Карточка-задание по английскому языку на тему «MEDICAL WRITING: CASE ABSTRACT_84»
«MEDICAL WRITING: CASE ABSTRACT_84»
·What is a medical case report?
·What parts does it include?
·What is an abstract?
Read the abstract of the medical case
Hypercapnic cerebral edema
presenting in a woman with asthma: a case report
Common causes of non-traumatic
acute cerebral edema include malignant hypertension, hyponatremia, anoxia, and
cerebral vascular accident. The computed tomographic images and data obtained
during care of the patient described in this case report provide evidence that
hypercarbia can cause increased intracranial pressure and coma without
permanent brain injury. Partial pressure of carbon dioxide evaluation for coma
is essential to provide faster diagnosis and therapeutic correction in certain
common critical disease states. We present the case of a patient in a coma
associated with cerebral edema during a typical asthma exacerbation with
hypercapnic respiratory failure.
An obese 63-year-old African
American woman with asthma presented to our hospital with facial swelling and
shortness of breath. Immediately following intubation for hypercapnic
respiratory failure, she was noted to have a dilated, unresponsive right pupil.
An emergent computed tomographic head scan revealed that she had increased
intracranial pressure. A neurosurgeon agreed with the computed tomography
interpretation and recommended no surgical intervention. The patient's
respiratory acidosis was corrected with ventilatory management over several
hours in the intensive care unit. Nine and one-half hours later a follow-up
head computed tomographic scan was read as normal without cerebral edema. At 12
hours, the patient's right pupil was 5 mm in diameter and reactive. By 24
hours, her pupils were symmetrically equal and reactive. Her symptoms had
improved, and she was extubated. A brain magnetic resonance imaging scan
revealed no abnormalities.
Alteration of consciousness
related to hypercapnia during respiratory failure is not generally thought to
be related to cerebral edema. Respiratory acidosis resulting from hypercarbia
is known to produce carbon dioxide narcosis and coma, but no current treatment
algorithm suggests that rapid hypercapnia correction can be critical to
neurologic outcome. To the best of our knowledge, our case is a unique example
of the physiological changes that may occur in relation to arterial carbon
dioxide concentration in the normal brain in the setting of typical hypercapnic
respiratory failure. Correction of respiratory acidosis reversed the neurologic
symptoms and physiology causing cerebral edema and coma in our patient. Rare
similar cases have been sporadically reported in the medical literature,
typically in children. Our case is also unusual in that rapid deterioration and
clinical status were directly observed on simultaneous computed tomographic
scans. Had this patient been found unresponsive, or had she had brief
respiratory or cardiac arrest, the scan could have been interpreted as global
anoxic injury leading to a different therapeutic course.
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1.Is this the first report of this kind in the literature?
2.What are brief details of what the patient(s) presented with?
3.What the reader should learn from the case report?
4.What the clinical impact will be?
5.Is it an original case report of interest to a particular clinical
specialty of medicine?
6.Will it have a broader clinical impact across medicine?
7.Are any teaching points identified?
·Why abstract is the most important part for case
published in electronic databases?
·What are basics of abstract writing?
КАРТОЧКА - ЗАДАНИЕ НА ТЕМУ «MEDICAL
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