Ruptured distal anterior cerebral artery aneurysm presenting as subdural hemorrhage
We report on a 64-year-old man with no history of trauma who went into a deep coma after aneurysmal rupture. The brain computed tomography (CT) scan showed interhemisphere and convexity subdural hemorrhage (SDH) without detectable subarachnoid hemorrhage. The CT angiography confirmed a rare condition of pericallosal aneurysmal rupture. We emphasize that when a patient with an unclear history of head trauma presented with acute convexity and interhemispheric SDH, the possibility of distal pericallosal artery aneurysmal rupture should be considered. We also recommend CT angiography must be performed as soon as possible to de...
Source: Journal of Acute Medicine - November 25, 2014 Category: Emergency Medicine Source Type: research
Atypical presentation of sarcoidosis among older individuals
We present the case of a 91-year-old woman admitted with symptoms secondary to hypercalcemia and diagnosed with sarcoidosis, a rare cause of hypercalcemia in an older individual. (Source: Journal of Acute Medicine)
Source: Journal of Acute Medicine - November 25, 2014 Category: Emergency Medicine Source Type: research
Citalopram-induced severe hyponatremia
Publication date: Available online 25 November 2014 Source:Journal of Acute Medicine Author(s): Rajashri V. Patil , Ryan Buchanan , Hannah Kingston , Sandeep Deshmukh Citalopram-induced syndrome of inappropriate antidiuretic hormone secretion (SIADH) causing hyponatremia is well documented; however, severe hyponatremia with small doses has not been previously reported. An 84-year-old woman presented with acute confusion and gait disturbance of 3–4 days' duration and a 2-day history of vomiting but managed to maintain fluid intake. Seven days earlier she was started on citalopram 10 mg per day for low mood. On ex...
Source: Journal of Acute Medicine - November 25, 2014 Category: Emergency Medicine Source Type: research
Psychotic appearances in a young girl: Thyroid storm
In this report, a 14-year-old teenage girl presented to the emergency department (ED) under suspicion of sexual assault by her father. The initial vital signs were low-grade fever, sustained tachycardia, and psychosis-like behavior. A series of examinations was performed during the ED survey, but no definite diagnosis was found. After a 24-hour observation period, her consciousness level deteriorated, followed by the onset of seizures. She was promptly diagnosed with thyroid storm. This case should alert ED physicians to the potential clinical significance of thyroid storm in a pediatric patient presenting with psychotic s...
Source: Journal of Acute Medicine - October 12, 2014 Category: Emergency Medicine Source Type: research
The fatal rupture of an Aspergillus aneurysm of the cerebral artery that presented as a flu-like syndrome
We reported a 61-year-old male with the above presentations collapsed unexpectedly shortly after been seen by emergency physicians without any imminent signs. He was eventually diagnosed as having an Aspergillus infection of the central nervous system. The clinical manifestations of intracranial Aspergillus infection are subtle and highly variable in term of severity, onset and progression. Early detection is often difficult and even aggressive treatment often results in a drastic medical outcome, which has legal implications for the treating physicians. This case typifies the high stakes associated with the diagnostic cha...
Source: Journal of Acute Medicine - October 12, 2014 Category: Emergency Medicine Source Type: research
Prediction of early mortality in patients with paraquat intoxication
Conclusion The presence of systemic inflammatory response syndrome, early tachycardia and renal failure predicted early mortality. (Source: Journal of Acute Medicine)
Source: Journal of Acute Medicine - October 12, 2014 Category: Emergency Medicine Source Type: research
Emergency department staff's attitudes toward narcotics and drug-seeking patients who fabricate symptoms: A multicenter survey
Conclusion The fabricated drug-seeking behavior patterns described by the ED staff were similar to the descriptions mentioned in the literature and their attitudes toward prescribing narcotics were conservative. However, more interventions to overcome staff's opiophobia are needed to improve pain management. Reported fabricating drug seekers usually complain of abdominal pain, while parenteral meperidine was the most sought-after drug. (Source: Journal of Acute Medicine)
Source: Journal of Acute Medicine - October 12, 2014 Category: Emergency Medicine Source Type: research
Comment on “An extremely rare case of whirl sign in combination with colonic pneumatosis intestinalis: What is your provisional diagnosis?”
Publication date: June 2013 Source:Journal of Acute Medicine, Volume 3, Issue 2 Author(s): Yi-Hsien Huang , Wing-Keung Cheung , Min-Po Ho (Source: Journal of Acute Medicine)
Source: Journal of Acute Medicine - October 12, 2014 Category: Emergency Medicine Source Type: research
Occult thoraco-abdominal injuries from an airbag and seatbelt
We report a case of occult thoraco-abdominal trauma in a patient who was wearing a three-point seatbelt and had airbag protection. A 59-year-old man presented to the emergency department in shock after a motor vehicle accident. He was protected by a three-point seatbelt and airbag. Chest radiographs and focused assessment with sonography for trauma showed no abnormalities. However, computed tomography revealed multiple injuries in the chest and abdomen. This case report highlights occult thoraco-abdominal trauma in a victim protected by a seatbelt and airbag, which may be a pitfall for emergency physicians. Emergency physi...
Source: Journal of Acute Medicine - October 12, 2014 Category: Emergency Medicine Source Type: research
Coexisting atrial fibrillation and paralysis as a result of hypokalemia in a Caucasian man with Graves' disease
Publication date: June 2013 Source:Journal of Acute Medicine, Volume 3, Issue 2 Author(s): Neslihan Kurtulmus , Seden Erten Çelik A 29-year-old Caucasian man with a history of Graves' disease for 6 weeks presented to our emergency department at midnight with muscle weakness. He had woken up after 1–2 hours of sleep with weakness in his lower extremities. Electrocardiography (ECG) showed atrial fibrillation. His potassium level was 2.6 mEq/L. His ECG was monitored, and potassium chloride mixed with a normal saline infusion (20 mEq/L) was given for 1 hour. After his potassium level returned to normal (4.63 mEq/L)...
Source: Journal of Acute Medicine - October 12, 2014 Category: Emergency Medicine Source Type: research
Initial presentation of mesenteric venous thrombosis mimicking acute duodenitis: A true gastrointestinal vascular emergency
We present a patient who had a 3-day history of epigastric pain and acid regurgitation and was found to have gastroesophageal reflux disease and duodenitis by esophagogastroduodenoscopy. His symptoms were refractory to treatment with a proton pump inhibitor. Peritonitis developed subsequently. Enhanced computed tomography (CT) confirmed a diagnosis of mesenteric venous thrombosis (MVT) with jejunum infarction. Emergency exploratory laparotomy with segmental resectioning of the jejunum was performed. We emphasize that emergency department (ED) physicians should always thoroughly re-evaluate patients with abdominal pain usin...
Source: Journal of Acute Medicine - October 12, 2014 Category: Emergency Medicine Source Type: research
Effect of 70% ethanolic extract of roots of Paeonia officinalis Linn. on hepatotoxicity
Conclusion The results of this study indicate that roots of P. officinalis possess hepatoprotective activity. (Source: Journal of Acute Medicine)
Source: Journal of Acute Medicine - October 12, 2014 Category: Emergency Medicine Source Type: research
Hematological and biochemical changes in diabetic rats fed with fiber-enriched cake
Conclusion These results indicate the potentials of the fiber-enriched cake as a functional food with a therapeutic effect against hematological and biochemical changes associated with diabetes mellitus. Consequently, such a cake can serve as an adjunct to dietary therapy for diabetes. (Source: Journal of Acute Medicine)
Source: Journal of Acute Medicine - October 12, 2014 Category: Emergency Medicine Source Type: research
Evaluation of the association between postintubation hypotension and lidocaine administered as a premedication for rapid sequence intubation: A comparison between traditional regression methods and propensity score matching-based method
Conclusion Lidocaine injection could be associated with PIH; however, further investigation is needed. Alternative statistical methods should be considered when making a causal inference. (Source: Journal of Acute Medicine)
Source: Journal of Acute Medicine - October 12, 2014 Category: Emergency Medicine Source Type: research
Upper abdominal pain and hypovolemic shock in pregnancy
Publication date: September 2013 Source:Journal of Acute Medicine, Volume 3, Issue 3 Author(s): Fayna Rodríguez-González , Efrén Martínez-Quintana (Source: Journal of Acute Medicine)
Source: Journal of Acute Medicine - October 12, 2014 Category: Emergency Medicine Source Type: research
