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The authors show that application of anticipated postoperative intensive care gives the possibility ot obtain more complete effect of compensation. The basic components of this therapy are the following: removal of hypovolemia and anemia, combined (central and regional) anesthesia, prevention of pneumonia, normalization of salt and water exchange, removal of excessive catabolism, adequate ensuring of organism with energy and plastic material for long-time compensation, prophylaxis and treatment of paresis of digestive tract, chemoprophylaxis of wound infection. The proposed program of intensive therapy gives the possibility to minimize the lethality among wounded with penetrating abdominal gunshot injuries and can be used as a basic one for the development of various schemes of intensive therapy for other categories of wounds.
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PMID:[Postoperative intensive therapy in penetrating gunshot wounds of the abdomen]. 157 Jun 95

The literature contains about 500 cases of equine leucosis, though the reports are deposited in a great number of journals and vary considerably concerning particular topics. During the last years there has been a remarkable increase of publications about this syndrome in the equine. The clinical leucosis key recommended by us has been confirmed in principle considering the latest literature. In about 70 individual symptoms which can be clinically observed in equine with leucosis 11 can be considered as main symptoms because of their frequency; they are again classified in primary (lymph node tumours including splenomegaly--loss of condition, weakness--cachexia, weight loss, periphery oedema), secondary (anorexia, inappetence--fever--paleness of mucous membrane--anaemia--tachycardia) and accessory (incoordination--tachypnoea, dyspnoea--apathy, lethargy) main symptoms. Furthermore in future it will be necessary to take into more consideration the symptoms "recurrent colic" and "hydrothorax" within differential diagnosis. The main symptom "incoordination" (ataxia, asynergy, paresis, paralysis) is used by us more precisely only in case of impairment of nervous system by neoplastic infiltrations and does not signify as possible symptoms of general physical weakness, for example faltering, staggering, tumbling or lameness. The morphological classification follows further on our previous recommendation. There exist generalized forms with tumour infiltrations in abdominal and in thoracic cavity as well as especially in peripheral lymph nodes. On the other hand there are characteristic manifestations in certain regions of the body, which establish distinctly the clinical symptomatology. They are marked as regional multicentric forms with the main localizations "mediastinal", "splenic", "mesenteric" or "intestinal".(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical diagnostic keys and special manifestations in equine leukosis]. 195 30

The acquired immunodeficiency syndrome (AIDS) was first diagnosed in burundi in 1983 when a large number of patients were registered with Kaposi's sarcoma, cryptococcal meningitis, and disseminated candidiasis. In the 1st phase of the disease the vi rus is dormant. In the 2nd phase seroconversion appears; and in the 3rd phase generalized adenopathy emerges. In the 4th phase the full-blown disease appears as a result of cellular immunity deficit with emaciation, fever, sweating, chronic diarrhea, asthenia, blood parameter changes (lymphopenia, thrombocytopenia, leukopenia, anemia, and specific immune disorders). The early phases can be diagnosed by serological tests. During 1989 a group of 155 patients with 1st signs of seropositivity were studied in the central hospital of Bugumbura. The available clinical diagnostic markers were: 56 cases of herpes, 26 cases of generalized adenopathy, 25 cases of inflammatory infiltration of paraganglionic zones, 13 abscesses and phlegmons, 8 cases of chronic proctitis, 8 prurigo cases, 7 cases of chronic pneumonia and bronchitis, 4 cases of paresis of the facial nerve, 4 cases of Kaposi's sarcoma, 2 cases of fresh syphilis, 2 cases of anemia, asthenia, dizziness, and weight loss. Tomo- and zonographical X-ray study of the thorax of 80 patients aged 20-65 (51 men and 29 women) was performed. In 62 patients changes in the lungs were evident. In 2 patients tuberculosis of the lungs was diagnosed: miliary TB in a 26-year woman and disseminated TB in a 31-year man. 2 chronic and 3 bronchial, and 10 interstitial pneumonia cases were diagnosed in 15 patients with average age of 30 years. 4 patients had peribronchial and pneumonic infiltrations. In a group of 45 patients magnified picture showed no deformation in the lungs; and only 5 had respiratory organ pathology. Interstitial pneumonia was the most often diagnosed ailment by X-ray inpatients infected with HIV.
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PMID:[X-ray pulmonary manifestations in patients infected with the human immunodeficiency virus]. 196 22

On 36,536 abdominal operations, in 36 patients (0.1%) there was necessary to perform a relaparotomy due to intraabdominal hemorrhage, of whom in 28 patients this complication arised after emergency surgical interventions, while in 8 cases after elective surgery. The cause of bleeding in 26 patients were technical mistakes during the first intervention, in two the overdosage of anticoagulants, in other two a fibrinolysis, and in one patient haemophilia. In 5 patients the origin of the hemorrhage could not be verified at relaparotomy. Clinical picture of an intraabdominal bleeding depended on its acuity and extent; in 18 patients the massive bleeding manifested suddenly or by progressive development of heart failure. In 7 patients slow evolution of the blood loss manifested with anemia and intestinal paresis. Hemoperitoneum arised in 6 patients, but without anemia, and in the other five remaining patients, a circuscripted intraabdominal hematoma was formed. In 8 patients laparocentesis was diagnostically successful. (The re-laparotomy was lifesaving for 26 patients). 12 patients died. The authors believe that well knowning of parameters of central hemodynamics, together with prolonged paresis of the gut, hyperthermia and hyperleucocytosis it is possible to recognize the predominant signs of acute postoperative hemorrhage.
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PMID:[Relaparotomy for intra-abdominal hemorrhage]. 224 13

A 24-year-old female was admitted to our hospital on Aug. 20 in 1986 because of blurred vision and right pupillary dilatation. She had sometimes noticed headache later than 1976, and blurred vision without headache several times a year later than 1983. She had been told her right pupil dilated when she had complained of blurred vision. Neurological examination revealed abnormal findings as follows; diminished sense of smell in the right side, anisocoria (R 8 mm, L 5 mm), bilateral hippus, hypesthesioalgesia in her right face, left trunk and left arm. The pupils were round and contracted promptly to light. Accommodation reflex and ciliospinal reflexes were normal. Neither blepharoptosis nor external ocular muscle paresis were observed. Deep tendon reflexes were normal. Planter responses were flexor. There was no meningeal irritative sign. No abnormal findings were obtained in blood and urine, chest X-p, brain enhanced CT scan, EEG, and cerebral angiography except for slight degree of anemia. Serum TPHA was negative. However, the cell count of cerebrospinal fluid (CSF) was 18/mm3 (Ly 100%) and decreased to 9/mm3 (Ly 100%) in nine days. Protein content and glucose level of CSF were normal. Pupils were not constricted by 0.125% pilocarpine instillation. Loss of smell and sensory disturbance disappeared within three days and her pupils became isocoric by five days after admission. The patients of episodic unilateral mydriasis without apparent cause had relatively same clinical features as "unilateral springing pupil" proposed by Hallett et al. (1970). Except for mydriasis, they had no abnormal findings of neurological and laboratory examinations.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Recurrent episodic unilateral mydriasis with pleocytosis in the cerebrospinal fluid--a case report]. 259 48

The clinical, biochemical and pathological effects of the fresh shoots of Chrozophora plicata on Nubian goats and Desert sheep were investigated. The animals were given single or repeated daily doses of 10, 5, 1 and 0.5 g/kg of chrozophora shoots by stomach tube and died at various times post dosing. The main signs of Chrozophora poisoning in both species of ruminants were salivation, dyspnea, bloat, inappetence, dullness, diarrhea, paresis of the hind limbs, recumbency and lateral deviation of the head and neck. The main lesions were hemorrhage in the lungs, heart and kidneys, pulmonary cyanosis and edema, hepatic fatty change and depletion of glycogen, catarrhal enteritis, ascites, hydropericardium and serous atrophy of the cardiac fat and renal pelvis. An increase in the concentration of urea, ammonia and bilirubin and in the activity of GOT and a decrease in total protein were detected in the serum. Hematological changes indicated the development of anemia.
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PMID:Experimental Chrozophora plicata poisoning in goats and sheep. 318 65

An anorectic, adult West African dwarf crocodile was examined because of bilateral hind limb paresis. Clinical findings included multiple skin wounds, osteomyelitis of the distal portions of the right radius and ulna, severe anemia, and Serratia marcescens bacteremia. The crocodile died after a blood transfusion. At necropsy, hemorrhage in the subarachnoid space, suppurative polyarthritis, and gastric ulceration were found. Serratia marcescens and Morganella morganii were isolated from multiple tissues and body fluids. It was concluded that the bilateral paresis was caused by severe septic arthritis secondary to bacteremia, and that the crocodile died from spinal injury caused by the blood transfusion into the supravertebral vein.
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PMID:Bacteremia and septic arthritis in a West African dwarf crocodile. 329 93

Intestinal Ileus is Gut Shock caused by Bowel Hypoxia. The morbidity and mortality of Intestinal Ileus has puzzled more than two generations of investigators because they have overlooked the fact that the gas which collects in obstructed small intestine is mostly (90+%) Nitrogen. For some strange reason a gut full of nitrogen has not been looked on as comparable to a lung full of nitrogen, even though the lung and gut have a common embryological origin. My proposal is that intestinal epithelium lining a nitrogen filled lumen becomes as oxygen starved as alveolar lining in a similar circumstance. Bowel hypoxia may be brought about either by failure of the intestine to "breathe out", having breathed in due to mechanical block, or gut paralysis, from any cause, of which one may be failure of blood borne oxygen transport to the bowel, Individually, or together, these may reduce or stop the flow of air and/or aerated intestinal contents along the lumen. Local (bowel) or general underperfusion +/- hypovolaemia +/- anaemia may be a particular cause of paresis or paralysis (aperistalsis) of intestinal muscle. The non-contracting gut then fails to transport the luminal current of fluid and air (oxygen), and adds lumenal to blood-borne oxygen deficiency. The intestinal mucosa utilises oxygen from the current of air churned along the bowel by normal peristalsis to mix with and dissolve in the luminal contents. Should this current be obstructed or the propulsive churning activity cease, oxygen will be "used up", the residual gas become almost entirely nitrogen, and the mucosa must necessarily become oxygen starved and suffocated. Hypoxic mucosa lives in a dangerous environment, at risk of autodigestion by self-produced proteolytic or other enzymes secreted into the lumen by exocrine glands, and it may rapidly become necrotic and gangrenous. Different presentations of Ileus are different degrees of the same Gut Shock due to different levels and durations of tissue hypoxia brought about by different mechanisms with that final common path, complicated by different degrees of autodigestive mucosal destruction, bowel wall oedema, and fluid exudation into the lumen comparable to that through BURNED skin. This idea is new only in so far as it has been put together in this way. Parts have been anticipated by other writers. No new ways of managing ileus are proposed, but it is suggested that existing empirical methods be rationalised and applied more widely and logically.
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PMID:The physiology of intestinal oxygenation and the pathophysiology of intestinal ileus. 355 73

An outbreak of a neurological disease in pigeons caused by avian paramyxovirus type I occurred in the New York metropolitan area in 1984. It was characterized clinically by head tremors, paresis of the wings and legs, ataxia, torticollis, and loose droppings. Clinical pathologic evaluation revealed anemia and elevated plasma transaminase enzymes. Mortality was virtually 100% in juvenile pigeons, whereas the adults generally experienced much lower morbidity and mortality.
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PMID:Avian paramyxovirus type I infection in pigeons: clinical observations. 383 25

For Sarcocystis tenella, the second microscopic sarcocyst in sheep, the dog was shown to act as final host shedding sporocysts measuring 13.75-15.8 (14.8 +/- 0.8) X 9.7-10.8 (10.1 +/- 0.4) micron after a prepatent period of 8-13 days. The clinical signs and the course of experimental infections in sheep were most similar to S. ovicanis. After high doses of sporocysts sheep had temperatures up to 42 degrees C, anaemia, and paresis; they finally died from haemorrhagic diathesis. The development of S. tenella in sheep was studied and it resulted in microscopic cysts in the musculature that measured 300-650 X 20-50 micron. They showed hair-like delicate protrusions of the cyst wall measuring 6-8 X less than 0.5 micron, by which S. tenella could be clearly differentiated from S. ovicanis from day 60 p.i. onwards. The decreasing number of S. tenella through degeneration of cysts is suggested to be a self-cleaning process.
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PMID:Life cycle of Sarcocystis tenella in sheep and dog. 681 16


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