Objective:To identify the early predictors of severe envenomation in the southern region of Tunisia.Methods:It was a retrospective monocentric study including consecutive patients admitted to the emergency department ...Objective:To identify the early predictors of severe envenomation in the southern region of Tunisia.Methods:It was a retrospective monocentric study including consecutive patients admitted to the emergency department for snakebite envenomation.Snakebite envenomation was defined by a history of snakebite.Predictors of severe envenomation were determined by univariate and multivariate analyses.Results:Our sample consisted of 109 patients aged 30(20-44)years with a 1.1:1 sex-ratio(56 males and 53 females).During the 24-hour surveillance period,25 patients developed severe envenomation(22.9%).The in-hospital mortality rate was 4.6%(n=5).The independent predictors of severe snakebite envenomation were leucocyte count over 11550/mm3(OR:18.7,95%CI:3.3-107.8),creatine kinase over 155 IU/L(OR:6.16,95%CI:1.1-35.6),and/or tourniquet before arrival to the ED(OR:32.14,95%CI:3.5-295.9).Conclusions:This study emphasizes the importance of early evaluation of snakebite envenomation.Further studies are required to approve a severity scale proper to snakebite envenomation in Tunisia.展开更多
Renal injuries are commonly reported in blunt abdominal trauma and are usually associated to other abdominal injuries. Renal rupture may be misdiagnosed and its management, especially in severe lesions, is still contr...Renal injuries are commonly reported in blunt abdominal trauma and are usually associated to other abdominal injuries. Renal rupture may be misdiagnosed and its management, especially in severe lesions, is still controversial. We describe the case of renal rupture diagnosed in the Emergency Department and conservatively managed. The outcome was good thanks to the early diagnosis and the management of the renal trauma. Conservative management in renal rupture is possible in stable patients provided that the imaging is early done.展开更多
Rationale:Acute complications of cirrhosis can be life-threatening.One of the less common acute complications is hepatic hydrothorax whose medical management is rarely successful and is still controversial.Patient con...Rationale:Acute complications of cirrhosis can be life-threatening.One of the less common acute complications is hepatic hydrothorax whose medical management is rarely successful and is still controversial.Patient concerns:A 51-year-old patient presenting to the emergency room for a massive pleural effusion.Diagnosis:A hepatic hydrothorax with a placed chest tube whose removal was not possible.Interventions:Increased doses of diuretics with a strict salt-free diet.Outcomes:An improvement of the clinical state,with no recurrent pleural effusion up to one month.Lessons:Medical management of hepatic hydrothorax is possible.展开更多
Acute intoxication with nicotine is possible to cause nonspecific clinical signs and may be serious and lead to the death. We report a rare and severe form of acute nicotine poisoning secondary to dermal absorption of...Acute intoxication with nicotine is possible to cause nonspecific clinical signs and may be serious and lead to the death. We report a rare and severe form of acute nicotine poisoning secondary to dermal absorption of tobacco.展开更多
文摘Objective:To identify the early predictors of severe envenomation in the southern region of Tunisia.Methods:It was a retrospective monocentric study including consecutive patients admitted to the emergency department for snakebite envenomation.Snakebite envenomation was defined by a history of snakebite.Predictors of severe envenomation were determined by univariate and multivariate analyses.Results:Our sample consisted of 109 patients aged 30(20-44)years with a 1.1:1 sex-ratio(56 males and 53 females).During the 24-hour surveillance period,25 patients developed severe envenomation(22.9%).The in-hospital mortality rate was 4.6%(n=5).The independent predictors of severe snakebite envenomation were leucocyte count over 11550/mm3(OR:18.7,95%CI:3.3-107.8),creatine kinase over 155 IU/L(OR:6.16,95%CI:1.1-35.6),and/or tourniquet before arrival to the ED(OR:32.14,95%CI:3.5-295.9).Conclusions:This study emphasizes the importance of early evaluation of snakebite envenomation.Further studies are required to approve a severity scale proper to snakebite envenomation in Tunisia.
文摘Renal injuries are commonly reported in blunt abdominal trauma and are usually associated to other abdominal injuries. Renal rupture may be misdiagnosed and its management, especially in severe lesions, is still controversial. We describe the case of renal rupture diagnosed in the Emergency Department and conservatively managed. The outcome was good thanks to the early diagnosis and the management of the renal trauma. Conservative management in renal rupture is possible in stable patients provided that the imaging is early done.
文摘Rationale:Acute complications of cirrhosis can be life-threatening.One of the less common acute complications is hepatic hydrothorax whose medical management is rarely successful and is still controversial.Patient concerns:A 51-year-old patient presenting to the emergency room for a massive pleural effusion.Diagnosis:A hepatic hydrothorax with a placed chest tube whose removal was not possible.Interventions:Increased doses of diuretics with a strict salt-free diet.Outcomes:An improvement of the clinical state,with no recurrent pleural effusion up to one month.Lessons:Medical management of hepatic hydrothorax is possible.
文摘Acute intoxication with nicotine is possible to cause nonspecific clinical signs and may be serious and lead to the death. We report a rare and severe form of acute nicotine poisoning secondary to dermal absorption of tobacco.
