Pediatric emergency care
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Pediatric emergency care · Jan 2014
Observational StudyVariability in Discharge Instructions and Activity Restrictions for Patients Evaluated in a Children's Emergency Department Following Concussion.
The objective of this study was to describe discharge instructions given to school-aged patients evaluated in a children's emergency department (ED) following concussion. ⋯ Most children meeting diagnostic criteria for concussion were discharged without concussion-specific diagnoses or activity restrictions. Given the risks associated with untimely return to both physical and cognitive activity after concussion, improved awareness and standardization of disposition are imperative for the management of these young patients in the ED.
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Pediatric emergency care · Jan 2014
Case ReportsA rare cause of acute abdominal pain: Herlyn-Werner-Wunderlich syndrome.
Herlyn-Werner-Wunderlich (HWW) syndrome is a rare müllerian duct anomaly with uterus didelphys, unilateral obstructed hemivagina, and ipsilateral renal agenesis. Patients with this syndrome generally present after menarche with pelvic pain and mass and, rarely, primary infertility in later years. Strong suspicion and knowledge of this syndrome are mandatory for an accurate diagnosis. ⋯ Her condition was diagnosed with the use ultrasonography and magnetic resonance imaging as a case of HWW syndrome. She was treated with vaginal hemiseptal resection. The HWW syndrome should be considered among the differential diagnoses in girls with renal anomalies presenting with pelvic mass, symptoms of acute abdominal pain, and acute urinary retention.
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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 ReportsAcute-onset choreiform movements in a previously healthy 4-year-old patient.
We report the case of 4-year-old male with sinus venous thrombosis leading to bilateral thalamic and basal ganglia strokes presenting as generalized choreiform movements. Acute-onset chorea in the pediatric population is most commonly associated with Sydenham chorea, which is a manifestation of acute rheumatic fever. Chorea is a much less commonly noted sign of stroke, and when it occurs, it typically presents as hemichorea. Given the unlikely presentation, rapid and appropriate imaging was the key to diagnosis.