scholarly journals Severe Methemoglobinemia due to Sodium Nitrite Poisoning

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Kenichi Katabami ◽  
Mineji Hayakawa ◽  
Satoshi Gando
Keyword(s):  
Intensive Care Unit ◽  
Methylene Blue ◽  
Sodium Nitrite ◽  
Blood Test ◽  
Gastric Lavage ◽  
Accurate Diagnosis ◽  
Loss Of Consciousness ◽  
Methemoglobin Level ◽  
Neurologic Impairment ◽  
Transient Loss

Case. We report a case of severe methemoglobinemia due to sodium nitrite poisoning. A 28-year-old man was brought to our emergency department because of transient loss of consciousness and cyanosis. He was immediately intubated and ventilated with 100% oxygen. A blood test revealed a methemoglobin level of 92.5%.Outcome. We treated the patient with gastric lavage, activated charcoal, and methylene blue (2 mg/kg) administered intravenously. Soon after receiving methylene blue, his cyanosis resolved and the methemoglobin level began to decrease. After relocation to the intensive care unit, his consciousness improved and he could recall ingesting approximately 15 g sodium nitrite about 1 hour before he was brought to our hospital. The patient was discharged on day 7 without neurologic impairment.Conclusion. Severe methemoglobinemia may be fatal. Therefore, accurate diagnosis of methemoglobinemia is very important so that treatment can be started as soon as possible.

scholarly journals Sex and age impact prevalence and symptoms of vasovagal syncope: Implications for accurate diagnosis

2021 ◽  
pp. 1-3
Author(s):  
Hailey Gregson ◽  
Ana Ivkov
Keyword(s):  
Blood Flow ◽  
Spontaneous Recovery ◽  
Vasovagal Syncope ◽  
Common Type ◽  
Accurate Diagnosis ◽  
Loss Of Consciousness ◽  
Transient Loss Of Consciousness ◽  
Transient Loss ◽  
Autonomic Reflex ◽  
The Brain

Syncope is characterized by the transient loss of consciousness followed by spontaneous recovery. The mechanism which underlies this condition is reduced blood flow to the brain [1]. Vasovagal syncope, often termed reflex syncope, is the most common type of syncope [1]. Vasovagal Syncope is caused by the abnormal autonomic reflex to certain stimuli such as pain, micturition/defecation, fear, seeing blood, etc., which results in vasodilation and often times, bradycardia [1].

scholarly journals Severe Hypocalcemia and Extreme Elevation of Serum Creatinkinase in a 16-Year Old Boy with Pseudohypoparathyroidism Type Ib

2018 ◽  
Vol 61 (2) ◽  
pp. 53-56 ◽  
Author(s):  
Štěpán Kutílek ◽  
Ivana Plášilová ◽  
Kristýna Hasenöhrlová ◽  
Hana Černá ◽  
Kristýna Hanulíková
Keyword(s):  
Intensive Care Unit ◽  
Biochemical Parameters ◽  
Normal Values ◽  
Clinical Signs ◽  
Loss Of Consciousness ◽  
Rare Manifestation ◽  
Laboratory Results ◽  
Transient Loss ◽  
Muscular Function ◽  
Very High

Calcium is essential for proper muscular function and metabolism. Myopathy with high creatinkinase activity can be a rare manifestation of hypocalcemia of various origin, such as vitamin D deficiency, hypoparathyroidism, pseudohypoparathyroidism (PHP). 16-year old previously healthy boy was admitted to intensive care unit with convulsions lasting for three minutes and a transient loss of consciousness. Laboratory results revealed severe hypocalcemia (total S-Ca < 1.0 mmol/L; normal 2.2–2.6 mmol/L), hyperphosphatemia (S-P 2.8 mmol/L; normal 0.6–1.6 mmol/L). Serum creatinkinase (S-CK) activity was 32 μkat/L (normal 0.57–2.45 μkat/L). Other basic biochemical parameters including creatinine, troponin, alkaline phosphatase were within normal values. Calcemia was gradually corrected within two weeks by intravenously and orally administered calcium and by cholecalciferol. S-CK reached a maximum of 222 μkat/L on day 4 and dropped to 7.2 μkat/L on day 14. Boy had no myalgias, neither clinical signs of myopathy. Echocardiography was normal with normal myocardial contractility, without any signs of calcification. The serum level of parathyroid hormone (S-PTH) was high (12 pmol/L; normal 0.7–5.5 pmol/L), fully compatible with the diagnosis of PHP. Molecular analysis revealed pseudohypoparathyroidism type Ib (PHPIb).In conclusion, manifest tetany and even mild myopathy with very high S-CK can occur in hypocalcemic patients and usually resolves after normalization of hypocalcemia.

Sa107 THE ROLE OF FECAL OCCULT BLOOD TEST IN THE EVALUATION OF ANEMIA IN THE INTENSIVE-CARE UNIT: A RETROSPECTIVE STUDY ASSESSING THE CLINICAL UTILITY OF THE TEST

2021 ◽  
Vol 160 (6) ◽  
pp. S-423-S-424
Author(s):  
Thanita Thongtan ◽  
Anasua Deb ◽  
Ashley Maveddat ◽  
Paibul Suriyawongpaisal ◽  
Passisd Laoveeravat ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Test ◽  
Clinical Utility ◽  
Fecal Occult Blood Test ◽  
Occult Blood ◽  
Fecal Occult Blood ◽  
Occult Blood Test ◽  
Fecal Occult

Forensic Electrochemical Presumptive Blood Test Based on the Voltammetric Behaviour of Methylene Blue and Whole Blood

2021 ◽  
Author(s):  
Sarah Cook ◽  
Kevin C. Honeychurch
Keyword(s):  
Methylene Blue ◽  
Whole Blood ◽  
Blood Test ◽  
Archaeological Sciences

The ability to identify the presence of blood residues is important in a number of fields, such as in the forensic and archaeological sciences. A number of tests presently exist;...

scholarly journals Management of transient loss of consciousness of suspected syncopal cause, after the initial evaluation in the Emergency Department

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Ivo Casagranda ◽  
Michele Brignole ◽  
Simone Cencetti ◽  
Gianfranco Cervellin ◽  
Giorgio Costantino ◽  
...  
Keyword(s):  
Emergency Department ◽  
Initial Evaluation ◽  
Loss Of Consciousness ◽  
Transient Loss Of Consciousness ◽  
Risk Levels ◽  
Risk Patients ◽  
Life Threatening ◽  
Transient Loss ◽  
Multidisciplinary Group ◽  
Diagnostic Investigations

The recommendations enclosed in the present document have been developed by a group of experts appointed by the <em>Gruppo Multidisciplinare per lo Studio della Sincope</em> (Multidisciplinary Group for the Study of Syncope; GIMSI) and Academy of Emergency Medicine and Care (AcEMC). The aim is to define the diagnostic pathway and the management of patients referred to the Emergency Department (ED) for transient loss of consciousness of suspected syncopal cause, which is still unexplained after the initial evaluation. The risk stratification enables the physician to admit, discharge or monitor shortly the patient in the intensive short-stay Syncope Observation Unit (SOU). There are three risk levels of life-threatening events or serious complications (low, moderate, high). Low risk patients can be discharged, while high risk ones should be monitored and treated properly in case of worsening. Moderate risk patients should undergo clinical and instrumental monitoring in SOU, inside the ED. In all these three cases, patients can be subsequently referred to the Syncope Unit for further diagnostic investigations.

Transient Loss of Consciousness

2020 ◽  
pp. 1-16
Author(s):  
Giuseppe Micieli ◽  
Umberto Aguglia ◽  
Francesca Baschieri ◽  
Giovanna Calandra Buonaura ◽  
Anna Cavallini ◽  
...  
Keyword(s):  
Loss Of Consciousness ◽  
Transient Loss Of Consciousness ◽  
Transient Loss

scholarly journals EKG-gyöngyszem: tónusos-clonusos epilepsziás roham kimutatása implantábilis loop recorderrel

2019 ◽  
Vol 160 (29) ◽  
pp. 1143-1145
Author(s):  
János Tomcsányi ◽  
Zoltán Nényei ◽  
Anna Kelemen ◽  
Anita Kamondi
Keyword(s):  
Antiepileptic Drug ◽  
Loss Of Consciousness ◽  
Implantable Loop Recorder ◽  
Loop Recorder ◽  
Transient Loss Of Consciousness ◽  
Transient Loss ◽  
Clonic Seizures

Abstract: A 52-year-old woman is presented with repetitive transient loss of consciousness. Implantable loop recorder (ILR) recorded muscle artifacts during the generalized tonic-clonic seizures. Seizure was diagnosed and antiepileptic drug was started. The patient has been asymptomatic for 9 months. Orv Hetil. 2019; 160(29): 1143–1145.

scholarly journals Cardioneuroablation: Catheter Vagal Denervation as a New Therapy for Cardioinhibitory Syncope

2020 ◽  
Vol 32 (3) ◽  
pp. 182-196
Author(s):  
José Carlos Pachon Mateos ◽  
Enrique I Pachón Mateos ◽  
Christian Higuti ◽  
Tomas Guilhermo Santillana Peña ◽  
Tasso Julio Lobo ◽  
...  
Keyword(s):  
Heart Disease ◽  
Preventive Measures ◽  
Therapeutic Option ◽  
Vasovagal Syncope ◽  
Pacemaker Implantation ◽  
Young Patients ◽  
Loss Of Consciousness ◽  
Spectral Mapping ◽  
Transient Loss ◽  
Vagal Reflex

The vasovagal syncope is the most frequent cause of transient loss of consciousness, especially in young people without significant heart disease. The malignant cardioinhibitory form is caused by abrupt and intense vagal reflex with or without defined triggers. Refractory cases to preventive measures and pharmacological handling has been treated with definitive pacemaker implantation. Besides showing questionable results, pacemaker implantation is highly rejected by young patients. In the late 1990s, we proposed specific vagal denervation by catheter ablation and spectral mapping, for paroxysmal AF, functional bradyarrhythmias and severe cases of malignant cardioinhibitory syncope giving rise to cardioneuroablation. Recently, many authors worldwide have been reproducing the cardioneuroablation results where elimination or significant reduction of the vagal response were observed, which abolished symptoms in more than 75% of patients followed up to 14 years, without complications. Therefore, cardioneuroablation has shown to be a real therapeutic option in malignant syncope cardioinhibitory and in any exclusive vagal mediated bradyarrhythmia without the need for pacemaker implantation.

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