BACKGROUND: In recent years, thrombolytic therapy has become the main treatment of ischemic stroke. But the increasing use of alteplase in ischemic stroke has made some complications more evident. Angioedema is a rare...BACKGROUND: In recent years, thrombolytic therapy has become the main treatment of ischemic stroke. But the increasing use of alteplase in ischemic stroke has made some complications more evident. Angioedema is a rare but potentially life-threatening complication of alteplase treatment. Only a few studies have examined the incidence of angioedema after treatment with alteplase for stroke.METHODS: A 75-year-old man complaining of right hemiparesis was admitted to our emergency department. He was diagnosed as having acute ischemic stroke, and alteplase infusion was given two hours after the onset of stroke symptoms. Immediately after the completion of infusion he was noted to have a large swollen tongue.RESULTS: His neurological symptoms resolved gradually within 4 hours, whereas his upper extremity strength improved to 4/5 and lower extremity 5/5. Lingual edema resolved within 16 hours without any complication. He died from presumed nosocomial infection 5 days later.CONCLUSIONS: Lingual angioedema may appear as a possible complication in patients who were treated with alteplase. The management of these patients should be very careful.展开更多
Pulmonary embolism (PE) is a clinical entity with high mortality rate and therefore rapid diagnosis is necessary. For this purpose many diagnostic strategies have been developed for avoiding or necessitating further i...Pulmonary embolism (PE) is a clinical entity with high mortality rate and therefore rapid diagnosis is necessary. For this purpose many diagnostic strategies have been developed for avoiding or necessitating further investigations. The hallmark of these strategies is assessing the pretest clinic probability of PE. In this study, the effectiveness of Wells, Geneva and Kline methods were investigated in a university hospital emergency department. 74 patients were enrolled in this study. The inter-group differences in scoring systems were significant for Wells and Kline but non-significant for Geneva method. The diagnosis of PE was correlated with Wells and Kline system but Geneva system lacked it. The Receiver Operating Characteristic analyses was performed for comparing the pretest clinical probability scoring systems and the greatest area under the curve was found in Wells system. Wells method seems more useful compared to Geneva and Kline methods particularly in emergency department.展开更多
文摘BACKGROUND: In recent years, thrombolytic therapy has become the main treatment of ischemic stroke. But the increasing use of alteplase in ischemic stroke has made some complications more evident. Angioedema is a rare but potentially life-threatening complication of alteplase treatment. Only a few studies have examined the incidence of angioedema after treatment with alteplase for stroke.METHODS: A 75-year-old man complaining of right hemiparesis was admitted to our emergency department. He was diagnosed as having acute ischemic stroke, and alteplase infusion was given two hours after the onset of stroke symptoms. Immediately after the completion of infusion he was noted to have a large swollen tongue.RESULTS: His neurological symptoms resolved gradually within 4 hours, whereas his upper extremity strength improved to 4/5 and lower extremity 5/5. Lingual edema resolved within 16 hours without any complication. He died from presumed nosocomial infection 5 days later.CONCLUSIONS: Lingual angioedema may appear as a possible complication in patients who were treated with alteplase. The management of these patients should be very careful.
文摘Pulmonary embolism (PE) is a clinical entity with high mortality rate and therefore rapid diagnosis is necessary. For this purpose many diagnostic strategies have been developed for avoiding or necessitating further investigations. The hallmark of these strategies is assessing the pretest clinic probability of PE. In this study, the effectiveness of Wells, Geneva and Kline methods were investigated in a university hospital emergency department. 74 patients were enrolled in this study. The inter-group differences in scoring systems were significant for Wells and Kline but non-significant for Geneva method. The diagnosis of PE was correlated with Wells and Kline system but Geneva system lacked it. The Receiver Operating Characteristic analyses was performed for comparing the pretest clinical probability scoring systems and the greatest area under the curve was found in Wells system. Wells method seems more useful compared to Geneva and Kline methods particularly in emergency department.
