Acute Confusion: An Unusual Presentation of Miliary Tuberculosis
A middle aged African-American gentleman was brought to the emergency department by the emergency medical services with altered mental status. The patient was found confused,
A middle aged African-American gentleman was brought to the emergency department by the emergency medical services with altered mental status. The patient was found confused,
The care of the critically ill patient in the pediatric intensive care unit (PICU) has remained an important topic for those health care providers dealing with children. The purpose of this article is to introduce to the reader a summary of selected papers which we consider relevant to the care of the pediatric critically ill patient and that were published in the year 2006. These articles were selected on the basis of application to the PICU, overall importance and are not to be solely considered authoritative in their field. There are many other useful articles.
Purpose: The use of therapeutic hypothermia (TH) has increased in the treatment of comatose victims of cardiac arrest, traumatic brain injury, refractory dysrhythmias, neonatal encephalopathy and asphyxia, near-drowning and hemorrhagic shock. The purpose of this study was to ascertain the level of understanding of TH use for comatose victims of cardiac arrest among healthcare providers in two developing countries.
Alternative medicine techniques are commonly used across the world and not uncommonly encountered even in the intensive care setting. The use of these unconventional remedies,
A 39-year old gentleman with pancreatitis sustained cardiorespiratory arrest due to tension pneumothorax after a Swan-Ganz catheter placement. Despite recovering cardio-respiratory function, he did not regain consciousness. Three months later, he seemed awake, but did not answer questions, follow commands, blink to threat or exhibit purposeful movements. He had spastic quadraparesis, decerebrate posturing in response to noxious stimuli, sustained ankle clonus and bilateral Babinski sign. The electroencephalogram showed burst-suppression.
Life-threatening hyponatremia can occur when sodium concentration falls to 125 mmol/L or less. Symptoms usually do not depend on the absolute sodium concentration but on the rate of fall. Estimates of mortality in acute hyponatremia are as high as 50%. Marathon runners are at particular risk of developing a syndrome which consists of severe hyponatremia, pulmonary edema and cerebral edema as originally described by Varon and Ayus. This syndrome, if not managed appropriately has a very high morbidity and mortality.