Magnum, P.I.

​An 11-year-old boy with cerebral palsy presented to the emergency department unresponsive. His mother said the child was in his normal state earlier that morning, but was blue and unresponsive when she tried to wake him from his morning nap. A home pulse oximeter reported an oxygen level of 55%.The mother placed the child on oxygen and called 911. He was still unresponsive on arrival, and his physical examination demonstrated flaccid paralysis and a GCS score of 3 with fixed dilated pupils. He was tachycardic with shallow respirations. His initial vital signs were a temperature of 36.9°C, a heart rate of 136 bpm, a respiratory rate of 16 bpm, and a blood pressure of 89/38 mm Hg.The boy was G-tube dependent, and his mother stated that he also had chronic GI bleeding and was supposed to see the gastroenterologist the next day. His medication list included valproic acid, felbamate, topiramate, and baclofen. His initial VBG showed a pH of 7.01, a CO2 of 126.02, and an HCO3 of 31.1, with a lactic acid of 2.8. He was intubated because of his mental status and admitted to the PICU, where the mother reported that she had also given him 240 mL of magnesium citrate to prep him for a colonoscopy he was due to have the following day.What Is the Differential?Brain stem herniationSepsisBaclofen, topiramate, or valproic acid overdoseHyperammonemia secondary to valproic acidHypermagnesemia The Clinical Effects of HypermagnesemiaNormal serum levels range from 1.3 to 2.2 mEq/L. Onl...
Source: The Tox Cave - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Related Links:

Authors: Rombauts A, Abelenda-Alonso G, Cuervo G, Gudiol C, Carratalà J Abstract INTRODUCTION: Despite adequate antibiotic coverage, community-acquired pneumonia (CAP) remains a leading cause of hospitalization and mortality worldwide. It induces both a local pulmonary and a systemic inflammatory response, particularly significant in severe cases. The intensity of the dysregulated host response varies from patient to patient and has a negative impact on survival and other outcomes. AREAS COVERED: This comprehensive review summarizes the pathophysiological aspects of the inflammatory response in CAP, brie...
Source: Expert Review of Anti-Infective Therapy - Category: Infectious Diseases Tags: Expert Rev Anti Infect Ther Source Type: research
Publication date: Available online 30 September 2020Source: Journal of Hazardous MaterialsAuthor(s): Anthony Beauvois, Delphine Vantelon, Jacques Jestin, Martine Bouhnik-Le Coz, Charlotte Catrouillet, Valérie Briois, Thomas Bizien, Mélanie Davranche
Source: Journal of Hazardous Materials - Category: Environmental Health Source Type: research
Publication date: Available online 10 October 2020Source: American Journal of Kidney DiseasesAuthor(s): Ibironke W. Apata, Sarah Kabbani, Alicia M. Neu, Tamara M. Kear, Erika M.C. D’Agata, David J. Levenson, Alan S. Kliger, Lauri A. Hicks, Priti R. Patel, authors constitute the ASN and CDC Antibiotic Stewardship White Paper Writing Group
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
Source: European Journal of Sport Science - Category: Sports Medicine Authors: Source Type: research
Authors: Zhao N, Xiang Q, Liu Z, Zhao X, Cui Y Abstract INTRODUCTION: There remains an unmet need for better anticoagulants. The phase I clinical trial is of great significance in the development of anticoagulants, and the design is special. This system review aims to provide insights for the design of future phase I clinical trials of anticoagulants. AREAS COVERED: We searched the database PubMed and ClinicalTrail.gov website, to collate the phase I clinical trial of anticoagulants in healthy people. The study protocol, inclusion exclusion criteria, safety and pharmacodynamic indexes were reviewed. EXPERT ...
Source: Expert Review of Clinical Pharmacology - Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research
Authors: Saavedra J, Reyes JG, Salinas DG Abstract Cytosolic Ca2+ concentration ([Ca2+ ]) has an important role in spermatozoa and hence it regulates fertilization. In male germinal cells, there are indirect evidences that this ion could regulate physiological processes in spermatogenesis. Since little is known about Ca 2+ homeostasis in spermatogenic cells, in this work we propose a mathematical model that accounts for experimental [Ca2+ ] dynamics triggered by blockade of the SERCA transport ATPase with thapsigargin in round rat spermatids, without external Ca2+ and with different extracellular lactate concentrat...
Source: Channels - Category: Molecular Biology Tags: Channels (Austin) Source Type: research
Conclusion: By underlining the gaps of knowledge and attitude towards breastfeeding of nurses working in NICUs, this study provides an insight into what needs to be improved, with the aim of promoting higher rates of breastfeeding in the preterm population.What is Known:•Breastfeeding is particularly challenging in the preterm population, despite its universally recognized health benefits.•Improving healthcare professionals ’ knowledge and attitude towards breastfeeding has been shown to be crucial for promoting breastfeeding in NICUs.What is New:•Our results provide useful insight into nurses ’ ...
Source: European Journal of Pediatrics - Category: Pediatrics Source Type: research
Publication date: October 2020Source: Brain, Behavior, and Immunity, Volume 89Author(s): Mario Gennaro Mazza, Rebecca De Lorenzo, Caterina Conte, Sara Poletti, Benedetta Vai, Irene Bollettini, Elisa Maria Teresa Melloni, Roberto Furlan, Fabio Ciceri, Patrizia Rovere-Querini, COVID-19 BioB Outpatient Clinic Study group, Francesco Benedetti
Source: Brain, Behavior, and Immunity - Category: Neurology Source Type: research
Publication date: October 2020Source: Brain, Behavior, and Immunity, Volume 89Author(s): Xiaoqin Liu, Trine Munk-Olsen, Clara Albiñana, Bjarni J. Vilhjálmsson, Emil M. Pedersen, Vivi Schlünssen, Marie Bækvad-Hansen, Jonas Bybjerg-Grauholm, Merete Nordentoft, Anders D. Børglum, Thomas Werge, David M. Hougaard, Preben B. Mortensen, Esben Agerbo
Source: Brain, Behavior, and Immunity - Category: Neurology Source Type: research
Publication date: October 2020Source: Brain, Behavior, and Immunity, Volume 89Author(s): Fernando Lopes, Fernando A. Vicentini, Nina L. Cluny, Alexander J. Mathews, Benjamin H. Lee, Wagdi A. Almishri, Lateece Griffin, William Gonçalves, Vanessa Pinho, Derek M. McKay, Simon A. Hirota, Mark G. Swain, Quentin J. Pittman, Keith A. Sharkey
Source: Brain, Behavior, and Immunity - Category: Neurology Source Type: research
More News: Baclofen | Bleeding | Blogging | Brain | Calcium | Cardiology | Cerebral Palsy | Children | Chloride | Colonoscopy | Constipation | Depression | Dialysis | Emergency Medicine | Furosemide | Gastroenterology | Heart | Hemodialysis | Hospitals | Magnesium | Men | Milk | Neurology | Overdose | Pneumonia | Potassium | Pre-eclampsia | Respiratory Medicine | Sodium Chloride | Topamax | Toxicology