1/14. The adult respiratory distress syndrome after dextran infusion as an antithrombotic agent in free TRAM flap breast reconstruction.adult respiratory distress syndrome occurred in a patient who had received dextran as a routine antithrombotic agent during and after free TRAM breast reconstruction. Although most patients who receive dextran have no adverse reaction, particularly after hapten inhibition by dextran 1 infusion, the serious nature of this complication in an elective operation calls into question the continuing routine use of dextran in microsurgery.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/14. Fatal paraquat poisoning: report of two cases.paraquat, a dipyridium compound is widely used as a herbicide. It is available in india as a liquid concentrate for agricultural use and is highly toxic if ingested. It leads to renal, hepatic, cardiac and pulmonary toxicity and also causes burns of oral mucosa and esophagus as it is caustic in nature. We describe two cases of paraquat poisoning who developed serious toxicity following its ingestion and died of respiratory failure.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/14. Pulmonary granulomatosis associated with insoluble fillers in a heroin addict.We report a case of acute respiratory distress syndrome (ARDS) and pulmonary granulomatosis after intravenous injection of heroin. This 46-year-old male had a 2-year history of heroin addiction. The recent admission was due to loss of consciousness after intravenous injection of diluted heroin with unknown filler. Initial chest X-ray revealed a picture of ARDS. blood routine and biochemistry were normal except for leukocytosis. urine morphine test was positive. The blood and sputum culture yielded no pathogens. After supportive treatment, his condition improved, and the follow-up chest X-ray showed diffuse micronodules in both lung fields. Subsequently, open-lung biopsy of the right upper and lower lobes on the 26th hospital day showed large amounts of foreignbody granulomas distributed over perivascular areas, bronchiolar areas and interstitium. Staining for bacteria, fungi, and mycobacteria was all negative. The morphology of foreign-bodies could be divided into 2 types: 1) periodic acid-Schiff (PAS)-positive, aggregated fine crystals in round form; and 2) PAS-negative, yellow long crystals. The pathological diagnosis of pulmonary granulomatosis was made based on the finding of filler foreign bodies. The nature of these foreign bodies remained undetermined. The case suggests that pulmonary granulomatosis with the radiographic appearance of chronic interstitial pneumonia can occur in patients with a history of heroin use.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/14. Complex pain consultations in the pediatric intensive care unit.The assessment and management of pain in children is not always easy and it is clearly more difficult in the critical care setting. pain management is further complicated in this vulnerable population by the nature of their critical condition, the complexity and multidimensionality of their illness or injuries, and the intensity of emotions in this environment. A variety of pain syndromes are encountered in the pediatric intensive care unit, and the staff there may not be familiar with or comfortable managing these cases. Pain assessment and treatment can be more appropriately managed when guided by the experts of a multidisciplinary pediatric pain service.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/14. Acute respiratory distress syndrome with transiently impaired left ventricular function and torsades de pointes arrhythmia unmasking congenital long qt syndrome in a 25-yr-old woman.We report a case of recurrent episodes of torsades de pointes arrhythmia in the setting of transiently impaired left ventricular ejection fraction, acute respiratory distress syndrome, transient hypokalaemia and QT-prolonging drugs, in a previously healthy 25-yr-old female patient. In the course of the clinical and genetic work-up this patient was newly diagnosed with a mutation in KCNH2 encoding the alpha-subunit of the human repolarizing potassium channel I(Kr). This case report illustrates the multivariate nature of long-QT syndrome, and emphasizes the usefulness of a pharmacological test for repolarization abnormalities.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/14. bronchoalveolar lavage in recurrent aspirin-induced adult respiratory distress syndrome.aspirin has been reported to induce the adult respiratory distress syndrome (ARDS) in humans. The mechanism of injury appears to be similar to other forms of experimentally induced high-permeability edema in which leukocytes play an important role. In a patient who suffered two episodes of aspirin-related ARDS, bronchoalveolar lavage showed a significant influx of leukocytes. This represents the first reported bronchoalveolar lavage in aspirin-related ARDS, as well as the first documentation of the nonhydrostatic nature of the edema in a patient with recurrence of this entity.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/14. adult respiratory distress syndrome secondary to ethylene glycol ingestion.Presented is a case of ethylene glycol poisoning in a 24-year-old man who subsequently developed adult respiratory distress syndrome. The noncardiogenic nature of the patient's pulmonary edema was documented with hemodynamic monitoring, and a successful outcome was achieved with hemodialysis, ethanol, and intermittent mechanical ventilation with positive end-expiratory pressure.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/14. ARDS due to ingestion of denatured rapeseed oil.Among the different etiologies of noncardiogenic acute pulmonary edema is found the administration or ingestion of various substances. We have studied two patients with ARDS secondary to the ingestion of toxic oil. Both patients presented similar roentgenographic findings characterized by interstitial and alveolar infiltration in "butterfly" distribution, pleural effusion, and a normal cardiac silhouette. The two cases also showed a pulmonary compliance either normal or slightly diminished. With the aid of artificial ventilation, they evolved favorably, gaseous exchange and chest x-ray films returning to normal 16 and 22 days after admission.- - - - - - - - - - ranking = 4keywords = nature (Clic here for more details about this article) |
9/14. Acute respiratory distress syndrome after peritoneovenous shunt.A case is presented in which a fatal acute respiratory distress syndrome, associated with disseminated intravascular coagulation, developed immediately after the insertion of a peritoneovenous shunt for management of refractory ascites. The absence of left-sided heart failure or fluid overload was established by (a) lack of diuresis from intravenous furosemide; (b) repeatedly normal pulmonary wedge pressures; and (c) autopsy findings. The nature of the toxic effect of this patient's ascites upon the alveolar membrane remains obscure.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/14. Post-traumatic bronchial stenosis and acute respiratory insufficiency.A 31-year-old woman sustained multiple injuries, including severe contusion of the right lung with massive subcutaneous emphysema. Four weeks later she was transferred to our institution with post-traumatic adult respiratory distress syndrome and carbon dioxide retention, resulting from a postlaceration stenosis of the left main-stem bronchus. Bronchoplasty was contraindicated because of the serious condition of the patient. Repeated bronchial dilatations produced initial improvement in oxygenation and minute ventilation requirements. However, because of the nature of the stenosis and the lack of recovery of right lung function, the patient's encouraging clinical course reached a plateau and attempts at weaning from the respirator were unsuccessful. Bronchoplasty was performed on postadmission day 50 and resulted in gradual recovery of pulmonary function. Six months following discharge, the patient continues a steady improvement. Management of the patient's injuries represented a unique challenge previously unencountered.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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