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1.
Food Res Int ; 190: 114582, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38945602

RESUMO

Infants have digestive environments that are more favorable for microbial proliferation and subsequent endogenous nitrite production than those of adults, but direct evidence of this has been lacking. In this study, we propose a novel epidemiology of infant methemoglobinemia by demonstrating the risk posed by nitrite-producers in the gastrointestinal tract. Nitrite-producers from vegetables (n = 323) were exposed to stress factors of the gastrointestinal environment (gastric pH, intestinal bile salts, anaerobic atmosphere) reflecting 4 different postnatal age periods (Neonate, ≤1 month; Infant A, 1-3 months; Infant B, 3-6 months; Infant C, 6-12 months). "High-risk" strains with a nitrate-to-nitrite conversion rate of ≥1.3 %, the minimum rate corresponding to nitrite overproduction, under the Neonate stress condition were analyzed for intestinal adhesion. Among all the phyla, Pseudomonadota achieved the highest survival (P < 0.05; survival rate of 51.3-71.8 %). Possible cross-protection against bile resistance due to acid shock was observed for all the phyla. All the high-risk strains exhibited moderate autoaggregation (14.0-36.4 %), whereas only a few exhibited satisfactory surface hydrophobicity (>40 %). The Pantoea agglomerans strain strongly adhered to Caco-2 cells (7.4 ± 1.1 %). This study showed the ability of the Pantoea, Enterobacter, and Klebsiella strains to survive under gastrointestinal stress for ≤12 months, to excessively produce nitrite under neonatal stress conditions, and to settle in the human intestine. To our knowledge, this is the first study to reveal the role of the natural flora of vegetables in the epidemiology of infant methemoglobinemia through a multilateral approach.


Assuntos
Metemoglobinemia , Nitritos , Verduras , Humanos , Verduras/microbiologia , Lactente , Metemoglobinemia/metabolismo , Nitritos/metabolismo , Recém-Nascido , Aderência Bacteriana , Ácidos e Sais Biliares/metabolismo , Trato Gastrointestinal/microbiologia , Trato Gastrointestinal/metabolismo , Concentração de Íons de Hidrogênio , Microbioma Gastrointestinal
2.
BMJ Case Rep ; 17(5)2024 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-38806397

RESUMO

We present a case of a man in his late 40s presenting with generalised tonic-clonic seizures and profound methaemoglobinaemia shortly after inadvertent ingestion of amyl nitrite. Arterial blood gas analysis demonstrated methaemoglobin levels exceeding the upper detection threshold of our analyser, accompanied with profound cyanosis despite apparent oxygen saturations of 94%. Prompt administration of intravenous methylene blue led to a rapid and complete recovery. This case highlights the importance of swift recognition and treatment of methaemoglobinaemia particularly when the precipitating factor may be unknown at the time of presentation. This case also demonstrates the potential limitations of bedside blood gas analysers in diagnosis.


Assuntos
Nitrito de Amila , Metemoglobinemia , Azul de Metileno , Convulsões , Humanos , Metemoglobinemia/induzido quimicamente , Metemoglobinemia/diagnóstico , Masculino , Nitrito de Amila/intoxicação , Nitrito de Amila/efeitos adversos , Azul de Metileno/uso terapêutico , Convulsões/induzido quimicamente , Adulto , Gasometria
3.
Pan Afr Med J ; 47: 92, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38799189

RESUMO

Indoxacarb, a large-spectrum non-organophosphorus oxadiazine insecticide, is broadly used in farming whose mechanism of action is the blockage of voltage-gated sodium channels of insects. There is restricted data on human poisoning. We report a case of an 18-year-old male patient without comorbidities presented with unconsciousness and cyanosis after the intentional ingestion of indoxacarb in a suicide attempt. Methemoglobinemia was clinically suspected and was successfully treated after methylene blue injection, associated with supportive and symptomatic management. This case emphasizes the importance of considering methemoglobinemia after indoxacarb ingestion in addition to its early recognition and timely injection of methylene blue which led to complete recovery without sequelae.


Assuntos
Inseticidas , Metemoglobinemia , Azul de Metileno , Oxazinas , Tentativa de Suicídio , Humanos , Metemoglobinemia/induzido quimicamente , Metemoglobinemia/diagnóstico , Masculino , Azul de Metileno/administração & dosagem , Adolescente , Inseticidas/intoxicação , Oxazinas/intoxicação , Oxazinas/administração & dosagem , Cianose/induzido quimicamente
4.
Am J Emerg Med ; 81: 159.e1-159.e5, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38627127

RESUMO

INTRODUCTION: Methemoglobinemia, characterized by the conversion of functional hemoglobin to methemoglobin, can significantly impede tissue oxygenation. Prompt diagnosis and treatment of methemoglobinemia are critical to optimizing clinical outcomes. Although the underlying etiology of methemoglobinemia is often attributed to a medication reaction or chemical exposure, its association with battlefield trauma remains underexplored. This case series explores the presence of methemoglobinemia in nine soldiers evacuated from tanks targeted by explosives, shedding new light on screening needs and treatment strategies. CASES DESCRIPTION: Nine combat trauma patients with methemoglobinemia were admitted to Soroka Medical Center over a two-month period. Detailed case descriptions illustrate the diverse presentations and treatment responses. Notably, the administration of methylene blue resulted in rapid methemoglobin reductions and an improvement in oxygenation without any observed side effects. DISCUSSION: This series highlights an unexpected consequence of an explosion within an armored fighting vehicle and the challenges related to standard pulse oximetry interpretation and accuracy in the presence of methemoglobinemia, emphasizing the need for vigilant monitoring and co-oximetry utilization. Additionally, the coexistence of carboxyhemoglobin further warrants attention due to its synergistic and deleterious effects on oxygen delivery. Collaborative efforts with military authorities should aim to explore the underlying mechanisms associated with trauma and methemoglobinemia and optimize battlefield care. CONCLUSION: This case series underscores the significance of methemoglobinemia screening in combat trauma patients, and advocates for systematic co-oximetry utilization and methylene blue availability in combat zones. Early detection and intervention of methemoglobinemia in combat soldiers are often difficult in the context of battlefield injuries but are necessary to mitigate the potentially fatal consequences of this condition.


Assuntos
Metemoglobinemia , Azul de Metileno , Humanos , Metemoglobinemia/induzido quimicamente , Metemoglobinemia/diagnóstico , Masculino , Azul de Metileno/uso terapêutico , Adulto , Militares , Oximetria , Adulto Jovem , Traumatismos por Explosões/complicações , Programas de Rastreamento/métodos
5.
Int J Mol Sci ; 25(7)2024 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-38612599

RESUMO

Methemoglobinemia is a potentially life-threatening, rare condition in which the oxygen-carrying capacity of hemoglobin is diminished. We present the case of a 3-year-old boy treated for T-cell acute lymphoblastic leukemia (T-ALL) who developed methemoglobinemia (MetHb 57.1%) as a side effect of ifosfamide administration. Due to his critical condition, the patient was transferred to the intensive care unit (ICU). The therapy included methylene blue administration, an exchange transfusion, catecholamine infusion, and steroids. Improving the general condition allowed for continuing chemotherapy without ifosfamide and completion of the HR2 block. Vigilance for methemoglobinemia as a very rare side effect should be widespread when using ifosfamide in the treatment protocols.


Assuntos
Metemoglobinemia , Leucemia-Linfoma Linfoblástico de Células T Precursoras , Masculino , Humanos , Pré-Escolar , Metemoglobinemia/induzido quimicamente , Ifosfamida/efeitos adversos , Azul de Metileno/efeitos adversos , Catecolaminas
7.
J Neonatal Perinatal Med ; 17(2): 261-264, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38640175

RESUMO

 Cyanosis is a bluish discoloration of the tissues due to increased levels of deoxygenated hemoglobin in capillaries. It is a common finding in newborn infants that can be caused by different diseases, including pulmonary, cardiac, infectious, and hematological disorders. Methemoglobinemia is a rare cause of cyanosis, in which hemoglobin is oxidized, changing its heme iron configuration from the ferrous (Fe2 +) to the ferric (Fe3 +) state, creating methemoglobin (Met-Hb), a form that does not bind oxygen, leading to decreased oxygen delivery to the tissues and cyanosis. We report a rare case of a preterm newborn, who developed cyanosis and worsening hypoxemia on day ten of life, she was found to have elevated Met-Hb percentage in blood gas analysis that required treatment with intravenous methylene blue. Her symptoms resolved after a period of maintenance treatment with oral methylene blue and ascorbic acid, and the etiology of her disease remains unclear.


Assuntos
Ácido Ascórbico , Cianose , Recém-Nascido Prematuro , Metemoglobinemia , Azul de Metileno , Humanos , Metemoglobinemia/diagnóstico , Metemoglobinemia/etiologia , Recém-Nascido , Feminino , Azul de Metileno/uso terapêutico , Cianose/etiologia , Ácido Ascórbico/uso terapêutico , Ácido Ascórbico/administração & dosagem , Gasometria , Hipóxia/etiologia
8.
Arch. argent. pediatr ; 122(2): e202310095, abr. 2024. tab
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1537751

RESUMO

La intoxicación por naftaleno es poco frecuente en los niños. Es causada por la ingesta, la inhalación o el contacto con la piel de sustancias que contienen naftaleno. Los pacientes suelen tener orina de color marrón oscuro, diarrea acuosa y vómito bilioso. Los signos incluyen fiebre, taquicardia, hipotensión y valores bajos en la oximetría de pulso, incluso con oxigenoterapia. Los análisis de sangre detectan anemia hemolítica, metahemoglobinemia, insuficiencia renal e hiperbilirrubinemia. Además del tratamiento sintomático, se hacen transfusiones de eritrocitos y se les administran ácido ascórbico, azul de metileno y N-acetilcisteína. En este artículo, presentamos el caso de un paciente masculino de 23 meses de edad con metahemoglobinemia y hemólisis intravascular aguda que recibió atención en la unidad de cuidados intensivos durante cinco días por intoxicación por naftaleno. Si bien la intoxicación por naftaleno es muy poco frecuente, tiene consecuencias mortales y se debe ejercer precaución con su uso y venta.


Poisoning by naphthalene is uncommon in children. It is a type of poisoning brought on by ingesting, inhaling, or coming into touch with naphthalene-containing substances on the skin. Patients typically present with an initial onset of dark brown urine, watery diarrhea, and bile vomit. The signs include fever, tachycardia, hypotension, and low pulse oximetry readings even with oxygen support. Hemolytic anemia, methemoglobinemia, renal failure, and hyperbilirubinemia are all detected in blood tests. Erythrocyte transfusion, ascorbic acid, methylene blue, and N-acetylcysteine (NAC) therapies are provided to inpatients in addition to symptomatic treatment. We present a 23-month-old male patient who developed methemoglobinemia and acute intravascular hemolysis, who was followed up in the intensive care unit for five days due to naphthalene intoxication. Although naphthalene poisoning is very rare, it should be known that it has fatal consequences, and more care should be taken in its use and sale.


Assuntos
Humanos , Masculino , Lactente , Anemia Hemolítica/diagnóstico , Metemoglobinemia/diagnóstico , Metemoglobinemia/induzido quimicamente , Ácido Ascórbico , Hemólise , Naftalenos
9.
J Med Case Rep ; 18(1): 163, 2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38500232

RESUMO

BACKGROUND: Herbal products and traditional remedies are commonly used by individuals worldwide for the management of common ailments, even though most are not without risks. Acalypha indica is a popular medicinal plant consumed in some Asian countries. CASE PRESENTATION: This case report presents a 40-year-old previously unevaluated Sri Lankan female and her 8-year-old son who presented with severe glucose-6-phosphate dehydrogenase (G6PD) deficiency related acute intravascular oxidative haemolysis and methaemoglobinaemia precipitated by Acalypha indica consumption, successfully managed with supportive care and blood transfusion. CONCLUSIONS: This case highlights the potential hemolytic and methaemoglobinaemic effects of ingesting oxidant herbal products and the importance of considering such exposures in patients presenting with hemolysis and multiorgan involvement, particularly in communities where herbal product intake is popular. Healthcare providers should be aware of the risks associated with traditional remedies and maintain a high index of suspicion to ensure prompt recognition and appropriate management.


Assuntos
Acalypha , Deficiência de Glucosefosfato Desidrogenase , Metemoglobinemia , Plantas Medicinais , Adulto , Criança , Feminino , Humanos , Acalypha/efeitos adversos , Deficiência de Glucosefosfato Desidrogenase/complicações , Hemólise , Metemoglobinemia/induzido quimicamente , Estresse Oxidativo , Masculino
10.
J Med Case Rep ; 18(1): 157, 2024 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-38493134

RESUMO

INTRODUCTION: This case study reports on a suicide attempt involving indoxacarb and vitamin C. Indoxacarb is a neurotoxic insecticide used in agriculture and as a flea controller in pets. Cotton, vegetables, and fruits are treated with indoxacarb, an insecticide that can be applied both indoors and outdoors. It causes skin allergies, methemoglobinemia, and hemolytic anemia. It is also attributed to allergic reactions through ingestion, inhalation, physical contact, and translaminar action. This case report highlights use of vitamin C in methemoglobinemia caused by indoxacarb poisoning. Indoxacarb poisoning has the potential to be extremely serious and even lethal. In this instance, the patient initially had no symptoms after ingesting a substance containing indoxacarb in an attempt at suicide. However, further tests revealed methemoglobinemia and low oxygen levels. CASE PRESENTATION: A 28-year-old south-east Asian female patient ingested an insecticide containing 5.25% novaluron, 4.5% indoxacarb, and 25% thiamethoxam, and reported that she noticed muddy brown urine but presented with no active signs or symptoms of poisoning. Upon examination, the patient was fully conscious, alert, and hemodynamically stable, but had an oxygen saturation of 84%. Gastric lavage was performed, and blood investigations revealed a muddy-brown-colored blood sample and methemoglobin levels of 12%. The patient was treated with high-dose vitamin C and showed significant improvement, with a drop in methemoglobin levels to 1.2% and an increase in oxygen saturation to 97%. DISCUSSION: Indoxacarb poisoning can cause severe methemoglobinemia. Vitamin C may be a useful treatment option for methemoglobinemia caused by indoxacarb, particularly in cases in which traditional treatment with methylene blue is contraindicated or not tolerated. Hence high doses of ascorbic acid, that is, vitamin C, were administered to the patient, which lowered their methemoglobin levels and improved oxygen levels without much safety concerns. CONCLUSION: This example emphasizes the significance of early indoxacarb poisoning detection and treatment as well as the possible advantages of utilizing ascorbic acid in the management of methemoglobinemia, and highlights the use of vitamin C in the treatment of methemoglobinemia caused by indoxacarb poisoning. Therefore, it is important for healthcare professionals to be aware of the potential for indoxacarb to cause methemoglobinemia and to consider vitamin C as a treatment option.


Assuntos
Inseticidas , Metemoglobinemia , Oxazinas , Adulto , Feminino , Humanos , Ácido Ascórbico/uso terapêutico , Inseticidas/intoxicação , Metemoglobina , Metemoglobinemia/diagnóstico , Oxigênio , Vitaminas/uso terapêutico
12.
Transplant Proc ; 56(2): 453-455, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38336484

RESUMO

We describe the case of a 51-year-old Caucasian man with a background of a cardiac and renal transplant who developed Enterocytozoon bieneusi colitis and pneumocystis jirovecii (PJP) pneumonia following treatment for suspected rejection. The patient developed methemoglobinemia which was attributed to primaquine. He was treated with intravenous methylene blue leading to clinical and biochemical resolution. We describe in detail the pathophysiological mechanism for methemoglobinemia and its treatment, in particular with methylene blue.


Assuntos
Transplante de Rim , Metemoglobinemia , Pneumocystis carinii , Pneumonia por Pneumocystis , Humanos , Masculino , Pessoa de Meia-Idade , Transplante de Rim/efeitos adversos , Metemoglobinemia/induzido quimicamente , Metemoglobinemia/diagnóstico , Metemoglobinemia/complicações , Azul de Metileno , Pneumonia por Pneumocystis/diagnóstico , Pneumonia por Pneumocystis/tratamento farmacológico , Pneumonia por Pneumocystis/complicações , Primaquina/efeitos adversos
13.
Food Res Int ; 178: 113966, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38309914

RESUMO

Nitrite, which has been mainly regarded as a chemical hazard, can induce infant methemoglobinemia. As for nitrite as a product of microbial metabolism, the contribution of the oral or gut microbiome has mostly received attention, whereas the role of nitrite-producing bacteria (NPBs) in food has been less elucidated. In this study, mesophilic NPBs were isolated from food samples (n = 320) composed of raw ingredients for weaning foods (n = 160; beetroot, broccoli, carrot, lettuce, rice powder, spinach, sweet potato, and honey) and processed baby foods (n = 160; cereal snack, cheese, yogurt, powdered infant formula, sorghum syrup, vegetable fruit juice, and weaning food). The phylogenetic diversity of the NPB strains was analyzed via 16S rRNA sequencing. All 15 food items harbored NPBs, with a prevalence of 71.9 % and 34.4 % for the raw ingredients and processed foods, respectively. The NPBs isolated from the foods were identified as Actinomycetota (Actinomycetes), Bacteroidota (Flavobacteriia, Sphingobacteriia), Bacillota (Bacilli), or Pseudomonadota (Alpha-, Beta-, and Gammaproteobacteria). Among the raw and processed foods, beetroot (85.0 %) and powdered infant formula (70.0 %) showed had the highest NPB prevalence (P > 0.05). Bacillota predominated in both types of food. The contamination source of Pseudomonadota, which was another major phylum present in the raw ingredients, was presumed to be the soil and endophytes in the seeds, whereas that of Bacillota was the manufacturing equipment used with the raw ingredients. Common species for probiotics, such as Lacticaseibacillus, Leuconostoc, Enterococcus, and Bacillus, were isolated and identified as NPBs. To our knowledge, this is the first study to reveal the taxonomical diversity and omnipresence of NPBs in food for babies. The results of this study highlight the importance of food-mediated microbiological risks of infant methemoglobinemia which are yet underrecognized.


Assuntos
Metemoglobinemia , Nitritos , Humanos , Lactente , Nitritos/análise , Filogenia , Alimento Processado , Metemoglobinemia/epidemiologia , Prevalência , RNA Ribossômico 16S/genética , Fórmulas Infantis , Bactérias/genética , Verduras/microbiologia
15.
BMJ Case Rep ; 17(1)2024 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-38199656

RESUMO

Methaemoglobinaemia occurs when iron in haemoglobin is oxidised into a form that cannot transport oxygen. At low levels, it is asymptomatic, though at rising levels symptoms arise from impaired oxygenation, and it can ultimately be fatal. While uncommon, it is important to consider in hypoxaemic COVID-19 patients, especially if they are not clinically improving on standard treatments and workup for other causes does not explain the ongoing hypoxaemia. It is often diagnosed through a mismatch in peripheral and arterial oxygen, with the former typically less than the latter. We present the case of a COVID-19 patient who was found to have methaemoglobinaemia due to dapsone use for Pneumocystic jirovecii pneumonia (PJP) prophylaxis while on chemotherapy. Dapsone was stopped and supplemental high-flow nasal cannula was provided, and methaemoglobin levels improved over a 5-day period. She was discharged to follow-up with her haematologist in the clinic.


Assuntos
COVID-19 , Metemoglobinemia , Feminino , Humanos , Metemoglobinemia/induzido quimicamente , Metemoglobinemia/diagnóstico , Metemoglobina , Dapsona/efeitos adversos , Oxigênio
16.
Arch Pediatr ; 31(2): 155-156, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38262857

RESUMO

We present the case of a 3-month-old boy who accidentally ingested poppers. The patient presented with refractory hypoxemia and compensated circulatory failure associated with severe methemoglobinemia. He made a full recovery after treatment with the specific antidote methylene blue. This is the first report of popper poisoning in a child - a rare case of poisoning in pediatrics.


Assuntos
Metemoglobinemia , Azul de Metileno , Masculino , Lactente , Humanos , Criança , Metemoglobinemia/induzido quimicamente , Metemoglobinemia/diagnóstico , Antídotos
17.
Arch Argent Pediatr ; 122(2): e202310095, 2024 04 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37801672

RESUMO

Poisoning by naphthalene is uncommon in children. It is a type of poisoning brought on by ingesting, inhaling, or coming into touch with naphthalene-containing substances on the skin. Patients typically present with an initial onset of dark brown urine, watery diarrhea, and bile vomit. The signs include fever, tachycardia, hypotension, and low pulse oximetry readings even with oxygen support. Hemolytic anemia, methemoglobinemia, renal failure, and hyperbilirubinemia are all detected in blood tests. Erythrocyte transfusion, ascorbic acid, methylene blue, and N-acetylcysteine (NAC) therapies are provided to inpatients in addition to symptomatic treatment. We present a 23-month-old male patient who developed methemoglobinemia and acute intravascular hemolysis, who was followed up in the intensive care unit for five days due to naphthalene intoxication. Although naphthalene poisoning is very rare, it should be known that it has fatal consequences, and more care should be taken in its use and sale.


La intoxicación por naftaleno es poco frecuente en los niños. Es causada por la ingesta, la inhalación o el contacto con la piel de sustancias que contienen naftaleno. Los pacientes suelen tener orina de color marrón oscuro, diarrea acuosa y vómito bilioso. Los signos incluyen fiebre, taquicardia, hipotensión y valores bajos en la oximetría de pulso, incluso con oxigenoterapia. Los análisis de sangre detectan anemia hemolítica, metahemoglobinemia, insuficiencia renal e hiperbilirrubinemia. Además del tratamiento sintomático, se hacen transfusiones de eritrocitos y se les administran ácido ascórbico, azul de metileno y N-acetilcisteína. En este artículo, presentamos el caso de un paciente masculino de 23 meses de edad con metahemoglobinemia y hemólisis intravascular aguda que recibió atención en la unidad de cuidados intensivos durante cinco días por intoxicación por naftaleno. Si bien la intoxicación por naftaleno es muy poco frecuente, tiene consecuencias mortales y se debe ejercer precaución con su uso y venta.


Assuntos
Anemia Hemolítica , Metemoglobinemia , Humanos , Masculino , Criança , Lactente , Pré-Escolar , Hemólise , Metemoglobinemia/induzido quimicamente , Metemoglobinemia/diagnóstico , Anemia Hemolítica/diagnóstico , Ácido Ascórbico , Naftalenos
18.
Trop Doct ; 54(1): 39-41, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37807706

RESUMO

Acute diarrhoeal illness remains a common medical problem in children with nearly 1.7 billion cases globally every year. We report five infants who, following severe diarrhoea, developed methaemoglobinemia. This is an altered state of haemoglobin presenting with cyanosis and can pose a diagnostic dilemma. It should be suspected in young infants without cyanotic heart disease presenting with severe diarrhoea, sepsis and cyanosis disproportionate to their clinical status. Its outcome depends on prompt treatment, the severity of underlying sepsis and co-morbidity.


Assuntos
Metemoglobinemia , Sepse , Lactente , Criança , Humanos , Metemoglobinemia/complicações , Metemoglobinemia/diagnóstico , Metemoglobinemia/terapia , Diarreia/diagnóstico , Diarreia/etiologia , Cianose/etiologia , Cianose/complicações , Sepse/complicações
19.
J Perianesth Nurs ; 39(3): 345-348, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38159101

RESUMO

Hemoglobin M (Hb M) is a group of abnormal Hb variants that form methemoglobin, which leads to cyanosis. Patients with Hb M appear cyanotic but are usually asymptomatic. Cyanosis with low peripheral oxygen saturation is unresponsive to oxygen therapy despite normal partial pressure of oxygen. As such, close attention should be paid during anesthesia. We report the first case of a Hb M patient undergoing laparoscopic uterine myomectomy under general anesthesia.


Assuntos
Laparoscopia , Miomectomia Uterina , Feminino , Humanos , Anestesia Geral/métodos , Laparoscopia/métodos , Leiomioma/cirurgia , Leiomioma/complicações , Metemoglobinemia , Miomectomia Uterina/métodos , Neoplasias Uterinas/cirurgia , Pessoa de Meia-Idade
20.
Anasthesiol Intensivmed Notfallmed Schmerzther ; 58(11-12): 655-658, 2023 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-38056444

RESUMO

Drug-induced methemoglobinemia is a well-known phenomenon as well as induction by poppers (alcylnitrites substance group). Usually, suspicion is thrown in the right direction by a thorough medical history and environmental survey. But if intoxication is unintended and happens within the very private environment diagnosis might be very tricky. We report on an unusual case of accidental intoxication with probably contaminated tablets which were bought in the darknet. Finally, diagnosis was made by blood gas analysis' methemoglobine values.


Assuntos
Contaminação de Medicamentos , Metemoglobinemia , Citrato de Sildenafila , Humanos , Metemoglobinemia/induzido quimicamente , Metemoglobinemia/diagnóstico , Citrato de Sildenafila/efeitos adversos , Comprimidos , Internet
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