BMC research notes
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Extracorporeal membrane oxygenation (ECMO) technology is a viable option for short-term support in the setting of acute cardiac ischemia. To supplement cardiopulmonary resuscitation (CPR) in select patients, ECMO is used successfully for witnessed in hospital cardiac arrest. In the setting of an acute myocardial infarction (MI), bridging to a revascularization procedure is important in improving overall survival. ⋯ Our case highlights the importance of early initiation of ECMO during PCI in achieving both improved cardiac and neurological outcomes during an acute coronary syndrome (ACS).
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Telemedicine is increasingly being used as part of routine practice for many physicians and healthcare providers across the country. Due to its visual nature, dermatology is ideally suited to benefit from this new technology. The use of teledermatology (telemedicine in dermatology) in a primary care setting allows for an expert opinion without the need for an in-person referral. Furthermore, it can improve patient access in remote areas. Store-and-forward teledermatology is the most commonly employed method. ⋯ This case demonstrates the utility of store-and-forward teledermatology in what is unfortunately not an uncommon scenario in Canada. The patient was successfully managed, and a logistically difficult and expensive in-person referral was avoided.
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Intraspinal neurocysticercosis is an uncommon manifestation that may present as an isolated lesion. Furthermore, acute hydrocephalus caused by isolated intraspinal neurocysticercosis without concomitant cerebral involvement is extremely rare. ⋯ Isolated spinal neurocysticercosis should be considered in the differential diagnosis of acute hydrocephalus when no explanation is found in the brain, particularly in geographical regions endemic for cysticercosis.
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The Centers for Disease Control and Prevention (CDC) and the United States Preventive Services Task Force (USPSTF) recently augmented risk-based hepatitis C (HCV) screening guidelines with a recommendation to perform one-time screening in all persons born during 1945 - 1965, a birth cohort known to have a higher prevalence of HCV. We sought to estimate the proportion of veterans seen at the Atlanta VA Medical Center (AVAMC) who had ever been screened for HCV infection by birth year. ⋯ Nearly half of the veterans seen in 2011 at the AVAMC had ever been tested for HCV infection. When examined by birth cohort, over half of the veterans born during 1945 - 1965 had been screened for HCV and 15% of those screened had a positive HCV antibody. Our findings confirm the increased prevalence of HCV infection in persons born during 1945 - 1965 as identified in the updated CDC and USPSTF recommendations.
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Although sevoflurane and propofol are commonly used anesthetics in rabbits, optimal doses of remain unclear. We thus assessed the optimal hypnotic doses of sevoflurane and propofol, and evaluated the influence of dexmedetomidine on sevoflurane and propofol requirements. ⋯ The optimal end-tidal concentration of sevoflurane alone was thus 3.9%, and optimal infusion rate for propofol alone was 102 mg∙kg(-1)∙hr(-1). Dexmedetomidine reduced sevoflurane requirement by 33% and propofol requirement by 11%.