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 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three patients with polycythemia and previous evidence of cardiovascular disease underwent routine phlebotomies. Systolic hypotension followed by ineffective volume replacement with electrolyte solutions developed in all patients after phlebotomy. In two patients acute myocardial infarction and in a third cardiovascular collapse and death were temporally related to the procedure. This experience suggests that phlebotomy in patients with cardiovascular disease should be performed by the slow removal of small volumes of blood under continuous blood pressure monitoring. Effective restoration of the plasma volume with plasma or colloid is essential unless volume overload is present.
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PMID:Hazards of phlebotomy in polycythemic patients with cardiovascular disease. 98 91

A 2-year-old, Quarter Horse filly was referred to Michigan State University, Veterinary Teaching Hospital with a 2-3 day history of depression and partial anorexia progressing to severe, watery diarrhea with severe neurologic abnormalities, including repetitive muscle fasciculations, muscle stiffening, and collapse. Laboratory findings included severe polycythemia, neutropenia, metabolic acidosis, and electrolyte and fluid loss, consistent with watery diarrhea and endotoxic shock. Increased creatine kinase and aspartate transaminase activities were consistent with recent transport and the muscle abnormalities. Severe hyperammonemia (1369.0 micromol/L; control value, 15.3 micromol/L) was found, without other substantial laboratory evidence of hepatic dysfunction. The horse was euthanized because of poor prognosis and rapid clinical deterioration. Necropsy findings were unremarkable with the exception of severe diffuse colitis. Culture of colonic contents recovered >1000 colony-forming units of Clostridium perfringens. Based on these findings, marked hyperammonemia in this filly was attributed to changes in colonic flora leading to increased bacterial production of ammonia that was readily absorbed through the inflamed bowel wall, exceeding the hepatic capacity for deamination. Intestinal bacteria as a source of hyperammonemia in the absence of hepatic disease has been linked rarely to positive culture results for clostridial organisms.
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PMID:Diarrhea and hyperammonemia in a horse with progressive neurologic signs. 1678 24

A 5-month old female Red-Holstein calf in poor condition was presented with a history of reduced appetite, respiratory disease and collapse. Clinical examination revealed an elevated heart rate and pronounced cyanosis of the mucous membranes. Heart and lung auscultation were normal. A complete blood count revealed profound polycythemia with severely increased values for packed cell volume, hemoglobin concentration and erythrocyte count. Cardiac ultrasonography revealed abnormal position of the great vessels with two arteries located in the right ventricle output tract and a high ventricular septum defect (VSD). Intracardial pressure and blood gas measurements confirmed pressure overload in the right heart, a left-to-right shunt through the VSD and a right-to-left-shunt leading to hypoxemia and secondary polycythemia. Based on poor prognosis, the animal was euthanized. Post-mortem examination confirmed the results of the further investigations conducted to determine the cause of polycythemia in this calf.
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PMID:[Severe cardiac malformation with secondary polycythemia in a 5-month old calf]. 2088 45