Impact of adherence with positive airway pressure therapy on hypercapnia in obstructive sleep apnea.

Background: Daytime hypercapnia is common in morbidly obese patients with obstructive sleep apnea and is associated with serious complications. Our objective was to quantify the effect of adherence with positive airway pressure on hypercapnia and hypoxia in these patients.

Methods: We performed a retrospective cohort study of 75 patients using a multivariable general linear model analysis to identify variables that predicted changes in PaCO2 and PaO2 after therapy.

Metal fume fever presenting as aseptic meningitis with pericarditis, pleuritis and pneumonitis.

Background: Metal fume fever (MFF) is a well-known complication of zinc oxide fume inhalation. Prompt recognition of this condition is essential for the proper medical management of this self-limited disease.

Aim: To present a unique and unusual case of MFF.

The effect of continuous positive airway pressure on glucose control in diabetic patients with severe obstructive sleep apnea.

Obstructive sleep apnea (OSA) is independently associated with glucose intolerance and insulin resistance, and recent studies have shown that continuous positive airway pressure (CPAP) improves insulin sensitivity. The objective of this study was to describe the change in glycosylated hemoglobin (HbA1c) after treatment with CPAP in patients with type 2 diabetes mellitus and OSA. To test this hypothesis, we performed a retrospective analysis of 38 patients seen in the sleep clinic of an urban public teaching hospital.

Positron emission tomography demonstrates radiation-induced changes to nonirradiated lungs in lung cancer patients treated with radiation and chemotherapy.

Study Objectives: To determine whether acute changes in shielded lungs can be detected by positron emission tomography (PET) after radiation therapy.

Design: Retrospective cohort study.

Setting: University-affiliated medical center.

Acute lung injury induced by arsenic trioxide in a patient with refractory myelodysplastic syndrome.

Arsenic trioxide has been used successfully for the treatment of refractory acute promyelocytic leukemia and has shown promise in the treatment of myelodysplastic syndrome (MDS), although it is not a labeled indication. Retinoic acid syndrome is manifested by fever, dyspnea, peripheral edema, pulmonary infiltrates, and pleural and/or pericardial effusions and is typically seen in conjunction with all- trans retinoic acid therapy of acute promyelocytic leukemia. We report a case of acute lung injury and a retinoic acid syndrome-like illness in a patient who received arsenic for MDS.

Torsade de pointes associated with the administration of intravenous haloperidol:a review of the literature and practical guidelines for use.

Haloperidol is the most commonly used medication for the treatment of delirium and psychosis in the critically ill patient. Whilst generally considered to be safe, haloperidol has been associated with a number of important cardiovascular side effects. The major toxicities include hypotension, cardiac arrhythmias and prolongation of the corrected QT (QTc) interval.

Torsade de pointes associated with the administration of intravenous haloperidol.

Torsade de pointes is a malignant dysrhythmia that has been reported in a variety of clinical settings and associated with several pharmacologic agents. Patients with a prolonged QTc for heart rate are at higher risk for the development of this arrhythmia. We review the literature supporting the relationship of haloperidol to the development of this malignant dysrhythmia.