LITFL Review 332

LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 332nd LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. Readers can subscribe to LITFL review RSS or LITFL review EMAIL subscription The Most Fair Dinkum Ripper Beauts of the Week Pulmonary embolism risk stratification is a must when working up your patients. FOAMCast goes over the current guidelines, while the latest SGEM episode discusses the PROPER trial with guest skeptic Jeff Kline. [MMS] The Best of #FOAMed Emergency Medicine In this post from ALIEM, the case is made regarding ketamine for ethanol withdrawal. There is a review of the pathophysiology of ethanol withdrawal and how ketamine works in the CNS. Three studies are detailed and their results would indicate there is a potential benefit of ketamine in select ethanol withdrawal patients. [TCN] Rory Spiegel dives into a hot off the press publication on bougie first intubation. It may be time for a paradigm shift of bougie as a rescue device. [SR] Clay Smith reviews a recent paper on atraumatic needles for lumbar puncture. Why are we still using the standard LP needles that come i...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: LITFL review LITFL R/V Source Type: blogs

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A 46-year-old man with a history of alcohol use disorder, tobacco use, and chronic pancreatitis complicated by an untreated pseudocyst presented with two days of right lower extremity swelling and pain, shortness of breath, and pleuritic chest pain. A right lower extremity Doppler showed a saphenous vein thrombus, and CT angiography of the chest revealed multiple bilateral segmental pulmonary emboli with involvement of the right distal main pulmonary artery. The patient had no personal or family history of venous thromboembolism, and review of systems was not concerning for an underlying oncologic or active inflammatory process.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Clinical Communication to the Editor Source Type: research
Introduction: In last few years, many studies have shown the impact of vitamin D deficiency in COPD exacerbation. We conducted this retrospective study in 90 COPD patients who presented with exacerbation due to various reasons to our hospital. We analysed, if vitamin D (2,5 OHD) deficiency of less then 30 ng/ml is associted with infective exacerbation of COPD.Method: Out of 90 COPD patients, 66 were males and 24 were females. Range of age was from 48 to 83 years. 64 out of 90 were active smokers at the time of presentation.The reason of exacerbation were established in every patient. Those, with increase in purulence of sp...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Airway pharmacology and treatment Source Type: research
In this study we aimed to examine the independent effect of baseline QoL and persistent CRT among pts with early BC.MethodsWe included data stage I-III BC pts treated with chemotherapy who were included in the CANTO prospective cohort study (NCT-01993498) from 03/2012 to 12/2014. The primary outcome was CRT defined as the presence at 3-6 months after the end of treatment, of any of the following toxicities (NCI-CTC-AE): infection, venous or arterial thrombosis, neurological G2-4, digestive G3-4 or pulmonary toxicities G3-4). Treatment deliver including chemotherapy dose reductions were also examined. The independent variab...
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
Publication date: Available online 25 July 2019Source: Journal of Clinical and Experimental HepatologyAuthor(s): Raseen Tariq, Page Axley, Ashwani SingalAbstractNon-Alcoholic Fatty Liver Disease (NAFLD) is now the leading cause of chronic liver disease worldwide with a strong association with metabolic syndrome. NAFLD is truly a systemic disease and is associated with a plethora of extra-hepatic manifestations or comorbidities. These are either related to secondary effects of associated obesity or from pathophysiological effects of insulin resistance in NAFLD. Three most common causes of increased morbidity and mortality a...
Source: Journal of Clinical and Experimental Hepatology - Category: Gastroenterology Source Type: research
Publication date: Available online 25 July 2019Source: Respiratory Medicine Case ReportsAuthor(s): Julie Bittar, Joshua GazzettaAbstractGardnerella vaginalis is an anaerobic, gram-variable bacterium primarily found in vaginal microflora of women. Previous reports of G. vaginalis cultured in men are few and have primarily been limited to the gastrointestinal and genitourinary tract.2−4 Few reports of G. vaginalis causing severe infections have been reported in the literature, including septicemia7 and two cases of perinephric abscess.8,9 There has been one previously reported case of G. vaginalis causing pulmonary com...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
Alcoholism is associated with variable effects on the coagulation system. Therefore, the aim of our study was to analyze the currently unknown association between chronic alcohol consumption and the risk of venous thromboembolism, which includes deep vein thrombosis (DVT) and pulmonary embolism (PE).
Source: Journal of Surgical Research - Category: Surgery Authors: Tags: Shock/Sepsis/Trauma/Critical Care Source Type: research
Usama Iqbal, Jeremy B Green, Srikant Patel, Yiru Tong, Marcus Zebrower, Alan D Kaye, Richard D Urman, Matthew R Eng, Elyse M Cornett, Henry LiuJournal of Anaesthesiology Clinical Pharmacology 2019 35(5):14-23 Enhanced recovery pathways are a novel approach focused on enhancing the care of surgical patients. “Prehabilitation” is the term applied to any intervention administered before surgery to reduce surgery-related morbidity, decrease the length of hospital stay, expedite the return of organ function, and facilitate the patient's return to normal life. A PubMed search was performed with the following key...
Source: Journal of Anaesthesiology Clinical Pharmacology - Category: Anesthesiology Authors: Source Type: research
Publication date: January 2019Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders, Volume 7, Issue 1Author(s): L.B. Harrington, K.A. Hagan, K.J. Mukamal, J.H. Kang, J. Kim, M. Crous-Bou
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
Conclusion: This data suggests that elevated serum Lipoprotein(a) in females younger than 50 years old is associated with DVT/PE events. Further investigation is required to confirm this finding. At this time it is not known if attempt to normalize Lipoprotein(a) will prevent recurrent PE/DVT and eliminate need for long life anticoagulation in patients with unprovoked VTE who have elevated lipoprotein(a).DisclosuresPakbaz: Novartis: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau.
Source: Blood - Category: Hematology Authors: Tags: 331. Pathophysiology of Thrombosis Source Type: research
We examined the relationship between newly diagnosed obstructive sleep apnea (OSA) and incident hospitalized atrial fibrillation (AF) over the subsequent ten years in a large arrhythmia-free cohort. METHODS: Adults referred between 1994 and 2010 to a large academic hospital with suspected OSA who were arrhythmia-free at the time of first diagnostic sleep study were included. Clinical data were linked to provincial health administrative data to define outcome. We used Cox regressions to investigate the relationship between OSA severity as measured by the apnea-hypopnea index (AHI) and degree of nocturnal hypoxemia, and...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
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