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Biomedical subjects

T Ezri

Publications and source records attributed to T Ezri.

At least 73 records · Page 4Linked to original sources
PubMed1993

Thionyl-chloride-induced lung injury and bronchiolitis obliterans.

Thionyl-chloride (TCl) is used in the manufacture of lithium batteries, producing SO2 and HCl fumes on contact with water. We report two cases of accidental TCl exposure resulting in lung injury that may vary from a relatively mild and reversible interstitial lung disease to a severe form of bronchiolitis obliterans causing, after a latent period, an acute/chronic respiratory failure as well as other complications (spontaneous pneumothorax and bronchopleural fistula), previously unreported in TCl fume inhalation.

Accidents, Occupational↗
PubMed1991

Symptomatic hyponatraemia due to inappropriate antidiuretic hormone secretion following minor surgery.

A rare case of the syndrome of inappropriate antidiuretic hormone secretion occurring after minor surgery is presented. A ten-year-old, previously healthy boy underwent general anaesthesia for detorsion and right orchiopexy. Throughout the operations, which lasted for one hour, he received 120 ml Ringer's lactate solution. The immediate postoperative period was uneventful. Twenty-two hours postoperatively he was found unconscious with generalized tonic-clonic seizures. Simultaneously obtained serum sodium concentration (121 mEq.L-1) serum osmolarity (265 mEq.L-1), urine sodium concentration (87 mEq.L-1) and urine osmolarity (525 mEq.L-1) suggested inappropriate antidiuretic hormone secretion which was confirmed by an elevated serum arginine-vasopressin (AVP) level of 14.5 pcg.ml-1 (normal 1-5 pcg.ml-1) measured by radioimmune assay. He was treated with a single iv dose of 30 mg furosemide and fluid restriction, which produced a gradual increase of his serum sodium concentration to normal within two days. He was well during the remainder of his hospitalization.

Child↗
PubMed1991

Influence of epidural anaesthesia on the course of labour in patients with antepartum fetal death.

The course of labour in 22 patients with antepartum fetal death who received epidural anaesthesia was evaluated as compared to 22 controls matched for parity and gestational age, who received narcotic pain relief. Both groups had similar preinduction cervical dilatation and the induction was performed by amniotomy and oxytocin infusion. The mean first stage of labour was 5.4 hours in the epidural group, and 8.7 hours in the controls (p = 0.0192). The mean cervical dilatation rate was 3.3 cm/hour and 1.0 cm/hour respectively (p = 0.0142). The second stage was similar in both groups. We conclude, that parturients receiving epidural anaesthesia may benefit both emotionally and physically from excellent pain relief and a shorter delivery process when going through the distressing experience of delivering a dead fetus.

Amnion↗
PubMed1990

[Inflammatory cells in bronchial lavage fluid after general anesthesia and artificial respiration].

Bronchial lavage was performed immediately after intubation and artificial respiration (sample A) and one hour later (sample B) in 26 patients who underwent general anesthesia for elective surgery, but were otherwise normal. The number of cells recovered in sample B was significantly greater than that in sample A (5.64 +/- 4.62 x 10(6) vs 1.42 +/- 0.99 x 10(6). This difference was greater in smokers than in nonsmokers. There was also a significantly greater proportion of granulocytes in sample B compared to sample A. The results were similar after inhalation or after intravenous anesthesia. There were dynamic changes in quality as well as quantity of inflammatory cells in the lower respiratory tract following intubation and artificial respiration.

Anesthesia, General↗
PubMed1990

Schizophrenia and fatal self-induced water intoxication with appropriately-diluted urine.

A 31-year-old woman with untreated chronic schizophrenia developed extreme polydipsia which rapidly led to coma and death due to cerebral edema. Hyponatremia (120 mEq/liter) and serum hypo-osmolality (260 mOsm/kg) were associated with marked polyuria (up to 1850 ml/hour) and appropriately low urinary osmolality (90 mOsm/kg) which responded to treatment. This case and few qualifying previous reports which are reviewed support the possibility that pure self-induced water intoxication with no major contribution of inadequate release of antidiuretic hormone may occur, and that extreme polydipsia can sometimes overwhelm normal renal diluting capacity in psychotic patients.

Adult↗
PubMedDate not supplied

Combined spinal-epidural anesthesia for Cesarean section in a patient with peripartum dilated cardiomyopathy.

PURPOSE: To report a case of peripartum dilated cardiomyopathy associated with morbid obesity and possible difficult airway presenting for elective Cesarean section, which was successfully managed with combined spinal-epidural anesthesia. CLINICAL FEATURES: A morbidly obese parturient with a potentially difficult airway, suffering from idiopathic peripartum cardiomyopathy (ejection fraction 20%), was scheduled for an elective Cesarean section. A combined spinal epidural anesthesia was performed and 6 mg of bupivacaine were injected into the subarachnoid space. This was supplemented after 60 min with 25 mg of bupivacaine injected epidurally. The patient's hemodynamic status was monitored with direct intra-arterial blood pressure and central venous pressure measurements. The patient's perioperative course was uneventful. CONCLUSION: In patients suffering from peripartum cardiomyopathy, undergoing Cesarean section, combined spinal-epidural anesthesia may be an acceptable anesthetic alternative.

Adult↗
PubMedDate not supplied

Pulse oximetry from the nasal septum.

STUDY OBJECTIVE: To evaluate the accuracy of the nasal septum site for pulse oximetry measurement of arterial oxyhemoglobin saturation (SpO2) in hypothermic patients. DESIGN: Prospective study. SETTING: Operating theater of a public hospital. PATIENTS: Fourteen hypothermic (temperature 34.6 degrees C to 36 degrees C) patients (eight males and six females) undergoing a major surgical abdominal procedure. INTERVENTIONS: Fifty estimations of SpO2 were simultaneously made by a flex sensor probe applied at the nasal septum site and by a finger sensor probe using a pulse oximeter. The results were compared with arterial oxygen saturation (SaO2) as measured by arterial blood gas sampling. MEASUREMENTS AND MAIN RESULTS: In 18% of the estimations, the finger probe produced unmeasurable results. The nasal septum probe did not produce any unmeasurable results (p = 0.0055). In the remaining 41 estimations, a comparison of the measurements from the nasal septum versus the controls showed a mean difference of 0.15 and a limit of agreement of -0.106 to +0.398. A comparison difference of 2.27 and a limit of agreement of 1.986 to 2.551. CONCLUSION: Monitoring SpO2 at the nasal septum site is more reliable than monitoring it at the finger site in hypothermic patients.

Adult↗
PubMedDate not supplied

Lidocaine inhalation attenuates the circulatory response to laryngoscopy and endotracheal intubation.

STUDY OBJECTIVE: To evaluate the effect of lidocaine inhalation on the circulatory response to direct laryngoscopy and endotracheal intubation. DESIGN: Prospective, randomized study. SETTING: Operating theater at a public hospital. PATIENTS: Eighty patients (ASA physical status I and II ages 25 to 45 years) scheduled for major abdominal surgery. INTERVENTIONS: In the first stage, 40 patients were randomly assigned to receive inhalation of either lidocaine 40 mg or a 0.9% solution of sodium chloride (placebo). In the second stage, the next 20 consecutive patients received inhalation of lidocaine 120 mg, and another 20 consecutive patients received intravenous (IV) lidocaine 1 mg/kg. MEASUREMENTS AND MAIN RESULTS: Mean arterial pressure rose significantly in the i.v. lidocaine group (21.2 mmHg; p < 0.05), the saline inhalation group (29.2 mmHg; p < 0.05), and the lidocaine 40 mg inhalation group (22.9 mmHg; p < 0.05), but not in the lidocaine 120 mg inhalation group (10.1 mmHg). The heart rate (HR) response to intubation with lidocaine inhalation was dose dependent. In the saline inhalation group, HR increased by 15.6 beats per minute (bpm) (p < 0.05); in the lidocaine 40 mg inhalation group, HR increased by 9.1 bpm (p < 0.05); and in the lidocaine 120 mg inhalation group, HR increased by only 3.1 bpm. CONCLUSION: Inhalation of lidocaine 120 mg prior to induction of anesthesia is an effective, safe, and convenient method to attenuate the circulatory response to laryngoscopy and endotracheal intubation.

Adult↗