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A Survey of Academic Intensivists' Use of Neuromuscular Blockade in Subjects With ARDS.

BACKGROUND: Our Cooling to Help Injured Lungs (CHILL) trial of therapeutic hypothermia in ARDS includes neuromuscular blockade (NMB) as an inclusion criterion to avoid shivering. NMB has been used to facilitate mechanical ventilation in ARDS and was shown to reduce mortality in the ACURASYS trial. To assess the feasibility of a multi-center CHILL trial, we conducted a survey of academic intensivists about their NMB use in patients with ARDS. METHODS: We distributed via email a 16-question survey about NMB use in patients with ARDS including frequency, indications, and dosing strategy. RESULT

Molecular cloning and functional characterization of a novel apple MdCIPK6L gene reveals its involvement in multiple abiotic stress tolerance in transgenic plants.

CBL-interacting protein kinases (CIPKs) are involved in many aspects of plant responses to abiotic stresses. However, their functions are poorly understood in fruit trees. In this study, a salt-induced MdCIPK6L gene was isolated from apple. Its expression was positively induced by abiotic stresses, stress-related hormones and exogenous Ca(2+). MdCIPK6L was not homologous to AtSOS2, however, its ectopic expression functionally complemented Arabidopsis sos2 mutant. Furthermore, yeast two-hybrid assay showed that MdCIPK6L protein interacted with AtSOS3, indicating that it functions in salt tolera

Respiratory distress secondary to both amphotericin B deoxycholate and lipid complex formulation.

A 73-y-old female with a history of adenocarcinoma of colon and refractory anemia developed febrile neutropenia following chemotherapy. Therapy with iv infusion of amphotericin B deoxycholate (AmBd) was initiated on day 8 of hospital admission. Premedications included acetaminophen, diphenhydramine and meperidine. Patient developed rigor, chill and elevated temperature approximately 100 min into the infusion. The infusion was temporarily discontinued and rigors subsided following administration of 25 mg meperidine im. Infusion was continued after cessation of the rigors with no further sequela

Alternative Anticoagulation Therapy in Tunnel Dialysis Catheter Septic Thrombus.

Patients may have tunnel dialysis catheters utilized for chronic maintenance hemodialysis. Patients can develop infected thrombi with the catheter which can further result in the development of septicemia. This case illustrates a patient who was sent to the Emergency department due to fever, chills, hypotension and significant mental status changes. He was successfully treated with appropriate intravenous antibiotics utilizing culture results and combined use of activated factor Xa inhibitors (Apixaban) to provide early resolution of infected thrombi bacteremia.

Shapiro's syndrome: episodic hypothermic hyperhidrosis.

SummaryShapiro's syndrome is a rare neurological disease. The triad of Shapiro's syndrome includes episodes of hyperhidrosis, hypothermia and complete/partial agenesis of the corpus callosum. We report a case of a young male who had episodic chills, increased sweating and fatigue. During these episodes, he was found to have bradycardia, hypotension and hypothermia. Clinical and neurological examinations were unremarkable. The MRI of the brain revealed agenesis of the corpus callosum. There was a good response to carbamazepine therapy.

A 29-Year-Old Woman With Cough, Dry Eyes, Pulmonary Cysts, and Nodules.

A 29-year-old woman who is a never smoker and has a medical history of systemic hypertension presented with a 3-week history of generalized fatigue and dry cough. She endorsed sicca symptoms of dry eyes and dry mouth. She denied breathlessness, fever, chills, night sweats, or weight loss. She had no heartburn, postnasal drip, joint pain, swelling, or skin lesions. She had no known lung disease or history of pneumothorax. Her family history was unremarkable.

Empyema Secondary to Actinomyces meyeri Treated Successfully with Ceftriaxone Followed by Doxycycline.

Actinomycosis is a relatively rare infection caused by Gram-positive bacteria. We present the case of a 54-year-old, previously healthy, male patient with a history of severe penicillin allergy who developed severe pneumonia and empyema caused by Actinomyces meyeri. Presenting symptoms included productive cough, right upper quadrant pain, and chills and rigors. He required drainage of the empyema via tube and prolonged antibiotic treatment with intravenous ceftriaxone for 2 weeks followed by oral doxycycline for 6 months.

Dapsone-induced haemolytic anaemia, hepatitis and agranulocytosis in a leprosy patient with normal glucose-6-phosphate-dehydrogenase activity.

A 21 year old boy with borderline lepromatous leprosy and normal glucose-6-phosphate-dehydrogenase activity developed haemolytic anaemia, hepatitis and agranulocytosis following 19 weeks of multi-bacillary multi-drug therapy. With early administration of antibiotics and G-CSF our patient recovered without residual complications. All patients taking dapsone should be warned to discontinue the drug immediately in the event of fever, chills and sore throat occurring within the treatment period until further investigations are performed.

Cyclic neutropenia: a case of asymptomatic appendicitis.

A seven year old boy with a history of cyclic neutropenia (CN) was admitted to the hospital after developing fever and chills following a bicycle accident. After admission, he had a rapidly deteriorating hospital course leading to shock and death. At autopsy, acute appendicitis with resultant peritonitis and sepsis was diagnosed. The peculiar clinical and microscopic aspects of this case will be presented and contrasted with the more usual signs and symptoms of this cyclic disease.

[T lymphocyte activation induced in vivo by the first injection of OKT3 monoclonal antibodies].

One of the major side effects induced by the in vivo administration of the murine monoclonal antibody OKT3 is a spontaneously reversible clinical syndrome associating in variable proportions depending on the patient: fever, chills, headaches, diarrhea and seldomly meningismus. Sera from 3 renal allograft recipients treated with OKT3 were studied and showed that a massive although transient release of some cytokines namely, Tumor Necrosis Factor alpha, Interleukin 2 and Interferon gamma is observed following the first OKT3 injection.

Effects of cryopreservation-related processes on the settlement competence of coral larvae.

Coral larval settlement constitutes a pivotal bottleneck in reef persistence, restoration efforts, and the development of assisted conservation strategies such as cryopreservation. Beyond survival, the ability of larvae to retain settlement competence following cryopreservation-related stress is essential for the successful application of these approaches. Despite its ecological significance, the mechanistic basis underlying settlement induction remains incompletely understood. Here, we systematically investigate the interactive effects of low temperature, water-soluble chemical cues, and lipi

The impact of plasma-activated water and selenium nanoparticle solution on the shelf life of Mandarin cv. Orlando Tangelo in storage.

This study investigates the potential of post-harvest immersion in plasma-activated water (PAW) and water containing 1 mg/L selenium nanoparticles (Se-NP solution) to extend the shelf life of mandarin fruit using a two-factor factorial experiment with three replications in a completely randomized design. Freshly harvested mandarins were divided into six groups: (1) control (immersed in distilled water), (2) and (3) treated with PAW for 2 and 4 min, respectively, (4) treated with aqueous solution of Se-NP for 5 min, and (5) and (6) treated sequentially with the Se-NP solution for 5 min combined

Rituximab dose-escalation trial in chronic lymphocytic leukemia.

PURPOSE: To conduct a dose-escalation trial of rituximab in patients with chronic lymphocytic leukemia (CLL) to define the maximum-tolerated … se (375 mg/m(2)) was noted in 94% of patients but was grade 1 or 2 in most, predominantly fever and chills. Six patients (12%) experienced severe toxicity with the first dose, including fever, chills, dyspnea, and hypoxia in all six patients, hypotension in five, and hypertension in one. Toxicity on subsequent doses was minimal until a dose of 2,250 mg/m …

Carbapenem-resistant Citrobacter amalonaticus and VRE bacteraemia in an immunocompetent patient after a urological Rezum procedure.

In this report, we discuss the case of a 62-year-old man who presented with gross haematuria, fever, and chills 1 day after undergoing a Rezum procedure and was found to have carbapenem-resistant Citrobacter amalonaticus and vancomycin-resistant Enterococcus faecalis bacteraemia. The patient was treated with daptomycin, eravacycline, and ceftalozane-tazobactam with positive results. We discuss our case and treatment of C. amalonaticus bacteraemia, a pathogen with limited existing literature on its incidence, presentation, and treatment.

Obstructive jaundice caused by ulcerative duodenal stenosis: A case report.

A peptic ulcer is a rare cause of distal common bile duct stricture, Obstructive jaundice as a complication of ulcerative duodenal stenosis is quite difficult to differentiate from malignant disease, especially in those in which esophagogastroduodenoscopy examination does not reveal an ulcer. In this case report, a 61-year-old male suffered from right upper quadrant pain, chills and fever caused by duodenal and distal common bile duct stenosis originating from ulcer and was treated surgically.

[Painful lymphadenopathy after an insect bite-a case report].

Tularemia is a bacterial zoonosis which is commonly transmitted through tick or insect bites or contact with meat of infected animals. We report the case of a 36-year-old man who developed fever, chills, headaches, and a painful, unilateral, inguinal lymphadenopathy with a red-livid skin discoloration after an insect bite on his abdomen. Ulceroglandular tularemia was diagnosed through polymerase chain reaction (PCR) and serology. Treatment with doxycycline for 21 days resulted in an excellent outcome.

Right Middle Lobe Collapse and Pleural Effusion in an 18-Year-Old Man.

An 18-year-old African American male subject presented to an acute care clinic with 3 days of productive cough, chills, pleuritic right chest pain, sore throat with hoarseness, congestion, and intermittent shortness of breath. He recently relocated to Texas from Georgia to undergo basic military training. He denied any other recent travel or contact with persons with pulmonary TB or other respiratory illnesses. His medical history was significant for glucose-6-phosphate dehydrogenase deficiency and sickle cell trait.

Visceral leishmaniasis in a psoriatic arthritis patient treated with methotrexate.

Visceral leishmaniasis, in Greece, represents a relatively rare, potentially fatal clinical entity. Here we describe a case of visceral leishmaniasis infection in a 65-year old Greek male with psoriatic arthritis treated with methotrexate, who presented with high grade fever, chills, splenomegaly, pancytopenia and polyclonal hypergammaglobulinaemia. A diagnosis of visceral leishmaniasis was finally established. Visceral leishmaniasis should be included in the differential diagnosis for infections in patients receiving methotrexate for rheumatic diseases, especially in endemic areas.

A case of organizing pneumonia associated with rituximab.

Rituximab is a human/murine chimeric anti-CD20 monoclonal antibody used to treat CD20-positive B-cell non-Hodgkin's lymphoma (NHL). Although most of the adverse effects associated with rituximab are usually reversible and temporary infusion-related reactions, including fever, chills, flushing and skin reactions, there are several reports of pulmonary events after long-term administration of rituximab. We present a case of asymptomatic nodular organizing pneumonia occurring during rituximab-based chemotherapy in a patient with non-Hodgkin's lymphoma.

Необычной причиной пероральной язвы.

Испаноязычная женщина в возрасте 25 лет подавала болезненные оральные язвы, боль в горле и дисфагию продолжительностью в две недели. Её эмпирически лечили ацикловиром от предполагаемого герпеса simpexstomatitis и пищефагита и отправили домой. Неделю спустя она вернулась с жалобами на ухудшение боли в горле, лихорадку (до 38,9 градуса С) и кашель, производящий желто-зеленую слюну. У нее не было холода, недостатка дыхания, горения мочеиспускания или изменения кишечных привычек.

Совпадение в аннотации оригинала
A 25-year-old Hispanic woman presented with painful oral ulcers, a sore throat, and dysphagia of two weeks' duration. She was treated empiri … throat, fever (as high as 38.9 degrees C), and cough producing yellow-green sputum. She had not had chills, shortness of breath, burning on urination, or a change in bowel habits.