RESUMO
We report the case of a patient who co-ingested a tricyclic antidepressant (amitriptyline), benzodiazepines (alprazolam and lormetazepam) and a neuroleptic drug (prothipendyl). Major neurologic and cardiac symptoms occurred including a prolonged cardiac arrest. The cardiopulmonary resuscitation phase was complicated by a haematoma of the liver treated by a left hepatectomy. The clinical features and management of this combined intoxication are discussed.
Assuntos
Alprazolam/intoxicação , Amitriptilina/intoxicação , Ansiolíticos/intoxicação , Antidepressivos Tricíclicos/intoxicação , Antipsicóticos/intoxicação , Benzodiazepinas , Reanimação Cardiopulmonar , Lorazepam/análogos & derivados , Lorazepam/intoxicação , Tentativa de Suicídio , Tiazinas/intoxicação , Adulto , Emergências , Feminino , Humanos , Fatores de TempoRESUMO
Plasma tocopherol, plasma total lipid levels and tocopherol-lipid ratio were measured every 6 h during 48 h in 12 critically ill patients and compared with those of a control group. The patients were divided into two groups. Group I comprised 6 critically ill patients with ARDS and group II comprised 6 severely ill patients without ARDS. The means for all observations of plasma tocopherol, total lipid levels and tocopherol-lipid ratio in groups I and II were significantly depressed relative to a control group (p less than 0.0001). The difference in the average tocopherol-lipid ratio between the three groups (p less than 0.0001) and between the groups I and II was statistically significant (p less than 0.0001). Our results indicated: (1) a decrease of vitamin E concentrations in the critically ill patients, particularly in ARDS patients; (2) the importance of the relationship between plasma tocopherol and plasma lipids levels in evaluating the deficiency in vitamin E which was evident in ARDS patients.
Assuntos
Lipídeos/sangue , Síndrome do Desconforto Respiratório/sangue , Vitamina E/sangue , Adulto , Idoso , Feminino , Humanos , Peroxidação de Lipídeos , Masculino , Pessoa de Meia-Idade , Síndrome do Desconforto Respiratório/fisiopatologia , Deficiência de Vitamina E/prevenção & controleRESUMO
Two female patients with grade IV primary biliary cirrhosis, untractable pruritus, arthralgias and xanthomatous neuropathy in one case, underwent long term plasmapheresis for 30 months (on a continuous centrifugation cell separator) and 18 months (on capillary plasma filters). Plasma exchange were performed monthly and substitution achieved by diluted human serum albumin. No major side effect occurred. Pruritus, arthralgias and xanthomatous neuropathy greatly improved or even disappeared. The plasma levels of transaminases, albumin, globulin and clotting factors were stable, alkaline phosphatases slightly diminished. Bilirubin, after an initial fall at 6 months, increased again. Cholesterol stabilized at near normal values. Bile acids blood levels decreased in both cases.
