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  1. Article: Severe Respiratory Alkalosis in Acute Ischemic Stroke: A Rare Presentation.

    Muppidi, Vijayadershan / Kolli, Sashank / Dandu, Vasuki / Pathireddy, Samata / Meegada, Sreenath

    Cureus

    2020  Volume 12, Issue 4, Page(s) e7747

    Abstract: Respiratory alkalosis is a rare but severe complication of acute ischemic stroke (AIS). In ischemic stroke, respiratory alkalosis results from hyperventilation due to the effect of stroke on the respiratory center. We report a case of a young male who ... ...

    Abstract Respiratory alkalosis is a rare but severe complication of acute ischemic stroke (AIS). In ischemic stroke, respiratory alkalosis results from hyperventilation due to the effect of stroke on the respiratory center. We report a case of a young male who presented with acute encephalopathy. Work-up revealed ischemic infarcts in the bilateral cerebellar and left posterior cerebral artery territory. Arterial blood gas (ABG) showed severe respiratory alkalosis with a pH of 7.72. Alkalosis resolved with mechanical ventilation. Such a high pH associated with AIS has not been reported in the medical literature so far. The index case highlights the severity of respiratory alkalosis that can be caused by an AIS. We conclude that early diagnosis and management of severe respiratory alkalosis is crucial for survival and recovery.
    Language English
    Publishing date 2020-04-20
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.7747
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Seizures, renal failure and acute respiratory failure: not your typical case of Henoch-Schonlein purpura.

    Bose, Subhasish / Pathireddy, Samata / Baradhi, Krishna M / Aeddula, Narothama Reddy

    BMJ case reports

    2019  Volume 12, Issue 7

    Abstract: A 30-year-old Caucasian woman with no prior medical history presented with pedal oedema, arthralgias and abdominal pain with diarrhoea, following a respiratory infection. She had mild abdominal tenderness along with a purpuric rash on the extremities and ...

    Abstract A 30-year-old Caucasian woman with no prior medical history presented with pedal oedema, arthralgias and abdominal pain with diarrhoea, following a respiratory infection. She had mild abdominal tenderness along with a purpuric rash on the extremities and was anaemic. Following initial workup for anaemia and rash, her condition deteriorated with renal impairment, respiratory failure and seizures necessitating ventilatory support, dialysis and steroids. Serologies were negative, and skin biopsy showed leucocytoclastic vasculitis without vascular IgA deposition, and renal biopsy showed subendothelial, mesangial deposits of IgA with C3 indicative of Henoch-Schonlein purpura (HSP). She was treated with steroids, haemodialysis and on 6-month follow-up recovered renal function. We present the case to illustrate that HSP, though rare in adults, can present with multiorgan failure, with renal, pulmonary and central nervous system involvement, and the need for early diagnosis and prompt treatment for rapid clinical recovery.
    MeSH term(s) Acute Kidney Injury/diagnosis ; Acute Kidney Injury/etiology ; Acute Kidney Injury/pathology ; Acute Kidney Injury/therapy ; Adrenal Cortex Hormones/therapeutic use ; Adult ; Anticonvulsants/therapeutic use ; Biopsy ; Electroencephalography ; Female ; Glomerulonephritis/etiology ; Glomerulonephritis/pathology ; Glomerulonephritis/therapy ; Humans ; Magnetic Resonance Imaging ; Purpura, Schoenlein-Henoch/complications ; Purpura, Schoenlein-Henoch/diagnosis ; Purpura, Schoenlein-Henoch/pathology ; Purpura, Schoenlein-Henoch/therapy ; Renal Dialysis ; Respiration, Artificial ; Respiratory Distress Syndrome/etiology ; Respiratory Distress Syndrome/therapy ; Seizures/diagnosis ; Seizures/drug therapy ; Seizures/etiology
    Chemical Substances Adrenal Cortex Hormones ; Anticonvulsants
    Language English
    Publishing date 2019-07-17
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2019-229939
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Epicardial Adipose Tissue and Renal Disease.

    Aeddula, Narothama Reddy / Cheungpasitporn, Wisit / Thongprayoon, Charat / Pathireddy, Samata

    Journal of clinical medicine

    2019  Volume 8, Issue 3

    Abstract: Epicardial adipose tissue (EAT) is derived from splanchnic mesoderm, localized anatomically between the myocardium and pericardial visceral layer, and surrounds the coronary arteries. Being a metabolically active organ, EAT secretes numerous cytokines, ... ...

    Abstract Epicardial adipose tissue (EAT) is derived from splanchnic mesoderm, localized anatomically between the myocardium and pericardial visceral layer, and surrounds the coronary arteries. Being a metabolically active organ, EAT secretes numerous cytokines, which moderate cardiovascular morphology and function. Through its paracrine and vasocrine secretions, EAT may play a prominent role in modulating cardiac function. EAT protects the heart in normal physiological conditions by secreting a variety of adipokines with anti-atherosclerotic properties, and in contrast, secretes inflammatory molecules in pathologic conditions that may play a dynamic role in the pathogenesis of cardiovascular diseases by promoting atherosclerosis. Considerable research has been focused on comparing the anatomical and biochemical features of EAT in healthy people, and a variety of disease conditions such as cardiovascular diseases and renal diseases. The global cardiovascular morbidity and mortality in renal disease are high, and there is a paucity of concrete evidence and societal guidelines to detect early cardiovascular disease (CVD) in this group of patients. Here we performed a clinical review on the existing evidence and knowledge on EAT in patients with renal disease, to evaluate its application as a reliable, early, noninvasive biomarker and indicator for CVD, and to assess its significance in cardiovascular risk stratification.
    Language English
    Publishing date 2019-03-02
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm8030299
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Alport's syndrome and intracranial aneurysm: mere coincidence or undiscovered causal relationship.

    Bose, Subhasish / Pathireddy, Samata / Baradhi, Krishna M / Aeddula, Narothama Reddy

    BMJ case reports

    2019  Volume 12, Issue 1

    Abstract: A 44-year-old Caucasian man with a history of deceased donor renal transplant for end-stage renal disease from Alport's syndrome (AS), presented with a spontaneous subarachnoid haemorrhage and hydrocephalus. Following an external ventricular drain for ... ...

    Abstract A 44-year-old Caucasian man with a history of deceased donor renal transplant for end-stage renal disease from Alport's syndrome (AS), presented with a spontaneous subarachnoid haemorrhage and hydrocephalus. Following an external ventricular drain for the hydrocephalus, a CT angiography revealed a dissection of the left vertebral artery extending into vertebro-basilar junction necessitating a bypass between left occipital artery to left posterior inferior cerebellar artery. He had a posterior fossa Craniectomy, C1 laminectomy and coiling off, of the left vertebral artery. Postprocedure course was prolonged but uneventful with complete recovery and normal renal function 18 months postpresentation. AS, a disease caused by abnormalities in the synthesis of type IV collagen, can cause aneurysms with severe and permanent neurological sequalae. We present a case of AS with intracranial arterial dissection with potential life-threatening consequences and discuss the genetic and molecular basis of AS along with review of the relevant literature.
    MeSH term(s) Adult ; Diagnosis, Differential ; Humans ; Intracranial Aneurysm/complications ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/surgery ; Male ; Nephritis, Hereditary/complications ; Nephritis, Hereditary/physiopathology ; Tomography, X-Ray Computed
    Language English
    Publishing date 2019-01-29
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2018-228175
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Methamphetamine (

    Baradhi, Krishna M / Pathireddy, Samata / Bose, Subhasish / Aeddula, Narothama Reddy

    BMJ case reports

    2019  Volume 12, Issue 9

    Abstract: A 26-year-old Caucasian man with no medical history, except years of oral and intravenous drug abuse, presented with fatigue, shortness of breath, epistaxis and uncontrolled hypertension. He was pale with skin ecchymosis over his thighs and was anaemic, ... ...

    Abstract A 26-year-old Caucasian man with no medical history, except years of oral and intravenous drug abuse, presented with fatigue, shortness of breath, epistaxis and uncontrolled hypertension. He was pale with skin ecchymosis over his thighs and was anaemic, with severe renal failure and metabolic acidosis. Following initial clinical stabilisation of the patient, a renal biopsy was obtained, which showed vascular and glomerular changes consistent with thrombotic microangiopathic injury and advanced glomerulosclerosis. He was treated with antihypertensives and required haemodialysis. He admitted using 'crystal meth' regularly for many years, which is likely responsible for his renal failure. We present the case to illustrate methamphetamine-induced renal disease leading to end-stage renal disease and to bring awareness among practising clinicians, ancillary healthcare workers and public health professionals of this often undervalued cause of renal failure, which can be prevented.
    MeSH term(s) Acidosis/complications ; Adult ; Disease Progression ; Humans ; Hypertension/complications ; Kidney Failure, Chronic/chemically induced ; Kidney Failure, Chronic/pathology ; Male ; Methamphetamine/adverse effects ; Substance Abuse, Intravenous ; Substance Abuse, Oral
    Chemical Substances Methamphetamine (44RAL3456C)
    Language English
    Publishing date 2019-09-19
    Publishing country England
    Document type Case Reports
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2019-230288
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Rare but not beyond care: a young female with altered mental status and seizures.

    Pathireddy, Samata / Bose, Subashish / Baradhi, Krishna / Aeddula, Narothama Reddy

    Oxford medical case reports

    2019  Volume 2019, Issue 8

    Abstract: A 40-year-old Caucasian lady with focal crescentic glomerulonephritis (p-ANCA) demonstrated by kidney biopsy, was treated with intravenous pulse steroids followed by weekly outpatient rituximab infusions (375 mg/m2). Five days after the fourth and final ... ...

    Abstract A 40-year-old Caucasian lady with focal crescentic glomerulonephritis (p-ANCA) demonstrated by kidney biopsy, was treated with intravenous pulse steroids followed by weekly outpatient rituximab infusions (375 mg/m2). Five days after the fourth and final rituximab infusion, she developed headaches, altered mental status and seizures. Upon transfer to our facility, magnetic resonance imaging of the brain revealed cortical white matter changes suggestive of possible progressive multifocal leukoencephalopathy (PML) or posterior reversible encephalopathy syndrome (PRES). She was aggressively treated with antihypertensives, anti-seizure medications, intravenous steroids, plasmapheresis and ventilatory support while awaiting cerebrospinal fluid analysis and polymerase chain reaction on John Cunningham virus DNA. She had a complete recovery and, at 1 year follow up, was found to be doing well. Awareness of potential complications of rituximab therapy, such as PRES or PML is critical in providing appropriate treatment.
    Language English
    Publishing date 2019-07-31
    Publishing country England
    Document type Journal Article
    ZDB-ID 2766251-2
    ISSN 2053-8855
    ISSN 2053-8855
    DOI 10.1093/omcr/omz072
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Guillain-Barre syndrome with concurrent posterior reversible encephalopathy syndrome and hyponatraemia: mere coincidence or rare coexistence.

    Drye, Carley / Bose, Subhasish / Pathireddy, Samata / Aeddula, Narothama Reddy

    BMJ case reports

    2019  Volume 12, Issue 7

    Abstract: A 61-year-old Caucasian woman with a history of hypertension presented with a week's history of confusion falls and back pain was found to have hyponatraemia from secretion of antidiuretic hormone and treated appropriately. Given her persistent symptoms, ...

    Abstract A 61-year-old Caucasian woman with a history of hypertension presented with a week's history of confusion falls and back pain was found to have hyponatraemia from secretion of antidiuretic hormone and treated appropriately. Given her persistent symptoms, despite a normal CT head on presentation, an MRI head was obtained, showing vasogenic oedema in line with posterior reversible encephalopathy syndrome (PRES). Despite aggressive antihypertensives and supportive measures, unfortunately, her condition deteriorated, with increased confusion, new left-sided flaccid paresis, paraesthesias and worsening of the back pain. Following further testing including a cerebrospinal fluid analysis, finally diagnosed with an atypical presentation of Guillain-Barre syndrome (GBS), and prompt management with intravenous immunoglobulins was initiated. She recovered clinically and returned to near-normal function on follow-up. We use this case to suggest the importance of dysautonomia in GBS and various clinical manifestations it can present with, including PRES and hyponatraemia.
    MeSH term(s) Accidental Falls ; Confusion/etiology ; Female ; Guillain-Barre Syndrome/diagnosis ; Guillain-Barre Syndrome/drug therapy ; Guillain-Barre Syndrome/physiopathology ; Humans ; Hyponatremia/drug therapy ; Hyponatremia/physiopathology ; Immunoglobulins, Intravenous/therapeutic use ; Immunologic Factors/therapeutic use ; Magnetic Resonance Imaging ; Middle Aged ; Posterior Leukoencephalopathy Syndrome/drug therapy ; Posterior Leukoencephalopathy Syndrome/physiopathology ; Treatment Outcome
    Chemical Substances Immunoglobulins, Intravenous ; Immunologic Factors
    Language English
    Publishing date 2019-07-11
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2019-229749
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Hydralazine-associated antineutrophil cytoplasmic antibody vasculitis with pulmonary-renal syndrome.

    Aeddula, Narothama Reddy / Pathireddy, Samata / Ansari, Asif / Juran, Peter J

    BMJ case reports

    2018  Volume 2018

    Abstract: Hydralazine, a vasodilator, is commonly used as an adjunctive treatment for moderate to severe hypertension, heart failure and hypertensive emergencies in pregnancy. Hydralazine-induced lupus was first described in 1953. Clinical presentation ranges from ...

    Abstract Hydralazine, a vasodilator, is commonly used as an adjunctive treatment for moderate to severe hypertension, heart failure and hypertensive emergencies in pregnancy. Hydralazine-induced lupus was first described in 1953. Clinical presentation ranges from arthralgia, myalgia, petechiae, or rash to single or multiorgan involvement. An occurrence of systemic vasculitis is a rare complication. When presented as the pulmonary-renal syndrome, it could have a rapidly progressive course which can be fatal. Here, we describe a case of hydralazine-associated rapidly progressive glomerulonephritis and pulmonary haemorrhage. We use this case to review the current literature and discuss and highlight the importance of a high degree of clinical acumen, early diagnosis and prompt treatment for better clinical outcomes.
    MeSH term(s) Aged ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/chemically induced ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/therapy ; Biopsy ; Blood Protein Electrophoresis ; Diagnosis, Differential ; Female ; Fluid Therapy ; Glomerulonephritis/chemically induced ; Glomerulonephritis/therapy ; Glucocorticoids ; Hemorrhage/chemically induced ; Hemorrhage/therapy ; Humans ; Hydralazine/adverse effects ; Immunologic Factors ; Kidney Glomerulus/drug effects ; Lung/drug effects ; Lung Diseases/chemically induced ; Lung Diseases/therapy ; Prednisolone ; Renal Dialysis ; Rituximab ; Syndrome ; Vasodilator Agents/adverse effects
    Chemical Substances Glucocorticoids ; Immunologic Factors ; Vasodilator Agents ; Hydralazine (26NAK24LS8) ; Rituximab (4F4X42SYQ6) ; Prednisolone (9PHQ9Y1OLM)
    Language English
    Publishing date 2018-11-08
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2018-227161
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Contribution of T-SPOT.TB Assay to the Diagnosis of Active Tuberculosis Infection among Chronic Kidney Disease Patients on Immunosuppressive Therapy.

    Aeddula, Narothama Reddy / Pathireddy, Samata / Thongprayoon, Charat / Bathini, Tarun / Cheungpasitporn, Wisit

    Journal of investigative surgery : the official journal of the Academy of Surgical Research

    2019  Volume 33, Issue 9, Page(s) 859–860

    MeSH term(s) Early Diagnosis ; Humans ; Immunosuppressive Agents ; Renal Insufficiency, Chronic ; Tuberculosis
    Chemical Substances Immunosuppressive Agents
    Language English
    Publishing date 2019-03-09
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 639444-9
    ISSN 1521-0553 ; 0894-1939
    ISSN (online) 1521-0553
    ISSN 0894-1939
    DOI 10.1080/08941939.2019.1574323
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2364: Show issues Location:
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  10. Article ; Online: Cholesterol efflux capacity and atherosclerosis.

    Aeddula, Narothama Reddy / Trivedi, Nitin / Pathireddy, Samata

    The New England journal of medicine

    2011  Volume 364, Issue 15, Page(s) 1472–3; author reply 1474–5

    MeSH term(s) Blood Glucose/metabolism ; Cholesterol/metabolism ; Exercise/physiology ; Humans ; Hyperglycemia/metabolism ; Lipoproteins, HDL/metabolism ; Macrophages/metabolism ; Oxidative Stress
    Chemical Substances Blood Glucose ; Lipoproteins, HDL ; Cholesterol (97C5T2UQ7J)
    Language English
    Publishing date 2011-04-14
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMc1101853#SA2
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    In stock of ZB MED Cologne/Königswinter

    Ua VI Zs.34: Show issues Location:
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