The American journal of emergency medicine
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Randomized Controlled Trial
Effectiveness of therapeutic plasma exchange in patients with intermediate syndrome due to organophosphate intoxication.
We aimed to determine effectiveness of therapeutic plasma exchange (TPE) in patients with intermediate syndrome (IMS) due to organophosphate (OP) intoxication. ⋯ In our study, it was observed that a significant decrease in the level of blood plasma OP and a significant increase in the level of PChE were achieved with TPE process in the early period of IMS due to OP poisoning. This study indicates that TPE is one of the effective treatment options for IMS due to OP intoxication.
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A 58-year-old man presented to the emergency department with a persistent left-sided sore throat of 2-month duration. The sore throat had not responded to antibiotic therapy. Over the past week, the soreness had increased and was aggravated by opening the mouth. ⋯ In the upper left neck, a 3-cm, firm, nontender, lymph node was palpated anterior to the sternocleidomastoid muscle. A computed tomography of the neck with contrast revealed an enhancing tonsillar mass as well as enlarged lymph nodes bilaterally. A transoral biopsy returned squamous cell carcinoma.
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Case Reports
Spontaneous hemothorax following thrombolytic and anticoagulant therapy for massive pulmonary embolism.
Massive spontaneous hemothorax following combined thrombolytic and anticoagulant therapy for pulmonary embolism(PE) is a rare event that is little documented in the literature. Here, we describe a rare case of spontaneous hemothorax in a 23-year-old woman with underlying systemic lupus erythematosus following combined administration of tissue plasminogen activator and low-molecular-weight heparin for massive PE. This report of our successful treatment of this case by video-assisted thoracoscopic thoracotomy demonstrates that although the occurrence is rare, massive hemothorax following anticoagulant and/or thrombolytic therapy for PE should be suspected if patients experience chest pain, dyspnea, or signs of anemia, and follow-up physical examination and hemogram should be performed to facilitate diagnosis of this life-threatening complication.