Successful Emergency Treatment in Bradypus variegatus following Non-Hemorrhagic Hypovolemic Shock

Background: The brown-throated sloth (Bradypus variegatus) occurs from the Nicaragua to Brazil. In brazilian amazonian, these animals are rescued with illnesses caused by anthropic actions. Emergencial treatment of sloths is complex because is a lack of specie-specific information allied to a particularly physiology. They have low metabolism and physiological parameters during resting time is 4-7 breaths/min, 40-100 heartbeats/min and temperature between 32-35ºC. They are also folivores, predisposing cases of dehydration and even hypovolemic shock. This study aimed to report the emergency treatment performed on a specimen of Bradypus variegatus affected by hypovolemic shock due to dehydration.Case: A male sloth weighing 2.7 kg was attended at the Veterinary Hospital-Wild Animals Sector of the Federal University of Pará (HVSAS-UFPA), victim of untreated hypovolemic shock due three days of forced eating with inadequate food, which resulted in dehydration, non-hemorrhagic hypovolemic shock, and severe apathy. Physiological parameters were 8 breaths/min, heart rate 90/min and rectal temperature of 33°C. Treatment begun with fluid therapy taking account of 10% of body dehydration (270 mL Ringer lactate, 8 mL vitamin complex and 2 mL glucose), for respiratory decompensation nebulization was conducted with epinephrine (0.5 mL/kg), and intramuscular administration of vitamin B complex (1 mg/kg), metoclopramide (0.2 mg/kg), ranitidine (0.5 mg/kg), and dexamethasone (0.3 mg/kg) to metabolic stimulation improvement. Physiological parameters were monitored every 10 min for the first 12 h of hospitalization. The management were gradually established as the clinical conditions were improved, including forced feeding, daily walks, and enclosure adapted for the minimal behavioral and biological requirements. After 14 days of intensive treatment, the animal was considered ready for release.Discussion: Treatment of critically ill and unnourishment patients requires prompt interventions. Animals with low metabolism potentially have reduced chances of success, therefore, a prompt establishment of viable airways and body temperature maintenance would allow the efficient drugs metabolization. Severe dehydration can lead to animal death by hypovolemic shock, as a consequence of low blood volume, diminish in blood pressure and in the amount of oxygen in body supply, so fluid replacement is essential, as well as stimulating respiratory compensation through bronchodilator drugs. Furthermore, metabolic stimulation is important in cases to prevent numbness, which is common in very weak sloths. The constant monitoring of physiological parameters since at first moment of hospitalization provided parameter to decide about particular needs adaptations during the animal recovery time. Such protocols described for the brown-throated sloth was absent in the literature. In conclusion, the therapeutic and management protocol implemented and adapted to a particular patience, as brown-throated sloth, resulted in a gradual clinical improvement and allowed to its return for the natural environment.

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Intraperitoneal hemorrhage after cupping therapy

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907918784076 ◽

2018 ◽

Vol 27 (2) ◽

pp. 107-109

Author(s):

Meng-Chuan Lu ◽

Chih-Jen Yang ◽

Shih-Hung Tsai ◽

Chih-Chieh Hung ◽

Sy-Jou Chen

Keyword(s):

Rare Complication ◽

Hypovolemic Shock ◽

Cupping Therapy ◽

Tissue Ischemia ◽

Intraperitoneal Hemorrhage ◽

Relieve Pain ◽

History Of ◽

Enhanced Computed Tomography ◽

Clinical Conditions ◽

High Degree

Introduction: Cupping therapy has been widely performed in oriental countries and considered a safety alternative to relieve pain. Here, we report a rare complication from abdominal cupping. Case presentation: A 49-year-old man presented with a 2-day history of left upper quadrant abdominal pain after cupping therapy 3 days earlier. His abdomen was soft but appeared a localized rebounding tenderness. Contrast-enhanced computed tomography of the abdomen showed intraperitoneal hemorrhage originated from the left upper quadrant of the omentum. Discussion: Several mechanisms are proposed for the development of intraperitoneal hemorrhage after cupping therapy, including the tensile stress generated by cupping that facilitates the disruption of omentum vessels, strong negative pressure generated by cupping that suppresses blood supply to the cup-applied sites causing adjacent tissue ischemia, and subsequent vascular extravasation. Treatment for intraperitoneal hemorrhage depends on clinical conditions. Stable patients can be managed conservatively, whereas surgery is reserved for those with continuous bleeding and hypovolemic shock. Conclusion: Cupping therapy complicated with omentum bleeding can present insidiously until peritoneal irritation developed by intraperitoneal hemorrhage. A comprehensive history taking and a high degree of vigilance are crucial to diagnose early patients with this rare complication.

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LIMITATIONS OF CONVENTIONAL FLUID REPLACEMENT WITH CRYSTALLOIDS IN HYPOVOLEMIC SHOCK.

Shock ◽

10.1097/00024382-199911001-00028 ◽

1999 ◽

Vol 12 (Supplement) ◽

pp. 9

Author(s):

Rocha M. e Silva

Keyword(s):

Hypovolemic Shock ◽

Fluid Replacement

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Hemoglobin measurement patterns during noninvasive diffuse optical spectroscopy monitoring of hypovolemic shock and fluid replacement

Journal of Biomedical Optics ◽

10.1117/1.2715189 ◽

2007 ◽

Vol 12 (2) ◽

pp. 024001 ◽

Cited By ~ 20

Author(s):

Jangwoen Lee ◽

Albert E. Cerussi ◽

Darin Saltzman ◽

Tom Waddington ◽

Bruce J. Tromberg ◽

...

Keyword(s):

Optical Spectroscopy ◽

Hypovolemic Shock ◽

Fluid Replacement ◽

Diffuse Optical Spectroscopy ◽

Hemoglobin Measurement

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Lighter Ingestion as an Uncommon Cause of Severe Vomiting in a Schizophrenia Patient

Case Reports in Gastrointestinal Medicine ◽

10.1155/2016/6301302 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Yahya Atayan ◽

Yasir Furkan Cagin ◽

Mehmet Ali Erdogan ◽

Yılmaz Bilgic ◽

Remzi Bestas ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Emergency Treatment ◽

Foreign Bodies ◽

Schizophrenia Patient ◽

Endoscopic Therapy ◽

Plain Radiograph ◽

Severe Vomiting ◽

Polypectomy Snare ◽

Clinical Conditions ◽

Swallowed Foreign Bodies

Background. Foreign bodies in the gastrointestinal tract are important morbid and mortal clinical conditions. Particularly, emergency treatment is required for cutting and drilling bodies. The majority of ingested foreign bodies (80–90%) leave gastrointestinal tract without creating problems. In 10–20% of cases, intervention is absolutely required. Less than 1% of cases need surgery. In this paper, we present a schizophrenia patient who swallowed multiple lighters.Case. A 21-year-old male schizophrenic patient who uses psychotic drugs presented to the emergency department with the complaints of abdominal pain, severe vomiting, and inability to swallow for a week. His physical examination revealed epigastric tenderness. A plain radiograph of the abdomen revealed multiple tiny metallic densities. Gastroscopy was performed. The lighters were not allowing the passage, and some of them had penetrated the gastric mucosa, and bezoars were observed. One lighter was extracted with the help of the polypectomy snare. Other lighters as a bezoar were removed by surgery.Conclusion. Excessive vomiting of swallowed foreign bodies in the etiology of psychotic patients should be kept in mind. Endoscopic therapy can be performed in the early stages in these patients, but in the late stage surgery is inevitable.

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A Systemic Capillary Leak Syndrome (Clarkson Syndrome) in a Patient with Chronic Lymphocytic Leukemia: A Case Report in an Out-of-Hospital Setting

Case Reports in Emergency Medicine ◽

10.1155/2016/5347039 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Manon Durand Bechu ◽

Antoine Rouget ◽

Christian Recher ◽

Elie Azoulay ◽

Vincent Bounes

Keyword(s):

Chronic Lymphocytic Leukemia ◽

Poor Prognosis ◽

Hypovolemic Shock ◽

Hospital Setting ◽

Capillary Leak Syndrome ◽

Lymphocytic Leukemia ◽

Fluid Replacement ◽

Capillary Leak ◽

Systemic Capillary Leak Syndrome ◽

Initial Care

Systemic Capillary Leak Syndrome (SCLS) is a rare disease with poor prognosis, characterized by the occurrence of mucocutaneous and visceral edema with hypotension, hemoconcentration, and unexpected hypoalbuminemia. The disease can be idiopathic (Clarkson syndrome) or secondary to other diseases and treatments. We describe this syndrome in a prehospitalized, 63-year-old patient with chronic lymphocytic leukemia and an idiopathic form of SCLS manifesting as hypovolemic shock. Initial care is hospitalization in intensive care. In addition to etiological treatment if fluid replacement is necessary, treatment must be closely monitored for secondary overload complications. Catecholamine rather than arrhythmogenic support may be associated.

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The role of differential phase contrast in electron microscopy

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100108027 ◽

1978 ◽

Vol 36 (1) ◽

pp. 176-177

Author(s):

E.M. Waddell ◽

J.N. Chapman ◽

R.P. Ferrier

Keyword(s):

Phase Contrast ◽

Practical Method ◽

Position Vector ◽

Differential Phase ◽

Pure Phase ◽

Differential Phase Contrast ◽

The Difference ◽

Image Position ◽

First Moment

Dekkers and de Lang (1977) have discussed a practical method of realising differential phase contrast in a STEM. The method involves taking the difference signal from two semi-circular detectors placed symmetrically about the optic axis and subtending the same angle (2α) at the specimen as that of the cone of illumination. Such a system, or an obvious generalisation of it, namely a quadrant detector, has the characteristic of responding to the gradient of the phase of the specimen transmittance. In this paper we shall compare the performance of this type of system with that of a first moment detector (Waddell et al.1977).For a first moment detector the response function R(k) is of the form R(k) = ck where c is a constant, k is a position vector in the detector plane and the vector nature of R(k)indicates that two signals are produced. This type of system would produce an image signal given bywhere the specimen transmittance is given by a (r) exp (iϕ (r), r is a position vector in object space, ro the position of the probe, ⊛ represents a convolution integral and it has been assumed that we have a coherent probe, with a complex disturbance of the form b(r-ro) exp (iζ (r-ro)). Thus the image signal for a pure phase object imaged in a STEM using a first moment detector is b2 ⊛ ▽ø. Note that this puts no restrictions on the magnitude of the variation of the phase function, but does assume an infinite detector.

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A Color Coded STEM/SEM Image Storage System

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100097880 ◽

1981 ◽

Vol 39 ◽

pp. 272-273

Author(s):

Y. Kokubo ◽

W. H. Hardy ◽

J. Dance ◽

K. Jones

Keyword(s):

Image Processing ◽

Electron Beam ◽

Storage System ◽

Particle Analysis ◽

Specific Information ◽

X Rays ◽

Sem Image ◽

Backscattered Electrons ◽

Wide Range ◽

Scanning Electron

A color coded digital image processing is accomplished by using JEM100CX TEM SCAN and ORTEC’s LSI-11 computer based multi-channel analyzer (EEDS-II-System III) for image analysis and display. Color coding of the recorded image enables enhanced visualization of the image using mathematical techniques such as compression, gray scale expansion, gamma-processing, filtering, etc., without subjecting the sample to further electron beam irradiation once images have been stored in the memory.The powerful combination between a scanning electron microscope and computer is starting to be widely used 1) - 4) for the purpose of image processing and particle analysis. Especially, in scanning electron microscopy it is possible to get all information resulting from the interactions between the electron beam and specimen materials, by using different detectors for signals such as secondary electron, backscattered electrons, elastic scattered electrons, inelastic scattered electrons, un-scattered electrons, X-rays, etc., each of which contains specific information arising from their physical origin, study of a wide range of effects becomes possible.

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Electron Microscopy in the Study of Natural Phytoplankton Assemblages

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100119831 ◽

1985 ◽

Vol 43 ◽

pp. 620-623

Author(s):

Linda Sicko-Goad

Keyword(s):

Electron Microscopy ◽

Aquatic Environment ◽

Size Range ◽

Physical Parameters ◽

Specific Information ◽

Phytoplankton Assemblages ◽

Phytoplankton Productivity ◽

Ecosystem Effects ◽

Time Of Year ◽

Species Specific

Although the use of electron microscopy and its varied methodologies is not usually associated with ecological studies, the types of species specific information that can be generated by these techniques are often quite useful in predicting long-term ecosystem effects. The utility of these techniques is especially apparent when one considers both the size range of particles found in the aquatic environment and the complexity of the phytoplankton assemblages.The size range and character of organisms found in the aquatic environment are dependent upon a variety of physical parameters that include sampling depth, location, and time of year. In the winter months, all the Laurentian Great Lakes are uniformly mixed and homothermous in the range of 1.1 to 1.7°C. During this time phytoplankton productivity is quite low.

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