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Use of High-dose Hydroxocobalamin for Septic Shock.
Chest
January 2025
The Pulmonary Center, Boston University Chobanian & Avedisian School of Medicine, Department of Medicine, Boston, Massachusetts.
Developments in the epidemiology of calcium channel blocker poisoning and implications for management.
Curr Opin Crit Care
December 2024
Department of Emergency Medicine Hennepin Healthcare.
Purpose Of Review: The aim of this study was to outline recent developments in calcium channel blocker (CCB) poisoning. The dihydropyridine CCB amlodipine is commonly prescribed in the United States, and amlodipine poisoning is increasing in frequency, presenting new challenges for clinicians because current paradigms of CCB poisoning management arose from literature on non-dihydropyridine agents.
Recent Findings: Amlodipine is now the most common CCB involved in poisoning.
Article Synopsis
- Vitamin B12 deficiency can lead to serious neurological issues, including developmental and epileptic encephalopathy, which is rare in infants.
- A case study presented an 11-month-old girl experiencing severe seizures and developmental delays caused by a mutation in the FUT2 gene that affects vitamin B12 absorption.
- Following diagnosis, she was treated with intramuscular hydroxocobalamin, highlighting the importance of identifying genetic causes of vitamin deficiencies in similar cases.
Improved biochemical and neurodevelopmental profiles with high-dose hydroxocobalamin therapy in cobalamin C defect.
J Inherit Metab Dis
January 2025
Division of Metabolic Diseases and Hepatology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Article Synopsis
- Cobalamin C (Cbl-C) defect leads to serious health issues like methylmalonic acidemia and cognitive impairment, but treatment with hydroxocobalamin (OH-Cbl) doses remains uncertain.
- * A study compared high-dose OH-Cbl treatment in newborn screening (NBS)-diagnosed patients to low-dose treatment in other groups, showing that the high-dose group had significantly better metabolic and neurodevelopmental outcomes.
- * Results indicated that while high-dose treatment improved overall health markers and cognitive performance, it did not affect the incidence of maculopathy, signaling a need for clearer dosing guidelines in Cbl-C treatment.*
Diagnosis and Management of Vasoplegia in Temporary Mechanical Circulatory Support: A Narrative Review.
J Cardiothorac Vasc Anesth
June 2024
Veterans Affairs Boston Healthcare System, Department of Anesthesia, Critical Care and Pain Medicine, and Tufts University School of Medicine, Boston, MA.
Refractory vasodilatory shock, or vasoplegia, is a pathophysiologic state observed in the intensive care unit and operating room in patients with a variety of primary diagnoses. Definitions of vasoplegia vary by source but are qualitatively defined clinically as a normal or high cardiac index and low systemic vascular resistance causing hypotension despite high-dose vasopressors in the setting of euvolemia. This definition can be difficult to apply to patients undergoing mechanical circulatory support (MCS).
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