Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034063 (pulmonary edema)
 10,665 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Several hemodynamic abnormalities in the patient with cirrhosis comprise a unique distributive circulatory disturbance that causes intractable ascites and that is, in turn, worsened by the resulting ascites. Ascites is promptly alleviated by drainage of the ascitic fluid into the intravascular compartment. The circulatory abnormalities improve in part because of elimination of the ascites, and also because of a compensatory hypervolemia. The consequences of the latter, especially in the immediate postoperative period, are increased likelihood of pulmonary edema and of gastrointestinal bleeding from heightened portal vein pressure. Postoperative coagulopathy is also a significant problem. Careful selection of patients for the procedure, close postoperative observation and vigorous use of diuretics and other agents will usually enable these complications to be obviated or successfully treated. Increases in body muscle and fat masses and serum albumin concentrations indicate nutritional improvement. Despite evidence of benefits from the procedure, these patients continue to die from the complications that threaten other cirrhotics: effects of return to alcoholism, gastrointestinal hemorrhage, recurrent infections and intestinal obstruction. Thus, it is not yet clear that the benefits include prolongation of life.
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PMID:Treatment of intractable ascites in patients with alcoholic cirrhosis by peritoneovenous shunting (LeVeen). 44 38

Fourteen body packers carrying 2-112 heroin packages are reported. Nine people swallowed the packets, and five inserted them rectally. The ingested packages were large and radio-opaque; they consisted of hard lumps of concentrated heroin usually covered with glove latex, white adhesive tape, and a toy balloon. There were two complications in the 14 patients. One patient developed a bowel obstruction; at laparotomy 8 packages were found in the stomach and 27 at the ileo-cecal valve. Another patient, with heroin wrapped only with black electrician's tape and no latex inner or outer wrappings, developed heroin intoxication, noncardiogenic pulmonary edema, and a bowel obstruction. Eighteen packages were surgically removed from his stomach and 26 from his bowel. We recommend bisacodyl suppositories, activated charcoal mixed with a 3% sodium sulfate cathartic, and phosphosoda enemas for package removal; close observation for heroin toxicity or bowel obstruction; and surgical intervention for continuing toxicity, retention of packages in the stomach, or bowel obstruction.
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PMID:Heroin body packers. 844 84

Opiate intoxication accounts for the majority of emergencies related to substance abuse. The concomitant intravenous and intramuscular administration of the specific narcotic antagonist naloxone is warranted in such cases. Further threatening complications of opiate abuse include rhabdomyolysis, noncardiogenic pulmonary edema, and both peripheral and central nervous lesions. Opiate abuse is often associated with benzodiazepine abuse. Hence, intravenous administration of the antagonist flumazenil is indicated in patients with suspected acute opiate intoxication resistant to naloxone. Cocaine abuse is not frequent in this country but is usually very severe and clinically heterogeneous. The clinical pattern of cocaine intoxication is initially due to excitatory and later to depressant effects on central nervous, circulatory and respiratory systems. The treatment of acute cocaine intoxication is symptomatic. The internal concealment of cocaine and other drugs in packets (body-packing) may lead to bowel obstruction or to acute intoxication following leaking or breaking of packets.
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PMID:[Drug emergencies]. 849 75

Although the dehydration-rehydration problem in end-of-life care is one of the most important issues, clinical indications of hydration therapy have not been clarified because the pathophysiology is poorly understood. To explore the physiological changes of fluid status in terminally ill cancer patients, a prospective observational study was performed. We obtained 9 pairs of blood samplings from hospice inpatients with irreversible bowel obstruction who underwent two or more laboratory examinations during the admission periods. The plasma renin activity (PRA) and brain natriuretic peptide (BNP) were measured, in addition to basic laboratory tests performed as clinically required. A chart review evaluated the degree of fluid retention symptoms. In 7 patients receiving intravenous rehydration of 700-2200 ml/day, the mean PRA level significantly increased from 3.5+/-2.5 ng ml(-1) h(-1) to 11+/-8.2 ng ml(-1) x h(-1) ( P=0.047), and the mean BNP level significantly decreased from 52+/-34 pg/ml to 22+/-14 pg/ml ( P=0.047). Edema, ascites, and pleural effusion/pulmonary edema deteriorated in 5, 3, and 5 patients, respectively. In 2 patients without rehydration therapy, peripheral edema deteriorated with increased PRA levels (0.5 to 20 ng ml(-1) x h(-1), 0.4 to 8.7 ng ml(-1) x h(-1), respectively). In conclusion, intravenous volume depletion with fluid retention symptoms was observed in terminally ill cancer patients with intestinal obstruction both receiving and not receiving intravenous hydration. The pathological mechanism hypothesized is the fluid shift from the intravascular compartment to the interstitial spaces.
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PMID:Fluid status of terminally ill cancer patients with intestinal obstruction: an exploratory observational study. 1235 26

Presented is material of 277 patients, who were treated due to acute abdomen illness in Intensive Therapy Unit at 2nd Department General Surgery Collegium Medicum Jagiellonian University during the time: from 01.07.1997 till 30.06.2002. This material regards only geriatric patients (patients > 65 years old). Patients analysis was divided into two main groups: patients with haemorrhagic shock caused by gastrointestinal bleeding (49 patients--group A) and by ruptured abdominal aneurysm (16 patients--group B), patients with hypovolemic and/or septic shock owing to diffuse peritonitis (150 patients--group C), and intestinal obstruction (62 patients--group D). The other principles of therapeutic procedures were described for every main group. In every illness group was showed: multiorgan dysfunction (acute myocardial ischemia with enzymatic and/or electrocardiographic changes, pulmonary oedema as acute left ventricular failure, respiratory and renal failure and metabolic dysfunction), actual punctuation into two scoring systems: APACHE II (28.8 points) and TISS-28 (44.5 points), time of hospitalization in the intensive therapy unit (mean 7.1 days), hospital's time of treatment (mean 17.5 days), mortality (for all patients 57.8%). These dates compared with dates from publications.
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PMID:[Treatment results in geriatric patients with acute abdomen in the intensive care unit]. 1467 91

A 72-year-old male patient with gall bladder perforation and small intestinal obstruction from impacted gall stone was posted for emergency laparotomy. He had congestive heart failure, severe hypertension at admission and history of multiple other coexisting diseases. On admission, he developed pulmonary oedema from systolic hypertension which was controlled by ventilatory support, nitroglycerine and furosemide. Preoperative international normalized ratio was 2.34 and left ventricular ejection fraction was only 20%. Because of risk of exaggerated fall in blood pressure during induction of anaesthesia (general or neuraxial), a transversus abdominis plane block via combined Petit triangle and subcostal technique was administered and supplemented with Propofol sedation.
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PMID:Transversus abdominis plane block for an emergency laparotomy in a high-risk, elderly patient. 2088 76

Dialysis-related amyloidosis predominantly occurs in osteo-articular structures and dialysis-related amyloid (DRA) substances also deposit in extra-articular tissues. Clinical manifestations of DRA include odynophagia, gastrointestinal hemorrhage, intestinal obstruction, kidney stones, myocardial dysfunction, and subcutaneous tumors. The pathological characteristics of DRA in the heart of hemodialysis patients have rarely been reported. We report the case of a 73-year-old female with a history of cerebral palsy and end-stage renal disease status post two failed renal transplants who had been on hemodialysis for 30 years. The patient was admitted with the working diagnosis of pneumonia. An echocardiography showed markedly reduced biventricular function manifested by low blood pressure with systolic in the 70s and elevated pulmonary artery pressure of 45 mmHg, which did not respond to therapy. Following her demise, the autopsy revealed bilateral pulmonary edema and pleural effusions. There was cardiac amyloid deposition exclusively in the coronary arteries but not in the perimyocytic interstitium. Amyloids were also found in pulmonary and intrarenal arteries and the colon wall. Previous case reports showed that beta 2-microglobulin amyloid deposits in various visceral organs but less frequently in the atrial and/or the ventricular myocardium. In the present case, amyloids in the heart were present in the intramural coronary arteries causing myocardial ischemia and infarction, which was the immediate cause of death.
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PMID:A case of intramural coronary amyloidosis associated with hemodialysis. 2853 82