Journal of the Chinese Medical Association : JCMA
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Randomized Controlled Trial Comparative Study Clinical Trial
Percutaneous dilatational tracheostomy versus open tracheostomy--a prospective, randomized, controlled trial.
Percutaneous dilatational tracheostomy has gained popularity, but its superiority to open tracheostomy is unclear. The object of this study was to compare procedure time, complication, safety and cost-effect between the percutaneous dilatational tracheostomy (PDT) and the conventional open tracheotomy (OT). ⋯ The PDT appears to be a simple, safe and time-saving bedside procedure. It can be recommended when an elective tracheostomy is needed in a critical patient.
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Endovascular embolization of wide neck aneurysm often results in incomplete occlusion or aneurysm recurrence. The purpose of this study is to assess the efficacy and safety of stent-assisted embolization of wide neck aneurysms of the internal carotid artery (ICA). ⋯ Stent-assisted embolization is a treatment of choice for wide neck aneurysms or for patient with herniation of coil loops to parent artery after coil detached. It was proven both safe and effective over a relatively long follow-up.
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Case Reports
Metformin-associated lactic acidosis and acute renal failure in a type 2 diabetic patient.
Metformin belongs to a class of drugs known as the biguanides that are widely used in the treatment of type 2 diabetes mellitus. Its association with lactic acidosis is well established, although rare. Metformin-associated lactic acidosis is recognized as a potentially lethal condition that can occur in patients with contraindications to the drug, such as renal dysfunction, liver diseases, alcoholism, and cardiopulmonary diseases. ⋯ We describe a 75-year-old diabetic woman with acute renal failure and life-threatening lactic acidosis due to metformin intoxication. Clinical manifestations included vomiting, diarrhea, hypothermia, hypotension and transitory blindness. Her initial renal function was recovered after hemodialysis and she was discharged 3 months after admission.