Posterior Reversible Encephalopathy Syndrome and Eclampsia in the Setting of Magnesium Toxicity: A Case Report.

Posterior reversible encephalopathy syndrome (PRES) is a rare neurologic condition and a feared complication of eclampsia. It is evidenced by acute neurologic dysfunction secondary to cerebral edema and is typically reversible in nature. Although it is a relatively new diagnosis, an increasing amount of literature has described its occurrence, including an association with hypomagnesemia.

Point-of-care Ultrasound Evaluation of Tibial Avulsion Fractures.

It can be difficult to diagnose a tibial avulsion fracture based on physical examination alone as findings are often non-specific. Emergency physicians will usually opt for radiography as their initial imaging modality, which has several disadvantages in evaluating tibial avulsion fractures. The objective of this case series is to describe the utility of point-of-care ultrasound (POCUS) in the evaluation of tibial avulsion injuries.

Point of Care Ultrasound Diagnosis of Upper Gastrointestinal Bleeding.

A 28-year-old male was brought to the emergency department by the Emergency medical services (EMS) after being found unconscious and unresponsive. Upon arrival, he was hypotensive, intubated with a Glasgow Coma Scale (GCS) 3T, without the signs of trauma or the evidence of bleeding. A focused assessment with sonography in trauma (FAST), point-of-care ultrasound (POCUS) was performed, obscuring part of the spleen from the distended stomach, which was filled with the heterogeneous contents, with the internal movement being identified.

Leading an organization through change. Interview by Barbara J. Linney.

Robert Jamplis, MD, FACPE, has been President and CEO of the Palo Alto Medical Foundation for the past 30 years. During those years, he has led his group through many of the changes that are just occurring in other medical group practices--movement away from long hospital stays and toward large integrated health care systems. In an interview conducted late in 1994, the author asked Dr.

Pneumothorax: a therapeutic update.

The traditional treatment of pneumothorax has been with a chest tube and hospitalization. A series of 35 patients with 41 pneumothoraces treated on an outpatient basis is presented here. A no.

Post-pneumonectomy syndrome. Surgical correction using Silastic implants.

A post-right pneumonectomy syndrome is described which manifests symptoms of exertional dyspnea and inspiratory stridor on rapid inspiration. These symptoms were associated with marked rightward and posterior deviation of the trachea, over-distention of the left lung with its herniation into the right side of the chest and kinking of the left lower lobe bronchus. At the time of surgery, the tracheal deviation, lung herniation and the kink in the left lower lobe bronchus were immediately corrected by releasing the adhesions between the malpositioned structures and the right chest wall.

Therapeutic angiography. Its value to the surgical patient.

Standard angiographic techniques formerly used exclusively as diagnostic modalities have been modified to serve as definitive or adjunctive therapeutic measured. The techniques include transcatheter embolization; infusion of vasoactive drugs, chemotherapeutic agents and radioactive particles; tamponade of bleeding arteries and balloon catheters; extraction of vascular foreign bodies and retained biliary tract stones and transluminal arterial dilation. These techniques have been proved effective and safe when used judiciously.

Peripheral pulmonary carcinoid tumors.

The light microscopic and ultrastructural features of five asymptomatic peripheral carcinoids presented as distinct pulmonary solitary nodules are described. By conventional microscopy the tumors displayed a variety of histologic patterns, the most unusual one showing tumor cells embedded in a richly vascular hyalinized stroma and forming papillary structures or cystic spaces lined by low cuboidal cells which ultrastructurally bore a strong resemblance to intermediate or transitional forms between types I and II pneumocytes. A striking feature of these tumors was their rich vasculature associated with a marked perivascular sclerosis composed of basement membrane-like material and collagen fibrils most likely produced by the increased numbers of pericytes surrounding these sclerotic vessels.