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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Swimming is one of the most popular recreational activities in the United States. The objective of this study was to investigate the epidemiology of the complete spectrum of injuries associated with swimming and swimming pools treated in US hospital emergency departments. ⋯ The observed increase in injuries among individuals older than 7 years underscores the need for increased prevention efforts, including education about safe swimming practices, supervision, and environmental modifications.
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A 40-year-old healthy woman presented to the emergency department with a complaint of intermittent hematemesis, despite the absence of usual factors associated with upper gastrointestinal bleeding (ie, nonsteroidal anti-inflammatory drugs, alcoholism, etc). The patient was diagnosed with a Dieulafoy lesion. This is an uncommon finding, which clinicians must be familiar with and maintain in the differential diagnosis because the consequences of this disease process are grave. It is vital to properly diagnose this condition and be familiar with the treatment.
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There are several causes of ST-segment elevation (STE) besides acute myocardial infarction (MI). ⋯ The diagnosis of false-positive STEMI is not uncommon. Detailed clinical evaluation and electrocardiogram interpretation may avoid partly unnecessary catheterization laboratory activation.
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Before the era of therapeutic hypothermia, a practice parameter including absent or extensor motor response at day 3 and the presence of myoclonus status epilepticus within 24 hours was used to assist prognostication of poor neurologic outcomes. There are conflicting results concerning whether hypothermia influences the reliability of the predictors and the accurate predictors and optimal timing for assessing neurologic recovery are largely unknown. ⋯ However, life support was reported to be withdrawn within 3 to 5 days in 25% to 50% cardiac arrest survivors treated with hypothermia when grave prognosis was predicted. The clinical course of the patient raises some important questions concerning the accuracy of current predictors, the optimal observation period for neurologic recovery, and the appropriate timing to determine withdrawal of life support in cardiac arrest victims receiving therapeutic hypothermia.