Biomedical-TeMU/CodiEsp_corpus · Datasets at Hugging Face

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- The catheter subsequently caused insufficient flow problems, often requiring local and systemic fibrinolytic treatment.
- For this reason, in November-06 anticoagulation with acenocoumarol (Sintrom®) was indicated, with mild functional improvement.
- In February-07 he suffered an episode of lower gastrointestinal bleeding due to ischemic colitis and colonic colitis conditioned by anticoagulant treatment.
- After removing acenocoumarol, the catheter stopped flowing.
- On 22-2-07, an attempt was made to replace the catheter through the same venous tract, making it impossible to introduce the new catheter due to complete thrombosis of the superior vena cava.
• On the same day 22-2-07, a temporary catheter was placed in the left femoral vein.
2-3-07 was removed when a functioning central catheter was available.
• On the 28-2-07, a tunnelled Split-Cath catheter was placed directly into the right atrium using a right anterior mini-thoracotomy.
- From the first dialysis session there was minimal blood leakage through the catheter connection ports.
It was not an impediment to continuing to treat him.
- Hospitalisation in October-07 due to catheter infection resolved with antibiotics.
- In November-07 there was a significant increase in blood leakage, with placement of a sterile silicone seal and placement of a PTFE silicone around the puncture site.
- In March 2009 the blood leak resolved with the same sealed procedure and returned PTFE.
- A new sealing attempt failed again on 30-11-09.
• 22-3-09 required insertion of a temporary catheter in the right femoral artery for a few days.
• On December 17, 2009, a new transthoracic dressing change was performed, and another Split-Cath catheter was placed.
- As a complication, she developed cardiogenic shock after surgery, and was then diagnosed with moderate to severe aortic valve stenosis.
- The catheter showed inadequate flow, with distal ends located in the suprahepatic vein.
- 25-3-10 was replaced with haemodynamics, the distal ends of the catheter being placed in the inferior vena cava.
- 24-9-10, again due to catheter dysfunction, was repositioned in hemodynamics, with distal ends lodged in the right atrium.
• A temporary right femoral catheter was inserted in 22-3-10 for a few days.
Since the last episode of day 24-9-10 and to date (10-02-2012), the patient is dialyzed in his dialysis center by transthoracic catheter, with no incidents and adequate catheter function.
A 33-year-old woman presented to the emergency department with asthenia, a history of unknown allergies, cutaneous lupus with malar erythema without treatment for 8 years and under rheumatology follow-up.
Very common:
Cholecystectomy.
Ex-smoker for 7 years.
Don't drink.
Non-toxic habits, except for drinks with quinine (tonic).
Anaemia episodes after 2 births
Cesarean section and ligation of dyes in the third.
Current illness:
She consulted due to intense asthenia and presyncopes one week later, which made it difficult to walk, along with anorexia without weight loss.
Very long lasting menstruation (8 days) and abundant.
Not melanic stools, cutaneous dryness and mucosa
Epistaxis and gingivorragia
The analytical highlights anemia with 6.7 gr / dl hemoglobin, thrombopenia with platelets of 6,000 / mm3.
LDH 1696 IU/l.
Blood smear with presence of schistoocytes
Normal test results.
Diagnosis: According to clinical and laboratory data, the patient presents a compatible picture of TTP in the context of SLE.
Upon admission, a concentrate of platelets is transfused.
One hour after the platelet count passed, the patient began with a picture of global aphasia and deviation of the oral commissure to the left without any other neurological focus.
Later he speaks with normal language without evident focus.
Due to the added neurological symptom, the patient was admitted to hospital for study.
When presenting the patient with thrombotic microangiopathy and seizures, plasmapheresis is requested from this service.
Due to the clinical worsening of the patient, she was admitted to the ICU.
Plasmapheresis session plan:
The replacement volume should be 1-1.5 times the plasma volume.
Treatment should be continued for up to 48 h after the response has been obtained.
The patient weighs 75 kgr., and according to relationship tables, it corresponds to a total of 3,500 cc. of volume to be reinfused, for which dialysis is programmed: 1,400 cc. peritoneal dialysis 20%.
Impact of meetings:
To perform the first plasmapheresis in the ICU, an attempt is made to implant a right jugular catheter, but due to its difficulty and excessive bleeding, a double-lumen catheter is placed in the left femoral artery.
The monitor used for the technique was a PRISMA CRRT-TPE (Hospal®), with PTE-2000 filter.
The dose of heparin was 15-5-5 mgr, with the duration of the sessions of approximately 210 minutes, with an average infusion of 980 ml/h, blood flows between 120-140 ml/min and 85 mmHg PPV-155.y
The patient in the ICU has a poor general condition (sedated), with maintained constants.
A total of 17 sessions were carried out.
Impact of the measures
The first session was very agitated.
In the 5th and 6th she suffers hypotension and major convulsions, with diazepam and physiological saline, finishing the treatment.
In the 16th there is an increase in MPT up to 55 mm Hg, missing 50 minutes, ending the session.
In the 17th, there was a failure of the air test when 90 minutes were missing, so the ETT had to be changed.
The rest of the sessions were carried out without problems, being well received by the patient.
We report the case of a 62-year-old patient who in December 2010 was operated on for a serous papillary carcinoma in the left ovary with involvement of a ganglia of the chain referral (stage IIIC).
Subsequently, she received adjuvant chemotherapy with ropivacaine and paclitaxel, finalized in June 2011.
Later, asymptomatic follow-up began until April 2013, when an increase of CA 125 of 88.4 U/ml (0-35 U/ml) was detected.
The CT scan showed an image adjacent to the colon and underwent anterior resection of the superior rectum with intraoperative biopsy of a liver lesion that confirmed the metastatic nature.
A second line treatment with platinum plus paclitaxel was established, showing an CA 125 value of 123.3 U/ml.
After a first cycle with good tolerance, we programmed the second one and during the first minutes of the infusion of dexamethasone/siloxane, the patient developed sudden dyspnea, vomiting, loss of consciousness and SBP/DBP of 70.
After corticosteroid infusion, the patient developed remission.
The Allergology Unit recommended a grading scheme with slowing infusion rate.
For this, three dissolutions were used with concentrations of 0.02, 0.2 and 2 mg/ml respectively, in addition to premedication the night before and half an hour before infusion with:
Cefuroximaxetil 125 mg Filmtabletten
In spite of this, within a few minutes she began with dyspnea, sweating and tensions of 85/60 mmHg, which forced her to stop the infusion and suggested that she did not use any saline solution again.
In September 2013, it was decided to start third line chemotherapy with trabectedin and pegylated liposomal adriamycin.
After the third cycle, the markers normalized and completed up to the sixth cycle, remaining in these moments free of disease.

- The catheter subsequently caused insufficient flow problems, often requiring local and systemic fibrinolytic treatment.

- For this reason, in November-06 anticoagulation with acenocoumarol (Sintrom®) was indicated, with mild functional improvement.

- In February-07 he suffered an episode of lower gastrointestinal bleeding due to ischemic colitis and colonic colitis conditioned by anticoagulant treatment.

- After removing acenocoumarol, the catheter stopped flowing.

- On 22-2-07, an attempt was made to replace the catheter through the same venous tract, making it impossible to introduce the new catheter due to complete thrombosis of the superior vena cava.

• On the same day 22-2-07, a temporary catheter was placed in the left femoral vein.

2-3-07 was removed when a functioning central catheter was available.

• On the 28-2-07, a tunnelled Split-Cath catheter was placed directly into the right atrium using a right anterior mini-thoracotomy.

- From the first dialysis session there was minimal blood leakage through the catheter connection ports.

It was not an impediment to continuing to treat him.

- Hospitalisation in October-07 due to catheter infection resolved with antibiotics.

- In November-07 there was a significant increase in blood leakage, with placement of a sterile silicone seal and placement of a PTFE silicone around the puncture site.

- In March 2009 the blood leak resolved with the same sealed procedure and returned PTFE.

- A new sealing attempt failed again on 30-11-09.

• 22-3-09 required insertion of a temporary catheter in the right femoral artery for a few days.

• On December 17, 2009, a new transthoracic dressing change was performed, and another Split-Cath catheter was placed.

- As a complication, she developed cardiogenic shock after surgery, and was then diagnosed with moderate to severe aortic valve stenosis.

- The catheter showed inadequate flow, with distal ends located in the suprahepatic vein.

- 25-3-10 was replaced with haemodynamics, the distal ends of the catheter being placed in the inferior vena cava.

- 24-9-10, again due to catheter dysfunction, was repositioned in hemodynamics, with distal ends lodged in the right atrium.

• A temporary right femoral catheter was inserted in 22-3-10 for a few days.

Since the last episode of day 24-9-10 and to date (10-02-2012), the patient is dialyzed in his dialysis center by transthoracic catheter, with no incidents and adequate catheter function.

A 33-year-old woman presented to the emergency department with asthenia, a history of unknown allergies, cutaneous lupus with malar erythema without treatment for 8 years and under rheumatology follow-up.

Very common:

Cholecystectomy.

Ex-smoker for 7 years.

Don't drink.

Non-toxic habits, except for drinks with quinine (tonic).

Anaemia episodes after 2 births

Cesarean section and ligation of dyes in the third.

Current illness:

She consulted due to intense asthenia and presyncopes one week later, which made it difficult to walk, along with anorexia without weight loss.

Very long lasting menstruation (8 days) and abundant.

Not melanic stools, cutaneous dryness and mucosa

Epistaxis and gingivorragia

The analytical highlights anemia with 6.7 gr / dl hemoglobin, thrombopenia with platelets of 6,000 / mm3.

LDH 1696 IU/l.

Blood smear with presence of schistoocytes

Normal test results.

Diagnosis: According to clinical and laboratory data, the patient presents a compatible picture of TTP in the context of SLE.

Upon admission, a concentrate of platelets is transfused.

One hour after the platelet count passed, the patient began with a picture of global aphasia and deviation of the oral commissure to the left without any other neurological focus.

Later he speaks with normal language without evident focus.

Due to the added neurological symptom, the patient was admitted to hospital for study.

When presenting the patient with thrombotic microangiopathy and seizures, plasmapheresis is requested from this service.

Due to the clinical worsening of the patient, she was admitted to the ICU.

Plasmapheresis session plan:

The replacement volume should be 1-1.5 times the plasma volume.

Treatment should be continued for up to 48 h after the response has been obtained.

The patient weighs 75 kgr., and according to relationship tables, it corresponds to a total of 3,500 cc. of volume to be reinfused, for which dialysis is programmed: 1,400 cc. peritoneal dialysis 20%.

Impact of meetings:

To perform the first plasmapheresis in the ICU, an attempt is made to implant a right jugular catheter, but due to its difficulty and excessive bleeding, a double-lumen catheter is placed in the left femoral artery.

The monitor used for the technique was a PRISMA CRRT-TPE (Hospal®), with PTE-2000 filter.

The dose of heparin was 15-5-5 mgr, with the duration of the sessions of approximately 210 minutes, with an average infusion of 980 ml/h, blood flows between 120-140 ml/min and 85 mmHg PPV-155.y

The patient in the ICU has a poor general condition (sedated), with maintained constants.

A total of 17 sessions were carried out.

Impact of the measures

The first session was very agitated.

In the 5th and 6th she suffers hypotension and major convulsions, with diazepam and physiological saline, finishing the treatment.

In the 16th there is an increase in MPT up to 55 mm Hg, missing 50 minutes, ending the session.

In the 17th, there was a failure of the air test when 90 minutes were missing, so the ETT had to be changed.

The rest of the sessions were carried out without problems, being well received by the patient.

We report the case of a 62-year-old patient who in December 2010 was operated on for a serous papillary carcinoma in the left ovary with involvement of a ganglia of the chain referral (stage IIIC).

Subsequently, she received adjuvant chemotherapy with ropivacaine and paclitaxel, finalized in June 2011.

Later, asymptomatic follow-up began until April 2013, when an increase of CA 125 of 88.4 U/ml (0-35 U/ml) was detected.

The CT scan showed an image adjacent to the colon and underwent anterior resection of the superior rectum with intraoperative biopsy of a liver lesion that confirmed the metastatic nature.

A second line treatment with platinum plus paclitaxel was established, showing an CA 125 value of 123.3 U/ml.

After a first cycle with good tolerance, we programmed the second one and during the first minutes of the infusion of dexamethasone/siloxane, the patient developed sudden dyspnea, vomiting, loss of consciousness and SBP/DBP of 70.

After corticosteroid infusion, the patient developed remission.

The Allergology Unit recommended a grading scheme with slowing infusion rate.

For this, three dissolutions were used with concentrations of 0.02, 0.2 and 2 mg/ml respectively, in addition to premedication the night before and half an hour before infusion with:

Cefuroximaxetil 125 mg Filmtabletten

In spite of this, within a few minutes she began with dyspnea, sweating and tensions of 85/60 mmHg, which forced her to stop the infusion and suggested that she did not use any saline solution again.

In September 2013, it was decided to start third line chemotherapy with trabectedin and pegylated liposomal adriamycin.

After the third cycle, the markers normalized and completed up to the sixth cycle, remaining in these moments free of disease.