The Mount Sinai journal of medicine, New York
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Methanol is a common component of gasoline, antifreeze, washer fluid, perfume, household cleaners and various other industrial products. Acute methanol poisoning produces severe metabolic acidosis, serious neurologic sequelae and rarely imaging findings. ⋯ Computed tomography (CT) showed widespread brain edema and hemorrhages localized in the supratentorial region of the temporal lobe, nearly 3 x 1 cm in a crescent shape, in the white matter surrounding the capsula externa and extending to the periventricular white matter and occipital lobes. Temporal lobe hemorrhage in our patient might also have been due to the effect of heparinization during hemodialysis, metabolic and lactic acidosis, or formate.
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Randomized Controlled Trial Clinical Trial
A randomized, placebo-controlled trial of a single dose of tropisetron for the prevention of vomiting after strabismus surgery in children.
This study evaluates the effect of different doses of tropisetron to prevent postoperative vomiting, which frequently occurs in children following strabismus surgery. ⋯ Tropisetron (0.5, 1.0, 1.5 and 2.0 mg/m(2)) decreased the incidence and severity of POV following strabismus surgery in children. All of the doses seemed to be equally effective. There was no difference in POV control between placebo and any of the doses of the tropisetron after six hours. So we suggest that 0.5 mg/m(2) single-dose tropisetron is enough for preventing POV following strabismus surgery in children.
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The September 11, 2001, terrorist attacks have been called "the worst environmental disaster in the history of New York City." As a result of the extensive nature of the destruction, our objective as pediatricians was to determine the experience and training needs of tri-state child health professionals in responding to the environmental health and bioterrorism-related demands placed on their practices. ⋯ Our results indicate that nearly all child health professionals would benefit from post-disaster education, especially trainees. A role for the pediatric associations in the dissemination of this crucial information is implied.
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Acute aortic dissection is an uncommon disease; however, it has a high mortality rate. Classically, aortic dissection presents with sudden and severe pain in the chest, back, or abdomen. ⋯ There are a few reports of atypical findings or no pain in the literature. We report a case of painless, acute aortic dissection presenting as acute stroke.
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This is a case report on a 45-year old African-American female with newly diagnosed hypertension, who was started on a combination pill of amlodipine/benazapril 10/5 mg. The very next day, she presented at the emergency room (ER) with abdominal pain, nausea and vomiting. Physical exam, complete metabolic panel, and hemogram were in the normal range. ⋯ Angiotensin-converting enzyme inhibitor (ACEI)-induced angioedema was suspected, and anti-hypertensive medications were discontinued. Her symptoms improved within the next 24 hours, and repeat CT after 72 hours revealed marked improvement in stomach and small bowel thickening and resolution of ascites. The recognition of angiotensin-converting enzyme (ACE) and angiotensin receptor blocker (ARB) intestinal angioedema constitutes a challenge to primary care physicians, internists, emergency room personal and surgeons.