The American journal of emergency medicine
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This study aimed to identify factors of neurologic prognosis in severe accidental hypothermic patients with cardiac arrest. ⋯ Patients with hypothermic cardiac arrest due to nonasphyxial hypothermia have improved neurologic outcomes when treated with ECPR compared to patients with asphyxial hypothermic cardiac arrest. Further investigation is needed to develop a prediction rule for patients with nonasphyxial hypothermic cardiac arrest to determine which patients would benefit from treatment with ECPR.
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Comparative Study
Outcome and adverse events with 72-hour cooling at 32°C as compared to 24-hour cooling at 33°C in comatose asphyxial arrest survivors.
Studies suggest that the current therapeutic hypothermia (TH) protocol does not improve outcomes in adult asphyxial arrest survivors. We sought to compare the effect of 24-hour cooling at 33°C vs that of 72-hour cooling at 32°C on outcomes and the incidence of adverse events in unconscious asphyxial arrest survivors. ⋯ The present study did not demonstrate an advantage of 72-hour cooling at 32°C in unconscious asphyxial arrest patients compared with 24-hour cooling at 33°C.
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Acute appendicitis, characterized as periumbilical pain, migrating to the right iliac fossa, is one of the most common acute surgical conditions. It is usually diagnosed on the basis of clinical signs and symptoms. ⋯ We report this first case of acute appendicitis who presented initially with complain of diarrhea accompanying hypokalemia. There have been no published data suggesting its existence in any parts of the world.
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Case Reports
The evaluation of acute vision loss: a case report of central serous chorioretinopathy.
Acute vision loss is frightening to patients and may represent serious pathology that is irreversible if not intervened upon quickly. We present a case of a 36-year-old man with sudden onset of unilateral painless central visual disturbance described as flashes of light. ⋯ Although there is no proven treatment regimen for acute disease, vision problems usually resolve. Some patients have recurrent episodes that can lead to permanent visual loss
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Severe hypothermia with a core temperature below 28°C is critical especially in patients with diabetic ketoacidosis (DKA) and carries a high risk of mortality. Our case of a 52-year-old woman presenting with DKA, pH of 6.9, potassium of 7.6 mEq/L, and body temperature of 26°C demonstrates that conservative management can be safe and successful. ⋯ Our patient arrived even more hypothermic than all previously described cases and regained normothermia and an equalized acid-base and electrolyte balance within 12 hours after admission. Eventually, no new neurologic deficit was present on discharge.