Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Nov 1996
Review Case Reports[Ventricular septal rupture after blunt chest trauma].
Case 1: a 20-year-old previously healthy man sustained multiple nonvascular injuries without visible chest trauma in a car accident. Four days later a loud systolic murmur was heard over the heart. Case 2: a 21-year-old man similarly sustained in a car accident multiple injuries without visible chest involvement but causing haemorrhagic shock. A loud systolic heart murmur was heard and after shock treatment he developed left heart failure requiring catecholamine infusions. ⋯ Ventricular septal rupture after blunt trauma to the chest is a rare occurrence. Even though in general the prognosis is good, a large intracardiac shunt may require early surgical repair.
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Dtsch. Med. Wochenschr. · Aug 1996
Review Case Reports[Severe metabolic alkalosis with a consciousness disorder].
A 47-year-old man in a reduced general condition, presumed to be a chronic alcoholic, was hospitalised in a sleepy state and impaired level of consciousness (Glasgow Coma Scale 8). There were no focal neurological deficits, but all proprioceptor reflexes were weak. Body temperature was 36.8 degrees C, blood pressure 90/60 mm Hg, and heart rate 80/min. ⋯ Even severe hypochloraemic alkalosis can be quickly reversed with infusion of chloride without sodium Successful treatment with chloride alone excludes alkalosis induced by mineralocorticoids.
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Dtsch. Med. Wochenschr. · Nov 1994
Review Case Reports[Iodine-induced hyperthyroidism in metastatic thyroid carcinoma].
A 75-year-old man with nodular goitre (for the preceding 2 years treated with 75 micrograms/dl L-thyroxine) complained of pain over the left hip: on auscultation an arterial flow murmur was audible over the hip. The radiograph demonstrated extensive osteolysis in the flat part of the ilium. Search for the primary tumour, including two pelvic angiographs, was unsuccessful. ⋯ Treatment with thiamazole (40 mg/d) and perchlorate (1 g/d) reduced the concentration of peripheral thyroid hormone, but the patient's general condition improved only slowly. As a result, radioiodine treatment could not be started until 9 months later. He died a further 9 months later from septicaemia originating from the metastasis.