Zhonghua yi xue za zhi = Chinese medical journal; Free China ed
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Zhonghua Yi Xue Za Zhi (Taipei) · Dec 1996
Treatment of carbon monoxide poisoning with hyperbaric oxygen.
Carbon monoxide poisoning is a major cause of accidental morbidity and mortality in Taiwan. Utilization of hyperbaric oxygen in severely carbon monoxide intoxicated patients has been investigated widely. The object of this study was to determine the nature of carbon monoxide poisoning and to evaluate the effect of hyperbaric oxygen therapy for such patients. ⋯ It was concluded that hyperbaric oxygen therapy is an effective method in treating carbon monoxide intoxicated patients. Understanding the pathogenesis of carbon monoxide poisoning and indications for hyperbaric oxygen therapy will help physicians manage such patients earlier and more adequately. Information on currently available hyperbaric facilities in Taiwan is necessary for timely transfer.
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Zhonghua Yi Xue Za Zhi (Taipei) · Nov 1996
Case ReportsHypercapnic respiratory acidosis precipitated by hypercaloric carbohydrate infusion in resolving septic acute respiratory distress syndrome: a case report.
Complications may occur when nutritional support is administered either parenterally or enterally. Inappropriate nutritional formulas with high carbohydrate loads can precipitate respiratory failure in patients with compromised lung function, induce respiratory distress which manifests as dyspnea and tachypnea in an originally normal lung condition, produce hypercapnic acidosis in mechanically ventilated patients with chronic obstructive pulmonary disease (COPD) as well as patients recovering from acute respiratory distress syndrome (ARDS) without chronic lung disease, or result in difficult weaning. ⋯ As carbohydrate calories were decreased, CO2 production diminished and the hypercapnia was resolved. The importance of indirect calorimetry cannot be overemphasized during tailoring of nutritional support for the critically ill patients.
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An Emergency Medical Services (EMS) system containing the advanced life support (ALS) and manned with paramedics, is developing in many countries in view of the importance of prehospital ALS skills on ALS eligible patients, although previous studies have only revealed that a meager need for ALS in urban community. The purpose of this study is to understand the real demand of ALS in a rural community, so that a well organized and cost-effective EMS system can be developed in this country. ⋯ Based on the characteristics of low demand for ALS services, more than half trauma-induced ALS cases, acceptable response time, short transportation time, extremely few medically-induced DOA cases, and quite a poor outcome in the setting of limited prehospital care, a unique EMS system different from that in the United States or in the urban area is needed in the rural area.
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Zhonghua Yi Xue Za Zhi (Taipei) · Aug 1996
Case ReportsMultiple symmetrical lipomatosis (Madelung's disease): a case report.
Multiple symmetrical lipomatosis (Madelung's disease) is a rare disease of undetermined cause characterized by symmetrical deposits of non-encapsulated fat on the suboccipital area, cervical area, shoulders and trunk. The patients are usually middle-aged male alcoholics. ⋯ Here a case of multiple symmetrical lipomatosis in a 43 year-old man is described. We describe his clinical course and review the literature.
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Zhonghua Yi Xue Za Zhi (Taipei) · Jun 1996
Randomized Controlled Trial Comparative Study Clinical TrialParoxetine in the treatment of Chinese patients with depressive episode: a double-blind randomized comparison with imipramine.
Paroxetine is a potent inhibitor of serotonin re-uptake. Although it has been widely used as an antidepressant in western countries, its efficacy and side effects in the Chinese are unknown. ⋯ In comparison with imipramine, paroxetine affords fewer anticholinergic adverse effects without the sacrifice of efficacy in the treatment of depressed Chinese patients.