Pediatric emergency care
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Cold urticaria (CU) is a subtype of physical urticaria characterized by the development of urticaria and angioedema after cold exposure. Symptoms typically occur minutes after skin exposure to cold air, liquids, and objects. ⋯ The greatest risk with this kind of urticaria is the development of systemic reaction resulting in a hemodynamic collapse during generalized cold exposure. We report a case of a patient who developed CU and anaphylaxis during swimming and diving in the sea.
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Pediatric emergency care · Jan 2014
Multicenter StudySynovial Fluid Findings in Children With Knee Monoarthritis in Lyme Disease Endemic Areas.
Although Lyme and septic arthritis of the knee may have similar clinical presentations, septic arthritis requires prompt identification and treatment to avoid joint destruction. We sought to determine whether synovial fluid cell counts alone can discriminate between Lyme, septic, and other inflammatory arthritis. ⋯ In Lyme endemic areas, synovial fluid results alone do not differentiate septic from Lyme arthritis. Therefore, other clinical or laboratory indicators are needed to direct the care of patients with knee monoarthritis.
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Novel classes of synthetic drugs, including synthetic cathinones ("bath salts") and synthetic cannabinoids ("spice" or "K2"), have recently emerged as popular drugs of abuse. Salvia divinorum, a naturally occurring herb, has gained popularity in the last decade as a hallucinogenic as well. ⋯ We present an up-to-date information about the legality of these substances. We also discuss the historical background, chemical composition, patterns of abuse, clinical presentations, laboratory analysis, and management strategies for these drugs, with an emphasis on synthetic cathinones.
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Pediatric emergency care · Jan 2014
Case ReportsThyrotoxic periodic paralysis in a pediatric patient.
Thyrotoxic periodic paralysis is a reversible metabolic disorder that is characterized by acute muscle weakness and hypokalemia. It predominantly affects males of Asian descent. ⋯ Laboratory test results initially revealed marked hypokalemia and later confirmed associated hyperthyroidism. Correction of the hypokalemia reversed the patient's weakness in the emergency department.
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Pediatric emergency care · Jan 2014
Case ReportsThe use of ultrasound to detect occult or unsuspected fractures in child abuse.
Occult fractures due to child abuse can be difficult to identify because there is usually no history of trauma, and chief complaints are vague. In addition, the osseous injuries are often subtle, becoming obvious only after healing begins. Missed injuries can lead to inappropriate disposition of a patient and can cause children to be placed at high risk for further injury and death. ⋯ The bedside ultrasound led to the identification of occult or unsuspected fractures in both children, and state social services were notified. In both cases, the cause of the fracture was determined to be from abuse, and necessary measures were taken to ensure the child's future safety. This report demonstrates that ultrasound may be useful for early identification of some types of occult or unsuspected fractures commonly seen in cases of child abuse.