Aortic dissection (AD) is a cardiovascular emergency whose most frequent symptom is chest pain. However, clinical presentation can also be varied and atypical. In the present study we report a case of painless AD, which resulted in a sudden memory loss at presentation. Physical examination and laboratory tests regarding the patient did not show any abnormal findings and a benign transient global amnesia was diagnosed. The day after being discharged, the patient came back to the emergency department because a recurrent episode of severe memory impairment occurred. This time, additional clinical and laboratory signs suggested clinical suspicion of AD. A chest computed tomography angiogram was performed and an extensive AD type A involving carotid and iliac arteries was found. Our case report shows that acute aortic dissection diagnosis can be difficult if clinical presentation is atypical and must be assessed in the light of various clinical signs and laboratory data
We report the case of a 57 year old woman who developed headache, nausea, palpitation, tachycardia and hypotensione 30 minutes after eating spoiled tuna. A detailed food history and clinical exclusion helped to confirm a suspected diagnosis of scombroid poisining. The sign, symptoms, pathophysiology and management of poisoning from spoiled scombroid fish are discussed. The patient doesn’t recovered in hospital, but she remained in Emergency Department for some hours under the medical observation; it was necessary for confirm the diagnosis and procure the therapy
Asthma is a chronic inflammatory disease affecting small airways, associated with hyperresponsiveness, reversible airflow-limitation and respiratory symptoms. During exhacerbations, the symptoms severity may vary from mild dyspnea to fatal status asthmaticus. Non-invasive ventilation is a respiratory support method that in COPD has been used succesfully in the last 20 years; there is an increasingly interest about using non-invasive ventilation also in asthmatic patients. However, its role in status asthmaticus has not been yet established. In this article we report a case of a patient succesfully treated with non-invasive ventilation and we also review the literature about non-invasive ventilation in acute asthm
Hyper-glycemy is commonly described as a complication in patients affected by septic states, regardless of their having had diabetes. Numerous studies also record the presence of glyco-metabolic decompensations in patients affected by leukemia and lymphoma treated with chemotherapy. The case under study interesting and peculiar as there is no mention of glycemy levels so high to be not suitable for life. It is interesting also the patient's good therapeutical response, their marrow aplasia status and general poor health condition notwithstanding
The process of full recognition of the nursing profession as sanitary profession, it has entirely modified also the juridical qualification of the documentation produced from nurses. The nursing documentation, it comes to assume equal dignity in comparison with that medical one. The focuses not much on the professional category that effects the detection, but on the content of the same and on the juridical probative value to it recognized. The developed project with the DEA San G. Bosco, illustrates the phases of the gateway from the employment of the nursing papery folder, to the computerization of the relief process that has consented to integrate the nursing documentation with that medical one. The conceived application software has furnished a contribution to the development of the reflection in action in the circle of the professional group of the service, with respect to the need to a change of the adopted relief mode
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