The American journal of the medical sciences
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Review Case Reports
Acute diquat poisoning causes rhabdomyolysis: a case report and literature review.
We studied the case of a 36-year-old female patient who self-administered about 30 ml of diquat solution (200 g/L) during a suicide attempt. She developed nausea, vomiting, dizziness, and weakness in her limbs and was admitted to the emergency department of our hospital 4 h later. The patient developed progressive swelling and pain in both calves 12 h after admission. ⋯ We attempted to analyze the mechanism of this symptom through a literature review. We recommend the routine monitoring of creatine phosphokinase (CK) and myoglobin (MYO) in patients with diquat poisoning to avoid missed diagnosis. Further, the mechanism of this poisoning symptom was discussed through the literature review.
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Diuretics are amongst the most prescribed medications in both the inpatient and outpatient settings. They are used extensively in diverse disease states including heart failure, acute and chronic kidney disease, cirrhosis, and diseases of excess capillary permeability such as sepsis, malignancy, and malnutrition. All are characterized by total body sodium overabundance which commonly manifests as edema. ⋯ These complications frequently limit the correction of hypervolemia, resulting in continued patient suffering and frustration for the clinician. In this review, we employ a case-based approach to discuss three common challenges encountered during diuretic therapy: diuretic resistance that characterizes the nephrotic syndrome, diuretic-induced metabolic alkalosis, and diuretic-associated hyponatremia. We empower the clinician to effectively meet these challenges by providing a mechanistic understanding of these complications and their solutions.
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Review Case Reports
Hepatic cortical blindness: a case report and comprehensive literature review.
Hepatic cortical blindness is an unusual clinical complication of hepatic encephalopathy, and its epidemiology has not been studied in detail. Herein, we present a case report of a 37-year-old male with liver cirrhosis and immunoglobulin A nephropathy who noted visual impairment after eating high-protein food. In addition to the case report, all previously documented cases of hepatic cortical blindness occurring across the globe published from inception until August 2019 were reviewed. ⋯ The diagnosis of hepatic cortical blindness is dependent on symptoms, and patients may experience several attacks of vision loss. Most patients experience complete blindness, but vision loss recovers within 10 min to one month. Early detection and therapy for hepatic encephalopathy may improve patient outcome.
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Hyperkalemia (HK) may be associated with poor clinical outcomes among COVID-19 patients. This study aimed to describe the prevalence of HK and evaluate the associations between HK and in-hospital mortality, intensive care unit (ICU) admission, length of hospital stay (LOS), and hospitalization cost among COVID-19 inpatients. ⋯ Presence of HK was independently associated with higher in-hospital mortality, LOS, and cost of care among COVID-19 inpatients. Detecting and closely monitoring HK are recommended to improve clinical outcomes and reduce LOS and healthcare cost among COVID-19 patients.
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A community-based, colorectal cancer (CRC) screening program for uninsured/underinsured individuals was successfully implemented in El Paso, Texas to increase CRC screening rates. Our aim was to determine the colorectal neoplasia prevalence among program participants and between screening groups. ⋯ This community-based CRC screening program in an enriched cohort of predominantly Mexican Americans was effective in identifying colorectal neoplasia and cancer. Additionally, there was an increased prevalence of colorectal neoplasia in average-risk, FIT-positive patients undergoing screening colonoscopy compared with above average-risk patients with a family history of CRC. Similar screening programs would likely benefit at-risk populations.