Tag Archives: critical care medicine

COVID-19 Infection or Buttock Injections? The Dangers of Aesthetics and Socializing During a Pandemic

DOI: 10.2478/jccm-2021-0043

Introduction: Silicone (polydimethylsiloxane) injections are used for cosmetic augmentation. Their use is associated with life-threatening complications such as acute pneumonitis, alveolar hemorrhage, and acute respiratory distress among others [1,2]. We report a case of a Hispanic woman who developed severe respiratory distress syndrome after gluteal silicone injections.
Case Presentation: A 44-year-old Hispanic female presented to the Emergency Department complaining of progressive dyspnea on exertion for two weeks. Chest imaging revealed patchy bibasilar airspace opacities of peripheral distribution. Labs were significant for leukocytosis, elevated PT, D-dimer, lactate dehydrogenase, and fibrinogen, concerning for COVID-19, however SARS-CoV-2 testing was negative multiple times. The patient later became encephalopathic, hypoxemic, and eventually required intubation. Further history uncovered that the patient had received illicit gluteal silicone injections a few days prior to her onset of symptoms. The patient was diagnosed with silicone embolism syndrome (SES) and initiated on high dose intravenous methylprednisolone [1].
Case Discussion: Patients from lower socioeconomic backgrounds utilize illicit services to receive silicone injections at minimal costs. This leads to dangerous outcomes. The serology and imaging findings observed in our case have similarities to the typical presentation of COVID-19 pneumonia making the initial diagnosis difficult. This case serves as a cautionary tale of the importance of thorough history taking in patients with concern for COVID-19.

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Transplant Critical Care: Is There A Need for Sub-specialized Units? — A Perspective

DOI: 10.2478/jccm-2018-0014

The critical care involved in solid-organ transplantation (SOT) is complex. Pre-, intra- and post-transplant care can significantly impact both – patients’ ability to undergo SOT and their peri-operative morbidity and mortality. Much of the care necessary for medical optimization of end-stage organ failure (ESOF) patients to qualify and then successfully undergo SOT, and the management of peri-operative and/or long-term complications thereafter occurs in an intensive care unit (ICU) setting. The current literature specific to critical care in abdominal SOT patients was reviewed. This paper provides a contemporary perspective on the potential multifactorial advantages of sub-specialized transplant critical care units in providing efficient, comprehensive, and collaborative multidisciplinary care.

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Should Critical Care Professionals Take Hoaxes/Rumours Seriously?

DOI: 10.1515/jccm-2016-0030

To the Editor of JCCM,
Thanks to the ever larger penetration of the Internet and especially with the advent of Web 2.0 and social media, hoaxes, rumours and urban legends have become an almost everyday occurrence. While social psychology research contends that rumors can negatively impact on the public by generating distress, intense fear, anxiety, possibly resulting in herd behaviour and violence [1], there is evidence that disease-related rumours may alter health-related behaviors and interfere with medical decision-making [2]. Medical misinformation is most frequently associated with collective emergency situations (e.g., Ebola infected patients refused to be hospitalized because of rumours that international health care workers intentionally brought the virus with them [3]; people from around Kenema, Sierra Leone attacked the hospital after hearing rumours of conspiracy [4]; during the 2011 Fukushima nuclear disaster in Japan, rumours that ingestion of iodized salt could prevent radiation damage lead to a shortage of the product in supermarkets and triggered panic and public unrest [1]) and miracle products or cures that can be commercially exploited [5]. However, there are a number of hoaxes/rumours that probably critical care specialists should neither take lightly as innocuous amusements, nor brush aside with a condescending smile.[More]

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