J Emerg Med
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Upper airway obstruction due to a subglottic tumor can be easily misdiagnosed as bronchial asthma. We report on a 50-year-old woman who was ultimately diagnosed with subglottic tumor, but who presented with near-fatal asthma. According to her medical history she had been treated with high doses of prednisolone and bronchodilators for the past year for difficult asthma. ⋯ After the operation, all symptoms and respiratory distress disappeared. This case report emphasizes the fact that not all wheezes are attributable to asthma. Upper airway obstructions can lead to asthma-like symptoms in which establishment of the correct diagnosis may be challenging.
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Case Reports
Heterotopic gestation: another possibility for the emergency bedside ultrasonographer to consider.
Emergency bedside ultrasonography has become an important tool in differentiating an intrauterine from an ectopic pregnancy. As the odds of a heterotopic pregnancy were thought to be minute, some ultrasonographers and Emergency Physicians certified in bedside ultrasonography have taught that an intrauterine gestation with fetal heart tones clinches the diagnosis of intrauterine pregnancy. However, with the current rise in heterotopic gestations, this standard of care should be re-evaluated. If emergency bedside ultrasonography reveals an intrauterine gestation in the presence of either a moderate amount of free fluid in the pelvis or a co-existent ovarian cyst, one must consider and search for a heterotopic pregnancy.
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The objectives of the present study were to determine the behavioral and psychological risk factors associated with injury. The most widely investigated risk factor for injury is alcohol use. However, other behavioral and psychological risk factors may also contribute to injuries. ⋯ The results from a multivariate analysis controlling for age, gender, and ethnicity indicated that, in addition to alcohol consumption (OR = 2.2, 95% CI = 1.1-4.5), driving (OR = 2.4, 95% CI = 1.7-3.5) and violence-related risk behaviors (OR = 1.6, 95% CI = 1.0-2.2) are significantly associated with injury. In conclusion, the engagement in injury-related risk behaviors, including alcohol use, is strongly associated with injury status. Brief interventions that directly address these behavioral risk patterns in injured patients may reduce their risk of future injury.