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Biomedical subjects

Bruce P Krieger

Publications and source records attributed to Bruce P Krieger.

6 recordsLinked to original sources
PubMed2005

Silicone embolism syndrome: a case report, review of the literature, and comparison with fat embolism syndrome.

Liquid silicone is an inert material that is utilized for cosmetic procedures by physicians as well as illegally by nonmedical personnel. We present a case report and collated clinical findings of 32 other patients who were hospitalized after illegal silicone injections. Symptoms and signs of the "silicone syndrome" included dyspnea, fever, cough, hemoptysis, chest pain, hypoxia, alveolar hemorrhage, and altered consciousness. Bilateral patchy alveolar infiltrates were present on the chest radiographs, and silicone pulmonary emboli were detected in all the patients. The patients could be divided into two groups based on the initial presentation and clinical outcome. Twenty-seven patients in group 1 presented predominantly with respiratory symptoms, and 93% of patients were discharged home within 3 weeks. Six patients (group 2) presented with severe neurologic findings, and experienced rapid deterioration and 100% mortality. The clinical findings after silicone embolism are very similar to the published reports of fat embolism, including hypoxemia in 92% of patients with silicone embolism (patients with fat embolism, 56 to 96%), dyspnea in 88% of patients (patients with fat embolism, 56 to 75%), fever in 70% of patients (patients with fat embolism, 23 to 67%), alveolar hemorrhage in 64% of patients (patients with fat embolism, 66%), neurologic symptoms in 33% of patients (patients with fat embolism, 22 to 86%), petechiae in 18% of patients (patients with fat embolism, 20 to 50%), chest pain in 15% of patients (patients with fat embolism, 26%), and mortality in 24% of patients (patients with fat embolism, 5 to 20%). The similarities among the mode of injury to the lung, the clinical findings, and the high incidence of alveolar hemorrhage suggest a common pathogenesis of silicone and fat embolism syndromes. We discuss the possibility that the activation of the coagulation system may be important in the development of these clinical syndromes.

Adult↗
PubMed2004

Pulmonary complications of pregnancy.

Pregnancy induces significant physiologic stresses on the pulmonary and cardiovascular systems that may precipitate respiratory compromise. In addition, certain disease states that are unique to the pregnant woman, such as amniotic fluid emboli syndrome, may be associated with respiratory failure. The physiologic changes that affect the pregnant woman are reviewed. Pregnancy-related conditions are discussed as well as how common diseases, such as the acute respiratory distress syndrome, asthma, pneumonia, and AIDS,have to be approached when balancing the needs of the fetus with maternal well-being.

Female↗
PubMed2002

When wheezing may not mean asthma. Other common and uncommon causes to consider.

Establishing that wheezing is not due to asthma requires attention to the patient's history, physical examination results, and response to therapy. If the diagnosis of asthma is questionable, appropriate pulmonary function tests should be performed to firmly establish or refute that the wheezing is due to asthma. If asthma is not the cause, other entities need to be considered so that inappropriate therapy is not prescribed.

Asthma↗
PubMedDate not supplied

Pulmonary artery rupture induced by a pulmonary artery catheter: a case report and review of the literature.

Placement and use of pulmonary artery catheters (PACs) carry potential risks. The authors describe a case of a patient who developed massive hemoptysis after placement of a PAC that caused a rupture of the pulmonary artery with pseudoaneurysm formation. Treatment was successfully achieved with transcatheter coil embolization. Pulmonary artery rupture and pseudoaneurysm formation are among the most serious complications of PAC use because of the associated risk of mortality. Patients with this complication may be asymptomatic or may present with variable amounts of hemoptysis immediately or days after using a PAC. The gold standard diagnostic test is pulmonary angiography, and the treatment of choice for most patients is transcatheter embolization. Physicians and other health care personnel handling these catheters should be familiar with the specific PAC balloon's inflation limits to avoid complications that may injure the patient.

Aged↗