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A Serious Diagnosis Lacking Common Symptoms
​BY JENNIFER TUONG; IVAN KHARCHENKO; JEAN LUC AGARD; & AHMED RAZIUDDIN, MDA 65-year-old man who had HIV well-controlled with highly active antiretroviral therapy, hypertension, sciatica, and restless leg syndrome presented to the emergency department with left leg pain. He also had had chemotherapy and radiation for anal cancer. The patient said the pain had started 45 minutes earlier when he was sitting on the toilet.He described the pain as sore in quality and 10/10 on the pain scale. He reported that it had started in his lower back and radiated to his left leg. He said he had had no trauma or weakness to the regi...
Source: The Case Files - May 28, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Prevalence of Hypertension among Patients Attending Mobile Medical Clinics in the Philippines after Typhoon Haiyan
Conclusions Better planning and preparation by humanitarian actors seeking to decrease the overall morbidity and mortality associated with disasters should include treatment of NCDs. There is limited evidence regarding the optimal management of hypertension in disaster settings. Clinical care of patients with hypertension and other NCDs is an important part of disaster relief and recovery. We recommend future studies to determine best practices and evidence-based management of other NCDs (such as diabetes mellitus, cardiovascular disease, chronic lung disease, mental health etc.) in post-disaster settings. Competing Inter...
Source: PLOS Currents Disasters - December 20, 2016 Category: Global & Universal Authors: lindamob01 Source Type: research

Trends in Hospitalization for Hypertensive Emergency, and Relationship of End-Organ Damage With In-Hospital Mortality.
CONCLUSION: A rising trend in hospitalization for HTNE, with an overall decrease in in-hospital mortality was observed from 2002 to 2012, possibly related to changes in coding practices and improved management. Presence of acute cardiorespiratory failure, stroke/TIA, chest pain, and aortic dissection were most predictive of higher hospital mortality. PMID: 28430850 [PubMed - as supplied by publisher]
Source: American Journal of Hypertension - April 20, 2017 Category: Cardiology Authors: Shah M, Patil S, Patel B, Arora S, Patel N, Garg L, Agrawal S, Jacobs L, Steigerwalt SP, Martinez MW Tags: Am J Hypertens Source Type: research

Preventable Cases of Oral Anticoagulant-Induced Bleeding: Data From the Spontaneous Reporting System
Conclusion: Our findings describe the most reported risk factors for preventability of oral anticoagulant-induced bleedings. These factors may be useful for targeting interventions to improve pharmacovigilance activities in our regional territory and to reduce the burden of medication errors and inappropriate prescription. Introduction Oral anticoagulant therapy is widely used for the prevention of stroke and systemic embolism in patients with atrial fibrillation, or for the prevention and treatment of deep vein thrombosis and pulmonary embolism (Raj et al., 1994; Monaco et al., 2017). Oral anticoagulants can be di...
Source: Frontiers in Pharmacology - April 29, 2019 Category: Drugs & Pharmacology Source Type: research

Sudden Death in High School Athletes: A Case Series Examining the Influence of Sickle Cell Trait
We present a case series of fatal ECAST in high school athletes aged 14 to 16 years. All 3 athletes experienced collapse during practice sessions with muscle pain or weakness. Upon evaluation at the hospital, the athletes had a significant metabolic acidosis that did not respond as expected to fluid resuscitation. Admitting diagnoses for the athletes included exertional heat stroke or dehydration. All 3 athletes had profound rhabdomyolysis leading to acute renal failure, worsening metabolic acidosis, and hyperkalemia. They rapidly progressed to disseminated intravascular coagulation, multiorgan system failure, and death. T...
Source: Pediatric Emergency Care - February 1, 2022 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Acute Aortic Emergencies—Part 2 Aortic Dissections
Patients with aortic disease are some of the highest acuity patients that emergency clinicians encounter. Dissection is the most common aortic catastrophe and involves separation of the aortic layers in a longitudinal fashion leading to diminished perfusion and systemic ischemia. Characteristics of pain, branch vessel involvement, and incidence lead to an understanding of patient presentation, morbidity, and mortality. Diagnosis, selection of diagnostic studies, the degree of preoperative ischemia, and risk of operative mortality can be accomplished using validated clinical decision tools. Emergency interventions are guide...
Source: Advanced Emergency Nursing Journal - January 1, 2013 Category: Emergency Medicine Tags: Cases of Note Source Type: research

Contemporary Management of Type B Aortic Dissection in the Endovascular Era.
Authors: Bannazadeh M, Tadros RO, McKinsey J, Chander R, Marin ML, Faries PL Abstract Aortic dissection (AD) is one of the most common catastrophic pathologies affecting the aorta. Anatomic classification is based on the origin of entry tear and its extension. Type A dissections originate in the ascending aorta, whereas the entry tear in Type B dissections starts distal to the left subclavian artery. The patients with aortic dissection who manifest complications such as rupture, malperfusion, aneurysmal degeneration, and intractable pain are classified as complicated AD. Risk factors for developing aortic dissectio...
Source: Surgical Technology International - May 15, 2016 Category: Surgery Tags: Surg Technol Int Source Type: research

Patterns and consequences of multimorbidity in the general population: There is no chronic disease management without rheumatic disease management
Conclusion: Our study emphasizes RMDs as a major presence in multimorbidity in the general population. All multimorbidity patterns were associated with a wide set of adverse health outcomes. Management strategies for the patient with chronic cardiometabolic, respiratory or depressive conditions should also target RMDs. This article is protected by copyright. All rights reserved.
Source: Arthritis Care and Research - August 1, 2016 Category: Rheumatology Authors: Daniela Sim ões, Fábio A. Araújo, Milton Severo, Teresa Monjardino, Ivo Cruz, Loreto Carmona, Raquel Lucas Tags: Original Article Source Type: research

Case Report: First Two Identified Cases of Fabry Disease in Central Asia
Conclusion: This is the first description of cases of Fabry disease in Central Asia. An extensive family pedigree enabled the identification of ten additional family members. Patients with rare genetic diseases often experience substantial delays in diagnosis due to their rarity and non-specific symptoms, which can negatively impact their management and delay treatment. FD may be difficult to diagnose because of the non-specificity of its early and later-onset symptoms and its X-linked inheritance. Raising awareness of clinicians is important for earlier diagnosis and optimal outcome of specific therapies.
Source: Frontiers in Genetics - April 27, 2021 Category: Genetics & Stem Cells Source Type: research

Pulmonary Embolism and Cardiac Tamponade in Critical Care Patients with COVID-19; Telemedicine's Role in Developing Countries: Case Reports and Literature Review
CONCLUSIONS: During admission, both patients had sudden deterioration characterized by oxygen desaturation and hypotension necessitating inotropic support. As a result, for both patients, bedside echocardiography was performed by the attending intensivist. Echocardiographic findings showed cardiac tamponade and acute pulmonary embolism, respectively, which were confirmed by a cardiologist through telemedicine technology. Proper emergency management was initiated, and both patients recovered well. Limited bedside transthoracic echocardiography had a front-line impact on the treatment and outcome of the two patients with COV...
Source: Pain Physician - August 2, 2021 Category: Anesthesiology Authors: Islam Mohammed Sheata Scott Richard Smith Heba Kamel Giustino Varrassi Farnad Imani Abdolreza Dayani Dariusz Myrcik Ivan Urits Omar Viswanath Sameh Salem Taha Source Type: research