Abstract:
:Metabolic acidosis and hyperlactataemia are important, independent findings in acute illness, and the combination of these abnormalities carries a grave prognosis. Despite this there is still controversy about the most appropriate therapy of lactic acidosis, and the relationship of commonly used acid base measurements to blood lactate levels. This paper details studies in shock and multiple organ failure examining these issues. Shocked patients were studied during catecholamine therapy and showed improvements in acidosis and hyperlactataemia in conjunction with cardiorespiratory improvement. This supports a beneficial role for these agents in appropriately monitored, volume resuscitated and oxygenated patients with shock and lactic acidosis. Assessment of differences in mixed venous and arterial acid base status was performed in 32 patients. The relationship of blood lactate to acid base measurements was examined. There were no significant differences in [H+], [HCO3] or base excess. There was no significant correlation between any of these in arterial or mixed venous samples and arterial whole blood lactate. Mixed venous PCO2 was significantly higher than arterial PCO2. Haemodynamic, oxygen transport and acid base changes were documented in eight patients with multiple organ failure being treated by intermittent high volume haemofiltration (Gambro AK10 system) with lactate buffered replacement fluid PCO2 (Gambro haemofiltrasol). Cardiac output and oxygen delivery fell significantly during therapy but blood pressure was maintained by an increase in systemic vascular resistance as we have shown previously. Serious acid base derangements were not seen. Significant hyperlactataemia was present throughout haemofiltration as a result of the infusion of replacement fluid containing 45 mmol/l lactate. The only alterations in acid base status were transient falls in arterial bicarbonate and base excess at one hour.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Nimmo GR,Grant IS,Mackenzie SJsubject
Has Abstractpub_date
1991-01-01 00:00:00pages
S56-61eissn
0032-5473issn
1469-0756journal_volume
67 Suppl 1pub_type
杂志文章abstract::A patient with Laurence-Moon-Biedl syndrome and nephrotic range proteinuria is presented. Radiological investigation of the urinary tract revealed clubbed calyces but no evidence of obstruction or vesicoureteric reflux. Renal biopsy revealed occasional sclerotic glomeruli, extensive foot-process fusion and segmental g...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.64.754.621
更新日期:1988-08-01 00:00:00
abstract::The effects of cholestyramine in the peritoneal cavity of the rat are described. Cholestyramine causes mild peritonitis with adhesion formation between the liver and the omentum. In the management of biliary peritonitis, a lavage solution containing a suspension of cholestyramine would appear to be contra-indicated by...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.55.650.881
更新日期:1979-12-01 00:00:00
abstract::Autoimmune pancreatitis (AIP) is a form of chronic pancreatitis characterised clinically by frequent presentation with obstructive jaundice, histologically by a lymphoplasmacytic infiltrate with fibrosis, and therapeutically by a dramatic response to steroids. When so defined, AIP can be sub-classified into two subtyp...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2012-304224rep
更新日期:2014-01-01 00:00:00
abstract::Hypertension is a chronic disorder which often entails debilitating cardiovascular and renal complications. Hypertension mostly arises as a complex quantitative trait that is affected by varying combinations of genetic and environmental factors. Secondary hypertension has been encountered with increasing frequency. Th...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2011.118661
更新日期:2011-10-01 00:00:00
abstract::The body composition of the 17 members of the BMRES was studied using body weight and fat fold calipers, with measurements of whole body potassium and nitrogen. The full assessment was made just before departure from Birmingham and immediately on return. Daily observations of body weight and fat folds were made during...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.55.645.475
更新日期:1979-07-01 00:00:00
abstract:OBJECTIVE:Lactate dehydrogenase (LDH) anomaly is one of the macroenzymes. Macroenzymes are enzymes in serum that have formed high molecular mass complexes, either by self polymerisation or by association with other serum components. The aim of this study was to identify the properties of LDH anomaly and observe the cha...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2003.015420
更新日期:2004-08-01 00:00:00
abstract::A patient with the unusual post mortem finding of myocardial metastatic carcinoid tumour without classical valvular or endocardial carcinoid disease is described. This rare occurrence may represent an aggressive type of carcinoid tumour, with metastatic disease occurring before the development of classical fibrous val...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.72.854.751
更新日期:1996-12-01 00:00:00
abstract::Staging for non-small cell lung cancer (NSCLC) requires accurate assessment of the mediastinal lymph nodes which determines treatment and outcome. As radiological staging is limited by its specificity and sensitivity, it is necessary to sample the mediastinal nodes. Traditionally, mediastinoscopy has been used for eva...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2009.089391
更新日期:2010-02-01 00:00:00
abstract::Malignant hyperthermia is a rare autosomal dominant trait that predisposes affected individuals to great danger when exposed to certain anaesthetic triggering agents (such as potent volatile anaesthetics and succinylcholine). A sudden hypermetabolic reaction in skeletal muscle leading to hyperthermia and massive rhabd...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.74.867.11
更新日期:1998-01-01 00:00:00
abstract::In severe appendicitis, the effect of a single intravenous dose of metronidazole (500 mg) was compared with cefoxitin (1 g). The antibiotics were given by random allocation once the diagnosis had been established at operation. In the metronidazole group, 5 out of 48 patients developed a wound infection whilst in hospi...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/pgmj.59.697.720
更新日期:1983-11-01 00:00:00
abstract::Forty-five healthy men aged 21-34 years took part in a double-blind, parallel-group, placebo-controlled study of the effects of 28 days' treatment with lornoxicam 4 mg twice daily or indomethacin 50 mg twice daily on faecal blood loss and the endoscopic appearances of gastric and duodenal mucosa. After an initial endo...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/pgmj.66.778.622
更新日期:1990-08-01 00:00:00
abstract::There is an increasing awareness on the part both of the media and the profession of the need to co-operate in providing information and education on medical matters. This co-operation should be strongly encouraged. Where children are concerned the opportunities for education are great. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.54.629.225
更新日期:1978-03-01 00:00:00
abstract::During the previous 34 months, 3 hypertensive patients on long-term thiazide therapy were admitted to the medical department, Mubarak Hospital, Kuwait, with atrial fibrillation (AF) and hypokalaemia. They received potassium chloride by intravenous infusion, followed by oral therapy with reversion to sinus rhythm. Ther...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.62.734.1125
更新日期:1986-12-01 00:00:00
abstract:PURPOSE:Large population studies now demonstrate that frailty is prevalent in all adult age groups. Limited data exist on the association between frailty and surgical outcome in younger patients. The aim of the study was to explore the agreement between frailty identification tools and collect pilot data on their predi...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2020-139417
更新日期:2021-01-12 00:00:00
abstract::A 48 year old white woman was admitted to the hospital because of several bouts of migratory polyarthritis, weight loss, fever, and abdominal pain over a period of 15 months. She had been taking propylthiouracil 100 mg daily for three years for hyperthyroidism treatment. A test for antineutrophil cytoplasmic autoantib...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2004.026104
更新日期:2005-05-01 00:00:00
abstract::A 19-year-old girl developed generalised anhidrosis following typhoid fever. Elaborate investigations disclosed nothing abnormal. A skin biopsy revealed the presence of atrophic as well as normal eccrine glands. This appears to be the third case of its kind in the English literature. It is postulated that typhoid feve...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.71.837.435
更新日期:1995-07-01 00:00:00
abstract::New-onset seizures are frequent manifestations of central nervous system disorders in patients infected with human immunodeficiency virus (HIV). Seizures are more common in advanced stages of the disease, although they may occur early in the course of illness. In the majority of patients, seizures are of the generalis...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.75.885.387
更新日期:1999-07-01 00:00:00
abstract::Twenty-six patients with acute leukaemia and other malignancies susceptible to varicella were vaccinated with the Oka-strain live attenuated varicella vaccine during maintenance chemotherapy. All recipients showed no adverse clinical reactions. There was no spread of vaccine virus. Seroconversion was 94% in seronegati...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::Percutaneous endoscopic gastrostomy (PEG) was performed on 28 elderly patients (mean age 82 years) who were dysphagic and intolerant of naso-gastric feeding. Twenty-six patients were recovering from a stroke; the interval between the onset of stroke and PEG averaged 63 days. The procedure was successful and well toler...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.67.786.371
更新日期:1991-04-01 00:00:00
abstract::A child with the isolated anomaly of azygos continuation of the inferior vena cava is presented. The interest of this abnormality lies in its detection as a mediastinal mass on the chest radiograph. Computed tomography with intravenous contrast enhancement is the method of choice to diagnose this venous anomaly. Aware...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.762.253
更新日期:1989-04-01 00:00:00
abstract::The factors related to the occurrence of bacteraemia following urinary tract manipulation were studied in a large community hospital. During a 3-year period, forty-six of 326 episodes of hospital-acquired bacteraemia were associated with urinary tract manipulation. All thirty of forty-six cases felt to be definitely r...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.54.636.668
更新日期:1978-10-01 00:00:00
abstract::The healthcare industry has seen an increase in the adoption of team training, such as crew resource management (CRM), to improve teamwork and coordination within acute care medical teams. A meta-analysis was carried out in order to quantify the effects of CRM training on reactions, learning, behaviour and clinical ca...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,meta分析
doi:10.1136/postgradmedj-2014-132800
更新日期:2014-12-01 00:00:00
abstract::Patients with Cushing's syndrome rarely become pregnant. This is a high risk situation both for the fetus and the mother, if untreated. We report a patient with Cushing's syndrome due to adrenocortical adenoma who became pregnant and was successfully treated with ketoconazole during the last period of pregnancy. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.66.773.221
更新日期:1990-03-01 00:00:00
abstract::Mild and self-limiting fever following bleomycin use is common, and a fatal hyperpyrexial response occurs rarely. In previously reported cases, such hyperpyrexia occurred either after the initial administration of the drug or during subsequent therapy following an initial pyrexial response. We describe a fatal hyperpy...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.764.417
更新日期:1989-06-01 00:00:00
abstract::Clinical and biochemical data obtained from 163 patients who had taken an overdose of paracetamol were examined to determine which factors or measurements were of value in predicting the severity of ensuing liver damage early after ingestion of tablets. Although the overall severity of hepatic necrosis was found to in...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.619.243
更新日期:1977-05-01 00:00:00
abstract::Most consultants are involved in the training and assessment of several grades of doctors in training especially senior house officers (SHOs) and specialist registrars. In the medical and other specialties there is an increasing trend towards assessing junior doctors' competency using the record of in-training assessm...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pmj.2003.011718
更新日期:2004-02-01 00:00:00
abstract:AIMS:To review the clinical and pathological factors associated with fulminant amoebic colitis (FAC) requiring colonic resection and its outcome. METHODS:We retrospectively identified adult patients admitted to our centre between June 2007 and December 2011 with FAC who underwent colonic resection and were diagnosed w...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2014-132597
更新日期:2015-04-01 00:00:00
abstract::Tourette's syndrome is a neuropsychiatric disorder characterised by motor and phonic tics. Although tics are common in children, only about 1% of those affected meet the criteria for Tourette's syndrome, and many are not disabled by it. Associated problems such as attention deficit hyperactivity disorder and obsessive...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2010.223685rep
更新日期:2011-02-01 00:00:00
abstract:INTRODUCTION:Potentially inappropriate medication (PIM) prescribing is a global problem. Limited data are available on the prevalence of PIMs in elderly patients with chronic kidney disease (CKD). We examined the PIM prevalence in elderly patients with CKD, the most common drugs implicated and the levels of polypharmac...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2012-130889
更新日期:2013-05-01 00:00:00
abstract::A 65 year old man was admitted with segmental consolidation of the left upper lobe after having stayed in a hotel for 2 days. He deteriorated rapidly on conventional antibiotic therapy and required ventilatory support. Acinetobacter calcoaceticus var. anitratus was grown from the sputum and blood cultures, which was t...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.69.818.934
更新日期:1993-12-01 00:00:00