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Health Sci Rep 2018 Mar 20;1(3):e22. Epub 2017 Dec 20.

Internal Medicine and Endocrinology, Department of Internal Medicine, Division of Endocrinology Cukurova University Medical Faculty Adana Turkey.

Background: Adrenal incidentalomas are adrenal masses that are discovered by imaging tests performed for other reasons.

Aims: In this retrospective study, we analysed 229 Turkish patients with adrenal masses and who presented with or without complaints.

Study Design: Descriptive retrospective study and review of the literature. Read More

Cochrane Database Syst Rev 2018 Dec 31;12:CD004328. Epub 2018 Dec 31.

Royal National Throat, Nose and Ear Hospital, 330 Gray's Inn Road, London, UK, WC1X 8DA.

Background: Epistaxis (nosebleed) most commonly affects children and the elderly. The majority of episodes are managed at home with simple measures. In more severe cases medical intervention is required to either cauterise the bleeding vessel, or to pack the nose with various materials. Read More

Eur J Obstet Gynecol Reprod Biol 2018 Nov 30;233:38-42. Epub 2018 Nov 30.

Obstetrics and Gynecology Department, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon, France.

Objectives: Adrenal vein thrombosis during pregnancy is a rare thromboembolic event but is not exceptional. The objective of this study was to described the symptoms, diagnosis, treatment and follow-up of patients with this condition.

Study Design: This was a retrospective descriptive study of 14 cases (13 patients, one recurrence) that occurred in the three university maternity hospitals in Lyon (France) from 2008 to 2016. Read More

Exp Clin Endocrinol Diabetes 2018 Dec 18. Epub 2018 Dec 18.

Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany.

Addison's disease - the traditional term for primary adrenal insufficiency (PAI) - is defined as the clinical manifestation of chronic glucocorticoid- and/or mineralocorticoid deficiency due to failure of the adrenal cortex which may result in an adrenal crisis with potentially life-threatening consequences. Even though efficient and safe pharmaceutical preparations for the substitution of endogenous gluco- and mineralocorticoids are established in therapy, the mortality in patients with PAI is still increased and the health-related quality of life (HRQoL) is often reduced.PAI is a rare disease but recent data report an increasing prevalence. Read More

Gland Surg 2018 Oct;7(5):428-432

Endocrine Surgery Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.

Background: Acute adrenal haemorrhage is a rare medical emergency. The aim of the series was to study the clinical presentation and management of patients presenting with acute non-traumatic adrenal haemorrhage.

Methods: The records of patients presenting with an acute abdomen secondary to adrenal haemorrhage and treated in a tertiary endocrine surgical unit over a period of 6 years were reviewed. Read More

Can J Ophthalmol 2018 Dec 5;53(6):621-626. Epub 2018 Apr 5.

Department of Ophthalmology, McGill University, Montréal, Qué.

Objective: To characterize the ocular response to retrobulbar anaesthesia and to evaluate the efficacy of retrobulbar anaesthesia for adjustable strabismus surgery in adults.

Design: Prospective observational study.

Participants: Adult patients undergoing adjustable strabismus surgery under retrobulbar anaesthesia. Read More

Endocrinol Diabetes Metab Case Rep 2018 Nov 22;2018. Epub 2018 Nov 22.

Endocrinology, Diabetes and Metabolism Department, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal.

Addison's disease (AD) is the most common endocrine manifestation of antiphospholipid syndrome (APS), but it remains a very rare complication of the syndrome. It is caused by adrenal venous thrombosis and consequent hemorrhagic infarction or by spontaneous (without thrombosis) adrenal hemorrhage, usually occurring after surgery or anticoagulant therapy. We present a clinical case of a 36-year-old female patient with a previous diagnosis of APS. Read More

Medicine (Baltimore) 2018 Nov;97(47):e13329

Department of Radiology.

Rational: Spontaneous adrenal hematoma in pregnancy is a very rare condition. Herein we present an additional rare case of unilateral spontaneous adrenal hematoma in a pregnant woman, aiming to share this experience and summarize the signal characteristics of simple adrenal hematoma in magnetic resonance imaging (MRI).

Patient Concerns: A 28-year old pregnant woman was referred to our hospital with a vague paroxysmal left-side back pain at 17 weeks of gestation. Read More

BMC Surg 2018 Nov 20;18(1):103. Epub 2018 Nov 20.

Department of Clinical and Experimental Medicine, Unit of General Surgery 2, University of Sassari, Sassari, Italy.

Background: Adrenal cavernous hemangiomas are very rare benign tumors that usually present as incidental findings on abdominal imaging. Preoperative differential diagnosis from other benign or malignant adrenal neoplasms may be challenging.

Case Presentation: A 70-year old man was referred for an 8-cm abdominal mass incidentally discovered on a contrast-enhanced computed tomography (CT) performed to investigate a pulmonary nodule. Read More

Orthop Surg 2018 Nov 8;10(4):287-295. Epub 2018 Nov 8.

Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, China.

The present study assessed the effectiveness of the combined administration of tranexamic acid (TXA) plus low-dose epinephrine in primary total knee arthroplasty (TKA). We searched the following Chinese electronic databases: China National Knowledge Infrastructure and WanFang Data. We also searched the following English electronic databases: PubMed, Embase, Web of Science, and Central Register of Controlled Trials. Read More

Pan Afr Med J 2018 13;30:121. Epub 2018 Jun 13.

Katutura State Hospital, UNAM School of Medicine, Windhoek, Namibia.

Tuberculosis is still one of the most common respiratory diseases in Africa and worldwide and miliary tuberculosis is a regular manifestation of it. Idiopathic pulmonary hemosiderosis is a rare disease entity, presenting in children as well as adults. It is characterized by the triad of recurrent episodes of alveolar hemorrhage, presenting as hemoptysis, iron deficiency anemia and bilateral pulmonary infiltrates seen on chest X-ray. Read More

Endokrynol Pol 2018 Oct 23. Epub 2018 Oct 23.

Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center, Belgrade, Serbia; Medical Faculty, University of Belgrade, Belgrade, Serbia.

Pheochromocytomas and sympathetic paragangliomas are rare catecholamine-secreting tumors and represent very rare causes of intracerebral hemorrhage in young, with only few cases reported. A 32-year-old man presented to our emergency department because of sudden onset of severe headache. He had a six months history of paroxysmal headache, palpitations and sweating. Read More

Clin Endocrinol (Oxf) 2019 Jan 15;90(1):74-78. Epub 2018 Nov 15.

Departments of Transplant and Endocrine Surgery, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.

Objective: Adrenal surgery remains a distinct surgical challenge. Technical challenges associated with laparoscopic adrenalectomy are tumour size, haemorrhage control and oncological compromise. Hand-assisted laparoscopic (HAL) adrenalectomy, utilizing a hand-port device, offers minimally invasive surgery with the advantages and safety of tactile feedback. Read More

Wilderness Environ Med 2018 Dec 8;29(4):504-507. Epub 2018 Oct 8.

Department of Internal Medicine, Trichy SRM Medical College Hospital and Research Center, Irungalur, Trichy, India (Prof Thirumalaikolundusubramanian).

Snakebite envenomation is an important public health problem in tropical countries. We report a case of bilateral adrenal hemorrhage in a 28-y-old man with Russell's viper bite that occurred in the Sathyamangalam forest range in the Indian state of Tamil Nadu. In this case, a combination of early bite recognition, hospital-based supportive care, corticosteroid therapy, and timely administration of polyvalent antivenom resulted in a favorable clinical outcome. Read More

Endocrinol Diabetes Metab Case Rep 2018 Sep 25;2018. Epub 2018 Sep 25.

Endocrinology, Niguarda Hospital, Milan, Italy

A 69-year-old male was admitted for severe hyponatremia disclosed after an accidental fall. He was anticoagulated from 2 months after the implantation of a biologic aortic valve prosthesis. The work-up disclosed adrenal failure and MRI showed bilateral adrenal hemorrhage. Read More

Quant Imaging Med Surg 2018 Sep;8(8):853-875

Department of Radiology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China.

Besides ultrasound and nuclear medicine techniques, computed tomography (CT) and magnetic resonance imaging (MRI) are commonly used to examine adrenal lesions in both symptomatic and asymptomatic patients. Some adrenal lesions have characteristic radiological features. If an adrenal nodule is discovered incidentally, determining whether the lesion is benign or malignant is of great importance. Read More

J Laryngol Otol 2018 Oct 9;132(10):911-922. Epub 2018 Oct 9.

Department of Otorhinolaryngology - Head and Neck Surgery,Turku University Hospital,Finland.

Objectives: In order to evaluate the safety of tonsillectomy among children, we retrospectively studied the incidence of post-operative complications, adverse events and their association with peri-operative medication.

Methods: Data were collected from the medical records of 691 patients aged 1-16 years, including details of post-operative complications (any unplanned contact with the hospital), analgesics, dexamethasone, 5-HT3 antagonists, local anaesthetic and haemostatic agents.

Results: Recovery was complicated in 13. Read More

J Med Case Rep 2018 Oct 8;12(1):295. Epub 2018 Oct 8.

Department of General Internal Medicine, Musashino Red Cross Hospital, Tokyo, Japan.

Background: TAFRO syndrome, which was first reported in 2010 in Japan, is a relatively rare disease characterized by thrombocytopenia, anasarca, fever, renal impairment, reticulin fibrosis, and organomegaly. Although this disease is considered similar to multicentric Castleman disease, some of the clinical features, such as thrombocytopenia, are different from typical cases of multicentric Castleman disease. In addition, the etiology of TAFRO syndrome remains unknown and controversial. Read More

Acta Chir Belg 2018 Oct 1:1-5. Epub 2018 Oct 1.

a Departments of Critical Care Medicine, Hepatobiliary, Transplantation and Endocrine Surgery , Antwerp University Hospital University of Antwerp , Edegem , Belgium.

Most adrenal injuries are asymptomatic. In traumatic events, adrenal haemorrhage is very likely to be accompanied by injuries to other organs. Isolated adrenal injury after trauma is very rare and mostly unilateral. Read More

J Obstet Gynaecol Can 2018 Sep;40(9):1219-1239

Vancouver, BC.

Objective: To assess the benefits and risks of antenatal corticosteroid therapy for women at risk of preterm birth or undergoing pre-labour Caesarean section at term and to make recommendations for improving neonatal and long-term outcomes.

Options: To administer or withhold antenatal corticosteroid therapy for women at high risk of preterm birth or women undergoing pre-labour Caesarean section at term.

Outcomes: Perinatal morbidity, including respiratory distress syndrome, intraventricular hemorrhage, bronchopulmonary dysplasia, infection, hypoglycemia, somatic and brain growth, and neurodevelopment; perinatal mortality; and maternal morbidity, including infection and adrenal suppression. Read More

Wiad Lek 2018;71(6):1284-1287

Department Of Internal Medicine And Infectious Diseases, Higher State Educational Establishment "Bukovinian State Medical University", Chernivtsi, Ukraine.

Meningococcal infection remains a leading cause of morbidity and mortality. Based on the sequence of pathophysiological mechanisms and the agent and host factors, a wide spectrum of presentations may be seen. Here we report a non-fatal case of fulminant form of meningococcemia beginning as food poisoning complicated with shock I degree due to partially adrenal hemorrhage in Caucasian adult male. Read More

Acta Clin Croat 2018 Mar;57(1):161-165

Department of Pediatrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.

Adrenal hemorrhage is a rare clinical entity in the neonatal period, with an incidence of 1.7-2.1/1000 births. Read More

Vet Surg 2018 Nov 23;47(8):1031-1038. Epub 2018 Sep 23.

Department of Surgical and Radiological Sciences, University of California-Davis, Davis, California.

Objective: To compare anatomic sources and underlying etiology of hemorrhage in small vs large dogs with spontaneous hemoperitoneum (SH).

Study Design: Retrospective cross-sectional study.

Animals: Client-owned dogs with SH at 2 academic institutions. Read More

J Orthop Surg Res 2018 Sep 21;13(1):242. Epub 2018 Sep 21.

Department of Orthopaedics, The 82rn Hospital of People's Liberation Army of China, No. 100, Jiankangdong Road, Huai'an, Jiangsu, China.

Background: The standard protocol to achieve haemostasis during total hip arthroplasty (THA) is uncertain. Tranexamic acid plus diluted epinephrine (DEP) and tranexamic acid (TXA) alone are the two most common alternatives. The purpose of this study was to compare the efficacy and safety of TXA plus DEP to treat blood loss in THA patients. Read More

J Stroke Cerebrovasc Dis 2018 Nov 12;27(11):3163-3171. Epub 2018 Sep 12.

Department of Neurology, CHU de Bordeaux, Bordeaux, France / Except Yahsou Delmas: Department of Nephrology, CHU de Bordeaux, Bordeaux, France.

Introduction: Immune thrombotic thrombocytopenic purpura (i-TTP), related to acquired ADAMTS-13 dysfunction, can lead to various neurological symptoms including ischemic stroke. To date the clinical, radiological, and biological characteristics of patients having a stroke as the inaugural manifestation of i-TTP are largely unknown.

Methods: Probable immune-TTP was defined by a low ADAMTS-13 activity associated with the presence of ADAMTS-13 inhibitors and/or favorable clinicobiological response under immunological treatments. Read More

Int J Endocrinol Metab 2018 Jul 25;16(3):e65233. Epub 2018 Jun 25.

The Diabetes and Endocrine Unit, Department of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia.

Introduction: Ketoconazole has long been the first-line medical therapy for controlling hypercortisolism secondary to either pituitary or adrenal pathology. However, it is largely unavailable in most countries. As a result, we have turned to fluconazole as a viable alternative in view of its favourable safety profile. Read More

Quintessence Int 2018 ;49(9):719-732

The purpose of this topic review is to give a general overview of gingival retraction agents used during prosthodontic treatment, and the possible difficulties connected to them that may be faced by the dentist. Hemostatic agents are important for successful gingival retraction and in achieving hemostasis. However, these agents may show numerous negative effects on the prosthodontic treatment and oral tissues of which the practicing dentist must be aware, and which will be elucidated in this review. Read More

Clin Orthop Surg 2018 Sep 22;10(3):380-384. Epub 2018 Aug 22.

Department of Orthopedics, Seoul Sacred Heart General Hospital, Seoul, Korea.

Background: The incidence of cardiovascular and neurovascular diseases has been increasing with the aging of the population, and antiplatelet drugs (APDs) are more frequently used than in the past. With the average age of spinal surgery patients also increasing, there has been a great concern on the adverse effects of APD on spine surgery. To our knowledge, though there have been many studies on this issue, their results are conflicting. Read More

Am J Case Rep 2018 Aug 28;19:1025-1029. Epub 2018 Aug 28.

Department of Pulmonary and Critical Care Medicine, China Medical University Hospital, Taichung, Taiwan.

BACKGROUND Aortoesophageal fistula is a rare etiology of serious gastrointestinal bleeding. Most aortoesophageal fistulas resulted from thoracic aortic aneurysms, foreign bodies, or esophageal malignancy. To our knowledge, spontaneous aortoesophageal fistula due to dermatomyositis and high dose steroid therapy has not been reported. Read More

Int J Surg Case Rep 2018 17;51:90-94. Epub 2018 Aug 17.

4th Surgical Department, Evaggelismos General Hospital, Athens, Greece.

Introduction: Spontaneous bilateral adrenal hemorrhage or hemorrhagic necrosis due to adrenal vein thrombosis is an uncommon condition that may lead to acute adrenal insufficiency and death. The objective of this report is to enhance recognition of this potentially fatal disorder in surgical patients.

Presentation Of Cases: We present two cases of acute adrenal insufficiency due to bilateral adrenal hemorrhage associated with primary antiphospholipid antibody syndrome (APS). Read More

Cureus 2018 Jun 18;10(6):e2830. Epub 2018 Jun 18.

Internal Medicine, Shifa College of Medicine, Islamabad, PAK.

Bilateral adrenal hemorrhage (BAH) is a rare but potentially fatal entity that carries a mortality rate of 15%. Most cases are associated with sepsis, antiphospholipid syndrome, the use of anticoagulants, as well as trauma and surgery. In this case report, we present a case of BAH in a previously healthy man with a recent history of corticosteroid use. Read More

Urol Case Rep 2018 Nov 3;21:5-7. Epub 2018 Aug 3.

Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Nehru Nagar, Belagavi, 590010, India.

QJM 2018 Nov;111(11):799-806

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantari Nagar, Puducherry, India.

Background: Viper envenomation contributes to nearly 50% of snake-bite deaths in India, chiefly due to circulatory shock. The mechanisms leading to circulatory shock include bleeding, capillary leak syndrome (CLS) and myocardial depression. Pituitary-adrenal axis involvement in circulatory shock, though described, has not been fully elucidated. Read More

Saudi Med J 2018 Aug;39(8):829-833

Department of Internal Medicine, King Fahad Military Medical Complex, Dhahran, Kingdom of Saudi Arabia. E-mail.

A 43-year-old man with Hashimoto's thyroiditis and previous thromboembolic events treated with warfarin for 6 months, presented with right flank pain accompanied with vomiting, dizziness, and altered mental status 2 weeks after discontinuation of warfarin. His clinical examination findings were unremarkable. Routine blood work showed lymphopenia, thrombocytopenia, and hypoosmolar hyponatremia. Read More

J Pain Res 2018 31;11:1421-1424. Epub 2018 Jul 31.

Department of Urology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China,

Background: Acute abdominal pain is a common complaint of patients presenting at the emergency department (ED). It can be caused by a broad spectrum of diseases. Providing care for patients with acute abdominal pain requires familiarity with the epidemiology, prevalence, and presentation of abdominal pathology, as well as a working knowledge of the differential diagnoses. Read More

Acad Radiol 2018 Jul 31. Epub 2018 Jul 31.

Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030-4008.

Rationale And Objective: To evaluate computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) imaging manifestations of lymphomas secondarily involving the adrenal gland.

Materials And Methods: Seven patients (Five men, two women; median age [range], 66 years [34-75 years]) with pathologically proven adrenal lymphoma were assessed retrospectively. Clinical findings, prior history of lymphoproliferative malignancy, CT (n = 7) and fludeoxyglucose positron emission tomography-computed tomography (F-FDG-PET-CT) (n = 6) features were analyzed. Read More

Radiol Case Rep 2018 Jun 23;13(3):596-598. Epub 2018 Mar 23.

Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health Systems, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.

Hematochezia may be a result of anatomic, vascular, inflammatory, infectious, or neoplastic diseases. Colonoscopic evaluation and therapy may be limited because of intermittent bleeding in the setting of numerous diverticula. This report describes a patient with diverticulosis who presented with hematochezia and hemodynamic instability with failed colonoscopic and arteriographic evaluations, and was treated with percutaneous transcolonic diverticular cyanoacrylate and epinephrine injection. Read More

Dtsch Med Wochenschr 2018 08 30;143(15):1076-1081. Epub 2018 Jul 30.

Charité-Universitätsmedizin Berlin.

Immune thrombocytopenia (ITP) is a heterogeneous disease. Diagnosis of primary ITP continues to be based on the exclusion of all known causes for secondary ITP. The new ITP classification distinguishes three categories. Read More

Dig Dis Sci 2018 11 27;63(11):3026-3032. Epub 2018 Jul 27.

Department of Internal Medicine, Digestive Disease Center and Research Institute, Soon Chun Hyang University College of Medicine, Bucheon, South Korea.

Background: Endoscopically applicable hemostatic agents have been demonstrated to have high initial hemostasis rates in cases of upper gastrointestinal bleeding (UGIB).

Aims: The authors developed a new hemostatic powder (CEGP-003) and evaluated its hemostatic and ulcer healing effects in UGIB.

Methods: Patients with peptic ulcer or post-endoscopic resection bleeding were randomly assigned to be treated by epinephrine injection or CEGP-003 spray. Read More

J Endod 2018 Aug;44(8):1205-1209

Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.

Introduction: Several variables have been associated with a better prognosis of periapical surgery. The aim of this study was to evaluate the influence of 2 hemostatic agents on the prognosis of periapical surgery at 12 months.

Methods: A prospective study was designed with 2 randomized parallel groups established depending on the hemostatic agent used: epinephrine or aluminum chloride. Read More

Paediatr Child Health 2018 Aug 3;23(5):303-305. Epub 2018 Feb 3.

Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario.

Front Pediatr 2018 10;6:192. Epub 2018 Jul 10.

Division of Neonatology and Pediatric Critical Care, Department of Pediatrics and Adolescent Medicine, Ulm University, Ulm, Germany.

Evidence for recommendations on the use of volume expansion during cardiopulmonary resuscitation in newborn infants is limited. To develop a newborn piglet model with asphyxia, hemorrhage, and cardiac arrest to test different volume resuscitation on return of spontaneous circulation (ROSC). We hypothesized that immediate red cell transfusion reduces time to ROSC as compared to the use of an isotonic crystalloid fluid. Read More

Ned Tijdschr Geneeskd 2018 May 25;162. Epub 2018 May 25.

Bernhoven, afd. Intensive Care, Uden.

Background: The Waterhouse-Friderichsen syndrome (WFS) is a serious illness associated with a high mortality rate and characterized by septic shock and signs of adrenocortical insufficiency.

Case Description: A 33-year-old male was seen in the emergency department with severe abdominal and back pain with diffuse mottled skin and rapidly progressive petechiae all over his body. Laboratory results showed severe lactate acidosis with renal dysfunction and indications of diffuse intravascular coagulation. Read More

Prenat Diagn 2018 Oct 5;38(11):829-834. Epub 2018 Aug 5.

Department of Ultrasound, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.

Objectives: The objective of the study is to evaluate the diagnostic value of ultrasonography in cystic lesions of the adrenal gland.

Methods: Twenty-two cases of adrenal cystic lesions found in the foetal period were retrospectively analysed. All foetuses were followed up by ultrasound after birth, and all lesions were confirmed by operation or ultrasound-guided biopsy. Read More

Urol Clin North Am 2018 Aug;45(3):365-387

Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street Unit 1473, Houston, TX 77030, USA.

Various pathologies can affect the adrenal gland. Noninvasive cross-sectional imaging is used for evaluating adrenal masses. Accurate diagnosis of adrenal lesions is critical, especially in cancer patients; the presence of adrenal metastasis changes prognosis and treatment. Read More

Am J Case Rep 2018 Jul 20;19:849-853. Epub 2018 Jul 20.

Department of General Surgery and Liver Transplantation, Azienda Ospedaliero Universitaria Policlinico, Bari, Italy.

BACKGROUND Gastrointestinal stomal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, and the stomach is the most commonly involved organ. Complete surgical resection with negative margins is the primary and only potentially curative treatment. Surgeon experience with minimally invasive gastric resections in addition to the tumor size and site has to be considered in the choice of laparoscopic or open surgical approach in order to remove the lesion. Read More

A A Pract 2019 Jan;12(2):37-40

From the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California.

During a cesarean hysterectomy for placenta percreta, transesophageal echocardiography was used to monitor volume status and guide resuscitation. After delivery of the neonate but before massive surgical hemorrhage, a thrombus appeared in the inferior vena cava. Roughly 3 hours later, the patient had hemodynamic changes consistent with an intraoperative pulmonary embolism. Read More

J Neurosci Nurs 2018 Aug;50(4):225-230

Elizabeth Crago, PhD RN, School of Nursing, University of Pittsburgh, Pittsburgh, PA. Yuefang Chang, PhD, Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA. Theodore F. Lagattuta, RN, School of Nursing, University of Pittsburgh, Pittsburgh, PA. Khadejah Mahmoud, BSN RN, School of Nursing, University of Pittsburgh, Pittsburgh, PA. Lori Shutter, MD, University of Pittsburgh School of Medicine, and Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA. Jeffrey R. Balzer, PhD, School of Nursing, University of Pittsburgh, and Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA. Michael R. Pinsky, MD CM DrHC, University of Pittsburgh School of Medicine, and Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA. Robert M. Friedlander, MD, Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA. Marilyn Hravnak, PhD RN ACNP-BC FCCM FAAN, School of Nursing, University of Pittsburgh, Pittsburgh, PA.

Introduction: Vasopressors are commonly used after aneurysmal subarachnoid hemorrhage (aSAH) to sustain cerebral pressure gradients. Yet, the relationship between vasopressors and the degree of cerebral microcirculatory support achieved remains unclear. This study aimed to explore the changes in cerebral and peripheral regional tissue oxygen saturation (rSO2) as well as blood pressure (BP) before and after vasopressor infusion in patients with aSAH. Read More

Curr Med Res Opin 2018 Dec 7;34(12):2165-2168. Epub 2018 Aug 7.

h Yajuan Cui, Department of Hematology , The Second Xiangya Hospital, Central South University , Hunan , PR China.

Background: Adrenal hemorrhage caused by antiphospholipid syndrome (APS) secondary to systemic lupus erythematosus (SLE) is very rare, especially in males.

Report: This study reports a 45-year-old male patient who presented with fatigue, loss of appetite, nausea, and vomiting for 2 months with a history of recurring epilepsy. On examination, he had low blood pressure (95/53 mmHg) and hyponatremia (117. Read More