Biomarkers in Shock Patients and Their Value as A Prognostic Tool; A Prospective Multi-Center Cohort Study.

Objective: To investigate the prognostic value of clinical and laboratory tests in prediction of outcome in patients at day 30 post presentation to hospital with shock and to determine the prognostic value of mid regional pro-adrenomedullin (MR-proADM) on mortality prediction at 30 days in the same patient cohort.

Method: This prospective multicenter cohort study analyzed data from patients who had presenting with shock to the emergency departments of eleven urban, tertiary-care University hospitals in Spain between March, 2011 and May, 2011. Recruitment of patients was via convenience sampling.

Dover sole.

Negative pressure pulmonary edema (NPPE) is a clinical syndrome well described in the literature and easy to recognize in cases of suspicion, but probably underdiagnosed. It can be a cause of morbidity and admission to the intensive care unit of healthy young individuals. It is present in approximately one in every thousand anesthetics and in 10% of the episodes of upper airway obstruction that are observed in routine clinical practice.

Physical fitness as an indicator of health status and its relationship to academic performance during the prepubertal period.

Physical activity (PA) is considered one of the most important determinants of the health status in children, and predictor of morbidity/mortality in adults. The aim is to examine the relationship between physical fitness (PF), PA, obesity and academic performance (AP) in primary school children. Cross-sectional studies including 91 primary school students, aged 9 to 12 years, from the province of Córdoba.

Swimming-induced pulmonary oedema an uncommon condition diagnosed with POCUS ultrasound.

Swimming Induced Pulmonary Edema, or SIPE, is an emerging condition occurring in otherwise healthy individuals during surface swimming or diving that is characterized by cough, dyspnea, hemoptysis, and hypoxemia. It is typically found in those who spend time in cold water exercise with heavy swimming and surface swimming, such as civilian training for iron Man, triathalon, and military training. We report the case of a highly trained young female swimmer in excellent cardiopulmonary health, who developed acute alveolar pulmonary oedema in an open water swimming training diagnosed in the emergency department using POCUS ultrasound.

Acute ischemic stroke what is hidden behind?

Acute aortic dissection (AAD) is a rare and potentially fatal disease. The classic presentation is sudden and severe pain in the chest, back, or abdomen, described as tearing or ripping pain radiating to the interscapular region. Cerebral ischemic complications occur in 18-30% of aortic dissections and patients may present to the emergency department (ED) with isolated focal neurology and no chest pain.

Catastrophic antiphospholipid antibody syndrome presenting as acute vascular occlusion in a young female patient.

Acquired thrombotic and thromboembolic disorders may be presented initially with symptoms and signs of acute ischaemia or organ dysfunction that will lead many of these patients to seek care in the emergency department. We report a case of a 19-year-old female patient who developed catastrophic antiphospholipid syndrome (CAPS syndrome or Asherson syndrome) 6 weeks post stillbirth with an initial presentation of acute vascular occlusion. The patient was immediately operated and anticoagulated with significant improvement.

Characteristics and mortality of elderly patients admitted to the Intensive Care Unit of a district hospital.

Aim: To study all the elderly patients (≥75 years) who were admitted in an Intensive Care Unit (ICU) of a Spanish hospital and identify factors associated with mortality.

Patients And Methods: A retrospective, observational data collected prospectively in patients ≥75 years recruited from the ICU in the period of January 2004 to December 2010.

Results: During the study period, 1661 patients were admitted to our unit, of whom 553 (33.

Community Acquired Spondylodiscitis caused by Escherichia Coli; Case Report and Literature Review.

Vertebral osteomyelitis, or spondylodiscitis, is a rare disease with increasing prevalence in recent years due to a greater number of spinal surgical procedures, nosocomial bacteraemia, an aging population and intravenous drug addiction. Haematogenous infection is the most common cause of spondylodiscitis. We report a 47-year-old man diagnosed with Escherichia coli spondylodiscitis.

Limb-Shaking TIA Presenting as Hemichorea-Hemiballismus: TIA Chameleons Diagnostic Challenge in the Emergency Department.

Background: demonstrate the importance of considering limb-shaking syndrome in the differential diagnosis of patients who present to the emergency department (ED) with hyperkinetic movements.

Methods: In this article, we describe a diagnostic challenge in the ED in which a patient presents with hyperkinetic movements that are initially diagnosed as hemichorea-hemiballismus (HCHB) but are subsequently found to be limb-shaking syndrome with important therapeutic opportunities.

Results: Following a diagnosis of left carotid obstruction, the patient underwent left carotid endarterectomy 5 days after admission.

Bilateral stones as a cause of acute renal failure in the emergency department.

Background: Acute renal failure (ARF) due to obstructive uropathy is a urological emergency. The standard radiological investigations in the emergency setting include X-ray, ultrasonography and computed tomography. But occasionally the cause of obstruction may be elusive.

Varicella zoster encephalitis mimicking stroke.

Physicians need to consider a broad differential diagnosis when evaluating a patient presenting with a suspected stroke. The rates of overdiagnosis of stroke in studies of consecutive patients vary from 19% to 31%. The two most common stroke mimics are hypoglycemia and seizure, but several etiologies have been reported.

Gastric wall abscess presenting as thoracic pain: rare presentation of an old disease.

Acute phlegmonous gastritis, a suppurative infection of the gastric wall, has a high mortality rate. This disease remains a mystery to most clinicians. The rarity of this disease and its nonspecific presentation make early diagnosis difficult, especially in the emergency department.

A report of disseminated adenocarcinoma presenting as thrombotic thrombocytopenic purpura.

Thrombotic microangiopathies (TMAs) represent a heterogeneous group of diseases characterized by a microangiopathic hemolytic anemia, peripheral thrombocytopenia, and organ failure of variable severity. TMAs encompass thrombotic thrombocytopenic purpura (TTP), typically characterized by fever, central nervous system manifestations and hemolytic uremic syndrome (HUS), in which renal failure is the prominent abnormality. In patients with cancer TMAs may be related to various antineoplastic drugs or to the malignant disease itself.