BMC research notes
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Extracorporeal membrane oxygenation (ECMO) technology is a viable option for short-term support in the setting of acute cardiac ischemia. To supplement cardiopulmonary resuscitation (CPR) in select patients, ECMO is used successfully for witnessed in hospital cardiac arrest. In the setting of an acute myocardial infarction (MI), bridging to a revascularization procedure is important in improving overall survival. ⋯ Our case highlights the importance of early initiation of ECMO during PCI in achieving both improved cardiac and neurological outcomes during an acute coronary syndrome (ACS).
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Leptospirosis is an important zoonotic disease of variable severity and is a common cause of acute kidney injury (AKI) in tropics. However the knowledge on long term renal outcome in leptospirosis is scarce. This study aims to assess the long-term renal outcome of AKI caused by leptospirosis. ⋯ The long term renal outcome of AKI following leptospirosis is satisfactory as only 9% of patients had abnormal renal functions compatible with early stage of CKD. Even among them, advanced CKD or dialysis dependency had not been observed.
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Telemedicine is increasingly being used as part of routine practice for many physicians and healthcare providers across the country. Due to its visual nature, dermatology is ideally suited to benefit from this new technology. The use of teledermatology (telemedicine in dermatology) in a primary care setting allows for an expert opinion without the need for an in-person referral. Furthermore, it can improve patient access in remote areas. Store-and-forward teledermatology is the most commonly employed method. ⋯ This case demonstrates the utility of store-and-forward teledermatology in what is unfortunately not an uncommon scenario in Canada. The patient was successfully managed, and a logistically difficult and expensive in-person referral was avoided.
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Late presentations of congenital diaphragmatic hernia are rare and differ from the classic neonatal presentation. The association with other congenital malformations in children, mainly intestinal malrotation, is well documented. The diagnosis of this association in adults is very rare, and depends on a high degree of suspicion. ⋯ This case shows a rare association of two rare conditions in adults, and highlights the challenge in reaching the diagnosis and management options.
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Acute kidney injury (AKI) is a common and a serious complication among patients admitted to intensive care units (ICUs), and has been the focus of many studies leading to recent advances in diagnosis and classification. The incidence and outcome of AKI in Sri Lankan ICUs is largely unknown. The aim of this study was to describe the incidence, severity and outcome of AKI among patients admitted to the medical ICU, National Hospital, Colombo, Sri Lanka (NHSL). ⋯ The incidence of AKI is high at 60% among our ICU patients, and those with AKI had higher mortality and longer duration of ICU stay. Age, gender or the presence of co-morbidities was not associated with a higher risk of AKI. Patients with SOFA scores over 9 within the first 24 hours were more likely to develop AKI and had higher risk of death.