Connecticut medicine
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Connecticut medicine · Aug 2011
Case ReportsIntracranial hemorrhage from undetected aneurysmal rupture complicating transphenoidal pituitary adenoma resection.
We report a case of a 39-year-old man who presented with a nonfunctioning pituitary macroadenoma which extended into the suprasellar region. He underwent a transcranial resection of the tumor followed eight months later by transsphenoidal surgery for the residual tumor. ⋯ A cerebral angiogram revealed a leaking anterior communicating artery aneurysm which was not seen on the computed tomography angiography and magnetic resonance angiography before the surgery. Complications of transsphenoidal surgery, particularly vascular hemorrhagic complications, and risk of rupture of undetected aneurysms are discussed.
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Connecticut medicine · Apr 2011
Availability and clinical utilization of capnography in the prehospital setting.
Capnography provides a continuous and objective measure of ventilation that can alert a provider immediately to a problem with airway or ventilation. Capnography has been recommended in the monitoring of patients during transport and can be utilized as a measure of ventilation or perfusion in other clinical scenarios. The objective of this study is to determine the current availability and utilization of capnography by Connecticut prehospital providers. ⋯ Capnography is often used to confirm endotracheal intubations, monitor ventilation, and during cardiopulmonary resuscitations. Prehospital providers are using this monitoring device increasingly in the field for critically ill patients. However, it's use could still be increased in other clinical situations.