The American journal of emergency medicine
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Syncope is a common emergency department (ED) chief complaint, with many known but also unknown causes. Here we present a novel ED presentation of a young woman with new-onset hyperthyroidism that masqueraded as a syncopal event with head trauma. ⋯ Persistent tachycardia during her ED course after an unremarkable full trauma evaluation prompted ordering of additional lab testing, which revealed evidence of thyrotoxicosis. Here we consider the possibility of thyroid dysfunction resulting in syncope.
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We aimed to describe characteristics, etiology and health care use in children with low back pain (LBP) presenting to pediatric emergency department (ED) and to develop an algorithm to design a diagnostic approach. ⋯ Our study identified significative high-risk factors (red flags) associated with serious outcomes (SPC group) compared to the non-SPC group, thereby ensuring specific treatment. We developed an algorithm based on previous literature and the findings of our study, which will need to be validated by future prospective research.
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Letter Randomized Controlled Trial
Which technique for resuscitation physicians should use? Preliminary data.
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Case Reports
Digoxin-specific Fab and therapeutic plasma exchange for digitalis intoxication and renal failure.
Treatment of chronic digitalis intoxication includes suspension of drug intake, which may be sufficient in case of mild manifestations, and supportive measures. Severe bradycardia requires the administration of atropine or isoproterenol; placement of a temporary pacemaker may be required in case of absent response to pharmacological therapy. ⋯ Therapeutic plasma exchange has been suggested, in addition to Fab therapy, to maximize the clearance of Fab-digoxin complexes in patients with renal failure. To date, few case reports have described the use of such a therapeutic approach; currently, extracorporeal methods are not recommended as part of the treatment of digitalis intoxication, and stronger evidence is required to establish their benefit.
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A healthy 30 year old female G1P1 presented to the ED with a chief complaint of abdominal pain, shortness of breath and bloating 72 hours after an egg retrieval out of state. She states she had two injections of an unknown hormone therapy and that the retrieval was uncomplicated. ⋯ Her abdomen is distended and non-focally tender but not peritoneal. Point-of-care FAST exam was immediately performed showing free fluid (Fig. 1) and enlarged, cystic appearing ovaries (Fig. 2).