The Mount Sinai journal of medicine, New York
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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.
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Obstruction of blood flow in the superior vena cava results in the signs and symptoms of superior vena cava (SVC) syndrome. Venous collaterals form, to establish alternative pathways for return of venous blood to the right atrium. The rapidity of onset of symptoms and signs from SVC obstruction is directly related to the rate at which obstruction occurs and how effective the formed collaterals are. ⋯ Facial swelling, distended veins over the neck, upper extremity swelling, and dyspnea are common findings. Proptosis, periorbital swelling (including eyelid), conjunctival suffusion and elevated intraocular pressure are documented ophthalmic findings in SVC syndrome. We present a rare case of conjunctival suffusion in a 72-year-old male diagnosed with superior vena cava syndrome secondary to lung cancer.
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Until recently neurogenesis in mammals was considered to occur only during the embryonic and early post-natal periods and to have no significant role in the adult nervous system. However, it is now accepted that neurogenesis occurs in two brain regions in adult mammals, namely, the hippocampus and olfactory bulb. In both regions new neurons arise from a resident population of neural progenitor cells that are maintained throughout adult life. ⋯ After transplantation into adult brain, neural stem cells are capable of surviving and differentiating into both neurons and glial cells, offering hope that stem cell therapy may be utilized to treat a variety of neurological and perhaps psychiatric disorders. The widespread existence of endogenous neural progenitors even in non-neurogenic brain regions also offers hope that the potential of these cells may be harnessed to repair cellular injuries caused by injuries such as stroke, trauma or neurodegenerative diseases. While obstacles remain to both approaches, stem-cell-based therapies remain an area of intense research interest.