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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 13 (1987), S. 175-182 
    ISSN: 1432-1238
    Keywords: Miliary tuberculosis ; Adult respiratory distress syndrome ; Multiple organ system failure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Although, miliary tuberculosis is an unusual cause of severe acute respiratory failure, we describe nine patients with miliary tuberculosis who developed adult respiratory distress syndrome. This complication occurred in seven patients despite treatment with antituberculous drugs. In two patients who developed the syndrome, miliary tuberculosis was diagnosed only at postmortem. The presence of pulmonary hypertension in all cases and disseminated intravascular coagulation in seven cases suggests a possible pathophysiologic relationship with severe pulmonary vascular damage. The high mortality rate (88.8%) was associated with nonpulmonary organ system failure. Miliary tuberculosis should be considered in patients with adult respiratory distress syndrome of unknown etiology, and simple diagnostic procedures such as sputum, bronchial brushing, and gastric examination should be followed by invasive diagnostic procedures to confirm this etiology. Since untreated miliary tuberculosis is usually fatal, early recognition of this disease is of great importance, and specific therapy may play a lifesaving role.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1238
    Keywords: Haemoperfusion ; Intoxication ; Plasmapheresis ; Thyrotoxicosis ; Thyroxine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Six patients were admitted after erroneous massive intake of levothyroxine (70–1200mg over an interval of 2–12 days). All patients developed classical symptoms of thyrotoxicosis within 3 days of the first dose; five patients presented grade II–III coma and one became stuporous (days 7–10). Two patients developed left ventricular failure and three had arrhythmias (days 8–11). Total thyroid hormone levels in serum on admission ranged 935–7728 nmol/l for T4 (TT4) and 23–399 nmol/l for T3 (TT3). All patients received treatment with hydrocortisone and Propranolol. Propylthiouracil was also given in 3 cases. Extractive techniques (charcoal haemoperfusion and/or plasmapheresis) were initiated 8–14 days after the first dose of L-T4. The plasma disappearance rate (K) of TT4 with plasmapheresis was 30 times higher, on average, than under standard medical treatment (M). Also, K of TT4 under haemoperfusion was about five times higher than K under M. K changes for TT3 were higher under haemoperfusion than under plasmapheresis. Furthermore, extractive procedures shortened the average half life of TT4, (from 106.5±44.6 to 59.7±20.2 h, p〈0.05).
    Type of Medium: Electronic Resource
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