Medicine
Amir Heydarian; Baharak Najafi Fakhraei Azar
Abstract
The management of acute abdomen referred in the emergency department is a complex and challenging task for healthcare professionals. Acute abdomen referred refers to abdominal pain that is perceived in a location distant from the actual underlying pathology. In the emergency department setting, the primary ...
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The management of acute abdomen referred in the emergency department is a complex and challenging task for healthcare professionals. Acute abdomen referred refers to abdominal pain that is perceived in a location distant from the actual underlying pathology. In the emergency department setting, the primary goals of management are to rapidly assess the patient, make an accurate diagnosis, and provide timely interventions to alleviate pain and prevent complications. In this conclusion, we will summarize the key aspects of managing acute abdomen referred in the emergency department. The management of acute abdomen referred in the emergency department begins with a thorough history and physical examination, which can provide valuable clues to the underlying cause. Prompt imaging studies, such as ultrasound, CT scans, or MRI, are often utilized to aid in the diagnosis. These imaging modalities provide detailed anatomical information and help identify the affected organs or structures contributing to the referred pain. Pharmacological interventions play a crucial role in the emergency management of acute abdomen referred. Analgesics, such as NSAIDs or opioids, are administered to relieve pain and provide comfort to the patient. Antibiotics may be initiated in cases where infection is suspected or confirmed. Proton pump inhibitors and antispasmodics are used to address specific causes of referred pain, such as peptic ulcers or functional gastrointestinal disorders. Surgical intervention may be necessary in cases where conservative management approaches fail or when a definitive diagnosis requires direct visualization and tissue sampling. Emergency surgical procedures such as appendectomy, cholecystectomy, or salpingectomy are performed to address specific underlying causes of acute abdomen referred. In the emergency department, timely decision-making and effective communication among healthcare professionals are crucial for the optimal management of acute abdomen referred. Multidisciplinary collaboration, involving emergency physicians, surgeons, radiologists, and other specialists, ensures a comprehensive approach to diagnosis and management.
Medicine
Omar A. Hassan; Behzad Nazari
Abstract
Introduction: The current American Thyroid Association (ATA) recommendations support the intravenous administration of a loading dose of levothyroxine and an empiric glucocorticoid as part of the initial therapy despite the lack of adequate evidence. SH may ultimately direct patients to the intensive ...
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Introduction: The current American Thyroid Association (ATA) recommendations support the intravenous administration of a loading dose of levothyroxine and an empiric glucocorticoid as part of the initial therapy despite the lack of adequate evidence. SH may ultimately direct patients to the intensive care unit (ICU) for organ support and specialized care. Material and Methods: The following baseline data were available at the time of ICU admission: demographics, the modified Charlson score, the Simplified Acute Physiology Score II (SAPS II), the SOFA score, the presence of an underlying thyroid condition, precipitating factors, clinical symptoms, and laboratory results. Results: Cardiovascular SOFA =2 patients had lower heart rates, higher arterial lactate, and a higher risk of aspiration pneumonia and cardiac arrest prior to ICU admission than those without hemodynamic impairment. Conversely, patients who did not have cardiovascular failure experienced hypercapnia more frequently. In the population as a whole with SH, the median TSH, FT4, and FT3 levels were 51pmol/L, respectively. Notably, there were no differences in thyroid hormone levels, SH etiology, or triggers between patients with and without hemodynamic impairment.Conclusion: The overall ICU and 6-month post-admission mortality rates were 26% and 39%, respectively, based on 82 patients with SH admitted to ICUs. Age, hemodynamic and respiratory failure, but not neurological failure, were factors that were strongly linked to fatal outcomes. This extremely high mortality for a treatable condition necessitates early diagnosis, prompt levothyroxine administration, and careful cardiac and hemodynamic monitoring. More information is still required to more precisely define the ideal dosage and route of administration for this critical treatment.
