Id: 53: sever symptomatic babesiosis co-infection with lyme disease
Discussion Humans are opportunistic hosts to Babesia when bitten by nymph or adult ticks; the most known ticks are Ixodes. Babesiosis should be considered in patients who have a malaria-like illness in areas endemic for Babesia infection. The symptoms usually begin 2–4 weeks after a tick bite. The presentation includes constitutional symptoms, abdominal pain and dark urine. Labs finding include hemolytic anemia and elevated liver enzymes. Urinalysis reveals hemoglobinuria without red blood cells. The diagnosis of Babesiosis is usually established by microscopic examination of Giems or Wright-stained blood smears, indirect immunofluorescent antibody tests and PCR. In healthy individuals with intact spleens, the symptoms resolve spontaneously without treatment. For mild to moderate babesiosis, combination therapy with atovaquone and azithromycin for 7 days. However, in patients who are asplenic or immunocompromized, babesiosis is quite severe and is associated with higher mortality, the preferred treatment is intravenous clindamycin and oral quinine. In patients who are refractory to pharmacological treatment, red blood cells exchange transfusion has been shown to improve mortality. It is very important to consider other tick-borne agents that may be co-transmitted with Babesia such as B. burgdorferi; the agent of Lyme disease. Co-infection should be considered in patients with a poor response to conventional antimicrobial therapy or atypical clinical presentations. When ...
ConclusionsImprovement was seen in most patients. One year after the start of treatment, more than half of the patients were untreated and around one-third in remission. Residual symptoms and deficits were common regardless of treatment.
ConclusionsIn this updated systematic review and meta-analysis, uterine exteriorization was associated with an increased risk of IONV but no significant change in perioperative hemoglobin decrease compared within situ repair.Study registrationPROSPERO (CRD42020190074); registered 5 July 2020.
ConclusionsGiven the perceived benefits of regional over general anesthesia, approximately half of the members of three regional anesthesia societies seem to have expanded their use of regional anesthesia techniques during the initial surge of the COVID-19 pandemic.
ConclusionsIntra-abdominal hypertension is very common during cardiac surgery but its clinical implications are uncertain.
“For me, my own personal stories of opioid patients come to mind, including one who keyed my car when I stopped prescribing his opioid after an acute injury. I think of some local opioid overdose deaths in my community. I would love to hear what other doctors and clinicians have to say about these issues,Read more …Coal mining culture and the opioid crisis [PODCAST] originally appeared inKevinMD.com.
AbstractPurposeTraumatic thoracolumbar vertebral fractures are frequently treated with posterior fixation (PF) and vertebral augmentation. Sometimes, it is deemed too risky to offer vertebral augmentation under fluoroscopic guidance alone. Adjuvant CT/fluoroscopy-guided percutaneous vertebroplasty (PVP) could be offered in certain scenarios. The aim was to evaluate feasibility, safety and effectiveness of PVP in patients presenting with vertebral non-union (VNU) following PF performed without concomitant vertebral augmentation.Materials and MethodsAll patients treated in our institution with PVP between July 2015 and July ...
AbstractMigraineurs show impaired cognitive functions interictally, mainly involving information processing speed, basic attention, and executive functions. We aimed to assess executive impairment in migraine patients with different attack frequencies through a task-switching protocol designed to assess different sub-processes of executive functioning. We enrolled 42 migraine patients and divided them into three groups based on the attack frequency: 13 subjects had episodic migraine with a low frequency (LFEM, 4 –7 migraine days per month), 14 subjects had high-frequency episodic migraine (HFEM, 8–14 days)...
PARACETAMOL, also known as acetaminophen, is a commonly used medicine that can help treat pain and reduce a high temperature. Paracetamol is widely available as tablets and capsules.
A Horsham medical device company signed a deal to get its lasers distributed in Israel.
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