PubMed Health⌕ Search

Biomedical subjects

R M Walls

Publications and source records attributed to R M Walls.

48 records · Page 3Linked to original sources
PubMedDate not supplied

"Cotton fever": a benign febrile syndrome in intravenous drug abusers.

Cotton fever is a benign, self-limited syndrome that may mimic sepsis in intravenous drug addicts. We present an illustrative case and a review of the literature. Serious illness such as pneumonia and infectious endocarditis must always be considered in febrile addicts. However, trivial illness accounts for 16% to 26% of such fevers. Recent evidence suggests that emergency physicians are able to diagnose trivial illness with 93% specificity in febrile adult drug addicts. Short-term observation units may be an alternative to hospital admission for febrile drug users with a presumptive diagnosis of trivial illness and in those in whom the diagnosis of cotton fever is entertained.

Adult↗
PubMedDate not supplied

Blindness following minor head trauma in children: a report of two cases with a review of the literature.

The spectrum of closed head injury ranging from asymptomatic to lethal is well described in the literature. In a small number of cases, dramatic neurologic symptoms normally associated with cerebrovascular accident or vascular headache may arise following apparently insignificant head trauma. We report two cases of young males who developed transient blindness accompanied by significant neurologic abnormality following trivial head injuries. These phenomena are previously well documented, and it is believed that in certain individuals, minor head trauma can induce a type of migraine equivalent known as "footballer's migraine" or "posttraumatic cortical blindness." Current knowledge of these two conditions is reviewed.

Accidental Falls↗
PubMedDate not supplied

Acute mesenteric ischemia in a middle-aged patient: case report and discussion.

Mesenteric ischemia usually occurs in elderly patients, especially those with predisposing factors. It has also been described in young patients using oral contraceptive pills or illicit drugs. We present a case of a middle-aged woman who developed acute focal ischemia of the small intestine without predisposing factors. The unusual presentation of this patient, combined with her relative youth, obscured the diagnosis, which was ultimately made at laparotomy. The diagnosis of mesenteric ischemia should be considered in patients of any age presenting with recurrent or severe abdominal pain, particularly when no alternative cause is apparent. The definitive study to diagnose mesenteric ischemia is angiography. Unless identified early in its course, the condition may progress to frank infarction with a significant increase in morbidity and mortality. Because of this, an aggressive approach to the diagnosis and therapy of mesenteric ischemia is essential.

Abdominal Pain↗
PubMedDate not supplied

Delay in thrombolysis administration: causes of extended door-to-drug times and the asymptote effect.

We retrospectively analyzed medical records and critical pathway data forms of all patients who received thrombolytic therapy for acute myocardial infarction (AMI) over a 2 1/2-year period. The time spent by each patient in the emergency department (ED) prior to receiving thrombolytic therapy (the door-to-drug time) was determined. Records of those patients with door-to-drug times exceeding the median were closely examined to determine the cause of treatment delays. Results indicated that treatment delays resulted from delays in obtaining the initial electrocardiogram (24%), atypical presentations (11%), the need to rule out a potential contraindication (11%), the need to confirm the diagnosis (14%), and miscellaneous causes (8%). Many patients had no identifiable reason for their delay (32%). A certain population of AMI patients either do not satisfy thrombolytic criteria upon initial ED presentation or require prolonged evaluation to investigate possible contraindications to thrombolysis such as aortic dissection. The inclusion of patients in this separate population in a general analysis of median door-to-drug times results in an artificial asymptote effect and may confound quality initiatives.

Electrocardiography↗