RESUMO
Dyspnea in the elderly can be due to a wide array of pathologies. We discuss a case of an elderly gentleman with an extensive cardiovascular history presenting with acute worsening of chronic dyspnea. Because of persistent respiratory distress unresponsive to standard therapy for congestive heart failure, chronotropic insufficiency, and pulmonary hypertension, further evaluation was undertaken which revealed that diaphragmatic weakness was the etiology of his respiratory failure. EMG and muscle biopsy confirmed the diagnosis of inclusion body myositis (IBM).
Assuntos
Dispneia/diagnóstico , Miosite de Corpos de Inclusão/diagnóstico , Idoso de 80 Anos ou mais , Biópsia , Doença Crônica , Diafragma/diagnóstico por imagem , Diafragma/patologia , Dispneia/diagnóstico por imagem , Dispneia/terapia , Eletromiografia , Evolução Fatal , Humanos , Masculino , Músculo Esquelético/patologia , Miosite de Corpos de Inclusão/diagnóstico por imagem , Miosite de Corpos de Inclusão/terapiaAssuntos
Face , Traumatismos Faciais/etiologia , Cabelo , Serviços Hospitalares de Assistência Domiciliar , Oxigenoterapia , Queimaduras/etiologia , Queimaduras/prevenção & controle , Contraindicações , Traumatismos Faciais/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
Urinary catheterization is a common procedure, particularly among patients with neurogenic bladder secondary to spinal cord injury. Urethral catheterization is associated with the well-recognized complications of catheter-associated urinary tract infections and limited genitourinary trauma. Unintentional ureteral cannulation represents a rare complication of urethral catheterization and has been previously described in only eight cases within the literature. We describe two cases of aberrant ureteral cannulation involving two patients with quadriplegia. These cases along with prior reports identify the spastic, insensate bladder and altered pelvic sensorium found in upper motor neuron syndromes as major risk factors for ureteral cannulation with a urinary catheter.