scholarly journals A Review of Biophysiological and Biochemical Indicators of Stress for Connected and Preventive Healthcare

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 556
Author(s):  
Talha Iqbal ◽  
Adnan Elahi ◽  
Pau Redon ◽  
Patricia Vazquez ◽  
William Wijns ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Medical Conditions ◽  
Review Of The Literature ◽  
Stress Monitoring ◽  
Preventive Healthcare ◽  
Connected Health ◽  
Root Cause ◽  
Chemical Indicators ◽  
Life Threatening ◽  
Assessment Of Stress

Stress is a known contributor to several life-threatening medical conditions and a risk factor for triggering acute cardiovascular events, as well as a root cause of several social problems. The burden of stress is increasing globally and, with that, is the interest in developing effective stress-monitoring solutions for preventive and connected health, particularly with the help of wearable sensing technologies. The recent development of miniaturized and flexible biosensors has enabled the development of connected wearable solutions to monitor stress and intervene in time to prevent the progression of stress-induced medical conditions. This paper presents a review of the literature on different physiological and chemical indicators of stress, which are commonly used for quantitative assessment of stress, and the associated sensing technologies.

scholarly journals Prevention and management of major complications in percutaneous endoscopic gastrostomy

2021 ◽  
Vol 8 (1) ◽  
pp. e000628
Author(s):  
Kurt Boeykens ◽  
Ivo Duysburgh
Keyword(s):  
Clinical Practice ◽  
Abdominal Wall ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Early Recognition ◽  
Endoscopic Technique ◽  
Abdominal Wound ◽  
Review Of The Literature ◽  
Endoscopic Gastrostomy ◽  
Major Complications ◽  
Life Threatening

BackgroundPercutaneousendoscopic gastrostomy is a commonly used endoscopic technique where a tube isplaced through the abdominal wall mainly to administer fluids, drugs and/orenteral nutrition. Several placement techniques are described in the literaturewith the ‘pull’ technique (Ponsky-Gardener) as the most popular one.Independent of the method used, placement includes a ‘blind’ perforation of thestomach through a small acute surgical abdominal wound. It is a generally safetechnique with only few major complications. Nevertheless these complicationscan be sometimes life-threatening or generate serious morbidity.MethodAnarrative review of the literature of major complications in percutaneousendoscopic gastrostomy.ResultsThis review was written from a clinical viewpoint focussing on prevention andmanagement of major complications and documentedscientific evidence with real cases from more than 20 years of clinical practice.ConclusionsMajorcomplications are rare but prevention, early recognition and popper management areimportant.

Safety and Efficacy of Vitamin K Antagonists versus Rivaroxaban in Hemodialysis Patients with Atrial Fibrillation: A Multicenter Randomized Controlled Trial

2021 ◽  
pp. ASN.2020111566
Author(s):  
An S. De Vriese ◽  
Rogier Caluwé ◽  
Hans Van Der Meersch ◽  
Koen De Boeck ◽  
Dirk De Bacquer
Keyword(s):  
Atrial Fibrillation ◽  
Major Bleeding ◽  
Cardiovascular Events ◽  
Vitamin K Antagonists ◽  
Vitamin K2 ◽  
Composite Outcome ◽  
End Point ◽  
Life Threatening ◽  
K2 Group

BackgroundIn patients with normal renal function or early stage CKD, the risk-benefit profile of direct oral anticoagulants (DOACs) is superior to that of vitamin K antagonists (VKAs). In patients on hemodialysis, the comparative efficacy and safety of DOACs versus VKAs are unknown.MethodsIn the Valkyrie study, 132 patients on hemodialysis with atrial fibrillation were randomized to a VKA with a target INR of 2–3, 10 mg rivaroxaban daily, or rivaroxaban and vitamin K2 for 18 months. Patients continued the originally assigned treatment and follow-up was extended for at least an additional 18 months. The primary efficacy end point was a composite of fatal and nonfatal cardiovascular events. Secondary efficacy end points were individual components of the composite outcome and all-cause death. Safety end points were life-threatening, major, and minor bleeding.ResultsMedian (IQR) follow-up was 1.88 (1.01–3.38) years. Premature, permanent discontinuation of anticoagulation occurred in 25% of patients. The primary end point occurred at a rate of 63.8 per 100 person-years in the VKA group, 26.2 per 100 person-years in the rivaroxaban group, and 21.4 per 100 person-years in the rivaroxaban and vitamin K2 group. The estimated competing risk–adjusted hazard ratio for the primary end point was 0.41 (95% CI, 0.25 to 0.68; P=0.0006) in the rivaroxaban group and 0.34 (95% CI, 0.19 to 0.61; P=0.0003) in the rivaroxaban and vitamin K2 group, compared with the VKA group. Death from any cause, cardiac death, and risk of stroke were not different between the treatment arms, but symptomatic limb ischemia occurred significantly less frequently with rivaroxaban than with VKA. After adjustment for competing risk of death, the hazard ratio for life-threatening and major bleeding compared with the VKA group was 0.39 (95% CI, 0.17 to 0.90; P=0.03) in the rivaroxaban group, 0.48 (95% CI, 0.22 to 1.08; P=0.08) in the rivaroxaban and vitamin K2 group and 0.44 (95% CI, 0.23 to 0.85; P=0.02) in the pooled rivaroxaban groups.ConclusionsIn patients on hemodialysis with atrial fibrillation, a reduced dose of rivaroxaban significantly decreased the composite outcome of fatal and nonfatal cardiovascular events and major bleeding complications compared with VKA.Clinical Trial registry name and registration number:Oral Anticoagulation in Hemodialysis, NCT03799822

scholarly journals Basal cell carcinoma‑not always the ‘good guy’: Case report of a life‑threatening basosquamous carcinoma and review of the literature

2021 ◽  
Vol 22 (4) ◽  
Author(s):  
Cornel Petreanu ◽  
Elena-Daniela Șerban ◽  
Maria-Magdalena Constantin ◽  
Cornel Savu ◽  
Alexandru Zariosu ◽  
...  
Keyword(s):  
Case Report ◽  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Review Of The Literature ◽  
Life Threatening

scholarly journals Osteogenesis Imperfecta and Extra-/Intradural Hematomas: A Case Report and Review of the Literature

2018 ◽  
Vol 07 (04) ◽  
pp. 185-190
Author(s):  
Emrah Celtikci ◽  
Onur Ozgural ◽  
Umit Eroglu ◽  
Yusuf Caglar ◽  
Fatih Yakar
Keyword(s):  
Osteogenesis Imperfecta ◽  
Epidural Hematoma ◽  
Skull Fracture ◽  
Bleeding Diathesis ◽  
Review Of The Literature ◽  
Life Threatening ◽  
Brittle Bone Disease ◽  
Platelet Defects ◽  
Threatening Situation ◽  
Management Challenge

AbstractOsteogenesis imperfecta, also named as brittle bone disease, is characterized by fragile bones and short stature caused by mutations in the collagen gene. Subdural and intraparenchymal hematomas are defined and associated with trauma, vascular causes, and systemic bleeding diathesis. Skull fragility may lead to epidural hematoma, which is a life-threatening situation. Vascular fragility and intrinsic platelet defects are the causes of bleeding in patients with osteogenesis imperfecta, which is a major management challenge for neurosurgeons. Here, we reported on a 5-year-old boy with osteogenesis imperfecta with epidural hematoma and skull fracture following a trivial trauma, and made a literature review of 28 cases with extra-/intradural hematoma.

Thoracic Transillumination: Aid in the Diagnosis and Treatment of Pneumopericardium

PEDIATRICS ◽  
1979 ◽  
Vol 64 (6) ◽  
pp. 958-960 ◽  
Author(s):  
Eresvita E. Cabatu ◽  
Edwin G. Brown
Keyword(s):  
Mechanical Ventilation ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Hyaline Membrane Disease ◽  
Pericardial Tamponade ◽  
Review Of The Literature ◽  
Air Leak ◽  
Hyaline Membrane ◽  
Life Threatening

A frequent complication of continuous positive airway pressure and mechanical ventilation used to treat neonates who have hyaline membrane disease and other forms of respiratory distress is an air leak from alveolar rupture. Pneumothorax and pneumomediastinum are common. Pneumopericardium does not occur often, but it can be life-threatening if it produces acute cardiac tamponade. In a review of the literature, Brans and associates1 found that pneumopericardium in neonates was treated by pericardiocentesis in one half of the published cases; 79% of them survived or they ultimately died of complications unrelated to pericardial tamponade. However, only 32% of the infants treated conservatively survived.

Fluoropyrimidine-induced toxicity and DPD deficiency.. A case report of early onset, lethal capecitabine-induced toxicity and mini review of the literature. Uridine triacetate: Efficacy and safety as an antidote. Is it accessible outside USA?

2019 ◽  
Vol 26 (3) ◽  
pp. 747-753 ◽  
Author(s):  
Dimitra Ioanna Lampropoulou ◽  
Konstantinos Laschos ◽  
Anna-Lea Amylidi ◽  
Ariadni Angelaki ◽  
Nikolaos Soupos ◽  
...  
Keyword(s):  
Early Onset ◽  
Dehydrogenase Deficiency ◽  
Colorectal Cancer Patient ◽  
Dihydropyrimidine Dehydrogenase ◽  
Efficacy And Safety ◽  
Review Of The Literature ◽  
Time Restrictions ◽  
Timely Access ◽  
Life Threatening ◽  
Chemotherapy Dose

Fluoropyrimidine-based regimens are among the most commonly used chemotherapy combinations for the treatment of solid tumors. Several genetic polymorphisms that are implicated with fluoropyrimidine anabolism and catabolism have been associated with the development of life-threatening toxicities. Uridine triacetate is an FDA-approved antidote for 5-fluorouracil or capecitabine overdose and early-onset, life-threatening toxicity within 96 h of last chemotherapy dose. To date, it is not accessible for Greek patients as per the current summary of product characteristic's time restrictions. We report and discuss the course and outcome of capecitabine toxicity in a 66-year-old female colorectal cancer patient with heterozygous dihydropyrimidine dehydrogenase deficiency. This paper highlights the difficulty in timely access of this lifesaving medication for Greek and possibly other European patients.

Rescue carotid puncture for ischemic stroke treated by endovascular therapy: a multicentric analysis and systematic review

2020 ◽  
pp. neurintsurg-2020-016725
Author(s):  
Julien Allard ◽  
Sam Ghazanfari ◽  
Mehdi Mahmoudi ◽  
Julien Labreuche ◽  
Simon Escalard ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Elderly Patients ◽  
Functional Outcome ◽  
Endovascular Therapy ◽  
Older Patients ◽  
Intravenous Thrombolysis ◽  
Review Of The Literature ◽  
Femoral Access ◽  
Life Threatening

BackgroundEndovascular therapy (EVT) for acute ischemic stroke (AIS) can be challenging in older patients with supra-aortic tortuosity. Rescue carotid puncture (RCP) can be an alternative in case of supra-aortic catheterization failure by femoral access, but data regarding RCP are scarce. We sought to investigate the feasibility, effectiveness and safety of RCP for AIS treated by EVT.MethodsPatients treated by EVT with RCP were included from January 2012 to December 2019 in the Endovascular Treatment in Ischemic Stroke (ETIS) multicentric registry. Main outcomes included reperfusion rates (≥TICI2B), 3 month functional outcome (modified Rankin Scale) and 3 month mortality. We also performed an additional systematic review of the literature according to the PRISMA checklist to summarize previous studies on RCP.Results25 patients treated by EVT with RCP were included from the ETIS registry. RCP mainly concerned elderly patients (median age 85 years, range 73–92) with supra-aortic tortuosity (n=16 (64%)). Intravenous thrombolysis (IVT) was used for nine patients (36%). Successful reperfusion was achieved in 64%, 87.5% of patients were dependent at 3 months, and 3 month mortality was 45.8%. The systematic review yielded comparable results. In pooled individual data, there was a shift toward better functional outcome in patients with successful reperfusion (median (IQR) 4 (2–6) vs 6 (4–6), p=0.011).ConclusionRCP mainly concerned elderly patients admitted for AIS with anterior LVO with supra-aortic tortuosity. The procedure seemed feasible, notably for patients treated with IVT, and led to significant reperfusion rates at the end of procedure, but with pronounced unfavorable outcomes at 3 months. RCP should be performed under general anesthesia to avoid life-threatening complications and ensure airways safety. Finally, RCP led to low rates of closure complications, emphasizing that this concern should not withhold RCP, if indicated.

scholarly journals LethalClostridium difficileColitis Associated with Paclitaxel and Carboplatin Chemotherapy in Ovarian Carcinoma: Case Report and Review of the Literature

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
V. Masciullo ◽  
S. Mainenti ◽  
D. Lorusso ◽  
P. A. Margariti ◽  
G. Scambia
Keyword(s):  
Antibiotic Use ◽  
Aggressive Treatment ◽  
Review Of The Literature ◽  
Serous Adenocarcinoma ◽  
Coffee Ground ◽  
Adenocarcinoma Of The Ovary ◽  
Life Threatening ◽  
Clostridium Difficile Colitis ◽  
Prompt Diagnosis ◽  
Prior Antibiotic Therapy

Clostridium difficile colitis, although rare, could represent a serious complication following chemotherapy. Prior antibiotic use has been considered the single most important risk factor in the development ofC. difficileinfection. Recently, the association between antineoplastic therapy andC. difficile-associated diarrhea in the absence of a prior antibiotic therapy has become more apparent. A 75-year-old woman with serous adenocarcinoma of the ovary developed lethal pancolitis caused byC. difficileafter five cycles of paclitaxel- and carboplatin-based chemotherapy. She presented with diarrhea, coffee-ground emesis, and oliguria and was hospitalized immediately for aggressive treatment. Despite all the medical efforts, her condition worsened and she died after twenty days. We describe the second case reported of a patient developing a severeC. difficilecolitis following chemotherapy without any recent antibiotic use and review the data of the literature, emphasizing the need to a prompt diagnosis and management that can significantly decrease the morbidity and life-threatening complications associated with this infection.

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