The American journal of emergency medicine
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A 42-year-old woman presented to our emergency department with headache, nausea, and confusion after completing an Ironman triathlon. She performed the race at a slow pace, in hot and dry weather. The first medical examination reported confusion with a Glasgow Coma Scale score of 13. ⋯ A cerebral CT scan showed disappearance of cerebral edema. One month later, the patient had good recovery apart from some residual memory problems. Six months later, she was able to come back to work.
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Alaska's 1049-mile Iditarod Trail Sled Dog Race is the world's longest sled dog race and the flagship event in the sport of sled dog racing. Race conditions are typically harsh. Physicians are not officially enlisted to care for human competitors. Instead, medical needs are met through an informal system of volunteers, local health care providers, and a fleet of bush planes. The goals of this study were to identify the types of human injury and illness experienced and the methods by which these conditions are treated. ⋯ Most injuries and illnesses sustained by mushers in the Iditarod are minor and self-treatable. Life-threatening conditions are rare, and the need for an organized medical care system seems low.
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Case Reports
Restrictive cardiomyopathy in a patient presented with fever, vomiting, and consciousness disorder.
Restrictive cardiomyopathy (RCM) is an uncommon form of myocardial disorder characterized by diastolic dysfunction and increased myocardial stiffness. Endomyocardial fibrosis is one type of RCM hallmarked by formation of fibrous tissue on the endocardium. This report describes a case of RCM confirmed by autopsy in a young man who presented atypically with fever, vomiting, and delirium.