Reducing treatment delay and improving diagnostic accuracy for patients with acute stroke.
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Acute Disease↗
Biomedical subjects
D Mines
Publications and source records attributed to D Mines.
Poisonings: food, fish, shellfish.
Not every traveler who gets sick away from home has an infection; some are poisoned. This article describes common and dangerous illnesses caused by food-borne toxins. It explores the toxic illnesses acquired from fish or seafood, including scombroid, ciguatera, pufferfish toxicity, and a variety of shellfish poisonings. It also provides a brief overview of plant toxicity. Although gastroenteritis is a common feature of many food poisonings, this article emphasizes those processes associated with neurologic manifestations, as they tend to be more dangerous to patients and less well understood by physicians. It also stresses strategies to prevent food poisoning.
Animals↗
Hydroxyapatite pseudopodagra in a young man: acute calcific periarthritis of the first metatarsophalangeal joint.
Pain and swelling at the first metatarsophalangeal joint can be caused by acute calcific periarthritis (ACP), an inflammatory condition resulting from deposition of hydroxyapatite crystals. A case is reported of a 23-year-old man in whom ACP was initially mistaken for gout, septic arthritis, and cellulitis. The diagnosis of ACP is based on the finding of inflammation around a joint along with radiographic evidence of periarticular soft tissue calcifications. Calcifications may disappear over time, as they did in this case. Failure to recognize this condition can lead to unnecessary testing and inappropriate treatment.
Acute Disease↗
The ED status board as a threat to patient confidentiality.
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Confidentiality↗
Serum tryptase in idiopathic anaphylaxis: a case report and review of the literature.
Anaphylaxis is a life-threatening disease that characteristically presents with multiple arrays of dermatologic, respiratory, cardiovascular, and gastrointestinal derangements, in general, suddenly after exposure to an allergen. It can, however, occur without an identifiable precipitant or event, and this well-defined entity has been called idiopathic anaphylaxis. The diagnosis of idiopathic anaphylaxis is made after an appropriate allergic evaluation and exclusion of a provocative trigger. We report an unusual case of manifesting with gastroenteritis, urticaria, hypotension, and syncope. Measurement of serum tryptase, a mast cell enzyme, was used to substantiate the diagnosis. Tryptase level is a useful test that can be used to help diagnose this potentially fatal disease.
Adolescent↗
Needle thoracostomy fails to detect a fatal tension pneumothorax.
Needle thoracostomy is an emergency procedure used to both diagnose and initially treat a tension pneumothorax. We report a case of fatal tension pneumothorax in an intubated patient with chronic obstructive pulmonary disease that was missed by this technique. A tension pneumothorax involving only the right middle and lower lobes was found at autopsy. The autopsy also suggested that needle thoracostomy was misleading because it sampled air from a noncommunicating bulla in the right upper lobe rather than from the pleural space. Tension physiology can exist with only localized collapse of a lung, and diagnostic needle thoracostomy can be falsely negative. When tension pneumothorax is strongly suspected, if empiric thoracentesis does not vent air under pressure, subsequent tube thoracostomy is indicated.
Acute Disease↗
Splenic artery aneurysm rupture.
Splenic artery aneurysms are rare and usually asymptomatic. However, rupture can produce severe abdominal pain and prove lethal. Two cases of ruptured splenic artery aneurysm are presented. In one, cocaine injection occurred immediately prior to the onset of symptoms and may have precipitated the event.
Adult↗