Fulminant myocarditis is commonly recognized as an acute myocarditis with cardiogenic shock requiring mechanical support systems. Before the development of mechanical assist devices, previous study described that most...Fulminant myocarditis is commonly recognized as an acute myocarditis with cardiogenic shock requiring mechanical support systems. Before the development of mechanical assist devices, previous study described that most of patients with fulminant myocarditis die at acute phase because of rapidly progressive cardiac decompensation. To investigate the feature of myocarditis, we checked consecutive 18 patients (10 men, 8 women, 12yr-80yr) from April in 2001 to September 2008 in University. Of these patients 3 needed intraaortic balloon pumping (IABP) (2 men, 1 woman), 6 did both IABP and percutaneous cardiopulmonary support (PCPS) (2 men, 4 women). Three patients who need both IABP and PCPS died (2 men, 49yr and 65yr, 1 woman, 54yr) because of uncontrolled bacterial infection. No patients whose age was under 40yr (5 men, 4 women) died although a man needed IABP and 3 women did both IABP and PCPS. Sixteen patients were able to resume a normal life although 1 male patient needed permanent pacemaker, 1 female did cardiac resynchronization therapy, and a male and a female had left ventricular systolic dysfunction. In conclusion, the young patients had better prognosis than older even if mechanical assist is needed. Although half of patients needed mechanical assist, the prevention of multi-organ complications including bacterial infection is one of the most important keys in the treatment of fulminant myocarditis.展开更多
Technological advances, a deeper understanding of disease processes and increased sophistication of therapeutic methods have all led to better outcomes in rare diseases which previously had devastating effects on many...Technological advances, a deeper understanding of disease processes and increased sophistication of therapeutic methods have all led to better outcomes in rare diseases which previously had devastating effects on many women’s lives. The inevitable result of this progress is that women, who in the past did not contemplate pregnancy because of significant morbidity, now get to adulthood and are reasonably “disease free” enough to have their own families. The ever expanding, but relatively new specialty of Obstetric medicine seeks to further improve the outcome in pregnant women with intercur</span><span style="font-family:"">r</span><span style="font-family:"">ent disease by enhancing the literature base, thereby contributing to the creation of appropriate guidance in the management of these patients. This article is a brief but useful guide for the busy obstetrician who may have limited experience in dealing with multiple sclerosis in pregnant women.展开更多
文摘Fulminant myocarditis is commonly recognized as an acute myocarditis with cardiogenic shock requiring mechanical support systems. Before the development of mechanical assist devices, previous study described that most of patients with fulminant myocarditis die at acute phase because of rapidly progressive cardiac decompensation. To investigate the feature of myocarditis, we checked consecutive 18 patients (10 men, 8 women, 12yr-80yr) from April in 2001 to September 2008 in University. Of these patients 3 needed intraaortic balloon pumping (IABP) (2 men, 1 woman), 6 did both IABP and percutaneous cardiopulmonary support (PCPS) (2 men, 4 women). Three patients who need both IABP and PCPS died (2 men, 49yr and 65yr, 1 woman, 54yr) because of uncontrolled bacterial infection. No patients whose age was under 40yr (5 men, 4 women) died although a man needed IABP and 3 women did both IABP and PCPS. Sixteen patients were able to resume a normal life although 1 male patient needed permanent pacemaker, 1 female did cardiac resynchronization therapy, and a male and a female had left ventricular systolic dysfunction. In conclusion, the young patients had better prognosis than older even if mechanical assist is needed. Although half of patients needed mechanical assist, the prevention of multi-organ complications including bacterial infection is one of the most important keys in the treatment of fulminant myocarditis.
文摘Technological advances, a deeper understanding of disease processes and increased sophistication of therapeutic methods have all led to better outcomes in rare diseases which previously had devastating effects on many women’s lives. The inevitable result of this progress is that women, who in the past did not contemplate pregnancy because of significant morbidity, now get to adulthood and are reasonably “disease free” enough to have their own families. The ever expanding, but relatively new specialty of Obstetric medicine seeks to further improve the outcome in pregnant women with intercur</span><span style="font-family:"">r</span><span style="font-family:"">ent disease by enhancing the literature base, thereby contributing to the creation of appropriate guidance in the management of these patients. This article is a brief but useful guide for the busy obstetrician who may have limited experience in dealing with multiple sclerosis in pregnant women.
