Characterization and preventability of adverse drug events as cause of emergency department visits: a prospective 1-year observational study.

Background: Adverse drug events (ADEs) are a significant cause of emergency department (ED) visits, with a major impact on healthcare resource utilization. A multicentre observational study, aimed to describe frequency, seriousness and preventability of ADEs reported in four EDs, was performed in Sicily (Italy) over a 1-year period.

Methods: Two trained monitors for each ED supported clinicians in identifying ADEs of patients admitted to EDs between June 1st, 2013 and May 31st, 2014 through a systematic interview of patients or their caregivers and with an additional record review.

Early repolarization syndrome and Brugada syndrome: is there any linkage?

Early repolarization syndrome (ERS) is characterized by the presence, in most cases in mid-to-lateral precordial leads, of a J wave on the downsloping portion of the QRS complex, followed by an elevation of the ST-segment with upward concavity. ERS is considered a benign electrocardiographic pattern of ventricular repolarization and, thus far, clinical interest in this syndrome has been confined to its differential diagnosis from myocardial infarction and pericarditis. Brugada syndrome (BS), an inherited cardiac disease first described in 1992, exhibits a characteristic electrocardiographic pattern consisting of a J wave mimicking a right bundle branch block with typical ST-segment elevation in the right precordial leads.

Brugada-like electrocardiographic pattern: a challenge for the clinician.

A right bundle branch block with ST-segment elevation in the V1-V3 leads in characteristic coved or saddleback configuration may be encountered as an incidental finding. However, not all patients with a Brugada-like electrocardiographic pattern are affected by the Brugada syndrome; in fact, this pattern may also be found in healthy individuals. Whether symptomatic patients affected by the syndrome are at a high risk of developing life-threatening ventricular arrhythmias and should immediately receive an automatic, implantable defibrillator is open to debate, as is the clinical management of asymptomatic patients, because data from the scientific literature are controversial.

Anticholinergic toxicity associated with lupin seed ingestion: case report.

We describe a case of acute poisoning in a 51-year-old female patient who presented to the Emergency Department with weakness, anxiety, dry mouth, bilateral mydriasis and lid drop. In differential diagnosis, botulism, Guillain-Barré syndrome and myasthenia gravis were considered, as well as cerebral haematoma because of a cranial injury a week before. Symptoms, which resolved within 12 h without any therapy, were instead related to the ingestion of lupin seeds.