The American journal of emergency medicine
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This case report describes a young patient presenting to the ED with altered mental status several days after being diagnosed with a Boxer's fracture and ultimately discovered to have toxic leukoencephalopathy. We review the clinical features in his presentation leading to his diagnosis, as well as MRI imaging findings frequently found in his condition.
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Minoxidil is an antihypertensive that works by directly dilating peripheral vessels. This medication is typically reserved for patients with resistant hypertension, whose blood pressure remains above goal despite being on multiple agents. A rare but potentially dangerous side effect of Minoxidil is drug-induced pericardial effusion. Here we report a case of a patient who was taking Minoxidil and subsequently developed a large pericardial effusion, with concerns for impending cardiac tamponade.
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Emergency department (ED) patients may elect to refuse any aspect of medical care. They may leave prior to physician evaluation, elope during treatment, or leave against medical advice during treatment. This study was undertaken to identify patient perspectives and reasons for refusal of care. ⋯ ED patients who refused care were significantly younger than the general ED population. Common reasons cited by patients for refusal of care included wait time, unmet expectations, and negative interactions with ED staff.