Comparing characteristics of adverse drug events between older and younger adults presenting to a Taiwan emergency department.

To compare the proportion, seriousness, preventability of adverse drug events (ADEs) between the older adults (≥ 65 years old) and younger adults (<65 years old) presenting to the emergency department (ED), we conducted a prospective observational cohort study of patients 18 years and older presenting to the ED. For all ED visits between March 1, 2009, and Feb 28, 2010, investigators identified ADEs and assessed cases using the Naranjo adverse drug reaction probability scale. Outcomes (proportion, seriousness, and preventability of ADE, length of ED stay, and hospitalization) and associated variables were measured and compared between younger and older adults.

Toxin ophthalmia caused by nuchal gland secretion of the Taiwan tiger keelback (Rhabdophis tigrinus formosanus).

Rhabdophis tigrinus is a common colubrid snake that can be found in an extensive geographical region in East Asia. It consists of two subspecies: R.t.

Risk factors associated with adverse drug events among older adults in emergency department.

Background: Little is known about the emergency department (ED) visits from drug-related injury among older adults in Taiwan. This study seeks to identify risk factors associated with adverse drug events (ADEs) leading to ED visits.

Methods: We prospectively conducted a case-control study of patients 65years and older presenting to the ED.

Emergency department neurologic deterioration in patients with spontaneous intracerebral hemorrhage: incidence, predictors, and prognostic significance.

Objectives:   The objective was to explore the incidence, predictors, and prognostic significance of emergency department (ED) neurologic deterioration in patients with spontaneous intracerebral hemorrhage (SICH).

Methods:   This was a retrospective cohort study conducted at the ED, neurocritical care unit, and general intensive care unit of a university-affiliated medical center. Consecutive adult SICH patients treated in our ED from January 2002 through December 2009 were included, identified from the registered stroke data bank.

Atrioventricular conduction abnormality and hyperchloremic metabolic acidosis in toluene sniffing.

Toluene is an aromatic hydrocarbon with widespread industrial use as an organic solvent. As a result of the euphoric effect and availability of these substances, inhalation of toluene-based products is popular among young adults and children. Chronic or acute exposure is known to cause acid-base and electrolyte disorders, and to be toxic to the nervous and hematopoietic systems.

Plasma corticotrophin response to desmopressin in patients with Cushing's disease correlates with the expression of vasopressin receptor 2, but not with that of vasopressin receptor 1 or 3, in their pituitary tumours.

Objectives: Most patients with Cushing's disease (CD) respond to corticotrophin-releasing hormone (CRH) or desmopressin with increased corticotrophin (ACTH) and cortisol levels. Although the vasopressin receptor subtype located on normal corticotrophs is the V3 receptor (V3R), desmopressin is a selective V2 receptor (V2R) agonist and it is unclear whether corticotrophinomas exhibit aberrant V2R expression. Furthermore, no studies have determined the relationship between the in vivo response of CD patients to desmopressin and vasopressin receptor expression, or between the response to CRH and CRH receptor (CRHR) expression.

Anticoagulant-induced intramural intestinal hemorrhage.

Background: Long-term use of warfarin can provide benefits in the treatment of many diseases, but adverse bleeding events are unpreventable because of a narrow therapeutic range.

Objective: The aim of this retrospective chart review with data abstraction was to investigate the clinical presentations of intestinal intramural hemorrhage in emergency department (ED) patients.

Methods: We reviewed the cases of 17 patients with acute abdominal pain in our ED.

Diagnosis of unrecognized primary overt hypothyroidism in the ED.

Objective: The aims of the study were to evaluate the incidence of newly diagnosed primary overt hypothyroidism among adults admitted through the emergency department (ED) and to assess how previously undiagnosed hypothyroidism presents.

Methods: From July 1, 2002 to June 30, 2006, 56 adult patients were enrolled for further analysis.

Results: The incidence of newly diagnosed primary overt hypothyroidism among adults admitted through the ED is 0.

Usefulness of triggering receptor expressed on myeloid cells-1 in differentiating between typical and atypical community-acquired pneumonia.

Objectives: The purpose of this study is to investigate the clinical use of inflammatory marker triggering receptor expressed on myeloid cells (TREM)-1 at admission for differentiating between typical and atypical bacterial community-acquired pneumonia (CAP).

Methods: A prospective, noninterventional study of patients with CAP hospitalized through the emergency department was performed. Surface expression of TREM-1 was analyzed using flow cytometry on peripheral blood cells, and soluble TREM-1 (sTREM-1) concentration was determined in plasma.

Gamma knife surgery for cavernous hemangiomas in the cavernous sinus.

Background: Cavernous hemangioma in the cavernous sinus (CS) is a rare vascular tumor. Direct microsurgical approach usually results in massive hemorrhage. Radiosurgery has emerged as a treatment alternative to microsurgery.

The effects of lazaroid U-74389G in a rat sepsis model.

Objective And Design: To examine the protective effects of a lazaroid, 21-aminosteroid U-74389G, in a rat septic shock model.

Materials Or Subjects: Male Sprague-Dawley rats (n = 60) aged 6-8 months.

Treatment: Groups were exposed to 500 cGy radiation followed by E.

Features and prognostic factors for elderly with acute poisoning in the emergency department.

Background: Elderly persons with acute poisoning in the emergency department (ED) and prognostic factors of outcomes have not been well addressed in previous research. This study aimed to investigate the characteristics of elderly patients with acute poisoning visiting the ED, and to identify the possible predictive factors of mortality.

Methods: Patients aged > or = 65 years with acute poisoning who visited the ED in Taipei Veterans General Hospital from January 1, 2006 through to September 30, 2008 were enrolled in the study.

Alternations of heart rate variability at lower altitude in the predication of trekkers with acute mountain sickness at high altitude.

Objective: To determine the change and relationship of spectral components of heart rate variability (HRV) measurements in subjects with or without acute mountain sickness (AMS) at both low and high altitude.

Design: A prospective study.

Setting: A 12-day itinerary by trekking to the Namche Bazaar, 3440 m in Nepal.

Bajiaolian poisoning-a poisoning with high misdiagnostic rate.

Background: One of the oldest Chinese herbal medicine, bajiaolian is widely used in traditional therapy. In Taiwan, bajiaolian is the fifth highest cause of poisoning among herbal medicines. The diagnosis is difficult because physicians are unfamiliar with this medicine's multiple presentations in different stages of intoxication.

Emergency department (ED) utilization and outcome of oldest old men presenting with geriatric syndromes in a veterans care home in Taiwan.

The first presentation of elderly people in the emergency department (ED) is commonly nonspecific and atypical, often in the form of geriatric syndromes, i.e. falls, immobility, incontinence, or deteriorating mental function.

Spleen artery embolization aggravates endotoxin hyporesponse of peripheral blood mononuclear cells in patients with spleen injury.

Background: : Spleen artery embolization (SAE) increases the success of nonoperative management of spleen injury; however, the immune alternation after SAE is unclear. This study searched the endotoxin responses of peripheral blood mononuclear cells (PBMCs) in injured patients who received SAE.

Methods: : Patients were subsequently enrolled when their spleen injuries were confirmed by computed tomographic scan.

D-dimer in patients with suspected acute mesenteric ischemia.

Objectives: The aims of this study were to assess the diagnostic value of D-dimer in patients with suspected acute mesenteric ischemia (AMI) and to evaluate the correlation between D-dimer levels and the severity of bowel necrosis.

Methods: A prospective, noninterventional study of 67 patients with clinical suspicion of AMI was performed. Measurement of D-dimer levels was performed using a latex turbidimetric method.

Aorto-left renal cyst fistula: a rare complication of abdominal aortic aneurysm rupture.

Abdominal aortic aneurysm (AAA) rupture can occur in different ways, such as closed rupture into the retroperitoneum, open rupture into the peritoneal cavity, rupture into surrounding hollow structures, and chronic contained or sealed rupture. Here, we report an unusual case of spontaneous rupture of AAA into a renal cyst that presented with hematuria, abdominal pain and shock, and which was diagnosed with multidetector computed tomography. We also review the literature on unusual patterns of AAA rupture.

Spontaneous esophageal injury: esophageal intramural hematoma.

Acute chest pain can indicate a life-threatening condition and it is important for physicians to diagnose and treat it as a matter of urgency. We report 1 rare case of esophageal intramural hematoma (IMH) that presented with chest pain at the emergency department and which was initially clinically suspected to be due to aortic dissection. The case was diagnosed preoperatively by multidetector computed tomography.

Urine output and performance of runners in a 12-hour ultramarathon.

Objective: To understand the urination pattern and to determine the relationships between urine output and performance of ultramarathon runners.

Design: Prospective observational study.

Setting: The 2005 Soochow University international ultramarathon, in which each athlete ran for 12 hours.

Prognostic factors for mortality following falls from height.

Aim: To identify the potential prognostic factors for mortality after falls from height.

Method: A retrospective clinical observational study included victims of fall of >6m from October 2000 to December 2007. Variables studied comprised each casualty's age, gender, height of fall, Glasgow Coma Scale (GCS) score, Abbreviated Injury Scale scores, Injury Severity Score, heart rate, Mean Arterial Pressure (MAP), White Blood Cell (WBC) count, haemoglobin, serum glucose, Creatine Kinase and duration of hospital stay.

Reappraisal of radiographic signs of pneumoperitoneum at emergency department.

Purpose: This study aimed to evaluate the sensitivities of the reported free air signs on supine chest and abdominal radiographs of hollow organ perforation. We also verified the value of supine radiographic images as compared with erect chest and decubitus abdominal radiographs in detection of pneumoperitoneum.

Methods: Two hundred fifty cases with surgically proven hollow organ perforation were included.

Use of screw-rod system in occipitocervical fixation.

Background: This study retrospectively reviewed 9 patients who underwent occipitocervical fixation with a newly developed screw-rod fixation system between April 2004 and November 2005. The objective was to evaluate the clinical result of occipitocervical fixation with the screw-rod fixation system, including symptom relief, fusion rate and complications.

Methods: All 9 patients received occipitocervical fixation surgery with screw-rod fixation system and autologous bone grafts for fusion.