The American journal of emergency medicine
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Ovarian vein thrombosis (OVT) is a rare but potentially serious condition that affects mostly postpartum women. It has also been associated with other conditions, such as pelvic inflammatory disease, malignancy, sepsis, inflammatory bowel disease, and recent pelvic or abdominal surgery. It is critical to recognize and treat this condition as early as possible to avoid the potential complications of the thrombosis and adverse sequelae such as infection and sepsis. ⋯ Patient did well and was discharged after 2 days on Coumadin and oral antibiotics. Ovarian vein thrombosis is a rare condition with a number of serious and life-threatening complications. Therefore, not only is a high level of scrutiny required, but also an increased index of suspicion is essential for diagnosis of OVT and prevention of these dangerous outcomes.
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Case Reports
Bispectral index monitoring in subarachnoid hemorrhage-associated out-of hospital cardiac arrest.
Bispectral index (BIS) is a simple, noninvasive, and continuous electroencephalographic monitor that could reflect the level of consciousness. Initially, BIS was developed to measure the anesthetic depth during operation; now, BIS could be used as a predictor of neurologic outcome in postresuscitative care. We report a case that had out-of cardiac arrest due to subarachnoid hemorrhage, and we used BIS to monitor the patient's consciousness level. ⋯ Low bispectral index and high suppression ratio represent decreasing brain activity suggestive hypoxic ischemic encephalopathy. This was confirmed by brain perfusion scan and standard electroencephalographic study. Using BIS, we can identify patients with poor neurologic outcome earlier, and treatment could be alleviated if prognosis is futile.
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Septic arthritis is a rare infection usually involving the knee or hip but can infrequently affect less obvious joints such as the pubic symphysis. Risk factors for septic arthritis include joint repair or replacement surgery, systemic infection, intravenous recreational drug use, and alcoholism. ⋯ The infecting pathogen was identified as Streptococcus anginosus or S constellatus, both being normal intestinal flora. Infection by either bacterium is rare in septic arthritis.
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A rare case of sequential bilateral anterior shoulder dislocation in an older adult after trauma is presented. The shoulders were dislocated sequentially in 2 separate falls. To the best of our knowledge, this is the second case of sequential or non simultaneous bilateral anterior shoulder dislocation reported to date.