J Emerg Med
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Review Case Reports
Management of Subcutaneous Emphysema with "Gills": Case Report and Review of the Literature.
Subcutaneous emphysema is often a symptom of a serious pathologic condition but rarely requires direct treatment. Subcutaneous emphysema itself occasionally may interfere with effective cardiopulmonary resuscitation and require direct intervention. ⋯ Subcutaneous emphysema and pneumomediastinum can cause tension physiology, impairing normal cardiovascular and pulmonary function. Only with release of this tension can normal cardiopulmonary function return. The gills procedure is one of several possible therapeutic options.
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Angiotensin-converting-enzyme inhibitors (ACEI) are one of the most prescribed medications worldwide. Angioedema is a well-recognized adverse effect of this class of medications, with a reported incidence of ACEI angioedema of up to 1.0%. Of importance to note, ACEI angioedema is a class effect and is not dose dependent. The primary goal of this literature search was to determine the appropriate Emergency Department management of patients with ACEI angioedema. ⋯ The literature search did not support any specific treatment protocol with a high level of evidence due to the limited--and limitations of the--available studies.
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Review Case Reports
Pericarditis and Pulmonary Artery Stenosis Due to an Extragonadal Non-seminomatous Germ Cell Tumor: Case Report and Review of the Literature.
Chest pain is a common complaint in the Emergency Department that rarely can be attributed to anterior mediastinal masses. ⋯ Pericarditis and right ventricular outflow obstruction are potential complications of anterior mediastinal non-seminomatous germ cell tumors.
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Angioedema (AE) is characterized by nonpitting edema of the dermis and subcutaneous layers. The most common sites of involvement are the tongue, lips, face, and throat; however, swelling can also occur in the extremities, genitalia, and viscera. Life-threatening airway swelling can also occur. AE may be allergic or nonallergic. The overall lifetime incidence of AE is reported to be as high as 15%. ⋯ New HAE medications that correct imbalances in the kallikrein-kinin system may prove safe and efficacious in the treatment of ACEi-AE.
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Review Case Reports
Septic Arthritis of the Temporomandibular Joint: Case Reports and Review of the Literature.
Septic arthritis of the temporomandibular (TM) joint is rare, but it is associated with high risk for significant morbidity. ⋯ Septic arthritis of the TM joint may be caused by hematogenous spread of distant infection or local spread of deep masticator space infections. Patients may present with TM joint septic arthritis acutely or sub-acutely. Septic arthritis of the TM joint should be considered in the differential diagnosis of patients who present with trismus and pain or fever.