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Query: UMLS:C0344329 (collapse)
 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of severe rhabdomyolysis with extensive myocardial involvement in a 32 year old alcoholic man is reported. He referred effort dyspnea for the last eight months which worsened thirteen days before his death. Admitted at the institute he was obnubilated and dyspneic. Massive pulmonary thromboembolism was suspected and heparin was given. He was then transferred to our intensive care unit in circulatory collapse. A chest Rx showed cardiomegaly. A Swan-Ganz catheter was introduced and abnormal parameters corrected. Evolution was complicated with acute cholecystitis, nosocomial bronchopneumonia and hypoxic brain damage. A net reduction of cardiac size as judged by a chest roentgenogram was noted in the final days. Necropsy showed skeletal and cardiac rhabdomyolysis, early alcoholic cirrhosis, diffuse peritonitis and bronchopneumonia. To our knowledge, this case is the first in the literature to provide anatomical evidence of cardiac rhabdomyolysis, a fact which was suspected on clinical grounds but had not been proven.
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PMID:[Alcoholic rhabdomyolysis with myocardial involvement]. 229 13

An association of alcoholic cirrhosis of the liver, hepatoma, extensive aortic thrombosis, and chronic bleeding peptic ulcer of the duodenal bulbus in a patient who survived only three days after hospitalisation is reported. An explanation of each disease is given and the fact that a basically hypocoagulative situation (cirrhosis) can give rise to thrombosis of the aorta is stressed. Production and release into the circulation of thromboplastins by the hepatoma (paraneoplastic syndrome), leading aortic atherosclerosis and slow circulation due to haemorrhagic cardiocirculatory collapse was the most likely explanation.
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PMID:[Association of liver cirrhosis, hepatoma, extensive aortic thrombosis and chronic duodenal peptic ulcer in the same patient]. 626 18

The investigation of socio-economic differences in mortality in Russia was effectively prohibited in the Soviet period. The extent and nature of any such differences is of considerable interest given the very different principles upon which Russian society has been organised for most of this century compared to the West where socio-economic differences in health have been extensively documented. Using cross-sectional data on mortality in Russia around the 1979 and 1989 Censuses, we have analysed mortality gradients according to length of education. Our results show that educational differences in mortality are at least as big as seen in Western countries, and are most similar to the recently reported differences observed for other former communist countries such as the Czech Republic, Estonia and Hungary. As observed in many other countries the strength of association of mortality with education declines with age, varies by cause of death and is generally stronger among men than women. Differentials are particularly large for accidents and violence, where for men and women the mortality rate among those with primary or basic secondary education is over twice that of people with higher education. Even larger effects are seen for causes directly related to alcohol (including alcoholic cirrhosis and accidental poisoning by alcohol), and for infectious and parasitic diseases and respiratory diseases. These educational differences may in part be related to educational differences in alcohol consumption. Of particular significance is the fact that there are indications that socio-economic differences in mortality have widened considerably in the 1990s, a period during which there was a huge increase in the national burden of alcohol-related deaths. This widening of socio-economic differences at this time suggest that these increases in consumption were especially acute among those with less education. At a more general level the fact that large educational differences in mortality were seen in Russia in 1979 and 1989, prior to the collapse of the Soviet Union, is very striking and informative. In this period there was a far weaker association between income and education than is seen in the West, suggesting that the education effects are unlikely to be driven by underlying differences in financial resources. The protective effect of education, in the Russian context at least, has been driven by more subtle and mechanisms. The apparent widening of socio-economic mortality differences since the collapse of the Soviet Union suggests that the transformation underway in Russian society requires a strengthening of the public health function.
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PMID:Educational level and adult mortality in Russia: an analysis of routine data 1979 to 1994. 968 6

Two autopsy cases of fulminant-type infection associated with necrotizing fasciitis were analyzed clinicopathologically. Both cases involved 57-year-old alcohol abusers. The former was a woman with group A (beta) hemolytic Streptococcus pyogenes infection, and the latter was a man with Vibrio vulnificus infection. The sudden onset of shock with high fever resulted in sepsis, decreased clotting, and hepatorenal symptoms, followed by death within a few days. Post-mortem examination showed widespread congestion and bleeding, and alcoholic liver cirrhosis was observed. Necrotizing fasciitis was identified in both cases. Bacteria from the pharynx or intestinal tract invaded the blood, and marked bacterial proliferation produced sepsis, resulting in necrotizing fasciitis. Despite the presence of sepsis, bilateral pulmonary congestion and bleeding were observed without pneumonia. Due to the rapid progression of sepsis, there was no time for granulocyte migration from the bone marrow. It seems that almost all mature granulocytes which had already existed in the bone marrow accumulated at the focus of necrotizing fasciitis because the bone marrow had few mature granulocytes and lacked hypercellularity. The cause of death in each case was circulatory collapse due to septic shock. It was difficult to distinguish the type of infection on histopathology. Cultures were necessary to determine the bacterial agents involved.
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PMID:Autopsy cases of fulminant-type bacterial infection with necrotizing fasciitis: group A (beta) hemolytic Streptococcus pyogenes versus Vibrio vulnificus infection. 1825 85

Dengue fever and dengue hemorrhagic fever are re-emerging diseases that are endemic in the Tropics. The global prevalence of dengue cases has increased in South-East Asia, Africa, the Western Pacific, and the Americas. The increasingly widespread distribution and the rising incidence of dengue virus infections are related to increased distribution of Aedes aegypti, an increasingly urban population, and increasing air travel. Several Southeast Asian countries show that the age of the reported dengue cases has increased from 5-9 years, to older children and young adults. Dengue infection in adolescents and adults has also been recognized as a potential hazard to international travelers returning from endemic areas, especially SoutheastAsia. Dengue is one disease entity with different clinical presentations; often with unpredictable clinical evolutions and outcomes. Bleeding manifestations in adult patients, including petechiae and menorrhagia were also frequently found; however, massive hematemesis may occur in adult patients because of peptic ulcer disease and may not be associated with profound shock as previously reported in children. Although shock and plasma leakage seem to be more prevalent as age decreases, the frequency of internal hemorrhage rises as age increases. Increase in liver enzymes found in both children and adults indicated liver involvement during dengue infections. Pre-existing liver diseases in adults such as chronic hepatitis, alcoholic cirrhosis, and hemoglobinopathies may aggravate the liver impairment in dengue infection. Fulminant hepatitis is a rare but well described problem in adult patients with dengue infection. Currently, no specific therapeutic agent exists for dengue. The early recognition of dengue infection, bleeding tendency, and signs of circulatory collapse would reduce mortality rates in adult patients with dengue infection.
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PMID:DENGUE FEVER AND DENGUE HEMORRHAGIC FEVER IN ADULTS. 2650 34