The American journal of the medical sciences
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Often seen in childhood, Henoch-Schönlein purpura (HSP) is a self-limiting illness, in which complications involving intussusception are rarely found in adults. This study reported a case of HSP initially presented as intussusception in a 60-year-old man. Gastrointestinal manifestations before the onset of rash may prevent an accurate diagnosis and appropriate management. Primary care physicians should be alert for this association between intussusception and HSP, especially in adult patients.
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Case Reports
Anicteric leptospirosis-associated severe pulmonary hemorrhagic syndrome: a case series study.
In leptospirosis, severe pulmonary hemorrhagic syndrome has replaced Weil's disease as the main cause of mortality, with rates of up to 75%. Four men, all farmers, were admitted to the intensive care unit between August 2009 and July 2010 with a diagnosis of acute respiratory distress syndrome. ⋯ Empirical therapy with ceftriaxone was administered immediately to all patients, while implementation of ARDSnet protective mechanical ventilation approach combined with an early goal-directed hemodynamic approach led to a relatively low mortality rate (25%). Acute Physiology and Chronic Health Evaluation II, Simplified Acute Physiology Score II and Sepsis-Related Organ Failure Assessment scoring systems were unable to predict the outcome of the patients with leptospirosis-associated severe pulmonary hemorrhagic syndrome.
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Although there have been previous efforts to optimize dose intensity or change the chemotherapy protocol for osteosarcoma, long-term survival has not been markedly improved during the past 15 years. ⋯ The antitumor effect of Abraxane was demonstrated in osteosarcoma xenografts in vivo. It suggests that SPARC tends to be highly expressed in osteosarcoma and further experiments need to explore its clinical relevance and the possible mechanisms.
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Atrial fibrillation/flutter is the most common cardiac arrhythmia that can potentially result in stroke and death. For many years, aspirin and warfarin have been the cornerstone of stroke prevention among such patients. ⋯ Thus, the need for a better and more consistent anticoagulant therapy was necessary and has been under development with various successes for many years. This article will review 3 new antithrombotic medications that may potentially become the mainstay for treatment of patients with atrial fibrillation in the near future.
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Comparative Study
Predictive value of acute kidney injury in medical intensive care patients with sepsis originating from different infection sites.
Sepsis is the most common noncoronary cause of mortality in intensive care units (ICUs). This study compared different systems for predicting outcomes in a population of critically ill patients with sepsis originating from different infection sites, including intra-abdominal and pulmonary infections. ⋯ This investigation confirms that different infection sites have different outcomes. In terms of mortality prediction, outcome scoring systems are significantly more accurate in patients with intra-abdominal infections than in those with pulmonary infections.