Thyroid Hemorrhage Causing Airway Obstruction After Intravenous Thrombolysis for Acute Ischemic Stroke

Background: There are several life-threatening complications associated with intravenous thrombolysis after acute ischemic stroke such as symptomatic intracerebral hemorrhage, orolingual angioedema, or less frequent, bleedings of the mucosa or ecchymosis. Aside from these known critical incidents, rare and unfamiliar complications may be even more challenging, as they are unexpected and may mimic events that appear more frequently. We report a rare and unusual acute complication of intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) (0.9mg/kg) administered for acute ischemic stroke. Methods: Medical records, radiologic imaging, and pathologic specimens were reviewed. Results: A 86-year-old woman developed acute respiratory failure 20h after thrombolysis with suspected angioedema triggered by intravenous rt-PA. The inspiratory stridor and dyspnea were unresponsive to bronchodilators, corticosteroids, and inhaled adrenaline. After endotracheal intubation, laryngoscopy showed no significant supraglottic narrowing. Thyroidal sonography and cervical computed tomography revealed a thyroidal mass causing a tracheal and vascular compression compatible with thyroidal hemorrhage. Sonography showed a nodular goiter of the right thyroid gland. A total thyroidectomy was performed and histologic analysis confirmed a hemorrhage of the right thyroidal lobe. Conclusions: Acute airway obstruction with respiratory failure due to thyroidal hemorrhage after intravenous thrombolysis is an important life-threatening complication, mimicking an anaphylactic reaction or a more frequent orolingual angioedem

Mehrsprachiger Fachsprachenaufbau im Geographieunterricht. GW-Unterricht|GW-Unterricht 149|

Mehrsprachigkeit ist ein gesellschaftlicher Fakt, dem sich auch Fachdidaktiken stellen müssen, da sich fachliches Vorwissen der Schüler/innen u. a. über eine hohe sprachliche Diversität auszeichnet. Es gilt sprachliche Lernvoraussetzungen nutzbar zu machen, um die Bildungschancen zu erhöhen. Der Beitrag fokussiert, ausgehend von einer theoretisch-konzeptionellen Herleitung, die Entwicklung eines systematischen, mehrsprachigen Fachkonzeptaufbaus. Dieser sprachensensible Aufbau wird an einem typischen Beispiel der Klassen 5/6 angewandt

Weissenburg – 10 pfennigs : Monnaies de guerre / Lauer, L. Ch., Nuremberg (Allemagne)

Appartient à l’ensemble documentaire : BNUStras1Appartient à l’ensemble documentaire : BNUStr017Appartient à l’ensemble documentaire : Alsace

Adaptronische Transportsysteme mit elektrorheologischen Fluessigkeiten (ERFs) zur Befoerderung sensibler Gueter. Teilvorhaben: Entwickung einer Ansteuerelektronik und eines aktiven Lagersystems fuer adaptronische Transportsysteme mit elektrorheologischen Fluessigkeiten (ERFs) zur Befoerderung sensibler Gueter. T. 1 und 2 Entwicklung einer Leistungsverstaerker-Ansteuerung fuer das Hydrauliksystem. Simulation und Entwicklung eines aktiven Regelsystems. Abschlussbericht

A demonstration system has been developed and implemented in which the transport platform of a goods vehicle is decoupled from the bumpiness of the roads and from the acceleration when driving through bends by the use of ER-fluids. For the drive of valves with ER fluids high-voltage amplifiers with an output voltage of 4.5 kV and an output power of up to 200 W were developed. The high voltage required was generated by the on-vehicle voltage of 24 V. After extensive system studies and the elaboration of different simulation models the complete control software was developed and successfully integrated into the overall system. The parameters required for the calculation models were identified through measurements and calculations; in particular the static and dynamic transmission behaviour of a valve with ER-fluids was examined in detail within the framework of preliminary tests. With the aid of the simulation models the behaviour of single system elements could be determined and based on this knowledge a suitable control concept could be elaborated. In final field test the function of the demonstration system could definitely be proved. (orig.)SIGLEAvailable from TIB Hannover: F00B708+a / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Bildung und Forschung, Berlin (Germany)DEGerman

Baugruppen und Werkstoffe fuer eine Heisswandanlage zur Zuechtung von Galliumarsenid-Einkristallen

Available from TIB Hannover: RA 831(2511) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

Thyroid hemorrhage causing airway obstruction after intravenous thrombolysis for acute ischemic stroke

There are several life-threatening complications associated with intravenous thrombolysis after acute ischemic stroke such as symptomatic intracerebral hemorrhage, orolingual angioedema, or less frequent, bleedings of the mucosa or ecchymosis. Aside from these known critical incidents, rare and unfamiliar complications may be even more challenging, as they are unexpected and may mimic events that appear more frequently. We report a rare and unusual acute complication of intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) (0.9 mg/kg) administered for acute ischemic stroke.; Medical records, radiologic imaging, and pathologic specimens were reviewed.; A 86-year-old woman developed acute respiratory failure 20 h after thrombolysis with suspected angioedema triggered by intravenous rt-PA. The inspiratory stridor and dyspnea were unresponsive to bronchodilators, corticosteroids, and inhaled adrenaline. After endotracheal intubation, laryngoscopy showed no significant supraglottic narrowing. Thyroidal sonography and cervical computed tomography revealed a thyroidal mass causing a tracheal and vascular compression compatible with thyroidal hemorrhage. Sonography showed a nodular goiter of the right thyroid gland. A total thyroidectomy was performed and histologic analysis confirmed a hemorrhage of the right thyroidal lobe.; Acute airway obstruction with respiratory failure due to thyroidal hemorrhage after intravenous thrombolysis is an important life-threatening complication, mimicking an anaphylactic reaction or a more frequent orolingual angioedema