Internal and emergency medicine
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Current data suggest that up to 60 % of patients presenting to the emergency department with syncope leave the hospital without a defined etiology. Prior studies suggest a prevalence of psychiatric disease as high as 26 % in patients with syncope of unknown etiology. The objective of this study was to determine whether psychiatric disease is associated with an increased incidence of syncope of unknown etiology. ⋯ However, among women with syncope of unknown etiology, there was no significant difference between those with and without psychiatric disease (34.4 vs. 32.7 %) with p = 0.77. Our results suggest that men with psychiatric disease have an increased incidence of syncope of unknown etiology. Given this relationship, clinicians might consider screening for psychiatric disorders in syncopal patients when no clear etiology can be identified.
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Letter Case Reports
ST-segment elevation myocardial infarction after drowning.
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Chest ultrasonography is a useful tool to assess extravascular lung water at bedside. In presence of interstitial-alveolar imbibition, vertical artifacts arising from the pleura are detected; these are called B-lines. Although a positive linear correlation between B-lines and extravascular lung water has been shown in symptomatic heart failure patients, the subclinical phase of pulmonary imbibition and the clearance of B-lines after rapid body fluid removal have been less investigated. ⋯ Moreover, B-lines reduction was significantly related to weight loss. Ultrasound performed at the bedside can detect lung water and intravascular overload and their reduction after dialysis in yet asymptomatic patients. These observations add further evidence regarding the use of lung ultrasound and inferior vena cava measurement in estimating volume overload and monitoring the response to therapy both in hemodialysis and congestive heart failure patients.