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Biomedical subjects

D J Bihari

Publications and source records attributed to D J Bihari.

10 recordsLinked to original sources
PubMed1992

The EPIC study.

Explore the source record for details and available documents.

Cross Infection↗
PubMed1992

An uncommon cause of acute right ventricular failure and high mixed venous oxygen saturation.

Ruptured sinus of Valsalva aneurysms are rare. We report a case in which the usual clinical manifestations were not present and the patient was initially treated as an acute pulmonary embolus. Despite three negative echocardiograms an intra-cardiac shunt was suspected because of a persistently elevated mixed venous oxygen saturation. Cardiac catheterisation confirmed the diagnosis. Surgical repair was performed and post operative recovery was uneventful.

Aortic Rupture↗
PubMed1990

Septicaemia--the clinical diagnosis.

The production and consequences of the components of the state defined as 'clinically significant sepsis', as seen in patients undergoing intensive therapy--fever, shock, respiratory failure and multiple system failure--are complex. The syndrome is not necessarily accompanied by detectable bacteraemia; the effective management cannot wait upon positive blood cultures. Possibilities for more effective intervention include the use of monoclonal antibodies to endotoxin or to tumour necrosis factor, and of prostaglandins to alter the microcirculation. More refined definition of the severe sepsis syndrome will be required before these measures can be fully evaluated.

Acute Disease↗
PubMed1988

The therapeutic value of vasodilator prostaglandins in multiple organ failure associated with sepsis.

There is considerable evidence from animal and human studies of sepsis and acute lung injury that prostacyclin and PGE1 may have a beneficial effect on tissue perfusion with a reduction in the severity of tissue damage associated with these disorders. As yet, there are no good data from controlled clinical trials that these agents improve survival and it is not clear whether in the future such data will be forthcoming. Nevertheless, using various physiological end-points, both prostaglandins seem to be beneficial in sepsis and when used in combination with the whole process of Intensive Therapy, may contribute to the survival of some cases. Although the assessment of combinations of agents designed to inhibit mediator release might be more useful, it remains to be seen whether the relatively insensitive controlled clinical trial, with survival as its endpoint, is the appropriate tool for assessing efficacy in the ITU. Perhaps, the 'consensus' approach has something to offer in this situation!

Critical Care↗
PubMed1986

Metabolic acidosis.

Metabolic acidosis is the most frequent acid-base abnormality observed in the critically ill. Although there are many different causes, in the absence of ketosis and renal failure lactic acidosis is the most likely underlying disturbance. Controversy continues to surround the relative roles of the liver and the kidneys in the control of acid-base balance. There is no consensus concerning the use of bicarbonate in the treatment of a life-threatening metabolic acidosis.

Acidosis↗