Pediatric emergency care
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Pediatric emergency care · Dec 2016
Case ReportsFracture and Nonaccidental Injury: A Case Report of a Lateral Condylar Fracture in a 13 Month Old.
Pediatric nonaccidental injury (NAI) is an important entity that is commonly seen in a variety of medical settings. These children often present to the emergency department or primary care physicians as the first point of contact after an NAI. ⋯ As fracture is the second most common manifestation of NAI, practitioners should be vigilant to recognize unusual fractures in atypical age ranges to aid in its diagnosis. Here, we present a novel case of a lateral condylar fracture in an almost 13-month-old-child that has not been previously associated with NAI.
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Pediatric emergency care · Dec 2016
Case ReportsInfected Congenital Epicardial Cyst Presenting as Acute Abdomen.
A previously healthy 3-year-old boy presented to the emergency department with abdominal pain, fever, and emesis. Laboratory and radiologic evaluation for causes of acute abdomen were negative; however, review of the abdominal x-ray demonstrated cardiomegaly with the subsequent diagnosis of pericardial cyst by echocardiogram and computed tomography. ⋯ His abdominal pain and fever resolved postoperatively and he completed a 3-week course of ceftriaxone for treatment of Propionibacterium acnes infected congenital epicardial cyst. Emergency department physicians must maintain a broad differential in patients with symptoms of acute abdomen to prevent complications from serious cardiac or pulmonary diseases that present with symptoms of referred abdominal pain.
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Pediatric emergency care · Dec 2016
Letter Case ReportsFlumazenil Use for Isolated Ataxia in a Child.
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Pediatric emergency care · Dec 2016
Laughing Gas in a Pediatric Emergency Department-Fun for All Participants: Vitamin B12 Status Among Medical Staff Working With Nitrous Oxide.
The efficiency of nitrous oxide in an equimolar mixture with oxygen or in concentrations up to 70% is approved for short painful procedures. Evaluation of the vitamin B12 levels in anesthetic staff applying nitrous oxide showed reduced vitamin B12 plasma levels. ⋯ The vitamin B12 status was evaluated by measuring homocysteine, methylmalonic acid, vitamin B12, blood count, and the MTHFR C677T genotype. As a control group, medical personnel working in the "nitrous oxide-free" pediatric intensive care unit were recruited.
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Pediatric emergency care · Dec 2016
Case ReportsTorticollis as the Presenting Sign of Cervical Spondylodiscitis.
Acquired torticollis is a common clinical finding in children evaluated in the pediatric emergency department. It may be the presentation symptom of different illnesses, such as trauma, muscle contraction, infections, or malignancies, and an accurate differential diagnosis is required to correctly identify the cause and choose the right treatment. Spondylodiscitis is a low-grade bacterial infection that involves intervertebral disks and the adjacent vertebral bodies. ⋯ The magnetic resonance imaging of cervical spine showed the alteration of cervical vertebral bodies and intervertebral disks, suggesting the diagnosis of cervical spondylodiscitis. The patient recovered after endovenous antibiotic treatment. We suggest that cervical spondylodiscitis should be suspected and investigated by means of an magnetic resonance imaging in every case of unexplained torticollis with persisting symptoms.