Journal of acute medicine最新文献

{"title":"Pre- and Post-Implementation of One-Hour Rule for the Boarding of Referral of Critically Ill Patients in the Emergency Department.","authors":"Chia-Fen Yang,&nbsp;Kuang-Leei Chang,&nbsp;Chee-Seong Phan,&nbsp;Fei-Yi Lin,&nbsp;Yao-Dong Wang,&nbsp;Sai-Wai Ho","doi":"10.6705/j.jacme.202112_11(4).0003","DOIUrl":"https://doi.org/10.6705/j.jacme.202112_11(4).0003","url":null,"abstract":"<p><p>In 2017, the Taiwan Ministry of Health and Welfare established a regional electronic referral system in Central Taiwan to streamline transfers of critically ill patients from the intensive care unit (ICU) of a regional hospital to a medical hospital center. Moreover, in 2018, a one-hour rule for the boarding of referral of critically ill patients from emergency department (ED) to ICU was implemented. This pre- and post-implementation study enrolled consecutive critically ill referral patients from a single academic medical center hospital from January 1, 2017 to December 31, 2018. After implementation of the one-hour rule, two interventions, namely, active bed management before patient arrival and no requirement for laboratory test results to be completed before ICU admissions, were used to improve patient flow in the ED. After implementation of one-hour rule, the proportion of patients transferred to the ICU within 1 hour increased from 3.1% to 65.9% (p < 0.001). Median ED length of stay (LOS) reduced from 129.5 minutes to 52.0 minutes (p < 0.001). The overall mortality rate decreased from 34.4% to 26.8%, without a significant difference. In conclusion, the implementation of the one-hour rule for the boarding of referral of critically ill patients in the ED is safe and possible. Achieving the target significantly reduced ED LOS by 77.5 minutes without an increase in patient mortality rate.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"11 4","pages":"141-145"},"PeriodicalIF":0.6,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8743190/pdf/jacme-11-4-03.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39914921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Container Houses to Reduce the Risks to Health-Care Workers While Performing the Throat Swab Test and Blood Sampling for SARS-CoV-2.","authors":"Yang-Tse Lin,&nbsp;Yu-Chi Tseng,&nbsp;Chan-Peng Hsu","doi":"10.6705/j.jacme.202112_11(4).0004","DOIUrl":"https://doi.org/10.6705/j.jacme.202112_11(4).0004","url":null,"abstract":"<p><p>Coronavirus disease 2019 (COVID-19) is still pandemic all over the world. Patients requesting screening in emergency departments (ED) have continually increased. Establishing additional screening stations outside of the ED to increase the number of patients tested and protect the safety of health care workers poses an urgent challenge. We employed a container house near the entrance of an ED to create an outdoor screening station, which separates suspected patients of COVID-19 from regular emergency patients to prevent cross infections. In our experience, a container house station can not only provide additional screen area but also reduce the consumption of personal protective equipment. Container houses are sturdier than tents and can be fully assembled rapidly. Appropriate protective equipment can be installed with them to fulfi ll demands for COVID-19 screening.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"11 4","pages":"146-149"},"PeriodicalIF":0.6,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8743189/pdf/jacme-11-4-04.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39914922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Opioids and Outcomes of Pneumonia: Results From the US Nationwide Inpatient Sample.","authors":"Yeongjun James Park,&nbsp;Chia-Hung Yo,&nbsp;Wan-Ting Hsu,&nbsp;Eric Po-Yang Tsou,&nbsp;Yu-Chiang Wang,&nbsp;Dean-An Ling,&nbsp;An-Fu Lee,&nbsp;Michael A Liu,&nbsp;Chien-Chang Lee","doi":"10.6705/j.jacme.202112_11(4).0001","DOIUrl":"https://doi.org/10.6705/j.jacme.202112_11(4).0001","url":null,"abstract":"<p><strong>Background: </strong>Opioids have been shown to increase risk of pneumonia among susceptible population. However, the effect of opioid abuse on the outcome of pneumonia has not been evaluated at the population level. We aimed to compare the outcomes of pneumonia among patients with opioid use disorder and patients without substance use disorder using a large population database.</p><p><strong>Methods: </strong>We assembled a pneumonia cohort composed of 11,186,564 adult patients from the National Inpatient Sample (NIS; 2005-2014). Patients with opioid disorder were identified using the International Classification of Diseases, 9th Revision, Clinical Modification codes. We compared health-related and economic outcomes between patients with and without opioid disorders using propensity score matching (PSM) analysis to balance baseline differences. The survival differences between two groups of patients were assessed using a Cox proportional hazard model. We further explored the possibility of effect modification by interaction analyses in different populations.</p><p><strong>Results: </strong>After PSM, patients with opioid use disorder were at increased risk of ventilator use (odds ratio [OR]: 1.22, 95% confidence interval [CI]: 1.08 to 1.38, p = 0.0014) and associated with increased length of hospital stay by 0.59 days (95% CI: 0.35 to 0.83, p < 0.001), compared with those without substance use disorder. Patients with opioid use also had higher daily (228.00 USD, 95% CI: 180.51 to 275.49, p < 0.001) and total (1,875.72 USD, 95% CI: 1,259.63 to 2,491.80, p < 0.001) medical costs. Subgroup analyses showed similar results.</p><p><strong>Conclusions: </strong>Compared with patients without any drug dependence, patients with opioid use disorders had increased risk of complications and resource utilization. This study adds evidence for increased risk for pneumonia complications in the growing patients with opioid use disorders.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"11 4","pages":"113-128"},"PeriodicalIF":0.6,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8748203/pdf/jacme-11-4-01.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39741508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Woman With Ptosis.","authors":"Li-Hsiu Tai,&nbsp;Sai-Wai Ho","doi":"10.6705/j.jacme.202109_11(3).0006","DOIUrl":"https://doi.org/10.6705/j.jacme.202109_11(3).0006","url":null,"abstract":"An 87-year-old woman, with a medical history of type 2 diabetes mellitus, hypertension, and dementia, reported right ptosis and ophthalmoplegia for 6 days. On arrival at the emergency department (ED), the patient was alert and oriented without acute distress. Her body temperature was 35.7°C, her heart rate was 82 beats/min, her respiratory rate was 16 breaths/min, and her blood pressure was 147/66 mm Hg. Tracing back her history, the patient had chronic nasal congestion for 1 year. There was no fever and no headache. Neurological examination showed paralysis of the right oculomotor nerve, presenting with right eye ptosis, mydriasis, and outer-down position. The blood laboratory results were unremarkable. Cranial computed tomography (CT) revealed a heterogeneous mass with calcifi cations in the right maxillary and left sphenoid sinuses with bony erosion (Fig. 1). Subsequently, contrast-enhanced magnetic resonance imaging (MRI) was performed, which showed a hypointense lesion with peripheral enhancement over the left sphenoid, right maxillary, right ethmoid sinuses, and compression of the right inferior rectus muscle (Fig. 2). After surgical debridement was performed, the pathology report of the specimen revealed aspergillosis. Antibiotics were discontinued and anti-fungal agents were started. Afrer 1 month after the initial treatment passed, she was able to the right eye halfway.","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"11 3","pages":"108-109"},"PeriodicalIF":0.6,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8440440/pdf/jacme-11-3-06.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39475500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prothrombin Complex Concentrate for Trauma Induced Coagulopathy: A Systematic Review and Meta-Analysis.","authors":"Ting-Wei Kao,&nbsp;Yi-Chin Lee,&nbsp;Hsiang-Ting Chang","doi":"10.6705/j.jacme.202109_11(3).0001","DOIUrl":"https://doi.org/10.6705/j.jacme.202109_11(3).0001","url":null,"abstract":"<p><strong>Background: </strong>Optimal management for trauma-induced coagulopathy (TIC) is a clinical conundrum. In conjunction with the transfusion of fresh-frozen plasma (FFP), additional administration of prothrombin complex concentrate (PCC) was proposed to bring about further coagulative benefit. However, investigations evaluating the efficacy as well as corresponding side effects were scarce and inconsistent. The aim of this study was to systematically review current literature and to perform a meta-analysis comparing FFP+PCC with FFP alone.</p><p><strong>Methods: </strong>Web search followed by manual interrogation was performed to identify relevant literatures fulfilling the following criteria, subjects as TIC patients taking no baseline anticoagulants, without underlying coagulative disorders, and reported clinical consequences. Those comparing FFP alone with PCC alone were excluded. Comprehensive Meta-analysis software was utilized, and statistical results were delineated with odd ratio (OR), mean difference (MD), and 95% confidence interval (CI). I² was calculated to determine heterogeneity. The primary endpoint was set as all-cause mortality, while the secondary endpoint consisted of international normalized ratio (INR) correction, transfusion of blood product, and thrombosis rate.</p><p><strong>Results: </strong>One hundred and sixty-four articles were included for preliminary evaluation, 3 of which were qualified for meta-analysis. A total of 840 subjects were pooled for assessment. Minimal heterogeneity was present in the comparisons (I² < 25%). In the PCC + FFP cohort, reduced mortality rate was observed (OR: 0.631; 95% CI: 0.450-0.884, <i>p</i> = 0.007) after pooling. Meanwhile, INR correction time was shorter under PCC + FFP (MD: -608.300 mins, <i>p</i> < 0.001), whilst the rate showed no difference (<i>p</i> = 0.230). The PCC + FFP group is less likely to mandate transfusion of packed red blood cells (<i>p</i> < 0.001) and plasma (<i>p</i> < 0.001), but not platelet (<i>p</i> = 0.615). The incidence of deep vein thrombosis was comparable in the two groups (<i>p</i> = 0.460).</p><p><strong>Conclusions: </strong>Compared with FFP only, PCC + FFP demonstrated better survival rate, favorable clinical recovery and no elevation of thromboembolism events after TIC.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"11 3","pages":"81-89"},"PeriodicalIF":0.6,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8440438/pdf/jacme-11-3-01.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39475494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Restless Stone.","authors":"Chi-Heng Lee,&nbsp;Shu-Chuan Chen,&nbsp;Hsien-Lin Chen,&nbsp;Pei-I Zhang","doi":"10.6705/j.jacme.202109_11(3).0005","DOIUrl":"https://doi.org/10.6705/j.jacme.202109_11(3).0005","url":null,"abstract":"<p><p>Gallstone ileus is an infrequent cause of mechanical small bowel obstruction. The mortality rate of gallstone ileus remains relatively high, since gallstone ileus usually presents on elderly patients with multiple underlying diseases. Typically, the way of gallstone migration to small bowel is through biliary-enteric flstula, which is a rare complication of chronic cholecystitis. Patients present with diffuse abdominal pain and vomiting when the gallstone lodges in distal small bowel. The goals of surgical intervention include release of the bowel obstruction and closure of biliary-enteric flstula.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"11 3","pages":"105-107"},"PeriodicalIF":0.6,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8440432/pdf/jacme-11-3-05.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39475499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Endotracheal Intubations Performed With Direct Laryngoscopy and Video Laryngoscopy Scenarios With and Without Compression: A Manikin-Simulated Study.","authors":"Mustafa Kürşat Ayrancı,&nbsp;Kadir Küçükceran,&nbsp;Zerrin Defne Dündar","doi":"10.6705/j.jacme.202109_11(3).0002","DOIUrl":"https://doi.org/10.6705/j.jacme.202109_11(3).0002","url":null,"abstract":"<p><strong>Background: </strong>Optimal management for trauma-induced coagulopathy (TIC) is a clinical conundrum. In conjunction with the transfusion of fresh-frozen plasma (FFP), additional administration of prothrombin complex concentrate (PCC) was proposed to bring about further coagulative benefit. However, investigations evaluating the efficacy as well as corresponding side effects were scarce and inconsistent. The aim of this study was to systematically review current literature and to perform a meta-analysis comparing FFP+PCC with FFP alone.</p><p><strong>Methods: </strong>Web search followed by manual interrogation was performed to identify relevant literatures fulfilling the following criteria, subjects as TIC patients taking no baseline anticoagulants, without underlying coagulative disorders, and reported clinical consequences. Those comparing FFP alone with PCC alone were excluded. Comprehensive Meta-analysis software was utilized, and statistical results were delineated with odd ratio (OR), mean difference (MD), and 95% confidence interval (CI). I² was calculated to determine heterogeneity. The primary endpoint was set as all-cause mortality, while the secondary endpoint consisted of international normalized ratio (INR) correction, transfusion of blood product, and thrombosis rate.</p><p><strong>Results: </strong>One hundred and sixty-four articles were included for preliminary evaluation, 3 of which were qualified for meta-analysis. A total of 840 subjects were pooled for assessment. Minimal heterogeneity was present in the comparisons (I² < 25%). In the PCC + FFP cohort, reduced mortality rate was observed (OR: 0.631; 95% CI: 0.450-0.884, <i>p</i> = 0.007) after pooling. Meanwhile, INR correction time was shorter under PCC + FFP (MD: -608.300 mins, <i>p</i> < 0.001), whilst the rate showed no difference (<i>p</i> = 0.230). The PCC + FFP group is less likely to mandate transfusion of packed red blood cells (<i>p</i> < 0.001) and plasma (<i>p</i> < 0.001), but not platelet (<i>p</i> = 0.615). The incidence of deep vein thrombosis was comparable in the two groups (<i>p</i> = 0.460).</p><p><strong>Conclusions: </strong>Compared with FFP only, PCC + FFP demonstrated better survival rate, favorable clinical recovery and no elevation of thromboembolism events after TIC.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"11 3","pages":"90-98"},"PeriodicalIF":0.6,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8440434/pdf/jacme-11-3-02.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39475496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Plastic Bag to Reduce Risks in Operators During Endotracheal Intubation of Patients With Coronavirus Disease 2019.","authors":"Yu-Jie Yuan,&nbsp;Yu-Chi Tseng,&nbsp;Chan-Peng Hsu,&nbsp;Cho-Chao Feng,&nbsp;Chaou-Shune Lin,&nbsp;Yang-Tse Lin","doi":"10.6705/j.jacme.202109_11(3).0003","DOIUrl":"https://doi.org/10.6705/j.jacme.202109_11(3).0003","url":null,"abstract":"<p><p>The rapid spread of coronavirus disease 2019 (COVID-19) has led to a large number of patients being admitted to hospitals, resulting in a near collapse of the medical system. The shortage of negative pressure isolation rooms and personal protective equipment is a potential problem. It is a pressing challenge to prevent the risk of infection in emergency physicians (EPs) during the endotracheal intubation of patients with COVID-19. We used a large clear plastic bag, cut an opening that covered the patient's head, and created a negative pressure environment inside the plastic bag using the hospital's medical gas pipeline system; thus reducing the amount of virus-containing aerosols leaked out and the risk of infection in the operators performing intubation. The video (http://www.caregiver.com.tw/Article.asp?ID=1258#article) about the detailed preparation of the plastic bag intubation kit (PBIK) has been posted on the website. This technique for safe endotracheal intubation in patients with COVID-19 is being used not only by EPs in Taiwan, but also by physicians and paramedics from other countries. Regarding designing the PBIK, our original intention was to use readily available materials to make tools that can improve the safety of the operators performing the intubations in situations where medical resources are exhausted. However, due to limited time and patients, further research is needed for validation.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"11 3","pages":"99-101"},"PeriodicalIF":0.6,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8440435/pdf/jacme-11-3-03.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39475497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient Atrioventricular Block as a Complication of Influenza A Virus: A Case Report.","authors":"Wan-Ling Cheng,&nbsp;Chaou-Shune Lin","doi":"10.6705/j.jacme.202109_11(3).0004","DOIUrl":"https://doi.org/10.6705/j.jacme.202109_11(3).0004","url":null,"abstract":"<p><p>Influenza is one of the most common respiratory viral infections, causing annual epidemics of respiratory illnesses characterized by sudden onset of fever, malaise, myalgias, cough, and other respiratory complaints. A spectrum of cardiovascular complications has also been reported in association with influenza infection. Cardiovascular involvement can occur through the direct effects of the virus on the myocardium or through the exacerbation of the existing cardiovascular disease. We report the case of an 86-year-old woman without a history of cardiac disease before admission who developed a transient complete atrioventricular block without myocarditis after acute infection with the influenza A virus.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"11 3","pages":"102-104"},"PeriodicalIF":0.6,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8440439/pdf/jacme-11-3-04.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39475498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Young Boy With Lethargy After Shaking.","authors":"Thian-Hwang Ho,&nbsp;Sai-Wai Ho","doi":"10.6705/j.jacme.202109_11(3).0007","DOIUrl":"https://doi.org/10.6705/j.jacme.202109_11(3).0007","url":null,"abstract":"A previously healthy 22-month-old boy was brought to the emergency department (ED) by his father because of progressive lethargy lasting for the past 12 hours after playing and unintentional vertical shaking by his father. No wound or ecchymosis was found on his body. At the ED, his Glasgow Coma Scale score was E2V3M4. His vital signs revealed a heart rate of 140 beats/min (normal upper limit 140 beats/min), blood pressure of 105/79 mm Hg (normal lower limit 75/50 mm Hg), respiratory rate of 35 breaths/min (normal upper limit 40 breaths/min), and body temperature of 36.2°C. The pulse oximetry level was 100%. The physical examination findings were unremarkable. Isocoric pupil and no neck stiffness were observed. Blood laboratory findings showed a white blood count of 6,490/mm and a hemoglobin level of 12.7 g/dL. The levels of blood glucose, C-reactive protein, lactic acid, aspartate aminotransferase, creatinine, and electrolytes were normal. A brain computed tomography (CT) was performed because of a suspicion of a shaken baby syndrome. However, the CT scan showed a right intraocular heterogeneous mass with calcifications and vitreous hemorrhage (Fig. 1). An ophthalmologist was consulted, and a diagnosis of retinoblastoma rupture with vitreous hemorrhage was made by ophthalmoscopy. After brain magnetic resonance imaging and lumbar puncture to exclude central nervous system diseases, he was transferred to other hospital for surgical enucleation. His father reported that the patient recovered consciousness after the surgery. Altered mental status (AMS) is a common condition that leads to the admission of pediatric patients to the ED for prompt diagnosis and management. The differential diagnoses of AMS are numerous, ranging from common benign disorders to life-threatening diseases. Although the mnemonic AEIOU TIPS (alcohol, encephalopathy, insulin, opiates, uremia, trauma, infection, poisoning, and seizure) is a useful tool for organizing differential diagnoses, and herein, we encountered a case of AMS which was caused by ophthalmic disease. Retinoblastoma is not an uncommon disease in infants and young children. Of all cases, Fig. 1. Non-contrast computed tomography image showing right intraocular calcification (long arrow) and vitreous hemorrhage (short arrow).","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"11 3","pages":"110-111"},"PeriodicalIF":0.6,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8440437/pdf/jacme-11-3-07.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39475501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}