

    Science.gov (United States)

    ... and given back to the patient through an infusion . These reinfused stem cells grow into (and restore) ... will also have combination chemotherapy. Supportive care including antibiotics and red blood cell and platelet transfusions . CNS ...

  9. Analysis of peripheral blood parameter in children patients with acute generalized pustular psoriasis%儿童急性泛发性脓疱型银屑病外周血参数分析

    Institute of Scientific and Technical Information of China (English)

    王艺蓉; 程茹虹; 李明; 姚志荣

    2015-01-01

    Objective:To determine the changes of the levels of peripheral blood platelet parameters, Cre-active protein (CRP) and eosnophils (EOS) in children with acute generalized pustular psoriasis (AGPP). Methods:The levels of peripheral blood platelet parameters, CRP and EOS in 41 children with AGPP, 37 healthy children and 31 children with psoriasis vulgaris were detected. Results: The levels of PLT count, platelet hematocrit ( PCT) and CRP in the active stage of AGPP group were higher than those in the other two groups ( P0.05). The levels of PLT count, PCT and CRP in the recovery stage of AGPP were lower than those in active stage. Conclusion:Platelet parameters and CRP level could be as assistant indicators in monitoring the progression of children with AGPP.%目的::明确儿童急性泛发型脓疱性银屑病(AGPP)血小板参数、C反应蛋白(CRP)及嗜酸粒细胞水平变化。方法:检测41例儿童AGPP患者、37例健康儿童对照及31例儿童寻常型银屑病患者( PV)血小板参数、CRP及嗜酸粒细胞水平。结果: AGPP进展期PLT计数、血小板压积( PCT), CRP均显著高于儿童PV患者及儿童正常对照组( P0.05)。消退期AGPP患者PLT计数、PCT及CRP显著低于进展期AGPP患者( P<0.05)。结论:血小板参数及CRP水平可作为AGPP病程进展及治疗评价的参考指标。

  10. Acute abdomen

    Directory of Open Access Journals (Sweden)

    Wig J

    1978-01-01

    Full Text Available 550 cases of acute abdomen have been analysed in detail includ-ing their clinical presentation and operative findings. Males are more frequently affected than females in a ratio of 3: 1. More than 45% of patients presented after 48 hours of onset of symptoms. Intestinal obstruction was the commonest cause of acute abdomen (47.6%. External hernia was responsible for 26% of cases of intestinal obstruction. Perforated peptic ulcer was the commonest cause of peritonitis in the present series (31.7% while incidence of biliary peritonitis was only 2.4%.. The clinical accuracy rate was 87%. The mortality in operated cases was high (10% while the over-all mortality rate was 7.5%.

  11. Acute Pancreatitis Concomitant Acute Coronary Syndrome

    Directory of Open Access Journals (Sweden)

    Okay Abacı

    2013-03-01

    Full Text Available Acute pancreatitis is an inflammatory syndrome with unpredictable progression to systemic inflammation and multi-organ dysfunction. As in our case rarely, acute pancreatitis can be presented with the coexistance of acute coronary syndrome. To prevent a misdiagnosis of acute situation presented with chest or abdominal pain, physicians must be aware for coexisting pathophysiologies and take into account the differential diagnosis of all life-threatening causes such as cardiac ischemia or acute abdominal situations.

  12. Acute cervicitis and vulvovaginitis may be associated with Cytomegalovirus

    OpenAIRE

    Abou, Magali; Dällenbach, Patrick

    2013-01-01

    Cytomegalovirus (CMV) infection in immunocompetent hosts is generally asymptomatic or may present as a mononucleosic syndrome. Its association with acute cervicitis and vulvovaginitis has rarely been reported.

  13. [Acute heart failure: acute cardiogenic pulmonary edema and cardiogenic shock].

    Science.gov (United States)

    Sánchez Marteles, Marta; Urrutia, Agustín

    2014-03-01

    Acute cardiogenic pulmonary edema and cardiogenic shock are two of the main forms of presentation of acute heart failure. Both entities are serious, with high mortality, and require early diagnosis and prompt and aggressive management. Acute pulmonary edema is due to the passage of fluid through the alveolarcapillary membrane and is usually the result of an acute cardiac episode. Correct evaluation and clinical identification of the process is essential in the management of acute pulmonary edema. The initial aim of treatment is to ensure hemodynamic stability and to correct hypoxemia. Other measures that can be used are vasodilators such as nitroglycerin, loop diuretics and, in specific instances, opioids. Cardiogenic shock is characterized by sustained hypoperfusion, pulmonary wedge pressure > 18 mmHg and a cardiac index 30 mmHg) and absent or reduced diuresis (< 0.5 ml/kg/h). The most common cause is left ventricular failure due to acute myocardial infarction. Treatment consists of general measures to reverse acidosis and hypoxemia, as well as the use of vasopressors and inotropic drugs. Early coronary revascularization has been demonstrated to improve survival in shock associated with ischaemic heart disease.

  14. [Perioperative acute kidney injury and failure].

    Science.gov (United States)

    Chhor, Vibol; Journois, Didier

    2014-04-01

    Perioperative period is very likely to lead to acute renal failure because of anesthesia (general or perimedullary) and/or surgery which can cause acute kidney injury. Characterization of acute renal failure is based on serum creatinine level which is imprecise during and following surgery. Studies are based on various definitions of acute renal failure with different thresholds which skewed their comparisons. The RIFLE classification (risk, injury, failure, loss, end stage kidney disease) allows clinicians to distinguish in a similar manner between different stages of acute kidney injury rather than using a unique definition of acute renal failure. Acute renal failure during the perioperative period can mainly be explained by iatrogenic, hemodynamic or surgical causes and can result in an increased morbi-mortality. Prevention of this complication requires hemodynamic optimization (venous return, cardiac output, vascular resistance), discontinuation of nephrotoxic drugs but also knowledge of the different steps of the surgery to avoid further degradation of renal perfusion. Diuretics do not prevent acute renal failure and may even push it forward especially during the perioperative period when venous retourn is already reduced. Edema or weight gain following surgery are not correlated with the vascular compartment volume, much less with renal perfusion. Treatment of perioperative acute renal failure is similar to other acute renal failure. Renal replacement therapy must be mastered to prevent any additional risk of hemodynamic instability or hydro-electrolytic imbalance.

  15. Acute arterial occlusion - kidney

    Science.gov (United States)

    Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... kidney can often result in permanent kidney failure. Acute arterial occlusion of the renal artery can occur after injury or trauma to ...

  16. Acute cerebellar ataxia

    Science.gov (United States)

    Cerebellar ataxia; Ataxia - acute cerebellar; Cerebellitis; Post-varicella acute cerebellar ataxia; PVACA ... Acute cerebellar ataxia in children, especially younger than age 3, may occur several weeks after an illness caused by a virus. ...

  17. Acute Appendicitis

    DEFF Research Database (Denmark)

    Tind, Sofie; Qvist, Niels

    2017-01-01

    BACKGROUND: The classification of acute appendicitis (AA) into various grades is not consistent, partly because it is not clear whether the perioperative or the histological findings should be the foundation of the classification. When comparing results from the literature on the frequency...... patients were included. In 116 (89 %) of these cases, appendicitis was confirmed histological. There was low concordance between the perioperative and histological diagnoses, varying from 16 to 76 % depending on grade of AA. Only 44 % of the patients receiving antibiotics postoperatively had a positive...... peritoneal fluid cultivation. CONCLUSION: There was a low concordance in clinical and histopathological diagnoses of the different grades of appendicitis. Perioperative cultivation of the peritoneal fluid as a standard should be further examined. The potential could be a reduced postoperative antibiotic use...

  18. Imaging of acute pancreatitis and its complications. Part 1: acute pancreatitis.

    Science.gov (United States)

    Türkvatan, A; Erden, A; Türkoğlu, M A; Seçil, M; Yener, Ö

    2015-02-01

    Acute pancreatitis is an acute inflammatory disease of the pancreas that may also involve surrounding tissues or remote organs. The Atlanta classification of acute pancreatitis was introduced in 1992 and divides patients into mild and severe groups based on clinical and biochemical criteria. Recently, the terminology and classification scheme proposed at the initial Atlanta Symposium have been reviewed and a new consensus statement has been proposed by the Acute Pancreatitis Classification Working Group. Generally, imaging is recommended to confirm the clinical diagnosis, investigate the etiology, and grade the extend and severity of the acute pancreatitis. Ultrasound is the first-line imaging modality in most centers for the confirmation of the diagnosis of acute pancreatitis and the ruling out of other causes of acute abdomen, but it has limitations in the acute clinical setting. Computed tomography not only establishes the diagnosis of acute pancreatitis, but also enables to stage severity of the disease. Magnetic resonance imaging has earned an ever more important role in the diagnosis of acute pancreatitis. It is especially useful for imaging of patients with iodine allergies, characterizing collections and assessment of an abnormal or disconnected pancreatic duct. The purpose of this review article is to present an overview of the acute pancreatitis, clarify confusing terminology, underline the role of ultrasound, computed tomography and magnetic resonance imaging according to the proper clinical context and compare the advantages and limitations of each modality.

  19. GENERAL ASPECTS

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    960566 Acute nectrotic fasciitis in infancy.Zhang Shaojin (张绍锦), et al.Dept Surg,Qinghai Child Hosp, Xining 810007.Chin JPediatr Surg 1996; 17(4): 237-239 Thirty infants of acute necrotic fascitis wereadmitted. Three cases had a history of intra-muscular injection. The situs of 26 cases werein lumbodorsal and buttocks. The offending or-ganism was a mixed infection of staphylococ-cus aureus, streptococcus, colibacillus or an-acrobic bacillus (bactericides fragile). Thetreatment included early multiple incision and

  20. Acute Myopericarditis Mimicking Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Seval İzdeş

    2011-08-01

    Full Text Available Acute coronary syndromes among young adults are relatively low when compared with older population in the intensive care unit. Electrocardiographic abnormalities mimicking acute coronary syndromes may be caused by non-coronary syndromes and the differential diagnosis requires a detailed evaluation. We are reporting a case of myopericarditis presenting with acute ST elevation and elevated cardiac enzymes simulating acute coronary syndrome. In this case report, the literature is reviewed to discuss the approach to distinguish an acute coronary syndrome from myopericarditis. (Journal of the Turkish Society Intensive Care 2011; 9:68-70

  1. Management of rhinosinusitis in Dutch general practice

    NARCIS (Netherlands)

    Hoffmans, R.; Schermer, T.R.J.; Weel, C. van; Fokkens, W.

    2011-01-01

    AIMS: To determine whether general practitioners (GPs) distinguish between the management of acute rhinosinusitis (ARS) and chronic rhinosinusitis (CRS), especially with regard to prescription of antibiotics and nasal steroids. METHODS: A questionnaire on the management of rhinosinusitis was sent to

  2. Acute otitis externa.

    Science.gov (United States)

    Hui, Charles Ps

    2013-02-01

    Acute otitis externa, also known as 'swimmer's ear', is a common disease of children, adolescents and adults. While chronic suppurative otitis media or acute otitis media with tympanostomy tubes or a perforation can cause acute otitis externa, both the infecting organisms and management protocol are different. This practice point focuses solely on managing acute otitis externa, without acute otitis media, tympanostomy tubes or a perforation being present.

  3. Acute otitis externa

    OpenAIRE

    2013-01-01

    Acute otitis externa, also known as ‘swimmer’s ear’, is a common disease of children, adolescents and adults. While chronic suppurative otitis media or acute otitis media with tympanostomy tubes or a perforation can cause acute otitis externa, both the infecting organisms and management protocol are different. This practice point focuses solely on managing acute otitis externa, without acute otitis media, tympanostomy tubes or a perforation being present.

  4. Acute tubulo-interstitial nephritis leading to acute renal failure following multiple hornet stings

    Directory of Open Access Journals (Sweden)

    Bambery Pradeep

    2006-11-01

    Full Text Available Abstract Background Hornet stings are generally associated with local and occasionally anaphylactic reactions. Rarely systemic complications like acute renal failure can occur following multiple stings. Renal failure is usually due to development of acute tubular necrosis as a result of intravascular haemolysis, rhabdomyolysis or shock. Rarely it can be following development of acute tubulo-interstitial nephritis. Case presentation We describe a young male, who was stung on face, head, shoulders and upper limbs by multiple hornets (Vespa orientalis. He developed acute renal failure as a result of acute tubulo-interstitial nephritis and responded to steroids. Conclusion Rare causes of acute renal failure like tubulo-interstitial nephritis should be considered in a patient with persistent oliguria and azotemia following multiple hornet stings. Renal biopsy should be undertaken early, as institution of steroid therapy may help in recovery of renal function

  5. [Acute coronary syndrome -- 2012].

    Science.gov (United States)

    Becker, Dávid; Merkely, Béla

    2012-12-23

    The acute coronary syndrome is the most severe form of coronary artery disease. It is an immediate threat of life and the mortality rate can be high without proper therapy and patient management. Based on the first ECG, two different forms can be distinguished: acute coronary syndrome with and without ST elevation. Besides adequate medication, management of these patients is an essential part of treatment. In case of ST elevation, coronarography and percutaneous coronary intervention is needed in general, within 24 hours from the onset of symptoms. When ST elevation is not detected on the ECG, individual ischemic risk factors and predictable mortality of the patient may define the necessity and the date of the invasive examination. The Hungarian hemodynamic laboratory network covers almost the whole country and, therefore, practically each patient may receive a state-of-the-art therapy. Although indicators of cardiovascular diseases are still prominent, the mortality rate of myocardial Infarction is decreasing in Hungary due to the well-organized invasive care.

  6. Diagnosis and treatment of acute and chronic leukemia

    Energy Technology Data Exchange (ETDEWEB)

    1978-01-01

    The Cancergram covers both acute and chronic leukemia in all of its forms (acute lymphocytic, acute monocytic, acute or sub-acute granulocytic, chronic granulocytic, chronic lymphocytic, chronic monocytic, plasma cell, stem cell, and hairy cell). Other neoplastic conditions of the reticuloendothelial system, lymphatic system, spleen, multiple myeloma, macroglobulinemia and other monoclonal gammopathies are excluded, and will be coveted by other Cancergrams now under development. This Cancergram includes abstracts concerning all clinical aspects of the disease, such as diagnosis and staging, supportive care, evaluation, and therapy. Animal models, tissue culture experiments, carcinogenesis and other pre-clinical studies are generally excluded, except for those considered to have direct clinical relevance.

  7. Primary hyperparathyroidism presenting as acute gallstone pancreatitis

    Institute of Scientific and Technical Information of China (English)

    HE Jian-hong; ZHANG Quan-bao; LI Yu-min; ZHU You-quan; LI Xun; SHI Bin

    2010-01-01

    @@ Primary hyperparathyroidism (PHPT) is a generalized disorder of calcium metabolism resulting from an abnormally high level of serum calcium and an increased level of parathormone (PTH).1,2 Traditionally, symptomatic PHPT patients present with a variety of disorders including fatigue, amyotrophy, memory impairment, emotional instability, hallucination, irritation, loss of consciousness, abdominal distention, nausea, vomiting, constipation, acute pancreatitis, refractory peptic ulcer, osteopenia, hypertension, etc.3-5 Acute pancreatitis (AP) is an uncommon presentation of PHPT.6-8 We report a typical case of primary hyperparathyroidism with hypercalcemic crisis presenting as acute gallstone pancreatitis.

  8. [Pregnancy-related acute kidney injury].

    Science.gov (United States)

    Filipowicz, Ewa; Staszków, Monika

    Acute kidney injury (AKI) in obstetrics may be caused by the same disorders that are observed in the general population or may be specific for a pregnancy such as: preeclampsia, HELLP syndrome or acute fatty liver of pregnancy. The renal changes may be only temporary, and resolve within a few weeks postpartum, or may become irreversible leading to a progression of chronic kidney disease (CKD). In the article the most important pregnancy related syndromes associated with AKI have been shortly reviewed.

  9. [Acute postpartum psychoses].

    Science.gov (United States)

    Tabbane, K; Charfi, F; Dellagi, L; Guizani, L; Boukadida, L

    1999-11-01

    The post-partum is a high risk period for the development of acute psychotic disorders. The frequence of post-partum psychoses is evaluated at 1 to 2 per 1,000 births. Post-partum psychosis include major affective disorders which is the most frequent diagnosis. The clinical pictures have specific characteristics: rapid change of symptomatology, liability of mood, and frequent confusional signs. The short-term prognosis is generally good but the risk of recurrence of the mental disorder, in or outside puerperal context, is high. At clinical, evolutive and genetic levels, the studies do not provide arguments for nosological autonomy of post-partum psychosis. At therapeutic level, the ECT is particularly efficient in this indication.

  10. Acute graft versus host disease

    Directory of Open Access Journals (Sweden)

    Vogelsang Georgia B

    2007-09-01

    Full Text Available Abstract Acute graft-versus-host disease (GVHD occurs after allogeneic hematopoietic stem cell transplant and is a reaction of donor immune cells against host tissues. Activated donor T cells damage host epithelial cells after an inflammatory cascade that begins with the preparative regimen. About 35%–50% of hematopoietic stem cell transplant (HSCT recipients will develop acute GVHD. The exact risk is dependent on the stem cell source, age of the patient, conditioning, and GVHD prophylaxis used. Given the number of transplants performed, we can expect about 5500 patients/year to develop acute GVHD. Patients can have involvement of three organs: skin (rash/dermatitis, liver (hepatitis/jaundice, and gastrointestinal tract (abdominal pain/diarrhea. One or more organs may be involved. GVHD is a clinical diagnosis that may be supported with appropriate biopsies. The reason to pursue a tissue biopsy is to help differentiate from other diagnoses which may mimic GVHD, such as viral infection (hepatitis, colitis or drug reaction (causing skin rash. Acute GVHD is staged and graded (grade 0-IV by the number and extent of organ involvement. Patients with grade III/IV acute GVHD tend to have a poor outcome. Generally the patient is treated by optimizing their immunosuppression and adding methylprednisolone. About 50% of patients will have a solid response to methylprednisolone. If patients progress after 3 days or are not improved after 7 days, they will get salvage (second-line immunosuppressive therapy for which there is currently no standard-of-care. Well-organized clinical trials are imperative to better define second-line therapies for this disease. Additional management issues are attention to wound infections in skin GVHD and fluid/nutrition management in gastrointestinal GVHD. About 50% of patients with acute GVHD will eventually have manifestations of chronic GVHD.

  11. Pentoxifylline Treatment in Acute Pancreatitis (AP)

    Science.gov (United States)

    2016-09-14

    Acute Pancreatitis (AP); Gallstone Pancreatitis; Alcoholic Pancreatitis; Post-ERCP/Post-procedural Pancreatitis; Trauma Acute Pancreatitis; Hypertriglyceridemia Acute Pancreatitis; Idiopathic (Unknown) Acute Pancreatitis; Medication Induced Acute Pancreatitis; Cancer Acute Pancreatitis; Miscellaneous (i.e. Acute on Chronic Pancreatitis)

  12. Derivación de pacientes geriátricos subagudos a un hospital de atención intermedia como alternativa a la permanencia en un hospital general Intermediate hospital care for subacute elderly patients as an alternative to prolonged acute hospitalization

    Directory of Open Access Journals (Sweden)

    Marco Inzitari

    2012-04-01

    Full Text Available Objetivos: Evaluar la derivación rápida de pacientes ancianos con enfermedades crónicas reagudizadas desde un hospital general a un hospital de atención intermedia. Métodos: Estudio de cohortes. Se valora el cumplimiento de estándares de calidad premarcados y la adecuación de la selección. Resultados: Se derivaron 68 pacientes (edad media 82,6 años, 48,5% hombres desde urgencias (69,1% o desde servicios médicos (estancia media [desviación estándar, DE] global en agudos = 2,6 [2,9] días, en urgencias = 1,5 [1,6] días. La estancia media postaguda fue de 11,4 (4,2 días. Al alta, 56 pacientes (82,4% regresaron al domicilio habitual (domicilio o residencia geriátrica, siete fueron derivados a larga estancia, dos a urgencias y tres murieron. Los estándares de calidad se cumplieron. En un análisis multivariado, ser hombre y el riesgo de desnutrición se asociaban a un riesgo incrementado de no regresar al domicilio habitual (p Objectives: We evaluated the rapid discharge of older patients with reactivated chronic diseases from an acute general hospital to an intermediate care hospital. Methods: A cohort study was carried out. Compliance with predefined quality standards and patient selection were evaluated. Results: Sixty-eight patients (mean age 82.6 years, 48.5% men were discharged from the emergency department (69.1% or medical wards (mean [SD] global length of stay 2.6 [2.9] days in acute wards and 1.5 [1.6] days in the emergency department. Mean post-acute length of stay (SD was 11.4 (4.2 days. Fifty-six patients (82.4% were discharged to their previous living situation (home or nursing home, two back to the emergency department, seven to long-term care, and three died. All quality standards were met. In a multivariate analysis, male gender and a higher risk of malnutrition were associated with an increased risk of not returning to the previous living situation (p <0.05. Conclusions: Intermediate care for selected patients with

  13. The treatment of acute vertigo.

    Science.gov (United States)

    Cesarani, A; Alpini, D; Monti, B; Raponi, G

    2004-03-01

    Vertigo and dizziness are very common symptoms in the general population. The aim of this paper is to describe the physical and pharmacological treatment of symptoms characterized by sudden onset of rotatory vertigo. Acute vertigo can be subdivided into two main groups: (1) spontaneous vertigo and (2) provoked vertigo, usually by postural changes, generally called paroxysmal positional vertigo (PPV). Sudden onset of acute vertigo is usually due to acute spontaneous unilateral vestibular failure. It can be also fluctuant as, e.g., in recurrent attacks of Ménière's disease. Pharmacotherapy of acute spontaneous vertigo includes Levo-sulpiride i.v., 50 mg in 250 physiologic solution, once or twice a day, methoclopramide i.m., 10 mg once or twice a day, or triethilperazine rectally, once or twice a day, to reduce neurovegetative symptoms; diazepam i.m., 10 mg once or twice a day, to decrease internuclear inhibition, sulfate magnesium i.v., two ampoules in 500 cc physiological solution, twice a day, or piracetam i.v., one ampoule in 500 cc physiological solution, twice a day, to decrease vestibular damage. At the onset of the acute symptoms, patients must lie on their healthy side with the head and trunk raised 20 degrees. The room must be quiet but not darkened. If the patient is able to swallow without vomiting, it is important to reduce nystagmus and stabilize the visual field with gabapentine, per os, 300 mg twice or three times a day. The first step of the physical therapy of acute vertigo is vestibular electrical stimulation, that is to say, a superficial paravertebral electrical stimulation of neck muscles, aimed to reduce antigravitary failure and to increase proprioceptive cervical sensory substitution. PPV is a common complaint and represents one of the most common entities in peripheral vestibular pathology. While the clinical picture is well known and widely described, the etiopathogenesis of PPV is still a matter of debate. Despite the different

  14. Histoplasmosis - acute (primary) pulmonary

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000098.htm Histoplasmosis - acute (primary) pulmonary To use the sharing features on this page, please enable JavaScript. Acute pulmonary histoplasmosis is a respiratory infection that is caused by ...

  15. Acute respiratory distress syndrome

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000103.htm Acute respiratory distress syndrome To use the sharing features on this page, please enable JavaScript. Acute respiratory distress syndrome (ARDS) is a life-threatening lung condition that ...

  16. Acute kidney failure

    Science.gov (United States)

    Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute ... There are many possible causes of kidney damage. They include: ... cholesterol (cholesterol emboli) Decreased blood flow due to very ...

  17. Acute bee paralysis virus [

    Lifescience Database Archive (English)

    Full Text Available Acute bee paralysis virus [gbvrl]: 14 CDS's (15780 codons) fields: [triplet] [frequ...osomal protein / MAP kinase List of codon usage for each CDS (format) Homepage Acute bee paralysis virus ...

  18. Acute Mesenteric Ischemia

    Science.gov (United States)

    ... Side Effects Additional Content Medical News Acute Mesenteric Ischemia By Parswa Ansari, MD, Department of Surgery, Lenox ... Abscesses Abdominal Wall Hernias Inguinal Hernia Acute Mesenteric Ischemia Appendicitis Ileus Intestinal Obstruction Ischemic Colitis Perforation of ...

  19. Acute acalculous cholecystitis complicating chemotherapy for acute myeloblastic leukemia

    OpenAIRE

    Olfa Kassar; Feten Kallel; Manel Ghorbel; Hatem. Bellaaj; Zeineb Mnif; Moez Elloumi

    2015-01-01

    Acute acalculous cholecystitis is a rare complication in the treatment of acute myeloblastic leukemia. Diagnosis of acute acalculous cholecystitis remains difficult during neutropenic period. We present two acute myeloblastic leukemia patients that developed acute acalculous cholecystitis during chemotherapy-induced neutropenia. They suffered from fever, vomiting and acute pain in the epigastrium. Ultrasound demonstrated an acalculous gallbladder. Surgical management was required in one patie...

  20. Acute mastoiditis in children

    DEFF Research Database (Denmark)

    Anthonsen, Kristian; Høstmark, Karianne; Hansen, Søren;

    2013-01-01

    Conservative treatment of acute otitis media may lead to more complications. This study evaluates changes in incidence, the clinical and microbiological findings, the complications and the outcome of acute mastoiditis in children in a country employing conservative guidelines in treating acute...... otitis media....

  1. Generalized product

    OpenAIRE

    Greco,Salvatore; Mesiar, Radko; Rindone, Fabio

    2014-01-01

    Aggregation functions on [0,1] with annihilator 0 can be seen as a generalized product on [0,1]. We study the generalized product on the bipolar scale [–1,1], stressing the axiomatic point of view. Based on newly introduced bipolar properties, such as the bipolar increasingness, bipolar unit element, bipolar idempotent element, several kinds of generalized bipolar product are introduced and studied. A special stress is put on bipolar semicopulas, bipolar quasi-copulas and bipolar copulas.

  2. The trAPP-study: Cost-effectiveness of an unsupervised e-health supported neuromuscular training program for the treatment of acute ankle sprains in general practice: Design of a randomized controlled trial

    NARCIS (Netherlands)

    A.K.E. Mailuhu (Adinda); E.A.L.M. Verhagen (Evert); J.M. van Ochten (John); P.J.E. Bindels (Patrick); S.M. Bierma-Zeinstra (Sita); M. van Middelkoop (Marienke)

    2015-01-01

    textabstractBackground: Ankle sprains are one of the most frequent injuries of the musculoskeletal system, with yearly around 680.000 new sprains in the Netherlands. Of these, about 130.000 people will visit the general practitioner (GP) each year. In addition, patients have an increased risk of a r

  3. Crohn's disease and acute pancreatitis. A review of literature.

    Science.gov (United States)

    Jasdanwala, Sarfaraz; Babyatsky, Mark

    2015-03-01

    Crohn's disease, a transmural inflammatory bowel disease, has many well-known extra-intestinal manifestations and complications. Although acute pancreatitis has a higher incidence in patients with Crohn's disease as compared to the general population, acute pancreatitis is still relatively uncommon in patients with Crohn's disease. Patients with Crohn's disease are at an approximately fourfold higher risk than the general population to develop acute pancreatitis. The risk of developing acute pancreatitis is higher in females as compared to males. Acute pancreatitis can occur at any age with higher incidence reported in patients in their 20s and between 40-50 years of age. The severity and prognosis of acute pancreatitis in patients with Crohn's disease is the same as in general population. Acute pancreatitis can occur before onset of intestinal Crohn's disease, this presentation being more common in children than adults. It can also occur as the presenting symptom. However, most commonly it occurs after intestinal symptoms have manifest with a mean time interval between the initial presentation and development of acute pancreatitis being 2 years. There are several etiological factors contributing to acute pancreatitis in patients with Crohn's disease. It is not clear whether acute pancreatitis is a direct extra-intestinal manifestation of Crohn's disease; however, majority of the cases of acute pancreatitis in patients with Crohn's disease are due to GS and medications. Drugs used for the treatment of Crohn's disease that have been reported to cause acute pancreatitis include 5-ASA agents, azathioprine and 6 mercaptopurine, metornidazole and corticosteroids. Recent evidence has emerged correlating both type 1 and 2 autoimmune pancreatitis with Crohn's disease. Understanding the association between the two disease entities is key to effectively manage patients with Crohn's disease and acute pancreatitis.

  4. Imaging of Acute Pancreatitis.

    Science.gov (United States)

    Thoeni, Ruedi F

    2015-11-01

    Acute pancreatitis is an acute inflammation of the pancreas. Several classification systems have been used in the past but were considered unsatisfactory. A revised Atlanta classification of acute pancreatitis was published that assessed the clinical course and severity of disease; divided acute pancreatitis into interstitial edematous pancreatitis and necrotizing pancreatitis; discerned an early phase (first week) from a late phase (after the first week); and focused on systemic inflammatory response syndrome and organ failure. This article focuses on the revised classification of acute pancreatitis, with emphasis on imaging features, particularly on newly-termed fluid collections and implications for the radiologist.

  5. Observational Study of the Genetic Architecture of Neutrophil-Mediated Inflammatory Skin Diseases

    Science.gov (United States)

    2016-09-26

    Other Specified Inflammatory Disorders of Skin or Subcutaneous Tissue; Pyoderma Gangrenosum; Erosive Pustular Dermatosis of the Scalp; Sweet's Syndrome; Behcet's Disease; Bowel-associated Dermatosis-arthritis Syndrome; Pustular Psoriasis; Acute Generalized Exanthematous Pustulosis; Keratoderma Blenorrhagicum; Sneddon-Wilkinson Disease; IgA Pemphigus; Amicrobial Pustulosis of the Folds; Infantile Acropustulosis; Transient Neonatal Pustulosis; Neutrophilic Eccrine Hidradenitis; Rheumatoid Neutrophilic Dermatitis; Neutrophilic Urticaria; Still's Disease; Erythema Marginatum; Unclassified Periodic Fever Syndromes / Autoinflammatory Syndromes; Dermatitis Herpetiformis; Linear IgA Bullous Dermatosis; Bullous Systemic Lupus Erythematosus; Inflammatory Epidermolysis Bullosa Aquisita; Neutrophilic Dermatosis of the Dorsal Hands (Pustular Vasculitis); Small Vessel Vasculitis Including Urticarial Vasculitis; Erythema Elevatum Diutinum; Medium Vessel Vasculitis

  6. Acute loss of consciousness.

    Science.gov (United States)

    Tristán, Bekinschtein; Gleichgerrcht, Ezequiel; Manes, Facundo

    2015-01-01

    Acute loss of consciousness poses a fascinating scenario for theoretical and clinical research. This chapter introduces a simple yet powerful framework to investigate altered states of consciousness. We then explore the different disorders of consciousness that result from acute brain injury, and techniques used in the acute phase to predict clinical outcome in different patient populations in light of models of acute loss of consciousness. We further delve into post-traumatic amnesia as a model for predicting cognitive sequels following acute loss of consciousness. We approach the study of acute loss of consciousness from a theoretical and clinical perspective to conclude that clinicians in acute care centers must incorporate new measurements and techniques besides the classic coma scales in order to assess their patients with loss of consciousness.

  7. Difusion weighted imaging characteristics differentiate acute symptomatic cerebral microbleeds from silent microbleeds: An acute pontine microhemorrhage case presentation

    Directory of Open Access Journals (Sweden)

    Arda Yılmaz

    2015-04-01

    Full Text Available Cerebral microbleeds (CMBs on susceptibility weighted imaging (SWI have generally been considered to be silent. Recent reports indicated that, albeit it is a rarity, CMBs can cause acute focal neurological symptoms. Herein we present a patient who was admitted with cheiro-oral syndrome due to an acute izolated pontine microbleed. Combination of diffusion weighted imaging and SWI can be useful in the differentiation of acute symptomatic cerebral microbleeds from chronic ones.

  8. Therapeutic hypothermia for acute stroke

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Weber, Uno Jakob; Kammersgaard, Lars Peter

    2003-01-01

    Experimental evidence and clinical experience show that hypothermia protects the brain from damage during ischaemia. There is a growing hope that the prevention of fever in stroke will improve outcome and that hypothermia may be a therapeutic option for the treatment of stroke. Body temperature...... is directly related to stroke severity and outcome, and fever after stroke is associated with substantial increases in morbidity and mortality. Normalisation of temperature in acute stroke by antipyretics is generally recommended, although there is no direct evidence to support this treatment. Despite its...... obvious therapeutic potential, hypothermia as a form of neuroprotection for stroke has been investigated in only a few very small studies. Therapeutic hypothermia is feasible in acute stroke but owing to serious side-effects--such as hypotension, cardiac arrhythmia, and pneumonia--it is still thought...

  9. Decitabine in Treating Children With Relapsed or Refractory Acute Myeloid Leukemia or Acute Lymphoblastic Leukemia

    Science.gov (United States)

    2013-01-22

    Childhood Acute Myeloblastic Leukemia With Maturation (M2); Childhood Acute Promyelocytic Leukemia (M3); Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Secondary Acute Myeloid Leukemia

  10. Acute Pancreatitis as the Initial Presentation of Systematic Lupus Erythematosus

    OpenAIRE

    Yi Jia; Arleen Ortiz; Richard Mccallum; Hasan Salameh; Pedro Serrato

    2014-01-01

    Systematic lupus erythematosus (SLE) is a multisystem disease, including the gastrointestinal system in about half of SLE patients. As a rare complication of SLE, acute pancreatitis presents as generalized flare-ups in most cases of patients previously diagnosed with SLE. Here we report a rare case of acute pancreatitis as the initial presentation with later diagnosis of SLE.

  11. Acute Pancreatitis as the Initial Presentation of Systematic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Yi Jia

    2014-01-01

    Full Text Available Systematic lupus erythematosus (SLE is a multisystem disease, including the gastrointestinal system in about half of SLE patients. As a rare complication of SLE, acute pancreatitis presents as generalized flare-ups in most cases of patients previously diagnosed with SLE. Here we report a rare case of acute pancreatitis as the initial presentation with later diagnosis of SLE.

  12. Acute pancreatitis as the initial presentation of systematic lupus erythematosus.

    Science.gov (United States)

    Jia, Yi; Ortiz, Arleen; Mccallum, Richard; Salameh, Hasan; Serrato, Pedro

    2014-01-01

    Systematic lupus erythematosus (SLE) is a multisystem disease, including the gastrointestinal system in about half of SLE patients. As a rare complication of SLE, acute pancreatitis presents as generalized flare-ups in most cases of patients previously diagnosed with SLE. Here we report a rare case of acute pancreatitis as the initial presentation with later diagnosis of SLE.

  13. Splenic artery pseudoaneurysm due to acute pancreatitis in a 6-year-old boy with acute lymphoblastic leukaemia treated with L-aspariginase

    DEFF Research Database (Denmark)

    Larsen, Cæcilie Crawley; Laursen, Christian B; Dalby, Kasper;

    2014-01-01

    Acute pancreatitis is a rare phenomenon in children but its incidence seems to be increasing. In children, it is generally caused due to systemic illness, biliary disease, trauma, idiopathy and side effects of medicines like L-aspariginase. Acute pancreatitis is difficult to diagnose in children...... pseudoaneurysm due to acute pancreatitis in a 6-year-old boy with acute lymphoblastic leukaemia treated with L-aspariginase. He presented with fever, irritability and pain in his left groin region....

  14. Acute pancreatitis in acute viral hepatitis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To elucidate the frequency and characteristics of pancreatic involvement in the course of acute (nonfulminant) viral hepatitis.METHODS: We prospectively assessed the pancreatic involvement in patients with acute viral hepatitis who presented with severe abdomimanl pain.RESULTS: We studied 124 patients with acute viral hepatitis, of whom 24 presented with severe abdominal pain. Seven patients (5.65%) were diagnosed to have acute pancreatitis. All were young males. Five patients had pancreatitis in the first week and two in the fourth week after the onset of jaundice. The pancreatitis was mild and all had uneventful recovery from both pancreatitis and hepatitis on conservative treatment.The etiology of pancreatitis was hepatitis E virus in 4,hepatitis A virus in 2, and hepatitis B virus in 1 patient.One patient had biliary sludge along with HEV infection.The abdominal pain of remaining seventeen patients was attributed to stretching of Glisson's capsule.CONCLUSION: Acute pancreatitis occurs in 5.65% of patients with acute viral hepatitis, it is mild and recovers with conservative management.

  15. Acute otitis media and acute bacterial sinusitis.

    Science.gov (United States)

    Wald, Ellen R

    2011-05-01

    Acute otitis media and acute bacterial sinusitis are 2 of the most common indications for antimicrobial agents in children. Together, they are responsible for billions of dollars of health care expenditures. The pathogenesis of the 2 conditions is identical. In the majority of children with each condition, a preceding viral upper respiratory tract infection predisposes to the development of the acute bacterial complication. It has been shown that viral upper respiratory tract infection predisposes to the development of acute otitis media in 37% of cases. Currently, precise microbiologic diagnosis of acute otitis media and acute bacterial sinusitis requires performance of tympanocentesis in the former and sinus aspiration in the latter. The identification of a virus from the nasopharynx in either case does not obviate the need for antimicrobial therapy. Furthermore, nasal and nasopharyngeal swabs are not useful in predicting the results of culture of the middle ear or paranasal sinus. However, it is possible that a combination of information regarding nasopharyngeal colonization with bacteria and infection with specific viruses may inform treatment decisions in the future.

  16. Acute chylous peritonitis due to acute pancreatitis.

    Science.gov (United States)

    Georgiou, Georgios K; Harissis, Haralampos; Mitsis, Michalis; Batsis, Haralampos; Fatouros, Michalis

    2012-04-28

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse. The development of chylous ascites is usually a chronic process mostly involving malignancy, trauma or surgery, and symptoms arise as a result of progressive abdominal distention. However, when accumulation of "chyle" occurs rapidly, the patient may present with signs of peritonitis. Preoperative diagnosis is difficult since the clinical picture usually suggests hollow organ perforation, appendicitis or visceral ischemia. Less than 100 cases of acute chylous peritonitis have been reported. Pancreatitis is a rare cause of chyloperitoneum and in almost all of the cases chylous ascites is discovered some days (or even weeks) after the onset of symptoms of pancreatitis. This is the second case in the literature where the patient presented with acute chylous peritonitis due to acute pancreatitis, and the presence of chyle within the abdominal cavity was discovered simultaneously with the establishment of the diagnosis of pancreatitis. The patient underwent an exploratory laparotomy for suspected perforated duodenal ulcer, since, due to hypertriglyceridemia, serum amylase values appeared within the normal range. Moreover, abdominal computed tomography imaging was not diagnostic for pancreatitis. Following abdominal lavage and drainage, the patient was successfully treated with total parenteral nutrition and octreotide.

  17. Acute chylous peritonitis due to acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Georgios K Georgiou; Haralampos Harissis; Michalis Mitsis; Haralampos Batsis; Michalis Fatouros

    2012-01-01

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse.The development of chylous ascites is usually a chronic process mostly involving malignancy,trauma or surgery,and symptoms arise as a result of progressive abdominal distention.However,when accumulation of "chyle" occurs rapidly,the patient may present with signs of peritonitis.Preoperative diagnosis is difficult since the clinical picture usually suggests hollow organ perforation,appendicitis or visceral ischemia.Less than 100 cases of acute chylous peritonitis have been reported.Pancreatitis is a rare cause of chyloperitoneum and in almost all of the cases chylous ascites is discovered some days (or even weeks) after the onset of symptoms of pancreatitis.This is the second case in the literature where the patient presented with acute chylous peritonitis due to acute pancreatitis,and the presence of chyle within the abdominal cavity was discovered simultaneously with the establishment of the diagnosis of pancreatitis.The patient underwent an exploratory laparotomy for suspected perforated duodenal ulcer,since,due to hypertriglyceridemia,serum amylase values appeared within the normal range.Moreover,abdominal computed tomography imaging was not diagnostic for pancreatitis.Following abdominal lavage and drainage,the patient was successfully treated with total parenteral nutrition and octreotide.

  18. Acute and chronic pancreatitis: surgical management.

    Science.gov (United States)

    Dzakovic, Alexander; Superina, Riccardo

    2012-08-01

    Pancreatitis is becoming increasingly prevalent in children, posing new challenges to pediatric health care providers. Although some general adult treatment paradigms are applicable in the pediatric population, diagnostic workup and surgical management of acute and chronic pancreatitis have to be tailored to anatomic and pathophysiological entities peculiar to children. Nonbiliary causes of acute pancreatitis in children are generally managed nonoperatively with hydration, close biochemical and clinical observation, and early initiation of enteral feeds. Surgical intervention including cholecystectomy or endoscopic retrograde cholangiopancreatography is often required in acute biliary pancreatitis, whereas infected pancreatic necrosis remains a rare absolute indication for pancreatic debridement and drainage via open, laparoscopic, or interventional radiologic procedure. Chronic pancreatitis is characterized by painful irreversible changes of the parenchyma and ducts, which may result in or be caused by inadequate ductal drainage. A variety of surgical procedures providing drainage, denervation, resection, or a combination thereof are well established to relieve pain and preserve pancreatic function.

  19. Acute Respiratory Distress in Children: Croup and Acute Asthma.

    Science.gov (United States)

    Sharma, B S; Shekhawat, Dhananjay S; Sharma, Prity; Meena, Chetan; Mohan, Hari

    2015-07-01

    Acute respiratory distress is one of the most common reason for emergency visits in children under 5 y of age. An accurate understanding of the epidemiology of these diseases, identification of risk factors and etiology is critical for successful treatment and prevention of related mortality. The cause of acute respiratory distress varies in etiology, and hence is amenable to different treatment modalities. Depending on the predominant symptoms and signs, a child presenting to the clinician can be divided into six groups, viz., stridor; cough, fever and difficulty in breathing or fast breathing; wheezing; mediastinal shift with severe respiratory distress; slow or irregular breathing in absence of any pulmonary sign; and respiratory distress with cardiac findings. A detailed history followed by a thorough clinical examination and laboratory evaluation assisted by imaging modalities if indicated, helps to establish the exact cause of respiratory distress in the child. Early recognition and prompt institution of appropriate management or referral can significantly improve the outcome of this illness. This article offers clinicians a brief update on the general management guidelines of respiratory distress in pediatric patients. Specific treatment depends on the exact cause, however croup and acute severe asthma have been discussed in this article.

  20. Pharm GKB: Leukemia, Nonlymphocytic, Acute [PharmGKB

    Lifescience Database Archive (English)

    Full Text Available Overview Alternate Names: Synonym ANLL; Acute Nonlymphoblastic Leukemia; Acute Nonl...ymphoblastic Leukemias; Acute Nonlymphocytic Leukemia; Acute Nonlymphocytic Leukemias; Leukemia, Acute Nonly...mphoblastic; Leukemia, Acute Nonlymphocytic; Leukemia, Nonlymphoblastic, Acute; Leukemias, Acute Nonlymphoblastic; Leukemias, Acute... Nonlymphocytic; Nonlymphoblastic Leukemia, Acute; Nonlymphoblastic Leukemias, Acut...e; Nonlymphocytic Leukemia, Acute; Nonlymphocytic Leukemias, Acute PharmGKB Accessi

  1. Pharm GKB: Leukemia, Myeloid, Acute [PharmGKB

    Lifescience Database Archive (English)

    Full Text Available Amino Acid Translations are all sourced from dbSNP 144 Overview Alternate Names: Synonym AML - Acute... myeloblastic leukaemia; Acute Myeloblastic Leukemia; Acute Myeloblastic Leukemias; Acute... Myelocytic Leukemia; Acute Myelocytic Leukemias; Acute Myelogenous Leukemia; Acute Myelogenous Leukemias; Acute... granulocytic leukaemia; Acute myeloblastic leukemia; Acute myeloid leukaemia; Acute myeloid leukaemia - category; Acute... myeloid leukaemia, disease; Acute myeloid leukemia; Acute myelo

  2. Acute otitis media in neonatal life: a review.

    Science.gov (United States)

    Syggelou, A; Fanos, V; Iacovidou, N

    2011-06-01

    Acute otitis media is frequently encountered by general practitioners and pediatricians. In the neonatal period acute otitis media may present as an isolated local infection or as part of septicemia. Diagnosis of the condition by otoscopy is difficult. Considering the wide spectrum of middle ear disorders (acute otitis media, otitis media with effusion, chronic suppurative otitis media) one can appreciate why opinions on the management of the condition are diverse. This is a review of the literature on clinical presentation, etiology, risk factors, treatment and prevention of acute otitis media in neonatal life.

  3. Generalized polygons

    CERN Document Server

    Van Maldeghem, Hendrik

    1998-01-01

    Generalized Polygons is the first book to cover, in a coherent manner, the theory of polygons from scratch. In particular, it fills elementary gaps in the literature and gives an up-to-date account of current research in this area, including most proofs, which are often unified and streamlined in comparison to the versions generally known. Generalized Polygons will be welcomed both by the student seeking an introduction to the subject as well as the researcher who will value the work as a reference. In particular, it will be of great value for specialists working in the field of generalized polygons (which are, incidentally, the rank 2 Tits-buildings) or in fields directly related to Tits-buildings, incidence geometry and finite geometry. The approach taken in the book is of geometric nature, but algebraic results are included and proven (in a geometric way!). A noteworthy feature is that the book unifies and generalizes notions, definitions and results that exist for quadrangles, hexagons, octagons - in the ...

  4. Acute Stroke | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available n(s) being investigated Acute Stroke MedDRA Classification E.1.3Condition being s... General Information on the Trial E.1 Medical condition or disease under investigation E.1.1Medical conditio

  5. [Acute rheumatic fever].

    Science.gov (United States)

    Maier, Alexander; Kommer, Vera

    2016-03-01

    We report on a young women with acute rheumatic fever. Acute rheumatic fever has become a rare disease in Germany, especially in adults. This carries the risk that it can be missed in the differential diagnostic considerations of acute rheumatic disorders and febrile status. If rheumatic fever is not diagnosed and treated correctly, there is a considerable risk for rheumatic valvular heart disease. In this article diagnosis, differential diagnosis and therapy of rheumatic fever are discussed extensively.

  6. Acute Idiopathic Scrotal Edema

    Directory of Open Access Journals (Sweden)

    Micheál Breen

    2013-01-01

    Full Text Available We report a case of acute idiopathic scrotal edema (AISE in a 4-year-old boy who presented with acute scrotal pain and erythema. The clinical features, ultrasound appearance, and natural history of this rare diagnosis are reviewed. In this report, we highlight the importance of good ultrasound technique in differentiating the etiology of the acute scrotum and demonstrate the color Doppler “Fountain Sign” that is highly suggestive of AISE.

  7. [Oral glucocorticoids for acute rhinosinusitis: an RCT

    NARCIS (Netherlands)

    Venekamp, R.P.; Bonten, M.J.; Rovers, M.M.; Verheij, T.J.; Sachs, A.P.

    2013-01-01

    OBJECTIVE: To determine the efficacy of a short course of oral glucocorticoids in adult patients with acute rhinosinusitis. DESIGN: A double blind, placebo-controlled, randomized study conducted in 54 general practices in the Netherlands from December 2008 to March 2011 (NTR1295; http://www.trialreg

  8. Legislation hampers medical research in acute situations

    DEFF Research Database (Denmark)

    Thomsen, Jakob Hartvig; Hassager, Christian; Bro-Jeppesen, John;

    2015-01-01

    INTRODUCTION: Informed consent in incapacitated adults is permitted in the form of proxy consent by both the patients' closest relative (next of kin, NOK) and general practitioner (GP). In research in acute situations not involving pharmaceuticals, Danish legislation allows for randomisation...

  9. Generalized derivations and general relativity

    CERN Document Server

    Heller, M; Pysiak, L; Sasin, W

    2013-01-01

    We construct differential geometry (connection, curvature, etc.) based on generalized derivations of an algebra A. Such a derivation, introduced by Bresar in 1991, is given by a linear mapping u: A -> A such that there exists a usual derivation d of A satisfying the generalized Leibniz rule u(a b) = u(a) b + a d(b) for all a,b in A. The generalized geometry "is tested" in the case of the algebra of smooth functions on a manifold. We then apply this machinery to study the generalized general relativity. We define the Einstein-Hilbert action and deduce from it Einstein's field equations. We show that for a special class of metrics containing, besides the usual metric components, only one non-zero term, the action reduces to O'Hanlon action that is a Brans-Dicke action with potential and with the parameter \\omega equal to zero. We also show that the generalized Einstein equations (with zero energy-stress tensor) are equivalent to those of the Kaluza-Klein theory satisfying a "modified cylinder condition" and hav...

  10. Pharm GKB: Kidney Failure, Acute [PharmGKB

    Lifescience Database Archive (English)

    Full Text Available iew Alternate Names: Synonym ARF - Acute renal failure; Acute Kidney Failure; Acute Kidney Failures; Acute K...idney Insufficiencies; Acute Kidney Insufficiency; Acute Renal Failure; Acute Renal Failures; Acute... Renal Insufficiencies; Acute Renal Insufficiency; Acute renal failure syndrome, NOS; Failure, Acute... Kidney; Failure, Acute Renal; Failures, Acute Kidney; Failures, Acute Renal; Insufficiencies, Acute... Kidney; Insufficiencies, Acute Renal; Insufficiency, Acute Kidney; Insufficiency, Acute

  11. GENERAL EQUILIBRIUM

    Directory of Open Access Journals (Sweden)

    Monique Florenzano

    2008-09-01

    Full Text Available General equilibrium is a central concept of economic theory. Unlike partial equilibrium analysis which study the equilibrium of a particular market under the clause “ceteris paribus” that revenues and prices on the other markets stay approximately unaffected, the ambition of a general equilibrium model is to analyze the simultaneous equilibrium in all markets of a competitive economy. Definition of the abstract model, some of its basic results and insights are presented. The important issues of uniqueness and local uniqueness of equilibrium are sketched; they are the condition for a predictive power of the theory and its ability to allow for statics comparisons. Finally, we review the main extensions of the general equilibrium model. Besides the natural extensions to infinitely many commodities and to a continuum of agents, some examples show how economic theory can accommodate the main ideas in order to study some contexts which were not thought of by the initial model

  12. Diagnosis and Treatment of Acute Hepatitis C Among HIV Positive Men Having Sex with Men

    NARCIS (Netherlands)

    S.J. Hullegie (Sebastiaan)

    2016-01-01

    textabstractThe general aim of this thesis is to study different aspects of an acute HCV infection in HIV positive MSM. The primary aim is to study the effectivity and safety of boceprevir in addition to pegIFN and RBV for the treatment of acute HCV infections within the Dutch Acute HCV in HIV study

  13. Mixed phenotype acute leukemia

    Institute of Scientific and Technical Information of China (English)

    Ye Zixing; Wang Shujie

    2014-01-01

    Objective To highlight the current understanding of mixed phenotype acute leukemia (MPAL).Data sources We collected the relevant articles in PubMed (from 1985 to present),using the terms "mixed phenotype acute leukemia","hybrid acute leukemia","biphenotypic acute leukemia",and "mixed lineage leukemia".We also collected the relevant studies in WanFang Data base (from 2000 to present),using the terms "mixed phenotype acute leukemia" and "hybrid acute leukemia".Study selection We included all relevant studies concerning mixed phenotype acute leukemia in English and Chinese version,with no limitation of research design.The duplicated articles are excluded.Results MPAL is a rare subgroup of acute leukemia which expresses the myeloid and lymphoid markers simultaneously.The clinical manifestations of MPAL are similar to other acute leukemias.The World Health Organization classification and the European Group for Immunological classification of Leukaemias 1998 cdteria are most widely used.MPAL does not have a standard therapy regimen.Its treatment depends mostly on the patient's unique immunophenotypic and cytogenetic features,and also the experience of individual physician.The lack of effective treatment contributes to an undesirable prognosis.Conclusion Our understanding about MPAL is still limited.The diagnostic criteria have not been unified.The treatment of MPAL remains to be investigated.The prognostic factor is largely unclear yet.A better diagnostic cdteria and targeted therapeutics will improve the therapy effect and a subsequently better prognosis.

  14. General Relativity

    CERN Document Server

    Canuto, V

    2015-01-01

    This is an English translation of the Italian version of an encyclopedia chapter that appeared in the Italian Encyclopedia of the Physical Sciences, edited by Bruno Bertotti (1994). Following requests from colleagues we have decided to make it available to a more general readership. We present the motivation for constructing General Relativity, provide a short discussion of tensor algebra, and follow the set up of Einstein equations. We discuss briefly the initial value problem, the linear approximation and how should non gravitational physics be described in curved spacetime.

  15. Infant acute myocarditis mimicking acute myocardial infarction

    Science.gov (United States)

    Tilouche, Samia; Masmoudi, Tasnim; Sahnoun, Maha; Chkirbène, Youssef; Mestiri, Sarra; Boughamoura, Lamia; Ben Dhiab, Mohamed; Souguir, Mohamed Kamel

    2016-01-01

    Myocarditis is an inflammatory disease of the myocardium with heterogeneous clinical manifestations and progression. In clinical practice, although there are many methods of diagnosis of acute myocarditis, the diagnosis remains an embarrassing dilemma for clinicians. The authors report the case of 9-month-old infant who was brought to the Pediatric Emergency Department with sudden onset dyspnea. Examination disclosed heart failure and resuscitation was undertaken. The electrocardiogram showed an ST segment elevation in the anterolateral leads with a mirror image. Cardiac enzyme tests revealed a significant elevation of troponin and creatine phosphokinase levels. A diagnosis of acute myocardial infarction was made, and heparin therapy was prescribed. The infant died on the third day after admission with cardiogenic shock. The autopsy showed dilatation of the ventricles and massive edema of the lungs. Histological examinations of myocardium samples revealed the presence of a marked lymphocytic infiltrate dissociating myocardiocytes. Death was attributed to acute myocarditis. The authors call attention to the difficulties of differential diagnosis between acute myocarditis and acute myocardial infarction especially in children, and to the important therapeutic implications of a correct diagnosis. PMID:28210569

  16. Generale preventie

    NARCIS (Netherlands)

    1949-01-01

    In part I of this study a survey has veen given of what Dutch authors have written since 1870, when capital punishment was abolished, on subjects concerning the general preventive effect of punishment. This historical survey ends where, during the years 1940-1945, under the stress of the occupation

  17. General Assembly

    CERN Multimedia

    Staff Association

    2016-01-01

    5th April, 2016 – Ordinary General Assembly of the Staff Association! In the first semester of each year, the Staff Association (SA) invites its members to attend and participate in the Ordinary General Assembly (OGA). This year the OGA will be held on Tuesday, April 5th 2016 from 11:00 to 12:00 in BE Auditorium, Meyrin (6-2-024). During the Ordinary General Assembly, the activity and financial reports of the SA are presented and submitted for approval to the members. This is the occasion to get a global view on the activities of the SA, its financial management, and an opportunity to express one’s opinion, including taking part in the votes. Other points are listed on the agenda, as proposed by the Staff Council. Who can vote? Only “ordinary” members (MPE) of the SA can vote. Associated members (MPA) of the SA and/or affiliated pensioners have a right to vote on those topics that are of direct interest to them. Who can give his/her opinion? The Ordinary General Asse...

  18. Noninvasive ventilation in acute respiratory failure

    Directory of Open Access Journals (Sweden)

    Mas A

    2014-08-01

    Full Text Available Arantxa Mas, Josep MasipCritical Care Department, Consorci Sanitari Integral (CSI, Hospital Sant Joan Despí Moisès Broggi and Hospital General de l’Hospitalet, University of Barcelona, Barcelona, SpainAbstract: After the institution of positive-pressure ventilation, the use of noninvasive ventilation (NIV through an interface substantially increased. The first technique was continuous positive airway pressure; but, after the introduction of pressure support ventilation at the end of the 20th century, this became the main modality. Both techniques, and some others that have been recently introduced and which integrate some technological innovations, have extensively demonstrated a faster improvement of acute respiratory failure in different patient populations, avoiding endotracheal intubation and facilitating the release of conventional invasive mechanical ventilation. In acute settings, NIV is currently the first-line treatment for moderate-to-severe chronic obstructive pulmonary disease exacerbation as well as for acute cardiogenic pulmonary edema and should be considered in immunocompromised patients with acute respiratory insufficiency, in difficult weaning, and in the prevention of postextubation failure. Alternatively, it can also be used in the postoperative period and in cases of pneumonia and asthma or as a palliative treatment. NIV is currently used in a wide range of acute settings, such as critical care and emergency departments, hospital wards, palliative or pediatric units, and in pre-hospital care. It is also used as a home care therapy in patients with chronic pulmonary or sleep disorders. The appropriate selection of patients and the adaptation to the technique are the keys to success. This review essentially analyzes the evidence of benefits of NIV in different populations with acute respiratory failure and describes the main modalities, new devices, and some practical aspects of the use of this technique. Keywords

  19. Abdominal Pain in the Female Patient: A Case of Concurrent Acute Appendicitis and Ruptured Endometrioma

    Science.gov (United States)

    Louis, Martine A.; Lin, Elizabeth; Baek, Ji Yoon; Andoni, Alda; Wang, Xiao Hui

    2016-01-01

    General surgeons are often asked to evaluate acute abdominal pain which has an expanded differential diagnosis in women of childbearing age. Acute appendicitis accounts for many surgical emergencies as a common cause of nongynecologic pelvic pain. In some rare instances, acute appendicitis has been shown to occur simultaneously with a variety of gynecologic diseases. We report a case of concurrent acute appendicitis and ruptured ovarian endometrioma. PMID:28097032

  20. Acute myopericarditis masquerading as acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Wen Tian; Zixin Zhang; Xiaojuan Bai; Dingyin Zeng; Guoxian Qi

    2008-01-01

    Patients with abrupt onset of chest pain, ischemic ECG abnormalities and elevated levels of cardiac markers could be given a diagnosis of acute myocardial infarction. However, some other diseases should be taken into consideration in this clinical setting when coronary arteries are proven to be normal. Here we report a case of acute myopericarditis with clinical presentation of myocardial infarction and normal coronary anatomy. The Herpes Simplex Virus Ⅱ was considered as the organism causing myopericarditis and the patient was recovered by the treatment with valacicloavir. A precise diagnosis is a prerequisite of successful treatment and favorable prognosis.

  1. Acute pancreatitis-induced thrombotic thrombocytopenic purpura with recurrent acute pancreatitis.

    Science.gov (United States)

    Fujino, Yasuhisa; Inoue, Yoshihiro; Onodera, Makoto; Kikuchi, Satoshi; Sato, Masayuki; Kojika, Masahiro; Sato, Hisaho; Suzuki, Keijiro; Matsumoto, Masanori

    2016-04-01

    Recent successive reports on acute pancreatitis-induced thrombotic thrombocytopenic purpura (TTP) have revealed that TTP-related microvascular damage is an aggravating factor of acute pancreatitis. Here, we report the case of a 26-year-old man diagnosed with acute pancreatitis due to high alcohol consumption. The patient was unconscious as he had taken an overdose of medication, and presented with fever and renal failure due to acute pancreatitis on admission. Although the pancreatitis subsequently improved, the symptoms were still observed; on the next day, he exhibited hemoglobinuria, anemia, and thrombocytopenia. Moreover, general blood examinations indicated the presence of schistocytes and reduced activity of ADAMTS13 (a disintegrin-like metalloproteinase with thrombospondin type 1 motif 13) to 47 %. Thus, the patient was diagnosed with TTP, and plasma exchange was performed. After the development of TTP, the acute pancreatitis recurred, but a severe pathogenesis was prevented by plasma exchange. Thus, ADAMTS13 activity may be useful for predicting a severe pathogenesis of acute pancreatitis. In ADAMTS13-deficient cases, plasma exchange may be an effective technique for preventing aggravation of acute pancreatitis.

  2. [Acute kidney injury

    NARCIS (Netherlands)

    Hageman, D.; Kooman, J.P.; Lance, M.D.; Heurn, L.W. van; Snoeijs, M.G.

    2012-01-01

    - 'Acute kidney injury' is modern terminology for a sudden decline in kidney function, and is defined by the RIFLE classification (RIFLE is an acronym for Risk, Injury, Failure, Loss and End-stage kidney disease).- Acute kidney injury occurs as a result of the combination of reduced perfusion in the

  3. Leukocytosis in acute stroke

    DEFF Research Database (Denmark)

    Kammersgaard, L P; Jørgensen, H S; Nakayama, H

    1999-01-01

    Leukocytosis is a common finding in the acute phase of stroke. A detrimental effect of leukocytosis on stroke outcome has been suggested, and trials aiming at reducing the leukocyte response in acute stroke are currently being conducted. However, the influence of leukocytosis on stroke outcome has...

  4. Acute recurrent polyhydramnios

    DEFF Research Database (Denmark)

    Rode, Line; Bundgaard, Anne; Skibsted, Lillian

    2007-01-01

    Acute recurrent polyhydramnios is a rare occurrence characterized by a poor fetal outcome. This is a case report describing a 34-year-old woman presenting with acute recurrent polyhydramnios. Treatment with non-steroidal anti-inflammatory drugs (NSAID) and therapeutic amniocenteses was initiated ...

  5. [General psychotherapy].

    Science.gov (United States)

    Vymetal, J

    2003-01-01

    Nowadays a theoretical psychotherapeutical thinking develops from the eclectic practice and uses particularly the research of the effective factors of the therapy. Best they can be characterized as differentiate, synthetic, integrative and exceeding other approaches. The development in question goes on with attempts of creating a general model of the psychotherapy that could be a basis for models of special psychotherapies. The aim of such a model is to describe all that is present as important factor for inducing a desirable change of a human in all psychotherapeutical approaches. Among general models we can mention the generic model of D. E. Orlinski and K. I. Howard, Grawe's cube (the author is K. Grawe) and the equation of the psychotherapy.

  6. Acute kidney injury during pregnancy.

    Science.gov (United States)

    Van Hook, James W

    2014-12-01

    Acute kidney injury complicates the care of a relatively small number of pregnant and postpartum women. Several pregnancy-related disorders such as preeclampsia and thrombotic microangiopathies may produce acute kidney injury. Prerenal azotemia is another common cause of acute kidney injury in pregnancy. This manuscript will review pregnancy-associated acute kidney injury from a renal functional perspective. Pathophysiology of acute kidney injury will be reviewed. Specific conditions causing acute kidney injury and treatments will be compared.

  7. Pharm GKB: Leukemia, Monocytic, Acute [PharmGKB

    Lifescience Database Archive (English)

    Full Text Available Overview Alternate Names: Synonym Acute Monoblastic Leukemia; Acute Monoblastic Leukemias; Acute... Monocytic Leukemia; Acute Monocytic Leukemias; Acute monoblastic leukaemia; Acute monoblastic leukemia; Acute... monocytic leukaemia; Acute monocytic leukemia, morphology; Acute monocytoid leukemia; Leukemia, Acute... Monoblastic; Leukemia, Acute Monocytic; Leukemia, Monoblastic, Acute; Leukemia, Myeloid, Acute... Schilling-Type Myeloid; Leukemias, Acute Monoblastic; Leukemias, Acute Monocytic; M5a - Acute monoblastic leukaemia; M5a - Acute

  8. Generalized polygons

    CERN Document Server

    Maldeghem, Hendrik

    1998-01-01

    This book is intended to be an introduction to the fascinating theory ofgeneralized polygons for both the graduate student and the specialized researcher in the field. It gathers together a lot of basic properties (some of which are usually referred to in research papers as belonging to folklore) and very recent and sometimes deep results. I have chosen a fairly strict geometrical approach, which requires some knowledge of basic projective geometry. Yet, it enables one to prove some typically group-theoretical results such as the determination of the automorphism groups of certain Moufang polygons. As such, some basic group-theoretical knowledge is required of the reader. The notion of a generalized polygon is a relatively recent one. But it is one of the most important concepts in incidence geometry. Generalized polygons are the building bricks of Tits buildings. They are the prototypes and precursors of more general geometries such as partial geometries, partial quadrangles, semi-partial ge­ ometries, near...

  9. [Chronic pancreatitis, acute pancreatitis].

    Science.gov (United States)

    Mabuchi, T; Katada, N; Nishimura, D; Hoshino, H; Shimizu, F; Suzuki, R; Sano, H; Kato, K

    1998-11-01

    MRCP has been recognized as a safe and noninvasive diagnostic method. In the present study we evaluated the usefulness of MRCP in diagnosis of chronic and acute pancreatitis. Two-dimensional fast asymmetric spin-echo (FASE) MRCP was performed in 40 patients with chronic pancreatitis and 13 with acute pancreatitis. In 29 patients (72.5%) with chronic pancreatitis and 9 (66.7%) with acute pancreatitis, main pancreatic duct (MPD) was visualized entirely. MRCP could demonstrate the characteristic findings of chronic pancreatitis such as dilatation and irregularity of MPD in most cases. In acute pancreatitis, MRCP indicated that MPD was normal in diameter, but irregular in configuration compared with that of the control group. MRCP may facilitate the diagnosis of chronic and acute pancreatitis.

  10. Bedside Assessment of Acute Dizziness and Vertigo.

    Science.gov (United States)

    Welgampola, Miriam S; Bradshaw, Andrew Phillip; Lechner, Corinna; Halmagyi, Gabor Michael

    2015-08-01

    Dizziness is a common symptom in emergency departments, general practice, and outpatient clinics. Faced with an acutely dizzy patient, the frontline physician must determine whether or not the symptoms are vestibular in origin and, if they are, which vestibular disorder they best fit. A focused history provides useful clues to the likely cause of dizziness, yet it is the clinical examination that yields the final answer. This article summarizes history and examination techniques that are useful in the assessment of acutely dizzy patients and discusses oculomotor signs that accompany common vestibular disorders.

  11. Acute infantile motor unit disorder. Infantile botulism?

    Science.gov (United States)

    Clay, S A; Ramseyer, J C; Fishman, L S; Sedgwick, R P

    1977-04-01

    Eight infants with an acute reversible motor unit disorder are described, including two infants from whom Clostridum botulinum type A was isolated from stool specimens. The clinical spectrum includes constipation, cranial nerve deficits, pupillary involvement, and generalized hypotonic weakness. There were no deaths, and all infants have had complete clinical recovery. A characteristic electromyographic (EMG) pattern was present in part until clinical recovery. This distinctive pattern consisted of brief, small, abundant for power exerted motor unit potentials. This EMG pattern in the context of the clinical syndrome may well be diagnostic for acute infantile motor unit disorder.

  12. ERCP in acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Jijo V Cherian; Joye Varghese Selvaraj; Rajesh Natrayan; Jayanthi Venkataraman

    2007-01-01

    BACKGROUND:The role of endoscopic retrograde cholangiopancreatography (ERCP) in the management of acute pancreatitis has evolved over years since its introduction in 1968. Its importance in diagnosing the etiology of pancreatitis has steadily declined with the advent of less invasive diagnostic tools. The therapeutic implications of ERCP in acute pancreatitis are many fold and are directed towards management of known etiological factors or its related complications. This article highlights the current status of ERCP in acute pancreatitis. DATA SOURCES:An English literature search using PubMed database was conducted on ERCP in acute pancreatitis, the etiologies and complications of pancreatitis amenable to endotherapy and other related subjects, which were reviewed. RESULTS: ERCP serves as a primary therapeutic modality for management of biliary pancreatitis in speciifc situations, pancreatitis due to microlithiasis, speciifc types of sphincter of Oddi dysfunction, pancreas divisum, ascariasis and malignancy. In recurrent acute pancreatitis and smoldering pancreatitis it has a deifnite therapeutic utility. Complications of acute pancreatitis including pancreatic-duct disruptions or leaks, benign pancreatic-lfuid collections and pancreatic necrosis can be beneifcially dealt with. Intraductal ultrasound and pancreatoscopy during ERCP are useful in detecting pancreatic malignancy. CONCLUSIONS:The role of ERCP in acute pancreatitis is predominantly therapeutic and occasionally diagnostic. Its role in the management continues to evolve and advanced invasive procedures should be undertaken only in centers dedicated to pancreatic care.

  13. Acute acalculous cholecystitis complicating chemotherapy for acute myeloblastic leukemia

    Directory of Open Access Journals (Sweden)

    Olfa Kassar

    2015-01-01

    Full Text Available Acute acalculous cholecystitis is a rare complication in the treatment of acute myeloblastic leukemia. Diagnosis of acute acalculous cholecystitis remains difficult during neutropenic period. We present two acute myeloblastic leukemia patients that developed acute acalculous cholecystitis during chemotherapy-induced neutropenia. They suffered from fever, vomiting and acute pain in the epigastrium. Ultrasound demonstrated an acalculous gallbladder. Surgical management was required in one patient and conservative treatment was attempted in the other patient. None treatment measures were effective and two patients died. Acute acalculous cholecystitis is a serious complication in neutropenic patients. Earlier diagnosis could have expedited the management of these patients.

  14. Acute oncological emergencies.

    LENUS (Irish Health Repository)

    Gabriel, J

    2012-01-01

    The number of people receiving systemic anti-cancer treatment and presenting at emergency departments with treatment-related problems is rising. Nurses will be the first point of contact for most patients and need to be able to recognise oncological emergencies to initiate urgent assessment of patients and referral to the acute oncology team so that the most appropriate care can be delivered promptly. This article discusses the role of acute oncology services, and provides an overview of the most common acute oncological emergencies.

  15. General Relativity

    CERN Document Server

    Khriplovich, I. B

    2005-01-01

    This book offers an alternative to other textbooks on the subject, providing a more specific discussion of numerous general relativistic effects for readers who have knowledge of classical mechanics and electrodynamics, including special relativity. Coverage includes gravitational lensing, signal retardation in the gravitational field of the Sun, the Reissner-Nordström solution, selected spin effects, the resonance transformation of an electromagnetic wave into a gravitational one, and the entropy and temperature of black holes. The book includes numerous problems at various levels of difficulty, making it ideal also for independent study by a broad readership of advanced students and researchers. I.B. Khriplovich is Chief Researcher, Budker Institute of Nuclear Physics, Novosibirsk, and Chair of Theoretical Physics at Novosibirsk University. Dr. Khriplovich is a Corresponding Member of the Russian Academy of Sciences. He has been awarded the Dirac Medal ``For the advancement of theoretical physics'' by Univ...

  16. [General anesthesia].

    Science.gov (United States)

    Feiss, P

    2001-04-30

    General anaesthesia is a reversible loss of consciousness induced and maintained with a hypnotic drug given either by venous injection and infusion, or by inhalation. A potent opioid is usually associated to inhibit the transmission of pain and thus to lessen sympathetic and endocrine reactions to nociceptive stimuli. Myorelaxation is used to facilitate tracheal intubation and surgery. Whatever the anaesthetic protocol use, the patient and anaesthesia machine require close monitoring. In addition to vital signs, the depth of anaesthesia may be monitored using automated electroencephalographic analysis and myorelaxation should always be monitored using a nerve stimulator, but pain or analgesia evaluation is only based on clinical signs of sympathetic stimulation. Because anaesthesia-related death and morbidity have decreased considerably, future improvements in outcome should concern perioperative comfort, i.e. prevention of cognitive disturbances, nausea, vomiting and pain.

  17. Acute pancreatitis and fibromyalgia: Cytokine link

    Directory of Open Access Journals (Sweden)

    Sadat Muzammil

    2011-01-01

    Full Text Available Context: Fibromyalgia is a widespread musculoskeletal pain disorder found in 2% of the general population and with a preponderance of 85% in females, and has both genetic and environmental contribution. Acute pancreatitis is a severe condition and in most cases gallstones disease represents approximately half of the cases of acute pancreatitis, and 20-25% are related to alcohol abuse. Small numbers of cases are caused by a variety of other reasons but a few cases have no obvious cause, referred to as ′idiopathic′. Here we present a case where fibromyalgia might be linked to acute pancreatitis. We believe this has not been reported in this context in literature. Case Report: Fibromyalgia is a widespread musculoskeletal pain disorder found in 2% of the general population and with a preponderance of 85% in females, and has both genetic and environmental contribution. Patient had a cholecystectomy eight years previously. Patient feels tired almost all the time due to her fibromyalgia and requires family support for daily routine. Patient′s blood results showed alanine transaminase 527 IU/L, alkaline phosphatase 604 IU/L, bilirubin 34 μmol/L, amylase 2257 IU/L, C-reactive protein 19 mg/L, Gamma-Glutamyl transpeptidase 851 IU/L, renal function and electrolytes were within normal limits. The patient was admitted to the high dependency unit with a diagnosis of acute pancreatitis. Conclusion: There is a known increase in levels of cytokines in patients with fibromyalgia. Part of the pathophysiology of acute pancreatitis is related to raised cytokines and immune deregulations. We hypothesize that elevated levels of cytokines in fibromyalgia has led to acute pancreatitis in our patient. Further epidemiological research on the incidence of pancreatitis in cytokine mediated conditions such as fibromyalgia is required.

  18. Bilateral acute retinal necrosis after herpetic meningitis

    Directory of Open Access Journals (Sweden)

    Katsura T

    2012-04-01

    Full Text Available Keisho Hirota1,2, Masayuki Akimoto1,3, Toshiaki Katsura21Department of Ophthalmology, Kyoto Medical Center, National Hospital Organization, 2Internal Medicine, Kyoto Medical Center, 3Clinical Research Center, Kyoto Medical Center, Kyoto, JapanPurpose: The report of a case of bilateral acute retinal necrosis after herpetic meningitis.Case report: A 47-year-old man was admitted with the chief complaint of persistent high fever and transient loss of consciousness. Although his general condition improved after intravenous acyclovir administration, the patient presented with visual loss in both eyes 4 days after admission. Visual acuity in his right eye was 20/200 and his left eye had light perception alone. Both eyes showed panretinal arteritis diagnosed as acute retinal necrosis. Panretinal photocoagulation was performed for both eyes. Progression of retinal detachment was prevented in both eyes; however, visual acuity of the left eye was totally lost because of neovascular glaucoma. Visual acuity of the right eye recovered to 20/20.Conclusion: Although cases of bilateral acute retinal necrosis have been reported after herpetic encephalitis, this condition is rare after herpetic meningitis. Prophylactic acyclovir therapy and early panretinal photocoagulation may prevent retinal detachment and improve the prognosis. Neurologists and ophthalmologists should be aware that not only herpetic encephalitis but also herpetic meningitis can lead to acute retinal necrosis within a very short interval.Keywords: acute retinal necrosis, herpetic meningitis, herpes simplex, varicella zoster virus

  19. Treatment of acute gout.

    Science.gov (United States)

    Schlesinger, Naomi

    2014-05-01

    This article presents an overview of the treatment of acute gout. Nonpharmacologic and pharmacologic treatments, monotherapy versus combination therapy, suggested recommendations, guidelines for treatment, and drugs under development are discussed.

  20. Acute genital ulcers.

    Science.gov (United States)

    Delgado-García, Silvia; Palacios-Marqués, Ana; Martínez-Escoriza, Juan Carlos; Martín-Bayón, Tina-Aurora

    2014-01-28

    Acute genital ulcers, also known as acute vulvar ulcers, ulcus vulvae acutum or Lipschütz ulcers, refer to an ulceration of the vulva or lower vagina of non-venereal origin that usually presents in young women, predominantly virgins. Although its incidence is unknown, it seems a rare entity, with few cases reported in the literature. Their aetiology and pathogenesis are still unknown. The disease is characterised by an acute onset of flu-like symptoms with single or multiple painful ulcers on the vulva. Diagnosis is mainly clinical, after exclusion of other causes of vulvar ulcers. The treatment is mainly symptomatic, with spontaneous resolution in 2 weeks and without recurrences in most cases. We present a case report of a 13-year-old girl with two episodes of acute ulcers that fit the clinical criteria for Lipschütz ulcers.

  1. Acute Radiation Syndrome

    Science.gov (United States)

    ... Matters Information on Specific Types of Emergencies Acute Radiation Syndrome (ARS): A Fact Sheet for the Public ... is called the radiation dose. People exposed to radiation will get ARS only if: The radiation dose ...

  2. Acute Intermittent Porphyria (AIP)

    Science.gov (United States)

    ... attacks, but are usually not chronic. Wearing a Medic Alert bracelet is advisable for patients who have ... Week is ONE Month Away! Mar 17, 2017 Access to Care Toolkit for the Acute Porphyrias is ...

  3. Acute Lymphocytic Leukemia

    Science.gov (United States)

    ... for information in your local library and on the Internet. Good sources include the National Cancer Institute, the ... mayoclinic.org/diseases-conditions/acute-lymphocytic-leukemia/basics/definition/CON-20042915 . Mayo Clinic Footer Legal Conditions and ...

  4. Acute Myelogenous Leukemia (AML)

    Science.gov (United States)

    ... for information in your local library and on the Internet. Good sources include the National Cancer Institute, the ... mayoclinic.org/diseases-conditions/acute-myelogenous-leukemia/basics/definition/CON-20043431 . Mayo Clinic Footer Legal Conditions and ...

  5. Acute mountain sickness

    Science.gov (United States)

    High altitude cerebral edema; Altitude anoxia; Altitude sickness; Mountain sickness; High altitude pulmonary edema ... Acute mountain sickness is caused by reduced air pressure and lower oxygen levels at high altitudes. The faster you ...

  6. Low back pain - acute

    Science.gov (United States)

    Backache; Low back pain; Lumbar pain; Pain - back; Acute back pain; Back pain - new; Back pain - short-term; Back ... lower back supports most of your body's weight. Low back pain is the number two reason that ...

  7. Acute liver failure

    DEFF Research Database (Denmark)

    Larsen, Fin Stolze; Bjerring, Peter Nissen

    2011-01-01

    Acute liver failure (ALF) results in a multitude of serious complications that often lead to multi-organ failure. This brief review focuses on the pathophysiological processes in ALF and how to manage these.......Acute liver failure (ALF) results in a multitude of serious complications that often lead to multi-organ failure. This brief review focuses on the pathophysiological processes in ALF and how to manage these....

  8. [Acute Kidney Injury].

    Science.gov (United States)

    Brix, Silke; Stahl, Rolf

    2017-02-01

    Acute kidney injury (AKI) is an important part of renal diseases and a common clinical problem. AKI is an acute decline in renal function. Due to a lack of therapeutic options, prevention and optimal management of patients with AKI are the most important strategies. Although seldom the sole cause of patients' death, AKI is associated with a significant increase in mortality. Our objective is to draw the attention towards the prevention of AKI of non-renal causes.

  9. An Unusual Case of Acute Epiglottic Abscess

    Directory of Open Access Journals (Sweden)

    Tanthry Deepalakshmi

    2014-01-01

      Incision and drainage was performed under general anaesthesia after haematological investigations. Patient was extubated the next day, and was discharged after two days, also oral antibiotics, and analgesics were prescribed. Patient was reviewed after 2 weeks, and indirect laryngoscopy revealed a normal epiglottis.Although pharyngitis is the most common cause of sore throat in adults, acute epiglottitis must be considered in differential diagnosis when there is unrelenting throat pain, and minimal objective signs of pharyngitis. Epiglottic abscess formation is more common in adults than children. They most commonly occur as a complication of acute pharyngitis or with abscess of lingual tonsil .The abscess most frequently comes to a point on or near the lingual surface of the epiglottis. Streptococcus was isolated more frequently. Other organisms reported were Haemophilus influenzae, E.coli, Pseudomonas, Micro- coccus catarrhalis, Pneumococci. In our case, there were no preceding symptoms of acute pharyngitis. Risk factors include adult age at onset, diabetes mellitus, trauma, presence of a foreign body, and immune- compromised state. This case is unusual because of the absence of above risk factors. Incision and drainage under general anaesthesia is the treatment of choice. To the author’s knowledge, very few cases of acute epiglottic abscesses have been reported in the literature. This case is unusual because there are no preceding symptoms of pharyngitis or tonsillitis, and no association of risk factors like diabetes mellitus, trauma, foreign body or immunocompromised state.

  10. Focus on acute diarrhoeal disease

    Institute of Scientific and Technical Information of China (English)

    Fabio Baldi; Maria Antonia Bianco; Gerardo Nardone; Alberto Pilotto; Emanuela Zamparo

    2009-01-01

    Diarrhoea is an alteration of normal bowel movement characterized by an increase in the water content,volume, or frequency of stools. Diarrhoea needs to be classified according to the trends over time (acute or chronic) and to the characteristics of the stools (watery, fatty, inflammatory). Secretory diarrhoeas,mostly acute and of viral aetiology in more than 70% of cases, are by far the most important subtype of diarrhoeas in terms of frequency, incidence and mortality (over 2.5 million deaths/year in developing countries). Natural and synthetic opiates such as morphine, codeine, and loperamide which react with endogenous opiates (enkephalins, beta-endorphins,dynorphins) mainly act on intestinal motility and slow down transit. An antidiarrhoeal drug developed in recent years, racecadotril, acts as an enkephalinase inhibitor.Clinical studies have shown that it is just as effective as loperamide in resolving acute diarrhoea but with greater reduction in pain and abdominal distension.Some studies have explored the prevalence of diarrhoea in old age. An epidemiological study carried out in Italy by 133 General Practitioners on 5515 elderly outpatients reported a prevalence of diarrhoea, defined according to the Rome criteria, of 9.1%. Infectious diseases (19%) and drug use (16%) were the most commoncauses of diarrhoea in old age. Regardless of the cause,the treatment of elderly patients with diarrhoea must include rehydration and nutritional support. Every year,more than 50 million tourists travel from industrialized countries to places where hygiene levels are poor. At least 75% of those travelling for short periods mention health problems, and in particular traveller's diarrhoea.

  11. An uncommon shape of epiglottis misleading as acute epiglottitis.

    Science.gov (United States)

    Sasaki, Toru; Nomura, Yasuyuki; Tsunoda, Koichi

    2012-07-27

    We report a case of a 31-year-old Japanese woman with an uncommon shape of epiglottis misleading as acute epiglottitis. She presented with high fever, arthralgia, general fatigue and strong throat pain. Laryngeal fiberscopy showed a markedly swollen epiglottis suggestive of acute epiglottitis, though she had no signs of asphyxia. A careful observation and detailed medical history ruled out acute epiglottitis. However, without clinical discretion, it might have been misinterpreted as acute epiglottitis. She was diagnosed later with Behçet's disease, which is reported to present pharyngeal stenosis. Two years later, a repeat laryngeal fiberscopy showed exactly the same appearance of the epiglottis, suggesting its shape to be permanent. The cause of this misleading shape of the epiglottis in this patient is yet unknown. For similar cases, a possibility of this kind of epiglottis should be considered before diagnosing as acute epiglottitis.

  12. Differentiating Acute Otitis Media and Acute Mastoiditis in Hospitalized Children.

    Science.gov (United States)

    Laulajainen-Hongisto, Anu; Aarnisalo, Antti A; Jero, Jussi

    2016-10-01

    Acute otitis media is a common infection in children. Most acute otitis media episodes can be treated at an outpatient setting with antimicrobials, or only expectant observation. Hospital treatment with parenteral medication, and myringotomy or tympanostomy, may be needed to treat those with severe, prolonged symptoms, or with complications. The most common intratemporal complication of acute otitis media is acute mastoiditis. If a child with acute mastoiditis does not respond to this treatment, or if complications develop, further examinations and other surgical procedures, including mastoidectomy, are considered. Since the treatment of complicated acute otitis media and complicated acute mastoiditis differs, it is important to differentiate these two conditions. This article focuses on the differential diagnostics of acute otitis media and acute mastoiditis in children.

  13. Sepsis and Acute Kidney Injury.

    Science.gov (United States)

    Bilgili, Beliz; Haliloğlu, Murat; Cinel, İsmail

    2014-12-01

    Acute kindney injury (AKI) is a clinical syndrome which is generally defined as an abrupt decline in glomerular filtration rate, causing accumulation of nitrogenous products and rapid development of fluid, electrolyte and acid base disorders. In intensive care unit sepsis and septic shock are leading causes of AKI. Sepsis-induced AKI literally acts as a biologic indicator of clinical deterioration. AKI triggers variety of immune, inflammatory, metabolic and humoral patways; ultimately leading distant organ dysfunction and increases morbidity and mortality. Serial mesurements of creatinine and urine volume do not make it possible to diagnose AKI at early stages. Serum creatinine influenced by age, weight, hydration status and become apparent only when the kidneys have lost 50% of their function. For that reason we need new markers, and many biomarkers in the diagnosis of early AKI activity is assessed. Historically "Risk-Injury-Failure-Loss-Endstage" (RIFLE), "Acute Kidney Injury Netwok" (AKIN) and "The Kidney Disease/ Improving Global Outcomes" (KDIGO) classification systems are used for diagnosing easily in clinical practice and research and grading disease. Classifications including diagnostic criteria are formed for the identification of AKI. Neutrophil gelatinase associated lipocalin (NGAL), cystatin-C (Cys-C), kidney injury molecule-1 (KIM-1) and also "cell cycle arrest" molecules has been concerned for clinical use. In this review the pathophysiology of AKI, with the relationship of sepsis and the importance of early diagnosis of AKI is evaluated.

  14. A Generalization of Generalized Fibonacci and Generalized Pell Numbers

    Science.gov (United States)

    Abd-Elhameed, W. M.; Zeyada, N. A.

    2017-01-01

    This paper is concerned with developing a new class of generalized numbers. The main advantage of this class is that it generalizes the two classes of generalized Fibonacci numbers and generalized Pell numbers. Some new identities involving these generalized numbers are obtained. In addition, the two well-known identities of Sury and Marques which…

  15. Management of acute hepatitis B.

    Science.gov (United States)

    Shiffman, Mitchell L

    2010-02-01

    Acute hepatitis B virus (HBV) is a common cause of acute icteric hepatitis in adults. The vast majority of these patients resolve this acute infection and develop long-lasting immunity. In contrast, the vast majority of patients who develop chronic HBV have minimal symptoms and do not develop jaundice after becoming infected with HBV. These patients will frequently remain undiagnosed for years or decades. Approximately 1% of persons with acute HBV develop acute liver failure. Preventing acute HBV with vaccination is the best treatment. Although universal vaccination is now administered to newborns in many countries, the majority of adults have not been vaccinated and remain at risk. Because the majority of patients with acute HBV resolve this infection spontaneously, treatment with an oral anti-HBV agent is not necessary. However, the use of an oral anti-HBV agent is not unreasonable to use in a patient who is developing acute liver failure from severe acute HBV.

  16. Acute pulmonary edema after intramyometrial prostodin

    Directory of Open Access Journals (Sweden)

    Neha Baduni

    2011-01-01

    Full Text Available A 25 year old, 68 kg, primigravida, was taken up for emergency caesarean section for meconium stained liquor and fetal distress. She was a known case of pre eclampsia and her blood pressure was controlled on tab methyl dopa. she was administered general anaesthesia. after delivery of baby she went into postpartum hemorrhage which was controlled with intramyometrial prostodin. but immediately after its administration she went into acute pulmonary edema.

  17. Clinical Review: Emergency management of acute poisoning

    Directory of Open Access Journals (Sweden)

    D.J. van Hoving

    2011-06-01

    The aim of this commissioned review was to establish concise guidelines for the initial management of the acutely poisoned patient in the Emergency Centre. The American Academy of Clinical Toxicology and the European Association of Poisons Centres and Clinical Toxicologists are the international leaders in the field of toxicology and the guidelines in their position papers were generally followed. Most of the dosage regimes are according to the South African Medicines Formulary.

  18. Action of Antiproteases on the Inflammatory Response in Acute Pancreatitis

    Directory of Open Access Journals (Sweden)

    Chun-Chia Chen

    2007-07-01

    Full Text Available The spectrum of acute pancreatitis ranges from mild edematous disease to a severe necrotizing process which is usually accompanied by local or systemic complications and even mortality. Early deaths (within the first week due to severe acute pancreatitis are generally caused by massive inflammatory responses which result in multiple organ failure. Although the exact mechanisms which trigger the inflammatory and necrotizing processes are not completely understood, it is generally accepted that autodigestion and activated leukocytes play important roles in the pathogenesis of acute pancreatitis. Proinflammatory cytokines are associated with systemic inflammatory response syndrome and multiple organ failure syndrome in acute pancreatitis. A compensatory anti-inflammatory response occurs in parallel with systemic inflammatory response syndrome. Trypsin secreted by the pancreatic acinar cells activates proteaseactivated receptor-2 which can result in the production of cytokines. Protease inhibitors such as aprotinin, gabexate mesilate, nafamostat mesilate, ulinastatin, etc. can inhibit the various enzymes and inflammatory response in experimental and clinical studies. Thus, protease inhibitors have been considered as a potential treatment to inhibit the pancreatic inflammation in acute pancreatitis. The beneficial effects of antiproteases on experimental severe acute pancreatitis may be, in part, due to the modulation of inflammatory cytokine responses. The effect of protease inhibitors on the inflammatory response in human acute pancreatitis deserves further study.

  19. Is ketamine a lifesaving agent in childhood acute severe asthma?

    OpenAIRE

    Hendaus MA; Jomha FA; Alhammadi AH

    2016-01-01

    Mohamed A Hendaus,1,2 Fatima A Jomha,3 Ahmed H Alhammadi1,2 1Department of Pediatrics, Section of Academic General Pediatrics, Hamad Medical Corporation, Doha, 2Department of Clinical Pediatrics, Weill Cornell Medical College in Qatar, Doha, Qatar; 3School of Pharmacy, Lebanese International University, Khiara, Lebanon Abstract: Children with acute severe asthma exacerbation are at risk of developing respiratory failure. Moreover, conventional aggressive management might be futile in acute ...

  20. Audit in acute severe asthma--who benefits?

    Science.gov (United States)

    Harrison, B D; Pearson, M G

    1993-10-01

    This paper reviews published audit activity for a single common condition (asthma). Has this effort brought about better care for the patient? The result of this audit of audits reveals that specialists do follow the guidelines on the management of acute asthma with good results, but that general physicians, in whose care perforce many acute episodes are managed, do not seem to be aware of the published good practice guidelines.

  1. Diphenhydramine-induced acute dystonia.

    Science.gov (United States)

    Etzel, J V

    1994-01-01

    A 45-year-old woman was administered oral and intravenous diphenhydramine 25 mg for the treatment of an allergic reaction. Within 2 minutes she rapidly developed trismus, dysarthria, tremors of the upper extremities, left-sided weakness, and diminished consciousness. She was treated with intravenous diazepam and benztropine with good response. After approximately 12 hours the patient's condition was completely resolved except for minor subjective weakness of her left extremities. Her hospital stay was uneventful, and she was discharged after 4 days after refusing rechallenge with the drug. Several cases of acute dystonic reactions secondary to antihistamines have been reported in the literature, four of which involved diphenhydramine. Such reactions may occur after short- or long-term therapy. Most patients experienced rapidly developing trismus, facial dystonia, dysarthria, and occasionally, decreases in consciousness, motor incoordination, and weakness. Because of the widespread availability of diphenhydramine and other antihistamines to the general public, awareness of this effect is of great importance.

  2. Treatment of acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Al-Mofleh Ibrahim

    1998-01-01

    Full Text Available There is no specific treatment for acute pancreatitis. Majority of patients with acute pancreatitis respond to medical therapy. Supportive measures and close observations represent the cornerstone of the medical therapy. Failure to respond to medical treatment may indicate choledocholithiasis or infected necrosis. Endoscopic papillotomy with stone retrieval is beneficial in patients with severe biliary pancreatitis. Image-guided fine needle aspiration and bacteriological examination of aspirate is reliable in detecting infection and deliniating causative pathogen. Surgical debridement is the method of choice for treatment of infected necrosis. In contrast, in pancreatic abscess, surgery is preserved for those, who do not respond to percutaneous drainage combined with antibiotics. The benefit of antisecretory and antiproteolytic agents is debatable. A combination of antioxidants, calcium channel antagonists and antibiotics may play a major role in the treatment of acute pancreatitis in the future.

  3. [Acute hypertrygliceridemic pancreatitis].

    Science.gov (United States)

    Senosiain Lalastra, Carla; Tavío Hernández, Eduardo; Moreira Vicente, Victor; Maroto Castellanos, Maite; García Sánchez, Maria Concepción; Aicart Ramos, Marta; Téllez Vivajos, Luis; Cuño Roldán, José Luis

    2013-04-01

    Acute hypertriglyceridemic pancreatitis is the third cause of acute pancreatitis in the Western population. There is usually an underlying alteration in lipid metabolism and a secondary factor. Clinical presentation is similar to that of pancreatitis of other etiologies, but the course of acute hypertriglyceridemic pancreatitis seems to be worse and more recurrent. Some laboratory data can be artefacts, leading to diagnostic errors. This is the case of amylase, which can show false low levels. Treatment is based on intense fluidotherapy and analgesia. When there is no response to conservative management, other methods to lower triglyceride levels should be used. Several options are available, such as plasmapheresis, insulin, and heparin. The present article provides a review of the current literature on this entity.

  4. Acute management of stones

    DEFF Research Database (Denmark)

    Jung, Helene; Osther, Palle J S

    2015-01-01

    INTRODUCTION: Stone management is often conservative due to a high spontaneous stone passage rate or non-symptomatic calyceal stones that do not necessarily require active treatment. However, stone disease may cause symptoms and complications requiring urgent intervention. MATERIAL AND METHODS......: In this review, we update latest research and current recommendations regarding acute management of stones, with particular focus on imaging, pain management, active stone interventions, medical expulsive therapy, and urolithiasis in pregnancy and childhood. RESULTS: Acute stone management should be planned...... with careful consideration of stone size and location, symptoms, patient comorbidity and radiation dose. CONCLUSION: In case of infective hydronephrosis, compromised renal function or persistent pain despite adequate analgesic treatment acute intervention is indicated....

  5. Pharm GKB: Leukemia, Promyelocytic, Acute [PharmGKB

    Lifescience Database Archive (English)

    Full Text Available Overview Alternate Names: Synonym APL - Acute promyelocytic leukaemia; APL - Acute ...promyelocytic leukemia; APML - Acute promyelocytic leukaemia; APML - Acute promyelocytic leukemia; Acute Promyelocytic Leukemia; Acut...e Promyelocytic Leukemias; Acute myeloid leukaemia, PML/RAR-alpha; Acute myeloid le...ukemia, PML/RAR-alpha; Acute myeloid leukemia, t(15;17)(q22;q11-12); Acute promye...locytic leukaemia (clinical); Acute promyelocytic leukaemia, FAB M3; Acute promyelocytic leukaemia, PML/RAR-alpha; Acute

  6. Pharm GKB: Leukemia, Erythroblastic, Acute [PharmGKB

    Lifescience Database Archive (English)

    Full Text Available Overview Alternate Names: Synonym AML M6; Acute Erythroblastic Leukemia; Acute Erythroblastic Leukemias; Acu...te erythraemic myelosis [obs]; Acute erythremia [obs]; Acute erythremic myelosis [obs]; Acute... erythroid leukaemia; Acute erythroid leukemia; Acute myeloid leukaemia, M6 type; Acute myeloid le...Erythroblastic Leukemia, Acute; Erythroblastic Leukemias, Acute; Erythroleukaemia...; Erythroleukemia; Erythroleukemias; FAB M6; Leukemia, Acute Erythroblastic; Leukemia, Myeloid, Acute, M6; Leukemias, Acute

  7. Congenital acute megakaryocytic leukemia

    Directory of Open Access Journals (Sweden)

    N B Mathur

    2011-01-01

    Full Text Available Congenital leukemia (CL is an extremely rare disorder in the newborn, significant proportion of which is of myeloid origin, primarily of M4 or M5 morphology. As compared to pediatric leukemia, CL is a more aggressive disease. Acute myeloid leukemia (AML-M7 or acute megakaryocytic leukemia is a rare type of AML with an incidence of 0.5 per million per year. Median age of presentation is 6 years, and children may present with a broad variety of symptoms including low-grade fever, diarrhea, easy bruising, failure to gain weight and life-threatening conditions.

  8. Generalized periodic and generalized Boolean rings

    Directory of Open Access Journals (Sweden)

    Howard E. Bell

    2001-01-01

    Full Text Available We prove that a generalized periodic, as well as a generalized Boolean, ring is either commutative or periodic. We also prove that a generalized Boolean ring with central idempotents must be nil or commutative. We further consider conditions which imply the commutativity of a generalized periodic, or a generalized Boolean, ring.

  9. Acute myeloid leukemia (AML) - children

    Science.gov (United States)

    Acute myeloid leukemia is a cancer of the blood and bone marrow. Bone marrow is the soft tissue inside ... develops quickly. Both adults and children can get acute myeloid leukemia ( AML ). This article is about AML in children.

  10. Loperamide-Induced Acute Pancreatitis

    Directory of Open Access Journals (Sweden)

    Halla Vidarsdottir

    2013-01-01

    Full Text Available Acute pancreatitis is a common disease leading to hospitalizations, most often caused by gallstones or alcohol. We present a case of a patient diagnosed with acute pancreatitis considered to be due to loperamide treatment for diarrhea.

  11. Diagnosis and treatment of acute bronchitis.

    Science.gov (United States)

    Albert, Ross H

    2010-12-01

    Cough is the most common symptom bringing patients to the primary care physician's office, and acute bronchitis is usually the diagnosis in these patients. Acute bronchitis should be differentiated from other common diagnoses, such as pneumonia and asthma, because these conditions may need specific therapies not indicated for bronchitis. Symptoms of bronchitis typically last about three weeks. The presence or absence of colored (e.g., green) sputum does not reliably differentiate between bacterial and viral lower respiratory tract infections. Viruses are responsible for more than 90 percent of acute bronchitis infections. Antibiotics are generally not indicated for bronchitis, and should be used only if pertussis is suspected to reduce transmission or if the patient is at increased risk of developing pneumonia (e.g., patients 65 years or older). The typical therapies for managing acute bronchitis symptoms have been shown to be ineffective, and the U.S. Food and Drug Administration recommends against using cough and cold preparations in children younger than six years. The supplement pelargonium may help reduce symptom severity in adults. As patient expectations for antibiotics and therapies for symptom management differ from evidence-based recommendations, effective communication strategies are necessary to provide the safest therapies available while maintaining patient satisfaction.

  12. Acute kidney injury in the pregnant patient.

    Science.gov (United States)

    Nwoko, Rosemary; Plecas, Darko; Garovic, Vesna D

    2012-12-01

    Acute kidney injury (AKI) is costly and is associated with increased mortality and morbidity. An understanding of the renal physiologic changes that occur during pregnancy is essential for proper evaluation, diagnosis, and management of AKI. As in the general population, AKI can occur from prerenal, intrinsic, and post-renal causes. Major causes of pre-renal azotemia include hyperemesis gravidarum and uterine hemorrhage in the setting of placental abruption. Intrinsic etiologies include infections from acute pyelonephritis and septic abortion, bilateral cortical necrosis, and acute tubular necrosis. Particular attention should be paid to specific conditions that lead to AKI during the second and third trimesters, such as preeclampsia, HELLP syndrome, acute fatty liver of pregnancy, and TTP-HUS. For each of these disorders, delivery of the fetus is the recommended therapeutic option, with additional therapies indicated for each specific disease entity. An understanding of the various etiologies of AKI in the pregnant patient is key to the appropriate clinical management, prevention of adverse maternal outcomes, and safe delivery of the fetus. In pregnant women with pre-existing kidney disease, the degree of renal dysfunction is the major determining factor of pregnancy outcomes, which may further be complicated by a prior history of hypertension.

  13. Pregnancy related acute kidney injury: nondialytic management

    Directory of Open Access Journals (Sweden)

    Kaliki Hymavathi Reddy

    2015-04-01

    Full Text Available Acute Kidney Injury (AKI is associated with increased mortality and morbidity unless timely diagnosed and promptly managed. An understanding of the renal physiologic changes that occur during pregnancy is essential for Proper evaluation, diagnosis, and management of Pregnancy Related AKI (PRAKI. In the general population, AKI can occur from prerenal, intrinsic/renal, and post-renal causes. Major causes of pre-renal azotemia include hyperemesis gravidarum and uterine hemorrhage in the setting of placental abruption. Intrinsic etiologies include infections from acute pyelonephritis and septic abortion, bilateral cortical necrosis, and acute tubular necrosis. Particular attention should be paid to specific conditions that lead to AKI during the second and third trimesters, such as preeclampsia, HELLP syndrome, acute fatty liver of pregnancy, and TTP-HUS. An understanding of the various etiologies of AKI in the pregnant patient is key to the appropriate clinical management and prevention of adverse maternal/fetal outcomes. Sometimes PRAKI may require intensive management and even dialysis adding additional economical burden to the patient. We here, with report an interesting case of PRAKI diagnosed and managed in time by simple medical measures thus delivering an effective treatment at a much lesser cost. [Int J Reprod Contracept Obstet Gynecol 2015; 4(2.000: 486-489

  14. New biomarkers of acute kidney injury

    Directory of Open Access Journals (Sweden)

    Ruya Ozelsancak

    2013-04-01

    Full Text Available Acute kidney injury is a clinical syndrome which is generally defined as an abrupt decline in glomerular filtration rate causing accumulation of nitrogenous products and rapid development of fluid, electrolyte and acid-base disorders. It is an important clinical problem increasing mortality in patient with several co-morbid conditions. The frequency of acute kidney injury occurrence varies from 5% on the inpatients wards to 30-50% in patients from intensive care units. Serial measurement of creatinine and urine volume do not make it possible to diagnose acute kidney injury at early stages. Serum creatinine may be influenced by age, weight, hydration status and become apparent only when the kidneys have lost 50% of their function. For that reasons we need new markers. Here, we are reviewing the most promising new acute kidney injury markers, neutrophil gelatinase associated lipocalin, cystatin-C, kidney injury molecule-1, liver fatty acid binding proteins and IL-18. [Archives Medical Review Journal 2013; 22(2.000: 221-229

  15. Childhood Acute Lymphoblastic Leukemia

    DEFF Research Database (Denmark)

    Pui, Ching-Hon; Yang, Jun J; Hunger, Stephen P;

    2015-01-01

    PURPOSE: To review the impact of collaborative studies on advances in the biology and treatment of acute lymphoblastic leukemia (ALL) in children and adolescents. METHODS: A review of English literature on childhood ALL focusing on collaborative studies was performed. The resulting article was re...

  16. Acute cough in adults

    Institute of Scientific and Technical Information of China (English)

    Jochen W L Cals; Nick A Francis

    2010-01-01

    @@ A healthy, non-smoking 54 year old woman consults with a severe acute cough. It started two weeks ago with symptoms of a common cold, but she is worried about its duration and would like something to "clear it up. "

  17. Acute hemiplegia in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Okuno, Takehiko; Takao, Tatsuo; Itoh, Masatoshi; Konishi, Yukuo; Nakano, Shozo (Kyoto Univ. (Japan). Faculty of Medicine)

    1983-04-01

    The results of CT in 100 patients with acute hemiplegia in childhood are reported here. The etiology was various: 2 patients had infratentorial brain tumors, 56 had cerebral vascular diseases, 3 had head injuries, 16 had intracranial infectious diseases, one had postinfectious encephalomyelitis, one had multiple sclerosis, 2 had epilepsy, and the diagnosis of 19 were unknown. Eleven patients had a normal CT and a good prognosis. As for the type of onset, there were patients of type 1 with fever and 42 with convulsions and unconsciousness; those of type 2 with convulsions and unconsciousness were 12, and those of type 3 without fever and convulsions were 46. This classification is assumed to be useful, as the type of onset is characteristic of the etiology. Six patients were diagnosed correctly by repeated examinations, although the first CT did not reveal any remarkable findings. Capsular infarction, occlusion of the posterior cerebral artery in acute hemiplegia in childhood, abnormal findings of the internal capsule, thalamus, and midbrain in a patient with postinfectious encephalomyelitis, and a diffuse low density in the CT of the unilateral hemisphere in the patients with acute encephalopathy and acute hemiplegia of an obscure origin have been found after the introduction of computerized tomography.

  18. [Acute pancreatitis and pregnancy].

    Science.gov (United States)

    Scollo, P; Licitra, G

    1993-12-01

    Aetiologic factors (gallstones, hyperlipidemia I-IV, hypertriglyceridaemia) make their occurrence, mainly, in the third trimester of gestation. Two cases of acute pancreatitis in pregnancy are described; in both cases patients referred healthy diet, no habit to smoke and no previous episode of pancreatitis. An obstructive pathology of biliary tract was the aetiologic factor. Vomiting, upper abdominal pain are aspecific symptoms that impose a differential diagnosis with acute appendicitis, cholecystitis and obstructive intestinal pathology. Laboratory data (elevated serum amylase and lipase levels) and ultrasonography carry out an accurate diagnosis. The management of acute pancreatitis is based on the use of symptomatic drugs, a low fat diet alternated to the parenteral nutrition when triglycerides levels are more than 28 mmol/L. Surgical therapy, used only in case of obstructive pathology of biliary tract, is optimally collected in the third trimester or immediately after postpartum. Our patients, treated only medically, delivered respectively at 38th and 40th week of gestation. Tempestivity of diagnosis and appropriate therapy permit to improve prognosis of a pathology that, although really associated with pregnancy, presents high maternal mortality (37%) cause of complications (shock, coagulopathy, acute respiratory insufficiency) and fetal (37.9%) by occurrence of preterm delivery.

  19. Acute liver failure

    DEFF Research Database (Denmark)

    Bernal, William; Lee, William M; Wendon, Julia;

    2015-01-01

    Over the last three decades acute liver failure (ALF) has been transformed from a rare and poorly understood condition with a near universally fatal outcome, to one with a well characterized phenotype and disease course. Complex critical care protocols are now applied and emergency liver...

  20. [Acute arsenic poisoning].

    Science.gov (United States)

    Montelescaut, Etienne; Vermeersch, Véronique; Commandeur, Diane; Huynh, Sophie; Danguy des Deserts, Marc; Sapin, Jeanne; Ould-Ahmed, Mehdi; Drouillard, Isabelle

    2014-01-01

    Acute arsenic poisoning is a rare cause of suicide attempt. It causes a multiple organs failure caused by cardiogenic shock. We report the case of a patient admitted twelve hours after an ingestion of trioxide arsenic having survived thanks to a premature treatment.

  1. [Acute plasma cell leukemia].

    Science.gov (United States)

    Monsalbe, V; Domíngues, C; Roa, I; Busel, D; González, S

    1989-01-01

    Plasma Cell Leukemia is a very rare form of plasmocytic dyscrasia, whose clinical and pathological characteristics warrant its recognition as a distinct subentity. We report the case of a 60 years old man who presented a rapidly fatal acute plasma cell leukemia, with multiple osteolytic lesions, hipercalcemia, renal and cardiac failure.

  2. Drug-induced acute pancreatitis

    NARCIS (Netherlands)

    I.A. Eland (Ingo)

    2003-01-01

    textabstractAcute pancreatitis is an inflammatory disease of the pancreas with sudden onset. The severity of acute pancreatitis may vary from mild to life threatening. There are many risk factors for acute pancreatitis, among which gallstones and alcohol abuse are most widely known. Drugs are consid

  3. General(es) remisión de V. escuelas general(es).

    OpenAIRE

    2011-01-01

    [ES] Definición del término General(es) remisión de V. escuelas general(es). en el diccionario Dicter. [EN] Definition of the word General(es) remisión de V. escuelas general(es). in the dictionary Dicter.

  4. Acute periodontal lesions.

    Science.gov (United States)

    Herrera, David; Alonso, Bettina; de Arriba, Lorenzo; Santa Cruz, Isabel; Serrano, Cristina; Sanz, Mariano

    2014-06-01

    This review provides updates on acute conditions affecting the periodontal tissues, including abscesses in the periodontium, necrotizing periodontal diseases and other acute conditions that cause gingival lesions with acute presentation, such as infectious processes not associated with oral bacterial biofilms, mucocutaneous disorders and traumatic and allergic lesions. A periodontal abscess is clinically important because it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth and bacteria within the abscess can spread and cause infections in other body sites. Different types of abscesses have been identified, mainly classified by their etiology, and there are clear differences between those affecting a pre-existing periodontal pocket and those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, while an evaluation of the need for systemic antimicrobial therapy will be made for each case, based on local and systemic factors. The definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal diseases present three typical clinical features: papilla necrosis, gingival bleeding and pain. Although the prevalence of these diseases is not high, their importance is clear because they represent the most severe conditions associated with the dental biofilm, with very rapid tissue destruction. In addition to bacteria, the etiology of necrotizing periodontal disease includes numerous factors that alter the host response and predispose to these diseases, namely HIV infection, malnutrition, stress or tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in nonresponding conditions, being the first option metronidazole. Once the acute

  5. Acute pyelonephritis in ER

    Directory of Open Access Journals (Sweden)

    Giovanni Volpicelli

    2007-10-01

    Full Text Available Symptoms and signs of acute pyelonephritis sometimes are subtle and emergency physicians attending overcrowded and busy institutions could easily miss the right diagnosis. The presence of a renal damage is decisive in the therapeutic choice. Aims of our study are: 1 to assess prevalence of renal damage in patients presenting to our ED with symptoms and signs of primary urinary tract infection (UTI; 2 to evaluate the reliability of such symptoms and signs in predicting a renal damage; 3 to assess accuracy of the contrast enhanced ultrasound (CEUS in the ED diagnosis of renal damage due to acute uncomplicated pyelonephritis. We studied 54 patients with suspected UTI. Each patient underwent clinical examination, routine blood and urine sampling and conventional renal ultrasound (US. 23 patients had confirmation of acute primary UTI, and performed renal magnetic resonance (MR to rule out renal parenchymal involvement. In 16 patients (69,6% one or more parenchymal lesions were visualized at MR, and diagnosis of acute uncomplicated pyelonephritis was confirmed (group A. The other 7 patients had a diagnosis of UTI without renal involvement (group B. Some of 23 patients presented with few atypical symptoms. Lumbar pain was the most frequent symptom (n = 21, without a statistically significant difference between group A and B (P 0,958; p = 0,328. No other symptom or sign has demonstrated statistically valid in predicting the renal involvement. Renal US was positive in only 3 patients of group A (18,7%. During this first part of our study, CEUS was performed in a limited number of patients (n = 8, and in 7 examinations data were concordant with MR. In conclusion, analysis of our preliminary data confirms that a distinction between patients with different extension of the UTI is not possible through the simple clinical examination and routine tests. CEUS is very promising and its routine employment in the ED could simplify the diagnostic practice in

  6. Acute and sub-acute oral toxicity profile of Acorus calamus (Sweet flag) in rodents

    Institute of Scientific and Technical Information of China (English)

    Arunachalam Muthuraman; Nirmal Singh

    2012-01-01

    Objective: To determine the acute and sub-acute oral toxicity profile of the hydroalcoholic extract of Acorus calamus (HAE-AC) in mice and rats respectively. Methods: In acute toxicity study, mice were assessed to any alteration of general behavior and mortality rate within 24 h. Further, in sub-acute toxicity study, rats were used for assessment of mortality, body weight, hematological, biochemical and histopathological changes. Results: Single oral administrations of the HAE-AC 2500-10000 mg/kg induced increase in general behavioral abnormalities in mice. The mortality rate also increased with increasing dosage (median lethal dose; LD50 = 5 070.59 mg/kg). Daily single oral doses of HAE-AC 200, 500 and 1 000 mg/kg were observed to be well tolerated behaviorally after 28 days of dosing and induced no significant changes in body and organs weights of rats. Further, a mild rise in the levels of alanine transaminase (ALT), aspartate transaminase (AST) and histopatholological changes in liver tissue was noted at 1000 mg/kg dose of HAE-AC. Conclusions: Overall, the findings of this study indicate that, HAE-AC is non-toxic and has at high dose, a mild but acceptable toxicity potential.

  7. Implementation of a pre-hospital decision rule in general practice. Triage of patients with suspected myocardial infarction

    NARCIS (Netherlands)

    E.W.M. Grijseels (Els); J.W. Deckers (Jaap); A.W. Hoes (Arno); H. Boersma (Eric); J.A.M. Hartman; E. van der Does (Emiel); M.L. Simoons (Maarten)

    1996-01-01

    textabstractOBJECTIVE: To improve pre-hospital triage of patients with suspected acute cardiac disease. DESIGN: Prospective study. SUBJECTS. Patients with symptoms suggestive of acute cardiac pathology, who were seen by a general practitioner, for whom acute admission into hospital was requested, an

  8. Severe Acute Pancreatitis in Pregnancy

    Directory of Open Access Journals (Sweden)

    Bahiyah Abdullah

    2015-01-01

    Full Text Available This is a case of a pregnant lady at 8 weeks of gestation, who presented with acute abdomen. She was initially diagnosed with ruptured ectopic pregnancy and ruptured corpus luteal cyst as the differential diagnosis. However she then, was finally diagnosed as acute hemorrhagic pancreatitis with spontaneous complete miscarriage. This is followed by review of literature on this topic. Acute pancreatitis in pregnancy is not uncommon. The emphasis on high index of suspicion of acute pancreatitis in women who presented with acute abdomen in pregnancy is highlighted. Early diagnosis and good supportive care by multidisciplinary team are crucial to ensure good maternal and fetal outcomes.

  9. Programmatic Implications of Acute and Early HIV Infection.

    Science.gov (United States)

    Suthar, Amitabh B; Granich, Reuben M; Kato, Masaya; Nsanzimana, Sabin; Montaner, Julio S G; Williams, Brian G

    2015-11-01

    Human immunodeficiency virus (HIV) infection includes acute, early, chronic, and late stages. Acute HIV infection lasts approximately 3 weeks and early HIV infection, which includes acute HIV infection, lasts approximately 7 weeks. Many testing and blood screening algorithms detect HIV antibodies about 3 weeks after HIV infection. Incidence estimates are based on results of modeling, cohort studies, surveillance, and/or assays. Viral load is the key modifiable risk factor for HIV transmission and peaks during acute and early HIV infection. Empirical evidence characterizing the impact of acute and early HIV infection on the spread of the HIV epidemic are limited. Time trends of HIV prevalence collected from concentrated and generalized epidemics suggest that acute and early HIV infection may have a limited role in population HIV transmission. Collectively, these data suggest that acute and early HIV infection is relatively short and does not currently require fundamentally different programmatic approaches to manage the HIV/AIDS epidemic in most settings. Research and surveillance will inform which epidemic contexts and phases may require tailored strategies for these stages of HIV infection.

  10. Acute intermittent porphyria and pregnancy: an obstetric challenge

    Directory of Open Access Journals (Sweden)

    Pragati Meena

    2016-02-01

    Full Text Available Acute intermittent porphyria is a rare autosomal dominant disease caused by a mutation in the gene coding for the porphobillinogen deaminase enzymes in heam biosynthesis. The disease manifests as acute attacks of neuropsychiatric dysfunction and neurovisceral manifestations presenting as acute abdomen. In pregnancy, 54% patient has exacerbation of attacks in the form of seizures and acute abdomen occurs due to hormonal changes. Prevalence of acute intermittent porphyria is 1-2/200000 in general. Here we report a case of 36 year old women, G4P1L2A2 presenting at 10+4 weeks of gestation requesting pregnancy termination. Patient was diagnosed as case of acute intermittent porphyria with porphyic polyneuropathy 6 months back. At that time her main symptoms were acute pain abdomen with numbness and weakness in all four limbs. Her urinary porphobillinogen and 5 ALA raised. Her CECT of brain and nerve conduction studies were normal. Since then she is on Tablet Gabapentin 300 mg H.S. She underwent successful pregnancy termination by suction and evacuation under spinal anesthesia and she refused for copper-T insertion. Only safe drugs were used for procedure and she was discharged with advice of barrier contraception. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 542-544

  11. Acute Glomerulonephritis in Southern Iran

    Directory of Open Access Journals (Sweden)

    Ali Derakhshan

    2008-05-01

    Full Text Available Objective: Acute post streptococcal glomerulonephritis (APSGN is the most common type of in-patient glomerulonephritis (GN in childhood. It has not been studied well in this region yet. Here, we report our experience with APSGN in a tertiary referral center during a five-year period. Material & Methods: Hospital records of all 137 children who had been admitted to Nemazee hospital, between 2001 and 2006, with diagnosis of acute glomerulonephritis (AGN were reviewed. All demographic, clinical, paraclinical data and consumed medications were obtained.Findings: Among 137 children diagnosed as AGN, 122 (89% had APSGN. Other 15 (11% children had membranoproliferative glomerulonephritis (n=4, mesangioproliferative glomerulonephritis (n=4, IgA nephropathy (n=2, lupus nephritis (n=2, rapidly progressive glomerulonephritis (n=2, and focal segmental glomerulosclerosis (n=1. Mean (SD age in children with APSGN was 8.5 (3.5 (range, 3.5-13 years, 117 (96% children developed APSGN following a sore throat and 5 (4% following an impetigo, with 95 (78% during the cold seasons of the year. Periorbital edema was found in 97.5%, hypertension 75%, gross hematuria 72%, oliguria 37%, generalized edema 19%, azotemia (BUN>20 80%, and nephrotic-range proteinuria 24.5%. A high anti streptolysin-O (ASO titer and a low C3 level was detected in 84% and 86%, respectively. There was dilutional anemia in 51.5%, hyponatremia in 27%, and hyperkalemia 14%. With regard to medications, 19 patients received only furosemide, 73 cases furosemide and nifidipine, and 10 patients furosemide, nifidipine, and another antihypertensive medication. Hypertensive encephalopathy occurred in 3 cases, but no mortality was reported during the study period. Conclusion: APSGN is the most common type of glomerulonephritis in this region. It follows sore throat in the majority of cases. It usually has an uneventful course.

  12. Conservative treatment in patients with an acute lumbosacral radicular syndrome: design of a randomised clinical trial [ISRCTN68857256].

    NARCIS (Netherlands)

    P.A.J. Luijsterburg (Pim); A.P. Verhagen (Arianne); R.W.J.G. Ostelo (Raymond); H.J. van den Hoogen (Hans); W.C. Peul (Wilco); C.J.J. Avezaat (Cees); B.W. Koes (Bart)

    2004-01-01

    textabstractBACKGROUND: The objective is to present the design of randomised clinical trial (RCT) on the effectiveness of physical therapy added to general practitioners management compared to general practitioners management only in patients with an acute lumbosacral radicular syn

  13. Acute chylous ascites mimicking acute appendicitis in a patient with pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Emily K Smith; Edmund Ek; Daniel Croagh; Lavinia A Spain; Stephen Farrell

    2009-01-01

    We report a case of acute chylous peritonitis mimicking acute appendicitis in a man with acute on chronic pancreatitis. Pancreatitis, both acute and chronic, causing the development of acute chylous ascites and peritonitis has rarely been reported in the English literature. This is the fourth published case of acute chylous ascites mimicking acute appendicitis in the literature.

  14. Acute marijuana effects on social conversation.

    Science.gov (United States)

    Higgins, S T; Stitzer, M L

    1986-01-01

    The present study assessed the acute effects of smoked marijuana on social conversation. Speech quantity was recorded continuously in seven moderate marijuana users during separate 1 h experimental sessions following the paced smoking of 0, 1.01, 1.84, and 2.84% THC marijuana cigarettes. Subjects engaged in conversation with undrugged partners who smoked placebo marijuana cigarettes. The active marijuana produced significant decreases in speech quantity, increases in heart rate, and increases in self-reports of "high" and sedation. Partners showed no effects in speech quantity or self-reports of drug effects that were systematically related to the doses administered to the subject pair members. The effects on speech quantity observed in the present study after acute dosing are similar to the effects on social conversation reported previously during chronic marijuana dosing. Marijuana appears to be an exception to the general rule that drugs of abuse increase verbal interaction.

  15. Advances in management of patients with acute diverticulitis

    Institute of Scientific and Technical Information of China (English)

    Sibilla Focchi; Alberto Carrara; Ettore Contessini Avesani

    2015-01-01

    Objective: To analyse the development of the medical and surgical treatment of acute diverticulitis to develop an appropriate decision-making algorithm. Methods:We analysed the demographic characteristics, radiological images, disease severity, treatments and surgical outcomes of all of the patients with a diagnosis of acute diverticulitis admitted to the Department of General and Emergency Surgery between 1 January 2009 and 30 June 2014. Results:During the 66-month study period, 219 patients with acute diverticulitis attended our department; 69% had simple diverticulitis (93% were treated conservatively and 7% surgically) and 31% had complicated diverticulitis (76% were treated surgically and 24% conservatively). Of the patients who were treated surgically, 62.5% underwent primary resection with anastomosis, 31.94% Hartmann's procedure, and 5.56% laparoscopic lavage and drainage. Conclusions: Our cases and a careful review of the literature allowed us to develop a decision-making algorithm for patients with acute diverticulitis.

  16. Acute pancreatitis caused by leptospirosis: Report of two cases

    Institute of Scientific and Technical Information of China (English)

    Ekrem Kaya; Adem Dervisoglu; Cafer Eroglu; Cafer Polat; Mustafa Sunbul; Kayhan Ozkan

    2005-01-01

    Two cases of acute pancreatitis with leptospirosis are reported in this article. Case 1: A 68-year-old woman,presented initially with abdominal pain, nausea, vomiting,and jaundice. She was in poor general condition, and had acute abdominal signs and symptoms on physical examination. Emergency laparotomy was performed, acute pancreatitis and leptospirosis were diagnosed on the basis of surgical findings and serological tests. The patient died on postoperative d 6. Case 2: A 62-year-old man, presented with fever, jaundice, nausea, vomiting, and malaise. Acute pancreatitis associated with leptospirosis was diagnosed,according to abdominal CT scanning and serological tests.The patient recovered fully with antibiotic treatment and nutritional support within 19 d.

  17. A case of scrub typhus complicated by acute calculous cholecystitis.

    Science.gov (United States)

    Lee, Su Jin; Cho, Young Hye; Lee, Sang Yeoup; Jeong, Dong Wook; Choi, Eun Jung; Kim, Yun Jin; Lee, Jeong Gyu; Lee, Yu Hyun

    2012-07-01

    We report a case of acute calculous cholecystitis through scrub typhus. A 69-year-old woman presented with a history of general myalgia, fever, and right abdominal pain. She referred to our hospital for surgical treatment of clinically suspected acute cholecystitis. Physicians concluded the cause of cholecystitis as gall bladder (GB) stone and proper antibiotics treatment of scrub typhus was started later. The patient developed acute respiratory distress syndrome and multi organ failure through scrub typhus. Five days after admission, the patient was treated with proper antibiotics and discharged on the 13th day after starting doxycycline treatment without any sequelae. In areas endemic for tsutsugamushi disease, even though a patient with GB stone presents with symptoms of acute cholecystitis, careful history and physical examination are required to reveal the existence of eschars or skin eruptions.

  18. Acute stroke: postprocedural care and management of complications.

    Science.gov (United States)

    de Carvalho, Flávio Augusto; de Figueiredo, Marcelo Marinho; Silva, Gisele Sampaio

    2012-03-01

    Endovascular treatment for acute ischemic stroke is an important alternative to thrombolysis with recombinant tissue plasminogen activator (rt-PA) for patients who present beyond the thrombolysis time window, those who are ineligible for rt-PA, or those who do not improve after intravenous rt-PA. These patients generally require special attention in the postprocedural period because, although not frequent, complications of endovascular procedures in acute ischemic stroke have the potential to be devastating. Neurocritical care is essential to reduce and appropriately treat complications after endovascular procedures. Neurointensivists and neurocritical care nurses are experts in both critical care and neurologic disorders and have special training to recognize early physiological derangements in patients presenting with acute stroke. Close attention to the serial neurological examination, blood pressure control, adequate management of glucose, temperature, and immediate identification of complications such as reocclusion and hemorrhagic transformation are key elements that exemplify the importance of postprocedural neurocritical care in acute ischemic stroke.

  19. Prevention of acute malnutrition

    DEFF Research Database (Denmark)

    de Pee, Saskia; Grais, Rebecca; Fenn, Bridget;

    2015-01-01

    Acute malnutrition is associated with increased morbidity and mortality risk. When episodes are prolonged or frequent, acute malnutrition is also associated with poor growth and development, which contributes to stunting Nutrition-specific and nutrition-sensitive strategies to prevent...... undernutrition during the first 1,000 days from conception to 24 months of age can reduce the risks of wasting, stunting, and micronutrient deficiencies. Under circumstances that exacerbate the underlying causes of undernutrition and increase the incidence of wasting, such as food insecurity related to lean...... seasons or emergencies, or increased incidence of illness, such as diarrhea or measles, additional efforts are required to prevent and treat wasting. Special nutritious foods directly meet the increased nutrient requirements of children at risk for wasting; assistance to vulnerable households, in the form...

  20. Streptococcal acute pharyngitis

    Directory of Open Access Journals (Sweden)

    Lais Martins Moreira Anjos

    2014-07-01

    Full Text Available Acute pharyngitis/tonsillitis, which is characterized by inflammation of the posterior pharynx and tonsils, is a common disease. Several viruses and bacteria can cause acute pharyngitis; however, Streptococcus pyogenes (also known as Lancefield group A β-hemolytic streptococci is the only agent that requires an etiologic diagnosis and specific treatment. S. pyogenes is of major clinical importance because it can trigger post-infection systemic complications, acute rheumatic fever, and post-streptococcal glomerulonephritis. Symptom onset in streptococcal infection is usually abrupt and includes intense sore throat, fever, chills, malaise, headache, tender enlarged anterior cervical lymph nodes, and pharyngeal or tonsillar exudate. Cough, coryza, conjunctivitis, and diarrhea are uncommon, and their presence suggests a viral cause. A diagnosis of pharyngitis is supported by the patient's history and by the physical examination. Throat culture is the gold standard for diagnosing streptococcus pharyngitis. However, it has been underused in public health services because of its low availability and because of the 1- to 2-day delay in obtaining results. Rapid antigen detection tests have been used to detect S. pyogenes directly from throat swabs within minutes. Clinical scoring systems have been developed to predict the risk of S. pyogenes infection. The most commonly used scoring system is the modified Centor score. Acute S. pyogenes pharyngitis is often a self-limiting disease. Penicillins are the first-choice treatment. For patients with penicillin allergy, cephalosporins can be an acceptable alternative, although primary hypersensitivity to cephalosporins can occur. Another drug option is the macrolides. Future perspectives to prevent streptococcal pharyngitis and post-infection systemic complications include the development of an anti-Streptococcus pyogenes vaccine.

  1. Acute appendicitis in pregnancy

    OpenAIRE

    Ortiz-Gualdrón César Augusto

    2012-01-01

    Acute appendicitis is the most common non-obstetric surgery pathology in pregnancy, itsincidence can be varied and occurs at a higher rate during the first and second trimesterof gestation. Its diagnosis is difficult and can be confused by the anatomical andphysiological changes during pregnancy, which alter their clinical presentation. Commonsymptoms are abdominal located pain, vomiting and nausea. The diagnosis is mainlyclinical, but laboratory tests and additional imaging help confirm or r...

  2. Acute ischemic cerebral attack

    OpenAIRE

    Franco-Garcia Samir; Barreiro-Pinto Belis

    2010-01-01

    The decrease of the cerebral blood flow below the threshold of autoregulation led to changes of cerebral ischemia and necrosis that traduce in signs and symtoms of focal neurologic dysfunction called acute cerebrovascular symdrome (ACS) or stroke. Two big groups according to its etiology are included in this category the hemorragic that constitue a 20% and the ischemic a 80% of cases. Great interest has wom the ischemic ACS because of its high social burden, being the third cause of no violen...

  3. Cardiorenal Syndromes : An Executive Summary from the Consensus Conference of the Acute Dialysis Quality Initiative (ADQI)

    NARCIS (Netherlands)

    Ronco, Claudio; McCullough, Peter A.; Anker, Stefan D.; Anand, Inder; Aspromonte, Nadia; Bagshaw, Sean M.; Bellomo, Rinaldo; Berl, Tomas; Bobek, Ilona; Cruz, Dinna N.; Daliento, Luciano; Davenport, Andrew; Haapio, Mikko; Hillege, Hans; House, Andrew; Katz, Nevin M.; Maisel, Alan; Mankad, Sunil; Zanco, Pierluigi; Mebazaa, Alexandre; Palazzuoli, Alberto; Ronco, Federico; Shaw, Andrew; Sheinfeld, Geoff; Soni, Sachin; Vescovo, Giorgio; Zamperetti, Nereo; Ponikowski, Piotr; Ronco, C; Bellomo, R; McCullough, PA

    2010-01-01

    The cardiorenal syndrome (CRS) is a disorder of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. The general definition has been expanded into five subtypes reflecting the primacy of organ dysfunction and the time-frame of

  4. High frequency of BTG1 deletions in acute lymphoblastic leukemia in children with down syndrome

    DEFF Research Database (Denmark)

    Lundin, Catarina; Hjorth, Lars; Behrendtz, Mikael;

    2012-01-01

    Previous cytogenetic studies of myeloid and acute lymphoblastic leukemias in children with Down syndrome (ML-DS and DS-ALL) have revealed significant differences in abnormality patterns between such cases and acute leukemias in general. Also, certain molecular genetic aberrations characterize DS...

  5. Risk of acute pancreatitis in patients with cronic inflammatory bowel disease

    DEFF Research Database (Denmark)

    Rasmussen, Henrik Højgaard; Fonager, Kirsten; Sørensen, Henrik Toft;

    1999-01-01

    of patients with acute pancreatitis was compared with expected numbers on the basis of age, sex, and calendar-specific incidence rates in the general population. RESULTS: Overall, 15,526 patients were discharged and followed up for 112,824 person-years. The standardized incidence ratio (SIR) for acute...

  6. Perioperative acute renal failure.

    LENUS (Irish Health Repository)

    Mahon, Padraig

    2012-02-03

    PURPOSE OF REVIEW: Recent biochemical evidence increasingly implicates inflammatory mechanisms as precipitants of acute renal failure. In this review, we detail some of these pathways together with potential new therapeutic targets. RECENT FINDINGS: Neutrophil gelatinase-associated lipocalin appears to be a sensitive, specific and reliable biomarker of renal injury, which may be predictive of renal outcome in the perioperative setting. For estimation of glomerular filtration rate, cystatin C is superior to creatinine. No drug is definitively effective at preventing postoperative renal failure. Clinical trials of fenoldopam and atrial natriuretic peptide are, at best, equivocal. As with pharmacological preconditioning of the heart, volatile anaesthetic agents appear to offer a protective effect to the subsequently ischaemic kidney. SUMMARY: Although a greatly improved understanding of the pathophysiology of acute renal failure has offered even more therapeutic targets, the maintenance of intravascular euvolaemia and perfusion pressure is most effective at preventing new postoperative acute renal failure. In the future, strategies targeting renal regeneration after injury will use bone marrow-derived stem cells and growth factors such as insulin-like growth factor-1.

  7. Diagnosis of acute rhinosinusitis.

    Science.gov (United States)

    Esposito, Susanna; Marchisio, Paola; Tenconi, Rossana; Tagliaferri, Laura; Albertario, Giada; Patria, Maria Francesca; Principi, Nicola

    2012-08-01

    Rhinosinusitis is almost always a complication of a viral infection involving the upper respiratory tract. A common cold is the first symptom of rhinosinusitis, but infectious processes involving the nose inevitably affect the paranasal sinuses because of their anatomical contiguity. The symptoms remain those of a common cold as long as nasal phlogosis is moderate and the ostia between the nose and sinuses are patent. If the inflammation is intense, edema may obliterate the ostia and isolate the sinuses, thus stopping the removal of the exudates. The duration of symptoms makes it possible to distinguish acute (10-30 days) from subacute (30-90 days) and chronic rhinosinusitis (>90 days). The diagnosis of rhinosinusitis should only be based on anamnestic and clinical criteria in children with serious or persistent symptoms of upper respiratory tract infection, or which appear within a short time of an apparent recovery. Computed tomography and magnetic resonance images of the paranasal sinuses should be reserved for children reasonably considered to be candidates for surgery. Antibiotics are recommended in cases of mild acute bacterial rhinosinusitis as a means of accelerating the resolution of symptoms. The use of antibiotics is mandatory in severe acute bacterial rhinosinusitis to cure the disease and avoid the possible onset of severe complications.

  8. PROSPECTIVE STUDY OF CT IN ACUTE PANCREATITIS AND ITS COMPLICATIONS

    Directory of Open Access Journals (Sweden)

    Shivanand S .

    2015-09-01

    Full Text Available Visualization of the pancreas was far better by CT than b y ultrasound. Ultrasound had certain limitation. Due to bowel gas the pancreas may not be visualized. Extra pancreatic spread of inflammation and vascular complications was not always picked up by Ultrasonography. These limitations were overcome with the u se of CT which yielded more diagnostic information in the evaluation of acute pancreatitis. CT is a confirmative investigation in diagnosis and staging of acute pancreatitis. MCTSI is a very useful tool for the screening of patients with acute pancreatitis for the classification of severity accurately and to predict the clinical outcome. OBJECTIVES OF STUDY: To determine the value of computed tomography in evaluation of early diagnosis of acute pancreatitis. To evaluate the complications using computed tom ography severity index. MATERIAL AND METHODS: The study was conducted on 100 patients with clinical suspicion of acute pancreatitis, altered biochemical parameters (Serum amylase, Serum lipase in favor of acute pancreatitis, ultrasonography suggestive of acute pancreatitis and complications known case of chronic pancreatitis with features of acute symptoms who were referred to the department of Radiodiagnosis, Basaveshwar teaching & General Hospital, Kalaburagi. Before evaluating a patient by CT imaging, i nformed consent was obtained from the patient or guardian. The patient were informed about the radiation exposure in the examination. CT was carried out using Philips 6 slice scanner. Scan was obtained with both plain and contrast study. RESULT: 100 patien ts were included in the study. 83% patients were males and 17% patients were females. Majority of patients belonged to 31 - 40 yrs. of age group. Alcohol was the most common cause of acute pancreatitis. 73 patients had positive ultrasound finding while CT wa s positive in all cases. According to, MCTSI 63 patients had moderate, 26 patients had mild and 11 patients had severe

  9. Acute pancreatitis and acute renal failure complicating doxylamine succinate intoxication.

    Science.gov (United States)

    Lee, Yang Deok; Lee, Soo Teik

    2002-06-01

    Doxylamine succinate is an antihistaminic drugwith additional hypnotic, anticholinergic and local anesthetic effects first described in 1948. In Korea and many other countries, it is a common-over-the counter medication frequently involved in overdoses. Clinical symtomatology of doxylamine succinate overdose includes somnolence, coma, seizures, mydriasis, tachycardia, psychosis, and rhabdomyolysis. A serious complication may be rhabdomyolysis with subsequent impairment of renal function and acute renal failure. We report a case of acute renal failure and acute pancreatitis complicating a doxylamine succinate intoxication.

  10. Pharm GKB: Leukemia, Biphenotypic, Acute [PharmGKB

    Lifescience Database Archive (English)

    Full Text Available Overview Alternate Names: Synonym Acute bilineal leukaemia; Acute bilineal leukemia; Acute... biphenotypic leukaemia; Acute biphenotypic leukemia; Acute mixed lineage leukaemia; Acute mixed line...age leukemia; B and T Cell Acute Lymphoblastic Leukemia; B and T Cell Leukemia, Acute; B- and T-Cell Acute L...ymphoblastic Leukemia; B- and T-Cell Leukemia, Acute; Leukemia, Lymphocytic, Acute..., Mixed Cell; Leukemia, Lymphocytic, Acute, Mixed-Cell; Leukemia, Mixed Cell; Leukemia, Mixed, B and T Cell

  11. [The general practitioner and insomnia].

    Science.gov (United States)

    Cambron, L; Bruwier, G; De Bock, I; Poirrier, R

    2006-01-01

    A complaint of insomnia has to be analysed, and differentiated from hypochondria and, overall, from hypersomnia. Once confirmed and assessed as acute or chronic, it is often considered a disorder of hyperarousal, that is an imbalance between a central nervous system activating and a central nervous system inhibiting system with subcontinuous overflow from the former. An acute insomnia is less than one month of duration. As a disease, insomnia has to be categorized as a secondary or a primary disorder. Thereafter, it remains to assess the extent of social, psychological and economical interactions. These factors intervene as consequences or perpetuating factors. The capacity to assess the whole situation is really the great strength of the general practitioner who, more than anybody else, is on home ground. Laboratory findings and specialist examination come only as supporting evidence for causal links. A polysomnography realized in a sleep disorder center provides data reinforcing or correcting the diagnosis. From a sound assessment of the disease, the treatment has to be deduced by following a rigorous reasoning, devoid of guilty feelings as they are suggested to patients by mass-media talking, as well as freed from fashionable non medical practices. Today, we know that chronic insomnia is a disease with potential severe consequences and that it does not heal spontaneously.

  12. [Acute pulmonary edema secondary to acute upper airway obstruction].

    Science.gov (United States)

    Sánchez-Ortega, J L; Carpintero-Moreno, F; Olivares-López, A; Borrás-Rubio, E; Alvarez-López, M J; García-Izquierdo, A

    1992-01-01

    We report a 72 years old woman with mild arterial hypertension and no other pathological history who presented an acute pulmonary edema due to acute obstruction of the upper airway secondary to vocal chord paralysis developing during the immediate postoperative phase of thyroidectomy. The acute pulmonary edema resolved after application of tracheal reintubation, mechanical ventilation controlled with end expiratory positive pressure, diuretics, morphine, and liquid restriction. We discuss the possible etiopathogenic possibilities of this infrequent clinical picture and we suggest that all patients who suffered and acute obstruction of the upper airways require a careful clinical surveillance in order to prevent the development of the pulmonary syndrome.

  13. A focus on acute cholecystitis and acute cholangitis

    Institute of Scientific and Technical Information of China (English)

    Massimo Sartelli; Cristian Tranà

    2012-01-01

    Biliary infections are very common intra-abdominal infections. Laparoscopic cholecystectomy for acute cholecystitis and endoscopic retrograde management of acute cholangitis play important roles in the treatment of biliary infections. Also antimicrobial therapy is nevertheless important in the overall management of biliary infections. A multidisciplinary team of physicians, including surgeons trained in laparoscopic techniques, interventional gastroenterologists, and interventional radiologists may improve outcomes of patients with biliary infections. This review focuses the clinical presentation, diagnosis, and state of the art management of acute cholecystitis and acute cholangitis.

  14. A focus on acute cholecystitis and acute cholangitis

    Directory of Open Access Journals (Sweden)

    Massimo Sartelli

    2012-01-01

    Full Text Available Biliary infections are very common intra-abdominal infections. Laparoscopic cholecystectomy for acute cholecystitis and endoscopic retrograde management of acute cholangitis play important roles in the treatment of biliary infections. Also antimicrobial therapy is nevertheless important in the overall management of biliary infections. A multidisciplinary team of physicians, including surgeons trained in laparoscopic techniques, interventional gastroenterologists, and interventional radiologists may improve outcomes of patients with biliary infections. This review focuses the clinical presentation, diagnosis, and state of the art management of acute cholecystitis and acute cholangitis.

  15. Acute leukemic appendicitis in a patient with acute promyelocytic leukemia

    Directory of Open Access Journals (Sweden)

    Hatim Karachiwala

    2012-01-01

    Full Text Available Leukemic and lymphomatous infiltration of the appendix is a rare complication. We present the case of a 31-year-old male with acute promyelocytic leukemia who developed acute abdomen on day 11 of induction chemotherapy with idarubicin and cytarabine. After appropriate work-up, a clinical diagnosis of acute appendicitis was made. Despite severe pancytopenia, he successfully underwent laparoscopic appendectomy. The final pathology revealed leukemic infiltration of the appendix. It is hypothesized that the leukemic infiltration may play a role in the development of acute appendicitis. Further, this case demonstrates the need to maintain a high index of suspicion and prompt surgical intervention for surgical pathologies in neutropenic patients.

  16. Treatment and prevention of acute radiation dermatitis;Traitement et prevention des radiodermites aigues

    Energy Technology Data Exchange (ETDEWEB)

    Benomar, S.; Hassam, B. [Service de dermatologie, CHU Ibn-Sina, universite Mohamed-V, Rabat (Morocco); Boutayeb, S.; Errihani, H. [Service de d' oncologie medicale, Institut national d' oncologie, Universite Mohamed-V, Rabat (Morocco); Lalya, I.; El Gueddari, B.K. [Service de radiotherapie, Institut national d' oncologie, universite Mohamed-V, Rabat (Morocco)

    2010-06-15

    Acute radiation dermatitis is a common side-effect of radiotherapy which often necessitates interruption of the therapy. Currently, there is no general consensus about its prevention or about the treatment of choice. The goal of this work was to focus on optimal methods to prevent and manage acute skin reactions related to radiation therapy and to determine if there are specific topical or oral agents for the prevention of this acute skin reaction. The prevention and the early treatment are the two focus points of the management of the acute radiation dermatitis. (authors)

  17. Acute thrombosis of abdominal aortic aneurysm subsequent to Heimlich maneuver: a case report.

    Science.gov (United States)

    Kirshner, R L; Green, R M

    1985-07-01

    We report a case of acute thrombosis of an abdominal aortic aneurysm secondary to a correctly applied and successful Heimlich maneuver. Although the Heimlich maneuver is generally safe and effective, this possible catastrophic consequence needs to be recognized.

  18. Pathogenic aspects of acute cholangitis

    Directory of Open Access Journals (Sweden)

    V. Borisenko

    2014-10-01

    Full Text Available The research is aimed at the study of dynamic pathomorphological changes of choledoch and acute cholangitis development factors determined during the experiment. 36 rats of Wistar line were under trial. The main group consisted of 30 animals undergoing the open laparotomy, choledoch ligation and puncture modeling of acute cholangitis by E. coli culture in 1 х 108 CFU/ml concentration under general anesthesia. 6 healthy rats were included in the control group. Samples of general biliary duct under autopsy for pathomorphological study were taken on the 3rd, 7th, 14th, 21st and 30th day. In panoramic samples colored by hematoxilin and eozin the degree of dystrophic, necrobiotic, hemodynamic, inflammatory and atrophic manifestations’ changes were studied. Average depth of choledoch wall and height of its epithelial lining were morphometrically estimated. Collagen of the IV type as well as expressing receptors to CD34 were defined with the help of monoclonal antibodies in choledoch epithelial cells of basal membranes and choledoch vessels endotheliocytes. In choledoch, enhancement of edema and inflammatory infiltration by lymphoplasmocytic elements with the admixture of neutrofils with granulation tissue was detected from the 3rd up to the 30th day of the experiment. From the 14th day formation of bile clots of blood was detected in choledoch clearance, part of which was locked to its de-epitheliolized internal surface. According to morphometrical study data, choledoch wall depth increased from 261.1 ± 3.13 µm on the 3rd day to 572.5 ± 3.42 µm on the 30th day of the experiment. Mucosa membrane has lost its folding on the 14th day, epitheliocytes flattening was replaced by their destruction with fragments rejection into the duct lumen by the 30th day of the experiment. The epithelium height index decreased from 14.8 ± 0.09 µm on the 3rd day to 11.7 ± 0.15 µm on the 30 day of the experiment. Collagen of the IV type fluorescence intensity of

  19. Acute otitis media in children

    Directory of Open Access Journals (Sweden)

    Cherpillod J

    2011-06-01

    Full Text Available Jacques CherpillodEar, Nose and Throat Department, Childrens’ University Hospital, Lausanne, SwitzerlandDate of preparation: 6th March 2011Conflict of interest: None declaredClinical question: What is the best treatment for acute otitis media in children?Results: Watchful waiting, followed by amoxicillin treatment, if necessary, is the best first-line treatment for acute otitis media in children aged six months or older.Keywords: acute otitis media, antibiotics, watchful waitin

  20. Clostridium difficile causing acute renal failure: Case presentation and review

    OpenAIRE

    Arrich, Jasmin; Sodeck, Gottfried H.; Sengölge, Gürkan; Konnaris, Christoforos; Müllner, Marcus; Anton N Laggner; Domanovits, Hans

    2005-01-01

    AIM: Clostridium difficile infection is primarily a nosocomial infection but asymptomatic carriers of Clostridium difficile can be found in up to 5% of the general population. Ampicillin, cephalosporins and clindamycin are the antibiotics that are most frequently associated with Clostridium difficile-associated diarrhea or colitis. Little is known about acute renal failure as a consequence of Clostridium difficile-associated diarrhea.

  1. Cerebral edema associated with acute hepatic failure.

    Directory of Open Access Journals (Sweden)

    Fujiwara,Masachika

    1985-02-01

    Full Text Available The clinicopathological findings of cerebral edema were investigated in patients with acute hepatic failure autopsied at Okayama University Hospital between 1970 and 1980 retrospectively. Nine (64% of 14 hepatic failure cases were found to have cerebral edema during a post-mortem examination of the brain. Clinical features of the patients with cerebral edema were not significantly different from those of the patients without cerebral edema. However, general convulsions were observed more frequently in patients later found to have cerebral edema. Moreover, the length of time from deep coma to death was much shorter in the brain edema cases with cerebral herniation than without herniation.

  2. [Diagnosis and treatment of acute pancreatitis].

    Science.gov (United States)

    Dalgat, D M; Magomaev, M Sh; Medzhidov, R T; Kurbanov, K M

    1986-04-01

    In diagnosis of acute pancreatitis of special importance is determination of the activity of transamidinase, phospholipase A, lipase, concentration of copper, calcium and triglycerides in blood serum as well as laparoscopy with biopsy and local thermometry of the pancreas. The dosage of 5-fluoruracil in the complex treatment of patients should be differentiated corresponding to the form of the disease: 3 mg/kg in the endomatous form, 5 mg/kg in the destructive form. The general lethality was 1.4%. In conservative treatment there were no lethal outcomes.

  3. Gynecologycal acute abdomen in an adolescent

    Directory of Open Access Journals (Sweden)

    Caroline Rosa Pellicciari

    2013-03-01

    Adnexial torsion is defined as a partial or complete rotation of the adnexial vascular pedicle, causing circulatory ischemia and future necrosis. It is rare, hard to diagnosis and therefore of commonly delayed treatment. Clinical symptoms are nonspecific and similar to acute abdomen what may lead to a delay in its identification, generally performed by ultrasound examination. Treatment is surgical and may include adnexial extraction. Such uncommon diagnosis should always be remembered in adolescents patients whose abdominal pain does not resolve after conventional clinical treatment. In this study we report a demonstrative case of this important pathology.

  4. Prinzmetals Angina Masquerading as Acute Pericarditis

    Science.gov (United States)

    Jayaram, Ashwal Adamane; Rao, Mugula Sudhakar; Padmakumar, R

    2017-01-01

    Coronary artery spasm is an intense vasoconstriction of the coronary arteries and may be responsible for the myocardial ischemia, myocardial infarction as well as sudden deaths. Coronary angiography is generally needed to identify the cause. Coronary artery spasm is a multifactorial disease with underlying mechanism still poorly understood. Here, we present case of a 48-year-old male with no significant past history who presented with acute episodic onset chest pain. Clinical, Electrocardiography (ECG) and echocardiographic findings suggested pericarditis but a diagnostic coronary angiography revealed significant coronary vasospasm. Patient’s symptoms significantly improved with calcium channel blockers and Nitroglycerine (NTG).

  5. KEGG PATHWAY / Acute myeloid leukemia [KEGG

    Lifescience Database Archive (English)

    Full Text Available PATHWAY: map05221 Entry map05221Pathway Name Acute myeloid leukemia Description Acute...Class Human Diseases; Cancers Pathwaymap map05221Acute myeloid leukemia Disease H00003Acute myeloid leukemia...inkDB DBGET integrated database retrieval system KEGG PATHWAY / Acute myeloid leukemia ...

  6. Pharm GKB: Acute abdomen [PharmGKB

    Lifescience Database Archive (English)

    Full Text Available Overview Alternate Names: PharmGKB Accession Id: PA165109055 External Vocabularies MeSH: Abdomen, Acute... (D000006) SnoMedCT: Acute abdomen (9209005) UMLS: C0000727 (C0000727) MedDRA: Abdominal... syndrome acute (10000096) NDFRT: Abdomen, Acute [Disease/Finding] (N0000000260) Common Searches Search Medline Plus Search CTD Pharm GKB: Acute abdomen ...

  7. Acute Pancreatitis Associated with Brucellosis

    Directory of Open Access Journals (Sweden)

    Demetrios Papaioannides

    2006-01-01

    Full Text Available Context :Acute pancreatitis can be caused by a variety of infectious agents but it is regarded as an extremely rare complication of brucellosis. Case report: We briefly describe a 56-yearold man who presented with acute pancreatitis, fever, myalgia, and other clinical symptoms. Brucella melitensis was cultured from his blood. All clinical manifestations gradually resolved with the institution of intramuscular streptomycin and oral doxycycline therapy. Conclusion :Acute pancreatitis may rarely be a complication of infection with B. melitensis. In areas where brucellosis is endemic, it should be kept in mind that acute pancreatitis may result from infection with brucella organisms..

  8. Acute exacerbation of COPD.

    Science.gov (United States)

    Ko, Fanny W; Chan, Ka Pang; Hui, David S; Goddard, John R; Shaw, Janet G; Reid, David W; Yang, Ian A

    2016-10-01

    The literature of acute exacerbation of chronic obstructive pulmonary disease (COPD) is fast expanding. This review focuses on several aspects of acute exacerbation of COPD (AECOPD) including epidemiology, diagnosis and management. COPD poses a major health and economic burden in the Asia-Pacific region, as it does worldwide. Triggering factors of AECOPD include infectious (bacteria and viruses) and environmental (air pollution and meteorological effect) factors. Disruption in the dynamic balance between the 'pathogens' (viral and bacterial) and the normal bacterial communities that constitute the lung microbiome likely contributes to the risk of exacerbations. The diagnostic approach to AECOPD varies based on the clinical setting and severity of the exacerbation. After history and examination, a number of investigations may be useful, including oximetry, sputum culture, chest X-ray and blood tests for inflammatory markers. Arterial blood gases should be considered in severe exacerbations, to characterize respiratory failure. Depending on the severity, the acute management of AECOPD involves use of bronchodilators, steroids, antibiotics, oxygen and noninvasive ventilation. Hospitalization may be required, for severe exacerbations. Nonpharmacological interventions including disease-specific self-management, pulmonary rehabilitation, early medical follow-up, home visits by respiratory health workers, integrated programmes and telehealth-assisted hospital at home have been studied during hospitalization and shortly after discharge in patients who have had a recent AECOPD. Pharmacological approaches to reducing risk of future exacerbations include long-acting bronchodilators, inhaled steroids, mucolytics, vaccinations and long-term macrolides. Further studies are needed to assess the cost-effectiveness of these interventions in preventing COPD exacerbations.

  9. [Pharmacological treatment of acute catatonia].

    Science.gov (United States)

    Cárdenas-Delgado, Christian L

    2012-01-01

    Catatonia is a neuropsychiatric syndrome of psychomotor dysregulation that can be present in a broad spectrum of clinical situations. Advances made over the last decades have progressively contributed to its clinical differentiation and its conceptual delimitation. Both Benzodiazepines (BZD) and Electroconvulsive therapy (ECT) have been consolidated as first-line therapy. In this regard, a BZD response rate ranging from 70 to 90 per cent has been reported in different case series. Furthermore, NMDA receptor antagonists represent an emerging strategy in the therapeutic approach to the disorder. Most of the evidence that supports the aforementioned treatment recommendations arises from descriptive observational studies. Traditionally, catatonia pathophysiological research focused on the study of subcortical brain structures. Currently there exists compelling evidence that supports a cortical origin of the syndrome, emphasizing the role of the prefrontal cortex. Neuropsychiatric catatonia models that integrate clinical, pathophysiological, and neurobiological findings have been postulated. The aim of the present review is to summarize up-to-date available evidence associated with the pharmacotherapeutic approach to acute catatonia as well as the neurochemical basis of its effectiveness. Likewise, general measures intended to prevent morbimortality are subject to discussion herein.

  10. Torsadogenic index for prevention of acute death

    Directory of Open Access Journals (Sweden)

    Adrián Ángel Inchauspe

    2015-10-01

    Full Text Available This risk management project aims to apply a global preventive and predictive measure in potential victims of acute death and heart failure. Among the main causes are identified sub-diagnosed genetic mutations; prescription, interaction, self-medication or abuse of suspected drugs due to internet prospect's consult; and a parasitic pandemia, the Chagas disease (over 100000000 population is potentially infected worldwide. Promoting a global extensive determination of the torsadogenic index which was successfully published in Frontiers of Pharmacology Journal, will allow to monitor general population, set security patterns to categorize silent high risk groups of serious prognosis of tachyarrhythmias. For this purpose, applications of known QT determinations are proposed, recommending Dr. Rautaharju's formula, actually improved with gender adult versions. Torsadogenic index will allow to establish an individual traceability, obtain comparative samples that are alert to possible QT enlargements. Thus, torsadogenic index results a valuable, simple and costless resource to consider in the fight against acute death and cardiac arrest. Torsadogenic index represents a global indicator capable of predicting and preventing acute death and heart failure for most relevant reasons.

  11. Torsadogenic index for prevention of acute death

    Institute of Scientific and Technical Information of China (English)

    Adrián Ángel Inchauspe

    2015-01-01

    This risk management project aims to apply a global preventive and predictive measure in potential victims of acute death and heart failure. Among the main causes are identified sub-diagnosed genetic mutations; prescription, interaction, self-medication or abuse of suspected drugs due to internet prospect's consult; and a parasitic pandemia, the Chagas disease (over 100 000 000 population is potentially infected worldwide). Promoting a global extensive determination of the torsadogenic index which was successfully published in Frontiers of Pharmacology Journal, will allow to monitor general population, set security patterns to categorize silent high risk groups of serious prognosis of tachyarhythmias. For this purpose, applications of known QT determinations are proposed, recommending Dr. Rautaharju's formula, actually improved with gender adult versions. Torsadogenic index will allow to establish an individual traceability, obtain comparative samples that are alert to possible QT enlargements. Thus, torsadogenic index results a valuable, simple and costless resource to consider in the fight against acute death and cardiac arrest. Torsadogenic index represents a global indicator capable of predicting and preventing acute death and heart failure for most relevant reasons.

  12. Acute appendicitis in pregnancy: literature review

    Directory of Open Access Journals (Sweden)

    Antônio Henriques de Franca Neto

    2015-04-01

    Full Text Available Introduction: suspected appendicitis is the most common indication for surgery in non-obstetric conditions during pregnancy and occurs in about one in 500 to one in 635 pregnancies per year. This occurs more often in the second trimester of pregnancy. Acute appendicitis is the most common general surgical problem encountered during pregnancy. Methods: a literature review on research of scientific articles, under the terms “acute appendicitis” and “pregnancy”, in PubMed, Lilacs/SciELO, Scopus, Cochrane Library and Uptodate databases. Results: the clinical manifestations of appendicitis are similar to non-pregnant women, however, without a classic presentation, which often occurs, diagnosis is difficult and must be supported by imaging. Discussion: clinical diagnosis should be strongly suspected in pregnant women with classic findings such as abdominal pain that migrates to the right lower quadrant. The main purpose of imaging is to reduce delays in surgical intervention due to diagnostic uncertainty. A secondary objective is to reduce, but not eliminate, the negative appendectomy rate. Differential diagnosis of suspected acute appendicitis usually includes pathologies considered in non-pregnant people. Conclusion: the imaging study of choice is ultrasound, MRI may be used when the former is not conclusive and, as a last resort, a CT scan can be performed. The treatment remains appendectomy by laparotomy, since the feasibility of video- assisted surgery in these cases remains controversial.

  13. Neuroprotection against diisopropylfluorophosphate in acute hippocampal slices

    Science.gov (United States)

    Ferchmin, P. A.; Pérez, Dinely; Cuadrado, Brenda L.; Carrasco, Marimée; Martins, Antonio H.; Eterović, Vesna A.

    2015-01-01

    Diisopropylfluorophosphate (DFP) is an irreversible inhibitor of acetylcholine esterase (AChE) and a surrogate of the organophosphorus (OP) nerve agent sarin. The neurotoxicity of DFP was assessed as a reduction of population spike (PS) area elicited by synaptic stimulation in acute hippocampal slices. Two classical antidotes, atropine, and pralidoxime, and two novel antidotes, 4R-cembranotriene-diol (4R) and a caspase 9 inhibitor, were tested. Atropine, pralidoxime, and 4R significantly protected when applied 30 min after DFP. The caspase inhibitor was neuroprotective when applied 5–10 min before or after DFP, suggesting that early synaptic apoptosis is responsible for the loss of PSs. It is likely that apoptosis starts at the synapses and, if antidotes are not applied, descends to the cell bodies, causing death. The acute slice is a reliable tool for mechanistic studies, and the assessment of neurotoxicity and neuroprotection with PS areas is, in general, pharmacologically congruent with in vivo results and predicts the effect of drugs in vivo. 4R was first found to be neuroprotective in slices and later we demonstrated that 4R is neuroprotective in vivo. The mechanism of neurotoxicity of OPs is not well understood, and there is a need for novel antidotes that could be discovered using acute slices. PMID:26438150

  14. Implementation of a competency assessment tool for agency nurses working in an acute paediatric setting.

    LENUS (Irish Health Repository)

    Hennerby, Cathy

    2012-02-01

    AIM: This paper reports on the implementation of a competency assessment tool for registered general agency nurses working in an acute paediatric setting, using a change management framework. BACKGROUND: The increased number of registered general agency nurses working in an acute children\\'s hospital alerted concerns around their competency in working with children. These concerns were initially raised via informal complaints about \\'near misses\\

  15. Acute otitis media.

    Science.gov (United States)

    Dickson, Gretchen

    2014-03-01

    One in 4 children will have at least 1 episode of acute otitis media (AOM) by age 10 years. AOM results from infection of fluid that has become trapped in the middle ear. The bacteria that most often cause AOM are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Differentiating AOM from otitis media with effusion (OME) is a critical skill for physicians, as accurate diagnosis will guide appropriate treatment of these conditions. Although fluid is present in the middle ear in both conditions, the fluid is not infected in OME as is seen in AOM patients.

  16. [Treatment of acute leukemias].

    Science.gov (United States)

    Gross, R; Gerecke, D

    1982-11-12

    The effective treatment of acute (myeloblastic and lymphoblastic) leukaemias depends on the induction of remissions as well as on the maintenance of these remissions. Whereas the use of anthracyclines and of cytosine arabinoside in different combinations notably increased the rate of induction of remissions, their maintenance was less successful until now. We present a scheme using, beside MTX and 6-MP, modified COAP regimes periodically every 3 months. The follow-up of 26 patients treated in this way is encouraging since nearly one third remained in full haematological remission after 3 years of observation.

  17. Acute calculous cholecystitis

    OpenAIRE

    Angarita, Fernando A.; University Health Network; Acuña, Sergio A.; Mount Sinai Hospital; Jimenez, Carolina; University of Toronto; Garay, Javier; Pontificia Universidad Javeriana; Gömez, David; University of Toronto; Domínguez, Luis Carlos; Pontificia Universidad Javeriana

    2010-01-01

    Acute calculous cholecystitis is the most important cause of cholecystectomies worldwide. We review the physiopathology of the inflammatory process in this organ secondary to biliary tract obstruction, as well as its clinical manifestations, workup, and the treatment it requires. La colecistitis calculosa aguda es la causa más importante de colecistectomías en el mundo. En esta revisión de tema se resume la fisiopatología del proceso inflamatorio de la vesículabiliar secundaria a la obstru...

  18. Diagnosis of acute neuropathies

    DEFF Research Database (Denmark)

    Crone, Clarissa; Krarup, Christian

    2007-01-01

    Acute and subacute polyneuropathies present diagnostic challenges since many require prompt initiation of treatment in order to limit axonal degeneration and since an exact and detailed diagnosis is a prerequisite for making the correct choice of treatment. It is for instance of utmost importance...... to recognize whether the underlying pathological changes are due to demyelination or to axonal degeneration and electrodiagnostic tests can thus in most cases contribute considerably to the securing of an exact diagnosis. The specific and characteristic electrophysiological findings in the different types...

  19. Acute Calculous Cholecystitis: What is new in diagnosis and therapy?

    Directory of Open Access Journals (Sweden)

    Dirk J. Gouma

    1992-01-01

    Full Text Available The management of patients with acute calculous cholecystitis has changed during recent years. The etiology of acute cholecystitis is still not fully understood. Infection of bile is relatively unimportant since bile and gallbladder wall cultures are sterile in many patients with acute cholecystitis. Ultrasonography is first choice for diagnosis of acute cholecystitis and cholescintigraphy is second best. Percutaneous puncture of the gallbladder that can be used for therapeutic drainage has also diagnostic qualities. Early cholecystectomy under antibiotic prophylaxis is the treatment of choice, and has been shown to be superior to delayed surgery in several prospective trials. Mortality can be as low as 0.5% in patients younger than 70–80 years of age, but a high mortality has been reported in octogenerians. Selective intraoperative cholangiography is now generally accepted and no advantage of routine cholangiography was shown in clinical trials. Percutaneous cholecystostomy can be successfully performed under ultrasound guidance and has a place in the treatment of severely ill patients with acute cholecystitis. Laparoscopic cholecystectomy can be done safely in patients with acute cholecystitis, but extensive experience with this technique is necessary. Endoscopic retrograde drainage of the gallbladder by introduction of a catheter in the cystic duct is feasible but data are still scarce.

  20. Pharmaceutical Sponsorship Bias Influences Thrombolytic Literature in Acute Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Ryan P Radecki

    2011-05-01

    Full Text Available Background: The efficacy of thrombolytic therapy for acute ischemic stroke remains controversial in Emergency Medicine and has not been fully endorsed by either the American College of Emergency Physicians or the American Academy of emergency medicine. A growing recognition exists of the influence of pharmaceutical sponsorship on the reported findings of published clinical trials. Sponsorship bias has been suggested as a potential criticism of the literature and guidelines favoring thrombolytic therapy. Objective: The objective of this study is to review the most influential literature regarding thrombolytic therapy for acute ischemic stroke and document the presence or absence of pharmaceutical sponsorship. Methods: A publication-citation analysis was performed to identify the most frequently cited articles pertaining to thrombolytic therapy for acute ischemic stroke. Identified articles were reviewed for disclosures of pharmaceutical funding. Results: Of the 20 most-cited articles pertaining to thrombolytic therapy for acute stroke, 17 (85% disclosed pharmaceutical sponsorship. These disclosures range from general sponsorship to direct employment of authors by pharmaceutical companies. Conclusion: An overwhelming predominance of the most influential literature regarding thrombolytic therapy for acute ischemic stroke is susceptible to sponsorship bias. This potential bias may provide a basis for physician concern regarding the efficacy and safety of thrombolytic therapy. Further, large, independent, placebo-controlled studies may be required to guide therapy and professional guidelines definitively for acute ischemic stroke. [West J Emerg Med. 2011;12(4:435–441.

  1. Acute intermittent porphyria in the puerperium

    Directory of Open Access Journals (Sweden)

    Sparić Radmila

    2010-01-01

    Full Text Available Introduction. Acute intermittent porphyria emerges as a result of partial defect of porphobilinogen deaminase and is manifested by repeated episodes of somatic, psychiatric and neurological disorders. The disease is conducted via the autosomaldominant gene of variable penetration, so most of the carriers never experience seizures. Timely making of diagnosis, screening of blood relatives of the patient and education of patients on avoidance of provoking factors are the key to adequate treatment. Case Outline. A 23-year-old patient having born the third child was hospitalized due to pains in the abdomen and convulsive seizures nine days after the vaginal delivery. At admittance, she suffered a generalized convulsive seizure of clonic-tonic type. The patient immediately underwent a complete clinical, laboratory, bacteriological and ultrasound examination. Bearing in mind the fact that the patient had several convulsive seizures even after the given neurological therapy, haem-arginate was introduced into therapy during four days. The administration of haem-arginate led to the normalization of blood pressure, pulse and bowel function. The administration of haem-arginate led to the normalization of blood pressure, pulse and bowel function. The patient was treated by a team of doctors, in the intensive care ward, with the use of medicaments, which are allowed in the case of acute porphyria. Sixteen days after the admittance, with clean neurological status and gynaecological and ultra-sound findings, she was released for ambulatory treatment. Conclusion. The presented case exhibits the gravity of making a diagnosis of acute intermittent porphyria in puerperium and the necessity of multi-disciplinary approach in treating this disease. Acute intermittent porphyria should be considered in cases of ambiguous abdominal pain, as well as in patients having abdominal pains followed by neuro-psychiatric disorders.

  2. Acute retinal necrosis

    Directory of Open Access Journals (Sweden)

    Hugo Hernán Ocampo

    2009-12-01

    Full Text Available Purpose: Clinical features in a case of acute retinal necrosis are described as well as its diagnostic approach and response to early treatment. Methods: This is a descriptive and retrospective study case report of a 26 year old male patient who arrived to the emergency room with a three day history of sudden visual loss in the right eye (RE. At initial evaluation a visual acuity of hand movements in the RE, 20/15 in the left eye (LE and a right relative afferent pupillary defect were found. Fundoscopy revealed profuse soft exudates and hemorrhages involving posterior pole, inferior hemiretina and superotemporal periphery. Infectious workup and fluoresceinic angiography were made and positive serologies for herpes virus types 1 and 2, without HIV, were found. A diagnosis of acute retinal necrosis was made and treatment with intravenous valgancyclovir for two weeks and intra-vitreous triamcinolone for severe vasculitis, was given. Then a 3 months treatment with oral antiviral agents was prescribed. Results: Patient’s evolution showed improvement with treatment and at two and a half months of follow up, visual acuity was 20/50 in the right eye, normal slit lamp examination, tonometry of 12 mm Hg and fundoscopy improved when compared to initial pictures.Conclusions: A high index of suspicion is needed for diagnosing ARN taking into account clinical findings. Prompt intravenous and intra-vitreous treatments are needed to achieve good clinical and functional outcomes and to avoid central nervous system complications.

  3. Escroto agudo Acute scrotum

    Directory of Open Access Journals (Sweden)

    Lisieux Eyer de Jesus

    2000-08-01

    Full Text Available Este artigo pretende fazer uma revisão geral do tema, com ênfase em conceitos atuais e/ou controversos no manejo das situações clínicas em questão, em especial conceitos ainda polêmicos quanto à fisiopatologia e ao manejo diagnóstico. Também é feita uma revisão extensa quanto aos aspectos clínicos e terapêuticos da torção de testículo neonatal e quanto aos aspectos de diagnóstico diferencial na síndrome do escroto agudo. São citadas informações estatísticas derivadas dos principais estudos clínicos publicados nos últimos 20 anos em literatura médica ocidental.This article intends to review "Acute Scrotum" emphasizing modern and controversial aspects on clinical situations, specially concepts on physiopathology and diagnosis. We also review clinical and therapeutic aspects of neonatal testicular torsion and the differential diagnosis in the acute scrotum syndrome. Statistical information are derived from main studies published in the last 20 years.

  4. Acute Recurrent Pancreatitis

    Directory of Open Access Journals (Sweden)

    Glen A Lehman

    2003-01-01

    Full Text Available History, physical examination, simple laboratory and radiological tests, and endoscopic retrograde cholangiopancreatography (ERCP are able to establish the cause of recurrent acute pancreatitis in 70% to 90% of patients. Dysfunction of the biliary and/or pancreatic sphincter, as identified by sphincter of Oddi manometry, accounts for the majority of the remaining cases. The diagnosis may be missed if the pancreatic sphincter is not evaluated. Pancreas divisum is a prevalent congenital abnormality that is usually innocuous but can lead to recurrent attacks of acute pancreatitis or abdominal pain. In select cases, endoscopic sphincterotomy of the minor papilla can provide relief of symptoms and prevent further attacks. A small proportion of patients with idiopathic pancreatitis have tiny stones in the common bile duct (microlithiasis. Crystals can be visualized during microscopic analysis of bile that is aspirated at the time of ERCP. Neoplasia is a rare cause of pancreatitis, and the diagnosis can usually be established by computerized tomography or ERCP. A wide variety of medications can also cause recurrent pancreatitis. ERCP, sphincter of Oddi manometry, and microscopy of aspirated bile should be undertaken in patients with recurrent pancreatitis in whom the diagnosis is not obvious.

  5. Delirium and dementia in acute hospitals: assessing the impact of RMN input.

    Science.gov (United States)

    Law, Emma

    2008-11-01

    There is evidence that provision for the mental health needs of older people in acute hospitals is generally poor. This article describes a study undertaken over a nine-month period at Perth Royal Infirmary, a 317-bed district general hospital. The study sought to measure the impact of input from an RMN in an acute hospital setting and within a multidisciplinary liaison model. The article examines the implications, preparation, implementation and evaluation of RMN input, and the baseline knowledge and expectations of acute hospital staff when caring for patients with dementia and delirium.

  6. Acute-care surgical service: a change in culture.

    Science.gov (United States)

    Parasyn, Andrew D; Truskett, Philip G; Bennett, Michael; Lum, Sharon; Barry, Jennie; Haghighi, Koroush; Crowe, Philip J

    2009-01-01

    The provision of acute surgical care in the public sector is becoming increasingly difficult because of limitation of resources and the unpredictability of access to theatres during the working day. An acute-care surgical service was developed at the Prince of Wales Hospital to provide acute surgery in a more timely and efficient manner. A roster of eight general surgeons provided on-site service from 08.00 to 18.00 hours Monday to Friday and on-call service in after-hours for a 79-week period. An acute-care ward of four beds and an operating theatre were placed under the control of the rostered acute-care surgeon (ACS). At the end of each ACS roster period all patients whose treatment was undefined or incomplete were handed over to the next rostered ACS. Patient data and theatre utilization data were prospectively collected and compared to the preceding 52-week period. Emergency theatre utilization during the day increased from 57 to 69%. There was a 11% reduction in acute-care operating after hours and 26% fewer emergency cases were handled between midnight and 08.00 hours. There was more efficient use of the entire theatre block, suggesting a significant cultural change. Staff satisfaction was high. On-site consultant-driven surgical leadership has provided significant positive change to the provision of acute surgical care in our institution. The paradigm shift in acute surgical care has improved patient and theatre management and stimulated a cultural change of efficiency.

  7. Acute brain hemorrhage in dengue

    Institute of Scientific and Technical Information of China (English)

    Somsri Wiwanitkit; Viroj Wiwanitkit

    2014-01-01

    Dengue is a tropical arboviral infection that can have severe hemorrhagic complication.Acute brain hemorrhage in dengue is rare and is a big challenge in neurosurgery.To perform surgery for management of acute brain hemorrhage in dengue is a controversial issue.Here, the authors try to summarize the previous reports on this topic and compare neurosurgery versus conservative management.

  8. Acute arsenic poisoning diagnosed late.

    Science.gov (United States)

    Shumy, Farzana; Anam, Ahmad Mursel; Kamruzzaman, A K M; Amin, Md Robed; Chowdhury, M A Jalil

    2016-04-01

    Acute arsenicosis, although having a 'historical' background, is not common in our times. This report describes a case of acute arsenic poisoning, missed initially due to its gastroenteritis-like presentation, but suspected and confirmed much later, when the patient sought medical help for delayed complications after about 2 months.

  9. Canagliflozin-Associated Acute Pancreatitis.

    Science.gov (United States)

    Verma, Rajanshu

    2016-01-01

    Canagliflozin is a new drug in class of sodium-glucose cotransporter 2 inhibitors used for treatment of type 2 diabetes mellitus. We describe a patient who developed moderately severe acute pancreatitis as an untoward consequence after being initiated on this drug. To the best of our knowledge, this is the first reported case of canagliflozin-associated acute pancreatitis in clinical literature.

  10. Calfornia General Plans Rural

    Data.gov (United States)

    California Department of Resources — We undertook creating the first ever seamless statewide General Plan map for California. All county general plans and many city general plans were integrated into 1...

  11. General Ultrasound Imaging

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z General Ultrasound Ultrasound imaging uses sound waves to produce pictures ... limitations of General Ultrasound Imaging? What is General Ultrasound Imaging? Ultrasound is safe and painless, and produces ...

  12. General Nuclear Medicine

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z General Nuclear Medicine Nuclear medicine imaging uses small amounts of ... limitations of General Nuclear Medicine? What is General Nuclear Medicine? Nuclear medicine is a branch of medical ...

  13. Calfornia General Plans

    Data.gov (United States)

    California Department of Resources — We undertook creating the first ever seamless statewide General Plan map for California. All county general plans and many city general plans were integrated into 1...

  14. [Acute rhinosinusitis: diagnostics and treatment].

    Science.gov (United States)

    Lazarevich, I A; Kozlov, V S

    2013-01-01

    Acute rhinosinusitis is a challenging clinical problem due to its high prevalence. The overwhelming majority of the cases of acute rhinosinusitis (ARS) have viral etiology. Clinical manifestations of viral and bacterial rhinosinusitis can be very similar. Similar expert communities have proposed their recommendations on diagnostics and treatment of acute rhinosinusitis in the recent decade. These recommendations are underlain by the principles of evidence-based medicine, take into consideration the result of reliable investigations, and reflect the opinions of leading specialists in otorhinolaryngology, allergology and immunology. The present review contains the analysis of consensus documents and recommendations. The results of ongoing research provide convincing evidence of the effectiveness of intranasal application of corticosteroids in the patients presenting with acute rhinosinusitis. Antibacterial therapy of acute rhinosinusitis is indicated only in the case of severe or complicated clinical course of the disease.

  15. Nutrition Support in Acute Pancreatitis

    Directory of Open Access Journals (Sweden)

    Orestis Ioannidis

    2008-07-01

    Full Text Available The management of acute pancreatitis differs according to its severity. Approximately 75% of patients with acute pancreatitis have mild disease with a mortality rate below 1%. Mortality increases up to 20% if the disease progresses to its severe necrotizing form and, in the most severe cases, mortality can increase to 30-40%. Severe acute pancreatitis is usually accompanied by systemic inflammatory response syndrome (SIRS which results in hypermetabolism with prominent protein catabolism. Acute malnutrition, commonly observed in patients with acute pancreatitis, is associated with immunological disturbances, septic complications and delayed healing of surgical wounds, and may lead to multiorgan dysfunction or failure syndrome (MODS or MOFS and increased morbidity and mortality [1].

  16. ST-elevation acute myocardial infarction in pregnancy: 2016 update.

    Science.gov (United States)

    Ismail, Sahar; Wong, Cynthia; Rajan, Priya; Vidovich, Mladen I

    2017-02-13

    Acute myocardial infarction (AMI) during pregnancy or the early postpartum period is rare, but can be devastating for both the mother and the fetus. There have been major advances in the diagnosis and treatment of acute coronary syndromes in the general population, but there is little consensus on the approach to diagnosis and treatment of pregnant women. This article reviews the literature relating to the pathophysiology of AMI in pregnant patients and the challenges in diagnosis and treatment of ST-elevation myocardial infarction (STEMI) in this unique population. From a cardiologist, maternal-fetal medicine specialist, and anesthesiologist's perspective, we provide recommendations for the diagnosis and management of STEMI occurring during pregnancy.

  17. A Rare Acute Abdomen Reason: Perforated Jejunal Diverticulitis

    Directory of Open Access Journals (Sweden)

    Oktay Karakose

    2014-06-01

    Full Text Available Jejunal diverticulosis is a rare case that is diagnosed incidental. Although it is generally asymptomatic, it can cause non-spesific symptoms like stomachache, nausea, diarrhoea, malabsorption, bleeding, obstruction and / or perforation. Perforated jejunal diverticulitis is a very rare acute abdomen cause. The acute complications of jejunal diverticulosis can be cause of significant morbidity and mortality especially in old patients. In this text, we report a 81 year old woman case that was operated emergently because of perforated jejunal diverticulitis and was lost in postoperation term because of multiple organ failure.

  18. Acute small bowel obstruction due to chicken bone bezoar

    Directory of Open Access Journals (Sweden)

    Vetpillai P

    2012-12-01

    Full Text Available Preadeepan Vetpillai,1 Ayo Oshowo21CT2 Surgery in General, Charing Cross Hospital, 2Colorectal and Laparoscopic Surgery, Whittington Hospital, London, UKAbstract: Acute intestinal obstruction due to foreign bodies, or bezoar, is a rare occurrence in an adult with a normal intestinal tract. We report an unusual case of a 43-year-old black man with no previous abdominal surgery and no significant medical history who presented with an acute episode of small bowel obstruction due to an impacted undigested chicken bone.Keywords: small bowel obstruction, chicken bone, bezoar

  19. Gemtuzumab Ozogamicin in Treating Patients With Relapsed or Refractory Acute Myeloid Leukemia or Acute Promyelocytic Leukemia

    Science.gov (United States)

    2016-07-26

    Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Acute Promyelocytic Leukemia (M3); Childhood Acute Promyelocytic Leukemia (M3); Recurrent Adult Acute Myeloid Leukemia; Recurrent Childhood Acute Myeloid Leukemia

  20. Influence of acute hypervolemic hemodilution on pharmacodynamics of cisatracurium in patients undergoing general anesthesia%急性高容量血液稀释对全麻患者顺式阿曲库铵药效学的影响

    Institute of Scientific and Technical Information of China (English)

    林文前; 谭红鹰; 白晓晖; 操隆辉; 曾维安

    2010-01-01

    Objective To investigate the influence of acute hypervolemic hemodilution (AHH) on pharmacodaynamics of cisatracurium in patients undergoing general anesthesia. Methods Sixty ASA Ⅰ or Ⅱ patients aged 18-60 yr scheduled for major abdominal surgery under general anesthesia were randomly allocated into 2 groups (n = 30 each): control group and AHH group. Each group was further divided into 3 subgroups according to the initial dose of cisatracurium (30, 40, 50 μg/kg) . The radial artery and right internal jugular vein were cannulated. BP, HR, CVP, SpO_2, P_(ET) CO_2 and body temperature were continuously monitored. The response of left adductor pollicis muscle to TOF stimulation of ulna nerve was monitored using TOF- Watch~R SX (Organon). Both groups received 10 ml/kg multiple electrolyte solution (plasma-Lyte A) during induction of anesthesia. In group AHH 15 ml/kg 6% hydroxyethyl starch (HES) 130/0.4 solution was infused via internal jugular vein over 30-40 min in addition to plasma-Lyte A. Five minutes after completion of plasma-Lyte A or HES, cisatracurium 30, 40 or SO fig/kg was injected iv in the respective subgroups. After the maximal T_1 block was achieved, the second dose was given to reach a total dose of 100 μg/kg. The onset time, duration of clinical action, total duration of action and recovery index were recorded. The doses for 50% , 90% and 95% T_1 depression (ED_(50), ED_(90), ED_(95)) were calculated by Probit method. Results The ED_(50), ED_(90), ED_(95) of cisatracurium were significantly higher in AHH group than in control group. The onset time of cisatracurium was significantly longer but clinical and total duration of action was significantly shorter in AHH group than in control group. There was no significant difference in recovery index between the two groups. Conclusion AHH can decrease the potency of cisatracurium.%目的 探讨急性高容量血液稀释(AHH)对全麻患者顺式阿曲库铵药效学的影响.方法 择期

  1. Acute upper gastrointestinal bleeding.

    Science.gov (United States)

    Kurien, Matthew; Lobo, Alan J

    2015-10-01

    Acute upper gastrointestinal bleeding (AUGIB) is a frequently encountered medical emergency with an incidence of 84-160/100000 and associated with mortality of approximately 10%. Guidelines from the National Institute for Care and Care Excellence outline key features in the management of AUGIB. Patients require prompt resuscitation and risk assessment using validated tools. Upper gastrointestinal endoscopy provides accurate diagnosis, aids in estimating prognosis and allows therapeutic intervention. Endoscopy should be undertaken immediately after resuscitation in unstable patients and within 24 hours in all other patients. Interventional radiology may be required for bleeding unresponsive to endoscopic intervention. Drug therapy depends on the cause of bleeding. Intravenous proton pump inhibitors should be used in patients with high-risk ulcers. Terlipressin and broad-spectrum antibiotics should be used following variceal haemorrhage. Hospitals admitting patients with AUGIB need to provide well organised services and ensure access to relevant services for all patients, and particularly to out of hours endoscopy.

  2. Acute human schistosomiasis mansoni

    Directory of Open Access Journals (Sweden)

    Ana Rabello

    1995-04-01

    Full Text Available The acute schistosomiasis is the toxemic disease that follow the Schistosoma cercariae active penetration trough screen in the immunologicaly naive vertebrate host. The clinical picture starts two to eight weeks after the first contact with the contaminated water. Susceptible patients present a syndrome comprising fever, diarrhea, toxemia and hepatosplenomegaly. Diagnosis is based on epidemiological and clinical features, presence of Schistosoma eggs in the feces, enlargement of abdominal lymph nodes by ultrasonography and by detection of high antibodies levels against the antigen keyhole limpet haemocyanin. Different rates of cure have been observed with specific medication and for the most severe clinical presentations the use of steroids reduces the systemic and allergic manifestations.

  3. Acute intermittent porphyria.

    Science.gov (United States)

    Herrick, Ariane L; McColl, Kenneth E L

    2005-04-01

    Acute intermittent porphyria (AIP) is characterised by neurovisceral crises the most common clinical presentation of which is abdominal pain. It is an autosomal dominant condition with incomplete penetrance and is potentially life-threatening. The key point in management is to suspect and confirm the diagnosis as early as possible in order to treat the attack and to avoid inappropriate treatments which may exacerbate the crisis. In this chapter we briefly outline the haem biosynthetic pathway and how deficiencies in individual enzymes give rise to the different porphyrias. We then describe the clinical features and diagnosis of AIP, followed by a discussion of pathogenesis, highlighting advances in the molecular biology of AIP and introducing the debate as to whether neurovisceral crises might result from porphyrin precursor neurotoxicity or from haem deficiency. Finally we discuss management, including family screening, avoidance of triggering factors, analgesia, maintenance of a high calorie intake, and administration of haem derivatives.

  4. Acute capsular infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kashihara, M.; Matsumoto, K.

    1985-05-01

    Sixty-three patients with lacunar-type of acute capsular infarction were treated in our service during the last 2 years. Their lesions were identified by computed tomography (CT) and classified into six types according to their locations: anterior, lateral, posterior, superior, inferior and multiple. The lesions were thought to be in the watershed areas of the regional arterial supplies, and the areas were considered to be prone to ischemia. The clinical course of each type showed characteristic features of ischemic strokes. In the majority of the patients with the lateral type, reversible ischemic neurological deficit (RIND) was seen as the predominant symptom, transient ischemic attack (TIA) was noted in the patients with the superior type, and major completed stroke was observed in those with posterior type.

  5. Acute coagulopathy of trauma

    DEFF Research Database (Denmark)

    Johansson, P I; Ostrowski, S R

    2010-01-01

    Acute coagulopathy of trauma predicts a poor clinical outcome. Tissue trauma activates the sympathoadrenal system resulting in high circulating levels of catecholamines that influence hemostasis dose-dependently through immediate effects on the two major compartments of hemostasis, i.......e., the circulating blood and the vascular endothelium. There appears to be a dose-dependency with regards to injury severity and the hemostatic response to trauma evaluated in whole blood by viscoelastic assays like thrombelastography (TEG), changing from normal to hypercoagulable, to hypocoagulable and finally......, is an evolutionary developed response that counterbalances the injury and catecholamine induced endothelial activation and damage. Given this, the rise in circulating catecholamines in trauma patients may favor a switch from hyper- to hypocoagulability in the blood to keep the progressively more procoagulant...

  6. Encephalitis, acute renal failure, and acute hepatitis triggered by a viral infection in an immunocompetent young adult: a case report

    Directory of Open Access Journals (Sweden)

    Khattab Mahmoud

    2009-11-01

    Full Text Available Abstract Introduction Cytomegalovirus generally causes self-limited, mild and asymptomatic infections in immunocompetent patients. An aggressive course in immunocompetent healthy patients is unusual. Case presentation We report the case of an immunocompetent 16-year-old Egyptian boy with encephalitis, acute renal failure, and acute hepatitis triggered by viral infection with a complete recovery following antiviral treatment. Conclusion We believe that this case adds to the understanding of the molecular biology, clinical presentation and increasing index of suspicion of many viral infections.

  7. Acute myocarditis triggering coronary spasm and mimicking acute myocardial infarction.

    Science.gov (United States)

    Kumar, Andreas; Bagur, Rodrigo; Béliveau, Patrick; Potvin, Jean-Michel; Levesque, Pierre; Fillion, Nancy; Tremblay, Benoit; Larose, Eric; Gaudreault, Valérie

    2014-09-26

    A 24-year-old healthy man consulted to our center because of typical on-and-off chest-pain and an electrocardiogram showing ST-segment elevation in inferior leads. An urgent coronary angiography showed angiographically normal coronary arteries. Cardiovascular magnetic resonance imaging confirmed acute myocarditis. Although acute myocarditis triggering coronary spasm is an uncommon association, it is important to recognize it, particularly for the management for those patients presenting with ST-segment elevation and suspect myocardial infarction and angiographically normal coronary arteries. The present report highlights the role of cardiovascular magnetic resonance imaging to identify acute myocarditis as the underlying cause.

  8. Acute appendicitis mistaken as acute rejection in renal transplant recipients.

    Directory of Open Access Journals (Sweden)

    Talwalkar N

    1994-01-01

    Full Text Available Case histories of 2 renal transplant recipients are reported who had presenting features of fever, leukocytosis and pain/tenderness over right iliac fossa and were diagnosed to be due to acute appendicitis rather than more commonly suspected acute rejection episode which has very similar features. Diagnosis of acute appendicitis was suspected on the basis of rectal examination and later confirmed by laparotomy. The purpose of this communication is to emphasize the need for proper diagnosis in patient with such presentation; otherwise wrong treatment may be received.

  9. Acute pancreatitis and acute renal failure following multiple hornet stings

    Directory of Open Access Journals (Sweden)

    N. Sharma

    2006-04-01

    Full Text Available Hymenoptera is a class of insects that sting in order to subdue their prey. Humans coming into accidental contact with these insects results in stings that may cause from mild local reaction like weal formation around the sting site to severe systemic reactions such as intravascular hemolysis, acute renal failure, pulmonary edema, cerebral edema, and rarely pancreatitis. We report here the clinical course of a patient who developed concurrent acute pancreatitis and pigment-induced acute renal failure after multiple hornet stings.

  10. Acute myocarditis triggering coronary spasm and mimicking acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Andreas; Kumar; Rodrigo; Bagur; Patrick; Béliveau; Jean-Michel; Potvin; Pierre; Levesque; Nancy; Fillion; Benoit; Tremblay; éric; Larose; Valérie; Gaudreault

    2014-01-01

    A 24-year-old healthy man consulted to our center because of typical on-and-off chest-pain and an electrocardiogram showing ST-segment elevation in inferior leads. An urgent coronary angiography showed angiographically normal coronary arteries. Cardiovascular magnetic resonance imaging confirmed acute myocarditis. Although acute myocarditis triggering coronary spasm is an uncommon association, it is important to recognize it, particularly for the management for those patients presenting with ST-segment elevation and suspect myocardial infarction and angiographically normal coronary arteries. The present report highlights the role of cardiovascular magnetic resonance imaging to identify acute myocarditis as the underlying cause.

  11. Acute myelogenous leukemia and acute leukemic appendicitis: A case report

    Institute of Scientific and Technical Information of China (English)

    Po-Jen Hsiao; Shih-Ming Kuo; Jia-Hong Chen; Hsuen-Fu Lin; Pau-Ling Chu; Shih-Hua Lin; Ching-Liang Ho

    2009-01-01

    Acute myelogenous leukemia (AML) can involve the gastrointestinal tract but rarely involves the appendix.We report a male patient who had 1 year partial remission from AML and who presented with apparent acute appendicitis as the initial manifestation of leukemia relapse. Pathological findings of the appendix revealed transmural infiltrates of myeloblasts, whichindicated a diagnosis of leukemia. Unfortunately, the patient died from progression of the disease on the 19th d after admission. Although leukemic cell infiltration of the appendix is uncommon, patients with leukemia relapse can present with symptoms mimicking acute appendicitis.

  12. Acute pericarditis and renal failure complicating acute hepatitis A infection.

    Science.gov (United States)

    Beyazit, Yavuz; Guven, Gulay Sain; Kekilli, Murat; Koklu, Seyfettin; Yolcu, Omer Faruk; Shorbagi, Ali

    2006-01-01

    Hepatitis A infection may result in acute hepatitis, and rarely, fulminant hepatitis may ensue. Extrahepatic manifestations of hepatitis A are uncommon. The authors present the case of a 77-year-old male who had development of acute renal failure and pericarditis during the clinical course of acute hepatitis A infection. He died as a result of septic shock on the fifth day of hospitalization. To the best of our knowledge, this is the first report of both these rare and serious complications appearing in the same patient.

  13. General Practitioner Antimicrobial Stewardship Programme Study (GAPS)

    DEFF Research Database (Denmark)

    Avent, Minyon L; Hansen, Malene Plejdrup; Gilks, Charles;

    2016-01-01

    BACKGROUND: There is a strong link between antibiotic consumption and the rate of antibiotic resistance. In Australia, the vast majority of antibiotics are prescribed by general practitioners, and the most common indication is for acute respiratory infections. The aim of this study is to assess...... have previously been demonstrated to be effective at reducing antibiotic prescribing for acute respiratory infections, are: delayed prescribing; patient decision aids; communication training; commitment to a practice prescribing policy for antibiotics; patient information leaflet; and near patient...... testing with C-reactive protein. In addition, two sub-studies are nested in the main study: (1) point prevalence estimation carriage of bacterial upper respiratory pathogens in practice staff and asymptomatic patients; (2) feasibility of direct measures of antibiotic resistance by nose/throat swabbing...

  14. Generalized holomorphic structures

    Science.gov (United States)

    Wang, Yicao

    2014-12-01

    We define the notion of generalized holomorphic principal bundles and establish that their associated vector bundles of holomorphic representations are generalized holomorphic vector bundles defined by M. Gualtieri. Motivated by our definition, several examples of generalized holomorphic structures are constructed. A reduction theorem of generalized holomorphic structures is also included.

  15. GENERALIZED WEAK FUNCTIONS

    Institute of Scientific and Technical Information of China (English)

    丁夏畦; 罗佩珠

    2004-01-01

    In this paper the authors introduce some new ideas on generalized numbers and generalized weak functions. They prove that the product of any two weak functions is a generalized weak function. So in particular they solve the problem of the multiplication of two generalized functions.

  16. How general is general information construct?

    Directory of Open Access Journals (Sweden)

    Predrag Zarevski

    2005-04-01

    Full Text Available There is a small number of constructs in the field of differential psychology that have raised so much debate between psychologists and professionals in related disciplines as is the case of general (verbal information construct. It seemed reasonable to test the validity of this construct measured with general information test in comparison with other measures of knowledge (cultural knowledge, vocabulary, knowledge of the most recent events, foreign language knowledge, and a standard verbal type g test. A sample of 376 candidates for state services was tested in a selection situation. Three analyses were conducted to determine the position of general information test in the space of other verbal competency measures. The first analysis questioned latent structure of the space of four tests having the same format and asking about the knowledge of international terms, general culture, knowledge of most recent events, and general information. The second analysis included the g-factor intelligence test so to see how the above described structure changes when this new test is introduced. The third analysis introduced an English language test. In all of the three component analyses only one eigenvalue was larger than 1 and it explained between 52 and 64% of variance. In all analyses general information test had the highest projection on the only significant latent dimension of these cognitive spaces. In other words, it can be concluded that the construct of general information is in the center of this hyperconus. That is why we consider measurement of general information knowledge, as well as the construct itself, to be an important question in psychological diagnostics. Thus, it is important to go further with the investigation of this construct because it does not seem that it is named general information by accident.

  17. Managing Acute Complications Of Sickle Cell Disease In Pediatric Patients.

    Science.gov (United States)

    Subramaniam, Sathyaseelan; Chao, Jennifer H

    2016-11-01

    Sickle cell disease is a chronic hematologic disease with a variety of acute, and often recurring, complications. Vaso-occlusive crisis, a unique but common presentation in sickle cell disease, can be challenging to manage. Acute chest syndrome is the leading cause of death in patients with sickle cell disease, occurring in more than half of patients who are hospitalized with a vaso-occlusive crisis. Uncommon diagnoses in children, such as stroke, priapism, and transient red cell aplasia, occur more frequently in patients with sickle cell disease and necessitate a degree of familiarity with the disease process and its management. Patients with sickle cell trait generally have a benign course, but are also subject to serious complications. This issue provides a current review of evidence-based management of the most common acute complications of sickle cell disease seen in pediatric patients in the emergency department.

  18. Antibiotic prescribing for acute bronchitis

    DEFF Research Database (Denmark)

    Llor, Carl; Bjerrum, Lars

    2016-01-01

    INTRODUCTION: Acute bronchitis is a self-limiting infectious disease characterized by acute cough with or without sputum but without signs of pneumonia. About 90% of cases are caused by viruses. AREAS COVERED: Antibiotics for acute bronchitis have been associated with an approximately half...... discusses the reason for this antibiotic overprescription. Other therapies targeted to control symptoms have also demonstrated a marginal or no effect. EXPERT COMMENTARY: Clinicians should be aware of the marginal effectiveness of antibiotic therapy. Some strategies like the use of rapid tests, delayed...

  19. Bacteriotherapy of acute radiation sickness

    Energy Technology Data Exchange (ETDEWEB)

    Mal' tsev, V.N.; Korshunov, V.M.; Strel' nikov, V.A.; Ikonnikova, T.B.; Kissina, E.V.; Lyannaya, A.M.; Goncharova, G.I.; Pinegin, B.V.

    1979-04-01

    Acute sickness is associated with intestinal dysbacteriosis; there is a radical decrease in number of microorganisms of lactic fermentation (bifidobacterium, lactobacillus) and an increase in E. coli proteus, enterococcus, and clostridium. Extensive use is made of live microorganisms in the treatment of various diseases associated with intestinal dysbacteriosis; in the case of acute radiation sickness, yeast, colibacterin, and E. coli have been used. In a number of cases, such therapy increased survival and life expectancy of irradiated animals. In this study, microorganisms of lactic fermentation (lactobacillus, bifidobacterium) and colibacterin were used for treatment of acute radiation sickness.

  20. Early management of acute pancreatitis.

    Science.gov (United States)

    Schepers, Nicolien J; Besselink, Marc G H; van Santvoort, Hjalmar C; Bakker, Olaf J; Bruno, Marco J

    2013-10-01

    Acute pancreatitis is the most common gastro-intestinal indication for acute hospitalization and its incidence continues to rise. In severe pancreatitis, morbidity and mortality remains high and is mainly driven by organ failure and infectious complications. Early management strategies should aim to prevent or treat organ failure and to reduce infectious complications. This review addresses the management of acute pancreatitis in the first hours to days after onset of symptoms, including fluid therapy, nutrition and endoscopic retrograde cholangiography. This review also discusses the recently revised Atlanta classification which provides new uniform terminology, thereby facilitating communication regarding severity and complications of pancreatitis.

  1. Cerebrogenic tachyarrhythmia in acute stroke

    Directory of Open Access Journals (Sweden)

    A S Praveen Kumar

    2012-01-01

    Full Text Available The electrocardiac abnormalities following acute stroke are frequent and seen in both ischemic and hemorrhagic stroke. The changes seen in electrocardiogram (ECG consist of repolarization abnormalities such as ST elevation, ST depression, negative T waves, and QT prolongation. Among tachyarrhythmias, atrial fibrillation is the most common and occurrence of focal atrial tachycardia is very rare though any cardiac arrhythmias can follow acute stroke. We report a case of focal atrial tachycardia following acute ischemic stroke in 50-year-old female without structural heart disease, and their mechanisms and clinical implications.

  2. [Cerebrolysin for acute ischemic stroke].

    Science.gov (United States)

    iganshina, L E; Abakumova, T R

    2013-01-01

    The review discusses existing evidence of benefits and risks of cerebrolysin--a mixture of low-molecular-weight peptides and amino acids derived from pigs' brain tissue with proposed neuroprotective and neurotrophic properties, for acute ischemic stroke. The review presents results of systematic search and analysis of randomised clinical trials comparing cerebrolysin with placebo in patients with acute ischemic stroke. Only one trial was selected as meeting quality criteria. No difference in death and adverse events between cerebrolysin and placebo was established. The authors conclude about insufficiency of evidence to evaluate the effect of cerebrolysin on survival and dependency in people with acute ischemic stroke.

  3. Pharm GKB: Leukemia, Eosinophilic, Acute [PharmGKB

    Lifescience Database Archive (English)

    Full Text Available Overview Alternate Names: Synonym Acute Eosinophilic Leukemia; Acute Eosinophilic Leukemias; Acute... eosinophilic leukemia; Eosinophilic Leukemia, Acute; Eosinophilic Leukemias, Acute; Leukemia, Acute... Eosinophilic; Leukemias, Acute Eosinophilic PharmGKB Accession Id: PA446179 External Vocabularies Me...SH: Leukemia, Eosinophilic, Acute (D015472) SnoMedCT: Acute eosinophilic leukemia... (277604002) UMLS: C0023439 (C0023439) NDFRT: Leukemia, Eosinophilic, Acute [Disease/Finding] (N0000003269)

  4. Pharm GKB: Leukemia, Myelomonocytic, Acute [PharmGKB

    Lifescience Database Archive (English)

    Full Text Available Overview Alternate Names: Synonym Acute Myelomonocytic Leukemia; Acute Myelomonocytic Leukemias; Acute... myelomonocytic leukaemia (clinical); Acute myelomonocytic leukemia (clinical); Acute mye...lomonocytic leukemia, FAB M4; Leukemia, Acute Myelomonocytic; Leukemia, Myeloid, Acute, M4; Leukemia, Myeloi...d, Naegeli-Type; Leukemia, Naegeli-Type Myeloid; Leukemias, Acute Myelomonocytic; Myeloid Leukemia, Acute..., M4; Myeloid Leukemia, Naegeli Type; Myeloid Leukemia, Naegeli-Type; Myelomonocytic Leukemia, Acute

  5. Perceived stress in general public during prevalence of severe acute respiratory syndrome and its impact on health behavior%严重急性呼吸综合征流行期间公众知觉压力及其对健康行为的影响

    Institute of Scientific and Technical Information of China (English)

    吕书红; 田本淳; 杨廷忠; 陈定湾; 池延花

    2010-01-01

    Objective To find out the perceived stress in general public during prevalence of severe acute respiratory syndrome (SARS) and its impact on health behavior. Methods A retrospective survey was conducted in Guangzhou, Hangzhou, and Taiyuan according to the epidemic situations of SARS, and 2532 subjects were randomly selected from constructive industry, school, and commercial business and residents in urban and rural areas. The perceive stress was measured by Chinese perceived stress scale (CPSS), and health related behavior during SARS was tested by uniform and self-made questionnaire. EpiData 2. 0 was used for data management and CPSS value was calculated according to answer to 14 questions contained in the scale. Health risk stress among different population group and health related behavior among low, medium and high stress state were analyzed by SPSS 11.5. Results 2424 subjects were involved in the survey. The CPSS value was measured from 0 -49(22.7±6. 8) ,M =24. 0. 39.3% (953/2379) subjects were under the health risk stress. The health related behaviors such as washing hands, opening the window for air, keeping away from others when cough and sneeze,doing exercises etc were reduced with the stress increased. Logistic regression indicated that compared with the persons with the thoughts of nothing serious of SARS,without any dread of SARS,and knowing nothing about prevention of SARS,the perceived stress was significantly related with perceiving of the thread to certain extent (β = 0. 41, Wald χ~2 = 4. 84, P = 0. 03), worrying little about the epidemic (β = 0. 50, Wald χ~2 = 6. 69, P = 0. 01), worrying about it to certain extent (β= 1.39, Wald χ~2 = 48. 59 ,P = 0. 00)and scared so much (β = 1.77, Wald χ~2= 53.59, P = 0. 00), and knowing little about the prevention(β = 0. 74, Wald χ~2 = 4. 48, P = 0. 03), knowing something about prevention (β = - 0. 98, Wald χ~2 = 8. 29, P = 0. 00) and knowing the prevention very well (β = - 1.18, Wald χ~2 = 10. 66

  6. Generalized adjoint systems

    CERN Document Server

    Serakos, Demetrios

    2015-01-01

    This book defines and develops the generalized adjoint of an input-output system. It is the result of a theoretical development and examination of the generalized adjoint concept and the conditions under which systems analysis using adjoints is valid. Results developed in this book are useful aids for the analysis and modeling of physical systems, including the development of guidance and control algorithms and in developing simulations. The generalized adjoint system is defined and is patterned similarly to adjoints of bounded linear transformations. Next the elementary properties of the generalized adjoint system are derived. For a space of input-output systems, a generalized adjoint map from this space of systems to the space of generalized adjoints is defined. Then properties of the generalized adjoint map are derived. Afterward the author demonstrates that the inverse of an input-output system may be represented in terms of the generalized adjoint. The use of generalized adjoints to determine bounds for ...

  7. Acute Psychosis as Main Manifestation of Central Pontine Myelinolysis

    Directory of Open Access Journals (Sweden)

    Mangala Gopal

    2017-01-01

    Full Text Available Central pontine myelinolysis (CPM is an acute demyelinating neurological disorder affecting primarily the central pons and is frequently associated with rapid correction of hyponatremia. Common clinical manifestations of CPM include spastic quadriparesis, dysarthria, pseudobulbar palsy, and encephalopathy of various degrees; however, coma, “locked-in” syndrome, or death can occur in most severe cases. Rarely, CPM presents with neuropsychiatric manifestations, such as personality changes, acute psychosis, paranoia, hallucinations, or catatonia, typically associated with additional injury to the brain, described as extrapontine myelinolysis (EPM. We present a patient with primarily neuropsychiatric manifestations of CPM, in the absence of focal neurologic deficits or radiographic extrapontine involvement. A 51-year-old female without significant medical history presented with dizziness, frequent falls, diarrhea, generalized weakness, and weight loss. Physical examination showed no focal neurological deficits. Laboratory data showed severe hyponatremia, which was corrected rather rapidly. Subsequently, the patient developed symptoms of an acute psychotic illness. Initial brain magnetic resonance imaging (MRI was unremarkable, although a repeat MRI two weeks later revealed changes compatible with CPM. This case demonstrates that acute psychosis might represent the main manifestation of CPM, especially in early stages of the disease, which should be taken into consideration when assessing patients with acute abnormalities of sodium metabolism.

  8. Acute Psychosis as Main Manifestation of Central Pontine Myelinolysis

    Science.gov (United States)

    Gopal, Mangala; Patel, Harsh

    2017-01-01

    Central pontine myelinolysis (CPM) is an acute demyelinating neurological disorder affecting primarily the central pons and is frequently associated with rapid correction of hyponatremia. Common clinical manifestations of CPM include spastic quadriparesis, dysarthria, pseudobulbar palsy, and encephalopathy of various degrees; however, coma, “locked-in” syndrome, or death can occur in most severe cases. Rarely, CPM presents with neuropsychiatric manifestations, such as personality changes, acute psychosis, paranoia, hallucinations, or catatonia, typically associated with additional injury to the brain, described as extrapontine myelinolysis (EPM). We present a patient with primarily neuropsychiatric manifestations of CPM, in the absence of focal neurologic deficits or radiographic extrapontine involvement. A 51-year-old female without significant medical history presented with dizziness, frequent falls, diarrhea, generalized weakness, and weight loss. Physical examination showed no focal neurological deficits. Laboratory data showed severe hyponatremia, which was corrected rather rapidly. Subsequently, the patient developed symptoms of an acute psychotic illness. Initial brain magnetic resonance imaging (MRI) was unremarkable, although a repeat MRI two weeks later revealed changes compatible with CPM. This case demonstrates that acute psychosis might represent the main manifestation of CPM, especially in early stages of the disease, which should be taken into consideration when assessing patients with acute abnormalities of sodium metabolism.

  9. A Case Report of Acute Hemorrhagic Edema of Infancy

    Directory of Open Access Journals (Sweden)

    M. Safari

    2005-10-01

    Full Text Available Introduction: Acute hemorrhagic edema of infancy is an acute and rare cutaneous disorder that affects children between 4 months to 2 years of age and characterized by cutaneous purpuric lesions with millimeters to centimeters diameter. Systemic involvement is rare. The disease is benign and spontaneously resolved in 1-3 weeks.Case Report: Here we described a 22-months old girl with acute hemorrhagic edema of infancy who hospitalized in department of pediatric with the presence of erythematous-purpuric lesions localized on the face, ears and lower limbs that developed suddenly two days before hospitalization. Laboratory examination revealed including normal cell blood counts, serum complements, serum electrolytes and creatinin. ANA was negative. Coagulation tests were normal. ESR was 45 mm/h. Urine analysis and stool examination revealed no abnormal findings. Disease resolved spontaneously without any problem.Conclusion: According to the contrast between the acuteness of the cutaneous sign, which are typical and unmistakable, and the general condition of the patient, which was good and the laboratory findings, our patient labeled as acute hemprrhagic edema of infancy.

  10. Understanding Health Care Costs in a Wisconsin Acute Leukemia Population

    Directory of Open Access Journals (Sweden)

    Patricia Steinert

    2016-08-01

    Full Text Available Purpose: We investigated factors driving health care costs of patients with a diagnosis of acute myeloid and acute lymphoblastic leukemia. Methods: Standard costs identified in insurance claims data obtained from the Wisconsin Health Information Organization were used in a sample of 837 acute leukemia patients from April 2009 to June 2011. The Andersen behavioral model of health care utilization guided selection of patient and community factors expected to influence health care costs. A generalized linear model fitting gamma-distributed data with log-link technique was used to analyze cost. Results: Type of treatment received and disease severity represented significant cost drivers, and patients receiving at least some of their treatment from academic medical centers experienced higher costs. Inpatient care and pharmacy costs of patients who received treatment from providers located in areas of higher poverty experienced lower costs, raising questions of potential treatment and medical practice disparities between provider locations. Directions of study findings were not consistent between different types of services received and underscore the complexity of investigating health care cost. Conclusions: While prevalence of acute leukemia in the United States is low compared to other diseases, its extreme high cost of treatment is not well understood and potentially influences treatment decisions. Acute leukemia health care costs may not follow expected patterns; further exploration of the relationship between cost and the treatment decision, and potential treatment disparities between providers in different socioeconomic locations, is needed.

  11. Decongestion in acute heart failure

    NARCIS (Netherlands)

    Mentz, Robert J.; Kjeldsen, Keld; Rossi, Gian Paolo; Voors, Adriaan A.; Cleland, John G. F.; Anker, Stefan D.; Gheorghiade, Mihai; Fiuzat, Mona; Rossignol, Patrick; Zannad, Faiez; Pitt, Bertram; O'Connor, Christopher; Felker, G. Michael

    2014-01-01

    Congestion is a major reason for hospitalization in acute heart failure (HF). Therapeutic strategies to manage congestion include diuretics, vasodilators, ultrafiltration, vasopressin antagonists, mineralocorticoid receptor antagonists, and potentially also novel therapies such as gut sequesterants

  12. Depression following acute coronary syndrome

    DEFF Research Database (Denmark)

    Joergensen, Terese Sara Hoej; Maartensson, Solvej; Ibfelt, Else Helene;

    2016-01-01

    PURPOSE: Depression is common following acute coronary syndrome, and thus, it is important to provide knowledge to improve prevention and detection of depression in this patient group. The objectives of this study were to examine: (1) whether indicators of stressors and coping resources were risk...... factors for developing depression early and later after an acute coronary syndrome and (2) whether prior depression modified these associations. METHODS: The study was a register-based cohort study, which includes 87,118 patients with a first time diagnosis of acute coronary syndrome during the period.......8 % developed a recurrent depression. Most patient characteristics (demographic factors, socioeconomic status, psychosocial factors, health-related behavioural factors, somatic comorbidities, and severity of acute coronary syndrome) were significantly associated with increased HRs for both early and later...

  13. Acute intestinal anisakiasis: CT findings.

    Science.gov (United States)

    Ozcan, H N; Avcu, S; Pauwels, W; Mortelé, K J; De Backer, A I

    2012-09-01

    Small bowel anisakiasis is a relatively uncommon disease that results from consumption of raw or insufficiently pickled, salted, smoked, or cooked wild marine fish infected with Anisakis larvae. We report a case of intestinal anisakiasis in a 63-year-old woman presenting with acute onset of abdominal complaints one day after ingestion of raw wild-caught herring from the Northsea. Computed tomography (CT) scanning demonstrated thickening of the distal small bowel wall, mucosa with hyperenhancement, mural stratification, fluid accumulation within dilated small-bowel loops and hyperemia of mesenteric vessels. In patients with a recent history of eating raw marine fish presenting with acute onset of abdominal complaints and CT features of acute small bowel inflammation the possibility of anisakiasis should be considered in the differential diagnosis of acute abdominal syndromes.

  14. Antibiotics for acute maxillary sinusitis

    DEFF Research Database (Denmark)

    Ahovuo-Saloranta, Anneli; Borisenko, Oleg V; Kovanen, Niina;

    2008-01-01

    BACKGROUND: Expert opinions vary on the appropriate role of antibiotics for sinusitis, one of the most commonly diagnosed conditions among adults in ambulatory care. OBJECTIVES: We examined whether antibiotics are effective in treating acute sinusitis, and if so, which antibiotic classes...... or antibiotics from different classes for acute maxillary sinusitis in adults. We included trials with clinically diagnosed acute sinusitis, whether or not confirmed by radiography or bacterial culture. DATA COLLECTION AND ANALYSIS: At least two review authors independently screened search results, extracted...... with a pooled RR of 0.74 (95% CI 0.65 to 0.84) at 7 to 15 days follow up. None of the antibiotic preparations was superior to each other. AUTHORS' CONCLUSIONS: Antibiotics have a small treatment effect in patients with uncomplicated acute sinusitis in a primary care setting with symptoms for more than seven...

  15. Thrombolysis in Acute Cerebrovascular Disease

    Institute of Scientific and Technical Information of China (English)

    刘泽霖

    2003-01-01

    @@ Large-scale trials have shown that thrombolytic therapy reduces mortality and preserves left ventricular function in patients with acute myocardial infarction (AMI). That's a rationale for the use of thrombolytic agents in the management of ischemic stroke.

  16. Acute Theophylline Intoxication: Case Report

    Directory of Open Access Journals (Sweden)

    Zehra Baykal Tutal

    2016-01-01

    Full Text Available Theophylline is an efficient bronchodilatator, which is used in the treatment of the disease such like Chronic Obstructive Pulmoner Disease (COPD neonatal apnea, bradycardial syndrome. Blood levels of theophylline above 15 ug/ml have risk of intoxication. Acute and chronic intoxication can be seen. Nausea, vomitin, agitation, palpitation and metabolic abnormalities such as, hyperglisemia, hypokalemia, impairment in acid base equilibrium and leukocytosis can be seen in acute theophylline intoxication. Acute theophylline intoxications can result life threatening situations such as convulsions, ventricular arrhythmias and death. Theophylline intoxications are often iatrogenic. In this case, the clinical course of a patient with COPD who took theophylline with the intention of suicide attempt is to mentioned and discussion of diagnosis, treatment and clinical course of acute theophylline intoxication was to aimed.

  17. Acute stroke imaging research roadmap

    NARCIS (Netherlands)

    Wintermark, Max; Albers, Gregory W.; Alexandrov, Andrei V.; Alger, Jeffry R.; Bammer, Roland; Baron, Jean-Claude; Davis, Stephen; Demaerschalk, Bart M.; Derdeyn, Colin P.; Donnan, Geoffrey A.; Eastwood, James D.; Fiebach, Jochen B.; Fisher, Marc; Furie, Karen L.; Goldmakher, Gregory V.; Hacke, Werner; Kidwell, Chelsea S.; Kloska, Stephan P.; Koehrmann, Martin; Koroshetz, Walter; Lee, Ting-Yim; Lees, Kennedy R.; Lev, Michael H.; Liebeskind, David S.; Ostergaard, Leif; Powers, William J.; Provenzale, James; Schellinger, Peter; Silbergleit, Robert; Sorensen, Alma Gregory; Wardlaw, Joanna; Warach, Steven

    2008-01-01

    The recent "Advanced Neuroimaging for Acute Stroke Treatment" meeting on September 7 and 8, 2007 in Washington DC, brought together stroke neurologists, neuroradiologists, emergency physicians, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke (

  18. Biomarkers in acute lung injury.

    Science.gov (United States)

    Mokra, Daniela; Kosutova, Petra

    2015-04-01

    Acute respiratory distress syndrome (ARDS) and its milder form acute lung injury (ALI) may result from various diseases and situations including sepsis, pneumonia, trauma, acute pancreatitis, aspiration of gastric contents, near-drowning etc. ALI/ARDS is characterized by diffuse alveolar injury, lung edema formation, neutrophil-derived inflammation, and surfactant dysfunction. Clinically, ALI/ARDS is manifested by decreased lung compliance, severe hypoxemia, and bilateral pulmonary infiltrates. Severity and further characteristics of ALI/ARDS may be detected by biomarkers in the plasma and bronchoalveolar lavage fluid (or tracheal aspirate) of patients. Changed concentrations of individual markers may suggest injury or activation of the specific types of lung cells-epithelial or endothelial cells, neutrophils, macrophages, etc.), and thereby help in diagnostics and in evaluation of the patient's clinical status and the treatment efficacy. This chapter reviews various biomarkers of acute lung injury and evaluates their usefulness in diagnostics and prognostication of ALI/ARDS.

  19. [Ascites and acute kidney injury].

    Science.gov (United States)

    Piano, Salvatore; Tonon, Marta; Angeli, Paolo

    2016-07-01

    Ascites is the most common complication of cirrhosis. Ascites develops as a consequence of an abnormal splanchnic vasodilation with reduction of effecting circulating volume and activation of endogenous vasoconstrictors system causing salt and water retention. Patients with ascites have a high risk to develop further complications of cirrhosis such as hyponatremia, spontaneous bacterial peritonitis and acute kidney injury resulting in a poor survival. In recent years, new studies helped a better understanding of the pathophysiology of ascites and acute kidney injury in cirrhosis. Furthermore, new diagnostic criteria have been proposed for acute kidney injury and hepatorenal syndrome and a new algorithm for their management has been recommended with the aim of an early diagnosis and treatment. Herein we will review the current knowledge on the pathophysiology, diagnosis and treatment of ascites and acute kidney injury in patients with cirrhosis and we will identify the unmet needs that should be clarified in the next years.

  20. The Generalized KKM Map and Its Applications to Variztional Inequalities

    Institute of Scientific and Technical Information of China (English)

    李耀堂

    1993-01-01

    In this paper,applying the concept of generalized KKM map,we study problems of variational inequalities.We weaken convexity(concavity) conditions for a functional of two variables ψ(x,y) in the general variational inequalities.Last,we show a proof of non-topological degree meth-od of acute principle about monotone operator as an application of these results.

  1. Acute pancreatitis, acute hepatitis and acute renal failure favourably resolved in two renal transplant recipients.

    Science.gov (United States)

    Voiculescu, Mihai; Ionescu, Camelia; Ismail, Gener; Mandache, Eugen; Hortopan, Monica; Constantinescu, Ileana; Iliescu, Olguta

    2003-03-01

    Renal transplantation is often associated with severe complications. Except for acute rejection, infections and toxicity of immunosuppressive treatment are the most frequent problems observed after transplantation. Infections with hepatic viruses (HBV, HDV, HCV, HGV) and cytomegalic virus (CMV) are the main infectious complications after renal transplantation. Cyclosporine toxicity is not unusual for a patient with renal transplantation and is even more frequent for patients with hepatic impairment due to viral infections. The subjects of this report are two renal transplant recipients with acute pancreatitis, severe hepatitis and acute renal failure on graft, receiving immunosuppressive therapy for maintaining renal graft function

  2. Rational management of acute keratoconus

    Directory of Open Access Journals (Sweden)

    Yu. B. Slonimskiy

    2015-01-01

    Full Text Available Acute keratoconus is a common and severe complication of advanced progressive keratoconus that occurs in more than 30 % of cases. Acute corneal edema in advanced progressive keratectasia is reffered to as acute corneal hydrops (hydrops corneae. It has been also reported in other ectatic disorders such as pellucid marginal degeneration. The most common misdiagnosis in hydrops is HSV disciform keratitis or acute bacterial keratitis. 126 corneal hydrops patients (79 men, 47 women aged 16‑63 (129 eyes were observed and treated over the last five years. 124 patients were diagnosed with acute keratoconus and 2 patients were diagnosed with pellucid marginal degeneration. Acute kereatoconus patientsrepresented a special and compromised cohort with systemic allergic diseases (neurodermatitis and various atopic disorders, n = 48, Down’s syndrome (n = 16 or mental disorders (n = 19. In many of these patients who vigorously rubbed their eyes, keratectasia progressed more rapidly. In 7 cases, acute keratoconus developed during pregnancy. 3 cases of recurrent keratoconus were reported — in a woman with Down’s syndrome (recurrence in 3 years, in a man with severe neurodermatitis (recurrence in 5 years, and in a man with anamnestic acute keratoconus (recurrence in 20 years. 3 patients experienced bilateral acute keratoconus. Acute keratoconus can be subdivided by the area of corneal edema into three categories, i.e., partial (6 mm or less, 52 eyes, subtotal (7‑10 mm, 56 eyes, and total (more than 10 mm, 21 eyes. Corneal edema ultimately disappeared, however, acute keratoconus resulted in a deep local scarring through the corneal layers. Slit lamp exam revealed Descemet’s membrane ruptures (so-called fish mouth. 73 eyes were referred to refractive penetrating keratoplasty (PKP. Corneal perforation was unusual even in severe corneal thinning (4 cases. In one case, descemetocele with a high risk of perforation was observed. 4 eyes

  3. On generalized extending modules

    Institute of Scientific and Technical Information of China (English)

    ZENG Qing-yi

    2007-01-01

    A module M is called generalized extending if for any submodule N of M, there is a direct summand K of M such that N≤K and K/N is singular. Any extending module and any singular module are generalized extending. Any homomorphic image of a generalized extending module is generalized extending. Any direct sum of a singular (uniform) module and a semi-simple module is generalized extending. A ring R is a right Co-H-ring ifand only ifall right R modules are generalized extending modules.

  4. SIRT1-mediated acute cardioprotection

    OpenAIRE

    Nadtochiy, Sergiy M; Yao, Hongwei; McBurney, Michael W.; Gu, Wei; Guarente, Leonard; Rahman, Irfan; Paul S. Brookes

    2011-01-01

    Overexpression studies have revealed a role for silent information regulator of transcription 1 (SIRT1) lysine deacetylase in cardioprotection against ischemia-reperfusion injury via long-term transcriptional effects. However, short-term SIRT1-mediated lysine deacetylation, within the context of acute cardioprotection, is poorly understood. In this study, the role of SIRT1 in the acute cardioprotective paradigm of first window ischemic preconditioning (IPC) was studied using SIRT1-deficient (...

  5. Injury to skeletal muscle of mice following acute and sub-acute pregabalin exposure

    Science.gov (United States)

    Moshiri, Mohammad; Moallem, Seyed Adel; Attaranzadeh, Armin; Saberi, Zahra; Etemad, Leila

    2017-01-01

    Objective(s): Pregabalin (PGB) is a new antiepileptic drug that has received FDA approval for patient who suffers from central neuropathic pain, partial seizures, generalized anxiety disorder, fibromyalgia and sleep disorders. This study was undertaken to evaluate the possible adverse effects of PGB on the muscular system of mice. Materials and Methods: To evaluate the effect of PGB on skeletal muscle, the animals were exposed to a single dose of 1, 2 or 5 g /kg or daily doses of 20, 40 or 80 mg/kg for 21 days, intraperitoneally (IP). Twaenty-four hr after the last drug administration, all animals were sacrificed. The level of fast-twitch skeletal muscle troponin I and CK-MM activity were evaluated in blood as an indicator of muscle injury. Skeletal muscle pathological findings were also reported as scores ranging from 1 to 3 based on the observed lesion. Results: In the acute and sub-acute toxicity assay IP injection of PGB significantly increased the activity and levels of CK-MM and fsTnI compared to the control group. Sub-acute exposure to PGB caused damages that include muscle atrophy, infiltration of inflammatory cells and cell degeneration. Conclusion: PGB administration especially in long term care causes muscle atrophy with infiltration of inflammatory cells and cell degeneration. The fsTnI and CK-MM are reliable markers in PGB-related muscle injury. The exact mechanisms behind the muscular damage are unclear and necessitate further investigations. PMID:28392896

  6. Acute diarrhea in children

    Directory of Open Access Journals (Sweden)

    Radlović Nedeljko

    2015-01-01

    Full Text Available Acute diarrhea (AD is the most frequent gastroenterological disorder, and the main cause of dehydration in childhood. It is manifested by a sudden occurrence of three or more watery or loose stools per day lasting for seven to 10 days, 14 days at most. It mainly occurs in children until five years of age and particularly in neonates in the second half-year and children until the age of three years. Its primary causes are gastrointestinal infections, viral and bacterial, and more rarely alimentary intoxications and other factors. As dehydration and negative nutritive balance are the main complications of AD, it is clear that the compensation of lost body fluids and adequate diet form the basis of the child’s treatment. Other therapeutic measures, except antipyretics in high febrility, antiparasitic drugs for intestinal lambliasis, anti-amebiasis and probiotics are rarely necessary. This primarily regards uncritical use of antibiotics and intestinal antiseptics in the therapy of bacterial diarrhea. The use of antiemetics, antidiarrhetics and spasmolytics is unnecessary and potentially risky, so that it is not recommended for children with AD.

  7. Acute Respiratory Distress Syndrome

    Directory of Open Access Journals (Sweden)

    Carmen Sílvia Valente Barbas

    2012-01-01

    Full Text Available This paper, based on relevant literature articles and the authors' clinical experience, presents a goal-oriented respiratory management for critically ill patients with acute respiratory distress syndrome (ARDS that can help improve clinicians' ability to care for these patients. Early recognition of ARDS modified risk factors and avoidance of aggravating factors during hospital stay such as nonprotective mechanical ventilation, multiple blood products transfusions, positive fluid balance, ventilator-associated pneumonia, and gastric aspiration can help decrease its incidence. An early extensive clinical, laboratory, and imaging evaluation of “at risk patients” allows a correct diagnosis of ARDS, assessment of comorbidities, and calculation of prognostic indices, so that a careful treatment can be planned. Rapid administration of antibiotics and resuscitative measures in case of sepsis and septic shock associated with protective ventilatory strategies and early short-term paralysis associated with differential ventilatory techniques (recruitment maneuvers with adequate positive end-expiratory pressure titration, prone position, and new extracorporeal membrane oxygenation techniques in severe ARDS can help improve its prognosis. Revaluation of ARDS patients on the third day of evolution (Sequential Organ Failure Assessment (SOFA, biomarkers and response to infection therapy allows changes in the initial treatment plans and can help decrease ARDS mortality.

  8. Nutrition and acute schistosomiasis

    Directory of Open Access Journals (Sweden)

    Eridan M. Coutinho

    1992-01-01

    Full Text Available In northeast Brazil, nutritional deficiency diseases and schistosomiasis mansoni overlap. An experimental model, wich reproduces the marasmatic clinical form of protein-energy malnutrition, was developed in this laboratory to study these interactions. Albino Swiss mice were fed with a food association ingested usually by human populations in northeast Brazil. This diet (Regional Basic Diet - RBD has negative effects on the growth, food intake and protein utilization in infected mice (acute phase of murine schistosomiasis. Nitrogen balance studies have also shown that infection with Schistosoma mansoni has apparently no effect on protein intestinal absorption in well nourished mice. However, the lowest absorption ratios have been detected among RBD - fed infected animals, suggesting that suprerimposed schistosome infection aggravated the nutritional status of the undernourished host. The serum proteins electrophoretic pattern, as far as albumins are concerned, is quite similar for non-infected undernourished and infected well-fed animals. So, the significance of albumins as a biochemical indicator of the nutritional status of human populations residing in endemic foci of Manson's schistosomiasis, is discussable.

  9. Pharm GKB: Acute-Phase Reaction [PharmGKB

    Lifescience Database Archive (English)

    Full Text Available Overview Alternate Names: Synonym Acute Phase Reaction; Acute Phase State; Acute-Phase Response; Acute...-Phase State; Reaction, Acute Phase; Reaction, Acute-Phase; Response, Acute Phase; Response, Acute...-Phase; State, Acute-Phase PharmGKB Accession Id: PA443262 External Vocabularies MeSH: Acute-Phase ...Reaction (D000210) UMLS: Acute-Phase Reaction [Disease/Finding] (C0001349) NDFRT: Acute...-Phase Reaction [Disease/Finding] (N0000000303) Common Searches Search Medline Plus Search CTD Pharm GKB: Acute-Phase Reaction ...

  10. Physical therapy plus general practitioners' care versus general practitioners' care alone for sciatica: a randomised clinical trial with a 12-month follow-up

    OpenAIRE

    Luijsterburg, Pim; Verhagen, Arianne; Ostelo, Raymond; Hoogen, Hans; Peul, Wilco; Avezaat, Cees; Koes, Bart

    2008-01-01

    textabstractA randomised clinical trial in primary care with a 12-months follow-up period. About 135 patients with acute sciatica (recruited from May 2003 to November 2004) were randomised in two groups: (1) the intervention group received physical therapy (PT) added to the general practitioners' care, and (2) the control group with general practitioners' care only. To assess the effectiveness of PT additional to general practitioners' care compared to general practitioners' care alone, in pa...

  11. Contemporary therapy: aromatherapy in the management of acute pain?

    Science.gov (United States)

    Ching, M

    1999-12-01

    Recent surveys indicate that people are increasingly using complementary therapies as an adjunct or alternative to conventional treatment options as well as for general health and well being. Whilst complementary therapies such as aromatherapy have been utilised in clinical settings as diverse as long term care facilities and palliative care, its application to the acute care setting has not been explored in depth. The changes in contemporary health care practices such as post-operative pain management and length of hospital admissions have provided nurses with the challenge of examining the range of therapeutic interventions that can be applied to their practice. The purpose of this paper is to examine critically the potential uses of aromatherapy in the management of acute post-operative pain. The concept of aromatherapy will be explored in relation to its effects on the pain pathways, methods of administration and therapeutic effects. Specific reference will be made to Lavender (Lavandula angustifolia) and its use in aromatherapy. A review of the literature points to gaps in the knowledge related to the clinical application of aromatherapy in relation to issues of dosage, methods of administration and therapeutic effects. The relatively small number of studies that have looked at aromatherapy in the acute care setting supports the literature reviewed. Issues such as small sample sizes and the difficulty in replicating these studies make it difficult to generalize the findings. In order to achieve best practice, further research is necessary to explore the use of aromatherapy in the management of acute post-operative pain.

  12. Pizotifen relieves acute migraine symptoms

    Directory of Open Access Journals (Sweden)

    A.S.M. Kamrul Huda

    2008-01-01

    Full Text Available To The Editor: Various pharmacological agents are used for the treatment of migraine. In the last five years, various drug companies in Bangladesh have been marketing pizotifen as a preventive treatment of all types of migraine. Pizotifen is a serotonin antagonist acting mainly at the 5-HT1, 5-HT2A and 5HT2C receptors. It also has some activity as an antihistamine (1. Pizotifen is a well-established preventative therapy of migraine. I would like to report my own experience in using pizotifen in treating the acute attacks of migraine. Pizotifen was prescribed as acute therapy in 11 patients, 6 females (4 had migraine without aura and 2 had migraine with aura and 5 males (all had migraine without aura. Three female and 5 male patients, who had migraine without aura, reported no beneficial effect of pizotifen as treatment for the acute attacks. Three female patients (two with migraine with aura and one with migraine without aura had their headache relieved by use of pizotifen as treatment for the acute attacks. This is an initial observation about the effectiveness of pizotifen as acute therapy in migraine. However, this could be simply a placebo affect. Nevertheless, it will be worth exploring the role of pizotifen as a therapeutic agent for acute attacks of migraine by conducting well-designed randomized, controlled studies.

  13. [Correlation between hyperamylasemia and acute pancreatitis].

    Science.gov (United States)

    Monaco, R; Durante, E; Pampolini, M; Tioli, P

    1981-05-31

    It is often difficult to differentiate acute pancreatitis (A.P.) from some other acute abdominal diseases, when there is an elevated serum amylase. In contrast, the renal clearance of amylase, expressed as a percentage of creatinine clearance, can separate patients with A.P. from patients with acute colecistitis, common duct stone without pancreatitis, hyperamylasemia after biliary surgery, acute peptic ulcer and acute salivary diseases.

  14. KEGG DISEASE / Acute encephalitis [KEGG DISEASE

    Lifescience Database Archive (English)

    Full Text Available DISEASE: H01417 Entry H01417Disease Name Acute encephalitis Description Acute encep...ns Infections caused by dsDNA viruses H01417Acute encephalitis Human diseases in ICD-10 classification [BR:b...of the central nervous system G04Encephalitis, myelitis and encephalomyelitis H01417Acute encephalitis Patho...elines for management. Journal Eur J Neurol 12:331-43 (2005) KEGG DISEASE / Acute encephalitis ...

  15. Acute normobaric hypoxia stimulates erythropoietin release.

    Science.gov (United States)

    Mackenzie, Richard W A; Watt, Peter W; Maxwell, Neil S

    2008-01-01

    Investigations studying the secretion of EPO (erythropoietin) in response to acute hypoxia have produced mixed results. Further, the errors associated with the various methods used to determine EPO are not well documented. The purpose of the current study was to determine the EPO response of 17 trained male subjects to either an acute bout of normobaric hypoxia (Hy; n = 10) or normoxia (Con; n = 7). A secondary aim was to determine the error associated with the measurement of EPO. After baseline tests, the treatment group (Hy) underwent a single bout of hypoxic exposure (F(I(O(2))) approximately 0.148; 3100 m) consisting of a 90-min rest period followed by a 30-min exercise phase (50% V(O)(2max)). Venous blood samples were drawn pre (0 min) and post (120 min) each test to assess changes in plasma EPO (DeltaEPO). The control (Con) group was subjected to the same general experimental design, but placed in a normoxic environment (F(I(O(2))) approximately 0.2093). The Hy group demonstrated a mean increase in EPO [19.3 (4.4) vs. 24.1 (5.1) mU/mL], p < 0.04, post 120 min of normobaric hypoxia. The calculated technical error of measurement for EPO was 2.1 mU/mL (9.8%). It was concluded that an acute bout of hypoxia, has the capacity to elevate plasma EPO. This study also demonstrates that the increase in EPO accumulation was 2 times greater than the calculated measurement of error.

  16. [Thyroid function tests in acute drug intoxication].

    Science.gov (United States)

    Tseng, F Y; Chen, C S

    1992-03-01

    It is well known that thyroid function tests may be changed in non-thyroidal illnesses. To understand the influence of acute drug intoxication on thyroid function tests, 31 drug intoxicated patients without previous thyroid disorders and systemic diseases were included in our study. T3, T4, TSH, and resin T3 uptake were checked as soon as they arrived at our emergency service and were compared to that of 58 healthy volunteers. Within 31 patients, 14 were intoxicated by organophosphorous compounds, 6 by sedatives and hypnotics, 3 by strong acid, 2 by paraquet, 2 by rodenticides (warfarin), 2 by lysol and the other 2 were intoxicated by acetaminophen. The mean T3 and TSH levels were significantly lower in the drug intoxicated group. Among the 31 patients, 14 (45.2%) had a low T3, 2 (6.5%) had a low T3 and T4, and 6 (19.3%) had an elevated T4. All of the patients with an elevated T4 were intoxicated by organophosphates. If we divided the 31 patients into 2 subgroups: organophosphate intoxicated group and non-organophosphate intoxicated group, T4 and FT4I were significantly higher in the former group. Thyroid function tests became normal after treatment in 27 patients, discharged in good general condition. T3 and T4 became extremely low in 4 patients before they expired. The present study confirms that acute drug intoxication, like other non-thyroidal illnesses, affects thyroid function tests. Acute organophosphate intoxication may cause transient hyperthyroxinemia.

  17. General IC Symptoms

    Science.gov (United States)

    ... IC Symptoms of IC General IC Symptoms General IC Symptoms Symptoms of interstitial cystitis (IC) differ from ... news and events. Please leave this field empty Interstitial Cystitis Association 7918 Jones Branch Drive, Suite 300 McLean, ...

  18. Immune thrombocytopenic purpura as sole manifestation in a case of acute hepatitis A.

    Science.gov (United States)

    Tanir, Gönül; Aydemir, Cumhur; Tuygun, Nilden; Kaya, Ozge; Yarali, Neşe

    2005-12-01

    Acute hepatitis due to hepatitis A virus is usually a benign selflimiting disease during childhood. Although many viral infections such as hepatitis B virus, Parvovirus, and Epstein-Barr virus are associated with extrahepatic autoimmune phenomena, such manifestations are rare in patients with acute hepatitis A infection. Immune thrombocytopenia is a benign, self-limiting disease in children, responding well to treatment and generally associated with viral infections. Immune thrombocytopenic purpura is rarely reported as a manifestation of acute hepatitis A. We report a five-year-old boy with immune thrombocytopenic purpura as the sole manifestation of anicteric acute hepatitis A infection. Acute hepatitis A should be included in the differential diagnosis of immune thrombocytopenic purpura.

  19. Generalized convexity, generalized monotonicity recent results

    CERN Document Server

    Martinez-Legaz, Juan-Enrique; Volle, Michel

    1998-01-01

    A function is convex if its epigraph is convex. This geometrical structure has very strong implications in terms of continuity and differentiability. Separation theorems lead to optimality conditions and duality for convex problems. A function is quasiconvex if its lower level sets are convex. Here again, the geo­ metrical structure of the level sets implies some continuity and differentiability properties for quasiconvex functions. Optimality conditions and duality can be derived for optimization problems involving such functions as well. Over a period of about fifty years, quasiconvex and other generalized convex functions have been considered in a variety of fields including economies, man­ agement science, engineering, probability and applied sciences in accordance with the need of particular applications. During the last twenty-five years, an increase of research activities in this field has been witnessed. More recently generalized monotonicity of maps has been studied. It relates to generalized conve...

  20. Generalized Poisson sigma models

    CERN Document Server

    Batalin, I; Batalin, Igor; Marnelius, Robert

    2001-01-01

    A general master action in terms of superfields is given which generates generalized Poisson sigma models by means of a natural ghost number prescription. The simplest representation is the sigma model considered by Cattaneo and Felder. For Dirac brackets considerably more general models are generated.

  1. Forces in General Relativity

    Science.gov (United States)

    Ridgely, Charles T.

    2010-01-01

    Many textbooks dealing with general relativity do not demonstrate the derivation of forces in enough detail. The analyses presented herein demonstrate straightforward methods for computing forces by way of general relativity. Covariant divergence of the stress-energy-momentum tensor is used to derive a general expression of the force experienced…

  2. Generalized Fourier transforms classes

    DEFF Research Database (Denmark)

    Berntsen, Svend; Møller, Steen

    2002-01-01

    The Fourier class of integral transforms with kernels $B(\\omega r)$ has by definition inverse transforms with kernel $B(-\\omega r)$. The space of such transforms is explicitly constructed. A slightly more general class of generalized Fourier transforms are introduced. From the general theory...

  3. 应用广义规则归纳探讨缺血性中风急性期证候与OCSP分型的相关性%Exploring the correlation between TCM syndrome of acute cerebral ischemic stroke and OCSP types based on general rule induction

    Institute of Scientific and Technical Information of China (English)

    黄粤; 张华; 高颖; 钟海珍

    2011-01-01

    Objective:To study the correlation between TCM syndrome in the acute stage of ischemic stroke and OCSP with GRI. Method:846 patients were chosen in the acute stage of ischemic stroke, and were obtained their types in OCSP. Ischemic Stroke TCM Syndrome Factor Diagnostic Scale was used to diagnose TCM syndrome of these patients. The clinical data of 10152 cases from the third to fourteenth day after falling ill were analyzed with GRI. Result:9 association rules were procured which contained the information of TCM syndrome factor and OCSP with GRI. 2 of these rules shew the Correlation between TCM Syndrome, OCSP and the days after falling ill. Conclusion:There is Correlation between TCM Syndrome, OCSP and the days after falling ill in the acute stage of ischemic stroke which shows the concept of “integrating disease and syndrome”. It will provide data for clinician to get the message of regularity to change of disease through TCM syndrome of patients.%目的:使用广义规则归纳探讨缺血性中风急性期证候与OCSP分型的相关性.方法:选择846例缺血性中风急性期患者进行OCSP分型,采用判断证候,运用广义规则归纳对发病第3天至第14天共12个时间点共计10152例次的临床数据进行分析.结果:广义规则归纳得出语句包含证候要素和OCSP分型的关联规则共9条,并有2条规则体现出证候、OCSP分型与发病天数的相关性.结论:缺血性中风急性期、中医证候与OCSP分型、发病天数之间存在相关性.体现了”病证结合”的理念,为临床医师通过患者的中医证候把握疾病发展规律提供了数据支持.

  4. Activation and Regulation of Hemostasis in Acute Liver Failure and Acute Pancreatitis

    NARCIS (Netherlands)

    Lisman, Ton; Porte, Robert J.

    2010-01-01

    Acute liver failure and acute pancreatitis are accompanied by substantial changes in the hemostatic system. In acute liver failure, defective synthesis of coagulation factors and intravascular activation of coagulation results in thrombocytopenia and reduced levels of proteins involved in coagulatio

  5. Acute liver failure and acute kidney injury: Definitions, prognosis, and outcome

    NARCIS (Netherlands)

    Włodzimirow, K.A.

    2013-01-01

    The objective of this thesis was to investigate definitions, prognostic indicators and their association with adverse events, mainly mortality for acute liver failure (ALF), acute-on-chronic liver failure (ACLF) and acute kidney injury (AKI).

  6. [Severe acute liver failure: a case study].

    Science.gov (United States)

    Moreno Arroyo, M Carmen; Puig Llobet, Montserrat; Cuervo Lavado, Luis

    2012-01-01

    Fulminant hepatic failure (FHF), also known as fulminant hepatitis, is a rare and extremely serious condition with a high mortality rate. Its rapid evolution and complexity in managing the treatment, creates the need to provide some immediate care by a team that specialises in intensive care. This acute decompensation is usually associated with other disorders, such as coagulopathy and hepatic encephalopathy, being responsible for major complications that can lead to organ failure. In our region the most common origin is unknown, followed by acute infection with hepatitis B. The treatment of this syndrome is based on the general measures applicable to any critically ill patient: treat the cause and early detection of extrahepatic complications, urgent liver transplantation being one of the alternatives with a better prognosis. This article presents a case report describing the monitoring of an Irish woman of 20 years who was transferred from a hospital in Ibiza to a hospital in Barcelona, with a suspected diagnosis of FHF. Following the conceptual model of Virginia Henderson, the collaborative problems and nursing diagnoses are described, presenting a care plan according to NANDA (North American Nursing Association), NIC (Nursing Intervention Classification), NOC (Nursing Outcomes Classification). This case helps to establish an individualised care plan that provides guidance to nurse professionals in critical patient care by increasing the knowledge of FHF.

  7. Acute kidney injury: Global health alert

    Directory of Open Access Journals (Sweden)

    Philip Kam Tao Li

    2013-01-01

    Full Text Available Acute kidney injury (AKI is increasingly prevalent in developing and developed countries and is associated with severe morbidity and mortality. Most etiologies of AKI can be prevented by interventions at the individual, community, regional and in-hospital levels. Effective measures must include community-wide efforts to increase an awareness of the devastating effects of AKI and provide guidance on preventive strategies, as well as early recognition and management. Efforts should be focused on minimizing causes of AKI, increasing awareness of the importance of serial measurements of serum creatinine in high risk patients, and documenting urine volume in acutely ill people to achieve early diagnosis; there is as yet no definitive role for alternative biomarkers. Protocols need to be developed to systematically manage prerenal conditions and specific infections. More accurate data about the true incidence and clinical impact of AKI will help to raise the importance of the disease in the community, increase awareness of AKI by governments, the public, general and family physicians and other health care professionals to help prevent the disease. Prevention is the key to avoid the heavy burden of mortality and morbidity associated with AKI.

  8. Changes in the approach to acute diverticulitis.

    Science.gov (United States)

    Jaung, Rebekah; Robertson, Jason; Vather, Ryash; Rowbotham, David; Bissett, Ian P

    2015-10-01

    Acute diverticulitis (AD) is one of the most common acute admission diagnoses for general surgery, and its prevalence is increasing, in part due to the ageing population. Currently, most patients who present to a tertiary hospital are admitted for a period of treatment and observation. Simple, safe and cost-effective strategies for improving our current treatment of this condition will be invaluable in providing the most appropriate management for individual patients and for reducing the health resources expended on hospital admissions and parenteral antibiotics. AD can be categorized as uncomplicated or complicated, these two subtypes have a very different clinical course. The management of uncomplicated AD has become increasingly conservative, with a focus on symptomatic relief and supportive management. Recent research has brought into question the need for extended hospital admission and questioned the current use of antibiotics. Anti-inflammatory agents that reduce local inflammation in uncomplicated AD may be a useful means of reducing damage caused by inflammation and aiding earlier resolution of the inflammatory response and associated symptoms. Mesalazine is an anti-inflammatory agent that has been trialled in uncomplicated AD. Mesalazine has been shown to improve time to resolution of endoscopic and histological evidence of inflammation following an episode of AD and also reduce the rate of recurrence. In this literature review, we provide an overview of recent advances in AD classification, pathophysiology and management, and examine the possibility of introducing the use of anti-inflammatory agents in the management of uncomplicated AD.

  9. Acute Kidney Injury:Global Health Alert

    Institute of Scientific and Technical Information of China (English)

    Philip Kam TaoLi; Emmanuel A Burdmann; Ravindra L Mehta

    2013-01-01

    Acute kidney injury (AKI) is increasingly prevalent in developing and developed countries and is associated with severe morbidity and mortality.Most etiologies of AKI can be prevented by interventions at the individual,community,regional and in-hospital levels.Effective measures must include community-wide efforts to increase an awareness of the devastating effects of AKI and provide guidance on preventive strategies,as well as early recognition and management.Efforts should be focused on minimizing causes of AKI,increasing awareness of the importance of serial measurements of serum creatinine in high risk patients,and documenting urine volume in acutely ill people to achieve early diagnosis; there is as yet no definitive role for alternative biomarkers.Protocols need to be developed to systematically manage prerenal conditions and specific infections.More accurate data about the true incidence and clinical impact of AKI will help to raise the importance of the disease in the community,increase awareness of AKI by governments,the public,general and family physicians and other health care professionals to help prevent the disease.Prevention is the key to avoid the heavy burden of mortality and morbidity associated with AKI.

  10. Acute lorazepam effects on neurocognitive performance.

    Science.gov (United States)

    Loring, David W; Marino, Susan E; Parfitt, David; Finney, Glen R; Meador, Kimford J

    2012-11-01

    A double-blind, placebo-controlled, crossover design was employed to determine whether acute lorazepam (2 mg orally) cognitive side effects would emerge in a differential age-dependent fashion in 15 young (mean age=22 years) and 12 older (mean age=64 years) subjects. Acute use of lorazepam is frequently the initial treatment choice for convulsive status epilepticus or repetitive seizure clusters. Cognitive assessment was performed during drug and placebo conditions using a computerized battery of cognitive tests. With the exception of performance on the reasoning composite score, significant drug effects were present on all primary cognitive domain measures. However, the only significant drug-by-age interaction effect was seen for dual-task performance. The relationship between test performance and plasma lorazepam concentrations was generally modest and non-significant, suggesting that individual differences in pharmacokinetics are not a major factor contributing to the emergence of cognitive side effects. Despite robust lorazepam effects on multiple measures of neurocognitive function, differential age effects are largely restricted to dual-task performance. These results indicate that with the exception of dual-task performance, older individuals in the age range of this study do not appear to be at increased risk for the emergence of cognitive side effects following a single 2-mg dose of lorazepam.

  11. Boussignac CPAP in acute respiratory failure

    Directory of Open Access Journals (Sweden)

    Federico Lari

    2013-03-01

    Full Text Available Introduction: The application of continuous positive airway pressure (CPAP is one of the most important therapeutic interventions used in patients with acute respiratory failure (ARF secondary to acute cardiogenic pulmonary edema (ACPE. Thanks to its positive effects on both hemodynamics and ventilation, CPAP improves clinical and blood-gas parameters. Compared with standard oxygen therapy, use of CPAP is associated with decreased mortality and reduced need for intubation in these patients. Aim of the study: This review examines the principles of CPAP, techniques and equipment used to deliver it, and clinical applications. Special emphasis is placed on CPAP delivered with the Boussignac device. Discussion and conclusions: In emergency departments, this simple, lightweight, disposable device has proved to be well tolerated and similar to Venturi-like flow generators in terms of effectiveness. These findings suggest that Boussignac CPAP might be useful for managing ARF in non-critical care areas where other more complicated CPAP equipment (Venturi-like flow generators and ventilators are not available (for example, in general medical wards.

  12. Review: Acute phase reaction and acute phase proteins

    Institute of Scientific and Technical Information of China (English)

    GRUYS E.; TOUSSAINT M.J.M.; NIEWOLD T.A.; KOOPMANS S.J.

    2005-01-01

    A review of the systemic acute phase reaction with major cytokines involved, and the hepatic metabolic changes,negative and positive acute phase proteins (APPs) with function and associated pathology is given. It appears that APPs represent appropriate analytes for assessment of animal health. Whereas they represent non-specific markers as biological effect reactants,they can be used for assessing nutritional deficits and reactive processes, especially when positive and negative acute phase variables are combined in an index. When such acute phase index is applied to separate healthy animals from animals with some disease, much better results are obtained than with single analytes and statistically acceptable results for culling individual animals may be reached.Unfortunately at present no cheap, comprehensive and easy to use system is available for assessing various acute phase proteins in serum or blood samples at the same time. Protein microarray or fluid phase microchip technology may satisfy this need;and permit simultaneous analysis of numerous analytes in the same small volume sample and enable integration of information derived from systemic reactivity and nutrition with disease specific variables. Applying such technology may help to solve health problems in various countries not only in animal husbandry but also in human populations.

  13. Acute symptoms of drug hypersensitivity (urticaria, angioedema, anaphylaxis, anaphylactic shock).

    Science.gov (United States)

    Limsuwan, Ticha; Demoly, Pascal

    2010-07-01

    Drug hypersensitivity reactions (HSRs) are the adverse effects of drugs which, when taken at doses generally tolerated by normal subjects, clinically resemble allergy. Immediate-reaction of drug HSRs are those that occur less than 1 hour after the last drug intake, usually in the form of urticaria, angioedema, rhinitis, conjunctivitis, bronchospasm, and anaphylaxis or anaphylactic shock. Acute urticarial and angioedema reactions are common clinical problems frequently encountered by internists and general practitioners. They are not specific to drug allergic reaction, and can be caused by various pathogenic mechanisms. Despite the benign course of urticaria and angioedema, a mucocutaneous swelling of the upper respiratory tract could be life-threatening by itself or a feature of anaphylaxis. This article reviews acute symptoms of drug HSR-related urticaria, angioedema, anaphylaxis, and anaphylactic shock, and how clinicians should approach these problems.

  14. Prognostic implication of out-of-hospital cardiac arrest in patients with cardiogenic shock and acute myocardial infarction

    DEFF Research Database (Denmark)

    Ostenfeld, Sarah; Lindholm, Matias Greve; Kjaergaard, Jesper

    2015-01-01

    OBJECTIVES: To compare outcome in patients with acute myocardial infarction (MI) and cardiogenic shock (CS) presenting with and without out-of-hospital cardiac arrest (OHCA). BACKGROUND: Despite general improvement in outcome after acute MI, CS remains a leading cause of death in acute MI patients...... to a tertiary centre with the diagnosis of CS and acute MI were enrolled, 118 (48%) presented with OHCA and 130 (52%) without (non-OHCA patients). Mean lactate level at admission was significantly higher in OHCA patients compared with non-OCHA patients (9mmol/l (SD 6) vs. 6mmol/l (SD 4) p

  15. Generalization Rough Set Theory

    Institute of Scientific and Technical Information of China (English)

    XIAO Di; ZHANG Jun-feng; HU Shou-song

    2008-01-01

    In order to avoid the discretization in the classical rough set theory, a generlization rough set theory is proposed.At first, the degree of general importance of an attribute and attribute subsets are presented.Then, depending on the degree of general importance of attribute, the space distance can be measured with weighted method.At last, a generalization rough set theory based on the general near neighborhood relation is proposed.The proposed theory partitions the universe into the tolerant modules, and forms lower approximation and upper approximation of the set under general near neighborhood relationship, which avoids the discretization in Pawlak's rough set theory.

  16. Diagnosis of acute necrotizing pancreatitis and acute hemorrhagic pancreatitis in 5 severe acute pancreatitis by plain computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Keishoku; Kim, Jong-hyo; Nakasaku, Osamu

    1987-12-01

    The diagnosis of acute pancreatitis is still mainly based on the clinical signs and symptoms of patients. In a prospective study of 64 patients with acute pancreatitis, computed tomography (CT) findings were correlated with the clinical types of acute pancreatitis. We were able to correctly diagnose 3 acute necrotizing pancreatitis with autopsy and 2 acute hemorrhagic pancreatitis by plain CT about 48 hours after onset. At present, CT about 48 hours after onset seems to be the most accurate method for the early detection of necrotizing, hemorrhagic and edematous forms of acute pancreatitis.

  17. Pancreatic pseudocyst after acute organophosphate poisoning.

    Science.gov (United States)

    Kawabe, Ken; Ito, Tetsuhide; Arita, Yoshiyuki; Sadamoto, Yojiro; Harada, Naohiko; Yamaguchi, Koji; Tanaka, Masao; Nakano, Itsuro; Nawata, Hajime; Takayanagi, Ryoichi

    2006-04-01

    Acute organophosphate poisoning (OP) shows several severe clinical symptoms due to its strong blocking effect on cholinesterase. Acute pancreatitis is one of the complications associated with acute OP, but this association still may not be widely recognized. We report here the case of a 73-year-old man who had repeated abdominal pain during and after the treatment of acute OP. Hyperamylasemia and a 7-cm pseudocyst in the pancreatic tail were noted on investigations. We diagnosed pancreatic pseudocyst that likely was secondary to an episode of acute pancreatitis following acute OP. He was initially treated with a long-term intravenous hyperalimentation, protease inhibitors and octerotide, but eventually required surgical intervention, a cystgastrostomy. Acute pancreatitis and hyperamylasemia are known to be possible complications of acute OP. It is necessary to examine and assess pancreatic damage in patients with acute OP.

  18. [cerebral Hemometabolism: Variability In The Acute Phase Of Traumatic Coma].

    OpenAIRE

    Falcão,A. L.; Araújo, S; Dragosavac, D; Terzi, R G; Thiesen, R A; Cintra, E A; Sardinha, L A; Capone Neto, A; Dantas Filho, V P; Quagliato, E M

    2015-01-01

    to evaluate the interrelationships between cerebral and systemic hemometabolic alterations in patients with severe traumatic brain injury managed according to a standardized therapeutic protocol. prospective, interventional study in patients with traumatic coma. a general Intensive Care Unit in a teaching hospital. twenty-seven patients (21M e 6F), aging 14 - 58 years, with severe acute brain trauma, presenting with three to eight points on the Glasgow Coma Scale, were prospectively evaluated...

  19. [Acute rhabdomyolysis after spinal anesthesia for knee arthroscopy].

    Science.gov (United States)

    Bouché, P M; Chavagnac, B; Cognet, V; Banssillon, V

    2001-08-01

    We report an observation of acute rhabdomyolysis of gluteus maximum muscles occurring in a non-obese patient installed in supine position that underwent knee arthroscopy under spinal anaesthesia. The patient had insulin-dependent diabetes melitus with documented microangiopathy. The interest of this observation resides in the occurrence of the syndrome after a short period of time (one hour) of installation in the supine position in a patient that did not have any of the generally described risk factors of rhabdomyolysis.

  20. Acute Hepatitis and Pancytopenia in Healthy Infant with Adenovirus

    Directory of Open Access Journals (Sweden)

    Amr Matoq

    2016-01-01

    Full Text Available Adenoviruses are a common cause of respiratory infection, pharyngitis, and conjunctivitis in infants and young children. They are known to cause hepatitis and liver failure in immunocompromised patients; they are a rare cause of hepatitis in immunocompetent patients and have been known to cause fulminant hepatic failure. We present a 23-month-old immunocompetent infant who presented with acute noncholestatic hepatitis, hypoalbuminemia, generalized anasarca, and pancytopenia secondary to adenovirus infection.

  1. Treatment of acute abdominal pain in the emergency room: a systematic review of the literature.

    Science.gov (United States)

    Falch, C; Vicente, D; Häberle, H; Kirschniak, A; Müller, S; Nissan, A; Brücher, B L D M

    2014-08-01

    Appropriate pain therapy prior to diagnosis in patients with acute abdominal pain remains controversial. Several recent studies have demonstrated that pain therapy does not negatively influence either the diagnosis or subsequent treatment of these patients; however, current practice patterns continue to favour withholding pain medication prior to diagnosis and surgical treatment decision. A systematic review of PubMed, Web-of-Science and The-Cochrane-Library from 1929 to 2011 was carried out using the key words of 'acute', 'abdomen', 'pain', 'emergency' as well as different pain drugs in use, revealed 84 papers. The results of the literature review were incorporated into six sections to describe management of acute abdominal pain: (1) Physiology of Pain; (2) Common Aetiologies of Abdominal Pain; (3) Pre-diagnostic Analgesia; (4) Pain Therapy for Acute Abdominal Pain; (5) Analgesia for Acute Abdominal Pain in Special Patient Populations; and (6) Ethical and Medico-legal Considerations in Current Analgesia Practices. A comprehensive algorithm for analgesia for acute abdominal pain in the general adult population was developed. A review of the literature of common aetiologies and management of acute abdominal pain in the general adult population and special patient populations seen in the emergency room revealed that intravenous administration of paracetamol, dipyrone or piritramide are currently the analgesics of choice in this clinical setting. Combinations of non-opioids and opioids should be administered in patients with moderate, severe or extreme pain, adjusting the treatment on the basis of repeated pain assessment, which improves overall pain management.

  2. Acute kidney injury in acute liver failure: a review.

    Science.gov (United States)

    Moore, Joanna K; Love, Eleanor; Craig, Darren G; Hayes, Peter C; Simpson, Kenneth J

    2013-11-01

    Acute liver failure is a rare and often devastating condition consequent on massive liver cell necrosis that frequently affects young, previously healthy individuals resulting in altered cognitive function, coagulopathy and peripheral vasodilation. These patients frequently develop concurrent acute kidney injury (AKI). This abrupt and sustained decline in renal function, through a number of pathogenic mechanisms such as renal hypoperfusion, direct drug-induced nephrotoxicity or sepsis/systemic inflammatory response contributes to increased morbidity and is strongly associated with a worse prognosis. Improved understanding of the pathophysiology AKI in the context of acute liver failure may be beneficial in a number of areas; the development of new and sensitive biomarkers of renal dysfunction, refining prognosis and organ allocation, and ultimately leading to the development of novel treatment strategies, these issues are discussed in more detail in this expert review.

  3. Pathogenesis of acute lung injury in severe acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    SHI Lei; YUE Yuan; ZHANG Mei; PAN Cheng-en

    2005-01-01

    Objective:To study the pathogenesis of acute lung injury in severe acute pancreatitis (SAP). Methods:Rats were sacrificed at 1, 3, 5, 6, 9 and 12 h after establishment of inducing model. Pancreas and lung tissues were obtained for pathological study, microvascular permeability and MPO examination. Gene expressions of TNF-α and ICAM-1 in pancreas and lung tissues were detected by RT-PCR. Results:After inducing SAP model, the injury degree of the pancreas and the lung increased gradually, accompanied with gradually increased MPO activity and microvascular permeability. Gene expressions of TNF-α and ICAM-1 in pancreas rose at 1 h and reached peak at 7 h. Relatively, their gene expressions in the lungs only rose slightly at 1 h and reached peak at 9-12 h gradually. Conclusion:There is an obvious time window between SAP and lung injury, when earlier protection is beneficial to prevent development of acute lung injury.

  4. Acute chest pain:what about the time before visiting to the physician?

    Institute of Scientific and Technical Information of China (English)

    Beuy Joob; Viroj Wiwanitkit

    2013-01-01

    Acute chest pain is an important medical complaint that needs proper management.The acute myocardial infarction, which is an emergency condition primarily presented with chest pain.The important concerns in management are early diagnosis and prompt treatment.An important factor determining the success of treatment is the time before visiting to the physicians.In this report, the authors summarize on the time before visiting to the physicians.It can be seen that the health education to general people on the danger of acute chest pain is required.

  5. Acute Liver Failure Associated with Levetiracetam and Lacosamide Combination Treatment for Unspecified Epileptic Disorder

    Directory of Open Access Journals (Sweden)

    Ylse Gutiérrez-Grobe

    2013-01-01

    Full Text Available Background and Aim. Levetiracetam is a second-generation antiepileptic drug. It is approved as an adjunctive treatment of partial onset seizures with or without secondary generalization. It is considered safe with less than 1% of patients with transient elevations of liver enzymes. Methods. We report a case of acute liver failure secondary to Levetiracetam in combination with Lacosamide documented with a liver biopsy. Results. Liver biopsy demonstrated acute liver injury with a predominant submassive necrosis pattern and features of a drug-induced hepatitis. Conclusions. This is the first published case of acute liver failure due to antiepileptic therapy with Levetiracetam in combination with Lacosamide.

  6. Endovascular Intervention for Acute Ischemic Stroke in Light of Recent Trials

    Directory of Open Access Journals (Sweden)

    Kenan Alkhalili

    2014-01-01

    Full Text Available Three recently published trials, MR RESCUE, IMS III, and SYNTHESIS Expansion, evaluating the efficacy and safety of endovascular treatment of acute ischemic stroke have generated concerns about the future of endovascular approach. However, the tremendous evolution that imaging and endovascular treatment modalities have undergone over the past several years has raised doubts about the validity of these trials. In this paper, we review the role of endovascular treatment strategies in acute ischemic stroke and discuss the limitations and shortcomings that prevent generalization of the findings of recent trials. We also provide our experience in endovascular treatment of acute ischemic stroke.

  7. Acute liver failure | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available nvestigation E.1.2Version 14.1 E.1.2Level LLT E.1.2Classification code 10049844 E.1.2Term Acute liver failur...n(s) being investigated Acute liver failure MedDRA Classification E.1.2 Medical condition or disease under i... General Information on the Trial E.1 Medical condition or disease under investigation E.1.1Medical conditio

  8. Acute Alcoholic Hepatitis | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available UK - MHRA A.2EudraCT number2006-004419-24 A.3Full title of the trial The Use of Sulfasalazine as an Anti-fibrotic in Acute...General Information on the Trial E.1 Medical condition or disease under investigation E.1.1Medical condition...(s) being investigated Acute Alcoholic Hepatitis MedDRA Classification E.1.2 Medical condition or disease un

  9. Recurrent Acute Decompensated Heart Failure Owing to Severe Iron Deficiency Anemia Caused by Inappropriate Habitual Bloodletting

    Science.gov (United States)

    Lim, Woo-Hyun; Kim, Hack-Lyoung; Kim, Ki-Hwan; Na, Sang Hoon; Lee, Hyun-Jung; Kang, Eun Gyu; Seo, Jae-Bin; Chung, Woo-Young; Zo, Joo-Hee; Hong, Jung Ae; Kim, Kwangyoun; Kim, Myung-A

    2015-01-01

    A 68-year-old woman visited the emergency department twice with symptoms of acute heart failure including shortness of breath, general weakness, and abdominal distension. Laboratory findings showed extremely low level of serum hemoglobin at 1.4 g/dL. Echocardiographic examination demonstrated dilated left ventricular cavity with systolic dysfunction and moderate amount of pericardial effusion. In this patient, acute heart failure due to severe iron deficiency anemia was caused by inappropriate habitual bloodletting. PMID:26755934

  10. The 12 Gastrointestinal Pathogens Spectrum of Acute Infectious Diarrhea in a Sentinel Hospital, Shenzhen, China

    OpenAIRE

    Shen, Hongwei; Zhang, Jinjin; Li, Yinghui; Xie, Sirou; Jiang, Yixiang; Wu, Yanjie; Ye, Yuhui; Yang, Hong; Mo, Haolian; Situ, Chaoman; Hu, Qinghua

    2016-01-01

    Acute infectious gastroenteritis is one of the most common diseases among all ages, particularly in developing countries. The pathogen spectrum may differ among different regions and seasons. To investigate the etiology of acute diarrhea in Shenzhen, a prospective study was conducted from August 2014 to September 2015. Stools from 412 patients with diarrhea (286 of whom were adults) including the general epidemiological information of the patients were collected. The 19 pathogens were detecte...

  11. The nineteen gastrointestinal pathogens spectrum of acute infectious diarrhea in a sentinel hospital, Shenzhen, China

    OpenAIRE

    Hongwei Shen; Jinjin Zhang; Yinghui Li; Sirou Xie; Yixiang Jiang; Yanjie Wu; Yuhui Ye; Hong Yang; Haolian Mo; Chaoman Situ; Qinghua Hu

    2016-01-01

    Acute infectious gastroenteritis is one of the most common diseases among all ages, particularly in developing countries. The pathogen spectrum may differ among different regions and seasons. To investigate the etiology of acute diarrhea in Shenzhen, a prospective study was conducted from August 2014 to September 2015. Stools from 412 patients with diarrhea (286 of whom were adults) including the general epidemiological information of the patients were collected. The 19 pathogens were detecte...

  12. Erythropoietin (EPO) in acute kidney injury.

    Science.gov (United States)

    Moore, Elizabeth; Bellomo, Rinaldo

    2011-03-21

    Erythropoietin (EPO) is a 30.4 kDa glycoprotein produced by the kidney, and is mostly well-known for its physiological function in regulating red blood cell production in the bone marrow. Accumulating evidence, however, suggests that EPO has additional organ protective effects, which may be useful in the prevention or treatment of acute kidney injury. These protective mechanisms are multifactorial in nature and include inhibition of apoptotic cell death, stimulation of cellular regeneration, inhibition of deleterious pathways, and promotion of recovery.In this article, we review the physiology of EPO, assess previous work that supports the role of EPO as a general tissue protective agent, and explain the mechanisms by which it may achieve this tissue protective effect. We then focus on experimental and clinical data that suggest that EPO has a kidney protective effect.

  13. Sudden psychotic episode probably due to meningoencephalitis and Chlamydia pneumoniae acute infection

    Directory of Open Access Journals (Sweden)

    Canas Nuno

    2005-09-01

    Full Text Available Abstract Background Since 9% to 20% of all cases of acute psychosis presenting to an Emergency Department (ED are due to a general medical condition, cautious medical workup should be mandatory in such patients. Differential diagnosis must consider conditions as diverse as renal failure or CNS infection. Acute Chlamydia pneumoniae infection usually causes a self-limited respiratory syndrome. Rarely, acute neurological complications occur, with acute meningoencephalitis most frequently reported. Diagnosis requires a high level of suspicion and is difficult to confirm. Case report We describe a 22 year-old female Caucasian who, three days after a mild pharingitis, developed an acute psychosis with exuberant symptoms interspersed with periods of lucidity, in a background of normal consciousness and orientation. Initial medical and imagiological workup were inconclusive. After 20 days of unsuccessful treatment with antipsychotics she developed a high fever and was re-evaluated medically. Lumbar puncture revealed an inflammatory cerebrospinal fluid. MRI showed irregular thickening and nodularity of the lateral ventricles' lining. An anti-Chlamydia pneumoniae IgM antibody titter of 85 IU/ml was detected. All symptoms cleared after treatment with antibiotics and corticosteroids. Conclusion This is, to our knowledge, the first reported case of acute CP-associated meningoencephalitis manifesting as an acute psychotic episode. It illustrates the principle that non-organic psychiatric syndromes must remain a diagnosis of exclusion in first-time acute psychosis.

  14. Decitabine, Cytarabine, and Daunorubicin Hydrochloride in Treating Patients With Acute Myeloid Leukemia

    Science.gov (United States)

    2016-07-20

    Adult Acute Basophilic Leukemia; Adult Acute Eosinophilic Leukemia; Adult Acute Monoblastic Leukemia; Adult Acute Monocytic Leukemia; Adult Acute Myeloid Leukemia With Maturation; Adult Acute Myeloid Leukemia With t(9;11)(p22;q23); MLLT3-MLL; Adult Acute Myeloid Leukemia Without Maturation; Adult Acute Myelomonocytic Leukemia; Alkylating Agent-Related Acute Myeloid Leukemia; Secondary Acute Myeloid Leukemia; Untreated Adult Acute Myeloid Leukemia

  15. Acute Respiratory Distress Syndrome in Obstetric Patients

    Directory of Open Access Journals (Sweden)

    S. V. Galushka

    2007-01-01

    Full Text Available Objective: to define the specific features of the course of acute respiratory distress syndrome (ARDS in puer-peras with a complicated postpartum period. Subjects and methods. Sixty-seven puerperas with ARDS were examined. Group 1 included 27 puerperas with postpartum ARDS; Group 2 comprised 10 puerperas who had been treated in an intensive care and died; Group 3 consisted of nonobstetric patients with ARDS of various genesis (a control group. Results. In obstetric patients, the baseline oxygenation index was significantly lower than that in the control group. However, Group 1 patients showed a rapid increase in PaO2/FiO2 on days 3—4 of treatment. In the control group, the changes occurred later — on days 5—6. The baseline alveolar-arterial oxygen difference was significantly higher in the obstetric patients than that in the controls. In Group 1, AaDpO2 drastically decreased on days 3—4, which took place in parallel with an increase in the oxygenation index. At the beginning of the study, pulmonary shunting was high in the group of survivors, deceased, and controls. In Group 1, the shunting decreased on days 3—4 whereas in the control group this index normalized later — only by days 6—7. In Group 1, compliance remained lower throughout the observation, but on day 7 there was a significant difference in this index between the deceased, survivors, and controls. Conclusion. Thus, more severe baseline pulmonary gas exchange abnormalities are observed in obstetric patients than in general surgical and traumatological patients; the oxygenation index, alveolar-arterial oxygen difference, and pulmonary shunting index more rapidly change in patients with severe obstetric disease in its favorable course than in general surgical and traumatological patients; throughout the observation, thoracopulmonary compliance was less in obstetric patients than in the controls. Key words: acute respiratory distress syndrome, puerperium.

  16. Vorinostat in Treating Patients With Acute Myeloid Leukemia

    Science.gov (United States)

    2014-04-30

    Adult Acute Erythroid Leukemia (M6); Adult Acute Megakaryoblastic Leukemia (M7); Adult Acute Minimally Differentiated Myeloid Leukemia (M0); Adult Acute Monoblastic Leukemia (M5a); Adult Acute Monocytic Leukemia (M5b); Adult Acute Myeloblastic Leukemia With Maturation (M2); Adult Acute Myeloblastic Leukemia Without Maturation (M1); Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Acute Myelomonocytic Leukemia (M4); Adult Acute Promyelocytic Leukemia (M3); Recurrent Adult Acute Myeloid Leukemia; Refractory Cytopenia With Multilineage Dysplasia; Secondary Acute Myeloid Leukemia; Untreated Adult Acute Myeloid Leukemia

  17. Acute Uvulitis in Adults

    Institute of Scientific and Technical Information of China (English)

    Mohammad Z. Ansari; Shakeeb Khan

    2014-01-01

    Inflammation of Uvula occurs in isolation or along with supraglottitis. The annual incidence of supraglottitis is described as0.97 to 1.8 per 100,000. The author presents 15 cases of Uvulitis seen in a General hospital of the United Kindgom. Age group ofpatients was between 25-38 years, 9 males and 6 females. One patient developed Uvilitis following inhalation of cannabis and twofollowing the use of marijuana, three were diagnosed to be suffering with bacterial infection. All the patients were treated with steroidsand inhaled adrenaline. Those suffering with bacterial uvilitis required antibiotics.

  18. Unsupervised Learning and Generalization

    DEFF Research Database (Denmark)

    Hansen, Lars Kai; Larsen, Jan

    1996-01-01

    The concept of generalization is defined for a general class of unsupervised learning machines. The generalization error is a straightforward extension of the corresponding concept for supervised learning, and may be estimated empirically using a test set or by statistical means-in close analogy ...... with supervised learning. The empirical and analytical estimates are compared for principal component analysis and for K-means clustering based density estimation......The concept of generalization is defined for a general class of unsupervised learning machines. The generalization error is a straightforward extension of the corresponding concept for supervised learning, and may be estimated empirically using a test set or by statistical means-in close analogy...

  19. Generalized Group Signature Scheme

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The concept of generalized group signature scheme will bepresent. Based on the generalized secret sharing scheme proposed by Lin and Ha rn, a non-interactive approach is designed for realizing such generalized group signature scheme. Using the new scheme, the authorized subsets of the group in w hich the group member can cooperate to produce the valid signature for any messa ge can be randomly specified

  20. Generalized quasi variational inequalities

    Energy Technology Data Exchange (ETDEWEB)

    Noor, M.A. [King Saud Univ., Riyadh (Saudi Arabia)

    1996-12-31

    In this paper, we establish the equivalence between the generalized quasi variational inequalities and the generalized implicit Wiener-Hopf equations using essentially the projection technique. This equivalence is used to suggest and analyze a number of new iterative algorithms for solving generalized quasi variational inequalities and the related complementarity problems. The convergence criteria is also considered. The results proved in this paper represent a significant improvement and refinement of the previously known results.

  1. Challenges in uncomplicated acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    Fernando Resende; Ana Beatriz Almeida; Jose Costa Maia; Renato Bessa Melo

    2016-01-01

    Acute appendicitis is one of the most common abdominal emergencies requiring surgery. It still represents, however, a challenging diagnosis. In order to facilitate this process, several scoring systems were developed, namely, the Alvarado score, acute inflammatory response and Raja Isteri Pengiran Anak Saleha Appendicitis scores, which are the most used in clinical practice. This clinical condition encompasses a wide spectrum of clinical presentations, from the uncomplicated form to the one with diffuse peritonitis. Treatment of uncomplicated acute appendicitis remains a matter of discussion. Although appen-dectomy has been regarded as the gold-standard, conservative management with antibi-otics is gaining more and more acceptance. The approach to appendectomy constitutes another controversial issue, namely, its performance through an open or a laparoscopic approach, which seems to be establishing itself, in some centers, as the standard of care. With this paper, we intend to give some insight on the aforementioned topics, through a review of the available literature on uncomplicated appendicitis.

  2. Management of Acute Skin Trauma

    Institute of Scientific and Technical Information of China (English)

    Joel W. Beam

    2010-01-01

    @@ Acute skin trauma (ie, abrasions, avulsions, blisters, incisions, lacerations, and punctures) is common among individuals involved in work, recreational, and athletic activities. Appropriate management of these wounds is important to promote healing and lessen the risk of cross-contamination and infection. Wound management techniques have undergone significant changes in the past 40 years but many clinicians continue to manage acute skin trauma with long-established, traditional techniques (ie, use of hydrogen peroxide, adhesive strips/patches, sterile gauze, or no dressing) that can delay healing and increase the risk of infection. The purpose of this review is to discuss evidence-based cleansing, debridement, and dressing techniques for the management of acute skin trauma.

  3. Acute Stroke Imaging Research Roadmap

    Science.gov (United States)

    Wintermark, Max; Albers, Gregory W.; Alexandrov, Andrei V.; Alger, Jeffry R.; Bammer, Roland; Baron, Jean-Claude; Davis, Stephen; Demaerschalk, Bart M.; Derdeyn, Colin P.; Donnan, Geoffrey A.; Eastwood, James D.; Fiebach, Jochen B.; Fisher, Marc; Furie, Karen L.; Goldmakher, Gregory V.; Hacke, Werner; Kidwell, Chelsea S.; Kloska, Stephan P.; Köhrmann, Martin; Koroshetz, Walter; Lee, Ting-Yim; Lees, Kennedy R.; Lev, Michael H.; Liebeskind, David S.; Ostergaard, Leif; Powers, William J.; Provenzale, James; Schellinger, Peter; Silbergleit, Robert; Sorensen, Alma Gregory; Wardlaw, Joanna; Wu, Ona; Warach, Steven

    2009-01-01

    The recent “Advanced Neuroimaging for Acute Stroke Treatment” meeting on September 7 and 8, 2007 in Washington DC, brought together stroke neurologists, neuroradiologists, emergency physicians, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke (NINDS), the National Institute of Biomedical Imaging and Bioengineering (NIBIB), industry representatives, and members of the US Food and Drug Administration (FDA) to discuss the role of advanced neuroimaging in acute stroke treatment. The goals of the meeting were to assess state-of-the-art practice in terms of acute stroke imaging research and to propose specific recommendations regarding: (1) the standardization of perfusion and penumbral imaging techniques, (2) the validation of the accuracy and clinical utility of imaging markers of the ischemic penumbra, (3) the validation of imaging biomarkers relevant to clinical outcomes, and (4) the creation of a central repository to achieve these goals. The present article summarizes these recommendations and examines practical steps to achieve them. PMID:18477656

  4. Plasma cytokines in acute stroke

    DEFF Research Database (Denmark)

    Christensen, Hanne Krarup; Boysen, Gudrun; Christensen, Erik

    2011-01-01

    GOALS: The aim of this study was to test the relations between plasma cytokines and the clinical characteristics, course, and risk factors in acute stroke. PATIENTS AND METHODS: The analysis was based on 179 patients with acute stroke included within 24 hours of stroke onset. On inclusion and 3...... measured by enzyme-linked immunoassay (ELISA). FINDINGS: The levels of most cytokines were significantly different in acute stroke from the levels 3 months later; but only IL-10 was positively associated with stroke severity. C-reactive protein and white blood cell count were positively associated...... with the cytokine response. CONCLUSIONS: We found a substantial overall cytokine reaction that reflected the stroke incident. However, these results do not, at present, suggest a potential for clinical use, as they do not seem to add to the information obtained from the clinical workup of the individual patient....

  5. Generalized Fibonacci zone plates

    CERN Document Server

    Ke, Jie; Zhu, Jianqiang

    2015-01-01

    We propose a family of zone plates which are produced by the generalized Fibonacci sequences and their axial focusing properties are analyzed in detail. Compared with traditional Fresnel zone plates, the generalized Fibonacci zone plates present two axial foci with equal intensity. Besides, we propose an approach to adjust the axial locations of the two foci by means of different optical path difference, and further give the deterministic ratio of the two focal distances which attributes to their own generalized Fibonacci sequences. The generalized Fibonacci zone plates may allow for new applications in micro and nanophotonics.

  6. Transient Hearing Loss in Adults Associated with Zika Virus Infection.

    Science.gov (United States)

    Vinhaes, Eriko S; Santos, Luciane A; Dias, Lislane; Andrade, Nilvano A; Bezerra, Victor H; de Carvalho, Anderson T; de Moraes, Laise; Henriques, Daniele F; Azar, Sasha R; Vasilakis, Nikos; Ko, Albert I; Andrade, Bruno B; Siqueira, Isadora C; Khouri, Ricardo; Boaventura, Viviane S

    2016-12-07

    In 2015, during the outbreak of ZIKAV in Brazil, we identified three cases of acute hearing loss after exanthematous illness. Serology yielded finding compatible with ZIKAV as the cause of a confirmed (1patient) and a probable (2 patients) flavivirus infection, indicating an association between ZIKAV infection and transient hearing loss.

  7. Management of Acute Kidney Injury in Pregnancy for the Obstetrician.

    Science.gov (United States)

    Acharya, Anjali

    2016-12-01

    Acute kidney injury (AKI) is a complex disorder that occurs in several clinical settings. During pregnancy, there are additional unique conditions that contribute to AKI. The clinical manifestations of AKI during pregnancy range from a minimal elevation in serum creatinine to renal failure requiring renal replacement therapy, similar to AKI in the general population. Recent epidemiologic studies in the general population show an increase in mortality associated with AKI, particularly when dialysis is required. The incidence of AKI in pregnancy remains a cause of significant morbidity and mortality.

  8. Treatment of acute viral bronchiolitis.

    Science.gov (United States)

    Eber, Ernst

    2011-01-01

    Acute viral bronchiolitis represents the most common lower respiratory tract infection in infants and young children and is associated with substantial morbidity and mortality. Respiratory syncytial virus is the most frequently identified virus, but many other viruses may also cause acute bronchiolitis. There is no common definition of acute viral bronchiolitis used internationally, and this may explain part of the confusion in the literature. Most children with bronchiolitis have a self limiting mild disease and can be safely managed at home with careful attention to feeding and respiratory status. Criteria for referral and admission vary between hospitals as do clinical practice in the management of acute viral bronchiolitis, and there is confusion and lack of evidence over the best treatment for this condition. Supportive care, including administration of oxygen and fluids, is the cornerstone of current treatment. The majority of infants and children with bronchiolitis do not require specific measures. Bronchodilators should not be routinely used in the management of acute viral bronchiolitis, but may be effective in some patients. Most of the commonly used management modalities have not been shown to have a clear beneficial effect on the course of the disease. For example, inhaled and systemic corticosteroids, leukotriene receptor antagonists, immunoglobulins and monoclonal antibodies, antibiotics, antiviral therapy, and chest physiotherapy should not be used routinely in the management of bronchiolitis. The potential effect of hypertonic saline on the course of the acute disease is promising, but further studies are required. In critically ill children with bronchiolitis, today there is little justification for the use of surfactant and heliox. Nasal continuous positive airway pressure may be beneficial in children with severe bronchiolitis but a large trial is needed to determine its value. Finally, very little is known on the effect of the various

  9. Delay factors on the administration of thrombolytic therapy in patients diagnosed with acute myocardial infarction in a general hospital Factores que atrasan la administración de trombolítico en pacientes con diagnóstico de infarto agudo del miocardio atendidos en un hospital general Fatores que retardam a administração de trombolítico em pacientes com diagnóstico de infarto agudo do miocárdio atendidos em um hospital geral

    Directory of Open Access Journals (Sweden)

    Luis Antônio Muller

    2008-02-01

    Full Text Available OBJECTIVE: To identify factors that delay the onset of thrombolysis in patients with acute myocardial infarction (AMI. METHODS: A cohort study was carried out with 146 patients, each diagnosed with AMI and subjected to thrombolytic therapy. The data was extracted from medical records between January 2002 and December 2004. RESULTS: The average age of the studied population was 57.5 ± 9 years, 64.4% were male. The average time between the onset of pain and arrival at the hospital was 254.7 ± 126.6 minutes, 28.1% used an ambulance for the trip to the hospital, the door-to-electrocardiogram time averaged 19.4 ± 7.3 minutes and the door-to-needle time was 51.1 ± 14.9 minutes. There was no significant difference between the time of arrival to the hospital and the method of transportation used (P= 0.81, and those seen by cardiologists and during the nightshift had a reduction in the door-to-needle time, respectively (P=0.014 and (P=0.034. CONCLUSIONS: Study results show that the delay in the search for medical service, and the long time taken from door-to-electrocardiogram and to reach the AMI diagnosis were the factors involved in the delay of thrombolytic treatment.OBJETIVO: Identificar los factores que retardan el inicio de la trombolisis en pacientes con IAM. MÉTODOS: Estudio de coorte, en 146 pacientes, con diagnóstico de IAM sometidos a la terapéutica trombolitica. Los datos fueron extraídos de prontuarios, entre enero de 2002 y diciembre de 2004. RESULTADOS: El promedio de edad fue de 57,5 ± 9 años y 64% eran del sexo masculino. El tiempo promedio transcurrido entre el inicio del dolor y la entrada al hospital fue de 254,7 ± 126,6 minutos; 28% utilizaron la ambulancia como medio de transporte; el tiempo promedio porta ECG (tiempo porta ECG: intervalo entre el ingreso del paciente al hospital y la realización del electrocardiograma fue de 19,4 ± 7,3 minutos y el tiempo porta aguja de 51,1 ± 14,9 minutos (tiempo porta aguja

  10. [Pregnancy and acute ischemic stroke].

    Science.gov (United States)

    Bereczki, Dániel

    2016-05-15

    Pregnancy-related ischemic strokes play an important role in both maternal and fetal morbidity and mortality. Changes in hemostaseology and hemodynamics as well as risk factors related to or independent from pregnancy contribute to the increased stroke-risk during gestation and the puerperium. Potential teratogenic effects make diagnostics, acute therapy and prevention challenging. Because randomized, controlled trials are not available, a multicenter registry of patients with gestational stroke would be desirable. Until definite guidelines emerge, management of acute ischemic stroke during pregnancy remains individual, involving experts and weighing the risks and benefits.

  11. Neonatal acute apendicitis, case report

    OpenAIRE

    Romero Rojas, Nery; Instituto de Patología, UNMSM; Sánchez García, Luis; Hospital Nacional Docente de Cajamarca

    2016-01-01

    Introduction. Acute appendicitis is a rare disease in newborns with a high mortality because of unspecific clinical features. We report a case of non-perforated acute appendicitis in a newborn at the San Bartolome Hospital in Lima. Case report. A female newborn weighing 3 170 g in the first day repelled maternal lactation; at the third day, she presented 39°C fever, and later, abdominal distention, constipation, and abundant vomiting. The X-ray films showed a distended gastric camera and para...

  12. Sympathetic crashing acute pulmonary edema.

    Science.gov (United States)

    Agrawal, Naman; Kumar, Akshay; Aggarwal, Praveen; Jamshed, Nayer

    2016-12-01

    Sympathetic crashing acute pulmonary edema (SCAPE) is the extreme end of the spectrum of acute pulmonary edema. It is important to understand this disease as it is relatively common in the emergency department (ED) and has better outcomes when managed appropriately. The patients have an abrupt redistribution of fluid in the lungs, and when treated promptly and effectively, these patients will rapidly recover. Noninvasive ventilation and intravenous nitrates are the mainstay of treatment which should be started within minutes of the patient's arrival to the ED. Use of morphine and intravenous loop diuretics, although popular, has poor scientific evidence.

  13. Intravenous magnesium for acute asthma?

    Science.gov (United States)

    2003-10-01

    Each year in the UK, around 1,500 people die from asthma. Standard treatment has been based on bronchodilators (e.g. beta 2-stimulants) and anti-inflammatory drugs (corticosteroids). The recently revised British Guideline on the Management of Asthma suggests also using a single dose of i.v. magnesium sulphate in patients with acute severe asthma, an unlicensed indication. Here we discuss the rationale for giving i.v. magnesium and whether it offers any advantage for patients with acute severe asthma.

  14. Biliary acute pancreatitis: a review

    Institute of Scientific and Technical Information of China (English)

    Osvaldo M. Tiscomia; Susana Hamamura; Enriqueta S. de Lehmann; Graciela Otero; Hipólito Waisman; Patricia Tiscornia-Wasserman; Simmy Bank

    2000-01-01

    @@INTRODUCTION It is axiomatic that the most effective and soundly based plan of treatment of any disorder is one aimed at the mechanism or mechanisms responsible for its development[1]. This basic notion, coupled with recent reports[2- 11] in which, surprisingly there is a total lack of reference to the probable involvement of autonomic-arc-reflexes in the physiopathogenesis of biliary acute pancreatitis have prompted this presentation. Undoubtedly, this disease entity has numerous causes, an obscure physiopathology, few effective remedies, and, often, an unpredictable outcome. At the turn of the century, Opie[12,13] brought to light the association between gallstone migration and acute pancreatitis.

  15. Reliability Generalization: "Lapsus Linguae"

    Science.gov (United States)

    Smith, Julie M.

    2011-01-01

    This study examines the proposed Reliability Generalization (RG) method for studying reliability. RG employs the application of meta-analytic techniques similar to those used in validity generalization studies to examine reliability coefficients. This study explains why RG does not provide a proper research method for the study of reliability,…

  16. On generalized topological spaces

    OpenAIRE

    Piȩkosz, Artur

    2009-01-01

    In this paper a systematic study of the category GTS of generalized topological spaces (in the sense of H. Delfs and M. Knebusch) and their strictly continuous mappings begins. Some completeness and cocompleteness results are achieved. Generalized topological spaces help to reconstruct the important elements of the theory of locally definable and weakly definable spaces in the wide context of weakly topological structures.

  17. Communication: General Semantics Perspectives.

    Science.gov (United States)

    Thayer, Lee, Ed.

    This book contains the edited papers from the eleventh International Conference on General Semantics, titled "A Search for Relevance." The conference questioned, as a central theme, the relevance of general semantics in a world of wars and human misery. Reacting to a fundamental Korzybski-ian principle that man's view of reality is distorted by…

  18. Certificateless Generalized Signcryption

    Science.gov (United States)

    Ji, Huifang; Han, Wenbao; Zhao, Long

    Generalized Signcryption is a fresh cryptographic primitive that not only can obtain encryption and signature in a single operation, but also provide encryption or signature model alone when needed. This paper proposed a formal definition of certificateless generalized signcryption(CLGSC), then provide the security model of CLGSC. A concrete CLGSC scheme is also given in this paper.

  19. On Generalized Bell Polynomials

    Directory of Open Access Journals (Sweden)

    Roberto B. Corcino

    2011-01-01

    Full Text Available It is shown that the sequence of the generalized Bell polynomials Sn(x is convex under some restrictions of the parameters involved. A kind of recurrence relation for Sn(x is established, and some numbers related to the generalized Bell numbers and their properties are investigated.

  20. Generalizing: The descriptive struggle

    Directory of Open Access Journals (Sweden)

    Barney G. Glaser, Ph.D.; Hon Ph.D.

    2006-11-01

    Full Text Available The literature is not kind to the use of descriptive generalizations. Authors struggle and struggle to find and rationalize a way to use them and then fail in spite of trying a myriad of work-arounds. And then we have Lincoln and Guba’s famous statement: “The only generalization is: there is no generalization” in referring to qualitative research. (op cit, p. 110 They are referring to routine QDA yielding extensive descriptions, but which tacitly include conceptual generalizations without any real thought of knowledge about them. In this chapter I wish to explore this struggle for the purpose of explaining that the various contra arguments to using descriptive generalizations DO NOT apply to the ease of using conceptual generalizations yielded in SGT and especially FGT. I will not argue for the use of descriptive generalization. I agree with Lincoln and Guba with respect to QDA, “the only generalization is: there is no generalization.” It is up to the QDA methodologists, of whom there are many; to continue the struggle and I wish them well.

  1. Acute Pancreatitis: Surgery, Pathophysiology and Probiotic Prophylaxis

    NARCIS (Netherlands)

    Minnen, L.P. van

    2006-01-01

    Acute pancreatitis is a challenging disease with a clinical course that is often difficult to predict. In severe acute pancreatitis, mortality increases significantly if intestinal bacteria translocate from the intestine and infect pancreatic necrosis. Surgical and prophylactic treatment strategies

  2. General relativity and cosmology

    CERN Document Server

    Bucher, Martin

    2015-01-01

    This year marks the hundredth anniversary of Einstein's 1915 landmark paper "Die Feldgleichungen der Gravitation" in which the field equations of general relativity were correctly formulated for the first time, thus rendering general relativity a complete theory. Over the subsequent hundred years physicists and astronomers have struggled with uncovering the consequences and applications of these equations. This contribution, which was written as an introduction to six chapters dealing with the connection between general relativity and cosmology that will appear in the two-volume book "One Hundred Years of General Relativity: From Genesis and Empirical Foundations to Gravitational Waves, Cosmology and Quantum Gravity," endeavors to provide a historical overview of the connection between general relativity and cosmology, two areas whose development has been closely intertwined.

  3. Generalized Galilean Genesis

    CERN Document Server

    Nishi, Sakine

    2015-01-01

    The galilean genesis scenario is an alternative to inflation in which the universe starts expanding from Minkowski in the asymptotic past by violating the null energy condition stably. Several concrete models of galilean genesis have been constructed so far within the context of galileon-type scalar-field theories. We give a generic, unified description of the galilean genesis scenario in terms of the Horndeski theory, i.e., the most general scalar-tensor theory with second-order field equations. In doing so we generalize the previous models to have a new parameter (denoted by {\\alpha}) which results in controlling the evolution of the Hubble rate. The background dynamics is investigated to show that the generalized galilean genesis solution is an attractor, similarly to the original model. We also study the nature of primordial perturbations in the generalized galilean genesis scenario. In all the models described by our generalized genesis Lagrangian, amplification of tensor perturbations does not occur as ...

  4. Generalized connectivity of graphs

    CERN Document Server

    Li, Xueliang

    2016-01-01

    Noteworthy results, proof techniques, open problems and conjectures in generalized (edge-) connectivity are discussed in this book. Both theoretical and practical analyses for generalized (edge-) connectivity of graphs are provided. Topics covered in this book include: generalized (edge-) connectivity of graph classes, algorithms, computational complexity, sharp bounds, Nordhaus-Gaddum-type results, maximum generalized local connectivity, extremal problems, random graphs, multigraphs, relations with the Steiner tree packing problem and generalizations of connectivity. This book enables graduate students to understand and master a segment of graph theory and combinatorial optimization. Researchers in graph theory, combinatorics, combinatorial optimization, probability, computer science, discrete algorithms, complexity analysis, network design, and the information transferring models will find this book useful in their studies.

  5. Generalized Kahler geometry

    CERN Document Server

    Gualtieri, Marco

    2010-01-01

    Generalized Kahler geometry is the natural analogue of Kahler geometry, in the context of generalized complex geometry. Just as we may require a complex structure to be compatible with a Riemannian metric in a way which gives rise to a symplectic form, we may require a generalized complex structure to be compatible with a metric so that it defines a second generalized complex structure. We explore the fundamental aspects of this geometry, including its equivalence with the bi-Hermitian geometry on the target of a 2-dimensional sigma model with (2,2) supersymmetry, as well as the relation to holomorphic Dirac geometry and the resulting derived deformation theory. We also explore the analogy between pre-quantum line bundles and gerbes in the context of generalized Kahler geometry.

  6. Clostridium difficile causing acute renal failure: Case presentation and review

    Institute of Scientific and Technical Information of China (English)

    Jasmin Arrich; Gottfried H. Sodeck; Gürkan Seng(o)lge; Christoforos Konnaris; Marcus Müllner; Anton N. Laggner; Hans Domanovits

    2005-01-01

    AIM: Clostridium difficile infection is primarily a nosocomial infection but asymptomatic carriers of Clostridium difficile can be found in up to 5% of the general population.Ampicillin, cephalosporins and clindamycin are the antibiotics that are most frequently associated with Clostridium difficile-associated diarrhea or colitis. Little is known about acute renal failure as a consequence of Clostridium difficile-associated diarrhea.METHODS: In this case report, we describe the course of Clostridium difficile-associated diarrhea in an 82-yearold patient developing acute renal failure. Stopping the offending agent and symptomatic therapy brought a rapid improvement of diarrhea and acute renal failure, full recovery was gained 18 d after admission. In a systematic review we looked for links between the two conditions.RESULTS: The link between Clostridium difficilr-associated diarrhea and acute renal failure in our patient was most likely volume depletion. However, in experimental studies a direct influence of Clostridium difficile toxins on renal duct cells could be shown.CONCLUSION: Rapid diagnosis, nonspecific supportive treatment and specific antibiotic treatment, especially in the elderly, may lower excess mortality Clostridium difficile-associated diarrhea and renal failure being possible complications.

  7. Training vs practice: A tale of opposition in acute cholecystitis

    Institute of Scientific and Technical Information of China (English)

    Purvi; P; Patel; Shaun; C; Daly; Jose; M; Velasco

    2015-01-01

    Acute cholecystitis is one of the most common surgical diagnoses encountered by general surgeons.Despite its high incidence there remains a range of treatment of approaches.Current practices in biliary surgery vary as to timing,intraoperative utilization of biliaryimaging,and management of bile duct stones despite growing evidence in the literature defining best practice.Management of patients with acute cholecystitis with early laparoscopic cholecystectomy(LC)results in better patient outcomes when compared with delayed surgical management techniques including antibiotic therapy or percutaneous cholecystostomy.Regardless of this data,many surgeons still prefer to utilize antibiotic therapy and complete an interval LC to manage acute cholecystitis.The use of intraoperative biliary imaging by cholangiogram or laparoscopic ultrasound has been demonstrated to facilitate the safe completion of cholecystectomy,minimizing the risk for inadvertent injury to surrounding structures,and lowering conversion rates,however it is rarely utilized.Choledocholithiasis used to be a diagnosis managed exclusively by surgeons but current practice favors referral to gastroenterologists for performance of preoperative endoscopic removal.Yet,there is evidence that intraoperative laparoscopic stone extraction is safe,feasible and may have added advantages.This review aims to highlight the differences between existing management of acute cholecystitis and evidence supported in the literature regarding best practice with the goal to change surgical practice to adopt these current recommendations.

  8. Obesity in patients with acute lymphoblastic leukemia in childhood

    Directory of Open Access Journals (Sweden)

    Iughetti Lorenzo

    2012-01-01

    Full Text Available Abstract Acute lymphoblastic leukemia is the most common malignancy in childhood. Continuous progress in risk-adapted treatment for childhood acute lymphoblastic leukemia has secured 5-year event-free survival rates of approximately 80% and 8-year survival rates approaching 90%. Almost 75% of survivors, however, have a chronic health condition negatively impacting on cardiovascular morbidity and mortality. Obesity can be considered one of the most important health chronic conditions in the general population, with an increasing incidence in patients treated for childhood cancers and especially in acute lymphoblastic leukemia survivors who are, at the same time, more at risk of experiencing precocious cardiovascular and metabolic co-morbidities. The hypothalamic-pituitary axis damage secondary to cancer therapies (cranial irradiation and chemotherapy or to primary tumor together with lifestyle modifications and genetic factors could affect long-term outcomes. Nevertheless, the etiology of obesity in acute lymphoblastic leukemia is not yet fully understood. The present review has the aim of summarizing the published data and examining the most accepted mechanisms and main predisposing factors related to weight gain in this particular population.

  9. Minimally Invasive Surgical Treatment of Acute Epidural Hematoma: Case Series

    Directory of Open Access Journals (Sweden)

    Weijun Wang

    2016-01-01

    Full Text Available Background and Objective. Although minimally invasive surgical treatment of acute epidural hematoma attracts increasing attention, no generalized indications for the surgery have been adopted. This study aimed to evaluate the effects of minimally invasive surgery in acute epidural hematoma with various hematoma volumes. Methods. Minimally invasive puncture and aspiration surgery were performed in 59 cases of acute epidural hematoma with various hematoma volumes (13–145 mL; postoperative follow-up was 3 months. Clinical data, including surgical trauma, surgery time, complications, and outcome of hematoma drainage, recovery, and Barthel index scores, were assessed, as well as treatment outcome. Results. Surgical trauma was minimal and surgery time was short (10–20 minutes; no anesthesia accidents or surgical complications occurred. Two patients died. Drainage was completed within 7 days in the remaining 57 cases. Barthel index scores of ADL were ≤40 (n=1, 41–60 (n=1, and >60 (n=55; scores of 100 were obtained in 48 cases, with no dysfunctions. Conclusion. Satisfactory results can be achieved with minimally invasive surgery in treating acute epidural hematoma with hematoma volumes ranging from 13 to 145 mL. For patients with hematoma volume >50 mL and even cerebral herniation, flexible application of minimally invasive surgery would help improve treatment efficacy.

  10. Pharm GKB: Leukemia, B-Cell, Acute [PharmGKB

    Lifescience Database Archive (English)

    Full Text Available UTR Alleles, Functions, and Amino Acid Translations are all sourced from dbSNP 144 Overview Alternate Names: Synonym Acute... B-Cell Leukemia; Acute B-Cell Leukemias; Acute B-Lymphocytic Leukemia; Acute... B-Lymphocytic Leukemias; Acute lymphoblastic leukaemia, Burkitt's type; Acute lymphoblastic leuka...emia, mature B-cell type; Acute lymphoblastic leukemia, Burkitt's type; Acute lymphoblastic leukemia, mature... B-cell type; B Cell Leukemia, Acute; B Lymphocytic Leukemia, Acute; B-ALL; B-Cell Leukemia, Acute

  11. Pancreatic Pseudocyst after Acute Organophosphate Poisoning

    OpenAIRE

    Kawabe, Ken; Ito, Tetsuhide; Arita, Yoshiyuki; Sadamoto, Yojiro; Harada, Naohiko; Yamaguchi, Koji; Tanaka, Masao; Nakano, Itsuro; Nawata, Hajime; Takayanagi, Ryoichi

    2006-01-01

    Acute organophosphate poisoning(OP) shows several severe clinical symptoms due to its strong blocking effect on cholinesterase. Acute pancreatitis is one of the complications associated with acute OP, but this association still may not be widely recognized. We report here the case of a 73-year-old man who had repeated abdominal pain during and after the treatment of acute OP. Hyperamylasemia and a 7-cm pseudocyst in the pancreatic tail were noted on investigations. We diagnosed pancreatic pse...

  12. Inductive, Analogical, and Communicative Generalization

    Directory of Open Access Journals (Sweden)

    Adri Smaling

    2003-03-01

    Full Text Available Three forms of inductive generalization - statistical generalization, variation-based generalization and theory-carried generalization - are insufficient concerning case-to-case generalization, which is a form of analogical generalization. The quality of case-to-case generalization needs to be reinforced by setting up explicit analogical argumentation. To evaluate analogical argumentation six criteria are discussed. Good analogical reasoning is an indispensable support to forms of communicative generalization - receptive and responsive (participative generalization — as well as exemplary generalization.

  13. Simultaneous Acute Cholecystitis and Acute Appendicitis Treated by a Single Laparoscopic Operation

    Directory of Open Access Journals (Sweden)

    Jonas P. DeMuro

    2012-01-01

    Full Text Available While acute appendicitis and acute cholecystitis are both common, they are only rarely seen simultaneously. The clinical presentation and hospital course of a 45-year-old female with concurrent acute appendicitis and acute cholecystitis is presented. The laparoscopic approach is ideal for dealing with multiple, simultaenous abdominal pathologies.

  14. Simultaneous Acute Cholecystitis and Acute Appendicitis Treated by a Single Laparoscopic Operation

    OpenAIRE

    DeMuro, Jonas P.

    2012-01-01

    While acute appendicitis and acute cholecystitis are both common, they are only rarely seen simultaneously. The clinical presentation and hospital course of a 45-year-old female with concurrent acute appendicitis and acute cholecystitis is presented. The laparoscopic approach is ideal for dealing with multiple, simultaenous abdominal pathologies.

  15. Gemtuzumab Ozogamicin in Treating Patients With Acute Myeloid Leukemia

    Science.gov (United States)

    2013-09-23

    Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Acute Promyelocytic Leukemia (M3); Recurrent Adult Acute Myeloid Leukemia

  16. Decitabine and Bortezomib in Treating Patients With Acute Myeloid Leukemia

    Science.gov (United States)

    2014-11-06

    Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Recurrent Adult Acute Myeloid Leukemia; Secondary Acute Myeloid Leukemia; Untreated Adult Acute Myeloid Leukemia

  17. GLYCYRRHIZA GLABRA IN ACUTE CONJUNCTIVITIS

    OpenAIRE

    C. Srinivas

    1986-01-01

    Conjunctivitis and its treatment have been widely described in ancient Indian medicine, 50 cases of Conjunctivitis (Acute) were clinically studied with Glycyrrhiza glabra along with comparative approach of Chlorophenicol. 25 cases studied with Glycyrrhiza glabra have shown encouraging results from which the author concludes that, the drug has got a definite role in Conjunctivitis

  18. Hypokalemia in acute medical patients

    DEFF Research Database (Denmark)

    Jensen, Helene Christine Kildegaard; Brabrand, Mikkel; Vinholt, Pernille Just

    2015-01-01

    . METHODS: We conducted a prospective cohort study involving all first time admissions (n=11988) to the Acute Medical Department at Odense University Hospital linking potassium level at admission with registry data on patient characteristics, laboratory data, redeemed prescriptions and time of death...... or betagonist use. CONCLUSIONS: In a mixed population of hospitalized medical patients, hypokalemia is common and plasma [K(+)

  19. Redox signaling in acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Salvador Pérez

    2015-08-01

    Full Text Available Acute pancreatitis is an inflammatory process of the pancreatic gland that eventually may lead to a severe systemic inflammatory response. A key event in pancreatic damage is the intracellular activation of NF-κB and zymogens, involving also calcium, cathepsins, pH disorders, autophagy, and cell death, particularly necrosis. This review focuses on the new role of redox signaling in acute pancreatitis. Oxidative stress and redox status are involved in the onset of acute pancreatitis and also in the development of the systemic inflammatory response, being glutathione depletion, xanthine oxidase activation, and thiol oxidation in proteins critical features of the disease in the pancreas. On the other hand, the release of extracellular hemoglobin into the circulation from the ascitic fluid in severe necrotizing pancreatitis enhances lipid peroxidation in plasma and the inflammatory infiltrate into the lung and up-regulates the HIF–VEGF pathway, contributing to the systemic inflammatory response. Therefore, redox signaling and oxidative stress contribute to the local and systemic inflammatory response during acute pancreatitis.

  20. Plasma volume in acute hypoxia

    DEFF Research Database (Denmark)

    Poulsen, T D; Klausen, T; Richalet, J P

    1998-01-01

    Exposure to acute hypoxia is associated with changes in body fluid homeostasis and plasma volume (PV). This study compared a dye dilution technique using Evans' blue (PV[Evans']) with a carbon monoxide (CO) rebreathing method (PV[CO]) for measurements of PV in ten normal subjects at sea level...

  1. Orlistat-induced acute pancreatitis

    OpenAIRE

    2012-01-01

    Drug-induced pancreatitis is a rare but important cause of pancreatic injury. Orlistat is a pancreatic lipase inhibitor licensed for the treatment of obesity. We present a case of orlistat- induced mild acute pancreatitis that developed 8 days after starting treatment.

  2. Studies on acute hepatic insufficiency

    NARCIS (Netherlands)

    G.H. de Groot (Gerrit Harmen)

    1984-01-01

    textabstractAcute hepatic failure (AHF) is one of the most dramatic situations that a clinical physician can encounter. It is also one of the most frustating since death is the result in a large majority of the cases, despite all efforts of the medical and nursing staffs. Although a wide variety of

  3. Managing acute invasive fungal sinusitis.

    Science.gov (United States)

    Dwyhalo, Kristina M; Donald, Carrlene; Mendez, Anthony; Hoxworth, Joseph

    2016-01-01

    Acute invasive fungal sinusitis is the most aggressive form of fungal sinusitis and can be fatal, especially in patients who are immunosuppressed. Early diagnosis and intervention are crucial and potentially lifesaving, so primary care providers must maintain a high index of suspicion for this disease. Patients may need to be admitted to the hospital for IV antifungal therapy and surgical debridement.

  4. Systemic corticosteroids for acute sinusitis

    NARCIS (Netherlands)

    Venekamp, R.P.; Thompson, M.J.; Hayward, G.; Heneghan, C.J.; Mar, C.B. Del; Perera, R.; Glasziou, P.P.; Rovers, M.M.

    2014-01-01

    BACKGROUND: Acute sinusitis is the inflammation and swelling of the nasal and paranasal mucous membranes and is a common reason for patients to seek primary care consultations. The related impairment of daily functioning and quality of life is attributable to symptoms such as facial pain and nasal c

  5. Diarrheal Diseases - Acute and Chronic

    Science.gov (United States)

    ... acute, watery diarrhea are caused by viruses (viral gastroenteritis). The most common ones in children are rotavirus and in adults are norovirus (this is sometimes called “cruise ship diarrhea” due to well publicized epidemics). Bacteria are a common cause of traveler’s diarrhea. Causes – ...

  6. Redox signaling in acute pancreatitis.

    Science.gov (United States)

    Pérez, Salvador; Pereda, Javier; Sabater, Luis; Sastre, Juan

    2015-08-01

    Acute pancreatitis is an inflammatory process of the pancreatic gland that eventually may lead to a severe systemic inflammatory response. A key event in pancreatic damage is the intracellular activation of NF-κB and zymogens, involving also calcium, cathepsins, pH disorders, autophagy, and cell death, particularly necrosis. This review focuses on the new role of redox signaling in acute pancreatitis. Oxidative stress and redox status are involved in the onset of acute pancreatitis and also in the development of the systemic inflammatory response, being glutathione depletion, xanthine oxidase activation, and thiol oxidation in proteins critical features of the disease in the pancreas. On the other hand, the release of extracellular hemoglobin into the circulation from the ascitic fluid in severe necrotizing pancreatitis enhances lipid peroxidation in plasma and the inflammatory infiltrate into the lung and up-regulates the HIF-VEGF pathway, contributing to the systemic inflammatory response. Therefore, redox signaling and oxidative stress contribute to the local and systemic inflammatory response during acute pancreatitis.

  7. Acute and dramatic saxophone penis

    Directory of Open Access Journals (Sweden)

    Carlota Gutiérrez García-Rodrigo

    2015-01-01

    Full Text Available We present a case of intense genital swelling because of a hereditary angioedema. This rare disease should be included in the differential diagnosis of acute and asymptomatic genital edema, because it may prevent future potentially life-threatening episodes of visceral angioedema.

  8. Neuroprotection in acute ischemic stroke

    NARCIS (Netherlands)

    De Keyser, Jacques; Uyttenboogaart, Maarten; Koch, Marcus W; Elting, Jan Willem; Sulter, Geert; Vroomen, Patrick C; Luijckx, Gert Jan

    2005-01-01

    Neuroprotection of patients with acute ischemic stroke should start at the scene and continue in the ambulance with the assessment and treatment of the airway, breathing, circulation, body temperature, and blood glucose. The key goal in eligible patients should be fast vessel recanalization with int

  9. The management of acute asthma.

    Science.gov (United States)

    Cross, S

    1997-04-01

    Health professionals likely to come into contact with people experiencing an acute episode of asthma, such as school nurses, ambulance personnel and A&E staff, need clear guidelines on management. The British Thoracic Society guidelines, revised this year, advise on the categorisation of asthma, assessment and treatment.

  10. Acute psychosis: A neuropsychiatric dilemma

    Directory of Open Access Journals (Sweden)

    Daniel Saldanha

    2013-01-01

    Full Text Available The acute onset of psychotic symptoms in elderly can be the presenting clinical feature for various Central Nervous System as well as other systemic illnesses. The diagnosis and treatment of such presentation require a cautious medical work up and high level of suspicion even if the patient is not showing any cardinal symptoms for organic pathology.

  11. [Acute cardiac failure in pheochromocytoma.

    DEFF Research Database (Denmark)

    Jønler, Morten; Munk, Kim

    2008-01-01

    Pheochromocytoma (P) is an endocrine catecholamine-secreting tumor. Classical symptoms like hypertension, attacks of sweating, palpitations, headache and palor are related to catecholamine discharge. We provide a case of P in a 71 year-old man presenting with acute cardiac failure, severe reduction...

  12. Sildenafil Induced Acute Interstitial Nephritis

    Directory of Open Access Journals (Sweden)

    Ryan Burkhart

    2015-01-01

    Full Text Available Acute interstitial nephritis (AIN is characterized by inflammation of the renal interstitium and usually occurs in a temporal relationship with the medication. We present a case of an Asian male who had nephrotic range proteinuria and presented with acute kidney injury. The patient reported an acute change in physical appearance and symptomatology after the ingestion of a single dose of sildenafil. Renal biopsy was notable for minimal change disease (MCD with acute and chronic interstitial nephritis. Renal replacement and glucocorticoid therapy were initiated. Renal recovery within six weeks permitted discontinuation of dialysis. AIN superimposed on MCD is a known association of NSAID induced nephropathy. The temporal association and the absence of any new drugs suggest that the AIN was most likely due to the sildenafil. NSAIDs are less likely to have caused the AIN given their remote use. The ease of steroid responsiveness would also suggest another cause as NSAID induced AIN is often steroid resistant. The MCD was most likely idiopathic given the lack of temporal association with a secondary cause. As the number of sildenafil prescriptions increases, more cases of AIN may be identified and physician awareness for this potential drug disease association is necessary.

  13. Acute fatty liver in pregnancy.

    NARCIS (Netherlands)

    Tan, A.; Krieken, J.H.J.M. van; Peters, W.H.M.; Steegers, E.A.P.

    2002-01-01

    When confronted with liver abnormalities during the third trimester of pregnancy, one should consider acute fatty liver of pregnancy. The differential diagnosis with (pre-)eclampsia and HELLP syndrome is sometimes difficult. In these cases a liver biopsy is helpful though rarely performed during pre

  14. Diagnosis of Acute Groin Injuries

    DEFF Research Database (Denmark)

    Serner, Andreas; Tol, Johannes L; Jomaah, Nabil;

    2015-01-01

    BACKGROUND: Acute groin injuries are common in high-intensity sports, but there are insufficient data on injury characteristics such as injury mechanisms and clinical and radiological findings. PURPOSE: To describe these characteristics in a cohort of athletes. STUDY DESIGN: Cross-sectional study...

  15. The management of otitis externa in UK general practice.

    Science.gov (United States)

    Pabla, L; Jindal, M; Latif, K

    2012-03-01

    Acute otitis externa is common and provides a heavy workload for general practitioners. We aim to determine the first-line treatment used by general practitioners in the management of otitis externa and subsequent second-line treatment in a hospital ENT clinic. In addition, this study aims to ascertain whether local and national guidelines are being followed appropriately. A prospective observational study on the management of otitis externa in consecutive patients referred to an ENT emergency clinic was undertaken. Data were collected and analysed on symptoms, initial management by general practitioners, findings and treatment in the ENT clinic. A total of 106 patients were studied. The mean duration of symptoms before presentation to clinic was 13 days; 42% of patients received no treatment by their GP prior to referral to the ENT emergency clinic. Only 14% of patients received topical antibiotics alone, whilst 44% received oral antibiotics, either alone or in conjunction with topical antibiotics by their GP. Of the 106 patients, 86% received topical antibiotics in the ENT emergency clinic and oral antibiotics were reserved for those presenting with complicated acute otitis externa. Topical antibiotics are associated with a decrease in disease persistence, whilst oral antibiotics are associated with an increase. However, general practitioners are prescribing oral antibiotics more often than required. There are few regional guidelines and no explicit national guidelines on the management of acute otitis externa for GPs to refer to. We suggest the implementation of national guidelines to aid clinical practice.

  16. KEGG DISEASE / Acute alcohol sensitivity [KEGG DISEASE

    Lifescience Database Archive (English)

    Full Text Available DISEASE: H01071 Entry H01071Disease Name Acute alcohol sensitivity Description Alde...bolism Congenital disorders of carbohydrate metabolism H01071Acute alcohol sensit...eases. Journal Cardiovasc Res 88:51-7 (2010) KEGG DISEASE / Acute alcohol sensitivity ...

  17. Context-dependent generalization.

    Science.gov (United States)

    Taylor, Jordan A; Ivry, Richard B

    2013-01-01

    The pattern of generalization following motor learning can provide a probe on the neural mechanisms underlying learning. For example, the breadth of generalization to untrained regions of space after visuomotor adaptation to targets in a restricted region of space has been attributed to the directional tuning properties of neurons in the motor system. Building on this idea, the effect of different types of perturbations on generalization (e.g., rotation vs. visual translation) have been attributed to the selection of differentially tuned populations. Overlooked in this discussion is consideration of how the context of the training environment may constrain generalization. Here, we explore the role of context by having participants learn a visuomotor rotation or a translational shift in two different contexts, one in which the array of targets were presented in a circular arrangement and the other in which they were presented in a rectilinear arrangement. The perturbation and environments were either consistent (e.g., rotation with circular arrangement) or inconsistent (e.g., rotation with rectilinear arrangement). The pattern of generalization across the workspace was much more dependent on the context of the environment than on the perturbation, with broad generalization for the rectilinear arrangement for both types of perturbations. Moreover, the generalization pattern for this context was evident, even when the perturbation was introduced in a gradual manner, precluding the use of an explicit strategy. We describe how current models of generalization might be modified to incorporate these results, building on the idea that context provides a strong bias for how the motor system infers the nature of the visuomotor perturbation and, in turn, how this information influences the pattern of generalization.

  18. Context-dependent Generalization

    Directory of Open Access Journals (Sweden)

    Jordan A Taylor

    2013-05-01

    Full Text Available The pattern of generalization following motor learning can provide a probe on the neural mechanisms underlying learning. For example, the breadth of generalization to untrained regions of space after visuomotor adaptation to targets in a restricted region of space has been attributed to the directional tuning properties of neurons in the motor system. Building on this idea, the effect of different types of perturbations on generalization (e.g., rotation versus visual translation have been attributed to the selection of differentially tuned populations. Overlooked in this discussion is consideration of how the context of the training environment may constrain generalization. Here, we explore the role of context by having participants learn a visuomotor rotation or a translational shift in two different contexts, one in which the array of targets were presented in a circular arrangement and the other in which they were presented in a rectilinear arrangement. The perturbation and environments were either consistent (e.g., rotation with circular arrangement or inconsistent (e.g., rotation with rectilinear arrangement. The pattern of generalization across the workspace was much more dependent on the context of the environment than on the perturbation, with broad generalization for the rectilinear arrangement for both types of perturbations. Moreover, the generalization pattern for this context was evident, even when the perturbation was introduced in a gradual manner, precluding the use of an explicit strategy. We describe how current models of generalization might be modified to incorporate these results, building on the idea that context provides a strong bias for how the motor system infers the nature of the visuomotor perturbation and, in turn, how this information influences the pattern of generalization.

  19. Pharm GKB: Acute cholecystitis unspecified [PharmGKB

    Lifescience Database Archive (English)

    Full Text Available Overview Alternate Names: PharmGKB Accession Id: PA165108452 External Vocabularies MeSH: Cholecystitis, Acut...e (D041881) SnoMedCT: Acute cholecystitis unspecified (197409009) UMLS: C0149520 (C0149520) MedDRA: Acute... cholecystitis (10000691) NDFRT: Cholecystitis, Acute [Disease/Finding] (N0000010952) ...Common Searches Search Medline Plus Search CTD Pharm GKB: Acute cholecystitis unspecified ...

  20. Pharm GKB: Acute cholecystitis NOS [PharmGKB

    Lifescience Database Archive (English)

    Full Text Available Overview Alternate Names: PharmGKB Accession Id: PA165108810 External Vocabularies MeSH: Cholecystitis, Acut...e (D041881) SnoMedCT: Acute cholecystitis NOS (197411000) UMLS: C0149520 (C0149520) MedDRA: Acute... cholecystitis (10000691) NDFRT: Cholecystitis, Acute [Disease/Finding] (N0000010952) Common Searches Search Medline Plus Search CTD Pharm GKB: Acute cholecystitis NOS ...