study of surfactant proteins A and D in asymptomatic cigarette smokers versus nonsomkers

The reconstruction of the soft tissue defect around the elbow joint is a challenge to the plastic surgeon. Many techniques have been published. This included skin graft local fasciocutaneous transposition, island flaps, distant flaps and free flaps. This paper presented the use of the distally based reversed lateral arm flap for the coverage of soft tissue defect around the elbow joint

cardiac arrhythmias during management of acute severe asthma in the intensive care unit

This study was carried out to evaluate the occurrence of cardiac arrhythmias during therapy with I.V. aminophylline infusion and nebulized salbutamol of 50 consecutive patients with acute severe asthma. Vital signs, arterial blood gases, PEFR, serum potassium and total magnesium were measured on admission in emergency department, on admission in ICU and one hour thereafter. Continuous ECG monitoring and recordings were performed to capture the occurrence of cardiac rhythm disturbance. The results showed that initially in emergency department there was increase in pH, decrease in PaO2, PaCO2 and PEFR together with mild decrease in levels of serum potassium and magnesium. On admission in ICU, the patients showed more decline in PaO2 and PEFR, with increase in PaCO2 and mild decrease in pH together with more decrease in serum potassium and magnesium. After one hour of initiation of treatment in ICU, there was improvement in pH, PaO2, PaCO2, PEFR und serum potassium and magnesium. Premature ventricular contractions [PVCs] occurred in 24 patients; 15 patients had occasional unifocal PVCs and only 9 patients developed severe ventricular arrhythmias: frequent PVCs more than 10/h [n = 5] multifocal PVCs [n = 2] and a short run of ventricular tachycardia [n = 2]. Serious supraventricular arrhythmias occurred in only 5 cases who developed runs of atrial tachycardia in 3 patients and atrial fibrillation in 2 patients. These arrhythmias were clinically well tolerated and spontaneously resolved without any antiarrhythmic treatment. It is concluded that cardiac dsyrhythmias, observed during the combined therapy with aminophylline and salbutamol, were self limited and possibly related to treatment as well as hypoxia and particularly in presence of hypokalemia and hypomagnesmia during episodes of acute severe asthma