The American journal of emergency medicine
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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.
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Performance of percutaneous coronary intervention (PCI) within 90 minutes of hospital arrival for ST-segment elevation myocardial infarction patients is a commonly cited clinical quality measure. The Centers for Medicare and Medicaid Services use this measure to adjust hospital reimbursement via the Value-Based Purchasing Program. This study investigated the relationship between hospital performance on this quality measure and emergency department (ED) operational efficiency. ⋯ Better performance on measures associated with ED efficiency is associated with more timely PCI performance.
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Klebsiella pneumonia is a common human pathogen, and endogenous endophthalmitis is a vision-threatening infection presentedwith pain, redness, decreased vision acuity, and intraocular inflammation. Endogenous endophthalmitis caused by Klebsiella pneumoniae is uncommon and usually happens in patients with immunosuppression conditions. Diabetes is a predisposing risk factor, and liver abscess is a major source of Klebsiella pneumonia endogenous endophthalmitis (KPEE). Here, we report a case of KPEE in a patient who lost his vision in one eye after treatment.
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Hamate fractures represent only 2% to 4% of all carpal bone fractures because they require a large degree of force to the hand or wrist. This is a case report of a patient with hamate and capitate fractures after a punch injury. It details the minute change seen in routine 3-view radiographic imagery and indications for computed tomography. ⋯ The risks to not detecting a hamate body fracture are nonunion of the bone, posttraumatic arthritis, decreased grip strength, and decreased range of motion of the hand. Because of rarity, there is no criterion standard therapy, but the general approach is open reduction and internal fixation using Kirschner wires and wrist immobilization for a minimum of 8 weeks. A high degree of clinical suspicion on examination is required for the proper approach to confirm a hamate fracture.