The American journal of emergency medicine
-
Iron products are widely available over the counter and have the potential to cause serious toxicity. Iron concentrations can be used to prognosticate and guide treatment during acute ingestions. Traditionally, a concentration of 350 μg/dL with symptoms, or 500 μg/dL without symptoms, is considered toxic and will likely need treatment to prevent decompensation. It is generally recommended that an iron concentration is obtained at least 4 h after exposure to provide adequate absorption time and avoid falsely low iron concentrations. Despite this, many iron overdoses have concentrations drawn immediately upon patient presentation. The utility of an iron concentration drawn before 4 h in assessing exposure risk is not clear. The purpose of this study is to determine if patients' symptoms and iron concentrations obtained between 2 and 4 h can predict the development of iron concentrations after 4 h. ⋯ Patients with only minor GI symptoms and an iron concentration of ≤ 300 μg/dL between 2 and 4 h post-ingestion are unlikely to develop further toxicity. In this case series, a concentration of 300 μg/dL or less between 2 and 4 h was the ideal cutoff to predicting subsequent potentially toxic concentrations, with a sensitivity of 100 % and a specificity of 54 %.
-
Post-cardiac arrest care advancements have improved resuscitation outcomes, but many survivors still face severe neurological deficits or death from brain injury. Herein, we propose a consistent prognosis prediction approach using magnetic resonance imaging (MRI) to analyze anatomical regions represented by the gray and white matter, and subsequently apply it on computed tomography (CT) to calculate the gray-white matter ratio (GWR). We compared this novel method with traditional measures to validate its ability to predict the prognosis of patients resuscitated after cardiac arrest. ⋯ Our study introduces a novel method for measuring GWR using MRI-based brain CT, demonstrating superior prognostic accuracy in predicting neurological outcomes in patients with post-cardiac arrest syndrome compared to traditional methods.