Articles: patients.
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Journal of anesthesia · Jan 2001
The combination of a fiberoptic stylet and a McCoy laryngoscope facilitates tracheal intubation in difficult airway cases.
Fiberoptic stylets are considered useful for difficult airway management. In the present study, we assessed the usefulness of a fiberoptic stylet when the stylet was used with a Macintosh or a McCoy laryngoscope. ⋯ The combination of a new handy fiberoptic stylet and a McCoy laryngoscope facilitated tracheal intubation of patients whose airway had no distance between the epiglottis and the posterior wall of the pharynx in laryngoscopic vocal cord view.
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Dynamics (Pembroke, Ont.) · Jan 2001
Transfer stress and medical intensive care patients and family members.
To explore the phenomenon of transfer stress in medical intensive care (MICU) patients and family members. ⋯ Transfer stress frequently occurs in MICU patients and family members and should be an area of concern for health care professionals.
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Dtsch. Med. Wochenschr. · Jan 2001
[Myocardial infarction and coronary artery ventricular fistulas due to blunt chest trauma]
An 18-year-old previously healthy, cigarette smoking man with no other risk factors for ischaemic heart disease, was admitted to hospital after being kicked in the chest by a horse. On arrival he complained about pain in the lower mediastinum. INVESTIGATIONS: The ECG showed sinus rhythm, right bundle branch block and convex bowed ST elevation in leads V1-V3. Sixty minutes after the incident the cardiac enzymes (creatinekinase-MB fraction, troponin I) were significantly raised. Despite an only slightly reduced left ventricular function documented by transthoracic echocardiography, SPECT-thallium scan showed large scintigraphic defects. Coronary heart disease was excluded by coronary angiography. Four small coronary-ventricular fistulas were identified. Laevocardiography showed a hypokinesia in the antero-septal region. DIAGNOSIS, TREATMENT AND COURSE: We assumed traumatic myocardial infarction of the anterior wall and rupture of multiple small coronary vessels, leading to coronary-ventricular fistulas. No interventional or surgical therapy was performed. Later on the left ventricular function became normal. Echocardiography merely outlined an akinetic scar in the middle of the septum. At exercise ECG test sixteen months later, the patient remained asymptomatic and was able to exercise without any signs of ischaemia up to a work load of 175 W. Furthermore, the fistulas could be seen by echocardiography. ⋯ Cardiac involvement should be considered in all cases of blunt chest trauma. In addition to a traumatic myocardial infarction fistulas may also, though rarely, occur. Myocardial scintigraphy after cardiac contusion is not suitable for diagnosing myocardial ischaemia or vitability.
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A number of case reports and nonplacebo controlled studies have documented the efficacy of clonazepam (Klonopin) in the treatment of a number of chronic pain syndromes including lancinating and neuropathic/deafferentation pain. There are, however, no data on the efficacy of clonazepam for chronic pain (CP) associated with myofascial pain syndrome (MFPS). Therefore, we wish to report the results of an open clinical treatment trial of clonazepam for CP associated with MFPS. ⋯ Clonazepam may have an antinociceptive effect for pain associated with myofascial pain syndrome.