The American journal of emergency medicine
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Sympathomimetic use results in a triad of hypokalemia, hyperglycemia, and elevated white blood cell count. Transient hypokalemia results from activation of the Na+/K+ pump and transport of potassium intracellularly. Increased serum glucose and insulin may also contribute to the intracellular shift of potassium after sympathomimetic use. ⋯ These cases demonstrated that significant depressions in serum potassium can occur after pediatric albuterol overdose. Although transient, the dose-response relationship and duration of effect is unknown. Although significant hypokalemia can occur after ingestion of oral sympathomimetics, replacement should be managed on an individual basis until further studies are completed.
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Case Reports
Severe low back pain secondary to acute interstitial nephritis following administration of ranitidine.
Acute interstitial nephritis is a disease characterized by renal inflammation and is thought to be secondary to a hypersensitivity reaction. Although the causes of acute interstitial nephritis are numerous, adverse reactions to many common drugs, particularly antibiotics and nonsteroidal anti-inflammatory agents, are important etiological factors. ⋯ A case of acute, severe, low-back pain and rash in a healthy woman found to be secondary to acute interstitial nephritis is reported. The etiology of acute interstitial nephritis in this patient's case is suspected to be ranitidine (Zantac; Glaxo Pharmaceuticals, Research Triangle Park, NC), which has not been previously associated with this syndrome.
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The case of a patient with a false-positive fracture on the panoramic view of the mandible is presented. The patient motion produced a spurious image that perfectly mimicked a fracture without any evidence of motion. To better assess motion artifact, panoramic views of a "phantom" human skull were developed with movement during the exposure. ⋯ Some radiographs were created by movement that mimicked fractures without the telltale signs of motion artifact. These "motion pseudofractures" are diagnosed clinically if the examiner knows that motion can mimic fractures, and all x-ray findings are carefully correlated with clinical findings. Diagnosis of a motion pseudofracture will avoid the additional expense and time of a specialty consultation.
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Review Case Reports
Diagnosis, complications, and treatment of dentoskeletal malocclusion.
The frequency of correctable malocclusion makes it imperative that the condition be diagnosed and referred for appropriate treatment. A complete dentofacial examination, which assesses facial symmetry and the dentition in the transverse, sagittal, and centric relations, is appropriate. ⋯ A combination of orthodontic treatment and orthognathic surgery will correct the dentoskeletal malocclusion and prevent any long-term complications. The purpose of this case report is to describe a patient with severe dentoskeletal malocclusion who benefitted from appropriate orthodontic treatment and orthognathic surgery.
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Review Case Reports
Ceramic lead glaze ingestions in nursing home residents with dementia.
Three cases of acute lead ceramic glaze ingestions that occurred in elderly patients during art therapy classes in nursing homes are reported. Initial blood lead levels were 109 micrograms/dL (5.23 mumol/L), 259 micrograms/dL (10.43 mumol/L), and 85 micrograms/dL (4.08 mumol/L), respectively, and all patients underwent chelation therapy. ⋯ Ceramic lead glaze ingestions among institutionalized patients may be more common than generally appreciated and occasionally are associated with significant morbidity or, rarely, mortality. Simple preventive measures could eliminate the majority of such occurrences.