Markers of immune-mediated inflammation in the brains of young adults and adolescents with type 1 diabetes and fatal diabetic ketoacidosis. Is there a difference?

Due to the limited data on diabetic ketoacidosis and brain edema (DKA/BE) in children/adolescents and the lack of recent data on adults with type 1 diabetes (T1D), we addressed the question of whether neuroinflammation was present in the fatal DKA of adults. We performed immunohistochemistry (IHC) studies on the brains of two young adults with T1D and fatal DKA and compared them with two teenagers with poorly controlled diabetes and fatal DKA. C5b-9, the membrane attack complex (MAC) had significantly greater deposits in the grey and white matter of the teenagers than the young adults (p=0.

Sudden cardiac arrest as a presentation of Brugada syndrome unmasked by thyroid storm.

An 18-year-old man suffered a sudden cardiac arrest with ventricular fibrillation and was successfully resuscitated. He had neither a medical nor family history of cardiac disease/sudden death, but was known to have Graves' disease, for which he was treated with radioactive iodine. Recently, block-and-replacement therapy had been discontinued to evaluate thyroid functioning.

An unusual neurological consequence of massive wasp stings.

Although rare, central and peripheral neurological manifestations after single or multiple wasp stings have been reported. The authors describe a 45-year-old man who developed periods of sudden loss of consciousness with a Glasgow Coma Scale of 6 after being stung by fifty wasps. These periods were seen directly after being stung and were continuing months later.

Haemodynamic consequences of mild therapeutic hypothermia after cardiac arrest.

Background And Objective: Mild therapeutic hypothermia (MTH) is used after out-of-hospital cardiac arrest (OHCA) to minimize cerebral damage. Induced hypothermia may further interfere with cardiac function and influence haemodynamics after OHCA.

Methods: This was a prospective study of haemodynamic variables in 50 consecutive patients with OHCA treated with MTH.

[Mild therapeutic hypothermia following resuscitation; experience and results in the first two years after introduction].

Objective: To describe the results of mild therapeutic hypothermia (MTH) following resuscitation in the 'Gelderse Vallei' hospital, Ede, the Netherlands.

Design: Descriptive, retrospective.

Method: Patient data was collected from patients who had undergone MTH during the first two years following introduction of this treatment in the intensive care department of the 'Gelderse Vallei' hospital, Ede.

Progressive respiratory distress due to neck mass.

The present report describes the case of an 80-year-old woman who presented at the emergency department with progressive respiratory distress caused by a massive anterior neck mass with tracheal deviation and compression. A CT scan showed diffuse enlargement of the thyroid gland. The patient underwent a left-sided hemithyroidectomy.

Extracorporeal elimination in acute valproate intoxication.

Severe poisoning with valproate may result in coma and death. The management of valproate intoxication is principally supportive. Valproate is scarcely excreted renally and is mainly protein bound and, therefore, not considered to be amenable for extracorporeal elimination.

Anesthesia care for living-related liver transplantation for infants and children with end-stage liver disease: report of our initial experience.

Study Objective: To describe our initial experience of the perioperative anesthetic care provided to pediatric recipients during living-related liver transplantation.

Design: Cohort review of the perioperative anesthetic care for living-related liver transplantation.

Setting: Tertiary referral and postgraduate teaching hospital.

Effects of a simple protocol on infective complications in intensive care unit patients undergoing percutaneous dilatational tracheostomy.

In our intensive care unit we monitored infection in 228 patients who underwent percutaneous dilatational tracheostomy (PDT). In the first phase of the study 128 PDTs were performed during a 33-month period and there were 41 infection complications (nosocomial pneumonia, bacteremia with sepsis, and septic shock) in the perioperative period (immediately prior to and for 5 days after PDT). A significant risk factor among patients with nosocomial pneumonia was empirical administration of inappropriate antibiotics, compared to appropriate antibiotics (34% versus 4%, p < 0.