The Mount Sinai journal of medicine, New York
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There is conflicting evidence of the effect of intravenous fat emulsions on pancreatic secretion. Intralipid is a safe component of intravenous nutritional support in patients with pancreatic fistulas, though it may minimally increase the volume, as well as the bicarbonate and amylase concentrations, of the output. Intravenous fat emulsions may rarely cause pancreatitis; this may be more likely in patients with Crohn's disease, given that three of the four reported cases occurred in patients with Crohn's disease. ⋯ Intravenous fat emulsions appear to be a safe component of intravenous nutritional support for the patient with pancreatitis, based on multiple studies proving their safety in a total of nearly 100 patients. It seems prudent to avoid hypertriglyceridemia secondary to intravenous fat emulsions, as this alone is a cause of pancreatitis, albeit uncommon, in patients with abnormalities of triglyceride metabolism. However, hypertriglyceridemia resulting from parenteral nutrition may be caused by glucose intolerance and not intravenous fat emulsion administration.
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We have attempted to acquaint the internist with some aspects of anesthesiology that need to be kept in mind when performing perioperative consultation. Communication among and between the entire operative team will reduce risk and untoward reactions and will enhance the likelihood of successful outcome and rapid recovery.
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Review Case Reports
Asbestos-associated rounded atelectasis: a case report and review of the literature.
Asbestos-associated rounded atelectasis is a nonmalignant radiographic consequence of asbestos exposure that can mimic neoplasia. It is infrequently mentioned in reviews of the radiographic features of nonmalignant asbestos-associated disease. Distinguishing it from malignant disease without resorting to chest surgery is important. This report presents a case of such atelectasis, and a review of the relevant literature.