Unilateral Labial Edema in a Female Adolescent: A Gynecologic Presentation of Rhabdomyolysis

Background

Rhabdomyolysis can be the result of vigorous physical activity. Typical signs and symptoms at presentation are muscle pain, weakness, or dark colored urine. There is no scientific literature associating rhabdomyolysis with gynecologic signs and symptoms.

左卡尼汀对大鼠横纹肌溶解急性肾损伤炎性反应因子表达的影响

 目的 探讨左卡尼汀对大鼠横纹肌溶解急性肾损伤的保护作用及其作用机制。方法 48只大鼠,随机分为空白组、模型组、盐水治疗组及左卡尼汀治疗组。肌内注射50%甘油建立横纹肌溶解急性肾损伤模型,盐水治疗组、左卡尼汀治疗组分别腹腔注射生理盐水和左卡尼汀。测血清肌酸激酶(creatine kinase,CK)、尿素氮(urea nitrogen,BUN)和肌酐(serum creatinine,Scr)水平,光镜下观察肾脏病理;RT-PCR和免疫组化分别检测肾脏TLR4、NF-kB;酶联免疫吸附法检测肾脏IL-6、TNF-α。结果 与空白组相比,模型组及盐水治疗组CK、BUN、Scr、TLR4、NF-kB、IL-6、TNF-α及急性肾小管坏死(acute tubular necrosis,ATN)评分均明显升高(F=9.12~211.77,q=5.40~20.3,P<0.05);与模型组相比,左卡尼汀治疗组CK、BUN、Scr、TLR4、NF-kB、IL-6、TNF-α及ATN评分水平明显降低(q=4.37~16.03,P<0.05)。结论 左卡尼汀缓解横纹肌溶解急性肾损伤的机制可能与其抗免疫炎性反应通路TLR4/NF-kB有关。     

Imaging of post-traumatic cardiac rhabdomyolysis with normal coronary arteries

Numerous cases of acute myocardial infarction (AMI) have been reported in the literature following closed chest injuries, due to post-traumatic dissection or thrombosis of a coronary artery. In the follow-up of AMI, wall thickness during diastole and systole provides important information on heart viability. Multidetector computed tomography (MDCT) is currently the only noninvasive instrumental investigation which provides an appreciable assessment of the coronary arteries, as well as heart wall thickness measurements. We describe and discuss the clinical and imaging findings, especially of MDCT, in a case of post-traumatic regional myocardial necrosis with normal coronary arteries.     

AIDS and Athletes

In brief: AIDS is the most significant public health problem of our generation and has implications for athletes and their health care professionals. A growing body of scientific data supports the position that most individuals infected with the human immunodeficiency virus (HIV) can and should remain physically active and may participate in most sports. Current public health guidelines regarding transmission of HIV also apply to the training room and to organized sports. In addition, physicians and athletic trainers who disseminate the facts about AIDS and HIV are invaluable assets in the worldwide effort to eradicate AIDS.     

How to Keep Your Bones Healthy

Blunt laryngeal injury is a rare but potentially catastrophic event. If the airway is not totally obstructed, the on-site physician should manage the upper airway following basic airway protocols. If the airway becomes totally obstructed on-site, orotracheal intubation using a small-diameter endotracheal tube is the procedure of choice. Translaryngeal ventilation and surgical cricothyrotomy are relatively contraindicated but may need to be used as a last resort. When the need for advanced airway procedures is likely, the patient should be transported expediently by advanced life support ambulance to the nearest appropriate emergency department.     

非外伤性横纹肌溶解症的临床特点

目的了解非外伤性横纹肌溶解症(RM)的临床特点和发病机制。方法对11例非外伤性RM的病因和临床表现进行回顾性分析。结果本组病因包括药物性3例,一氧化碳中毒2例,高强度运动2例,高强度农业劳动1例,其他3例。临床表现为肌无力、肌痛、肌肿胀、茶色尿、肾功能衰竭,实验室检验包括肌酸激酶增高,各种电解质紊乱。结论药物是引起非外伤性RM的主要原因,诊断主要依据临床表现和血清肌酸激酶显著升高。急性肾功能衰竭是其严重和导致死亡的主要并发症。     

Rapid reduction of substantially increased myoglobin and creatine kinase levels using a hemoadsorption device (CytoSorb®)—A case report

Rhabdomyolysis (RM) is a potentially life‐threatening entity that can lead to acute kidney injury (AKI). Continuous renal replacement therapy (CRRT) alone is known as effective therapy, but the additional use of a hemoadsorber (like CytoSorb^®) might increase its efficacy.     

When the color of peritoneal dialysis effluent can be used as a diagnostic tool

Peritoneal dialysis (PD) effluent is normally transparent. A change in its appearance may be the first indication of an intra‐ or extraperitoneal abnormality which may or may not be related to the peritoneal dialysis technique itself. What diagnosis should be considered when PD effluent turns on red, orange, cloudy, milky white, green, yellow, purple or black in color? After review of the literature, we propose a differential diagnosis, as well as some management recommendations, for specific abnormal color presentations of the PD effluent.     

Exertional rhabdomyolysis: Evaluation and management

Exertional rhabdomyolysis is a condition that is becoming more frequently diagnosed and of increasing importance to orthopedic surgeons. A delay in diagnosis and treatment can lead to serious, even fatal, complications. We report a case of exertional rhabdomyolysis followed by a general discussion of this disorder along with its evaluation and management.