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Bronchiectasis is a sequel to permanent chronic airway inflammation and defined as 'irreversible bronchial dilatation'. It is increasingly being recognized with the wider availability of high-resolution computed tomography. Children with noncystic fibrosis can be seen with improvement in bronchiectasis even resolution, as opposed to adults. We report a case of reversible bronchial dilatation in an adult as evidenced by high-resolution computed tomography, which demonstrates that, although quite rare in adults, spontaneous resolution may occur.
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Postintubation Tracheoesophageal fistula (TEF) is a rare complication. Acquired TEF most commonly occurred following prolonged mechanical ventilation with an endotracheal or tracheostomy tube, cuff-related tracheal injury, post-intubation injury. We present a case of both tracheomegaly and tracheosephagial fistula following mechanical ventilation for 15 days, in the light of the literature.
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BACKGROUND: Preeclampsia and Hemolysis, Elevated Liver enzymes, Low Platelet (HELLP) syndrome are important disorders affecting the health of both the mother and fetus. Prediction of the maternal and perinatal outcomes at early and late gestational age is important for the management of both disorders. AIMS: The purpose of the study was to investigate adverse maternal and perinatal outcomes in severe preeclampsia and HELLP syndrome cases according to gestational age. STUDY DESIGN: Retrospective cross-sectional study. METHODS: One hundred and ninety-seven pregnancies with severe preeclampsia and 56 pregnancies with HELLP syndrome were included the study. Clinical characteristics and adverse maternal and perinatal outcomes were noted from medical records. Participants were divided into two groups at <34 and ≥34 weeks' gestation: the severe preeclampsia group and the HELLP syndrome group. The differences between the outcomes in the groups were investigated. Statistical analysis was performed using the Student t test, Fisher Exact test and Yates' Chi-square test. RESULTS: Eclampsia was more common in HELLP syndrome cases at <34 weeks' gestation (p 0.028). However, eclampsia rates were statistically similar between groups at ≥34 weeks' gestation. The requirement for blood products transfusion was higher in the HELLP group at all gestational weeks. No statistical difference was found in perinatal outcomes between severe preeclampsia and HELLP groups at less than and more than 34 weeks' gestation. CONCLUSION: Eclampsia risk increases in HELLP syndrome, especially at gestations less than 34 weeks. Perinatal morbidity at less than 34 weeks' gestation and mortality were similar in severe preeclampsia and HELLP syndrome cases at the same gestational age.
RESUMO
PURPOSE: The aim of this study was to determine the effect of local anesthetic instillation, to compare bupivacaine and ropivacaine in patients undergoing a laparoscopic cholecystectomy. METHODS: A total of 80 patients were randomly assigned to four groups to receive the intraperitoneal instillation of 21 ml of either 100 mg bupivacaine (Group B), 100 mg ropivacaine (Group R1), 150 mg ropivacaine (Group R2) or saline with epinephrine 1/200,000 at the end of the surgery. The postoperative pain was evaluated and the analgesic requirement was also assessed. RESULTS: The intraperitoneal instillation of 100 mg bupivacaine, 100 mg ropivacaine, or 150 mg ropivacaine at the end of a laparoscopic cholecystectomy significantly reduced the morphine consumption during the first 24 h. For preventing postoperative pain 150 mg ropivacaine proved to be significantly more effective than either 100 mg bupivacaine or 100 mg ropivacaine. CONCLUSION: We herein showed that the intraperitoneal instillation of local anesthetic during laparoscopic cholecystectomy is a noninvasive, rapid, safe and simple analgesic technique that reduces the total morphine consumption during first 24 h.
