ABSTRACT
Dislocation of the proximal tibiofibular joint (PTJ) is a knee injury that occurs infrequently. In this case, the dislocation of the PJT of the right knee was reported with subsequent pain and limitation in range of motion, caused by trauma during the practice of a soccer game. An intense pain was observed in the area where the head of the fibula is located without finding crepitation or deformity. Initially, comparative anteroposterior and lateral X-rays of the knees were requested, showing proximal tibiofibular joint incongruity with anterolateral displacement without evidence of fracture lines. For this reason, it was decided to take a tomography of the right knee that confirmed the presence of anterior dislocation of the proximal tibiofibular joint. Closed reduction under sedation was scheduled.
ABSTRACT
Introducción: Las estatinas son los medicamentos más recetados en el mundo, por el beneficio y la seguridad que ofrecen. Sin embargo, pueden causar reacciones adversas a escala neurológica, gastrointestinal, renal y muscular. Objetivo: Es describir el curso clínico de una paciente con reacción adversa medicamentosa a la lovastatina. Métodos: Reporte de caso y revisión de la literatura. Resultados: Mujer de 52 años con psicosis súbita y rabdo-miólisis secundaria al consumo de lovastatina, clínica que remite con la suspensión del fármaco. La relación causal se establece a través de la escala de Naranjo, con puntuación de 6 (probable reacción adversa medicamentosa). Conclusión: La manifestación simultánea de psicosis y rabdomiólisis representa un caso clínico atípico y único consecuente a la ingesta de lovastatina
Introduction: Statins are the most prescribed drugs worldwide given the benefit and security they offer. However, they can cause severe neurological, gastrointestinal, renal and mus-cular side effects. Objective: To describe the clinical course of a female patient with adverse drug reaction to Lovastatin. Methods: Case report and literature review. Results: 52-year old woman with sudden psychosis and rhabdomyolysis secondary to Lovastatin and ending after the drug suspension. The causal relationship was corroborated with a score of 6 (probable ADR) on Naranjos Scale. Conclusions: The simultaneous manifestation of psychosis and rhabdomiolysis represents an atypical and unique case following Lovastatin ingestion
Subject(s)
Pharmacology , Psychotic Disorders , RhabdomyolysisABSTRACT
INTRODUCTION: Statins are the most prescribed drugs worldwide given the benefit and security they offer. However, they can cause severe neurological, gastrointestinal, renal and muscular side effects. OBJECTIVE: To describe the clinical course of a female patient with adverse drug reaction to Lovastatin. METHODS: Case report and literature review. RESULTS: 52-year old woman with sudden psychosis and rhabdomyolysis secondary to Lovastatin and ending after the drug suspension. The causal relationship was corroborated with a score of 6 (probable ADR) on Naranjo's Scale. CONCLUSIONS: The simultaneous manifestation of psychosis and rhabdomiolysis represents an atypical and unique case following Lovastatin ingestion.
ABSTRACT
OBJECTIVE: The accuracy of pre-hospital crash scene details and crash victim assessment has important implications for initial trauma care assessment and management. Similarly, it is known to influence physician perception of crash victim injury severity. The goal of this feasibility study was to examine paramedic accuracy in predicting crash victim injury profile, disability outcome at hospital discharge, and reporting vehicle damage with other crash variables. METHODS: This prospective case series study was undertaken at a Southern California, Level I trauma center certified by the American College of Surgeons. Paramedics transporting crash injured motor vehicle occupants to our emergency department (ED)/trauma center were surveyed. We abstracted ED and in-patient records of injured vehicle occupants. Vehicle and crash scene data were obtained from a professional crash reconstruction, which included the assessment of deformation, crash forces, change in velocity, and the source of each injury. RESULTS: We used survey, injury, and crash reconstruction data from 22 collision cases in the final analysis. The median Injury Severity Score (ISS) was five (range 1-24). No enrolled patients died, and none were severely disabled at the time of discharge from the hospital. The paramedic crash injury severity predictions were sensitive for an Abbreviated Injury Scale (AIS) of 2-4. Paramedics often agreed with the crash reconstruction on restraint use, ejection, and other fatalities at the scene, and had lower levels of agreement for front airbag deployment, steering wheel damage, and window/windshield impact. Paramedics had 80% accuracy in predicting any disability at the time of hospital discharge. CONCLUSION: Paramedic prediction of injury profile was sensitive, and prediction of disability outcome at discharge was accurate when compared to discharge diagnosis. Their reporting of vehicle specific crash variables was less accurate. Further study should be undertaken to assess the benefits of crash biomechanics education for paramedics and other pre-hospital care providers.
