Persistent paralysis in critically ill patients after long-term administration of vecuronium

Article Abstract:

Patients given the muscle relaxant vecuronium for more than two consecutive days may have neuromuscular paralysis from six hours to seven days after treatment has been discontinued. Patients studied had no movement, did not respond to stimulation and stopped breathing. The drug, which makes mechanical ventilation easier, caused more complications in women than men. Patients also had higher magnesium concentrations, metabolic acidosis, renal failure and high plasma concentrations of 3-desacetylvecuronium. There was no relationship between the amount of drug received, rate of administration or length of treatment and the onset of paralysis. Renal failure only occurred most often in paralyzed patients who had received the largest daily doses. This association was not true for patients who did not experience paralysis.

Causes of, Muscle relaxants, Paralysis

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A six-year-old girl with tick paralysis

Article Abstract:

All children who are hospitalized with difficulty walking and other signs of developing paralysis may have a tick on their scalp. Doctors report the case of a 6-year-old girl whose rapidly developing paralysis was thought to be Guillain-Barre syndrome. Two days after she was admitted to a hospital, a pediatric resident examined her long hair and found an engorged female tick on her scalp. The tick was removed with tweezers and within 24 hours, she had returned to normal. Many ticks produce a toxin that affects the nervous system.

Case studies, Tick paralysis

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Soluble triggering receptor expressed on myeloid cells and the diagnosis of pneumonia

Article Abstract:

The presence of a substance called triggering receptor expressed on myeloid cells (TREM-1) in fluid from the lungs of patients on a ventilator is a sign that the patient may have pneumonia, according to a study of 148 patients. TREM-1 was a more accurate indicator of pneumonia than many other symptoms and blood tests. TREM-1 is produced in greater amounts when bacteria and fungi infect the body.

Diagnosis, Physiological aspects, Pneumonia, Bacterial pneumonia

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