PubMed Health⌕ Search

Biomedical subjects

M Balla

Publications and source records attributed to M Balla.

14 recordsLinked to original sources
PubMed1999

Bacterial sepsis-induced rhabdomyolysis.

OBJECTIVE: To describe the syndrome of rhabdomyolysis during bacterial sepsis with regard to incidence, blood bacteriology and complications and to examine the association between hyperosmolal state and rhabdomyolysis, evaluating the relationship between plasma osmolality (Posm) and serum creatine phosphokinase (CPK) levels. DESIGN: Prospective study including all patients admitted to the intensive care unit (ICU) for sepsis with positive blood culture and rhabdomyolysis over a 3-year period. SETTING: Seven-bed medical/surgical ICU of a teaching hospital. PATIENTS: 35 patients (group 1) with bacterial sepsis-induced rhabdomyolysis (15 males, 20 females; mean age 71+/-13 years) and 122 (group 2) bacteraemic septic patients without rhabdomyolysis (49 males, 73 females; mean age 68+/-15) were studied. Patients with rhabdomyolysis were divided into gram(+) and gram(-) subgroups according to the blood culture growth. RESULTS: From 491 patients recorded, 35 fulfilled the inclusion criteria for bacterial sepsis-induced rhabdomyolysis (7.1%). Gram-positive bacteria predominated in group 1 (69%), while gram-negative predominated (60%) in group 2. There was a correlation between CPK and Posm levels in the rhabdomyolysis Group (r = 0.52, R2 = 0.27, p = 0.003). There was a stronger correlation between these two variables (r = 0.67, R2 = 0.45, p = 0.001) in the gram(+).subgroup. Acute renal failure (68.5%) and electrolyte disorders such as hyperkalaemia (34%) and hypocalcaemia (48.5%) were the major complications in the rhabdomyolysis group. Sixteen (45.7%) patients in group 1 and 49 (40%) in group 2 died during their stay in the ICU from sepsis and multiple organ failure. Rhabdomyolysis was not considered a contributing factor to their death, as none of our patients died during or immediately after the syndrome. CONCLUSION: Bacterial sepsis-induced rhabdomyolysis results from certain types of microorganisms, mainly gram-positive and to a lesser extent gram-negative. Hyperosmolality is a predisposing mechanism for rhabdomyolysis during bacteraemic sepsis from any type of bacterial microorganism.

Acute Kidney Injury↗
PubMed1996

Reversal of liver failure in sickle cell vaso-occlusive crisis.

A severe but unusual complication of sickle cell vaso-occlusive crisis is acute liver failure related to intrahepatic cholestasis. The outcome is usually fatal in adults. A case of reversible acute liver failure in a patient with s/beta+ thalassemia is reported. The patient was admitted to the intensive care unit because of major organ failure related to vascular occlusion phenomena. After blood-plasma transfusion and supportive therapy for acute liver failure, complete recovery was noted. A liver biopsy performed at the stage of recovery was compatible with intrahepatic cholestasis and sickling. Even though patients with s/beta+ thalassemia usually manifest milder symptoms, they rarely develop major organ failure such as acute liver failure.

Acute Disease↗
PubMed1996

Group peer review in psychiatry: the relationship to quality improvement and quality care.

OBJECTIVE: This study sought to elucidate the contribution of peer review groups involving psychiatrists to quality improvement and quality care. METHOD: Audio-taped interviews of groups engaged in peer review were analysed using a qualitative methodology. Participants' views of the ways in which they experienced and conceptualised peer review were explored. RESULTS: The views of participants in peer review groups were analysed, and categories evolved which identified differences in how they perceived the structure and function of group peer review. CONCLUSIONS: Participants in the groups studied perceived peer review as a professional growth forum within a quality improvement framework providing critical review of treatment, continuing education, and a sense of collegiality. Boundaries of acceptable practice were tested and defined. At its best, participation in peer review groups enhanced reflective practice which achieved new understandings of clinical work. In this regard, peer review is seen as a highly desirable method for the maintenance of professional standards.

Attitude of Health Personnel↗
PubMed1995

Multiple systems organ failure from organophosphate poisoning.

A 68-year-old man was admitted to an intensive care unit after a suicidal ingestion of dimethoate with organophosphate poisoning. Despite temporary improvement, the patient's condition progressively deteriorated with the development of adult respiratory distress syndrome and acute renal failure. Hemodynamic measurements substantiated the evidence of non cardiogenic pulmonary edema, while renal indices the presence of acute tubular necrosis. Despite vigorous organ specific support the patient died on the 12th hospital day. An autopsy confirmed the presence of adult respiratory distress syndrome and acute tubular necrosis. Organophosphate poison can be added to the list of toxins that caused adult respiratory distress syndrome and acute tubular necrosis and provoked the development of multiple systems organ failure.

Aged↗
PubMed1990

[Radium contact irradiation of vocal cord carcinoma--a possible treatment method?].

In the course of the use of carrier- bounded radioactive substances for the treatment of the vocal cord carcinoma, 113 patients with a vocal cord carcinoma were treated with radium contact irradiation after thyroid cartilage windowing at the ENT University Clinic Essen. The period of study extended from 1972 to 1983. 88,6% of the patients with vocal cord carcinoma, who showed a typical localisation for radium contact irradiation, became recurrence-free. About 88,0% of the patients, who were led through an irradiation treatment of extended indication, became recurrence-free. A normal vocal function was achieved in 71,7% of all cases.

Brachytherapy↗