Mumps virus infection in adults: three cases of supraglottic edema.

Mumps virus infection in adults: three cases of supraglottic edema.

Laryngoscope. 2006 Dec

Ishida M,
Fushiki H,
Morijiri M,
Maruyama M,
Motoshima H,
Asai M,
Watanabe Y.

Department of Otolaryngology, Head & Neck Surgery, University of Toyama, Toyama, Japan.

Mumps virus infections primarily involve the parotid glands and most frequently affect school-aged children. We present three unusual adult cases of mumps with dyspnea secondary to severe swelling of the salivary glands and review previously reported cases in the literature. Dyspnea developed progressively after the onset of salivary gland swelling. Laryngoscopy revealed an advanced edematous change in the supraglottis obstructing the airway. In two cases, tracheotomy was needed because of rapid worsening of the supraglottic edema. Questioning regarding breathing problems and laryngoscopic examination is therefore recommended when one encounters a mumps case with combined parotid and salivary gland swelling.

Lippincott Williams & Wilkins

A case of unilateral leg edema due to abdominal aortic aneurysm with aortocaval fistula.

A case of unilateral leg edema due to abdominal aortic aneurysm with aortocaval fistula.

Ann Thorac Cardiovasc Surg. 2007

Abstract

Takaseya T,
Hiromatsu S,
Akashi H,
Okazaki T,
Tobinaga S,
Aoyagi S.
Department of Surgery, Kurume University School of Medicine, Kurume, Japan.

Aortocaval fistula (ACF) is a rare complication of abdominal aortic aneurysm (AAA), and its preoperative diagnosis is often difficult. A 71-year-old woman was admitted to our hospital due to unilateral leg edema. Abdominal computed tomography (CT) showed an abdominal aortic aneurysm (AAA), a common iliac aortic aneurysm (CIAA) and ACF was suspected. Digital subtraction angiography (DSA) was performed, enabling us to identify the region of ACF with AAA preoperatively. ACF is associated with high mortality because it is difficult to control venous bleeding from ACF. Detailed preoperative diagnosis of ACF can provide many advantages to control bleeding from ACF during an operation.

Full Text Article

High grade MRI bone edema in rheumatoid arthritis patients undergoing joint replacement

High grade MRI bone edema is common within the surgical field in rheumatoid arthritis patients undergoing joint replacement and is associated with osteitis in subchondral bone.

Ann Rheum Dis. 2007 May 9
McQueen FM,
Gao A,
Ostergaard M,
King A,
Shalley G,
Robinson E,
Doyle A,
Clark B,
Dalbeth N.
Auckland University, New Zealand.

OBJECTIVES: /B> MRI bone oedema has been observed in early and advanced RA and may represent a cellular infiltrate (osteitis) in subchondral bone. We studied MRI scans from RA patients undergoing surgery, seeking to identify regions of bone oedema and examine its histopathological equivalent in resected bone.

METHODS: /B> Pre-operative contrast-enhanced MRI scans were obtained in 11 RA patients scheduled for orthopaedic surgery to the hands/wrists or feet. In 9, MRI scans were scored by 2 readers for bone oedema (RAMRIS system). Its distribution with respect to surgical site was investigated. In 4 patients, 7 bone samples were examined for a cellular infiltrate and this was compared with MRI bone oedema, scored for spatial extent and intensity.

RESULTS: /B> Inter-reader ICCs for bone oedema were 0.51 (all sites) and 0.98 (bone samples for histology). Bone oedema was observed at 60% of surgical sites vs 38% of non-surgical sites. High grade bone oedema (score = or >50% maximum) was strongly associated with the surgical field (OR 9.3 [3.5-24.2], P<0.0001). r="0.67," p="0.048)" r="0.86," p="0.01).">

CONCLUSION: High grade MRI bone oedema was common within the field of intended surgery and associated with pain. There was concordance between the presence and severity of MRI bone oedema and osteitis on histology, with an MRI threshold effect due to differences in image resolution.

PMID: 17491098 [PubMed - as supplied by publisher]

High altitude pulmonary edema in a patient with previous pneumonectomy.

High altitude pulmonary edema in a patient with previous pneumonectomy.
J Formos Med Assoc. 2007 Apr
Chou YT,
Wang CL,
Kao KC,
Wu YK,
Tsai YH.
Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.

High altitude pulmonary edema (HAPE) is a life-threatening illness that can occur in individuals ascending to altitudes exceeding 2400 m. The risk factors are rapid ascent, physical exertion and a previous history of HAPE. This work presents a case study of a 74-year-old man who underwent left side pneumonectomy 40 years ago and subsequently experienced several instances of HAPE. The well-known risk factors for HAPE were excluded in this patient. We suspect that the post-pneumonectomy condition may be a risk factor for HAPE based on this case.

PMID: 17475610 [PubMed - in process]

Transpulmonary dilution-derived extravascular lung water as a measure of lung edema.

Transpulmonary dilution-derived extravascular lung water as a measure of lung edema.
Curr Opin Crit Care. 2007 Jun

Khan S,
Trof RJ,
Groeneveld AJ.
Department of Intensive Care, VU University Medical Center, Amsterdam, The Netherlands.

PURPOSE OF REVIEW: This review highlights current insights concerning the (measurement of) extravascular lung water as an index of pulmonary edema, by transpulmonary dilution techniques. The focus is on the applicability of the technique at the bedside in monitoring critically ill patients.

RECENT FINDINGS: Several (animal) studies have been performed to validate the technique by postmortem gravimetry in different conditions. Moreover, recent clinical data emphasize the utility of the thermodilution-derived extravascular lung water, its contribution to the clinical manifestations of acute lung injury/acute respiratory distress syndrome, its response to treatment aimed at edema prevention or resolution, and as a prognostic parameter.

SUMMARY: The thermodilution-derived extravascular lung water is a useful adjunct to assess lung vascular injury, cardiogenic edema and overhydration and to guide treatment in critically ill patients. The effects on morbidity and mortality of this approach need to be studied further.

PMID: 17468563 [PubMed - in process]