Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health
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Hawaii J Med Public Health · Dec 2018
High Resource Utilization of Psychiatric Emergency Services by Methamphetamine Users.
Methamphetamine use has increased throughout the United States in recent years, and is historically prevalent in Hawai'i. This retrospective study aimed to determine the effect of methamphetamine use on emergency department (ED) resources, by examining visits to an emergency department (ED) in an urban hospital in Hawai'i from 2007 - 2011. The rate of patients who tested positive for amphetamine was measured and broken down by year. ⋯ Amphetamine-positive patients spent more time per visit on average in the ED, and were more likely to require medication and physical restraints, compared to amphetamine-negative patients. Amphetamine positive patients were admitted to inpatient psychiatry less frequently than negative-testing patients. In summary, there is higher resource utilization per psychiatric emergency service visit by amphetamine-positive patients; however if patients can be stabilized in the ED, the increased ED resources utilized may be offset by the reduced burden on inpatient facilities.
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Hawaii J Med Public Health · Jun 2018
Case ReportsRight Atrium Invasion of Tumor Thrombus from Hepatocellular Carcinoma Incidentally Found on Transthoracic Echocardiogram.
Hepatocellular carcinoma (HCC) is a highly aggressive malignancy in which tumor thrombus can invade portal and hepatic veins in late stages. However, an antemortem diagnosis of right atrial invasion by tumor thrombus is very rare and confers a poor prognosis. ⋯ The patient was also noted to have an acute increase in alpha-fetoprotein (AFP). Our case suggests the importance of imaging studies and monitoring AFP levels in patients with long standing HCC.
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Hawaii J Med Public Health · May 2018
Case ReportsTreatment of Prurigo Pigmentosa with Diet Modification: A Medical Case Study.
Prurigo pigmentosa is a rare inflammatory dermatitis first described in 1971. While the etiology of Prurigo pigmentosa is yet unknown, conditions associated with ketosis often accompany this rash. ⋯ We report two cases successfully treated with increase of dietary carbohydrate intake. The second case suggests that cessation of ketosis may not be necessary to resolve Prurigo pigmentosa.
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Hawaii J Med Public Health · Nov 2017
Case ReportsBenign Granuloma Masquerading as Squamous Cell Carcinoma Due to a "Floater".
Pathology specimen cross-contamination is a rare phenomenon in diagnostic pathology. Such "floaters" may result in delayed, missed or erroneous diagnoses. We describe the case of a patient with benign granuloma of the lung initially misdiagnosed as squamous cell carcinoma due to a "floater."