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At least 631 records · Page 35Linked to original sources
PubMed1984

Aphakic cystoid macular edema. The pharmacology of ocular trauma.

Ocular tissues, like those of other organs, exhibit limited morphologic reactions to trauma, i.e., hyperemia, abrupt vasodilation, increased blood flow; increased permeability of blood vessels, edema and increased tissue pressure (disrupted blood-ocular barrier); and later, a cellular inflammatory response. The cystoid macular edema (CME) that occurs after surgery for cataract has a considerably higher incidence in more severely traumatized eyes. It is characterized by increased perifoveal capillary permeability that may be related either to prior vasoconstriction or to vasodilation, and it may be accompanied by a cellular inflammatory response either in the (uvea) ciliary body, vitreous, or retina, or in combination thereof. Virtually all the physiologic, metabolic, and morphologic responses to trauma can be assigned to liberation of endogenous mediators. The lesions that occur after ocular trauma may be related to the synthesis and release of prostaglandins. There is moderate support for this hypothesis, but other or additional endogenous mediators must also be considered as contributing to the production of retinal edema as a nociceptive response to trauma. The various factors that may contribute to development of CME, and their mechanisms of action, are discussed. The speculations and hypotheses contained in this review need to be confirmed or denied by applications to the eye of techniques that have been used successfully in other organ systems. Adequate prophylaxis may be provided by cyclooxygenase inhibitors, but it is more likely accomplished with corticosteroids. However, definitive clinical tests have not been done, and it should be noted that excellent surgery with minimal disruption of the blood-ocular barrier is the best prophylaxis for this iatrogenic disease. When the lesion is established and does not respond to large doses of corticosteroids, a careful study is needed to decide whether vitreous inflammation and/or strand formation accounts for the irreversibility.

Animals↗
PubMed1992

Pneumoscrotum: report of two cases and review of mechanisms of its development.

Scrotal emphysema and, less frequently, pneumatocele are uncommon signs of pneumoscrotum caused by a variety of pathogenic and iatrogenic disease processes. The finding of air in the scrotal sac may be an early sign of a life-threatening condition or may represent an incidental finding associated with more benign conditions. The three basic mechanisms by which air becomes localized to the scrotum are discussed, the literature is reviewed, and 2 new cases are presented.

Aged↗
PubMed1995

[Drug-induced hepatitis: epidemiologic, clinical, diagnostic and physiopathologic aspects in 1995].

Drug-induced hepatotoxicity is a major cause of iatrogenic diseases. More than 900 compounds, including herbal medicines are involved and can reproduce the full spectrum of liver injuries. Acute hepatitis are the most frequently observed. Three types are described: acute hepatocellular hepatitis which are frequently similar to viral hepatitis, and can lead to fulminant liver failure and death within a few days, or, more insidiously, to cirrhosis; acute cholestatic hepatitis, which exhibits a better prognosis, may be misleading by mimicking biliary obstruction; mixed-pattern hepatitis, which associates features of hepatocellular and cholestatic hepatitis. Acute hepatitis generally exhibits no specific patterns. Then, the diagnosis is difficult and relies upon the elimination of other causes and a compatible or a suggestive time-relationship between drug ingestion and the onset of hepatitis as well as between drug withdrawal and recovery. Sometimes, drug hepatotoxicity is suggested by the association of hepatitis to hypersensitivity manifestations (hypereosinophilia), to some histopathological features (eosinophilic infiltration, microvesicular steatosis, giant hepatocytes) or, more uncommonly, to specific autoantibodies (anti-mitochondrial type 6, anti-LKM2, anti-LM antibodies). Cross hepatotoxicity may occur between drugs having related chemical structures.

Acute Disease↗
PubMed1997

The pacemaker syndrome -- a matter of definition.

Pacemaker syndrome is an iatrogenic disease that is often underdiagnosed. We propose that pacemaker syndrome represents the clinical consequences of suboptimal atrioventricular (AV) synchrony or AV dyssynchrony, regardless of the pacing mode. Clinicians implanting and programming pacemakers should attempt to optimize AV synchrony to prevent the occurrence of pacemaker syndrome.

Cardiac Output, Low↗
PubMed1977

Enlarging intratracheal tube cuff diameter: a quantitative roentgenographic study of its value in the early prediction of serious tracheal damage.

A prospective study to radiographically document impending tracheal damage in patients on continuous mechanical ventilation was done in 135 intubated adult patients over an eighteen month period. The previously unrecognized enlarging cuff/trachea ratio over 150% was seen in 18 patients. Five of 9 patients who died with C/T ratio over 150% were autopsied; all had severe tracheal damage at the cuff site. Four of 5 patients who were decannulated/extubated developed tracheal stenosis at the cuff site, necessitating tracheal resection in 3 patients. Thus a C/T ratio over 150% is a reliable clinical indicator of tracheal damage. Some thoughts as to prevention of this iatrogenic disease are presented.

Adolescent↗
PubMed1987

Esophageal perforation in the neonate: an emerging problem in the newborn nursery.

We report 11 cases of esophageal perforation in the neonate, in whom no surgery was performed for repair of the perforation, nor was any cervical or mediastinal drainage carried out. The perforation was in the cervical esophagus in all cases where an esophagram was performed. Nine were in premature babies (580 to 1,350 g), and two were full-term babies. There were two deaths in small prematures (580 and 935 g), from extreme prematurity and intraventricular hemorrhage, with no morbidity or mortality related to the esophageal perforation. The babies presented as esophageal atresia, or pneumothorax with the feeding tube in the right chest, or an abnormal right upper extrapleural air collection with infiltrate. Barium esophagram showed a classic "double esophagus" configuration. Two babies were mistakenly operated on, one with a diagnosis of esophageal duplication, and one had a gastrostomy for a diagnosis of esophageal atresia. Esophageal perforation in the neonate is an iatrogenic disease that may mimic esophageal atresia, and may be managed without surgical intervention.

Diagnosis, Differential↗
PubMed2001

Revision endoscopic frontal sinus surgery.

Frontal sinusitis following functional endoscopic sinus surgery may represent persistent, recurrent, or iatrogenic disease. The narrow frontal recess is unforgiving of technical errors, and surgery within its confines requires ample training, skill, and patience. Revision surgery in this area, compromised by scarring and long-standing mucosal disease, demands even more of the endoscopic sinus surgeon. While successful treatment of this condition is a formidable task, strict attention to principles of proper medical and surgical therapy can increase the chances of a favorable outcome.

Chronic Disease↗
PubMed2001

[Ureteral complications of retroperitoneal prosthetic vascular surgery].

OBJECTIVE: Ureteral obstruction following retroperitoneal vascular by-pass has rarely been reported in the international world literature (only 169 cases). That's why we present three new cases to contribute at best knowledge of this iatrogenic disease. MATERIAL AND METHOD: Our cases were diagnosed by symptoms (number 2 and 3) and incidentally (number 1). The case 3 is exceptional because only 6 cases were previously described. RESULTS: Three different treatments were applied in our cases. The urinary fistula resulted into nephrectomy and the others were treated by endourological and reconstructive methods. We noted that the added comorbidity factors in all these cases make the pronogstic hazardous.

Blood Vessel Prosthesis Implantation↗
PubMed2001

Biomechanics of the cervical spine Part 2. Cervical spine soft tissue responses and biomechanical modeling.

OBJECTIVE: The responses and contributions of the soft tissue structures of the human neck are described with a focus on mathematical modeling. Spinal ligaments, intervertebral discs, zygapophysial joints, and uncovertebral joints of the cervical spine are included. Finite element modeling approaches have been emphasized. Representative data relevant to the development and execution of the model are discussed. A brief description is given on the functional mechanical role of the soft tissue components. Geometrical characteristics such as length and cross-sectional areas, and material properties such as force-displacement and stress-strain responses, are described for all components. Modeling approaches are discussed for each soft tissue structure. The final discussion emphasizes the normal and abnormal (e.g., degenerative joint disease, iatrogenic alteration, trauma) behaviors of the cervical spine with a focus on all these soft tissue responses. A brief description is provided on the modeling of the developmental biomechanics of the pediatric spine with a focus on soft tissues. Relevance. Experimentally validated models based on accurate geometry, material property, boundary, and loading conditions are useful to delineate the clinical biomechanics of the spine. Both external and internal responses of the various spinal components, a data set not obtainable directly from experiments, can be determined using computational models. Since soft tissues control the complex structural response, an accurate simulation of their anatomic, functional, and biomechanical characteristics is necessary to understand the behavior of the cervical spine under normal and abnormal conditions such as facetectomy, discectomy, laminectomy, and fusion.

Adult↗
PubMed1984

Myospherulosis of the mandible. Report of a case and review of the literature.

A case of myospherulosis in a 67-year-old female is reported. The lesion appeared as a submucosal mass firmly attached to the buccal periosteum of the right molar region of the mandible. Although the records of our case did not specify what medication was placed in the lesion, clinicopathologic features further supported the hypothesis that myospherulosis may be a unique instance of iatrogenic disease caused by petrolatum-based antibiotic ointments.

Aged↗
PubMed2002

Potential drug-drug interactions in elderly patients presenting with syncope.

Adverse drug reactions and interactions are a common cause of iatrogenic disease. Although there are resources available that have been developed for assessing potential drug-drug interactions (DDIs), one must first consider the possibility in order to apply these tools. This cross-sectional analysis of elderly patients evaluates Emergency Physician documentation of potential DDIs and assesses the utility of computer software recognition of interactions that can lead to syncope. In this study, lack of documentation of a patient's past medical history and medications suggests that Emergency Physicians are not evaluating DDIs as a possible source of their patient's symptoms. The computer resources evaluated were found to be easy to use and reliable. Rectifying and preventing potential DDIs can be an indispensible service provided by the Emergency Physician.

Aged↗
PubMed2006

The causation and prevention of bed sores.

The best recognised and most widespread example of tissue necrosis is the 'bed sore'. This is said to be the commonest iatrogenic disease and the bed has been called the most dangerous splint yet devised by mankind. Factors which may play a significant part in tissue necrosis are discussed, followed by the logistics of a programme to prevent the development of bed sores. It is suggested that the problem is one of economic feasibility rather than lack of preventive knowledge.

Humans↗
PubMed1999

Topical inhalant steroid (budesonide, Pulmicort nasal) therapy in intubation granuloma.

Intubation granuloma of the larynx is an iatrogenic disease which is induced by endotracheal intubation. It has basically been managed by conservative medical treatment with observation. Surgical excision can be considered as a last resort due to the high recurrence rate which subjects the patients to repeated anaesthesia. The purpose of this study is to evaluate the therapeutic effect of topical steroid in intubation granuloma, comparing the results of conservative medical treatment with, or without, surgery (Group I, 14 patients) and inhalant therapy with topical budesonide (Group II, 20 patients). In Group I, complete disappearance of granuloma occurred in six cases within a year (42.8 per cent) with conservative therapy only. Microlaryngeal surgery was performed on the eight cases of persisting granuloma after conservative therapy for a year, resulting in two cases of recurrence. In Group II, the granuloma disappeared completely in 85 per cent within six months and in 95 per cent within 12 months without any remarkable side-effects. We concluded that intubation granuloma of the larynx could be treated with topical inhalant steroid as the first choice of therapy rather than other medical treatment or surgical intervention.

Administration, Inhalation↗
PubMed1997

Low albumin gradient ascites complicating severe pseudomembranous colitis.

Pseudomembranous colitis (PMC) is a frequently severe, sometimes fatal iatrogenic disease that is antibiotic-associated in almost all cases. The most common clinical features of PMC include abdominal pain, watery diarrhea, fever, leukocytosis, hypoalbuminemia, and hypovolemia. Ascites, not considered a well-known feature of PMC, is fairly common, based on a review of the English language literature but has not been characterized fully. This case report describes 5 patients with PMC who presented with low serum-ascites albumin gradient (SAAG) and neutrocytic ascites, without evidence of infectious, malignant, or inflammatory peritoneal disease, which has not been reported previously. In 1 patient, massive low SAAG ascites was the presenting manifestation of PMC, a feature also not reported previously. Three of the 5 (60%) patients had acquired immunodeficiency syndrome. The characteristics of the fluid specimens in these 5 patients and the possible pathogenetic mechanisms are proposed. The findings suggest that PMC should be included in the differential diagnosis of low SAAG ascites, especially in patients with acquired immunodeficiency syndrome.

Acquired Immunodeficiency Syndrome↗
PubMed1977

[Retrolental fibroplasia: retrospective study (author's transl)].

Retrolental fibroplasia (RLF) is an iatrogenic disease of immature or dystrophic newborns who had been given oxygen treatment. Exchange transfusions seem to be of aetiological importance because they change the oxygen dissociation curve. Oxygen treatment of the newborn requires exact monitoring which can be done only in specially equipped departments. The retinal changes, up to the full-blown picture of RLF, progress rapidly. Ophthalmological control is, therefore, necessary as early as four weeks of age. If early RLF changes are demonstrated serial examinations every two weeks are indicated so that, if progression is demonstrated, treatment can be instituted.

Age Factors↗
PubMed1993

Drug-resistant tuberculosis.

Multidrug-resistant tuberculosis (MDRTB) is an iatrogenic disease that is emerging as a major infectious disease problem throughout the world. The AIDS pandemic, increased incidence of tuberculosis in populations with easy access to antituberculosis medications, the deterioration of the public health infrastructure, and inadequate training of health care providers in the epidemiology of tuberculosis are some of the factors contributing to the increased incidence of MDRTB. Mortality from MDRTB exceeds 80% in persons infected with human immunodeficiency virus (HIV) but is also high in patients free of HIV. The management of MDRTB is complicated by the lack of methods for rapid detection of resistant strains of Mycobacterium tuberculosis. The risk of infection among close contacts of patients with MDRTB, the probability of the development of active MDRTB after infection, and the likelihood of cure of MDRTB need to be determined quantitatively. Attributable risk estimates for factors associated with MDRTB should be calculated for each community as part of the strategies to prevent MDRTB. Issues regarding chemoprophylaxis in newly infected contacts of MDRTB cases remain unanswered. Basic research on the mechanisms of action of existing antituberculosis drugs may contribute to an understanding of the mechanism of resistance in M. tuberculosis. There is an urgent need to expand the scope of epidemiological, clinical, and laboratory research to address these problems.

Drug Resistance, Microbial↗