scholarly journals Favorable Outcome of Severe Poisoning by Snake Green Mamba (Dendroaspis viridis) Clinical Case

2019 ◽  
Vol 15 (2) ◽  
pp. 21-26
Author(s):  
A. R. Nasibullina ◽  
A. N. Lodyagin ◽  
V. A. Vdovin ◽  
N. E. Filippova ◽  
B. V. Batotsyrenov ◽  
...  
Keyword(s):  
Critical Care ◽  
Clinical Case ◽  
Life Support ◽  
Treatment Protocol ◽  
Acute Poisoning ◽  
Favorable Outcome ◽  
Channel Blockers ◽  
Antioxidant Mechanism ◽  
Comprehensive Therapy ◽  
Toxic Myopathy

This clinical case of acute poisoning due to bite of snake Dendroaspis viridis seems interesting to share because of its rare incidence inRussiaand management peculiarities: the critical care was conducted without specific antidote therapy due to absence of the antidote.The prevailing clinical presentation included signs of toxic myopathy combined with paresis of skeletal and breathing muscles that led to development of acute respiratory failure and metabolic disorders. The processes described were induced by the action of snake poison dendrotoxins featuring the activities of potassium channel blockers and acetyl cholinesterase inhibitors.The proper critical care included conduct of syndrome therapy aimed at maintaining life support systems adequately to condition (replacement of the breathing and circulation functions), antibiotic therapy and desensitizing treatment and metabolic care by administration of drugs characterized by antihypoxant/antioxidant mechanism of action.The comprehensive therapy applied has resulted in a favorable outcome of acute poisoning by snake green mamba without development of possible complications even when the specific antidote drug has not been included into the treatment protocol.

Computer Implementation of the Hierarchical-Modular Approach to Treatment Protocols

1982 ◽  
Vol 21 (03) ◽  
pp. 117-126 ◽  
Author(s):  
S. Michelson ◽  
M. Ben-Bassat ◽  
A. Macneil ◽  
M. H. Weil
Keyword(s):  
Critical Care ◽  
Knowledge Base ◽  
Life Support ◽  
Treatment Protocol ◽  
Modular Approach ◽  
Computer Implementation ◽  
Treatment Protocols ◽  
Treatment Information ◽  
Simple Language ◽  
Medical Disciplines

A computer implementation of the hierarchical modular approach to treatment protocols [1] is presented. By this approach the clinical treatment is defined in terms of a hierarchical structure composed of several substructures each varying with the complexity of treatment-related action that is required.The treatment protocol software consists of two major components. The first elicits treatment protocols from experts and stores them in the system’s knowledge base. The second component accesses those elements of the knowledge base relevant to the disorders and specific features (medical findings) of the patient, and drives the display of treatment information tailored specifically to the particular patient. The system interacts with the user in a friendly and very simple language. Displays are formatted in a structured manner and contain as much or as little detail as necessary. This system may find application in various areas, including generation of nursing and life support protocols as well as treatment protocols for critical care and other medical disciplines.

scholarly journals Successful treatment of polymedicamentous poisoning with metoprolol, diltiazem and cilazapril

2009 ◽  
Vol 66 (11) ◽  
pp. 904-908 ◽  
Author(s):  
Milan Radovanovic ◽  
Goran Miletic ◽  
Mirjana Radovanovic
Keyword(s):  
Mechanical Ventilation ◽  
Cardiopulmonary Resuscitation ◽  
Beta Blockers ◽  
Multidisciplinary Treatment ◽  
Phosphodiesterase Inhibitors ◽  
Complete Recovery ◽  
Acute Poisoning ◽  
Current Therapy ◽  
Channel Blockers ◽  
Heart Activity

Introduction. Poisoning caused by drugs with cardiodepressive effects is an urgent condition in medicine which is associated with high mortality rate regardless of modern therapeutic methods. Accidental or intentional poisoning whit these drugs produces heart activity depression and cardiovascular collapse as consequences. Current therapy for severe poisoning caused by beta-blockers and calcium channel blockers includes both unspecific and specific antidote therapy whit glucagon, as well as application of adrenergic drugs, calcium, phosphodiesterase inhibitors and hyperinsulinemia/euglycemia therapy. However, even whit the application of these drugs, prompt measures of unspecific detoxication therapy and cardiopulmonary reanimation are crucial for survival of patients with severe poisoning. Case report. A 28-year-old female patient was hospitalized for cardiogenic shock and altered state of conscioussnes (Glasgow coma score = 4), caused by acute poisoning with 2 g of metoprolol (Presolol?), 1.8 g of diltiazem (Cortiazem?) and 50 mg of cilazapril (Zobox?). Prolonged cardiopulmonary resuscitation was applied during the first 16 hours of hospitalization, including administration of crystaline solutions (8 L), 17 mg of adrenaline, 4 mg of atropine, 4 mg of glucagone and 1.6 g of dopamine, with electro-stimulation by temporary pacemaker and mechanical ventilation. In a defined time period, normalized state of consciousness was registered, mechanical ventilation was stopped and normal heart activity and hemodynamic stability were accomplished. During hospitalization the patient was treated for mild pneumonia and after ten days, completely recovered, was released and sent to home treatment. Conclusion. Prompt measures of cardiopulmonary resuscitation and multidisciplinary treatment in intensive care units significantly increase the chances of complete recovery of a patient with severe poisoning caused by drugs with cardiodepressive efects.

scholarly journals ADVANTAGES AND DISADVANTAGES OF DIGITAL SURGERY IN DENTAL REHABILITATION. LITERATURE REVIEW WITH A DESCRIPTION OF THE CLINICAL CASE

2021 ◽  
Vol 16 (4) ◽  
pp. 13-19
Author(s):  
Aleksandr Ivashov ◽  
Kristina Dement'eva ◽  
Petros Nersesyan ◽  
Yuliya Mandra ◽  
Valery Khodko
Keyword(s):  
Clinical Case ◽  
Treatment Protocol ◽  
Operation Time ◽  
Treatment Method ◽  
Bibliographic Databases ◽  
Navigation Surgery ◽  
Advantages And Disadvantages ◽  
Implant Placement ◽  
Dental Implantation ◽  
Surgical Template

Subject. With the advent of advanced imaging technology and CAD/CAM technologies, the possibility of guided surgery has become of wide interest among implantology. The article is devoted to the use of surgical template implantation in the rehabilitation of a dental patient. It provides information about some advantages and disadvantages of the digital protocol in comparison with traditional dental implantation. The main stages of navigation surgery in a clinical case are described. Goal. To evaluate the actual clinical advantages and disadvantages of dental implant placement using a surgical template compared to the traditional treatment protocol. Methodology. The literature search was conducted in scientific search bibliographic databases such as PubMed, eLIBRARY, Medline, and Google Academy. More than 384 studies up to 2014 were found under the thematic headings "Dental implantation" and "Surgical template". During the study of these works, the sample included 56 articles and literature reviews. Conclusions. Recently, implant placement using a surgical template has become a popular treatment method among dental surgeons. The study of modern literature allowed us to formulate the main advantages and disadvantages of this method. Advantages of the method: precise positioning of implants; flap-free surgery reduces the operation time and is characterized by a favorable postoperative course; integration of restoration determinants in surgical planning, which leads to a more aesthetic, functional and predictable result of prosthetics; the possibility of pre-manufacturing a prosthesis based on the planned position of the implant; simplification of the surgical procedure for the dentist. However, this method is not without its drawbacks: the surgeon's inability to visualize anatomical structures; the risk of axis and depth deviation during implant placement; requires additional digital planning.

scholarly journals Mandibular Osteonecrosis Induced by Bisphosphonates in a Carrier of Chronicle Kidney Disease

2018 ◽  
Vol 4 (1) ◽  
pp. 1119-1125
Author(s):  
Kaohana Da Silva ◽  
Greison De Oliveira ◽  
Eleonor Garbin-Júnior ◽  
Natasha Magro-Érnica ◽  
Geraldo Griza ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Multiple Myeloma ◽  
Renal Function ◽  
Bone Resorption ◽  
Kidney Disease ◽  
Impaired Renal Function ◽  
Clinical Case ◽  
Treatment Protocol ◽  
Inorganic Pyrophosphate ◽  
Jaw Osteonecrosis

The bisphosphonates are synthetic substances of inorganic pyrophosphate that have been the basis of treatment of patients with osteolytic diseases, such as multiple myeloma, malignant hypercalcemia, Paget's disease, or patients with bone metastases. Its main pharmacological effect is inhibition of bone resorption caused by osteoclasts, which have a reduced function. Their adverse effects are infrequent but include pyrexia, impaired renal function, hypocalcemia, and more recently, maxillo-mandibular ostenecrose induced bofosfonatos. In this report we describe a clinical case of jaw osteonecrosis induced by bisphosphonates in patient with chronic kidney disease and the treatment protocol performed.

Medical Student Introduction to ‘Patient Centred Healthcare' Through a ‘Constructivist' Learning Session in Cardiology

2013 ◽  
Vol 3 (4) ◽  
pp. 37-49
Author(s):  
Monika Pathania ◽  
Aditi Chaturvedi ◽  
Rakesh Biswas
Keyword(s):  
Medical Students ◽  
Clinical Case ◽  
Life Support ◽  
Cognitive Domain ◽  
Case Discussion ◽  
Learning Session ◽  
Cross Sectional ◽  
Medical Educators ◽  
Power Point ◽  
Self Learning

To compare constructivist and traditional power point teaching modalities in a cardiology workshop for medical undergraduates. The purpose of introducing the constructivist method was to activate the cognitive domain of the students and promote self learning. A cross sectional qualitative and quantitative study was planned on hundred, second and third professional medical students (III to IX semester) who were screened to participate. Topics discussed with the constructivist method were clinical case discussion, basic and advanced cardiac life support, electrocardiography, and community cardiology. The traditional power point method topics discussed were cardiac surgeries, paediatric cardiology and advanced diagnostic cardiology. Assessment on feedback of the students and interpretation of the interviews of medical educators, students and patients and grading of lectures from 0-10 was undertaken. Seventy two percent liked the active participation of students in the constructivist method of teaching. Seventy two percent of the participants found power point presentations as monotonous and no different from the usual didactic lectures conducted in the class room teaching. There was an up gradation of scores after the teaching sessions for clinical case discussion, ECG, BLS/ACLS and cardiac surgeries. The medical educators also found the constructivist method of teaching more practical. Constructivist method of teaching may be regarded as a new better way of teaching medical students as it considers the students as adult learners and promotes self learning.

Early versus Late Tracheostomy for Intubated Patients

2017 ◽  
Author(s):  
Rachel J. Kwon
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Clinical Case ◽  
Critically Ill Patient ◽  
Early Tracheostomy ◽  
Surgical Critical Care ◽  
The Family ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study in surgical critical care. Does early tracheostomy reduce mortality in ventilated critically ill patients? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case on discussing the option of a tracheostomy with the family of a critically ill patient.

Sign in / Sign up

Export Citation Format

Share Document