Inhalation Injury, Respiratory Failure, and Ventilator Support in Acute Burn Care.

Sustaining an inhalation injury increases the risk of severe complications and mortality. Current evidential support to guide treatment of the injury or subsequent complications is lacking, as studies either exclude inhalation injury or design limit inferences that can be made. Conventional ventilator modes are most commonly used, but there is no consensus on optimal strategies.

Everolimus induced organizing pneumonia in a patient with tuberous sclerosis complex.

Organizing pneumonia is characterized by a distinct histologic pattern in the lung interstitium and presents clinically as hypoxemia, fever, cough, and dyspnea that is not attributable to concurrent infection. Typical etiologies of this condition include inflammatory disease, malignancy, toxic inhalation, and an array of medications including the mTOR inhibitor everolimus. In this report, we describe the case of a female with tuberous sclerosis complex on everolimus therapy for renal angiomyolipomas who presented to the hospital with persistent cough, dyspnea, and fevers and bilateral lower lobe opacities on chest X-ray despite multiple courses of antibiotic therapy.

Optimization of an empiric vancomycin dosing algorithm for improved target concentration attainment in patients with thermal injury.

Objective: Vancomycin empirical dosing studies in thermally injured patients have netted low successful target attainment and most excluded renal dysfunction, limiting applicability. In a previous study, the authors performed a retrospective analysis of 124 patients' measured pharmacokinetic parameters to calculate optimal dose and interval for intermittent infusion regimens and find predictors of clearance and total daily dose. The objective of this study was to improve the accuracy of attaining goal therapeutic targets with initial vancomycin regimens in patients with thermal injury through retrospective modeling.

Predictors for Identifying Burn Sepsis and Performance vs Existing Criteria.

Sepsis is the largest cause of mortality in thermally injured patients. Traditional systemic inflammatory response syndrome (SIRS) criteria do not aid diagnosis of sepsis in burn centers. Studies have attempted identification of the best indicators of sepsis in the thermal injured patient, but predictive variables are inconsistent across the various studies.

Pulmonary Air Embolism: An Infrequent Complication in the Radiology Suite.

BACKGROUND Air embolism can occur in a number of medical-surgical situations. Venous air embolism is frequently lethal when a substantial amount enters the venous circulation rapidly and can lead to significant morbidity if crossover to the systemic arterial circulation occurs. The diagnosis of massive air embolism is usually made on clinical grounds by the development of abrupt hemodynamic compromise.

Systemic lupus erythematosus associated with type 4 renal tubular acidosis: a case report and review of the literature.

Introduction: Type 4 renal tubular acidosis is an uncommon clinical manifestation of systemic lupus erythematosus and has been reported to portend a poor prognosis. To the best of our knowledge, this is the first case report which highlights the successful management of a patient with systemic lupus erythematosus complicated by type 4 renal tubular acidosis who did not do poorly.

Case Presentation: A 44-year-old Hispanic woman developed a non-anion gap hyperkalemic metabolic acidosis consistent with type 4 renal tubular acidosis while being treated in the hospital for recently diagnosed systemic lupus erythematosus with multi-organ involvement.

A myxoid chondrosarcoma associated with an anti-Hu-positive paraneoplastic encephalomyelitis.

Extraskeletal myxoid chondrosarcoma is a rare tumor with less than 100 cases reported in the literature. The prevalence of anti-Hu positive myxoid chondrosarcoma-associated paraneoplastic subacute cerebellar degeneration is exceedingly rare. We present a report of a patient with confirmed myxoid chondrosarcoma-associated paraneoplastic subacute cerebellar degeneration, who exhibited marked improvement within 1 week of receiving chemotherapy, intravenous immunoglobulin (IVIG), and hydrocortisone treatment.

Variation in the prevalence of gastric cancer in Perú.

Most cases of gastric cancers occur in non-industrialized countries but there is scarce information about the epidemiology of this illness in these countries. Our study examined whether there was a variation in the prevalence of gastric cancer in Lima, Perú over the last 2 decades. Subjects older than 29 years of age were included.