Retroperitoneal hematoma in patients undergoing cardiac catheterization.

Objective: To retrospectively study demographic, clinical and hospital outcomes in patients who developed RPH following cardiac catheterization.

Methods: Charts of patients with RPH from cardiac catheterization, between January 1, 2000 and July 30, 2005 were reviewed and compared with two control groups (Grp-I, 90 patients with local groin complications and Grp-II, 98 patients with no bleeding complications).

Results: 31 cases of RPH (0.

Postpartum ovarian vein thrombosis presenting as ureteral obstruction.

Ovarian vein thrombosis (OVT) is a relatively uncommon but serious postpartum complication. Although infrequent, OVT may progress to involve the inferior vena cava, the renal vein or may cause sepsis and septic pulmonary embolism, all of which are potentially life-threatening. Clinical misdiagnosis is common, and, unfortunately, most affected women undergo laparotomy for possible appendicitis.

Acute aortic dissection.

Acute aortic dissection is an uncommon but potentially catastrophic illness with high mortality. Significant advances in the understanding, diagnosis, and management have been made since the first reported case of aortic dissection 3 centuries ago. This comprehensive review discusses the pathophysiology, classification, clinical manifestations, early diagnosis, and management of this important cardiovascular emergency.

Conversion of atrial fibrillation to sinus rhythm during treatment with intravenous esmolol or diltiazem: a prospective, randomized comparison.

Prior studies have suggested that intravenous diltiazem reduces the probability of spontaneous conversion of atrial fibrillation (AF) to sinus rhythm in the electrophysiology laboratory and in patients with postoperative AF. Whether diltiazem exerts the same effect in patients presenting to the emergency department (ED) with spontaneous AF is unclear. Fifty patients presenting to the ED with new-onset or paroxysmal AF and a rapid ventricular rate (>100 beats per minute) were randomly assigned to receive intravenous diltiazem or esmolol during the first 24 hours of presentation.

Epidemiology and clinical outcomes of infective endocarditis in hemodialysis patients.

Background: Infective endocarditis is one of the most serious complications of bacteremia in patients undergoing chronic hemodialysis and is more frequent than previously recognized. The aim of our study was to describe the clinical characteristics, outcome, and factors predicting mortality of infective endocarditis in hemodialysis patients.

Methods: In this retrospective review, all patients on chronic hemodialysis admitted to a 600-bed urban teaching hospital with infective endocarditis over a 15-year period (1990 to 2004), were identified using discharge codes.

Usefulness of clinical evaluation, troponins, and C-reactive protein in predicting mortality among stable hemodialysis patients.

This study prospectively examined the hypothesis that dividing stable dialysis patients into different clinical subsets by presence or absence of coronary disease equivalent will lead to clearer risk stratification by abnormal troponins and highly sensitive C-reactive protein (hs-CRP). Patients with end-stage renal disease have an annual mortality of 18%. Previous studies have shown that elevated cardiac troponins T and I and hs-CRP predict increased mortality, although these studies have not taken clinical parameters into account.

Peduncular hallucinosis: unusual complication of cardiac catheterization.

Peduncular hallucinosis (PH) is a rare form of visual hallucination characterized by vivid, nonstereotypical visual images of people, animals, and plants of brief duration that are nonthreatening to the patient. The clinical syndrome of PH consists of formed visual hallucinations, localizing signs of the offending lesion, and sleep disturbances. In the absence of localizing focal neurologic deficits, it is easily confused with a delirium or psychosis.

Severe and disabling diabetic autonomic neuropathy: a case report.

We report a case of a woman with several and severe disabling manifestations of autonomic neuropathy in whom reasonable quality of life was established by combining continuous insulin infusion, jejunal feeding, colostomy and bladder self-catheterisation. We discuss the prevalence rates, pathophysiology, management and prognosis of this disabling condition.