Notes

Facile synthesis involving N-halamine-labeled silica-polyacrylamide multilayer core-shell nanoparticles pertaining to antibacterial ability.
We present the case of a 74-year-old female patient who presented to the emergency department with lower extremity weakness found to have a fixed frequency square wave artifact in all leads of her electrocardiogram (ECG). After troubleshooting, faulty external cardiac monitor leads were identified as the cause of this unique artifact.

The ECG is an important diagnostic tool for medical providers. Electrocardiogram artifacts are extremely common, and knowledge of artifacts is necessary to prevent inappropriate interpretation, diagnostic error, and unnecessary workup. Medical providers should have a low threshold for suspicion when ECG findings do not correlate with the patient's chief complaint or history of present illness. They must also be familiar with the most frequent ECG artifact variants and be prepared to follow a stepwise approach to troubleshoot less frequent variants.
The ECG is an important diagnostic tool for medical providers. Electrocardiogram artifacts are extremely common, and knowledge of artifacts is necessary to prevent inappropriate interpretation, diagnostic error, and unnecessary workup. Medical providers should have a low threshold for suspicion when ECG findings do not correlate with the patient's chief complaint or history of present illness. They must also be familiar with the most frequent ECG artifact variants and be prepared to follow a stepwise approach to troubleshoot less frequent variants.
The patient was a 33-year-old woman with inflammatory bowel disease presenting for worsening lower leg lesions with significant pain recalcitrant to oral doxycycline.

Pyoderma gangrenosum is a rare ulcerative skin condition with significant pain that is often associated with other systemic diseases typically treated with immunosuppressive medications aimed at the underlying cause.
Pyoderma gangrenosum is a rare ulcerative skin condition with significant pain that is often associated with other systemic diseases typically treated with immunosuppressive medications aimed at the underlying cause.
A 93-year-old man living in a nursing home presented to our emergency department with altered mental status. Examination revealed hypotension and severe hypoxia. Chest radiograph showed infiltrates in the right upper lobe, and computed tomography of the abdomen and pelvis demonstrated a left femoral neck fracture. A point-of-care transthoracic echocardiogram (TTE) revealed an enlarged right ventricle, severe tricuspid regurgitation, and numerous white floating dots moving toward the right atrium from the inferior vena cava (IVC), leading to the diagnosis of fat embolism syndrome (FES).

Although imaging studies can facilitate diagnosis, the diagnosis of FES is typically made by clinical history and presentation, making a swift diagnosis often difficult in those who are critically ill. Recent case reports have described that TTE can detect fat emboli, seen as flowing hyperechoic particles in IVC. This image demonstrates the utility of TTE to diagnose FES.
Although imaging studies can facilitate diagnosis, the diagnosis of FES is typically made by clinical history and presentation, making a swift diagnosis often difficult in those who are critically ill. Recent case reports have described that TTE can detect fat emboli, seen as flowing hyperechoic particles in IVC. This image demonstrates the utility of TTE to diagnose FES.
We describe a complete right hemithorax Westermark sign found in a patient with a near-complete, right pulmonary artery trunk occlusion secondary to a pulmonary embolus.

We review the sensitivity and specificity of a Westermark sign in the identification of a pulmonary embolism, and how this aided us in managing our patient in the emergency department.
We review the sensitivity and specificity of a Westermark sign in the identification of a pulmonary embolism, and how this aided us in managing our patient in the emergency department.
A 64-year-old man presented to the emergency department with a chief complaint of left shoulder pain after a mechanical fall from standing. Plain radiography revealed a displaced fracture of the inferior glenoid rim. A computed tomography further characterized the fracture and the patient was taken emergently by an orthopedic surgeon for open reduction and internal fixation.

Scapula fractures, especially isolated glenoid rim fractures, are rare and most typical of high-energy mechanism traumas. A missed or delayed diagnosis can result in long-term suffering and disability. Awareness of radiographic as well as physical findings and the subsequent classification system described below can optimize outcomes for trauma patients with glenoid fractures.
Scapula fractures, especially isolated glenoid rim fractures, are rare and most typical of high-energy mechanism traumas. A missed or delayed diagnosis can result in long-term suffering and disability. Awareness of radiographic as well as physical findings and the subsequent classification system described below can optimize outcomes for trauma patients with glenoid fractures.
An elderly man presented to the emergency department after a fall from a 15-foot height. Initial examination revealed signs of head and neck trauma without airway compromise. Computed tomography imaging identified cervical fractures at the first and second level with a retropharyngeal hematoma. In discussion with the trauma service, the patient was admitted to the hospital for airway monitoring. After 10 hours he clinically deteriorated, resulting in acute respiratory failure, and ultimately required intubation. The patient was intubated with a hyperangulated video laryngoscopy, and a surgical set-up was also prepared. Torin 1 molecular weight The intubation was uncomplicated and resulted in clinical improvement. The patient was extubated after three days without difficulty and was ultimately discharged following an uncomplicated hospital course.

Retropharyngeal hematoma is a rare but significant clinical condition. Rapid decline and airway compromise have been described. Patients often require intubation and mechanical ventilation to avoid airway obstruction and respiratory failure. Coagulopathies should be reversed, if present. Prompt recognition and treatment of this condition is crucial to successful management.
Retropharyngeal hematoma is a rare but significant clinical condition. link2 Rapid decline and airway compromise have been described. Patients often require intubation and mechanical ventilation to avoid airway obstruction and respiratory failure. Coagulopathies should be reversed, if present. Prompt recognition and treatment of this condition is crucial to successful management.
A five-year-old boy presented to our emergency department with severe posterior neck pain that was exacerbated upon neck movement. Cervical spine radiography revealed calcification in the cervical intervertebral disk 3-4.

Pediatric idiopathic intervertebral disk calcification is a benign, rare condition that might be complicated by associated severe neurological symptoms. link3 In this case, the symptoms gradually subsided with conservative management alone.
Pediatric idiopathic intervertebral disk calcification is a benign, rare condition that might be complicated by associated severe neurological symptoms. In this case, the symptoms gradually subsided with conservative management alone.
A 14-year-old boy presented to the emergency department complaining of severe groin pain on the right side following a minor fall. Computed tomography and magnetic resonance imaging revealed a hematoma in his right iliacus muscle. He was diagnosed with a traumatic iliacus hematoma, and he recovered spontaneously with short-term oral analgesics.

Traumatic iliacus hematomas are rare entities and subside with conservative management in most cases. However, this condition may be associated with femoral nerve palsy, and surgery is indicated in severe cases. Traumatic iliacus hematoma should be considered in the differential diagnosis of severe groin pain.
Traumatic iliacus hematomas are rare entities and subside with conservative management in most cases. However, this condition may be associated with femoral nerve palsy, and surgery is indicated in severe cases. Traumatic iliacus hematoma should be considered in the differential diagnosis of severe groin pain.
We describe a middle-aged male presenting to the emergency department with bilateral shoulder pain, holding both arms in abduction after trauma. Radiographs demonstrated a bilateral inferior dislocation of the glenohumeral joints consistent with luxatio erecta humeri.

We review the clinical presentation of luxatio erecta and its complications. We also describe the characteristic presentation on radiographs. Our case illustrates the hallmark findings of luxatio erecta of an abducted humeral shaft parallel to the scapular spine.
We review the clinical presentation of luxatio erecta and its complications. We also describe the characteristic presentation on radiographs. Our case illustrates the hallmark findings of luxatio erecta of an abducted humeral shaft parallel to the scapular spine.
Aseptic inflammatory arthritis has been reported from thorns or cactus needles after inadvertent arthrotomy. Agave sap irritants may cause an aseptic inflammatory arthritis mimicking a septic joint.

A 27-year-old male presented with left knee pain and swelling two hours after suffering an accidental stab wound to his left lateral knee by an agave plant spine. Synovial fluid white blood cell count was 92,730 mm
with 75% neutrophils and no crystals. Surgical washout was remarkable for turbid fluid and no foreign body. Synovial fluid and blood cultures remained without growth. At two-week follow-up, the patient had recovered.

Penetrating injuries from agave thorns can cause an inflammatory arthritis that mimics septic arthritis.
Penetrating injuries from agave thorns can cause an inflammatory arthritis that mimics septic arthritis.
Infectious aortitis is a rare condition with mortality rates approaching 100% without surgical intervention. Symptoms and findings may be vague. Computed tomography (CT) with intravenous (IV) contrast, once the gold standard of diagnosis, may only show subtle findings. More recently, CT angiography (CTA) and magnetic resonance angiography have become the diagnostic modalities of choice.

A 58-year-old diabetic male presented to our emergency department with nausea, vomiting, diarrhea, fevers, and abdominal pain of two weeks duration. The patient had been seen just days before at another facility with the same complaints. He received an abdominal CT with IV contrast that was reported as negative and discharged with the diagnosis of gastroenteritis. He failed to improve and presented to our facility. On presentation, the patient was diaphoretic and uncomfortable. A repeat abdominal CT with IV contrast revealed a mantle of low density around the aorta. The patient was started on IV antibiotics, and a follow-u with IV contrast, may not be adequate to make the diagnosis.
Metronidazole, a nitroimidazole antibiotic, is a well-known antibacterial and antiprotozoal agent that is generally well tolerated without many serious side effects. Most adverse reactions affect the gastrointestinal or genitourinary system, but the central nervous system may also be afflicted. In addition to headache and dizziness, cerebellar dysfunction can occur with metronidazole use.

We discuss the clinical presentation and imaging findings of metronidazole-induced encephalopathy in a 12-year-old male. The patient had a history of Crohn's disease and chronic Clostridium difficile infection for which he had received metronidazole for approximately 75 days prior to arrival to a local emergency department (ED). He presented with five days of progressive vertigo, nausea, vomiting, and ataxia. Subsequent magnetic resonance imaging showed symmetric hyperintense dentate nuclei lesions, characteristic of metronidazole-induced encephalopathy. The patient's symptoms improved rapidly after cessation of metronidazole, and his symptoms had completely resolved by discharge on hospital day two.
Website: https://www.selleckchem.com/products/torin-1.html