- Palliative care patient emergency department visits at tertiary university-based emergency department in Ireland. [Journal Article]Am J Emerg Med. 2023 Jan 23; 66:76-80.AJ
- CONCLUSIONS: Palliative care patients utilize ED services not uncommonly. Though many of these patients presented with higher acuity triage scores, 42% had lower ESI scores and may be effectively managed outside of the ED. These data suggest developing mechanisms for these patients to be urgently evaluated in their homes or facilities obviating the need for an ED evaluation.
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- The Rationale for Using Corticosteroids in COVID-19 Encephalopathy: Lessons From a Case Report With Evidence From Literature. [Case Reports]Cureus. 2023 Jan; 15(1):e33233.C
- The coronavirus disease 2019 (COVID-19) virus primarily affects the pulmonary system, but neurological manifestations and complication of COVID-19 has been reported in abundance in the literature. We present a case of a middle-aged Caucasian male who was brought to the emergency department for altered mental status. His chief complaints were neurological rather than respiratory. A positive severe…
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- Indications for continuous electroencephalographic (cEEG) monitoring: What do they tell us? [Journal Article]Epilepsy Res. 2023 Jan 20; 190:107088.ER
- CONCLUSIONS: Our findings highlight the differences in patients undergoing cEEG for AMS vs. SLE. SLE as a cEEG indication represents an independent predictor of seizures on cEEG and, therefore, deserves special attention. Future multicenter studies are needed to validate our findings.
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- Stercoral Colitis as a Cause of Altered Mental Status in a Patient With Cerebral Palsy. [Case Reports]
- Stercoral colitis (SC) is a rare inflammatory colitis that occurs due to increased intraluminal pressure from impacted fecal content in the colon. Chronic constipation is the major risk factor for this condition. Delayed diagnosis is associated with high morbidity and mortality, with complications ranging from colonic perforation to intestinal ulcers. Patients usually present with non-specific sy…
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- GeneReviews®: Molybdenum Cofactor Deficiency [BOOK]GeneReviews®. University of Washington, Seattle: Seattle (WA)BOOK
- Molybdenum cofactor deficiency (MoCD) represents a spectrum, with some individuals experiencing significant signs and symptoms in the neonatal period and early infancy (termed early-onset or severe MoCD) and others developing signs and symptoms in childhood or adulthood (termed late-onset or mild MoCD). Individuals with early-onset MoCD typically present in the first days of life with severe ence…
- An Interesting Case of Severe Hyponatremia. [Journal Article]Am J Forensic Med Pathol. 2023 Jan 30 [Online ahead of print]AJ
- In this report, we present an unusual and multifactorial case of severe hyponatremia with important clinical implications. The decedent was a 42-year-old woman who was discovered at her place of residence with altered mental status and profuse watery diarrhea. The scene was significant for numerous empty water bottles. She was transported to the emergency department of a local medical center and …
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- Calcium Carbonate (Tums)-Associated Hypercalcemic Crisis. [Case Reports]
- Hypercalcemic crisis due to severe decompensated hypercalcemia represents a life-threatening medical emergency leading to renal failure and altered mental status. Hypercalcemic crisis most commonly results from hypercalcemia of malignancy, undiagnosed primary hyperparathyroidism, granulomatous diseases, and medication-induced hypercalcemia. Commonly prescribed medications like thiazide diuretics,…
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- Appropriateness of antibiotic use in patients with and without altered mental status diagnosed with a urinary tract infection. [Journal Article]
- CONCLUSIONS: Patients with AMS are prescribed antibiotic therapy without symptoms indicative of UTI at a higher rate than those without AMS, according to LMC. Further antimicrobial stewardship efforts should focus on prescriber education and development of clearly defined criteria for patients with and without AMS.
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- Methanol Intoxication-Associated Brain Hemorrhages: Can Early Detection Be Life-Saving? A Case Report. [Case Reports]Am J Case Rep. 2023 Jan 30; 24:e938749.AJ
- BACKGROUND Methanol can cause many acute complications when ingested, either intentionally or accidentally. One rare complication is cerebral hemorrhage, which can present with focal neurologic deficits, decreased consciousness, and fixed, dilated pupils. With vigilant monitoring of patients in the acute period of toxicity, rapid identification, and initiation of treatment, outcomes can potential…
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- Evaluation of Dexmedetomidine as an Adjunct to Phenobarbital for Alcohol Withdrawal in Critically Ill Patients. [Journal Article]J Intensive Care Med. 2023 Jan 26 [Online ahead of print]JI
- CONCLUSIONS: This analysis suggests the use of adjunctive DEX with PHB for AWS was associated with a prolonged ICU LOS. Additional studies are needed to further understand the role of adjunctive DEX in the treatment of AWS in critically ill patients.
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- Gender-dependent impact of COVID-19 lockdown on metabolic and psychological aspects. [Journal Article]
- The first COVID-19 lockdown resulted in enforced quarantine of heavily affected areas with social isolation and related measures by several governments to slow the spread of the disease. The general population experienced several mental and lifestyle changes. Herein, we aimed to evaluate the metabolic and psychological effects induced by lifestyle changes during COVID-19 self-isolation among an A…
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- Reprint of: The Diagnostic and Prognostic Utility of Incorporating DAXX, ATRX, and Alternative Lengthening of Telomeres (ALT) to the Evaluation of Pancreatic Neuroendocrine Tumors (PanNETs). [Editorial]Hum Pathol. 2023 Feb; 132:1-11.HP
- Pancreatic neuroendocrine tumors (PanNETs) are a heterogeneous group of neoplasms with increasing incidence and an ill-defined pathobiology. Although many PanNETs are indolent and remain stable for years, a subset may behave aggressively and metastasize widely. Thus, the increasing and frequent detection of PanNETs presents a treatment dilemma. Current prognostic systems are susceptible to interp…
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- Characteristics of Mid-Term Post-Intensive Care Syndrome in Patients Attending a Follow-Up Clinic: A Prospective Comparison Between COVID-19 and Non-COVID-19 Survivors. [Journal Article]Crit Care Explor. 2023 Jan; 5(1):e0850.CC
- CONCLUSIONS: In our follow-up clinic at 3 months after discharge, the proportion of patients presenting alterations in the main PICS domains was similar whether they survived a COVID-19 or another critical illness, despite longer ICU stay in COVID group. Cognition and sleep were the two most affected PICS domains.
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- Endovascular thrombectomy for cerebral venous sinus thrombosis using the Penumbra Indigo® Aspiration System. [Journal Article]Interv Neuroradiol. 2023 Jan 23 [Online ahead of print]IN
- We present a 35-year-old male with ulcerative colitis initially admitted for a flare-up who then presented with altered mental status and was found to have extensive cerebral venous sinus thrombosis on computed tomography imaging. The patient underwent successful partial recanalization of the superior sagittal sinus and bilateral transverse sinuses using the Penumbra Indigo® Aspiration System wit…
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- AI-based dimensional neuroimaging system for characterizing heterogeneity in brain structure and function in major depressive disorder: COORDINATE-MDD consortium design and rationale. [Journal Article]
- CONCLUSIONS: We describe the consortium, imaging protocols and analytics using preliminary results. Our findings thus far demonstrate how datasets across many sites can be harmonized and constructively pooled to enable execution of this large-scale project.
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- Bacterial meningitis in adults: a retrospective study among 148 patients in an 8-year period in a university hospital, Finland. [Journal Article]
- CONCLUSIONS: The number of cases with nosocomial BM was surprisingly high and should be further investigated. The usage of pre-diagnostic antibiotics was also quite high. Headache was associated with unfavorable outcome. The frequency of unfavorable outcome of BM was 40.5%, although mortality in our patients was lower than in most previous studies.
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- Clinical Characteristics and Follow-up of Cases of Streptococcus suis Meningitis in Patients of Liuzhou, China. [Journal Article]Am J Trop Med Hyg. 2023 Jan 23 [Online ahead of print]AJ
- We analyzed the clinical characteristics and outcomes of patients with Streptococcus suis meningitis in Liuzhou, China, to improve diagnostic accuracy and lower the chances of misdiagnosis. The major clinical manifestations, auxiliary examination results, treatment strategies, treatment efficacy, and follow-up results of 17 consecutively admitted patients with S. suis meningitis were evaluated. T…
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- Small for date preterm infants and risk of higher blood pressure in later life: A systematic review and meta-analysis. [Review]Paediatr Perinat Epidemiol. 2023 Jan 23 [Online ahead of print]PP
- CONCLUSIONS: Evidence indicates that preterm infants born SGA are not at increased risk of developing higher BP as children or as adults as compared to non-SGA preterm infants.
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- Potential therapeutic mechanism of deep brain stimulation of the nucleus accumbens in obsessive-compulsive disorder. [Journal Article]
- Deep brain stimulation (DBS) of the nucleus accumbens (NAc) (NAc-DBS) is an effective solution to refractory obsessive-compulsive disorder (OCD). However, evidence for the neurobiological mechanisms of OCD and the effect of NAc-DBS is still lacking. One hypothesis is that the electrophysiological activities in the NAc are modulated by DBS, and another hypothesis is that the activities of neurotra…
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- Home-based exercise program in the indeterminate form of Chagas disease (PEDI-CHAGAS study): A study protocol for a randomized clinical trial. [Journal Article]
- CONCLUSIONS: The findings from the present study may support public health intervention strategies to improve physical and mental health parameters to be implemented more effectively in this population.
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- The Serious Impact of Comorbidities on Methemoglobinemia: A Case Report. [Case Reports]
- Methemoglobinemia is a rare, life-threatening condition that occurs when the body is exposed to oxidative stress. We present the case of a 72-year-old female with a past medical history of hypertension, obesity, dyslipidemia, and heart failure who was admitted to the emergency department with altered mental status and respiratory failure. After admission, we also identified an atrioventricular bl…
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- Meeting the Challenges of Sepsis in Severe Coronavirus Disease 2019: A Call to Arms. [Journal Article]
- Sepsis is a life-threatening organ dysfunction that is caused by a dysregulated host response to infection. Sepsis may be caused by bacterial, fungal, or viral pathogens. The clinical manifestations exhibited by patients with severe coronavirus disease 2019 (COVID-19)-related sepsis overlap with those exhibited by patients with sepsis from secondary bacterial or fungal infections and can include …
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- Cerebral Salt Wasting Syndrome Associated with Status Epilepticus. [Case Reports]
- Cerebral salt wasting syndrome (CSWS) is defined as a renal loss of sodium in cerebral disorders causing hyponatremia and loss of extracellular fluid volume. Similar laboratory findings may be seen in other conditions such as syndrome of inappropriate antidiuretic hormone secretion (SIADH). A 58-year-old male visited our emergency department because of the sudden development of seizures during sl…
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- Severe hypernatremia in hyperglycemic conditions; managing it effectively: A case report. [Case Reports]
- CONCLUSIONS: The combination of DKA, HHS and hypernatremia is rare and extremely challenging to manage, but the most challenging part of this condition is selecting the correct type of fluids to treat these conditions. Our case illustrates that desmopressin and free water administration via the NG route can be helpful in this situation.
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- Community-acquired Staphylococcus aureus meningitis in adults. [Journal Article]J Infect. 2023 Jan 20 [Online ahead of print]JI
- CONCLUSIONS: Community-acquired S. aureus meningitis is a severe disease with a high case fatality rate, occurring mainly in patients with concomitant endocarditis or spondylodiscitis.
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- Zero the hero: Evidence for involvement of the ventromedial prefrontal cortex in affective bias for free items. [Journal Article]Cortex. 2022 Dec 29; 160:24-42.C
- Recent evidence from psycho-economics shows that when the price of an item decreases to the extent that it becomes available for free, one can observe a remarkable increase of subjective utility toward this item. This phenomenon, which is not observed for any other price but zero, has been termed the zero-price effect (ZPE). The ZPE is attributed to an affective heuristic where the positive affec…
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- Progressive Cerebral Venous Thrombosis with Cranial Nerve Palsies in an Adolescent African Girl & Associated Diagnostic Pitfalls: A Rare Case Report. [Case Reports]
- Cerebral venous thrombosis (CVT) is a cerebrovascular disorder caused by complete or partial occlusion of the cerebral venous and sinus system. The etiology has been attributed to hypercoagulability and pro-thrombotic states, leading to raised intracranial pressures that often manifest as headaches and focal neurological deficits. However, the multifactorial nature of CVT can create a diagnostic …
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- Chronic Posterior Tibiofemoral Dislocation of a Cruciate Retaining Total Knee Arthroplasty in the Setting of Wernicke-Korsakoff Syndrome: A Case Report. [Case Reports]
- CONCLUSIONS: Wernicke-Korsakoff Syndrome is an uncommon condition that affects alcoholics and complicates treatment with joint replacement surgery. Patients with Wernicke-Korsakoff syndrome provide a unique set of challenges that may require multiple surgeries and varying prostheses. Chronic posterior tibiofemoral dislocation is one specific complication that may affect the management of these patients. As orthopedic surgeons, it is important to consider alcohol use disorder and Wernicke-Korsakoff Syndrome when treating patients with total joint replacement.
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- Delayed Postoperative Tension Pneumocephalus Treated With a Subdural Evacuating Port System: A Case Report and Review of the Literature. [Case Reports]
- Tension pneumocephalus (TP) is a rare neurosurgical emergency due to the rise of intracranial pressure from air in the cranial cavity. Tension pneumocephalus' clinical presentation ranges from headache, visual alterations, altered mental status, and death. Given its nonspecific clinical presentation, tension pneumocephalus is usually diagnosed via computed tomography (CT) imaging. Open burr hole …
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- Vitamin D Toxicity Presenting as Altered Mental Status in Elderly Patients. [Journal Article]
- Background and objective Around 25-30% of elderly patients present to emergency departments (ED) with altered mental status (AMS), with hypercalcemia being one of the metabolic causes. Elderly patients, due to their multiple vulnerability factors and relative homeostenosis, are susceptible to alterations in mental state at even milder grades of hypercalcemia. There is a trend of overzealous presc…
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