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At least 127 records · Page 7Linked to original sources
PubMed1998

Fatal and near-fatal complications of liposuction.

Cosmetic liposuction is considered to be safe and effective in properly selected patients and is widely done as an outpatient or office procedure. When major complications occur, office-based practitioners may refer patients to a hospital emergency department, where medical personnel unfamiliar with this procedure may underestimate the risk of serious infection or other major complications. We present two cases of massive necrotizing fasciitis treated in a burn center after liposuction surgery. One patient died, and the second required lengthy hospitalization, extensive debridement, and split-thickness skin grafting of 22% of the total body surface area. Pain out of proportion to clinical findings is a hallmark of necrotizing fasciitis and should prompt consideration of this entity even in the absence of cutaneous signs of infection. Definitive diagnosis is made by biopsy and rapid section histologic analysis. Liposuction may result in major complications or death. Emergency department physicians or general surgeons may be called upon to manage such complications and should be aware of these risks.

Abdominal Muscles↗
PubMed2000

Fatal and non-fatal chromobacterial septicemia: report of two cases.

Chromobacterium violaceum is frequently found in soil and water in tropical and subtropical regions. The organism rarely causes infection in humans, but is associated with a high mortality rate when it occurs. Septicemia associated with abscess in multiple organs such as the liver, skin, lungs, spleen, lymph nodes, and brain has been reported. We report on 2 patients with systemic infections with Chromobacterium violaceum. One presented with a fulminant course with multiple organ involvement and died 78 days later. The other presented with a milder course and survived after antibiotic therapy. In conclusion, infection with Chromobacterium violaceum is rare but its course is usually fulminant with high mortality especially in patients with sepsis and multiple organ involvement. We hope this report will provide additional information to physicians in the treatment of this disease.

Adult↗
PubMed1990

Surveillance of fatal and non-fatal farm injuries in Kentucky.

This report describes one approach to establish a surveillance method of farm injuries. The surveillance system is designed to be used to evaluate ongoing prevention activities related to education, training, and equipment design. To define the subset of information to be included in a surveillance system, existing data were analyzed. The mortality data were death certificates and the morbidity data were from the Farm Accident Survey conducted in 1978, (National Safety Council forms and sampling design). Limitations of the data currently available are discussed; information needs for an agricultural injury surveillance system are presented.

Accidents, Occupational↗
PubMed2001

Fatal and non fatal cardiac arrests related to anesthesia.

PURPOSE: The aim of this study was to assess the incidence and causes of cardiac arrests related to anesthesia. METHODS: All patients undergoing anesthesia over a six year period were included in a prospective study. The cardiac arrests encountered during anesthesia and the first twelve postoperative hours in the PACU or ICU were analysed. For each arrest, partially or totally related to anesthesia, the sequence of events leading to the accident was evaluated. RESULTS: Eleven cardiac arrests related to anesthesia were identified among the 101,769 anesthetic procedures (frequency: 1.1/10,000 [0.44-1.72]). Mortality related to anesthesia was 0.6/10,000 [0.12-1.06]. Age over 84 yr and an ASA physical status > 2 were found to be risk factors of cardiac arrest related to anesthesia. The main causes of anesthesia related cardiac arrest were anesthetic overdose (four cases), hypovolemia (two cases) and hypoxemia due to difficult tracheal intubation (two cases). No cardiac arrests due to alveolar hypoventilation were noted during the postoperative periods in either PACU or ICU. At least one human error was noted in ten of the eleven cardiac arrests cases, due to poor preoperative evaluation in seven. All cardiac arrests totally related to anesthesia were classified as avoidable. CONCLUSION: Efforts must be directed towards improving preoperative patient evaluation. Anesthetic induction doses should be titrated in all ASA 3 and 4 patients. The prediction of difficult tracheal intubation, and if required, the use of awake tracheal intubation techniques, should remain a priority when performing general anesthesia.

Adolescent↗
PubMed1991

Serum levels of tumor necrosis factor determine the fatal or non-fatal course of endotoxic shock.

The role of tumor necrosis factor alpha (TNF alpha) in endotoxin-induced shock was investigated in pigs receiving 5 micrograms kg-1 of Escherichia coli endotoxin (LPS) during 60 min of continuous infusion into the superior mesenteric artery. LPS concentration in aortic plasma, as determined by a chromogenic Limulus amoebocyte lysate (LAL) test, reached a peak of approximately 1000 ng l-1 during LPS infusion, and declined rapidly after discontinuation of the infusion. Serum TNF levels were determined by a bioassay using the L929 murine transformed fibroblast line. Eight of the 17 animals infused with LPS died within 30 min after beginning LPS administration, while the other 9 pigs survived beyond the experimental observation period of 3 h, although they were in a state of shock. No difference in LPS concentration was found between the survivors and the non-survivors. However, the serum TNF levels in non-survivors were significantly higher than in survivors when measured at 30 min after beginning LPS administration. In survivors, the peak increase in serum TNF levels was measured at 60 min after the beginning of LPS injection and returned rapidly to the baseline values. Although the role of TNF inducing rapid death seems to be dominant, the hemodynamic, hematology and blood chemistry disturbances seen during shock continued in survivors long after the return of TNF to baseline levels. These findings indicate that besides TNF other mediators are also involved in the LPS infusion-induced shock.

Anaphylaxis↗
PubMed1989

Fatal and non-fatal methomyl intoxication in an attempted double suicide.

A 79-year-old man and his 73-year-old wife attempted double suicide by ingesting methomyl powder. The woman died 19 h after ingestion in spite of intensive care. At autopsy a large number of miliary hemorrhages were found in both thalami of the brain. Her husband, however, recovered after 10 days of treatment. Methomyl (CAS No. 16752-77-5, Lannate) in the biological materials was analyzed by gas chromatography-mass spectrometry. The methomyl concentration was 44 micrograms/g in the wife's serum sample collected 1 h after ingestion, and 0.2 microgram/g in the blood sample collected at autopsy. The methomyl concentration in the husband's blood sample collected 28 h after ingestion was from 0.01 to 0.1 microgram/g. It is suggested that prompt and adequate intensive care including a direct hemoperfusion is necessary to effect the recovery of patients with lethal blood levels of methomyl. The miliary hemorrhages found in the thalami of the brain are suspected to have been caused by asphyxia induced by methomyl intoxication.

Aged↗
PubMed1990

Cocaine fatality: an unexplained blood concentration in a fatal overdose.

A case is presented of a 26-year-old female who died as a result of cocaine intoxication. A blood cocaine concentration of 330 mg/l, about 1.5 times greater than the highest concentration previously reported, was found. Blood benzoylecgonine and ecgonine methyl ester concentrations were 50 and 18 mg/l, respectively. The unusually high blood concentrations of cocaine and the metabolites are suggestive of a massive administration, however, the history suggests a series of recreational uses. The manner of death was undetermined.

Adult↗
PubMed2005

Fatal and non-fatal bilateral delayed carotid artery dissection after manual strangulation.

Carotid artery (CA) dissection and/or thrombosis may occur in a number of medical and forensic relevant situations. However, post traumatic carotid artery dissection is considered rare, and often underestimated due to possible delayed presentation. We describe two cases of carotid artery dissection following strangulation with delayed symptoms as well as discuss medical diagnostic problems and their forensic implications.

Adult↗
PubMed1999

A comparison of fatal with non-fatal knife injuries in Edinburgh.

Assault using a knife is a common problem in the United Kingdom. Between February 1992 and December 1996, 120 individuals died or received hospital treatment in Edinburgh after being assaulted with a knife. Twenty individuals (17%) died as a result of their injuries. Comparison of the survivors with non-survivors revealed both groups to have similar age and sex distributions, but those who died had significantly more severe injuries when scored according to the Abbreviated Injury Scale. Eight individuals died of unsurvivable chest injuries at the scene of the attack and of the remainder, only five reached hospital with signs of life. Analysis of hospital treatment using TRISS methodology revealed there to be two unexpected survivors and no unexpected deaths. The risk of death appears to depend mostly upon injuries sustained and also to a lesser extent upon other factors such as alcohol consumption and the presence of a bystander capable and willing to request emergency medical assistance. There does not appear to be much potential to save lives by improving hospital treatment for those assaulted with a knife in Edinburgh. Instead, greater focus needs to be placed upon rapid transfer to hospital and upon restricting the possession and use of knives.

Adolescent↗