The American journal of emergency medicine
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Vibrio vulnificus typically causes septicemia and necrotic wound infection. Among V vulnificus–related complications, acute nonthrombotic myocardial damage has not been reported. The most effective antibiotic treatment of V vulnificus infection includes combination of a third-generation cephalosporin and a tetracycline or its analogue. ⋯ A 67-year-old diabetic man acquired V vulnificus infection via a fish-stunning wound on the right foot. The patients developed septicemia and hemorrhagic bullous necrotic wounds and followed by acute nonthrombotic cardiac injury with low cardiac output. After initial resuscitation, we applied dobutamine inotropic therapy with combination of cefpirome and ciprofloxacin or minocycline, which achieved a good clinical outcome.
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Ocular trauma is recognized as the leading cause of unilateral blindness. However, few studies to date have focused on the clinical features of hospital-based ocular emergencies. Effectiveness of trauma centers in treating ocular emergencies was compared with treatment in traditional community hospital emergency departments. Demographics, causes, and nature of ocular emergencies, as well as visual outcome in community hospitals emergency departments and trauma centers, were also examined. ⋯ The middle-aged, white men are more vulnerable to ocular injuries caused mainly by motor vehicle accidents. The ability of trauma centers to provide comparable increases in vision outcomes, despite treating more severe ocular emergencies, demonstrates the effectiveness of trauma centers. Patients diagnosed as having orbital contusions or who have fall injuries deserve careful evaluation because they are more likely to have more severe sight-threatening injuries.
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Comparative Study Clinical Trial
Finger counting: an alternative method for estimating pediatric weights.
We compared the accuracy of a conceptually simple pediatric weight estimation technique, the finger counting method, with other commonly used methods. ⋯ The finger counting method is an acceptable alternative to the Broselow method for weight estimation in children aged 1 to 9 years. It outperforms the traditional APLS method but underestimates weights compared with parental estimate and the Luscombe formula.
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Glyphosate-surfactant herbicide is promoted by the manufacturer as having no risks to human health. Glyphosate surfactant has recently been used with increasing frequency in suicide attempts, so clinical toxicologists occasionally encounter cases of severe systemic toxicity. The purpose of this study was to identify the early predictive factors of patients at risk for mortality and the usefulness of the corrected QT interval (QTc interval) for predicting mortality from glyphosate-surfactant intoxication. ⋯ Prolonged QTc interval seems to be a useful prognostic factor for mortality in patients intoxicated with glyphosate-surfactant herbicide.
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This report presents a 16-year-old adolescent boy with intentional ingestion of a 6-cm-length iron nail in detention center 6 hours ago. There was no symptom and sign of acute abdominal pain. Abdominal computed tomographic scan was performed, and an iron nail was found in the left upper quadrant abdomen. ⋯ No painkiller was used after the surgery. The patient was discharged on postoperative day 3 without any complication. To our knowledge, it is the first report on removal of ingested foreign body located in jejunum using single-incision laparoscopic surgery technique.