The American journal of emergency medicine
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We report a case where an emergency physician using bedside ocular ultrasound was able to diagnose vitreous hemorrhage and lens dislocation in an elderly patient. Bedside ultrasound performed by a physician trained in this imaging modality can diagnose ocular emergencies, facilitating appropriate consultation and treatment.
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Case Reports
Lung injury and pneumothorax after defibrillation as demonstrated with computed tomography.
Many patients present for emergency services after electric injuries or require defibrillation during emergency services. Although the defibrillation process is safe, skin burns and myocardial injuries are reported after defibrillation procedures. ⋯ To the best of our knowledge, this is the first reported case in which computed tomography is used to demonstrate that a trace of electric current passed through the lung. Computed tomography may be an excellent diagnostic modality to demonstrate the severity and extent of electric injuries to the lung.
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Cannabinoid hyperemesis syndrome (CHS) is a condition characterized by cyclical vomiting without other identifiable cause in patients with chronic cannabis use. Patients with CHS report that compulsive bathing and hot showers are the only reliable treatments to improve symptoms. Cannabinoid hyperemesis syndrome is usually unresponsive to conventional pharmacologic antiemetics, and patients often require hospital admission. We report a case of CHS that improved significantly after treatment with haloperidol in the emergency department.
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Pigmented lymph nodes are traditionally associated with melanoma and metastatic malignancy. This report describes the case of 22-year-old white man, who presented with painful right groin lymphadenopathy. Groin ultrasound and computed tomography confirmed an enlarged (2 cm) right inguinal lymph node. ⋯ Although a suspicious finding, histologic examination demonstrated black pigment infiltration from a decorative tattoo on the right leg. Unresolving, painful, pigmented lymphadenopathy can result from decorative tattooing. Selective excision of the affected lymph node and histologic examination result in symptom resolution and can aide in appropriate diagnosis.
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Case Reports
Warburg effect associated with transformed lymphoplasmacytic lymphoma to diffuse large B-cell lymphoma.
Warburg effect is a rare metabolic complication in hematologic malignancies, commonly presented with lactic acidosis and hypoglycemia. Mechanism explained by abnormality of mitochondrial oxidative phosphorylation in cancer cells and energy production is mostly dependent on anaerobic respiration or glycolysis pathway to meet large tumor demand. We present a case with history of lymphoplasmacytic lymphoma and Waldenstörm macroglobulinemia, partial response to chemotherapy. ⋯ Warburg effect represents poor prognosis no matter with or without hypoglycemia. Treatment of choice is cytoreduction with early chemotherapy. Our patient died 2 days after Warburg effect occurred.