[Carotid sinus syncope: report of a case subjected to surgical treatment].
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Biomedical subjects
Publications and source records attributed to E Knobel.
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The interaction of delta9-tetrahydrocannabinol (delta9-THC) and cannabinol (CBN) was studied in man. Five male volunteers were given placebo, 50 mg CBN, 25 mg delta9-THC, 12.5 mg delta9-THC + 25 mg CBN, and 25 mg delta9-THC + 50 mg CBN (orally). Administrations were spaced 1 week apart. With physiological measures, delta9-THC produced an increase in heart rate while CBN did not. When combined, no change of the delta9-THC effect occurred. No changes occurred on the electrocardiogram, blood pressure, or body temperature. With psychophysical measures no changes occurred in pain thresholds or skin sensitivity as a function of drug treatment. In time estimates of the passage of 1 minute, delta9-THC alone produced underestimates of the passage of 1 minute and CBN alone had no effect. In combination the two drugs had a tendency to produce significant overestimates and underestimates of the passage of 1 minute. On a 66-item adjective-pair drug reaction scale, the volunteers reported feeling drugged, drunk, dizzy, and drowsy under the delta9-THC condition, but not under the CBN condition. With combined drug treatment, volunteers reported feeling more drugged, drunk, dizzy, and drowsy than under the delta9-THC condition alone. None of the drug treatments produced significant changes on other items which included items on perception, emotion, cognition and sociability. It appears that CBN increases the effect of delta9-THC on some aspects of physiological and psychological processes, but that these effects are small and cannot account for the greater potency which has been reported when plant material is used.
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OBJECTIVE: To alert physicians to the possibility of pulmonary edema as a complication of diabetic ketoacidosis. METHODS: We report a case of adult respiratory distress syndrome after resuscitative efforts to compensate the first episode of diabetic ketoacidosis in a previously healthy young woman. RESULTS: In a 26-year-old woman with a 3-day history of malaise, polyuria, nausea, and vomiting, severe hypoxia and rales developed, and intubation and mechanical ventilation became necessary. Hemodynamic evaluation and striking electron microscopic findings on open-lung biopsy confirmed the diagnosis of adult respiratory distress syndrome. Despite adequate ventilatory support and hemodynamic management, death ensued and was attributed to irresponsive and progressive acute respiratory failure due to increased pulmonary capillary permeability edema. CONCLUSION: Clinicians should be aware of this possibly fatal pulmonary complication of diabetic ketoacidosis.
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The insertion of central venous catheters (CVC) represent a very common procedure in intensive care units. The purpose of this study was to determine the via that provide the best chance for a good location of the tip of a CVC. The 563 CVCs that were inserted percutaneously and that had a radiology control were analyzed. The infraclavicular via was used for 303 (25%) CVCs; the jugular via had 142 (25%) CVCs and the supraclavicular via was used in 118 (21%) CVCs. The rate of bad location of the tip of the CVC were 17%, 6% and 9%, respectively. There was a significant difference when the insertion through infraclavicular via and jugular via were compared. There were 9 pneumothorax (1.4%). 127 CVCs were sent to microbiology laboratory, 26 (20%) had positive culture (> 15 colony forming units). The most frequent agents isolates were: Candida spp (7), S. aureus (5), S. epidermidis (4) and P. aeruginosa (3).