The American journal of emergency medicine
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Review Case Reports
A rare seizure: Tumor lysis syndrome after radiation therapy of a solid tumor.
Tumor lysis syndrome (TLS) is an uncommon but life threatening condition seen in oncology patients. Due to its underlying pathophysiology, it is classically associated with hematologic malignancies following chemotherapeutic treatment. In this article, we present a case of TLS in the setting of two rare features: a solid tumor malignancy and the absence of recent chemotherapy. We briefly review risk factors and the diagnosis of this potentially fatal but treatable condition.
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Observational Study
Temperature variability during targeted temperature management is not associated with neurological outcomes following cardiac arrest.
Recent studies on comatose survivors of cardiac arrest undergoing targeted temperature management (TTM) have shown similar outcomes at multiple target temperatures. However, details regarding core temperature variability during TTM and its prognostic implications remain largely unknown. We sought to assess the association between core temperature variability and neurological outcomes in patients undergoing TTM following cardiac arrest. ⋯ In this study, individual core temperature variability during TTM was not associated with poor neurological outcomes or death at hospital discharge.
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Observational Study
Evaluating the value of dynamic procalcitonin and presepsin measurements for patients with severe sepsis.
This study comparatively evaluated the value of dynamic procalcitonin (PCT) and presepsin measurements in assessing therapeutic efficacy and prognosis for patients with severe sepsis. ⋯ Dynamic monitoring of presepsin and PCT demonstrated that both presepsin and CR of presepsin are continuous and better markers than are PCT and CR of PCT for evaluating the therapeutic efficacy and prognosis of patients with severe sepsis.
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Observational Study
Simple method for obtaining the optimal laryngoscopic view in children: A prospective observational study.
Head and neck positioning has an important effect on laryngeal visualization during laryngoscopy. For small children and infants, a head-flat position is traditionally assumed; however, during laryngoscopy, the optimal head position may result in a superior laryngeal view in certain patients. ⋯ Positioning of the head in order to align it with the external auditory meatus and sternal notch was associated with superior laryngoscopic visualization in pediatric patients. This resulted, in a more straightforward laryngoscopic procedure.
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Case Reports
Post-partum hemorrhage complicated by reverse-Takotsubo cardiogenic shock; a novel therapeutic approach.
Takotsubo Cardiomyopathy (TTC) is a type of transient, yet severe left ventricular systolic dysfunction, rarely complicating extreme emotional stress ("primary" TTC) or critical medical/surgical illness ("secondary" TTC forms). Although usually reversible, TTC may result in cardiogenic shock with dismal prognosis. "Secondary" TTC forms are particularly in danger for this complication, bearing significantly worse short and long-term prognosis. Herein, we report a rare case of a life-threatening "secondary" TTC in a patient with post-cesarean section severe hemorrhage, and we point out that early co-administration of esmolol and levosimendan might be an effective and safe therapeutic approach in "reversing" TTC-induced cardiogenic shock, especially when invasive therapeutic strategies are practically unfeasible.