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    Cerebral salt wasting syndrome in patients with minor head trauma - two case reports.
    Rom J Anaesth Intensive Care 2016 Oct;23(2):155-158
    Department of Anaesthesia and Intensive Care, Emergency County Hospital, Cluj-Napoca, Romania.
    We describe two polytrauma patients without severe head trauma who developed Cerebral Salt Wasting Syndrome (CSWS) during their stay in our ICU with natriuresis, hyponatremia and hypovolemia. Hyponatremia encountered in CSWS and the syndrome of inadequate antidiuretic hormone secretion (SIADH) is a common electrolyte finding in patients with severe head trauma, subarachnoid hemorrhage, malignancy and infections of the central nervous system. CSWS was an unexpected electrolyte finding in our patients with minor head trauma without neurological or neurosurgical problems. Read More

    Neonatal adrenal hemorrhage presenting as "Acute Scrotum"-looking beyond the obvious: a sonographic insight.
    J Ultrasound 2017 Sep 28;20(3):253-259. Epub 2017 Apr 28.
    Department of Radio-diagnosis, University College of Medical Sciences (University of Delhi) and GTB Hospital, Dilshad Garden, Delhi, 110095 India.
    Acute swelling and discoloration of scrotum in new born can have many localized causes like testicular torsion, inguinal hernia, scrotal or testicular edema, hydrocele, or even remote causes like adrenal hemorrhage. We report a neonate of adrenal hemorrhage presenting clinically as acute scrotum misguiding the clinician to rule out a local scrotal pathology. As the local clinical examination is not reliable in a newborn, it definitely requires an imaging evaluation to establish the diagnosis. Read More

    Spontaneous Adrenal Hematoma in a Pregnant Woman; a Case Report.
    Emerg (Tehran) 2017 24;5(1):e59. Epub 2017 Feb 24.
    Department of Anesthesiology, Imam Hosein Hospital, ShahidBeheshti University of Medical Sciences, Tehran, Iran.
    Spontaneous adrenal hematoma is a very rare condition and its prevalence has been reported to be about 1% in previous studies. Although various causes have been proposed to explain its incidence in existing case reports, the etiology and pathology of this condition is still not known. The present study presents a case of spontaneous adrenal hematoma in a pregnant 31 year old womanwithout history of trauma or other probable risk factors of hemorrhage, presenting to the emergency department with chief complaint of pain in the right flank. Read More

    Assessment of Neonatal Adrenal size using high resolution 2D ultrasound and its correlation with birth demographics & clinical outcomes.
    J Matern Fetal Neonatal Med 2017 Sep 10:1-15. Epub 2017 Sep 10.
    d Department of Pediatrics , Department of Neonatology , Case Western Reserve University , MetroHealth Medical Center , Cleveland , Ohio , USA.
    Objective: Assessment of adrenal function in a sick neonate remains a challenge in spite of major advances in neonatal care. We used 2D ultrasound of adrenal glands to assess maturity of adrenal glands in extremely preterm infants and sick term and near term infants.

    Study Design: We collected demographics details of 99 mother-infants pairs (24-41 weeks) and obtained 2D ultrasound scans of adrenal glands in first week of life to measure adrenal volume, fetal zone size and adrenal to kidney ratios. Read More

    Management of primary aldosteronism in patients with adrenal hemorrhage following adrenal vein sampling: A brief review with illustrative cases.
    J Clin Hypertens (Greenwich) 2017 Sep 9. Epub 2017 Sep 9.
    Section on Endocrinology & Genetics (SEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA.
    The authors describe the clinical investigation of two cases of primary aldosteronism with adrenal hemorrhage (AH) following adrenal vein sampling. A literature review was conducted regarding the medical management of primary aldosteronism in patients with AH following adrenal vein sampling. Guidelines on the management of primary aldosteronism with AH following adrenal vein sampling are lacking. Read More

    Organ- and cell-specific immune responses are associated with the outcomes of intracerebral hemorrhage.
    FASEB J 2017 Sep 6. Epub 2017 Sep 6.
    Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China;
    Severe brain injury significantly influences immune responses; however, the levels at which this influence occurs and which neurogenic pathways are involved are not well defined. Here, we used MRI to measure spleen volume and tissue diffusion changes in patients with intracerebral hemorrhage (ICH). We observed increased capillary exchange and spleen shrinkage by d 3 post-ICH, with recovery by d 14. Read More

    The radiographically diagnosed adrenal myelolipoma: what do we really know?
    Endocrine 2017 Sep 2. Epub 2017 Sep 2.
    Departments of Surgery and Radiology, University of California, Davis Medical Center, Sacramento, CA, USA.
    Purpose: Adrenal myelolipomas are uncommon, benign tumors of the adrenal glands that are not routinely evaluated for autonomous hormone secretion or followed by repeat imaging, but may lead to retroperitoneal hemorrhage. Little is known about the natural history these tumors with the majority of previous publications being confined to case reports and small case series.

    Methods: We reviewed the computed tomography (CT) reports of 62,279 patients evaluated at a tertiary referral center between 2002 and 2015 for the presence of an adrenal myelolipoma >1 cm in size. Read More

    Inducing heat shock protein 70 expression provides a robust antithrombotic effect with minimal bleeding risk.
    Thromb Haemost 2017 Aug 27;117(9):1722-1729. Epub 2017 Jul 27.
    José Hermida, MD,PhD, University of Navarra, Center for Applied Medical Research (CIMA), Laboratory of Thrombosis and Haemostasis, Pío XII 55, Pamplona 31008, Spain, Tel.: +34948194700×3027, Fax: +34948194716, E-mail:
    Antithrombotic medications target coagulation factors. Their use is associated with an increased bleeding risk. Safer drugs are needed. Read More

    Acute hypopituitarism associated with periorbital swelling and cardiac dysfunction in a patient with pituitary tumor apoplexy: a case report.
    J Med Case Rep 2017 Aug 24;11(1):235. Epub 2017 Aug 24.
    Department of Respiratory Medicine, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan.
    Background: Pituitary tumor apoplexy is a rare clinical syndrome caused by acute hemorrhage or infarction in a preexisting pituitary adenoma. It typically manifests as an acute episode of headache, visual disturbance, mental status changes, cranial nerve palsy, and endocrine pituitary dysfunction. However, not all patients present with classical symptoms, so it is pertinent to appreciate the clinical spectrum of pituitary tumor apoplexy presentation. Read More

    Nontraumatic adrenal hemorrhage: the adrenal stress.
    Radiol Case Rep 2017 Sep 15;12(3):483-487. Epub 2017 Apr 15.
    Radiology Department, San Carlo Hospital, Potito Petrone St, 85100 Potenza, Italy.
    Bilateral adrenal hemorrhage is a rare condition, which is burdened by potentially life-threatening consequences related to the development of acute adrenal insufficiency. Despite treatment with stress-dose glucocorticoids, a mortality rate of 15% has been reported, which varies according to the severity of underlying predisposing illness and could be much more higher if the adrenal insufficiency is not promptly recognized. An early diagnosis is crucial, though, because of nonspecific clinical and laboratory findings, adrenal hemorrhage is rarely suspected. Read More

    [Fortuitous discovery of an adrenal mass following spontaneous retroperitoneal hemorrhage].
    Rev Med Liege 2017 Jul;72(7-8):358-362
    Service de Chirurgie Digestive, CH Bois de l'Abbaye, Seraing, Belgique.
    We report a case of spontaneous retroperitoneal haemorrhage by bleeding of an adrenal adenoma. Retroperitoneal haemorrhages are rarely encountered in practice, but must be rapidly diagnosed due to the life threatening risk. The etiologies, clinical assessment, management and differential diagnosis of spontaneous retroperitoneal haemorrhages are discussed. Read More

    Brain-Heart Interaction: Cardiac Complications After Stroke.
    Circ Res 2017 Aug;121(4):451-468
    From the Gerontology and Neurological Institute, Tianjin Medical University General Hospital, China (Z.C., T.Y., J.C.); Department of Neurology, Henry Ford Hospital, Detroit, MI (P.V., D.S., M.C., J.C.); and Department of Physics, Oakland University, Rochester, MI (M.C.).
    Neurocardiology is an emerging specialty that addresses the interaction between the brain and the heart, that is, the effects of cardiac injury on the brain and the effects of brain injury on the heart. This review article focuses on cardiac dysfunction in the setting of stroke such as ischemic stroke, brain hemorrhage, and subarachnoid hemorrhage. The majority of post-stroke deaths are attributed to neurological damage, and cardiovascular complications are the second leading cause of post-stroke mortality. Read More

    Non-Surgical Management of Bilateral Adrenal Abscess in Neonates: Report of Two Cases.
    J Neonatal Surg 2017 Apr-Jun;6(2):31. Epub 2017 Apr 15.
    Department of Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, India.
    Adrenal hemorrhage is not uncommon in neonates but the development of an adrenal abscess is extremely rare. Bilateral adrenal abscess is even rarer with less than ten cases documented in the medical literature. It may have a fatal outcome if inadequately treated. Read More

    Upper Gastrointestinal Bleed as a Manifestation of Poorly Differentiated Metastatic Squamous Cell Carcinoma of the Lung.
    J Clin Diagn Res 2017 Jun 1;11(6):OD13-OD14. Epub 2017 Jun 1.
    Attending Physician, Department of Gastroenterology and Hepatology, University of Connecticut, Farmington, Connecticut, USA.
    Gastrointestinal (GI) metastasis from primary lung cancer is a rare clinical finding. Lung cancer most often metastasizes to the brain, bone, liver, and adrenal glands; with gastrointestinal involvement being very rare. We report a case of a 39-year-old female with a diagnosis of poorly differentiated Squamous Cell Carcinoma (SCC) of the lung presenting with dizziness and melena. Read More

    Adrenal Imaging.
    Endocrinol Metab Clin North Am 2017 Sep 12;46(3):741-759. Epub 2017 Jun 12.
    Department of Radiology, University of Michigan Health System, 1500 East Medical Center Drive, B1G503, Ann Arbor, MI 48109-5030, USA. Electronic address:
    Cross-sectional imaging can make a specific diagnosis in lesions, such as myelolipomas, cysts, and hemorrhage, and is often sufficient to distinguish benign from malignant adrenal processes. CT and MRI are useful studies to identify pheochromocytomas and cortisol-secreting or androgen-secreting tumors. In patients with primary aldosteronism, adrenal venous sampling remains the most accurate localizing study and should be performed in all patients older than 35. Read More

    In Individuals Following Aneurysmal Subarachnoid Haemorrhage, Hair Cortisol Concentrations Are Higher and More Strongly Associated with Psychological Functioning and Sleep Complaints than in Healthy Controls.
    Neuropsychobiology 2017 Jul 28;75(1):12-20. Epub 2017 Jul 28.
    Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
    Background: Following an aneurysmal subarachnoid haemorrhage (aSAH), many patients report persistent deficits in psychological functioning, characterised by high levels of stress and symptoms of depression, low life satisfaction, along with poor sleep. Such deficits have been associated with altered saliva and serum cortisol levels due to a dysregulation of hypothalamic-pituitary-adrenal axis activity (HPA-AA). However, hair cortisol concentrations (HCCs) have not been assessed in this population, although this method allows a long-term insight into cortisol values. Read More

    Marked bleeding diathesis in patients with platelet dysfunction due to a novel mutation in RASGRP2, encoding CalDAG-GEFI (p.Gly305Asp).
    Platelets 2017 Jul 20:1-3. Epub 2017 Jul 20.
    b McAllister Heart Institute , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA.
    Congenital platelet function disorders are often the result of defects in critical signal transduction pathways required for platelet adhesion and clot formation. Mutations affecting RASGRP2, the gene encoding the Rap GTPase activator, CalDAG-GEFI, give rise to a novel, and rare, group of platelet signal transduction abnormalities. We here report platelet function studies for two brothers (P1 and P2) expressing a novel variant of RASGRP2, CalDAG-GEFI(p. Read More

    Duodenal hematoma caused by endoscopic hemostatic procedures (sclerotherapy).
    Rev Esp Enferm Dig 2017 Sep;109(9):666
    Servicio de Aparato Digestivo A, Complejo Hospitalario de Navarra, España.
    Endoscopic hemostatic procedures such as local injection of epinephrine are commonly used for the treatment of bleeding ulcers. Although the risks are usually considered to be minimal, there are reports describing that duodenal intramural hematomas may develop as a complication after endoscopy especially in patients susceptible to hemorrhage such as those with anticoagulants therapy or blood dyscrasia. Read More

    Metachronous bilateral adrenal hemorrhage in primary antiphospholipid syndrome.
    Med Clin (Barc) 2017 Oct 26;149(7):318. Epub 2017 Jun 26.
    Servicio de Endocrinología y Nutrición, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas (CIBERDEM), Barcelona, España; Universidad de Barcelona, Barcelona, España.

    BIlateral juxtapapillary retinal capillary haemangioma: Usefulness of aflibercept in the management of its complications.
    Arch Soc Esp Oftalmol 2017 Jun 23. Epub 2017 Jun 23.
    Servicio de Oftalmología, Hospital Virgen del Puerto, Plasencia (Cáceres), España.
    Case Report: A 45 year-old man with a history of adrenal phaeochromocytoma presented with a subretinal juxtapapillary haemorrhage on his left eye and a small asymptomatic vascular tumour in the contralateral eye. With the mentioned findings, the patient was diagnosed with bilateral retinal capillary haemangioma in the context of a von Hippel Lindau disease. Intravitreal aflibercept was prescribed, with a good outcome of the disease. Read More

    Data-mining for detecting signals of adverse drug reactions of fluoxetine using the Korea Adverse Event Reporting System (KAERS) database.
    Psychiatry Res 2017 Oct 13;256:237-242. Epub 2017 Jun 13.
    Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea. Electronic address:
    Selective serotonin reuptake inhibitors (SSRIs) have become one of the most broadly used medications in psychiatry. Fluoxetine is the first representative antidepressant SSRI drug approved by the Food and Drug Administration (FDA) in 1987. Safety information on fluoxetine use alone was less reported than its combined use with other drugs. Read More

    Differences between Takotsubo cardiomyopathy and reverse Takotsubo cardiomyopathy associated with subarachnoid hemorrhage.
    Int J Cardiol Heart Vasc 2016 Jun 11;11:99-103. Epub 2016 May 11.
    Department of Neurosurgery, Fujita Health University Hospital, Toyoake, Japan.
    Background: Both Takotsubo cardiomyopathy (TTC) and reverse TTC (r-TTC) are characterized by reversible regional wall motion abnormalities of the heart unrelated to coronary artery pathology. It remains unclear whether and/or how r-TTC differs from TTC. Subarachnoid hemorrhage (SAH) is occasionally causative of TTC/r-TTC, and this study was conducted to detect possible differences between TTC and r-TTC associated with SAH. Read More

    A case of acute Sheehan's syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage.
    BMC Pregnancy Childbirth 2017 Jun 14;17(1):188. Epub 2017 Jun 14.
    Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
    Background: Sheehan's syndrome occurs because of severe postpartum hemorrhage causing ischemic pituitary necrosis. Sheehan's syndrome is a well-known condition that is generally diagnosed several years postpartum. However, acute Sheehan's syndrome is rare, and clinicians have little exposure to it. Read More

    Tranexamic acid plus diluted-epinephrine versus tranexamic acid alone for blood loss in total joint arthroplasty: A meta-analysis.
    Medicine (Baltimore) 2017 Jun;96(24):e7095
    aDepartment of Traumatology, Linyi People's Hospital bDepartment of Surgery; Feixian people's Hospital, Linyi, Shandong, China.
    Background: We conducted the present meta-analysis to assess the efficacy and safety of tranexamic acid (TXA) plus diluted-epinephrine (DEP) for patients with total joint arthroplasty (TJA, including total knee arthroplasty (TKA) and total hip arthroplasty (THA)).

    Methods: Electronic databases (PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Wanfang databases, and Google databases) were systematically searched up to December 2016. Only randomized controlled trials (RCTs) were included. Read More

    Plasma Resuscitation Improved Survival in a Cecal Ligation and Puncture Rat Model of Sepsis.
    Shock 2017 Jun 6. Epub 2017 Jun 6.
    *Center for Translational Injury Research, University of Texas Health Science Center, Houston, TX †Department of Surgery, McGovern Medical School, University of Texas Health Science Center, Houston, TX ‡Capital Region Blood Bank, Rigshospitalet, Copenhagen, Denmark §Department of Pathology & Laboratory Medicine, University of California San Francisco, San Francisco, CA ||Blood Systems Research Institute, San Francisco, CA ¶Department of Surgery, Oregon Health & Science University, Portland, OR.
    Background: The paradigm shift from crystalloid to plasma resuscitation of traumatic hemorrhagic shock has improved patient outcomes due in part to plasma-mediated reversal of catecholamine and inflammation-induced endothelial injury, decreasing vascular permeability and attenuating organ injury. Since sepsis induces a similar endothelial injury as seen in hemorrhage, we hypothesized that plasma resuscitation would increase 48-hour survival in a rat sepsis model.

    Methods: Adult male Sprague-Dawley rats (375-425 g) were subjected to 35% cecal ligation and puncture (CLP) (t = 0 h). Read More

    Perimortem Demonstration and Treatment of Recipient-to-Donor Transfusion in Monochorionic-Diamniotic Twin Gestation.
    Fetal Diagn Ther 2017 Jun 2. Epub 2017 Jun 2.
    KU Center for Advanced Fetal Care, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Kansas School of Medicine, Kansas City, KS, USA.
    Twin-twin transfusion syndrome is a complication of monochorionic-diamniotic placentation. Should one twin die, ≈30% of co-twins will also die, and if they survive, ≈30% experience severe morbidity rates, each believed secondary to hemorrhage of the co-twin into the deceased twin. We report apparently the first ultrasound-documented case of perimortem hemorrhage in twin-twin transfusion syndrome and its treatment by emergent ultrasound-guided percutaneous cord occlusion followed by percutaneous fetal intravascular transfusion. Read More

    A case of stiff-person syndrome due to secondary adrenal insufficiency.
    Rinsho Shinkeigaku 2017 Jun 26;57(6):298-302. Epub 2017 May 26.
    Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University.
    We report a case of flexion contractures in a patient's legs secondary to postpartum hypopituitarism. A 56-year-old woman presented with a 3-year history of worsening flexion contractures of the hips and knees. On admission, her hips and knees could not be extended, and she had muscle stiffness and tenderness to palpation of the lower extremities. Read More

    Clinical endoscopic management and outcome of post-endoscopic sphincterotomy bleeding.
    PLoS One 2017 17;12(5):e0177449. Epub 2017 May 17.
    Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
    Post-endoscopic sphincterotomy bleeding is a common complication of biliary sphincterotomy, and the incidence varies from 1% to 48%. It can be challenging to localize the bleeder or to administer various interventions through a side-viewing endoscope. This study aimed to evaluate the risk factors of post-endoscopic sphincterotomy bleeding and the outcome of endoscopic intervention therapies. Read More

    Comparison of the efficacy and safety of 2% lidocaine HCl with different epinephrine concentration for local anesthesia in participants undergoing surgical extraction of impacted mandibular third molars: A multicenter, randomized, double-blind, crossover, phase IV trial.
    Medicine (Baltimore) 2017 May;96(21):e6753
    aDepartment of Dental Anesthesiology bDepartment of Dental Anesthesiology and Dental Research Institute, Seoul National University School of Dentistry cDepartment of Oral & Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul dDepartment of Dental Anesthesiology, Dankook University College of Dentistry, Dankook University, Cheonan-si, Chungnam eDepartment of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University and Institute of Translational Dental Sciences, Pusan National University fDepartment of Dental Anesthesia and Pain Medicine, School of Dentistry, Pusan National University and Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Gyeongnam gCollege of Dentistry, Wonkwang University, Iksan city, Jeonbuk hDepartment of Oral and Maxillofacial Surgery, Dankook University College of Dentistry, Dankook University, Cheonan-si, Chungnam iDepartment of Oral & Maxillofacial Surgery, Kyung Hee University Dental Hospital Kyung Hee University School of Dentistry, Seoul jR&D Center, Huons Co. Ltd., College of Pharmacy, Hanyang University, Ansan-si, Kyeonggi-do, Republic of Korea.
    Background: The most commonly impacted tooth is the third molar. An impacted third molar can ultimately cause acute pain, infection, tumors, cysts, caries, periodontal disease, and loss of adjacent teeth. Local anesthesia is employed for removing the third molar. Read More

    Adrenal obliteration by balloon-occluded retrograde venous ethanol injection in a swine model.
    Minim Invasive Ther Allied Technol 2017 May 19:1-9. Epub 2017 May 19.
    a Department of Radiology , Shiga University of Medical Science , Shiga , Japan.
    Purpose: To evaluate the effects of adrenal obliteration by balloon-occluded retrograde venous ethanol injection.

    Material And Methods: We inserted a micro-balloon catheter into the left adrenal vein of six pigs and retrogradely injected absolute ethanol (0.06 ml/kg) under balloon occlusion. Read More

    Development of intracerebral hemorrhage in the short-term clinical course of a patient with microscopic polyangiitis without neurological symptoms at diagnosis: an autopsy case.
    CEN Case Rep 2016 Nov 5;5(2):173-178. Epub 2016 Apr 5.
    Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kitaku, Okayama City, 700-8558, Japan.
    A 77-year-old man with high-grade fever, progressive renal dysfunction, high serum level of C-reactive protein and positive serum myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA) was diagnosed with microscopic polyangiitis with rapidly progressive glomerulonephritis, and remission induction treatment with glucocorticoids and intravenous cyclophosphamide was initiated. Although his general condition improved in a short time, intracerebral hemorrhage occurred 12 days after the initiation of treatment and emergent hematoma evacuation was performed. However, he passed away on day 14. Read More

    Two Cases of Thrombocytopenia, Anasarca, Fever, Reticulin Fibrosis/Renal Failure, and Organomegaly (TAFRO) Syndrome with High Serum Procalcitonin Levels, Including the First Case Complicated with Adrenal Hemorrhaging.
    Intern Med 2017 15;56(10):1247-1252. Epub 2017 May 15.
    Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Japan.
    Thrombocytopenia, Anasarca, Fever, Reticulin fibrosis/Renal failure, and Organomegaly (TAFRO) syndrome is a recently described systemic inflammatory disorder characterized by thrombocytopenia, anasarca, fever, reticulin fibrosis/renal failure, and organomegaly. It has an acute or subacute onset of unknown etiology, although some pathological features resemble those of multicentric Castleman disease. We here report two cases of TAFRO syndrome. Read More

    TAK-264 (MLN0264) in Previously Treated Asian Patients with Advanced Gastrointestinal Carcinoma Expressing Guanylyl Cyclase C: Results from an Open-label, Non-randomized Phase 1 Study.
    Cancer Res Treat 2017 May 10. Epub 2017 May 10.
    Department of Experimental Therapeutics, National Cancer Center Hospital East, Chiba, Japan.
    Purpose: This phase 1 dose-escalation portion of the study evaluated the safety, pharmacokinetics (PK), and antitumor activity of TAK-264 in Asian patients with advanced gastrointestinal (GI) carcinoma or metastatic or recurrent gastric or gastroesophageal junction adenocarcinoma expressing guanylyl cyclase C (GCC).

    Materials And Methods: Adult patients with advanced GI malignancies expressing GCC (H-score ≥ 10) received TAK-264 on day 1 of 3-week cycles as 30-minute intravenous infusions for up to 1 year or until disease progression or unacceptable toxicity. The primary objectives were to evaluate the safety profile including dose-limiting toxicities (DLTs) during cycle 1, determine the maximum tolerated dose (MTD), and characterize the PK profile of TAK-264 (NCT02391038). Read More

    Epinephrine-Induced Takotsubo Cardiomyopathy During Laparoscopic Myomectomy: Case Report and Review of the Literature.
    J Minim Invasive Gynecol 2017 Sep - Oct;24(6):1037-1039. Epub 2017 May 6.
    Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Riad El-Solh, Beirut, Lebanon.
    Laparoscopic myomectomy, a minimally invasive procedure performed for the management of uterine leiomyomas, involves a challenging aspect: excessive local bleeding. Hemorrhage control during laparoscopic myomectomy can be achieved through the use of a wide range of vasoconstrictors, including epinephrine. Epinephrine is frequently used for the control of local bleeding during surgery; however, it has been associated with several complications. Read More

    Antenatal corticosteroids for neonates born before 25 Weeks-A systematic review and meta-analysis.
    PLoS One 2017 9;12(5):e0176090. Epub 2017 May 9.
    Department of Neonatal Pediatrics, King Edward Memorial Hospital, Perth, Western Australia.
    Background: Efficacy of antenatal corticosteroids before 25 weeks of gestation is unclear.

    Objective: To assess and compare neonatal outcomes following ANC exposure at 22, 23 and 24 weeks of gestation by conducting systematic review and meta- analysis.

    Methods: A systematic review of randomised controlled trials (RCT) and non-RCTs reporting on neonatal outcomes after exposure to ANC up to 246 weeks of gestation using the Cochrane systematic review methodology. Read More

    Clinical Characteristics and Current Interventions in Shock Patients in Chinese Emergency Departments: A Multicenter Prospective Cohort Study.
    Chin Med J (Engl) 2017 May;130(10):1146-1154
    Emergency Department, Peking Union Medical College Hospital, Beijing 100730, China.
    Background: Shock is a life-threatening condition in emergency departments (EDs) and is associated with a high mortality; however, its clinical characteristics and current interventions in China are seldom reported. This study investigated the clinical characteristics and current interventions of shock patients in Chinese EDs.

    Methods: This multicenter prospective cohort study was conducted in the EDs of 33 academic hospitals in 16 Chinese provinces. Read More

    The efficacy and safety of epinephrine for postoperative bleeding in total joint arthroplasty: A PRISMA-compliant meta-analysis.
    Medicine (Baltimore) 2017 Apr;96(17):e6763
    Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin, PR China.
    Background: Total joint arthroplasty (TJA) usually results in postoperative bleeding. Some randomized controlled trials (RCTs) and nonrandomized controlled trials (non-RCTs) have been performed to evaluate the effects of epinephrine on postoperative bleeding after TJA. However, this remained controversial about the efficacy and safety of epinephrine for postoperative bleeding in TJA. Read More

    Spontaneous Adrenal Hemorrhage in Pregnancy: A Case Series.
    Case Rep Obstet Gynecol 2017 22;2017:3167273. Epub 2017 Mar 22.
    Department of Obstetrics and Gynecology, Crozer Chester Medical Center, One Medical Center Boulevard, Upland, PA 19013, USA.
    Background. Abdominal pain during pregnancy has a broad differential diagnosis which includes spontaneous adrenal hemorrhage (SAH). There is scant literature available on optimal mode of delivery in stable patients. Read More

    Cardiopulmonary resuscitation of out-of-hospital traumatic cardiac arrest in Qatar: A nationwide population-based study.
    Int J Cardiol 2017 Aug 30;240:438-443. Epub 2017 Mar 30.
    Department of Medicine Solna, 171 00, Karolinska Institutet, Sweden. Electronic address:
    Background: Traumatic cardiac arrest studies have reported improved survival rates recently, ranging from 1.7-7.5%. Read More

    Preoperative adrenal artery embolization followed by surgical excision of giant hypervascular adrenal masses: report of three cases.
    Acta Chir Belg 2017 Apr 7:1-7. Epub 2017 Apr 7.
    a Istanbul Faculty of Medicine, General Surgery Department , Istanbul University , Istanbul , Turkey.
    Background: Transcatheter arterial embolization (TAE) is an effective minimally invasive adjunct to surgery for the management and/or palliation of adrenal tumors.

    Methods: In this case study, we reported three patients who underwent preoperative TAE before adrenalectomy for large hypervascular adrenal tumors. All patients underwent preoperative embolization 24 h before the operation and were then followed up at the intensive care unit surgery. Read More

    Postural Syncope and Constipation: An Unusual Presentation of a Duodenal Dieulafoy's Lesion.
    Case Rep Gastrointest Med 2017 7;2017:6983434. Epub 2017 Mar 7.
    Department of Internal Medicine, Seton Hall University School of Health and Medical Sciences, Saint Francis Medical Center, Trenton, NJ, USA.
    Dieulafoy lesions are a rare etiology of gastrointestinal bleeding from a large caliber-persistent tortuous submucosal artery. They account for 1-2% of all causes of acute gastrointestinal hemorrhage with 80%-95% of these lesions located in the stomach along the lesser curvature. One-third of these lesions present at an extragastric location, with the proximal duodenum accounting for 15% of them. Read More

    Exposure to any antenatal corticosteroids and outcomes in preterm infants by gestational age: prospective cohort study.
    BMJ 2017 Mar 28;356:j1039. Epub 2017 Mar 28.
    Division of Neonatology, University of Alabama at Birmingham, AL 35233, USA.
    Objective To determine whether exposure to any antenatal corticosteroids is associated with a lower rate of death at each gestational age at which administration is currently recommended.Design Prospective cohort study.Settings 300 participating neonatal intensive care units of the Pediatrix Medical Group in the United States. Read More

    Early tranexamic acid administration ameliorates the endotheliopathy of trauma and shock in an in vitro model.
    J Trauma Acute Care Surg 2017 Jun;82(6):1080-1086
    From the Michael and Marian Ilitch Department of Surgery (L.N.D., J.V.M., D.M.L.), Wayne State University School of Medicine, Detroit, Michigan.
    Background: Systemic vascular endothelial injury is a consequence of trauma (T)/hemorrhagic shock (HS) which results in disturbances of coagulation, inflammation, and endothelial barrier integrity. The effect of T/HS on the endothelium (endotheliopathy of trauma [EoT]) is of intense research interest and may lead to EoT-directed therapies. Administration of tranexamic acid (TXA) in trauma patients is associated with a survival benefit and fewer complications if given early after injury. Read More

    Adrenal Histologic Stress-related Changes in Third Trimester Stillbirth.
    Pediatr Dev Pathol 2017 Mar-Apr;20(2):112-119. Epub 2017 Jan 25.
    1 Department of Pathology, Hutzel Women's Hospital and Harper University Hospital, Wayne State University School of Medicine, Detroit, Michigan, USA.
    Adrenal histologic changes, including compact cell change (CCC), cystic change (CYC), and adrenal hemorrhage (AH), and their clinical correlations have only infrequently been investigated in stillbirth. We evaluated 75 third trimester singleton stillborns with complete autopsies (30 term and 45 preterm). A total of 58 had unexplained stillbirth and 17 had clinical placental abruption. Read More

    Chronic Subdural Hematoma ICU Management.
    Neurosurg Clin N Am 2017 Apr;28(2):239-246
    Departments of Neurosurgery and Neurology, Division of Neurocritical Care McGovern Medical School, 6431 Fannin Street, Medical School Building 7.152, University of Texas Health Science Center at Houston, Houston, TX 77030, USA. Electronic address:
    Patients with cSDH presenting with new or worsening neurological deficits, especially if they are debilitating and adversely affecting quality of life require urgent medical and surgical attention. Neurological and neurosurgical critical care team need to stabilize the patient by reversing any underlying coagulopathy states in order to prevent further hematoma expansion.In the event of brain herniation and presumed ICP elevation and CPP compromise, step-wise ICP management should be instituted promptly. Read More

    Chronic Subdural Medical Management.
    Neurosurg Clin N Am 2017 Apr 1;28(2):211-217. Epub 2017 Feb 1.
    Department of Neurology, Columbia University Medical Center, 177 Fort Washington Avenue, Milstein Building 8GS-300, New York, NY 10032, USA.
    Chronic subdural hematomas (cSDHs) that are asymptomatic or have minimal symptoms have become more prevalent, with an increased rate of detection with neuroimaging in the setting of an aging population and increasing use of anticoagulants. These cSDHs have been known to spontaneously resolve, and subsequent efforts have been made to study the role of nonoperative initial medical management strategies in these patients. Current and potential strategies for the medical management of cSDH are discussed. Read More

    Characteristics and outcomes of very low birth weight infants receiving epinephrine during delivery room resuscitation.
    Resuscitation 2017 Jun 18;115:1-4. Epub 2017 Mar 18.
    Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Memphis, TN, USA; OB/GYN, University of Tennessee Health Science Center, Memphis, TN, USA. Electronic address:
    Background: Delivery room resuscitation of very low birth weight infants can involve use of endotracheal or intravenous epinephrine. Data of the past 19 years were reviewed to identify the usage of epinephrine in delivery room and identify characteristics of these babies.

    Methods: Neonates with ≤1500g birthweight from January 1996 to August 2014 were reviewed. Read More

    Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth.
    Cochrane Database Syst Rev 2017 03 21;3:CD004454. Epub 2017 Mar 21.
    Liggins Institute, The University of Auckland, Park Rd, Grafton, Auckland, New Zealand, 1142.
    Background: Respiratory morbidity including respiratory distress syndrome (RDS) is a serious complication of preterm birth and the primary cause of early neonatal mortality and disability. While researching the effects of the steroid dexamethasone on premature parturition in fetal sheep in 1969, Liggins found that there was some inflation of the lungs of lambs born at gestations at which the lungs would be expected to be airless. Liggins and Howie published the first randomised controlled trial in humans in 1972 and many others followed. Read More

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