The American journal of emergency medicine
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This study aims to quantify the relationship between overall elder abuse and specific subtypes of elder abuse and rate of emergency department (ED) utilization in a community-dwelling population. ⋯ Elder abuse was associated with increased rates of ED utilization in this community population. Specific subtypes of elder abuse had differential association with increased rate of ED utilization.
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The aim of the study was to describe the prevalence, demographic, and clinical characteristics and etiologies of hypercalcemia in emergency department patients. ⋯ Hypercalcemia is a rare but harmful electrolyte disorder in emergency department patients. Unspecific symptoms such as a change in mental state, weakness, or gastrointestinal symptoms should prompt physicians to order serum calcium measurements, at least in patients with known malignancy or renal insufficiency.
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Case Reports
Identification of painless aortic dissection before thrombolytic treatment for acute ischemic stroke.
Early detection of acute ischemic stroke secondary to painless aortic dissection is a challenge for emergency physicians, especially when under the stress of the 3-hour golden time window for thrombolytic therapy. We reported a 57-year-old man with acute right hemisphere watershed ischemic stroke caused by painless type A aortic dissection was diagnosed in time with computed tomographic (CT) angiography. The possible detrimental impact which may have been incurred by thrombolytic therapy was avoided. We suggest that cerebral CT angiography, covering from the aortic arch to intracranial arteries, should be performed in acute ischemic stroke patients, particularly in those with watershed CT perfusion deficits, to exclude the possibility of aortic dissection before thrombolytic treatment.
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Spontaneous spinal epidural hematoma (SEH) is a rare disease. Furthermore, Brown-Séquard syndrome due to spontaneous SEH has been rarely reported. ⋯ We report a case of a 30-year-old patient who presented with Brown-Séquard syndrome due to spontaneous SEH. The patient has recovered successfully without any complications through surgical decompression within 12 hours of onset.
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The platypnea-orthodeoxia syndrome is a rare clinical manifestation. Platypnea is defined as shortness of breath that worsens in the upright position, and orthodeoxia represents hypoxemia that aggravates in the upright position. We report a case of a patient with platypnea-orthodeoxia syndrome associated with pulmonary embolism and patent foramen ovale.