The American journal of emergency medicine
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Case Reports
Cerebral venous sinus thrombosis as an initial manifestation of primary antiphospholipid syndrome.
Cerebral venous sinus thrombosis is a rare neurologic manifestation of antiphospholipid syndrome. We report a case of a 49-year-old woman who presented to the emergency department with recurrent episodes of transient clumsiness of the left upper extremity. ⋯ Thrombophilia screen disclosed positive lupus anticoagulant. In this case report, we aim to emphasize the significance of recognizing an unusual presentation of antiphospholipid syndrome.
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The present study was designed to evaluate the effects of ulinastatin (UTI) on cardiac dysfunction after cardiopulmonary resuscitation (CPR). ⋯ The progression of proinflammatory responses, oxidative stress, and myocardial injury have been linked to the reduced EF after VF/CPR, and the administration of UTI at a cardioprotective dosage preserved the cardiac function after VF/CPR.
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This is a report of a 4-year-old Hispanic boy who presented with skin changes to the lips and oral cavity, a generalized rash, edema of hands and feet, and peeling of the periungual areas of the fingers as well as to the groin and perianal areas. Fourteen days earlier, his 19-month-old brother was diagnosed and treated for Kawasaki disease. Upon laboratory investigation, our patient was found to have an elevated sedimentation rate, C-reactive protein, and serum γ-glutamyl transferase. Infectious disease and cardiology consultations subsequently diagnosed and treated our patient for incomplete Kawasaki disease.
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Takotsubo cardiomyopathy (TTC) is uncommon emergency condition usually precipitated by emotional or physical stress and is characterized by near-normal coronary arteries and regional wall motion abnormalities that extend beyond a single coronary vascular territory. Variants of TTC include classic apical ballooning syndrome and less commonly, mid, basal, and biventricular variants. Cardiac arrest is an uncommon complication of TTC. ⋯ All 3 patients had normal QTc interval and were found to have normal coronary arteries on cardiac catheterization at presentation. Mid ventricular TTC was confirmed on contrast left ventriculography and echocardiography. Cardiac arrest myocarditis was ruled out by myocardial biopsy in 2 deceased patients and by cardiac magnetic resonance imaging in the one who survived.
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Case Reports
Worsening Wenckebach after calcium gluconate injection: not uncommon but frequently missed diagnosis.
The objective of the study is to demonstrate a common etiology of hyperkalemia and illustrate a potential iatrogenic errors in treatment.