Vancomycin-Induced Red Man Syndrome

PEDIATRICS ◽  
1990 ◽  
Vol 86 (4) ◽  
pp. 572-580
Author(s):  
Maurice Levy ◽  
Gideon Koren ◽  
Lee Dupuis ◽  
Stanley E. Read
Keyword(s):  
Signs And Symptoms ◽  
The Body ◽  
Control Group ◽  
Severe Hypotension ◽  
The Face ◽  
Red Man Syndrome ◽  
History Of ◽  
Serum Vancomycin ◽  
Mild Temperature ◽  
Cold Extremities

A total of 11 cases of red man syndrome collected among 650 children who had received vancomycin in our hospital between 1986 and 1988 (estimated prevalence 1.6%) were retrospectively analyzed. These 11 children were compared with 11 age-matched children who received vancomycin in whom red man syndrome did not develop. Of the patients with red man syndrome, 73%, and of the patients with no reaction, 45.4% received vancomycin for penicillin-resistant Staphylococcus epidermidis-positive cultures, or because of history of penicillin allergy. No difference was observed in the dose per kilogram given to both groups (12.9 ± 3.5 mg/kg per dose in those with red man syndrome vs 12.3 ± 6.9 mg/kg per dose in control childrens. The duration (mean ± standard deviation) of vancomycin infusion was 45.9 ± 16.7 minutes (range 10 to 90 minutes) in patients with red man syndrome and 54.5 ± 7.6 minutes (range 45 to 65 minutes) in the control group (P = .07). In the 5 children with red man syndrome rechallenged with vancomycin, slower infusion rates prevented or reduced the syndrome, which emphasized the fact that the rate of administration is the important determinant of red man syndrome in susceptible cases. Clinically, the syndrome developed at the end of the infusion in most patients, but appeared as early as 15 minutes after initiation of the infusion. It was mostly manifested as a flushed, erythematous rash on the face, neck, and around the ears. Less frequently, the rash was distributed all over the body. Pruritus was usually localized to the upper trunk but was also generalized (2 of 11 children). Associated signs and symptoms were hypotension, watery puffy eyes, tachycardia, respiratory distress, dizziness, agitation, and mild temperature increase. A premature infant with the red man syndrome had skin rash associated with poor perfusion, cold extremities, increased need for oxygen, and severe hypotension. The rash disappeared within 20 minutes (range 5 minutes to 7 hours) after vancomycin infusion was stopped. There was no association between serum vancomycin concentrations and red man syndrome; in both groups of patients therapeutic as well as subtherapeutic concentrations were observed, suggesting that this is an idiosyncratic and not a concentration-dependent phenomenon.

scholarly journals Organophosphorus Poisoning

2008 ◽  
Vol 47 (172) ◽  
Author(s):  
Buddhi Prasad Paudyal
Keyword(s):  
Signs And Symptoms ◽  
Clinical Problem ◽  
Acute Poisoning ◽  
The Body ◽  
Organophosphorus Insecticides ◽  
Basic Principles ◽  
Initial Management ◽  
Organophosphorus Poisoning ◽  
Life Threatening ◽  
History Of

Acute poisoning by organophosphorus (OP) compounds is a major global clinical problem, withthousands of deaths occurring every year. Most of these pesticide poisoning and subsequentdeaths occur in developing countries following a deliberate self ingestion of the poison. Metacid(Methyl parathion) and Nuvan (Dichlorovos) are commonly ingested OP pesticides; Dimethoate,Profenofos, and Chlorpyrifos are other less frequently ingested compounds in Nepal. The toxicityof these OP pesticides is due to the irreversible inhibition of acetylcholinesterase (AChE) enzymeleading to accumulation of acetylcholine and subsequent over-activation of cholinergic receptorsin various parts of the body. Acutely, these patients present with cholinergic crisis; intermediatesyndrome and delayed polyneuropathy are other sequel of this form of poisoning. The diagnosisdepends on the history of exposure to these pesticides, characteristic manifestations of toxicityand improvements of the signs and symptoms after administration of atropine. The supportivetreatment of OP poisoning includes the same basic principles of management of any acutelypoisoned patient i.e., rapid initial management of airways, breathing, and circulation. Gastriclavage and activated charcoal are routinely used decontamination procedures, but their valuehas not been conclusively proven in this poisoning. Atropine is the mainstay of therapy, andcan reverse the life threatening features of this acute poisoning. However, there are no clearcut guidelines on the dose and duration of atropine therapy in OP poisoning. Cholinesterasereactivators, by regenerating AChE, can reverse both the nicotinic and muscarinic effects;however, this benefit has not been translated well in clinical trials. All these facts highlight thatthere are many unanswered questions and controversies in the management of OP poisoningand there is an urgent need for research on this aspect of this common and deadly poisoning.Key Words: poisoning, organophosphorus insecticides, decontamination, antidotes

scholarly journals Extraoral Sinus Tracts of Odontogenic Origin: A Case Series

2020 ◽  
Author(s):  
Ellahe Azizlou ◽  
Mohsen AminSobhani ◽  
Sholeh Ghabraei ◽  
Mehrfam Khoshkhounejad ◽  
Abdollah Ghorbanzadeh ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Case Series ◽  
Signs And Symptoms ◽  
Complete Recovery ◽  
Cutaneous Lesions ◽  
Odontogenic Origin ◽  
The Face ◽  
History Of ◽  
Relationship Of ◽  
Dental Infections

Extraoral sinus tracts of odontogenic origin often develop as the result of misdiagnosis of persistent dental infections due to trauma, caries, or periodontal disease. Due to these lesions' imitation from cutaneous lesions, misdiagnosis, and mismanagement, which we frequently encounter, this article aims to describe four cases with manifestations in different parts of the face and the neck. Patients were referred to an endodontist with a history of several surgical procedures and/or antibiotic therapy due to misdiagnosis. After comprehensive examinations, root canal treatment was performed. The resolution of signs and symptoms during the follow-up period confirmed the correct diagnosis. Dermatologists and other physicians should be aware of the possibility of the relationship of extraoral sinus tracts with dental infections. Precise examination and taking a comprehensive history can aid to prevent unnecessary and incorrect therapeutic and/or pharmaceutical interventions. Elimination of dental infection leads to complete recovery in such patients.

scholarly journals Orbital Emphysema after a Protracted Episode of Sneezing in a Patient with no History of Trauma or Sinus Surgery

2010 ◽  
Vol 89 (11) ◽  
pp. E12-E13 ◽  
Author(s):  
Qasim A. Khader ◽  
Khader J. Abdul-Baqi
Keyword(s):  
Signs And Symptoms ◽  
Sinus Surgery ◽  
Blowout Fracture ◽  
Orbital Emphysema ◽  
The Face ◽  
History Of ◽  
Limiting Condition ◽  
The Right ◽  
Systemic Antibiotics ◽  
Periorbital Swelling

Orbital emphysema is a benign self-limiting condition. It can occur directly (as a result of trauma to the face) or indirectly (secondary to a blowout fracture). We report a case of orbital emphysema in a 38-year-old man who presented with ecchymosis of the right eye, pressure within the right orbit, and periorbital swelling following a protracted episode of vigorous sneezing. The diagnosis was confirmed by computed tomography. Systemic antibiotics were given, and the patient was cautioned to avoid blowing his nose. His signs and symptoms resolved within 1 week.

scholarly journals Editorial

2005 ◽  
Vol 22 (2) ◽  
pp. i-iv
Author(s):  
Katherine Bullock
Keyword(s):  
Arab World ◽  
Medical Center ◽  
Knowledge Society ◽  
The Body ◽  
Modern World ◽  
Ibn Sina ◽  
Muslim Countries ◽  
The Face ◽  
History Of ◽  
Independent Thought

As Mehmet Mahfuz Söylemez documents in his “The Jundishapur School:Its History, Structure, and Functions,” Southwest Asia has long been a sitefor a cross-fertilization of ideas that have led to productive societies.Although Jundishapur’s excellence as a medical center predates the comingof Islam, it nevertheless played a key role in transmitting knowledge toMuslim physicians as well as contributing to Baghdad’s development as anup-and-coming center of excellence. In an open and welcoming climate,the scholars and physicians of Jundishapur and Baghdad fostered a learningenvironment that allowed Muslim civilizations to flourish.Today’s Muslims often look back to such “golden ages” with wistfulness,admiration, and frustration. Given the constant defeats and subjugationfaced by Muslim countries since western colonization, this wistfulness is notsurprising. In order to bolster their identity to defend themselves against thiscontinuing subjugation, Muslims often offer this glorious past to anIslamophobic world: “We are not barbarians! See what Muslim civilizationwas capable of!” And in the face of Eurocentric curricula that largely denyany role to a non-European civilization in the history of ideas since Plato,such reminders are crucial.But as Dieter Weiss’ “Paths toward an Arab Knowledge Society” inadvertentlyhighlights, such wistfulness is underscored by an ignorance of justwhat it takes to produce a golden age. For a society to flourish, it must createthe conditions that enable its inhabitants to engage in knowledge creation:the freedom to think, debate, and discuss. While he focuses only onthe Arab world, one would have to be blind to reality not to realize that thesame deplorable situation can be found in most Muslim countries today.Imagine what kind of Muslim cultural and political society must haveexisted for Ibn Sina, who produced great medical and philosophical workswhile denying the resurrection of the body. Compare that with the assassinations,death threats, and the like facing contemporary writers who engagein independent thought about Islam and the modern world. Think of the roleof caliph Ma’mun’s bayt al-hikmah (House of Wisdom), where Christians,Muslims, and scholars who followed other religions worked side-by-side to ...

scholarly journals Sports education an element of academic development

2020 ◽  
pp. 1-6
Author(s):  
Brenda Ivonne MORALES-BENÍTEZ ◽  
Ramiro MORALES-HERNÁNDEZ ◽  
Ramsés Josafath ALCARAZ-GONZÁLEZ
Keyword(s):  
Positive Influence ◽  
Point Of View ◽  
The Body ◽  
Middle Level ◽  
Control Group ◽  
Participation Decision ◽  
History Of ◽  
Academic Competencies ◽  
Middle Level Students ◽  
Made In

Sport is regularly seen as one of the forms of activation of the body that provide motor skills and contribute to healthy health, however it is important to appreciate it from the point of view of knowledge, so its contribution in aspects of academic competencies in students was analyzed upper middle level. In the first part, the history of sport was discussed, as well as the contributions of authors about educational sport and the learning generated. Subsequently, a comparison was made in young upper-middle-level students divided into two groups: the experiential group (they practice and perform exercise, sport and physical activity) and the control group (individuals who are totally sedentary), in order to observe performance. in school performance, class participation, decision making as well as knowing how influential or manipulable their peers can be to analyze and solve problems, in the study a questionnaire was applied to both groups using the Likert scale to know these results. The information obtained shows the positive influence that sport has on the development of educational capacities in students.

scholarly journals CORRECTION OF HYPODINAMY AS A FACTOR OF THE RISK OF OBESITY DEVELOPMENT IN FIRE-RESCUERS

2018 ◽  
Vol 25 (3) ◽  
pp. 40-45
Author(s):  
E. V. BURDYUKOVA ◽  
A. N. ARKHANGELSKAYA ◽  
S. N. ALEKSEENKO ◽  
I. A. YAKIREVICH ◽  
E. A. DMITRIEVA ◽  
...  
Keyword(s):  
High Efficiency ◽  
Statistical Processing ◽  
Main Group ◽  
The Body ◽  
Control Group ◽  
Test Results ◽  
Food Label ◽  
Development Indicators ◽  
History Of ◽  
In Fire

Aim. To evaluate the effectiveness of the developed special sports complex in the prevention of hypodynamia and obesity among firefighters-rescuers.Materials and methods. A survey of 490 men with no history of chronic infectious and non-infectious diseases aged 20-59 was conducted. 328 people were the main group, 162 people were the control group. The baseline data included anthropometric development indicators, bioimpedance test results, the extraction of biochemical blood test results; the body mass index (BMI) and the ratio of waist and hip circumference were determined. A questionnaire was conducted to identify hypodynamia (according to the IPAQ questionnaire) and the nutrition structure (according to the questionnaire on the food label literacy questionnaire, past). Both questionnaires were adapted to the Russian Federation. Statistica for Windows 8.0 was used for statistical processing. We used a comparison of the means of the Student method. To compare the values expressed in percent, the method of inverse trigonometric Fisher transformations was used.Results. We have developed and proposed for firefighters-rescuers, included in the main group, special sports complexes, which were used for 6 months. These complexes represent additional physical training by the developed method. There are two of them: one with an emphasis on the prevention and rehabilitation of people with osteochondrosis of the lumbar spine, and the other for cervical and thoracic localization, including with a syndrome of shoulder-scapular periarthritis.Classes were held 3 times a week, the duration of 1 session was 45-50 minutes. The choice of the complex was carried out at the request of firefighters-rescuers. The first complex was selected by 52 people. Based on the results of the study, against the background of the use of sports complexes, there was a 2-fold decrease in the incidence of obesity. Such a high efficiency is due to the fact that obesity of the I degree prevailed among the firefighters-rescuers. In addition, the frequency of occurrence of dyslipidemia, hyperglycemia, and hypodynamia decreased.Conclusion. The use of this sports complex can reduce the risk factors for development of disability among rescue firefighters by preventing hypodynamia and reducing the incidence of hyperglycemia and dyslipidemia, as factors in the development of obesity.

scholarly journals P-R interval in porcine model of chronic tachycardia-induced cardiomyopathy

2013 ◽  
Vol 57 (3) ◽  
pp. 437-441
Author(s):  
Piotr Skrzypczak ◽  
Dorota Zyśko ◽  
Urszula Pasławska ◽  
Agnieszka Noszczyk-Nowak ◽  
Adrian Janiszewski ◽  
...  
Keyword(s):  
Body Mass ◽  
Porcine Model ◽  
The Body ◽  
Atrioventricular Conduction ◽  
Control Group ◽  
Nervous System Activity ◽  
Pr Interval ◽  
Ventricular Stimulation ◽  
History Of ◽  
Tachycardia Induced Cardiomyopathy

Abstract The aim of the study was to assess the atrioventricular conduction in the model of porcine pacing induced tachycardiomyopathy. Fifty-one swine were examined: 27 were paced and 24 served as a control group. Every 4 weeks, the animals were anaesthetised for 1 h and an ECG Holter was performed. Thirty minutes after the onset of anaesthesia, P-R and R-R intervals were measured. Each result was assigned to the subgroup according to the animal’s weight and the presence or absence of previous pacing. P-R interval was longer in animals after at least 4 weeks of rapid ventricular stimulation than in adjusted group of the animals according to the body mass. Multivariate analysis has showed that longer P-R interval was related to male gender, higher body mass, slower heart rate, and history of previous pacing. Chronic ventricular pacing led to the slowing of atrioventricular conduction. The presence of differences in the duration of R-R intervals between groups was only found in swine weighing 120-139 kg. The R-R interval was shorter in paced animals, whereas PR interval was longer in that group, indicating that PR prolongation is related to electrical or structural remodelling of the cardiac conductive tissue but not increased sympathetic nervous system activity, which is expected to produce corresponding changes in PR and R-R intervals.

Therapeutic management of blood transfusion reaction in a crossbred cow

2016 ◽  
Author(s):  
N. Chand ◽  
P. S. Dhaliwal ◽  
S. K. Uppal
Keyword(s):  
Blood Transfusion ◽  
Tick Infestation ◽  
The Body ◽  
Transfusion Reaction ◽  
Pale Mucous Membrane ◽  
Blood Smear Examination ◽  
The Face ◽  
History Of ◽  
Veterinary Hospital ◽  
Crossbred Cow

A crossbred cow aged 6 year was presented to Teaching Veterinary Hospital of the Institute with the history of fever, tick infestation, anemia and decreased milk yield since last 10 days. Clinical examination revealed fever, pale mucous membrane and nil rumen motility. Hematological examination findings were anemia, leucopenia, relative neutrophilia and lymphopenia and decreased platelets. Blood smear examination revealed Anaplasma Marginale infection. Animal was treated with blood transfusion, oxytetracyclin, oral hematinic and multivitamin. After half an hour of start of transfusion, cow showed transfusion reaction in the form of urticarial eruptions all over the body, edema of eyelids, lips and over the face, frothy discharge from mouth with muscle tremor and shivering. Transfusion reaction was successfully managed with Adrenalin, Dexona, Avil along with normal saline.

scholarly journals Metastatic Cutaneous Melanoma of the Gallbladder

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Dhruvan Patel ◽  
Shazia Sohrawardy ◽  
Yub Raj Sedhai ◽  
Soney Basnyat ◽  
Anisha Daxini ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Metastatic Melanoma ◽  
Cutaneous Melanoma ◽  
Wedge Resection ◽  
The Body ◽  
Aggressive Disease ◽  
Laparoscopic Excision ◽  
The Face ◽  
History Of

Metastatic melanoma is an aggressive disease that can spread to many organs of the body. In rare cases, it can spread to the gallbladder causing secondary lesions, yet presenting with little to no symptoms. Therefore, most cases of metastatic melanoma lesions to the gallbladder go undiagnosed. Here, we present the case of a 41-year-old male with a four-month history of melanoma of the face, with a postresection status, who presented with right upper quadrant abdominal pain. Doppler ultrasound and computed tomography confirmed the presence of a mass on the gallbladder. Laparoscopic excision along with liver wedge resection was performed. Pathology staining revealed the presence of a malignant metastatic melanoma lesion of the gallbladder.

Childhood Headache Risk: Warning Signs and Symptoms Present During the First Six Months of Life*

Cephalalgia ◽  
1984 ◽  
Vol 4 (4) ◽  
pp. 237-242 ◽  
Author(s):  
Vincenzo Guidetti ◽  
Salvatore Ottaviano ◽  
Marina Pagliarini
Keyword(s):  
Signs And Symptoms ◽  
Warning Signs ◽  
Common Finding ◽  
Control Group ◽  
Periodic Syndrome ◽  
Risk Warning ◽  
Behavioural Characteristics ◽  
Childhood Headache ◽  
History Of ◽  
A Prospective Study

In the history of children suffering from non-organic headache, the presence of periodic syndromes can often be found. In previous observations we ascertained that periodic syndromes are a common finding in children showing physical and behavioural characteristics of “hyperreactivity” in the first months of their lives. We have tried to verify, through a prospective study, whether children with “hyperreactivity” in the first months of life are particularly prone to develop periodic syndromes and/or non-organic headache. We have developed an appropriate test for the assessment of hyperreactivity in the first 6 months of life. We have isolated 183 hyperreactive subjects; 102 of them have been followed-up to an average age of 10.8 years, together with a control group of 80 subjects followed-up to an average age of 10.2 years. Of the 102 hyperreactive infants, 54 (52.9%) suffered from common migraine, versus 12 (15%) of the control group; 66 (64.5%) hyperreactive infants suffered from periodic syndrome, versus 10 (12.5%) of the control group. There was frequently a co-existence of migraine and periodic syndrome. It is thus possible to identify infants who are particularly prone to develop periodic syndromes and headache.

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