ABSTRACT
A focused point-of-care abdominal ultrasound is an examination performed at the patient's location and interpreted within the clinical context. This review gives an overview of this examination modality. The objective is to rapidly address predefined dichotomised questions about the presence of an abdominal aortic aneurysm, gallstones, cholecystitis, hydronephrosis, urinary retention, free intraperitoneal fluid, and small bowel obstruction. FAUS is a valuable tool for emergency physicians to promptly confirm various conditions upon the patients' arrival, thus reducing the time to diagnosis and in some cases eliminating the need for other imaging.
Subject(s)
Aortic Aneurysm, Abdominal , Hydronephrosis , Ultrasonography , Humans , Ultrasonography/methods , Aortic Aneurysm, Abdominal/diagnostic imaging , Hydronephrosis/diagnostic imaging , Abdomen/diagnostic imaging , Gallstones/diagnostic imaging , Cholecystitis/diagnostic imaging , Intestinal Obstruction/diagnostic imaging , Urinary Retention/diagnostic imaging , Urinary Retention/etiology , Point-of-Care SystemsABSTRACT
We report a case of atypical ketoacidosis in a patient treated with a sodium-glucose cotransporter- (SGLT) 2 inhibitor. The 25-year-old woman, who one year earlier had been prescribed dapagliflozin for presumed Type 2 diabetes, came to the emergency department in a state of severe ketoacidosis, pH 6.85, and a plasma glucose level of 14.3 mmol/l. She received standard treatment and recovered. We discuss the increasing evidence for atypical ketoacidosis being a serious side effect of the SGLT2 inhibitors.
Subject(s)
Benzhydryl Compounds/adverse effects , Diabetic Ketoacidosis/chemically induced , Glucosides/adverse effects , Hypoglycemic Agents/adverse effects , Sodium-Glucose Transporter 2 Inhibitors , Adult , Benzhydryl Compounds/administration & dosage , Benzhydryl Compounds/therapeutic use , Diabetes Mellitus, Type 2/drug therapy , Diabetic Ketoacidosis/therapy , Female , Glucosides/administration & dosage , Glucosides/therapeutic use , Humans , Hypoglycemic Agents/administration & dosage , Hypoglycemic Agents/therapeutic useABSTRACT
Nutritional deficiency anaemia in vegans is common and usually due to lack of vitamin B12, as this vitamin is found almost exclusively in animal-based food products. In this case report we present a 39-year-old male vegan with severe macrocytic anaemia due to vitamin B12 deficiency as well as secondary hyperparathyroidism due to severe vitamin D deficiency. We want to emphasize the importance of a detailed nutritional history for patients with anaemia, and the need for vitamin B12 and vitamin D supplements for people who comply with a vegan diet.
Subject(s)
Anemia, Macrocytic/etiology , Diet, Vegan/adverse effects , Hyperparathyroidism, Secondary/etiology , Adult , Anemia, Macrocytic/drug therapy , Dietary Supplements , Humans , Hyperparathyroidism, Secondary/drug therapy , Male , Vitamin B 12/therapeutic use , Vitamin B 12 Deficiency/complications , Vitamin B 12 Deficiency/drug therapy , Vitamin B 12 Deficiency/etiology , Vitamin D/therapeutic use , Vitamin D Deficiency/complications , Vitamin D Deficiency/drug therapy , Vitamin D Deficiency/etiologyABSTRACT
Serious anaphylactic reactions to systemic glucocorticoids are rare and have previously mainly been reported in patients with asthma or aspirin allergy. We report a case of severe anaphylactic reaction to an intravenous (IV) glucocorticoid in a patient with chronic obstructive pulmonary disease. A 61-year-old male developed severe bronchospasm within seconds after IV injection of methylprednisolone sodium succinate. The condition was immediately treated with adrenaline and the patient recovered quickly. Clinicians should be aware of the possibility of anaphylactic reactions to glucocorticoids.
Subject(s)
Anaphylaxis/chemically induced , Glucocorticoids/adverse effects , Methylprednisolone Hemisuccinate/adverse effects , Administration, Intravenous , Anaphylaxis/complications , Anaphylaxis/drug therapy , Bronchial Spasm/chemically induced , Bronchial Spasm/complications , Bronchial Spasm/drug therapy , Epinephrine/therapeutic use , Glucocorticoids/administration & dosage , Glucocorticoids/therapeutic use , Humans , Male , Methylprednisolone Hemisuccinate/administration & dosage , Methylprednisolone Hemisuccinate/therapeutic use , Middle Aged , Pulmonary Disease, Chronic Obstructive/complicationsABSTRACT
Non-adherence or incomplete adherence to drug prescriptions is common. In long-term therapy for chronic disease, it has been estimated that only half of all drug doses are taken as prescribed. In this article we discuss poor adherence in terms of prevalence, clinical significance, treatment opportunities and ethical aspects.
