ABSTRACT
Post-Obstructive Diuresis (POD) is a polyuria that occurs following the release of an obstruction from the urinary tract that prevents the flow of urine. POD requires prompt diagnosis to avoid complications. Although its pathophysiology is better understood, there is little scientific evidence for its treatment. Restoration of renal homeostasis requires correction of blood volume and electrolyte disturbances to prevent complications, which can be serious. In this article, we propose a synthesis of knowledge on the subject, as well as a management strategy.
Subject(s)
Diuresis , Physicians , Humans , Diuresis/physiology , Kidney , Polyuria/diagnosis , Polyuria/etiologyABSTRACT
Bacterial meningitis in adults is fatal in 20% of patients and leads to sequels in 30%. The clinical presentation includes two of the following four symptoms and signs: fever, headache, stiff neck, altered mental status. The essential ancillary test is the analysis of the cerebrospinal fluid. Sometimes, the lumbar puncture is not feasible or deferred (brain computer tomography), requiring antibiotics and corticosteroids early. 80% of bacterial meningitis are secondary to pneumococcus or meningococcus. Empirical antibiotics must be given as soon as possible and provide coverage for these both bacteria. Corticosteroids are also recommended for some meningitis. A score can predict the evolution. Preventive measure must be taken for close contacts of a patient with a meningococcal meningitis.
Subject(s)
Meningitis, Bacterial , Acute Disease , Adult , Community-Acquired Infections/diagnosis , Community-Acquired Infections/drug therapy , Community-Acquired Infections/prevention & control , Humans , Meningitis, Bacterial/diagnosis , Meningitis, Bacterial/drug therapy , Meningitis, Bacterial/prevention & controlSubject(s)
Education, Medical, Continuing/organization & administration , Interdisciplinary Communication , Medicine/statistics & numerical data , Physicians/statistics & numerical data , Specialization , Specialties, Surgical/statistics & numerical data , Education, Medical , Education, Medical, Continuing/methods , Female , Humans , Male , Specialties, Surgical/education , Surveys and Questionnaires , SwitzerlandABSTRACT
A 29-year-old woman, addicted to heroin since the age of 15 years, presented with a 4-day history of acute inspiratory chest pain, dyspnoea and vomiting associated with hypoventilation. She died 3 h after admission to the intensive care unit in spite of active resuscitative measures. The main autopsy findings were limited to the heart, which showed widespread cardiac vein thrombosis, and both ventricles and the atria were associated with multiple areas of haemorrhagic myocardial necrosis. We review the literature of this uncommon pathological entity and discuss its possible pathogenesis.
Subject(s)
Coronary Thrombosis/complications , Hemorrhage/complications , Hemorrhage/pathology , Myocardium/pathology , Adult , Fatal Outcome , Female , Humans , Necrosis , VeinsABSTRACT
We report the case of a 34-year-old Japanese man suffering from a nephrogenic diabetes insipidus (NDI) associated with bilateral hydronephrosis, hydroureters and enlarged trabeculated bladder without obstruction. He also presented with chronic renal failure which has rarely occurred in similar cases. The patient was admitted after a traumatic rupture of the left urinary tract which had never been described until now in NDI. He was treated successfully by transient peritoneal and vesical drainages. This paper focuses on the very rare complication of chronic renal failure secondary to hydronephrosis in cases of NDI. The literature of this association is reviewed.
Subject(s)
Diabetes Insipidus/complications , Hydronephrosis/complications , Kidney Failure, Chronic/etiology , Urinary Tract/injuries , Adult , Diabetes Insipidus/epidemiology , Humans , Hydronephrosis/epidemiology , Kidney Failure, Chronic/epidemiology , Male , RuptureABSTRACT
A 45-year-old man with acquired immune deficiency syndrome (AIDS) presented with an unusual peritonitis resulting from a microsporidian infection. An inflammatory mass formed by the omentum magnum was revealed at partial autopsy. This mass was infested with parasites measuring 2.5-2.6 microns by 1.2-1.5 microns, which appeared gram positive and stained dark blue with Giemsa stain. These organisms were pale pink with Kinyoun stain, and occasionally one of their poles was periodic acid-Schiff positive. Sporoblasts and spores contained in parasitophorous vacuoles were revealed by electron microscopic examination. These spores were mononucleated, without mitochondria, and had a polar filament with four or five coils. They were identified as Encephalitozoon cuniculi. Peritonitis resulting from this parasite has not been reported previously, however, it should be suspected among rare infections resulting from unusual parasites in patients with AIDS.