ABSTRACT
Apnea test is a crucial requirement for determining the diagnosis of brain death (BD). There are few reports considering clinical complications during this procedure. We describe a major complication during performing the apnea test. We also analyse their practical and legal implications, and review the complications of this procedure in the literature. A 54 year-old man was admitted for impaired consciousness due to a massive intracerebral hemorrhage. Six hours later, he had no motor response, and all brainstem reflexes were negative. The patient fulfilled American Academy of Neurology (AAN) criteria for determining BD. During the apnea test, the patient developed pneumothorax, pneumoperitoneum, and finally cardiac arrest. Apnea test is a necessary requirement for the diagnosis of brain death. However, it is not innocuous and caution must be take in particular clinical situations. Complications during the apnea test could be more frequent than reported and may have practical and legal implications. Further prospective studies are necessary to evaluate the frequency and nature of complications during this practice.
Subject(s)
Apnea/diagnosis , Brain Death/diagnosis , Pneumoperitoneum/etiology , Pneumothorax/etiology , Humans , Intubation, Intratracheal/adverse effects , Male , Middle Aged , Practice Guidelines as Topic , Risk FactorsABSTRACT
Due to increasing international travelling of European population, tropical parasitic diseases may be imported more frequently in temperate countries. We describe a subject who travelled in Brasil and returned to Italy with a subcutaneous nodule containing a phase-II Dermatobia hominis larva; such larva is reported with photographic documentation.
Subject(s)
Diptera , Myiasis/diagnosis , Animals , Brazil , Europe , Humans , Middle Aged , Myiasis/surgery , TravelABSTRACT
The neurologic findings in 120 patients with possible diagnosis of hyperparathyroidism are reported and the world literature on this matter is reviewed. The neurologic signs and symptoms were divided in 3 categories: central, peripheral and miscellaneous. Headache, cramps weakness and depression where the most frequent complaints but with a so wide list of symptoms we expect mainly to salient the importance of calcium and phosphorus blood levels on neurologic patients as well as the value of neurologic evaluation on hyperparathyroid patients.
Subject(s)
Hypercalcemia/complications , Hyperparathyroidism/complications , Nervous System Diseases/etiology , Adolescent , Adult , Aged , Calcium/blood , Central Nervous System Diseases/etiology , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Neuromuscular Diseases/etiology , Peripheral Nervous System Diseases/etiology , Phosphorus/bloodABSTRACT
E feito um estudo retrospectivo de 120 pacientes internados para investigacao de hiperparatireoidismo. Tendo em vista as manifestacoes neurologicas do hiperparatireoidismo primario realizamos tambem um confronto com os achados de outros autores
Subject(s)
Hyperparathyroidism , Nervous System Diseases , Neurologic ManifestationsABSTRACT
Os autores relatam o caso de uma paciente que apresentava movimentos involuntarios do tipo coreiforme e hiperparatiroidismo primario.Tentaram especular sobre a relacao dessas duas entidades, uma vez que os movimentos involuntarios regrediram totalmente apos remocao das paratiroides hiperplasticas e retorno da calcemia ao normal