Cases reported "Dehydration"

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1/10. Hyperhomocysteinaemia and upper extremity deep venous thrombosis: a case report.

    A case is presented of a 24 yr old military aircrew applicant who developed a right axillary subclavian deep venous thrombosis following physical exertion. Investigations revealed damage to the right axillary subclavian venous system and limitation to flow. Coagulation studies also showed an elevated plasma homocysteine level. hyperhomocysteinemia has recently been recognized as a risk factor for venous thromboembolic disease. Damage caused by the thrombosis, the hyperhomocysteinemia and environmental factors encountered in flight, may predispose him to recurrent episodes of thrombosis. This complex case involves aspects of hematology and the nature of coagulation which are only just being elucidated and as yet are poorly understood, and highlights some serious aeromedical implications for pilots afflicted with these conditions.
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ranking = 1
keywords = thrombosis, venous thrombosis, deep
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2/10. Severe hypernatremic dehydration and death in a breast-fed infant.

    breast milk is acknowledged as the best source of nutrition for neonates. We present the case of a full-term newborn who was fed solely breast milk and developed severe dehydration and hypernatremia. The patient developed cerebral edema, transverse sinus thrombosis, and died. The literature on the uncommon entity of breast-feeding hypernatremia and dehydration is reviewed, and management strategies are presented.
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ranking = 0.1130268368224
keywords = thrombosis
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3/10. Classic heat stroke in a case of simple hypohydrosis with "bad prognostic indicators" but a remarkable recovery.

    heat stroke occurs in the desert area of saudi arabia quite frequently and manifest in different patterns including coagulopathy. Frequently encountered complications include renal or hepatic failure, rhabdomyolysis, acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation (DIC), and seizure. Not all of these complications usually occur in the same patient, in case it occurs the mortality reported is significantly high. We describe a case of heat stroke that had nearly all the known complications of heat stroke but recovered from all, except minor neurological deficit in the form of dysarthria and exaggerated deep reflexes.
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ranking = 0.00012012125426131
keywords = deep
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4/10. pulmonary embolism: a rare cause of sudden infant death.

    pulmonary embolism can be observed at any age, but it occurs very rarely in the infant. The authors report the case of a 12-month-old boy who suddenly died during clinical improvement of gastroenteritis associated with otitis. autopsy showed signs of dehydration and acute left pulmonary embolism, which was the cause of death. Thrombosis of the inferior vena cava extending into renal veins was seen. In this case, plasma hyperosmolality caused by dehydration might have favored the formation of venous thromboses. The various risk factors of pulmonary embolism in the child are discussed, including genetic factors.
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ranking = 0.00021097138360701
keywords = vein
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5/10. The syndrome of absent or faint second heart sound, rapid systole and forward collapsing pulse.

    A syndrome consisting of an absent or faint second heart sound, prominent cardiac impulse and non-regurgitant or forward collapse of the pulse is described. There was, moreover, no second sound or flow murmur audible in either the aortic or the pulmonary area even though the impulse and collapsing pulse suggested a hyperdynamic circulation; the upstroke was sharp but without the full waterhammer knock. It is argued that the dominant cause of the collapsing pulse will usually be vasodilation, that absence or faintness of the second sound is due to a narrow angle of divergence between the ventricular and arterial pressure decay curves, and that in marked contrast to aortic regurgitation the quality of the impulse derives from rapid systole of lightly loaded ventricles. Although they described its separate elements, pre-homeostatic era clinicians may have overlooked the syndrome in the belief that the heart regulated a largely passive circulation, regarding only primary intracardiac events and the first heart sound as important. Sir William Stokes nevertheless foresaw that alterations in the second sound might be due to changes in vascular tone as well as in elasticity. Wider recognition, deeper understanding and appropriate correction of this syndrome may prove both useful and enlightening.
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ranking = 0.00012012125426131
keywords = deep
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6/10. A case of cerebral sinus thrombosis developed during a high-altitude expedition to Gasherbrum I.

    We report a case of cerebral sinus thrombosis, which is a rare but serious complication that may develop during high-altitude climbing. A climber who reached the summit of Gasherbrum I (8068 m) suffered from motor weakness and gait disturbance as he descended from the peak. Within a few days, the symptoms progressed until he could not walk. Following a difficult and week-long rescue mission by his colleagues, he was hospitalized and diagnosed with thrombosis at the superior sagittal and right transverse sinuses. Climbers and rescuers should know the risk factors of this complication, such as hemoconcentration, procoagulability, and dehydration.
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ranking = 0.67816102093438
keywords = thrombosis
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7/10. Complications of scalp vein infusion in infants.

    The scalp vein is an invaluable route for venous access in infants. Complications are rarely reported.
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ranking = 0.0010548569180351
keywords = vein
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8/10. A case of diabetic non-ketotic hyperosmolar coma with an increase with plasma 3-hydroxybutyrate.

    We have seen a case of "diabetic non-ketotic hyperosmolar coma" with ketosis. An 84-year-old man was brought into the hospital in a deeply comatous and dehydrated state. The initial blood glucose level was 1252 mg/dl with plasma osmolarity of 435 mOsm/l, but no ketonuria was detected by the nitroprusside method (Ketostix). However, the plasma 3-hydroxybutyrate (3-OHBA) level was 5 mM in a newly developed bedside film test. The serum ketone bodies were later found to be 5.56 and 0.82 mmol/l for 3-OHBA and acetoacetate (AcAc), respectively. A marked increase in glucagon, cortisol and ADH with renal dysfunction (creatinine 5.0 mg/dl) were noted. An abnormal electrocardiogram, occular convergence and chorea like movement disappeared after correction of metabolic disturbances. The moderate level of IRI (14 microU/ml) on admission and a good response to glucagon 2 months after admission also indicate that the present case is a typical hyperosmolar non-ketotic coma. Because of a preferential increase in 3-OHBA, ketonuria seemed to be absent in the regular nitroprusside test. Marked dehydration is thought to cause renal dysfunction, and the increase in ADH may have helped to prevent further aggravation of ketoacidosis. We propose to change the term hyperosmolar non-ketotic coma (HNC) to diabetic hyperosmolar coma (DHC), because sometimes patients with hyperosmolar non-ketotic diabetic coma are ketotic, as seen in the present case. Determination of 3-OHBA or individual ketone bodies in blood is important and essential for the differential diagnosis of diabetic coma. The diagnosis of either ketoacidotic or hyperosmolar coma should be made depending on the major expression of ketoacidosis or hyperglycemic hyperosmolarity.
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ranking = 0.00012012125426131
keywords = deep
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9/10. Insidious rifampin-associated renal failure with light-chain proteinuria.

    A patient who was receiving rifampin treatment for tuberculosis developed heterogenous light-chain proteinuria and insidious renal failure after a period of fluid restriction. The renal damage was characterized pathologically by an interstitial nephritis with invasive tubular casts and an associated renal vein thrombosis. The possible role of the light-chain proteinuria in the pathogenesis of the renal failure is discussed.
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ranking = 0.113237808206
keywords = thrombosis, vein
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10/10. Resolution of proteinuria secondary to bilateral renal vein thrombosis after treatment with systemic thrombolytic therapy.

    A case of significant proteinuria occurred as a result of bilateral renal vein thrombosis secondary to dehydration, which resolved after treatment with urokinase. The patient developed nausea and vomiting from viral gastroenteritis with subsequent volume contraction. He later noted the onset of aching lower abdominal and flank pain. On admission, he was noted to have a serum creatinine of 1.7 mg/dL, and 4 proteinuria on urinalysis. A 24-hour urine collection showed 2.34 g protein. A renal venogram showed bilateral renal vein thrombosis (RVT) without involvement of the inferior vena cava. Therapy was initiated with heparin at 1,000 U/hr, followed by intravenous (IV) urokinase, 4,400 U/kg bolus, followed by 4,400 U/kg/hr with continuous infusion for 12 hours. A repeat renal venogram done at this time showed partial resolution of thrombosis bilaterally. A second 12-hour infusion of urokinase at 5,000 U/kg/hr was performed; at this time, the patient reported resolution of his flank and abdominal pain. A repeat 24-hour urine collection showed 60 mg protein with a normal creatinine clearance. Levels of antithrombin iii, protein c, and protein s were all normal. A renal biopsy was performed and showed normal histology on light, immunofluorescent, and electron microscopic evaluation. The patient has done well on no therapy and has had no recurrence of thrombosis or proteinuria after 2.5 years. This is a US government work. There are no restrictions on its use.
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ranking = 0.90548052288082
keywords = thrombosis, vein
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