The American journal of emergency medicine
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Case Reports
Resistant lactic acidemia due to accidental cheese starter culture ingestion: A case report.
Lactic acid is the end-product of anaerobic glycolysis. It is generally believed that elevated blood lactate levels are associated with poor patient outcomes. Literature reports that lactic acidosis can be related to supplementary food intake in the pediatric age group however, in adult patients, it is not common to see lactic acidosis due to oral ingestion unless the patient has a history of short bowel syndrome or jejunoileal bypass surgery. With the current case presentation, we report an accidental cheese starter culture intake that resulted in resistant lactic acidosis with no signs of critical illnesses.
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To determine the association between emergency department point-of-care cardiac ultrasonography (POCUS) utilization and time to pericardial effusion drainage during an 8-year period when the emergency ultrasound program was established at our institution. ⋯ POCUS was associated with an earlier time to intervention for pericardial effusions after adjustment for multiple confounding factors. Failure to diagnose pericardial effusion in the ED using any diagnostic testing including POCUS, was associated with increased 28-day mortality.
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Identifying which patients with COVİD-19 have a high risk of severe illness is essential to optimizing management and resource utilization strategies. ⋯ In this external validation of the Covichem score, we found that it performed worse than in the original derivation and validation study, even with the assistance of a new cutoff.