Volume 3 Number 1

Acute isolated sphenoid sinusitis in a 4-year-old child: a rare case with an atypical presentation (Views : 11609 times)


Acute, isolated, sphenoid sinusitis is unusual, especially in children. Its incidence is about 2.7% of all sinus infections and is even rarer in children under the age of six years. It is frequently misdiagnosed because of its atypical presentation and it can cause serious complications because of the sphenoid sinus' anatomical relations with many intracranial structures.
We report a case of a previously healthy 4 year old boy, whose sole symptom at presentation was drowsiness. Physical examination and initial laboratory investigations were normal. Diagnosis was made after computed tomography of the head revealed left sphenoiditis. Although under treatment, the child manifested meningism during the first day of hospitalization, which subsided the next day. He was treated with ceftriaxone plus clindamycin and had a good outcome, without complications or neurological sequelae.

Key words: sphenoiditis, intracranial complications, children


Anthracycline-related cardiotoxicity: risk factors and therapeutic options in childhood cancers (Views : 12076 times)


Anthracyclines play an important role in chemotherapeutic regimens for a wide spectrum of childhood tumors, but they can cause cytotoxic damage to cardiac cells, especially in combination with radiotherapy. Furthermore, cardiotoxicity increases with the cumulative dose and may lead to congestive heart failure and cardiomyopathy. Other factors, including age, pre-existing cardiac disease, length of follow-up, gender, route of administration, concomitant exposure to some chemotherapeutic drugs, trisomy 21 and black race, play a role in increasing the risk of cardiac dysfunction. The prevention of anthracycline-induced cardiotoxicity is mandatory as children are expected to survive for decades after being cured of their cancer. The purpose of this work is to point out the major risk factors of cardiotoxicity in children and to summarize some strategies to limit or prevent this complication and to treat the development of acute heart failure.

Keywords: anthracycline, cardiotoxicity, childhood cancer, risk factors, prevention, acute heart failure


Difficult airway management in the emergency room using an airway scope (Views : 8475 times)


In the emergency room, some cases need adequate airway management. We present a patient whom we intubated using a new device. This device might be an option in airway management but some considerations should also be taken into account.

Key words: airway management, sco-pe, secretions, bleeding


Emerging considerations in the reversal of neuromuscular blockade and residual block (Views : 17656 times)


Incomplete recovery following reversal of neuromuscular blockade can present as a clinical problem in surgical patients. Emerging pharmacologic solutions may prevent such adverse outcomes in the future. We briefly review two methods of pharmacologic reversal of neuromuscular blockade. Both methods of reversal are effective. However the early studies of the new compound, sugammadex has been shown to achieve a more rapid, stable reversal of steroidal based neuromuscular blocking agents compared to neostigmine. Due to the novel mechanism of action of this agent, sugammadex has been demonstrated to be effective even when administered during profound neuromuscular block, without evidence of recurarization.

Key words: sugammadex, Org 25969, cyclodextrin, rocuronium, cholinesterase inhibitor


Inpatient management of alcohol withdrawal: a practical approach (Views : 55629 times)


Alcohol intake contributes directly or indirectly to 15 to 20% of medical problems in primary care or an inpatient setting. It is estimated that approximately 500,000 episodes of withdrawal will be severe enough to require pharmacologic intervention. The total cost to the United States economy from alcohol abuse was estimated to be $185 billion for 1998. This review attempts to put forth a practical and evidence based approach towards the inpatient management of alcohol withdrawal. Various agents and their pharmacology are described. Strength of evidence regards to efficacy and shorter inpatient stays is examined.

Key words: substance abuse, pharmacology, addiction, pathophysiology, critical care




Most Accessed Articles

Original Articles


Abstract Introduction. The contribution of tracheotomy in comparison to intubation in patients on the resuscitation ward ...

Clinical s

Abstract Elevated intraabdominal pressure (IAP) has been claimed to play a role in abdominal compartment syndrome. ...


Abstract Objectives. We examined the relationship between partial end-tidal CO2 (pet) and mean arterial pressure in ...

Case Reports

Severe barium sulphate aspiration: a report of two cases and review of the literature

Abstract Aspiration of barium sulphate is a well-recognized complication, occurring accidentally during examinations of the upper gastrointestinal system using contrast media. Rarely, large amounts of barium sulphate are inadvertently aspirated into ...

Pulmonary hypertension leading to right heart failure in a patient with IgA gammapathy

Abstract Amyloidosis is a rare disorder characterized by the deposition of amorphous, extracellular, insoluble fibrillar protein in various tissues of the body. Pulmonary hypertension usually occurs in the last stages of ...

Myotubular myopathy associated with hypoxic-ischemic encephalopathy as a cause of prolonged ventilat

Keywords: myotubular myopathy, muscle biopsy, genetic analysis hypoxic-ischemic ...

Review Articles

Venous oximetry

Abstract Tissue hypoxia is the central pathophysiological process in shock and an important co-factor in the development of organ dysfunction. Hemodynamic parameters, usually used to assess the perfusion of organs and ...

Pediatric Shock

Abstract Millions of children die of shock due to various etiologies each year. Shock is a state of circulatory dysfunction where the metabolic demands of the tissue cannot be met by ...

Inpatient management of alcohol withdrawal: a practical approach

Abstract Alcohol intake contributes directly or indirectly to 15 to 20% of medical problems in primary care or an inpatient setting. It is estimated that approximately 500,000 episodes of withdrawal will ...

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