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        תוצאת חיפוש

        פברואר 2002

        ערן סגל
        עמ'

        ערן סגל

         

        ההודעה של ה-FDA על מתן אישור לתרופה קטיגריס (xigris) של חברת לילי לטיפול באלח דם קשה, היא מהחדשות המרשימות ביותר הנוגעות לטיפול בחולים במצב קשה. הודעה זו באה לאחר פירסום תוצאות מחקר רב-מרכזי, כפול סמיות שלב III, שנערך מטעם חברת לילי ופורסם ב-New England Journal of Medicine בחודש מרס 2001. במחקר זה נמצא, כי התרופה קטיגריס מפחיתה את שיעור התמותה מאלח דם ב- 6% - מ-30% ל-24%.

        אוגוסט 2001

        ארז סקפה, אלכסנדר בטלר, דוד חסדאי
        עמ'

        ארז סקפה, אלכסנדר בטלר, דוד חסדאי

         

        המערך לקרדיולוגיה, מרכז רפואי רבין, קמפוס בילינסון, פתח תקוה

         

        הלם שמקורו בלב (cardiogenic shock) (המ"ל) הוא תיסמונת קלינית, הנגרמת מירידה בתפוקת-הלב המערכתית בנוכחות נפח תוך-כלי תקין. כתוצאה מכך, נגרמות ירידה בזילוח רקמות והפרעה באספקת חמצן לרקמות. בסקירה זו נתייחס למאמרים העיקריים שפורסמו בנושא זה וננסה לגבש עמדה לגבי אפשרויות הטיפול בחולים אלה.

        פברואר 2000

        אמנון הדר, גרשון הולצברג ומשה מזור
        עמ'

        Anaphylactic Shock after Diclofenac Sodium 


        Amnon Hadar, Gershon Holcberg, Moshe Mazor

         

        Division of Obstetrics and Gynecology, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba

         

        Anaphylaxis due to diclofenac sodium (Voltaren) is rare. We describe a 39-year-old woman who received a suppository of diclofenac for analgesia 6-hours after cesarean section. She developed severe angioedema and profound hemodynamic shock 10 minutes after the diclofenac, to which she had been exposed in the past without any side-effects. There are few reports of such an acute, life-threatening, multisystem reaction to this drug in the English literature.

        ינואר 2000

        יעל גרייף, אבנר גורן ואבנר רשף
        עמ'

        Recurrent Anaphylactic Reactions During Hospitalization – an Unusual Etiology 


        Y. Graif, A. Goren, A. Reshef

         

        Military Allergy Clinic, Israel Defense Forces and Allergy and Immunology Clinic, Sheba Medical Center, Tel Hashomer

         

        The prevalence of hypersensitivity and untoward reactions to natural rubber latex (NRL) products is increasing, particularly among specific risk groups. A young man aged 23 years who experienced several episodes of allergic reactions, 2 of which included anaphylactic shock during hospital admission, is presented. These episodes were initially attributed to intravenous medication, but were most probably caused by inadvertent exposure to latex.

        Medical facilities may contain large amounts of latex, and therefore present a hazardous environment for sensitive people. Increasing awareness of latex sensitivity among patients-at-risk and medical personnel, and implementing simple prophylactic measures, may reduce morbidity and mortality. We propose simple and practical guidelines for diagnosis and treatment.

        יולי 1999

        אמיר הלקין, דינה לב, עודד סולד, פיליפ בידרמן, שרה בולוצ'ניק, פנחס הלפרן ופטריק סורקין
        עמ'

        Severe Heat Stroke in an Intensive Care Unit

         

        Amir Halkin, Dina Lev, Oded Szold, Philip Bidermann, Sarah Bulocnic, Pinchas Halpern, Patrick Sorkine

         

        Depts. of Medicine and Surgery, and Intensive Care Unit, Tel Aviv Medical Center

         

        During the August 1998 heat wave in Tel Aviv we admitted many patients for acute heat-related illness; 6 had severe heat stroke and were admitted in critical condition. We describe their clinical courses during the first 5 days of hospitalization, including response to treatment and implications for future management of this disorder.

         

        The mean APACHE II score of the 6 was 30±3.5 and mean Glasgow Coma Scale rating 3.5±0.5; they were in hypovolemic shock and respiratory failure, necessitating mechanical ventilation. Despite early effective therapy (core temperature in all was reduced to less than 398C in less than 1 hour), there was 1 death (mortality 15%) and 4 required further intensive care for life-threatening multiple organ failure.

         

        During severe heat waves a significant number of referrals for acute heat-related illness must be anticipated, possibly overwhelming admission capacity of regional intensive-care units. Severe heat stroke complicated by multi-organ failure is not necessarily related to prior physical activity. Although important in determining prognosis, early treatment does not prevent severe complications. Mechanisms regulating body heat may remain disturbed for days following early treatment and apparent stabilization, mandating continued hospitalization.

        ינואר 1999

        גד שקד, אריה אריש ודוד צייגר
        עמ'

        Traumatic Aortocaval Fistula

         

        Gad Shaked, Arie Arisch, David Czeiger

         

        Surgery Dept., Soroka University Hospital, Beer Sheba

         

        Arterio-venous fistula is a relatively rare form of vascular injury. A cof an unusual fistula between aorta and inferior vena cava is presented. Occasionally this type of is difficult to diagnose early. Life-threatening conditions may mandate prompt treatment and the use of damage control strategy. It is also important to diagnose and treat this injury in order to prevent complications. Sudden hemorrhage and congestive heart failure are the major disturbances that result from aortocaval fistula.

        אוגוסט 1998

        י' שפירא, ילנה צוקרמן, תאופיק זועבי ועודד זורים
        עמ'

        Pheochromocytoma Multi-Organ Crisis: Nonseptic Hyperthermia and Shock

         

        Michael Y. Shapira, Elena Zuckerman, Taufic Zuebi, Oded Jurim

         

        Divisions of Medicine and Surgery, Hadassah-University Hospital; Geriatrics Dept.; Herzog Hospital, Jerusalem; and Dept. of Medicine, Yoseftal Hospital, Eilat

         

        Pheochromocytoma usually presents with nonspecific symptoms such as headache, palpitation, chest pain and hypertension. We present a 48-year-old woman hospitalized due to a pheochromocytoma multi-organ crisis (PMC). It consists of a tetrad of symptoms: multi-organ failure, hyperthermia, encephalopathy and unstable blood pressure. Distinguishing PMC from septic shock may be difficult, and requires needs a high clinical index of suspicion.

        מאי 1997

        גדי פישמן ודב אופיר
        עמ'

        Toxic Shock Syndrome

         

        Gadi Fishman, Dov Ophir

         

        ENT and Head Neck Surgery Dept., Meir Hospital, Kfar Saba

         

        Toxic shock syndrome (TSS) is a rare, life-threatening, acute multisystem illness usually characterized by sudden onset of high fever, diffuse sunburn-like erythroderma and a variety of other signs and symptoms. It may progress rapidly to hypotension and shock with multiple organ failure. Its exact cause is unknown, but in almost all cases there has been an infection with exotoxin-producing strains of phage group I Staphylococcus aureus. Although initially described in association with the use of super-absorbent tampons in menstruation, TSS has complicated a variety of surgical procedures. Recently in head and neck surgery attention has focused on absorbent packing materials, such as those used in postoperative nasal care.

        TSS developed in a 12-year-old 28 hours after tonsillectomy, nasal septoplasty and inferior turbinectomy in which absorbent packing material was used. It is important to maintain a high index of suspicion for TSS in all postoperative patients with fever, hypotension and erythroderma.

        הבהרה משפטית: כל נושא המופיע באתר זה נועד להשכלה בלבד ואין לראות בו ייעוץ רפואי או משפטי. אין הר"י אחראית לתוכן המתפרסם באתר זה ולכל נזק שעלול להיגרם. כל הזכויות על המידע באתר שייכות להסתדרות הרפואית בישראל. מדיניות פרטיות
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