Assuntos
Ingestão de Energia/fisiologia , Fígado/metabolismo , Distúrbios Nutricionais/etiologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Aumento de Peso/fisiologia , Adulto , Alanina Transaminase/metabolismo , Análise de Variância , Aspartato Aminotransferases/metabolismo , Índice de Massa Corporal , Distribuição de Qui-Quadrado , Exercício Físico , Feminino , Humanos , Tempo de Internação , Fígado/enzimologia , Testes de Função Hepática , Estudos Longitudinais , Masculino , Distúrbios Nutricionais/dietoterapia , Distúrbios Nutricionais/epidemiologia , Estudos Retrospectivos , Centros de Tratamento de Abuso de SubstânciasRESUMO
OBJECTIVE: To examine the judicial outcomes for intoxicated drivers who were admitted to regional trauma centers as a result of motor vehicle collisions (MVCs). METHODS: A retrospective review of the trauma registry of a Level I trauma center was conducted for the period from January 1, 1989, through December 31, 1990. Inclusion criteria for entry into the study were 1) identification of the patient as the driver involved in an MVC, 2) a blood alcohol content (BAC) above 0.10 g/dL, and 3) survival until discharge from the hospital. A total 245 patients from the trauma registry met the inclusion criteria. The number of persons from the submitted list who were later convicted of driving under the influence of alcohol (DUI) was obtained from the Department of Motor Vehicles (DMV) of the Common- wealth of Virginia. RESULTS: Of the list submitted to the DMV, only nine individuals (3.7%; 95% confidence interval = 1.3--6.0%) were convicted of DUI during the MVCs that led to hospitalization during the study period. During the same time period, the statewide conviction rate for DUI-cited drivers was 85%. CONCLUSION: Admission to the trauma service at a Level I trauma center may provide a refuge from legal consequences for intoxicated drivers involved in MVCs.
Assuntos
Acidentes de Trânsito/legislação & jurisprudência , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Crime/legislação & jurisprudência , Humanos , Estudos Retrospectivos , Centros de Traumatologia , VirginiaRESUMO
Angiotensin-converting enzyme inhibitors are a widely used antihypertensive modality. While they have a favorable side effect profile, there is a .1% to .2% incidence of potentially life threatening angioedema. The edema usually presents in the head and neck, especially the face, lips, tongue, and glottis. Patients may initially be treated with standard anti-allergic therapy; however, the situation may dictate a more aggressive therapeutic approach. The authors present the case of a patient who presented with angioedema 18 times over a 3-year period to qualified emergency physicians before the correct diagnosis of angiotensin-converting enzyme inhibitor-induced angioedema was made. Despite recent literature on the subject, there appears to be a lack of familiarization among emergency department physicians regarding this relatively common adverse effect.
Assuntos
Angioedema/induzido quimicamente , Angioedema/diagnóstico , Inibidores da Enzima Conversora de Angiotensina/efeitos adversos , Adulto , Angioedema/terapia , Diagnóstico Diferencial , Serviço Hospitalar de Emergência , Enalapril/efeitos adversos , Humanos , MasculinoRESUMO
Metal fume fever is an ancient occupational disease still encountered among metal workers. The delay between exposure and onset of non-specific symptoms makes this an elusive diagnosis. We present the case of a patient who developed symptoms several hours after welding. The historical background, pathogenesis, clinical presentation, and self-limited course of this common, yet frequently unrecognized illness are discussed.
