The American journal of emergency medicine
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The presence of the sonographic sliding lung sign (SLS) is a sensitive indicator for the absence of a pneumothorax. ⋯ Prehospital critical care providers can accurately determine the presence or absence of the sonographic SLS following a brief tutorial and retain the skill set following a 9-month interval.
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Radiation sialadenitis is an uncommon adverse reaction to radioactive iodide therapy. Sialadenitis due to radiation exposure has a dose-related damage that can follow an acute or chronic inflammatory nature. We present a case of a patient who developed radiation sialadenitis after radioactive iodide therapy for papillary thyroid cancer resulting in severe parotid swelling and swelling, which resulted in an emergency department visit and had complete resolution with conservative management.
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Spontaneous rupture of the short gastric artery is an extremely rare event that can cause abdominal apoplexy or spontaneous hemoperitoneum. For the emergency physician, simultaneous restoration of circulatory volume and a rapid diagnosis remain central to a successful outcome in such critical cases. ⋯ The patient underwent emergency exploratory laparotomy with a good outcome. Abdominal apoplexy should be considered in the differential diagnosis of unexplained hemorrhagic shock with an abrupt onset of severe abdominal pain associated with vomiting.
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Fetal loss in symptomatic first-trimester pregnancy with documented yolk sac intrauterine pregnancy.
The possibility of spontaneous miscarriage is a common concern among pregnant women in the emergency department (ED). ⋯ Seventy percent of women diagnosed with a yolk sac IUP in the ED carried their pregnancy to at least 20 weeks. The remaining women (30%) experienced fetal loss. Vaginal bleeding (with or without pain) increased the rate of fetal loss compared with women with pain only. These data will assist the emergency physician in counseling women with symptomatic first-trimester pregnancies.
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Risk of cerebrovascular disease is increased in patients with HIV infection; however, cerebral venous sinus thrombosis is not commonly reported in this condition. We report a case of young man with intracranial hemorrhage whose radiologic investigations revealed thrombosis of the left transverse and sigmoid sinuses extending into the left internal jugular vein. ⋯ He was started on anticoagulant therapy, after which he showed gradual recovery. This case highlights a rarely encountered presentation of HIV infection as cerebral venous sinus thrombosis.