Open Access DOI:10.23937/2378-3656/1410304
Remifentanil: Pharmacokinetics, Pharmacodynamics, and Current Clinical Applications
Marco A Maurtua, MD, Amanda Pursell, MD, Kyle Damron, MD and Patel Sonal, MD
Article Type: Review Article | First Published: April 15, 2020
Remifentanil is a mu-receptor agonist chemically related to fentanyl, alfentanil, and sufentanil that was approved for use in general anesthesia in 1996 by the US Food and Drug Administration. It is a piperidine derivative, a 3-(4-methoxycarbonyl-4-[(L-oxopropyl)- phenylamino]-L-piperidine) propanoic acid, methyl ester. The introduction of the methyl ester group onto the N-acyl side chain of the piperidine ring is what makes remifentanil structurally unique among the currently available opioids....
Open Access DOI:10.23937/2378-3656/1410303
Subnormal Thyroid Makes the Heart Skip a Beat
Supraja Thunuguntla, MD, Rizwan Mohammed, MBBS, Lauren Muenchow, MS and Jose Campo Maldonado, MD, FACP
Article Type: Case Report | First Published: April 11, 2020
A 72-year-old Hispanic male with an unconfirmed history of alcohol-related cirrhosis presented to the hospital for rectal bleeding and dark stool for two days. Vitals included a heart rate of 90-120 bpm, blood pressure 90-140 over 50-60 mmHg. A left thyroid nodule was appreciated on physical exam. His pertinent labs included TSH, free T3 and T4 levels that were 0.033 mU/L (low), 3.33 mU/L and 1.33 mU/L (both within normal limits) respectively. A TSH done 3 days later was low (0.024). Thyroid per...
Open Access DOI:10.23937/2378-3656/1410302
Trench Fever in Texas
E Jane Gibson, MD, Tuyet T Pham, MD, Tove M Goldson, MD, PhD and Samuel N Forjuoh, MD, MPH, DrPH
Article Type: Case Report | First Published: March 30, 2020
Trench Fever is caused by Bartonella quintana, a small fastidious gram-negative rod organism carried by the body louse. We report a case of a 62-year-old woman who was admitted to a hospital in central Texas for a two-week history of fever and malaise. She was initially treated for Q fever which is usually caused by inhaling dust particles contaminated by infected animals, given that she was regularly around farm animals, but when her extensive infectious disease panel came back negative, the se...
Open Access DOI:10.23937/2377-4630/1410105
Intraoperative Activation of Very Wide Range Cold Agglutinins during a Cardiac Bypass Case
Saurin J Shah, MD, Juan C Mora, MD, Shashank S Shettar, MD and John P Pirris, MD
Article Type: Case Report | First Published: April 22, 2020
Cold agglutinin disease is a rare form of autoimmune hemolytic anemia mediated mainly by IgM antibodies reacting to surface antigens of the red blood cells at low temperatures causing agglutination and posterior hemolysis on rewarming. Patients with this condition might never be symptomatic, but when they are exposed to hypothermia during cardiovascular procedures, these reactions can be triggered leading to serious organ damage. We describe/discuss a case of a patient with a wide range cold agg...
Open Access DOI:10.23937/2572-3286.1510050
A Case of Cryoglobulinemia after Successful Hepatitis C Virus Treatment
Christopher Farmakis, MD, Victor Canela, DO, Leigh Hunter, MD, FACP, Ravina Linenfelser, DO, Brooke Mills, MD, Kyawt Shwin, MD and Anne R Murray, PhD
Article Type: Case Report | First Published: April 09, 2020
Cryoglobulinemic vasculitis is a complex and destructive disease process that affects multiple organ systems. The pathophysiology includes formation of immune complex deposits that create an inflammatory response in various organs, yielding distinct presentations such as purpura, arthralgias, neuropathy, fever, and pulmonary vasculitis. Over 30% of cryoglobulinemic vasculitis cases present with glomerulonephritis, which carries a worse prognosis. The majority of mixed cryoglobulinemia cases are ...
Open Access DOI:10.23937/2378-3672/1410043
Purine Nucleoside Phosphorylase Inhibitors as Novel Immuno- Oncology Agent and Vaccine Adjuvant
Shanta Bantia
Article Type: Original Article | First Published: April 06, 2020
Purine Nucleoside Phosphorylase (PNP) deficiency in humans causes lymphopenia and this provided the rationale for developing PNP inhibitors as immunosuppressive agents. However, careful re-evaluation of clinical history of PNP deficient patients and clinical experience with PNP inhibitors together with new experimental data suggest inhibition of PNP may have immune activating effects through elevation of guanosine and activation of various tolllike receptors (TLRs). This paper proposes a mechani...
Open Access DOI:10.23937/2469-5742/1510069
Radical Prostatectomy versus External Beam Radiotherapy - Indication and the Way to the Decision: A Cumulative Non- Interventional Unicentric Retrospective Trial of about 20 Years
Wolf-Diether U Boehm, Rainer Koch, Michael Froehner, Stefanie Wenzel, Carmen Werner, Alexander Mehnert and Manfred P Wirth
Article Type: Original Article | First Published: April 06, 2020
From the clinical reality of a private consultation, a non-interventional, parallel, two-armed, non-randomized study was started in close cooperation with the Regional Clinical Cancer Register Dresden for the period 1996-2016, in order to objectively define the allocation algorithms for the primary therapy decision RPE vs. ERBT retrospectively in the curative setting for clinically, localized to locally advanced tumor. Furthermore, the implications of this decision on the result should be review...
Open Access DOI:10.23937/2572-4061.1510031
Epidemiology and Diffusion of Some Relevant Virus: Latitude, Air Pollutants and Humidity Role, Hypothesis of Work: Covid-19 Effect on the Air Pollution in Some World Region: What Implications?
Luisetto M, Ahmed Yesvi Rafa, Khaled Edbey, Ghulam Rasool Mashori, Farhan Ahmad and Oleg Yurevich Latyshev
Article Type: Research Article | First Published: April 09, 2020
Related some recent example of human virus diffusion and epidemiology is interesting to observe some facts related latitude, climate, air pollutants and other. In this work only few images are used to submit and hypothesis of work to better understand some process. Is interesting to observe that WUHAN is a region characterized by a specific air pollutants status and near two big river in a determinate latitude. Obviously, the human transmission and the relationship with animal transmission can n...
Open Access DOI:10.23937/2474-3658/1510116
COVID-19 Threat to Major Global Urban Centers
Jean-dAmour K Twibanire
Article Type: Original Article | First Published: April 22, 2020
The world is facing an unprecedented test by an enemy, a novel and deadly enemy, the COVID-19 pandemic. As COVID-19 continues to spread all around the world, social, political and serious economic consequences await this planet. After the introduction and a brief epidemiological summary, this article discusses the threat that is COVID-19 to major global urban centers. The impact of COVID-19 across the globe is particularly inimitable and more so in major global urban centers for several reasons ...