Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0028961 (oliguria)
 1,847 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From April 1981 to December 1988, a total of 23 patients were operated upon for the repair of an aneurysm of the descending thoracic aorta with a tridodecylmethylammonium chloride (TDMAC)-heparin-impregnated shunt. There were 20 men and 3 women. The ages ranged from 29 to 72 years with a mean of 52.3 years. The major pathological change of the aortic wall was medial cystic necrosis in 19 patients and atherosclerosis in 4. Among them, only 6 patients underwent elective surgery, while 17 patients underwent emergency operations with the surgical indication being shock in 4, oliguria in 3, persistence of chest pain in 2, massive hemoptysis in 1, rapid size progression of the aneurysm in 3, and impending rupture of the aneurysm in 4. During surgery, the aortic cross-clamping time ranged from 40 to 76 minutes with a mean of 54 minutes. Hospital death was limited to 2 patients with a mortality rate of 8.7%. Postoperative complications were noted in 5 patients, cerebrovascular accidents in 4 and transient paraparesis in 1. However, the clinical conditions recovered before those patients were discharged. The follow-up period ranged from 4 to 84 months with a mean of 32.3 months. Except for 1 patient who died of anaphylactic shock due to drug allergy, the other 20 survivors had an apparent improvement of their clinical status and life quality.
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PMID:The use of TDMAC-heparin-impregnated shunt for managing aneurysm of the descending thoracic aorta. 197 26

Two cases of successful staged replacement of multiple aortic aneurysms are reported. Case 1: A 65-year-old man was found to have abdominal aortic and aortic arch aneurysms. He underwent abdominal aneurysmectomy and Y-grafting in the first stage. A month after his discharge, he was transferred to our hospital because of abrupt chest pain. Two days later, he fell into shock and emergent aortic arch replacement was performed successfully. Case 2: A 46-year-old man was transferred to our hospital because of abrupt abdominal pain and shock. CT scan revealed the rupture of the abdominal aneurysm. He received emergent abdominal aneurysmectomy and Y-grafting successfully. Three months later, he was readmitted because of back pain. CT scan revealed DeBakey Type I dissecting aneurysm. After three days, PaO2 of blood gas analysis fell to 46 mmHg, and absent femoral pulsation and oliguria were also observed. Therefore, aortic arch replacement was performed in emergency. The intimal tear was found in the distal aortic arch. The both of cases are doing well 24 months and 10 months after surgery respectively. It is important to scrutinize the order of surgery for multiple aortic aneurysms and to control blood pressure properly after aneurysmectomy.
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PMID:[Aortic arch replacement performed in emergency in a short-term after grafting for abdominal aortic aneurysm]. 938 50

Retinoic acid syndrome (RAS) is the clinical syndrome that occurs after treatment of acute promyelocytic leukemia with all-trans-retinoic acid (ATRA). The patients experience fever, dyspnea, hypotension, respiratory distress, edema and weight gain. Chest x-ray will show pulmonary infiltrates and pleuropericardial effusion. The onset of this syndrome is usually 5-21 days after ATRA treatment when white blood cell counts are rising more than 10,000/cu.mm. The authors have reported a case of RAS. The patient was a 29-year-old man who had been working in a battery manufacturing factory for 7 years. He presented with easily bruising for one month. The initial blood test showed hematocrit of 36.2%, white blood cells count of 3,200/cu.mm with 28% neutrophils, 20% lymphocytes, 2% eosinophils and 50% promyelocytes and platelet of 20,000/cu.mm. Peripheral blood smear revealed numerous fragmented red blood cells. Bone marrow examination showed hypercellularity with abnormal promyelocytes of 95% and bone marrow cytogenetics was translocation of chromosome 15 and 17 [t (15;17)(q22;q12)]. The diagnosis was acute promyelocytic leukemia and the patient was treated with ATRA 45 mg/m2/day per oral starting on day 1 and intravenous idarubicin 10 mg/n2 on day 4, 5 and 6. On day 13, he had a body temperature of 39 degrees C and a dry cough. The white blood cells were rising to 7,400/cu.mm with 16% neutrophils. On day 18, he had oliguria, high grade fever, hypotension, cough with chest pain and white blood cells rose to 21,300/cu.mm with 65% neutrophils and rising of blood urea nitrogen and creatinine. Chest x-ray showed enlarged cardiac shadow with pleural effusion. Echocardiogram revealed moderate amount of pericardial effusion. The diagnosis of RAS was made and ATRA was withdrawn. Intravenous dexamethasone 4 mg every 6 hours and hemodialysis was started. The patient's symptoms improved dramatically and bone marrow examination was in complete remission. He was subsequently given cytarabine and idarubicin as consolidation. This patient had clinical manifestation consistent with RAS, which improved after prompt treatment.
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PMID:Successful treatment of retinoic acid syndrome with dexamethasone: a case report. 1685 73

A 91-year-old man was transferred to our hospital because of severe chest pain. Chest computed tomography (CT) scan showed impending rupture of the true aneurysm of the aortic arch. The patient underwent emergent graft replacement of the total aortic arch. He was extubated on the 1st postoperative day, and received continuous hemodiafiltration (CHDF) for oliguria. However, he recovered from oliguria and renal dysfunction. He discharged at the 67th postoperative day.
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PMID:[Total aortic arch replacement for aortic aneurysm in a 91-year-old man: report of a case]. 2084 1

Pulmonary embolism (PE) is the third most common cause of death in hospitalized patients. Diagnosis is often missed because of a non-homogeneous clinical picture. We present a case of an 89-year-old patient with an acquired murmur associated with pulmonary embolism. When examined by a family physician the patient had no symptoms typical for PE. During hospitalization, dyspnoea was exacerbated; a non-productive cough, chest pain and oliguria were observed. Pulmonary embolism was diagnosed, but because of the renal failure diagnosis was not confirmed by angio-CT.
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PMID:An 89-year-old patient with acquired murmur associated with pulmonary embolism. 2229 39

An adult male labourer, a smoker and alcoholic was admitted to our hospital with a short history of fever, myalgia, breathlessness and oliguria. On examination he was icteric and hypotensive. Calf muscle tenderness was present. A provisional diagnosis of leptospirosis was made and he was started on treatment with crystalline penicillin. Blood pressure (BP) did not improve with fluids. Inotropes were started. The patient was taken for Slow Low Efficiency Daily Dialysis (SLEDD) during which he developed chest pain. ECG showed an anterolateral myocardial infarction (MI). He also complained of breathlessness and haemoptysis. Antiplatelets were withheld in view of thrombocytopaenia and haemoptysis; heparin could not be given because of the deranged coagulation parameters. The patient was managed symptomatically with nitrates. After the BP improved SLEDD was restarted. On day 3 of admission the patient became tachypnoeic and hypoxic, bilateral coarse crackles were present on auscultation. He was intubated and mechanically ventilated. Suctioning of endotracheal tube revealed fresh blood, and chest CT revealed alveolar haemorrhage. In spite of aggressive resuscitative measures, mechanical ventilation and antibiotics, the patient expired on the 12th day following admission.
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PMID:Therapeutic dilemma in a case of acute coronary syndrome (ACS). 2336 65

In very long-chain acylCoA dehydrogenase deficiency (VLCAD), the activity of this enzyme is either reduced or absent with the inability to use long-chain fatty acids as energy substrates. A 25-year old male with VLCAD was admitted to the Emergency Department of Policlinico Teaching Hospital (Modena, Italy)for generalized weakness and oliguria, after a period of physical and mental stress and inadequate compliance to a long-chain fatty acid free diet. Laboratory tests were compatible with acute kidney injury. Seventy-two hours after admission, the subject had an episode of chest pain with elevated markers of myocardial necrosis. The rapid deterioration of muscular strength and the subsequent worsening respiratory failure necessitated ventilator support within the local Medical Intensive Care Unit. There, the patient showed a prompt normalization of respiratory parameters and a steady improvement of renal function. An inadequate compliance to lifestyle and dietary restriction in VLCAD may trigger severe and potentially lethal crisis. The in-hospital management of these patients calls for early intensive care admission as their conditions may deteriorate without warning.
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PMID:Critical illness in energy metabolism genetic disorder: rhabdomyolysis, acute kidney injury, respiratory arrest. 2501 67

Mechanical circulatory assist devices are now commonly used in the treatment of severe heart failure as bridges to cardiac transplant, as destination therapy for patients who are not transplant candidates, and as bridges to recovery and "decision-making". These devices, which can be used to support the left or right ventricles or both, restore circulation to the tissues, thereby improving organ function. Left ventricular assist devices (LVADs) are the most common support devices. To care for patients with these devices, health care providers in emergency departments (EDs) and intensive care units (ICUs) need to understand the physiology of the devices, the vocabulary of mechanical support, the types of complications patients may have, diagnostic techniques, and decision-making regarding treatment. Patients with LVADs who come to the ED or are admitted to the ICU usually have nonspecific clinical symptoms, most commonly shortness of breath, hypotension, anemia, chest pain, syncope, hemoptysis, gastrointestinal bleeding, jaundice, fever, oliguria and hematuria, altered mental status, headache, seizure, and back pain. Other patients are seen for cardiac arrest, psychiatric issues, sequelae of noncardiac surgery, and trauma. Although most patients have LVADs, some may have biventricular support devices or total artificial hearts. Involving a team of cardiac surgeons, perfusion experts, and heart-failure physicians, as well as ED and ICU physicians and nurses, is critical for managing treatment for these patients and for successful outcomes. This review is designed for critical care providers who may be the first to see these patients in the ED or ICU.
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PMID:Mechanical circulatory assist devices: a primer for critical care and emergency physicians. 2734 73