scholarly journals Torsade de Pointes Induced by Hypokalemia from Imipenem and Piperacillin

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Varun Kumar ◽  
Sandeep Khosla ◽  
Monica Stancu
Keyword(s):  
Adverse Effects ◽  
Case Reports ◽  
Torsade De Pointes ◽  
Torsades De Pointes ◽  
Interesting Case ◽  
The Past ◽  
The Many

Imipenem-cilastatin and piperacillin-tazobactam are two antibiotics with broad antimicrobial coverage. Besides the many well established adverse effects of these drugs, there have been few case reports of hypokalemia. Here we present an interesting case of resistant hypokalemia caused by these drugs leading to Torsades de Pointes which has never been reported in the past. Hypokalemia resolved with discontinuation of piperacillin.

scholarly journals A case of hypoglycemiainduced QT prolongation leading to torsade de pointes and a review of pathophysiological mechanisms

2017 ◽  
Vol 7 (3) ◽  
Author(s):  
Faris Hannoodi ◽  
Hashim Alwash ◽  
Kushal Shah ◽  
Israa Ali ◽  
Sarwan Kumar ◽  
...  
Keyword(s):  
Torsade De Pointes ◽  
Torsades De Pointes ◽  
Serum Glucose ◽  
Interesting Case ◽  
Qt Prolongation ◽  
Calcium Oscillations ◽  
Calcium Overload ◽  
Interval Prolongation ◽  
Qt Interval Prolongation ◽  
Life Threatening

<em>Torsades de pointes</em> is a life-threatening cardiac arrhythmia. Occurrence of this arrhythmia as a result of hypoglycemia has not been reported in the literature. We describe an interesting case of an insulindependent diabetic patient presenting with torsades de pointes resulting from hypoglycemia. A 62-year-old male was admitted to the hospital following an episode of severe insulin-induced hypoglycemia and a cardiac arrest. He was found to unresponsive at home after taking insulin. His serum glucose was found to be 18. He was given juice initially to normalize his glucose and was then transferred by EMS to ER where he was given 5% dextrose infusion. Analysis of the LifeVest rhythm recording showed torsades de pointes that was terminated by defibrillation of the LifeVest. Several mechanisms are responsible for torsade, including QT interval prolongation, adrenalin secretion and calcium overload leading to intracellular calcium oscillations. These mechanisms are a trigger to torsade de pointes. Predisposing factors were present leading torsade to occur.

scholarly journals Message

2020 ◽  
Vol 35 (1) ◽  
pp. 2
Author(s):  
Cecilia Gretchen Navarro-Locsin
Keyword(s):  
Head And Neck ◽  
Case Reports ◽  
Surgical Techniques ◽  
Neck Surgery ◽  
Editorial Staff ◽  
Evidence Base ◽  
Interesting Case ◽  
Head And Neck Surgery ◽  
The Past ◽  
Good Reading

Greetings! This year marks the 64th year of the Philippine Society of Otolaryngology-Head and Neck Surgery. It is a defining year, marked by both national and international events that changed and will most likely continue to change medical practice, public health policy, socio-economic concepts and structures. The SARS-coronavirus-2 (COVID-19) pandemic crashed into the first quarter of 2020 unannounced and with great fury. This great unknown served as the impetus for a flurry of research into every aspect of the disease – its origins, biology, clinical course, and treatment. It initiated an unprecedented interest in research, not just among scientists and clinicians, but most especially amongst the general population. But what is RESEARCH? Re-search - to look again at the past with spectacles, to look at the past with new eyes, to look at the present with a microscope, and to look at the far distance with binoculars – all to better see & perhaps to find answers to our questions. Research fuels the evidence base of our understanding of diseases and the principles of our clinical and surgical practice. Our specialty of Otolaryngology, during this time of the pandemic, will be at the forefront of an exciting time for a renewed quest for knowledge. And what better vehicle to transport us into this new and uncharted world than the Philippine Journal of Otolaryngology Head and Neck Surgery? It is a testament to the unparalleled dedication of the editor-in-chief and editorial staff and the enthusiasm of the contributors, that every year the PJOHNS publishes interesting case reports, relevant descriptive and analytical studies, papers on surgical techniques & instrument innovations, and insightful commentaries. The journal is a platform for our questions and hypotheses. The journal is a venue for our discoveries. But most importantly, the journal is a celebration of our passion for Otolaryngology.                 Good reading to all!   Cecilia Gretchen S. Navarro – Locsin, MD President Philippine Society of Otolaryngology – Head and Neck Surgery

On Future Directions in Pathology

1982 ◽  
Vol 40 ◽  
pp. 274-277
Author(s):  
Benjamin F. Trump ◽  
Irene K. Berezesky ◽  
Raymond T. Jones
Keyword(s):  
Electron Microscopy ◽  
Transmission Electron Microscopy ◽  
Clinical Pathology ◽  
Future Directions ◽  
Diagnostic Pathology ◽  
The Past ◽  
Transmission Electron ◽  
Organ Systems ◽  
The Many

The role of electron microscopy and associated techniques is assured in diagnostic pathology. At the present time, most of the progress has been made on tissues examined by transmission electron microscopy (TEM) and correlated with light microscopy (LM) and by cytochemistry using both plastic and paraffin-embedded materials. As mentioned elsewhere in this symposium, this has revolutionized many fields of pathology including diagnostic, anatomic and clinical pathology. It began with the kidney; however, it has now been extended to most other organ systems and to tumor diagnosis in general. The results of the past few years tend to indicate the future directions and needs of this expanding field. Now, in addition to routine EM, pathologists have access to the many newly developed methods and instruments mentioned below which should aid considerably not only in diagnostic pathology but in investigative pathology as well.

A 200-Year History of the Study of Childhood Language Disorders of Unknown Origin: Changes in Terminology

2020 ◽  
Vol 5 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Laurence B. Leonard
Keyword(s):  
Language Impairment ◽  
Specific Language Impairment ◽  
Scientific Literature ◽  
Language Disorder ◽  
Language Disorders ◽  
Unknown Origin ◽  
Developmental Language Disorder ◽  
The Past ◽  
History Of ◽  
The Many

Purpose The current “specific language impairment” and “developmental language disorder” discussion might lead to important changes in how we refer to children with language disorders of unknown origin. The field has seen other changes in terminology. This article reviews many of these changes. Method A literature review of previous clinical labels was conducted, and possible reasons for the changes in labels were identified. Results References to children with significant yet unexplained deficits in language ability have been part of the scientific literature since, at least, the early 1800s. Terms have changed from those with a neurological emphasis to those that do not imply a cause for the language disorder. Diagnostic criteria have become more explicit but have become, at certain points, too narrow to represent the wider range of children with language disorders of unknown origin. Conclusions The field was not well served by the many changes in terminology that have transpired in the past. A new label at this point must be accompanied by strong efforts to recruit its adoption by clinical speech-language pathologists and the general public.

The Many Pasts of Detective Fiction

2020 ◽  
Vol 1 (2) ◽  
pp. 157-172
Author(s):  
Thomas Leitch
Keyword(s):  
Detective Fiction ◽  
Golden Age ◽  
Public History ◽  
Detective Novel ◽  
Sherlock Holmes ◽  
Detective Story ◽  
The Past ◽  
Wide Range ◽  
Detective Novels ◽  
The Many

Building on Tzvetan Todorov's observation that the detective novel ‘contains not one but two stories: the story of the crime and the story of the investigation’, this essay argues that detective novels display a remarkably wide range of attitudes toward the several pasts they represent: the pasts of the crime, the community, the criminal, the detective, and public history. It traces a series of defining shifts in these attitudes through the evolution of five distinct subgenres of detective fiction: exploits of a Great Detective like Sherlock Holmes, Golden Age whodunits that pose as intellectual puzzles to be solved, hardboiled stories that invoke a distant past that the present both breaks with and echoes, police procedurals that unfold in an indefinitely extended present, and historical mysteries that nostalgically fetishize the past. It concludes with a brief consideration of genre readers’ own ambivalent phenomenological investment in the past, present, and future each detective story projects.

Partial Adrenal Suppression with Prolonged Use of Depo-Provera

2019 ◽  
Vol 4 (1) ◽  
pp. 64
Author(s):  
Nur Aisyah Zainordin ◽  
Fatimah Zaherah Mohamed Shah ◽  
Rohana Abdul Ghani
Keyword(s):  
Weight Gain ◽  
Medroxyprogesterone Acetate ◽  
Side Effect ◽  
Case Reports ◽  
Adrenal Incidentaloma ◽  
Adrenal Suppression ◽  
Private Pharmacy ◽  
Significant Weight Gain ◽  
The Past ◽  
Depo Provera

A 49-year old patient presented with symptoms of adrenal suppression following an attempt to withdraw Depo-Provera or Depot Medroxyprogesterone Acetate (DMPA) injection. She had been receiving DMPA injections for the past 16 years for contraception. She was initially prescribed DMPA by her gynaecologist but later on began obtaining the medication directly from a private pharmacy without prior consultation from her gynaecologist. Clinically, she had been experiencing significant weight gain and appeared cushingoid. Blood investigations confirmed partial adrenal suppression with presence of an adrenal incidentaloma. This case reports a known side effect of DMPA but occurring at a much lower dose than previously described. It also highlights the need to increase the awareness of the insidious side effect of DMPA and to avoid unsupervised use of the drug.

Law as a Field of Tension

2018 ◽  
Author(s):  
Andrea Gamberini
Keyword(s):  
Public Authority ◽  
The Public ◽  
The Past ◽  
Political Cultures ◽  
The Many

As it had been in the communal age, so, in the Visconti-Sforza era, law was the instrument that the public authority relied upon in order to subordinate the many actors present and to subjugate their political cultures. There is, therefore, the attempt to tighten a vice around competing powers—a vice that is at the same time legislative, doctrinal, and judicial. And yet, it is difficult to escape the impression of an effort whose outcomes were somewhat more uncertain than had been the case in the past. The chapter focuses on all these aspects of the deployment of legal and other stratagems to consolidate or to wrest power.

Evidence-based Assessment

2010 ◽  
pp. 76-98
Author(s):  
John Hunsley ◽  
Eric J. Mash
Keyword(s):  
Decision Making ◽  
Clinical Assessment ◽  
Assessment Process ◽  
Evidence Based ◽  
The Past ◽  
Specific Assessment ◽  
The Many ◽  
Selection Of ◽  
Made In

Evidence-based assessment relies on research and theory to inform the selection of constructs to be assessed for a specific assessment purpose, the methods and measures to be used in the assessment, and the manner in which the assessment process unfolds. An evidence-based approach to clinical assessment necessitates the recognition that, even when evidence-based instruments are used, the assessment process is a decision-making task in which hypotheses must be iteratively formulated and tested. In this chapter, we review (a) the progress that has been made in developing an evidence-based approach to clinical assessment in the past decade and (b) the many challenges that lie ahead if clinical assessment is to be truly evidence-based.

scholarly journals Digital Glomus Tumor: Bibliographic Review of the Studies Published over the Past 10 Years

2021 ◽  
Vol 49 (01) ◽  
pp. 046-055
Author(s):  
Victoria Hernández ◽  
Tania Lena ◽  
Eliana Camacho ◽  
Matías Craviotto
Keyword(s):  
Glomus Tumor ◽  
Case Reports ◽  
Low Frequency ◽  
Benign Neoplasm ◽  
Surgical Excision ◽  
Soft Tissue Tumors ◽  
Glomus Tumors ◽  
The Past ◽  
Pubmed Search ◽  
Magnetic Resonance Imaging Mri

AbstractGlomus tumors are a mostly benign neoplasm that constitutes less than 4% of upper-limb soft-tissue tumors. Its unspecific clinical presentation, added to its low frequency, leads to a late diagnosis.The objective of the present study is to update the clinical-paraclinical approach and the surgical technique used in the treatment.We carried out a literature review from 2014 to 2019 on digital glomus tumor in the hand in adult patients using the PubMed search engine.In most of the publications analyzed, the diagnosis was clinical, with a delay of 1 to 10 years. Plain radiography is the most requested study; of the 16 articles reporting its indication, only half evidenced compatible changes. Magnetic resonance imaging (MRI) was requested in 15 articles, presenting normal results in 3 of them. The treatment of choice was surgical excision using a transungual approach. Only 4 articles report recurrence after excision.Although there is diversity in the approach to these tumors, we conclude that the diagnosis is clinical, and the treatment surgical, and there is no consensus regarding the paraclinical indication. The information available comes mainly from case reports, publications that contribute to the generation of evidence for the clinical practice in rare diseases such as this one.

CPT-based liquefaction case histories compiled from three earthquakes in Canterbury, New Zealand

2021 ◽  
pp. 875529302199636
Author(s):  
Mertcan Geyin ◽  
Brett W Maurer ◽  
Brendon A Bradley ◽  
Russell A Green ◽  
Sjoerd van Ballegooy
Keyword(s):  
New Zealand ◽  
Case History ◽  
Prediction Models ◽  
Free Field ◽  
Case Histories ◽  
Cone Penetration ◽  
History Data ◽  
The Past ◽  
Surface Manifestation ◽  
The Many

Earthquakes occurring over the past decade in the Canterbury region of New Zealand have resulted in liquefaction case-history data of unprecedented quantity. This provides the profession with a unique opportunity to advance the prediction of liquefaction occurrence and consequences. Toward that end, this article presents a curated dataset containing ∼15,000 cone-penetration-test-based liquefaction case histories compiled from three earthquakes in Canterbury. The compiled, post-processed data are presented in a dense array structure, allowing researchers to easily access and analyze a wealth of information pertinent to free-field liquefaction response (i.e. triggering and surface manifestation). Research opportunities using these data include, but are not limited to, the training or testing of new and existing liquefaction-prediction models. The many methods used to obtain and process the case-history data are detailed herein, as is the structure of the compiled digital file. Finally, recommendations for analyzing the data are outlined, including nuances and limitations that users should carefully consider.

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