1/4. Platypnea-orthodeoxia associated with a fenestrated atrial septal aneurysm: case report.BACKGROUND: Platypnea-orthodeoxia describes the condition of combined dyspnea and hypoxia respectively, whilst in the upright position, which improves in the recumbent position. CASE REPORT: We present a case of platypnea-orthodeoxia due to a fenestrated atrial septal defect associated with an atrial septal aneurysm. Due to the fenestrated nature of the atrial septal defect, surgical rather than percutaneous correction was performed. CONCLUSION: A high index of suspicion is required to diagnose the syndrome of platypnea-orthodeoxia. Careful echocardiographic evaluation is required to identify the syndrome, and to determine suitability for percutaneous repair.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/4. Postanoxic symptomatic oscillatory myoclonus.Two young patients with a history of birth anoxia and cerebral palsy developed paroxysmal irregularly oscillating muscle jerks at rest and during voluntary movement. Electrophysiologic studies revealed short bursts of alternating activity at 4 to 6 Hz in antagonist muscles. The absence of time-locked EEG discharges suggests a subcortical origin for this unusual form of myoclonus. A comparison is made between this and previously reported conditions with a similar paroxysmal burstlike nature.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/4. Anoxic tonic seizures due to asthma; a serious complication in adults.Anoxic tonic seizures are reported as a complication of severe asthma in two adults. The nature of these attacks can be misinterpreted. They do not indicate the presence of a recurrent seizure problem unconnected to the episodes of anoxia caused by asthma. These attacks do not respond to antiepileptic medication, but cease if the asthma can be controlled. One of our patients developed an anoxic encephalopathy and the other died. The need for prompt diagnosis and appropriate treatment is emphasized.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/4. The incidence and spectrum of neurological injury after open fetal surgery.A preterm infant's immature brain is susceptible to both anoxic and hemorrhagic injury during periods of physiological stress. The advent of in utero surgery has created a new population of premature patients at risk for central nervous system (CNS) injury. The aim of this study was to evaluate the frequency and nature of CNS injuries in fetal surgical patients. Of 33 fetuses with known neurological outcome after fetal surgery, CNS injuries were identified in seven (21%). Of the seven, four had significant episodes of fetal bradycardia (3) or neonatal hypotension (1), which suggests that asphyxia contributed to the neurological injury. The CNS injuries in the other three patients occurred unexpectedly and without associated signs of fetal distress. The authors speculate that these injuries may have been caused by sudden fluxes in cerebral blood flow, induced by maternal hypoxia (1) or by maternally administered tocolytic drugs (2) used to treat postoperative preterm labor.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |