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The rarity of severe allergic reactions to contrast material challenges educators to achieve radiology resident competency in this setting. However, using a simulated anaphylactic contrast reaction paradigm, we have drawn two conclusions: 1 Residents are insufficiently prepared to recognize and manage these life-threatening events and 2 with an interactive, computer-based tool we can significantly improve resident performance in these situations. Simulation is a growing tool in medicine and allows standardized resident exposure to uncommon events in a setting that is conducive to resident education without fear of repercussions see Ruddy and Patterson in this issue of Pediatric Radiology.
More important, simulation provides a cornerstone in patient safety resident education without putting patients at risk.
Full Text Available In the last decade, the desire for safer oral anticoagulants OACs led to the emergence of newer drugs. Available clinical trials demonstrated a lower risk of OACs-associated life-threatening bleeding events, including intracranial hemorrhage, compared to warfarin.
Nontraumatic spinal hematoma is an uncommon yet life-threatening neurosurgical emergency that can be associated with the use of these agents. Rivaroxaban, one of the newly approved OACs, is a direct factor Xa inhibitor. To the best of our knowledge, to date, only two published cases report the incidence of rivaroxaban-induced nontraumatic spinal subdural hematoma SSDH.
Our case is the third one described and the first one to involve the cervicothoracic spine. Full Text Available Heparin, a commonly used anticoagulant agent, is frequently used in patients undergoing hemodialysis. As with most medications, heparin has a significant side effect profile. Two of its most important side effects, major bleeding and hyperkalemia, may be devastating without immediate diagnosis and treatment. Major bleeding such as gastrointestinal, genitourinary or intracranial bleeding is occasionally encountered and rarely neglected.
However, heparin-induced cardiac tamponade is rarely encountered and may be easily overlooked. Another side effect, heparin-induced hyperkalemia, an unusual but well-described side effect, is frequently forgotten until life-threatening arrhythmia has occurred. We report a case involving a year-old male patient with uremia, who had received heparin for 10 days for deep vein thrombosis in the left lower extremity.
Hemopericardium with cardiac tamponade and life-threatening hyperkalemia were both noted in this patient. Life-threatening hereditary angio-oedema: Challenges of care in South Africa. The report and description by Coovadia et al. Mobile phone use for contacting emergency services in life-threatening circumstances.
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The potential health benefits of mobile phone use have not been widely studied, except for telemedicine-type applications. This study seeks to determine whether initial contact with emergency services via a mobile phone in life-threatening situations is associated with potential health benefits when compared to contact via a landline. A record-linkage study was carried out in which data from all emergency dispatches for immediately life-threatening events from a United Kingdom county ambulance service were linked to the Patient Admission System at two major local hospitals.
Mortality at the scene, at the emergency department [ED], and during hospitalization ; transfer to the ED; admission inpatient care, and intensive care unit ; and length of stay were analyzed for calls classified as Code Red immediately life-threatening by initial exposure mobile phone vs. Mobile phone compared to landline reporting of emergencies resulted in significant reductions in the risk of death at the scene odds ratio [OR] 0. The risk of being transferred to the ED and subsequent inpatient admission were significantly lower with reporting from mobile phones compared to landline OR 0.
In this study, evidence of statistical association was demonstrated between the use of mobile phones to alert ambulance services in life-threatening situations and improved outcomes for patients. Full Text Available Background.
We present a case of life-threatening haemorrhage caused by a large ulcerating duodenal GIST arising from the third part of the duodenum managed by a limited duodenal wedge resection. Case Presentation. A year-old patient presented with acute life-threatening gastrointestinal bleeding. A successful limited wedge resection of the tumour mass was performed.
Histopathology subsequently confirmed a duodenal GIST. The patient remained well at month followup with no evidence of local recurrence or metastatic spread. In the context of acute haemorrhage, even relatively large duodenal GISTs can be treated by limited wedge resection. This is a preferable alternative to duodenopancreatectomy with lower morbidity and mortality but comparable oncological outcome.
Objective: to determine the ratio cost-utility of cardiovascular diseases CVD promotion and prevention programs in a health care providing institution in the city of Medellin Colombia. Methodology: the preventive program was compared before and after with the conventional control scheme under the design of a quasi experimental study evaluation with a non equivalent control group.
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Results: in the evaluated groups a statistically meaningful difference was found between the initial and final moments for the variables:Framingham score, direct cost of the program, quality of life , health indexes and quality-adjusted years of life. Conclusion: the participation of patients in CVD prevention and promotion programs is related with risk reduction and a better quality of life.
In France, acute life-threatening situations are handled by the French Secours a Personne assistance to persons and emergency medical facilities. An unequivocal success, this early management of life-threatening emergency situations relies upon centralized call reception, medical dispatching, and immediate on-site emergency medical care.
We describe the different emergency care providers and steps involved in the response to emergency situations. Each call centre Samu, phone number 15; Sapeurs-Pompiers, 18 provides a response tailored to the nature of incoming calls for assistance. In life-threatening emergency situations, patients must be brought straight to the appropriate reference emergency healthcare facility, as quickly as possible, without prior admittance to an emergency department.
The reasons for suboptimal emergency care in life-threatening situations are currently a major issue, with medical facilities being reduced in some areas. Simple descriptive analyses, Pearson's correlation coefficient, Student's t-test for non-related samples, analyses of variance, linear regression analyses and variance inflation factor were performed. The significance level for all statistical tests was set at 0. Not having a conjugal life implied greater perception in the social domain; developing leisure activities and having an income over five minimum wages implied greater perception in the environment domain.
In contrast, psychological factors, as assessed by the Geriatric Depression Scale, and sociodemographic characteristics, such as marital status, income and leisure activities, had an impact on quality of life. A world-society that ranges from the Westernization of the world to cultural diversity, from progress to poverty, and from the "society's metamorphosis alternatives or its disaster" MORIN, a, p. Overcoming the fragmentation of knowledge, reconnect knowledge and transpose the shortcomings of the information society set the open horizon of complex knowledge and a reform of thought and education.
Sevoflurane therapy for life-threatening acute severe asthma: a case report. Acute severe asthma is a life-threatening form of bronchial constriction in which the progressively worsening airway obstruction is unresponsive to the usual appropriate bronchodilator therapy. Pathophysiological changes restrict airflow, which leads to premature closure of the airway on expiration, impaired gas exchange, and dynamic hyperinflation "air-trapping". Additionally, patients suffering from asthma for a prolonged period of time usually have serious comorbidities.
These conditions constitute a challenge during the treatment of this disease. Therapeutic interventions are designed to reduce airway resistance and improve respiratory status. To achieve therapeutic goals, appropriate bronchodilator treatment is indispensable, and mechanical ventilation under adequate sedation may also be required. The volatile anesthetic agent, sevoflurane, meets both criteria; therefore, its use can be beneficial and should be considered.
A yr-old Caucasian male presented with acute life-threatening asthma provoked by an assumed upper airway infection and non-steroidal anti-inflammatory drug antipyretics, complicated by chronic atrial fibrillation and hemodynamic instability. Due to frequent premature ventricular contractions, conventional treatment was considered unsafe and discontinued, and sevoflurane inhalation was initiated via the AnaConDa Anaesthetic Conserving Device.
Symptoms of life-threatening bronchospasm resolved, and the patient's respiratory status improved within hours. Adequate sedation was also achieved without any hemodynamic adverse effects. The volatile anesthetic agent, sevoflurane, is used widely in anesthesia practice. Its utility for treatment of refractory bronchospasm has been appreciated for years; however, its administration was difficult within the environment of the intensive care unit due to the need for an anesthesia machine and a scavenging system. The introduction of the AnaConDa eliminates these obstacles and makes the use of.
Life-threatening event reduces subjective well-being through activating avoidance motivation: a longitudinal study. Drawing on the approach-avoidance theory, we have examined the role of avoidance motivation in explaining the negative effects of a life-threatening event on subjective well-being SWB. Moreover, within the southern sample, the drop in avoidance motivation over time mediated the parallel drop in SWB.
In contrast to avoidance motivation, approach motivation remained stable over time and was related to positive emotions. The role of avoidance and approach motivations in life-threatening situations is further discussed. A pediatric case of life-threatening airway obstruction caused by a cervicomediastinal thymic cyst. Most patients with thymic cysts complain of a slowly enlarging, asymptomatic cervical mass. In some rare cases sudden onset of severe dyspnoea or asphyxia is the first symptom, especially in neonates and small infants.
We report a unique case of a month-old child, who required emergency tracheal intubation due to asphyxia. Cervicomediastinal thymic cyst might need to be included in causes of life-threatening airway obstruction in young children. Successful reversal of life threatening cardiac effect following dosulepin overdose using intravenous lipid emulsion.
A year-old female following the ingestion of 5. Cyclic antidepressants affect the cardiac conduction system and the myocardium. The exact mechanism of action from intravenous lipid emulsions may not be determined from the data presented, and the obtained effect does not rule out the supposed effects of alkalinisation Full Text Available Adenoidectomy is a commonly performed surgery in children, even though its effectiveness is still under investigation.
However, in children with risk factors such as age under 3 years old, associated comorbidities, or severe obstructive sleep apneas, a high postoperative respiratory morbidity is possible.
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We report the case of a month-old boy with Noonan syndrome and a complex clinical history, who presented with a life-threatening obstructive sleep apnea due to hypertrophy of the adenoids which resolved completely after adenoidectomy. Resolution of a life-threatening complication after lung radiofrequency ablation. Lung radiofrequency ablation RFA is an option for the treatment of unresectable lung cancer. Clinical investigators have previously warned against severe complications associated with this procedure.
We report a case of life-threatening complication after lung RFA for non-operable non-small-cell lung cancer consisting of pulmonary abscess evolving into a bronchopleural fistula, severe pneumothorax and septic pleuritis, which was successfully treated with a multimodal conservative approach. Water balance is controlled by thyroid, glucocorticoid, and principally ADH working at the renal effector level while the RAAS principally controls sodium balance.
Together these hormones tightly regulate serum sodium concentration. It is usually better to err on the side of mild hyponatremia than holding DDAVP in these complex patients which can lead to life threatening hypernatremia. Personalidades vocacionais e processos de carreira na vida adulta Personalidades vocacionales y procesos de carrera en la vida adulta Vocational personalities and career processes in adult life.
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