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- Reply to the letter regarding NADPH oxidase inhibitor
- Practical guide for the management of systemic tox...
- High‐risk symptoms do not predict gastric cancer p...
- Extragastric diseases correlated with Helicobacter...
- Issue Information
- Hypopyon pustules of Sneddon‐Wilkenson disease
- A case of Kindler syndrome in a young Indian femal...
- Multidermatomal zosteriform lichen planus pigmento...
- Interventions for infantile haemangiomas of the sk...
- Psoriasis in a cohort of patients with common vari...
- A Case of Acute Pemphigus Vulgaris Relapses Associ...
- Periostin deletion suppresses late-phase response ...
- Contents
- Editorial Board
- Endoscopic lateralization of the vocal fold
- Programme des cas cliniques de l’ADF
- Place des laboratoires de génétique, d’anatomie pa...
- Giant nonfunctioning adrenal tumors: two case repo...
- Elevated CSF GAP-43 is Alzheimer's disease specifi...
- Vitamin D supplementation and neurofilament light ...
- Measurement of the suppression and azimuthal aniso...
- Measurements of differential cross sections of top...
- Expression and secretion of synaptic proteins duri...
- Observation of an Unusual Upward-Going Cosmic-Ray-...
- Blood-based biomarkers for Alzheimer's disease - a...
- Search for resonant W Z production in the fully le...
- Object Classification Using Hybrid Fiber Optical F...
- CrossTalk proposal: a central hypoxia sensor contr...
- Extending the SACOC algorithm through the Nystrom ...
- Multi-organ quantitative MRI for the assessment of...
- Properties of the signal mode in the polariton opt...
- The Zurich Corpus of Vowel and Voice Quality, Vers...
- Cardiomyopathies in children: Mitochondrial and st...
- Evolution of Electrochemical Cell Designs for In-S...
- Enhanced trypsin thermostability in Pichia pastori...
- Autonomous Object Handover Using Wrist Tactile Inf...
- Circulating Metabolic Biomarkers of Screen-Detecte...
- Cell cycle, apoptosis, cellular uptake and whole-t...
- Ethnic and Age Disparities in Outcomes among Liver...
- First Report of siRNA Uptake During Ex Vivo Hypoth...
- Patient selection and ethical considerations - jus...
- Pretransplant cancer in kidney recipients in relat...
- Steatosis in Liver Transplantation: Current Limita...
- Impact of Donor Hepatectomy Time during Organ Proc...
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Ετικέτες
Σάββατο 10 Νοεμβρίου 2018
Practical guide for the management of systemic toxicity caused by local anesthetics
Abstract
Systemic toxicity from local anesthetics can occur in any of the wide range of situations in which these agents are used. This practical guide is created to generate a shared awareness of the prevention, diagnosis, and treatment of local anesthetic systemic toxicity among all medical professionals who perform nerve blocks. Systemic toxicity of local anesthetic is induced by an increase of its protein-unbound plasma concentration. Initial symptoms are characterized by central nervous system signs such as excitation, convulsions, followed by loss of consciousness and respiratory arrest. These symptoms are often accompanied with cardiovascular signs such as hypertension, tachycardia and premature ventricular contractions. Further increase of plasma concentration of local anesthetic induces bradycardia, conduction disturbances, circulatory collapse and asystole. The incidence of local anesthetic systemic toxicity is 1–11 cases per 10,000. Infants, patients with decreased liver function and low cardiac output are vulnerable to systemic toxicity. When performing regional anesthesia, the guideline-directed monitoring, securing a venous line, preparation of medication to treat convulsions and lipid emulsions are required. For prevention of local anesthetic systemic toxicity, small-dose, divided administration, using agents with low toxicity such as ropivacaine and levobupivacaine, performing an aspiration test are recommended. If systemic toxicity is suspected, halt administration of local anesthetic, request assistance, secure venous line, airway, administration of 100% oxygen and if necessary tracheal intubation and artificial respiration should be immediately performed. Benzodiazepines are recommended to treat convulsions. Administration of 20% lipid emulsion according to the protocol is recommended to treat severe hypotension and arrhythmia.
https://ift.tt/2PjDxAB
High‐risk symptoms do not predict gastric cancer precursors
Abstract
Background & Study Aims
Gastric intestinal metaplasia (GIM) is the most common precursor of gastric cancer. Our aim is to determine if presenting symptoms predict gastric cancer precursor lesions in a high‐risk population.
Patient and Methods
Consecutive unique patients evaluated by endoscopy for upper gastrointestinal symptoms at the Los Angeles County Hospital between 2010 and 2014 were evaluated. Presenting symptoms were classified as low‐ or high‐risk depending on the procedure indication as coded using the Clinical Outcomes Research Initiative (CORI) system. Endoscopy and histology results were used to classify findings as benign, GIM, high‐risk GIM, or malignant. The primary outcome was the proportion of patients with premalignant or malignant gastric findings who had high‐risk clinical indications for endoscopy relative to those with benign results.
Results
A total of 3699 patients underwent endoscopy to evaluate upper gastrointestinal symptoms. There were 373 (10.1%) patients with GIM of which 278 had high‐risk GIM. One hundred and sixty (4.3%) patients were diagnosed with gastric cancer. High‐risk indications for upper endoscopy predicted gastric cancer (OR 1.8 [95% CI 1.3‐2.6]) but not GIM (OR 1.0 [0.8‐1.3]) or high‐risk GIM (OR 0.9 [0.7‐1.2]). Hispanic or Asian patients and patients >50 years old were more likely to have GIM, high‐risk GIM, and cancer.
Conclusions
Performance of upper endoscopy for high‐risk indications is inadequate to detect GIM and marginal for malignancy. At risk patients should undergo upper endoscopy for both low‐ and high‐risk symptoms. Screening certain populations deserve additional study and may, in fact, be cost‐effective.
https://ift.tt/2AZcLEW
Issue Information
https://ift.tt/2PR007s
Interventions for infantile haemangiomas of the skin: abridged Cochrane systematic review including GRADE assessments
Summary
Infantile haemangiomas (IH) are soft swellings of the skin that occur in 3‐10% of infants. When haemangiomas occur in high‐risk areas or when complications develop, active intervention is necessary. This is an update of a Cochrane Review assessing the interventions for the management of IH in children. We searched for randomized controlled trials in CENTRAL, MEDLINE, Embase, LILACS, AMED, PsycINFO, CINAHL and six trials registers to February 2017. We included 28 trials (1728 participants) assessing 12 interventions. We downgraded evidence from high to moderate/low for issues related to risk of bias and imprecision. Oral propranolol (3 mg/kg/day) probably improves clinician‐assessed clearance compared to placebo (risk ratio (RR) 16·61, 95% confidence interval (CI) 4·22 to 65·34; moderate quality of evidence (QoE)); we found no evidence of a difference in terms of serious adverse events (RR 1·05, 95% CI 0·33 to 3·39; low QoE). We found the chance of reduction of redness may be improved with topical timolol maleate (0·5% gel applied twice daily) when compared to placebo (RR 8·11, 95% CI 1·09 to 60·09; low QoE). We found no instances of bradycardia or hypotension for this comparison. Our key results indicate that oral propranolol and topical timolol maleate are more beneficial than placebo in terms of clearance or other measures of resolution, or both, without an increase in harms.
This article is protected by copyright. All rights reserved.
https://ift.tt/2qDYabP
Psoriasis in a cohort of patients with common variable immunodeficiency
Abstract
Common variable immunodeficiency (CVID) is the most common symptomatic primary immunodeficiency in adults. CVID is characterized by reduced serum levels of IgG, IgA, and/or IgM, recurrent bacterial infections, autoimmune and inflammatory diseases and malignancies. According to literature, autoimmune diseases occur in 20–30% of CVID patients. Dermatological involvement has occasionally been reported in CVID and includes alopecia totalis, lichen planus, and vitiligo. Data regarding the frequency and features of psoriasis in CVID are scant.
This article is protected by copyright. All rights reserved.
https://ift.tt/2FcpzMk
A Case of Acute Pemphigus Vulgaris Relapses Associated with Cocaine Use and Review of the Literature
Abstract
Pemphigus is a bullous autoimmune disease that affects the skin and mucous membranes. It is very difficult to establish the etiology and the triggering factors that influence reactivations in pemphigus vulgaris (PV). The case of a 33-year-old male with chronic history of intranasal cocaine consumption is presented in this report. We present the clinical case of the patient, followed for a total of 86 weeks, with ten relapses secondary to probable cocaine use. The patient was admitted to the emergency department after presenting polymorphic dermatosis characterized by blisters, vesicles, and excoriations extending from the oral cavity to the thorax, and to the inguinal and genital regions, affecting approximately 35 % of the body surface area with a score of 56 on the Pemphigus Skin Disorder Index. Skin biopsies were compatible with PV diagnosis. The patient had clinical improvement with a combination of methylprednisolone 500 mg intravenously (IV) and cyclophosphamide 500 mg IV every 15 days, along with prednisone 50 mg orally (PO) q24 h and mycophenolic acid 500 mg PO q6 h. Persistent cocaine use is highly likely to be the factor triggering lesion reactivation and responsible for the torpid evolution. We cannot definitively conclude whether the change from azathioprine to mycophenolic acid after the tenth relapse was the adjuvant medication responsible for the end of the consolidation phase and complete remission on therapy. This case study could potentially serve as a guide for management of patients who continuously persist with cocaine use, leading to a clinical picture refractory to multiple therapeutic schemes.
https://ift.tt/2PoGjEL
Periostin deletion suppresses late-phase response in mouse experimental allergic conjunctivitis
Publication date: Available online 9 November 2018
Source: Allergology International
Author(s): Yosuke Asada, Mikiko Okano, Waka Ishida, Satoshi Iwamoto, Ken Fukuda, Toshiaki Hirakata, Norihiro Tada, Atsuki Fukushima, Nobuyuki Ebihara, Akira Kudo, Akira Matsuda
Abstract
Background
To investigate the potential roles of periostin (POSTN), an extracellular matrix preferentially expressed in Th2-skewed conditions in the pathophysiology of allergic conjunctivitis.
Methods
The roles of POSTN in ragweed-induced experimental allergic conjunctivitis (RW-EAC) were evaluated using both POSTN-knockout (KO) and congenic BALB/c wild-type mice. Histological analysis was carried out to enumerate eosinophils/basophils in the conjunctival tissue. Th2 cytokine expression was evaluated by quantitative polymerase chain reaction (Q-PCR), and microarray analysis was performed to elucidate genes differentially expressed in POSTN-KO and wild-type mice in the RW-EAC model.
Results
Upregulation of POSTN expression and eosinophil infiltration was observed in subconjunctival tissue of RW-EAC in the wild-type mice. The number of infiltrating eosinophils in the conjunctivae of RW-EAC was diminished in POSTN-KO mice compared to wild-type mice. Q-PCR analysis of conjunctival tissue showed induction of Th2 cytokine (Ccl5, Il4, Il5, Il13) expression in the RW-EAC and attenuated Ccl5, Il4, Il13 mRNA expression in the conjunctivae of the RW-EAC using POSTN-KO mice. Microarray analysis and immunohistochemical analysis showed diminished basophil marker (Mcpt8) expression and reduced numbers of infiltrating basophils in the conjunctivae of RW-EAC in POSTN-KO mice.
Conclusions
POSTN expression in conjunctival tissue plays an indispensable role in the late-phase reaction of the RW-EAC model by facilitating eosinophil/basophil infiltration and augmenting Th2 cytokine expression.
https://ift.tt/2Dd3Dhk
Contents
Publication date: December 2018
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 135, Issue 6
Author(s):
https://ift.tt/2DdO7Sc
Editorial Board
Publication date: December 2018
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 135, Issue 6
Author(s):
https://ift.tt/2PNJTrk
Endoscopic lateralization of the vocal fold
Publication date: Available online 9 November 2018
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): C. Fabre, C.A. Righini, P.F. Castellanos, I. Atallah
Abstract
Vocal fold paralysis in adduction can result in significant breathing difficulties. Techniques such as vocal fold lateralization and/or arytenoidopexy help to improve respiratory function in this setting. These techniques require open approach or specific instruments. The authors describe an original vocal fold lateralization technique performed exclusively via an endoscopic approach. This technique helps to enlarge the glottic aperture, while preserving laryngeal architecture, and permanently improves respiratory function in patients with vocal fold paralysis in adduction.
https://ift.tt/2De1yll
Programme des cas cliniques de l’ADF
Publication date: Available online 10 November 2018
Source: Annales de Dermatologie et de Vénéréologie
Author(s):
https://ift.tt/2JT3kcW
Place des laboratoires de génétique, d’anatomie pathologique et d’immunologie dans la prise en charge des maladies rares dermatologiques
Publication date: Available online 9 November 2018
Source: Annales de Dermatologie et de Vénéréologie
Author(s): D. Vidaud, C. Silve, S. Leclerc-Mercier, S. Hüe, S. Ingen-Housz-Oro, C. Bodemer
https://ift.tt/2AWgJ0W
Giant nonfunctioning adrenal tumors: two case reports and review of the literature
There are an estimated 1–2 cases per million per year of adrenocortical carcinoma in the USA. It represents a rare and aggressive malignancy; it is the second most aggressive endocrine malignant disease after ...
https://ift.tt/2Deet6E
Elevated CSF GAP-43 is Alzheimer's disease specific and associated with tau and amyloid pathology
Sandelius, Å; Portelius, E; Källén, Å; Zetterberg, H; Rot, U; Olsson, B; Toledo, JB; ... Blennow, K; + view all Sandelius, Å; Portelius, E; Källén, Å; Zetterberg, H; Rot, U; Olsson, B; Toledo, JB; Shaw, LM; Lee, VMY; Irwin, DJ; Grossman, M; Weintraub, D; Chen-Plotkin, A; Wolk, DA; McCluskey, L; Elman, L; Kostanjevecki, V; Vandijck, M; McBride, J; Trojanowski, JQ; Blennow, K; - view fewer (2018) Elevated CSF GAP-43 is Alzheimer's disease specific and associated with tau and amyloid pathology. Alzheimer's and Dementia 10.1016/j.jalz.2018.08.006 . (In press). Green open access
https://ift.tt/2qGwvXT
Vitamin D supplementation and neurofilament light chain in multiple sclerosis
Holmøy, T; Røsjø, E; Zetterberg, H; Blennow, K; Lindstrøm, JC; Steffensen, LH; Kampman, MT; (2018) Vitamin D supplementation and neurofilament light chain in multiple sclerosis. Acta Neurologica Scandinavica 10.1111/ane.13037 . (In press).
https://ift.tt/2FhAnIV
Measurement of the suppression and azimuthal anisotropy of muons from heavy-flavor decays in Pb plus Pb collisions at root s(NN)=2.76 TeV with the ATLAS detector
Aaboud, M; Aad, G; Abbott, B; Abdinov, O; Abeloos, B; Abhayasinghe, DK; Abidi, SH; ... 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Brenner, R; Bressler, S; Brickwedde, B; Briglin, DL; Britton, D; Britzger, D; Brock, I; Brock, R; Brooijmans, G; Brooks, T; Brooks, WK; Brost, E; Broughton, JH; de Renstrom, PAB; Bruncko, D; Bruni, A; Bruni, G; Bruni, LS; Bruno, S; Brunt, BH; Bruschi, M; Bruscino, N; Bryant, P; Bryngemark, L; Buanes, T; Buat, Q; Buchholz, P; Buckley, AG; Budagov, IA; Buehrer, F; Bugge, MK; Bulekov, O; Bullock, D; Burch, TJ; Burdin, S; Burgard, CD; Burger, AM; Burghgrave, B; Burka, K; Burke, S; Burmeister, I; Burr, JTP; Buescher, D; Buescher, V; Buschmann, E; Bussey, P; Butler, JM; Buttar, CM; Butterworth, JM; Butti, P; Buttinger, W; Buzatu, A; Buzykaev, AR; Cabras, G; Cabrera Urban, S; Caforio, D; Cai, H; Cairo, VMM; Cakir, O; Calace, N; Calafiura, P; Calandri, A; Calderini, G; Calfayan, P; Callea, G; Caloba, LP; Calvente Lopez, S; Calvet, D; Calvet, S; Calvet, TP; Calvetti, M; Toro, RC; Camarda, S; Camarri, P; Cameron, D; Armadans, RC; Camincher, C; Campana, S; Campanelli, M; Camplani, A; Campoverde, A; 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Expression and secretion of synaptic proteins during stem cell differentiation to cortical neurons
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Observation of an Unusual Upward-Going Cosmic-Ray-like Event in the Third Flight of ANITA
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Blood-based biomarkers for Alzheimer's disease - an update
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Search for resonant W Z production in the fully leptonic final state in proton–proton collisions at √s = 13 TeV with the ATLAS detector
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Object Classification Using Hybrid Fiber Optical Force/Proximity Sensor
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CrossTalk proposal: a central hypoxia sensor contributes to the excitatory hypoxic ventilatory response
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Extending the SACOC algorithm through the Nystrom method for dense manifold data analysis
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Multi-organ quantitative MRI for the assessment of liver disease - A whole much more than the sum of its parts
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Properties of the signal mode in the polariton optical parametric oscillator regime
Dunnett, K; Ferrier, A; Zamora, A; Dagvadorj, G; Szymanska, MH; (2018) Properties of the signal mode in the polariton optical parametric oscillator regime. Physical Review B , 98 (16) 10.1103/PhysRevB.98.165307 . Green open access
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The Zurich Corpus of Vowel and Voice Quality, Version 1.0
Maurer, D; D'Heureuse, C; Suter, H; Dellwo, V; Friedrichs, D; Kathiresan, T; (2018) The Zurich Corpus of Vowel and Voice Quality, Version 1.0. In: Yegnanarayana, B, (ed.) Proceedings of INTERSPEECH 2018. (pp. pp. 1417-1421). International Speech Communication Association (ISCA) Green open access
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Cardiomyopathies in children: Mitochondrial and storage disease
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Evolution of Electrochemical Cell Designs for In-Situ and Operando 3D Characterization
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Enhanced trypsin thermostability in Pichia pastoris through truncating the flexible region
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Autonomous Object Handover Using Wrist Tactile Information
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Circulating Metabolic Biomarkers of Screen-Detected Prostate Cancer in the ProtecT Study
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Cell cycle, apoptosis, cellular uptake and whole-transcriptome microarray gene expression analysis of HeLa cells treated with a ruthenium(II)-arene complex with an isoquinoline-3-carboxylic acid ligand
Jovanovic, KK; Tanic, M; Ivanovic, I; Gligorijevic, N; Dojcinovic, BP; Radulovic, S; (2016) Cell cycle, apoptosis, cellular uptake and whole-transcriptome microarray gene expression analysis of HeLa cells treated with a ruthenium(II)-arene complex with an isoquinoline-3-carboxylic acid ligand. Journal of Inorganic Biochemistry , 163 pp. 362-373. 10.1016/j.jinorgbio.2016.04.011 . Green open access
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Ethnic and Age Disparities in Outcomes among Liver Transplant Waitlist Candidates
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Pretransplant cancer in kidney recipients in relation to recurrent and de novo cancer incidence posttransplantation and implications for graft and patient survival
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Steatosis in Liver Transplantation: Current Limitations and Future Strategies
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Impact of Donor Hepatectomy Time during Organ Procurement in Donation after Circulatory Death Liver Transplantation: The United Kingdom Experience
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