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Biomedical subjects

A M Ho

Publications and source records attributed to A M Ho.

50 records · Page 3Linked to original sources

Failure to wean from cardiopulmonary bypass after myocardial revascularization: successful treatment with verapamil via the aortic root.

Severe ventricular dysfunction in a patient prevented weaning from cardiopulmonary bypass after myocardial revascularization. Calcium chloride and increasing doses of dopamine had no effect. Coronary vasospasm was diagnosed based on ST elevation and myocardial failure. Verapamil 0.5 mg, injected into the aortic root, was followed by a dramatic improvement in cardiac contractility and successful weaning from cardiopulmonary bypass without inotropic support.

Cardiopulmonary Bypass↗

Spurious hyperkalaemia associated with severe thrombocytosis and leukocytosis.

A patient with marked thrombocytosis and leukocytosis associated with myelofibrosis was found to have spurious hyperkalaemia caused by in vitro cell lysis. Initial failure to recognize the cause of the hyperkalaemia led to an inappropriate and potentially harmful intervention in an effort to optimize the patient's preoperative status.

Aged↗

Delayed digoxin toxicity following discontinuance in acute renal failure.

A digitalized 75-year-old patient with postoperative renal failure demonstrated a progressive rise in serum digoxin concentration, peaking at 3.4 nmol X L-1 three days following discontinuance of the drug. This was accompanied by cardiac bradyarrhythmias. Although the serum digoxin concentration had already started to climb from a therapeutic level prior to the discontinuance of the drug, the unabated and substantial rise was consistent with a dramatic decrease in the apparent volume of distribution of digoxin accompanying acute renal failure. Serum digoxin levels were determined with fluorescence polarization immunoassay, which has an improved specificity when compared to the commonly used radioimmunoassays for digoxin.

Acute Kidney Injury↗

The role of arthrography in the management of dysplasia epiphysealis hemimelica.

Dysplasia epiphysealis hemimelica can be diagnosed on plain radiographs of the affected areas. However, double contrast arthrography in three new cases provided additional information. The cartilaginous portions of the lesion at the articular surface of the bone were precisely demonstrated, aiding the orthopedic surgeon in deciding which patients should have surgery and planning the extent of operation necessary.

Adolescent↗

Ciguatera poisoning: a report of three cases.

Confirmed ciguatera poisoning is reported in three Canadian adults who ingested grouper imported from Florida. Two required hospitalization for management of marked gastrointestinal, neurological, and cardiovascular disturbances. Outside of endemic areas, the recognition of this type of fish poisoning may be inadequate. The pathogenesis, diagnosis, and therapy of the disease are outlined.

Adult↗

Thoracic paravertebral block for management of pain associated with multiple fractured ribs in patients with concomitant lumbar spinal trauma.

BACKGROUND AND OBJECTIVES: The need for continual neurological assessment in patients with lumbar spinal injury poses a challenge for effective management of pain associated with multiple fractured ribs. Two cases are presented to illustrate the benefits of using thoracic paravertebral block to control the pain of multiple fractured ribs without compromising the ongoing neurological assessment. CASE REPORT: Thoracic paravertebral block was used in 2 patients with concomitant multiple fractured ribs and lumbar spinal injury. Case 2 also had a head injury and there was moderate coagulopathy. The thoracic paravertebral catheter was placed in the upper thoracic region and radiological imaging was used to delineate spread before the injection of relatively small volumes (10 to 15 mL) of local anesthetic. In case 1, the thoracic paravertebral block produced ipsilateral segmental thoracic anesthesia, providing excellent pain relief for the fractured ribs. It also spared the lumbar and sacral nerve roots, preserving neurological function in the lower extremities and bladder sensation. In case 2, effective analgesia without systemic sedation and opioids resulted in the patient regaining consciousness, which allowed continuous assessment of central and peripheral neurological function. CONCLUSION: Thoracic paravertebral block is an option for managing pain associated with multiple fractured ribs in the presence of concomitant lumbar spinal injury requiring continual neurological assessment.

Amides↗