Heart & lung : the journal of critical care
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Case Reports
Atypical presentation of varicella-zoster virus encephalitis in an immunocompetent adult.
Varicella-zoster virus encephalitis is uncommon, but not rare, in immunocompetent adults. Typically, patients develop stroke with hemiplegia caused by large vessel vasculopathy days to weeks after herpes zoster ophthalmicus. ⋯ This is a case of varicella-zoster virus encephalitis in an immunocompetent patient presenting without typical rash and with clinicoradiologic features of multifocal encephalitis, which characterize immunosuppression.
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The objective was to study patients' interpretations, thoughts, and actions after symptom onset in acute coronary syndrome (ACS) in total and in relation to gender, age, history of coronary artery disease, type of syndrome, and residential area and its influence on prehospital delay. ⋯ Interpreting symptoms as cardiac in origin and approaching someone after symptom onset were major reasons for a shorter prehospital delay in ACS.
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Comparative Study
Needs of family members of critically ill patients: a comparison of nurse and family perceptions.
Critical illness often occurs without warning. leaving families feeling vulnerable and helpless with no clear knowledge of what to expect from health care professionals or patient outcome. The challenge for critical care nurses (Registered Nurses [RNs]) is to provide care for aggressively managed, critically ill patients while attending to the needs of stressed family members. ⋯ Family needs were categorized according to Leske's dimensions of assurance, proximity, information, comfort, and support. By implementing specific cost-effective strategies to increase family access to the patient, to improve communication with the physician and the health care team, and to create a family-friendly environment, critical care RNs can meet family member needs and improve the quality of nursing care.
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A 24-year-old man developed systolic hypertension as a result of renal contusion, perinephric fluid collection, and renal compression (Page kidney) after blunt renal trauma. The patient was treated with an angiotensin-converting enzyme inhibitor for 30 days, after which his blood pressure normalized and the medications were discontinued. ⋯ Transient hypertension may develop in patients after blunt renal injury as a result of Page phenomenon. Appropriate medical therapy is warranted and may be successful because spontaneous resolution may be delayed or not occur at all.