Subject(s)
Heart Septal Defects, Atrial/complications , Pulmonary Embolism/diagnostic imaging , Adult , Embolectomy/methods , Heart Septal Defects, Atrial/diagnostic imaging , Heart Septal Defects, Atrial/surgery , Hemodynamics , Humans , Male , Pulmonary Embolism/physiopathology , Pulmonary Embolism/surgery , Subarachnoid Hemorrhage/complications , Tomography, X-Ray Computed/methodsABSTRACT
This is a report of an aircrew member who suffered a serious physiological incident in the form of pulmonary barotrauma and cerebral arterial gas embolism during hypobaric chamber training, and who subsequently was shown to have a cyst in the upper lobe of the left lung. The likely origin of the cyst is discussed, as well as the aeromedical disposition following thoracotomy and apical segmentectomy to remove the cyst.
Subject(s)
Aerospace Medicine , Altitude , Barotrauma/etiology , Cerebral Arteries , Cysts/etiology , Decompression Sickness/etiology , Embolism, Air/etiology , Lung Diseases/etiology , Military Personnel , Adult , Australia , Barotrauma/diagnostic imaging , Barotrauma/therapy , Cysts/diagnostic imaging , Cysts/therapy , Decompression Sickness/diagnostic imaging , Decompression Sickness/therapy , Embolism, Air/diagnostic imaging , Embolism, Air/therapy , Humans , Hyperbaric Oxygenation , Inservice Training , Lung Diseases/diagnostic imaging , Lung Diseases/therapy , Male , Tomography, X-Ray ComputedABSTRACT
Total plasma antioxidant status (TPAS), lipid peroxide concentration (LPX) and cardiac troponin T (cTnT) were measured in 24 patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). Samples were obtained preoperatively and at 1.5 h, 6 h, 24 h and 72 h after CPB. The absolute TPAS values were significantly lower at 1.5 h, 6 h, 24 h and 72 h after CPB than were preoperative values (P < 0.05). The LPX concentration was significantly elevated at 1.5 h after CPB (P < 0.05). Cardiac troponin T concentrations were significantly elevated at all time points postoperatively (P < 0.05). Preoperative TPAS values were significantly correlated with the magnitude of fall in TPAS at 1.5 h (P < 0.05). The greater the fall in TPAS between 0 and 1.5 h, the less LPX was formed between 0 and 1.5 h. The LPX at 1.5 h displayed a significant correlation with cTnT release from myocardial myocytes (P < 0.05). These data provide evidence for the first time that the consumption of antioxidants during CABG surgery with CPB protects against the production of reactive oxygen species and subsequent myocyte necrosis. Furthermore, the availability of protective antioxidants is dependent upon preoperative TPAS.
Subject(s)
Antioxidants/metabolism , Coronary Artery Bypass , Lipid Peroxidation , Reactive Oxygen Species/metabolism , Troponin T/metabolism , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Myocardium/metabolism , Oxidative StressSubject(s)
Cinchona , Malaria/history , Plants, Medicinal , England , Europe , History, 17th Century , Humans , Malaria/drug therapy , Plant Extracts/history , Plant Extracts/therapeutic useABSTRACT
Nineteen of 25 patients (14 female) with advanced malignant disease completed a randomized controlled trial of a new high-dose (200 mg) tablet formulation of controlled-release morphine. Compared with the currently available 100-mg tablets there were no differences in pain severity or adverse effects with the new formulation. In four patients, full 12-hr plasma morphine concentration profiles at steady state were obtained and showed no significant differences between the same dose provided as 100-mg and 200-mg tablets in Cmax, tmax, or other pharmacokinetic indices.
