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684201. Cerbera odollam: a 'suicide tree' and cause of death in the state of Kerala, India. (Abstract)

Cerbera odollam: a 'suicide tree' and cause of death in the state of Kerala, India. Cerbera odollam is a tree belonging to the poisonous Apocynaceae family, which includes the yellow and common oleanders. The seeds are excessively toxic, containing cerberin as the main active cardenolide. Cerbera venenifera, a related species found in Madagascar, has a long history as an ordeal poison, and was responsible for the death of 3000 people per year in previous centuries. The odollam tree

2004 Journal of Ethnopharmacology

684202. Induction and mechanism of apoptotic cell death by propofol in HL-60 cells. (Abstract)

Induction and mechanism of apoptotic cell death by propofol in HL-60 cells. Apoptosis (programmed cell death) occurs in various physiological and pathological conditions, exhibits a characteristic mechanism of intracellular sequential reaction and may be involved in determining clinical outcome. The antioxidant activity of propofol (2,6-diisopropylphenol) together with the stimulating effect of protein kinase C suggests that propofol might have the potential to modulate apoptosis. Thus (...) in growth inhibition with the formation of apoptotic bodies in a concentration-dependent manner. DNA fragmentation and ladder formation was also observed in a concentration-dependent manner. Propofol treatment resulted in activation of caspase-3, -6, -8 and -9, thereby suggesting that cell surface death receptor activation of the caspase cascade mediates propofol-induced apoptosis with consequent formation of the cleaved product of Bid (a pro-apoptotic Bcl-2 family member protein) and activation

2002 Acta Anaesthesiologica Scandinavica

684203. Fatal lipoid pneumonia due to bronco-aspiration of isoparaffin after ingestion of an organophosphate insecticide. (Abstract)

Fatal lipoid pneumonia due to bronco-aspiration of isoparaffin after ingestion of an organophosphate insecticide. A 66-year-old-male patient with a history of depression voluntarily ingested around 400 ml of an insecticide composed of 5% methylparathion, 75% isoparaffin, 8% etoxylated oleic acid, 4% 1,2,4-trimethylbenzene, 6% naphtha, 1% 1,3,5- trimethylbenzene, 0.4% propylbenzene and 0.3% xylene. The patient was conscious and alert at admission. Gastric lavage was performed and activated (...) . Abundant lipin-laden macrophages were observed within the alveolar spaces. We review the most relevant aspects of cases of fatal lipoid pneumonia and point out that on occasion severe or fatal intoxication is due to the substances accompanying the active ingredients.

2003 Acta Anaesthesiologica Scandinavica

684204. Brain death: an important paradigm shift in the 20th century. (Abstract)

Brain death: an important paradigm shift in the 20th century. The description of death in medical or pathophysiological terms changed during the last century. The focus of attention shifted from the condition of the heart to the state of the brain. The current paper investigates the time period from 1866, when the effects of an increased intracranial pressure (ICP) were studied experimentally, to 1967, when the first heart transplantation was performed. Between 1894 and 1965 four neurosurgeons (...) : Horsley in England, Cushing in USA, Wertheimer in France and Frykholm in Sweden made important contributions. Documented discussions, if ventilator treatment should be stopped in patients with a dead brain and a beating heart, began in 1959. However, already during the latter part of the 19th century it was shown that the heart could continue to beat if artificial ventilation was performed, when spontaneous respiration had ceased due to a high ICP. Furthermore, brain death was by chance implemented

2003 Acta Anaesthesiologica Scandinavica

684205. A fatal case of malignant hyperthermia complicated by generalized compartment syndrome and rhabdomyolysis. (Abstract)

A fatal case of malignant hyperthermia complicated by generalized compartment syndrome and rhabdomyolysis. A healthy 21-year-old male who had previously been anaesthetized without complications underwent a laparotomy following a skiing accident. He developed severe malignant hyperthermia. The initial reaction was successfully treated with dantrolene, but during the following days the patient developed several compartment syndromes requiring fasciotomies. The patient died of hyperkalaemia

2003 Acta Anaesthesiologica Scandinavica

684206. Postrelapse survival in osteosarcoma of the extremities: prognostic factors for long-term survival. Full Text available with Trip Pro

Postrelapse survival in osteosarcoma of the extremities: prognostic factors for long-term survival. To identify factors that influence postrelapse survival (PRS) in patients with nonmetastatic osteosarcoma of the extremity.One hundred sixty-two patients with recurrent osteosarcoma of the extremity were retrospectively reviewed. The first-line treatment included surgery of the primary lesion and chemotherapy with methotrexate, doxorubicin, cisplatin, and ifosfamide.The projected 5-year PRS rate

2003 Journal of Clinical Oncology

684207. Ethyl ether fraction of Gastrodia elata Blume protects amyloid beta peptide-induced cell death. (Abstract)

Ethyl ether fraction of Gastrodia elata Blume protects amyloid beta peptide-induced cell death. Alzheimer's disease is the most common cause of dementia in the elderly. Recently, it has been reported that Alzheimer's disease is associated with cell death in neuronal cells including the hippocampus. Amyloid beta-peptide stimulates neuronal cell death, but the underlying signaling pathways are poorly understood. In order to develop anti-dementia agents with potential therapeutic value, we (...) examined the effect of the herbal compound Gastrodia elata Blume (GEB) on neuronal cell death induced by amyloid beta-peptide in IMR-32 neuroblastoma cells. The fractionation of GEB was carried out in various solvents. The hydroxyl radical scavenging effect of the ethyl ether fraction was more potent than any other fractions. In cells treated with amyloid beta-peptide, the neuroprotective effect of the ethyl ether, chloroform, and butanol fractions was 92, 44, and 39%, respectively, compared

2003 Journal of Ethnopharmacology

684208. Dissemination of information on potentially fatal adverse drug reactions for cancer drugs from 2000 to 2002: first results from the research on adverse drug events and reports project. (Abstract)

Dissemination of information on potentially fatal adverse drug reactions for cancer drugs from 2000 to 2002: first results from the research on adverse drug events and reports project. To describe the clinical findings, occurrence rates, causality evidence, and dissemination media for serious cancer drug-associated adverse drug reactions (ADRs) reported in the postmarketing setting.ADRs were termed serious if they resulted in death or severe organ failure. ADR information for oncology drugs

2003 Journal of Clinical Oncology

684209. Treatment with granulocyte colony-stimulating factor after allogeneic bone marrow transplantation for acute leukemia increases the risk of graft-versus-host disease and death: a study from the Acute Leukemia Working Party of the European Group for Blood a (Abstract)

Treatment with granulocyte colony-stimulating factor after allogeneic bone marrow transplantation for acute leukemia increases the risk of graft-versus-host disease and death: a study from the Acute Leukemia Working Party of the European Group for Blood a Granulocyte colony-stimulating factor (G-CSF) is given after bone marrow transplantation (BMT) to shorten the neutropenic phase. Its effects have not been evaluated in a large patient population.We studied 1,789 patients with acute leukemia (...) neutrophils greater than 0.5 x 10(9)/L (P <.01), but platelet engraftment ( > 50 x 10(9)/L) was slower (P <.001). In the BMT patients, acute graft-versus-host disease (GVHD) grades II to IV was 50% +/- 5% (+/- 95% CI) in the G-CSF group versus 39% +/- 3% in the controls (relative risk [RR], 1.33; P =.007, in the multivariate analysis). The incidence of chronic GVHD was also increased (RR, 1.29; P =.03). G-CSF was associated with an increase in transplantation-related mortality (TRM; RR, 1.73; P =.00016

2004 Journal of Clinical Oncology

684210. Difficulty in brainstem death testing in the presence of high spinal cord injury. Full Text available with Trip Pro

Difficulty in brainstem death testing in the presence of high spinal cord injury. In the UK, when the standard brain death criteria are met, further investigations are not necessary. Confirmatory tests can be useful, however, when it is not possible to carry out all of the brainstem tests. We report the case of a patient with multiple trauma and a high spinal cord injury who was apnoeic. Confirmatory tests (EEG, brainstem, auditory evoked potential) were essential in supporting the diagnosis (...) of brainstem death to allow withdrawal of artificial ventilation, as organ donation was being considered.

2004 British Journal of Anaesthesia

684211. Fatal streptococcal necrotizing fasciitis as a complication of axillary brachial plexus block. Full Text available with Trip Pro

Fatal streptococcal necrotizing fasciitis as a complication of axillary brachial plexus block. A 74-yr-old diabetic woman developed necrotizing fasciitis of the right upper limb after axillary brachial plexus block for carpal tunnel decompression. Clinical signs included oedema, diffuse swelling and bullae; rapidly followed by toxic shock syndrome and multiorgan failure. The patient died 48 h after hospital admission, despite broad-spectrum antibiotics, surgical treatment and supportive

2004 British Journal of Anaesthesia

684212. Fatal myocardial infarction after lung resection in a patient with prophylactic preoperative coronary stenting. Full Text available with Trip Pro

Fatal myocardial infarction after lung resection in a patient with prophylactic preoperative coronary stenting. In this report we present the case of a 77-yr-old man who underwent resection of the upper lobe of the left lung for a carcinoma, six weeks after percutaneous transluminal coronary angioplasty (PTCA) with stenting of the left anterior descending (LAD) and circumflex coronary arteries. Antiplatelet therapy with clopidogrel was interrupted two weeks before surgery to allow for epidural

2004 British Journal of Anaesthesia

684213. Brainstem death testing in the UK--time for reappraisal? Full Text available with Trip Pro

Brainstem death testing in the UK--time for reappraisal? A diagnosis of brainstem death in the UK is based on clinical assessment rather than technical investigations, but is considered rigorous enough to be legally synonymous with death.A questionnaire in five sections concerning clinician details, initiation of support, criteria for testing, conduct of the tests, and the process of organ donation, was sent to all members of the Neuroanaesthesia Society.The survey reveals evidence of failure

2004 British Journal of Anaesthesia

684214. Fatal acute pulmonary embolism in a patient with pelvic lipomatosis after surgery performed after transatlantic airplane travel. (Abstract)

Fatal acute pulmonary embolism in a patient with pelvic lipomatosis after surgery performed after transatlantic airplane travel. We describe a case of a 37-yr-old patient who traveled from Europe to the United States and succumbed to a massive pulmonary embolism 6 days after elective pelvic surgery despite routine postoperative thrombotic prophylaxis. In retrospect, he was likely to have developed a deep venous thrombosis during the transatlantic trip to our hospital. Anesthesiologists

2004 Anesthesia and Analgesia

684215. Acute fatal haemorrhage during percutaneous dilatational tracheostomy. (Abstract)

Acute fatal haemorrhage during percutaneous dilatational tracheostomy. Percutaneous dilatational tracheostomy (PDT) is associated with a number of life-threatening complications. We present a case of massive and fatal arterial haemorrhage that occurred in the intensive care unit during an elective PDT on an 86-year-old woman following earlier evacuation of a traumatic subdural haematoma. An avulsed right subclavian artery was found at post mortem. Previous thyroid surgery and aberrant arterial (...) anatomy contributed to the fatal outcome.

2003 British Journal of Anaesthesia

684216. Brain stem death and organ donation--11 years on. (Abstract)

Brain stem death and organ donation--11 years on. We studied previously patterns of organ donation in a teaching hospital. Eleven years later we repeated the study to investigate how patterns had changed. We also wanted to see whether non-heart beating donation was being practised in our intensive care units.All deaths were prospectively audited to identify potential heart beating and non-heart beating organ donors. The actual organ donors and reasons for not donating were identified.Overall

2003 British Journal of Anaesthesia

684217. Non-fatal amniotic fluid embolism after cervical suture removal. (Abstract)

Non-fatal amniotic fluid embolism after cervical suture removal. We describe a case of pulmonary oedema occurring at 37 weeks gestation, following the attempted removal of a cervical suture under general anaesthesia. The use of an ultrasound technique to demonstrate the patient's fluid status is described. Signs of amniotic fluid embolism and how it exerts its influence on the circulation are discussed.

2003 British Journal of Anaesthesia

684218. Treatment of uncontrolled hemorrhagic shock after liver trauma: fatal effects of fluid resuscitation versus improved outcome after vasopressin. (Abstract)

Treatment of uncontrolled hemorrhagic shock after liver trauma: fatal effects of fluid resuscitation versus improved outcome after vasopressin. In a porcine model of uncontrolled hemorrhagic shock, we evaluated the effects of vasopressin versus an equal volume of saline placebo versus fluid resuscitation on hemodynamic variables and short-term survival. Twenty-one anesthetized pigs were subjected to severe liver injury. When mean arterial blood pressure was <20 mm Hg and heart rate decreased (...) , pigs randomly received either vasopressin IV (0.4 U/kg; n = 7), an equal volume of saline placebo (n = 7), or fluid resuscitation (1000 mL each of lactated Ringer's solution and hetastarch; n = 7). Thirty minutes after intervention, surviving pigs were fluid resuscitated while bleeding was surgically controlled. Mean (+/- SEM) arterial blood pressure 5 min after the intervention was significantly (P < 0.05) higher after vasopressin than with saline placebo or fluid resuscitation (58 +/- 9 versus 7

2004 Anesthesia and Analgesia

684219. Postoperative death in a patient with unrecognized arrhythmogenic right ventricular dysplasia syndrome. (Abstract)

Postoperative death in a patient with unrecognized arrhythmogenic right ventricular dysplasia syndrome. Arrhythmogenic right ventricular dysplasia is an inherited disease causing fatty replacement of heart tissue. This disease often presents as T-wave inversion in the anterior leads of the electrocardiogram (ECG) with life-threatening ventricular arrhythmias. In older patients, progressive right and left ventricular failure can develop. This is a case report of postoperative death occurring

2004 Anesthesia and Analgesia

684220. Do anesthesiologists die at a younger age than other physicians? Age-adjusted death rates. (Abstract)

significant younger mean age at death (crude mortality) (68.98 +/- 15.55 yr) (n = 723) than did internists (74.41 +/- 14.24 yr) (n = 2285) and all other physicians (75.21 +/- 13.3 yr) (n = 18,328) (P < 0.001). However, by factoring in the ages of the living members of the study populations, there was no statistical difference in age-specific mortality.It has been suggested that one of the potential occupational hazards of the practice of anesthesiology is premature death. This study disproves the notion (...) Do anesthesiologists die at a younger age than other physicians? Age-adjusted death rates. I designed this study to determine whether anesthesiologists are susceptible to premature death. Three specialty groups were studied: anesthesiologists, internists, and all other physicians. Records were examined of all American physicians who died in the years 1989, 1990, 1995, 2000, and 2001, and those who were alive at the end of 1989, 1995, 2000, and 2001. Anesthesiologists had a statistically

2004 Anesthesia and Analgesia

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