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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Medical personnel should be able to recognize vascular injuries. Knowing the key signs of ischemia, namely pallor, pulselessness, pain, paresis, and paresthesia and the soft signs of vascular injury will help to prevent limb loss.
Mil Med 1990 May
PMID:Recognition of vascular injury in the trauma patient. 211 86

Heat injury, exertional rhabdomyolysis, and anterior compartment syndrome are all conditions seen in strenuously exercising populations. We report four cases of acute heat injury followed by significant but varying degrees of focal tissue ischemia with rhabdomyolysis. One patient died and all survivors experienced a significant deficit in function. We feel that meticulous attention given to preventive measures may reduce the incidence of this catastrophic event.
Mil Med 1989 Sep
PMID:The spectrum of heat related injury with compartment syndrome. 250 62

We compared duplex scanning and cerebral angiography in patients with hemispheric ischemia, testing the premise that carotid endarterectomy (CEA) or medical management may be recommended on the basis of duplex scanning alone. Charts of 152 patients who had both studies were reviewed. A positive study (implying an operable lesion) showed any ulcerated plaque or stenosis of 50% to 99% on the symptomatic side. A positive duplex scan correctly predicted the need for CEA (with no additional essential information gained from angiography) more than 98% of the time. Equally important, patients with a negative duplex or patients in whom carotid occlusion is suspected ought to have angiography.
Mil Med 1993 Nov
PMID:Evaluation of focal carotid ischemia: will duplex scanning suffice, or is angiography needed? 828 65

Gut-origin sepsis is a serious medical complication of military injuries following hemorrhage. Splanchnic ischemia induces intestinal necrosis leading to systemic bacteremia. Rat and mouse models of hemorrhagic shock were used to investigate bacterial translocation from the gut. Orally administered ameliorative treatments using the cytokine interleukin-6 (IL-6) were able to reduce or eliminate sepsis following hemorrhage. To mimic battlefield wounds and hemorrhage, anesthetized mice were bled from the femoral artery, held at a mean arterial blood pressure of 35 mm Hg for 1 hour, and then resuscitated with shed blood and 2-fold volume lactated Ringer's solution. Anesthetized rats were bled from the carotid artery at a rate of 15 ml/kg at 1 ml/minute. Bacteriological cultures of livers and mesenteric lymph nodes from hemorrhaged animals given recombinant IL-6 had significantly fewer colonies per gram of tissue than saline-fed controls. 125I-labeled IL-6 remained in the gut for up to 6 hours giving regional protection, whereas labeled interleukin-2 was disseminated throughout the body in the same time. In vivo and vitro studies of IL-6 showed that long incubations with high doses of trypsin, chymotrypsin, or intestinal contents were necessary to inactivate the bioactivity of this cytokine. Electron microscopy showed that epithelial cells from hemorrhaged mice fed saline had sparse or missing villi and vacuolated cytoplasm. Epithelial cells from control mice or mice hemorrhaged and fed cytokine appeared completely normal. Oral administration of IL-6 on the battlefield may be an important treatment for the prevention of sepsis following hemorrhage.
Mil Med 1997 May
PMID:Systemic sepsis following hemorrhagic shock: alleviation with oral interleukin-6. 915 11

This case study describes myocardial ischemia and stunning after the topical application of phenylephrine-soaked pledgets (0.25%) in a 63-year-old female undergoing elective endoscopic sinus surgery. The patient had no previous history of cardiovascular disease or illicit drug use. Transient myocardial ischemia was associated with acute hypertension, chest pain, and S-T segment changes 4 minutes after pledget placement. Angiography revealed normal coronary blood flow and severe left ventricular systolic and diastolic dysfunction. Follow-up echocardiography demonstrated improved left ventricular function within 1 week and total resolution of dysfunction by 4 weeks after ischemia.
Mil Med 1997 Dec
PMID:Myocardial ischemia and stunning induced by topical intranasal phenylephrine pledgets. 943 94

Controversy exists regarding the indications and methods for lower-extremity fasciotomy. Two recent cases at our institution in which recurrent, acute limb-threatening ischemia occurred despite adequate fascial division have convinced us that in certain situations subcutaneous fasciotomy is clearly inadequate. In both patients, both of whom were young, intact healthy skin between the lower extent of the incision and the malleolus acted as a tourniquet, causing recurrent compartment syndrome as reperfusion edema occurred after initial repair. We believe that therapeutic fasciotomy in young patients with relatively noncompliant skin should include division of skin from the knee to the ankle on at least one side to prevent a tourniquet effect by intact skin at the ankle.
Mil Med 1998 Nov
PMID:A condemnation of subcutaneous fasciotomy. 981 45

To determine the effects of intermittent compression on foot swelling, intracompartmental pressures, and hospital stay associated with acute calcaneus fractures, we retrospectively reviewed the records of 55 patients between January 1990 and July 1992 whose management profile included preoperative use of an intermittent compression foot pump and surgical treatment by open reduction and internal fixation. Average times were: injury to admission, 6.04 days; admission to surgery, 1.35 days; and surgery to discharge, 3.38 days. Hospital stay averaged 4.73 days. In 27 patients with suspected compartmental ischemia, admission and preoperative pressures in three compartments were averaged and compared: 18.22 and 3.81 mm Hg, respectively (p < 0.001). The authors concluded that the intermittent compression pump appears to rapidly reduce swelling of the foot and decrease elevated compartment pressures associated with calcaneus fractures, which may play a role in decreasing hospital stay.
Mil Med 2000 Oct
PMID:The use of a pneumatic intermittent impulse compression device in the treatment of calcaneus fractures. 1105 Aug 65

Takayasu arteritis is a rare autoimmune disease affecting large and moderate sized arteries, often involving the aorta or coronary vasculature. We report a case of an adolescent male with a history of recurrent respiratory tract infections who presented with fever, cough, and shortness of breath and who was diagnosed with acute aortic valve failure and coronary ischemia. Ultimately, the patient's condition was attributed to Takayasa arteritis. This typical presentation of an atypical disease provides valuable teaching points, including the use of bedside echocardiography for the diagnosis of acute aortic insufficiency and the differential diagnosis of increased erythrocyte sedimentation rate. It also serves to remind clinicians to maintain a high index of suspicion for unusual disease processes in patients who fail to respond to empiric therapy for recurrent subacute illnesses.
Mil Med 2002 Feb
PMID:Takayasu arteritis presenting as a recurrent respiratory tract infection: a diagnosis facilitated by bedside echocardiography and increased erythrocyte sedimentation rate. 1187 45

"Trench foot" is a particular risk for those involved in adventure tourism, for soldiers in winter mountain training exercises, and for the homeless. Nonfreezing cold nerve injury is characterized by axonal degeneration, which is attributed to free radicals released during cycles of ischemia and reperfusion. This pilot study sought to determine whether the administration of antioxidants might prevent or ameliorate the development of cold nerve injury. Twenty-six rats were divided into two groups. Group 1 animals received, by gavage, a mixture of vitamin C (150 mg/kg/d), vitamin E (100 mg/kg/d), and N-acetyl-L-cysteine (250 mg/kg/d) daily for 4 weeks. Allopurinol (20 mg/kg/d) was added in the last 4 days of treatment. Group 2 animals served as controls and did not receive any antioxidant supplements. After 1 month, two cycles of sciatic nerve cooling (0 degrees C) were induced in 10 controls and 10 experimental animals using circulating water through a nerve cuff. Six additional control animals were subjected to surgery but did not undergo nerve cooling. All animals were killed on the third postoperative day, and their nerves were processed for ultrastructural and quantitative studies. The proportion of degenerated myelinated and unmyelinated axons showed no significant difference between treated and untreated animals. We conclude that the administration of commonly used antioxidants does not prevent cold nerve injury.
Mil Med 2002 Sep
PMID:Use of antioxidants for the prophylaxis of cold-induced peripheral nerve injury. 1236 67

Chest pain with electrocardiographic changes is usually a life-threatening presentation of cardiac ischemia. There are, however, a variety of noncardiac conditions that have been reported to mimic these clinical and electrocardiographic changes. An Asian woman presented with chest pain and ST segment elevations in the distribution of the left anterior descending artery. She had persisting chest pain and ST segment elevations that were refractory to medical therapy, leading to thrombolytic therapy and rescue angiography, which revealed no evidence of coronary artery disease by coronary catherization. Cholecystitis was subsequently diagnosed with hepatobiliary scintigraphy. The patient's fever and ST segment elevations promptly resolved with antibiotic treatment. Four previous cases of ST segment elevation attributed to cholecystitis have been reported. Although the electrocardiographic changes attributed to cholecystitis have been shown to be correctable, the pathophysiological mechanism underlying these changes remains unclear. Prompt recognition of cholecystitis can ensure appropriate treatment and may prevent the performance of unnecessary diagnostic and therapeutic interventions.
Mil Med 2006 Dec
PMID:Chest pain and ST segment elevation attributable to cholecystitis: a case report and review of the literature. 1725 96


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