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Biomedical subjects

D J Bihari

Publications and source records attributed to D J Bihari.

9 recordsLinked to original sources

The EPIC study.

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Cross Infection

An uncommon cause of acute right ventricular failure and high mixed venous oxygen saturation.

Ruptured sinus of Valsalva aneurysms are rare. We report a case in which the usual clinical manifestations were not present and the patient was initially treated as an acute pulmonary embolus. Despite three negative echocardiograms an intra-cardiac shunt was suspected because of a persistently elevated mixed venous oxygen saturation. Cardiac catheterisation confirmed the diagnosis. Surgical repair was performed and post operative recovery was uneventful.

Aortic Rupture

Septicaemia--the clinical diagnosis.

The production and consequences of the components of the state defined as 'clinically significant sepsis', as seen in patients undergoing intensive therapy--fever, shock, respiratory failure and multiple system failure--are complex. The syndrome is not necessarily accompanied by detectable bacteraemia; the effective management cannot wait upon positive blood cultures. Possibilities for more effective intervention include the use of monoclonal antibodies to endotoxin or to tumour necrosis factor, and of prostaglandins to alter the microcirculation. More refined definition of the severe sepsis syndrome will be required before these measures can be fully evaluated.

Acute Disease

Metabolic acidosis.

Metabolic acidosis is the most frequent acid-base abnormality observed in the critically ill. Although there are many different causes, in the absence of ketosis and renal failure lactic acidosis is the most likely underlying disturbance. Controversy continues to surround the relative roles of the liver and the kidneys in the control of acid-base balance. There is no consensus concerning the use of bicarbonate in the treatment of a life-threatening metabolic acidosis.

Acidosis