The American journal of emergency medicine
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Rescuers that undergo acute ascent without acclimatization can experience acute mountain sickness. Although performing cardiopulmonary resuscitation (CPR) for a short period requires intensive effort at sea level, performing CPR at high altitude is even more exhausting and can endanger the rescuer. Therefore, we conducted a pilot study to compare the quality of resuscitation in health professionals at high altitude (3100 m) and that at sea level. ⋯ The quality of CC rapidly declined at high altitude. At high altitude, the average number of effective CC decreases; and this decrease became significant after continuous CCs had been performed for 1 minute.
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A 32-year-old female patient with systemic lupus erythematosus presented with 1 month of nocturnal subjective fevers, night sweats, poor appetite, malaise, 8-kg weight loss, and a 6-cm painful sternal mass. She had normal vital signs with a physical examination notable only for the presence of a fluctuating sternal mass. ⋯ Histologic examination of the bone tissue revealed extensive necrosis and granulomas with multinucleated giant cells. The bone, secretion, and soft tissue were negative for acid-fast bacillae on Ziehl-Neelsen stain; but culture grew Mycobacterioum tuberculosis, and she was started on 4 first-line antituberculosis medications, showing rapid symptomatic improvement, and was discharged 4 weeks after admission (Fig. 3).
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Laparoscopic cholecystectomy, because it is the less invasive surgical procedure, has been established as the procedure of choice for the treatment of patients with symptomatic gallbladder stones. However, bile leakage after laparoscopic cholecystectomy should not be overlooked. It is generally due to a minor biliary complication, although it can sometimes herald a major duct injury. Bile leakage rates of 1.2% to 4.0% in laparoscopic cholecystectomies have been reported, which are higher than the incidence with open cholecystectomies.
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N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been used in the evaluation on heart function in many heart diseases. However, little is known in patients with acute carbon monoxide poisoning (ACOP). Left ventricular ejection fraction (LVEF) can be applied as a preliminary test method to measure the left ventricular function. In the present study, we investigate the clinical significance of NT-proBNP combined with LVEF on heart function in 68 patients with ACOP. ⋯ There are an increased level of NT-proBNP and a decrease of LVEF, which represents a clear sign of heart malfunction by ACOP. Combined NT-proBNP and LVEF detection technique has a significant advantage in the diagnosis of patients with myocardial contraction function damage after ACOP.
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Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri, is often a debilitating condition characterized by headaches, blurry vision, nausea, and vomiting. Lumbar puncture (LP) is an essential component of the diagnostic and therapeutic approach; however, the procedure itself can cause postlumbar puncture headache. In addition to the clinical presentation, the use of bedside ultrasound to measure the optic nerve sheath diameter may aid in differentiating the 2 conditions. We hereby report a case of a 33-year old woman with known IIH who presented with recurrent headache after the initial therapeutic LP.