Le Journal médical libanais. The Lebanese medical journal
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Multicenter Study
[Assessment of the reasons prompting a first echocardiography in children: a Lebanese multicenter study].
To study the different indications behind performance of a first Doppler echocardiography (DE) in children, to assess the results and their impact on the residency teaching program in Lebanon. ⋯ DE should be a complement to clinical exam, which is often sufficient to reveal a cardiac pathology. However, some conditions, where cardiovascular exam is normal require a DE. The question of when and why to request a DE must be a priority in the pediatric resident training program.
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Review Case Reports
Gastric pneumatosis as a manifestation of ischemic infarction of the stomach. Report of a case and review of the literature.
Gastric pneumatosis is a very rare entity, and of the hollow viscera, the stomach is the least often reported site for intramural gas. ⋯ Surgeons, internists and gastroenterologists should be aware of the possibility of gastric pneumatosis in some cases. Underlying disease are important to clarify in order to apply the adequate treatment.
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Noninvasive ventilation is currently an established therapeutic tool. The tendency to its generalization emanates from the avoidance of invasive endotracheal intubation but also from the reduction of the duration of stay in critical care unit, the reduction in the incidence of nosocomial pneumonia and the reduction of mortality. The success of noninvasive ventilation requires a coordinated staff work between the couple physiotherapist/nurse responsible of the application of noninvasive ventilation and the treating physician responsible of the adjustments and modifications of the respiratory parameters. The follow-up appreciates the effectiveness, detects the complications and checks that ventilation is applied correctly.
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Comparative Study
[Interest of the noninvasive techniques for the measurement of the blood pressure in critical care].
The goal of this study is to compare three techniques for the measurement of arterial blood pressure (invasive (I), oscillometric (O), and sphygmomanometric (S)) in critically ill patients to determine if the noninvasive techniques can replace the arterial catheterization, and to see whether the relation between these three methods varies over time. ⋯ Oscillometry can replace the direct intra-arterial standard technique for the monitoring of the blood pressure in the intensive care unit. In contrast, the sphygmomanometry in the ICU gives inaccurate results that could lead to inappropriate therapeutic attitudes.
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In the setting of acute myocardial infarction (AMI), several investigators have demonstrated that emergency coronary angioplasty (PTCA) reduces in-hospital mortality of primary cardiogenic shock (CS) from 90% to less than 50% ; however, few studies have focused on the current outcome of non selected patients in whom the onset of AMI is immediately complicated by CS. ⋯ Direct PTCA for AMI immediately complicated by CS, can be achieved with a high success rate, and can significantly reduce in-hospital mortality; this improvement of survival is most evident if revascularizarion is performed early.