The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society
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Carbon monoxide (CO) poisoning is preventable, yet it remains one of the most common causes of poisoning in the United States. This analysis was performed to estimate the number of emergency department (ED) visits in 2010 in Louisiana for all-cause (fire-related, non-fire, and unknown) unintentional CO poisoning. Results demonstrate approximately 1,696,746 total ED visits occurred in 2010. ⋯ The most common symptoms included headache, hypertension, nausea, and dizziness. The ED database presented more cases of the most common CO poisoning cases (non-fatal) than previously used surveillance databases. This study demonstrated the utility and importance of ED data as a surveillance tool.
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Pericardial effusions are common in postoperative cardiac surgical patients. Cardiac tamponade occurs relatively infrequently postoperatively and may mimick other conditions, such as heart failure, renal failure, and pulmonary emboli. Echocardiographic examination is frequently hampered in the immediate postoperative period due to suboptimal imaging. The current case series focuses on the echocardiographic findings in tamponade in the postoperative patient with emphasis on ventricular interdependence as an early sign of impending tamponade.
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Due to concern for bleeding from severe thrombocytopenia, some thrombotic thrombocytopenic purpura (TTP) patients receive platelet transfusion prior to central venous catheter placement. However, studies have shown that blood loss associated with this procedure is minimal, and platelet administration is unnecessary. ⋯ Before central line placement, two of the 11 received platelet transfusions, while nine did not. Blood loss in all patients was not significant, supporting the position that platelet transfusion prior to central venous catheter placement in TTP patients is unnecessary.
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Primary amebic meningoencephalitis (PAM), a typically fatal, free-living amebic infection of the central nervous system (CNS), is caused by the thermophilic, freshwater protozoan, Naegleria fowleri. More than 145 cases of PAM have been reported worldwide, with most reported cases in the United States (US). Since annual PAM case clusters in the US and worldwide have demonstrated recent increases over background cases, the objectives of this investigation included (1) an epidemiological and statistical analysis of a 2007 cluster of six PAM cases in the southern US, nested in a retrospective review of 121 confirmed US cases of PAM over the period, 1937 to 2007; and (2) a statistical analysis of all existing demographic, temporal, and behavioral risk factors for PAM. ⋯ Although there have been a few recent survivors of PAM treated with combinations of intensive critical care, antifungals, and synergistic antibiotics, case fatality rates for PAM remain very high. PAM is best prevented by combinations of public health educational and behavioral modification strategies. Further investigations will be required to determine the significance of freshwater wakeboarding as a significant risk factor for PAM and to determine any dose-response effects of global warming on rising freshwater temperatures and the growth of aquatic Naegleria fowleri.