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By Jason Mann No BS pulmonary critical care fellow
Peter J Neuburger, Aubrey C Galloway, Michael D Zervos, Marc S Kanchuger
Hemoptysis after cardiopulmonary bypass (CPB) occasionally occurs, and has varying clinical significance based upon amount of bleeding. Hemoptysis resulting in a clot and airway obstruction is an extremely rare event found almost exclusively in the intensive care unit. We describe a unique case of hemoptysis resulting in bronchial impaction from a clot requiring an emergent return to CPB during valve replacement surgery. We used a rigid bronchoscope, without an endotracheal tube, to facilitate airway patency in a patient with diffuse airway bleeding after bronchial disimpaction to separate from CPB...
January 2012: Anesthesia and Analgesia
Said A Al-Busafi, Peter Ghali, Marc Deschênes, Philip Wong
Chylous ascites refers to the accumulation of lipid-rich lymph in the peritoneal cavity due to disruption of the lymphatic system secondary to traumatic injury or obstruction. Worldwide, abdominal malignancy, cirrhosis, and tuberculosis are the commonest causes of CA in adults, the latter being most prevalent in developing countries, whereas congenital abnormalities of the lymphatic system and trauma are commonest in children. The presence of a milky, creamy appearing ascitic fluid with triglyceride content above 200 mg/dL is diagnostic, and, in the majority of cases, unless there is a strong suspicion of malignancy, further investigations are not required in patients with cirrhosis...
2014: ISRN hepatology
Alexandre Nuzzo, Olivier Corcos
A 60-year-old man presented with abdominal pain and hypotension. He had recently had thrombosis of the superior mesenteric artery, which required extensive resection of the distal jejunum and ileum. His serum lactate level was 2.6 mmol per liter (normal range, 0.5 to 2.2), and his creatinine level..
October 13, 2016: New England Journal of Medicine
Andrew D Mihalek, Carissa Haney, Maria Merino, Sinchita Roy-Chowdhuri, Joel Moss, Kenneth N Olivier
Amyloid primarily affecting the lungs is a seldom seen clinical entity. This case discusses the work-up of a patient presenting with exercise-induced haemoptysis and diffuse cystic lung disease on radiographic imaging. The common clinical and radiographic findings of diffuse cystic lung diseases as well as a brief overview of pulmonary amyloid are presented.
September 2016: Thorax
Priyanka Rajaram, Brent Little, J P Norvell, Morgan McLemore, Srihari Veeraraghavan
A 49-year-old man with a history of cryptogenic cirrhosis was referred to pulmonary clinic for evaluation prior to liver transplantation. Chest imaging obtained as part of the transplant workup had shown evidence of interstitial abnormalities. The patient noted shortness of breath on moderate exertion that was worsening over the past 2 to 3 years and associated with a nonproductive cough. He denied chest pain, chills, or fevers. His past medical history was significant for hypothyroidism. He did not have a history of alcohol consumption, smoking, or occupational exposures...
February 2016: Chest
Dania Nachira, Marco Chiappetta, Maria Teresa Congedo, Maria Letizia Vita, Stefano Margaritora
No abstract text is available yet for this article.
May 2016: Thorax
Marco Vola, Jean-Francois Fuzellier, Salvatore Campisi, Daniel Grinberg, Jean-Noël Albertini, Jerôme Morel, Antoine Gerbay
Transcatheter valve implantation is progressively becoming the first line option for high risk patients in the management of severe aortic valve stenosis. Surgery is likely to remain the gold standard treatment option for intermediate risk patients since it ensures ablation of the underlying pathology and the calcified aortic valvular tissue, which potentially can act as a nidus of chronic embolization and provoke neurocognitive dysfunction in this subset of active patients. The surgical approach is continually evolving, with sutureless technology having the potential to facilitate ministernotomy and minithoracotomy approaches...
March 2015: Annals of Cardiothoracic Surgery
Stijn J B Van Weyenberg, Fred J Stam, Willem Marsman
No abstract text is available yet for this article.
July 2014: Gastrointestinal Endoscopy
Davide Bona, Alberto Aiolfi, Emanuele Rausa, Luigi Bonavina
Boerhaave's syndrome is a spontaneous barotraumatic disruption of the distal oesophagus secondary to an abrupt increase in intraoesophageal pressure during vomiting. Management ranges from a conservative approach to an oesophagectomy. The over-the-scope-clip (OTSC, Ovesco Endoscopy GmbH, Tuebingen, Germany) system is a newly designed clipping method for tissue mechanical compression in the gastrointestinal tract. We report the case of a patient referred with a delayed diagnosis of Boerhaave's syndrome and successfully treated by OTSC application followed by lung decortication...
April 2014: European Journal of Cardio-thoracic Surgery
Lian Jian, Wenli Liang, Yuan Zhang, Lingjie Li, Yijie Mei, Rui Tan, Ledong Sun
A 76-year-old woman has got both lower limbs petechia and ecchymosis for 1 month, edema for 6 days and fever for 3 days. The patient suffered from purpura of both lower limbs, edema, arthralgia, recurrent fever, kidney damages, serositis, progressive reduction of platelet, moderate anemia and lymphadenopathy during the last two months. Laboratory examinations showed that her whole blood cells, platelet counts, serum albumin level and complements were all decreased and her titres of antibodies to double-stranded DNA (ds-DNA) were high...
2015: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
Kjartan Eskjaer Hannig, Rasmus Wulff Hauritz, Erik Lerkevang Grove
Lazarus phenomenon or autoresuscitation is a very rare condition defined as delayed unassisted return of spontaneous circulation after cessation of cardiopulmonary resuscitation. Based on a case with a 67-year-old male who came back to life after discontinuation of cardiopulmonary resuscitation, we discuss the background and possible countermeasures related to the Lazarus phenomenon.
2015: Case Reports in Medicine
Robert L Cowie, Diane P Conley, Margot F Underwood, Patricia G Reader
OBJECTIVE: To assess the effectiveness of a non-pharmacological intervention in patients with asthma on conventional therapy including inhaled corticosteroid. DESIGN: A randomised controlled trial of the Buteyko technique in a group of adults with asthma. The control group was trained by a physiotherapist in breathing and relaxation techniques. SETTING: A single centre associated with a University-based asthma programme. MAIN OUTCOME MEASURE: Asthma control, defined by a composite score based on the Canadian asthma consensus report 6 months after completion of the intervention...
May 2008: Respiratory Medicine
Vincent Labbé, El Mahdi Hafiani
No abstract text is available yet for this article.
August 15, 2015: American Journal of Respiratory and Critical Care Medicine
Guido Tavazzi, Marco Pozzi, Gabriele Via, Silvia Mongodi, Antonio Braschi, Francesco Mojoli
No abstract text is available yet for this article.
January 1, 2016: American Journal of Respiratory and Critical Care Medicine
Emmanuelle Begot, Marc Clavel, Alessandro Piccardo, Rémi Bellier, Bruno François, Nicolas Pichon, Philippe Vignon
BACKGROUND: Hemodynamic monitoring is frequently needed in ventilated patients with unstable hemodynamics after open-heart surgery. Novel miniaturized single-use transesophageal echocardiographic probe has been scarcely used in this clinical setting. CASE PRESENTATION: A patient who underwent a scheduled open-heart surgery developed a ventilator-associated pneumonia and was referred to the intensive care unit for post-operative acute respiratory distress syndrome...
2015: BMC Medical Imaging
Rohit Venkatesan, Nilubon Methachittiphan, Rafic F Berbarie, Emily Aaron, Zehra Jaffery, Umamahesh Rangasetty
No abstract text is available yet for this article.
February 2016: American Journal of Emergency Medicine
Jonah Cohen, Sharukh Lokhandwala, Khaled Sorour
No abstract text is available yet for this article.
November 1, 2015: American Journal of Respiratory and Critical Care Medicine
Risa Haruki, Takuya Kimura, Hitomi Iwasaki, Kana Yamada, Ikuo Kamiyama, Mitsutomo Kohno, Kazuaki Taguchi, Saori Nagao, Toru Maruyama, Masaki Otagiri, Teruyuki Komatsu
A hemoglobin (Hb) wrapped covalently by human serum albumins (HSAs), a core-shell structured hemoglobin-albumin cluster designated as "HemoAct", is an O2-carrier designed for use as a red blood cell (RBC) substitute. This report describes the blood compatibility, hemodynamic response, and pharmacokinetic properties of HemoAct, and then explains its preclinical safety. Viscosity and blood cell counting measurements revealed that HemoAct has good compatibility with whole blood. Intravenous administration of HemoAct into anesthetized rats elicited no unfavorable increase in systemic blood pressure by vasoconstriction...
2015: Scientific Reports
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