Aortic rupture

There is one other toxin, about which very little is known, which affects the heart and very rapidly causes death. This is sarafotoxin from the Middle Eastern Burrowing Asp Atractapsis engaddensis) it interacts with a specific receptor (the endothelin receptor) which causes blood vessel constriction (vasoconstriction). Sarafotoxin causes massive constriction of the blood vessels with a concomitant rise in blood pressure. This blood pressure rise can be so rapid and great that death results from blood vessel (e.g. aortic) rupture. 

Copper deficiency gives rise to many distinct aspects of pathology that can be identified with specific cuproenzymes - for example, depigmentation and low tyrosinase activity or aortic rupture and bone disorders and low lysyl oxidase activity. The normative copper requirement of non-ruminants is... 

Shah, C.S., Yang, K.H., Hardy, W.N., Wang, H.K., and King, A.I., Development of a Computer Model to Predict Aortic Rupture due to Impact Loading. SAE 2001-22-0007, Society of Automotive Engineers, Warrendale, PA, Stapp Car Crash /., 45 161-182,2001. 

Dennis LN, Rogers LF (1989) Superior mediastinal widening from spine fractures mimicking aortic rupture on chest radiographs. AJR Am J Roentgenol 152 27-30 Epstein NE, Epstein JA, Mauri T (1989) Treatment of fractures of the vertebral limbus and spinal stenosis in five adolescents and five adults. Neurosurgery 24 595-604 Ferguson RL, Allen BL Jr (1984) A mechanistic classification of thoracolumbar spine fractures. Clin Orthop Relat Res 77-88... 

Observational studies Another radioactive iodine compound, I, can be used in seed implants as an adjunct to surgical resection of advanced thoracic malignancies. In 59 patients who had close or positive margins on the surgical resection specimen, the use of I seeds resulted in local control rates of 80% at 1 year and 67% at 2 years [10 ]. Grade 3 and 4 adverse reactions, which were reported in seven subjects, included esopha-geal/bronchialfistulae, radiation pneumonitis, hydropneumothorax, persistent pneumothorax, and possible aortic rupture [11 . ... 

Complications Transverse myelitis, aortic rupture, and ulceration of the trachea and esophagus complicate bronchial artery infusion of chemotherapeutic agents. Fever, malaise, and chemical pneumonitis, in addition to skin necrosis, have also been reported. Hemoptysis has occurred in the absence of residual tumor, presumably related to the infusion itself. These complications have minimized the rewards of infusion. 

As might be expected, copper (Cu) is needed to maintain normal CAO levels as some is lost in normal metabolism. So in, for example, poultry, copper deficiency results in changes in elastin and death (largely) due to aortic ruptures. 

An early and specific sign of impendent aortic rupture can be observed in CT as a sickle-shaped hematoma within the thrombus of a large AAA (Rakita et al. 2007). Due to its high density, it can most clearly... 

Dangerous comphcations like aortic rupture, pericardial tamponade, or hemothorax can be identified easily by CT. However, echocardiography or MRI is required in order to determine the function of the valves. 

Accompanying IMHs can be detected in nonenhanced scans and verify the penetrating character of the lesion. Furthermore, nonenhanced scans facihtate the therapeutically relevant differentiation between pseudoaneurysms as a comphcation of a PAU and a sacciform aortic aneurysm. Mural calcifications suggest an aneurysm. In the case of a spacious IMH or paraaortic hematoma, the differentiation between a ruptured aneurysm and a complicated PAU can be impossible. However, in both cases, an immediate therapeutic intervention is indicated. Complications of a PAU, hke AD, formation of a pseudoaneurysm, or aortic rupture can all be detected or excluded in the same scan. 

Abnormal elastic membranes and death from aortic rupture are not limited to copper-deficient chicks. Coulson and Carnes (1963) and Shields et al. (1962) observed high mortality resulting from aortic rupture in pigs fed copper-deficient diets. These investigators also observed histological defects in the aortic elastin tissue from copper-deficient pigs. 

Kaartinen M, Penttila A, Kovanen PT Accumulation of activated mast cells in the shoulder region of human coronary atheroma, the predilection site of atheromatous rupture. Circulation 1994 90 1669. Kaartinen M, Penttila A. Kovanen PT Mast cells of two types differing in neutral protease composition in the human aortic intima. Demonstration of tryptase- and tryptase/chymase-containing mast cells in normal intimas, fatty streaks, and the shoulder region of atheromas. Arterioscler Thromb 1994 14 966. 

Myocardial ischemia has been reportedly precipitated by intramuscular administration of betamethasone (SEDA-21, 413 23). It has been suggested that longterm glucocorticoid therapy accelerates atherosclerosis and the formation of aortic aneurysms, with a high risk of rupture (SEDA-20, 369 24). 

Fifteen years ago, the only option for patients with large abdominal aortic aneurysms (AAA) that required either elective or emergent repair was an open surgical approach using a transperitoneal or retroperitoneal incision. Now with the advent of endovascular approaches to aortic diseases, many patients, especially those in the high-risk groups, have a minimally invasive option to permit repair of aortic aneurysms, dissections, pseudoaneurysms, and ruptures. 

Lee WA, Hirneise CM, Tayyarah M, et al, Impact of endovascular repair on early outcomes of ruptured abdominal aortic aneurysms, J Vase Surg 2004 40(2) 21 1-215,... 

Ohki T Veith FJ, Endovascular therapy for ruptured abdominal aortic aneurysms, Adv Surg 2001 35 131-151,... 

Fransen GA, Vallabhaneni SR Sr, van Marrewijk CJ, et al, Rupture of infra-renal aortic aneurysm after endovascular repair a series from EUROSXAR registry, Eur J Vase Endovasc Surg 2003 26(5) 487-493. 

Cocaine abuse is a risk factor for myocardial ischemia, infarction, and dysrhythmias, as well as pulmonary edema, ruptured aortic aneurysm, infectious endocarditis, vascular thrombosis, myocarditis, and dilated cardiomyopathy (35). 

A 71-year-old man with bladder carcinoma in situ received six instillations of BCG at weekly intervals followed 3 months later by three booster instillations at weekly intervals. Four months later an inflammatory aortic aneurysm, which had ruptured into a pseudoaneurysm, was diagnosed and excised. Mycobacterium bovis was found. After treatment with isoniazid and rifampicin he recovered. There was no sign of tumor in the bladder at cystocopy 8 months after the last BCG instillation. 

Cocaine abuse is a risk factor for myocardial ischemia, infarction, and dysrhythmias, as well as pulmonary edema, ruptured aortic aneurysm, infectious endocarditis, vascular thrombosis, myocarditis, and dilated cardiomyopathy (32). Acutely, cocaine suppresses myocardial contractility, reduces coronary caliber and coronary blood flow, induces electrical abnormalities in the heart, and increases heart rate and blood pressure. These effects can lead to myocardial ischemia (33,34). However, intranasal cocaine in doses used medicinally or recreationally does not have a deleterious effect on intracardiac pressures or left ventricular performance (35). 

Microwave heating of crystalloid fluids has been recommended as a method of correcting hypothermia during resuscitation. Severe full-thickness bums and venous thrombosis occurred after infusion of over-heated crystalloid fluid in the management of a ruptured aortic aneurysm in a 75-year-old man (1). Measuring the temperature of the fluid before starting the infusion is necessary to avoid this complication. 

A 67-year-old man underwent laparotomy for a ruptured abdominal aortic aneurysm (20). Postoperatively he was treated with hemodialysis because of acute renal insufficiency. Hyperkalemia was treated with sodium polystyrene sulfonate, after which he developed ulceration of the colon and required a hemicolectomy because of intractable blood loss. 

Pancreatitis, any cause (P-AMY T) Pancreatic trauma (P-AMYT) Biliary tract disease (P-AMYT) - Intestinal obstruction (PtAMYT) Mesenteric infarction (P-Alv4Y(t Perforated peptic ulcer (P-AMYiT) Gastritis, duodenitis (P-AMY ) Ruptured aortic aneurysm Acute appendicitis Peritonitis Trauma... 

Despite timely and appropriate reversal of the enticing insult... many patients develop the syndrome. Mortality is proportional to the number and depth of system dysfunction and the mortality of MODS after (for example) repair of ruptured abdominal aortic aneurysm is little changed despite three decades of medical progress. 

A rapid depletion of folate may occur in critically ill patients. Beard (B21) described four patients with a ruptured abdominal aortic aneurysm who... 

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