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Biomedical subjects

G Lewinsohn

Publications and source records attributed to G Lewinsohn.

At least 19 recordsLinked to original sources
PubMed1995

[Endotracheal intubation and mechanical ventilation in severe asthma].

Retrospective analysis of all patients with acute bronchial asthma who required intubation and mechanical ventilation was performed in 1987-1993. Our study group comprised 29 patients with a total of 31 episodes of mechanical ventilation. Indications for intubation and ventilation were cardio-respiratory arrest in 9 episodes, and deterioration of clinical status despite aggressive therapy in 22 episodes. Mechanical ventilation strategy was to avoid high air-way pressures of more than 50 cm H2O even if respiratory acidosis persisted. The risk of barotrauma was thus eliminated; other complications were few and reversible, and all patients survived. We conclude that intubation and mechanical ventilation in severe asthma is beneficial and safe, and the prognosis very good.

Asthma↗
PubMed1994

Critically ill obstetrical patients: outcome and predictability.

OBJECTIVE: To determine the applicability of the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system in predicting outcome in a subgroup of critically ill obstetrical patients. DESIGN: Retrospective data collection. SETTING: A multidisciplinary intensive care unit (ICU) in a university hospital. PATIENTS: All patients (n = 1,670) admitted for > 24 hrs to the ICU during an 8-yr period, of whom 58 were obstetrical patients and 120 were nonobstetrical young women. MEASUREMENTS AND MAIN RESULTS: The mean APACHE II score in the obstetrical group was 11, with a mortality risk of 16.6%. In this group, the mortality ratio, which is the ratio between actual and predicted mortality rate, was low (0.416) and significantly (p = .021) different from the expected mortality ratio of 1. The mean APACHE II score in the group of nonobstetrical young women was 10, with a mortality risk of 10.17%. In all nonobstetrical ICU patients including all the admitted patients excluding the obstetrical patients, the mean APACHE II score was 15, with a mortality risk of 24.18%. The mortality ratio in the nonobstetrical young women group and in the nonobstetrical ICU patient group was 0.986 and 1.006, respectively, which was nonsignificantly different from the expected mortality ratio. CONCLUSIONS: Obstetrical patients requiring intensive care in our ICU had a better outcome than predicted, as expressed by a low mortality ratio. Various explanations that may be applicable to any subgroup of critically ill patients with a different mortality ratio are presented. The subgroup itself may be uniquely different, similar to our obstetrical patients with their physiologic changes of pregnancy. Another explanation may relate to an improvement in care of the subgroup and therefore a better outcome.

Critical Illness↗
PubMed1992

[Central venous catheterization via the axillary vein].

Central venous catheterization is a common procedure in the intensive care unit. The vessels usually selected for access include those of the arm and the external and internal jugular, subclavian and femoral veins. We find the axillary vein also suitable. It is a safe and reliable route with few complications, and is especially recommended in ventilated and/or tracheotomized patients. We describe our experience in 80 patients, with a success rate of 90% and very few complications.

Axillary Vein↗
PubMed1990

[Local thrombolytic therapy for axillary vein thrombosis].

Deep vein thrombosis of the upper limb is much rarer than that of the lower limb. Despite conventional treatment with systemic heparin, there are residual symptoms in many patients. An alternative method of local thrombolytic therapy was used with success in a 30-year-old-women with thrombosis in his arm. 1 year later s/he is well and symptom-free.

Adult↗
PubMed1990

Aeromonas species bacteremia in nonimmunocompromised hosts. Two case reports and a review of the literature.

Aeromonas hydrophila septicemia usually occurs in immunocompromised hosts. We present two case reports of Aeromonas hydrophila septicemia in uncompromised patients from two medical centers. Three additional cases (two in immunocompromised hosts and one in a normal host) were found in these centers after retrospective screening of bacteriologic records over the last 3 years. A review of the English medical literature over four decades revealed only 24 additional cases of Aeromonas infection in the nonimmunocompromised host. The primary sources of Aeromonas bacteremia are abdominal and soft tissue infections. In the normal host the prognosis is good when antibiotic treatment is initiated early. Aeromonas are sensitive to aminoglycosides, second- and third-generation cephalosporins, chloramphenicol, cotrimoxazole and ureidopenicillin. There appears to be an increased recognition of this organism, as well as an increase in frequency of Aeromonas-related infection.

Aeromonas↗
PubMed1989

Rhabdomyolysis and acute renal failure induced by paraphenylenediamine.

1. We present a 40-year-old healthy man who developed a typical clinical picture of rhabdomyolysis following the administration of paraphenylenediamine by a witchdoctor as a pain killer. 2. Two groups of 15 mice were given paraphenylenediamine 70 mg/kg and 35 mg/kg respectively. Biochemical and histological findings of rhabdomyolysis developed in both groups, without kidney damage. 3. Paraphenylenediamine may cause rhabdomyolysis resulting in acute renal failure in humans. In mice, however, it produces rhabdomyolysis, but the kidneys are not affected.

Acute Kidney Injury↗
PubMed1982

Mechanical ventilation in fiberoptic-bronchoscopy: comparison between high frequency positive pressure ventilation and normal frequency positive pressure ventilation.

High frequency positive pressure ventilation (HFPPV) was compared with normal frequency positive pressure ventilation (NFPPV) during diagnostic fiberoptic-bronchoscopy. HFPPV was achieved by a simple modification of the Minivent, and gave satisfactory alveolar ventilation and oxygenation. In all 11 patients and over periods of at least 40 min, HFPPV gave normal PaCO2 and high levels of PAO2. Arterial blood pressures were higher and the airway pressures were lower than during NFPPV.

Adult↗