SummaryIn recent years an increasing number of different energy drinks have been introduced to provide an energy boost. They contain high levels of caffeine and other additives that act as stimulants. Several recent studies present that energy drinks could increase the risk of seizures, acid-base disorders and cardiovascular events. The authors report a 28-year-old man who was brought to the emergency room after sudden onset of tonic-clonic seizures and metabolic acidosis after drinking several cans of a caffeinated energy drink. The authors believe that this clinical picture was caused by caffeine intoxication from an energetic drink causing a syndrome of catecholamine excess. The patient was discharged within a week with no complaints and no neurological signs. Finally, recognising the features of caffeine intoxication and its potential health consequences may be especially relevant when treating younger persons who may be more likely to consume energy drinks.
In recent years an increasing number of different energy drinks have been introduced to provide an energy boost. They contain high levels of caffeine and other additives that act as stimulants. Several recent studies present that energy drinks could increase the risk of seizures, acid-base disorders and cardiovascular events. The authors report a 28-year-old man who was brought to the emergency room after sudden onset of tonic-clonic seizures and metabolic acidosis after drinking several cans of a caffeinated energy drink. The authors believe that this clinical picture was caused by caffeine intoxication from an energetic drink causing a syndrome of catecholamine excess. The patient was discharged within a week with no complaints and no neurological signs. Finally, recognising the features of caffeine intoxication and its potential health consequences may be especially relevant when treating younger persons who may be more likely to consume energy drinks.
SUMMARYLyell's syndrome or toxic epidermal necrolysis (TEN) is a rare dermatological disease that causes serious morbidity and mortality. It is most commonly drug induced. The authors report the case of a 57-year-old woman who was admitted to our hospital with severe rash all over the body. She had been previously submitted to brain surgery for total resection of a large meningioma and medicated with phenytoin for seizures prophylaxis. During this treatment, erythematous lesions and blisters were observed first on her face and trunk and then spreading to the entire body. Detachment of the skin, as well as mucous involvement especially of mouth and conjunctiva, was also observed. TEN was diagnosed, and phenytoin was discontinued. Intravenous fluids, systemic steroids and tightened infection control measures were implemented. After 10 days, skin recovery and reepithelialisation were established, temperature decreased and mucosal complications stabilised. The patient was discharged after 1 month of hospitalisation. BACKGROUND
A hemorragia intracraniana espontânea afeta anualmente mais de 1 milhão de pessoas, representando 9% a 27% do total de acidentes vasculares cerebrais a nível mundial, e apresenta uma elevada taxa de mortalidade e morbilidade. Tratando-se de uma emergência médica, o rápido diagnóstico e instituição de medidas terapêuticas com impacto reconhecido na mortalidade e morbilidade é fundamental. Este artigo pretende, à luz das recomendações mais recentes e dados mais relevantes publicados na literatura, rever a abordagem diagnóstica e terapêutica médica dos doentes com hemorragia intracraniana espontânea. Após o rápido diagnóstico, a utilização de escalas de gravidade é fundamental para a estratificação do risco e definição da estratégia terapêutica mais adequada, seja a nível de terapêutica médica, como da eventual indicação cirúrgica emergente. As intervenções médicas na hemorragia intracraniana podem dividir-se em primárias e secundárias, consoante o timing da sua instituição. As primárias assentam no controlo rápido e agressivo da tensão arterial, correção da coagulopatia e avaliação/intervenção neurocirúrgica. As intervenções secundárias incluem o controlo da temperatura corporal, manutenção da normoglicemia, monitorização hemodinâmica, do estado de consciência e da pressão intracraniana. Concomitantemente com a abordagem terapêutica, devem ser iniciadas diligências no sentido de orientar o doente para o local mais adequado à gravidade do seu quadro, já que atrasos nesta definição estão associados a pior prognóstico clínico. Assim com este artigo pretende criar-se uma ferramenta auxiliar na otimização da prestação de cuidados aos doentes admitidos com hemorragia intracraniana
A 26 year-old man arrested for presumed drug smuggling was brought to the Emergency Room complaining of diffuse abdominal pain, nausea and bloating for 48 hours. He denied fever, constipation, diarrhea or vomiting. He smoked 20 cigarrettes/day and denied taking any medication or drug. His father had died of colorectal cancer at the age of 40. At physical examination, the patient presented tachycardia (120 bpm), fever (38.2 º C) and diaphoresis. At abdominal examination, he had no abdominal distension and the bowel sounds were normal. He had no palpable masses, organomegalies or signs of peritoneal irritation. Blood pressure was 120/80 mmHg and respiratory rate was 20 cpm, with 98% SatO 2 on oximetry. Cardiac and pulmonary auscultation, as well as the neurological examination were unremarkable. Electrocardiogram revealed sinusal tachycardia. Laboratory studies showed normal white blood cell count, C-reactive protein level, liver and renal function tests. Lipase and troponin-I levels were normal. Fever subsided after 1 g of acetaminophen. An upright abdominal x-ray was performed (Fig.).The plain abdominal X-ray showed numerous hypotransparent nodules in the entire colon, without small or large bowel dilation, pneumoperitoneum or bowel obstruction. The nodules corresponded to the drug capsules the patient had ingested before his arrest. Since there were no signs of severe acute cocaine
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.