Acute Care Medicine Surgery and Anesthesia最新文献

COVID-19 in pregnant women: description of a possible case of COVID-19-linked HELLP-like syndrome 孕妇感染 COVID-19：描述一例可能与 COVID-19 相关的 HELLP-like 综合征病例

Acute Care Medicine Surgery and Anesthesia Pub Date : 2024-03-25 DOI: 10.4081/amsa.2024.39

Fara Russo, Anna Vitiello, Maria Carolina Russo, Alfonso Riccio, Camillo Candurro

{"title":"COVID-19 in pregnant women: description of a possible case of COVID-19-linked HELLP-like syndrome","authors":"Fara Russo, Anna Vitiello, Maria Carolina Russo, Alfonso Riccio, Camillo Candurro","doi":"10.4081/amsa.2024.39","DOIUrl":"https://doi.org/10.4081/amsa.2024.39","url":null,"abstract":"New evidence suggests that Sars-CoV2 infection during pregnancy may result in complications such as hypertension, nephropathy, thrombocytopenia, and liver damage. A pre-eclampsia-like syndrome has also been proposed in pregnant women with severe SARS-CoV-2 infection, which meets the pre-eclampsia criteria but resolves without delivery, with improvement in respiratory symptoms. 31-year-old, second pregnancy, in Emergency Room for PROM (premature rupture of membranes), has Sars-CoV2 infection and has not been vaccinated. Normal examinations and mild hypertension were present upon admission, but no treatment was administered. Vaginal Leukocytic Delivery 12 hours after admission, newborn Apgar score 9/10, weight 3.250 kg. At 20 hours after delivery, epigastric pain VAS 8-9 for 20 minutes, systolic/diastolic hypertension peak, increase in transaminases, LDH, ALP, Bilirubin, Dimer, platelet and fibrinogen drop. Neurological and respiratory objectivity were negative, and renal indices were within normal limits, so nifedipine 30mgx2/day + methyldopa 500 mgx2/day was started. Abdominal ultrasound revealed a thin perihepatic fluid stratum. A prophilaxis of dexamethasone 12mg twice a day and magnesium sulfate was introduced. At 32 hours after delivery, the laboratory detected an increase in transaminases, LDH, and worsening of thrombocytopenia. The patient is always eupnoic, and the diuresis is adequate. Blood tests improved gradually after 56 hours postpartum. Methyldopa and steroids are escalating. On day 7, discharge with normalized platelet and bilirubin counts and a decreasing trend in transaminases, LDH, and PAL. At the one-week follow-up, liver enzymes and coagulation were completely normal, and blood pressure was well controlled with methyldopa. We conclude that the simultaneous presence of the two diseases could have had a synergistic or opportunistic effect, resulting in severe clinical manifestations via interaction with the Renin-Angiotensin-Aldosterone system.","PeriodicalId":486793,"journal":{"name":"Acute Care Medicine Surgery and Anesthesia","volume":"2 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140381910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Loxosceles rufescens: single-institutional epidemiology, diagnosis and treatment 红腹狐臭：单一机构的流行病学、诊断和治疗

Acute Care Medicine Surgery and Anesthesia Pub Date : 2024-01-22 DOI: 10.4081/amsa.2024.38

F. Coletta, Simone Esposito, Giovanna Di Maiolo, Filomena Lo Chiatto, Mariarosaria Cuomo, Giovanna Paola De Marco, Pasqualina Amitrano, Crescenzo Sala, Antonio Tomasello, Romolo Villani

{"title":"Loxosceles rufescens: single-institutional epidemiology, diagnosis and treatment","authors":"F. Coletta, Simone Esposito, Giovanna Di Maiolo, Filomena Lo Chiatto, Mariarosaria Cuomo, Giovanna Paola De Marco, Pasqualina Amitrano, Crescenzo Sala, Antonio Tomasello, Romolo Villani","doi":"10.4081/amsa.2024.38","DOIUrl":"https://doi.org/10.4081/amsa.2024.38","url":null,"abstract":"Loxosceles rufescens, also known as “violin spider” due to its characteristic appearance, is a medium-sized spider species that can potentially pose a threat to humans. For this study, patients who presented to our hospital’s Poison Control Center between January 1, 2022, and December 31, 2022, and met the following inclusion criteria were included: Suspicion of a violin spider bite, as evaluated by our center. Our protocol involves an initial local treatment, which includes local washing with copious water and disinfection, along with the application of chlorotetracycline hydrochloride. Systemic therapy utilizes Amoxicillin and Clavulanic Acid as the first-line medication. The primary endpoints of this study are the timing and effectiveness of the treatment for cutaneous lesions. Demographic and anamnestic information regarding age, gender, and timelines was summarized using descriptive methods. Our study’s results indicate that erythema and pain are the most frequent symptoms. Loxoscelism is highly concentrated in the Western hemisphere and is considered the only proven arachnological cause of dermo-necrosis. In recent years, there has been an increase in diagnoses.","PeriodicalId":486793,"journal":{"name":"Acute Care Medicine Surgery and Anesthesia","volume":"38 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139608915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dealing with specialist pathology: an unusual case of ovarian hyperstimulation syndrome managed in the emergency department with point of care ultrasound 处理专科病理：急诊科利用护理点超声波处理卵巢过度刺激综合征的不寻常病例

Acute Care Medicine Surgery and Anesthesia Pub Date : 2023-12-21 DOI: 10.4081/amsa.2023.31

Roberto Lazzari, Mariona Condom Siñol

引用次数: 0

Current need for guidelines in emergency surgery in peritoneal carcinomatosis 目前腹膜癌急诊手术指南的需求

Acute Care Medicine Surgery and Anesthesia Pub Date : 2023-10-02 DOI: 10.4081/amsa.2023.27

Melissa Nardecchia, Carlo Vallicelli, Mauro Stefano, Vanni Agnoletti, Luca Ansaloni, Paola Fugazzola, Federico Coccolini, Marco Vaira, Massimo Sartelli, Fausto Catena

引用次数: 0