Intraoperative Diagnosis and Treatment of Thyroid Storm in a 15-Year-Old Male
Thyroid storm, a severe complication of hyperthyroidism, can be a devastating medical emergency requiring rapid management. Intraoperative thyrotoxicosis, a hypermetabolic syndrome with increased thyroid hormone levels, also presents a challenging scenario. Clinical suspicion is key along with eliminating other potentially catastrophic emergencies such as malignant hyperthermia or pheochromocytoma. In this case report, we describe a 15-year-old male undergoing halo traction placement for displaced dens and C1 fractures. Preoperative tachycardia and a history suggestive of hyperthyroidism raised our clinical suspicion for thyrotoxicosis when hypertension and tachycardia developed after induction of anesthesia.
Conclusions: There is a risk of leptospira infections having a late diagnosis given their unspecific clinical presentation, which generates a high number of differential diagnoses. The early management in the intensive care unit could decrease the incidence of complications and the mortality of patients with leptospirosis. PMID: 31529853 [PubMed - in process]
This study indicates that delay in the intestinal transit in late phase of surgically induced POI involves an ET-dependent mechanism. PMID: 31527357 [PubMed - in process]
ConclusionsThe use of dexmedetomidine is associated with differentially expressed microRNAs which may be involved in cardioprotection following administration of dexmedetomidine.
Publication date: Available online 18 September 2019Source: Advances in AnesthesiaAuthor(s): Justin E. Richards, Ron E. Samet, A. Kennedy Koerner, Thomas E. Grissom
Conclusions: Common bile duct clearance by Endoscopic Retrograde Cholangio-Pancreatography requires multiple procedures and complications are frequent leading to prolonged treatment and hospitalization suggesting a limited efficacy. PMID: 31526285 [PubMed - as supplied by publisher]
Publication date: Available online 18 September 2019Source: Journal of Clinical NeuroscienceAuthor(s): Yahia Zaid, Abbas Rajeh, Saeed Hosseini Teshnizi, Ali Alqarn, Firoozeh Tarkesh, Zahra Esmaeilinezhad, Reza NikandishAbstractBackground/objectiveStroke is the second leading cause of death globally that predisposed to sepsis. Therefore, this study was aimed to assess the risk factors and epidemiologic features of sepsis in ischemic stroke patients admitted to ICUs.MethodsThroughout this prospective study, we investigated all severe ischemic stroke patients admitted to ICUs of Namazi and Ali-Ashghar Hospitals in Shiraz. Aft...
Publication date: October 2019Source: The Annals of Thoracic Surgery, Volume 108, Issue 4Author(s): Hengrui Liang, Jun Liu, Shilong Wu, Yaoliang Zhang, Hui Liu, Hanyu Yang, Yi Zhao, Zhexue Hao, Wenhua Liang, Jianxing HeBackgroundNonintubated spontaneous ventilation video-assisted thoracoscopic surgery (NI-VATS) has been investigated to reduce the adverse effects of tracheal intubation, mechanical ventilation, and general anesthesia in several thoracic diseases. We comparatively assess the comparison between NI-VATS vs intubated anesthesia VATS (I-VATS) on early outcomes of mediastinal lesion resection.MethodsPatients who u...
CONCLUSION: VZV infection should be suspected in any patient with signs and symptoms of viral meningitis or encephalitis, irrespective of age, immune status, presence or absence of vesicles, fever, or neck stiffness. PMID: 31526545 [PubMed - as supplied by publisher]
AbstractSildenafil (REVATIO®) was approved for the treatment of adult Pulmonary Arterial Hypertension (PAH) in the US and the EU. A pediatric study has been performed and sildenafil was approved in the EU for pediatric PAH. The long-term extension of this study revealed good survival but also an increased mortality with the high dose of sildenafil compared to lower doses. As a consequence, FDA required Pfizer to evaluate REVATIO®’s effect on the risk of death in adults with PAH. Following FDA’s rationale a survival model was developed to characterize the exposure–mortality relationship and assess ...
Conclusion: The proposed newly devised hypothyroid scale correctly identified subjects with TSH elevation and clinical/subclinical hypothyroidism based on their clinical signs and symptoms. In this particular subset of patients, the hypothyroid symptom scale showed a statistically significant improvement in the sum of the signs and symptoms with the normalization of the subjects' thyroid function.