Severity: Warning
Message: file_get_contents(https://...@gmail.com&api_key=61f08fa0b96a73de8c900d749fcb997acc09&a=1): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
Filename: helpers/my_audit_helper.php
Line Number: 197
Backtrace:
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 197
Function: file_get_contents
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 271
Function: simplexml_load_file_from_url
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 3165
Function: getPubMedXML
File: /var/www/html/application/controllers/Detail.php
Line: 597
Function: pubMedSearch_Global
File: /var/www/html/application/controllers/Detail.php
Line: 511
Function: pubMedGetRelatedKeyword
File: /var/www/html/index.php
Line: 317
Function: require_once
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Rationale: Symmetrical peripheral gangrene (SPG) is a rare and life-threatening condition characterized by symmetrical distal ischemic damage that can progress to gangrene at 2 or more anatomical sites, without involvement of a large vessel obstruction or vasculitis. We report the case of an older adult female who developed septic shock and disseminated intravascular coagulation (DIC) postoperatively, complicated by the onset of SPG.
Patient Concerns: A 66-year-old female was transferred to the intensive care unit for postoperative management. She subsequently developed septic shock and DIC. On the 10th day of admission, acral necrosis was observed in both feet.
Diagnoses: Septic shock complicated by DIC and SPG.
Interventions: Upon intensive care unit admission, the patient received ongoing organ support and anti-infection therapy. Phentolamine was applied via wet compresses to both feet.
Outcomes: Due to anastomotic leakage and multiple organ failure, the patient's family chose to discharge her from the hospital.
Lessons: In cases of SPG, prevention is more important than treatment. Early correction of underlying conditions and identification of risk factors can improve patient outcomes.
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Source |
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12384844 | PMC |
http://dx.doi.org/10.1097/MD.0000000000044099 | DOI Listing |