A systematic review of adverse drug events associated with administration of common asthma medications in children.

Objective: To systematically review the literature and determine frequencies of adverse drug events (ADE) associated with pediatric asthma medications.

Methods: Following PRISMA guidelines, we systematically searched six bibliographic databases between January 1991 and January 2017. Study eligibility, data extraction and quality assessment were independently completed and verified by two reviewers.

Back pain in the emergency department: Pathological fracture following spinal manipulation.

Back pain is one of the most common presentations to the emergency department. Though case reports of patients presenting with increased back pain following chiropractic spinal manipulations are rare, we have identified a case rarely reported in the literature where a potential injury from chiropractic manipulation resulted in a diagnosis of multiple myeloma. We have reported a previously healthy 66-year-old male who presented with persistent lower back pain over 4 weeks.

Urine metabolomic profiling of children with respiratory tract infections in the emergency department: a pilot study.

Background: Clinicians lack objective tests to help determine the severity of bronchiolitis or to distinguish a viral from bacterial causes of respiratory distress. We hypothesized that children with respiratory syncytial virus (RSV) infection would have a different metabolomic profile compared to those with bacterial infection or healthy controls, and this might also vary with bronchiolitis severity.

Methods: Clinical information and urine-based metabolomic data were collected from healthy age-matched children (n = 37) and those admitted to hospital with a proven infection (RSV n = 55; Non-RSV viral n = 16; bacterial n = 24).

Intravenous and Oral Contrast vs Intravenous Contrast Alone Computed Tomography for the Visualization of Appendix and Diagnosis of Appendicitis in Adult Emergency Department Patients.

Purpose: The study sought to compare radiologist's ability to 1) visualize the appendix; 2) diagnose acute appendicitis; and 3) diagnose alternative pathologies responsible for acute abdominal pain among adult patients undergoing computed tomography (CT) scan with 3 different protocols: 1) intravenous (IV) contrast only; 2) IV and oral contrast with 1-hour transit time; and 3) IV and oral contrast with 3-hour transit time.

Methods: We collected data of 225 patients; 75 consecutive patients with a clinical suspicion of appendicitis received oral contrast for 3 hours and IV contrast, 75 received oral contrast for 1 hour and IV contrast, and 75 trauma patients received IV contrast only. Three independent reviewers, blinded to final pathology, retrospectively analysed the cases and documented visualization of the appendix, periappendiceal structures, and their confidence in diagnosing appendicitis.

Monitoring asthma status.

Purpose: Asthma is a chronic disorder of the airways involving inflammation and airway hyper-reactivity. Clinical diagnosis and monitoring of asthma must incorporate the immunological, biochemical, and histological changes of a chronic disorder, while recognizing acute phenotypic changes in order to optimally tailor therapeutics to each individual.

Recent Findings: Articles published within the previous 18 months are summarized in this article in order to present an up to date review of the latest findings regarding the monitoring of asthma.

Metabolomic profiling of asthma: diagnostic utility of urine nuclear magnetic resonance spectroscopy.

Background: The ability to diagnose and monitor asthma on the basis of noninvasive measurements of airway cellular dysfunction is difficult in the typical clinical setting.

Objective: Metabolomics is the study of molecules created by cellular metabolic pathways. We hypothesized that the metabolic activity of children with asthma would differ from healthy children without asthma.

Pneumococcal pneumonia: potential for diagnosis through a urinary metabolic profile.

Pneumonia, an infection of the lower respiratory tract, is caused by any of a number of different microbial organisms including bacteria, viruses, fungi, and parasites. Community-acquired pneumonia (CAP) causes a significant number of deaths worldwide, and is the sixth leading cause of death in the United States. However, the pathogen(s) responsible for CAP can be difficult to identify, often leading to delays in appropriate antimicrobial therapies.

Metabolomic biomarkers in a model of asthma exacerbation: urine nuclear magnetic resonance.

Rationale: Airway obstruction in patients with asthma is associated with airway dysfunction and inflammation. Objective measurements including sputum analysis can guide therapy, but this is often not possible in typical clinical settings. Metabolomics is the study of molecules generated by metabolic pathways.

Investigations of the effects of gender, diurnal variation, and age in human urinary metabolomic profiles.

Metabolomics may have the capacity to revolutionize disease diagnosis through the identification of scores of metabolites that vary during environmental, pathogenic, or toxicological insult. NMR spectroscopy has become one of the main tools for measuring these changes since an NMR spectrum can accurately identify metabolites and their concentrations. The predominant approach in analyzing NMR data has been through the technique of spectral binning.

NMR analysis of neutrophil activation in sputum samples from patients with cystic fibrosis.

Disorders of the respiratory system, such as cystic fibrosis (CF), involve the infiltration and activation of airway inflammatory cells, including neutrophils. This leads to the secretion of peroxidases, which react further with substrates in solution to produce oxidative metabolites, such as 3-chlorotyrosine. Elevated levels of modified tyrosine residues in the airways of patients with CF may be detectable by nuclear magnetic resonance (NMR) in correlation with inflammatory cell influx.

Kinetic studies of calcium and cardiac troponin I peptide binding to human cardiac troponin C using NMR spectroscopy.

Ca2+ and human cardiac troponin I (cTnI) peptide binding to human cardiac troponin C (cTnC) have been investigated with the use of 2D [1H,15N] HSQC NMR spectroscopy. The spectral intensity, chemical shift, and line-shape changes were analyzed to obtain the dissociation ( K(D)) and off-rate ( k(off)) constants at 30 degrees C. The results show that sites III and IV exhibit 100-fold higher Ca2+ affinity than site II ( K(D(III,IV)) approximately 0.